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Community Psychiatry has generated so much clinical and philosophical ferment, so much drama and heartache, that it is hard to believe this action has all taken place in less than a decade. It was only in 1963 that the Community Mental Health Centers Act was adopted, with far-reaching implications for the nation at large. Psychoanalysts provided outstanding leadership in this development. For those of our colleagues who have contended that Community Psychiatry is a mere fad I would like to say, to the contrary, that it has been responsible for crucial changes in health planning throughout the United States.
The basic concepts have become quite familiar. Community Psychiatry is a point of view that in most cases with reversible mental illness the treatment locale of choice is the community in which the patient resides. This deceptively simple proposition has a number of important corollaries. For example, continuity of care in the treatment of major mental disorders became possible for the first time; treatment became family centered; the concept of crisis intervention led to a new appreciation of the role of precipitating factors in emotional decompensation and the significance of ego strengths in restitution to normality.
A concern for early case finding and primary prevention has led compellingly to an awareness that mental health is inseparable from general health and that Community Psychiatry is a part of Community Medicine. An appreciation of the significance of social environment in health and disease has led to a commitment to regionalized care encompassing all aspects of health, education, and welfare.
Thus Community Psychiatry, in its brief presence on the national scene, has moved into successively new positions. Its growth and development are by no means concluded. Indeed, we are on the