An Assessment Of The Community Mental Health Movement

Examining the issues of treatment, organizational planning, and research, this multidimensional study offers a critique of both the theoretical and programmatic aspects of providing mental health services to traditionally underserved populations. Focusing on minority groups, the book uses the case of Hispanics to illustrate the largely unaddressed need for services that are relevant to social groups with diverse cultural and linguistic backgrounds. Vega and Murphy maintain that the present service system is socially insensitive, that mental health services in the United States were never designed to serve a multicultural population, and that, in general, those who dominate the current mental health system from administrator-clinicians to bureaucrats and politicians do not know how to direct their services to minority groups. Calling for fundamental reconceptualization and change, the book argues for community-based planning and intervention as an enlightened and necessary alternative, and provides a detailed description of such a program in terms of both philosophy and method. The eight chapters offer a reassessment based on understanding not only the rationale for these necessary services, but also the important philosophical and pragmatic issues that have resulted in the current, inadequate system; they provide the new thinking necessary to reframe the objectives of mental health services for cultural minorities. The early chapters explore some of the critical junctures in the community mental health movement between 1946 and 1981, the development of theory in the movement's early days, and the thrust of community-based intervention--the culture-specific methodology that has not been well-understood or implemented. Chapters 4 and 5 focus on the relationship between medicalization and the degradation of culture and on the reconceptualization of knowledge, order, illness, and intervention. The last three chapters analyze an example of community-based intervention in operation, and citizen involvement and the political aspects of community-based policies are reviewed. This timely discussion of the requirements for a socially responsible and community-based services delivery program lays the theoretical foundation for a future public mental health system. As such, it will prove invaluable and important reading for advanced undergraduate and graduate students in the health and human services areas, including social work, clinical psychology, and medical sociology; it also has much to offer professional administrators and planners. Culture and the Restructuring of Community Mental Health has been designed to meet the needs of both academics and practitioners.

There are wide inconsistencies between, and even within, countries in how community-orientated care is defined and interpreted. The analysis presented in this book take as a starting point an evidence-based balanced care model in which services are provided in community settings close to the populations served, with hospital stays being reduced as far as possible, usually located in acute wards in general hospitals. The surprising conclusion from the research is that the same problems arise in all countries, regardless of resource status, and thus the recommendations of this book apply to mental health provision everywhere. This book reviews the implementation of community-orientated care using the balanced care model. It summarizes the steps, obstacles and mistakes that have been encountered in the implementation of community mental health care worldwide and presents guidelines on how to avoid them. It proposes realistic and achievable recommendations for the development and implementation of community-orientated mental health care over the next ten years. These guidelines will be of practical use to psychiatrists and other mental health and public health practitioners at all levels worldwide, including policy makers, commissioners, funders, non-governmental organisations, service users and carers. A core message of the book is that the mental health sector will more powerfully advocate for better services in future through strong and unified alliances, especially with powerful representation from consumer/service user and carer groups. Community-orientated care draws on a wide range of practitioners, providers, care and support systems (both professional and non-professional), though particular components may play a larger or lesser role in different settings depending on the local context and the available resources, especially trained staff. Research by a WPA task force has demonstrated that most of the challenges are common and global, but with local variations. The book is therefore relevant to psychiatrists and mental health workers in developed countries who are trying to deliver better health care on reduced budgets and for those in the developing economies who are in the position to modernise their mental health care. It provides clear, concise guidance on policy and practice decisions, learning from what has and has not worked in regions in the world. The book contains many tables documenting the evidence, supported by an essential reference list, and a Key Points summary for each chapter. Highly Commended in the Psychiatry section of the 2012 BMA Book Awards.

The newest edition of Community Mental Health continues to be at the leading edge of the field, providing the most up-to-date research and treatment models that encompass practice in community settings. Experts from a wide range of fields explore the major trends, best practices, and policy issues shaping community mental health services today. New sections address the role of spirituality, veterans and the military, family treatment, and emerging new movements. An expanded view of recovery ensures that a thorough conversation about intersectionality and identity runs throughout the book.

The first edition of Community Mental Health quickly established itself as one of the most comprehensive and timely books about mental health practice in community settings. Readers will find that this new edition is also on the leading edge of the field, providing the most up-to-date research and treatment models in the field. Experts from a wide range of professions – social work, nursing, psychology, psychiatry, public health, sociology, and law – explore the major trends, best practices, and policy issues shaping community mental health services today. Coverage of each topic shifts the focus from management to recovery in the treatment of chronically mentally ill patients. Coverage of organizational and policy issues gives students a head start on mastering the overarching factors that shape their field. This book offers the greatest breadth of coverage available, including hot-button topics like the following: evidence-based treatments neuropsychiatric perspectives Diversity Substance abuse New chapters cover a variety of special populations, which ensures students are prepared to work with a wide range of issues, including: returning veterans military families and families of the mentally ill people affected by the "Great Recession" teenagers children the homeless Students preparing to become mental health professionals, practitioners in community mental health settings, and policy planners and advocates engaged in the evaluation and development of programs in the human services will find this text to be an invaluable resource in their training and work. A collection of supplemental resources are available online to benefit both instructors and students. Instructors will find PowerPoint slides and test banks to aid in conducting their courses, and students can access a library of helpful learning activities, suggested readings and resources, and a glossary of important terms. These materials can be accessed at http://www.routledgementalhealth.com/cw/rosenberg.

Landmark events, such as the 50th anniversary of the Eisenhower Commission Report and the same anniversary of the Community Mental Health Act, helped launch the community mental health movement. The Rehabilitation Act of 1973 and the President's New Freedom Commission have continued this work by establishing funding sources and highlighting the importance of recovery and excellence in care. Modern Community Mental Health: An Interdisciplinary Approach integrates each of the key concepts contained within the presidential reports and landmark legislation into the context of today's community service delivery system. This pathfinding textbook promises to revolutionize community mental health training by responding to the realities of modern health care delivery systems, presenting an integrated, interdisciplinary paradigm of care. Extraordinarily broad in coverage, it will open a door of possibilities to those caring for the mentally ill in the community. Recognizing that community-based services must be truly collaborative in order to be effective and efficient, the editors have assembled a cast of contributors from among the brightest lights in community practice. Chapter authors, who are currently doing interdisciplinary work successfully on a daily basis, will collaborate on writing teams to offer their insight into the problems and triumphs that are part of this approach. They will cover not only macro issues such as the economics of behavioral healthcare, reimbursement models, and quality improvement, but the specific skills necessary for competent practice such as treatment planning, clinical documentation, risk management, and partnering with members of a team that may include social workers, psychiatrists, psychologists, and nurses. Twenty additional chapters will provide detailed roadmaps to practices and programs that have been shown to be effective when delivered in a community setting--such as supported employment, assertive community treatment (ACT) teams, crisis intervention training (CIT), family psychoeducation, and supported housing--and will be grounded in educational benchmarks, healthcare reform opportunities, and cultural competencies. By definition community mental health practice is never static. As communities change, the profession changes, and in recent years changes in funding have drastically impacted the system of care. We need empirically supported interventions, to include the voice of the consumers and their families, and have a way to educate current and future professionals so that we all truly work together.