The definitive guide to identify, assess, and create individualized treatment plans for high-risk clients who suffer from challenging co-occurring disorders

"Treat the person and not the diagnosis. Respect that all behaviors are purposeful. Remain mindful that nobody changes behaviors without motivation. These essential guiding principles are the framework of this book. They will be repeated quite often as we examine the challenging population of men and women with co-occurring disorders."

--From "Integrated Treatment for Co-Occurring Disorders"

Annual studies reveal that 70 percent of men and women who died by suicide were diagnosed with a mental illness or personality disorder and used drugs to gain temporary relief from the symptoms. Until now, very little has been written about how to identify, assess, and treat this population. "Integrated Treatment for Co-Occurring Disorders: Treating People, Not Behaviors" addresses that need.

Respectful of the client and filled with practical advice, this book: Examines the guiding principles for treating clients with co-occurring disordersDetails the methods of formulating an evidence-based individualized treatment plan for the self-medicating mentally illExplores how to assess this population for suicide risk and vulnerabilityFocuses on the person and not a behaviorally defined diagnostic categoryReflects state-of-the-art knowledge for the treatment of co-occurring disordersIllustrates how Motivational Enhancement Therapy can be an effective treatment strategy

With numerous clinical case studies to illustrate key points and reinforce learning, "Integrated Treatment for Co-Occurring Disorders" encourages a flexible, person-centered treatment approach that focuses on the individual rather than the diagnosis.

Patients with mental health issues present frequently in primary care and their consultations are often more challenging and time-consuming than those involving physical illness. For many patients there remains a significant stigma associated with mental ill-health and overcoming this adds further complexity to the consultation. Improving the Mental Health Consultation provides a simple 'short circuit' tool to help GPs and other healthcare professionals to explain mental health problems simply and effectively to their patients. The tool is straightforward, easy to convey within the confines of a 10-minute consultation and extremely effective in helping to break down the stigma that patients often feel. The tool has been developed and refined during over ten years of consultations in primary care. The detailed explanations of how to use the tool during the consultation, along with the extensive case studies, will help you to improve your mental health consultations and so help your patients deal better with their diagnosis. From anxiety to OCD and chronic fatigue to fibromyalgia, the book also provides detailed coverage of diagnosis and classification using ICD-11 and DSM-IV, and management using the latest NICE guidelines.

This volume describes a variety of public mental health and psychosocial programs in conflict and post-conflict situations in Africa and Asia. Each chapter details the psychosocial and mental health aspects of specific conflicts and examines them within their sociopolitical and historical contexts. This volume will be of great interest to psychologists, social workers, anthropologists, historians, human rights experts, and psychiatrists working or interested in the field of psychotrauma.

The two most important notions concerning the rights of people with mental illnesses are among the most neglected: the first is that human rights and duties are complementary and that both must be considered in constructing a framework for mental health care. The second is that we must strive for equity in developing mental health programs. Inequity and Madness: Psychosocial and Human Rights Issues addresses both these notions. It provides the background and the facts about fulfilment of needs and the protection of human rights of people with mental illnesses. The wealth of information that it provides and the clarity of its presentation make it a document of immediate practical usefulness to all those trying to help people with mental illnesses and those who look after them. At the same time, however, the sincerity and vigour of its text make it clear that this book is a personal statement of commitment to the achievement of equity for all people, with or without mental illnesses. "I hope that Inequity and Madness will be widely read and share the hope - which was clearly on Professor GuimA3n's mind when he undertook to produce this volume - that this book will contribute to improving the quality of life of those with mental illnesses and those who help them to live through times of devastating diseases and misery that is often an unnecessary consequence." Professor Norman Sartorius - From the Foreword.

Family Physicians need to be expert and active providers of mental health care. Their rapport with patients and accessibility enable them to control minor mental health conditions before these problems become critical. Brief Mental Health Interventions for the Family Physician is an ideal resource for Family Physicians. It provides a "refresher course" of sensible paths toward resolution of common mental health problems. It features an easy to read style, and well-focused references. The book summarizes the basic components of brief therapy and reviews how to conduct a brief therapy interview. It also includes chapters on specific clinical conditions and situations that routinely confront the family physician. Each chapter includes an outline, a case example or vignette, and a concise discussion of brief therapy strategies for the disorder. Primary care physicians will find this convenient text an ideal handy reference and review.

