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Variables associated with sexual abuse were examined among youth, ages 5 through 18, with severe mentalillness. Review of 499 patient records revealed abuse as an isolated event in 62 cases, intermittent abuse in 61 cases, and chronic abuse in 150. Sexual abuse was associated with inappropriate sexual behaviors, substance abuse, and posttraumatic…
Children exposed to parental substance abuse, mentalillness, and violence face profound challenges, including increased risk for emotional and behavioral problems, substance abuse, and victimization. In this article, we describe the characteristics of a sample of children of women entering treatment. These children had been exposed to domestic…
VanDeMark, Nancy R.; Russell, Lisa A.; O'Keefe, Maura; Finkelstein, Norma; Noether, Chanson D.; Gampel, Joanne C.
The Assertive Community Treatment model of mental health service delivery has been extensively studied and has undergone various modifications over the past twenty years. This article describes a modified ACT Team approach to the treatment of individuals who suffer from severe comorbid mentalillness and substance abuse. Demographics of patients who are chosen to receive these intensive services, service utilization
Tobacco use exerts a huge toll on persons with mentalillnesses and substance abuse disorders, accounting for 200,000 of the annual 443,000 annual tobacco-related deaths in the United States. Persons with chronic mentalillness die 25 years earlier than the general population does, and smoking is the major contributor to that premature mortality. This population consumes 44% of all cigarettes,
The current article outlines a comprehensive approach to evidence-based social work practice, and applies it to persons with severe and persistent mentalillness who also abuse alcohol and other drugs. Representative empirical literature is summarized within a framework that delineates the three major functions of evidence-based social work practice: assessment, intervention and evaluation. Assessment protocol, which incorporates the use of
This study examined the latent structure of a number of measures of mental health (MH) and mentalillness (MI) in substance use disorder outpatients to determine whether they represent two independent dimensions, as Keyes (2005) found in a community sample. Seven aspects of MI assessed were assessed - optimism, personal meaning, spirituality/religiosity, social support, positive mood, hope, and vitality. MI was assessed with two measures of negative psychological moods/states, a measure of antisociality, and the Addiction Severity Index's recent psychiatric and family-social problem scores. Correlational and exploratory factor analyses revealed that MH and MI appear to reflect two independent, but correlated, constructs. However, optimism and social support had relatively high loadings on both factors. Antisociality and the family-social problem score failed to load significantly on the MI factor. Confirmatory factor analysis supported the existence of two obliquely related, negatively correlated dimensions. Study findings, although generally supporting the independence of MH and MI, suggest that the specific answers to this question may be influenced by the constructs and assessments used to measure them. PMID:21052520
Alterman, Arthur I; Cacciola, John S; Ivey, Megan A; Coviello, Donna M; Lynch, Kevin G; Dugosh, Karen L; Habing, Brian
The high prevalence of alcohol and drug abuse and mentalillness imposes a substantial financial burden on those affected and on society. The authors present estimates of the economic costs from these causes for 1985 and 1988, based on current and reliable data available from national surveys and the use of new costing methodology. The total losses to the economy related to alcohol and drug abuse and mentalillness for 1988 are estimated at $273.3 billion. The estimate includes $85.8 billion for alcohol abuse, $58.3 billion for drug abuse, and $129.3 billion for mentalillness. The total estimated costs for 1985, $218.1 billion, include $51.4 billion for direct treatment and support costs; $80.8 billion for morbidity costs, the value of reduced or lost productivity; $35.8 billion for mortality costs, the value of foregone future productivity for the 140,593 premature deaths associated with these disorders, based on a 6 percent discount rate and including an imputed value for housekeeping services; and $47.5 billion in other related costs, including the costs of crime, motor vehicle crashes, fire destruction, and the value of productivity losses for victims of crime, incarceration, crime careers, and caregiver services. The cost of acquired immunodeficiency syndrome associated with drug abuse is estimated at $1 billion, and the cost of fetal alcohol syndrome is estimated at $1.6 billion. The estimates may be considered lower limits of the true costs to society of alcohol and drug abuse and mentalillness in the United States.
