Phil Brown (Ed.), Mental Health Care and Social Poiicy. London: Routledge & Kegan Paul, 1985, ix + 416 pp. Price (UK) £12.95 paperback, ISBN 07 10204728
✍ Scribed by Mono Chakrabarti
- Book ID
- 102254554
- Publisher
- John Wiley and Sons
- Year
- 1986
- Tongue
- English
- Weight
- 144 KB
- Volume
- 1
- Category
- Article
- ISSN
- 0749-6753
No coin nor oath required. For personal study only.
✦ Synopsis
Mental health services and coherent policies must be soundly based: on careful comparisons of alternative modes of managing psychological disorder; and, on considerations of the roles of a variety of professions that work with mentally ill people. Within these configurations, the views and expectations of the patients and ex-patients must also play a significant and relevant part. However, much planning in the area of mental health currently takes place in a context of great uncertainty. This uncertainty results from the ambiguous boundaries of what constitutes mental illness, and from the lack of adequate information on the success of alternative approaches to treatment and rehabilitation. The unknowns force us to make assumptions that are to some extent arbitrary, but we should be clear that these are assumptions often lacking a clear factual basis. This must be done with humility and not with dogmatism.
Mental Health Care and Social Policy is an anthology of articles which have already been published elsewhere. The rationale for this publication is to bring together discussions about diverse but inter-related psychiatric services in one volume and, to that extent, Phil Brown has succeeded very well indeed. This book gives a thorough analytical picture of the mental health services over time in the United States. The book is divided into four parts, starting with 'historical and conceptual concerns' and areas of conflict and consensus over definitional issues. It also highlights, in a relevant way, the importance of 'ideology' and its effect on social perception of mental illness. Unfortunately, this section does not acknowledge any contribution from the British Social Scientists in this area of debate-especially the writings of Laing, Cooper and Esterson.
The second section explores 'the changing mental health system', and the forces of institutional and non-institutional care. The growth and development of the community mental health movement is analysed superbly in Alberta Nassi's article 'Community Control or Controlling the Community'. This should be a timely reminder to all those working in this field that myths all too often blur the objectivity of the situation. 'Deinstitutionalization' could be a red herring if the numbers game falsifies the reality: that is, of hospital admission rates which have been increasing but the lengths of stay falling, primarily due to drugs. Although this section does not try to compare and contrast the cost implications of this movement, there is evidence to suggest, at least in the UK, that whether community care is cheaper than hospital care depends on who does the comparison and how it is done.
Section three looks at the professional service providers, and how their values and aspirations affect the direction of service delivery. On the face of it, nothing would seem more obvious than that the profession of psychiatry should take a