ABSTRACT
In the previous chapter, supportive administration was identified as a key element of MCHT programs. At the risk of sounding effete and elitist, the case will be made here that MCHT services require special attention; unless their unique needs and vulnerabilities are recognized and dealt with, they will not thrive. In Britain, where MCHT is becoming well established as part of the mental health system, these concerns may be less valid. However, where it is less established, they should be addressed. My experience, and that of others, has been that, although it is perfectly clear to those of us in MCHT services how these services work and what can be accomplished, it seems difficult for some to understand and become convinced; consequently, the administrator has to be a very credible and convincing communicator. Potential referrers, such as primary care physicians, ER physicians, and psychiatrists, may be sceptical about what level of risk can be managed and nervous about the medico-legal liabilities that may ensue from choosing MCHT over hospital for a patient. Administrators, too, may be uneasy about risks and unconvinced that cost savings can be achieved.
