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Mental Health Policy in the United States since 1950
The past half-century has been marked by major changes in the treatment of mental illness: important advances in understanding mental illnesses, increases in spending on mental health care and support of people with mental illnesses, and the availability of new medications that are easier for the patient to tolerate. Although these changes have made things better for those who have mental illness, they are not quite enough. In Better But Not Well, Richard G. Frank and Sherry A. Glied examine the well-being of people with mental illness in the United States over the past fifty years, addressing issues such as economics, treatment, standards of living, rights, and stigma. Marshaling a range of new empirical evidence, they first argue that people with mental illness—severe and persistent disorders as well as less serious mental health conditions—are faring better today than in the past. Improvements have come about for unheralded and unexpected reasons. Rather than being a result of more effective mental health treatments, progress has come from the growth of private health insurance and of mainstream social programs—such as Medicaid, Supplemental Security Income, housing vouchers, and food stamps—and the development of new treatments that are easier for patients to tolerate and for physicians to manage. The authors remind us that, despite the progress that has been made, this disadvantaged group remains worse off than most others in society. The "mainstreaming" of persons with mental illness has left a policy void, where governmental institutions responsible for meeting the needs of mental health patients lack resources and programmatic authority. To fill this void, Frank and Glied suggest that institutional resources be applied systematically and routinely to examine and address how federal and state programs affect the well-being of people with mental illness.
Political Group Dynamics and Foreign Policy-making
Strategic issues and crises in foreign policy are usually managed by relatively small groups of elite policymakers and their closest advisors. Since the pioneering work of Irving Janis in the early 1970s, we have known that the interplay between the members of these groups can have a profound and, indeed, at times a pernicious influence on the content and quality of foreign policy decisions. Janis argued that "groupthink," a term he used to describe a tendency for extreme concurrence-seeking in decision-making groups, was a major cause of a number of U.S. foreign policy fiascoes. And yet not all small groups suffer from groupthink; in fact many high-level bodies are handicapped by an inability to achieve consensus at all. Beyond Groupthink builds upon and extends Janis's legacy. The contributors develop a richer understanding of group dynamics by drawing on alternate views of small-group dynamics. The relevant literature is reviewed and the different perspectives are explored in detailed case studies. The contributors link the group process to the broader organizational and political context of the policy process and stress the need to develop a multi-level understanding of the collegial policy-making process, combining the insights drawn from micro-level theories with those derived from study of broader political phenomena. The contributors include Alexander George, Sally Riggs Fuller, Paul D. Hoyt, Ramon J. Aldag, Max V. Metselaar, Bertjan Verbeek, J. Thomas Preston, Jean A. Garrison, and Yaacov Y. I. Vertzberger. This book should appeal to political scienctists and international relations specialists, as well as researchers in social psychology, public administration, and management interested in group decision-making processes. Paul 't Hart is Associate Professor, Department of Public Administration, Leiden University and Scientific Director of of the Leiden-Rotterdam Crisis Research Center. Eric Stern is Professor of Political Science at Stockholm University. Bengt Sundelius is Professor of Political Science at Stockholm University.
Breastfeeding Constraints and Realities
Current public health promotion of breastfeeding relies heavily on health messaging and individual behavior change. Women are told that “breast is best” but too little serious attention is given to addressing the many social, economic, and political factors that combine to limit women’s real choice to breastfeed beyond a few days or weeks. The result: women’s, infants’, and public health interests are undermined. Beyond Health, Beyond Choice examines how feminist perspectives can inform public health support for breastfeeding.
Written by authors from diverse disciplines, perspectives, and countries, this collection of essays is arranged thematically and considers breastfeeding in relation to public health and health care; work and family; embodiment (specifically breastfeeding in public); economic and ethnic factors; guilt; violence; and commercialization. By examining women’s experiences and bringing feminist insights to bear on a public issue, the editors attempt to reframe the discussion to better inform public health approaches and political action. Doing so can help us recognize the value of breastfeeding for the public’s health and the important productive and reproductive contributions women make to the world.
Life, Death, and Social Policy
Health care spending in the United States today is approaching 20 percent of GDP, yet levels of U.S. population health have been declining for decades relative to other wealthy and even some developing nations. How is it possible that the United States, which spends more than any other nation on health care and insurance, now has a population markedly less healthy than those of many other nations? Sociologist and public health expert James S. House analyzes this paradoxical crisis, offering surprising new explanations for how and why the United States has fallen into this trap. In Beyond Obamacare, House shows that health care reforms, including the Affordable Care Act, cannot resolve this crisis because they do not focus on the underlying causes for the nation’s poor health outcomes, which are largely social, economic, environmental, psychological, and behavioral.
House demonstrates that the problems of our broken health care and insurance system are interconnected with our large and growing social disparities in education, income, and other conditions of life and work, and calls for a complete reorientation of how we think about health. He concludes that we need to move away from our misguided and almost exclusive focus on biomedical determinants of health, and to place more emphasis on addressing social, economic, and other inequalities.
House’s review of the evidence suggests that the landmark Affordable Care Act of 2010, and even universal access to health care, are likely to yield only marginal improvements in population health or in reducing health care expenditures. In order to rein in spending and improve population health, we need to refocus health policy from the supply side—which makes more and presumably better health care available to more citizens—to the demand side—which would improve population health though means other than health care and insurance, thereby reducing need and spending for health care. House shows how policies that provide expanded educational opportunities, more and better jobs and income, reduced racial-ethnic discrimination and segregation, and improved neighborhood quality enhance population health and quality of life as well as help curb health spending. He recommends redirecting funds from inefficient supply-side health care measures toward broader social initiatives focused on education, income support, civil rights, housing and neighborhoods, and other reforms, which can be paid for from savings in expenditures for health care and insurance.
