Review of Mental health law in Canada.

Reviews the book, Mental health law in Canada by Harvey Savage and Carla McKague (1987). Mental health professionals who come into contact with the law in the course of their work generally have an interest in the well-being of the client. However, they often feel dismayed and confused because of their lack of understanding of mental law and the legal system in general. Until recently, mental health professionals in Canada could not turn to a single volume which would help explain mental health law, including their clients' rights. However, Harvey Savage and Carla McKague's book, Mental health law in Canada, will help alleviate some of the concern and confusion Canadian mental health professionals have come to know. Although some authors have written about Canadian mental health law in specific contexts (e.g., criminal responsibility or fitness to stand trial), Savage and McKague's contribution is the only available comprehensive source directed to the law affecting psychiatric patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On Mariner's "lay analyst."

Comments on A. S. Mariner's (see record 1967-08073-001) article about professional education in the mental health field and argues against Mariner's use of the term "lay analyst" to refer to nonmedical analysts. Mariner also underestimated the numerical strength and the vigor of such analysts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Mental Health Concept.

In its recent report (Amer. Psychologist, 1959, 14, 820-825, see record 1961-00974-001) the Ad Hoc Planning Group on the Role of the APA in Mental Health Programs and Research makes several critical comments on the concepts of mental health and mental illness. These are listed in this article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental illness and mental retardation: Message from the President of the United States relative to mental illness and mental retardation.

2 health problems of critical size and tragic impact are mental illness and mental retardation. "There are now about 800,000 such patients in this Nation's institutions—600,000 for mental illness and over 200,000 for mental retardation." A 3-fold attack is proposed: (a) Ascertain causes and eradicate them. (b) Strengthen underlying resources of knowledge and of skilled manpower. (c) Strengthen and improve facilities serving the mentally ill and mentally retarded. A national program for mental health is proposed which emphasizes comprehensive community mental health centers, improved care in state mental institutions, and expansion of research activities and increase in professional manpower. A national program to combat mental retardation emphasizing prevention, community services, and research is also proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Role of Canadian Psychologists in Conducting Fitness and Criminal Responsibility Evaluations.

Historically, only physicians, typically psychiatrists, were permitted to conduct forensic mental health evaluations for the courts. In the United States, the courts have affirmed increasing acceptance of involvement of psychologists since the 1940s. In Canada, the legal system continues to adhere to the assumption of medical dominance to a large extent. For instance, Canadian legislation requires that a physician conduct court-ordered assessments of fitness to stand trial and criminal responsibility. In this article, relevant Canadian law is compared to American law, and empirical research on the ability of psychologists to assess fitness and criminal responsibility is discussed. These legal and empirical reviews are used to generate policy recommendations regarding the qualifications of forensic examiners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recovery in Serious Mental Illness: A New Wine or Just a New Bottle?

The notion of recovery has become a dominant force in mental health policy, evident in reports of the Surgeon General and President's New Freedom Commission. In both reports, recovery is stipulated as the overarching goal of care and foundation for reforms at state and local levels. Little consensus exists regarding the nature of recovery in mental illness, however, or about the most effective ways to promote it. The authors offer a conceptual framework for distinguishing between various uses of the term, provide a definition of recovery in mental health, and conclude with a discussion of the implications of this concept for meaningful reform. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns and predictors of mental health service use and mental illness among older and younger adults in the United States.

The present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65+) and younger (18-64) adults throughout the United States, and the extent to which various factors predict SMI and the use and magnitude of mental health treatment. Despite recent developments designed to improve mental healthcare access and treatment for older adults, older individuals were found to receive outpatient mental healthcare at very low rates. Compared to younger adults, older adults were three times less likely to report receiving treatment. Although prevalence estimates for SMI and specific syndromes were markedly lower among older than younger adults, older individuals most in need of care were highly unlikely to report receiving treatment. Findings point to the importance of perceived need in mental healthcare use. Significantly, however, those older adults that made it into services typically reported benefiting considerably from treatment, at least as much as all other age groups. Several predisposing, enabling, and need factors related to mental illness and service use were identified that have important implications for how we plan for, design, and deliver mental health services to older and younger Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An expanded perspective on children's mental health.

Comments on three articles (see records 2005-11115-003, 2005-11115-004, and 2005-11115-005) on the status of children's mental health services in the United States, which appeared in the September 2005 issue of the American Psychologist. The current authors suggest that, although this series of articles provides important information, the articles fall short in meeting the mark of comprehensively describing the solutions necessary to effectively address the crisis facing children's mental health in this country. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statement on mental illness and mental retardation.

The statement made on behalf of the American Psychological Association is in support of Senate Bills 755 and 756 developed by Congress in response to President Kennedy's message on mental illness and mental retardation. "The psychologist is vitually concerned with the problems of mental disorders and of mental retardation. He is especially interested in research, and in the provision of services to people through the organized agencies of society, such as the public schools, community mental health centers, hospitals, institutions for the retarded, and rehabilitation agencies of many kinds." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practice, policy and parity: The politics of persistence.

