Not so long ago, in 1947, psychiatric patients at Philadelphia State Hospital (and elsewhere) straggled, squatted, and sat like wretched zombies, naked in cold and empty wards, despoiled in their own incontinent filth, barely surviving conditions comparable to German concentration camps that America had liberated just two years before. (If you don’t believe this, Google “a mental ward exposed” and see for yourself…)
With the introduction of Thorazine in 1955 and the civil rights litigation in the 1960s, hospitals started to empty. But replacement mental health services in the community still were not present. As a result, tens of thousands of discharged patients went untreated and homeless into the streets. Those who remained in hospitals fared little better… [Read more…]
Healing The Broken Mind: Transforming America’s Failing Mental Health System, by Timothy J. Kelly
Everyone who encounter the public mental health system knows it. The President’s New Freedom Commission (2002), which assessed the public mental health system, declared it. America’s mental health delivery system is in shambles and needs dramatic reform. Of course this begs the question: how to reform it? The answer, unfortunately, has not been easy to find. Many in the field are good as diagnosing the system’s many problems. Few, however, have been good at prescribing a solution. Only work of David Mechanic and the fine book of Richard Frank and Sherry Glied (Better But Not Well) come to mind. [Read more…]
“As a family member navigating the maelstrom of a loved one’s serious mental illness, I have become highly attuned to the deficiencies of the public mental health system. As an older executive from banking, business, and nonprofit management now back in graduate school studying the business, management, and economics of mental health services delivery, I am searching for answers to the groaning social question of our time: how can we improve mental health services delivery?
“In my search for the value concept dialogue in mental health, I came across a collection of essays under the promising title, Outcomes Measurement in the Human Services: Cross-Cutting Issues and Methods in the Era of Health Reform. Edited by Jennifer Magnabosco and Ronald Manderscheid, two giants in the human services field, Outcomes first catalogues “overarching issues and methods””…[Read more]…
Reading a book called The Anatomy of Evil would be a challenge in any normal time. It is especially trying just now in the wake of the Sandy Hook school massacre. But read it we should, so better to think about a critical yet little understood reality that intrudes all too often in the world, as again it did in Newtown. Evil: we must learn to see more clearly what we sadly must sometimes confront.
After the Sandy Hook school massacre, the nation understandably erupted in a hysteric search for answers. A critical impediment is society’s imprecise understanding about distinction among possible causes of such violence. To hear some talking heads… [Read more…]
When individuals thrust into the maelstrom of mental illness, there can never be enough information. A short new book, Defying Mental Illness: Finding Recovery wiht Community Resources and Family Support by Paul Komarek and Andrea Schroer, is thus a welcome addition… [Read more] to the field of resources available for individuals with psychiatric disabilities. Based of their acquaintance of “many people who have made it through the struggle,” the authors wish to offer an introductory set of strength-based strategies to fight isolation, focus on recovery, and keep families together.
As the authors intend, Defying Mental Illness is an introduction to a family’s psychodyssey. It usefully covers the basic topics about types of mental illness and how treatment works. It also touches tactical subjects like finding treatment, paying for mental health care with Medicaid and Medicare, housing, and employment. For more experienced famiies in turbulent psychodyssies, the content may feel a little too introductory, more like a cruise brochure instead of a navigation manual. The section about Medicare and Medicaid, for instance, doesn’t get across the complexity and confusion that securing these important benefits often entails, and references to “SSI” without explanation of Supplemental Support Income might be confusing to the uninitiated.
But we must’t quibble. PsychOdyssey salutes Mr. Komarek and Ms. Schroer with thanks and kindred appreciation for their worthy contribution to helping loved one and their families to navigate their epic recovery journeys.
We haven’t have a chance to read it yet, but PsychOdyssey takes note of an interesting New York Times Book Review (February 2, 2011) of this newly published family account of living with schizophrenia. Anglo-Irish journalist Patrick Cockburn and his son Henry tell the story of Henry’s descent into schizophrenia. [Read more…]
A key facet of the new recovery model is learning to understand the “lived experience” of individuals. This is even truer for understanding individuals who endure the maelstrom of mental illness. We are lucky to have such a one in Will I Ever Be The Same Again, by Carol Kivler, who has experienced severe treatment-resistant clinical depression. When nothing else worked, she reluctantly accepted a medical recommendation that she try electroconvulsive therapy, or ECT, aka shock treatment. Unexpectedly, ECT turned out to be the “silver bullet” that helped her get beyond her maelstrom. Read the entire review here. See all of PsychOdyssey’s book reviews here.
