This handbook is the definitive resource for understanding current mental health policy controversies, options, and implementation strategies. It offers a thorough review of major issues in mental health policy to inform the policy-making process, presenting the pros and cons of controversial, significant issues through close analyses of data. Some of the topics covered are the effectiveness of various biomedical and psychosocial interventions, the role of mental illness in violence, and the effectiveness of coercive strategies. The handbook presents cases for conditions in which specialized mental health services are needed and those in which it might be better to deliver mental health treatment in mainstream health and social services settings. It also examines the balance between federal, state, and local authority, and the financing models for delivery of efficient and effective mental health services. It is aimed for an audience of policy-makers, researchers, and informed citizens that can contribute to future policy deliberations.
Intro; Preface; Contents; Contributors; List of Figures; List of Tables; Part I Foundations of American Mental Health Policy; 1 Mental Health Policy: Fundamental Reform or Incremental Change?; 1.1 Introduction; 1.2 Cycles of Reform; 1.3 Is It Fundamental Reform or a Sequence of Incremental Changes?; 1.3.1 Sequentialism and the Story of the National Plan for the Chronically Mentally Ill; 1.3.2 Behavioral Health Insurance Parity: Sequentialism Exemplified, Again; 1.3.3 What Is on the Policy Horizon in Terms of Fundamental Reform and Incremental Change?; 1.4 Conclusion; References
2 Division of Labor: Function Shifts and Realigned Responsibilities in the Evolving Mental Health Services System2.1 Introduction; 2.2 Multiple Functions of State Mental Hospitals; 2.3 Community Mental Health and Deinstitutionalization; 2.4 Mainstream Health and Social Disability Insurance Programs; 2.5 Challenges of Mental Health Fragmentation; 2.5.1 Assertive Community Treatment; 2.5.2 Local Mental Health Authorities; 2.5.3 Managed Behavioral Health Care; 2.6 Newer Service Integration Initiatives: Collaborative Care, Medical Homes, and Medicaid Health Homes; 2.6.1 Collaborative Care
2.6.2 Medical Homes2.6.3 Medicaid Health Homes; 2.7 Conclusion; References; 3 Economic Perspectives on the Organization and Governance of Mental Health Care; 3.1 Introduction; 3.2 Mental Illness and Institutional Roles; 3.3 Efficiency and Institutional Design; 3.4 Modes of Government Action; 3.5 The Evolution of Institutional Roles in Mental Health; 3.6 Conclusion; References; Part II Contemporary Issues in Mental Health Policy: Treatment Interventions and Supports; 4 What Is the Meaning of Recovery?; 4.1 Framing the Issue; 4.2 Questions
4.2.1 Will a Focus on Personal Recovery Provide an Excuse to Reduce Services and Blame Individuals for Their Own Poor Outcomes?4.2.2 How Does Personal Recovery Relate to Self-Determination and Community Inclusion?; 4.2.3 What Is the Relationship Between Clinical Recovery and Personal Recovery?; 4.2.4 What Are the Implications of Personal Recovery for Policy and Practice?; 4.3 Evidence; 4.3.1 Supported Housing; 4.3.2 Supported Employment; 4.3.3 Supported Living More Broadly; 4.3.4 Peer Support; 4.3.5 Wellness and Self-Management; 4.3.6 Person-Centered and Self-Directed Care; 4.4 Conclusions
4.4.1 Practice Directions4.4.2 Research Directions; 4.4.3 Policy Directions; References; 5 Balancing Access to Medications and Psychosocial Treatments; 5.1 Framing the Issue; 5.2 Questions; 5.2.1 How Do We Explain the Imbalance in Medication and Psychosocial Treatments?; 5.2.2 How Might We Correct the Balance in Favor of Psychosocial Treatments?; 5.3 Evidence; 5.3.1 Imbalance of Medication and Psychosocial Treatments; 5.3.2 Conflicting Information Regarding Best Practices; 5.3.3 Educational Policy and Practice; 5.3.4 State-Level Licensing, Certification and Continuing Education Challenges
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