Synopses & Reviews
and#160;While mental illness and mental health care are increasingly recognized and accepted in todayandrsquo;s society, awareness of the most severely mentally illandmdash;as well as those who care for themandmdash;is still dominated by stereotypes.and#160; Managing Madness in the Community
dispels the myth.and#160; Readers will see how treatment options often depend on the social status, race, and gender of both clients and carers; how ideas in the field of mental health careandmdash;conflicting priorities and approachesandmdash;actually affect what happens on the ground; and how, amid the competing demands of clients and families, government agencies, bureaucrats and advocates, the fragmented American mental health system really worksandmdash;or doesnandrsquo;t.
In the wake of movies like One Flew Over the Cuckooandrsquo;s Nest and Shutter Island, most people picture the severely or chronically mentally ill being treated in cold, remote, and forbidding facilities.and#160; But the reality is very different.and#160; Today the majority of deeply troubled mental patients get treatment in nonprofit community organizations.and#160; And it is to two such organizations in the Midwest that this study looks for answers.and#160; Drawing upon a wealth of unique evidenceandmdash;fifteen months of ethnographic observations, 91 interviews with clients and workers, and a range of documentsandmdash;Managing Madness in the Community lays bare the sometimes disturbing nature and effects of our overly complex and disconnected mental health system.
Kerry Michael Dobransky examines the practical strategies organizations and their clients use to manage the often-conflicting demands of a host of constituencies, laws, and regulations.and#160; Bringing to light the challenges confronting patients and staff of the community-based institutions that bear the brunt of caring for the mentally ill, his book provides a useful broad framework that will help researchers and policymakers understand the key forces influencing the mental health services system today.
"Laura Hirshbein demonstrates that the modern diagnosis of depression is only a recent creation and reveals more about our society and culture than our mental states. In tracing the manner in which depression entered medical diagnostic systems, she has made a major contribution that should force us to question claims about the pervasive nature of this diagnosis." department of history, University of Illinois
"Laura Hirshbein's analysis of the explosive growth of depression in American society, psychiatry, and pharmacology emphasizes the overlapping roles of the medicalization and commercialization of mental states; the contemporary hyper-consumerist American's habits; the quest of psychiatric communities for professional and scientific security; and the drive, relentless and resourceful, by global pharmaceutical companies for new markets. This book is likely to be regarded eventually as the finest and most in-depth account around of gender and depression." Mark S. Micale
"Hirshbein illustrates how and why depression became a medical, social, and cultural phenomenon. In paying careful attention to the role of gender in shaping the conception and treatment of depression, Hirshbein adds a new component to the literature on and understanding of depression. Highly recommended."
andquot;David Schuster's Neurasthenic Nation provides a vivid and compelling account of neurasthenia and its place in American medicine and culture.andquot;
"An interesting, useful, and exceptionally readable review of the evol Journal of the American Medical Association
"American Melancholy provides new insight into a diagnostic category that has become central not only to modern psychiatry but also to the very definition of ordinary life in late twentieth-century America. Perhaps its greatest contribution lies in Hirshbein's careful attention to the role of gender in shaping the conception and treatment of depression." Gerald N. Grob - Henry E. Sigerist Professor of the History of Medicine Emeritus, Rutgers Univers
"A badly needed book, executed brilliantly. Hirshbein's arguments are nuanced but forceful, and many readers should find themselves questioning commonly held notions about depression and diagnosis. Her analysis of gender, in particular, should compel re-evaluations of vast bodies of research on psychiatry and mental illness." Nancy Tomes - author of Madness in America
"Smoking Privileges is a compelling, authoritative, and relevant historical analysis of smoking policy, social attitudes, mental illness, scientific research, and industry."
andquot;Beyond being readable and engaging, this book is unique in its use of organizational theory to elucidate key features of the mental health system. The focus on institutional fragmentation is very original, and important from a policy perspective.andquot;
andquot;In this interesting new book, Dobransky carefully explores the often contradictory institutional logics of community-based psychiatric care and offers fresh insights on how these competing views shape our fragmented system of community mental healthcare.andquot;
andquot;Dobranskyandrsquo;s willingness to question the currently received wisdom about the value of currently popular service approaches and his use of a rich dataset both attest to the bookandrsquo;s potential.andquot;
andquot;Managing Madness in the Community is a timely read, presenting severe persistent mental illness (SPMI) and the delivery of community mental health in clear, understandable terms. Recommended.andquot;
andquot;[An] excellent study. The book is a worthy addition to the voluminous literature on neurasthenia.andquot;
andquot;David G. Schuster provides a comprehensive examination of the origins and nature of [neurasthenia], but more importantly he captures why it became such an important social, economic, and cultural phenomenon, as well as why, after 1920, it declined so precipitously.andquot;
offers a thoughtful and accessible guide to the history of neurasthenia in the United States, one especially sensitive to the role of gender and the relationship between clinicians and clients.andquot;
"In Smoking Privileges, Laura D. Hirshbein traces the inexorable linkages between smoking and mental illness up through the twentieth century, weaving in the dual stories of smoking's rise as a public health menace and the decline of state mental hospitals. A clinical psychiatrist, Hirshbein shares her perspective as someone with empathy for and experience with this population."
