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Abstract
Among several issues addressed in the 1987 Nursing Home Reform Act were concerns about the prevalence of mental disorders in nursing homes and the adequacy of such facilities to meet the mental health needs of their residents. Of particular concern was the appropriateness of care for those individuals with serious mental illness, excluding dementias. Fifteen case studies of such individuals, screened and approved for nursing home placement under the new regulations, were conducted to describe and explore the responses of nursing homes to the mental health needs of these residents. Both programmatic and social environmental responses are discussed.