The new careers program of the Harlem Rehabilitation Center seeks to develop new professional, paraprofessional, and patient-client roles to meet the needs of chronically ill persons, to broaden the mental health field, and to alter conditions that may have been among the determinants of mental disorder. In these aims, the center's program extends beyond the mere provision of jobs or reform in existing systems; it is a potential dynamic force for constructive change in human services. The authors discuss some of the problems that remain to be solved if the program is to meet the critical need for relevant and effective services in the center community.
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