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.

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.

Full Contributors:
Gavin Andrews, University of New South Wales, Australia Jesus Artal, University Hospital 'Marques de Valdecilla', Spain J.F. William,University of Manchester, UK F.W. Deakin, University of Manchester, UK Peter de Jong, University of Groningen, The Netherlands Linda Gask, University of Manchester, UK Kevin Gournay, Institute of Psychiatry, London, UK Scott Henderson, Australian National University, Canberra, Australia Andrès Herran, University Hospital 'Marques de Valdecilla', Spain Caroline Hunt, University of New South Wales, Australia Peter Huxley,University of Manchester, UK Rachel Jenkins, Institute of Psychiatry, London, UK Glyn Lewis, University of Wales College of Medicine, UK Elizabeth Lin Group Health Cooperative of Puget Sound, Seattle, USA Ita Lyons, University of Wales College of Medicine, UK Anthony Mann, Institute of Psychiatry, UK Malik Mubbashar, Rawalpindi General Hospital, Pakistan Hans Ormel, University of Groningen, The Netherlands Norman Sartorius, Hopitaux Universitaires de Genève, Switzerland Deborah Sharp, University of Bristol, UK Greg Simon, University of Washington, USA Michele Tansella, Università di Verona, Italy Graham Thornicroft, Institute of Psychiatry, London, UK André Tylee, Institute of Psychiatry, London, UK Josè Luis Vazquez-Barquero, University Hospital 'Marques de Valdecilla', Spain ^Michael Von Korff, Group Health Cooperative of Puget Sound, Seattle, USA

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.

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 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.

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.

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.

This book provides a comprehensive overview of current understanding about the provision of emergency mental health services in an era of community orientated care. It describes major research findings and theoretical models that will shape future services and illustrates successful services from both Europe and North America. A multidisciplinary team of contributors details 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. They explore the major factors that influence service development, including the costs of acute care, the legal framework for emergency mental health work, and the views of service users.

Mental Health Outcome Measures provides an authoritative review of measurement scales currently available to assess the outcomes of mental health service intervention. The excerpt of summaries by leading writers in the field assess the contributions of scale in areas including mental state examination, quality of life, patient satisfaction, needs assessments, measurement of service cost, global functioning scales, and social disability. These chapters provide a critical appraisal of how far such scales have been shown to be reliable and valid, and provide valuable insights in to their ease of use. This book will provide an invaluable reference manual for those who want to take research on mental health services, and for those who need to interpret this research for policy, planning, and clinical practice.

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.

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.

With the emerging international consensus toward community care of the mentally ill, there comes a growing need for meaningful evaluation of services. Redressing the current lack of guidance this book describes how to do mental health service research. Contributors comprehensively review the most recent developments in research design, method and measurement at the level of both whole service systems and individual programs within mental health services. Practical descriptions of comprehensive evaluation projects illustrate each issue and many chapters examine important earlier advances in effective service knowledge as well as future work that will further develop our understanding of meeting patient requirements.

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.

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.