Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cb9f654ff-r5d9c Total loading time: 0 Render date: 2025-08-07T13:57:38.931Z Has data issue: false hasContentIssue false

1 - Recovering the US Mental Healthcare System

The Past, Present, and Future of Psychosocial Interventions for Psychosis

Published online by Cambridge University Press:  03 March 2022

By
Charlie A. Davidson ,
Olivia Altamirano ,
Amy Weisman de Mamani  and
Meaghan Stacy
Edited by
Meaghan Stacy  and
Charlie A. Davidson
Meaghan Stacy
Affiliation:
Yale University, Connecticut
Charlie A. Davidson
Affiliation:
Emory University, Atlanta
Get access

Summary

“It is common knowledge that psychosis and schizophrenia-spectrum disorders are often associated with disability and suffering. What is less commonly known is the ample evidence for recovery. Images of disability and dangerousness are visible in our society and media, but we don’t see the millions of people who have lived well with or despite psychosis. For many Americans who experience psychosis, medication and risk management remain the focus of treatment despite the long history of effective psychosocial treatments for psychosis. Mental health stigma endures, both in society and as reflected in poor funding, workforce development, and implementation. This limits research, services available, and dissemination of proven interventions, even when they have empirical support and result in long-term cost savings. Mental health professionals can, and should, play a central role in supporting recovery for people with psychosis, changing harmful messages and stigma, and in advocating for the dissemination and availability of psychosocial interventions for psychosis. This chapter emphasizes historical, current, and intersectional perspectives and challenges to three factors we believe are essential to changing our system: 1. genuine hope; 2. available effective psychosocial interventions; and 3. changing attitudes to support dignity and autonomy.”

Keywords

recoveryempathystigmapsychosocial interventionsinjusticeexplanatory modelsbehavioral therapyhopepsychosocial rehabilitation

