Fifty-four billion dollars was spent on alcohol/drug abuse and mental
health treatment in 1990. These expenditures were concentrated in the
area of inpatient psychiatric care and on persons with severe mental h
ealth and substance abuse problems. The data on expenditure patters fo
r mental health and substance abuse care suggest that successful healt
h care reform in this area must implement mechanisms for controlling i
npatient utilization and managing the care of persons with the most se
vere disorders.