Contracting between public and private providers: A survey of mental health services in California

This paper reports on a public authority's decision to “make” or “buy” mental health services. Data come from key informant interviews with California county contract or program managers. The questionnaire measures the extent of contracting and the importance of factors that are hypothesized to affect the relative costs of contracting. The percent of contracting by programs ranges from zero to 100, averaging 41%. Sixty-two percent of rural programs perceive little or no competition for public mental health contracts, and contract significantly less than urban programs. The extent of contracting is related to economic and public organizational factors.