This book focuses on the priority that psychoanalysis places on the individual, how the treatment is conceived theoretically and the ways it can be incorporated in the overall organisation of an institution. It brings together the histories of a number of psychoanalytically informed hospitals.
This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons with mental disorders. The manual contains basic principles of prescribing followed by chapters on medicines used in psychotic disorders; depressive disorders; bipolar disorders; generalized anxiety and sleep disorders; obsessive compulsive disorders and panic attacks; and alcohol and opioid dependence. The annexes provide information on evidence retrieval, assessment and synthesis and the peer view process.
In 1963, President John F. Kennedy delivered an historic speech on mental illness and retardation. He described sweeping new programs to replace "the shabby treatment of the many millions of the mentally disabled in custodial institutions" with treatment in community mental health centers. This movement, later referred to as "deinstitutionalization," continues to impact mental health care. Though he never publicly acknowledged it, the program was a tribute to Kennedy's sister Rosemary, who was born mildly retarded and developed a schizophrenia-like illness. Terrified she'd become pregnant, Joseph Kennedy arranged for his daughter to receive a lobotomy, which was a disaster and left her severely retarded. Fifty years after Kennedy's speech, E. Fuller Torrey's book provides an inside perspective on the birth of the federal mental health program. On staff at the National Institute of Mental Health when the program was being developed and implemented, Torrey draws on his own first-hand account of the creation and launch of the program, extensive research, one-on-one interviews with people involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation. As such, this book provides historical material previously unavailable to the public. Torrey examines the Kennedys' involvement in the policy, the role of major players, the responsibility of the state versus the federal government in caring for the mentally ill, the political maneuverings required to pass the legislation, and how closing institutions resulted not in better care - as was the aim - but in underfunded programs, neglect, and higher rates of community violence. Many now wonder why public mental illness services are so ineffective. At least one-third of the homeless are seriously mentally ill, jails and prisons are grossly overcrowded, largely because the seriously mentally ill constitute 20 percent of prisoners, and public facilities are overrun by untreated individuals. As Torrey argues, it is imperative to understand how we got here in order to move forward towards providing better care for the most vulnerable.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
These guidelines from NICE set out clear recommendations, based on the best available evidence, for health care professionals on how to work with and implement physical, psychological and service-level interventions for people with various mental health conditions.The book contains the full guidelines that cannot be obtained in print anywhere else. It brings together all of the evidence that led to the recommendations made, detailed explanations of the methodology behind their preparation, plus an overview of the condition covering detection, diagnosis and assessment, and the full range of treatment and care approaches. There is a worse prognosis for psychosis and schizophrenia when onset is in childhood or adolescence, and this new NICE guideline puts much-needed emphasis on early recognition and assessment of possible psychotic symptoms. For the one-third of children and young people who go on to experience severe impairment as a result of psychosis or schizophrenia the guideline also offers comprehensive advice from assessment and treatment of the first episode through to promoting recovery.This guideline reviews the evidence for recognition and management of psychosis and schizophrenia in children and young people across the care pathway, encompassing access to and delivery of services, experience of care, recognition and management of at-risk mental states, psychological and pharmacological interventions, and improving cognition and enhancing engagement with education and employment.
This electronic version has been made available under a Creative Commons (BY-NC-ND) open access license. This book is available as an open access ebook under a CC-BY-NC-ND licence. What is autism and where has it come from? Increased diagnostic rates, the rise of the 'neurodiversity' movement, and growing autism journalism, have recently fuelled autism's fame and controversy. The metamorphosis of autism is the first book to explain our current fascination with autism by linking it to a longer history of childhood development. Drawing from a staggering array of primary sources, Bonnie Evans traces autism back to its origins in the early twentieth century and explains why the idea of autism has always been controversial and why it experienced a 'metamorphosis' in the 1960s and 1970s. Evans takes the reader on a journey of discovery from the ill-managed wards of 'mental deficiency' hospitals, to high-powered debates in the houses of parliament, and beyond. The book will appeal to a wide market of scholars and others interested in autism.
This book offers a new approach to understanding and treating psychotic symptoms using Cognitive Behavioural Therapy (CBT). CBT for Psychosis shows how this approach clears the way for a shift away from a biological understanding and towards a psychological understanding of psychosis. Stressing the important connection between mental illness and mental health, further topics of discussion include: the assessment and formulation of psychotic symptoms how to treat psychotic symptoms using CBT CBT for specific and co-morbid conditions CBT of bipolar disorders. This book brings together international experts from different aspects of this fast developing field and will be of great interest to all mental health professionals working with people suffering from psychotic symptoms.
Transference in Institutional Work with Psychosis and Autism presents Pierre Delion’s extensive experience in psychiatric institutions, focusing on the concept of the transferential constellation. Delion first discusses the pioneering work of François Tosquelles at the Saint Alban psychiatric hospital, which enabled psychoanalytic treatment to be applied in cases of severe psychopathologies. The book then explains how the transferential constellation can provide a deeper and more effective understanding of a patient’s needs by engaging all caregivers within an organisation over the course of the patient’s treatment history. Delion describes how regular meetings of all the team participants allow them to express different and even divergent views of the patient and to appreciate their complementary contributions to the institution. The transferential constellation is presented as an important development in the history of patient-centered psychiatric care and a touchstone for its ongoing humanistic development. Transference in Institutional Work with Psychosis and Autism will be of great interest to psychiatrists and psychotherapists in practice and in training. It will also be key reading for other practitioners and caregivers working in mental health institutions.