Evidence-Based Mental Health Practices: A Textbook, by Robert E. Drake, Matthew R. Merrens, and David W. Lynde.
All who need to have a fuller understanding of where mental health treatment is heading, and to help overcome the challenges still before it, will do well to read this book. Family members in particular should learn more about the evidence-based practices it describes so better to know about, participate in, and advocate for the improved care of… [read entire review]
Psychiatric Rehabilitation, by Carlos Pratt, et al.: Second Edition
I’m a parent to a young adult son with schizophrenia. Like so many others in my position, I have been navigating the maelstrom of mental disability. Tossing about on such turbulent seas, I have been hankering for a safe harbor of understanding from which I can chart a more productive course. I have found it in Psychiatric Rehabilitation… [read entire review]
Social Work Treatment, 4th Edition, by Francis J. Turner.
Just what is Social Work? Like most everyday people, I only had a vague notion. Social Work is do-good work, helping poor people, working with institutions, etc., etc. A history major, I have an enduring notion in my mind’s eye of the prototypical social worker. He or she is the official greeter at Ellis Island, welcoming huddled masses of wretched immigrants yearning to be free… [read entire review]
The Madness of Mary Lincoln. By Jason Emerson.
Did Abraham Lincoln suffer a mental illness? Well, the death of his first love, Ann Rutledge, may have pushed him for a time to the edge of despondency. But are we to believe that Father Abraham pulled off nothing less than the saving of democracy while also battling a severe mental disorder?… [read entire review]
Redefining Health Care–Creating Value-Based Competition on Results, by Michael E. Porter and Elizabeth Olmsted Treisberg.
As the son of a physician, I have a fondness for all things medical… except the current state of our American health care system! Michael Porter and Elizabeth Treisberg have done the nation an oustanding service to analyze the current mess and propose a meaningful way forward… [read entire review]
Multifamily Groups in the Treatment of Severe Pyschiatric Disorders, by William R. McFarlane.
How can families in the maelstrom regroup, reconnect, and rebuild? How can they best work with their loved ones to stabilize their family circumstances and support the loved one’s recovery? They can engage in a modality called Family Psychoeducation, one of the five established evidence-based psychosocial practices for the treatment of severe mental illness. They can specifically engage in the currently most effective method of Family Psychoeducation, the Multifamily
Group approach as advanced by Dr. William R. McFarlane in his 2002 book Multifamily Groups in the Treatment of Severe Psychiatric Disorders. [Read entire review].
How can family members cope with a loved one lacking insight? How can they get a loved one needed help if the loved one doesn’t acknowledge the need for help? Many family members in the maelstrom know the frustration of getting an oppositional loved one to do what might be good for them, at least as the family members perceive. Those in the earlier stages of their psychodysseys may feel particularly stressed by the apparent futility of talking a loved one out of his delusions or into a treatment for an illness he refuses to believe he has. In his classic work, I’m Not Sick; I Don’t Need Help!, clinical psychologist and Columbia University professor Xavier Amador proposes a simple technique. It is called LEAP, for Listen, Empathize, Agree, and Partner. PsychOdyssey’s review of Amador’s book appears here.
When families must navigate the maelstrom of mental illness, they need so much yet know so little. This is especially true of the world’s most devastating mental illness, schizophrenia. The burdens it imposes on families and society are enormous—to say nothing, of course, on those loved ones whom it afflicts. One of these burdens is acquiring the best information possible in the most expeditious manner from the most authoritative sources amidst the most confounding circumstances. When a family is flailing, there are precious few opportunities to exclaim, “Eureka!” Fortunately, such a chance comes to us (hopefully sooner rather than later in the journey) with E. Fuller Torrey’s definitive Surviving Schizophrenia, a gold mine of useful and sympathetic information for all those who are traumatized by this most tragic, devastating, misunderstood illness. Read PsychOdyssey’s review of this book here.