• Benjamin G Druss, Thomas Bornemann, Yvonne W Fry-Johnson, Harriet G McCombs, Robert M Politzer, and George Rust.
• Rollins School of Public Health, Emory University, Atlanta, Ga., USA. bdruss@emory.edu
• Am J Public Health. 2008 Sep 1; 98 (9 Suppl): S126-31.

ObjectiveWe examined trends in delivery of mental health and substance abuse services at the nation's community health centers.MethodsAnalyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care's (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data.ResultsBetween 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210,000 to 800,000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals.ConclusionsCommunity health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve.

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