"This rich array of essays shows how the lens of history can clarify contemporary health-policy dilemmas and enable the reader to see ahead more clearly." --Harvey V. Fineberg, President, Institute of Medicine "A refreshing antidote for those finding it difficult to envision a better future for health care in America...This excellent book helps us all to better understand the subtle relationship among values, institutions, economics, and medicine that shapes our health system." --Stuart M. Butler, Vice President for Domestic Policy, The Heritage Foundation "An important book for those wrestling with the appropriate role of markets in U.S. health policy." --Karen Davis, President, The Commonwealth Fund In this book, seventeen leading scholars make the case for the usefulness of history in evaluating and formulating health policy today. In looking at issues as varied as the consumer economy and the plight of the uninsured, the contributors uncover the ways we think about technology, the role of government, and contemporary medicine. They show how historical perspectives can help policy makers avoid the pitfalls of partisan, outdated, or merely fashionable approaches, as well as how knowledge of previous systems can offer alternatives when policy directions seem unclear. Rosemary A. Stevens is DeWitt Wallace Distinguished Scholar in social medicine and public policy at Weill Cornell Medical College and professor emerita of the history and sociology of science at the University of Pennsylvania. Charles E. Rosenberg is a professor of the history of science and Ernest E. Monrad Professor in the social sciences at Harvard University. Lawton R. Burns is the James Joo-Jin Kim Professor of Health Care Systems at the University of Pennsylvania. A volume in the Critical Issues in Health and Medicine series, edited by Rima D. Apple and Janet Golden

History and Health Policy in the United States: Putting the Past Back In

Community psychology can be seen as a vigorous, action-oriented movement. It is, however, still in the developmental stage characterized by the continued attempts to specify the goals and parameters of the field. The growing paraprofessional movement shares similar origins to community psychology and appears to provide answers to some of the questions raised about the accomplishments of the practitioners of community psychology. Some of the stated goals of community psychology are briefly reviewed and the paraprofessional movement is described in greater detail in an attempt to demonstrate the relationship between the accomplishments and trends of the paraprofessional movement and the goals espoused by community psychologists.

The paraprofessional movement as a paradigm community psychology endeavor.

Sociocultural influences are seen as pre-eminent in the development of community child psychiatry, with special emphasis given to issues of social reform, race and poverty. Current status of the field is discussed within the framework of a typology that identifies programs as being clinically-adapted, socially-adapted, or community-adapted.

Community child psychiatry: evolution and direction.

The ordinary ambiguity of clients' membership in service organizations is heightened when lay members of an organization's service community or catchment area are made members of its service staff. It is further heightened when the methods of training, supervising, and governing staff resemble the methods of serving or treating clients. The ethos or culture of the early community mental health movement promoted an extreme form of this ambiguity: an expressive openness between and equality of clients and staff, and a structural openness which allowed easy movement from the client role to the staff role and vice versa. A service organization of this kind would conflict with a more traditionally bureaucratic and professional organization, but an organization containing both community and traditional mental health ideologies contains a destructive form of culture conflict within itself. In such a self-contradictory organization the structural ambiguity of the client role cannot be adequately understood without first examining the nature of this culture conflict; this is the purpose of our ethnographic analysis of a community mental health center.

Culture Conflict in a Community Mental Health Center

Collaborative consultation: A process for joint professional‐consumer development of primary prevention programs

The events described are conceptualized in terms of the struggle for control of the Mental Health Center and as steps in the transfer of power from a white middle-class medical school to a ghetto population Implications of the use of local citizens as mental health workers are emphasized

Carol J. Eagle

Papers

Programmed failure: The Lincoln Hospital story

A clinic as catalyst in a Head Start program.

Special considerations in the operation of a head start program by a community child guidance clinic