Mental Health and Social Policy Beyond Managed Care

The most authoritative evidence-based approach to mental health policy and design.

Rooted in research findings that support an evidence-based orientation to treatment and recovery, the sixth edition of Mental Health and Social Policy takes a multidisciplinary approach to mental health and social policy. It examines the nature, origins, distribution, and consequences of disorders, while detailing information on the services, programs, and social policies that have been developed to assist people with mental health problems.

Learning Goals

Upon completing this book, readers will be able to:

• Understand the nature, origins, distribution and consequences of mental disorders.
• Examine the services, programs, and social policies developed to assist people with mental health problems.

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, 2^nd 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

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