Community Mental Health Movement Research Articles

Forging a psychological solidarity: from the community mental health movement to Latinx life coaching in the South Bronx

Forging a psychological solidarity: from the community mental health movement to Latinx life coaching in the South Bronx

A history of the community mental health movement and individuals with serious mental illness: A vision for the future.

The history of the development of the Global Alliance for Behavioral Health and Social Justice was founded on understanding the social determinants of mental health and society and the necessity for multiple disciplines to organize advocacy for human rights and social justice. This led way to a wide cross-section of disciplines working together to engage at the policy level, in legislation, and within community settings as the Community Mental Health Movement developed and made a path for the reformation of many forms within the mental health field. This article reviews some of that interesting history and the importance of understanding those fundamental roots as we also look at the future for what is next in advocacy, social justice action, and policy directions for advancing the lives of those with serious mental illness, who face some of the most oppressive forms of marginalization and rejection of human rights and citizenship. This article will outline social justice action agendas for the organization and diverse collaborative fields to pursue as we embark upon the future and envision the full rights of citizenship for those with serious mental illness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Intervention Studies for Mental Health: A Comprehensive Exploration of Historical Evolution, Theoretical Foundations, and Contemporary Applications

This research comprehensively explores the evolution of intervention studies in psychology, spanning the late 19th century to the present day. Grounded in the seminal works of Gergen, Kazdin, and Beck, the investigation traces the transition from behaviourism to cognitive-behavioural approaches, the rise of positive psychology, and the integration of cutting-edge technologies in the 21st century. Examining diverse domains such as mental health, education, social behaviour, and clinical disorders, the study illuminates the role of interventions in bridging the gap between theory and practical applications. Historical milestones, including World War II and the community mental health movement, are examined to reveal external influences on intervention research. The research emphasizes the transformative impact of technological advancements, ushering in a new era of digital interventions and virtual platforms that offer personalized, scalable solutions, underscoring the dynamic adaptability of intervention studies to contemporary societal needs. Keywords: Interventions, Historical Evolutions, Methods of Intervention, Issues of Intervention, Behaviour Modifications, Cognitive Behaviour Therapy.

Assembling Adjustment: Parergasia, Paper Technologies, and the Revision of Recovery

Drawing from research on 'paper technologies' conducted by medical historians Volker Hess and Andrew Mendelsohn, among others, this article explores how Adolf Meyer (1866-1950) and his staff at the Phipps Psychiatric Clinic used customized punch cards to develop an alternative conceptualization of schizophrenia: 'parergasia.' It begins by examining 'dementia praecox,' the conceptual precursor to both schizophrenia and parergasia, to explain how earlier paper technologies used to track patients transferred to asylums generated prognostic assumptions that precluded deinstitutionalization and community-based care. It then describes how Meyer's staff modified these technologies to define parergasia in opposition to dementia praecox and other diagnoses that resulted in prolonged hospitalization, primarily by conducting follow-up studies on discharged patients that correlated outcomes with various social factors. After demonstrating how the standardized forms used in these studies limited the possible metrics of recovery, it concludes by suggesting how Meyer'sresearch influenced leaders of the community mental health movement, and prefigured later trends in psychiatric services.

The role of Community Mental Health in a new architecture of World psychiatry and Global Mental Health

Introduction. The influx of new knowledge and scientific contributions into contemporary world psychiatry has counted on a vigorous dissemination through technology-inspired means. This process has led to the realities of Global Mental Health (GMH) inspired by “a new epistemology” of mostly positivistic roots. Objective. To explore the basis of these realities and the resulting homogenization attempts of psychiatry as a medical, clinical, and research discipline. Discussion and conclusion. The need for “a new architecture” of contemporary psychiatry is discussed as a reflection of a correct epistemological exercise and a renewed pact between professionals and communities, materialized in and enriched by the re-emerging Community Mental Health (CMH) movement. The essential bases of the movement are presented, and its mutually collaborative, multidisciplinary, integrated, and realistic nature, as reflected in national efforts like Peru’s in Latin America, is described.

