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Recovery from Schizophrenia: Psychiatry and Political Economy [Paperback]

Richard Warner
5.0 out of 5 stars  See all reviews (2 customer reviews)
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Book Description

20 Nov 2003 0415212677 978-0415212670 3Rev Ed
Recovery from Schizophrenia, from its first publication, was acclaimed as a work of major importance. It demonstrated convincingly, but controversially, how political, economic and labour market forces shape social responses to the mentally ill, mould psychiatric treatment philosophy, and influence the onset and course of one of the most common forms of mental illness.

In this revised and updated third edition, Dr Warner analyses the latest research to extend the conclusions of the original work and tells us whether conditions and outcomes for people with schizophrenia are getting better or worse for people in Britain and America in recent years. In addition, he
* critiques recent approaches to preventing the occurrence of schizophrenia
* suggests innovative strategies for advancing the economic situation of people with mental illness
* describes the latest advances in the rehabilitation of people with schizophrenia
* provides a guide on how to combat the stigma of mental illness at local and national level.

Recovery from Schizophrenia's radical analysis of the factors affecting the outcome of schizophrenia is essential reading for all psychiatrists, mental health professional, mental health advocates, social workers, rehabilitation personnel, and psychologists.

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Product details

  • Paperback: 424 pages
  • Publisher: Routledge; 3Rev Ed edition (20 Nov 2003)
  • Language: English
  • ISBN-10: 0415212677
  • ISBN-13: 978-0415212670
  • Product Dimensions: 23.4 x 15.5 x 2.6 cm
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (2 customer reviews)
  • Amazon Bestsellers Rank: 893,876 in Books (See Top 100 in Books)
  • See Complete Table of Contents

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Product Description

About the Author

Richard Warner is the Medical Director of the Mental Health Center of Boulder County, Colorado and Clinical Professor of Psychiatry and Adjunct Professor of Anthropology at the University of Colorado.

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7 of 7 people found the following review helpful
The central theme of this book is that the COURSE (as opposed to the CAUSE) of a Schizophrenic illness, the OUTCOME, the PROGNOSIS, is influenced by the environment in which a person diagnosed with Schizophrenia finds themselves in and also by the care they receive.

To some this may seem a truism, but the history of mental health services on both sides of the Atlantic have been marked by what Warner describes as 'therapeutic nihilism,' whereby the original conception of Schizophrenia as 'Dementia Praecox' - in other words as a form of 'Premature Dementia' - has come to determine the way those diagnosed 'Schizophrenic' have been perceived and treated.

It has been taken for granted amongst those delivering mental health services Warner contends that the prognosis for Schizophrenia by definition is poor and therefore no widespread and consistent attempt has been made to genuinely rehabilitate sufferers. A self-fulfilling prophecy has then ensued.

Warner's key insight is that what he describes as the 'political economy' has shaped the treatment that Schizophrenics have received. Simplified this means that in periods of full employment and a concomitant shortage of labour attempts have been made at rehabilitation, attempts that have produced results.

Warner cites two periods in history where this has happened. The first being what has come to be known as the 'Moral Movement' in the 19th century which prefigured the era of the large-scale County Asylums. The second came in the aftermath of WWII in this country during the same labour shortage that brought immigrants from the Commonwealth to these shores. Warner demonstrates that better outcomes for those dioagnosed as 'Schizophrenic' have resulted in these times.
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3 of 6 people found the following review helpful
Format:Paperback|Verified Purchase
I haven't read every word of this book but scanned it carefully. I am a social worker not a doctor and I was particularly interested in the chapter on medication which suggests that for many patients its use, while helpful in controlling symptoms, acts against their long term interests. This is at least partly because while antipsychotic medication seems to act by limiting dopamine reactions in the brain the long term effect of this is to make the brain extra sensitive to dopamine (because it is 'starved' of dopamine by the medication). Therefore when people stop their medication they're likely to have a rough time.

As the other reviewer explains this book has a lot to say about the influence of stress on schizophrenia, especially stress imposed by social conditions. In particular he brings a lot of evidence to suggest that outcomes for schizophrenia are far better in third world countries. This sppears to be to do with issues of stigma and the fact that those ill are less likely to be withdrawn from the community, more likely to carry on a normal life.

