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Tvp22 01 omslag kijk verder

Tijdschrift voor Psychiatrie 18 (1976) 1, 434 - 447

Korte bijdrage

De Community Mental Health Centers in de U.S.A.

A.E. Baert

After defining the concept of the Community Mental Health Centers and giving an overview of the principles, the author describes the five most needed ways for the operationalization and the implementation of the community approach in mental health care. The results, i.e. the successes, of the community mental health programme in the USA are discussed and also the various shortcomings: private psychiatrists and general practitioners are not integrated enough; overestimation of the need for the number of psychiatrie beds; need for cost analysis of the consultation and education part of the programmes in connexion with the need for adequate reimbursement; an evaluation programme should have been built in from the beginning; with the tremendous increase in perronnel costs and the general inflation of cost price, some parts of the output are not financially competitive with the private psychiatrie practice; two parallel systems still emerge, the CMHC and the State hospitals, frequently with not enough collaboration; and finally, the 'yavis' phenomenon with neglect of the unwanted, difficult, chronic patient, specially the defected schizophrenics.