As case management has replaced institutional care for mental health patients in recent decades, case management theory has grown in complexity and variety of models. But how are these models translated into real experience? How do caseworkers use both textbook and practical knowledge to assist clients with managing their medication and their money? Using ethnographic and historical-sociological methods, Meds, Money, and Manners: The Case Management of Severe Mental Illness uncovers unexpected differences between written and oral accounts of case management in practice. In the process, it suggests the possibility of small acts of resistance and challenges the myth of social workers as agents of state power and social control.
Floersch shows how and why case management and community support services replaced psychiatry and mental hospitals. The case manager's use of textbook and practical knowledge allows for the management of medication, money, and day-to-day life of adults with severe mental illnesses. Yet, Floersch asks, are social workers state agents controlling clients? This critical study examines everyday written and oral narratives to prove that this common critique is untrue.
An “extremely funny” take on the decline of civility, from the #1 New York Times–bestselling author of How the Hell Did This Happen? (The Plain Dealer). In Modern Manners, cultural guru P. J. O’Rourke provides the essential accessory for the truly contemporary man or woman—a rulebook for living in a world without rules. Traditionally, good manners were a means of becoming as bland and invisible as everyone else, thus avoiding calling attention to one’s own awkwardness and stupidity. Today, with everyone wanting to appear special, stupidity is at a premium, and manners—as outrageous and bizarre as possible—are a wonderful way to distinguish ourselves, or at least have a fine time trying. This irreverent and hilarious guide to anti-etiquette offers pointed advice on topics from sex and entertaining to reading habits and death. With the most up-to-date forms of vulgarity, churlishness, and presumption, the latest fashions in discourtesy and barbarous display, O’Rourke is our guide to the art of incivility. “Modern Manners is O’Rourke doing what he has always done: making hilarious, insightful, often vicious fun of the world and all its inhabitants.” —People “A reader who rushes through [Modern Manners] from cover to cover—like I did—will feel like a child who has gorged on chocolate cake: happy, but a bit disappointed that it’s all gone. The reason O’Rourke’s book is so successful, however, is not just his great sense of humor. O’Rourke’s writing has a cutting edge behind it, which makes a reader’s laughter just a bit thought-provoking, and just a bit rueful . . . Very funny.” —Chicago Tribune
Should we pay children to read books or to get good grades? Should we allow corporations to pay for the right to pollute the atmosphere? Is it ethical to pay people to test risky new drugs or to donate their organs? What about hiring mercenaries to fight our wars? Auctioning admission to elite universities? Selling citizenship to immigrants willing to pay? In What Money Can't Buy, Michael J. Sandel takes on one of the biggest ethical questions of our time: Is there something wrong with a world in which everything is for sale? If so, how can we prevent market values from reaching into spheres of life where they don't belong? What are the moral limits of markets? In recent decades, market values have crowded out nonmarket norms in almost every aspect of life—medicine, education, government, law, art, sports, even family life and personal relations. Without quite realizing it, Sandel argues, we have drifted from having a market economy to being a market society. Is this where we want to be?In his New York Times bestseller Justice, Sandel showed himself to be a master at illuminating, with clarity and verve, the hard moral questions we confront in our everyday lives. Now, in What Money Can't Buy, he provokes an essential discussion that we, in our market-driven age, need to have: What is the proper role of markets in a democratic society—and how can we protect the moral and civic goods that markets don't honor and that money can't buy?
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
“Very funny and unexpected, a material response to our times, plush as velvet.” –Rachel Cusk “A wickedly funny and emotionally expansive novel about all the bewildering ways we seek solace from the people and things that surround us.” – Jenny Offill David Leavitt returns with his signature “coolly elegant prose” (O, The Oprah Magazine) to deliver a comedy of manners for the Trump era. It is the Saturday after the 2016 presidential election, and in a plush weekend house in Connecticut, an intimate group of friends, New Yorkers all, has gathered to recover from what they consider the greatest political catastrophe of their lives. They have just sat down to tea when their hostess, Eva Lindquist, proposes a dare. Who among them would be willing to ask Siri how to assassinate Donald Trump? Liberal and like-minded-editors, writers, a decorator, a theater producer, and one financial guy, Eva's husband, Bruce-the friends have come to the countryside in the hope of restoring the bubble in which they have grown used to living. Yet with the exception of one brash and obnoxious book editor, none is willing to accept Eva's challenge. Shelter in Place is a novel about house and home, furniture and rooms, safety and freedom and the invidious ways in which political upheaval can undermine even the most seemingly impregnable foundations. Eva is the novel's polestar, a woman who moves through her days accompanied by a roving, carefully curated salon. She's a generous hostess and more than a bit of a control freak, whose obsession with decorating allows Leavitt to treat us to a slyly comic look at the habitués and fetishes of the so-called shelter industry. Yet when, in her avidity to secure shelter for herself, she persuades Bruce to buy a grand if dilapidated apartment in Venice, she unwittingly sets off the chain of events that will propel him, for the first time, to venture outside the bubble and embark on a wholly unexpected love affair. A comic portrait of the months immediately following the 2016 election, Shelter in Place is also a meditation on the unreliable appetites-for love, for power, for freedom-by which both our public and private lives are shaped.
On Being and Having a Case Manager stresses the importance of the process of building relationships in helping clients realize independent lives. Based on a two-year study of Marilyn and her case managers, this book emphasizes the intentional exchange of attention and information between case managers, clients, and others within the caring network and clearly outlines a practical method for all service providers, clients, family members, and close friends to follow. Throughout the day, from moment to moment, relationships fluctuate among doing for, doing with, standing by for support, and doing for oneself. By observing Marilyn and her case manager, the authors prove the value of mutually and continuously monitoring these fluctuations within three primary domains-feeling, thinking, and acting-while carrying out daily activities. These findings show that managers are often stuck in doing-for modes of relating. Indeed, this may be one of the factors that contribute most to case manager and client burnout. While some clients with severe and persistent symptoms may, in fact, frequently require others to do-for, some like Marilyn may not require as much. They may need more doing-with and standing-by to encourage mastery and the internalization of confidence.
This book explores the moral lives of mental health clinicians serving the most marginalized individuals in the US healthcare system. Drawing on years of fieldwork in a community psychiatry outreach team, Brodwin traces the ethical dilemmas and everyday struggles of front line providers. On the street, in staff room debates, or in private confessions, these psychiatrists and social workers confront ongoing challenges to their self-image as competent and compassionate advocates. At times they openly question the coercion and forced-dependency built into the current system of care. At other times they justify their use of extreme power in the face of loud opposition from clients. This in-depth study exposes the fault lines in today's community psychiatry. It shows how people working deep inside the system struggle to maintain their ideals and manage a chronic sense of futility. Their commentaries about the obligatory and the forbidden also suggest ways to bridge formal bioethics and the realities of mental health practice. The experiences of these clinicians pose a single overarching question: how should we bear responsibility for the most vulnerable among us?
