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October 1967

Becoming a Patient

Author Affiliations

New Haven, Conn; Cambridge, Mass; Southampton, NY
From the Department of Psychiatry and the Research Unit for Social Psychology and Psychiatry, Yale University (Dr. Levinson); the Department of Psychiatry, Harvard Medical School, and the Massachusetts Mental Health Center (Dr. Merrifield); and the Social Science Division, Southampton College, Southampton, NY (Dr. Berg). Dr. Berg is now at the Human Relations Commission, Suffolk City, NY.

Arch Gen Psychiatry. 1967;17(4):385-406. doi:10.1001/archpsyc.1967.01730280001001

THIS IS a study of the initial encounter between a psychiatric outpatient clinic and the persons who come to it seeking help. In the idiom of clinic culture, the help-seeker is identified from the start as a patient. We prefer to identify him as an applicant. He is seen by one or more agents—staff members who are assigned responsibility for the evaluation and screening of applicants. He becomes a patient when he and the agent reach a joint decision to embark upon a course of treatment. Many applicants, the majority, do not receive treatment.1-4 We shall use the term applicancy to refer to the proceedings which begin with the first contact between applicant and clinic, and which end either with the onset of treatment or with termination of the relationship by one or both parties. We present here some theoretical notions about applicancy and some empirical findings regarding the careers