A provocative reconceptualization of health in America, Beyond Obamacare looks past partisan debates to show how cost-efficient and effective health policies begin with more comprehensive social policy reforms.
Cultural History and Developmental Psychology
In 1900, Ellen Key wrote the international bestseller The Century of the Child. In this enormously influential book, she proposed that the world's children should be the central work of society during the twentieth century. Although she never thought that her "century of the child" would become a reality, in fact it had much more resonance than she could have imagined.
The idea of the child as a product of a protective and coddling society has given rise to major theories and arguments since Key's time. For the past half century, the study of the child has been dominated by two towering figures, the psychologist Jean Piaget and the historian Philippe Ariès. Interest in the subject has been driven in large measure by Ariès's argument that adults failed even to have a concept of childhood before the thirteenth century, and that from the thirteenth century to the seventeenth there was an increasing "childishness" in the representations of children and an increasing separation between the adult world and that of the child. Piaget proposed that children's logic and modes of thinking are entirely different from those of adults. In the twentieth century this distance between the spheres of children and adults made possible the distinctive study of child development and also specific legislation to protect children from exploitation, abuse, and neglect. Recent students of childhood have challenged the ideas those titans promoted; they ask whether the distancing process has gone too far and has begun to reverse itself.
In a series of essays, Beyond the Century of the Child considers the history of childhood from the Middle Ages to modern times, from America and Europe to China and Japan, bringing together leading psychologists and historians to question whether we unnecessarily infantilized children and unwittingly created a detrimental wall between the worlds of children and adults. Together these scholars address the question whether, a hundred years after Ellen Key wrote her international sensation, the century of the child has in fact come to an end.
Essays of Henri F. Ellenberger in the History of Psychiatry
Henri F. Ellenberger, the Swiss medical historian, is best remembered today as the author of The Discovery of the Unconscious (1970), a brilliant, encyclopedic study of psychiatric theory and therapy from primitive times to the mid-twentieth century. However, in addition to this well-known work, Ellenberger has written over thirty essays in the history of the mental sciences. This collection unites fourteen of Ellenberger's most interesting and methodologically innovative historical essays, many of which draw on new and rich bodies of primary materials. Several of the articles appear here in English translation for the first time.
The essays deal with subjects such as the intellectual origins of psycho-analysis, the work of the French psychological school of Jean-Martin Charcot and Pierre Janet, the role of the "great patients" in the history of psychiatry, and the cultural history of psychiatry. The publication of these writings, which corresponds with the opening in Paris of the Institut Henri Ellenberger, truly establishes Ellenberger as the founding figure of the historiography of psychiatry. Accompanying the essays are an extensive interpretive introduction and a detailed bibliographical essay by the editor.
Originally published in 1993.
The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.
Illness and the Limits of Expression
“Kathlyn Conway opens primordial questions about the shattering events of illness through close readings of selected illness narratives, proposing that only writing of a daring kind can utter the knowledge of the self-telling body. Wielding her ferocious intellect and braving exposure to self and other, Conway makes original discoveries about writing and illness and, more stunningly, about writing and life. Not a book about illness, this is a book about writing and being. It is taut, brave, unequalled in our scholarship, and true. Conway joins our most powerful investigators of the human predicament of mortality, helping us to see, helping us to live.”—Rita Charon, Columbia University, Program in Narrative Medicine
Published accounts of illness and disability often emphasize hope and positive thinking: the woman who still looked beautiful after losing her hair, the man who ran five miles a day during chemotherapy. This acclaimed examination of the genre of the illness narrative questions that upbeat approach. Author Kathlyn Conway, a three-time cancer survivor and herself the author of an illness memoir, believes that the triumphalist approach to writing about illness fails to do justice to the shattering experience of disease. By wrestling with the challenge of writing about the reality of serious illness and injury, she argues, writers can offer a truer picture of the complex relationship between body and mind.
A View from the Southeast
Investigations of skeletal remains from key archaeological sites reveal new data and offer insights on prehistoric life and health in the
The shift from foraging to farming had important health consequences for prehistoric peoples, but variations in health existed
within communities that had made this transition. This new collection draws on the rich bioarchaeological record of the Southeastern United States
to explore variability in health and behavior within the age of agriculture. It offers new perspectives on human adaptation to various geographic and
cultural landscapes across the entire Southeast, from Texas to Virginia, and presents new data from both classic and little-known sites.
The contributors question the reliance on simple cause-and-effect relationships in human health and behavior by addressing such key bioarchaeological issues as disease history and epidemiology, dietary composition and sufficiency, workload stress, patterns of violence, mortuary practices, and biological consequences of European contact. They also advance our understanding of agriculture by showing that uses of maize were more varied than has been previously supposed.
Representing some of the best work being done today by physical anthropologists, this volume provides new insights into human adaptation for both archaeologists and osteologists. It attests to the heterogeneous character of Southeastern societies during the late prehistoric and early historic periods while effectively detailing the many factors that have shaped biocultural evolution.
Contributors include: Patricia S. Bridges, Elizabeth Monaham Driscoll, Debra L. Gold, Dale L. Hutchinson, Keith P. Jacobi, Patricia M. Lambert, Clark Spencer Larsen, Lynette Norr, Mary Lucas Powell, Marianne Reeves, Lisa Sattenspiel, Margaret J. Schoeninger, Mark R. Schurr, Leslie E. Sering, David S. Weaver, and Matthew A. Williamson