The aim of this text is to provide mental health professionals, both those in the field and those in training, a better understanding of the service delivery system and ideas for how to work effectively in it. It examines various driving forces--deinstitutionalization, empirically based practices, managed care---both in the evolution of the present community mental health care system, as well as the impact on the overall system today. The text begins with an overview of the Community mental health field, including the impact of deinstitutionalization on it. Next, it provides a description of the ecological model and the prevention paradigm, both conceptualizations needed to navigate through the system. Individual-oriented tools include stress management and brief therapeutic techniques. Systems-oriented tools include consultation strategies, community research methods and change techniques. These techniques provide the professional with effective tools to produce large-scale reform.The values that community mental health professionals must consider include cultural responsiveness, empowerment, and the ethical concerns unique to helping agency-affiliated individuals in the community. The book concludes by exploring a vision of the future of the system: a description of the needs of the elderly, the fastest growing segment of our population. Also covered are programs designed to help this population and dramatic changes expected in the types of mental health interventions that corporate employers and their insurance companies will support.
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