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This chapter summarizes the key themes from the preceding chapters by experts in the field of psychosis: the connection between mental healthcare and the larger social climate; the need to combat stigma and change beliefs and attitudes; the important role of training; the necessity of breaking down silos; and the essential nature of learning from others. Given that successful implementation and dissemination will likely require interventions at multiple levels of the system, we apply best practices from organizational change management to provide a path forward. Using the ADKAR model to develop awareness of the need for change, foster desire to be involved in the change, generate the knowledge and ability to participate in the change, and reinforce desired behaviors are essential steps forward. We provide concrete suggestions to promote change of the mental healthcare system as each step of the change process.
Decades of research show that psychosocial treatments are effective for psychosis, yet they remain unimplemented as the American healthcare system relies primarily on pharmacological solutions instead. This book reviews the history and current state of research to provide a more nuanced understanding of the evidence for and barriers to psychosocial care for psychosis. It addresses a wide range of mental health research and multi-professional practice domains from historical, personal, societal, professional, and systems perspectives. The varied perspectives presented illustrate factors that limit support for recovery in SMI and psychosis as well as real hope for recovering the US mental healthcare system. With contributions of experts by training and by experience, this book represents an essential resource for students, practitioners and researchers.
“It is common knowledge that psychosis and schizophrenia-spectrum disorders are often associated with disability and suffering. What is less commonly known is the ample evidence for recovery. Images of disability and dangerousness are visible in our society and media, but we don’t see the millions of people who have lived well with or despite psychosis. For many Americans who experience psychosis, medication and risk management remain the focus of treatment despite the long history of effective psychosocial treatments for psychosis. Mental health stigma endures, both in society and as reflected in poor funding, workforce development, and implementation. This limits research, services available, and dissemination of proven interventions, even when they have empirical support and result in long-term cost savings. Mental health professionals can, and should, play a central role in supporting recovery for people with psychosis, changing harmful messages and stigma, and in advocating for the dissemination and availability of psychosocial interventions for psychosis. This chapter emphasizes historical, current, and intersectional perspectives and challenges to three factors we believe are essential to changing our system: 1. genuine hope; 2. available effective psychosocial interventions; and 3. changing attitudes to support dignity and autonomy.”