David Mechanic, Ph.D. is the René Dubos University Professor of Behavioral Sciences and Director of the Institute for Health, Health Care Policy, and Aging Research at Rutgers University. He holds faculty appointments in the School of Social Work and in the departments of sociology, psychology and psychiatry. Over the past 50 years he has taught undergraduate, graduate and postdoctoral students about mental health policy issues and carried out numerous research studies on mental health issues. He also has served on many national and international policy committees on issues covered in this book. Elected to the National Academy of Sciences, the American Academy of Arts of Sciences and the Institute of Medicine Mechanic also received many awards including the Rhoda and Bernard Sarnat International Prize in Mental Health from the Institute of Medicine, the Benjamin Rush Award from the American Psychiatric Association, the Distinguished Career Award for the Practice of Sociology from the American Sociological Association, and two major mental health awards from the American Public Health Association. Among his many government assignments, he was coordinator of the Panel on Problems, Scope and Boundaries of the President’s Commission on Mental Health
Donna D. McAlpine, PhD., is an Associate Professor of Public Health in the Division of Health Services Research & Policy at the University of Minnesota where she is the director of the MPH program in Public Health Administration and Policy. She received her doctorate in sociology from Rutgers University with a focus on medical sociology. She teaches graduate courses in community mental health and medical sociology. Her research focuses on patterns of treatment for persons with mental health and substance use problems, race and ethnic disparities in health, and survey methods. Over the past several years she has also been actively involved in partnering with community agencies in building capacity to do community-based participatory research
David A. Rochefort, Ph.D., is Arts and Sciences Distinguished Professor of Political Science at Northeastern University where he teaches courses on U.S. Health and Welfare Policy, Public Policy Analysis, Political Language, and Quantitative Techniques. At Northeastern, he has received both the Excellence-in-Teaching Award and the Practice-Oriented Education Award. In addition, he was Beverly Visiting professor, The Clarke Institute of Psychiatry, University of Toronto, and Fulbright Scholar at the University of Montreal. In 1986-87, he was an NIMH postdoctoral fellow in the Rutgers-Princeton Program in Mental Health Research. Rochefort’s previous publications on mental health include From Poorhouses to Homeless: Policy Analysis and Mental Health Care, 2nd ed. (1997) and editor of Handbook on Mental Health Policy in the United States (1989). He has served as consultant to the Rhode Island Department of Health, New Jersey Department of Human Services, Human Services Research Institute, Regional Office of Inspector General-U.S. Department of Health and Human Services, and other groups. He was also the recipient of the President’s Outstanding Service Award, Mental Health Association of Rhode Island
In this Section:
1. Brief Table of Contents
2. Full Table of Contents
Brief Table of Contents
Chapter 1: Mental Health and Illness as Social Issues
Chapter 2: What Is Mental Illness?
Chapter 3: Psychiatric Epidemiology: Science, Counting, and Making Sense of the Numbers
Chapter 4: The Causes of Mental Illness and Methods of Intervention
Chapter 5: Illness Behavior, the Entrance of Patients into Care, and Patterns of Service Utilization
Chapter 6: The Financing Delivery of Mental Health Services
Chapter 7: Managed Mental Health Care
Chapter 8: Dilemmas of Professional Practice
Chapter 9: A Brief History of Mental Health Policy in the United States
Chapter 10: Building an Effective Community Service System: Knowledge, Aspirations, and Social Policy
Chapter 11: Mental Illness, the Community, and the Law
Chapter 12: Mental Health Policy Analysis
Full Table of Contents
Chapter 1: Mental Health and Illness as Social Issues
The Consequences of Mental Illness
Consequences of Behavior Disorders in Childhood
Societal Burdens and Policy Dilemmas
Chapter 2: What Is Mental Illness?
The Classification of Mental Disorder
Contested Categories of Disorder
The Development of DSM-5
Schizophrenia: An Example in Psychiatric Conceptualization
Is Mental Illness a Social Judgment or a Disease?
Development Models
Conceptualizing Mental Health
Culture and the Definition of Mental Disorder
The Social Policy Connection
The Patient and Society: An Insoluble Dilemma
Chapter 3: Psychiatric Epidemiology: Science, Counting, and Making Sense of the Numbers
Development of Psychiatric Epidemiology
Analytical Quandaries
Continued Use of Symptom Indexes
Special Populations
Race, Ethnicity, and Culture
Toward a Fourth Generation of Research
Chapter 4: The Causes of Mental Illness and Methods of Intervention
Genes, Environment, and the Brain
The Psychosocial-Development Perspective
The Social-Stress Perspective
Inequality and Risk of Mental Disorders
Psychotherapeutic Approaches
Medication
Other Somatic Treatments
A Note on the Labeling Perspective
Chapter 5: Illness Behavior, the Entrance of Patients into Care, and Patterns of Service Utilization
Patterns of Service Use
Illness Behavior and Selection into Care
Special Populations
Race and Ethnicity
Primary Medical Care and the Promise of Integration
Conclusions
Chapter 6: The Financing Delivery of Mental Health Services
Mental Health Expenditures and Coverage
The Parity Struggle and Its Accomplishments
Payment Changes and Professional and Clinical Responses
Utilization of Services and Financing Patterns
The Economics of Mental Health Care
Psychiatric Care Under Prepayment Plans
The Structure of Insurance and Needed Mental Health Benefits
Impact of the Affordable Care Act
Chapter 7: Managed Mental Health Care
Basic Mechanisms of Managed Care
Types of Managed Care Organizations
Managed Care for Persons with Mental Illness
Opportunities and Special Problems in Managed Mental Health Care
Managed Care Performance
The Regulatory Debate in Managed Care
Chapter 8: Dilemmas of Professional Practice
Mental Health Professions and Their Work Patterns
Trust and the Mental Health Profession
Social Influences on Psychiatric Judgment
Personal and Social Biographies
The Sociocultural Context
Constraints of Practice Organization and Settings
Conclusion
Chapter 9: A Brief History of Mental Health Policy in the United States
A Century of State Hospital Care
The Shift to Community Care
More Attempts at National Policy Reform
Deinstitutionalization: A Deeper Look
Conclusion
Chapter 10: Building an Effective Community Service System: Knowledge, Aspirations, and Social Policy
Assessing Institutional and Community Environments
Mental Illness, Homelessness and Housing
Innovations in Employment
Ongoing Reform of Medicaid
The Role of Disability Programs
Redesigning Community Care Programs
Issues Concerning Case Management
Approaches to Integrating Services
Recognizing the Role of Families
Mental Health Policy and the Contemporary Era
Chapter 11: Mental Illness, the Community, and the Law
Involuntary Hospitalization
Psychiatric Advance Directives
Outpatient Commitment and Mental Health Courts
Criminalization of Persons with Mental Illness
A Note on Dangerousness and the Relationship between Mental Illness and Violence
The Right to Treatment
The Right to Treatment under the Americans with Disabilities Act and the Supreme Court Decision in Olmstead v. L.C.
Right to Treatment for Children under Medicaid
Right to Refuse Treatment
The Social Context of Legal Reform in Mental Health
Chapter 12: Mental Health Policy Analysis
Characteristics of the Mental Health Policy Domain
Five Approaches to Mental Health Policy Analysis
Conclusion
References
Name Index
Subject Index
