Classics of Community Psychiatry: Fifty Years of Public Mental Health Outside the Hospital

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The massive depopulation of state mental hospitals in the 1950s (known as "deinstitutionalization") posed special challenges to mental health consumers in need of intensive psychiatric treatment. No longer confined to long-term inpatient psychiatric wards, consumers were thrust into nursing homes, assisted living centers, and onto the streets. Psychiatric treatment was relocated to the community, and the concept of recovery took on a new meaning.

Classics in Community Psychiatry is the first volume to examine the course of the community psychiatry movement over the past fifty years. Starting with deinstitutionalization, the editors chart the progress and setbacks of the movement by presenting carefully selected primary source material from the realms of academia, politics, and even literature. For example, a classic journal article explores the relationship between social class and mental health, while excerpts from government documents describe mental health legislation. A novel demonstrates social attitudes toward the mentally ill, while a report from a federally funded task force discusses homelessness and severe mental illness. Each selection pinpoints a specific issue and moment of time during the history of mental health services over the past five decades, and is accompanied by insightful commentary from the volume's editors. The result is a unique, innovatively conceived book that incorporates many different viewpoints to illustrate the evolution of community psychiatry, as well as the need to devote more resources and planning to mental health services looking ahead. Classic in Community Psychiatry will be a valuable resource for mental health professionals, including psychiatrists, psychologists, social workers, administrators, and policymakers, and for graduate and undergraduate students in community psychology and psychiatry.

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Editorial Reviews

Doody's Review Service
Reviewer: Brett C. Plyler, M.D.(Northwestern Memorial Hospital)
Description: This book collects 45 classics of mental health from the inception of asylums to present day. Each classic represents a perspective on mental healthcare from the whole of range of participants involved in it — patients, caregivers, government employees, and more.
Purpose: The purpose in presenting these classics is to promote an understanding of the development of mental institutions, their subsequent demise, and the progression to the current community mental healthcare model.
Audience: The book is written for anyone interested in the history of mental healthcare in the U.S., whether they are patients, practitioners, family members, or even policymakers.
Features: Four different eras are presented: precommunity psychiatry (1850-1953), deinstitutionalization and community mental health center movement (1954-76), the community support movement and its demise (1977-97), and the recovery era (1998-present). Each section is prefaced by an introduction explaining the political and sociocultural factors that contributed to that era. In each section are the classics which are also introduced by an editorial. The classics range from legislative and policy (e.g., the 1961 Joint Commission report on mental illness) to literary (McDiarmid, "Scrambled Eggs for Brains," Psychiatric Services, April 2005) to clinical (Brenner's Mental Illness and the Economy (iUniverse, 1999) and practice/research (Drake et al., "Implementing Evidence-Based Practices in Routine Mental Health Service Settings," Psychiatric Services, February 2001). It concludes with the authors' thoughts about community psychiatry and the future.
Assessment: For anyone interested in the history of mental healthcare in the U.S., this is a fascinating book. It takes readers through the rise of institutionalization and asylums to their demise and the movement of reintroducing the mentally ill as members of society. The classics are well chosen and interesting to read, and they provide real insight into the mindset of the people involved in mental healthcare of their particular time period. The editorials are thoughtful and concise. This book gives readers a new appreciation of community mental healthcare and I would highly recommend it.
From the Publisher
"For anyone interested in the history of mental healthcare in the U.S., this is a fascinating book. It takes readers through the rise of institutionalization and asylums to their demise and the movement of reintroducing the mentally ill as members of society. The classics are well chosen and interesting to read, and they provide real insight into the mindset of the people involved in mental healthcare of their particular time period. The editorials are thoughtful and concise. This book gives readers a new appreciation of community mental healthcare and I would highly recommend it." —Doody's

"In addition to overview essays dealing with each of the eras, each account has a detailed introduction that provides background. The result is a thoughtfully bundled professional reader that also could serve as an excellent classroom text." — Health Affairs

"This is a fascinating and illuminating collection of writings that will be a nostalgic reminder of developments in the field for those who have devoted their careers to community psychiatry and a mine of valuable information for those who are just entering it...There is something to interest everyone in this fascinating collection." — The American Journal of Psychiatry

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Product Details

  • ISBN-13: 9780195326048
  • Publisher: Oxford University Press
  • Publication date: 4/26/2011
  • Pages: 648
  • Product dimensions: 7.40 (w) x 10.10 (h) x 1.60 (d)

