Stern R, Minkoff K
Hosp Community Psychiatry. 1979 Sep;30(9):613-7. doi: 10.1176/ps.30.9.613.
In attempting to build a successful program for chronic patients at the Somerville (Mass.) Mental Health Clinic, the authors first found it necessary to uncover, address, and resolve six fundamental paradoxes engendered by deinstitutionalization that were stressful to mental health clinic staff and inhibited effective programming. The paradoxes involve issues relating to community mental health ideology, clinicians' sources of self-esteem and professional ability, and clinicians' views of chronicity and the deinstitutionalization movement in general. Resolution of the paradoxes requires major value changes, which can be brought about by effective clinical leaders who serve as role models and teachers, and who set the tone for patient care.
在试图为萨默维尔（马萨诸塞州）心理健康诊所的慢性病患者建立一个成功的项目时，作者首先发现有必要揭示、解决由去机构化引发的六个基本矛盾，这些矛盾给心理健康诊所的工作人员带来压力，并阻碍了有效的项目开展。这些矛盾涉及与社区心理健康理念、临床医生的自尊来源和专业能力，以及临床医生对慢性病和去机构化运动的总体看法相关的问题。解决这些矛盾需要重大的价值观转变，这可以由有效的临床领导者来实现，他们作为榜样和教师，为患者护理定下基调。
