Changing American Psychiatry


Book Description

Psychiatrists, psychoanalysts, other mental health workers, behavioral scientists, and university medical and neuroscience professionals will benefit from this articulate insider's view of post-World War II psychiatry in Changing American Psychiatry: A Personal Perspective by Melvin Sabshin, M.D. Dr. Sabshin served as Medical Director of the American Psychiatric Association (APA) for 23 years, from 1974 to 1997, during a period of perhaps the greatest change in psychiatry since the World War II produced a dramatic modification of practice. The author describes in detail two extraordinary periods of change, the first stimulated by laudatory efforts to understand the high rate of psychiatric casualties among World War II veterans and to provide treatment for them. Psychiatry grew quickly during the postwar years, considerably influenced by the immigration of many Central European psychoanalysts. Gradually, however, psychiatry began to weaken its ties to medicine and lost much of its public respect. By the 1970s, postwar optimism had been replaced by widespread concern that psychiatric practice was being dominated by unsubstantiated formulations rather than reliable evidence. Psychiatry was dramatically impacted by enormous pressure for therapeutic accountability exerted by a managed care reimbursement system. The profession recognized the need for a new direction and resolved to change. In the foreword to the book, current APA Medical Director James H. Scully Jr., M.D., notes that Dr. Sabshin has woven a personal journey of the history of the intellectual conflicts and changes in the field of psychiatry in the post-war era, culminating in the remedicalization of psychiatry and the development of the DSM-III. Dr. Sabshin encourages psychiatric professionals to change the field so it can employ an empirically based "bio-psycho-social" model that has the potential to revitalize the next phase of American psychiatry. He details how the potential for the future of psychiatry can be enhanced by today's practicing professionals, stressing the: Need to incorporate the rapid developments of neuroscience into a professional practice that is increasingly integrated with empirically demonstrated psychological and social influences upon mental illness. Importance on continued research that is fed back into practice and keeps the professional evidence-based. Need of psychoanalysis to make its beliefs explicit, formulating hypotheses that can be tested scientifically in order to be employed reliably in evidence-based practice. This well-crafted historical account describes how the profession has become a more respected and accountable part of medicine and how it scientific credentials have risen as a result. Dr. Sabshin concludes that the use of psychological understanding and psychotherapies must play a major role combined with psychopharmacology in the treatment of psychiatric patients.




American Psychiatry After World War II (1944-1994)


Book Description

This volume summarizes the significant events and processes of the half-century following World War II. Most of this history is written by clinicians who were central figures in it.




The Social Determinants of Mental Health


Book Description

The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.




Lifestyle Psychiatry


Book Description

Exercise, a healthy diet, stress management, sound sleep: Most practitioners would agree that living well can mitigate the impact of mental disorders. Yet many are unprepared to address lifestyle factors in their care of patients. Lifestyle Psychiatry seeks to instill confidence by collating and analyzing the impressive emerging body of evidence that supports the efficacy of healthy lifestyle practices -- both as the primary intervention and in conjunction with traditional treatments such as psychopharmacology or psychotherapy -- in preventing and managing psychiatric disorders. This volume examines the impact of lifestyle interventions -- from exercise, yoga, and tai chi to mindfulness and meditation, diet and nutrition, and sleep management -- on psychiatric disorders, including depression, anxiety, posttraumatic stress disorder, schizophrenia, and addiction. Readers can readily find data to support the use of specific lifestyle interventions for a patient presenting with a specific disorder. Detailed descriptions of the mechanisms of each lifestyle intervention also prepare practitioners to educate their patients on the specific neurobiological and psychological effects of these interventions to support their recovery. With chapters that focus on developing a robust therapeutic alliance and inspiring patients to assume responsibility for their own well-being, this guide provides a framework for lasting, sustainable lifestyle changes. Additionally, the book discusses the impact of the provider's lifestyle on clinical behavior and the implications of lifestyle medicine and psychiatry for health care systems and population health, offering a broader examination of the important role this new field can play in leading a sophisticated, holistic approach to optimizing wellness.




