Problems in community psychiatry: difficulties, constraints and future considerations.
The difficulties and constraints of community psychiatry are reviewed from the feeling of omnipotence and false hopes it has engendered, to the problems posed for the psychiatrist (threat to status, unclear identity, conflicting demands and the necessity for increased training). Administrative problems and difficulties in providing effective care in the new system are outlined: isolation of community psychiatry from the mainstream of medicine due to reliance on the social rather than the medical model, necessity for decentralization leading to fragmentation of services, pressures from local interest groups, lack of continuity of service and disruption in the flow of information. The myriad of pressures to which the community psychiatry center is vulnerable are described: local groups seeking to politicize the center, conflict within the center as to most appropriate method of treatment, pressure to solve social problems such as crime and addiction, and the ever-present weight of setting priorities under conditions of limited financial and manpower resources. Means of dealing with many of these difficulties are discussed, and a model of a community psychiatry center is presented which minimizes the problems and maximizes service to the community and the individual.
D003158:Community Psychiatry / Q000639:trends*; D003220:Conflict, Psychological; D003695:Delivery of Health Care; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration; D010561:Personnel Staffing and Scheduling; D011057:Politics; D012922:Social Change