The Dilemma of Federal Mental Health Policy


Book Description

Severe and persistent mental illnesses are among the most pressing health and social problems in contemporary America. Recent estimates suggest that more than three million people in the U.S. have disabling mental disorders. The direct and indirect costs of their care exceed 180 billion dollars nationwide each year. Effective treatments and services exist, but many such individuals do not have access to these services because of limitations in mental health and social policies. For nearly two centuries Americans have grappled with the question of how to serve individuals with severe disorders. During the second half of the twentieth century, mental health policy advocates reacted against institutional care, claiming that community care and treatment would improve the lives of people with mental disorders. Once the exclusive province of state governments, the federal government moved into this policy arena after World War II. Policies ranged from those focused on mental disorders, to those that focused more broadly on health and social welfare. In this book, Gerald N. Grob and Howard H. Goldman trace how an ever-changing coalition of mental health experts, patients' rights activists, and politicians envisioned this community-based system of psychiatric services. The authors show how policies shifted emphasis from radical reform to incremental change. Many have benefited from this shift, but many are left without the care they require.




The Palgrave Handbook of American Mental Health Policy


Book Description

This handbook is the definitive resource for understanding current mental health policy controversies, options, and implementation strategies. It offers a thorough review of major issues in mental health policy to inform the policy-making process, presenting the pros and cons of controversial, significant issues through close analyses of data. Some of the topics covered are the effectiveness of various biomedical and psychosocial interventions, the role of mental illness in violence, and the effectiveness of coercive strategies. The handbook presents cases for conditions in which specialized mental health services are needed and those in which it might be better to deliver mental health treatment in mainstream health and social services settings. It also examines the balance between federal, state, and local authority, and the financing models for delivery of efficient and effective mental health services. It is aimed for an audience of policy-makers, researchers, and informed citizens that can contribute to future policy deliberations.




Mental Health and Mental Illness


Book Description

This text examines the public mental health policies, programs, and services that constitute a collective response to mental illness. The author explores the process and politics of policy making as a framework for understanding historical and current policies and services related to mental illness. Special attention is given to mental health issues related to such population groups as ethnic minorities, women, children and adolescents, the homeless mentally ill, and older adults. Each chapter highlights controversial issues related to mental health policy development and program implementation. The book is especially relevant for students preparing for practice as mental health professionals in social work, nursing, psychology, and counseling.




Better But Not Well


Book Description

The past half-century has been marked by major changes in the treatment of mental illness: important advances in understanding mental illnesses, increases in spending on mental health care and support of people with mental illnesses, and the availability of new medications that are easier for the patient to tolerate. Although these changes have made things better for those who have mental illness, they are not quite enough. In Better But Not Well, Richard G. Frank and Sherry A. Glied examine the well-being of people with mental illness in the United States over the past fifty years, addressing issues such as economics, treatment, standards of living, rights, and stigma. Marshaling a range of new empirical evidence, they first argue that people with mental illness—severe and persistent disorders as well as less serious mental health conditions—are faring better today than in the past. Improvements have come about for unheralded and unexpected reasons. Rather than being a result of more effective mental health treatments, progress has come from the growth of private health insurance and of mainstream social programs—such as Medicaid, Supplemental Security Income, housing vouchers, and food stamps—and the development of new treatments that are easier for patients to tolerate and for physicians to manage. The authors remind us that, despite the progress that has been made, this disadvantaged group remains worse off than most others in society. The "mainstreaming" of persons with mental illness has left a policy void, where governmental institutions responsible for meeting the needs of mental health patients lack resources and programmatic authority. To fill this void, Frank and Glied suggest that institutional resources be applied systematically and routinely to examine and address how federal and state programs affect the well-being of people with mental illness.




Transforming Mental Health Services


Book Description

This compendium of 17 articles addresses the goals set forth by the President's New Freedom Commission on Mental Health in its 2003 report, Achieving the Promise: Transforming Mental Health Care in America. The report represents the first time since the Carter Administration that such a high-level group evaluated U.S. mental health care. The report painted a dismal picture of the nation's mental health system, saying the system was so broken that it was "beyond simple repair." The Commission said that current services focused on "managing disabilities" rather than helping patients achieve a meaningful life in their communities. It also stated that mental health service providers ignored the preferences of consumers and their families. The articles in Transforming Mental Health Services: Implementing the Federal Agenda for Change, originally published between 2006 and 2009 in Psychiatric Services (journal of the American Psychiatric Association), offer recommendations to assist adults with serious mental illness and children with serious emotional disturbances. They include a series of reforms in which the emphasis is on recovery as an achievable goal, and the need for a person-centered orientation in service delivery. There is also discussion of the reasons many service providers resist using a recovery orientation and how this can be remedied. Transforming Mental Health Services: Implementing the Federal Agenda for Change consists of updates of papers written by the Commission's subcommittees addressing issues fundamental to those living with mental illness. It is organized into four sections: The first focuses on the interface between mental health and general health, and on employment, housing, and Medicaid financing. The second continues addressing financing and Medicaid as well as issues related to school mental health, recovery, transformation of data systems, and acceleration of research. The third includes reports from four states with transformation initiatives designed to ensure that consumers have a strong voice in the development of recovery-oriented services. The final section describes progress five years after the President's Commission Report and concludes with a proposal by the current director of the Center for Mental Health Services for a public health model of mental health care for the 21st century. This compilation of well-researched and well-written articles offers an excellent resource for frontline care providers, facility administrators and advocates. It serves as an equally valuable resource for state policy makers who wish to present a convincing case that change is happening and that the recommendations can be translated into effective policies. Although consumers and their families will receive support for their perception that service providers ignore their needs, they will also be encouraged that change for the better is coming to the U.S. mental health care system.







Achieving the Promise


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Inching Forward


Book Description