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17 to the middle school students especially. Lexington needs to adopt community mental health and environmental strategies,the youths said. The clinical administrator at RePlace believes that the most serious impediments to adequate mental health services include insufficient funding, limited access to hospitals, and incomplete emergency response capabilities. Many RePlace clients come to RePlace after their HMO insurance benefits have been exhausted. Some never had insurance in the first place. There is also a lack of collaboration among service providers. A provider needs to be known for a long period of time in Lexington before gaining the trust of other providers. They also believe that the quality of services in Lexington is excellent but that there is an inability to meet rising needs. Eliot Community Human Services. This agency serves a sizeable range of suburbs in Middlesex County. The Lexington branch located at 186 Bedford Street was at one time a substantial unit but services have recently been concentrated in Concord and reduced in Lexington. For instance,there had been a psychiatrist in the Lexington office one half day a week,but this has been discontinued. Eliot serves clients with significant mental illnesses, particularly schizophrenia and bipolar disorders, but medication provisions, outreach, and case management services are concentrated in the Concord office. Eliot maintains a 24-hour beeper system and assists parents who phone regarding runaway teenagers or those for whom medication balances get out of control. Psychotherapy is provided at the Lexington office for a few clients. From the point of view of the clinical administrator,there are not enough mental health services to meet needs in our region. Eliot, among others, has recently done little with outreach efforts in Lexington, after making a valiant effort in earlier years. Rates of reimbursement for mental illness and emotional distress are significantly lower than rates for physical illnesses. The state's new mental health parity law makes it sound to the public as if more services will become available, but the law requires proof that the illness being addressed constitutes a"medical necessity,"a standard that is very difficult to meet. In fiscal year 2002, Eliot provided 771.5 hours of services - a total of 791 sessions or appointments -to 21 residents of Lexington. The services ranged from individual therapy to family and couples therapy, to family and case consultations, diagnostic evaluations of