Job satisfaction, prestige, and the aftercare clinician

Few would disagree that programs designed to assist deinstitutionalized mental-health patients have been seen as the step-children of community mental health. Many community mental-health programs were built quickly to rise to the challenge of the flood emerging from the hospitals. Unfortunately, this resulted in programs being poorly defined and reactive rather than responsive in nature. One of the issues that emerges as crucial is the status afforded to the aftercare clinician by other mental-health professionals. Personal experiences shared by community mental-health personnel suggest that clinicians who work with aftercare patients or who work in aftercare settings are attributed less prestige than their outpatient counterparts. The authors review the pertinent literature and reveal the results of a survey suggesting that aftercare clinicians view themselves as expert, but the rest of the system does not, leading to the inconsistent status profile. The problem then emerges that the aftercare clinician must "market" his or her expertise and specialized skills so that other clinicians recognize the unique therapeutic contribution of aftercare. The authors offer recommendations.