Information

Type
Chapter
Information
Recovering the US Mental Healthcare System
The Past, Present, and Future of Psychosocial Interventions for Psychosis
 , pp. 1 - 24
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Albertson, E. M., Scannell, C., Ashtari, N., & Barnert, E. (2020). Eliminating gaps in medicaid coverage during reentry after incarceration. American Journal of Public Health, 110(3), 317–321.Google Scholar
Alang, SM. Mental health care among blacks in America: Confronting racism and constructing solutions. BMC Health Services Research, 2019; 54: 346–355. doi:10.1111/1475-6773.13115Google Scholar
Amsalem, D., Yang, L. H., Jankowski, S., Lieff, S. A., Markowitz, J. C., & Dixon, L. B. (2020). Reducing stigma toward individuals with schizophrenia using a brief video: A randomized controlled trial of young adults. Schizophrenia Bulletin, 47(1), 7–14. doi:10.1093/schbul/sbaa114Google Scholar
Barrett, N. M., Gill, K. J., Pratt, C. W., & Roberts, M. M. (2013). Psychiatric rehabilitation: Academic Press.Google Scholar
Bogart, K. R., Lund, E. M., & Rottenstein, A. (2018). Disability pride protects self-esteem through the rejection-identification model. Rehabilitation Psychology, 63(1), 155.Google Scholar
Bromage, B., Encandela, J. A., Cranford, M., Diaz, E., Williamson, B., Spell, V. T., & Rohrbaugh, R. M. (2019). Understanding health disparities through the eyes of community members: A structural competency education intervention. Academic Psychiatry, 43(2), 244–247. doi:10.1007/s40596-018-0937-zCrossRefGoogle ScholarPubMed
Brown, M., & Brown, R. S. (2020). Emancipatory perspectives on madness: psychological, social, and spiritual dimensions. Routledge. Oxfordshire, England, UK.Google Scholar
Cabassa, L. J., Zayas, L. H., & Hansen, M. C. (2006). Latino adults’ access to mental health care: A review of epidemiological studies. Administration and Policy in Mental Health, 33(3), 316–330. doi:10.1007/s10488-006-0040-8CrossRefGoogle ScholarPubMed
Canady, V. A. (2021). APA on MLK Day apologizes for its role in structural racism in psychiatry. Mental Health Weekly, 31(4), 1–3.Google Scholar
Corcoran, C. M. (2016). Ethical and epidemiological dimensions of labeling psychosis risk. AMA Journal of Ethics, 18(6), 633–642. doi:10.1001/journalofethics.2016.18.6.msoc2-1606Google Scholar
Corrigan, P. W., Markowitz, F. E., & Watson, A. C. (2004). Structural levels of mental illness stigma and discrimination. Schizophrenia Bulletin, 30(3), 481–491.CrossRefGoogle ScholarPubMed
Corrigan, P. W., Mueser, K. T., Bond, G. R., Drake, R. E., & Solomon, P. (2012). Principles and practice of psychiatric rehabilitation: An empirical approach. Guilford Press.Google Scholar
Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 139.Google Scholar
Cross, A. B., Mulvey, E. P., Schubert, C. A., Griffin, P. A., Filone, S., Winckworth-Prejsnar, K., & Heilbrun, K. (2014). An agenda for advancing research on crisis intervention teams for mental health emergencies. Psychiatric Services, 65(4), 530–536.Google Scholar
Dalsania, A. K., Fastiggi, M. J., Kahlam, A., Shah, R., Patel, K., Shiau, S., & DallaPiazza, M. (2021). The relationship between social determinants of health and racial disparities in COVID-19 mortality. Journal of Racial and Ethnic Health Disparities, 1–8. doi: 10.1007/s40615-020-00952-yGoogle Scholar
Dark, F., Scott, J. G., Baker, A., Parker, S., Gordon, A., Newman, E., & Penn, D. L. (2020). Randomized controlled trial of social cognition and interaction training compared to befriending group. British Journal of Clinical Psychology, 59(3), 384–402. doi:10.1111/bjc.12252Google Scholar
Dearing, K. S., & Steadman, S. (2009). Enhancing intellectual empathy: The lived experience of voice simulation. Perspectives in Psychiatric Care, 45(3), 173–182. doi:10.1111/j.1744-6163.2009.00219.xCrossRefGoogle ScholarPubMed
Deegan, P. E. (1996). Hearing voices that are distressing: A training and simulated experience. Lawrence, MA: The National Empowerment Center, Inc.Google Scholar
Delgado, R., & Stefancic, J. (2017). Critical Race Theory: An Introduction (Vol. 20). NYU Press. New York.Google Scholar
Dempsey, C., Quanbeck, C., Bush, C., & Kruger, K. (2020). Decriminalizing mental illness: Specialized policing responses. CNS Spectrums, 25(2), 181–195.Google Scholar
Desmond, M., Papachristos, A. V., & Kirk, D. S. (2016). Police violence and citizen crime reporting in the black community. American Sociological Review, 81(5), 857–876.Google Scholar
