title: The patient: first or last?
abstract: Too often mental health care professionals consider bureaucratic constraints rather than patient needs when making clinical, administrative, and public policy decisions. This sort of "top-down" decision-making leads to solutions that emphasize procedures and regulations rather than clinical results. After examining the disastrous effects of top-down planning in areas such as care of the chronic mental patient, the author concludes that in approaching current policy issues mental health professionals must forge solutions that meet the needs of patients rather than those of the external environment.
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005196:Family Therapy; D006801:Humans; D007591:Joint Commission on Accreditation of Healthcare Organizations; D008484:Medicaid / Q000191:economics; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D010344:Patient Advocacy; D012943:Social Security / Q000191:economics; D013808:Therapeutic Community; D014481:United States