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Time to Confront the Challenges of an Aging America
America is aging rapidly.1 Over the next few decades, the proportion of adults 65 and older will come to exceed the proportion of children under 18 – an historic first.2 And as the number of older adults grows from approximately 56 million at the beginning of this decade to 85 million in 2050,3...
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Coping With Chronic Pain: Good Advice Is Easy to Give but Hard to Take
Like many people, I live with pain every day. I’m lucky that, for the most part, my pain is tolerable and doesn’t interfere too much with my life. I walk slowly—but I walk. I sleep badly, but I sleep. It’s tough to sit in a car going long distances. Fortunately, my wife now does the...
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Critical Questions for the Development of Housing that Supports Recovery
There is no doubt that housing supports recovery – i.e., having a satisfying life as a person with a serious mental illness depends first and foremost on having a decent place to live – but many people need help to have decent housing. Amazingly, that was not recognized in the initial phase...
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“Decriminalization” is Misconceived: Towards Improved Drug Policy
Recent reports about the problems that have emerged with Oregon’s experiment in the decriminalization of drugs have rekindled debate about this approach to reducing the damage that results from the current policy of criminalizing illegal substances. I tilt against decriminalization as currently...
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Severe, Long-Term Mental Illness: What Does it Take to Live Well?
Typical images of people with severe, long-term mental illnesses are misleading. We think not of people who, despite mental illness, have lives that they find satisfying and meaningful but of homeless people dressed in rags pushing shopping carts with all their belongings and sleeping on heating...
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Overcoming the Stigma of Mental Illness: Changing Minds and Creating Opportunities
What can be done to overcome the stigma of mental illness? Because stigma is generally understood as a concatenation of negative attitudes and beliefs, community mental health education designed to change people’s minds seems to be what is needed. But there is another way to think about stigma -...
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From Blame to Burden and Beyond: Changing Perspectives on the Family and Behavioral Health
Over the past 40 years or so, there has been a dramatic shift in the views about the dynamics of families with mentally ill family members, a shift from blaming them to sympathizing with them for the burden they have to bear. 50 years ago, when I was learning to be a clinician, I was taught...
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Mental Health in America: Looking Back With Pride and Ahead With Hope
In the early 1970s at the height of deinstitutionalization in New York, I worked at a psychiatric rehabilitation program on the West Side of Manhattan that primarily served people who had been in state psychiatric hospitals for 5, 10, 20, even 40 years. Each week I went to Manhattan State Hospital...
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For One Mind, Too Many Silos
In the worlds of advocacy and policy making, there are sharp distinctions drawn among Alzheimer’s (and other dementias), mental illness, and substance use disorders. This results in separate, distinct, and insular fields of policy and practice, often referred to as “silos.” Frankly,...
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Stigma Is Being Used as a Political Weapon: Reject It
I and many others have said it before but, as recent events make clear, we will have to say it again and again and again: Mental illness is not the cause of mass murder in the United States. The continuing assertion by the political right that it is has become a core element of the vituperative...