Epidemiological studies in the United States estimate HIV seroprevalence rates ranging between 4% and 23% for serious mentallyill adults (SMIA; i.e., schizophrenia, bipolar disorder, and other chronic disorders with psychotic features), with substantially greater estimates for risky sexual behaviors. Among the most consistent factors linked to HIV risk in non-SMIA populations is a history of emotional, physical, or sexual
Robert M. Malow; Jessy G. Dévieux; Ligia Martinez; Fred Peipman; Barbara A. Lucenko; Seth C. Kalichman
Background Severe mentalillness is often exclusionary criteria for studies examining factors that influence addiction treatment outcome. Therefore, little is known about predictors of treatment response of individuals receiving psychosocial treatments for addictions who suffer from co-occurring severe mentalillness. Methods The impact of demographic, substance abuse severity, psychiatric severity, and service utilization variables on in-treatment performance (i.e., longest duration of abstinence) in a 12-week contingency management (CM) intervention for stimulant abuse in 96 severely mentallyill adults was investigated. A 4-step linear regression was used to identify independent predictors of in-treatment abstinence. Results This model accounted for 37.4% of variance in the longest duration of abstinence outcome. Lower levels of stimulant use (i.e., stimulant-negative urine test) and psychiatric severity (i.e., lower levels of psychiatric distress), as well as higher rates of outpatient treatment utilization at study entry were independently associated with longer duration of drug abstinence. Conclusion These data suggest that individuals with low levels of stimulant use and psychiatric severity, as well as those actively engaged in services are most likely to succeed in a typical CM intervention. For others, modifications to CM interventions, such as increasing the value of reinforcement or adding CM to evidence based psychiatric interventions may improve treatment outcomes.
Angelo, Frank N.; McDonell, Michael G.; Lewin, Michael R.; Srebnik, Debra; Lowe, Jessica; Roll, John; Ries, Richard
The prevalence of childhood sexual and physical abuse among persons with severe mentalillness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.
Meade, Christina S.; Kershaw, Trace S.; Hansen, Nathan B.; Sikkema, Kathleen J.
OBJECTIVES. This study examined the costs of psychiatric treatment for seriously mentallyill people with comorbid substance abuse as compared with mentallyill people not abusing substances. METHODS. Three different sources of data were used to construct client-level files to compare the patterns of care and expenditures of 16,395 psychiatrically disabled Medicaid beneficiaries with and without substance abuse: Massachusetts Medicaid paid claims; Department of Mental Health state hospital inpatient record files; and community support service client tracking files. RESULTS. Psychiatrically disabled substance abusers had psychiatric treatment costs that were almost 60% higher than those of nonabusers. Most of the cost difference was the result of more acute psychiatric inpatient treatment. CONCLUSIONS. Although the public health and financial costs of high rates of comorbidity are obvious, the solutions to these problems are not. Numerous bureaucratic and social obstacles must be overcome before programs for those with dual diagnoses can be tested for clinical effectiveness.
Objective: There were two aims: first, to examine the relationship between prior sexual abuse and three types of adult risky sexual behaviors [(1) ever traded sex for drugs or money, (2) had unprotected sex in the past 6 months, and (3) frequency of unprotected sex in the past 6 months] among persons with severe mentalillness (SMI), and second,…
Van Dorn, Richard A.; Mustillo, Sarah; Elbogen, Eric B.; Dorsey, Shannon; Swanson, Jeffrey W.; Swartz, Marvin S.
In-depth interviews were conducted with 13 formerly homeless mentallyill women to capture their individual life trajectories of mentalillness, substance abuse, and trauma in their own words. Cross-case analyses produced 5 themes: (a) betrayals of trust, (b) graphic or gratuitous nature of traumatic events, (c) anxiety about leaving their immediate surroundings (including attending group treatment programs), (d) desire for one's own space, and (e) gender-related status loss and stigmatization. Findings suggest formerly homeless mentallyill women need (and want) autonomy, protection from further victimization, and assistance in restoring status and devalued identity. Avenues for intervention include enhanced provider training, addressing experiences of betrayal and trauma, and more focused attention to current symptoms rather than previous diagnoses. PMID:17209714
Padgett, Deborah K; Hawkins, Robert Leibson; Abrams, Courtney; Davis, Andrew
Purpose of review To review recent research on the relationship between substance abuse, crime, violence and mentalillness, and suggest how this research could aid forensic psychiatrists, psychologists and other mental health professionals in assessing and managing risk, and balancing patient care and public protection. Recent findings Substance abuse in mentallyill forensic psychiatric patients should be considered an important risk factor for violence and re-offending. Summary Improved treatment for substance abuse in forensic psychiatric patients and other mentally disordered offenders together with the offer of monitored abstinence as a condition of leave or discharge could be usefully considered as a means of reducing and managing risk. This may improve patient care by addressing mental health needs and increasing opportunity and likelihood of successful re-integration into the community and better life prospects; protect the public by reducing risk of re-offending and offering real time monitoring and potential intervention when risk is heightened; and help forensic psychiatrists strike a balance between patient care and public protection, potentially alleviating some of the difficulty and anxiety that decisions to grant leave or discharge can create.