Sense of community, pathway to, or bridge from alienation?

Psychological Sense of Community (PSOC) represents a formative conceptual offering of Community Psychology to the social sciences. Nearly five decades ago, PSOC offered a window into the influence of ecological factors to understanding the emotional and behavioral well-being of members of disenfranchised and underserved segments of the population, especially members of minority and low-income subgroups. Our discipline's founders viewed PSOC as one promising vehicle for pursuing the desired paradigmatic shift from individual to systemically focused interventions to achieve intended outcomes of the emerging community mental health movement. This Commentary reflects the authors' shared thoughts to the adoption of PSOC by conservative spokespersons to explain the resistance of some to the diversification of the population and growing voice of progressive advocates.

"Services Not Mausoleums": Race, Politics, and the Concept of Community in American Medicine (1963-1970).

A romance with the concept of community has long characterized activist healthcare movements and has more recently been taken up by academic medical centers (AMCs) as a sign of virtuous civic engagement. During the late 1960s, the word community, as deployed by administrators at prestigious AMCs, became increasingly politicized, commodified and racialized. Here, we analyze how the concept of community was initially framed in the 1963 Community Mental Health Centers Act, the first legislation to establish community mental health centers in America. We then examine the Health Policy Advisory Center's analysis of the proposed Washington Heights Community Mental Health Center to be run by Columbia University's College of Physicians and Surgeons, an institution that had historically neglected residents' health needs. Community pushback against Columbia's plan to build a multi-block center, amplified by medical students and residents critical of the professionalized community mental health movement, escalated in the late 1960s, leading the city's planning board to reject Columbia and approve a community council's plan for preventive and rehabilitative local services. These conflicting overtones of "community" still inform understandings of the word in medicine today; thus, a critical historical analysis of "community" is warranted.

Poor Influences and Criminal Locations: Los Angeles’s Skid Row, Multicultural Identities, and Normal Homosexuality

In 1984 the City of Los Angeles implemented a new policing ordinance called the “containment and mitigation policy,” which did not target subjects for prison arrest but sought to achieve their open-air capture in a redesigned “homeless district” called skid row. The policy was devised by Mayor Tom Bradley and his black and gay allies as a solution that balanced the pressures of deinstitutionalization and deindustrialization with the objectives of the community mental health movement and black, gay, and downtown community redevelopment programs. Looking to archival material related to architectural landscapes oriented to normalizing race and homosexuality built by Bradley, community mental health professionals, and neighborhood activists in inner-city districts, this essay demonstrates that new discourses of racial and sexual liberalism, coded as “multiculturalism” and expressed as black and gay community pride campaigns, substantiated new forms of surveillance and policing that renewed violence on queer, homeless, trans, and disabled people of color that resulted in their spatial segregation in skid row. Rather than forward social justice, I argue that the city’s cultivation of multiculturalism obscured the processes of racial capitalism that underwrite the enlargement of carceral spaces and normalize surveillance and policing as a common good.

Pathologizing the Crisis: Psychiatry, Policing, and Racial Liberalism in the Long Community Mental Health Movement.

The community mental health movement has been generally regarded as a benevolent movement that replaced old notions of psychiatric racism with new ideas about the normality of race. Few studies, however, have explored the movement for its active support for new surveillance and policing strategies, particularly broken windows theory, a policing approach partly responsible for the expansion of prisons in the United States after the 1970s. Looking to racially liberal approaches to psychiatry in the 1960s and 1970s crafted by integrationist psychiatrist Louis Jolyon West and black nationalist psychiatrist J. Alfred Cannon at the University of California, Los Angeles, this essay demonstrates that cultural and biological explanations for racial violence in civil rights and black nationalist discourses renewed surveillance on poor people of color that resulted in increased forms of incarceration, segregation, and discrimination for them by the 1980s. Rather than forward racial justice, I argue that psychiatric discourses arguing for the racial sameness of white and black minds in the 1960s and 1970s relied on scientific and cultural narratives centered on child development, gender, and sexuality that obscured the processes of racial capitalism that continued to produce poverty and sickness in black communities.

