veloped programs, many of which have implications for mental health. The Institute has initiated efforts to established and maintain effective liaison and working relationships with these agencies and programs on an organized basis. Organized contacts with other agencies will make working relationships more effective by such means as information exchange programs, identification of and consutation with specialized experts, and concerted comprehensive inter-agency approaches to national problems of common concern. Among the major areas of mutual interest developing newer programs are housing and urban renewal, education, aging, civil rights, cultural deprivation, juvenile delinquency and crime, labor and manpower, and children and youth.

Examples of current and projected inter-agency liaison activities are: (1) Regular Institute consultation provided to the Office of Economic Opportunity on the mental health aspects of community action projects; (2) consultation provided to DHEW on the development of standards of care for psychiatric patients covered under the Medicare Act; (3) provision of psychiatric service and consultation to the Peace Corps staff and volunteers; and (4) joint consideration by the Institute and the President's Commission on Civil Rights of research involving the psychosocial impact and implications of desegration and integration.

Community mental health facilities and staffing administration.-For the first year of the community mental health centers construction program, 1965, the Congress appropriated $35 million. For 1966, $50 million was appropriated, and a request for $50 million for 1967 is proposed. First-year plans for the construetion of community mental health centers have been received from more than half of the States. It is anticipated that by the end of 1966 almost all of the first-year State plans will have been approved. There has been wide-spread community interest in construction grants, and by the end of the fiscal year 1966, it is expected that 75 such grants will have been made.

The combined appropriations for 1965 and 1966, when matched by the States share of construction funds, will construct the equivalent of approximately 170 community mental health centers capable of providing services to 17 million Americans, or 9 percent of the population.

Regional staffs.-The regional offices, responsible for carrying out assistance to States, serve as Institute field units providing consultative assistance and working with State agencies to implement inservice training, hospital improve ment projects, project grants, grants-in-aid, and construction of mental health centers.

The ultimate goal of regional office operations, to maximize the help provided to State and local agencies, is achieved through the design and implementation of program activities to meet agency needs at their current phase of development of mental health services.

National Clearinghouse for Mental Health Information: The National Clearinghouse for Mental Health Information was established in October 1962 in response to the need for a centrally coordinated source of scientific and professional information on all aspects of mental health and illness. The major specific objectives of the clearinghouse are to: (1) Serve as a resource for information and data needed in the program analysis activities and decision-making functions of the Institute; (2) maintain a centralized, technical resource for the systematic collection, storage, retrieval, and dissemination of the vast amount of material concerned with mental health; (3) provide its users-both inside and outside the Institute with substantive information in response to individual inquiries as well as on a regular distribution basis; and (4) analyze, synthesize, assess, and evaluate all information about mental health in order that it may be effectively utilized and exploited in the achievement of the new national mental health program of the Institute.

During the past year, the clearinghouse has achieved a number of major substantive accomplishments as well as an expansion and refinement of its overa!! program. The year has seen (1) an increased input information; (2) a high concentration of activity such as vocabulary building and design of procedures to handle this flow of information, (3) an intensive build-up of computer usage for information processing, (4) a concomitant increase in editing and publishing (5) a growing awareness of the clearinghouse accompanied by a greatly accelerated demand for services, and (6) the gradual assumption of many informational activities formerly scattered throughout the Institute-all of which are leading rapidly toward a fully operational clearinghouse.

A major characteristic of the clearinghouse interim system is the use of contracts for the collection, indexing, abstracting, and reviewing of mental health

information. Thirteen contracts for these purposes were negotiated, primarily with national organizations specializing in certain subject matter areas. An intense effort went into the preparation of controlled vocabularies and thesauri for indexing the information areas now being handled by the clearinghouse. The clearinghouse has now also organized its basic reference collection of mental health journals, reference works, directories, handbooks, dictionaries, etc., thus enabling staff to provide general information in mental health, as well as the information in special areas. The clearinghouse has built up a mechanized storage and retrieval system. All abstracts, bibliographies, and other collections of information are now going into this system.

In order to achieve its goal of a complete mental health information service as quickly as possible, the clearinghouse has begun to collect, process, and disseminate information in several special areas or topics. These special information areas are in various stages of development. Although each area is, for convenience, considered separately and independently, it should be emphasized that they are all part of the general clearinghouse information system and that searches or analyses can be conducted throughout the entire present system, not merely in the separate areas. These include psychopharmacology, crime and delinquency, drug dependence and abuse, social work and mental health, occupational mental health, educational materials in mental health, mental health films, and mental health services and programs.

