Organising Services for People with Mental Handicap: The Californian Experience

The organisation of services for California's mentally handicapped population is outlined and critically examined. Its distinctive features are noted: a concern for rights, rather than needs; an underlying free market philosophy; an explicit attempt to combine public and private enterprise; and an elaborate system of checks and balances designed to restrain the welfare bureaucracies and ensure that they remain responsive to the changing nature of individual need. It is argued that, despite certain limitations, the Californian system does seriously address three problems that bedevil all attempts to develop a satisfactory system of care for people with mental handicaps: the inherent powerlessness of the client group; the diversity and fragmentation of services; and bureaucratic inertia.