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This 1856 work, advocating the abolition of mechanical restraints in treating mentally ill patients, is a key text of asylum reform.
An urgent exposéf the mental health crisis in our courts, jails, and prisons America has made mental illness a crime. Jails in New York, Los Angeles, and Chicago each house more people with mental illnesses than any hospital. As many as half of all people in America's jails and prisons have a psychiatric disorder. One in four fatal police shootings involves a person with such disorders. In this revelatory book, journalist Alisa Roth goes deep inside the criminal justice system to show how and why it has become a warehouse where inmates are denied proper treatment, abused, and punished in ways that make them sicker. Through intimate stories of people in the system and those trying to fix it, Roth reveals the hidden forces behind this crisis and suggests how a fairer and more humane approach might look. Insane is a galvanizing wake-up call for criminal justice reformers and anyone concerned about the plight of our most vulnerable.
"In this in-depth critique of the mental healthcare system, a leading advocate for the mentally ill argues that the system fails to adequately treat the most seriously ill. He proposes major reforms to bring help to schizophrenics, the severely bipolar, and others"--
It has been said that how a society treats its least well-off members speaks volumes about its humanity. If so, our treatment of the mentally ill suggests that American society is inhumane: swinging between overintervention and utter neglect, we sometimes force extreme treatments on those who do not want them, and at other times discharge mentally ill patients who do want treatment without providing adequate resources for their care in the community. Focusing on overinterventionist approaches, Refusing Care explores when, if ever, the mentally ill should be treated against their will. Basing her analysis on case and empirical studies, Elyn R. Saks explores dilemmas raised by forced treatment in three contexts—civil commitment (forced hospitalization for noncriminals), medication, and seclusion and restraints. Saks argues that the best way to solve each of these dilemmas is, paradoxically, to be both more protective of individual autonomy and more paternalistic than current law calls for. For instance, while Saks advocates relaxing the standards for first commitment after a psychotic episode, she also would prohibit extreme mechanical restraints (such as tying someone spread-eagled to a bed). Finally, because of the often extreme prejudice against the mentally ill in American society, Saks proposes standards that, as much as possible, should apply equally to non-mentally ill and mentally ill people alike. Mental health professionals, lawyers, disability rights activists, and anyone who wants to learn more about the way the mentally ill are treated—and ought to be treated—in the United States should read Refusing Care.
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In the mid-1800s, a utopian movement to rehabilitate the insane resulted in a wave of publicly funded asylums—many of which became unexpected centers of cultural activity. Housed in magnificent structures with lush grounds, patients participated in theatrical programs, debating societies, literary journals, schools, and religious services. Theaters of Madness explores both the culture these rich offerings fomented and the asylum’s place in the fabric of nineteenth-century life, reanimating a time when the treatment of the insane was a central topic in debates over democracy, freedom, and modernity. Benjamin Reiss explores the creative lives of patients and the cultural demands of their doctors. Their frequently clashing views turned practically all of American culture—from blackface minstrel shows to the works of William Shakespeare—into a battlefield in the war on insanity. Reiss also shows how asylums touched the lives and shaped the writing of key figures, such as Emerson and Poe, who viewed the system alternately as the fulfillment of a democratic ideal and as a kind of medical enslavement. Without neglecting this troubling contradiction, Theaters of Madness prompts us to reflect on what our society can learn from a generation that urgently and creatively tried to solve the problem of mental illness.
Its landscaped ground, chosen by Frederick Law Olmsted and dotted with Tudor mansions, could belong to a New England prep school. There are no fences, no guards, no locked gates. But McLean Hospital is a mental institution-one of the most famous, most elite, and once most luxurious in America. McLean "alumni" include Olmsted himself, Robert Lowell, Sylvia Plath, James Taylor and Ray Charles, as well as (more secretly) other notables from among the rich and famous. In its "golden age," McLean provided as genteel an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean-despite its affiliation with Harvard University-is struggling to stay afloat. Gracefully Insane, by Boston Globe columnist Alex Beam, is a fascinating and emotional biography of McLean Hospital from its founding in 1817 through today. It is filled with stories about patients and doctors: the Ralph Waldo Emerson prot'g' whose brilliance disappeared along with his madness; Anne Sexton's poetry seminar, and many more. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness, of approaches to treatment, and of the economic pressures that are making McLean-and other institutions like it-relics of a bygone age. This is a compelling and often oddly poignant reading for fans of books like Plath's The Bell Jar and Susanna Kaysen's Girl, Interrupted (both inspired by their author's stays at McLean) and for anyone interested in the history of medicine or psychotherapy, or the social history of New England.
Throughout most of history, in China the insane were kept within the home and treated by healers who claimed no specialized knowledge of their condition. In the first decade of the twentieth century, however, psychiatric ideas and institutions began to influence longstanding beliefs about the proper treatment for the mentally ill. In The Invention of Madness, Emily Baum traces a genealogy of insanity from the turn of the century to the onset of war with Japan in 1937, revealing the complex and convoluted ways in which “madness” was transformed in the Chinese imagination into “mental illness.” ​ Focusing on typically marginalized historical actors, including municipal functionaries and the urban poor, The Invention of Madness shifts our attention from the elite desire for modern medical care to the ways in which psychiatric discourses were implemented and redeployed in the midst of everyday life. New meanings and practices of madness, Baum argues, were not just imposed on the Beijing public but continuously invented by a range of people in ways that reflected their own needs and interests. Exhaustively researched and theoretically informed, The Invention of Madness is an innovative contribution to medical history, urban studies, and the social history of twentieth-century China.
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.
This lecture delivered in 1838 promotes a more humane and compassionate approach to the treatment of the mentally ill in asylums. It is a fascinating historical document that sheds light on the early efforts to reform institutional care. This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.