To assess the readiness of mental health facilities in Oregon to implement medication algorithms using the Medication Management Approaches in Psychiatry toolkit (MedMAP) developed by the Substance Abuse and Mental Health Services Administration (SAMHSA), researchers conducted interviews with 68 clinical and administrative employees of four inpatient and four outpatient mental health facilities in Oregon. Opinions about the algorithms among respondents were generally positive, but were accompanied by many concerns about logistics and implementation, chiefly related to medication selection and expected restrictions on choices for prescribing providers and patients. The implementation of medication algorithms may benefit from assessing staff perspectives and capabilities of program infrastructure. The extent to which staff concerns, values, and needs are anticipated and promptly and responsively addressed is likely have a major influence on successful implementation. Keywords psychiatric medication; medication algorithms; organizational change; infrastructure assessment; Texas Medication Algorithm Project Psychiatric disorders are a great burden on patients' quality of life and an enormous contributor to the cost of state-funded health care, despite the availability of effective psychiatric interventions. State mental health authorities struggle with the high costs of antipsychotic medications 1 and are eager to find ways to reduce expenditures while maintaining or increasing Correspondence/reprints: Jennifer P. Wisdom PhD MPH.