I SHALL SPEAK of two matters. The first will deal with the psychiatric clinic and hospital in the university medical center and its implications for medicine in general. The second will deal with the current political and social movement intent upon the establishment of community mental health services and their possible implications for psychiatric theory and practice. As universities exist in communities, these two matters touch each other at many points.
What I shall have to say will be based in great part on personal experiences. I shall not present an exhaustive survey of the relevant literature nor have I attempted to poll opinions of colleagues. Most of the time in the past 30 years I have been engaged full-time in teaching, patient care, clinical investigation, and administration in university psychiatric clinics and hospitals in five of the six medical schools with which I have been associated.