... included on mental health-related disability and on suicide. This resource is a continuing work in progress, ... button to return to the directory. Prevalence Disability Suicide Cost Global Serious MentalIllness (SMI) Serious Mental ...
Since the Fair Housing Act of 1988, younger chronically mentallyill and substance abuse residents have been admitted to subsidized senior housing. This policy's main purpose was to furnish housing for younger homeless individuals and to improve rental income streams for senior facilities. The policy was also meant to promote age integration, improve social engagement, and enhance informal support in
This article describes the evolution of Personalized Nursing, a comprehensive nursing practice model of care. Findings from several nursing research studies contributed to the development of Personalized Nursing. The model includes a practice model of the art of nursing care based on nursing theory and a specific nursing process that directs nursing care delivery. The process of care delivery includes location of hard-to-reach clients; linkage to health care providers; integration of care among providers for clients diagnosed with HIV, mentalillness, and substance abuse; and strategies to promote retention in health care. Use of Personalized Nursing is designed to assist clients to improve their well-being and increase positive health-related behaviors. Personalized Nursing has been used in urban landscapes to serve multiply diagnosed clients at risk for HIV infection. The model is currently being used in a study targeting multiply diagnosed women who are lost to follow-up from medical care. PMID:14571686
There is little national information on the policies and procedures used by states to regulate residential treatment facilities for adults and children with mentalillness. As a result, policymakers and program administrators face major difficulties in determining both the effectiveness of current policies and the potential need for new policies that are responsive to emerging trends in mental health care.
There is little national information on the policies and procedures used by states to regulate residential treatment facilities for adults and children with mentalillness. As a result, policymakers and program administrators face major difficulties in determining both the effectiveness of current policies and the potential need for new policies that are responsive to emerging trends in mental health care.
The impact that substance use has on an individual with mentalillness has been documented; however, little is known about the impact that this may have for a family caregiver. Data was collected in a cross sectional study using mailed questionnaires to a convenience sample of family members of persons with mentalillness (n = 110). Hierarchical…
Mentalillness is one of the leading causes of disability in the United States; new State-level data produced by the Substance Abuse and Mental Health Services Administration (SAMHSA) will advance our understanding of the nature and extent of mental illne...
The prevalence of psychiatric disorders among incarcerated juveniles in Mississippi was examined. A total of 482 adolescents completed a diagnostic questionnaire and a subset (N = 317) was assessed with face-to-face semistructured interview. Most of the study participants met criteria for one mental disorder, 71?85% depending on assessment method,…
The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was…
This article describes one school's effort to establish a social work research development center in the area of coexisting drug and mental disorders (dual disorders), within the context of the social work profession's efforts to compete more effectively for federal research grants. This center was funded as part of a successful application in…
Singer, Mark I.; Kola, Lenore A.; Biegel, David E.
Given the high prevalence of HIV in South Africa and co-morbid mental disorders in people living with HIV/AIDs (PLWHA) we sought to validate a brief screening tool in primary HIV care. Methods: 366 PLWHA were recruited prior to combination anti-retroviral treatment (CART) initiation from two primary health HIV clinics. A mental health nurse administered a socio-demographic questionnaire and the Mini Neuropsychiatric Interview (MINI) and a lay counsellor administered the Substance and MentalIllness Symptom Screener (SAMISS). Results: Using the MINI, 17 % of participants were identified with either depression, anxiety disorders or adjustment disorder and 18 % with substance or alcohol abuse/dependence. The sensitivity and specificity of the SAMISS was 94 % (95 % CI: 88-98 %) and 58 % (95 % CI: 52-65 %) respectively, with the alcohol component (sensitivity: 94 %; specificity: 85 %) performing better than the mentalillness component of the SAMISS (sensitivity: 97 %; specificity: 60 %). The specificity of the tool improved when the cut-off for the mentalillness component was increased. Conclusion: The SAMISS may provide a useful first tier screening tool for common mental disorders in primary care for PLWHA. PMID:24452497
Breuer, Erica; Stoloff, Kevin; Myer, Landon; Seedat, Soraya; Stein, Dan J; Joska, John A
For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mentalillness married women are discriminated against married men. In the setting of mentalillness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations.
