Innovative Approaches for Difficult-to-Treat Populations makes recommendations for developing and disseminating innovative mental health services. It is geared toward clinicians, administrators, and policy-makers struggling to develop both clinically effective and cost-effective mental health and substance abuse services, and it focuses on services for individuals who use the highest proportion of mental health resources and for whom traditional services have not been effective. These target populations include youth with serious behavioral and emotional disturbances and adults with severe and persistent mental illnesses. The innovative approaches reviewed include diverse treatment methods for differing clinical populations.
These varied approaches have several common elements: * Social-ecological theory frameworks* An emphasis on delivering flexible, comprehensive, pragmatic, and goal-oriented interventions in persons' natural environments* Increased accountability on the part of service providers* The transition from centralized to community-based care is discussed, and normalizing a patient's daily routine as an important factor in the success of state-of-the-art community support programs is emphasized Innovative Approaches for Difficult-to-Treat Populations offers mental health professionals and students a firsthand look at the future direction of clinical services. Policy issues necessary to developing and disseminating progressive treatments are addressed, including the downsizing of state psychiatric hospitals, strategies for reforming state mental hospital systems, and ethical issues in research on child and adolescent mental disorders.
Scott W. Henggeler, Ph.D., works in the Department of Psychiatry and Behavioral Sciences and Director of the Family Services Research Center at the Medical University of South Carolina, Charleston, South Carolina. Alberto B. Santos, M.D., is currently the Director of the Division of Public Psychiatry and the Director of Psychiatry Residency Training in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina, Charleston, South Carolina.
Services for Children, Adolescents, and Their Families. Ecological trajectories in child mental health. Family preservation services for families with children who have mental health problems. Community- and neighborhood-based services for youth. Effective community-based treatments for serious juvenile offenders. Approaches to intervention with chronically neglecting families. Interventions for adolescents who abuse substances. The east Baltimore mental health partnership. Vocational initiatives for transition-age youths with severe mental illness. Approaches for Severely Ill Adult Populations. From the hospital to the community: the great American paradigm shift. Treating substance abuse in patients with severe mental illness. Family psychoeducation: basic concepts and innovative applications. Rural assertive community treatment: taking mental health services on the road. Adult foster care: the forgotten alternative? Mobile psychiatric emergency medical services. Optimal psychiatric inpatient care: from comprehensive to efficient treatment. Innovative services for elderly populations. Enhancing vocational outcomes for persons with psychiatric disabilities: a new paradigm. Policy Issues. Why don't the knuckleheads use common sense? Downsizing state psychiatric hospitals. Medicaid financing. Statewide program dissemination in Michigan. Strategies for reforming state mental health systems. An EPA for children: empowerment, prevention, and advocacy at work. Ethical issues in research on child and adolescent mental disorders: implications for a science of scientific ethics. Behavioral therapy research: a conceptualization of a process. Index.
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