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This paper evaluates and describes methods for making psychiatric distinctions. It is by means of psychiatric distinctions that individuals are labeled mentally ill or mentally well. Within the mentally ill category, patients are differentially placed according to the severity and type of their mental illness. The placement of individuals into psychiatric categories is an essential prerequisite not only to the clinical treatment of patients but also to any research where the objective is to determine empirical regularities associated with mental illness. Until the patient is categorized, the practitioner has no logical guide for how to perform treatment or even whether he should treat the patient—i.e, the patient may not be a patient. Similarly, unless the psychiatric researcher has categorized his subjects according to some notion of mental illness he has no way of making comparisons or of assessing change, the two essential processes in research. Thus, the logical first step for arty discovery of new knowledge in the field of mental illness is to appraise the reliability and validity of methods for making psychiatric distinctions. No research findings can be more reliable or valid than the psychiatric distinctions used in carrying oat the research. [ABSTRACT FROM AUTHOR]

Hospitalized mental patients are increasingly being discharged into the community. Yet, despite the construction of hundreds of community mental health centers, readmission rates continue to rise. This paper analyzes the reasons for this problem and provides suggestions for its solutions. [ABSTRACT FROM AUTHOR]

An account is given of the creation and management of an in-patient therapeutic programme for male alcoholics at Bellsdyke Hospital, Larbert, Stirlingshire, commencing with a selected group within a psychoneurotic unit which it was found necessary to convert into an unstaffed alcoholic unit with often admission procedure. Statistics over a two-year period are provided and discussed. In the discussion which followed an attempt was made to answer a series of questions posed by the experience involved. For their advice and support in the preparation of this Paper, I would like to thank Dr. A. P. Russell, Physician Superintendent, Bellsdyke Hospital, Larbert; Dr. D. A. Pemberton, Consultant Psychiatrist, Bellsdyke Hospital, Larbert; Dr. A. B. Sclare, Consultant Psychiatrist, Eastern District Hospital, Glasgow; Professor Ferguson Rodger. Chair of Psychiatry. Glasgow University; and Dr. R. J. Simpson, Registrar in Psychiatry, Bellsdyke HospitaL Larbert. [ABSTRACT FROM AUTHOR]

Mental health legislation in California brought about radical changes in commitment procedures. This paper describes the strains mental health personnel experienced in implementing the new law and proposes ways to manage such strains. [ABSTRACT FROM AUTHOR]

The article presents information about therapeutic group approaches in community mental health. This paper deals with the varicolored spectrum of group influence attempts that lie outside the more strictly clinical range of group psychotherapy. Recognition is the proved potency of these approaches in counteracting the noxious influences noted and in enhancing mental health and rehabilitation need not lead to an obliteration of the distinction between them and traditional group psychotherapy. One could argue to the contrary that a comprehensive view of all treatment modalities in the framework of planned intervention measures aimed at restoring adaptive in place of maladaptive social functioning only heightens the need for concise diagnostic assessment and treatment methods. This has been demonstrated in relation to crisis intervention and short-term psychotherapy in which "an orderly and integrated series of concepts" and methodology are considered even more necessary than in long-term treatment. The greater the need for flexibility in goals and innovations in methodology encountered in the context of a community mental health center, the greater the necessity for conceptual and methodological clarity and order.

According to the author, based on clinical experiences, in civilian as well as military settings, the authors believe that mental hygiene clinics, in general, are more oriented toward treatment than toward prevention. This paper is concerned with a "new" treatment program placed in operation in the psychiatric unit of a military general hospital. The hospital has a large teaching program within the departments of medicine and surgery, in addition to offering both outpatient and inpatient care to active duty personnel, their dependents, and eligible retired personnel. The teaching program does not, however, include formal training in psychiatry, psychology, or social work. The large dependent population relying on this hospital for total medical care resulted in a steady increase in requests for help with family problems, particularly marital and child behavior difficulties. Consequently, the staff had a choice of maintaining a long waiting list or revising theft methods of treating children. Since only a limited amount of time of the neuropsychiatric staff could be made available for consideration of children's problems a treatment program was initiated that utilized the energies of the entire clinic staff on a given afternoon.

