Research in the North Carolina Department of Mental Health – Brochure

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The cover represents approaches utilized in conducting
research on various mental health problems in the North
Carolina Department of Mental Health. The upper left
portion of the drawing depicts the facial expressiohspf a de-
pressed elderly patient; on the top right are nerve dms: and
the spinal cord whose malfunction appears causally related
to mental disease. The arrows below pointing toward various
circles indicate interaction between organizational com-
ponents; the formula permiïê> measurement program suc-
fbss. In the bottom segment of the drawing the mouse
inside the male and femalè symbols represents studies on
reproductive behavior. On the lower left in the geometric
pattern of the spider web, the builder’s behavior is made
measurable, and a chick embryo on the lower right stands
for one time of life at which abnormal development can
lead to behavioral disabilities after birth. (The drawing was
made by Sandy Huffaker of Raleigh, N. C.).
I. ITS TASKS AND ORGANIZATIONAL STRUCTURE
Q. What is research?
A. Research can be conceived as the continuous endeavor
of the human mind to ask the how and why of events
around and within us, and it can be regarded as an
exploratory mechanism which forms an integral part of
human progress. Most frequently, scientific methods are
used by trained researchers in seeking answers to these
questions.
Q. What is mental health research?
A. Studies which are specifically concerned with an analysis
^»f the causes of normal as w||i as abnormal behavior,
and possible ‘cures of abnormal behavior, comprise the
« of mental health research. It also involves investi-
gation of the management of mental health in the social
and political setting and helps clarify thinking about the
nature of mental health. In contrast to treatment of
patients, research provides the long-range, preventive
approach to problems in mental illness.
Q. What is the Division of Research in the North Carolina
Department of Mental Health?
A. It is a sub-unit of the North Carolina Department of
Mental Health consisting of a group of qualified research
scientists who, in various mental health programs all
over the state, investigate mental health problems and
advise on methodology and recent progress in the field.
An additional responsibility is to help improve services
by carrying out their research functions as close to the
services as possible, instilling a scientific approach into
patient management and other practical problems.
Q. Briefly, what are the functions of the Division of Re-
search in the North Carolina Department of Mental
Health?
A. The basic function of the Division of Research is to
contribute to the acquisition of new knowledge and to
aid in the dissemination of current research findings.
Because it is an integral part of the Department of Mental
Health, the Division of Research can aid in the rapid
identification of both administrative and clinical prob-
lems and thus contribute to their solution either by pro-
viding information or by conducting the necessary studies.
These functions both improve the quality and efficiency
of , services and, furthermore, assist in the training and
recruiting of high quality personnel.
Q. Is research in the Department of Mental Health in
danger of duplicating efforts elsewhere in the state,
particularly those of the universities?
A. The subject matter of mental health research is so ex-
tensive and inexhaustible that this constitutes no limi-
tations. In addition, the research in the Department of
Mental Health is related to its service functions, while
university research is geographically and in subject mat-
ter closely linked to the universities’ teaching functions.
Mental Health Department personnel and young scien-
tists work for periodsÉÉ several months to a few years in
mental health research to gain an in-service training
experience.
3
Q. What is the relationship between research conducted by
the North Carolina Department of Mental Health and
other research being carried out across the state and
nation?
A. Research scientists in the Department of Mental Health
have one or more university appointments, and lecture
at various universities in the state. At the national
level, the scientists check their procedures and results
with those of their peers at both national and interna-
tional meetings and in specialty journals.
Q. How does the Division of Research influence the services
provided by the Department of Mental Health?
A. The activities of the Division of Research yield both
immediate and long-range benefits to the department.
This atmosphere helps to attract high quality personnel
and, by emphasizing a scientific approach to problem-
solving rather than being oriented to specific subjects,
the division stimulates an investigative approach to the
many problems which the department must solve. The
basic and clinical research conducted in the division is
largely directed toward uncovering the roots and im-
proving treatment of mental diseases and thereby con-
tributes tb the world-wide effort to prevent and treat
mental illness.
Q. Is it possible to assess whether funding of research in a
state agency is a good investment for the taxpayer?
A. Industry, which has to account in terms of immediate and
long-term profits, has found that investment in research
is of prime importance for the success of an enterprise.
It can be safely assumed that state government, though
in many aspects different from industry, profits as much
from diverting some funds into research. Specifically,
with costs rapidly rising in our hospitals, all possible
efforts should be made to uncover preventive measures
and to expedite the release of patients. The conversion
of patients into productive citizens is advantageous to
both the patients and to the state.
