Nancy P. Kropf
Although the terms older adult and senior citizen are commonly defined as individuals 60 years and above, later adulthood contains various life-course phases and developmental periods. The “young-old,” defined as individuals in the age range of 60–75 years, often experience various health, social, and economic transitions. Both the individual and family systems must negotiate some of the concomitant changes that accompany the journey into later life. Therefore, this first decade of older adulthood is one that can simultaneously be enjoyable, exciting, demanding, and stressful for aging persons and their family.
Karen Kyeunghae Lee
Depression and bipolar mood disorders are mental disorders that are characterized by mood disturbance combined with decreased functioning of the affected individuals. This entry focuses on major depressive disorder and bipolar I and II disorders among adults in the United States. Bipolar disorder has unique clinical features and intervention options, and so it is discussed in a separate section after depression. Diagnosis, prevalence, comorbidity, risk factors, course, assessment, treatment, service utilization, and international perspectives are reviewed for each disorder. The implications for social work are briefly addressed at the end of this entry.
Vikki L. Vandiver
Since the mid-1980s, managed care has been one approach used to address the economic crisis in the American health-care system. This entry overviews managed care from the perspective of policy, procedure, practice, and system. Specifically, emphasis is given to understanding the emergence and history of managed care, multiple definitions, how it works, and examples of managed care plans, key legislation, existing research, its future, and implications for social-work practitioners.
Darrell P. Wheeler
Matthew Epperson, Julian Thompson, and Kelli E. Canada
This article discusses the emergence, structure, and purpose of the mental health court. It details the therapeutic aspects of the mental health court and its function as a specialized-treatment court serving persons with serious mental illnesses in the criminal justice system. Guiding themes, such as the criminalization of mental illness, therapeutic jurisprudence, and drug-treatment courts are described. It also identifies key legislation that contributed to the funding and proliferation of mental health courts. The effectiveness of mental health court, along with current criticisms regarding its impact on participants’ mental health and recidivism outcomes, are also covered. Last, social work values and the various roles of social workers in the mental health court are highlighted to demonstrate the relevance of mental health court to contemporary social work practice and intervention.
Continuing a history of inequity, private insurers have placed restrictions and limitations on coverage for mental health conditions making access to treatment services increasingly more challenging. A state-by-state advocacy movement has led to the enactment of various state laws to require mental health parity. With the Clinton Administration’s attempt at health care reform, mental health parity became part of the health reform debate and led to the passage of the Mental Health Parity Act of 1996. The inadequacies of this law were partially corrected in the Mental Health Parity and Addiction Equity Act of 2008, which included mandated coverage for substance use conditions. The Obama Administration in 2011 included these provisions in the Patient Protection and Affordable Care Act, which does not require compliance monitoring nor does it provide a definition for “mental health,” which leaves insurers to define it and hence determine what coverage will actually be available.
Catherine G. Greeno
Mental illnesses are very common; more than one-quarter of people will develop a mental illness during their lifetime. Mental illnesses are associated with substantial disability in work, relationships, and physical health, and have been clearly established as one of the leading causes of disability in the developing, as well as the industrialized world. Mental disorders are common in every service sector important to social workers, and affect outcomes in every service sector. Mental disorders are strongly associated with poverty worldwide, and are common and often unrecognized in the general health sector, child welfare, and criminal justice settings, among others. Basic information about mental health is thus important to all social workers. Information about classification systems and major categories of mental illnesses, including depression, anxiety, psychotic disorders, and substance abuse disorders, is presented. The service system for mental disorders is badly underdeveloped, and most people who need treatment do not receive it. There is an increasing body of evidence demonstrating effective treatments, and policy is moving toward requiring that treatments offered be evidence based. This is a period of a great explosion of knowledge about mental health, and we can expect considerable advances in the coming years.
This entry focuses on services for adults with severe mental illness, specifically the five psychosocial interventions considered evidence-based practices. The emergence of psychiatric rehabilitation, the only professional discipline designed to serve a specified population, is described. The primary historical practice approaches, which are the foundation for psychiatric rehabilitation, are discussed. Each of the five evidence-based practices is then described with the empirical supporting evidence. The emphasis on this population and interventions were selected as social workers are the major providers for this population and frequent implementers and developers of these interventions.
Catherine N. Dulmus and Albert R. Roberts
This entry focuses on serious mental illness among adults, including those having serious and persistent mental illness. Social work's historic and current roles in service delivery are reviewed, its present trends in the field (including the recovery movement, evidence-based practices, comorbidity, and the integration of physical and mental health), as well as the service delivery system and the current needs and challenges it faces, are discussed.
The primary focus of the entry is service utilization. As background, the risks for and prevalence of childhood mental disorders are summarized. Then, the current children's mental health services system is described, including the role of nonspecialty sectors of care and informal support systems. Service use barriers and disparities, pathways to services, and strategies to increase service use are discussed. The conclusion notes other current issues in child mental health, including the need to implement evidence-based treatments.