For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mentalillness married women are discriminated against married men. In the setting of mentalillness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations. PMID:23858262
Stigma surrounding major mentalillness creates many barriers. People who experience mentalillness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mentalillness. They define stigma and review theories that explain its…
The literature on homeless adults with severe mentalillness is generally silent on a critical issue surrounding service delivery—the contrast between housing first and treatment first program philosophies. This study draws on data from a longitudinal experiment contrasting a housing first program (which offers immediate permanent housing without requiring treatment compliance or abstinence) and treatment first (standard care) programs for
The literature on homeless adults with severe mentalillness is generally silent on a critical issue surrounding service delivery--the contrast between housing first and treatment first program philosophies. This study draws on data from a longitudinal experiment contrasting a housing first program (which offers immediate permanent housing without…
Padgett, Deborah K.; Gulcur, Leyla; Tsemberis, Sam
Linkage studies of mentalillness have provided suggestive evidence of susceptibility loci over many broad chromosomal regions. Pinpointing causative gene mutations by conventional linkage strategies alone is problematic. The breakpoints of chromosomal abnormalities occurring in patients with mentalillness may be more direct pointers to the relevant gene locus. Publications that describe patients where chromosomal abnormalities co-exist with mentalillness
D J MacIntyre; D H R Blackwood; D J Porteous; B S Pickard; W J Muir
In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mentalillness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mentalillness. Key Words: Agency • alchemy • behaviour • cause • chemistry • dignity
Patients with mentalillness have a higher incidence of smoking than the general population and are the major consumers of tobacco products. This population includes subjects with schizophrenia, manic depression, depression, posttraumatic stress disorder (PTSD), attention-deficit disorder (ADD), and several other less common diseases. Smoking cessation treatment in this group of patients is difficult, often leading to profound depression. Several recent findings suggest that increased smoking in the mentallyill may have an underlying biological etiology. The mentalillness schizophrenia has been most thoroughly studied in this regard. Nicotine administration normalizes several sensory-processing deficits seen in this disease. Animal models of sensory deficits have been used to identify specific nicotinic receptor subunits that are involved in these brain pathways, indicating that the alpha 7 nicotinic receptor subunit may play a role. Genetic linkage in schizophrenic families also supports a role for the alpha 7 subunit with linkage at the alpha 7 locus on chromosome 15. Bipolar disorder has some phenotypes in common with schizophrenia and also exhibits genetic linkage to the alpha 7 locus, suggesting that these two disorders may share a gene defect. The alpha 7 receptor is decreased in expression in schizophrenia. [(3)H]-Nicotine binding studies in postmortem brain indicate that high-affinity nicotinic receptors may also be affected in schizophrenia. PMID:11796154
Leonard, S; Adler, L E; Benhammou, K; Berger, R; Breese, C R; Drebing, C; Gault, J; Lee, M J; Logel, J; Olincy, A; Ross, R G; Stevens, K; Sullivan, B; Vianzon, R; Virnich, D E; Waldo, M; Walton, K; Freedman, R
Persons with severe mentalillness (SMI) engage in risky sexual behaviours and have high prevalence of HIV in high-income countries. Little is known about sexual behaviours and HIV risk among persons with SMI in sub-Saharan Africa. In this qualitative study we explored how SMI may influence sexual risk behaviours and sexual health risks in Uganda. Individual semi-structured interviews were conducted with 7 male and 13 female psychiatric patients aged 18–49 years. Participants were interviewed in hospital when clinically stable and capable of giving informed consent. Interview transcripts were analysed using manifest content analysis, generating the categories: (1) casual sex during illness episodes, (2) rape by non-partners, (3) exploitation by partners, (4) non-monogamous partners, and (5) sexual inactivity. Our findings suggest that SMI exacerbated sexual vulnerability in the women interviewed, by contributing to casual sex, to exploitative and non-monogamous sexual relationships, and to sexual assault by non-partners. No link could be established between SMI and increased sexual risk behaviours in the men interviewed, due to a small sample of men, and given that men's accounts showed little variability. Our findings also suggest that SMI caused sexual inactivity due to decreased sexual desire, and in men, due to difficulties forming an intimate relationship. Overall, our study highlights how SMI and gender inequality can contribute to the shaping of sexual risk behaviours and sexual health risks, including HIV risk, among persons with SMI in this Ugandan setting.
