Accompanying two decades of change in the mental health system have been a diffusion of the roles and practices of mental health professionals as well as shifts in the public's perceptions of the various specialties. In the present study, samples of patients and nonpatients used a 4-point Likert scale to rate (a) the competence of psychologists, psychiatrists, nonpsychiatric physicians, and the clergy to treat 10 different patient types, and (b) the personal qualities of the four practitioner groups along nine different dimensions. Psychiatrists and psychologists received significantly higher ratings than both nonpsychiatric physicians and the clergy on competence to treat most menial health problems. Intergroup differences on the ratings of personal qualities suggest a less uniformly favorable perception of psychiatrists and psychologists in comparison with the other two groups. Implications for the marketing and public relations efforts of mental health practitioners are discussed.Since World War II, members of the various mental health professions have experienced dramatic shifts in their respective roles, responsibilities, and public image. According to the Department of Health and Human Services, "the decades of the 1960's and I970's exceed in intensity, magnitude, and swiftness anything seen in the prior history of mental health care in the United States" (Taube, Burns, & Kessler, 1984).

Claims for physical health care among 220 Medicaid enrollees with severe mental illness and 166 Medicaid enrollees who were not enrolled in the public mental health system were compared. Claims for the mentally ill group were 18 percent less than for the group without severe mental illness. Twenty-eight percent of claims for mentally ill patients were for treatment in emergency rooms and ambulances, compared with 11 percent for patients without mental illness; 26 percent of claims for patients without mental illness were for care in outpatient surgical and outpatient hospital settings, compared with 14 percent for mentally ill patients. Results suggest inefficient use of the health care system by mentally ill patients and highlight the need for coordination of care.

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