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The field of academic psychiatry is in crisis, everywhere. It is not merely a health crisis of resource scarcity or distribution, competing claims and practice models, or level of development from one country to another, but a deeper, more fundamental crisis about the very definition and the theoretical basis of psychiatry. The kinds of questions that represent this crisis include whether psychiatry is a social science (like psychology or anthropology), whether it is better understood as part of the humanities (like philosophy, history, and literature), or if the future of psychiatry is best assured as a branch of medicine (based on genetics and neuroscience)? In fact, the question often debated since the beginning of modern psychiatry concerns the biomedical model so that part of psychiatry’s perpetual self-questioning is to what extent it is or is not a branch of medicine. This unique and bold volume offers a representative and critical survey of the history of modern psychiatry with deeply informed transdisciplinary readings of the literature and practices of the field by two professors of psychiatry who are active in practice and engaged in research and have dual training in scientific psychiatry and philosophy. In alternating chapters presenting contrasting arguments for the future of psychiatry, the two authors conclude with a dialogue between them to flesh out the theoretical, research, and practical implications of psychiatry’s current crisis, outlining areas of divergence, consensus, and fruitful collaborations to revision psychiatry today. The volume is scrupulously documented but written in accessible language with capsule summaries of key areas of theory, research, and practice for the student and practitioner alike in the social and human sciences and in medicine, psychiatry, and the neurosciences.
Written and edited by leading emergency psychiatrists, this is the first comprehensive text devoted to emergency psychiatry. The book blends the authors' clinical experience with evidence-based information, expert opinions, and American Psychiatric Association guidelines for emergency psychiatry. Case studies are used throughout to reinforce key clinical points. This text brings together relevant principles from many psychiatric subspecialties—community, consultation/liaison, psychotherapy, substance abuse, psychopharmacology, disaster, child, geriatric, administrative, forensic—as well as from emergency medicine, psychology, law, medical ethics, and public health policy. The emerging field of disaster psychiatry is also addressed. A companion Website offers instant access to the fully searchable text. (www.glickemergencypsychiatry.com)
Helping Kids in Crisis: Managing Psychiatric Emergencies in Children and Adolescents provides expert guidance to practitioners responding to high-stakes situations, such as children considering or attempting suicide, cutting or injuring themselves purposely, and becoming aggressive or violently destructive. Children experiencing behavioral crises frequently reach critical states in venues that were not designed to respond to or support them -- in school, for example, or at home among their highly stressed and confused families. Professionals who provide services to these children must be able to quickly determine threats to safety and initiate interventions to deescalate behaviors, often with limited resources. The editors and authors have extensive experience at one of the busiest and best regional referral centers for children with psychiatric emergencies, and have deftly translated their expertise into this symptom-based guide to help non-psychiatric clinicians more effectively and compassionately care for this challenging population. The book is designed for ease of use and its structure and features are helpful and supportive: The book is written for practitioners in hospital or community-based settings, including physicians in training, pediatricians who work in office-based or emergency settings, psychologists, social workers, school psychologists, guidance counselors, and school nurses -- professionals for whom child psychiatric resources are few. Clear risk and diagnostic assessment tools allow clinicians working in settings without access to child mental health professionals to think like trained emergency room child psychiatrists--from evaluation to treatment. The content is symptom-focused, enabling readers to swiftly identify the appropriate chapter, with decision trees and easy-to-read tables to use for quick de-escalation and risk assessment. A guide to navigating the educational system, child welfare system, and other systems of care helps clinicians to identify and overcome systems-level barriers to obtain necessary treatment for their patients. Finally, the book provides an extensive review of successful models of emergency psychiatric care from across the country to assist clinicians and hospital administrators in program design. An abundance of case examples of common emergency symptoms or behaviors provides professionals with critical, concrete tools for diagnostic evaluation, risk assessment, decision making, de-escalation, and safety planning. Helping Kids in Crisis: Managing Psychiatric Emergencies in Children and Adolescents is a vital resource for clinicians facing high-risk challenges on the front lines to help them intervene effectively, relieve suffering, and keep their young patients safe.
