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What is valuable is not new, and what is new is not valuable.
Daniel Webster, 1848.
Bellak suggests that community psychiatry represents a third evolutionary stage in the development of psychiatry. The first phase began at the end of the eighteenth century and marked a new, sympathetic attitude toward mental illness; the second phase was the development of psychoanalysis at the end of the nineteenth century. Bellak proposes his handbook as representing a third phase, assessing it as a new level of integration and understanding. 1. Basic concepts; 2. The scope of community psychiatry; 3. The members of the team and their role; 4. Program organization, administration and evaluation, comprise the major sections. There are chapters dealing with special problems in the practice of psychiatry in different kinds of community settings. Articles by Howe, Mayo and Klein, Leighton, Leighton and Armstrong, Black, and Caplan are thoughtful, well-written contributions. Some of the other contributions are distinctly polemical.
The many diverse and inconsistent concepts of community psychiatry presented in this book do little to clarify and nothing to justify the promise of the title. Psychoanalytic concepts are at best given lip service. In some instances vagueness may reflect a lack of data or experience sufficient to justify more precise formulations. Bellak's own contribution is merely a relabeling of long-established psychiatric practices.
The position of the reader can be paraphrased from Le Bourgeois Gentilhomme: I was startled to learn that I have always been a 'community psychiatrist'.