Graham Thornicroft – författare

People with mental illness commonly describe the stigma and discrimination they face as being worse than their main condition. Discrimination can pervade every part of their daily life - their personal life, working life, sense of citizenship, their ability to maintain even a basic standard of living. Though things have certainly improved in the past 50 years, discrimination against the mentally ill is still a major problem throughout the world. It can manifest itself in subtle ways, such as the terminology used to describe the person or their illness, or in more obvious ways - by the way the mentally ill might be treated and deprived of basic human rights. Should we just accept such discrimination as deeply rooted and resistant to change, or is this something that we can collectively change if we understand and commit ourselves to tackling the problem?Shunned presents clearly for a wide readership information about the nature and severity of discrimination against people with mental illness and what can be done to reduce this. The book features many quotations from people with mental illness showing how this has affected their home, personal, social, and working life. After showing, both from personal accounts and from a thorough review of the literature, the nature of discrimination, the book sets out a clear manifesto for change.Written by a leading figure in mental health in a lively and accessible manner, the book presents a fascinating and humane portrayal of the problem of stigma and discrimination, and shows how we can work to reduce it.

People with mental illness commonly describe the stigma and discrimination they face as being worse than their main condition. Discrimination can pervade every part of their daily life - their personal life, working life, sense of citizenship, their ability to maintain even a basic standard of living. Though things have certainly improved in the past 50 years, discrimination against the mentally ill is still a major problem throughout the world. It can manifest itself in subtle ways, such as the terminology used to describe the person or their illness, or in more obvious ways - by the way the mentally ill might be treated and deprived of basic human rights. Should we just accept such discrimination as deeply rooted and resistant to change, or is this something that we can collectively change if we understand and commit ourselves to tackling the problem?Shunned presents clearly for a wide readership information about the nature and severity of discrimination against people with mental illness and what can be done to reduce this. The book features many quotations from people with mental illness showing how this has affected their home, personal, social, and working life. After showing, both from personal accounts and from a thorough review of the literature, the nature of discrimination, the book sets out a clear manifesto for change.Written by a leading figure in mental health in a lively and accessible manner, the book presents a fascinating and humane portrayal of the problem of stigma and discrimination, and shows how we can work to reduce it.

Community mental health has evolved as a field of practice and as a research discipline during the last 50 years. Now newer concepts, such as shared decision-making, the recovery approach, evidence-based practice, implementation science, telemedicine, and mobile device technology, are adding layers of texture to this domain. These developments require an ever more sophisticated understanding of the very latest evidence and experience in community mental health care to respond to the values, goals, needs and preferences of people with lived experience of mental health conditions. This second edition of the Oxford Textbook of Community Mental Health addresses recent changes and achievements, current controversies, and future challenges while emphasizing areas of convergence, where social values, health, medical sciences, and policy formation converge and meet. This edition also features a new section on global mental health, to emphasise what is known about the mental health gap in low- and middle-income countries, and the evidence of how to respond to these huge global challenges.Like community mental health care itself, the authors are multidisciplinary, international, and bring both clinical and scientific perspectives to this volume. This textbook will be an invaluable and authoritative source of reference for all mental health specialists; for people with mental health conditions, for staff in non-governmental and governmental organisations, and indeed for all who are dedicated to creating better mental health services and systems.

Global mental health is a dynamic field of global health; a core aspect of the story which has led to its emergence has been the conduct of randomised controlled trials (RCTs) evaluating innovative delivery systems of packages of care for mental disorders in low-resource settings. Global Mental Health Trials brings together many of the world's leading researchers active in the fields of RCTs in low- and medium-resource countries and settings related to improving mental health care. It presents clear and practical information about how to conduct such trials in these settings, along with critical methodological and ethical issues related to such trials, learning from the positive and negative experiences of expert scientists in many countries worldwide who have completed such trials. This book serves as a valuable resource for practitioners in mental health - psychiatrists, psychiatric nurses nursing, psychologists, social workers, and occupational therapists - as well as researchers in the areas of psycho-social treatments in mental health, mental health services research, and programme and systems evaluation.