Announcing an editorial change

Announcing an editorial change

Colonizing the Greek Mind? The Reception of Western Psychotherapeutics in Greece ed. by Charles Stewart (review)

Reviewed by: Colonizing the Greek Mind? The Reception of Western Psychotherapeutics in Greece ed. by Charles Stewart Spyros D. Orfanos (bio) Charles Stewart, editor, Colonizing the Greek Mind? The Reception of Western Psychotherapeutics in Greece. DEREE—The American College of Greece. 2014. Pp. 113. Paper. Download free at: www.acg.edu/ckeditor_assets/attachments/888/thereceptionofwesternpsychotherapeuticsingreece.pdf. This interesting but uneven edited volume on psychotherapeutics in Greece and the question of colonization of Greek psychiatry by Western psychiatric models is composed of six chapters. Each chapter was originally a paper prepared for the conference “Colonizing the Greek Mind?” which was organized in 2011 by the volume’s editor, Charles Stewart, and held at Deree College—The American College of Greece. The chapters are written by three anthropologists, one historian, and two psychiatrists, one of whom is a priest. The lack of an introductory overview or preface makes it unclear as to who is the intended reader of the book. For this reviewer, there is something both familiar and unfamiliar about the styles and substance of the chapters in this slim volume of noble aims and critiques. Since I believe that it helps to know the reviewer in order to better understand the review, I offer some disclosures: I am a psychologist and psychoanalyst. I came of age as a psychologist during the ambitious U.S. community mental health movement of the 1970s, with its emphasis on educational and community interventions, not psychiatric interventions. I was trained in contemporary psychoanalysis in the late 1980s with an emphasis on both psychic and social realities as sources of suffering. I adhere to developments in attachment research, complexity theory, constructivism, and feminism. Thus, the psychiatric and Freudian-Oedipal ideologies interspersed in the various chapters in this volume seem somewhat dated to me. On the other hand, I find the anthropological perspective in many of the chapters thought provoking. These anthropological chapters raise a few questions. Do psychiatric concepts and psychoanalytic theories hold up in non-Western or traditional rural cultures? Are their observations universal? Can attempts at institutional psychiatric reform gain from anthropological interviewing in fieldwork situations? How do we learn about culture when we all have our own biases and cultural values? These types of questions are partially addressed in this book. The first and last chapters of this volume are the strongest. Editor Charles Stewart opens with a reference to Nikos Kazantzakis to highlight the Greek resistance to intellectual “colonization.” Astutely, Stewart reminds the reader that the people of Greece are too diverse and complex to classify “by such lumbering criteria as individualism and collectivism” (15). He moves from language to dreams to body to the evil eye to financial crisis with considerable scholarly ease. In the end, he answers his own question of whether the Greek mind has been colonized by Western therapeutics with an “It depends …” on what one means by the word colonized. He admits to using the word “colonizing” in order to provoke the reader. Frankly, I was less provoked by the word “colonizing” and more by the term “psychotherapeutics.” My understanding is that the term “psychotherapeutics” is used broadly in this volume, perhaps indicating a variety of interventions such as psychiatric, pharmacological treatments, psychotherapies, and self-help therapies. But it’s a new term for me, and I am not fully sure what is meant by it. [End Page 208] If one is a clinician, the last chapter on “The Problem of Culture” by anthropologist Elizabeth Anne Davis may be the most relevant one. The brief clinical narratives she provides are compelling, but it is her analysis of the distinctly Greek dialogue between anthropology and psychiatry on the concept of culture that is brilliant. While Davis is an on-the-ground data collector and not a mental health specialist, she does offer clinical material that directly addresses the matter of cultural diversity and Western psychiatry. Her illustrations are most welcome, as she gives brief vignettes of women from minority communities in Western Thrace: Turks, Pomaks, Gypsies, and Pontians, among others, who suffer from “hysteria,” according to their psychiatrists. The female patients are treated as primitive and Other. In my view, the interventions of the psychiatric clinic do not...