Q. Is all research in the North Carolina Department of
Mental Health financed with state funds?
A. No. In addition to state funds, individual research
scientists and institutions receive federal and private
support, usually on a matching basis. All such support
is administered by the North Carolina Foundation for
Mental Health Research, Inc., a nonprofit, independent
organization.
Q. How are federal funds for research obtained?
A. An investigator applies for funds for a specific project
to be conducted within a limited amount of time. The
aim of the research has to be significant and the in-
vestigator must demonstrate that he is qualified to carry
out the work. The proposal is evaluated by scientific
advisory panels, and based on their recommendation
and other factors, an award is made. Each application
to federal agencies competes for funds on a national basis.
A
Q. What is the fonction of the North Carolina Foundation
for Mental Health Research, Inc.?
A. It is charged with the specific task of administering funds
which are received from non-state sources, and of raising
funds of its own for support for mental health research
needs in the state.
Q. What is the administrative structure of the North Carolina
Foundation?
A. It is governed by a board of directors, a group of 15 to
30 distinguished and interested citizens in the state, and
administered by an executive committee consisting of
the executive director, executive secretary, the chairman
of the board, the president, and the vice president. None
of these persons can receive payment for his services.
The Foundation’s offices are located on the campus of
Dorothea Dix Hospital in Anderson Hall. The address
is P. O. Box 7532, Raleigh, N. C. 27611.
Q. How can a donation for support of mental health research
in North Carolina be made?
A. Anyone can designate or bequeath a sum of money or
other property as a tax deductible gift for general or
specific use in mental health projects in North Carolina.
The foundation will see to it that the gift is used for
its designated purpose and will, upon request, provide
reports of its activities to the donor.
Q. Does the North Carolina Foundation restrict its support
to research in the Department of Mental Health?
A. At present, the foundation mainly administers grant funds
for research in the Department of Mental Health; it
has only limited funds of its own for dispersal. It is, how-
ever, incorporated in such a way that it could handle
any funds for mental health research in the state.
Q. How many research scientists are fully employed by the
North Carolina Department of Mental Health at the
present time?
A. As of January 1, 1973, there are six: one psychiatrist,
one pharmacologist, two psychologists, one zoologist and
one biochemist. Their special areas of research are de-
scribed under Section II.
Q. Is additional research carried out, for example, on a
part-time basis in hospitals and centers throughout the
state?
A. In more than half of the institutions of the Department
of Mental Health some organized research is going on.
This is frequently carried out in spare time and with
little or no financial support from the state.
Q. Have any beneficial effects to mental health services been
produced by such a program?
A. Small contracts have been used as seed money for the
initiation of larger, federally funded research projects.
The results of the investigations are reported in research
papers and have found wide interest and application in
mental health programs; i.e., the value of alternate treat-
ment methods and social problems connected with com-
munity mental health services has been clarified.
5
Q. Who will protect the interests of patients and institutions
participating in research programs?
A. Research committees have been formed all over North
Carolina which screen protocols and monitor procedures
for patients’ and institutions’ interests and their con-
stitutional rights; they see to it that there is proper
attainment of consent, and minimum danger in any
mental health research project.
Q. How do research scientists from different units in the
state mental health system know each other, coordinate
their efforts, and profit from central research facilities?
A. A meeting of research scientists and mental health ad-
ministrators has been held every year in North Carolina
Since 1968. Important mental health concerns like
§||!‘child development3’ and^/‘evaluation” have formed a
, central theme such meetings. Every year a list of
research publications and completed projects is distrib-
uted to all mental health units: In addition, a weekly
seminar, dealing with wide-ranging problems in the areas
of behavior, the nervous system and mental health, is
held in the offices of the Research Division. Both local
national and international speakers are featured at these
weekly meetings. Research,. scientists are invited as
speakers to various mental health programs all over the
state and nation.
II. EXAMPLES OF CURRENT RESEARCH PROJECTS
Studies in Developmental Neurobiology
Psychology, biology and those other scientific disciplines
which study the behavior of man and animals have, in the
past, tended to neglect the period of time prior to birth.
This neglect has subsequently led to a de-emphasis, pr. out-
right ignoring, of the    important role this early
A chick embryo 10 days old (hatching occurs on the 20th day)
is being stimulated with a probe to determine the extent to which
the reflex connections in the nervous system have jmatured. A
“window” has been made over the embryo by removing the eggshell.
