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Morality and mental health are now inseparably linked in our view of character. Alcoholics are sick, yet they are punished for drunk driving. Drug addicts are criminals, but their punishment can be court ordered therapy. The line between character flaws and personality disorders has become fuzzy, with even the seven deadly sins seen as mental disorders. In addition to pathologizing wrong-doing, we also psychologize virtue; self-respect becomes self-esteem, integrity becomes psychological integration, and responsibility becomes maturity. Moral advice is now sought primarily from psychologists and therapists rather than philosophers or theologians.In this wide-ranging, accessible book, Mike W. Martin asks: are we replacing morality with therapy, in potentially confused and dangerous ways, or are we creatively integrating morality and mental health? According to him, it's a little bit of both. He surveys the ways in which morality and mental health are related, touching on practical concerns like love and work, self-respect and self-fulfillment, guilt and depression, crime and violence, and addictions. Terming this integrative development "the therapeutic trend in ethics," Martin uses examples from popular culture, various moral controversies, and draws on a line of thought that includes Plato, the Stoics, Freud, Nietzsche, and contemporary psychotherapeutic theories. Martin develops some interesting conclusions, among them that sound morality is indeed healthy, and that moral values are inevitably embedded in our conceptions of mental health. In the end, he shows how both morality and mental health are inextricably intertwined in our pursuit of a meaningful life. This book will be of interest to philosophers, psychologists, psychiatrists, and sociologists, as well as the general reader.
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.
Community mental health care has evolved as a discipline over the past 50 years, and within the past 20 years, there have been major developments across the world. The Oxford Textbook of Community Mental Health is the most comprehensive and authoritative review published in the field, written by an international and interdisciplinary team.
This book examines the occupational therapy paradigm (its focal viewpoint, core constructs, and values) as well as the role of complexity/chaos theory as a scientific framework for occupational therapy research and practice. Unlike other current OT texts, this book uses clinical case examples to illustrate application of proposed changes to make procedures consistent with the latest Occupational Therapy Practice Framework. The reader walks away with a clear grasp of the theoretical principles guiding his or her treatment interventions, the explanations behind those principles, and the applicable intervention for said techniques and procedures. An emphasis on clinical-reasoning skills, including information on different types of reasoning skills as well as the MAPP model of teaching helps the student and clinician translate theoretical principles into practice.The section on specific interventions addresses each of the conceptual practice models according to a consistent chapter template, which enables the reader to apply conceptual practice models in real-world contexts. Preview questions at the beginning of each chapter alert the reader to important concepts in the upcoming text.Critical analysis of the theoretical core provides suggested modifications to increase consistency with the new occupational therapy paradigm.
The use of coercion is one of the defining issues of mental health care. Since the earliest attempts to contain and treat the mentally ill, power imbalances have been evident and a cause of controversy. There has always been a delicate balance between respecting autonomy and ensuring that those who most need treatment and support are provided with it. Coercion in Community Mental Health Care: International Perspectives is an essential guide to the current coercive practices worldwide, both those founded in law and those 'informal' processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse disciplines such as history, law, sociology, anthropology and medicine to provide a comprehensive summary of the current debates in the field. Edited by leading researchers in the field, Coercion in Community Mental Health Care: International Perspectives provides a unique discussion of this prominent issue in mental health. Divided into five sections covering origins and extent, evidence, experiences, context and international perspectives this is ideal for mental health practitioners, social scientists, ethicists and legal professionals wishing to expand their knowledge of the subject area.
Here is the first practical guide for dealing with the moral issues that regularly confront clinicians in their work. Written for all mental health professionals, Doing the Right Thing: An Approach to Moral Issues in Mental Health Treatment offers a framework both for making moral decisions concerning the treatment of patients and for helping patients deal with their own moral concerns. Drawing on current thinking in several disciplines, Doing the Right Thing introduces the concept of moral functioning as a basis for therapeutic influence. Numerous case examples illustrate how to Assess patients' ability to function morally -- Learn how six basic capacities needed for moral functioning develop, and how identifying problems in an individual's moral functioning can help guide the formulation of a treatment plan. Treat patients with problems functioning morally -- Appreciate when it is time to set aside neutrality as a therapeutic stance in favor of a more direct approach to helping patients make moral commitments, decisions and self-assessments and develop moral character. Deal with the moral aspects of clinical decision-making -- Develop a framework for making moral choices in planning the direction of treatment, confronting resistance and addressing problems in caring effectively. Help patients address moral challenges -- Learn how to take into account your own and the patient's values in reasoning through moral dilemmas. Understand more clearly how to help patients deal with unfair pain caused by others, as well as the guilt and shame caused by their own moral failures. Employ the therapeutic potential of moral growth, transformation, and integration -- Discover the role of a clinician in helping demoralized patients reformulate their ideals for better outcomes. Recognize where a moral paradigm is useful in improving the delivery of mental health care. Concise, clear, and clinically relevant, Doing the Right Thing is a valuable, thought-provoking guide for both new and seasoned mental health practitioners who live and work in a morally complex environment. It is also an excellent supplementary text for courses dealing with the practice of psychotherapy and the ethical aspects of mental health care.
Social Order/Mental Disorder represents a provocative and exciting exploration of social response to madness in England and the United States from the eighteenth through the twentieth centuries. Scull, who is well-known for his previous work in this area, examines a range of issues, including the changing social meanings of madness, the emergence and consolidation of the psychiatric profession, the often troubled relationship between psychiatry and the law, the linkages between sex and madness, and the constitution, character, and collapse of the asylum as our standard response to the problems posed by mental disorder. This book is emphatically not part of the venerable tradition of hagiography that has celebrated psychiatric history as a long struggle in which the steady application of rational-scientific principles has produced irregular but unmistakable evidence of progress toward humane treatments for the mentally ill. In fact, Scull contends that traditional mental hospitals, for much of their existence, resembled cemeteries for the still breathing, medical hubris having at times served to license dangerous, mutilating, even life-threatening experiments on the dead souls confined therein. He argues that only the sociologically blind would deny that psychiatrists are deeply involved in the definition and identification of what constitutes madness in our world – hence, claims that mental illness is a purely naturalistic category, somehow devoid of contamination by the social, are taken to be patently absurd. Scull points out, however, that the commitment to examine psychiatry and its ministrations with a critical eye by no means entails the romantic idea that the problems it deals with are purely the invention of the professional mind, or the Manichean notion that all psychiatric interventions are malevolent and ill-conceived. It is the task of unromantic criticism that is attempted in this book.