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One in five U.S. adults experiences a mental illness within a given year. With more than 550,000 people working to support this underserved community, the mental healthcare system has grappled with inadequacies and shortcomings in safety, quality, and care delivery. There is a wide range of problems, from access-to-care issues and errors, to complications stemming from poor care. Our country is also on an unsustainable path as our healthcare expenditure keeps growing. To add to all of this, we are facing a rampant epidemic of burnout among healthcare workers. Modern advancements introduced with many promises—such as electronic medical records, newer medications, or advanced treatments—have created unique challenges when ushered into a highly regulated healthcare system. What does it take to provide patients with everything they need—the right quality of care, at the right time, and at the right cost—to keep them healthy? Which process steps add value? Which steps are wasteful? A widely accepted fact is that a conservative 30-50% of every step in the mental healthcare process does not help patients feel better or stay better. When considering delays in care, workarounds, excessive documentation, and an overuse of auditing, the care system has moved highly skilled clinicians away from providing value, as administrative tasks continue to encroach on their time. There is a clear need to rethink and redesign the system of care. This book is a primer for understanding the current state of the mental health system and the performance improvement skills and leadership acumen needed to address existing challenges. Sheppard Pratt, the award-winning, leading institution for mental healthcare in America, provided the focus on mental healthcare and became the laboratory for this body of work over the course of eight years. It hired a seasoned systems thinker with improvement expertise to work with mental health professionals and solve some of their most complex and chronic problems. The book is a result of the collaboration between a practicing psychiatrist in a leadership role and the systems engineer. Working together, they demonstrate how to think about redesigning care and redefining the nature of work to enhance value for both the people served and the healthcare workforce. They crafted a multi-pronged approach towards culture change at Sheppard Pratt, including implementing a course on "Learning to Improve," which introduced staff to a performance improvement methodology. There are several vignettes interwoven throughout the book that describe the complexities and constraints of the system. Solving some of these challenges creates a new paradigm of work while minimizing waste and enhancing value.
This book takes the lofty vision of "recovery" and of a "life in the community" for every adult with a mental illness promised by the U.S. President's New Freedom Commission and shows the reader what is entailed in making this vision a practical reality for people with mental illnesses and their families.
Provides a comprehensive ten-step sequence for implementing population-based services that improve wellness and academic success for individual students and entire schools, and offers suggestions for engaging parents.
"We have come a long way over the past few decades in our understanding of mental illness and its potential treatments. Yet, tragically, many across the country who struggle with serious mental illness are unable to find effective, quality medical treatment. As a federal commission on mental health concluded, the system of care is in shambles. But why? And how do we fix it?" "Timothy A. Kelly, former Commissioner of Virginia's Department of Mental Health, Retardation, and Substance Abuse, brings his three decades of experience as mental health commissioner, psychology professor, and clinician to bear in confronting this crisis in America's mental health care system. In clear and accessible terms, he exposes the weaknesses in the current system, examining how and why one of the world's richest and most advanced countries has allowed its most vulnerable citizens to be victimized by the very system designed to help them." --Book Jacket.
Address the urgent need for individualized, coordinated mental health care with this book--the only one-stop reference for establishing, evaluating, and improving services and systems of care for children and adolescents with mental health challenges and their families. The new cornerstone of the highly respected Systems of Care for Children's Mental Health series, this comprehensive volume helps administrators, program developers, and clinicians from mental health and partner child-serving systems skillfully navigate every key issue they may encounter on the road to effective service delivery. Weaving all the latest research and best practices into a single accessible handbook, more than 60 expert contributors give readers the in-depth, practical knowledge they need to develop comprehensive, community-based, coordinated systems of care for youth with mental health challenges and their families avoid duplication and fragmentation of services across mental health and other child-serving systems develop individualized care plans for children with complex needs and implement the "wraparound" approach to service delivery incorporate evidence-based practices into systems of care use smart financing strategies that make the most of multiple funding streams ensure the full participation of families and youth in service planning and delivery improve services and care coordination across a variety of systems--schools, child welfare, juvenile justice work effectively with youth and families from diverse backgrounds and communities conduct accurate program evaluation and continuous quality improvement use the best professional development strategies to ensure a skilled and dedicated workforce Throughout the book, extended case studies of children, youth, families, and successful programs take readers beyond the abstract and reveal in vivid detail how high-quality services can transform the lives of children and youth--from early childhood to their transition to adulthood--as well as their families and caregivers. A must-own compendium of knowledge for anyone involved in shaping the future of mental health services, this book is the new blueprint for systems of care that truly respond to the needs of children, youth and families. Learn more about the Systems of Care for Children's Mental Health series.
Mental Health Consultation in Infant?Toddler Child Care addresses the impact of the caregiver'child relationship on the mental health of young children. As young children spend more and more time in child care programs, those programs have an increasingly significant effect on their healthy social and emotional development. Kadija Johnston and Charles Brinnamen review current theory and offer practical suggestions for improving relationships between program directors, staff, parents, children, and mental-health consultants to help identify and remove obstacles to quality care. The authors also offer real-life examples of effective programmatic functioning, interstaff and parent'staff relationships, and direct child interventions. Mental health professionals at all levels, early childhood educators and trainers, and policy makers will find this book useful guide to making positive changes in the childcare environment.
