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This revised and expanded third edition text utilizes a public health framework and the latest epidemiological, treatment, and service systems research to promote a comprehensive understanding of the organization, financing, and delivery of mental health and substance abuse services in the United States. Written by national experts in the field, this timely work will provide policymakers, administrators, clinicians, and public health and behavioral health graduate students with the knowledge base needed to manage and transform mental health service systems, both nationally and locally.The book is unique in providing a public health framework of the most significant issues facing mental health policy makers, administrators, planners, and practitioners. It combines issues (e.g., evaluation; law; ethnicity) that extend across different age groups, treatment settings, and disorders, with issues that are population and disorder specific.The publication of this book is timely for those involved with the debate over national health care reform legislation, and provides important and timely information (on populations at-risk for mental disorders, services, and systems issues) for those responsible for implementing policies and programs resulting from this reform effort.
In the late 1960s, the World Health Organization initiated a series of international studies of the incidence, characteristics, course, and consequences of schizophrenia. Those studies - the largest ever in the history of psychiatry - provided important data about the disorder in groups of patients living in different countries and cultures, and first focused attention on the differences in short-term prognosis for schizophrenia between the third world and industrialized countries. In the 1990s, the International Study of Schizophrenia (ISoS) set out to relocate those subjects and to determine their clinical and social status some 15 to 25 years later. Recovery from Schizophrenia is a comprehensive account of what ISoS found, reporting follow-up results for over 1000 subjects examined in the earlier WHO studies (and in several local studies as well). The body of this volume consists of detailed descriptions of the long-term course and outcome of schizophrenia, together with portraits of the field research sites in 14 countries. Introductory and synoptic chapters lay out the origin and design of the WHO studies culminating in ISoS, and synthesize the study's main findings. ISoS shows that, with appropriate treatment, schizophrenia has a favorable outcome for a substantial portion of those afflicted. The surprising finding of the short-term follow-up studies - that outcome was better in the developing than in the developed countries - is confirmed here for long-term course. Yet while prognosis continues to favor subjects in developing countries, the varied outcomes for those in developed nations still offers ample reason for hope. This book is the first of its kind. The massive multinational investigations upon which it is based are unique in psychiatry and cross-cultural epidemiology. Recovery from Schizophrenia will be a valuable resource for researchers, epidemiologists, policymakers, and mental health professionals worldwide, providing evidence that supports investment in the care of persons with schizophrenia.