6
period may play in determining the capacities and capabili-
ties of the adult organism. Over the past several years,,
however, there has been a noticeable trend on the part of
scientists from all over the world — including those in the
Research Division — to devote more of their efforts to
understanding embryonic or prenatal behavioral and neural
development.
The neuroembryology laboratory takes an anatomical and
physiological approach to prenatal functional development,
although behavior, per se, also receives equal attention.
In short, an attempt is made to utilize the technology and
knowledge of several scientific disciplines in order to better
understand the challenging problem of how the normal
functional and anatomical organization of the nervous system
arises during ontogeny.
Currently in the neuroembryology laboratory, research
scientists, research associates, postdoctoral and predoctoral
students and research assistants are involved in several
separate projects. These include: (1) the use of various
pharmacological tools (e.g. neurotransmittors and their
antagonists, neuromuscular blocking agents, and agents which
selectively destroy parts of the developing nervous system)
in order to better understand the role of various specific
neural elements in behavior development; (2) an experi-
mental examination of the neural and hormonal basis of
coordinated motor behavior (i.e. hatching) in bird embryos;
(3) the examination of early behavioral development in a
primitive vertebrate such as a fish; (4) the detailed study of
synapse formation with the electron microscope; the rela-
tionship between synapse formation and behavior develop-
mehtifâhd (5) the transplantation and extirpation of specifiç
neural elements in bird embryos and the study of concomitant
behavioral development in such preparations.
Through the joint efforts of die research scientists in the
psychology and neuroembryology laboratories, preliminary
attempts are being made to use a marsupial, such as the
opossum, for studies in early behavioral and nervous system
development. A marsupial was chosen because of the im-
mature state of development of the young at birth, and be-
cause, being a mammal, information derived from a mar-
supial form will allow us to determine the ‘extent to which
the findings on bird embryos, discussed above, can be
generalized to higher forms.
Prenatal Behavior
Many scientists now/^l^ that both normal and ab-
normal behavior may be partly a consequence of events
which occurred prior to birth (prenatal influences). Ex-
periments conducted in the Research Division’s psychology
laboratory are aimed at unraveling some of the mysteries
associated with the development’of behavior prior to birth,
especially how prenatal sensory stimulation relates to normal
and abnormal behavior after birth. By making windows in
the d£e|l pf bird eggs, the behavior of the embryo can be
observed and its reactions to stimuli measured. Since the
early development of all vertebrate embryos follows essen-
tially the same course with respect to the maturation of the
brain, muscles, and sense organs, the results of experiments
with bird embryos can reveal some general principles which
apply to the behavioral development of both higher
(mammals) and lower animal forms.
The advantage of working with bird embryos is that they
can be directly observed without harmfully distorting their
usual prenatal environment. Though a lot of research has
been conducted on mammalian embryos, the embryoc have
been studied under adverse conditions and the results of such
7
For studies of the development of the nervous system and behavior,
duck embryos are fitted with recording electrodes. The line at top
shows the embryonic heartbeat, the second line indicates occurrence
of oral activity, and the third line depicts embryonic vocalizations.
experiments are almost always open to the question of
whether the reactions observed are normal or typical ones.
In order to study how sensory stimuli affect the embryo’s
normal development was first necessary to determine
when each sensory system becomes functional. This part of
the research was done at the division’s psychology laboratory,
as well as other laboratories around tile world. People are
usually surprised to learn that all of the sensory systems
(1) become functional prior to birth or hatching and (2)
that they do not all become functional at one time.
The first sensory system to become functional in the
course of embryonic development is touch or skin sensitivity.
The embryo reacts when its own body surfaces come into
contact (self-stimulation) or when it touches surrounding
membranes and tissues. The next sensory system to mature
is balance or gravitational sensitivity. The embryo’s balance
receptors are stimulated when the egg is turned or, in
mammals, when the mother changes her position or posture.
The third system to develop prior to birth or hatching is
that of hearing. Mammals are exposed to internal noises
as well as loud sounds which may be transmitted through
the maternal abdomen. Bird embryos can even respond to
low sounds coming from outside the egg, particularly the
calls of their parent or other embryos. (Duck embryos begin
vocalizing 4 days before hatching). Vision is probably the
last sensory system to develop. Surprisingly, the bird embryo
is capable of reacting to light even before hatching. It is
not yet definitely known when taste and smell develop in
8
the embryo; taste probably develops after hearing and before
vision. As far as we know, the above sequence of sensory
development holds for all vertebrate embryos including man.
