The dilemma of mental health paraprofessionals at home.

The use of community member paraprofessionals in the delivery of mental health services is complicated by the changing nature of the paraprofessional's social relationships within the community. We use an anthropological model of Coast Salish social organization and data from a current delivery system, the Swinomish (Washington) Tribal Mental Health Project, to suggest ways to conceptualize and account for such complications.