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To the Editor: In the June issue, Rissmiller and Rissmiller provide an interesting report on the development of alternative perspectives on the nature of mental illness and the role of treatment. The authors describe two movements: the intellectually and academically based antipsychiatry movement and the community-based-populist "consumerist" movement. They contend that as the antipsychiatry movement lost momentum in the early 1980s, it was essentially transformed and incorporated into the more mainstream "consumerist" movement. They believe that antipsychiatry tactics had a significant impact on the course followed by the "consumerist" movement and that it became more radicalized as a result.

Although there may be some controversy with regard to this view, their report does provide an accurate assessment of the reforms that these two movements, alone or in combination, brought about. Their concluding remarks are unfortunate, however, stressing divisions between psychiatrists and consumer activists. Although it is true that some psychiatrists have had difficulty interacting with the more hostile elements of the consumer movement, and these elements have likewise had difficulty softening their perception of psychiatry, psychiatrists and consumers have made great strides in creating a dialogue in recent years, regardless of sometimes divergent viewpoints. Failure to acknowledge this evolution misses the key to the transformation that is currently under way.

Dr. Sowers is president of the American Association of Community Psychiatrists and medical director of the Office of Behavioral Health, Allegheny County Department of Human Services, Pittsburgh.