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OBJECTIVE: To explore the question of how insurance coverage has changed among individuals with mental problems compared to the general population in the last two years. DATA SOURCES: HealthCare for Communities, a national survey to track health system changes. PRINCIPAL FINDINGS: The percentage of uninsured persons in the general population has not changed very much, and more respondents believe that health insurance coverage has improved rather than deteriorated over the years 1996 to 1998. However, among individuals with probable mental health disorders, more have lost insurance in those two years than have gained it and more report decreases in health benefits. Individuals with worse mental health consistently report a deterioration of access to care compared to individuals with better mental health. CONCLUSIONS: Substantial activity has taken place in state and federal legislation to increase the mental health benefits offered by health insurance. Although this activity could have improved health insurance especially for individuals with mental illness, such persons continue to fare significantly worse than the general population.