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    The Social Determinants of Mental Health

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    The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care.This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the «take-away» messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a «Call to Action,» offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities.Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

    The Behavioral Addictions

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    The Behavioral Addictions is the first American Psychiatric Publishing title to explore the diagnosis and treatment of patients who suffer from behavioral addictions, extreme forms of which share specific characteristics with severe forms of substance use disorders. These characteristics include tolerance (the need to use the substance or perform the troublesome behavior at higher doses, or more and more frequently, in order to achieve the same effect); withdrawal (feelings of restlessness, irritability, and discontent following abrupt discontinuation of the substance or the behavior); obsessive thinking and planning that block out anything other than obtaining or engaging in the addictive agent or behavior; and accompanying external consequences in related to finances, health, interpersonal relationships, legal affairs, etc. Although not all behavioral addictions are currently recognized as such by DSM-5, both substances and behaviors can hijack a person's pleasure-and-reward brain circuitry, causing great suffering.This case-based volume is practical and engaging and offers many features that make it not only informative but also accessible and entertaining: Behaviors covered, both those widely recognized and those less commonly accepted, involve exercise, food, gambling, Internet gaming, Internet surfing, kleptomania, love, sex, shopping, work, tanning, and e-mailing/texting. Introductory chapters discuss the relationship of behavioral or process addictions to substance use disorders across many spheres, and they provide an overview of the behavioral addictions from neurobiological, theoretical, clinical, and forensic perspectives. Gambling disorder is now classified in DSM-5 as a behavioral addiction, lending credence to the construct of behavioral addictions and providing precedent for future consideration of other behavioral addictions, such as those highlighted in the volume. Each chapter focuses on a real-life case study of a patient with a behavioral addiction. Videos that accompany the volume demonstrate encounters between a clinician and a patient exhibiting an addiction. This puts material on assessment, treatment, etc. into a real-world context. Key points for review and multiple-choice questions are included at the end of each chapter. Not simply an exaggeration of everyday social and personal ailments, these behavioral conditions present clinicians with unique and poorly researched challenges in everyday clinical practice. The Behavioral Addictions helps the reader to determine not only where to draw the line between healthy and unhealthy levels of participation in a behavior, but also how to intervene in ways that are therapeutic, effective, and evidence-based.

    Integrated Care

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    The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents an opportunity for newly insured patients and for funding models of integrated care, enabling psychiatrists to have a more significant population-level impact. The only book of its kind, the guide defines integrated care, reviews the evidence base, and addresses the three potential benefits of this model of care: improved outcomes, cost containment, and enhanced patient experience (also known as the «triple aim»). The new models of integrated care presented in this book are population-based, which is the key to improved outcomes, and they represent a change in how medicine in general and psychiatry in particular will approach health care delivery moving forward.The book's features are both high-impact and user-friendly: The book is divided into two sections, «Behavioral Health in Primary Care Settings» and «Primary Care in Behavioral Health Care Settings,» with Section 1 focused on improving the detection and treatment of behavioral health conditions by integrating behavioral health services into primary care settings and Section 2 focused on improving the health status of patient populations with serious mental illness by integrating primary care into behavioral health treatment. Each chapter presents a set of «core principles of effective collaborative care,» which serve as a guide for the structure and provision of care for the varying models, regardless of the setting. Contributors provide dozens of examples that highlight the impact psychiatrists can make in achieving the triple aim of improved outcomes, cost containment, and enhanced experience. Detailed case vignettes integrated throughout the book bring concepts to life and help clinicians to understand and improve the patient-provider relationship. The information presented in these chapters allows both practicing psychiatrists and those in training to develop a skill set essential to designing, working in, teaching, or promoting an integrated care program within a health care system. Evidence based and timely, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is a must read for clinicians in the brave new world of health care reform.

