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Article | April 01, 1984

The Patient: First or Last?

John A. Talbott

Psychiatric Services 1984; doi:

Cornell University Medical College; Payne Whitney Clinic, New York Hospital, 525 East 68th Street, New York, New York 10021

1984 by the American Psychiatric Association

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Abstract

Too often mental health care professionals consider bureaucratic constraints rather than patient needs when making clinical, administrative, and public policy decisions. This sort of "top-down" decision-making leads to solutions that emphasize procedures and regulations rather than clinical results. After examining the disastrous effects of top-down planning in areas such as care of the chronic mental patient, the author concludes that in approaching current policy issues mental health professionals must forge solutions that meet the needs of patients rather than those of the external environment.

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