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A bold, expert, and actionable map for the re-invention of America’s broken mental health care system. “Healing is truly one of the best books ever written about mental illness, and I think I’ve read them all." —Pete Earley, author of Crazy As director of the National Institute of Mental Health, Dr. Thomas Insel was giving a presentation when the father of a boy with schizophrenia yelled from the back of the room, “Our house is on fire and you’re telling me about the chemistry of the paint! What are you doing to put out the fire?” Dr. Insel knew in his heart that the answer was not nearly enough. The gargantuan American mental health industry was not healing millions who were desperately in need. He left his position atop the mental health research world to investigate all that was broken—and what a better path to mental health might look like. In the United States, we have treatments that work, but our system fails at every stage to deliver care well. Even before COVID, mental illness was claiming a life every eleven minutes by suicide. Quality of care varies widely, and much of the field lacks accountability. We focus on drug therapies for symptom reduction rather than on plans for long-term recovery. Care is often unaffordable and unavailable, particularly for those who need it most and are homeless or incarcerated. Where was the justice for the millions of Americans suffering from mental illness? Who was helping their families? But Dr. Insel also found that we do have approaches that work, both in the U.S. and globally. Mental illnesses are medical problems, but he discovers that the cures for the crisis are not just medical, but social. This path to healing, built upon what he calls the three Ps (people, place, and purpose), is more straightforward than we might imagine. Dr. Insel offers a comprehensive plan for our failing system and for families trying to discern the way forward. The fruit of a lifetime of expertise and a global quest for answers, Healing is a hopeful, actionable account and achievable vision for us all in this time of mental health crisis.
This work, the third panel of a triptych dedicated by the author to the notion of illness derived from the patristic and hagiographic texts of the Christian East from the first to the fourteenth centuries, makes an essential contribution to the history of mental illnesses and their therapies in a domain very little studied until now. Confronted by the numerous problems still posed today in understanding these illnesses, their treatment, and their relationship to those who are sick, he shows the importance offered for reflection and current practice by early Christian thought and experience. After indicating how the Fathers understood the psyche and its relationship with body and spirit, the author gives a detailed analysis of the different causes they attribute to mental illness and the various treatments recommended. At the same time he shows how, relying on fundamental Christian values, they manifest a constant solicitude and respect for the sick, and how they are at pains to integrate them into community life and have them participate in their own healing, foreshadowing in this way the needs and aspirations of our own time. The last part discloses the deep significance of one of the strangest and most fascinating forms of asceticism the Christian East has known: 'folly for the sake of Christ', a madness feigned with the goal of attaining a high degree of humility, but also a way well-suited, through a close experience of their condition, to help those who are often among, today as in the past, the most destitute. Jean-Claude Larchet is docteur dès lettres et sciences humaines, docteur en théologie, and docteur d'État en philosophie. The author of Thérapeutique des maladies spirituelles (Paris: Editions de l'Ancre, 1991) and The Theology of Illness (Crestwood, New York: St Vladimir's Seminary Press, 2002), he is a specialist in questions of health, sickness, and healing. He is today one of the foremost St Maximus the Confessor specialists.
Shock therapy is making a comeback today in the treatment of serious mental illness. Despite its reemergence as a safe and effective psychiatric tool, however, it continues to be shrouded by a longstanding negative public image, not least due to films such as the classic One Flew over the Cuckoo's Nest, where the inmate of a psychiatric clinic (played by Jack Nicholson) is subjected to electro-shock to curb his rebellious behavior. Beyond its vilification in popular culture, the stereotype of convulsive therapy as a dangerous and inhumane practice is fuelled by professional posturing and public misinformation. Electroconvulsive therapy, or ECT, has in the last thirty years been considered a method of last resort in the treatment of debilitating depression, suicidal ideation, and other forms of mental illness. Yet, ironically, its effectiveness in treating these patients would suggest it as a frontline therapy, bringing relief from acute symptoms and saving lives. Shock therapy is making a comeback today in the treatment of serious mental illness. Despite its reemergence as a safe and effective psychiatric tool, however, it continues to be shrouded by a longstanding negative public image, not least due to films such as the classic One Flew over the Cuckoo's Nest, where the inmate of a psychiatric clinic (played by Jack Nicholson) is subjected to electro-shock to curb his rebellious behavior. Beyond its vilification in popular culture, the stereotype of convulsive therapy as a dangerous and inhumane practice is fuelled by professional posturing and public misinformation. Electroconvulsive therapy, or ECT, has in the last thirty years been considered a method of last resort in the treatment of debilitating depression, suicidal ideation, and other forms of mental illness. Yet, ironically, its effectiveness in treating these patients would suggest it as a frontline therapy, bringing relief from acute symptoms and saving lives. -- Provided by publisher.