    Helping Kids in Crisis

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    Helping Kids in Crisis: Managing Psychiatric Emergencies in Children and Adolescents provides expert guidance to practitioners responding to high-stakes situations, such as children considering or attempting suicide, cutting or injuring themselves purposely, and becoming aggressive or violently destructive. Children experiencing behavioral crises frequently reach critical states in venues that were not designed to respond to or support them – in school, for example, or at home among their highly stressed and confused families. Professionals who provide services to these children must be able to quickly determine threats to safety and initiate interventions to deescalate behaviors, often with limited resources. The editors and authors have extensive experience at one of the busiest and best regional referral centers for children with psychiatric emergencies, and have deftly translated their expertise into this symptom-based guide to help non-psychiatric clinicians more effectively and compassionately care for this challenging population.The book is designed for ease of use and its structure and features are helpful and supportive: The book is written for practitioners in hospital or community-based settings, including physicians in training, pediatricians who work in office-based or emergency settings, psychologists, social workers, school psychologists, guidance counselors, and school nurses – professionals for whom child psychiatric resources are few. Clear risk and diagnostic assessment tools allow clinicians working in settings without access to child mental health professionals to think like trained emergency room child psychiatrists–from evaluation to treatment. The content is symptom-focused, enabling readers to swiftly identify the appropriate chapter, with decision trees and easy-to-read tables to use for quick de-escalation and risk assessment. A guide to navigating the educational system, child welfare system, and other systems of care helps clinicians to identify and overcome systems-level barriers to obtain necessary treatment for their patients. Finally, the book provides an extensive review of successful models of emergency psychiatric care from across the country to assist clinicians and hospital administrators in program design. An abundance of case examples of common emergency symptoms or behaviors provides professionals with critical, concrete tools for diagnostic evaluation, risk assessment, decision making, de-escalation, and safety planning. Helping Kids in Crisis: Managing Psychiatric Emergencies in Children and Adolescents is a vital resource for clinicians facing high-risk challenges on the front lines to help them intervene effectively, relieve suffering, and keep their young patients safe.

    Preventive Medical Care in Psychiatry

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    Preventive Medical Care in Psychiatry: A Practical Guide for Clinicians was written for psychiatrists in training and in clinical practice, as well as other health care providers who wish to learn an evidence-based and user-friendly approach to prevent commonly encountered, treatable, and potentially deadly illnesses in their patients. The poor health and early mortality of people with serious mental illnesses has been well documented: People who have serious mental illness have increased general medical comorbid conditions, receive minimal preventive medical services, and have a reduced life span of as much as thirty years when compared to the general population. In addition, there is now extensive data showing bidirectional interactions between chronic medical illnesses and mental disorders. Clearly, treating the whole person, instead of the disorder in isolation, is critical to improving outcomes and reducing suffering.The book's logical structure makes it easy to use, with sections devoted to general principles of preventive psychiatry, cardiovascular and pulmonary disorders, endocrine and metabolic disorders, infections disorders, and oncologic disorders. In addition, the volume: Provides evidence-based approaches to care across the prevention spectrum, from primary prevention (how to keep people healthy), to secondary prevention (how to detect early signs of common illnesses), through tertiary prevention (how to prevent disability and adverse outcomes once patients develop medical problems). Informs clinicians about how to more effectively interface with general medical practitioners, and instructs them in providing screening for common medical problems, as well as ensuring that preventive measures, such as vaccinations, are performed. Covers, in a section addressing «special topics,» child, adolescent, and geriatric populations, as well as strategies for assessing and managing chronic pain. Concludes with an appendix that features a health questionnaire, Preventive Medicine in Psychiatry (PMAP), for use in screening and follow-up, and a handy summary of age based preventive medicine recommendations, references to which clinicians will return repeatedly. The Affordable Care Act has provided mental health practitioners with new opportunities to develop integrated models of care that better serve patients and populations, furthering the existing trend of treating the whole patient. Preventive Medical Care in Psychiatry: A Practical Guide for Clinicians is a critical resource which will prove indispensable to clinicians dedicated to improving the quality of life and longevity for patients who suffer from serious mental illness. Twenty-five percent of royalties help support Resident-Fellow Members (RFM) within the California Psychiatric Association.

