The NIMH Community Support Program: Pilot Approach to a Needed Social Reform*

Health (NIMH) launched a modest but poten-tially significant pilot program titled the Com-munity Support Program (CSP). CSP is de-signed to improve services for one particularly vulnerable population—adult psychiatric pa-tients whose disabilities are severe and per-sistent but for whom long-term skilled or semi-skilled nursing care is inappropriate. Specifically, CSP involves contracts (not grants) between NIMH and State mental health agencies, many of whom will subcontract with local agencies for demonstration projects. To date, 19 States have been awarded CSP con-tracts amounting to a total of approximately $3.5 million for the first year's activities. Although the program is so new that little has been published about it, interpretations are beginning to appear in the press and the profes-sional literature. The New York Times (Feb-ruary 7, 1978), for example, while emphasizing the need for Federal leadership to improve ser-vices to chronic patients, referred to the CSP initiative in an editorial as "belatedly pulled to-gether " and "meager." Professional literature has viewed it more positively. A recent article in the Scientific American (Bassuk and Gerson 1978, p. 53), for example, highlighted the importance of the program in "the acknowledgment of the specific needs of the chronic severely disabled person," and "the willingness of the Federal government to accept more responsibility for the mentally ill. " The APA Monitor (Herbert 1977, p. 4) •Reprint requests should be addressed to the senior au-