It is only in the past 20 years that the concept of 'recovery' from mental health has been more widely considered and researched. Before then, it was generally considered that 'stability' was the best that anyone suffering from a mental disorder could hope for. But now it is recognised that, throughout their mental illness, many patients develop new beliefs, feelings, values, attitudes, and ways of dealing with their disorder. The notion of recovery from mental illness is thus rapidly being accepted and is inserting more hope into mainstream psychiatry and other parts of the mental health care system around the world. Yet, in spite of conceptual and other challenges that this notion raises, including a variety of interpretations, there is scarcely any systematic philosophical discussion of it. This book is unique in addressing philosophical issues - including conceptual challenges and opportunities - raised by the notion of recovery of people with mental illness. Such recovery - particularly in relation to serious mental illness such as schizophrenia - is often not about cure and can mean different things to different people. For example, it can mean symptom alleviation, ability to work, or the striving toward mental well-being (with or without symptoms). The book addresses these different meanings and their philosophical grounds, bringing to the fore perspectives of people with mental illness and their families as well as perspectives of philosophers, mental health care providers and researchers, among others. The important new work will contribute to further research, reflective practice and policy making in relation to the recovery of people with mental illness.It is essential reading for philosophers of health, psychiatrists, and other mental care providers, as well as policy makers.
An important and unique survey of the historical background to the descriptive categories of psychopathology.
"Madness" is, of course, personally experienced, but because of its intimate relationship to the sociocultural context, it is also socially constructed, culturally represented and socially controlled--all of which make it a topic rife for sociological analysis. Using a range of historical and contemporary textual material, this work exercises the sociological imagination to explore some of the most perplexing questions in the history of madness, including why some behaviors, thoughts and emotions are labeled mad while others are not; why they are labeled mad in one historical period and not another; why the label of mad is applied to some types of people and not others; by whom the label is applied, and with what consequences.
In 1963, President John F. Kennedy delivered an historic speech on mental illness and retardation. He described sweeping new programs to replace "the shabby treatment of the many millions of the mentally disabled in custodial institutions" with treatment in community mental health centers. This movement, later referred to as "deinstitutionalization," continues to impact mental health care. Though he never publicly acknowledged it, the program was a tribute to Kennedy's sister Rosemary, who was born mildly retarded and developed a schizophrenia-like illness. Terrified she'd become pregnant, Joseph Kennedy arranged for his daughter to receive a lobotomy, which was a disaster and left her severely retarded. Fifty years after Kennedy's speech, E. Fuller Torrey's book provides an inside perspective on the birth of the federal mental health program. On staff at the National Institute of Mental Health when the program was being developed and implemented, Torrey draws on his own first-hand account of the creation and launch of the program, extensive research, one-on-one interviews with people involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation. As such, this book provides historical material previously unavailable to the public. Torrey examines the Kennedys' involvement in the policy, the role of major players, the responsibility of the state versus the federal government in caring for the mentally ill, the political maneuverings required to pass the legislation, and how closing institutions resulted not in better care - as was the aim - but in underfunded programs, neglect, and higher rates of community violence. Many now wonder why public mental illness services are so ineffective. At least one-third of the homeless are seriously mentally ill, jails and prisons are grossly overcrowded, largely because the seriously mentally ill constitute 20 percent of prisoners, and public facilities are overrun by untreated individuals. As Torrey argues, it is imperative to understand how we got here in order to move forward towards providing better care for the most vulnerable.
Prevention of mental illness and mental health promotion have often been ignored in the past, both in undergraduate and postgraduate curricula. Recently, however, there has been a clear shift towards public mental health, as a result of increasing scientific evidence that both these actions have a serious potential to reduce the onset of illness and subsequent burden as a result of mental illness and related social, economic and political costs. A clear distinction between prevention of mental illness and mental health promotion is critical. Selective prevention, both at societal and individual level, is an important way forward. The Oxford Textbook of Public Mental Health brings together the increasing interest in public mental health and the growing emphasis on the prevention of mental ill health and promotion of well-being into a single comprehensive textbook. Comprising international experiences of mental health promotion and mental well-being, chapters are supplemented with practical examples and illustrations to provide the most relevant information succinctly. This book will serve as an essential resource for mental and public health professionals, as well as for commissioners of services, nurses and community health visitors.