Care for the mentally ill in the U. S. has traditionally been hospital-based; there are four times as many psychiatric beds per 1,000 population as in the U.S.S.R., where the district psychoneurological dispensary, emphasizing outpatient services and aftercare, is the focal point of treatment. These dispensaries, which the author describes, have features in common with the community mental health centers to be built in the U. S. The organizational structure for psychiatric services in this country is more complex than in the U.S.S.R. for various historical reasons; the success of the community mental health movement here will require a creative and flexible approach which can break down antiquated boundaries of responsibility.Abstract Teaser