Recently, the psychology laboratory staff has been in-
cubating eggs in individual soundproof chambers to de-
termine if isolation from sound affects the development of
hearing. The question is whether the auditory system re-
quires a certain amount of external stimulation to develop
normally or whether internal stimulation from sounds in
the egg is sufficient for the normal development of auditory
perception. Preliminary results indicate that depriving the
embryo of full exposure to the normal range of sounds from
outside the egg slows down the development of the embryo’s
usual auditory perceptual ability so that its auditory per-
ception is retarded at hatching, though the bird otherwise
appears normal. If these results are validated, the next
question is whether subsequent growth and experience after
hatching can remedy the deficiency or whether it is irre-
versible.
Since the above auditory response involves the hatchling’s
behavior toward the call of its parent, it is a very important
part of the hatchling’s behavioral repertoire, one that occurs
with such regularity under usual conditions that it is some-
times called “innate” or “instinctive.” Since many people
believe that innate behavior arises directly from genetic in-
heritance without the benefit of sensory stimulation or other
prenatal experiences, the results of the present experimental
program (if they are verified) will call for a modification in
the way that we look at the process of behavioral develop-
ment in both higher and lower animals.
Reproductive Behavior
The general goal of research in this laboratory is to
identify the critical attributes of the environment responsible
for behavioral changes and to unravel the physiological path-
ways lying between a change in the environment and a change
in behavior. This research is aimed at identifying the proper
types of environment necessary for healthy physical and
psychological development. Although the environmental
component in mental illness has long been recognized in a
general sense, we must now become more specific and only
through experimentation will we discover where the true
cause and effect relationships lie between environment and
mental disease.
To make broad goals such as the above obtainable, one
relationship between environment and behavior was chosen
for investigation—that between social stimulation and sexual
behavior. To effect changes in sexual behavior we must
alter the levels of hormones within the body, and these
levels are controlled by centers in the brain. Such brain
centers are affected by social stimulation and thus we have
come full circle: social stimulation — changes in the brain
E- changes in hormone levels — changes in sexual behavior
— and again to a change in social stimulation. Now that
we know that such a marvelously balanced system exists,
we must determine what types and amounts of social stimu-
lation are necessary for the optimal development and ex-
pression of sexual behavior.
Using mice, hamsters and monkeys, experiments are be-
ing conducted to explore these relationships. For example,
recent research on mice has shown that sexual maturation
can be remarkably accelerated by specific male stimuli.
This finding indicates that sexual maturation, formerly
thought to be largely the result of heredity, is susceptible to
influences from the social environment. In the past one
hundred years, the sexual maturation of western man has
9
been accelerating at a rapid rate; girls have been maturing
about three months earlier in each of the last ten decades.
The similarity in the process of sexual maturation in the
mouse and in man permits us to use the mouse as a model
system in an attempt to explain the accelerating rate of
sexual maturation in humans. We must understand the
physiological basis ^ puberty as well as the environmental
factors that influence it because of the overwhelming social
significance of early puberty. The period that today’s young-
sters have to cope with the flush of hormones and other
metabolic changes that accompany puberty is much longer
than that with which we, our parents, or our grandparents
had to contend.
In addition to the work on puberty, two other studies
are in progress to provide information in the relationship
between the environment, hormones and behavior. In one
of these, the role of sexually active females in stimulating
increases in male hormone output and sexual activity is
under examination. For this study, monkeys in a Puerto
Rican colony are utilized. The results to date indicate that
sexually active females can induce a remarkable increase
in male hormone output and return a sexually inactive
male to full capabilities.
The second area of investigation involves a series of
studies to determine the role of neonatal imbalances in
hormones on the expression of behavior during adulthood.
Previous work has shown that exposing fetal or newborn
female rodents to testosterone, the male sex hormone, in-
duces permanent changes in adult sexual orientation. Such
changes may result in reversed sex roles or a condition of
bisexuality. These remarkable findings have forced a re-
examination of the bases for sexuality. As a part of this
reexamination we are exploring the role of neonatal hor-
mones on the development of the ovary, its cyclicity and its
effects on the behavior of females after they attain adulthood.
