A Psychoanalytic Approach to the Mental Health Team

Historically, the study and treatment of behavior disorders in this country began in institutional settings. Although the first diagnostic and treatment clinic was established at a university by a psychologist, physicians and social workers participated actively. As the child guidance and mental health movements grew, the concept of the clinic team was evolved and later formalized in the term ‘orthopsychiatry’ (1). Its semantic bias reflects medical domination of the mental health team which has persisted for more than a quarter of a century. The member professions in the mental health family, psychiatry, psychology and social work, have developed independently and jointly. Interesting interprofessional and interpersonal dynamics have arisen which I wish here to explore.

First, I want to discuss that great American myth, The Team, especially as it appears in the field of mental health. We all know what a team is. Much American folklore since the days of the Founding Fathers surrounds the team idea. “If we don't hang together, we'll all hang separately.” Children know that being part of the team is part of being an American. This myth affects all walks of life: the family, sports, the military and government. Commerce and industry, as well as the professions, have gotten on the bandwagon. “Let's pull together!” “Our factory is one great big team!” “We are one happy family.” “Let's act like a team.” “The