Book Reviews
Clinicians Guide to Mental Illness
Dennis C. Daley and Ihsan M. Salloum
ISBN: 0-071347-16-X 2001 336 pages McGraw-Hill Medical Publishing Division
Lisa Lynch
Adolescent Recovery Centre, Child and Adolescent Mental Health Service, Southern Health, Centre for Psychiatric Nursing Research and Practice, School of Post Graduate Nursing, University of Melbourne, Carlton VIC
In short, this text provides comprehensive, practical and 'easy to read' information on common adult mental disorders and substance abuse disorders. The preface of this text clearly articulates its purpose, function and application, not only for mental health clinicians but also for all primary health care professionals. The chapters were written by a multidisciplinary team of researcher-practitioners and clinicians from Western Psychiatric Institute and Clinic, The Department of Psychiatry of The University of Pittsburgh Medical Centre; thus providing the reader with a well researched, balanced and practical text. Emphasis has been placed on integrating research and theory into practice, they have done this by organising each chapter into subsections. Each section covers: a specific disorder, prevalence, assessment & diagnoses and appropriate treatment, which includes practical plans and strategies for intervention. In addition, this text integrates information pertaining to the impact these disorders have on family members and significant others, with particular emphasis on comorbidity, treatment adherence and relapse prevention. Although the text is based on research and statistics collected in the United States of America. Much of the information is generalist enough (with the exception of prevalence) to be translated to adult mental disorders and substance abuse disorders in Australia. An essential point to note however is that this text only utilises the Diagnostic Statistical Manual of Mental Disorders, for diagnosis and in Australia the ICD10 (International Classification of Diagnoses) is also a widely used diagnostic tool.
The initial chapter provides a comprehensive and useful overview into 'Helping Patients with Mental Disorders and Substance Abuse Disorders'. Of particular note in this chapter is the subsection on 'Treatment of Mental Health and Substance Abuse Disorders'; it revisits the phenomenon of 'continuum of care' and emphasises the role and responsibilities of the health care professional in being conversant with this continuum. It is paramount with the multitude of services and treatment available, and with patients likely to require a number of services in their lifetime, that all health care professionals to be conversant with this treatment strategy is paramount. How often do we hear clinicians say, "they slipped through the cracks," or struggle with the collaboration between services and argue over which service is more appropriate for particular patients? This chapter reminds us of how essential this collaboration and the continuum of care is. Individual service plans and patient management plans in Australia provide mental health clinicians with a practical way to implement this essential concept.
One of the major strengths of this text is that it tackles the topical and controversial issues of substance abuse and comorbidity (or multiple disorders) in the second chapter, and continues to highlight these complex dilemmas throughout the entire text. Appropriate assessment, services and treatment for those individuals with a substance disorder or comorbidity has provided many challenges for the Australian Government and its provision of Health Services. This complexity and lack of clarity has contributed to immense frustration for clinicians and patients alike.
The text identifies the prevalence of substance abuse and comorbidity which further emphasises this dilemma; thus providing a solid argument for the need of the mental health patient to be assessed in a comprehensive and holistic manner and, for services and treatment to be coordinated and collaborative. Although this text does not necessarily provide startling or obvious systematic solutions to this problem, it allows the reader to revisit the issue and increase their awareness. It may also provide some clarity or practical solutions that could be implemented into the clinicians individual practice or workplace.
Due to the clear layout of each chapter the reader can easily refer to a section or sub-section of the text when they require specific information pertaining to a particular disorder, assessment or treatment. The information on diagnoses is simple and clear enough to be adapted for use with educating the patient, their families or significant others. Treatment strategies are in depth and comprehensive; providing a wide range of appropriate, researched treatment options which includes: pharmocotherapy, behavioural therapy, psychotherapy, cognitive behavioural therapy and family therapy. The treatment strategies suggested for each disorder also upholds the philosophies of continuum of care, individual care plans and treatment by multiple services with different resources. These treatment options, which are supported by rigorous research, include suggestions for: crisis intervention, brief therapy, medium to long term therapy and rehabilitation. Most importantly this text emphasises treatment adherence and relapse prevention strategies for each diagnostic group. The use of case studies interspersed throughout this text gives the reader further practical examples of implementation.
Overall this is a text valuable to both novice and expert alike and will be of benefit not only to mental health clinicians but all health care professionals. It is essential that clinicians are able to provide treatment that is appropriate and based on evidence when designing a treatment plan for patients. In conclusion this text is a useful guide in providing practical approaches for clinicians in assessment, diagnosis and treatment.
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