Dubreucq, J., Plasse, J., & Franck, N. (2021). Self-stigma in serious mental illness: A systematic review of frequency, correlates, and consequences. Schizophrenia Bulletin. doi:10.1093/schbul/sbaa181Google Scholar
Edwards, F., Lee, H., & Esposito, M. (2019). Risk of being killed by police use of force in the United States by age, race–ethnicity, and sex. Proceedings of the National Academy of Sciences, 116(34), 16793–16798.Google Scholar
Elbogen, E. B., Beckham, J. C., Butterfield, M. I., Swartz, M., & Swanson, J. (2008). Assessing risk of violent behavior among veterans with severe mental illness. Journal of Traumatic Stress, 21(1), 113–117.Google Scholar
Ellison, M. L., Belanger, L. K., Niles, B. L., Evans, L. C., & Bauer, M. S. (2018). Explication and definition of mental health recovery: A systematic review. Administration and Policy in Mental Health and Mental Health Services Research, 45(1), 91–102. doi:10.1007/s10488-016-0767-9Google Scholar
Francey, S. M., O’Donoghue, B., Nelson, B., Graham, J., Baldwin, L., Yuen, H. P., … McGorry, P. D. (2020). Psychosocial intervention with or without antipsychotic edication for first-episode psychosis: A randomized noninferiority clinical trial. Schizophrenia Bulletin Open, 1(1). doi:10.1093/schizbullopen/sgaa015Google Scholar
Frankham, E. (2018). Mental illness affects police fatal shootings. Contexts, 17(2), 70–72.CrossRefGoogle Scholar
Fuller, D. A., Lamb, H. R., Biasotti, M., & Snook, J. (2015). Overlooked in the undercounted: The role of mental illness in fatal law enforcement encounters. Treatment Advocacy Center. https://www.treatmentadvocacycenter.org/storage/documents/overlooked-in-the-undercounted.pdfGoogle Scholar
Gary, F. A. (2005). Stigma: Barrier to mental health care among ethnic minorities. Issues in Mental Health Nursing, 26(10), 979–999.Google Scholar
Gertner, A. K., Rotter, J. S., & Shafer, P. R. (2019). Association between state minimum wages and suicide rates in the US. American Journal of Preventive Medicine, 56(5), 648–654.Google Scholar
Goodheart, C. D., Kazdin, A. E., & Sternberg, R. J. (2006). Evidence-based psychotherapy: Where practice and research meet (pp. xi–295). Washington DC, USA. American Psychological Association.Google Scholar
Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., & Caine, E. D. (2020). Suicide risk and prevention during the COVID-19 pandemic. The Lancet Psychiatry, 7(6), 468–471.Google Scholar
Hamada, K., & Fan, X. (2020). The impact of COVID-19 on individuals living with serious mental illness. Schizophrenia Research 222, 3.Google Scholar
Hartz, S. M., Pato, C. N., Medeiros, H., Cavazos-Rehg, P., Sobell, J. L., Knowles, J. A., & Pato, M. T. (2014). Comorbidity of severe psychotic disorders with measures of substance use. The Journal of the American Medical Association Psychiatry, 71(3), 248–254.Google Scholar
Haushofer, J., Mudida, R., & Shapiro, J. P. (2020). The comparative impact of cash transfers and a psychotherapy program on psychological and economic well-being (No. w28106). National Bureau of Economic Research. Cambridge, MA, USA.Google Scholar
Heun-Johnson, H., Menchine, M., Axeen, S., Lung, K., Claudius, I., Wright, T., & Seabury, S. A. (2021). Association between race/ethnicity and disparities in health care use before first-episode psychosis among privately insured young patients. JAMA psychiatry, 78(3), 311–319.Google Scholar
Hollon, S. D. (2020). Is cognitive therapy enduring or antidepressant medications iatrogenic? Depression as an evolved adaptation. American Psychologist, 75(9), 1207.Google Scholar
Holttum, S., & Hayward, M. (2010). Perceived improvements in service user involvement in two clinical psychology training courses. Psychology Learning & Teaching, 9(1), 16–24. doi:10.2304/plat.2010.9.1.16Google Scholar
Humphreys, K., Blodgett, J. C., & Roberts, L. W. (2015). The exclusion of people with psychiatric disorders from medical research. Journal of Psychiatric Research, 70, 28–32.Google Scholar
Kopelovich, S. L., Hughes, M., Monroe-DeVita, M. B., Peterson, R., Cather, C., & Gottlieb, J. (2019). Statewide implementation of cognitive behavioral therapy for psychosis through a learning collaborative model. Cognitive and Behavioral Practice, 26(3), 439–452.Google Scholar
