It is probably no longer necessary to observe that psychiatry is in the midst of a great revolution. Patients with major mental illnesses who just a short time ago received custodial care only in remotely situated sanitaria are now treated intensively on an ambulatory basis or in general hospitals within the patient's own community. The effectiveness of these new patterns of patient care has been demonstrated statistically. The widely publicized report of the Joint Commission on Mental Illness and Health has outlined a program for expanding these concepts, both theoretically and in their practical applications. All levels of government are providing enthusiastic financial support for their implementation.

What has been the impact of these changes on psychoanalysts? They are leaving the seclusion of couch practice in large numbers and are undertaking positions of great responsibility on the faculties