Because of the difficulty of measuring mental health status and the lack of systematic and longitudinal data reflecting economic status and mental health, an arbitrary definition is used for this paper: changes in the accessibility to and utilization of psychiatric services by the poor compared with that of the nonpoor will be interpreted as changes in mental health status. Patterns of utilization of mental health facilities in the United States and in Monroe County, New York, by economic variables and/or by race, for periods spanning the Great Society programs, are described. In addition, the location and availability of services provided by community mental health centers since their development are examined. Although these data indicate increased accessibility to facilities by the poor, there continue to be differences in the ways different economic groups use psychiatric facilities. In addition to a discussion of the implications of the findings for service delivery, definitional limitations are cited and additional information needed for making any judgments totward planning future mental health programs are explored.
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