Public mental health agencies in the United States today face many challenges to providing effective services for people with mental illnesses. Continuing fiscal austerity is perhaps the most compelling of these challenges. Forty of the 50 states currently have general budget crises, and federal support for mental health services is dwindling, making it an absolute requirement to “do more with less.” For instance, in 1991, Oregon faced a 15% cut in funding for its public mental health program, forcing significant reduction and reorganization of services (R. Lippincott, personal communication, January 1992).