The twenty-first century has witnessed an explosion in studies on comparative health studies, but mental health remains virtually ignored. Unlike the well researched topic of health policy, there is a gap in the marketplace covering mental health policy and health care policymaking. This book fills that gap; it is a comparative analysis of the implementation of Assertive Community Treatment (ACT), an evidence-based practice employed in two states that promises to empower the well-being of individuals suffering from mental illness. Assertive Community Treatment specifically examines the tension separating the notion of client recovery and evidence-based programs. Johnson challenges the assumption that practitioners should rely on evidence-based practices to close the gap between scientific knowledge and practice. She argues that in an era of managed care, this encourages state mental health administrators to adopt policies that are overly focused on outcomes. Programs that can measure the outcomes of care provided, and evidence-based practices, have become central aspects of the quality care agenda. This study traces the role of policy entrepreneurs throughout the Assertive Community Treatment policymaking process. By differentiating mental health in general, qualitative research increases the chances of observing similarities and differences in outcomes. Johnson explains why the ACT model was adopted and implemented. She concludes that there is a clear monopoly by medical researchers and scientists within Assertive Community Treatment research, and as a result, too much emphasis is placed on the roles of policy entrepreneurs as the main innovators in the agenda and policy formulation stages. Johnson presents a strong argument for more innovation in the implementation stage.
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.
Forced hospitalization of people with mental disorders has long been a critical issue in the mental health services. Coercion and Aggressive Community Treatment is the first sustained description and analysis of what happens when `aggressive' treatment becomes `coerced' treatment. Mental health professionals poignantly discuss the tension they feel between wanting to do everything to treat desperately ill people and the need to respect the rights of these same people who want to make their own decisions, even if this means forgoing treatment.
This unique manual presents cognitive-behavioral social skills training (CBSST), a step-by-step, empirically supported intervention that helps clients with schizophrenia achieve recovery goals related to living, learning, working, and socializing. CBSST interweaves three evidence-based practices--cognitive-behavioral therapy, social skills training, and problem-solving training--and can be delivered in individual or group contexts. Highly user friendly, the manual includes provider scripts, teaching tools, and engaging exercises and activities. Reproducible consumer workbooks for each module include skills summaries and worksheets. The large-size format facilitates photocopying; purchasers also get access to a Web page where they can download and print the reproducible materials. Listed in SAMHSA's National Registry of Evidence-Based Programs and Practices
This is the first truly interdisciplinary book that examines how professionals work together within community mental health. It takes into account the key concepts of community mental health and combines them with current technology to develop an effective formula that redefines the community mental health practice.
As the first attempt to synthesize the movement toward widespread implementation of evidence-based mental health practices, this groundbreaking collection articulates the basic tenets of evidence-based medicine and shows how practices proven effective by clinical services research could improve the lives of many people. Intended to stimulate much-needed public discussion, these remarkable contributions cover both general issues, such as Implementing practices in routine mental health settings, including strategies for disseminating evidence-based practices to staff members Ensuring that efforts to implement such practices are informed by the knowledge and experience of administrators, clinicians, patients, and advocates Integrating evidence-based practices with the recovery model and focusing on guidelines and algorithms for pharmacologic treatment of people with severe mental illness Identifying the policy implications of the movement, particularly in public-sector settings, and describing eight courses of action for addressing the gap between science and practice and specific practices, such as Describing critical components of practices for which substantial evidence exists, such as supported employment, dual diagnosis services, and assertive community treatment Developing an evidence base for particular populations, such as children and adolescents and geriatric patients; and for clinical subgroups, such as patients with severe mental illness and posttraumatic stress disorder-and implementing a range of practices for each population Debate in public forums is critical to explaining the benefits of evidence-based care and allaying the fears of patients, practitioners, administrators, policy makers, and vested interest groups that evidence-based care excludes them from the decision-making process. Patients need to know that their individual characteristics, preferences, and autonomy are highly valued and won't be discounted by rigid adherence to the particular treatments. Practitioners need to know about the credibility of the evidence base and about new techniques and responsibilities and to understand that their favorite practices won't necessarily be excluded during initial attempts to implement evidence-based practices. Administrators and policy makers need to know about financing, organizing, implementing, and sustaining new practices. Finally, vested interest groups need to know that the introduction of evidence-based practices doesn't mean that what they do now is ineffective. This unique and densely informative volume will be welcomed by mental health care professionals and by lawmakers, planners, administrators, and others who are charged with the responsibility of providing effective care to vulnerable populations.
The use of coercion is one of the defining issues of mental health care. Since the earliest attempts to contain and treat the mentally ill, power imbalances have been evident and a cause of controversy. There has always been a delicate balance between respecting autonomy and ensuring that those who most need treatment and support are provided with it. Coercion in Community Mental Health Care: International Perspectives is an essential guide to the current coercive practices worldwide, both those founded in law and those 'informal' processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse disciplines such as history, law, sociology, anthropology and medicine to provide a comprehensive summary of the current debates in the field. Edited by leading researchers in the field, Coercion in Community Mental Health Care: International Perspectives provides a unique discussion of this prominent issue in mental health. Divided into five sections covering origins and extent, evidence, experiences, context and international perspectives this is ideal for mental health practitioners, social scientists, ethicists and legal professionals wishing to expand their knowledge of the subject area.
"This book provides an interdisciplinary approach summarising the key elements, issues, concepts, and procedures in developing and applying evidence-based practice. Discussions include programme evaluation, quality and operational improvement strategies, research grant applications, utilising statistical procedures, and more."--