Recovery From Schizophrenia: Psychiatry And Political Economy

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ContentsAcknowledgments viIntroduction viiiPART I Background 11 What is schizophrenia? 22 Health, illness and the economy 29Part II The political economy of schizophrenia 533 Recovery from schizophrenia 544 Deinstitutionalization 805 Madness and the Industrial Revolution 1026 Labor, poverty and schizophrenia 1277 Schizophrenia in the Third World 1488 The person with schizophrenia in Western society 1729 The incidence of schizophrenia 195PART III Treatment 21910 Antipsychotic drugs: use, abuse and non-use 22011 Work 24612 Desegregating schizophrenia 266Notes 301Bibliography 369Author index 374Subject index 374
AcknowledgmentsSeveral people were kind enough to give me criticism and encouragement whensome of the ideas in this book were first drafted in the form of a long article.Among these reviewers were John Strauss, John Wing, Loren Mosher, SolomonGoldberg, Lewis Wolberg, Bernard Bloom and Maxwell Jones. I am mostgrateful for their advice.I am also indebted to those who have discussed this research with me andreviewed sections of the book. I have received valuable critiques from thefollowing colleagues in various departments of the University of Colorado:Robert Freedman, Thomas Mayer, Edward Greenberg, and Paul Shankman. JaniLittle and Charles Judd have been invaluable statistical advisors and GaryMcClelland provided advice and instruction about probability theory and theprevention of schizophrenia. At the Mental Health Center of Boulder County,my associates Phoebe Norton and Ruth Arnold have made useful comments onsections of the manuscript. Julian Leff and Andrew Scull carefully reviewed largesections of the work and made many helpful suggestions.I gained a great deal from discussions with Loren Mosher, Julian Leff, PaulPolak, Robert Freedman, James Mandiberg and Ezra Susser. Robert Freedmancontributed to the development of the theory about the occurrence ofschizophrenia in Chapter 9. Much of the discussion in Chapter 10 about theeconomic advancement of the mentally ill in the community is a result of mycollaboration with Paul Polak. Ezra Susser has helped me with epidemiologicaladvice on many of the themes in the book. Sue Estroff and Joe Morrisey haveoften helped with ideas, information and insights. My research collaboration withDawn Taylor, Giovanni de Girolamo, Peter Huxley and Sherrill Evans, amongothers, has allowed many of the ideas in the book to be tested. Many colleaguesassociated with the World Psychiatric Association global anti-stigma programhave increased my understanding of how to tackle stigma; they include HughSchulze, Everett Rogers, Corinne Shefner-Rogers, Otto Wahl, Heather Stuartand Norman Sartorius. Gyles Glover, of the University of Durham, gathered thedata on National Health Service expenditure on mental illness, which are referredto in Chapter 6.I have been fortunate to work with many creative and talented colleagues atthe Mental Health Center of Boulder County in the past quarter-century. Their
Page 2 and 3: Recovery from SchizophreniaRecovery
Page 4 and 5: First edition published 1985by Rout
Page 8 and 9: devotion to excellence in creating
Page 10 and 11: ixA NOTE ON THEORYThe materialist t
Page 12 and 13: Part IBackground
Page 14 and 15: WHAT IS SCHIZOPHRENIA? 3WHAT IS SCH
Page 16 and 17: WHAT IS SCHIZOPHRENIA? 5syphilis, n
Page 18 and 19: WHAT IS SCHIZOPHRENIA? 7Table 1.1-c
Page 20 and 21: WHAT IS SCHIZOPHRENIA? 9complete sy
Page 22 and 23: WHAT IS SCHIZOPHRENIA? 11patients w
Page 24 and 25: WHAT IS SCHIZOPHRENIA? 13publicatio
Page 26 and 27: WHAT IS SCHIZOPHRENIA? 15Figure 1.1
Page 28 and 29: WHAT IS SCHIZOPHRENIA? 17intrusiven
Page 30 and 31: WHAT IS SCHIZOPHRENIA? 19Figure 1.3
Page 32 and 33: WHAT IS SCHIZOPHRENIA? 21Brain stru
Page 34 and 35: WHAT IS SCHIZOPHRENIA? 23system. Th
Page 36 and 37: WHAT IS SCHIZOPHRENIA? 25One thing
Page 38 and 39: WHAT IS SCHIZOPHRENIA? 27of worth,
Page 40 and 41: Chapter 2Health, illness and the ec
Page 42 and 43: HEALTH, ILLNESS AND THE ECONOMY 31a
Page 44 and 45: HEALTH, ILLNESS AND THE ECONOMY 33i
Page 46 and 47: HEALTH, ILLNESS AND THE ECONOMY 35B
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Page 50 and 51: HEALTH, ILLNESS AND THE ECONOMY 39d
Page 52 and 53: HEALTH, ILLNESS AND THE ECONOMY 41F
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HEALTH, ILLNESS AND THE ECONOMY 45T
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HEALTH, ILLNESS AND THE ECONOMY 47b
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HEALTH, ILLNESS AND THE ECONOMY 49F
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HEALTH, ILLNESS AND THE ECONOMY 51A
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Part IIThe political economy of sch
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RECOVERY FROM SCHIZOPHRENIA 55impro
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RECOVERY FROM SCHIZOPHRENIA 57categ
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RECOVERY FROM SCHIZOPHRENIA 59Table
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Table 3.1 -continuedRECOVERY FROM S
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RECOVERY FROM SCHIZOPHRENIA 73Figur
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Table 3.3 Recovery rates in the USA
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RECOVERY FROM SCHIZOPHRENIA 77the l
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THE POLITICAL ECONOMY OF SCHIZOPHRE
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MADNESS AND THE INDUSTRIAL REVOLUTI
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25 patients, and on the more distur
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Chapter 6Labor, poverty and schizop
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THE PERSON WITH SCHIZOPHRENIA IN WE
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Chapter 9The incidence of schizophr
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Part IIITreatment
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ANTIPSYCHOTIC DRUGS: USE, ABUSE AND
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TREATMENT 247indicated, unemploymen
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TREATMENT 249success, for the lodge
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TREATMENT 251vocational programming
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TREATMENT 253the job is permanent.
