Organisational structure and its effect on the therapeutic activity and effectiveness in an american mental health...

The mental health center movement represents a new mode of care for the mentally ill. People are treated on an out-patient basis rather than in institutions. The therapeutic work is mainly carried out by so-called paraprofessionals who seem to be well qualified for the job. However, when organizing such a treatment system there appear to be several important factors which need to be taken into account: (1) the therapist's need to work individually and independently, (2) the therapist's need for personal training, (3) the therapist's need to be heard when they channel information from the community to the service system, (4) the need for open and direct communication in the system to ensure that the therapists work within the frame of accepted therapeutic procedures, (5) the importance of the therapists' being represented at the highest decision-making level in the system in order to ensure that their needs are met. The author stresses this as an inevitable necessitiy in order to give the therapists the appropriate working-background.