A ground-breaking argument for better treatment of mental health from Richard Layard (author of Happiness) and David M. Clark. Britain has become a world leader in providing psychological therapies thanks to the work of Richard Layard and David Clark. But, even so, in Britain and worldwide the majority of people who need help still don't get treatment. This is both unjust and a false economy. This book argues for change. It shows that mental ill-health causes more of the suffering in our society than physical illness, poverty or unemployment. Moreover, greater spending on helping people to recover from mental health problems - and stay well - would generate massive savings to national economies, as those who suffer from depression and anxiety disorders account for nearly a half of all disability and are predominantly of working age. Modern talking therapies, such as CBT (Cognitive Behavioural Therapy), are highly effective, and if more sufferers got these treatments, lives would be turned around and the cost would be fully covered by the huge savings. Thrive explores the new effective solutions to the misery and injustice caused by mental illness. It describes how successful psychological treatments have been developed and explains what works best for whom. It also urges us to do all we can to prevent these problems in the first place, through better schools and a better society. And, most importantly, it offers real hope. 'This book is an inspiring success story and a stirring call to further action. Its message is as compelling as it is important: the social costs of mental illness are terribly high and the costs of effective treatments are surprisingly low' Daniel Kahneman 'Extremely easy and pleasurable to read. It's the most comprehensive, humane and generous study of mental illness that I've come across' Melvyn Bragg 'Remarkable . . . presents the issues in a style that easy for the professional, the general public, and policy makers to understand' Aaron T Beck 'Professors Layard and Clark (the Dream Team of British Social Science) make a compelling case for a massive injection of resources into the treatment and prevention of mental illness. This is simply the best book on public policy and mental health ever written' Martin Seligman RICHARD LAYARD is one of the world's leading labour economists, and in 2008 received the IZA International Prize for Labour Economics. A member of the House of Lords, he has done much to raise the public profile of mental health. His 2005 book Happiness has been translated into 20 languages. DAVID M. CLARK, Professor of Psychology at Oxford, is one of the world's leading experts on CBT, responsible for much progress in treatment methods. With Richard Layard, he was the main driver behind the UK's Improving Access to Psychological Therapies programme.
A pointed look at the state of tech-based mental healthcare and what we must do to change it Proponents of technology trumpet it as the solution to the massive increase in the mental distress that confronts our nation. They herald the arrival of algorithms, intelligent chatbots, smartphone applications, telemental healthcare services, and more—but are these technological fixes really as good as they seem? In Therapy Tech, Emma Bedor Hiland presents the first comprehensive study of how technology has transformed mental healthcare, showing that this revolution can’t deliver what it promises. Far from providing a solution, technological mental healthcare perpetuates preexisting disparities while relying on the same failed focus on personal responsibility that has let us down before. Through vivid, in-depth case studies, Therapy Tech reveals these problems, covering issues including psychosurveillance on websites like Facebook and 7 Cups of Tea, shortcomings of popular AI “doctors on demand” like Woebot, Wysa, and Joy, and even how therapists are being conscripted into the gig economy. Featuring a vital coda that brings Therapy Tech up to date for the COVID era, this book is the first to give readers a large-scale analysis of mental health technologies and the cultural changes they have enabled. Both a sobering dissection of the current state of mental health and a necessary warning of where things are headed, Therapy Tech makes an important assertion about how to help those in need of mental health services today.
Oaxaca is known for many things—its indigenous groups, archaeological sites, crafts, and textiles—but not for mental health care. When one talks with Oaxacans about mental health, most say it's a taboo topic and that people there think you "have to be crazy to go to a psychologist." Yet throughout Oaxaca are signs advertising the services of psicólogos; there are prominent conferences of mental health professionals; and self-help groups like Neurotics Anonymous thrive, where participants rise to say, "Hola, mi nombre es Raquel, y soy neurótica." How does one explain the recent growth of Euroamerican-style therapies in the region? Author Whitney L. Duncan analyzes this phenomenon of "psy-globalization" and develops a rich ethnography of its effects on Oaxacans' understandings of themselves and their emotions, ultimately showing how globalizing forms of care are transformative for and transformed by the local context. She also delves into the mental health impacts of migration from Mexico to the United States, both for migrants who return and for the family members they leave behind. This book is a recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.
This compendium of 17 articles addresses the goals set forth by the President's New Freedom Commission on Mental Health in its 2003 report, Achieving the Promise: Transforming Mental Health Care in America. The report represents the first time since the Carter Administration that such a high-level group evaluated U.S. mental health care. The report painted a dismal picture of the nation's mental health system, saying the system was so broken that it was "beyond simple repair." The Commission said that current services focused on "managing disabilities" rather than helping patients achieve a meaningful life in their communities. It also stated that mental health service providers ignored the preferences of consumers and their families. The articles in Transforming Mental Health Services: Implementing the Federal Agenda for Change, originally published between 2006 and 2009 in Psychiatric Services (journal of the American Psychiatric Association), offer recommendations to assist adults with serious mental illness and children with serious emotional disturbances. They include a series of reforms in which the emphasis is on recovery as an achievable goal, and the need for a person-centered orientation in service delivery. There is also discussion of the reasons many service providers resist using a recovery orientation and how this can be remedied. Transforming Mental Health Services: Implementing the Federal Agenda for Change consists of updates of papers written by the Commission's subcommittees addressing issues fundamental to those living with mental illness. It is organized into four sections: The first focuses on the interface between mental health and general health, and on employment, housing, and Medicaid financing. The second continues addressing financing and Medicaid as well as issues related to school mental health, recovery, transformation of data systems, and acceleration of research. The third includes reports from four states with transformation initiatives designed to ensure that consumers have a strong voice in the development of recovery-oriented services. The final section describes progress five years after the President's Commission Report and concludes with a proposal by the current director of the Center for Mental Health Services for a public health model of mental health care for the 21st century. This compilation of well-researched and well-written articles offers an excellent resource for frontline care providers, facility administrators and advocates. It serves as an equally valuable resource for state policy makers who wish to present a convincing case that change is happening and that the recommendations can be translated into effective policies. Although consumers and their families will receive support for their perception that service providers ignore their needs, they will also be encouraged that change for the better is coming to the U.S. mental health care system.