Richard G. Frank - Böcker

While there is a limited data on safety-sensitive professionals, substance use disorders potentially affect pilots and flight attendants at the same rate as the general population - around 15 percent - but due to the high-risk nature of their jobs, aircraft operators are held to a higher standard for substance misuse on the job.To protect the safety of the public and the aviation workforce, the Human Intervention Motivation Study (HIMS) and the Flight Attendant Drug and Alcohol Program (FADAP) were launched to help treat critical aviation workers - pilots and flight attendants, respectively - who misuse substances. In response to a congressional mandate, this new report reviews available evidence on the effectiveness of HIMS and FADAP and offers recommendations for improving these programs.

How do health insurance regulations affect the care of persons with mental illness? And how do such persons, in turn, affect the economy through lost productivity, reduced labor supply, and deviant behavior at the workplace? In "Economics and Mental Health", Richard G. Frank and Willard G. Manning, Jr., bring together a distinguished group of health care economists to explore the new and rapidly growing field of mental health economics. The authors begin by discussing the issue of care for severely mentally ill patients as it is influenced by differing modes of reimbursement. They then offer labor market analyses that shed light on the economic costs of mental illness. They analyze the interaction of health insurance and the demand for mental health care. And they present case studies that outline experimental systems of delivering health care.

In the last half-century, there have been major changes in the treatment of mental illness: physicians are more responsive, hospitals and treatment centers are more humane, and insurance companies are beginning to help lift the financial burden that mental illness causes. These changes, however, are not enough for the 20 percent of the general population who have mental illness. The U.S. Surgeon General reported in 1999 on the rich array of effective treatments for mental illness, but also pointed out that many people never receive these treatments and that the quality of treatment is highly uneven. Frank and Glied explore the changes occurring over the last fifty years in the lives of people with mental illness and assess the factors that generated these changes. State the authors, "Stressing only the deficiencies of the present -- without an understanding of how these relate to the past -- can lead to a replay of prior unproductive efforts to improve the situation.We believe that by carefully analyzing the forces that have guided the past transformation of mental health care, America will be better equipped to steer public policy in a direction that results in further gains for a most disadvantaged segment of Americans." This book will appeal to professionals and students in mental health care and health policy.

The past half-century has been marked by major changes in the treatment of mental illness: important advances in understanding mental illnesses, increases in spending on mental health care and support of people with mental illnesses, and the availability of new medications that are easier for the patient to tolerate. Although these changes have made things better for those who have mental illness, they are not quite enough. In Better But Not Well, Richard G. Frank and Sherry A. Glied examine the well-being of people with mental illness in the United States over the past fifty years, addressing issues such as economics, treatment, standards of living, rights, and stigma. Marshaling a range of new empirical evidence, they first argue that people with mental illness-severe and persistent disorders as well as less serious mental health conditions-are faring better today than in the past. Improvements have come about for unheralded and unexpected reasons.Rather than being a result of more effective mental health treatments, progress has come from the growth of private health insurance and of mainstream social programs-such as Medicaid, Supplemental Security Income, housing vouchers, and food stamps-and the development of new treatments that are easier for patients to tolerate and for physicians to manage. The authors remind us that, despite the progress that has been made, this disadvantaged group remains worse off than most others in society. The "mainstreaming" of persons with mental illness has left a policy void, where governmental institutions responsible for meeting the needs of mental health patients lack resources and programmatic authority. To fill this void, Frank and Glied suggest that institutional resources be applied systematically and routinely to examine and address how federal and state programs affect the well-being of people with mental illness.