A confusing array of options to reform mental health care is now under consideration by policymakers. To clarify the implications of these options, five categories of actions are distinguished. These reforms are: federal program change, litigation, state commitment statute reform, alterations in private market variables and efforts to change attitudes. The overlaps among them are discussed as is the importance of knowing more about the relative effectiveness of each action. Wide-ranging reforms have been underway on and hoc basis for some time. This paper argues that before further major initiatives are undertaken, the establishment of a better information base and an improved understanding of the interrelationships of the numerous mental health policies are necessary.