Lundberg, Patric; Johansson, Eva; Okello, Elialilia; Allebeck, Peter; Thorson, Anna
Persons with severe mentalillness (SMI) engage in risky sexual behaviours and have high prevalence of HIV in high-income countries. Little is known about sexual behaviours and HIV risk among persons with SMI in sub-Saharan Africa. In this qualitative study we explored how SMI may influence sexual risk behaviours and sexual health risks in Uganda. Individual semi-structured interviews were conducted with 7 male and 13 female psychiatric patients aged 18-49 years. Participants were interviewed in hospital when clinically stable and capable of giving informed consent. Interview transcripts were analysed using manifest content analysis, generating the categories: (1) casual sex during illness episodes, (2) rape by non-partners, (3) exploitation by partners, (4) non-monogamous partners, and (5) sexual inactivity. Our findings suggest that SMI exacerbated sexual vulnerability in the women interviewed, by contributing to casual sex, to exploitative and non-monogamous sexual relationships, and to sexual assault by non-partners. No link could be established between SMI and increased sexual risk behaviours in the men interviewed, due to a small sample of men, and given that men's accounts showed little variability. Our findings also suggest that SMI caused sexual inactivity due to decreased sexual desire, and in men, due to difficulties forming an intimate relationship. Overall, our study highlights how SMI and gender inequality can contribute to the shaping of sexual risk behaviours and sexual health risks, including HIV risk, among persons with SMI in this Ugandan setting. PMID:22253770
Lundberg, Patric; Johansson, Eva; Okello, Elialilia; Allebeck, Peter; Thorson, Anna
To examine the hypothesis that a demonstration clinic integrating homeless, primary care, and mental health services for homeless\\u000a veterans with serious mentalillness or substance abuse would improve medical health care access and physical health status.\\u000a A quasi-experimental design comparing a ‘usual VA care’ group before the demonstration clinic opened (N = 130) and the ‘integrated care’ group (N = 130). Regression models indicated
James McGuire; Lillian Gelberg; Jessica Blue-Howells; Robert A. Rosenheck
An open trial design was used to examine the implementation and effectiveness of a cognitive-behavioral intervention (Seeking Safety) for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) for incarcerated women with Axis I mental disorders who self-referred for specialty trauma treatment. The study sample was female inmates aged 18 and old who were primarily minority, had experienced childhood-based trauma, committed violent crimes, had a serious mentalillness, and resided in maximum, medium, and minimum compounds of a women's prison. A total of 74 women completed the group intervention, with the average attending 23 of the 28 sessions (82%). Implementation feasibility was demonstrated by the ability to recruit, screen, assign, and retain participation. Effectiveness was supported by changes pre-post intervention on the PTSD Checklist (ES=0.56) and Global Severity Index (ES=0.47). Of the 19 completers with PCL scores of 50 or higher pre-intervention, 16 (84%) had scores below 50, the "cut score" consistent with or supportive of a PTSD diagnosis. Three-quarters or more of participants reported that Seeking Safety was helpful in each of the following areas: overall, for traumatic stress symptoms, for substance use, to focus on safety, and to learn safe coping skills. Future directions include the need for larger scale randomized controlled trials in medium or maximum security prisons and fidelity evaluations of non-research dissemination efforts. PMID:22858893
Wolff, Nancy; Frueh, B Christopher; Shi, Jing; Schumann, Brooke E
The purpose of this broadcast is to: increase surveyors' knowledge of mentalillness: signs and symptoms of mentalillness and best practices in treating residents with mentalillness; educate surveyors about Preadmission Screening and Resident Review (PA...
