Unified services: concept and practice

Abstract

Unified services is a further development of the concept of a community mental health center, with the aim of providing coordinated, flexible, continuous, and nonduplicated services. Various states have attempted to translate the concept into systemic changes through legislation, usually making the approach optional. New York State, where five counties have adopted unified services, is used as the primary example; planning and coordinating for all services are in the hands of the counties. The authors discuss over-all benefits of unified systems, and territorial and fiscal problems in implementing them. States are at different stages of developing unified systems, ranging from maintenance of two separate systems of institutional and community programs to integration of planning and services but not funding. What is needed is a mechanism to integrate funding as well, a mechanism through which funds going to agencies will reflect the actual proportions of patients served.