In general this book appears to act as a summary of research on schizophrenia, especially the effects of treatment in different environments, and if you are really interested in outcomes and treatment of schizophrenia I would suggest this book is invaluable.
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Most Helpful Customer Reviews on (beta) 5.0 out of 5 stars  3 reviews
16 of 16 people found the following review helpful
5.0 out of 5 stars A neglected contribution 7 Dec 1999
By Richard Lichtman - Published on
(I have not yet read the second edition of this book but it is reasonable to assume that it is an updated version of the first edition, which is the book I am referring to.) This is an extraordinary book which reviews the entired field of social structure and mental illness. (In fact my only objection to the book is the title, which suggests a far narrower field than is actually covered in the work.) Warner seems to have read all the relevant literature and has the distinct advantage of being able to place studies of mental health in a social, historical and cross-cultural context. His analysis is thorough and creative and he makes a very persuasive case that the predominant causes of mental illness, including schizophrenia, are more deeply rooted in the social system than the myopic, insulated views of most psychiatrists, psychologists and therapists can envision. His arguments against the "social drift" hypothesis and other self serving illusions of contemporary psychotherapeutica reaserch are extremely important. His willingness to incorporate insights from a variety of social thinker, including Marx (yet, that Marx) give the book a deep analyitic resonance. It is not accidental that this book is not widely known for it does not fit easily into the reified bioligical accounts of mental illness that have been playing havoc with the field for the last 25 years or so.
5.0 out of 5 stars fantastic jaunt through this history of modern psychiatry 26 Nov 2013
By critical consumer - Published on
Format:Paperback|Verified Purchase
This is a really fantastic jaunt through this history of modern psychiatry through the lens of the treatment of schizophrenia. With scalpel-like precision, Warner, a British psychiatrist living in the US, dissects the statistics on recovery from schizophrenia and comes to an alarming conclusion: not only are outcomes no better for schizophrenia today, they may be even worse than in the 19th century! Unlike some other writers on this emotionally charged topic, Warner does not give way to polemic. His arguments are always reasoned and reasonable, his conclusions tentative, his exposition dispassionate. He considers all the evidence available at his disposal rather than selectively reviewing the literature, and at every turn considers alternative explanations before laying his weight behind the most likely.

In addition to providing the historical background to changing concepts of whether recovery is possible in this devastating illness, the book focuses on how large social and economic trends regarding to recession, labor surplus, work, industrialization affect the course of schizophrenia. Warner has a decisively Marxist bent to his arguments that may be offputting to some reasons. Nevertheless, it is hard to ignore the findings in this book because he so thoroughly discusses the evidence both for and against his arguments. Unlike many academic texts, this book is eminently readable, and even enjoyable. I read most of it over the course of a few days.

Warner's overarching message is a triumphant, positive one: the course of this serious mental illness is much less bleak than has previously presumed. People can and do recover from schizophrenia. Medications may have their place but they may also worsen the long-term course of the illness. Focusing on functionality and providing people with a sense of structure, and purpose often found in work may be key. In addition, Warner suggests looks at evidence for the role of obstetric complications and other environmental factors in schizophrenia, suggesting many cases could be prevented entirely.
5.0 out of 5 stars Refreshing new way of looking at mental illness 4 July 2012
By Kathy - Published on
Format:Paperback|Verified Purchase
Approaching mental illness from an economic standpoint has shed new light on the failure of treatment and recovery stratagies in the United States. As a student, this perspective is often over looked or ignored. This book makes perfect sense in light of our multibillion dollar-a-year pharmaceutical industry and broken family systems.

One thing is certain, Warner hits the nail on the head. The DSM and the APA are doing the mentally ill no favors by "labeling" them. Like modern day lepers, the mentally ill are labeled, handed over to a broken system-and then isolated and ostracized. Often jobless, and abandoned by their families, the mentally ill have little hope for complete recovery here in the wealthiest nation on earth.

I will be referring to Warner's book often over the next few years. In fact, this book has inspired me to seek out people from the Developing World, and interview them personally- to see what they are doing "right."

The western concept of mental illness has been flawed from the get-go. It's time to rethink mental illness, and admit where we fall short. This is a must read for all college students.
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