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Healing the Broken Mind

Transforming America’s Failed Mental Health System

Timothy Kelly

Publication Year: 2009

Few afflictions are as frightening or as heartbreaking as mental illness. It may be a topic that many would prefer to sweep under the rug, but it is a fact of life that we as a society can and must face. We have come a long way over the past few decades in our understanding of mental illness and its potential treatments. Yet, tragically, many across the country who struggle with serious mental illness are unable to find effective, quality medical treatment. As a federal commission on mental health concluded, the system of care is in shambles. But why? And how do we fix it?

Timothy A. Kelly, former Commissioner of Virginia's Department of Mental Health, Retardation, and Substance Abuse, brings his three decades of experience as mental health commissioner, psychology professor, and clinician to bear in confronting this crisis in America's mental health care system. In clear and accessible terms, he exposes the weaknesses in the current system, examining how and why one of the world's richest and most advanced countries has allowed its most vulnerable citizens to be victimized by the very system designed to help them.

Armed with the latest statistics, a lifetime of experience, and heartrending life stories, Kelly argues that the patchwork of care traditionally employed to treat mental illness is simply not up to the task, and that what we need is profound, fundamental, and system-wide change. He then goes on to provide an easy-to-follow road map for achieving lasting transformation, centered on five recommendations for creating a truly effective mental health system of care that enables patients to achieve a lasting recovery.

Mental illness is not going to just go away, but Kelly prescribes a comprehensive plan to make treatment accessible and effective so that those who suffer can rejoin their families and their communities. He shows how a transformed system of community-based care allows those with serious mental illness to finally be able to go home.

Published by: NYU Press

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pp. ix

It took me over ten years to write this book, which started out as a series of articles after I stepped down as Virginia’s ninth mental health commissioner. There are many among my friends, family, students, and colleagues whose support and encouragement kept me going, and I apologize that I cannot list everyone here. Nonetheless I am deeply grateful...

List of Abbreviations

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pp. xi

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1. Men in Diapers: A System in Shambles

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pp. 1-33

Mental illness can be frightening both for those who experience it and for their family and friends, who may try in vain to somehow just make it all go away. It strikes young and old, rich and poor, Democrat and Republican alike. Some of our greatest leaders have experienced it, such as President Lincoln, who struggled with depression. Some of the...

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2. That Which Is Measured Improves

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pp. 35-64

It was the summer of 1994, and I was just settling in as the newly appointed commissioner for Virginia’s Department of Mental Health, Mental Retardation, and Substance Abuse Services. Monday morning at nine was our scheduled weekly staff meeting, when the commissioner and central office managers discuss strategic concerns and plan for the coming...

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3. Monopolies Don’t Work

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pp. 65-89

One of the least exciting jobs of a mental health commissioner is to review and sign off on major contracts between various suppliers and the state. The contract could be for anything—food supplies or repairs for the hospitals, psychiatric medications, new computers for the central office— you name it. Every day a stack of such documents would appear on my...

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4. Fair Is Fair: Parity for Mental Health Coverage

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pp. 91-113

Ted and Joan thought they had prepared well to meet any and all needs for their family of four. They both had stable, good-paying professional jobs in the Washington, D.C., area, and they owned a nice three-bedroom home in a quiet neighborhood. They had dutifully taken care of their wills, making sure that trusts were in...

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5. Let the People Speak

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pp. 115-113

At the core of the American democratic concept is the principle that everyone affected by a policy or decision should have a voice at the table. This principle is based on the belief that people can be trusted to make good decisions on their own behalf. In America there is no place for autocracy, whether in government or in health care. Yet currently, a great...

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6. Transforming America’s Mental Health System

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pp. 139-164

We have come a long way since the opening statements of this book. We have defined serious mental illness and documented some of the failures of the current mental health system. We have pointed to the need for evidence-based practices and outcome-oriented care, as well as innovative community-based services. We have shown why monopolies don’t work...

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Postscript—Information on Mental Illness

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pp. 165

There are two sources of information for people with mental illness and their families that, in my opinion, outshine the rest. Both are Web sites. Whether one is looking for basic understanding about a particular mental disorder, the latest in treatment options, how to connect with others with similar needs, or books and articles on mental illness, these...


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pp. 167-172


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pp. 173-179


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pp. 181-192

About the Author

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pp. 193

E-ISBN-13: 9780814749104
E-ISBN-10: 0814749100
Print-ISBN-13: 9780814748121
Print-ISBN-10: 0814748120

Page Count: 208
Publication Year: 2009