Meet the Author

Michael Rowe, Associate Clinical Professor, Yale School of Medicine, Department of Psychiatry, Co-Director, Yale Program for Recovery and Community Health

Ken Thompson, Medical Director, federal Center for Mental Health Services, Substance Abuse and Mental Health Services Administration; Associate Professor, Department of Psychiatry, University of Pittsburgh Medical School

Martha Lawless, Program for Recovery & Community Health, Department of Psychiatry, Yale School of Medicine

Larry Davidson, Professor, Yale School of Medicine, Department of Psychiatry and Director, Yale Program for Recovery and Community Health

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Table of Contents

Foreword: Kathryn Power, Director, Center for Mental Health Services
Preface: Michael Rowe
Introduction: Richard Freeman and Michael Rowe

The Pre-Community Psychiatry Period (1850-1953): Francesca Martin and Elizabeth H. Flanagan

Deinstitutionalization and the Community Mental Health Center Movement (1954-1976): Rebecca Miller, Allison N. Ponce, and Kenneth S. Thompson

Government, Legislative, and Policy Classics
1. Joint Commission on Mental Illness and Health. (1961). Recommendations for a national mental health program. In Action for Mental Health: Final Report of the Joint Commission on Mental illness and Health. New York: Basic Books

First Person and Literary Classics
2. Greenberg, J. (1964). I never promised you a rose garden. New York: New American Library

Clinical and Systems Theory, Conceptual, and Historical Texts
3. Grob, G. N. (1991). From asylum to community: mental health policy in modern America. Princeton: Princeton University Press
4. Bockoven, J. S. (1956). Moral treatment in American psychiatry. Journal of Nervous and Mental Diseases, 124, 167-194, 292-321
5. Szasz, T. S. (1961). The myth of mental illness: Foundations of a theory of personal conduct. New York: Hoeber-Harper
6. Goffman, E. (1961). Asylums: Essays on the social situation of mental patients and other inmates. New York: Anchor Books
7. Brenner, M. H. (1973). Mental illness and the economy. Cambridge, MA: Harvard University Press
8. Scull, A. T. (1976). The decarceration of the mentally ill: A critical view. Politics and Society, 6: 173-212

Practice and Research Texts
9. Hollingshead, A. B., & Redlich, F. C. (1958). Social class and mental illness: A community study. New York: John Wiley & Sons Inc.: New York
10. Leighton, A. H., Lambo, T. A., Hughes, C. C., Leighton, D. C., Murphy, J. M., & Macklin, D. B. (1963). Psychiatric disorder in West Africa. American Journal of Psychiatry, 120, 521-527
11. Caplan, G. (1964). Principles of preventive psychiatry. New York: Basic Books
12. Fairweather, G. W., Sanders, D. J., Maynard, H., Cressler, D. L. with Bleck, D. S. (1969). Community life for the mentally ill: An alternative to institutional care. Chicago: Aldine Publishing Company
13. Lamb, H. R., & Goertzel, V. (1971). Discharged mental patients-Are they really in the community? Archives of General Psychiatry, 24, 29-34
14. Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26 (2), 57-63
15. Rosenhan, D. L. (1973). On being sane in insane places.Science, 179, 250-258
16. Stein, L. I., Test, M. A., and Marx, A. J. (1975). Alternative to the hospital: A controlled study. American Journal of Psychiatry, 132, 517-522

The Community Support Movement and its Demise (1977-1997): Larry Davidson and Priscilla Ridgway

Government, Legislative, and Policy Classics
17. U.S. Government Accountability Office. (1977). Returning the mentally disabled to the community: Government needs to do more. Washington, D.C.: Author. GAO Publication No. HRD-76-152
18. Sharfstein, S. S. (1982). Medicaid cutbacks and block grants: Crisis or opportunity for community mental health? American Journal of Psychiatry, 139 (4), 466-470

First Person and Literary Classics
19. Chamberlin, J. (1978). On our own: Patient-controlled alternatives to the mental health system. New York: Hawthorn Books
20. Leete, E. (1989). How I perceive and manage my illness. Schizophrenia Bulletin, 15 (2), 197-200

