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.

This book examines 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.

"Elliott's absorbing account will make readers think again about the ways that science shapes our personal identities."—American Scientist Americans have always been the world's most anxiously enthusiastic consumers of "enhancement technologies." Prozac, Viagra, and Botox injections are only the latest manifestations of a familiar pattern: enthusiastic adoption, public hand-wringing, an occasional congressional hearing, and calls for self-reliance. In a brilliant diagnosis of our reactions to self-improvement technologies, Carl Elliott asks questions that illuminate deep currents in the American character: Why do we feel uneasy about these drugs, procedures, and therapies even while we embrace them? Where do we draw the line between self and society? Why do we seek self-realization in ways so heavily influenced by cultural conformity?

CHAPTER 14: MAKING MARRIAGE (AND OTHER RELATIONSHIPS) WORK -- CHAPTER 15: THE JOYS OF LOVING: ENHANCING SEXUAL EXPERIENCES -- CHAPTER 16: RAISING OUR KIDS WELL: GUIDELINES FOR POSITIVE PARENTING -- CHAPTER 17: FINANCIAL SKILLS -- AUTHOR INDEX -- SUBJECT INDEX

Most of us want to make a difference. We donate our time and money to charities and causes we deem worthy, choose careers we consider meaningful, and patronize businesses and buy products we believe make the world a better place. Unfortunately, we often base these decisions on assumptions and emotions rather than facts. As a result, even our best intentions often lead to ineffective—and sometimes downright harmful—outcomes. How can we do better? While a researcher at Oxford, trying to figure out which career would allow him to have the greatest impact, William MacAskill confronted this problem head on. He discovered that much of the potential for change was being squandered by lack of information, bad data, and our own prejudice. As an antidote, he and his colleagues developed effective altruism, a practical, data-driven approach that allows each of us to make a tremendous difference regardless of our resources. Effective altruists believe that it’s not enough to simply do good; we must do good better. At the core of this philosophy are five key questions that help guide our altruistic decisions: How many people benefit, and by how much? Is this the most effective thing I can do? Is this area neglected? What would have happened otherwise? What are the chances of success, and how good would success be? By applying these questions to real-life scenarios, MacAskill shows how many of our assumptions about doing good are misguided. For instance, he argues one can potentially save more lives by becoming a plastic surgeon rather than a heart surgeon; measuring overhead costs is an inaccurate gauge of a charity’s effectiveness; and, it generally doesn’t make sense for individuals to donate to disaster relief. MacAskill urges us to think differently, set aside biases, and use evidence and careful reasoning rather than act on impulse. When we do this—when we apply the head and the heart to each of our altruistic endeavors—we find that each of us has the power to do an astonishing amount of good.

'This book fills a tremendous void...' wrote E. Fuller Torrey, M.D., about the first edition of I AM NOT SICK, I Don't Need Help! Ten years later, it still does. Dr. Amador's research on poor insight was inspired by his attempts to help his brother Henry, who developed schizophrenia, accept treatment. Like tens of millions of others diagnosed with schizophrenia and bipolar disorder, Henry did not believe he was ill. In this latest edition, 6 new chapters have been added, new research on anosognosia (lack of insight) is presented and new advice, relying on lessons learned from thousands of LEAP seminar participants, is given to help readers quickly and effectively use Dr. Amador s method for helping someone accept treatment. I AM NOT SICK, I Don't Need Help! is not just a reference for mental health practitioners or law enforcement professionals. It is a must-read guide for family members whose loved ones are battling mental illness. Read and learn as have hundreds of thousands of others...to LEAP-Listen, Empathize, Agree, and Partner-and help your patients and loved ones accept the treatment they need.

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.