History of Psychopharmacology.

We live in an age of psychopharmacology. One in six persons currently takes a psychotropic drug. These drugs have profoundly shaped our scientific and cultural understanding of psychiatric disease. By way of a historical review, we try to make sense of psychiatry's dependency on psychiatric drugs in the care of patients. Modern psychopharmacology began in 1950 with the synthesis of chlorpromazine. Over the course of the next 50 years, the psychiatric understanding and treatment of mental illness radically changed. Psychotropic drugs played a major part in these changes as state hospitals closed and psychotherapy gave way to drug prescriptions. Our review suggests that the success of psychopharmacology was not the consequence of increasingly more effective drugs for discrete psychiatric diseases. Instead, a complex mix of political economic realities, pharmaceutical marketing, basic science advances, and changes in the mental health-care system have led to our current infatuation with psychopharmacology

Mental ills and bodily cures: psychiatric treatment in the first half of the twentieth century

Mental Ills and Bodily Cures depicts a time when psychiatric medicine went to lengths we now find extreme and perhaps even brutal ways to heal the mind by treating the body. From a treasure trove of California psychiatric hospital records, including many verbatim transcripts of patient interviews, Joel Braslow masterfully reconstructs the world of mental patients and their doctors in the first half of the twentieth century. Hydrotherapy, sterilization, electroshock, lobotomy, and clitoridectomy - these were among the drastic somatic treatments used in these hospitals.By allowing the would-be healers and those in psychological and physical distress to speak for themselves, Braslow captures the intense and emotional interplay surrounding these therapies. His investigation combines revealing clinical detail with the immediacy of "being there" in the institutional setting while decisions are made, procedures undertaken, and results observed by all those involved. We learn how well-intentioned physicians could rationalize and regard as therapeutic treatments that often had dreadful consequences, and how much the social and cultural world is inscribed within the practice of biological psychiatry. The book will interest historians of medicine, practicing psychiatrists, and everyone who knows or has seen what it's like to be in mental distress

History of Psychopharmacology.

We live in an age of psychopharmacology. One in six persons currently takes a psychotropic drug. These drugs have profoundly shaped our scientific and cultural understanding of psychiatric disease. By way of a historical review, we try to make sense of psychiatry's dependency on psychiatric drugs in the care of patients. Modern psychopharmacology began in 1950 with the synthesis of chlorpromazine. Over the course of the next 50 years, the psychiatric understanding and treatment of mental illness radically changed. Psychotropic drugs played a major part in these changes as state hospitals closed and psychotherapy gave way to drug prescriptions. Our review suggests that the success of psychopharmacology was not the consequence of increasingly more effective drugs for discrete psychiatric diseases. Instead, a complex mix of political economic realities, pharmaceutical marketing, basic science advances, and changes in the mental health-care system have led to our current infatuation with psychopharmacology

Using Electronic Health Records to Enhance a Peer Health Navigator Intervention: A Randomized Pilot Test for Individuals with Serious Mental Illness and Housing Instability

Individuals with serious mental illnesses have high rates of comorbid physical health issues and have numerous barriers to addressing their health and health care needs. The present pilot study tested the feasibility of a modified form of the "Bridge" peer-health navigator intervention delivered in a usual care setting by agency personnel. The modifications concerned the use of an electronic personal health record with individuals experiencing with housing instability. Twenty participants were randomized to receive the intervention immediately or after 6 months. Health navigator contacts and use of personal health records were associated with improvements in health care and self-management. This pilot study demonstrated promising evidence for the feasibility of adding personal health record use to a peer-led intervention

Barriers to Serving Clients With Co-occurring Disorders in a Transformed Mental Health System

OBJECTIVE: The publication of the President’s New Freedom Commission Report in 2003 led to hope and anticipation that system transformation would address barriers that have impeded the delivery of integrated services for clients with co-occurring mental health and substance use disorders. Have problems been resolved? This study analyzed providers’ perspectives on serving clients with co-occurring disorders in a large mental health system that has undergone transformation. METHODS: Six focus groups were conducted with providers at specialty mental health treatment organizations that received funding to transform services. Using content analysis, the authors identified major themes of the focus group discussions. RESULTS: Participants reported several barriers within the mental health system and challenges associated with collaborating with specialty substance abuse treatment providers that impede the delivery of integrated care. CONCLUSIONS: In spite of efforts to improve co-occurring disorder service delivery in a transformed mental health system, barriers that have historically impeded integrated treatment persist