As American Melancholy
reveals, if you read about depression anywhere today—medical journal, popular magazine, National Institute of Mental Health pamphlet, or pharmaceutical company drug promotional literature--you will find three main pieces of information either explicitly stated or strongly implied: depression is a disease (like any other physical disease); it is extraordinarily prevalent in the world; and it occurs about twice as frequently in women as in men. Yet, depression was not classified as a disease until the 1980 publication of the American Psychiatric Association's Diagnostic and Statistical Manual-III (DSM-III).
How is it that such an illness, thought to affect between 14 and 17 million Americans, was not specifically defined until the late twentieth century?
American Melancholy traces the growth of depression as an object of medical study and as a consumer commodity and illustrates how and why depression came to be such a huge medical, social, and cultural phenomenon. It is the first book to address gender issues in the construction of depression, explores key questions of how its diagnosis was developed, how it has been used, and how we should question its application in American society.
In American Melancholy, Laura D. Hirshbein traces the growth of depression as an object of medical study and as a consumer commodity and illustrates how and why depression came to be such a huge medical, social, and cultural phenomenon. This is the first book to address gender issues in the construction of depression, explores key questions of how its diagnosis was developed, how it has been used, and how we should question its application in American society.
Neurasthenic Nation investigates how the concept of neurasthenia, the ill effects of modern civilization such as insomnia or impotence, helped doctors and patients, men and women, and advertisers and consumers negotiate changes commonly associated with andldquo;modernity.andrdquo; Combining a survey of medical and popular literature on neurasthenia with original research into rare archives of personal letters, patient records, and corporate files, David Schuster charts the emergence of a andldquo;neurasthenic nationandrdquo;andmdash;a place where people saw their personal health as inextricably tied to the pitfalls and possibilities of a changing world.
The mentally ill may represent as much as half of the smokers in America. In a groundbreaking look at this little-known public health problem, Smoking Privileges offers an insightful historical account of the intersection of smoking and mental illness, placing this issue in the context of changes in psychiatry, in the tobacco and pharmaceutical industries, and in the experience of mental illness over the last century.
Current public health literature suggests that the mentally ill may represent as much as half of the smokers in America. In Smoking Privileges, Laura D. Hirshbein highlights the complex problem of mentally ill smokers, placing it in the context of changes in psychiatry, in the tobacco and pharmaceutical industries, and in the experience of mental illness over the last century.Hirshbein, a medical historian and clinical psychiatrist, first shows how cigarettes functioned in the old system of psychiatric care, revealing that mental health providers long ago noted the important role of cigarettes within treatment settings and the strong attachment of many mentally ill individuals to their cigarettes. Hirshbein also relates how, as the sale of cigarettes dwindled, the tobacco industry quietly researched alternative markets, including those who smoked for psychological reasons, ultimately discovering connections between mental states and smoking, and the addictive properties of nicotine. However, Smoking Privileges warns that to see smoking among the mentally ill only in terms of addiction misses how this behavior fits into the broader context of their lives. Cigarettes not only helped structure their relationships with other people, but also have been important objects of attachment. Indeed, even after psychiatric hospitals belatedly instituted smoking bans in the late twentieth century, smoking remained an integral part of life for many seriously ill patients, with implications not only for public health but for the ongoing treatment of psychiatric disorders. Making matters worse, well-meaning tobacco-control policies have had the unintended consequence of further stigmatizing the mentally ill.A groundbreaking look at a little-known public health problem, Smoking Privileges illuminates the intersection of smoking and mental illness, and offers a new perspective on public policy regarding cigarettes.
and#160;The mentally ill might not go to Shutter Island or the Cuckooandrsquo;s Nest, but that doesnandrsquo;t mean theyandrsquo;re getting the best care they can.and#160; With extensive, unique ethnographic research at two community-based organizations that provide the bulk of suchand#160;care, Managing Madness in the Community lays bare the true nature, effects, and costs of our fragmented mental health system and provides a useful broad framework that will help researchers and policymakers understand the key forces influencing the system today.
As the United States rushed toward industrial and technological modernization in the late nineteenth century, people worried that the workplace had become too competitive, the economy too turbulent, domestic chores too taxing, while new machines had created a fast-paced environment that sickened the nation. Physicians testified that, without a doubt, modern civilization was causing a host of illsandmdash;everything from irritability to insomnia, lethargy to weight loss, anxiety to lack of ambition, and indigestion to impotence. They called this condition neurasthenia.
Neurasthenic Nation investigates how the concept of neurasthenia helped doctors and patients, men and women, and advertisers and consumers negotiate changes commonly associated with andldquo;modernity.andrdquo; Combining a survey of medical and popular literature on neurasthenia with original research into rare archives of personal letters, patient records, and corporate files, David Schuster charts the emergence of a andldquo;neurasthenic nationandrdquo;andmdash;a place where people saw their personal health as inextricably tied to the pitfalls and possibilities of a changing world.
About the Author
LAURA D. HIRSHBEIN, M.D. is a clinical associate professor of psychiatry at the University of Michigan and the author of American Melancholy: Constructions of Depression in the Twentieth Century (Rutgers University Press).
Table of Contents
Introduction: Smoking Privileges
1 Ecology of Smoking in Mental Hospitals through the 1970s
2 Conflict and Smoking in Mental Hospitals in the 1960s and 1970s
3 Smoker Psychology and the Tobacco Industry through the Early 1980s
4 Psychiatry Engages Smoking
5 The Many Faces of Nicotine
6 From Tolerance to Treatment
7 Tobacco Control and the Mentally Ill
8 Double Marginalization
Conclusion: Corporate Squeeze