ABSTRACT
The July 1996 issue of Money Magazine ranked Madison, Wisconsin, as the best place to live in America based on its vibrant economy (1.7% unemployment rate and plentiful jobs), excellent health care and educational systems, and low crime rate (Fried, 1996). In addition to being a great place to live and work, it is also a community that has a rich tradition of working together in solving problems. Madison achieved the highest ranking in health care which is largely provided through four primary managed care companies called Health Maintenance Organisations. Located in south-central Wisconsin, Madison is home of the state capitol, and makes up approximately half of the 390,000 residents of Dane County. Surrounded by plentiful lakes, dairy farms and biking trails, the half-mile-wide isthmus with the Capitol at the centre is where the core public mental health programmes exist in proximity to most of the consumers of mental health services. It is against this backdrop that the adult mental health system has evolved over the past 23 years.
