Psychiatry: Three models in search of a future

The author proposes three models for the future of psychiatry. The public health psychiatry model is rooted in psychiatry's participation in community mental health care for the past 50 years. It emphasizes ideological similarities between community mental health care and managed care. The clinical neuroscience model melds the specialties of neurology and psychiatry to form a clinical brain science, yielding the nonmedical care of mentally ill persons to nonmedical mental health professionals. In the primary care model, more intensive medical training would allow the psychiatrist to function either as a primary care physician or as a 'primary care specialist'.