Political-economic and professionalistic barriers to community control of mental health services: a commentary on Nassi.

Abstract

Nassi (1978) described the limits of community control in community mental health centers. This problem can be further understood by exploring the growth of professional dominance and psychiatric expansionism in the 1960s. One consequence was a 'social movement' ideology which psychologized political and economic phenomena, while actually opposing any effective mobilization for community control. Professionals have largely remained unaware and/or unresponsive to these tendencies. Likewise, they have failed to grasp the system of chaos which characterizes mental health policy in the U. S. Mental health care is increasingly falling under professional medical control, State-sponsored rationalization and efficiency planning, and private-profit concerns such as insurance companies and nursing homes. In this way, professionalism and capitalism coincide in their efforts to further their own efforts, while stemming community control in favor of social control.