Effective Utilization of the Psychiatric Hospital

Alfred B. Lewis Jr., MD
JAMA. 1966;197(11):871-877. doi:10.1001/jama.1966.03110110095021.
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The role of the psychiatric hospital in an expanding program of community psychiatry is undergoing redefinition.1 The general philosophy underlying the community mental health program is based largely on research findings from the social sciences,2,3 and can be summarized briefly as follows: mental illness in an individual is significantly influenced in its development and its progression by his relationship to his family and to the community. Psychotherapeutic attention must be focused on these relationships in order to achieve maximal effectiveness. The classical one-to-one therapy that predominates in the private practice of psychiatry is frequently ineffective in dealing with these relationships, and does not reach the less prosperous and less articulate classes of society, both because of its expense and because it seems to be tailored to middle class attitudes and values. The psychiatrist's concept of his role must therefore be broadened to include work with families and community


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