Common Mental Disorders in Primary Care provides a thorough overview of the diagnosis, treatment and management of the most common mental disorders encountered in primary care. In this book, published to mark the retirement of Professor Sir David Goldberg, distinguished contributors bring together clinical and research work drawn from psychiatry, medicine, psychology, social work and sociology, covering such topics as:* the biological basis of common mental disorders* disability and depression in primary care* the limits of mental health care in general medical clinics* improving the management of mental disorders in the elderly* training the whole primary care team.Common Mental Disorders in Primary Care provides an authoritative review of the subject for professionals working in the area of primary care.

Common Mental Disorders in Primary Care provides a thorough overview of the diagnosis, treatment and management of the most common mental disorders encountered in primary care. In this book, published to mark the retirement of Professor Sir David Goldberg, distinguished contributors bring together clinical and research work drawn from psychiatry, medicine, psychology, social work and sociology, covering such topics as:* the biological basis of common mental disorders* disability and depression in primary care* the limits of mental health care in general medical clinics* improving the management of mental disorders in the elderly* training the whole primary care team.Common Mental Disorders in Primary Care provides an authoritative review of the subject for professionals working in the area of primary care.

There have been major changes to mental health services internationally in recent years revolving around the concept of care in the community. Although speed of change and precise service mechanisms differ between countries there is nevertheless increasingly widespread consensus on key components essential to adequate care provision. This in turn provides an opportunity to develop a widely acceptable model framework to direct future developments. There is certainly still room for reform in recognition of specific needs and improvements in treatment and care intervention. This book proposes a simple model which can be used as a guide to increased clinical effectiveness through focused evidence-based reform. Using a time/space framework, it is intended to act as a practical aid to diagnosis of strengths and weaknesses in services that will be used by care providers, trainees and planners both at local and higher levels.

This book provides a comprehensive overview of our understanding about the provision of emergency mental health services in an era of community-orientated care. Major research findings and theoretical models which will shape future services are described and illustrated by detailed descriptions of successful services both from Europe and North America. A multidisciplinary team of contributors detail the full range of community-based services including acute respite care, home-based care, day hospitals and family placement schemes, as well as the use of Accident and Emergency Departments and acute in-patient wards. The major factors which influence service development are also explored, including the costs of acute care, the legal framework for emergency mental health work and the views of service users. All those with an interest in or responsibility for mental health will find this insight of value.

With the international consensus towards community care of the mentally ill, there came a growing need for meaningful evaluation of services. Redressing the lack of guidance this book describes how to do mental health service research. It comprehensively reviews developments in research design, method and measurement at the level of both whole service systems and individual programmes within mental health services. Each of the issues is adeptly illustrated with practical descriptions of comprehensive evaluation projects. The important advances already achieved in knowledge about effective services are highlighted along with descriptions of future work that will further develop our understanding of meeting patient requirements. This volume will appeal to all who are involved in mental health service research as well as those who make use of their results.

This book provides a comprehensive overview of our understanding about the provision of emergency mental health services in an era of community-orientated care. Major research findings and theoretical models which will shape future services are described and illustrated by detailed descriptions of successful services both from Europe and North America. A multidisciplinary team of contributors detail the full range of community-based services including acute respite care, home-based care, day hospitals and family placement schemes, as well as the use of Accident and Emergency Departments and acute in-patient wards. The major factors which influence service development are also explored, including the costs of acute care, the legal framework for emergency mental health work and the views of service users. All those with an interest in or responsibility for mental health will find this insight of value.

With the international consensus towards community care of the mentally ill, there came a growing need for meaningful evaluation of services. Redressing the lack of guidance this book describes how to do mental health service research. It comprehensively reviews developments in research design, method and measurement at the level of both whole service systems and individual programmes within mental health services. Each of the issues is adeptly illustrated with practical descriptions of comprehensive evaluation projects. The important advances already achieved in knowledge about effective services are highlighted along with descriptions of future work that will further develop our understanding of meeting patient requirements. This volume will appeal to all who are involved in mental health service research as well as those who make use of their results.

