Managing Uncertainty in Mental Health Care

ISBN : 9780197509326

Patricia Rockman; Jose Silveira
208 Pages
156 x 235 mm
Pub date
Nov 2021
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As the profound contribution of mental illness to disability, morbidity, and mortality has gained acceptance, mental health has grown into a global priority. One in five experience mental illness in their lifetime, and those who suffer are coming forward in unprecedented numbers. As more people seek care for themselves and others, providers are increasingly unable to meet the demand through existing systems and mental health care approaches. In Managing Uncertainty in Mental Health Care, Drs. Patricia Rockman and Jose Silveira critically examine core assumptions informing the primary approaches currently used to assess mental illness in clinical settings, with an emphasis on clinician certainty. They illustrate how current diagnostic frameworks obscure clinician uncertainty while encouraging overconfidence and go on to consider potential strategies for lessening the impact of inevitable errors. Ultimately, this book makes a case for acknowledging the fallibility of clinical judgment, independent of competence and experience, and the need to modify approaches to mental health care so that they align with the irreducible uncertainty of the domain. By exploring emerging transdiagnostic approaches to mental health care in terms of their alignment with irreducible uncertainty, Rockman and Silveira make space for error and offer clinicians a novel way to advance the fundamental aim of mental health care: to reduce the harm and suffering of all.


Prologue: Priorities for treating mental disorders
Introduction: Why Write This Book?
Chapter 1: The Problem of Uncertainty in Mental Health and Addictions
Chapter 2: Complexity
Chapter 3: The Limitations of Prioritizing Diagnosis
Chapter 4: Toward a conceptual shift -- Developing an approach to risk
Chapter 5: The Risk, Function and Symptoms Approach
Chapter 6: Principles of Practice
Chapter 7: Incentives and Disincentives to Treatment
Chapter 8: Medication Principles
Chapter 9: Decision Making under Duress
Chapter 10: Training, Supervision and Mentoring

About the author: 

Patricia Rockman, MD, is a psychotherapist and Associate Professor in the Department of Family and Community Medicine at the University of Toronto. Jose Silveira, MD, is a psychiatrist and Associate Professor in the Department of Psychiatry at the University of Toronto. Certified by the Royal College of Physicians and Surgeons of Canada in Psychiatry, Silveira serves as a diplomat of the American Board of Addiction Medicine. He is the Chief of the Department of Psychiatry and the Medical Director of the Mental Health and Addictions Program at St. Joseph's Health Care Center in Toronto. Silveira has extensive experience working across disciplines, including in Academic Health Science Centers and with the National Basketball Association's Player Assistance/Anti-Drug Program. He is the recipient of numerous awards and nominations and is regarded as a clinician, mentor, and ally of clinicians and patients alike.

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