Allen Frances, MD

In this 4-part collection, the author shares his experience and provides guidance to all involved in the mental health field-patients, physicians, families, and policymakers.

This third in the series provides advice to families on how best to cope with the psychiatric problems of a family member.

Recently DSM-IV Chair Allen Frances, MD wrote 50 pieces of advice to clinicians on how best to help their patients. It seems fitting, then, to provide an equal portion of advice for patients who seek help from those clinicians.

Here it is-the 50 most important things Allen Frances, MD, has learned in over 50 years studying psychiatry.

The “deinstitionalization” movement was meant to correct a stream of neglected patients, a demoralized and disengaged staff, and disappearing doctors. That didn't happen.

It takes decisive action, not words, to really end stigma.

More than any other medical specialty, we sometimes feel compelled, and empowered, to treat patients against their will. With this comes two great responsibilities.

We have criminalized mental health problems-a barbaric throwback to the dismal conditions before the Enlightenment.

In the opinion of the author, the psychiatry/anti-psychiatry rift has had a devastating effect on the lives of people with severe psychiatric problems.

Setting the record straight on what the literature does and does not say about long-term use of antipsychotics.

Here's why Trieste is the place this psychiatrist would most want to be if he had a severe mental illness.

By failing to provide adequate care and housing for the mentally ill, we have condemned 350,000 to jails and 250,000 to the streets.

There is no one-size-fits-all solution to how people and cultures should respond to overwhelming stress, depression, and trauma.

There has probably never been a worse place and worse time to have a severe mental illness than now in the United States. How did we get into this mess?

We are the richest nation in the history of the world and yet we provide the worst care ever conceived for the severely ill who most need it.

The author suggests a checklist to help clinicians think through the necessary steps that should be part of every careful prescription of medication for children.

The major focus of effective therapy-to establish a healing relationship and to inspire hope.

There is no worse death than a hospital death. This requires preparation and preparation requires recognizing that dying is a necessary, and indeed desirable, part of life.

Twenty five years ago, “hikikomori” was a new term in Japan, used to describe severe and prolonged school refusal in teenagers, sometimes evolving into complete social withdrawal. The shut-in phenomenon has since gone global.

We all become much better therapists if we have confidence in our healing gifts and focus on enhancing our relationships with patients.

Treatments that work well for most don’t work well for all. And even effective treatments have side effects and complications. This is true of medication and surgery-and it is also true of psychotherapy.

Many years ago, the model approach to mental health treatment was the therapeutic community: "As Aristotle noted long ago, man is a social animal and only in a social unit can he experience a whole life." More in this blog.

The author concludes that people inappropriately placed in psychiatric hospitals can lead to grave violation of human rights.

Mental disorders have become a global commodity. According to the author, "a diagnostic fad heavily promoted first in the US has now quickly spread around the world."

How do we catch up with other developed countries to create a compassionate, cost-effective mental health system? Psychiatric Times posed this question to some of the leading experts in the field.

Recently there has been considerable controversy and confusion around how the word "psychosis" should be used, if indeed it should be used at all. More in this commentary.

Dostoevsky wrote 135 years ago, but his critique of forensic psychiatry and forensic psychology stands the test of time.

In this commentary, the author states, “We must get back to treating the whole person, not just his brain circuits. The brain is involved in all we do and what we are, but it is also itself influenced by our psychology and social context.” Care to weigh in?

Everyone, in their own way, wants what's best for people with mental health challenges, but risks and benefits are interpreted through a personal lens.