• The reactions of patients in the community mental health system to the nuclear accident at Three Mile Island (TMI), Middletown, Pa, were assessed. The sample was composed of 151 patients from the TMI area and 64 patients from a comparison site where a similar nuclear plant is located. Mental health status was determined for the period immediately after the accident, nine to ten months later, and one year later. No significant differences were found between the TMI group and the comparison group. To isolate risk factors within the TMI group, patients who were most distressed were compared with patients with the least distress. The results showed that quality of network support and viewing TMI as dangerous were significantly associated with mental health.