title: The roles of psychiatrists in organized outpatient mental health settings.
abstract: OBJECTIVE
  This paper describes the clinical roles of psychiatrists in U.S. organized outpatient mental health settings.
  
  
  METHODS
  Data were analyzed from the 1986 National Institute of Mental Health Client/Patient Sample Survey. The authors determined the range, volume, and content of services provided to established outpatients treated by psychiatrists at six types of mental health organizations: state and county mental hospital clinics, general hospital mental health clinics, private psychiatric hospital clinics, U.S. Department of Veterans Affairs medical center mental health clinics, free-standing mental health clinics, and multiservice mental health organizations.
  
  
  RESULTS
  The psychiatrists treated nearly one-half (48.2%) of the established outpatients in organized settings, more than any other discipline. Most of the psychiatrists' patients (68.3%) were also treated by other mental health professionals. Psychiatrists treated a greater proportion of the patients at hospital-based clinics (60.7%) than at clinics without hospital affiliations (43.6%). They also treated larger proportions of the patients with schizophrenia (77.9%), affective disorders (50.6%), or anxiety disorders (59.2%) than those with adjustment disorders (23.7%), substance use disorders (34.3%), or childhood mental disorders (29.5%). The patients treated by psychiatrists commonly received psychotropic medications (77.3%) and individual therapy (66.3%) but less commonly received group (20.7%), skills (11.9%), or family (5.9%) therapy.
  
  
  CONCLUSIONS
  In organized outpatient settings, psychiatrists typically work with other mental health professionals to treat a select group of severely ill patients. However, there is considerable variation in the extent to which different types of mental health organizations rely on psychiatrists to provide clinical care.
authors: Department of Psychiatry, Cornell University Medical College, New York, NY.
authors: M
authors: M
authors: Olfson
authors: G L
authors: GL
authors: Klerman
authors: H A
authors: HA
authors: Pincus
mesh_terms: D000293:Adolescent; D000328:Adult; D003155:Community Mental Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups; D005260:Female; D006778:Hospitals, Psychiatric / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D010348:Patient Care Team; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D011570:Psychiatry / Q000193:education; D011613:Psychotherapy; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012720:Severity of Illness Index; D014481:United States
chemical_list: D011619:Psychotropic Drugs