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Treating the Poor: A Personal Sojourn Through the Rise and Fall of Community Mental Health

Carl C. Bell, MD
JAMA. 1994;271(19):1547-1548. doi:10.1001/jama.1994.03510430103049.
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The subtitle of this book, "A Personal Sojourn Through the Rise and Fall of Community Mental Health," adequately describes its focus. The author is a witty, biting, and compassionate physician who embraced the philosophy of community psychiatry as it was conceived in the 1960s. The book is filled with clinical vignettes and anecdotes that embody the principles of community psychiatry. Organized psychiatry would do well to heed these words of wisdom.

Psychiatry's sole emphasis on the biology of the brain is felt by the author to be arrogant in its assumptions and limiting in that it obstructs the ability to think contextually. As a result, there has been an inattention to issues of ethnicity, social class, and other realities of life. There is acrimonious condemnation of spending resources on patients with interesting and rare diseases rather than addressing common problems in the community.

Dr Dumont's personal experiences, including working with


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