A study to investigate the difference between episodic and comprehensive health care utilizers was undertaken with 196 mothers who registered their children at Project Pryme clinic. There were significant differences found between the two groups in the area of alienation and its subcatagories of normlessness, powerlessness and isolation. There were also significant differences found in socio-economic areas of income source, education and intactness of families. When the clinic patients were compared to the general population, it was found that the Project patients taken as a whole were alienated and much lower in ego strength. Discussion of these results focuses on the interplay of alienation and socio-economic factors as a cause to the existing situation of not only lack of clinic participation but also as a cause of their social plight. Possible solutions to diminish the alienation level and increase clinic participation are offered. (Author/KM)