The Role of the Psychiatrist in a Prepaid Group Medical Program

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Abstract
The St. Louis Labor Health Inst. (LHI), a union sponsored pre-paid medical care group, operating as a closely integrated team, employs 3 psychiatrists for a total of 20 hours per week. They provide psychiatric care to approximately 15,000 eligible members and their families. This service is both diagnostic and therapeutic, the latter consisting of supportive, suppressive or intensive psychotherapy as the need may be , and within the time and budgetary limits of the LHI. The membership represents a relatively homogeneous socioeconomic group, primarily semi-skilled workers in warehousing and light manufacturing plants with weekly wages of about $60 to $90. Incidence of illness requiring psychiatric care and treatment in this group was 6.6% during 1957. Optimal therapeutic results aimed at maintaining the patients" well being and ability to function at home and at work, required an average of 3 to 10 sessions of approximately 30 minutes each. Psychophysiological disorders responded best to this type of treatment. Close collaboration between psychiatrists and physicians in other specialties in treatment of patients was mutually beneficial and enhanced the overall care provided for patients. The potentialities for developing programs for research in psychiatry, mental health education of groups of patients, and studies of some aspects of industrial psychiatry, are inherent in the set up. These potentialities have been utilized to some extent already. Of greatest significance is the opportunity to provide needed psychiatric consultation and treatment for people in a socioeconomic group who ordinarily are unable to utilize private resources of the community.

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