In this work, John Z. Sadler examines the nature and significance for practice of the value-content of psychiatric diagnostic classification.

Most everyone agrees that having pneumonia or a broken leg is always a bad thing, but not everyone agrees that sadness, grief, anxiety, or even hallucinations are always bad things. This fundamental disjunction in how disease and disorders are valued is the basis for the considerations in Descriptions and Prescriptions. In this book John Z. Sadler, M.D., brings together a distinguished group of contributors to examine how psychiatric diagnostic classifications are influenced by the values held by mental health professionals and the society in which they practice. The aim of the book, according to Sadler, is "to involve psychiatrists, psychologists, philosophers, and scholars in related fields in an intimate exchange about the role of values in shaping past and future classifications of mental disorders." Contributors: George J. Agich, Ph.D., Cleveland Clinic Foundation; Carol Berkenkotter, Ph.D., Michigan Technological University; Lee Anna Clark, Ph.D., University of Iowa; K.W.M. Fulford, D.Phil., F.R.C.Psych., University of Warwick, Coventry; Irving I. Gottesman, Ph.D., University of Virginia; Laura Lee Hall, Ph.D.; Cathy Leaker, Ph.D., Empire State College; Chris Mace, M.D., M.R.C.Psych., University of Warwick, Coventry; Laurie McQueen, M.S.S.W., American Psychiatric Association, Washington, D.C.; Christian Perring, Ph.D., Dowling College; James Phillips, M.D., Yale University School of Medicine; Harold Alan Pincus, M.D., University of Pittsburgh School of Medicine; Jennifer H. Radden, D.Phil., University of Massachusetts; Doris J. Ravotas, M.A., L.L.P., Michigan Technological University; Patricia A. Ross, Ph.D., University of Minnesota; Kenneth F. Schaffner, M.D., Ph.D., George Washington University; Michael Alan Schwartz, M.D., Case Western Reserve University; Daniel W. Shuman, J.D., Southern Methodist University; Allyson Skene, Ph.D., York University; Jerome C. Wakefield, D.S.W., Rutgers University; Thomas A. Widiger, Ph.D., University of Kentucky; Osborne P. Wiggins, Ph.D., University of Louisville.

With a new edition of the 'bibles' of psychiatric diagnosis - the ICD and DSM - under development, it is timely to take a step back and evaluate how we diagnose and define mental disorder. This new book by Derek Bolton tackles the problems involved in the definition and boundaries of mental disorder.

Many published books that comment on the medical model have been written by doctors, who assume that readers have the same knowledge of medicine, or by those who have attempted to discredit and attack the medical practice. Both types of book have tended to present diagnostic categories in medicine as universally scientifically valid examples of clear-cut diseases easily distinguished from each other and from health; with a fixed prognosis; and with a well-understood aetiology leading to disease-reversing treatments. These are contrasted with psychiatric diagnoses and treatments, which are described as unclear and inadequate in comparison. The Medical Model in Mental Health: An Explanation and Evaluation explores the overlap between the usefulness of diagnostic constructs (which enable prognosis and treatment decisions) and the therapeutic effectiveness of psychiatry compared with general medicine. The book explains the medical model and how it applies in mental health, assuming little knowledge or experience of medicine, and defends psychiatry as a medical practice.

This open access book offers essential information on values-based practice (VBP): the clinical skills involved, teamwork and person-centered care, links between values and evidence, and the importance of partnerships in shared decision-making. Different cultures have different values; for example, partnership in decision-making looks very different, from the highly individualized perspective of European and North American cultures to the collective and family-oriented perspectives common in South East Asia. In turn, African cultures offer yet another perspective, one that falls between these two extremes (called batho pele). The book will benefit everyone concerned with the practical challenges of delivering mental health services. Accordingly, all contributions are developed on the basis of case vignettes, and cover a range of situations in which values underlie tensions or uncertainties regarding how to proceed in clinical practice. Examples include the patient’s autonomy and best interest, the physician’s commitment to establishing high standards of clinical governance, clinical versus community best interest, institutional versus clinical interests, patients insisting on medically unsound but legal treatments etc. Thus far, VBP publications have mainly dealt with clinical scenarios involving individual values (of clinicians and patients). Our objective with this book is to develop a model of VBP that is culturally much broader in scope. As such, it offers a vital resource for mental health stakeholders in an increasingly inter-connected world. It also offers opportunities for cross-learning in values-based practice between cultures with very different clinical care traditions.

This book provides an overview of the strengths and limitations of the currently available systems for the diagnosis and classification of mental disorders, in particular the DSM-IV and the ICD-10, and of the prospects for future developments. Among the covered issues are: * The impact of biological research * The diagnosis of mental disorders in primary care * The usefulness and limitations of the concept of comorbidity in psychiatry * The role of understanding and empathy in the diagnostic process * The ethical, legal and social aspects of psychiatric classification Psychiatric Diagnosis & Classification provides a comprehensive picture of the current state of available diagnostic and classificatory systems in psychiatry and the improvements that are needed.

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.