Role segregation, or the clear split between the role of staff and patient, has been a dominant feature of the traditional mental hospital and most contemporary community-based treatment facilities for the mentally ill. In contrast, this article reports on an innovative community-based therapeutic milieu for the chronically mentally ill in which a holistic healing philosophy and egalitarian ideology supports the blurring of roles of staff and patient. A detailed description and analysis of “role blurring' is offered that includes (1) an examination of its sources and organizational and therapeutic consequences, (2) the ways in which role and status are inevitably and subtly reasserted and differentiated by way of interactional strategies and structural factors, (3) this therapeutic community's place within the reforms of institutionalization and deinstitutionalization, and (4) a discussion of what other organizational contexts do and do not to promote “role blurring.”
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