The community mental health center: does it treat patients?

The original intent of community mental health centers was that they would treat the mentally ill. The more than 750 centers now operating are drifting away from that health service, however, toward a social service model offering counseling and crisis intervention for predictable problems of living. One result of the shift has been a marked decrease in medical involvement in the centers that has led to neglect of the mentally ill, especially chronic and deinstitutionalized patients. The author advocates a return to fulfilling the original mandate by giving centers clear responsibility for dealing with professionally diagnosed psychiatric illness, and by requiring that centers remain integrally involved with hospitals and hire staff that include an adequate number of psychiatrists. He also believes that scientific evaluations of community programs can and must be made in order to justify their expenditures and to attract support from funding agencies.