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With decreases in lengths of hospital stay and increases in alternatives to inpatient treatments, the field of hospital psychiatry has changed dramatically over the past 20 years. As the first comprehensive guide to be published in more than a decade, the Textbook of Hospital Psychiatry is a compilation of the latest trends, issues, and developments in the field. The textbook, written by 70 national experts and clinical specialists, covers a wide range of clinical and administrative topics that are central to today's practice of hospital psychiatry. This is the only textbook on the market today that provides information for psychiatric hospital clinicians and administrators in a single all-inclusive volume. It covers information not generally available in other textbooks and medical journals, touching on a variety of cutting-edge issues, such as safety improvement, use of seclusion and restraint, suicide prevention, and culturally competent psychiatric care. The book's 35 chapters are divided into four parts: Part I, Inpatient Practice -- focuses on specialty psychiatric units (e.g., acute stabilization unit, eating disorders unit, forensic unit, child unit), including the many psychopharmacological and psychosocial treatments used within each. This section also touches on specialized treatment for patients with co-occurring problems, such as substance abuse, developmental disabilities, and legal difficulties. Part II, Special Clinical Issues -- covers clinical issues from the perspective of different populations (consumers, families, suicidal patients). This section also examines the recent trend toward patient-centered care. Part III, The Continuum of Care -- addresses psychiatric services within the community, such as rehabilitation programs, day hospitals, and emergency services. It discusses the importance of understanding hospital-based treatment within the broader perspective of patients' lives. Part IV, Structure and Infrastructure -- focuses on such often-overlooked topics as financing of care, risk management, electronic medical records, and the actual architecture of psychiatric hospitals, as well as the roles of psychiatric hospital administrators, psychiatric nurses, and psychiatrists and psychologists. An invaluable resource for both clinicians and administrators, as well as a comprehensive teaching tool for residents, the Textbook of Hospital Psychiatry is a must-have for all professionals who work in psychiatric settings.
Principles of Inpatient Psychiatry is geared to psychiatrists working in inpatient settings: residents, psychiatrists who occasionally provide inpatient care, and psychiatric "hospitalists" who specialize in the inpatient arena. Inpatient settings contain the sickest psychiatric patients, such as those with a high risk of suicide, agitation requiring emergency management, or treatment-resistant psychosis and depression, all topics discussed in the book. Co-morbid general-medical illness is common, and the book focuses attention, supported by case examples, on medical and neuropsychiatric as well as general-psychiatric evaluation and management. Chapters address special clinical problems, including first-episode psychosis, substance abuse, eating disorders, and legal issues on the inpatient service. The editors bring expertise to bear on a wide range of treatments, including psychopharmacologic, psychodynamic, and milieu approaches.
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.
Many of the 61 million people who live in rural America have limited access to health care. Almost a quarter of the nation's population lives in rural places yet only an eighth of our doctors work there. Sponsored by the U.S. Office of Rural Health Policy, this unique book provides the facts about this imbalance and interprets them in the context of government programs that promote the placement of doctors and the operation of hospitals in rural places while paying them less to treat Medicare and Medicaid beneficiaries. The authors' comprehensive analysis of rural health care delivery shows where there are differences in rates of death and disease between rural areas using maps, graphs, and plain-English descriptions. The book provides a thorough look at health care in rural America, giving a snapshot of how doctors, hospitals, and technology are unevenly distributed outside the nation's metropolitan areas.
Psychiatric rehabilitation refers to community treatment of people with mental disorders. Community treatment has recently become far more widespread due to deinstitutionalization at government facilities. This book is an update of the first edition's discussion of types of mental disorders, including etiology, symptoms, course, and outcome, types of community treatment programs, case management strategies, and vocational and educational rehabilitation. Providing a comprehensive overview of this rapidly growing field, this book is suitable both as a textbook for undergraduate and graduate courses, a training tool for mental health workers, and a reference for academic researchers studying mental health. The book is written in an easy to read, engaging style. Each chapter contains highlighted and defined key terms, focus questions and key topics, a case study example, special sections on controversial issues of treatment or ethics, and other special features.*New chapters on supported education and integrated dual diagnosis treatment services*Comprehensive overview of all models and approaches of psychiatric rehabilitation*Special inserts on Evidence-Based Practices*New content on Wellness and Recovery*Class exercises for each chapter*Profiles of leaders in the field*Case study examples illustrate chapter points
Preeminent authorities from MGH present a reference that is carefully designed to simplify access to needed current clinical knowledge. A user-friendly organization - with abundant boxed summaries, bullet points, case histories, and algorithms--provided the speedy answers you need.
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.