Clinical and Systems Theory, Conceptual, and Historical Texts
21. Gronfein, W. (1985). Psychotropic drugs and the origin of deinstitutionalization. Social Problems, 32 (5), 437-454
22. Goldman, H. H., & Morrissey, J. P. (1985). The alchemy of mental health policy: Homelessness and the fourth cycle of reform. American Journal of Public Health, 75 (7), 727-731
23. Estroff, S. E. (1985). Medicalizing the margins: On being disgraced, disordered, and deserving. Psychosocial Rehabilitation Journal, 8 (4), 34-38
24. Anthony, W. A., and Liberman, R. P. (1986). The practice of psychiatric rehabilitation: Historical, conceptual, and research base. Schizophrenia Bulletin, 12 (4), 542-559
25. Scheper-Hughes, N., and Lovell, A. M. (1986). Breaking the circuit of social control: Lessons in public psychiatry from Italy and Franco Basaglia. Social Science and Medicine, 23 (2), 159-178
26. Mechanic, D., and Aiken, L. H. (1989). Improving the care of patients with chronic mental illness. New England Journal of Medicine, 317 (26), 1634-1638
27. Bachrach, L. L. (1988). Defi ning chronic mental illness: A concept paper. Hospital and Community Psychiatry, 39 (4), 383-388
28. Wing, J. K. (1990). The functions of asylum. British Journal of Psychiatry, 157, 822-827

Practice and Research Texts
29. Estroff, S. E. (1981). Making it crazy: An ethnography of psychiatric patients in an American community. Berkeley: University of California Press
30. Strauss, J. S., Hafez, H., Lieberman, P., and Harding, C. (1985). The course of psychiatric disorder III: Longitudinal principles. American Journal of Psychiatry, 142 (3), 289-296
31. Harding, C. M., Brooks, G. W., Ashikaga, T., Strauss, J. S., & Brier, A. (1987). The Vermont longitudinal study of persons with severe mental illness, II: Long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. American Journal of Psychiatry, 144, 727-735
32. Lefl ey, H. P., & Bestman, E. W. (1991). Public-academic linkages for culturally sensitive community mental health. Community Mental Health Journal, 27 (6), 473-488
33. Davidson, L., Hoge, M. A., Merrill, M. E., Rakfeldt, J., & Griffith, E. E. H. (1995). The experience of long-stay inpatients returning to the community. Psychiatry, 58, 122-132
34. Hopper, K., Jost, J., Hay, T., Welber, S., & Haugland, G. (1997). Homelessness, severe mental illness, and the institutional circuit. Psychiatric Services, 48 (4), 659-665

The Recovery Era (1998-present): Martha Staeheli Lawless and Michael Rowe

Government, Legislative, and Policy Classics
35. Talbott, J. A., & Lamb, H. R. Introduction and recommendations. In H. Richard Lamb, ed. (1984). The homeless mentally ill: A task force report of the American Psychiatric Association. Washington, D.C.: American Psychiatric Association, 1-10
36. National Association of State Mental Health Program Directors.(2006). Morbidity and mortality in people with serious mental illness. Alexandria, VA: NASMHPD

First Person and Literary Classics
37. McDiarmid, J. S. (2005). Scrambled eggs for brains. Psychiatric Services, 56 (1), 34
38. Weiner, S. (2007). A Socialist youth: An adult needing the welfare state. The Suspicious Humanist, 2/10/07

Clinical and Systems Theory, Conceptual, and Historical Texts
39. Rosenheck, R. (2000). The delivery of mental health services in the 21st century: Bringing the community back in. Community Mental Health Journal, 36 (1), 107-124
40. Thornicroft, G. & Tansella, M. (2004). Components of a modern mental health service: A pragmatic balance of community and hospital care. British Journal of Psychiatry, 185, 283-290
41. Frank, R. B., & Glied, S. A. (2006). Better but not well: Mental health policy in the United States since 1950. Baltimore: Johns Hopkins University Press
42. Hopper, K. (2007). Rethinking social recovery in schizophrenia: What a capabilities approach might offer. Social Science and Medicine, 65(5), 868-879
43. Andreasen, N. C. (2007). DSM and the death of phenomenology in America: An example of unintended consequences.Schizophrenia Bulletin, 33 (1), 108-112

Practice and Research Texts
44. Mosher, L. R. (1999). Soteria and other alternatives to acute psychiatric hospitalization: A personal and professional review. Journal of Nervous and Mental Diseases, 187 (3), 142-149
45. Drake, R. E., Goldman, H. H., Leff, H. S., Lehman, A. F., Dixon, L., Mueser, K. T., & Torrey, W. C. (2001). Implementing evidence-based practices in routine mental health settings. Psychiatric Services, 52 (2), 179-182

Conclusion: Community psychiatry and the Future: Michael Rowe and Kenneth S. Thompson

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