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The African Aids Epidemic: A History (review)

flicts among competing groups within the system, such as those that arise between advocacy groups that consist of family members and those representing mental health consumers. They tend to slight the negative influence of pharmaceutical companies on the medical and psychiatric professions, advocacy groups, and research. Their distinction between mental health technologies that reduce symptoms, are harmful, or are easier to use is innovative and useful—however, their unmitigated view of the benefits of current psychotropic medications seems overly sanguine. Their chief policy recommendation, creating a new federal agency for mental illness that would report directly to the president, seems unrealistic and could become a questionable precedent for innumerable agencies focusing on specific illnesses. These flaws, however, pale in comparison to the great achievements of the book. In fewer than 150 pages of text, the authors present a clear, systematic, and surprisingly complete analysis of the major forces driving changes in the mental health system, as well as valuable overviews of psychiatric epidemiology, the mental health professions, and the effectiveness of mental health treatments. They marshal a wide range of data that clearly document the policies and the resulting changes the system has undergone in the past fifty years, and that provide a firm grounding for their masterful and nuanced analysis of major social policies with their often unintended effects on the mental health system. They write in an accessible style that makes their book useful not only for professionals interested in a short, readable summary of policy changes in mental health, but also for upper-level undergraduate and graduate students. Especially when read in tandem with more-detailed historical studies such as Gerald Grob’s From Asylum to Community: Mental Health Policy in Modern America (1991), this book is a useful starting point for anyone who desires up-to-date and comprehensive data about the revolutionary changes in mental health care during the past half-century.