Mental Health and Social Policy : Beyond Managed Care

by Mechanic, David

• ISBN13: 9780205545933
• ISBN10: 0205545939
• Edition: 5th
• Format: Paperback
• Copyright: 2007-05-30
• Publisher: Pearson

Summary

The fifth edition text ofMental Health and Social Policytakes a multidisciplinary approach to mental health and social policy. It covers mental health issues and includes important new epidemiological studies, controlled clinical trials, and other investigations that inform the new thrust for evidence-based mental health services. It also covers cutting-edge new information on disparities in mental health care coverage, pharmaceutical companies and the marketing of drugs, PTSD in the wake of the Iraq war and 9/11, the Surgeon General Report on Mental health, the Bush New Freedom commission, and the criminalization of mental illness.

Table of Contents

Preface	p. xi
Mental Health and the Mental Health Professions	p. 1
Symptoms, Diseases, and Reaction Patterns	p. 3
Disease, Personality Disturbance, or Problem in Living	p. 3
Social Adjustment	p. 4
Concepts of Severe and Persistent Mental Illness	p. 5
Patterns of Mental Health Utilization	p. 6
The Mental Health Professions	p. 9
Mental Health Personnel and Work Patterns	p. 12
Trends in Mental Health Care	p. 17
Changing Inpatient Care	p. 20
What Are Mental Health and Mental Illness?	p. 23
Psychiatric Diagnosis Guidelines	p. 23
Varieties of Mental Illness	p. 27
Schizophrenia: An Example in Psychiatric Conceptualization	p. 28
Varying Conceptions of Mental Illness	p. 32
Developmental Models	p. 37
Changing Conceptions of Mental Illness	p. 39
Social Conceptions of Mental Illness	p. 41
Views of Mental Illness in Relation to Social Policy	p. 43
The Patient and the Society: An Insoluble Dilemma	p. 46
Social Problem or Mental Illness?	p. 47
Psychological Disorder and the Flow of Patients into Treatment: The Study of Psychiatric Epidemiology	p. 50
Identifying Psychological Problems in Community Populations	p. 51
Estimates of Prevalence of Disorder in Community Populations	p. 54
The Epidemiological Catchment Area Program and the National Comorbidity Survey	p. 55
Psychological Disorder and Utilization of Care	p. 57
Social Factors Associated with Psychiatric Conditions in the Community	p. 61
Race and Ethnic Disparities	p. 64
The Epidemiology of Antisocial Behavior and Behavior Disorders	p. 66
Conceptions of the Causes of and Means of Controlling Mental Illness	p. 68
The Impact of Environment on Mental Illness	p. 68
The Question of Inheritance and Environment	p. 69
A Note on Psychiatric Drugs	p. 73
The Psychosocial-Development Perspective	p. 80
The Learning Perspective: Behavior Therapy	p. 86
The Social-Stress Perspective	p. 88
The Labeling Perspective	p. 93
Collective Mobilization	p. 95
The Development of Mental Health Policy in the United States	p. 96
The Early History of Worcester State Hospital	p. 99
More Recent Developments in Mental Health Policy	p. 100
Post-World War II Developments in Mental Health Policy	p. 101
Postwar Psychiatry	p. 102
The Organization of State Mental Hospitals	p. 113
Programs of Community Care	p. 117
The Composition of the Seriously Mentally Ill Population	p. 117
Homelessness and Mental Illness	p. 119
The Recognition of Mental Disorders	p. 124
Mental Illness, Illness Behavior, and Entry into Psychiatric Care	p. 126
Community Definitions of Mental Illness	p. 132
The Course of Schizophrenia	p. 137
The Financing and Delivery of Mental Health Services	p. 140
Mental Health Coverage and Expenditures	p. 140
The Pattern of Inpatient Services	p. 144
Utilization of Services and Financing Patterns	p. 146
The Economics of Mental Health Care	p. 148
Psychiatric Care Under Prepayment Plans	p. 149
The Structure of Insurance and Needed Mental Health Benefits	p. 152
The Role of Primary Medical Care	p. 158
The Management of Psychological Distress	p. 162
Some Promising Signs	p. 166
Managed Mental Health Care	p. 167
Basic Mechanisms of Managed Care	p. 167
Types of Managed Care Organizations	p. 170
Managed Care for Persons with Mental Illness	p. 171
Opportunities and Special Problems in Managed Mental Health Care	p. 175
Performance of Managed Care	p. 177
Some Unresolved Issues in Managed Care	p. 181
Institutionalism and Deinstitutionalization: Building an Effective Community Services System	p. 185
Criteria for Evaluation	p. 185
Understanding the Processes of Deinstitutionalization	p. 192
Environmental Factors Promoting Effective Performance	p. 194
Implications of Community Institutional Placement	p. 200
Models for Community Care	p. 201
Points of Leverage	p. 211
Modifying State Mental Health Systems	p. 211
Medicaid Reform	p. 213
Improving Disability Determination	p. 214
The Case Management Approach	p. 217
Organizational Barriers	p. 219
The Absence of a Clear Focus of Responsibility and Authority	p. 220
Innovations in Mental Health Services	p. 222
Maintenance of Patients with Persistent Disorders	p. 225
A Further Note on Employment	p. 229
The Special Case of Children with Severe Emotional Disturbance	p. 231
Problems in the Diffusion of Mental Health Innovations	p. 233
Innovations in Housing	p. 234
Changing Roles of the Mental Health Professions	p. 235
Future Trends in Innovative Mental Health Services	p. 236
The Social Context of Mental Health Practice: Foundations of Trust	p. 238
Social Influences on Psychiatric Judgment	p. 241
Personal and Social Biographies	p. 242
The Sociocultural Context	p. 244
Constraints of Practice Organization and Settings	p. 248
Competition in the Allocation of Care	p. 249
A Note on the Care of Patients Who Have Chronic Impairment	p. 251
Mental Illness, the Community, and the Law	p. 252
Involuntary Hospitalization	p. 253
Outpatient Commitment and Mental Health Courts	p. 258
Criminalization of Persons with Mental Illness	p. 262
A Note on Dangerousness and the Relationship Between Mental Illness and Violence	p. 265
The Right to Treatment	p. 270
Right to Refuse Treatment	p. 273
The Americans with Disabilities Act and the Supreme Court Decision in Olmstead v. L.C.	p. 275
The Social Context of Legal Reform in Mental Health	p. 277
References	p. 279
Name Index	p. 304
Subject Index	p. 308
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