It must also be recognized that money comprises a significant dimension of the changes noted above.  The retrenchment and redirection of mental health practice will require sustained yearly investments of Billions of dollars in rigorous field trials to eliminate or limit ineffective treatment protocols and to discover and validate new options. A generation of practitioners must be re-trained in place.  As profit-driven organizations, pharmaceutical companies cannot be expected to support this process.  Although 3rd-party insurers necessarily have a financial interest in avoiding huge underwriting losses from lawsuits against mental health practitioners, it seems doubtful that they will choose to play a serious role in funding major research or the revision of practice standards in a CMHAP.  Given the size of the challenge, government is almost certainly the central effective player in these major changes.