The article presents information on effectiveness of social work in meeting mental health needs. Psychiatric social workers in large numbers work closely with psychiatrists, psychologists, nurses, and others in the treatment of the ill. With regard to detection of those becoming ill and community activities to promote mental health, the total social work profession is focally and extensively involved. The concern of this paper, after noting the size and nature of the problem, is to suggest some ways of increasing social work's effectiveness in dealing with it. A few nationwide statistics will serve to indicate the size of the problem of treating the mentally ill. Figures for 1958 show that of the 6,786 hospitals of all types in the United States, 518 are psychiatric. In any year, the mental hospitals care for about 1,070,000 different persons, there are also upward of 60,000 patients in institutions for the mentally retarded. Social workers can extend the social dimensions in mental health work by discreetly extending their own roles to include those of consultant and educator. Even concepts of mental illness and mental health are changing, with accentuation of social factors. The ill or maladjusted person is seen as a product of social and societal forces as well as of organic pathology or intrapsychic conflicts.

The article reports on psychological research in the community mental health service in the United States. The need is obvious for the development of public health practices which will control the causes of mental ill health as effectively as is now done with many other diseases. It is the purpose of this paper to discuss the opportunities and the methodological problems for the psychologist doing research in the field of community mental hygiene. Research on community mental hygiene, it seems to the author, can best be attacked by studying those factors in total community life which prevent or promote the development of healthy patterns of adjustment by individuals or groups. Stating this a little differently, research in community mental hygiene might best be concerned with the nature and the origin of conflicts, frustrations, or confusions for persons or groups which are part of the community way of life.

When do people see a doctor? At one extreme, blatant pathology and extreme pain will, with few exceptions, bring one to a doctor in those societies where doctors are available (with the possible exception of mental illness). At the other extreme, a small portion of the visits are accounted for by a preventive health orientation, where no symptoms have been perceived. But, as Zola points out (1966, 1968), "we find that the vast bulk [of a physician's load] is concerned with quite minor disorders." There is, on the other hand, he notes, a great body of data which show that there is much illness, defined as such both clinically and subjectively, which is not brought to the attention of the physician. What Zola is saying, then, is that the potential for entry into patienthood is extraordinarily widespread and continuous. One can be ill, clinically speaking, without going to the doctor; or one can go to the doctor, either without any particular change in one's clinical condition or even without any particular justification from the point of view of the physician. If variations among individuals, social subgroups, or societies in visiting rates cannot be explained, within limits, by variations in clinically-determinable morbidity, what are the factors that can predict such variations? It is the purpose of this paper to present a model which, though derived from the case of Israel, should be applicable to other societies as well. [ABSTRACT FROM AUTHOR]

The article reports the issue of position paper, "The Community and the Community Mental Health Center." The position paper was recently issued by the American Psychological Association (APA). The report, written by APA president Nicholas Hobbs and M. Brewster Smith, Director of the Institute of Human Development, University of California at Berkeley, analyzes the program of Community Mental Health Centers now being planned or started. This is the first position paper APA has addressed to the general public and community planners.

A major objective in the development of mental health services has been to provide treatment as early as possible in the course of the illness. In order to achieve this objective, it is necessary both that adequate treatment services be available and that they be perceived as necessary by the patients and/or his family. This article focuses on the steps by which hospitalization itself is arrived at. These are clearly two aspects of the same phenomenon which cannot be wholly separated: actions taken depend on what the actors see as the nature of the problem facing them, and in turn perceptions as to the nature of the problem are modified by the actions and interpretations of others involved in the process of dealing with the patient.