Mental Illness and American Society, 1875-1940


Book Description

Gerald N. Grob's Mental Institutions in America: Social Policy to 1875 has become a classic of American social history. Here the author continues his investigations by a study of the complex interrelationships of patients, psychiatrists, mental hospitals, and government between 1875 and World War II. Challenging the now prevalent notion that mental hospitals in this period functioned as jails, he finds that, despite their shortcomings, they provided care for people unable to survive by themselves. From a rich variety of previously unexploited sources, he shows how professional and political concerns, rather than patient needs, changed American attitudes toward mental hospitals from support to antipathy. Toward the end of the 1800s psychiatrists shifted their attention toward therapy and the mental hygiene movement and away from patient care. Concurrently, the patient population began to include more aged people and people with severe somatic disorders, whose condition recluded their caring for themselves. In probing these changes, this work clarifies a central issue of decent and humane health care. Gerald N. Grob is Professor of History at Rutgers University. Among his works are Mental Institutions in America: Social Policy to 1875 (Free Press), Edward Jarvis and the Medical World of Nineteenth-Century America (Tennessee), and The State and the Mentality III (North Carolina). Originally published in 1983. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.




American Psychiatry and Homosexuality


Book Description

Interviews and first-hand accounts of an historic decision that affected the mental health profession—and American society and culture Through the personal accounts of those who were there, American Psychiatry and Homosexuality: An Oral History examines the 1973 decision by the American Psychiatric Association (APA) to remove homosexuality from its diagnostic and statistical manual of mental disorders (DSM). This unique book includes candid one-on-one interviews with key mental health professionals who played a role in the APA’s decision, those who helped organize gay, lesbian, and bisexual psychiatrists after the decision, and others who have made significant contributions in this area within the mental health field. American Psychiatry and Homosexuality presents an insider’s view of how homosexuality was removed from the DSM, the gradual organization of gay and lesbian psychiatrists within the APA, and the eventual formation of the APA-allied Association of Gay & Lesbian Psychiatrists (AGLP). The book profiles 17 individuals, both straight and gay, who made important contributions to organized psychiatry and the mental health needs of lesbian and gay patients, and illustrates the role that gay and lesbian psychiatrists would later play in the mental health field when they no longer had to hide their identities. Individuals profiled in American Psychiatry and Homosexuality include: Dr. John Fryer, who disguised his identity to speak before the APA’s annual meeting in 1972 on the discrimination gay psychiatrists faced in their own profession Dr. Charles Silverstein, who saw the diagnosis of homosexuality as a means of social control Dr. Lawrence Hartmann, who helped reform the APA and later served as its President in 1991-92 Dr. Robert J. Campbell, who helped persuade the APA’s Nomenclature Committee to hear scientific data presented by gay activists Dr. Judd Marmor, an early psychoanalytic critic of theories that pathologized homosexuality Dr. Robert Spitzer, who chaired the APA’s Nomenclature Committee Dr. Frank Rundle, who helped organize the first meeting of what would become the APA Caucus of Gay, Lesbian and Bisexual Psychiatrists Dr. David Kessler, AGLP President from 1980-82 Dr. Nanette Gartrell, a pioneer of feminist issues within the APA Dr. Stuart Nichols, President of the AGLP in 1983-84 and a founding member of the Gay and Lesbian Psychiatrists of New York (GLPNY) Dr. Emery Hetrick, a founding member of both AGLP and GLPNY Dr. Bertram Schaffner, who was instrumental in providing group psychotherapy for physicians with AIDS Dr. Martha Kirkpatrick, a long-time leader in psychiatry and psychoanalysis, both as a woman and an “out” lesbian Dr. Richard Isay, the first openly gay psychoanalyst in the American Psychoanalytic Association Dr. Richard Pillard, best known for studying the incidence of homosexuality in families of twins Dr. Edward Hanin, former Speaker of the APA Assembly Dr. Ralph Roughton, the first openly gay Training and Supervising Psychoanalyst to be recognized within the American and International Psychoanalytic Associations American Psychiatry and Homosexuality presents the personal, behind-the-scenes accounts of a major historical event in psychiatry and medicine and of a decision that has affected society and culture ever since. This is an essential resource for mental health educators, supervisors, and professionals; historians; and LGBT readers in general.




