Abstract

During the past two decades, both the theory and practice of mental health work in the United States have been influenced significantly by the emergence of a community mental health movement. The proponents of this movement have urged conceptual and organizational reforms which would make psychiatric services more accessible and valuable to a broad range of society's population. Two of the most important of the suggested reforms represent significant challenges to the "medical model" which has long characterized American mental health practice. These mandates are: (1) to restructure traditionally stratified professional role relationships in more democratic ways, and (2) to replace traditional intrapsychic diagnostic and treatment models with more socially oriented ones. This paper examines the impact of these two proposed reforms upon the work of a group of traditionally trained mental health professionals who sought to implement the ideas of community mental health practice. It focuses, in particular, upon the status and ideological conflicts engendered by these new goals and on the factors that affect their resolution.

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