Soul of an Agency: Psychodynamic Principles in Action in the World of Community Mental Health

ABSTRACTCommunity mental health has undergone a number of evolutions since Lyndon Johnson declared a War on Poverty and gave birth to the community mental health movement. This paper describes a philosophy of treatment involving long‐term psychotherapy to resistant and multiple problem families in disadvantaged communities. The agency's primary philosophy is described as a psychoanalytic frame that guides treatment from a secure attachment site (clinic) in the community. The interventions use home and community based therapists with supports from psychiatry, psychology, and therapeutic mentoring. The focus of all treatment is for high‐risk families to remain in the community and not burden corrections, courts, child welfare, or juvenile justice systems. Therapy forms the connection that can help families navigate schools, medical providers, courts, and social service systems. The agency forms the positive attachment site; clinicians come and go. The net effect is sustained connection to families that would have otherwise been broken apart by domestic violence, school crimes, addiction, gangs, poverty, homelessness, and community violence. Copyright © 2014 John Wiley & Sons, Ltd.

Inovação em saúde mental sob a ótica de usuários de um movimento comunitário no nordeste do Brasil

This study, originating from a multidimensional analysis on the innovation category in a Community Mental Health Movement of Bom Jardim (Fortaleza, Brazil) that examines subjective and psychosocial dimensions, seeks to examine to what extent the work developed by this movement is effectively an innovative model in mental healthcare from the perspective of users of this service. The methodology adopted was a qualitative case study method based on a critical-interpretive approach employing techniques such as in-depth interviews associated with focus groups. The categorization of the discursive material was conducted using a model based on the four main dimensions of psychiatric reform, namely conceptual, technical, legal and socio-cultural aspects. The results reveal the following: an emphasis on the individual rather than focusing on the sickness; care as the basis for purposeful actions; the co-production of genuine dialogue with multiple stakeholders, and the construction of autonomy emphasizing individual potential. In conclusion, it can be said that healthcare practices developed by the Movement involve deconstructing the traditional model of mental healthcare, permitting new forms of citizenship, thereby contributing to deinstitutionalization.

Mental Health Care in the College Community

Back to table of contents Previous article Next article Communications and UpdatesFull AccessMental Health Care in the College CommunityRichard Kadison, M.D.Richard KadisonSearch for more papers by this author, M.D.Published Online:1 Oct 2011https://doi.org/10.1176/appi.ajp.2011.11040614AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail edited by KayJerald and SchwartzVictor. Hoboken, N.J., Wiley-Blackwell, 2010, 396 pp., $61.95.Mental Health Care in the College Community provides a comprehensive exploration of the evolution and structure of college and university mental health services. The book offers an in-depth look at key aspects of college mental health from a variety of perspectives. This text runs the gamut, from the early history of student mental health and its links to the community mental health movement that emerged in the early 1960s to the challenges and opportunities faced by student mental health centers today. Each chapter is a self-contained summary of key issues on the campus setting, written by a group of experienced clinicians and researchers.In the wake of the Virginia Tech and other campus tragedies, campus mental health has been in the spotlight, and a variety of very important issues have been raised. How do we identify high-risk students? How do we facilitate students accessing care? What can be done to reduce stigma? What kind of research is being done on campus? How about training? What treatment models work best on campus? How does psychiatry interface with the community at large? What are the legal obligations to the student and the community?The unique aspects of a campus community are key elements in designing effective models of care. In her chapter, Dr. Lorraine Siggins talks about the relationship of the mental health service with the community at large. How much information can be shared with faculty and staff? What about campus safety? She describes the ways in which the mental health service (called Mental Health and Counseling at Yale) can be available for consultation and support to faculty, staff, and peers when they have concerns about a student. Sometimes, the conversation is a one-way communication because of privacy rules. Siggins also notes that the mental health service can play an important role in responding to campus crises. Outreach to students puts a face on the service and provides a great opportunity for educating students and residential staff. This helps with early recognition of problems by the whole community, greater awareness of available resources, and reduction of stigma that so often delays referral and treatment. She also discusses the mission of the service and how to best provide care for the whole community given the available resources.Mental Health Care in the College Community provides an enormous amount of valuable information on a number of diverse topics pertaining to the campus setting. Working with parents, different models of care, suicide prevention, training programs, and working with special populations are just a few of the other issues discussed in this book.Cambridge, Mass.The author reports no financial relationships with commercial interests.Book review accepted for publication April 2011. FiguresReferencesCited byDetailsCited ByNone Volume 168Issue 10 October 2011Pages 1123-1123 Metrics PDF download History Accepted 1 April 2011 Published online 1 October 2011 Published in print 1 October 2011

