Recovery from Schizophrenia

Dr. Harding's incredible book asks a question that state leadership, especially mental health commissioners, will find critical to system redesign. 'What do you need to get out of the hospital?' Many patients are being custodialized in the community as well as the hospital with the stabilization, maintenance, meds, and entitlements model that represents little hope for getting better but staying chronic. They need to see a pathway out of community care into a real life for themselves from the time they arrive until they go. All of them need support and graduation to have a successful life in the community. So it is 'What do you need to get on the road to having a full life?' We are here to walk this path with you.

Auteur
Courtenay Harding has spent nearly 40 years as a professor of psychiatry. She has presented this evidence at least 550 times at international and national meetings, academic Grand Rounds, providers, families, patients, and government entities. She has received 47 awards and honors for her work.

Texte du rabat

Recovery from Schizophrenia describes two of the longest studies of schizophrenia and other psychoses, which found that one half to two thirds of even the most profoundly disabled people were able to reclaim their lives from the illness. The book features stories about patients finding their way, along with a brief history of the field of psychiatry as it struggled to understand these cases, and describes many successful recovery programs across the world.

Résumé
Evidence from two highly regarded three-decade NIMH follow-up studies of schizophrenia and other psychoses, conducted by Courtenay Harding and her research team, have revealed that one half to two-thirds of even the most disabled schizophrenia patients achieved significant improvement, and even recovery, over time. These findings are consistent with those from nine other decades'-long studies from across the world, as well as many shorter-term investigations as well. But the field of psychiatry has nevertheless largely failed to accept that recovery is possible for most psychotic patients. Recovery from Schizophrenia provides numerous examples of patients becoming productive citizens, overcoming difficult starts in early life, alongside exciting program strategies and additional research evidence - evidence that provides a blueprint for both how to build new and successful mental health systems, and how to significantly improve clinical training programs. Unfortunately, most service systems still provide primarily stabilization, maintenance, medications, and entitlements under the new guise of rehabilitation. Critical changes need to occur in public policy, funding mechanisms, program design, and new clinical expectations to improve patient care-all of which will promote much more significant improvement and recovery. Discussion of these critical issues is presented here in accessible prose, allowing readers from a range of backgrounds - families, clinicians, and researchers alike - to experience the ups and downs of an entire field trying to solve the puzzle of recovery from schizophrenia in the usual settings. Recovery from Schizophrenia is the remarkable story of these patients and the scientists and caring professionals who refused to let go of hope for better outcomes.

Contenu

• Foreword

• Introduction

• PART ONE: EVOLUTION OF A REVOLUTION

• Chapter 1 Shocking Treatment in Colonial Vermont

• Chapter 2 The Evolution of a Vermont Country Doctor

• Chapter 3 A Puzzled Psychiatrist Became a Revolutionary with the Help of His Patients

• Chapter 4 More Ingredients in the Early Vermont Program

• Chapter 5 Phase II: The Five-Year Follow-Up in 1965 and the Demise of Vermont State Hospital

• PART TWO: NEW TEAM, NEW STUDY, SAME SAMPLE, YEARS LATER

• Chapter 6 The Implausibility of a Housewife Who Became a NIMH Principal Investigator

• Chapter 7 Learning about Research, the Generosity of the Field, and Politics in Science

• Chapter 8 How We Measured a Life Lived: Preparation Is Worth all The Effort

• Chapter 9 Tough Questions from The Chief of Medical Biostatistics

• PART THREE: SURPRISES

• Chapter 10 Surprise Discoveries Out in the Field

• Chapter 11 "A Whole Bunch of People Got Better"

• Chapter 12 "I Don't Believe a Word She Just Said!"

• Chapter 13 Did Rediagnosis for Contemporary Schizophrenia Make a Difference in the Rates of Improvement and Recovery?

• Chapter 14 Vermont Data Supported the DSM-5 Deletion of Subtypes in Schizophrenia

• Chapter 15 The Role of Rehabilitation, Neural Plasticity, and Public Policy in Long-term Outcome--The Maine-Vermont Comparison Study

• Chapter 16 Northern New England: Perfect Environments for Longitudinal Research

• PART FOUR: NINE OTHER VERY LONG-TERM STUDIES FROM ACROSS THE WORLD AND THEIR IMPLICATIONS

• Chapter 17 World Wide Evidence of Recovery

• Chapter 18 Eating Humble Pie

• PART FIVE: SAMPLE OF REHABILITATION PROGRAMS HELPING PEOPLE IMPROVE AND RECOVER

• Chapter 19 World Programs

• Chapter 20 US Programs

• ACKNOWLEDGMENTS

• NOTES

• INDEX