This chapter examines the organization and delivery of mental health services in the United States from a public health perspective. This chapter will emphasize the need for mental health administrators to understand the external health care environment and the resulting impact changes in that environment has upon the functioning of their mental health agency. Because of the complex and continuous changes taking place in the field of mental health administration and behavioral health services, the management of mental health organizations should include the study of health policy and health services delivery issues in the external as well as internal organizational environment.