Personal Accounts: Transformation: Recovering Mental Health Treasures

Personal Accounts: Transformation: Recovering Mental Health Treasures

Psychodynamic Psychiatry, Psychotherapy, and Community Psychiatry

Community psychiatry is defined by mixed systems of care for patients with severe and persistent mental disorders, many of whom are indigent. Much of it dates back to the community mental health movement 50 years ago. The emphasis at that time was on deinstitutionalization, prevention, least restrictive options for care, and transformation of large public hospitals into multiservice regional centers. The current focus, in contrast, is on economy, local control and accountability, emphasizing, for example, manualized behavioral health techniques, pharmacotherapy, and case management by allied professionals. Psychodynamic psychiatry, particularly a psychodynamic orientation is uniquely helpful in complex, community-based clinical situations. Applicable psychodynamics include unconscious mental processes, psychological defenses, emotional relationships, a developmental perspective, disciplined use of the self for healing, transference, and communications in all forms as material for therapy. Literature and case reports illustrate the approach taken. These include examples of active listening, interprofessional collaboration, clinical continuity, appropriate boundaries, and thoughtful timing. Psychodynamic applications in community settings have passed the test of time and because of their validity could again become prevalent. Competence depends upon experience with well-supervised psychodynamic psychotherapy and interdisciplinary collaboration, in a variety of cultures and settings.

Conversation with Bruce Ritson

In this occasional series we record the views and personal experience of people who have especially contributed to the evolution of ideas in the journal's field of interest. Dr Bruce Ritson was formerly Consultant Psychiatrist at the Royal Edinburgh Hospital and Senior Lecturer at Edinburgh University. He currently chairs the medical campaign group, Scottish Health Action on Alcohol Problems (SHAAP), which is hosted by the Royal College of Physicians of Edinburgh. He has had a long and fruitful research career.

Disability, Social Policy and the Burden of Disease: Creating an “Assertive” Community Mental Health System in New York

One conclusion of the decade-long epidemiological Global Burden of Disease Project is that five of the top 10 disease “burdens” the world will face by 2020 will be related to mental disabilities. Therefore, developing social policy and community responses to the ways that people with mental disabilities are treated is becoming an important focus for community practitioners, political activists and legislators. The author explores some of the dynamics of our culture’s approach to dealing with difference, especially when manifested in disenfranchized individuals. He discusses a community development project created by a New York City advocacy and social policy organization following the 1999 murder of a woman by an individual whose mental health disability was never treated. Parallels are drawn between the civil rights and community mental health movements, which created a precedent for the 1990 Americans with Disabilities Act. Also examined are the ways in which community mental health systems manifest social policy that alternately resists, repeats and colludes with power operations. The unexamined assumptions that drive this dynamic are examined as ableism or disability oppression.

