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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.
The Substance Abuse and Mental Health Services Administration (SAMHSA), within the Department of Health and Human Services (HHS), is the lead federal agency for increasing access to behavioral health services. SAMHSA funds community-based mental health and substance abuse treatment and prevention services and collects information on the incidence and prevalence of mental illness and substance abuse at the national and state level. These activities support SAMHSA's mission to improve the lives of people with substance abuse disorders and mental illnesses. This book provides an overview of SAMHSA's organization and programs and includes some analysis of the agency's funding over the past decade. It also highlights some of the issues that may be addressed by Congress when it next considers legislation to reauthorize SAMHSA and its programs.
Co-occurring Mental Illness and Substance Use Disorders: A Guide to Diagnosis and Treatment provides a clinically detailed, evidence-based, and exhaustive examination of a topic rarely plumbed in psychiatry texts, despite the fact that co-occurring mental illness and substance use disorders are common. The authors argue for a more holistic and integrated approach, calling for clinicians to tactfully but persistently evaluate patients for a broad range of co-occurring disorders before determining appropriate treatment. Focusing on a substance use disorder in isolation, without determining whether another psychiatric disorder is co-occurring, can doom treatment efforts, and the reverse also is true. To help clinicians keep the big picture in mind, the book is organized around 18 cases, each of which addresses a particular diagnostic skill (e.g., assessment), group of disorders commonly comorbid with substance use disorders (e.g., PTSD, eating disorders), specific treatment (e.g., pharmacological interventions), or special population (e.g., adolescents). This case-based approach makes it easy for readers to understand strategies and master transferable techniques when dealing with their own patients. Because the initial face-to-face sessions are especially important with this patient population, the book includes chapters on the diagnostic assessment and the initial interview, as well as offering interviewing tips throughout to help the clinician develop the necessary care and skill in this arena. Also included is a chapter on integrating motivational interviewing into the treatment. Each of the 18 cases stands alone, allowing the reader flexibility in using the text. For example, the 18 cases and discussions can be read sequentially, or as needed, depending on the reader's special interest or current need. The book also features chapters on how to effectively work with patients whose disorders might be affecting other members of a patient's family, since the likelihood of a successful outcome is enhanced if an integrated treatment plan is developed for their co-occurring disorders. The questions that accompany each chapter can be used as an organizational tool prior to reading or to test knowledge and comprehension afterward. The text is completely up-to date and provides DSM-5 diagnostic information essential to each case. Co-occurring Mental Illness and Substance Use Disorders: A Guide to Diagnosis and Treatment offers a straightforward approach to people with complicated presentations, offering mental health clinicians the skills they require to effectively assess, diagnose, and treat these patients and their families.
(Publisher-supplied data) This book represents the first systematic discussion of the Gateway Hypothesis, a developmental hypothesis formulated to model how adolescents initiate and progress in the use of various drugs. In the United States, this progression proceeds from the use of tobacco or alcohol to the use of marijuana and other illicit drugs. This volume presents a critical overview of what is currently known about the Gateway Hypothesis. The authors of the chapters explore the hypothesis from various perspectives ranging from developmental social psychology to prevention and intervention science, animal models, neurobiology and analytical methodology. This volume is original and unique in its purview, covering a broad view of the Gateway Hypothesis. The juxtaposition of epidemiological, intervention, animal and neurobiological studies represents a new stage in the evolution of drug research, in which epidemiology and biology inform one another in the understanding of drug abuse.