Your series "Mental Disorder" has provided excellent coverage of complex issues. However, some key points about community support services need to be illuminated.

Community support merged two services with different reimbursement rates and credential requirements from the old system. With the new service, worker credentials were reduced to the lowest common denominator. Reimbursement rates are the same if the service is provided by an experienced master's level clinician or by someone who just graduated from a GED program.

CS is meant to provide not only skill-building in activities of daily living, but also more clinically sophisticated services such as counseling, managing symptoms, monitoring for possible medication side effects and helping patients deal with other chronic health conditions.

Designers opened the new system to market forces. It should come as no surprise then that 98 percent of this important service is being provided by high school graduates.

The Division of Mental Health, Substance Abuse and Developmental Disabilities has dragged its feet when pressed to correct this problem by lamenting that if given the opportunity, federal administrators might want to completely change things. Maybe change is not such a bad idea.

Beth McElhinney

Board director, Mental Health Association in Orange County

Durham