With few exceptions, studies of the families of mental patients have been focused on the parental family of the patient in an effort to trace the etiology of the illness. Almost no systematically collected data exist to permit an analysis of what happens within the family group when a member develops a mental illness. It is the aim of this article to study the problems which the family faces when one of its members becomes mentally ill and is hospitalized in a mental hospital. Systematic data were obtained on: (1) the process whereby the illness is defined; (2) the course of the family's functioning during the illness, in terms of its members' attempts to cope with the situation, both psychologically and materially, and; (3) the ways in which family members relate to each other, the patient, the hospital, and the society.

The article presents a list of books received by the journal including "Commitment to Deviance: The Nonprofessional Criminal in the Community," by Robert A. Stebbins, "Consultation and Community Organization in Community Mental Health Nursing," by Grace W. Deloughery, and "Control of Human Fertility," edited by Egon Diczfalusy and Ulf Borell.

This article presents discussion related to psychoses. The reader should be reminded that the system was developed on inpatients in public mental health facilities and therefore should work most effectively with such patients. The correlates also may be applicable to outpatients from such facilities, especially if they have become outpatients after having been inpatients, which frequently is the case, or readers familiar with computerized printouts of MMPI interpretations or with skillful clinical interpretations, the interpretive summaries given in this paper may be disappointing on several grounds: Prognostic statements are not included, the reports often are brief, the language in which the reports are cast lacks elegance, scales L, F, and K are not interpreted in terms of validity, and dynamic explanations of behavior are not attempted.

The development of a coordinated program utilizing a team approach to care of discharged psychiatric patients is described. [ABSTRACT FROM AUTHOR]

Description and discussion are presented of a program for more than 76,000 employees to deal with mental health problems that have an effect on employment, work habits, and related matters. The broader significance of such activities is stressed. [ABSTRACT FROM AUTHOR]

A study was made to see what categories of cases were referred to mental health consultants by health agencies, and to see whether in the course of time there was any change in the distribution of cases among the categories. Findings are reported. Although the original intent was not completely fulfilled, the discussion of the problems encountered will be of value to other investigators. [ABSTRACT FROM AUTHOR]

This article deals with one counseling approach used at a mental health center located in a small rural university community. Cognitive material used in the structured instructional segments of the group came from many sources. Basic transactional analysis (TA) theory was adapted from the works of scholar Eric Berne. The counselors wanted to acquaint the boys with TA ideas concerning ego states, transactions, scripts, strokes, and games. The bask principle behind the inclusion of each theoretical aspect was that intellectual insight is helpful in the development of emotional insight and behavior change. Concepts of individual "Okay-ness" were adapted from a sociologist and were especially important in view of the poor self-concepts held by the group members. A goal of counseling was to demonstrate to the boys that each of them bad many positive attributes and that it was possible for all of them to mobilize their strengths and overcome their self-identified areas of difficulty. From past experience in groups, one is aware of clients' tendency not to fully translate insights into behavior and not to work at an optimum level in searching for insights outside the group setting. To stimulate more work on behavioral change outside the group, the concept of structured homework was adopted. Sessions were 90 minutes long, each session having the same basic format.

The article presents information on a counseling program created to fight a kind of decay--juvenile delinquency. The idea for the program grew out of recent public interest in finding fresh approaches to the delinquency problem, as the inappropriateness of wholesale incarceration daily becomes more apparent. Not only is the institutionalization of children harsh, it is highly expensive and of dubious rehabilitative value. Attention is shifting from state schools as treatment centers to the youngsters' own communities, which means that more professional services are required on the local scene. Probation personnel realize that they are overworked and often lacking in the skills and training necessary to help troubled children. Most also find referral services in short supply. Few mental health centers are prepared to provide extensive treatment for resistant and manipulative adolescents. Psychiatric and psychological services at city and university hospitals are notoriously limited and costly. Schools, overcrowded and understaffed, typically respond to misbehavior by suspending the offender, which merely compounds the problem. Specialists who are available for referral often seem insufficiently acquainted with the juvenile justice system and therefore unable to understand the delinquent client's legal limitations and alternatives.