Multiple voices throughout the last century have preached the merits of various treatments for schizophrenia, ranging from cold baths to the currently accepted standards such as neuroleptic medication. Along with these ongoing treatments, there have been quiet commentaries, made mostly from the sidelines, suggesting the need to shift and refocus the way we think and talk about schizophrenia. Harry Stack Sullivan noted in 1927 that, 'The psychiatrist sees too many end states and deals professionally with too few of the pre psychotic" (Sullivan 192711994, p. 135). Similar thoughts have been echoed by purveyors of modem treatment for psychosis such as Thomas H. McGlashan: "Like others before me, I tried to make a difference . . . but like the others my efforts were largely in vain. I came upon the scene too late; most of the damage was already done" (McGlashan, 1996). Similar interest in the early phase of schizophrenia has developed across the globe and consolidated into a tentative, yet meaningful deliberation about the potential for prevention of psychotic illness through early identification and intervention. In the past decade, international support has grown from: Ian Falloon's prodromal intervention project in Great Britain (Falloon et aI., 1996); Patrick McGorry's and Jane Edward's first episode psychosis program in Melbourne, Australia (McGorry et al."

Multiple voices throughout the last century have preached the merits of various treatments for schizophrenia, ranging from cold baths to the currently accepted standards such as neuroleptic medication. Along with these ongoing treatments, there have been quiet commentaries, made mostly from the sidelines, suggesting the need to shift and refocus the way we think and talk about schizophrenia. Harry Stack Sullivan noted in 1927 that, 'The psychiatrist sees too many end states and deals professionally with too few of the pre psychotic" (Sullivan 192711994, p. 135). Similar thoughts have been echoed by purveyors of modem treatment for psychosis such as Thomas H. McGlashan: "Like others before me, I tried to make a difference . . . but like the others my efforts were largely in vain. I came upon the scene too late; most of the damage was already done" (McGlashan, 1996). Similar interest in the early phase of schizophrenia has developed across the globe and consolidated into a tentative, yet meaningful deliberation about the potential for prevention of psychotic illness through early identification and intervention. In the past decade, international support has grown from: Ian Falloon's prodromal intervention project in Great Britain (Falloon et aI., 1996); Patrick McGorry's and Jane Edward's first episode psychosis program in Melbourne, Australia (McGorry et al."

This book provides up-to-date, practical information for family doctors on how to assess and manage important mental health problems presenting in primary care settings. Patients frequently present with mental health problems in primary care settings around the world, yet family doctors consistently identify gaps in their knowledge, skills and confidence in how best to care for them. Contributors to the book are experts in primary mental health care and have consulted with family doctors around the world, to identify their main learning needs. Each of the nine core chapters will begin with a set of key points on 'how to do it' and will end with educational material in the form of clinical scenarios and multiple choice questions. This book describes core competencies for primary mental health care, clarifies how to conduct a first consultation about depression, reviews non-drug interventions for common mental health problems, discusses the management of unexplained physical symptoms, and advises on the physical health care of patients with severe mental illness. It explores the mental health needs of migrants and young people, and explains how to manage problems of frailty, multimorbidity and dementia. This book will be of interest to family doctors and students specialising in family medicine worldwide.

What happened when people went mad in the fledgling colony of New South Wales? In this important new history of the late eighteenth and early nineteenth centuries, we find out through the correspondence of tireless colonial secretaries, the brazen language of lawyers and judges and firebrand politicians, and heartbreaking letters from siblings, parents and friends. We also hear from the mad themselves. Class, gender and race became irrelevant as illness, chaos and delusion afflicted convicts exiled from their homes and living under the weight of imperial justice; ex-convicts and small settlers as they grappled with the country they had taken from its Indigenous inhabitants, as well as officers, officials and wealthy colonists who sought to guide the course of European history in Australia. This not a history of the miserable institutions built for the mentally ill, or those living within them, or the people in charge of the asylums. These stories of madness are woven together into a narrative about freedom and possibilities, and collapse and unravelling. The book looks at people at the edge of the world finding themselves at the edge of sanity, and is about their strategies for survival. This is a new story of colonial Australia, cast as neither a grim and fatal shore nor an antipodean paradise, but a place where the full range of humanity wrestled with the challenges of colonisation. The first book-length history of madness at the beginning ofEuropean Australia Original and evocative, it grapples seriously with the place ofmadness in Australia's convict history The book's intimate descriptions of madness and the response to itgive a unique picture of life in the early colony through the lens ofmental illness Awareness of mental health continues to rise globally. This bookexplores efforts to understand and to treat madness before asylums,hospitals and doctors made madness a medical problem. Meticulously researched by James Dunk, a young emerginghistorian of medicine and colonialism