    Study Guide to DSM-5®

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    The Study Guide to DSM-5® is an indispensable instructional supplement to DSM-5® to help teachers and students of psychiatry, psychology, social work, medical schools, and residency programs understand and apply diagnostic criteria and key clinical concepts through a variety of learning tools. The Study Guide can stand alone as a training supplement to DSM-5® or be paired with DSM-5® Clinical Cases as comprehensive instruction for understanding and applying DSM-5®. The Study Guide possesses a multitude of features that will benefit both learner and instructor: Foundational concepts of diagnosis are amplified with case vignettes, discussion questions, and recommended reading to enrich knowledge and practice. Content and features are consistent across the chapters for diagnostic classes. These chapters include an introduction, diagnostic pearls, summary discussion, and self-assessment questions and answers. In-depth discussions of key diagnoses within each class cover approach to the diagnosis, getting the history, diagnostic tips, clinical vignettes, and differential diagnosis. Key clinical vignettes exemplify diagnostic criteria while reflecting the complexity of real-life scenarios. In addition, examples are offered to help readers appreciate diagnostic variations and ambiguities. Discussion points and questions for self-assessment are provided for each diagnostic class throughout the guide, allowing readers to test their understanding of DSM-5® and helping teachers to focus on the most critical issues. A special section dedicated to an overview of diagnostic questions that cover material across the Study Guide and DSM-5® provides additional testing of knowledge, along with an answer key. Engagingly written, the Study Guide to DSM-5® introduces learners to DSM-5® and provides them with the tools they need to fully understand and deftly apply DSM-5® concepts and criteria.

    The Addiction Casebook

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    The Addiction Casebook presents 12 patients with DSM-5 addiction diagnoses – plus one experiencing problematic Internet use – and illustrates practical and successful strategies for diagnosing and treating these patients. The book's cases are analogous to those that clinicians commonly encounter in their everyday practice and effectively demonstrate the intersection of addiction with other psychiatric diagnoses. The experience and clinical wisdom of three generations of addiction specialists are distilled into a single volume that includes the most salient ideas and treatment suggestions for clinicians. This informative, practical volume strikes a colloquial, and sometimes humorous, tone. General psychiatrists and psychiatric residents seeking to gain expertise in and an understanding of addiction will find it a delight to read, as will a diverse audience of family practitioners, internists, pediatricians, medical students, allied professionals, and anyone interested in sharpening her or his clinical skills.The book is the first to cover the diagnosis, assessment, and treatment of substance use disorders and other addictions within the DSM-5® framework. Its many valuable and helpful features include An outline of the progression in thinking about psychiatric diagnoses with the move from DSM-IV-TR® to DSM-5®. Descriptions of hands-on experience with the current diagnosis and treatment of substance use disorders and other addictions that complement substance abuse textbooks and bring the material to life. Coverage of such subject areas as alcohol, caffeine, cannabis, hallucinogen, inhalant, opioid, sedative, hypnotic, anxiolytic, stimulant, tobacco, gambling, and Internet addictions. Key points and multiple-answer questions at the end of each chapter that highlight the chapter's most pertinent takeaways and apply and strengthen readers' knowledge of chapter information. Extensive use of tables, figures, charts, and other instructive materials to illuminate and clarify addiction concepts. In their preface, the authors assert their hope that the book «will provide the fundamental tools for working with the substance-using patient in the hospital, the clinic, and the community.» The Addiction Casebook exceeds its goal by providing mental health and other medical practitioners with timely, current strategies for addiction diagnosis and treatment in a succinct, engaging, and entertaining volume.

    DSM-5® Self-Exam Questions

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    DSM-5® Self-Exam Questions: Test Questions for the Diagnostic Criteria elucidates DSM-5® through self-exam questions designed to test the reader's knowledge of the new edition's diagnostic criteria. Mental health professionals, ranging from clinicians and students to psychiatric nurses and social workers, will benefit from this substantive text's 300-plus questions. This book is a «must have» for anyone seeking to fully understand the changes brought about by the groundbreaking launch of DSM-5®. Some of the book's most beneficial features include: Self-exam questions and cases designed to test the reader's knowledge of conceptual changes to DSM-5® (e.g., autism spectrum disorder), specific changes to diagnoses (e.g., the integration of childhood disorders within main disorders), and diagnostic criteria (e.g., the diagnostic criteria for major depressive disorder and bipolar disorders). Questions about each diagnosis in DSM-5®, including the proposed diagnoses in Section III, which enable readers to teach themselves about new and potential future diagnoses. A contrast of DSM-5® diagnoses with DSM-IV-TR® to assist readers in quickly learning about the changes in diagnostic classes and criteria. Short answers that explain the rationale for each correct answer (diagnostic criteria sets from DSM-5® are included as appropriate, and readers are directed to DSM-5® for further information). Question answers containing important information on diagnostic classifications, criteria sets, diagnoses, codes, and severity, dimension of diagnosis, and culture, age, and gender. Straightforward, practical, and illustrative, DSM-5® Self-Exam Questions: Test Questions for the Diagnostic Criteria will successfully test and broaden the DSM-5® knowledge of all mental health professionals.

