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IN many of the major cities of the United States (the Eastern Seacoast is most striking) an interesting and challenging phenomenon which has major medical and social consequences is taking place. We are experiencing an exodus to suburbia of the relatively more affluent in search of privacy, greenery, and better living conditions, leaving a core city population of so-called ethnic minority and lower-class origin.' 1 The population pattern of 50-100 years ago, which saw medical center complexes of the great cities arise in proximity to middle-class settings has been radically altered, and such centers as the Yale-New Haven The Johns Hopkins Medical Complex, to name but a few, stand essentially at the periphery of modern slums. The residual core city population of these slums differs significantly in its use of medical facilities from its predecessor, in that it uses the emergency services of available general hospitals in place of private practitioners of medicine. The use of psychiatric facilities is likewise different. It is largely polarized between the local State Hospital on the one hand, and the Emergency Room on the other; indeed, often using the latter as a way station to the former. This reflects the lack of an alternative facility, in turn indicative of insufficient professional concern with the specific needs of a poverty class. Psychiatric problems are perceived differently by professionals and by lay individuals, depending on age, education, social class, etc. of the latter. It follows logically that what is done or not done in the way of problem solving depends very much on the individual and group perception of the problem. The lower socio-economic class (Hollingshead's Class V Group)2 has been thought to be the least accessible to psychiatric help. In particular, this groups' involvement in psychotherapy has been singled out as being particularly poor, by virtue of nonpsychological-mindedness, distrust of authority and impulsivity, among other characteristics. Conflicting frames of reference between psychiatrist and client seem responsible for the failure of engagement in a treatment contract rather than especially deviant psychological processes. The patient's insistence on a physical frame of reference rather than an inner psychological frame may reflect only the central problem of engagement rather than a need for an abiding &dquo;noninsight contract&dquo; which once entered into can never be violated. How can psychological assistance then, be brought to bear on this particular population, which by all existing evidence is ill served by conventional modalities? This became a major question in the conceptualization and planning of emergency services for the Connecticut Mental Health Center. (A facility jointly operated by Yale University and the State of Connecticut, Department of Mental Hygiene.) A five to seven bed facility was planned to develop a treatat WESTERN OREGON UNIVERSITY on May 25, 2015 isp.sagepub.com Downloaded from
IN many of the major cities of the United States (the Eastern Seacoast is most striking) an interesting and challenging phenomenon which has major medical and social consequences is taking place. We are experiencing an exodus to suburbia of the relatively more affluent in search of privacy, greenery, and better living conditions, leaving a core city population of so-called ethnic minority and lower-class origin.' 1 The population pattern of 50-100 years ago, which saw medical center complexes of the great cities arise in proximity to middle-class settings has been radically altered, and such centers as the Yale-New Haven The Johns Hopkins Medical Complex, to name but a few, stand essentially at the periphery of modern slums. The residual core city population of these slums differs significantly in its use of medical facilities from its predecessor, in that it uses the emergency services of available general hospitals in place of private practitioners of medicine. The use of psychiatric facilities is likewise different. It is largely polarized between the local State Hospital on the one hand, and the Emergency Room on the other; indeed, often using the latter as a way station to the former. This reflects the lack of an alternative facility, in turn indicative of insufficient professional concern with the specific needs of a poverty class. Psychiatric problems are perceived differently by professionals and by lay individuals, depending on age, education, social class, etc. of the latter. It follows logically that what is done or not done in the way of problem solving depends very much on the individual and group perception of the problem. The lower socio-economic class (Hollingshead's Class V Group)2 has been thought to be the least accessible to psychiatric help. In particular, this groups' involvement in psychotherapy has been singled out as being particularly poor, by virtue of nonpsychological-mindedness, distrust of authority and impulsivity, among other characteristics. Conflicting frames of reference between psychiatrist and client seem responsible for the failure of engagement in a treatment contract rather than especially deviant psychological processes. The patient's insistence on a physical frame of reference rather than an inner psychological frame may reflect only the central problem of engagement rather than a need for an abiding &dquo;noninsight contract&dquo; which once entered into can never be violated. How can psychological assistance then, be brought to bear on this particular population, which by all existing evidence is ill served by conventional modalities? This became a major question in the conceptualization and planning of emergency services for the Connecticut Mental Health Center. (A facility jointly operated by Yale University and the State of Connecticut, Department of Mental Hygiene.) A five to seven bed facility was planned to develop a treatat WESTERN OREGON UNIVERSITY on May 25, 2015 isp.sagepub.com Downloaded from
America's securities markets constitute a central distinguishing feature of its brand of capitalism. What are their political origins? In contrast to arguments which point to business owners as determining the institutional foundations of America's political economy, this paper argues that farmers played a leading role. Indeed, the rules and regulations governing U.S. securities markets were created in opposition to the wishes of business owners, and without farmers' political influence, the U.S. may have developed a financial system similar to that found in continental Europe. Moreover, to the extent that U.S. securities regulations serve as a template for international financial standards, the paper shows that the humble American farmer inadvertently contributed to the financialization of the modern global economy.
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