There have been major changes to mental health services internationally in recent years revolving around the concept of care in the community. Although speed of change and precise service mechanisms differ between countries there is nevertheless increasingly widespread consensus on key components essential to adequate care provision. This in turn provides an opportunity to develop a widely acceptable model framework to direct future developments. There is certainly still room for reform in recognition of specific needs and improvements in treatment and care intervention. This book proposes a simple model which can be used as a guide to increased clinical effectiveness through focused evidence-based reform. Using a time/space framework, it is intended to act as a practical aid to diagnosis of strengths and weaknesses in services that will be used by care providers, trainees and planners both at local and higher levels.

Crisis resolution and home treatment teams respond rapidly to people experiencing mental health crises and offer an alternative to hospital admission. They are an increasingly important component of mental health care and are adopted by many health care systems around the world. This practical and pioneering book describes the evidence for the effectiveness of such teams, the principles underpinning them, how to set up and organise them, how patients should be assessed and what types of care the teams should offer. Other topics covered include integration of crisis teams with in-patient, community residential and day care services, the service users' experiences of crisis teams, and responding to diversity in home treatment. This book is essential reading for all policy makers, service managers and mental health workers interested in establishing or operating crisis resolution and home treatment services, as well as for researchers and students seeking to understand this model.

A concise guide to establishing, developing and evaluating modern mental health services, providing the relevant evidence to support necessary choices between alternative models of care. It includes a step-by-step guide to what to do and how to do it, taking into account the needs of people with mental illnesses in the general population, the available resources, and the main policy requirements. It also gives readers practical resources to assist them in their role in establishing and developing mental health services with examples of best practice taken from countries world-wide. In addition, key relevant issues such as international agreements on human rights and guidelines on best practice to reduce stigma and discrimination are explained.

Written by many of the world's leading practitioners in the delivery of mental health care, this book clearly presents the results of scientific research about care and treatment for people with mental illness in community settings. The book presents clear accounts of what is known, extensively referenced, with critical appraisals of the strength of the evidence and the robustness of the conclusions that can be drawn. Improving Mental Health Care adds to our knowledge of the challenge and the solutions and stands to make a significant contribution to global mental health.

This book describes clearly how legislation can be used to advance the rights and entitlements of people with mental health problems. Straightforward and practical, it provides useful information on how to address disabilities so these people may enjoy full citizenship. It presents the key issues succinctly and illustrates these with legislative examples from around the world. This book documents the role that law can play, at all levels, in combating such discrimination and abuse.

There are wide inconsistencies between, and even within, countries in how community-orientated care is defined and interpreted. The analysis presented in this book take as a starting point an evidence-based balanced care model in which services are provided in community settings close to the populations served, with hospital stays being reduced as far as possible, usually located in acute wards in general hospitals. The surprising conclusion from the research is that the same problems arise in all countries, regardless of resource status, and thus the recommendations of this book apply to mental health provision everywhere. This book reviews the implementation of community-orientated care using the balanced care model. It summarizes the steps, obstacles and mistakes that have been encountered in the implementation of community mental health care worldwide and presents guidelines on how to avoid them. It proposes realistic and achievable recommendations for the development and implementation of community-orientated mental health care over the next ten years. These guidelines will be of practical use to psychiatrists and other mental health and public health practitioners at all levels worldwide, including policy makers, commissioners, funders, non-governmental organisations, service users and carers. A core message of the book is that the mental health sector will more powerfully advocate for better services in future through strong and unified alliances, especially with powerful representation from consumer/service user and carer groups.Community-orientated care draws on a wide range of practitioners, providers, care and support systems (both professional and non-professional), though particular components may play a larger or lesser role in different settings depending on the local context and the available resources, especially trained staff. Research by a WPA task force has demonstrated that most of the challenges are common and global, but with local variations. The book is therefore relevant to psychiatrists and mental health workers in developed countries who are trying to deliver better health care on reduced budgets and for those in the developing economies who are in the position to modernise their mental health care. It provides clear, concise guidance on policy and practice decisions, learning from what has and has not worked in regions in the world.The book contains many tables documenting the evidence, supported by an essential reference list, and a Key Points summary for each chapter.Highly Commended in the Psychiatry section of the 2012 BMA Book Awards.

