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Book Review   |    
Nancy T. Block
Psychiatric Services 2007; doi: 10.1176/appi.ps.58.9.1231
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edited by B. Guy Peters and Jon Pierre; London, Sage Publications, 2006, 512 pages, $130

Dr. Block is clinical associate professor at the Department of Psychiatry, University of Medicine and Dentistry of New Jersey-New Jersey Medical School.

As a handbook intended "to cover the area of public policy studies," an entire specialized field of social theory and practice, Handbook of Public Policy is by necessity wide ranging and weighty. Over 500 pages in length, in small print—quotes and footnotes smaller yet—it is a compendium of 28 essays, with an ample introduction and contributions by 33 authors, including the editors, from ten countries. It is, not surprisingly, written from the perspective of the field's insiders and, one might surmise, would mainly serve the needs of graduate students and other serious inquirers willing to immerse themselves in its idiosyncratic language and culture. The appeal to this audience is evident in the first of the book's three sections, titled "Making Policy," and its eight chapters address the history, theories, and concepts that define this field of study.

To the uninitiated, digesting much of this material, replete with specialized words and usages as well as references to seminal writings with which the reader might not be familiar, can be difficult as one strives to follow the scholarly discussions of public policy as it evolved as a social science from its inception at mid-20th century to the present. Though this volume is well indexed, there is no handy glossary to guide the neophyte through the woods.

The development of this young social science, closely related to political science and economics with some blending in of insights from anthropology, psychology, and other academic disciplines, has been fueled by an increasing demand by governments and other decision-making bodies for expert analysis and advice concerning past and future policy choices. Inconsistencies in the application of the "policy sciences" to governance is a concern discussed lucidly in the second chapter, whose authors posit that the very complexity of major societal problems and the preoccupation of elected officials with political expediencies frequently discourage them from adopting an analytic view of policy choices when under pressure. The vagaries of human emotions and motivations, in other words, trump rationality much of the time. This, of course, is not news to the psychiatric community.

Most easily comprehended and interesting are the 14 essays in the second section, titled "Substantive Policy Areas," which covers a discrete topic of practical concern in modern society. Chapters on health policy, cultural policy, and criminal justice policy are especially enlightening, sometimes startling, and relevant to issues in mental health. For instance, the number of people incarcerated in the United States increased five fold between 1970 and 2003, while crime was actually diminishing.

The third section, titled "Evaluating Policy," contains six more essays including one on ethics and public policy. The shortest chapter is not least important, because it deals with the tension between simply applied monetary cost-benefit analysis and humanitarian considerations, such as the value of quality of life and fairness to the individual. Thoughtfully conceived and written, embodying the insights of numerous international scholars, this handbook might best serve the mental health field as a reference for administrators and other policy makers, though selected essays may have more general appeal.

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