THIS PAPER discusses some of the problems encountered in outpatient work with severely disturbed patients of the lowest socioeconomic level. It examines how patients discharged from a state hospital interacted with the staff of a university-community psychiatric clinic in an attempt to understand the apparent reluctance of patients and psychiatrists to work together.
The psychiatric clinic of the Grace-New Haven Community Hospital is staffed by faculty and residents of Yale's Department of Psychiatry and provides a variety of diagnostic, consultative, and treatment services. Residents' case loads are carefully limited, and most patients are seen weekly for an hour's interview. A few patients are seen more often and a number less frequently, usually for much shorter appointments in contacts that center around drug management. A major emphasis of the teaching program and of the residents' work is on interviewing and therapy skills. Because
CARLSON DA, COLEMAN JV, ERRERA P, HARRISON RW. Problems in Treating the Lower-Class Psychotic. Arch Gen Psychiatry. 1965;13(3):269–274. doi:10.1001/archpsyc.1965.01730030075010
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