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Community Psychiatry:  An Evolutionary Change in Medical Psychology in the United States

Bernard Rubin, MD
Arch Gen Psychiatry. 1969;20(5):497-507. doi:10.1001/archpsyc.1969.01740170001001.
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IN SPITE of a burgeoning literature and approximately two decades of activity, it is still difficult to know with any precision the origins and present boundaries of community psychiatry. This diffusion in relation to its concerns and limits is matched by a confusion about its role within the confines of psychiatry and the nature of its operations within educational, economic, legal, and political institutions within the community. In the development of community psychiatry in the past two decades this difficulty of boundaries, roles, and goals can best be understood in terms of an historical convergence of two streams of ideas and actions: the mental hygiene movement and the quest for social justice. I propose to examine these two sets of ideas as the major forces in the evolution of community psychiatry and then to describe how these forces have persisted and effected three aspects of community psychiatry: (1) the delivery


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