    Care of Military Service Members, Veterans, and Their Families

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    Care of Military Service Members, Veterans, and Their Families serves a critical need, which has been highlighted by recent reported rates of combat-related stress disorders and traumatic brain injury, as well as increases in suicide rates among service members and veterans over the past decade and the distress and challenges faced by their children and families. More than 2.5 million Americans currently serve in the U.S. military on active duty, in the Reserves, or in the National Guard, and more than 20 million civilians are veterans. Although patients are viewed here in the context of military service, they seek health care in military, veteran, and civilian settings, and their mental health concerns are as diverse as those encountered in the civilian population. This book is designed for clinicians in all care settings and provides thorough coverage of U.S. military structures and cultures across the armed services, as well as detailed material on the particular mental health challenges faced by service members and their families. A full overview of the military lifestyle is provided, including the life cycle of the military (recruitment to retirement), service subcultures (Navy, Army, Marines, Air Force, and Reserve and Guard components), challenges of military life for service members and families (moves, deployments, etc.), and military mental health. Material on military culture provides insight for practitioners who may not be familiar with this population. The book focuses on collaborative care, particularly between the military health care system and the Veterans Administration, providing clinicians with strategies to mitigate stigma and other barriers to care through mental health service delivery in primary care settings. The incidence of traumatic brain injury among service members has increased because of the use of improvised explosive devices, and an entire chapter is devoted to diagnosing and treating these injuries as well as educating patients and their families on the condition. The families of service members face significant challenges, and several chapters are devoted to the needs of military children, the families of ill and injured service members and veterans, deployment-related care, and caring for the bereaved. The book's comprehensive review of resources available to military service members, veterans, and families both ensures high-quality care and reduces the workload for treating physicians. Care of Military Service Members, Veterans, and Their Families is an authoritative and much-needed addition to the mental health literature.

    Infant and Early Childhood Mental Health

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    Infant and Early Childhood Mental Health: Core Concepts and Clinical Practice is a groundbreaking book that provides an overview of the field from both theoretical and clinical viewpoints. The editors and chapter authors – some of the field's foremost researchers and teachers – describe from their diverse perspectives key concepts fundamental to infant-parent and early childhood mental health work. The complexity of this emerging field demands an interdisciplinary approach, and the book provides a clear, comprehensive, and coherent text with an abundance of clinical applications to increase understanding and help the reader to integrate the concepts into clinical practice.Offering both cutting-edge coverage and a format that facilitates learning, the book boasts the following features and content: A focus on helping working professionals expand their specialization skills and knowledge and on offering core competency training for those entering the field, which reflects the Infant-Parent Mental Health Postgraduate Certificate Program (IPMHPCP) and Fellowship in Napa, CA that was the genesis of the book. Chapters written by a diverse group of authors with vastly different training, expertise, and clinical experience, underscoring the book's interdisciplinary approach. In addition, terms such as clinician, therapist, provider, professional, and teacher are intentionally used interchangeably to describe and unify the field. Explication and analysis of a variety of therapeutic models, including Perry's Neurosequential Model of Therapeutics; Brazelton's neurodevelopmental and relational Touchpoints; attachment theory; the Neurorelational Framework; Mindsight; and Downing's Video Intervention Therapy. An entire chapter devoted to diagnostic schemas for children ages 0–5, which highlights the Diagnostic Classification of Mental Health Disorders of Infancy and Early Childhood: Revised (DC:0-3R). With the release of DSM-5, this chapter provides a prototypical crosswalk between DC:0-3R and ICD codes. A discussion of the difference between evidence-based treatments and evidence-based practices in the field, along with valuable information on randomized controlled trials, a research standard that, while often not feasible or ethically permissible in infant mental health work, remains a standard applied to the field. Key points and references at the end of each chapter, and generous use of figures, tables, and other resources to enhance learning. The volume editors and authors are passionate about the pressing need for further research and the acquisition and application of new knowledge to support the health and well-being of individuals, families, and communities. Infant and Early Childhood Mental Health: Core Concepts and Clinical Practice should find a receptive audience for this critically important message.