Rapidly changing patterns of service principles and practices in community mental health services raise new dilemmas in sewice ethics and relationship boundaries for which staff have little guidance for decision making. Ethics and Boundaries Support Services: New Laurie C. Curtis, Martha Hodge in Community Challenges Diane walks into her twelve-step meeting and takes a chair. After a long day as a case manager at a community mental health support program, she is ready to share and feel the supportive fellowshp of the group. Just as her turn to speak arrives, the door opens and a late-comer walks in: Chris, a client on her case load, who has never attended this meeting before, and who has no idea that Diane is a member. She freezes, but her mind races. She glances at the placard promising confidentiality to all who attend this meeting. She remembers her academic training admonishing her not to disclose personal information to clients. How will simply being seen here affect her present and future clinical relationship wth Chris? Once again, she is faced with an eth- ical decision. It has been a week full of them. zyxwv . . . The day treatment program has been assertively soliciting volume referrals from case managers because they need to strengthen their funding base. Meanwhile, among her patients, she’s been trying to balance Tom’s desire to move into his own apartment against his family’s wish that he continue to live with them-apparently forever. Despite her own strong feelings about the right to life, she’s been having to advise Carol, who wants to terminate a pregnancy and has asked how to find the needed resources. And Patrick is demanding-and Diane thinks he would The authors acknowledge and thank the many mental health workers in the United States, Canada, Australia, and New Zealand whose candid discussions contributed richly to this chapter. In addition, the reviewers of earlier versions of this chapter provided invaluable feedback and ongoing support to present the issues raised here. zyxw NEW DlRECTIONS FOR MENTAL HEALTH SERVICES, no. 66. zyxwvutsr Summer zyxwvuts 1995 zyxwvuts 0 Jossey-Bass Publishers 43