Gerald Grob charts the growth of mental hospitals in response to the escalating numbers of the severely and persistently mentally ill and the deterioration of these hospitals under the pressure of too many patients and too few resources. Mounting criticism of psychiatric techniques such as shock therapies, drugs, and lobotomies and of mental institutions as inhumane places led to a new emphasis on community care and treatment. While some patients benefited from the new community policies, they were ineffective for many mentally ill substance abusers. Grob’s definitive history points the way to new solutions. It is at once an indispensable reference and a call for a humane and balanced policy in the future.
The services rendered by the hospital were of benefit not merely to the afflicted individual but to the community. Such an institution embodied a series of moral imperatives by providing humane and scientific treatment of disabled individuals, many of whose families were unable to care for them at home or to pay the high costs of private institutional care. Yet the mental hospital has always been more than simply an institution that offered care and treatment for the sick and disabled. Its structure and functions have usually been linked with a variety of external economic, political, social, and intellectual forces, if only because the way in which a society handled problems of disease and dependency was partly governed by its social structure and values.
The definition of disease, the criteria for institutionalization, the financial and administrative structures governing hospitals, the nature of the decision-making process, differential care and treatment of various socio-economic groups were issues that transcended strictly medical and scientific considerations. Mental Institutions in America attempts to interpret the mental hospital as a social as well as a medical institution and to illuminate the evolution of policy toward dependent groups such as the mentally ill. This classic text brilliantly studies the past in depth and on its own terms.
American constitutionalism represents this country’s greatest gift to human freedom, yet its story remains largely untold. For over two hundred years, its ideals, ideas, and institutions influenced different peoples in different lands at different times. American constitutionalism and the revolutionary republican documents on which it is based affected countless countries by helping them develop their own constitutional democracies. Western constitutionalism—of which America was a part along with Britain and France—reached a major turning point in global history in 1989, when the forces of democracy exceeded the forces of autocracy for the first time.
Historian George Athan Billias traces the spread of American constitutionalism—from Europe, Latin America, and the Caribbean region, to Asia and Africa—beginning chronologically with the American Revolution and the fateful "shot heard round the world" and ending with the conclusion of the Cold War in 1989. The American model contributed significantly by spearheading the drive to greater democracy throughout the Western world, and Billias’s landmark study tells a story that will change the way readers view the important role American constitutionalism played during this era.
During the 1950s and 1960s, as more and more people lived to the age of 65, older people emerged as a self-conscious group with distinct interests, and they rejected the pejorative concept of senescence. But they had pressing health needs, and preventing age-related decline became a focus for researchers and clinicians alike.
In analyzing how the normal aging of bones was transformed into a medical diagnosis requiring treatment, historian of medicine Grob explores developments in medical science as well as the social, intellectual, economic, demographic, and political changes that transformed American society in the postâ€“World War II decades.
Though seemingly straightforward, osteoporosis and its treatment are shaped by illusions about the conquest of disease and aging. These illusions, in turn, are instrumental in shaping our health care system. While bone density tests and osteoporosis treatments are now routinely prescribed, aggressive pharmaceutical intervention has produced results that are inconclusive at best.
The fascinating history in Aging Bones will appeal to students and scholars in the history of medicine, health policy, gerontology, endocrinology, and orthopedics, as well as anyone who has been diagnosed with osteoporosis.-- Beth Linker, University of Pennsylvania
Originally published in 1991.
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