Biochemical Research
Current thinking views mental illness as a disease resulting
from faulty adaptation to overwhelming psychological factors
which, in turn, lead to disturbances in the metabolic balance
of tiie body. Such disturbed body metabolism could play
a key role in the development of mental disease.
Efforts of many scientists are directed towards identifying
the particular substance or substances whose altered metab-
olism may be associated with development of mental di-
sease. The biochemical laboratory of the Research Division
has been conducting studies on the metabolism of calcium in
depressed patients. The findings so far have indicated that
the recovery from depression in patients treated with the
antidepressant drug, imipramine, or electric convulsive ther-
apy was associated with significant decrease in the concen-
tration of calcium in the serum and in the amount of calcium
excreted in the urine. This suggests a possible relationship
between relatively high serum calcium concentration and
depressive illness.
It is possible that the high serum calcium will affect the
calcium metabolism in the brain. To explore this problem,
the distribution of calcium in the brain of experimental
animals is under investigation. The brain is secured from
the skull, then homogenized in isotonic sucrose solution.
The homogenized brain is^iiibjected to high speed ultra
centrifugation for resolving its subcellular fractions such as
nuclei, mitochondria, microsomes, synaptosomes and super-
natant. It is hoped that these experiments will delineate
the subcellular structure or structures which are operative
in regulating calcium ion concentration in the cell. It is
also possible that the metabolic function of these cellular
ultra-structures may be affected due to excessive absomtion
of calcium.
Further work on the effect of psychoactive drugs, such
as L.S.D., chlorpromazine, imipramine and amphetamine,
on brain calcium distribution is planned for future research.
Another area of interest is the development of a test for
the detection of micro amounts of the hallucogenic com-
pound, L.S.D. Such a test will be helpful in identifying
patients consuming the drug, and allows for effective treat-
ment. Furthermore, blood samples of acute schizophrenics
could be tested for the presence of L.S.D. This will test
the notion that indogenous L.S.D. may be produced by
these psychotic patients. ,
Studies in Depression
It has been said that the history of depression is the
history of psychiatry. In the past three decades marked
advances have been made in the symptomatic treatment of
depression.
Despite these advances, several problems remain regarding
the understanding and management of depressive illness:
(a) delayed response to antidepressant medications exposes
the patient to the physical and psychological complications
of depression over a prolonged period of time; and (b)
knowledge of the etiology and pathogenesis of depression
is still obscured.
Our studies have been directed at (a) elucidating étiologie
factors; (b) defining chemical pathogenesis of depression;
and (c) studying the interaction of hormone substances with
antidepressant medications.
On the Clinical Research Unit at Dorothea Dix Hospital,
||f cooperative program sponsored by UNC-Chapel Hill, the
Research Division, and Dorothea Dix Hospital is underway.
It has been determined by staff on the unit that profound
interaction occurs between the tricyclic antidepressants and
various hormones, namely, tri-iodothyronine, thyroid stimu-
lating hormones, and ethinyl estradiol. By and large, these
substances accelerate the speed of recovery from depression.
Our interest at the present time is studying the antidepres-
Medical team on Clinical Research Unit tests reaction of patients
to drugs.
11
A    B
The adult female cross-spider (Araneus diadematus Clerk) had built
web A on the morning of the first day of observation, called “control
web.” That same day the spider drank 0.7 micro 1 of 1: 1000
d-amphetamine (“speed”) dissolved in sugar water at 4:00 p.m. The
next morning this spider built the web shown in B, which is character-
istically smaller (see scale upper right comer) and less regular than the
control. One day later the spider had recovered and -built a web
indistinguishable from the “control web.”
sant effects of thyrotropin releasing hormone, a tripeptide
substance secreted byjfhe hypothalamus in the brain.
Our investigations of the etiology and pathogenesis of de-
pression are directed at (a) defining possible genetic mech-
anisms involved |n the transmission ^depressive illness;
(b) linking predisposition to depression with various anthro-
morphic characteristics; and (c) defining changes in various
chemical systems during an acute depressive episode.
The Effects of Drugs on Motor Behavior
It is difficult to assess what goes on in another’s mind,
and there are several ways, all indirect, in which we try to do
this. One of the purposes of such assessment is the wish
to separate normal functioning from abnormal. This labora-
tory has approached the problem through a study of motor
behavior under the assumption that many aspects of the
functioning of the mind like fatigue, excitement, reaction
to stress, and variation 111 mood find expression in Subtle
changes of fine movements of the hands and face.
