The growing crisis in access to mental health services for middle-class families

S. S. Sharfstein, D. Y. Patterson

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


General economic factors squeeze the middle-class working family. There is less discretionary money at their disposal. Wage freezes and negotiated givebacks of fringe benefits are not uncommon. At the same time, cost of housing, utilities, and food is increasing. Additional part-time jobs are hard to come by, especially for adolescent children. Easy low-interest loans for college education are more difficult to obtain, and high interest rates deny middle-class homeowners their traditional last resort for cash-home refinancing. As a result of the above forces, the middle class is increasingly being squeezed out of the mental health care sector. Psychiatrists, other mental health providers, their patients, and their patients' families are caught in a new version of the 'salami game'. Usually programs and services are cut from both ends. Mental health services are being cut, not only from both ends but from the sides as well.

Original languageEnglish (US)
Pages (from-to)1009-1010+1014
JournalHospital and Community Psychiatry
Issue number11
StatePublished - 1983
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health


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