Essential Reading
1. For everyone and their dog (mainly the former unless your dog is particularly clever and/or politicised)
Asylums - Irving Goffman
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This is the book which has influenced me more than any other and fuelled my motivation for all the work I've done such as resettling people form long-stay 'mental handicap' hospitals, campaigning against the excessive use of imprisonment and now running Star Wards. (OK. It didn't really impact on the chocolate business I set up, but perhaps it was one reason why the business was a spectacular failure. My total lack of business acumen may also have played a small part.)
Asylums is the classic, highly influential analysis of how 'total institutions' work. It is credited with being a key factor in the political development of closing long-stay psychiatric and 'mental handicap' hospitals. Using a model which embraces all places and communities where a large number of people in the same situation, cut off from the wider society for an appreciable period of time, live together in an enclosed, formally administered environment. Prisons are probably the classic total institution because of the severity of most of these factors, but Goffman also includes the most extreme (concentration camps) to the benign - kibbutzim and monasteries. Helpfully for us, his main model is the one where he did his participation research - psychiatric hospitals.
Although a key feature of psychiatric hospitals, almost permanent residence, no longer (thank God) applies to the UK, the experience of patients is still highly relevant. Alan Quirk and Paul Lelliott have written a valuable critique of the relevance of Goffman's model to today's psychiatric hospitals, and replace the concept of 'total institutions' with one of 'permeability'. They describe how hospitals are now characterised by the fluidity of relationships between the hospital and the wider community.
Madness - a brief history - Roy Porter
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Roy Porter has written several books about the development of the treatment of the mentally ill, including the origins of hospitals. Take your pick - Madness - a brief history; Madmen: A Social History of Madhouses, Mad Doctors and Lunatics; Discovering the History of Psychiatry.
Madness and Civilization - Michel Focault
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I'd like to give you a very erudite account of this important French book. But I can't. Because I haven't read it. But along with Asylums, it is a much quoted, highly respected critique about the barbaric way that the mentally ill have been treated. So a great one to mention casually in any conversation where you're trying to impress people.
2. For people new to mental health
Plenty to choose from, for example:
Key Concepts in Mental Health - David Pilgrim
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A useful brief round-up of what it says on the cover, including a few pages on hospitals. Its three main sections are on mental health and mental health problems, mental health services and mental health and society. Easy to read and saves buying lots of separate books.
3. For people outraged by the public, political and media hysteria about how dangerous we are
Pure Madness - Jeremy Laurance
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Its sub-heading, How fear drives the mental health system, provides the book's main thesis which is that mental health policy and practice are (mis)informed more by the risk posed by a tiny minority of dangerous mentally ill people rather than by effective, evidence-based treatment. The impact of this is very apparent on many acute wards, where there is a dominant culture of staff being perpetually on 'high alert', waiting for trouble to erupt. This practice, manifesting itself in staff observing rather than engaging with patients, ironically makes it much more likely that violent incidents will occur, as patients are inevitably bored, offended and under-supported.
And of course Laurance's analysis also accounts for the government's crazy, irresponsible, damaging obsession with creating legislation to control psychiatric patients.
4. For ward staff
What patients want more than anything is simply to be listened to. (The occasional hug when we're distressed also goes down well.) Any book on listening skills is likely to be useful, but the most interesting one I've found is:
Time to Think - Nancy Kline
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An amazing book which, despite its title, is actually about power-listening - the ability to think well being the result of someone listening carefully to us. For example, I've been really influenced by Kline spelling out that when someone is searching for a word or thought, it is positively unhelpful to suggest what we think they're after. If we're wrong, they'll feel interrupted and at least a bit misunderstood. (And who likes to be interrupted?) If we guess correctly, we've prevented the person from expressing the word or thought in the exact way that is meaningful to them, so both people miss out on that precision. And, even more interestingly, Kline points out that the process of searching for the right word or thought is incredibly helpful to that person: "The search and the saying add to the quality of their thinking, to their process of understanding, of sorting things out, of gaining insight."
