ABSTRACT
This chapter describes both qualitative and quantitative data to analyze the organizational contexts within which providers work. It focuses on providers working in public, community-based mental health systems in order to analyze care within a bureaucracy. Different segments may correspond to occupational or professional subcultures; different occupations within an organization give rise to multiple cultures. Regulation of professional activity occurs by means of admission criteria, education, socialization, licensure, professional associations, and examining boards that are generally composed of one's peers. Providers wanted their job titles to reflect their professional qualifications and abilities. The best interprofessional relations occurred when providers were "all coming from the same direction, then there is a lot of support and support giving." More fundamentally, managed care prevents providers from performing the type of care they feel their clients need, and has led to a decrease in the provision of the basic components of community-based care.
