Drawing from a conceptual framework which hypothesizes a temporal sequence for persons who are in psychological distress, this paper focuses on two problems faced by chronically mentally ill (CMI) Hispanics in need of clinical services: (1) barriers in seeking follow-up clinical services upon discharge from a psychiatric hospital; and (2) barriers to effective psychiatric treatment. The research upon which the report is based compared data collected in a survey of residents of the Fordham Tremont area of the Bronx, New York City (the community sample), with data from all persons receiving services in November 1982 at Continuing Care, a mental health clinic for CMI patients from the same neighborhood. It was found that most Hispanics who underutilize mental health services do so because they do not recognize or acknowledge symptoms, while a smaller number acknowledge emotional problems but cannot get the services they need. Some evidence also was found for the existence of cultural and institutional barriers to the use of mental health services among Hispanics. Comparison of the community survey and clinic patient data also indicated that different Hispanic subgroups (recent immigrants, less acculturated) are less likely to seek treatment than are younger, better educated Hispanics, but more likely to persist in treatment and to have successful outcomes. Finally, instability in living arrangements was found to have a greater effect on clinical experiences than on utilization of mental health services. Based on these findings, this report presents extensive recommendations for increasing the number of CMI Hispanics utilizing mental health services and for improving treatment for CMI Hispanics. (GC)