The copying qf^à’ complex geometric pattern shows a
great number of variations from person to person, from
day to day, and from mood to mood. Placement of the
lines in’ terms of exactitude, distance and shape can be
measured and yield an enormous amount of data. The
measurements are fed into a computer, and it prints out
information about Vaçh drawing pattern in a few minutes,
and compares one pattern with other patterns, drawn by other
people and at other times. In this way, the effect of drugs,
as well as stress, has been objectively assessed. In the future
it is hoped that the evaluation of drawing patterns will make
it possible to follow the ups and downs of mental patients
under various treatment; in that manner we can evaluate
the various influences of therapeutic procedures and weigh
them against each other.
Because only a limited amount of investigations can be
done wi^h patients and because many behavioral functions
are similar in animal and man, animals are used as models
for the study of some aspects <2§p:human motor behavior.
The elaborate and complex structure of the orb web of the
spider Araneus diadematus Q.|$|iipit is built in 20-30
12
minutes every 24 hours, has been found relatively easy to
measure as well as sensitive to drugs and nervous system
disturbances.
The method is simple; about a hundred spiders are kept
in individual aluminum frames in the laboratory. They
each build a web in the early morning hours, every animal
in its frame. The web is lighted indirectly and subjected to
contrast photography thus providing a permanent record
for study. The effects of different drugs have been com-
pared by evaluating web patterns which had been con-
structed after substances had been fed to the spider.
We have looked for possible permanent damage after
repeated administration of hallucinatory drugs like mari-
huana. Efforts have been made, so far without success, to
identify hypothetical disease-causing substances in the body
fluid of mental patients by comparing spider webs built
after the animal had received a patient’s blood extract with
those built after the animal had received the blood extract
of a normal control subject. The disadvantage of using an
animal so remote from man as the spider is partly out-
weighed by the advantage of being able to employ as many
as 100 animals at a time and obtaining measurable results
a few hours later.
Another concem^^Ss laboratory has been the distribu-
tion of information on drug effects, particularly (hugs of
abuse, to university students and community drug training
programs.
Sociological Research
The statewide organization of mental health programs
and services iigu complex everchanging network which
seeks to administer effectively all available resources to
meet mental health needs of North Carolinians. Successful
administration of this mental health system requires sound
management techniques, accurate and reliable information
about the needs of the population, the extent to which
programs and services meet these needs, and information
concerning alternative methods of meeting these needs.
Several current projects employ scientific principles,
methods and theories to identify, measure and understand
factors which contribute to the effectiveness of mental health
systems, to contribute to the understanding of organizational
and behavioral changes, and to determine the relative merit
of new and existing mental health programs and services.
t These include projects to develop measures of population
change and manpower needs with special emphasis on par-
ticular sub-populations such as youth and aging minorities;
develop and test computerized goals fcr inpatient care and
treatment outcomes; refine and implement rating scales
, and goals for outpatient treatment; conduct follow-up studies
of discharged patients; examine the structure and function
of evolving area programs; evaluate the effectiveness of
educational programs for the mentally retarded; develop a
trainable achievement test for the mentally retarded; char-
acterize children and adults with self-injurious behavior;
and evaluate ESEA activities.
To provide better information for administrators, a series
of projects focuses on components and programs in state
psychiatric hospitals and community mental health centers.
A central concern is to identify and measure factors associa-
ted with program success. Program success (the extent to
which programs achieve expected results) is considered a
function of personal attitudes and attributes of staff and
clients, organizational structural variables, organizational
process variables, environmental pressures and residual fac-
tors. New programs do not enter a vacuum but a network
13
of relationships in and among these variables. These projects
aim to develop prediction models of organizational change
by isolating and measuring this network of relationships and
using these data to explain the variation between programs
with differential achievement of expected results. A similar
study of statewide alcoholism programs is in the process of
implementation.
In addition to extending scientific knowledge about or-
ganizational change, information derived from these studies
will provide baseline data from which programs are evalu-
ated; provide an accurate assessment of the role of psy-
chiatric hospitals and community mental health centers in
the delivery of mental health services; and provide for in-
formed decision-making on the part of administrators and
planners involved in the delivery of mental health services.
The Division of Program Evaluation also acts as a con-
sultant to both state and community mental health ad-
ministrators.
14
Carolina Department of Mental Health.
Research Personnel — North
January, 1973.