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Published Online:https://doi.org/10.1176/ajp.130.11.1275

The authors review the history of mental health models as well as related systems of professional education and service delivery. The current situation is criticized as being too concerned with professional privilege and hierarchies while seeming to ignore both gaps in and duplication of services. The authors therefore suggest the need for more organizational paradigms for the mental health field; these are to be derived rationally from the community's needs and the expanding knowledge pool. To the authors this suggests a system of hierarchical education based on career steps that could be entered at various levels of competence and certification.

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