Abstract

Objective: Self-help agencies are funded as adjuncts of, referral sources for, or alternatives to community mental health agencies. Little is known about how these two types of organization in geographic proximity interact, whom they attract as prospective clients, and what their clients bring to the service situation. The authors compared the characteristics and past service use of new enrollees of self-help agencies and community mental health agencies serving the same geographic area. Methods: Interview assessments were conducted with 673 new users at ten pairs of self-help and community mental health agencies serving the same geographic areas. Client characteristics were evaluated with multivariate analysis of variance and chi square tests. Results: Clients of community mental health agencies had more acute symptoms, lower levels of social functioning, and more life stressors in the previous 30 days than clients of self-help agencies. The self-help agency cohort evidenced greater self-esteem, locus of control, and hope about the future. Clients of self-help agencies had received more services from facilities other than self-help or community mental health agencies in the previous six months, and clients of self-help agencies who were not African American had more long-term mental health service histories. Conclusions: Although self-help and community mental health agencies both provide services to people with major mental disorders, community mental health agencies deliver primarily acute treatment-focused services, whereas self-help agencies provide services aimed at fostering socialization, mutual support, empowerment, and autonomy.