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TREATMENT 255Social enterprises in
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TREATMENT 257pharmacy technicians a
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TREATMENT 259The situation seems to
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TREATMENT 261Though these results a
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TREATMENT 263• raise the minimum
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TREATMENT 265• Social policy inno
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TREATMENT 267Table 12.1 Living situ
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TREATMENT 269A JAIL DIVERSION PROGR
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TREATMENT 271the office work and th
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TREATMENT 273One might imagine that
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TREATMENT 275studies may be the res
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TREATMENT 277established for some o
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TREATMENT 279Another residential pr
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TREATMENT 281interest loans and gra
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TREATMENT 283individual’s goals s
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TREATMENT 285Cognitive therapy, it
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TREATMENT 287Table 12.2 Facts about
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TREATMENT 289consumers and professi
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TREATMENT 291definitively not part
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FIGHTING STIGMAAlthough the mentall
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TREATMENT 295The National Alliance
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TREATMENT 297other medical disorder
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TREATMENT 299when a psychiatrist an
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NotesINTRODUCTION1 Harris, M., Cult
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NOTES 30333 Heston, L.L., “Psychi
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NOTES 30557 Sham, P.C., O’Callagh
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87 Dohrenwend, B. and Egri, G., “
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NOTES 30929 Srole, L., Langner, R.S
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NOTES 311unemployment cause the dea
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NOTES 313107 Warr, P., “Studies o
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138 Dear, M., Clark, G. and Clark,
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NOTES 3178 Epstein, L.J., Morgan, R
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NOTES 31943 Quirk, A. and Lelliott,
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NOTES 32349 Walton, “Pauper lunat
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105 Bockoven, J.S., Moral Treatment
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NOTES 32729 For positive evaluation
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66 Barker, D., “Moscow mayor has
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NOTES 33133 World Health Organizati
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NOTES 33380 Eliade, M., Shamanism:
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NOTES 335homelessness a mental heal
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NOTES 337Academic Press, 1978; Faul
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NOTES 339Washington, DC: House of R
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NOTES 34194 Read, J. and Baker, S.,
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132 Robinson, J.R and Shaver, P.R.,
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NOTES 345“Schizophrenia is not di
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NOTES 34748 Bagley, C., “The soci
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NOTES 34979 ni Nuallain, M., O’Ha
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NOTES 3514 Kapur, S. and Seeman, P.
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NOTES 35327 Pasamanick, B., Scarpet
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NOTES 355Archives of General Psychi
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NOTES 357“Prognostic factors in r
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NOTES 359Chandler, D., Meisel, J.,
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30, 1978; Moffit, R., “The econom
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NOTES 36312 Stein, L.I. and Test, M
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NOTES 36547 Personal communication,
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NOTES 367European Psychiatry, 15:26
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BibliographySTUDIES OF THE OUTCOME
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BIBLIOGRAPHY 371Horowitz, W.A. and
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BIBLIOGRAPHY 373Salokangas, R.K.R.,
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AUTHOR INDEX 375Dunham, Warren 31Du
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AUTHOR INDEX 377Urquhart, M.C. 129n
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SUBJECT INDEX 379atypical 20;compan
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SUBJECT INDEX 381CESP see Carer Edu
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SUBJECT INDEX 383disability pension
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SUBJECT INDEX 385diagnosis of 148;d
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SUBJECT INDEX 387Isle of Wight 33is
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SUBJECT INDEX 389Middlesex, Hanwell
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SUBJECT INDEX 391PACE see Personal
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SUBJECT INDEX 393economic condition
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SUBJECT INDEX 395self-employment 15
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SUBJECT INDEX 397symbolic thinking
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SUBJECT INDEX 399volition disturban
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