Increasingly throughout the western world, there are widespread plans to close psychiatric hospitals and care for the mental ill in the community. Most studies of the change have focused on the large political and economic aspects, and few have considered the impact on the people most directly involved. McCourt-Perring (government, Brunel U.) examines the opinions of the patients, and compares them to the assumptions of health-care workers. The study also demonstrated theoretical and methodological innovations in applying anthropology to one's own culture. No index. Acidic paper. Annotation copyright by Book News, Inc., Portland, OR
“Mikita Brottman is one of today’s finest practitioners of nonfiction.” —The New York Times Book Review Critically acclaimed author and psychoanalyst Mikita Brottman offers literary true crime writing at its best, taking us into the life of a murderer after his conviction—when most stories end but the defendant's life goes on. On February 21, 1992, 22-year-old Brian Bechtold walked into a police station in Port St. Joe, Florida and confessed that he’d shot and killed his parents in their family home in Silver Spring, Maryland. He said he’d been possessed by the devil. He was eventually diagnosed with schizophrenia and ruled “not criminally responsible” for the murders on grounds of insanity. But after the trial, where do the "criminally insane" go? Brottman reveals Brian's inner life leading up to the murder, as well as his complicated afterlife in a maximum security psychiatric hospital, where he is neither imprisoned nor free. During his 27 years at the hospital, Brian has tried to escape and been shot by police, and has witnessed three patient-on-patient murders. He’s experienced the drugging of patients beyond recognition, a sadistic system of rewards and punishments, and the short-lived reign of a crazed psychiatrist-turned-stalker. In the tradition of One Flew Over The Cuckoo’s Nest, Couple Found Slain is an insider’s account of life in the underworld of forensic psych wards in America and the forgotten lives of those held there, often indefinitely.
One of the most significant medical and social initiatives of the twentieth century was the demolition of the traditional state hospitals that housed most of the mentally ill, and the placement of the patients out into the community. The causes of this deinstitutionalization included both idealism and legal pressures, newly effective medications, the establishment of nursing and group homes, the woeful inadequacy of the aging giant hospitals, and an attitudinal change that emphasized environmental and social factors, not organic ones, as primarily responsible for mental illness. Though closing the asylums promised more freedom for many, encouraged community acceptance and enhanced outpatient opportunities, there were unintended consequences: increased homelessness, significant prison incarcerations of the mentally ill, inadequate community support or governmental funding. This book is written from the point of view of an academic neurologist who has served 60 years as an employee or consultant in typical state mental institutions in North Carolina and Ohio.
Blending personal memoir with social history, the author shares an “exquisitely written and provocative” account of mental illness and care (Sunday Times, UK). In the late 1970s, Barbara Taylor, then an acclaimed young historian, began to suffer from severe anxiety. Eventually, her struggles led her to be admitted to the infamous Friern Mental Hospital in North London—once known as the Colney Hatch Lunatic Asylum. The Last Asylum is a candid account of her time there, and probing look at the evolution of mental health treatment. Taylor was admitted to Friern in 1988, not long before England’s asylum system began to undergo dramatic change. The 1990s saw the old asylums shuttered, their patients left to navigate a perpetually overcrowded and underfunded mental health system. But Taylor contends that the emptying of the asylums also marked a bigger loss—a loss of community. Taylor credits her own recovery to the help of a steadfast psychoanalyst and a circle of friends, including Magda, her manic-depressive roommate, and Fiona, who shared stories of her boyfriend, the “Spaceman”. The support and trust of that network was crucial to Taylor’s recovery, offering a respite from the “stranded, homeless feelings” she and others found in the outside world.
When the wind of the 1960s blew through the world of psychiatry In 1961, when Franco Basaglia arrived outside the grim walls of the Gorizia asylum, on the Italian border with Yugoslavia, it was a place of horror, a Bedlam for the mentally sick and excluded, redolent of Basaglia’s own wartime experience inside a fascist gaol. Patients were frequently restrained for long periods, and therapy was largely a matter of electric and insulin shocks. The corridors stank, and for many of the interned the doors were locked for life. This was a concentration camp, not a hospital. Basaglia, the new Director, was expected to practise all the skills of oppression in which he had been schooled, but he would have none of this. The place had to be closed down by opening it up from the inside, bringing freedom and democracy to the patients, the nurses and the psychiatrists working in that “total institution.” Inspired by the writings of authors such as Primo Levi, R.D. Laing, Erving Goffman, Michel Foucault and Frantz Fanon, and the practices of experimental therapeutic communities in the UK, Basaglia’s seminal work as a psychiatrist and campaigner in Gorizia, Parma and Trieste fed into and substantially contributed to the national and international movement of 1968. In 1978 a law was passed (the “Basaglia law”) which sanctioned the closure of the entire Italian asylum system. The first comprehensive study of this revolutionary approach to mental health care, The Man Who Closed the Asylums is a gripping account of one of the most influential movements in twentieth-century psychiatry, which helped to transform the way we see mental illness. Basaglia’s work saved countless people from a miserable existence, and his legacy persists, as an object lesson in the struggle against the brutality and ignorance that the establishment peddles to the public as common sense.
In the late 1970s, Barbara Taylor, then an acclaimed young historian, began to suffer from severe anxiety. In the years that followed, Taylor's world contracted around her illness. Eventually, she was admitted to what had once been England's largest psychiatric institutions, the infamous Friern Mental Hospital in London
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.
When hospitals release seriously mentally ill patients too soon without outpatient follow-up, the patients can end up homeless, jailed, harming others, or even dead. When patients are deemed suitable for inpatient care, they can languish for weeks in hospital emergency departments before placements become available. Meanwhile, patients who fake the need for care are smoothly and swiftly moved to inpatient settings. Breakdown opens a dialogue with anyone interested in improving the system of care for the seriously mentally ill population. This book helps to answer questions such as: Is inpatient care too inaccessible to those who need it most? Do mental health professionals discriminate against mentally ill patients? Are more stringent measures needed to ensure that patients take their medication? Is borderline personality disorder too serious to be classified as just a personality disorder? Using vignettes based on real interactions with patients, their families, police officers, and other mental health providers, Lynn Nanos shares her passion for helping this population. With more than twenty years of professional experience in the mental health field, her deep interest in helping people who don’t know how to request help is evident to readers. A woman travels from Maine to Massachusetts because she was ordered by her voice, a spirit called "Crystal," to make the trip. A foul-smelling and oddly dressed man strolls barefooted into the office, unable to stop talking. A man delivers insects to his neighbors' homes to minimize the effects of poisonous toxins that he says exist in their homes. Breakdown uses objective and dramatic accounts from the psychiatric trenches to appeal for simple and common-sense solutions to reform our dysfunctional system. This book will benefit anyone interested in seeing a glimpse of the broken mental health system way beyond the classroom. It can guide legislative officials, family members, mental health professionals, and law enforcement officers toward a better understanding of the system.
Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.
