The impact of government economic restraint on mental health services in Canada.

The author discusses what he considers a fundamental change in the political, economic and social value system since the mid-1970s, and how this change is reflected in three trends of particular relevance to mental health services: the growing emphasis on the "residual" model of welfare; the "privatization" of mental health service delivery; and the tolerance of high levels of long-term unemployment. He criticizes the assumptions underlying these trends, and emphasizes that the choice of social and economic priorities is ultimately based on values rather than on empirical data. Accordingly, he argues for broad societal participation in the choice of priorities.