It is crucial for the quality of care of people with mental retardation that care providers experience their work as meaningful. A complexity, however, is the fact that this care is divided amongst a range of professions. This book addresses issues of meaning (meaning of care and meaning of life) from all the different professional perspectives involved. Such a multidisciplinary approach is unique and has never before been followed. The book contains the results of a series of interviews in which parents of people with mental retardation were asked what they conceive to be meaningful care. The results are placed in relation to experiences and conceptions of professional caregivers. Moreover, the study analyzes the cultural, philosophical, and theological significance of the concept, meaningful care'. Finally, the book explores the relevance of this concept for practical professions such as medical care, social work, educational psychology, pedagogic counseling, and pastoral care. Scholarly depth is combined with experiential knowledge of professional practice. Hence, this book is an outstanding source of reflection for all those who work professionally with people with mental retardation.

"Adapt or perish, now as ever, is Nature's inexorable imperative. " -H. G. Wells, Mind at the End of Its Tether (1946) Doctors are trained to treat people suffering from various diseases. This is the main form of their activity and usually the reason for which they selected medicine as their profession. The notion that they should become managers and engage in activi ties such as programming, calculating cost, assessing cost-benefit ratios, and thinking about pricing in accordance with the social utility of their intervention, is both foreign and abhorrent to them. They are sometimes willing to say how much they need in order to have a well-functioning service: usually they prefer to state what specific apparatus and other things they require without specifying the price of their demand. They can be persuaded to add a price tag to what they think is necessary for their work: but that was about as far as they would go, until recently. The growing emphasis on human rights over the past few decades, the greater emphasis on quality of life and the public's heightened expectations about their health led, in many industrialized countries, to a greater demand for health services. This, com bined with improved possibilities of diagnosis and treatment (at higher cost ), led to a significant increase in financial demands which made governments and health-care systems uneasy and ready to accept any solution that would stop the spiral of seem ingly endless cost augmentation."

For the first time in history, behavioral health providers are expected to understand and participate in activities intended to access and improve the quality of services they provide. This handbook is designed as a general resource in the field of behavioral health quality management for a very diverse group of readers, including graduate and undergraduate students, payors, purchasers and administrators within managed care organizations, public sector service system planners and managers, applied health services researchers and program evaluators. This volume provides a comprehensive context for the development of quality management (QM) in health services - behavioral health in particular - as well as an overview of tools, techniques, and programs reflecting QM in practice. It also offers perspectives on both internally- and externally-based QM activities.

Series Information:
Routledge Essentials for Nurses

This guide provides healthcare students and professionals with a foundational background on adverse childhood experiences (ACEs) - traumatic early life experiences, which can have a profound impact on health in later life. ACEs can include being a victim of abuse, neglect or exposure to risk in the home or community. How healthcare students and professionals learn to recognize, react and respond to persons affected by trauma will lay the foundation for their relationships with patients. This book intentionally uses micro-to-macro lenses accompanied by a structural competency framework to elucidate health implications across the lifespan. It explores the nature of adversity and its effects on the physical, emotional, cognitive and social health of individuals, communities and society. The book, written by two experienced psychiatric nurses, will equip healthcare students and professionals with an understanding for critical change in practice and offer action steps designed to assist them with prevention and intervention approaches and steps to help build resilience. This book will be core reading for healthcare students within mental health, pediatric and primary care nursing courses. It will also be of interest to students and professionals in the social work, psychology and public health fields who are exploring resilience and trauma-informed practices