The evaluation of a new community mental health service is discussed in four parts. One, the theoretical, ethical, and practical considerations in designing the described evaluation systems are reviewed. Two, the rationale or goals for the program are specified. Three, the therapy system and built-in evaluation is described. And finally, staff reactions and problems related to the procedures and evaluation in general are discussed. [ABSTRACT FROM AUTHOR]

The experience of the Denver Model City Mental Health Program is presented within the context of the forces that impinged on it. A major facet is the discussion of citizen participation and the lessons to be learned from developments in Denver. [ABSTRACT FROM AUTHOR]

Reorganization of the Illinois Department of Mental Health with revised programming during the period 1960-1970 should have improved patient services in the State of Illinois, and should be reflected in the Department's operating statistics. Several indices bearing on patient services are reviewed together with some speculative comment on the future of mental health services in the state. [ABSTRACT FROM AUTHOR]

A report is presented on a project to identify program costs for community mental health centers, and to establish principles for relating cost of input to types of services received by beneficiaries. Problem areas are delineated, discussed, and relation to possible measurement indicated. [ABSTRACT FROM AUTHOR]

Among relatives of formerly hospitalized patients, attitudes toward the etiology of mental illness, the mental hospital, the normaley of former patients, and the responsibility of patients for their condition were assessed by means of short, structured scales. These attitudes were found to be associated with education, age, and verbal ability. There was no relationship, however, between these attitudes and social class, independent of education. The analysis suggests that "enlightened" attitudes toward mental illness can be more parsimoniously accounted for on the basis of differential verbal skills than on the basis of differences in "style of life." Attitudes of relatives were also found to be associated with the post hospital behavior of the patients. Difficulty may be anticipated in implementing procedures to modify the attitudes of patients' family members, for their attitudes appear to be "rooted" in a set of diverse elements that includes socialization as well as situational variables. [ABSTRACT FROM AUTHOR]

The article presents several research on the role of classroom interactions and teachers influence in combating mental illness of children in the U.S. The report of the Joint Commission on Mental Illness and Health contained recommendations in combating mental illness which include balanced portfolio of mental health services and research, suggestion for increasing government spending for all levels of mental health services, encourage towards health and helping professions. Ralph Rabinovitch, director of Hawthorne Center, indicated that schools must offer psychological guide through organize and challenging programs of academic studies and routines for emotionally handicapped children.

The article focuses on the social work for the mental patients. Although rates of discharge from public mental hospitals are high, approximately two-thirds of the patients in public mental hospitals are difficult to discharge and maintain in the community, even with follow-up mental health services. The purpose of the program was to maintain patients who demonstrated a high potential for chronic hospitalization in the community and use the community as the treatment agent. A redefinition of mental health problems and perceptions regarding clients has precipitated changes in the delivery of social services. Social workers are now concerned with environmental stress and its effects on clients' ability to function. The worker was directly involved with the patients during individual conferences, group therapy sessions, and family meetings oriented toward preparing patients for discharge.

The hard-to-reach poor, hostile toward social agencies and defiant of authority, are not, the author maintains, rejecting services as a matter of choice but as an act of despair. The poor have never in fact had any options from which they could make a choice. When they are offered full participation in the choice of specific services and in the evaluation of the results of these services, they will not only accept but co-operate in and profit from these services, as is shown in the case illustrations presented. [ABSTRACT FROM AUTHOR]

The article presents information about social work in public health. Social work in public health is a timely subject since social work has become a part of the community sent ices of prevention in public health and mental health. Various new processes and techniques have been developed and tested in the practice of public health and they seem now to have relevance to the field of social work practice wherever it exists. Some of the newer techniques and the reasons for their development will be discussed in the setting of public health. In the past, public health was primarily concerned with the control of transmissible diseases through the protection of milk and water supplies and the disposal of wastes. There was then less emphasis on the participation of the individual. The public health officer utilized his authority to control both community infections and individuals with communicable diseases. Although this authority still rests in the public health department, it is today utilized in a different way. Efforts are made to gain the participation of the individual through his understanding of his need for care in order that infections within the community may be controlled. Now a broader program of services exists, including some programs of medical care for families and community groups.

