Coordination, Continuity, and Centralized Control: A Policy Perspective on Service Strategies for the Chronic Mentally Ill

Chronic mentally ill persons in the community depend on an array of psychological, social, and medical support services that are delivered by public and private sources and are under the auspices of different levels of government. In response to problems of fragmentation and disorganization of these services, improved coordination has emerged as a major objective of contemporary mental health policymaking. This article describes the major coordinating approaches that have been developed, analyzes barriers to their implementation based on insights from the policy sciences and other literatures, and examines the basis of coordination's appeal as a service system reform strategy.