Transinstitutionalization (ie, the criminalization of those with mentalillness) is relevant to individuals committing sexual offenses. Mentalillness can affect the treatment and risk management of individuals committing sexual offenses. In this article the current literature on mentally disordered sexual offenders is described, including how psychosis, mood disorders, anxiety disorders, attention-deficit/hyperactivity disorder, and dementing disorders may affect treatment and management. PMID:24877705
The author reviews the significance of the presence of mentalillnesses to the juvenile justice system. He acknowledges the absence of a satisfactory system for classifying mental disorders among children and adolescents and sketches what so far is known about certain childhood disorders which appear to have a special significance for delinquent behaviour. He reviews studies on the overlap between
Between 20% and 70% of psychiatric patients have a co-occurring substance use disorder and rates of substance abuse among patients with psychotic disorders are especially high. Patients with co-existing psychosis and substance use disorders typically have poorer outcomes than patients diagnosed with either disorder alone. Frequently, treatment services for such dually diagnosed patients are not integrated and organizational barriers may
Shelly F. Greenfield; Roger D. Weiss; Maurico Tohen
Technology is rapidly changing society, and many activities now require the ability to use technology. This situation has the potential to lead to problems for several populations, including the elderly, the disadvantaged, and people with severe mentalillness. In this column, we review the state of technology as it affects daily activities. We then review previous efforts to use technology positively for both the assessment and treatment of psychiatric conditions, including posttraumatic stress disorder and severe mentalillness. We conclude that technology-based interventions and assessment strategies have the potential to deliver benefit to a wide array of older people and those with severe mentalillness, including reaching people who would not have had access otherwise.
The effectiveness of efforts designed to address men- tal illness stigma will rest on our ability to under- stand stigma processes, the factors that produce and sustain such processes, and the mechanisms that lead from stigmatization to harmful consequences. Critical to such an understanding is our capacity to observe and measure the essential components of stigma processes. This article is
Bruce G. Link; Lawrence H. Yang; Jo C. Phelan; Pamela Y. Collins
Many former mental patients see their biggest problem in resuming community life to be their inability to be accepted by other people. The National Institute of Mental Health has worked to remove the stigma associated with mentalillness and research has unraveled many of the mysteries about the origins of mentalillness. Deinstitutionalization,…
National Inst. of Mental Health (DHHS), Rockville, MD.
Each year, an estimated 50 million Americans will experience a mental disorder while only one fourth of them will seek mental health services. Contends that this disparity results from the stigma attached to mentalillness. Proposes that counselors must educate the general public about the misconceptions of mentalillness and advocate for parity…
The over-representation of people with mentalillness in the criminal justice system highlights the need for legislative reform and the implementation of programs breaking the cycle of mentalillness, poverty, unemployment and substance abuse across Australia. Whilst there is no inherent association between mentalillness and crime, there is a…
Background To assess rates of screening and testing of HIV and HCV among those with serious mentalillness and co-occurring substance use disorders. Methods One hundred fifty-three people with serious mentalillness and cooccurring substance use disorders completed measures and were screened for HIV and HCV. Results Six percent were HIV positive and 25% were HCV positive. Almost a quarter reported a history of injection drug use and 86% reported a history of unprotected sexual encounters. Compared to those without a diagnosis of Hepatitis C, those diagnosed with Hepatitis C were significantly more likely to have a sexually transmitted infection, (p = 0.01), have a lifetime history of injection drug use, (p < 0.001), and a lifetime history of sniffing drugs, (p = 0.01). Conclusions Given the high levels of infection of HIV and HCV and high levels of transmission risk factors efforts to improve screening and provide risk reduction counseling are warranted.
Background: Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts. Methods: We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23 395). The survey had a multistage stratified cluster design (household response rate 79.8%). Results: The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose–response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men. Interpretation: We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.
