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.




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.




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.




The Mental Health and Substance Use Workforce for Older Adults


Book Description

At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.




Issues for Debate in Social Policy


Book Description

This collection of non-partisan reports focuses on 18 hot-button social policy issues written by award-winning CQ Researcher journalists. As an annual that comes together just months before publication, the volume is as current as possible. And because it’s CQ Researcher, the social policy reports are expertly researched and written, showing all sides of an issue. Chapters follow a consistent organization, exploring three issue questions, then offering background, current context, and a look ahead, as well as featuring a pro/con debate box. All issues include a chronology, bibliography, photos, charts, and figures.




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.




Oxford Textbook of Community Mental Health


Book Description

Community mental health care has evolved as a discipline over the past 50 years, and within the past 20 years, there have been major developments across the world. The Oxford Textbook of Community Mental Health is the most comprehensive and authoritative review published in the field, written by an international and interdisciplinary team.




From Asylum to Prison


Book Description

To many, asylums are a relic of a bygone era. State governments took steps between 1950 and 1990 to minimize the involuntary confinement of people in psychiatric hospitals, and many mental health facilities closed down. Yet, as Anne Parsons reveals, the asylum did not die during deinstitutionalization. Instead, it returned in the modern prison industrial complex as the government shifted to a more punitive, institutional approach to social deviance. Focusing on Pennsylvania, the state that ran one of the largest mental health systems in the country, Parsons tracks how the lack of community-based services, a fear-based politics around mental illness, and the economics of institutions meant that closing mental hospitals fed a cycle of incarceration that became an epidemic. This groundbreaking book recasts the political narrative of the late twentieth century, as Parsons charts how the politics of mass incarceration shaped the deinstitutionalization of psychiatric hospitals and mental health policy making. In doing so, she offers critical insight into how the prison took the place of the asylum in crucial ways, shaping the rise of the prison industrial complex.




Voices of Mental Health


Book Description

This dynamic and richly layered account of mental health in the late twentieth century interweaves three important stories: the rising political prominence of mental health in the United States since 1970; the shifting medical diagnostics of mental health at a time when health activists, advocacy groups, and public figures were all speaking out about the needs and rights of patients; and the concept of voice in literature, film, memoir, journalism, and medical case study that connects the health experiences of individuals to shared stories. Together, these three dimensions bring into conversation a diverse cast of late-century writers, filmmakers, actors, physicians, politicians, policy-makers, and social critics. In doing so, Martin Halliwell’s Voices of Mental Health breaks new ground in deepening our understanding of the place, politics, and trajectory of mental health from the moon landing to the millennium.




Population Mental Health


Book Description

First Published in 2012. Routledge is an imprint of Taylor & Francis, an informa company.