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Mind, State and Society examines the reforms in psychiatry and mental health services in Britain during 1960–2010, when de-institutionalisation and community care coincided with the increasing dominance of ideologies of social liberalism, identity politics and neoliberal economics. Featuring contributions from leading academics, policymakers, mental health clinicians, service users and carers, it offers a rich and integrated picture of mental health, covering experiences from children to older people; employment to homelessness; women to LGBTQ+; refugees to black and minority ethnic groups; and faith communities and the military. It asks important questions such as: what happened to peoples' mental health? What was it like to receive mental health services? And how was it to work in or lead clinical care? Seeking answers to questions within the broader social-political context, this book considers the implications for modern society and future policy. This title is also available as Open Access on Cambridge Core.
Since the earliest medical, philosophical, and literary texts in ancient civilizations, madness has posed some basic issues: how to separate sanity from insanity, to distinguish mental and bodily illnesses, and to specify the variety of internal and external forces that lead people to become mentally ill. This book explores the answers to these questions that have emerged over time and concludes that current portrayals are not much improved compared to those that emerged thousands of years ago. The puzzles that madness presents are likely to remain unresolved for the foreseeable future and perhaps forever.
Its landscaped ground, chosen by Frederick Law Olmsted and dotted with Tudor mansions, could belong to a New England prep school. There are no fences, no guards, no locked gates. But McLean Hospital is a mental institution-one of the most famous, most elite, and once most luxurious in America. McLean "alumni" include Olmsted himself, Robert Lowell, Sylvia Plath, James Taylor and Ray Charles, as well as (more secretly) other notables from among the rich and famous. In its "golden age," McLean provided as genteel an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean-despite its affiliation with Harvard University-is struggling to stay afloat. Gracefully Insane, by Boston Globe columnist Alex Beam, is a fascinating and emotional biography of McLean Hospital from its founding in 1817 through today. It is filled with stories about patients and doctors: the Ralph Waldo Emerson prot'g' whose brilliance disappeared along with his madness; Anne Sexton's poetry seminar, and many more. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness, of approaches to treatment, and of the economic pressures that are making McLean-and other institutions like it-relics of a bygone age. This is a compelling and often oddly poignant reading for fans of books like Plath's The Bell Jar and Susanna Kaysen's Girl, Interrupted (both inspired by their author's stays at McLean) and for anyone interested in the history of medicine or psychotherapy, or the social history of New England.
"When it was originally published in 2009, the Textbook of Hospital Psychiatry was the first comprehensive guide to hit the market in more than a decade. This updated edition includes new material in each of the 30 chapters, with a focus on treatment, staffing, and quality of care changes, and includes new, forward-looking chapters on consumer and family perspectives, collaborative care, measurement-based care, safety, and more. Providers and policymakers agree that integrating behavioral treatments into regular courses of patient care helps address post-discharge needs, including safe housing, reliable transportation, and nutrition. Behavioral wellness is currently benefitting from increased public attention, but disparities in access continue. There is a significant need for dedicated psychiatric hospitals and dedicated units in general hospitals to meet America's mental health needs. Progress is happening, but many familiar challenges remain. Inadequate healthcare coverage and reimbursement for services has left both patients and medical providers desperate for reform. Staffing shortages are worsening as practitioners in the baby boomer generation retire and those roles go unfilled by new graduates. Despite these challenges, psychiatric hospitals continue to evolve and discover new solutions to provide transformative care for patients. This updated textbook contains valuable knowledge and novel insights for clinicians regarding treatment, staffing, and care, and features new chapters on family involvement and safety, federal and local financing, and information on collaborative care and LEAN. Forward-looking chapters focus on the integration of treatment across settings and providers and examine new strategies such as telemedicine to extend the reach of clinicians. Together, and with expert guidance, readers of this must-have resource will find a roadmap for clinical, administrative, and financial steps to help providers take advantage of these unprecedented times to develop services and advance hospital psychiatry in the United States"--
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Inpatient units treat some of the most difficult psychiatric patients. This compact clinical manual is convenient for use on the ward and serves as a standard guide for treatment, addressing the common questions and issues that clinicians face in day-to-day psychiatric work with this challenging patient group. Chapters are organised around the diagnoses found on inpatient psychiatric units, with additional chapters addressing documentation and the care of young adult inpatients. Charts, tables and clinical hints amplify the text, allowing practising clinicians to find the information they need quickly and easily, and enabling students to master the field for board and end-of-clerkship exams. This practical manual is essential reading for practising psychiatrists, psychiatric residents and all psychiatric educators, as well as serving as an accessible reference for physicians in other specialties who consult on the psychiatric ward, psychiatric nurses and medical students.
Thirty years ago, it was estimated that less than five percent of the population had an anxiety disorder. Today, some estimates are over fifty percent, a tenfold increase. Is this dramatic rise evidence of a real medical epidemic?In All We Have to Fear, Allan Horwitz and Jerome Wakefield argue that psychiatry itself has largely generated this "epidemic" by inflating many natural fears into psychiatric disorders, leading to the over-diagnosis of anxiety disorders and the over-prescription of anxiety-reducing drugs. American psychiatry currently identifies disordered anxiety as irrational anxiety disproportionate to a real threat. Horwitz and Wakefield argue, to the contrary, that it can be a perfectly normal part of our nature to fear things that are not at all dangerous--from heights to negative judgments by others to scenes that remind us of past threats (as in some forms of PTSD). Indeed, this book argues strongly against the tendency to call any distressing condition a "mental disorder." To counter this trend, the authors provide an innovative and nuanced way to distinguish between anxiety conditions that are psychiatric disorders and likely require medical treatment and those that are not--the latter including anxieties that seem irrational but are the natural products of evolution. The authors show that many commonly diagnosed "irrational" fears--such as a fear of snakes, strangers, or social evaluation--have evolved over time in response to situations that posed serious risks to humans in the past, but are no longer dangerous today.Drawing on a wide range of disciplines including psychiatry, evolutionary psychology, sociology, anthropology, and history, the book illuminates the nature of anxiety in America, making a major contribution to our understanding of mental health.