Another astute issue that Kline spells out is in relation to silence in conversations: "The fact that people have stopped speaking does not mean that they have stopped thinking.... When people are quiet in this way, they are busy."
Effective Listening Skills - Dennis Kratz and Abby Robinson Kratz
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Most books on listening skills say pretty much the same thing, but this one is nice because, like the best conversations, it's well-structured and not too crammed.
How to Make Anyone Like You - Leil Lowndes
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A fab book. Who doesn't want everyone to like us? Lots of stuff in the book is about attentive listening, and its sister, saying the right thing to people. One thing I learnt from the book is that it's nicer to say to someone "Thank you for...." rather than just "thank you". Its more specific and reflects that you've noticed what you're appreciating. "Thank you for being so supportive to Robert when he was in a bad way." "Thank you for setting the table." "Thank you for being so open with me about what you're going through."
5. For ward managers
The 60 Second Leader - Phil Dourado
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Phil is one of my best mates and a wonderful, wonderful person. As he says in the introduction to the book, he cares for his wife who has Huntington's Disease - and the family have written the most mind-blowing book I've ever read about their experience. Each member of the family has written a chapter from their own perspective, and while each chapter is breath-taking, moving, harrowing, heartening, the chapters by Phils and Sandy's two sons, Brom and Danny, are extraordinary. People whose parents have the devastating Huntington's Disease (often described as "the cruellest disease"), have a 50% chance of developing it themselves. (I'm now crying. HD is vile and I love Brom and Danny.) They write in the most incredibly unself-pitying, thoughtful, astute, riveting and often witty way. You may never read two chapters which you find more moving, impressive and memorable. The book is: Learning to Live with Huntington's Disease, One Family's Story.
Returning to the book I'm supposed to be writing about, it's a collection of 'one minute bites' about how to be a great leader, covering issues ranging from intuition to innovation, luck to love. There are a zillion books about leadership, but get this one because its easy to read, practical and based on Phil's extensive knowledge and contact with some of the world's most successful and inspirational leaders.
6. For patients
Largely, of course, a matter of taste. What saw me through my involuntary stint at St Ann's was the delightful, undemanding Number One Ladies Detective Agency series by Alexander McCall Smith.
Similarly, I love good-natured, funny books such as those by Nick Hornby, Danny Wallace and John O'Farrell. If you work in an office, there's a hilarious book Who Moved my Blackberry? by Lucy Kellaway, which is handily mainly in chunks in the form of emails.
Books with more pictures than words are a mellow way to relax - The Earth from the Air is lovely, as are most nature and wildlife books. (Unless you don't like nature or wildlife.) Similarly, cartoon books are a pleasure - Gary Larsen is my favourite cartoonist.
When we're feeling a bit more together than at the start of our admission, self-help books can inspire and inform. You may well want one that relates specifically to your own illness or situation. For example, Dorothy Rowe's books on depression are popular and pretty easy to read.
7. For people wanting a more niche read
Therapeutic Communities - Penelope Campling and Rex Haigh
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There's lots of things of benefit to acute wards that we can learn from therapeutic communities, such as the recognition of the importance of joining and leaving, patient mutual support and attachment.
Social Inclusion and Recovery - Julie Repper and Rachel Perkins
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Spells out the relevance and practical application of the 'recovery model' for people with mental health problems, although unfortunately it has almost nothing about acute hospitals. Still pretty essential reading.
Handbook of Mentalization-Based Treatment - Jon Allen and Peter Fonagy
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A disproportionate number of (female) inpatients have borderline personality disorder. Mentalization Based Treatment has been designed especially for people with BPD, and its usefulness for acute wards includes its approach to treating people who self-harm and/or are suicidal. Talking of which....
The Scarred Soul - Tracy Alderman
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Possibly the best of the books about coping with self-harming, whether as someone who self-harms or a mental health professional. It's clear, non-judgemental and practical.
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