Kurtz, M. M., Gagen, E., Rocha, N. B. F., Machado, S., & Penn, D. L. (2016). Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies. Clinical Psychology Review, 43, 80–89. doi:10.1016/j.cpr.2015.09.003Google Scholar
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363–385.Google Scholar
López, S. R., Barrio, C., Kopelowicz, A., & Vega, W. A. (2012). From documenting to eliminating disparities in mental health care for Latinos. American Psychologist, 67(7), 511–523. doi:10.1037/a0029737CrossRefGoogle ScholarPubMed
López, S. R., Lara, M., Kopelowicz, A., Solano, S., Foncerrada, H., & Aguilera, A. (2009). La CLAve to increase psychosis literacy of Spanish-speaking community residents and family caregivers. Journal of Consulting and Clinical Psychology, 77(4), 763.CrossRefGoogle Scholar
Lucksted, A., Drapalski, A., Calmes, C., Forbes, C., DeForge, B., & Boyd, J. (2011). Ending self-stigma: Pilot evaluation of a new intervention to reduce internalized stigma among people with mental illnesses. Psychiatric Rehabilitation Journal, 35(1), 51.Google Scholar
Luigi, M., Rapisarda, F., Corbière, M., De Benedictis, L., Bouchard, A. M., Felx, A., … Lesage, A. (2020). Determinants of mental health professionals’ attitudes towards recovery: A review. Canadian Medical Education Journal, 11(5), e62.Google Scholar
Mabe, P. A., Ahmed, A. O., Duncan, G. N., Fenley, G., & Buckley, P. F. (2014). Project GREAT: Immersing physicians and doctorally-trained psychologists in recovery-oriented care. Professional Psychology: Research and Practice, 45(5), 347.Google Scholar
Magliano, L., Read, J., Rega, S., Oliviero, N., Sagliocchi, A., Patalano, M., & D’Ambrosio, A. (2011). The influence of causal explanations and diagnostic labeling on medical students’ views of schizophrenia. Academic Medicine, 86(9), 1155–1162.Google Scholar
Metzl, J. M. (2010). The protest psychosis: How schizophrenia became a black disease. Beacon Press. Boston, MA, USA.Google Scholar
Millett, G. A., Jones, A. T., Benkeser, D., Baral, S., Mercer, L., Beyrer, C., … Crowley, J. S. (2020). Assessing differential impacts of COVID-19 on black communities. Annals of Epidemiology, 47, 37–44.Google Scholar
Mitchell, A. J., & Selmes, T. (2007). Why don’t patients take their medicine? Reasons and solutions in psychiatry. Advances in Psychiatric Treatment, 13(5), 336–346. doi:10.1192/apt.bp.106.003194Google Scholar
Morrison, A. P., Pyle, M., Maughan, D., Johns, L., Freeman, D., Broome, M. R., … MacLennan, G. (2020). Antipsychotic medication versus psychological intervention versus a combination of both in adolescents with first-episode psychosis (MAPS): A multicentre, three-arm, randomised controlled pilot and feasibility study. The Lancet Psychiatry, 7(9), 788–800.Google Scholar
Mote, J., & Fulford, D. (2020). Now is the time to support black individuals in the US living with serious mental illness—A call to action. The Journal of the American Medical Association Psychiatry, 78(2), 129–130.Google Scholar
Mueser, K. T., Silverstein, S. M., & Farkas, M. D. (2013). Should the training of clinical psychologists require competence in the treatment and rehabilitation of individuals with a serious mental illness? Psychiatric Rehabilitation Journal, 36(1), 54.CrossRefGoogle ScholarPubMed
Muhammad, S. (July 9, 2020). Opinion: Daniel Prude’s death is a nightmare scenario for Black families like mine. The Washington Post. Retrieved from https://www.washingtonpost.com/opinions/2020/09/07/daniel-prude-death-policing-mental-illness/Google Scholar
Nemani, K., Li, C., Olfson, M., Blessing, E. M., Razavian, N., Chen, J., … Goff, D. C. (2021). Association of psychiatric disorders with mortality among patients with COVID-19. JAMA Psychiatry, 78(4), 380–386.Google Scholar
Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry, 52, 102066.Google Scholar
Reddy, F., Spaulding, W. D., Jansen, M. A., Menditto, A. A., & Pickett, S. (2010). Psychologists’ roles and opportunities in rehabilitation and recovery for serious mental illness: A survey of Council of University Directors of Clinical Psychology (CUDCP) clinical psychology training and doctoral education. Training and Education in Professional Psychology, 4(4), 254.Google Scholar
Rollins, A. C. Jr (2019). Assessment of public sector service quality: Gauging experiences and perceptions of racial profiling. Journal of Public Management & Social Policy, 26(1), 59–72.Google Scholar
