Innovating in Community Mental Health presents lively examples of successful attempts to change mental health service systems in innovative ways to achieve the goal of providing care for persons with severe mental illness. These examples are drawn from such diverse national settings as Italy, Russia, Germany, England, China, and the United States, and involve a range of stratgies from treatment teams of professionals, grassroots community organizations, consumer cooperatives, professional-volunteer teamwork, and housing-based alternatives. The stories of these varied innovations are told by established, knowledgeable scholars from each of the featured countries. The editors help us understand the triumphs and pitfalls involved in these innovations through the presentation of a broad, research-based theory of innovation and change, which is used to guide the presentation of the examples and subsequently to determine their similarities and differences.Through the theoretical framework presented, the nuances of the process of innovation are highlighted, including the importance of the type of innovation itself, the wider environmental influences, place of internal organizational structures, and the role of the individual change agent. Through this framework and the examples presented, the reader is given indications of how innovation and change may be possible in such diverse and seemingly difficult situations, and also of how effective strategies for change might be chosen by administrators, providers, and other policymakers.

PrefaceAcknowledgmentsA Framework for Innovation and Change to Improve the Quality of Life of Persons with Severe and Persistent Mental IllnessPersistent and Severe Mental Illness: Its Impact, Status, and Future Challenges by Leonard I. SteinTheory and Framework for Evaluating the Implementation of Change by Rockwell Schulz and Gregory Greenbergdeteriorating health-care system in the US and the toughchoices that will have to be made in the future before atotal collapse occurs in the not-too-distant future. Thebook is well written and avoids the pitfalls that couldtrap the author in clichés and hyper-speculation. Thereview of the current system is detailed and takes greatcare to explain to the reader how we got where we are now inhealth-care. In the second section, current needs areexamined with emphasis on long-term care, AIDS, and theright to die. The final section provides a comparison withthe Canadian system and explains the consequences of notbeginning health-care reform now. Useful in health-caremanagement and administration studies. ChoiceCH1095AAJPH596BIR495PrefaceIntroductionA System in Need of DirectionDissatisfaction Widespread--Our Leaders Receive a Wake-Up CallThe Changing Relationship with Your DoctorThe Growth of Managed Care and the BacklashThe Challenge to Providers