Sarah Y. Vinson – författare
549 kr
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676 kr
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Social justice entails equal access to liberties, rights, and opportunities, as well as care for the least advantaged members of society. The paradigm-shifting new book Social (In)Justice and Mental Health addresses the ways in which society''s failure to deliver on that humane ideal harms people with mental illness. The editors, at the forefront of the effort to make psychiatry responsive to critiques of institutional racism, argue that in the United States, a perfect storm of unfair and unjust policies and practices, bolstered by deep-seated beliefs about the inferiority of some groups, has led to a small number of people having tremendous advantages, freedoms, and opportunities, while a growing number are denied those liberties and rights. Mental health clinicians bear a special responsibility to be aware of these structural inequities, to question their own biases, to intervene on behalf of patients and their families, and to advocate for mental health equity. To that end, the book provides a framework for thinking about why these inequities exist and persist and provides clinicians with a road map to address these inequalities as they relate to racism, the criminal justice system, and other systems and diagnoses.
The book is hands-on, with topics mental health clinicians will find timely and relevant: The role of social injustice and specific diagnoses and conditions, including substance use disorders, schizophrenia, personality disorders, and child trauma, is covered. For example, research has shown that white psychiatrists are more likely to over diagnose schizophrenia in Black patients, and this diagnostic bias may partly account for Black men being involuntarily committed to mental institutions in higher numbers. The authors advocate for research that prioritizes the needs of participants and communities, rather than the needs of institutions, and focuses on structural, not individual-level, differences. Accompaniment, an important strategy for infusing social justice into clinical practice, is described and modeled. This process of radical empathy -- of trying to minimize power dynamics in clinical relationships by listening, witnessing, and advocating with patients -- is critically important in confronting mental health inequities. The inadequacy of current medical and mental health education and training in countering the powerful forces of social injustice in mental health is discussed in detail. The authors emphasize that change requires adopting an active practice of self-study and self-reflection, and accordingly, a list of self-study resources, consisting of books, documentaries, podcasts, and TED talks, is provided to further the reader''s knowledge and awareness. Of further assistance are the chapter-ending "Questions for Self-Reflection," which challenge mental health clinicians to examine their own attitudes and preconceived ideas about race, poverty, disabilities, and privilege.
Social (In)Justice and Mental Health addresses the context in which mental health care is delivered, strategies for raising consciousness in the mental health profession, and ways to improve treatment while redressing injustice. Clinicians owe it to themselves, their patients, and their profession to read -- and heed -- this important work.
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Approximately 1 in 5 children are diagnosed with a mental illness by the age of 18. Additionally, mental health conditions, including Attention Deficit Hyperactivity Disorder, are consistently among the most common chronic conditions in pediatric clinical populations. Delays in both diagnosis and treatment increase the morbidity associated with these conditions. These delays expose the child to negative ramifications of his/her illness and can impact rates of poor academic performance, substance use disorders and criminal justice system involvement – potentially impacting long-term life trajectories. Early identification of mental illness and appropriate intervention is critical to the healthy development of youth, though physicians in primary care and pediatrics are seldom trained to detect and treat such illnesses.
The importance of recognizing mental illness is reflected in practice guidelines for pediatric primary care providers as well as in how service delivery is being structured, but this does not offer in-depth clinical guidelines. Additionally, integrated care and medical home models include mental health as key components, though yet again physicians are often not trained to work with these models. While clearly indicated clinically, these requirements do not come with significant increases in reimbursement and are added to an already demanding schedule. Increasingly, providers are also expected to use evidence based screening instruments without exposure to this body of literature. Some guidance on using those instruments in context will help them to use those tools more effectively.
Finally, primary care providers and even some adult psychiatrists and psychologists are operating in a healthcare system with a severe, nationwide shortage of child and adolescent psychiatrists and mental healthcare providers. While a text certainly cannot single-handedly compensate for such a workforce shortage, it could potentially help to mitigate the negative impact on patients by facilitating early identification and treatment in the primary care setting. Additionally, with more effective treatment in pediatric settings, less complex cases may be addressed before specialty care is needed, and the expertise of child and adolescent psychiatrists can be more effectively used for more complex cases.
Pediatric Psychiatry in Primary Care is the ultimate resource for clinicians working with children, including pediatricians, family physicians, general psychiatrists, psychologists, early career child psychiatrists, social workers, nurses, school counselors, and all clinical professionals who may encounter children struggling with psychiatric disorders.