What are needs for mental health services, and how can they be measured? This book describes clearly the different approaches that can be taken to these vital questions. This completely revised version of the successful first edition provides professional, managerial and research staff in health and social care with all they need to understand and to put into practice the assessment of need in mental health.

How do we know if mental health services work? What are the best ways to measure the outcomes of care for people with mental health problems? This book contains five practical scales for assessing the outcomes of mental healthcare. They are the European versions of: Camberwell Assessment of Need (for unmet and met needs) Client Socio-demographic and Service Receipt Inventory (for service costs) Involvement Evaluation Questionnaire (for impact of care on family members) Lancashire Quality of Life Profile (for quality of life) Verona Service Satisfaction Scale (for service satisfaction). Each scale has been standardised (in Danish, Dutch, English, Italian and Spanish), and has been shown to be reliable and valid in all these European languages. The book contains full details of the development of these scales, manuals for their use, the scales themselves and instructions on how to use the results. These new measures will be invaluable to all those in research, evaluation, audit and management who have an interest in evidence-based policy and practice in mental healthcare.

The Camberwell Assessment of Need for Mothers (CAN-M) is a tool for assessing the needs of pregnant women and mothers with severe mental illness. It is a modification of the Camberwell Assessment of Need, the most widely used needs assessment for people with severe mental health problems. Comprehensive versions are included for research and for clinical use, as well as a short summary version suitable for both clinical and research use. The CAN-M has been rigorously developed by a multidisciplinary team at the Institute of Psychiatry, King's College London, and is suitable for use in mental health, obstetric and primary care settings. This book includes a review of the needs of pregnant women and mothers with severe mental illness, the rating scales, descriptions of how they were developed and their psychometric properties, administration details, a full training programme, guidance on scoring and blank assessment forms (for all three versions) for photocopying.

Evidence-based medicine demands that clinical outcomes are measurable and practicable. Yet mental health outcomes have always been notoriously difficult to quantify. This book guides the reader through the minefield of outcome measurement, providing the building blocks for evidence-based mental health service provision and evaluation. This new edition charts the increased range of outcome domains that are now measurable, while reflecting a new emphasis on positive outcomes and recovery, and the central role of the service user's experience. Fully revised and updated. New service-user focus and emphasis on recovery. Guide to a key aspect of evidence-based practice. With authors drawn from centres of excellence around the world, this volume will be essential for all those involved in research, commissioning and provision of mental health services.

The Camberwell Assessment of Need (CAN) has been the key measure for assessing the health and social needs of people with mental health problems for two decades. Aimed at mental health workers or researchers, it is suitable for clinical use in both community-based and hospital-based mental health services. Updated chapters bring guidance into line with modern social contexts, for example questions regarding 'Child Care' now focus on 'Dependents', reflecting changes relating to an ageing population. An extensive training programme and list of frequently asked questions are informed by the authors' decades of experience in using this essential resource. Containing four versions of the CAN (CANSAS, CANSAS-P, CAN-C, CAN-R) for use in different situations, systematic guidance for how to complete the assessments is also included in the book. Ready to use assessment forms are freely available to download from the CAN website (researchintorecovery.com/can) and on cambridge.org for use with service users.

The Camberwell Assessment of Need for adults with Developmental and Intellectual Disabilities (CANDID) is a widely used tool for the assessment of health and social needs of people with intellectual disabilities and mental health problems. It uses the assessment approach adopted by CAN, the world's leading mental health needs assessment measure. Two versions of the CANDID are available: CANDID-S (short version) and CANDID-R (research version). Both versions are aimed at researchers and practitioners working with people with intellectual disabilities, and are suitable for clinical use in community and hospital-based services. Fully updated based on current policy, practice and terminology, this second edition introduces a more intuitive need rating system and an accessible rating algorithm. Guidance on how to use the measures is provided, as well as an overview of research developments since the first edition. The assessment forms are freely available to download from the CAN website (researchintorecovery.com/can) and cambridge.org.