Citation: Hinden, B., Biebel, K., Nicholson, J., Henry, A., & Stier, L. (2002) Steps toward evidence-based practices for parents with mentalillness and their families. Rockville, MD: Center for Mental Health Services\\/Substance Abuse and Mental Health Services Administration.\\u000aThis report discusses the outcomes of a project that investigated evidence-based practices for parents with mentalillness and their families by identifying
Beth R. Hinden; Kathleen Biebel; Joanne Nicholson; Alexis D. Henry; Lawrence Stier
Content analysis of 83 newspaper articles from February 1991 to January 1993 was the chosen method to determine the role of newspapers in the portrayal of the mentallyill. Two emergent themes arose: the closure of a mental health hospital was viewed negatively; and the stereotypical perception of the mentallyill as violent and unpredictable was reinforced. Over the two year period of the study the shift in focus from the ideology of de-institutionalisation, funding issues, crisis and chaos in the mental health hospital eventuated in an emphasis on the negativity associated with mentalillness. PMID:7613057
Substance use disorder is the most common and clinically significant co-morbidity among clients with severe mentalillnesses, associated with poor treatment response, homelessness and other adverse outcomes. Residential programs for clients with dual disorders integrate mental health treatment, substance abuse interventions, housing and other supports. Ten controlled studies suggest that greater levels of integration of substance abuse and mental health
\\u000a Before delving into a discussion about care of the uninsured and underserved mentallyill population, it is important to reflect\\u000a on the historical under-representation of the field of mental health as a whole from a medical, political, social, and economic\\u000a standpoint. The approach to the care of the mentallyill has been an area of debate for centuries, and the
Faced with the closing of the state psychiatric hospital in their community, hospitals, law enforcement, mental health providers, and community agencies in Raleigh, NC, began collaborating on improving care and transitions for the mentallyill. The coalition created a standardized assessment tool and standardized transfer guidelines for mentallyill patients, along with other process improvements. As a result, Duke Raleigh Hospital is transferring more patients to mental health facilities direct from the emergency department rather than keeping them in an inpatient bed waiting for an opening. Hospital case managers get behavioral health patients a follow-up appointment with a mental health provider before they leave the hospital. PMID:24404739
The Substance Abuse and Mental Health Services Administration was established in 1992 and "leads Federal efforts to treat mentalillnesses by promoting mental health and by preventing the development or worsening of mentalillness when possible". To that end, the agency has created this website to provide information about its ongoing programs, along with offering information for the public who may be curious or concerned about these issues. Practitioners and the public will appreciate the well-organized Publications area which is organized thematically and includes topics such as preventions, disaster, and the elderly. The site also has a complete listing of related activities, such as the youth violence prevention initiative and the Center of Women, Violence and Trauma.
Media has a complex interrelationship with mentalillnesses. This narrative review takes a look at the various ways in which media and mentalillnesses interact. Relevant scientific literature and electronic databases were searched, including Pubmed and GoogleScholar, to identify studies, viewpoints and recommendations using keywords related to media and mentalillnesses. This review discusses both the positive and the negative portrayals of mentalillnesses through the media. The portrayal of mental health professionals and psychiatric treatment is also discussed. The theories explaining the relationship of how media influences the attitudes and behavior are discussed. Media has also been suggested to be a risk factor for the genesis or exacerbation of mentalillnesses like eating disorders and substance use disorders. The potential use of media to understand the psychopathology and plight of those with psychiatric disorders is referred to. The manner in which media can be used as a tool for change to reduce the stigma surrounding mentalillnesses is explored. PMID:24823515
We hypothesized that the integration of forensic psychiatrists and the forensic system into the general stream of mental health should lead to better reintegration of forensic patients into the society. The aims of the study were to explore the link between violence, murder, psychiatric disorders and other variables, and to suggest a mode of prevention of criminal recidivism. This investigation provided a more reflective profile of mentallyill persons convicted of murder, hospitalized in Psychiatric Hospital in Demir Hisar in Macedonia between 2007 and 2009. Study results indicated the offender with severe mentalillness incarcerated for murder in Demir Hisar Psychiatric Hospital to be predominantly suffering from a mood disorder, to be a male with secondary school education, and to have significant intimate and family relationships characterized by rage as a frequently mentioned motive for murder. On committing homicide, they frequently used firearm or sharp objects. The offenders lived in dysfunctional families, had extensive histories of substance abuse and criminal activity before their murder conviction, and received inadequate treatment for their mental disorder and substance abuse. We suggest that the offenders (murderers) continue their treatment in mental health forensic services upon completing their obligatory treatment at a psychiatric hospital. PMID:22649880
