It is sometimes said that the mental health system has many doors - and all of them are closed. To address this problem of access, some systems have found it most effective to designate a single agency as the "gatekeeper" or controller of entry to the system. Depending on such variables as geography and governmental structure, gatekeepers can take many forms. In some states, for example, a county-based system may be structured so that a single multiservice agency is responsible for all mental health services. By virtue of its "franchise," it becomes responsible for gatekeeping as well as for providing services. In other states, multiple agencies may provide services, but one may be designated as the point of entry, with responsibility for linking each client to those services appropriate to his or her needs. There are many manifestations of this concept, but the organizing idea is to make entrance into the system as user-friendly as possible.

This kind of arrangement encourages service integration, cuts down on conflicts and redundancies, and promotes more efficient use of resources. Most of all, it works to create a pathway through the system that, ideally, delivers to each client the mix of services that best meets his or her needs.