This history of one particular place for "madness" covers changing approaches to insanity and treatments over two centuries. The Norfolk Lunatic Asylum opened in 1814 as a pioneer county pauper institution and in 1998 St Andrew's featured among the last of the large psychiatric hospital closures. This history of one particular place for "madness" coverschanging approaches to insanity and treatments over two centuries. It draws extensively upon archival sources to examine the use of buildings and environments; the regimes of long-serving masters, superintendents and medical superintendents; the patients' own experiences; and the rationales, including cultural and gender issues, which informed therapies, relationships and hospital life. However, the contexts of national policies and economic constraints, professional and therapeutic developments, local economy and society, and current research findings are also acknowledged. Chapters dealing with the asylum's transformation as the 1915-19 Norfolk War Hospital and 1940-47 Emergency Hospital have disturbing revelations concerning wartime mental health care: similarly with the loss of local accountability and the experience of resource control under the National Health Service. Interviews with former staff and current personnel recall first-hand experiences of hospital life since the 1920s, the privations of wartime and the early NHS, hopes for new medications and conflicting views surrounding the closure of St Andrew's and thedelivery of community mental health care. STEVEN CHERRY is senior lecturer in history, Wellcome Unit for the History of Medicine, University of East Anglia.

This book explores the controversial relationship between mental health and offending and looks at the ways in which offenders with mental health problems are cared for, coerced and controlled by the criminal justice and mental health systems. It provides a much-needed criminological approach to the field of forensic mental health. Beginning with an exploration into why the relationship between mental health and offending is so complex, readers will be introduced to a range of perspectives through which mental health and its relationship to offending behaviour can be understood. The book considers the politics surrounding mental health and offending, focusing particularly on the changing policy response to mentally disordered offenders since the mid-1990s. With dedicated chapters concerning the police, courts, secure services and the community, this book explores a range of issues including: * The tensions between the care, coercion and control of mentally disordered offenders * The increasingly blurred boundaries between mental health and criminal justice * Rights, responsibilities, accountability and blame * Risk, public protection and precaution * Challenges involved with treatment, recovery and rehabilitation * Staffing challenges surrounding multi-agency working * Funding, privatisation and challenges surrounding service commissioning * Methodological challenges in the field. Providing an accessible and concise overview of the field and its key perspectives, this book is essential reading for undergraduate and postgraduate courses in mental health offered by criminology, criminal justice, sociology, social work, nursing and public policy departments. It will also be of interest to a wide range of mental health and criminal justice practitioners.

North America's Indigenous population is a vulnerable group, with specific psychological and healing needs that are not widely met in the mental health care system. Indigenous peoples face certain historical, cultural-linguistic and socioeconomic barriers to mental health care access that government, health care organizations and social agencies must work to overcome. This volume examines ways Indigenous healing practices can complement Western psychological service to meet the needs of Indigenous peoples through traditional cultural concepts. Bringing together leading experts in the fields of Aboriginal mental health and psychology, it provides data and models of Indigenous cultural practices in psychology that are successful with Indigenous peoples. It considers Indigenous epistemologies in applied psychology and research methodology, and informs government policy on mental health service for these populations.

Taking a critical and radical approach, this book calls for a return to mental health social work that has personal relationships and an emotional connection between workers and those experiencing distress at its core. The optimism that underpinned the development of community care policies has dissipated to be replaced by a form of bleak managerialism. Neoliberalism has added stress to services already under great pressure and created a danger that we could revert to institutional forms of care. This much-needed book argues that the original progressive values of community care policies need to be rediscovered, updated and reinvigorated to provide a basis for a mental health social work that returns to fundamental notions of dignity and citizenship.

This well-written text thoroughly addresses two quality of life issues in patients with a variety of neurological disorders: sexual and reproductive function. The de vasta stating effects of a variety of neurological diseases are well known to both the lay and medical communitIes, and are treated in numerous texts. However, as we continue to experience therapeutic breakthroughs in the tields of neurology and rehabilitation medicine, physicians and patients must become more aware of the issues discussed in this text. It is particularly important, as emphasized throughout the chapters, that the physician or therapist initiate conversations with the patients concerning both the possibility of parenting a child, as well as the ability of the patient to enhance his/her sexual functioning. Commonly in the patient who is otherwise perfectly normal, there is a reluctance to discuss these topics and couples often feel embarrassed to initiate a conversation with their physi cians. This reluctance to initiate a discussion is even more apparent in patients with a variety of neurological disorders, in which there are overriding fears concerning both function and survival, as well as deep concerns about their own attractiveness, and their sexual and repro ductive ability."

