This monograph is organized around an argument relating to the organization and prioritization of health care services. It is divided into four major sections. The first section contains a definition and discussion of the major mental illnesses found in Indian country. The second explores the cost of these illnesses for Indian people in terms of death and disability, and considers the planning of a service delivery system to treat or prevent such problems. The third outlines logical goals for the development and structure of local mental health programs based on present understanding of current mental health problems and treatments available for Indian people. Finally, the fourth section discusses types of resources that mental health programs can draw upon in developing needed interventions. This is part of the third volume of The Journal of the National Center for American Indian and Alaska Native Mental Health Research.