Problems of psychiatric practice in community mental health centers

Initial enthusiasm about community mental health centers (CMHCs) has diminished. The participation of psychiatrists in CMHCs declined in the 1970s and may decline further. The author describes one center to highlight problems encountered by community psychiatrists: 1) unrealistic treatment expectations, 2) limitations of psychiatric knowledge, 3) need for a broad range of clinical expertise, 4) supervision of other CMHC clinicians, 5) limited funds and rehabilitation facilities, 6) complex medical and legal problems, and 7) lack of adequate training in administration. She suggests that the public be reeducated regarding realistic treatment goals, that CMHCs be allied with university departments of psychiatry, that funding be stabilized, and that community psychiatrists be given more support.