The updated edition of the essential guide to environmental psychology Thoroughly revised and updated, the second edition, Environmental Psychology: An Introduction offers an overview of the interplay between humans and their environments. The text examines the influence of the environment on human experiences, behaviour and well-being and explores the factors influencing environmental behaviour, and ways to encourage pro-environmental behaviour. The revised edition is a state-of-the art review of relevant theories and research on each of these topics. With contributions from an international panel of noted experts, the text addresses a wealth of topics including the main research methods in environmental psychology; effects of environmental stress; emotional impacts and meanings of natural environment experience; aesthetic appraisals of architecture; how to measure environmental behaviour; cognitive, emotional and social factors explaining environmental behaviour; effects and acceptability of strategies to promote pro-environmental factors; and much more. This important book: Discusses the environmental factors that threaten and promote human wellbeing Explores a wide range of factors influencing actions that affect environmental conditions Discusses the effects and acceptability of approaches that aim to encourage pro-environmental behavior Presents research results conducted in different regions in the world Contains contributions from noted experts Written for scholars and practitioners in the field, the revised edition of Environmental Psychology offers a comprehensive review of the most recent research available in environmental psychology.

In 2001, the WHO recognized depressive disorders as the leading cause of disability worldwide. But most Americans who meet diagnostic criteria for major depression are untreated or undertreated. Luckily, recent advances have finally made it possible for the field of public health to address mental health in the population. Public Health Perspectives on Depressive Disorders fills a gap by identifying the tools and strategies of public health practice and by exploring their application to twenty-first-century public mental health policy and practice. By looking at depressive disorders through a public health lens, this book highlights the centrality of mental health to public health. Linking the available research on depressive illness at the population level with public mental health policy and practice, expert contributors set a research agenda that will help make mental health a central part of public health science and practice. This book is an invaluable resource for researchers and practitioners to develop, facilitate, and conduct pilot and feasibility studies of promising preventive and treatment interventions that might mitigate the progression toward major depression and other mental disorders among populations at risk. The first part of the book underscores the public health significance of depressive illness by focusing on the evidence provided by recent approaches to nosology, epidemiology, illness burden, and impact on overall health. The second part looks at the social and environmental influences on depressive disorders that are critical to future efforts to prevent illness and to promote mentally healthy communities. The third and longest part addresses the vulnerability of diverse groups to depressive illness and underscore best practices to mitigate risk while improving both the preventive and therapeutic armamentaria.

Forced hospitalization of people with mental disorders has long been a critical issue in the mental health services. Coercion and Aggressive Community Treatment is the first sustained description and analysis of what happens when aggressive' treatment becomes coerced' treatment. Mental health professionals poignantly discuss the tension they feel between wanting to do everything to treat desperately ill people and the need to respect the rights of these same people who want to make their own decisions, even if this means forgoing treatment.

The newest edition of Community Mental Health continues to be at the leading edge of the field, providing the most up-to-date research and treatment models that encompass practice in community settings. Experts from a wide range of fields explore the major trends, best practices, and policy issues shaping community mental health services today. New sections address the role of spirituality, veterans and the military, family treatment, and emerging new movements. An expanded view of recovery ensures that a thorough conversation about intersectionality and identity runs throughout the book.

The World Health Organization's concept of health as "the condition of psychophysical and social well-being" must be translated into opera tional terms. The objective is to place the human person within the social system, given that mental health, mental illness, and suffering are individual, despite the fact that their causes are to be sought in the society and environment that surround and interact with the indi vidual. One dimension that must be emphasized in this field is the contin uum that exists between social environment and cerebral development. This continuum consists of the physical and biological features of the two interacting systems: on one hand, the brain managed and con trolled by the genetic program, and, on the other hand, the environ ment, be it natural or social. A simple dichotomy of individual and environment is no longer a sufficient concept in understanding the etiology of mental health and illness. Needless to say, socioepidemiological research in psychiatry and transcultural psychiatry is useful in reaching these ends. However, at the root of mental illness, one can always find the same causal elements: informational chaos, inadequate dietary intake, substance abuse, trauma, conditioning, and so on, which make the interactive systems dysfunctional. Subsequent organic and psychotic disorders occur to the detriment of both the individual and society. Current biological psychiatry is inadequately equipped in treating mental illness."