THE MENTAL HEALTH organizations of the Cambridge-Somerville Area are working to improve and expand the delivery of care in the district. For example, since out-patient after-care for ex-mental patients is very expensive and since the staff at the Cambridge Hospital is small, the Community Service of the Hospital's Department of Psychiatry is working with organizations such as the Welfare Department and Neighborhood House to set up group after-care programs. Such efforts to increase the scope and quality of mental health services in Cambridge and Somerville must continue and accelerate if community mental health is to offer a real alternative to institutional care for the residents of this area.

The Harbor Area faces similar problems in the scale and quality of community care. Only Revere offers comprehensive help. The Bunker Hill Health Center in Charlestown, the Revere-Chelsea Clinic, and the North Suffolk Mental Health Center in East Boston provide effective, but more limited, mental health services. The North End, the West End and Beacon Hill still lack their own programs. The new Lindemann Center and the Acute Psychiatric Service of the Massachusetts General Hospital are moving to meet these needs, but their efforts have either just begun or are still in the planning stages. As in the Cambridge-Somerville Area, much remains to be done in creating a comprehensive mental health system in the Harbor Area.

The major obstacle to expansion and improvement of community mental health care is lack of money. For example, the Community Service of the Cambridge Hospital and the inpatient and out-patient programs of the Lindemann Center could really improve with an increase of funds and staff. An entire floor of the Lindemann Center designed for biochemical research remains totally unused because of a money shortage. Furthermore, community mental health workers have found that the more they extend their efforts into the community, the more people they find in need of help. For example, the new alcohol detoxification program at the Cambridge Hospital is already flooded with more applicants than it can handle. Meeting the mental health needs of the Cambridge-Somerville and Harbor Areas will require far more money than is currently available to expand existing programs, establish new ones, do research to develop more effective techniques of therapy, and train and hire mental health workers.

DESPITE the shortcomings and obstacles in the development of community mental health programs, the systems in Cambridge and Somerville and in the Harbor Area have come a long way and show great promise for the future. In 1965, none of the budget of the state Department of Mental Health went to community programs. Today 25 per cent of the budget is earmarked for such projects. This year the Department of Mental Health will try to convert money and transfer staff from the recently phased-down state hospitals to community programs. This trend in funding is likely to continue and accelerate in coming years.

Another resource for help in the development of community mental health programs, especially in the Boston area, is cooperation between these programs and universities. Harvard Medical School currently plays a key role in mental health projects at the Lindemann Center and the Cambridge Hospital; Harvard's Clinical Psychology Program and the mental health committee of Phillips Brooks House also participate in local programs. MIT gave a building to the Neighborhood Family Care Center. Students in graduate clinical psychology programs of Boston University, Boston College and the Simmons School of Social Work take part in local mental health services. These kinds of cooperative efforts should develop even further.

Since 1955, the number of patients in Massachusetts state mental hospitals has dropped 50 per cent. Mental institutions are being phased down throughout the state; one--Grafton State Hospital near Worcester--is even closing down. This progress has only been achieved because communities in the state, such as the Cambridge-Somerville and Harbor Areas, have begun to offer alternatives to neglect or institutionalization for people who need psychiatric help