Better But Not Well: Mental Health Policy in the United States since 1950 / Edition 1

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Overview

The past half-century has been marked by major changes in the treatment of mental illness: important advances in understanding mental illnesses, increases in spending on mental health care and support of people with mental illnesses, and the availability of new medications that are easier for the patient to tolerate. Although these changes have made things better for those who have mental illness, they are not quite enough.

In Better But Not Well, Richard G. Frank and Sherry A. Glied examine the well-being of people with mental illness in the United States over the past fifty years, addressing issues such as economics, treatment, standards of living, rights, and stigma. Marshaling a range of new empirical evidence, they first argue that people with mental illness—severe and persistent disorders as well as less serious mental health conditions—are faring better today than in the past. Improvements have come about for unheralded and unexpected reasons. Rather than being a result of more effective mental health treatments, progress has come from the growth of private health insurance and of mainstream social programs—such as Medicaid, Supplemental Security Income, housing vouchers, and food stamps—and the development of new treatments that are easier for patients to tolerate and for physicians to manage.

The authors remind us that, despite the progress that has been made, this disadvantaged group remains worse off than most others in society. The "mainstreaming" of persons with mental illness has left a policy void, where governmental institutions responsible for meeting the needs of mental health patients lack resources and programmatic authority. To fill this void, Frank and Glied suggest that institutional resources be applied systematically and routinely to examine and address how federal and state programs affect the well-being of people with mental illness.

Johns Hopkins University Press

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Editorial Reviews

International Psychogeriatrics - Burton V. Reifler

Will be of greatest interest to students of mental health economics, services, and policy, but clinicians interested in the relationship between health policy and everyday practice will also find it useful.

Journal of Mental Health - Bonnie Evans

Provides a necessary counterpart to much overenthusiastic optimism surrounding recent development in psychopharmacology and the neurosciences.

History of Psychiatry - Ellen Dwyer

Offers a fascinating... historical analysis of mental health policy.

Psychiatric Services - William Fisher

Should be assigned to every practitioner, mental health clinician, administrator, and advocate — as well as every legislator and policy maker—concerned with the status of Americans with serious mental illness.

Health Affairs - Roger Meyer

If one... has time to read one book on mental health policy this year, this should be the one.

Clergy Journal - Janet R. Nelson

A comprehensive assessment of changes in the life conditions and well-being of persons with serious mental illnesses over the past five decades.

Nursing History Review - Kathleen Brown RN

A well-written and important work that provides a definitive look at the past and a glimpse into the future of mental health policy in America.

Journal of Mental Health
Provides a necessary counterpart to much overenthusiastic optimism surrounding recent development in psychopharmacology and the neurosciences.

— Bonnie Evans

International Psychogeriatrics
Will be of greatest interest to students of mental health economics, services, and policy, but clinicians interested in the relationship between health policy and everyday practice will also find it useful.

— Burton V. Reifler

History of Psychiatry
Offers a fascinating... historical analysis of mental health policy.

— Ellen Dwyer

Psychiatric Services
Should be assigned to every practitioner, mental health clinician, administrator, and advocate — as well as every legislator and policy maker—concerned with the status of Americans with serious mental illness.

— William Fisher

New England Journal of Medicine
Offers many insights beneficial to the informed reader.

— David Mechanic

JAMA

The authors are true to their word in providing an excellent overview of changes in the last 50 years. They provide compelling evidence that the condition of many, if not most, persons with mental illness has improved during that period.

New England Journal of Medicine - David Mechanic

Offers many insights beneficial to the informed reader.

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Product Details

  • ISBN-13: 9780801884436
  • Publisher: Hopkins Fulfillment Service
  • Publication date: 7/28/2006
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 206
  • Sales rank: 1,175,423
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.47 (d)

Meet the Author

Richard G. Frank is the Morris Professor of Health Economics at Harvard University Medical School and a research associate at the National Bureau of Economic Research. Sherry A. Glied is a professor in and chair of the Department of Health Policy and Management at the Mailman School of Public Health, Columbia University.

Johns Hopkins University Press

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Table of Contents

1 Introduction 1
2 The population with mental illness 8
3 The evolving technology of mental health care 26
4 Health care financing and income support 48
5 The supply of mental health services 70
6 Policy making in mental health : integration, mainstreaming, and shifting institutions 91
7 Assessing the well-being of people with mental illness 104
8 Looking forward : improving the well-being of people with mental illness 140
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