Understanding Mental Disorders


Book Description

Understanding Mental Disorders: Your Guide to DSM-5® is a consumer guide for anyone who has been touched by mental illness. Most of us know someone who suffers from a mental illness. This book helps those who may be struggling with mental health problems, as well as those who want to help others achieve mental health and well-being. Based on the latest, fifth edition of the Diagnostic and Statistical Manual of Mental Disorders -- known as DSM-5® -- Understanding Mental Disorders provides valuable insight on what to expect from an illness and its treatment -- and will help readers recognize symptoms, know when to seek help, and get the right care. Featured disorders include depression, schizophrenia, ADHD, autism spectrum disorder, posttraumatic stress disorder, and bipolar disorder, among others. The common language for diagnosing mental illness used in DSM-5® for mental health professionals has been adapted into clear, concise descriptions of disorders for nonexperts. In addition to specific symptoms for each disorder, readers will find: Risk factors and warning signs Related disorders Ways to cope Tips to promote mental health Personal stories Key points about the disorders and treatment options A special chapter dedicated to treatment essentials and ways to get help Helpful resources that include a glossary, list of medications and support groups




Black Psychiatrists and American Psychiatry


Book Description

Presenting a vivid historical account of the contributions that black psychiatrists have made to American psychiatry, this important book documents the growth and influence of the group in tandem with the advancement of the field as a whole. It provides us with a deep appreciation for what these pioneers accomplished and the hurdles they overcame. Spurlock and the book's many distinguished contributors provide an overview of the history spanning generations and various areas of psychiatry. This volume documents early and contemporary pioneers and their contributions to modern psychiatry. Surveys of black psychiatrists in academia, child psychiatry, psychiatric research, forensic psychiatry, and psychoanalysis provide an enlightening view of their experiences. From a collection of descriptive essays, readers can step into the shoes of several pioneers and experience how they lived. These personal reflections provide enormous insight into the history of American psychiatry. Finally, the book addresses current mental health issues affecting African Americans as well as the barriers black psychiatrists face and the coping mechanisms they use. This work should be of particular interest to psychiatry students or residents and to anyone interested in the history of American psychiatry. It discusses the widening opportunities for professional growth for black psychiatrists and the important place black psychiatrists have reached in the present mental health arena.




A Psychiatrist's Guide to Advocacy


Book Description

"A Psychiatrist's Guide to Advocacy explores the diverse conditions that may demand an in-tervention or affirmative response from mental health practitioners charged with advocating for patients and the profession. The editors and authors argue for a greater culture of advo-cacy among psychiatrists to effect broad and lasting changes, emphasizing that advocacy takes many forms (e.g., organizational, patient-level, legislative, media, education). The au-thors identify systemic problems in mental health care, describe the essential factors needed for effective advocacy, and delineate the advocacy needs of diverse patient populations (e.g., children and families, older adults, LGBTQ patients, veterans)"--




Anatomy of an Epidemic


Book Description

Updated with bonus material, including a new foreword and afterword with new research, this New York Times bestseller is essential reading for a time when mental health is constantly in the news. In this astonishing and startling book, award-winning science and history writer Robert Whitaker investigates a medical mystery: Why has the number of disabled mentally ill in the United States tripled over the past two decades? Interwoven with Whitaker’s groundbreaking analysis of the merits of psychiatric medications are the personal stories of children and adults swept up in this epidemic. As Anatomy of an Epidemic reveals, other societies have begun to alter their use of psychiatric medications and are now reporting much improved outcomes . . . so why can’t such change happen here in the United States? Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public? Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up. Praise for Anatomy of an Epidemic “The timing of Robert Whitaker’s Anatomy of an Epidemic, a comprehensive and highly readable history of psychiatry in the United States, couldn’t be better.”—Salon “Anatomy of an Epidemic offers some answers, charting controversial ground with mystery-novel pacing.”—TIME “Lucid, pointed and important, Anatomy of an Epidemic should be required reading for anyone considering extended use of psychiatric medicine. Whitaker is at the height of his powers.” —Greg Critser, author of Generation Rx