Rüsch, N., Corrigan, P. W., Wassel, A., Michaels, P., Larson, J. E., Olschewski, M., … Batia, K. (2009). Self-stigma, group identification, perceived legitimacy of discrimination and mental health service use. The British Journal of Psychiatry, 195(6), 551–552.Google Scholar
Schlier, B., Lange, P., Wiese, S., Wirth, A., & Lincoln, T. (2016). The effect of educational information about treatments for schizophrenia on stigmatizing perceptions. Journal of Behavior Therapy and Experimental Psychiatry, 52, 11–16.Google Scholar
Schlier, B., Schmick, S., & Lincoln, T. M. (2014). No matter of etiology: Biogenetic, psychosocial and vulnerability-stress causal explanations fail to improve attitudes towards schizophrenia. Psychiatry Research, 215(3), 753–759.Google Scholar
Sher, L. (2020). The impact of the COVID-19 pandemic on suicide rates. QJM: An International Journal of Medicine, 113(10), 707–712.Google Scholar
Shevlin, M., Murphy, J., Read, J., Mallett, J., Adamson, G., & Houston, J. E. (2011). Childhood adversity and hallucinations: A community-based study using the National Comorbidity Survey Replication. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1203–1210.Google Scholar
Smith, M. K., Tamburrino, M. B., Naskar, I., Lynch, D. J., & Chen, Y. (2014). Hearing voices: Evaluation of a medical student training experience about psychosis. Academic Psychiatry, 38(4), 514–515. doi:10.1007/s40596-014-0166-zGoogle Scholar
Spaulding, W. D., Sullivan, M. E., Evans, E., & Avila, A. (2021). Inpatient settings and the people they serve. In Comprehensive Clinical Psychology (2nd ed.): Elsevier. https://www.sciencedirect.com/science/article/pii/B9780128186978000789?via%3DihubGoogle Scholar
Spaulding, W. D., Sullivan, M. E., & Poland, J. S. (2003). Treatment and Rehabilitation of Severe Mental Illness. Guilford Press. New York, NY, USA.Google Scholar
Sullivan, M. (1999). The unique roles of state hospital programs: Keeping what works in an evolving system. New Directions for Mental Health Services, 1999(84), 47–55.Google Scholar
Swan, S., Keen, N., Reynolds, N., & Onwumere, J. (2017). Psychological interventions for post-traumatic stress symptoms in psychosis: A systematic review of outcomes. Frontiers in Psychology, 8, 341.Google Scholar
Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: Bringing epidemiologic research to policy. Annals of Epidemiology, 25(5), 366–376.Google Scholar
Tan, S. B., deSouza, P., & Raifman, M. (2021). Structural racism and COVID-19 in the USA: A county-level empirical analysis. Journal of Racial and Ethnic Health Disparities, 1–11.Google Scholar
Tarasenko, M., Sullivan, M., Ritchie, A. J., & Spaulding, W. D. (2013). Effects of eliminating psychiatric rehabilitation from the secure levels of a mental-health service system. Psychological Services, 10(4), 442–451. doi:10.1037/a0030260Google Scholar
Tsoi, O. Y. Y., Chan, S. K. W., Chui, A. H. C., Hui, C. L. M., Chang, W. C., Lee, E. H. M., … Chen, E. Y. H. (2020). Effect of brief social contact video compared with expert information video in changing knowledge and attitude towards psychosis patients among medical students. Early Intervention in Psychiatry, 15(2), 278–285.Google Scholar
Villa, J., Ehret, B. C., & Depp, C. A. (2019). Systematic review of the inclusion of people with psychosis in suicide-specific clinical trials. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 41(3), 233–236.Google Scholar
Weisman, A. G., & López, S. R. (1997). An attributional analysis of emotional reactions to schizophrenia in Mexican and Anglo American cultures. Journal of Applied Social Psychology, 27(3), 223–244.Google Scholar
Weisman de Mamani, A., McLaughlin, M., Altamirano, O., Lopez, D., & Ahmad, S. S. (2020). Culturally informed therapy for Schizophrenia: A family-focused cognitive behavioral approach, clinician guide. Oxford University Press, Oxford, UK.Google Scholar
Wells, T. (2020). Lessons learned from Georgia’s 2010 Olmstead Settlement: The good, the bad, and the limitations of a Justice Department Olmstead Settlement. Journal of Legal Medicine, 40(1), 45–52. doi:10.1080/01947648.2020.1731334Google Scholar
Zarlock, S. P. (1966). Social expectations, language, and schizophrenia. Journal of Humanistic Psychology, 6(1), 68–74. doi:10.1177/002216786600600107Google Scholar

Accessibility standard: Unknown

Accessibility compliance for the PDF of this book is currently unknown and may be updated in the future.

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×