As the title suggests, Isabel Perera's exceptional book The Welfare Workforce: Why Mental Health Care Varies Across Affluent Democracies brings mental health policy into conversation with politics of the welfare state, and in so doing, upends our theoretical understandings. Perera points out that “the wide variation in the contemporary supply of mental health services across affluent democracies is surprising . . . [because] [t]hese differences align with neither the existing scholarly typologies of social policy systems nor those of health policy systems (30).” Because existing welfare state typologies do not explain existing state investments in mental health systems, Perera's book sets up an important puzzle—why do similarly situated countries take drastically divergent paths when they deinstitutionalize mental health? Her answer is straight-forward, powerful, and convincing: it is the level of investment in the welfare workforce—in this case investments in building up the supply of public sector workers (nurses, social workers, teachers, facility staff) and importantly, public sector managers—that determines whether political coalitions between workers and managers emerge and act as powerful and persistent policy feedback loops that put the system on one path or the other.

The book is extraordinarily well argue