The impact of community mental health centers on child psychiatry training.

In the mid-1960s, when the community mental health/mental retardation movement took shape, many child mental health professionals, especially those working in community services, welcomed it eagerly. Probably the majority of mental health professionals did not: they experienced serious misgivings, fearing that community mental health centers would have harmful effects on psychiatric and mental health practice and education. Nonetheless, there was clear-cut dissatisfaction with the mental illness services system as it had been operating. The establishment of community mental health centers offered hope that the shortcomings and defects that were evident in the mental health delivery system could be corrected or, at any rate, considerably ameliorated. Matching an early enthusiastic expectation of needed changes and improvements which the community mental health center would bring to mental health care were our hopes regarding its contribution to training. We viewed it as an unusually promising setting for the training of child psychiatrists, other child mental health professionals, and paraprofessionals. It appeared ideally suited to provide mental health professionals with: training in the use of multiple diagnostic and treatment modalities with patients in inpatient, partial hospitalization, and outpatient settings; supervised clinical experience with hitherto neglected populations of patients, including children at risk, poor and disadvantaged children and families, alcoholand drug-abusing adolescents, and delinquents; and training as part of an interdisciplinary team in services organized to provide continuity of care. Today, in the mid-1970s, community mental health centers are