[Social psychiatry in private practice].

Though in general the practice of Community Mental Health (or "Social Psychiatry") is a task of the State, the County or the City governments, the panel discussed two instances of sizeable contributions by private practices to the tasks of community mental health, such as crisis intervention or the care of the chronically psychiatrically handicapped, which are not commonly treated in psychiatrists' offices. The "Psychosoziale Arbeitsgemeinschaft" of Basle began in a psychiatric group practice through common sessions with public health nurses, social workers and other community helpers and served a workers' section of the city. In the course of five years several other services could be built up, such as a day-care center for psychically handicapped, a patient visiting program through voluntary helpers and a rehabilitation workshop. Ultimately subsidy from State and Federal funds could be obtained. Another program, in Zurich, started in a nonpsychiatric general practice, also in a workers' section. The physicians of that group hired, at their own expense, a social worker-educator and psychotherapist with a five year experience in community mental health work to care for the social and psychological problems commonly found in every general practice. The costs of her work cannot be generally billed to the health insurance carriers, but it is possible for the therapist to negotiate case by case with the insurance, this with success in a good many cases. The discussion with the audience shows that, in spite of considerable difficulty, it appears that private practice and especially a group practice, can make a valuable contribution to the mental health care of a disadvantaged segment of the population.