A Clinical Alternative to the Public Health Approach to Mental Illness: a forgotten social experiment

In the last half of the 20th century, the community mental health movement, based on a public health model, came to dominate patterns of care for mental patients. In the process, brutal deinstitutionalization of very ill patients took place, at least in the United States. These events were not inevitable. In 1949, the Menningers of Topeka, Kansas, began administering Topeka State Hospital, which was in deplorable condition. By concentrating expenditures on clinical personnel, the Menningers humanely deinstitutionalized many patients before chlorpromazine, before the entitlement programs of the U.S. federal government such as Medicaid (1965), and before the community psychiatry movement got under way. Topeka State Hospital furnished a model of mental health care that centered a whole system on a last-resort, large, specialized state mental hospital. This inadvertent social experiment suggests that a clinical approach to mental health care offers a hard-headed alternative to present arrangements.

Public mental health: An evolving imperative.

Byline: Nimesh. Desai The development of community mental health from clinical psychiatry has often been described as a process independent of the larger process of the development of the field of community health,[1],[2] and as if the movement towards the community was specific to psychiatry or mental health. The contributing factors and determinants of this movement have generally been identified as (i) institutional care being expensive and/or harmful in terms of 'institutionalization' syndrome, (ii) inadequacy of human resource or qualified professionals, (iii) and that the general health workers and paraprofessionals can be trained to deliver these services in their own settings for majority of patients. The fact that the movement occurred significantly as a part of the larger movement of community medicine or community health is also often overlooked. The Bhore Committee Report of 1946, which laid the foundation for the community health movement in India, not only combined the 'top down' and the 'bottom up' approaches but also included substantive emphasis on issues of mental health, albeit within the limitations of that period, much before some of the noted western movements of community mental health.[3] The 'top down' approach of building three apex institutions, viz. All India Institute of Medical Sciences (AIIMS), New Delhi; All India Institute of Hygiene and Public Health, Kolkata and All India Institute of Mental Health, Bangalore (later to become NIMHANS), along with the 'bottom up' approach of providing primary health care, and 'community orientation to medical services and medical education', also recognized psychiatry and mental health as integral parts. It is a different matter that the entire movement of the preventive and social medicine, including the development of the academic departments, have had a mixed impact, but the larger movement of community medicine or community health, as many progressive academic departments christened themselves later, has had significant impact in different spheres. The major guiding principle and the strategy had been of 'reaching the unreached' with a sense of paternalism if not charity, and was also governed by the socialist ideology in the socio-political atmosphere of the post-Independence period in India, as in many developing countries after the second world war. Psychiatry followed medicine in this approach, without realizing the need for a different and larger conceptual framework for mental health. Indeed, the field of community medicine had in the meanwhile, evolved to the larger concept of health, beyond the medical model, and recognized the need for working across sectors. The community psychiatry initiatives in the 1960s and 1970s culminated in the National Mental Health Programme (NMHP) in India, one of the earliest in the world with inadequate emphasis on the conceptual issues of community mental health. Some merits and benefits of these programmes as well as the experiences in implementation have been discussed.[4],[5] The limited success of the NMHP, and the community mental health movement has to be recognized and accepted. Although the community-oriented health models have significant improvements over the clinical models, their limita-tions are often not appreciated. Some important limitations are: (i) the paternalistic, charitable strategy of reaching the unreached, (ii) carrying the clinics to the community with no emphasis on prevention or promotion, (iii) being limited to treatment, (iv) limited scope in target conditions and interventions identified, and most importantly, (v) continued use of the dyadic paradigm borrowed from the medical and clinical models, of one 'patient' and one 'provider'. On the other hand, the public health, and as such the public mental health models have the advantages of (i) being larger on scope beyond treatment, including prevention of promotion, (ii) being intersectoral and cutting across sectors that impact health, (iii) population paradigm, focusing on millions and not individuals, (iv) policy leading to programmes, (v) expertise of basic sciences of epidemiology and biostatistics, (vi) inclusion of applied sciences such as health economics, and (vii) inputs from public participation through advocacy and activism. …