This chapter is divided into three sections. The first deals with the historical development of health and mental health care in this coun­try, highlighting some of the problems, di­lemmas, mistakes, progress, and conflicts. The second section deals with trends in the development of health care delivery systems, emphasizing mental health care; information regarding re­cent amendments to the Social Security Act, i.e., the development of Professional Stan­dards Review Organization (PSRO) legisla­tion and its implications for comprehensive mental health care delivery. The third section is a futuristic look at the delivery of mental health services. (70 pp.)