Abstract
The author, from a background of Canadian, British and European psychiatry, reviews the development of community psychiatry in the evolution of psychiatry in the United States. The essential premises of the sub-discipline are examined, with special emphasis upon the concept that mental illness is preventable. Specific aspects of the characteristics of community psychiatry are examined from a critical point of view. Given the need for social change and the improvement of the lot of mankind, the author questions whether the psychiatrist, by reason of his special training, is necessarily the most competent person to plan and institute this social change; suggesting that in certain areas the efforts of the psychiatrist may even obstruct change. When viewed in the total context of psychiatric history community psychiatry, the author suggests, may be yet another retrograde step in psychiatry's peculiar cyclical course. Finally, the author makes a plea for evaluative research to accompany, if not precede, the development of community psychiatry; and, on the basis of the more efficient use of manpower, to explore the possibility of training a new professional to do the greater part of the work currently being delegated to the community psychiatrist.