LIMITATIONS OF MEDICAL TRADITIONS ON COMMUNITY MENTAL HEALTH PROGRAMS

A series of entrenched medical traditions has been recognized as obstructive for the development of effective mental health practices and the on-going assessments of patient care. Traditional patterns of isolation within and between medical and non-medical facilities of the community's resources contribute to maintenance of weak patterns of coordination, communication and fulfillment of responsibility with consequent antitherapeutic fractionation, discontinuity and inflexibility of services. Some organizational traditions in state hospital systems, such as distance from the patient's home and poor liaison with other community facilities, impede postdischarge re-adjustment. In general hospitals the old tradition of placing those with greater professional experience on inpatient services which led to enhancement of their prestige is detrimental to the growth and strengthening of the admissions office and the outpatient departments which have major importance for community mental health programs and require high levels of professional expertness. These factors are reflected in traditional organizational features of general hospitals, and influence staffing patterns and admissions procedures and policies that are now adverse to early detection and treatment of psychiatric illness. They lead to incomplete and inaccurate recording of psychiatric diagnoses and minimal attention to outpatient charts. By identifying these traditions and the obstacles they raise, it is hoped that appropriate revisions come about which will lead to more effective patient care.