Alabama Mental Health Credit Union

Migration from less-developed nations to the United States and Western Europe is steadily increasing, and it is unlikely that this trend will reverse. There are currently over a hundred million immigrants worldwide. And many of these immigrants are in a condition of poverty or near poverty, while many also suffer from poor health. The articles in this collection address the health conditions of international labor migrants and the availability and limitations of human and health services for them. Written by leading social scientists and health professionals from both the United States and the European Union, six of the articles focus on Europe, three on the United States, and two on psychological issues related to immigration. The contributors to this volume, representing a wide variety of disciplines (including medicine, social work, political science, sociology, anthropology, psychology, and biology), are in agreement that the health and human services offered in industrial nations are generally monocultural, and not well suited for migrants from other cultures. One article even arrives at the disquieting conclusion that the mental health services offered to immigrants not only do not respond to their needs, but rather serve to reinforce negative perceptions regarding immigrants from third-world countries. This book represents a timely and urgently needed contribution to the discourse on health services for migrants. It demonstrates that the issues and problems of immigration in the United States and Europe have many commonalities and that much can be learned from examining the experiences, successes, and failures of both. Antonio Ugalde is Professor of Sociology at the University ofTexas at Austin and Adjunct Professor at the School of Public Health, University of Texas Health Science Center at Houston.

For hundreds of years, people diagnosed with mental illness were thought to be hopeless cases, destined to suffer inevitable deterioration. Beginning in the early 1990s, however, providers and policymakers in mental health systems came to promote recovery as their goal. But what does recovery truly mean? For example, to consumers of mental health services, it implies empowerment and greater resources dedicated to healing; to HMOs, it can suggest a means of cost savings when benefits cease upon recovery. This book considers "recovery" from multiple angles. Traditionally, Nora Jacobson notes, recovery was defined as symptom abatement or a return to a normal state of health, but as activists, mental health professionals, and policymakers sought to develop "recovery-oriented" systems, other meanings emerged. Jacobson's analysis describes the complexes of ideas that have defined recovery in various contexts over time. The first meaning, "recovery-as-evidence," involves the theories, statistics, therapies, legislation, and myriad other factors that constituted the first one hundred years of mental health services provision in the United States. "Recovery-as-experience" brought the voices of patients into the conversation, while "recovery-as-ideology" drew on both recovery-as-evidence and recovery-as-experience to rally support for specific approaches and service-delivery models. This in turn became the basis for "recovery-as-policy," which developed as assorted representative bodies, such as commissions and task forces, planned reforms of the mental health system. Finally, "recovery-as-politics" emerged as reformers confronted harsh economic realities and entrenched ideas about evidence,experience, and ideology. Throughout, Jacobson draws on her research in Wisconsin, a state with a long history of innovation in mental health services.