In recent years it has become increasingly apparent to professional persons in the field of social work that the needs of the public far exceed the facilities available. The public is becoming increasingly aware of the nature and implications of emotional disturbance and the part this plays in the life of the individual and of the family. Professional persons in the various helping agencies are recognizing the vast emotional implications of the problems of their clients and are concerned that those needing extensive casework or other service have this available to them. Every agency in the broad field concerned with problems of an emotional nature is faced with the question of how to balance quantity and quality, how to meet demands with services that are effective. Many agencies are making some efforts in this direction. In many mental health agencies where intensive treatment is undertaken, it has become necessary to make some estimate of success of treatment and to put effort into the selection of cases on the basis of prognosis.

The article discusses effects of urbanization on mental health. The question of whether modern civilization is responsible for the alleged increase if mental ill-health in the present world is still inconclusive, owing to the extreme difficulty involved in analyzing, understanding and measuring the intricate relationship of the human psychology to the environment, some knowledge has been gained through recent researches on social psychiatry. The article deals with this problem by showing the state of knowledge regarding the effect of urbanization on mental health and discusses the major factors that bring about undesirable consequences and possible ways in which some of these negative effects may be prevented or reduced to a minimum and positive effects maintained. A few investigations were made in recent decades to compare the frequency of mental disorder among the illiterate people in underdeveloped societies. A careful analysis of mental hospital statistics in Massachusetts during the past 100 years was made and found that the frequency of psychoses a hundred years ago was not less that it is today.

The article focuses on social aspects of mental health. Lack of mental health has obviously been recognized as far back as history. At times, its treatment has been lit up by flashes of great wisdom at other times it has been surrounded by much obscurity and neglect and many superstitious attitudes. The last thirty years have witnessed the most extraordinary advances in the care and psychiatric treatment of mental patients. It was because of the changed attitudes and opinions towards the problem of mental health in so many places that the World Federation for Mental Health (WFMH), decided to inaugurate a World Mental Health Year in 1960, to give scientific impetus to research and action in the field of mental health. The purpose of the World Mental Health Year is to encourage scientific progress and the translation of knowledge into the necessary action. World Health Organization (WHO) is dedicated, according to its constitution, to the pursuit of mental, physical and social well-being. Its mental health section was set up in a small scale in 1949. It has done a remarkable job during its nine years of existence. With an orientation which is primarily medical, WHO has perhaps made its greatest contribution in the medical fields of therapy and prevention.

The article presents a preliminary statement of a frame of reference for the collection and utilization of ethnographic and documentary data. This framework was developed as part of a six-year study of the Illinois zone center program. The Illinois Department of Mental Health has been decentralized into eight zones, with model comprehensive treatment facilities in some of the zones. Active community planning is emphasized. The overall study collates survey, interview, and records data to portray a comprehensive picture of the total community system for mental health care and control. The design of the study approximates the classic before/after with control model. Two counties are included, one served by one of the new zone mental health centers, and the other not. Baseline observations have been taken at the start of the study and will be repeated in another three years. In very general terms these data include: patient-flow data, mental patient careers, mental patient knowledgeability and attitudes, public attitudes and knowledgeable of services and facilities, referral patterns, and knowledgeable of frontline professionals such as physicians, clergymen, attorneys, peace officers and others.

