Mad Among Us

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In the first comprehensive one-volume history of the treatment of the mentally ill, the foremost historian in the field compellingly recounts our various attempts to solve this ever-present dilemma from colonial times to the present.

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.
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Publisher
Simon and Schuster
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Published on
Feb 21, 1994
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Pages
400
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ISBN
9781439105719
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Features
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Language
English
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Genres
History / General
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Content Protection
This content is DRM protected.
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Eligible for Family Library

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Gerald N. Grob's Mental Institutions in America: Social Policy to 1875 has become a classic of American social history. Here the author continues his investigations by a study of the complex interrelationships of patients, psychiatrists, mental hospitals, and government between 1875 and World War II. Challenging the now prevalent notion that mental hospitals in this period functioned as jails, he finds that, despite their shortcomings, they provided care for people unable to survive by themselves. From a rich variety of previously unexploited sources, he shows how professional and political concerns, rather than patient needs, changed American attitudes toward mental hospitals from support to antipathy.
Toward the end of the 1800s psychiatrists shifted their attention toward therapy and the mental hygiene movement and away from patient care. Concurrently, the patient population began to include more aged people and people with severe somatic disorders, whose condition recluded their caring for themselves. In probing these changes, this work clarifies a central issue of decent and humane health care.
Gerald N. Grob is Professor of History at Rutgers University. Among his works are Mental Institutions in America: Social Policy to 1875 (Free Press), Edward Jarvis and the Medical World of Nineteenth-Century America (Tennessee), and The State and the Mentality III (North Carolina).

Originally published in 1983.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

The distinguished historian of medicine Gerald Grob analyzes the post-World War II policy shift that moved many severely mentally ill patients from large state hospitals to nursing homes, families, and subsidized hotel rooms--and also, most disastrously, to the streets. On the eve of the war, public mental hospitals were the chief element in the American mental health system. Responsible for providing both treatment and care and supported by major portions of state budgets, they employed more than two-thirds of the members of the American Psychiatric Association and cared for nearly 98 percent of all institutionalized patients. This study shows how the consensus for such a program vanished, creating social problems that tragically intensified the sometimes unavoidable devastation of mental illness. Examining changes in mental health care between 1940 and 1970, Grob shows that community psychiatric and psychological services grew rapidly, while new treatments enabled many patients to lead normal lives. Acute services for the severely ill were expanded, and public hospitals, relieved of caring for large numbers of chronic or aged patients, developed into more active treatment centers. But since the main goal of the new policies was to serve a broad population, many of the most seriously ill were set adrift without even the basic necessities of life. By revealing the sources of the euphemistically designated policy of "community care," Grob points to sorely needed alternatives.

Originally published in 1991.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

In the middle of the twentieth century, few physicians could have predicted that the modern diagnostic category of osteoporosis would emerge to include millions of Americans, predominantly older women. Before World War II, popular attitudes held that the declining physical and mental health of older persons was neither preventable nor reversible and that older people had little to contribute. Moreover, the physiological processes that influenced the health of bones remained mysterious. In Aging Bones, Gerald N. Grob makes a historical inquiry into how this one aspect of aging came to be considered a disease.

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 post–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
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