Culture and the Restructuring of Community Mental Health - (International Contributions in Psychology) Annotated by William Vega & John W Murphy

About the Book

Examining the issues of treatment, organizational planning, and research, this multidimensional study offers a critique of both the theoretical and programmatic aspects of providing mental health services to traditionally underserved populations. Focusing on minority groups, the book uses the case of Hispanics to illustrate the largely unaddressed need for services that are relevant to social groups with diverse cultural and linguistic backgrounds. Vega and Murphy maintain that the present service system is socially insensitive, that mental health services in the United States were never designed to serve a multicultural population, and that, in general, those who dominate the current mental health system from administrator-clinicians to bureaucrats and politicians do not know how to direct their services to minority groups. Calling for fundamental reconceptualization and change, the book argues for community-based planning and intervention as an enlightened and necessary alternative, and provides a detailed description of such a program in terms of both philosophy and method.

The eight chapters offer a reassessment based on understanding not only the rationale for these necessary services, but also the important philosophical and pragmatic issues that have resulted in the current, inadequate system; they provide the new thinking necessary to reframe the objectives of mental health services for cultural minorities. The early chapters explore some of the critical junctures in the community mental health movement between 1946 and 1981, the development of theory in the movement's early days, and the thrust of community-based intervention--the culture-specific methodology that has not been well-understood or implemented. Chapters 4 and 5 focus on the relationship between medicalization and the degradation of culture and on the reconceptualization of knowledge, order, illness, and intervention. The last three chapters analyze an example of community-based intervention in operation, and citizen involvement and the political aspects of community-based policies are reviewed. This timely discussion of the requirements for a socially responsible and community-based services delivery program lays the theoretical foundation for a future public mental health system. As such, it will prove invaluable and important reading for advanced undergraduate and graduate students in the health and human services areas, including social work, clinical psychology, and medical sociology; it also has much to offer professional administrators and planners. Culture and the Restructuring of Community Mental Health has been designed to meet the needs of both academics and practitioners.

Book Synopsis

Examining the issues of treatment, organizational planning, and research, this multidimensional study offers a critique of both the theoretical and programmatic aspects of providing mental health services to traditionally underserved populations. Focusing on minority groups, the book uses the case of Hispanics to illustrate the largely unaddressed need for services that are relevant to social groups with diverse cultural and linguistic backgrounds. Vega and Murphy maintain that the present service system is socially insensitive, that mental health services in the United States were never designed to serve a multicultural population, and that, in general, those who dominate the current mental health system from administrator-clinicians to bureaucrats and politicians do not know how to direct their services to minority groups. Calling for fundamental reconceptualization and change, the book argues for community-based planning and intervention as an enlightened and necessary alternative, and provides a detailed description of such a program in terms of both philosophy and method.

The eight chapters offer a reassessment based on understanding not only the rationale for these necessary services, but also the important philosophical and pragmatic issues that have resulted in the current, inadequate system; they provide the new thinking necessary to reframe the objectives of mental health services for cultural minorities. The early chapters explore some of the critical junctures in the community mental health movement between 1946 and 1981, the development of theory in the movement's early days, and the thrust of community-based intervention--the culture-specific methodology that has not been well-understood or implemented. Chapters 4 and 5 focus on the relationship between medicalization and the degradation of culture and on the reconceptualization of knowledge, order, illness, and intervention. The last three chapters analyze an example of community-based intervention in operation, and citizen involvement and the political aspects of community-based policies are reviewed. This timely discussion of the requirements for a socially responsible and community-based services delivery program lays the theoretical foundation for a future public mental health system. As such, it will prove invaluable and important reading for advanced undergraduate and graduate students in the health and human services areas, including social work, clinical psychology, and medical sociology; it also has much to offer professional administrators and planners. Culture and the Restructuring of Community Mental Health has been designed to meet the needs of both academics and practitioners.

Review Quotes

?Its review of the literature both in community mental health and culturally competent services is exhaustive. And its critique of programs and services should be understood and recognized by anyone doing research in this field.?-Social Service Review

?This concise and provocative examination of the community mental health movement and its relationship to psychiatry in the US begins with the history of the movement and a critique of the "realist" psychological and sociological models upon which it was built. The authors argue that a culturally sensitive conceptual base and a reflexive methodology that avoids Cartesian dualism should serve as the basis for community mental-health care. Next, they explore epistemologic issues that underlie concepts of disease and deviance and that define appropriate modes of intervention. An example of their recommended approach is presented Proyecto Bienestar--a program for prevention of depression among women in an Hispanic community. Issues in designing, implementing, and evaluating the project are outlined and discussed briefly. Finally pragmatic and policy changes inherent in any move toward a community based approach are addressed, and political barriers to effecting such a change are identified. This is a book that should be carefully discussed both by members of the mental health establishment and by social scientists interested in the interplay between culture and healing. University collections.?-Choice

"Its review of the literature both in community mental health and culturally competent services is exhaustive. And its critique of programs and services should be understood and recognized by anyone doing research in this field."-Social Service Review

"This concise and provocative examination of the community mental health movement and its relationship to psychiatry in the US begins with the history of the movement and a critique of the "realist" psychological and sociological models upon which it was built. The authors argue that a culturally sensitive conceptual base and a reflexive methodology that avoids Cartesian dualism should serve as the basis for community mental-health care. Next, they explore epistemologic issues that underlie concepts of disease and deviance and that define appropriate modes of intervention. An example of their recommended approach is presented Proyecto Bienestar--a program for prevention of depression among women in an Hispanic community. Issues in designing, implementing, and evaluating the project are outlined and discussed briefly. Finally pragmatic and policy changes inherent in any move toward a community based approach are addressed, and political barriers to effecting such a change are identified. This is a book that should be carefully discussed both by members of the mental health establishment and by social scientists interested in the interplay between culture and healing. University collections."-Choice

About the Author

WILLIAM A. VEGA is Professor of Public Health at the University of California, Berkeley. He has published numerous articles on the subjects of minority mental health, psychosocial issues, and health promotion in diverse journals. In addition, he is the editor of Stress and Hispanic Mental Health and Hispanic Natural Support Systems.

JOHN W. MURPHY is Associate Professor of Sociology at the University of Miami, Coral Gables. He has contributed chapters, spoken, and published over 90 articles. In addition, he has published five books, including Qualitative Methodology: Theory and Application--A Guide for the Social Practitioner.