This book documents the ways that clinical practitioners and trainees have used the “structural competency” framework to reduce inequalities in health. The essays describe on-the-ground ways that clinicians, educators, and activists craft structural interventions to enhance health outcomes, student learning, and community organizing around issues of social justice in health and healthcare. Each chapter of the book begins with a case study that illuminates a competency in reorienting clinical and public health practice toward community, institutional and policy level intervention based on alliances with social agencies, community organizations and policy makers. Written by authors who are trained in both clinical and social sciences, the chapters cover pedagogy in classrooms and clinics, community collaboration, innovative health promotion approaches in non-health sectors and in public policies, offering a view of effective care as structural intervention and a road map toward its implementation. Structural Competency in Mental Health and Medicine is a cutting-edge resource for psychiatrists, primary care physicians, addiction medicine specialists, emergency medicine specialists, nurses, social workers, public health practitioners, and other clinicians working toward equality in health.

This book documents the ways that clinical practitioners and trainees have used the "structural competency" framework to reduce inequalities in health. The essays describe on-the-ground ways that clinicians, educators, and activists craft structural interventions to enhance health outcomes, student learning, and community organizing around issues of social justice in health and healthcare. Each chapter of the book begins with a case study that illuminates a competency in reorienting clinical and public health practice toward community, institutional and policy level intervention based on alliances with social agencies, community organizations and policy makers. Written by authors who are trained in both clinical and social sciences, the chapters cover pedagogy in classrooms and clinics, community collaboration, innovative health promotion approaches in non-health sectors and in public policies, offering a view of effective care as structural intervention and a road map toward its implementation. Structural Competency in Mental Health and Medicine is a cutting-edge resource for psychiatrists, primary care physicians, addiction medicine specialists, emergency medicine specialists, nurses, social workers, public health practitioners, and other clinicians working toward equality in health.

The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

Substantially revised to include a wealth of new material, the second edition of this highly acclaimed work provides a concise, coherent introduction that brings structure to an increasingly fragmented and amorphous discipline. Paul R. McHugh and Phillip R. Slavney offer an approach that emphasizes psychiatry's unifying concepts while accommodating its diversity. Recognizing that there may never be a single, all-encompassing theory, the book distills psychiatric practice into four explanatory methods: diseases, dimensions of personality, goal-directed behaviors, and life stories. These perspectives, argue the authors, underlie the principles and practice of all psychiatry. With an understanding of these fundamental methods, readers will be equipped to organize and evaluate psychiatric information and to develop a confident approach to practice and research.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

A powerful account of how cultural anxieties about race shaped American notions of mental illness The civil rights era is largely remembered as a time of sit-ins, boycotts, and riots. But a very different civil rights history evolved at the Ionia State Hospital for the Criminally Insane in Ionia, Michigan. In The Protest Psychosis, psychiatrist and cultural critic Jonathan Metzl tells the shocking story of how schizophrenia became the diagnostic term overwhelmingly applied to African American protesters at Ionia—for political reasons as well as clinical ones. Expertly sifting through a vast array of cultural documents, Metzl shows how associations between schizophrenia and blackness emerged during the tumultuous decades of the 1960s and 1970s—and he provides a cautionary tale of how anxieties about race continue to impact doctor-patient interactions in our seemingly postracial America. This book was published with two different covers. Customers will be shipped the book with one of the two covers.

Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.

This is a vital resource for anyone looking to better support people with psychosis and serious mental illnesses.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.