Psychiatric manpower and services in a community mental health system

Executive directors of Oregon's 36 community mental health programs were surveyed in the fall of 1983 to determine the nature of psychiatric services offered and the roles played by psychiatrists. The study showed that a total of 18.2 full-time-equivalent psychiatrists were working in the community system, a mean of .5 per program, considerably below the national average. None of the responding directors were psychiatrists, and only six employed psychiatrists as medical directors. The directors valued psychiatrists most highly for their skills in educating, supervising, and consulting with staff; for their unique clinical skills; and for medication management. They considered the biggest disadvantage of employing psychiatrists to be the expense. The authors discuss factors that contribute to psychiatrists' satisfaction with work in community mental health programs and strategies for recruiting and retaining psychiatrists in the programs.