The mental health system as we know it today is essentially a linear extension of the system in place thirty years ago. "System lethargy" results from planning which has relied excessively on past models and has emphasized "facts" over principles rather than taking advantage of changing values and societal trends. This paper identifies major environmental changes likely to influence the health field, including changes in technology, scale of organization, and leadership style. Vibrant mental health services of the future are likely to be less exclusively based in the health care system, with greater emphasis on initiatives in the workplace, more use of electronic media, development of new professional roles and more intensive client-focused programming.