American Journal of Psychiatry

MEYER, EUGENE; SPIRO, HERZL R.; SLAUGHTER, REGINA; POLLACK, IRWIN W.; WEINGARTNER, HERBERT; NOVEY, SAMUEL

doi: 10.1176/appi.ajp.124.4S.57pmid: 6050780

EUGENE MEYER M.D. 1 , HERZL R. SPIRO M.D. 2 , REGINA SLAUGHTER M.S.S.W. 3 , IRWIN W. POLLACK M.D. 4 , HERBERT WEINGARTNER PH.D. 5 , , and SAMUEL NOVEY M.D. 1 Professor of Psychiatry and Associate Professor of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. 21205 2 Assistant Professor of Psychiatry and Instructor in Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. 21205 3 Assistant Professor of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Md. 21205 4 Assistant Professor of Psychiatry and Instructor in Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. 21205, Chief, Department of Psychiatry, the Sinai Hospital of Baltimore 5 Assistant Professor of Medical Psychology, Johns Hopkins University School of Medicine, Baltimore, Md. 21205 This report concerns the variables influencing whether a patient showed up for his first psychotherapy appointment, dropped out of therapy, or completed treatment. As single variables, race, sex, age, socioeconomic status, marital status, psychiatric diagnosis, duration of symptoms, and history of parental loss did not relate significantly to completion of therapy. The data thus suggest that, contrary to common belief, patients from the lowest socioeconomic groups can be motivated to complete a program of structured psychotherapy.

YOLLES, STANLEY F.

doi: 10.1176/appi.ajp.124.4S.1pmid: 6050774

STANLEY F. YOLLES M.D. 1 1 Director of the National Institute of Mental Health, 5454 Wisconsin Avenue, Chevy Chase, Md. 20203 In this progress report on the community mental health centers program, the Director of the National Institute of Mental Health reviews existing patterns of support, community organization, staffing, and practice in the 256 centers funded during the past two years under the federal grants program. Early pessimism regarding rigidity of the federal regulations now seems unwarranted: diversity of local needs has resulted in a diversity of methods and flexibility in meeting those needs. The emerging profile of services now being offered provides a foundation upon which other communities can act as the program expands.

BOYLES, PAUL D.; WALDROP, GRAYSON S.

doi: 10.1176/appi.ajp.124.4S.29pmid: 6050776

PAUL D. BOYLES M.D. 1 , and GRAYSON S. WALDROP M.D. 2 1 Clinical Director, Unit C, Broughton Hospital, Morganton, N. C. 28655 2 Staff Physician, Unit C, Broughton Hospital, Morganton, N. C. 28655 A geographic unit in a large state hospital began a community-oriented program without significant increases in money or personnel. This was done by the alteration of many of the traditional staff functions and concentration on a patient-centered program. Striking declines occurred in average resident population, average length of stay, and readmission rate.

MULLER, JAMES J.; CHAFETZ, MORRIS E.; BLANE, HOWARD T.

doi: 10.1176/appi.ajp.124.4S.46pmid: 6050779

JAMES J. MULLER PH.D. 1 , MORRIS E. CHAFETZ M.D. 2 , , and HOWARD T. BLANE PH.D. 3 1 Assistant Psycologist, Department of Psychiatry, Massachusetts General Hospital, Boston, Mass. 02114, Research Associate in Psychology, Harvard Medical School 2 Department of Psychiatry, Massachusetts General Hospital, Boston, Mass. 02114, Director of the Alcohol Clinic and Acute Psychiatric Service, Assistant Clinical Professor, Harvard Medical School 3 Associate Psycologist, Department of Psychiatry, Massachusetts General Hospital, Boston, Mass. 02114, Associate in Psycology, Harvard Medical School From the point of view of community mental health, the critical aspect of the acute psychiatric admission to a general hospital service lies in the opportunity to establish a needed treatment relationship during the brief interval the patient (who is often chronic) is motivated to accept it. There is evidence that lower-class, chronic patients follow through on long-range treatment programs when such programs are actively promoted in the emergency service.

