In their classic study of the prevalence of treated mental disorder, Hollingshead and Redlich1 make a number of recommendations which they feel will aid in the handling of the mental health problem in this country. Their recommendations center on efforts to reduce the cost of psychiatric treatment and to make it more readily available to all who need it. They specifically recommend the further development of brief treatment methods and the training of nonmedical therapists to provide some forms of psychotherapy at fees within the reach of more people. This paper is a critique of these measures from one point of view: Their potential usefulness in improving the psychiatric care of the lower-class neurotic patient. I will not comment here on the management of psychotic patients.
There can be little doubt that the lower-class neurotic patient receives substandard care in terms of currently accepted