Social class and psychiatric practice: a revision of the Hollingshead and Redlich model

In 1958, Hollingshead and Redlich demonstrated that there were major differences in mental health care for lower-class patients: they primarily received low-intervention treatments from nonprofessional staff. The authors report a follow-up study initiated by F.C. Redlich that reveals new trends at the community mental health center (CMHC) serving the region studied by Hollingshead and Redlich. More than half of the lower-class patients who sought evaluation at this CMHC were discharged without a treatment assignment. Many lower-class patients, however, gained access to the CMHC's psychotherapy unit. Most of these patients were women, employed, and diagnosed as psychoneurotic. The authors conclude that the effect of social class on psychiatric care is less complete than Hollingshead and Redlich originally demonstrated.