BLANE, HOWARD T.; MULLER, JAMES J.; CHAFETZ, MORRIS E.

doi: 10.1176/appi.ajp.124.4S.37pmid: 6050778

HOWARD T. BLANE PH.D. 1 , JAMES J. MULLER PH.D. 1 , , and MORRIS E. CHAFETZ M.D. 2 1 Assistant Psycologist, Massachusetts General Hospital, Boston, Mass. 02114, Associate in Psycology, Harvard Medical School 2 Massachusetts General Hospital, Boston, Mass. 02114, Director of the Alcohol Clinic and Acute Psychiatric Service, Assistant Clinical Professor of Psychiatry, Harvard Medical School After reviewing emergency services in general hospitals, the authors conclude that only a few of them have innovative, community-oriented emergency programs; most seem to follow traditional practices. The authors suggest that we recognize that large segments of the population will always turn to the general hospital for emergency care: the potential for early psychiatric casefinding and preventive intervention with this group is substantial.

BOLMAN, WILLIAM M.

doi: 10.1176/appi.ajp.124.4S.8pmid: 6050782

WILLIAM M. BOLMAN M.D. 1 1 Assistant Professor of Psychiatry, Child Psychiatry Division, University of Wisconsin Medical Center, 1300 University Ave., Madison, Wisc. 53706 Community mental health has sturdy empirical bases in past public health experience and current health needs. Its application should be both controversial and highly rewarding in contributing to knowledge of social dynamics. An adaptation of general systems theory is proposed as a model for community mental health theory.

LEOPOLD, ROBERT L.

doi: 10.1176/appi.ajp.124.4S.69pmid: 6050781

ROBERT L. LEOPOLD M.D. 1 1 Associate Professor of Clinical Psychiatry and Director, Division of Community Psychiatry, University of Pennsylvania School of Medicine, 36th and Hamilton Walk, Philadelphia, Pa. 19104, Director of the West Philadelphia Mental Health Consortium The West Philadelphia Mental Health Consortium was developed as a partnership of six hospitals which expect to provide mental health services to a large catchment area. With the Department of Psychiatry of the University of Pennsylvania Medical School serving as the binding element, the consortium has involved many community agencies in a cooperative planning process, which it is hoped will continue as the mental health program starts operating.

HARRIS, M. ROBERT; KALIS, BETTY L.; SCHNEIDER, LIDA

doi: 10.1176/appi.ajp.124.4S.20pmid: 6050775

M. ROBERT HARRIS M.D. 1 , BETTY L. KALIS PH.D. 2 , , and LIDA SCHNEIDER A.M. 3 1 Associate Clinical Professor, University of California School of Medicine, Director, Langley Porter Community Mental Health Training Program, 401 Parnassus Ave., San Francisco, Calif. 94122 2 Associate Clinical Professor, University of California School of Medicine, Clinical Psycology Consultant, Langley Porter Community Mental Health Training Program, 401 Parnassus Ave., San Francisco, Calif. 94122 3 Lecturer in Psychiatric Social Work, University of California School of Medicine, and Social Work Consultant in the Langley Porter Community Mental Health Training Program The nation's investment in community mental health requires not only that significant numbers of specialists be trained but also that all mental health professionals acquire some basic skills in the theory and method of this field. The authors describe the community mental health training program at Langley Porter, which began in 1960. They believe that this kind of training should be a required rather than an elective assignment in the training of psychiatric residents.

JACOBSON, AVROHM

doi: 10.1176/appi.ajp.124.4S.14pmid: 6050773

AVROHM JACOBSON M.D., F.A.C.P. 1 1 Director of Psychiatry, Jersey Shore Medical Center, Neptune, N. J. 07753 Adult psychiatric clinics are frequently inefficient in the utilization of personnel. The "team" approach is of little value to the psychiatrist treating a patient; it is rarely used in private practice. Clinic growth spells diminished help to the individual patient. With increased funds available for expansion, it would be cruel to strive to treat the community and fail the individual patient. The patient needs the small clinic and its psychiatrist.

DANIELS, DAVID N.

doi: 10.1176/appi.ajp.124.4S.32pmid: 6050777

DAVID N. DANIELS M.D. 1 1 Assistant Professor, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, Calif. 94305 The community mental health center model with its varied direct clinical services becomes a white elephant when applied to rural states and areas. The model does not fulfill the mental health needs of the people—of meeting them where they live and serving them through the utilization of available personnel and resources. An alternative, indirect services model, which emphasizes consultation, education, preventive psychiatry, and community psychiatry as community organization, is proposed and explored.