Provides information on different approaches to emotional management of children with chronic illness in the U.S. Number of children surveyed by the National Health Survey who had restricted days of activity; Cooperation with all the medical personnel in order to correct the specific defect and control the symptoms of the particular illness; Steps taken in preventing the disease process and the treatment regimen.

By actively participating in family interviews, pediatric resident trainees sharpen their skills, discover the importance of intra- family dynamics, observe the interaction of biologic and psycho-social factors in illnesses and develop an awareness of their own potentialities and weaknesses for dealing with clinical problems referable to the behavioral and emotional aspects of pediatrics. [ABSTRACT FROM AUTHOR]

The article discusses consistency and change in judgment of criteria for mental health improvement. Patients may learn many of the attitudes expressed in the hospital about what kinds of behavior suggest improvement. Although their progress in and out of the wards can depend on how well they are able to adopt these behaviors, search of the literature reveals little information about what patients consider as signs of improvement. Different staff groups tend to stress behavior relating to their own specialized functions in patient care, and often to minimize the importance of other behaviors considered important by other staff groups. Patients, exposed to varied messages produced by persons to whom they look for care and supervision, must form their own attitudes systematically in the face of somewhat non-coherent communications, or flounder in confusion.

This article discusses relationships between staff and patients in judging criteria for improvement in mental health. A preliminary study suggested that different Levels of staff, and patients with different amounts of experience, mention different kinds of behaviors when asked what a patient does that implies he is getting better. The spontaneous replies of staff were related to their specialized roles in patient care; those of patients depended on amount of hospital experience. These people, however, may have omitted certain behaviors which are very common to this kind of judgment, because they took them for granted or they didn't occur to them. Furthermore, they did not weight their responses by importance.

The rapid growth of the community mental health movement has evoked both praise and scorn. A major aim of many community mental health specialists is the reduction or elimination of mental illness through primary prevention. Crucial for primary prevention is the notion that mental illness is etiologically or sequentially associated with social conditions such as poverty and racism. An examination of the empirical evidence largely fails to support this notion. Instead, belief in the efficacy of primary prevention rests on ideological grounds. Some of the logical implications of these ideologies are examined and their significance for the future of community mental health programs are assessed. [ABSTRACT FROM AUTHOR]

Three studies that bear on the societal reaction explanation of mental illness are critically evaluated. The first study focuses on the relationship between the decision to institute commitment proceedings and the degree of psychiatric disturbance, the second on the effect of power on the decision-making process in a psychiatric hearing, and the third on the severity of the psychiatric disorder of patients who have been committed. It is shown that, contrary to the interpretations of the investigators, the data in these studies do not clearly support the societal reaction perspective and are, in fact, open to interpretations that run counter to it. [ABSTRACT FROM AUTHOR]

This study investigates the relationship for communities between extent of common culture and hospitalized mental disorders. Common culture is measured by indices of (1) political consensus, (2) homogeneity of income, and (3) racial and ethnic similarity. Homogeneous communities tend to have a higher incidence of hospitalized mental disorders than heterogeneous communities. Data on community psychopathology, measured independently of mental hospital statistics, suggest that propensity to hospitalize may account for the observed differences in hospital admission rates between communities. Data on the circumstances surrounding admissions further suggest that hospitalized mental illness is higher in culturally homogeneous communities because of greater consensus as to what constitutes normal and abnormal behavior rather than because of rejection of the mentally ill. The influence of community structure on institutionalization of the mentally ill appears to operate chiefly for the less debilitating forms of mental illness. [ABSTRACT FROM AUTHOR]

In a study of 1,045 state mental hospital patients released on leave of absence during the calendar year of 1956 to the Oakland California Bureau of Social Work, a large amount of evaluative information was collected on post-hospital adjustment. Data from case records, administrative files, and hospital records were reviewed. They clearly demonstrated that most ex-patients did not possess a sufficient number of social resources to allow them to adapt to the world outside the state hospital. On the basis of these findings, one can easily understand why seven out of ten of these patients returned to the hospital. [ABSTRACT FROM AUTHOR]

