Mental Health and Social Policy

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 Contents2. Full Table of Contents  Brief Table of ContentsChapter 1:     Mental Health and Illness as Social IssuesChapter 2:     What Is Mental Illness?Chapter 3:     Psychiatric Epidemiology: Science, Counting, and Making Sense of the NumbersChapter 4:     The Causes of Mental Illness and Methods of InterventionChapter 5:     Illness Behavior, the Entrance of Patients into Care, and Patterns of Service UtilizationChapter 6:     The Financing Delivery of Mental Health Services Chapter 7:     Managed Mental Health CareChapter 8:     Dilemmas of Professional PracticeChapter 9:     A Brief History of Mental Health Policy in the United StatesChapter 10:   Building an Effective Community Service System: Knowledge, Aspirations, and Social PolicyChapter 11:   Mental Illness, the Community, and the LawChapter 12:   Mental Health Policy Analysis  Full Table of Contents Chapter 1:     Mental Health and Illness as Social IssuesThe Consequences of Mental IllnessConsequences of Behavior Disorders in ChildhoodSocietal Burdens and Policy Dilemmas  Chapter 2:     What Is Mental Illness?     The Classification of Mental DisorderContested Categories of DisorderThe Development of DSM-5Schizophrenia: An Example in Psychiatric ConceptualizationIs Mental Illness a Social Judgment or a Disease?Development ModelsConceptualizing Mental HealthCulture and the Definition of Mental DisorderThe Social Policy ConnectionThe Patient and Society: An Insoluble Dilemma  Chapter 3:     Psychiatric Epidemiology: Science, Counting, and Making Sense of the NumbersDevelopment of Psychiatric Epidemiology Analytical QuandariesContinued Use of Symptom IndexesSpecial PopulationsRace, Ethnicity, and CultureToward a Fourth Generation of Research  Chapter 4:     The Causes of Mental Illness and Methods of InterventionGenes, Environment, and the BrainThe Psychosocial-Development Perspective The Social-Stress Perspective         Inequality and Risk of Mental DisordersPsychotherapeutic ApproachesMedicationOther Somatic TreatmentsA Note on the Labeling Perspective  Chapter 5:     Illness Behavior, the Entrance of Patients into Care, and Patterns of Service UtilizationPatterns of Service UseIllness Behavior and Selection into CareSpecial Populations             Race and EthnicityPrimary Medical Care and the Promise of IntegrationConclusions  Chapter 6:     The Financing Delivery of Mental Health Services Mental Health Expenditures and CoverageThe Parity Struggle and Its AccomplishmentsPayment Changes and Professional and Clinical ResponsesUtilization of Services and Financing PatternsThe Economics of Mental Health CarePsychiatric Care Under Prepayment PlansThe Structure of Insurance and Needed Mental Health BenefitsImpact 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 PracticeMental Health Professions and Their Work PatternsTrust and the Mental Health ProfessionSocial Influences on Psychiatric JudgmentPersonal and Social BiographiesThe Sociocultural ContextConstraints of Practice Organization and SettingsConclusion  Chapter 9:     A Brief History of Mental Health Policy in the United StatesA Century of State Hospital CareThe Shift to Community CareMore Attempts at National Policy ReformDeinstitutionalization: A Deeper LookConclusion  Chapter 10:   Building an Effective Community Service System: Knowledge, Aspirations, and Social PolicyAssessing Institutional and Community EnvironmentsMental Illness, Homelessness and HousingInnovations in EmploymentOngoing Reform of MedicaidThe Role of Disability ProgramsRedesigning Community Care ProgramsIssues Concerning Case ManagementApproaches to Integrating ServicesRecognizing the Role of FamiliesMental Health Policy and the Contemporary Era  Chapter 11:   Mental Illness, the Community, and the Law    Involuntary Hospitalization    Psychiatric Advance DirectivesOutpatient Commitment and Mental Health CourtsCriminalization of Persons with Mental IllnessA Note on Dangerousness and the Relationship between Mental Illness and ViolenceThe Right to TreatmentThe 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 MedicaidRight to Refuse TreatmentThe Social Context of Legal Reform in Mental Health  Chapter 12:   Mental Health Policy AnalysisCharacteristics of the Mental Health Policy DomainFive Approaches to Mental Health Policy Analysis                              ConclusionReferences    Name Index   Subject Index