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.
While millions of patients with severe mental illnesses are neglected, those charged with caring for them are engaged in a troubling debate: Who should treat these patients-and how? On one side are psychoanalysts, on the other are pill-pushing psychiatrists. And on the fringe are neuroscientists, who are learning volumes about the brain but whose discoveries have largely been ignored. Truly, psychiatry is in crisis.In this important book, Harvard psychiatrist J. Allan Hobson and medical journalist Jonathan A. Leonard explore the roots of this predicament and propose, for the first time, the development of a more balanced approach to treatment-neurodynamics-that bridges the worlds of biomedicine, therapy, and neuroscience. Written with passion and informed by decades of experience, Out of Its Mind shows a clear path to reviving psychiatry, providing sound care for millions, and realizing humanity's ancient dream of treating not just the mind or brain alone, but both together.
Crisis resolution and home treatment teams respond rapidly to people experiencing mental health crises and offer an alternative to hospital admission. They are an increasingly important component of mental health care and are adopted by many health care systems around the world. This practical and pioneering book describes the evidence for the effectiveness of such teams, the principles underpinning them, how to set up and organise them, how patients should be assessed and what types of care the teams should offer. Other topics covered include integration of crisis teams with in-patient, community residential and day care services, the service users' experiences of crisis teams, and responding to diversity in home treatment. This book is essential reading for all policy makers, service managers and mental health workers interested in establishing or operating crisis resolution and home treatment services, as well as for researchers and students seeking to understand this model.
The author "reveals how we have failed our mentally ill and offers a viable, provocative blueprint for change."--Jacket.
Psychological Crisis Intervention: The SAFER-R Model is designed to provide the reader with a simple set of guidelines for the provision of psychological first aid (PFA). The model of psychological first aid (PFA) for individuals presented in this volume is the SAFER-R model developed by the authors. Arguably it is the most widely used tactical model of crisis intervention in the world with roughly 1 million individuals trained in its operational and derivative guidelines. This model of PFA is not a therapy model nor a substitute for therapy. Rather it is designed to help crisis interventionists stabile and mitigate acute crisis reactions in individuals, as opposed to groups. Guidelines for triage and referrals are also provided. Before plunging into the step-by-step guidelines, a brief history and terminological framework is provided. Lastly, recommendations for addressing specific psychological challenges (suicidal ideation, resistance to seeking professional psychological support, and depression) are provided.
This book focuses on how to formulate a mental health response with respect to the unique elements of pandemic outbreaks. Unlike other disaster psychiatry books that isolate aspects of an emergency, this book unifies the clinical aspects of disaster and psychosomatic psychiatry with infectious disease responses at the various levels, making it an excellent resource for tackling each stage of a crisis quickly and thoroughly. The book begins by contextualizing the issues with a historical and infectious disease overview of pandemics ranging from the Spanish flu of 1918, the HIV epidemic, Ebola, Zika, and many other outbreaks. The text acknowledges the new infectious disease challenges presented by climate changes and considers how to implement systems to prepare for these issues from an infection and social psyche perspective. The text then delves into the mental health aspects of these crises, including community and cultural responses, emotional epidemiology, and mental health concerns in the aftermath of a disaster. Finally, the text considers medical responses to situation-specific trauma, including quarantine and isolation-associated trauma, the mental health aspects of immunization and vaccination, survivor mental health, and support for healthcare personnel, thereby providing guidance for some of the most alarming trends facing the medical community. Written by experts in the field, Psychiatry of Pandemics is an excellent resource for infectious disease specialists, psychiatrists, psychologists, immunologists, hospitalists, public health officials, nurses, and medical professionals who may work patients in an infectious disease outbreak.