A description is presented of the development of mental health services for Mexican-Americans in a Texas city, and of the changes that occurred in the program in terms of philosophy and personnel. [ABSTRACT FROM AUTHOR]

The relationship between alienation and mental health is of interest to workers in mental health professions for another reason. This is the question of whether social values are affected by mental illness. It has often been assumed that they are, but there is a dearth of evidence on this question. It cannot be taken for granted that because a man enters a mental hospital, he has rejected the values of the dominant culture. On the basis of research on long stay patients, it appears more likely that large mental hospitals produce more alienation than they treat. Some patients on chronic wards have not visited a community in years. Many do not read a newspaper or receive mail. In such cases discussions of alienated mental patients should be centered on the disculturating effects of large isolated mental hospitals rather than the relationship between alienation and psychopathology. The task at hand is to investigate the degree of alienation of patients recently admitted to a large mental hospital.

The article attempts to determine how veterans who apply for outpatient treatment differ from veterans who do not, as indicated by certain variables which showed promise of predicting requests for clinic treatment. The variables studied were role in the family, rated percent of psychiatric disability, degree of urbanization, and decreased disability benefits. These results strongly indicate that rated percent of disability is the critical factor of those studied in identifying clinic corners, whereas the other variables appear to gain in importance mainly by virtue of their interaction with the disability dimension.

The article presents a research concerning the attribution theory concepts and outpatients' perceptions of the causal locus of their psychological problems in the U.S. The focus of this study was on variables deduced from the attribution theory related to the locus of casual attribution of behavior. The subjects of the study were adult outpatients seen for initial interviews during a 6-week period in community mental health facility. The results of the study suggested that problems perceived as caused by internal factors inclined to be comprehended as more severe and of longer duration. It was found out that the cause of difficulty was perceived more internal as the severity of the problem was increased.

The article discusses the conceptual framework for embarking on the design of objectives for a community mental health plan, where a number of administratively independent facilities provide mental health services to the population. Each component unit must determine and submit its own goals and objectives in designing a mental health plan subscribed to by various service organizations. The health plan's objectives should be proposed with due recognition for three characteristics, including relevancy, practicability and measurability.

The article focuses on the challenge of the new therapies to social work. Psychiatry continues to have the deep concern for the follow-up of treatment and for affecting social readjustment of former patients. With the trend toward community centered mental health programs moving further and further away from the old concept of custodial care for the mentally afflicted, there will be a far greater number of people needing mental hygiene attention and other community services to promote mental health. State hospital social workers trying through foster care to help recovered patients find their way back into community living. Help from the hospital means far less, for often such help makes it only the more obvious that only the hospital is really interested in the returning patient's welfare. The social group work field will have to come out of its knowledge of group process and special skills more purposefully to mental health organizations.

The article presents information about a comparison of random and judgmental methods of determining mode of outpatient mental hygiene treatment. Much has been written about ways of deciding how to treat patients with emotional problems. The best way of arriving at a clinical judgment for treatment is presumably provided by the "team", consisting of psychiatrist, psychologist and social worker, each contributing his specialized knowledge to the decision. In a recent study, it was found that each of the three disciplines on the team--psychiatry, psychology and social work--was about equally accurate in predicting what the therapist would, at the conclusion of treatment, describe as the preferred method of therapy. No group was very good, however, nor did meeting together as a team improve the predictions significantly.

It remains to be seen whether the plight of the elderly simply a slogan of pensioner polemics or is it a reflection of social realities. It is still unclear whether the present provisions of the medical, nursing and social services match the needs of the eight and a half million people in Great Britain of retirement age. Their numbers have doubled over the last 50 years from 8% to 16% of the population. The elderly now occupy 44 % of both general medical and mental illness beds in hospitals. In the Great Britain special residential accommodation and home nursing visits have both risen by a third in the last 10 years.