Unit costs of community mental health services

The unit (hourly) costs of delivering services for six community mental health agencies in the greater Portland, Oregon area were computed. The calculations include an explicit methodology for allocating indirect costs associated with clinical services and with administrative overhead. Substantial variation among the six agencies in their unit costs was found and is explained by agency differences in: use of high cost (chiefly medical) personnel, the fraction of time staff spend in direct face-to-face client contact, and numbers of clients in treatment groups. The methodology as well as the results are increasingly important for community mental health programs in the era of managed mental health care.