Organizational structure and state mental health expenditures

Abstract

State mental health agencies (SMHAs) are characterized by a variety of organizational and fiscal arrangements. SMHAs may be part of a multi-functional agency or free-standing. They may be devoted exclusively to mental health or also responsible for other human services. States also vary in terms of their SMHA-controlled expenditures on mental health services. This paper explores whether organizational structure affects expenditures on mental health. Consistent with some theories of bureaucratic behavior, we find (subject to data limitations) that SMHAs appear to compete for funds with other human service agencies and that the bargaining position of the SMHA is affected by its position in the state bureaucratic organization.