Recent Trends in Child Psychiatry

Abstract

During the past few years of rapid social transformations child psychiatry has shown signs of deep shifts and readjustments. Probably the most important single develop ment has been the rather sudden and definite widening of the circle of practice and interest from the individual child and the family to the community institutions and the social system at large. This development began gradually. The influence of society and culture on mental illness has been the subject of many studies over a number of years. These studies and the theoretical interest they initiated set the stage. Then the great social turbulence of the sixties, the rapid decay of our envi ronment and the explosive movements of repressed social groups forced upon our awareness the issue of the sick community and the urgency for appropriate action.This action began at all levels and has led to radical changes in thinking and at titudes. Decentralization and organization of facilities on a regional basis, removal of services from the hospital to non-medical community institutions, massive preventive and educative programs -all reflected the new awareness that the target is not the individual but rather the disabled and dis abling environment.These changes make heavy demands on the child psychiatrist. Originally associated with the pediatrician in the treatment of the child, he had recently moved into the general psychiatric unit as part of a larger team for the treatment of the family and the teaching of comprehensive psychiatry. Now the child .psychiatrist is asked to change affiliations and identity once again and to move into the community itself as a consultant and integrator of the most diverse services. Adjustment to these iAssociate Professor,

Judging the effectiveness of a consultation program to a community agency

“…Kubie (1968) feels that the young psychiatrist is seduced into an area that promises greater financial reward, yet allows him to preserve emotional distance from patients, thus failing to allow him to mature as a psychiatrist. Lester (1970), reviewing recent trends in child psychiatry, cautions with her concern about the present "zeal and therapeutic permissiveness," which she feels could invalidate all mental health programs. Wallerstein (1968) stresses also that community mental health programs will grow up apart from and conceptually antithetical to psychodynamic thinking.…”