Program plans in 1967

Community mental health facilities and staffing.—Approximately 60 new grants to partially support staffing costs in eligible community mental health centers will be awarded. These will be in addition to the approximately 63 grants awarded in 1966 which will have continuation awards in 1967. Consequently 10 positions and $219,000 are requested for administration of this program. The added staff will be engaged in consultation with State and local organizations, in the review and approval of State plans and project applications, in the promulgation of regulations, and other activities essential to carrying out the provisions of Public Law 89-105.

By the time Federal funds are available for 1967, it is estimated that every State will not only have finished its initial plan for centers, but will have established the processes of continuous planning and program development necessary to assure that communities most in need of services will be reached. By that time the real promise of the centers program can begin to be realized: that is, while nearly every community is now in need of a center, most communities also need time to raise their share of costs of both construction and operation. By 1967, most of those needy communities, using initial staffing grants, will be ready to participate. With the assistance of the requested $50 million for 1967, another 11,500,000 citizens will be able to find mental health services within their own communities.

Regional staffs.-The highest priority will be given to development of operating procedures to implement the new community mental health centers program and to furnishing States with the initial consultation attendant with their participation in this new program. Reviews of each of the several program activities will be made to ascertain the extent to which the program goals and objectives are alligned with the trend toward the treatment of patients near their homes in community based mental health facilities. Program guidelines will be revised as necessary to redefine and redirect each of the programs to best assist States in implementing their comprehensive mental health plans.

The National Clearinghouse for Mental Health Information.-Work will continue to be carried on in areas previously begun such as drug abuse, crime and delinquency, mental retardation, mental health programs, mental health education materials, etc.

Included in the net increase requested, $123,000 is for mandatory items, including annualization of positions new in 1966, the commissioned officers pay increase, annualization of the general schedule pay increase, and the social security tax increase, offset by a decrease of $24,000 due to nonrecurring items.

This activity supports the functions of the National Advisory Mental Health Council, numerous other technical consultants participating in the scientific review and evaluation of mental health programs, and the Institute staff responsible for the review, coordination, analysis, and administration of research fellowship and training grant programs.

Program plans in 1966 and 1967

Two positions and $69,000 will provide grants management staff in the Office of the Associate Director for Extramural Programs.

Included in the net increase requested is $27,000 for mandatory items including annualization of positions new in 1966, the commissioned officers pay increase, annualization of the general schedule pay increase, and the social security tax increase, offset by a decrease of $8,000 due to nonrecurring items There are also increases of $97,000 for centrally furnished services from the NIH management fund.

This activity includes the immediate office of the Director. In addition it provides for the Office of Administrative Management, which is the central Institute staff for budget, personnel, management analysis, and central administrative services.

Program plans in 1966 and 1967

Two positions and $42,000 is requested for the immediate Office of the Director in order to strengthen the budget and management analysis staffs.

Included in the net increase requested is $6,000 for mandatory items including the commissioned officers pay increase and annualization of the general schedule pay increase. There are also increases of $12,000 for centrally furnished services from the NIH management fund.

CONSTRUCTION OF COMMUNITY MENTAL HEALTH CENTERS
Amounts available for obligation

Grants, subsidies, and contributions (total obligations):

This program authorized in the "Community Mental Health Centers Act" of 1963, provides for the construction of centers to bring comprehensive and coordinated programs of mental health services to the community, through the allotment of funds to States based on financial need, population, and the need for centers. For the first year of the centers program, 1965, the Congress appropriated $35 million. For 1966, $50 million has been appropriated. A $50 million appropriation for 1967 is proposed.

Program plans in 1966

At the present time 15 State plans have been formally accepted, and final approval of 6 others is imminent. The 21 States submitting these plans represent about 63 percent of the Nation's population and have been allocated approximately 52 percent of the 1965 appropriation. It is anticipated that by the end of the current year, almost all of the first-year State plans will have been ap proved. Twelve construction grants have been made, and other project applicătions are under review. Thus, most of the administrative mechanics of the program and the State and community plans for centers have been or are being established. The $35 million appropriated for 1965 (with 2-year availability) is well on its way toward being obligated. Judging by the State and community response to the program, the Institute anticipates receiving more applications than can be awarded with the 1965 and 1966 appropriation. While the Community Mental Health Centers Act authorizes a Federal share of from one-third to two-thirds of a project's costs, it is estimated that, on the average, one-half the cost of a center's construction will be borne by a Federal grant. When the 1965 and 1966 appropriations are fully utilized, approximately 170 centers will have been built. The services of community centers would then be available to 17 million Americans, or 9 percent of the Nation's population.