The road to comprehensive mental health parity legislation at the state level often reaches a dead end when mental health advocates are forced to compromise by accepting partial parity for "severe mental illness" (SMI) only. In 1999 Connecticut became the first state to modify a biologically based or SMI mental health parity law into comprehensive mental health and substance abuse parity legislation. In this article we chronicle the fight for mental health parity in Connecticut and discuss subtleties of legislative advocacy. This information should prove useful to psychologists who are pursuing parity in other states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

L'accessibilité à des traitements pour les troubles anxieux au Canada: Un commentaire.

Responds to Gauthier (see record 2004-17185-003) who commented on the two articles by Koerner et al (see record 2004-17185-001) and by Roberge et al (see record 2004-17185-002. The purpose of this response is to discuss the issue of limited availability of mental health services for anxiety disorders in Canada. From a public health perspective, the authors emphasize the importance of gathering Canadian empirical data on the organization of mental health services for anxiety disorders. Specifically more research is needed on care requirements, and the financial and structural barriers that restrict access to mental health services at the regional, provincial and national levels. The authors also discuss the role of psychologists in improving mental health care in Canada. Cost-effectiveness studies conducted in interdisciplinary practice environments could demonstrate the value added by psychology in the organization of mental health care for anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reply to Cyr and Haley.

Responds to comments by Cyr and Haley, on the authors' original record entitled, "Extraneous factors in institutionalization for mental retardation: Demographic analyses for Ontario" (Canadian Journal of Community Mental Health, 1982, 1, 107-113). Silverman and Saunders discuss the effects of residence changes on readmissions to mental retardation institutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The uses of naming and the origin of the myth of mental illness.

"When we say that someone has or suffers from a mental illness, we assert a logically highly dubious proposition. It is virtually impossible to ascertain whether this proposition is true or false, because of the wide range of meaning that may be assigned to the term 'mental illness.' " Certain psychologists have used "the expression 'mental illness' to depreciate and injure others (particularly fellow professionals), but they also used its converse, 'mental health,' to promote the good fortune of those whom they liked and respected." It is desirable "to examine carefully the precise nature of the present status of our scientific (as well as everyday) attitudes toward problems of so-called mental illness." From Psyc Abstracts 36:02:2JA59S. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building a world-class mental health care system for America.

This article examines our current mental health care system, and what can be done to expand this current system. It focuses on the mental health needs of our children, and makes some suggestions to improve their care. Some things discussed are putting more mental health professionals in schools, affordable and convenient treatment options for parents, and flexible treatment arrangements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The link between childhood trauma and mental illness.

Reviews the book, The link between childhood trauma and mental illness by Barbara Everett and Ruth Gallop (see record 2000-16130-000). This is a very useful book, particularly for novice practitioners and front-line workers who may not have had a supervised experience dealing with abused individuals. The authors set out to provide a practical guide to the care of individuals who have experienced abuse (both sexual and physical) as children, and who present themselves as adults to mental health practitioners, in particular to those who are not practicing in specialized trauma clinics. I believe they have succeeded in their goal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Southern regional mental health program focuses on development of training and research.

"The American psychological profession is taking a leading role in the nation's first regional program to improve mental health and combat mental disease which the Southern Regional Education Board is conducting." The program reached its operational stage with the organization of the Southern Regional Council on Mental Health Training and Research in Atlanta on July 11-12, 1955, following 18 months of surveys and planning. The organization, problems, and activities of the Southern program are discussed. State committees have "… agreed that the need for new knowledge is as acute as the personnel shortage." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The mental hospital in the 21st century.

Reviews the book, The mental hospital in the 21st century by Emmanuel Persad, Shane S. Kazarian, and Llewellyn W. Joseph (1992). The authors not only review past endeavors in the delivery of mental health services but speculate as to the role the mental hospital may take in the years to come. The starting point for this book is a conference entitled "The Role of the Mental Hospital in the 21st Century" sponsored by the London Psychiatric Hospital in October 1990. The book features 20 brief chapters regrouped in three sections. In all, 29 contributors mainly from Canada, bring forth varying perspectives on the role of the mental hospital. The real contribution of this book is that it puts into perspective the magnitude of the challenge that confronts the major stakeholders in developing a comprehensive and balanced system of mental health services. The present book could serve as a starting point for some serious debate among the stakeholders about the way the mentally ill are treated and to determine how the role of the mental hospital should change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On Mental Illness.

Two official position papers of our APA seem to contradict each other with respect to whether mental illness is a myth or not. The APA official position paper, "The Community and the Community Mental Health Center," questions the appropriateness of the term "illness." The APA official position paper, "The Psychologist and Voluntary Health Insurance." identifies psychology in some of its roles as a health profession. Is psychology in some of its roles supposed to be a health profession that regards illness as a myth in some of its other roles? The answer seems to be, "Yes." If psychologists would switch hats as they changed roles from clinician to social science consultant, the contradiction would be resolved easily. Instead, the contradiction is denied by one role player or the other. Somehow, the medical model is supposed to be absolutely evil and to stand in the way of social progress. At the same time, psychiatrists seem to expect to exercise leadership in matters of social science. I believe that mental illness exists. Psychiatrists have primary responsibility for its treatment, and there is a very large and honorable role for clinical psychologists in the struggle against mental illness. Social disorganization exists. I doubt very much that psychologists deserve primary responsibility for the amelioration of social disorganization, but psychologists can make important contributions. Let us not overdefend against the boundless ambitions of our medical colleagues as social science experts by denying the legitimacy of mental illness and of the medical model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)