Managing Madness in the Community, Managing Madness in the Community, 0813563089, 0-8135-6308-9, 978-0-8135-6308-4, 9780813563084, , Critical Issues in Health and Medicine, Managing Madness in the Community, 0813563097, 0-8135-6309-7, 978-0-8135-6309-1, 9780813563091, , Critical Issues in Health and Medicine, Managing Madness in the Community, 0813563100, 0-8135-6310-0, 978-0-8135-6310-7, 9780813563107, , Critical Issues in Health and Medicine, Managing Madness in the Community, 0813571545, 0-8135-7154-5,
Managing Madness in the Community

The Challenge of Contemporary Mental Health Care
Kerry Michael Dobransky
192 pages, 4 tables, 6 x 9
Paper, March 2014 $29.95   ADD TO CART
Cloth, March 2014 $78.00   ADD TO CART
Web PDF, March 2014 $29.95   EBOOK VERSION AVAILABLE
epub, March 2014 $30.95   EBOOK VERSION AVAILABLE
Series: Critical Issues in Health and Medicine
Subject Area:
Health and Medicine, Sociology, Health Policy and Public Health, Current Affairs


 While mental illness and mental health care are increasingly recognized and accepted in today’s society, awareness of the most severely mentally ill—as well as those who care for them—is still dominated by stereotypes.  Managing Madness in the Community dispels the myth.  Readers will see how treatment options often depend on the social status, race, and gender of both clients and carers; how ideas in the field of mental health care—conflicting priorities and approaches—actually affect what happens on the ground; and how, amid the competing demands of clients and families, government agencies, bureaucrats and advocates, the fragmented American mental health system really works—or doesn’t.

In the wake of movies like One Flew Over the Cuckoo’s Nest and Shutter Island, most people picture the severely or chronically mentally ill being treated in cold, remote, and forbidding facilities.  But the reality is very different.  Today the majority of deeply troubled mental patients get treatment in nonprofit community organizations.  And it is to two such organizations in the Midwest that this study looks for answers.  Drawing upon a wealth of unique evidence—fifteen months of ethnographic observations, 91 interviews with clients and workers, and a range of documents—Managing Madness in the Community lays bare the sometimes disturbing nature and effects of our overly complex and disconnected mental health system.

Kerry Michael Dobransky examines the practical strategies organizations and their clients use to manage the often-conflicting demands of a host of constituencies, laws, and regulations.  Bringing to light the challenges confronting patients and staff of the community-based institutions that bear the brunt of caring for the mentally ill, his book provides a useful broad framework that will help researchers and policymakers understand the key forces influencing the mental health services system today.


"Beyond being readable and engaging, this book is unique in its use of organizational theory to elucidate key features of the mental health system. The focus on institutional fragmentation is very original, and important from a policy perspective."
—Teresa L. Scheid, University of North Carolina at Charlotte

"In this interesting new book, Dobransky carefully explores the often contradictory institutional logics of community-based psychiatric care and offers fresh insights on how these competing views shape our fragmented system of community mental healthcare."
—Eric R. Wright, professor of sociology and public health, Georgia State University

"Dobransky’s willingness to question the currently received wisdom about the value of currently popular service approaches and his use of a rich dataset both attest to the book’s potential."
—Russell K. Schutt, University of Massachusetts Boston

"Managing Madness in the Community is a timely read, presenting severe persistent mental illness (SPMI) and the delivery of community mental health in clear, understandable terms. Recommended."

"Provides important insights into the mental health system in the United States."
—American Journal of Sociology

Author / Editor Bio

 KERRY MICHAEL DOBRANSKY is an assistant professor of sociology at James Madison University. 

Table Of Contents

List of Tables
Preface and Acknowledgments

1. Introduction
2. Logic and Constraint
3. Diagnosis, Labeling, and Social Control
4. Empowerment Practice, Practical Empowerment
5. The Realities of Community Integration
6. The Right Person for the Job: Fragmentation in Staffing and Worker-Client Interaction
7. Conclusion



A Year in White
C. Lynn Carr
Coming to Term
Jon Cohen
Health Care Safety Net in a Post-Reform World
Mark A. Hall, Sara Rosenbaum
Ann V. Bell