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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.
This module provides practical guidance on how to improve access to psychotropic drugs and promote their effective use. Issues such as the rational selection of drugs, affordability, sustainable financing and the availability of reliable health and supply systems are discussed in order to demonstrate practical ways to promote access. A number of educational, managerial and regulatory strategies to promote the effective use of psychotropic medicines are also highlighted. Other modules included in the package: Child and Adolescent Mental Health Policies and Plans Mental Health Policy, Plans and Programmes. Updated version Mental Health Context Mental Health Financing Advocacy for Mental Health Quality Improvement for Mental Health Organization of Services for Mental Health Planning and Budgeting to Deliver Services for Mental Health Mental Health Legislation and Human Rights Mental Health Policies and Programmes in the Workplace Mental Health Information Systems Human Resources and Training in Mental Health Monitoring and Evaluation of Mental Health Policies and Plans
This Handbook outlines in detail the features and challenges of rural and remote mental health service delivery and pragmatic considerations to address these, to ensure people in less populated areas receive an equivalent quality of service to their city-dwelling counterparts. The scope of the book includes general descriptions of the rural and remote context as well as the professional and ethical considerations involved in working in these areas. The book includes information specific to the professions that contribute to effective and efficient mental health services, as well as addressing specific areas of practice that warrant focused attention because of their importance. In order to cover the field comprehensively, the Handbook has four sections. The first section deals with the general context of rural and remote practice including a description of the general features of the setting and the importance of attention to ethical and professional standards. The second section of the Handbook describes different ways of working in rural and remote contexts. Rural and remote contexts provide many opportunities for innovation and creativity but it is imperative that novel approaches do not compromise the quality and integrity of the service. The third section covers individual professions in detail and the fourth section focuses specifically on particular areas of practice that present challenges for rural and remote areas. Academics will find this Handbook a valuable evidence-based resource to enhance their teaching of undergraduate and postgraduate mental health students. Practitioners will find this book an important reference guide to enrich and broaden their rural and remote experiences. They will be informed of the latest research evidence and will be provided with practical advice and strategies to promote advanced clinical practice in this challenging context. .
In this stirring and beautifully written wake-up call, psychiatrist Daniel Carlat writes with bracing honesty about how psychiatry has so largely forsaken the practice of talk therapy for the seductive—and more lucrative—practice of simply prescribing drugs, with a host of deeply troubling consequences. Psychiatrist Daniel Carlat has noticed a pattern plaguing his profession. Psychiatrists have settled for treating symptoms rather than causes, embracing the apparent medical rigor of DSM diagnoses and prescription in place of learning the more challenging craft of therapeutic counseling, gaining only limited understanding of their patients’ lives. Talk therapy takes time, whereas the fifteen-minute "med check" allows for more patients and more insurance company reimbursement. Yet, DSM diagnoses, he shows, are premised on a good deal less science than we would think. Writing from an insider’s perspective, with refreshing forthrightness about his own daily struggles as a practitioner, Dr. Carlat shares a wealth of stories from his own practice and those of others that demonstrate the glaring shortcomings of the standard fifteen-minute patient visit. He also reveals the dangers of rampant diagnoses of bipolar disorder, ADHD, and other "popular" psychiatric disorders, and exposes the risks of the cocktails of medications so many patients are put on. Especially disturbing are the terrible consequences of overprescription of drugs to children of ever younger ages. Taking us on a tour of the world of pharmaceutical marketing, he also reveals the inner workings of collusion between psychiatrists and drug companies. Concluding with a road map for exactly how the profession should be reformed, Unhinged is vital reading for all those in treatment or considering it, as well as a stirring call to action for the large community of psychiatrists themselves. As physicians and drug companies continue to work together in disquieting and harmful ways, and as diagnoses—and misdiagnoses—of mental disorders skyrocket, it’s essential that Dr. Carlat’s bold call for reform is heeded.
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.
"This book has been divided into three main sections. Part I deals with global issues that bear on the assessment and formulation of possible adverse effects and with pertinent concepts related to basic pharmacology, physiology, and medical monitoring. The chapters in Part II present information organized by individual organ systems or specific medical circumstances rather than by drugs or drug classes. This approach seems to provide a logical and comprehensible format that allow readers to search out information as referenced by a particular side effect (and its varied potential causes) and to locate a discussion of practical management strategies. Part III focuses on summary recommendations covering all the material presented in the book and is followed by helpful appendixes on self-assessment questions and resources for practitioners. The book is meant to serve as a ready reference that simultaneously provides scientific and scholarly discussion of available treatment options and presents their scientific rationales."--page xx.
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.