Parents with a mentalillness experience the same parenting stressors that other parents do, and at the same time need to manage their mentalillness. However, few programmes are designed for parents who have a mentalillness, with older children (as opposed to interventions for mothers with infants). This study identified the common components across six programmes developed for parents with a mentalillness who have older children. Australian clinicians, responsible for six parenting programmes for those with a mentalillness, participated in individual, semi-structured interviews, during 2008. Programme manuals and evaluation reports were also sourced. Analyses involved thematic analysis, inter-rater reliability and respondent validation. Data were organized in three main areas: (1) programme description (format, goals, length and participants' inclusion criteria); (2) theoretical framework (including clinicians' beliefs and evidence underpinning programmes); and (3) evaluation designs and methodologies. It was found that clinicians facilitated education and support via a peer intervention model for parents with various mentalillness diagnoses, responsive to the needs of parents and in a time flexible manner. At the same time, clinicians found it difficult to articulate the theoretical framework of their programmes and employed mostly simplistic evaluation strategies. PMID:21395917
Examined physical health of 72 users of homeless shelters, comparing shelter users with mentalillness or substance abuse problems with those without these problems. Found that alcohol abusers were significantly more likely to have low blood pressure, symptoms of liver disease, and tuberculosis treatment history. Found no health differences for…
Regrettably for African Americans, research has rarely addressed issues that affect their health and well-being. This lack of attention manifests itself in the dearth of literature available while doing literature reviews on prevention of comorbid mentalillness and substance abuse (MISA) and substance use and abuse disorders in African Americans. However, there are a few studies on the prevention of
The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mentalillness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions…
An indication of the failure of the mental health system in this country is reflected in the increasingly visible homeless population, many of whom suffer from some form of untreated mentalillness. Public policy priorities have shifted from proactive, treatment-oriented policies to reactive, punitive institutionalization. The…
The possible casues of abuse of mentally retarded persons in residential facilities are examined and a study of all reported abuse cases occurring in Alabama's residential facilities from January, 1984, to September, 1986 is reviewed. Fifty-seven confirmed cases of abuse were identified for further examination using facility records and system…
Objectives: Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mentalillness experience, given during the first-year neuroscience course, and titled "MentalIllness Among Us…
Aggarwal, Anuj K.; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H.
The current study examines the role of mentalillness-related stigma on romantic or sexual relationships and sexual behavior among youth with mentalillness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted…
Support from social networks is imperative to mental health recovery of persons with mentalillness. However, disclosing mentalillness may damage a person's participation in networks due to mentalillness stigma, especially in Chinese immigrant communities where social networks (the guanxi network) have specific social-cultural significance. This study focused on mentalillness disclosure in Chinese immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from 2 Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semistructured interview, including 6 questions on mentalillness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants' consideration of 3 critical elements of social relationships. Ganqing, affection associated with relationship building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network, involuntary disclosure could happen without participants' permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations in which they experienced little discriminatory treatment, and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mentalillness disclosure among Chinese immigrants were discussed. PMID:23647389
Chen, Fang-Pei; Lai, Grace Ying-Chi; Yang, Lawrence
Support from social networks is imperative to mental health recovery of persons with mentalillness. However, disclosing mentalillness may damage a person’s participation in networks due to mentalillness stigma, especially in Chinese-immigrant communities where social networks (the guanxi network) has specific social-cultural significance. This study focused on mentalillness disclosure in Chinese-immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from two Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semi-structured interview, including 6 questions on mentalillness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants’ consideration of three critical elements of social relationships. Ganqing, affection associated with relationship-building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network involuntary disclosure could happen without participants’ permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations where they experienced little discriminatory treatment and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mentalillness disclosure among Chinese immigrants were discussed.
Chen, Fang-pei; Ying-Chi Lai, Grace; Yang, Lawrence
The perormance of two groups of hospitalized mentallyill patients (schizophrenia and major depression) and two groups of non-mentally-ill patients (patients hospitalized for ischemic heart disease and non-ill primary care patients) was compared on a standardized, objective instrument for assessing patients' understanding of information relevant for patient decision making (consent) about treatment with medication. Generally, hospitalized schizophrenic patients manifested significantly
Society is ingrained with prejudice toward mentalillness, and sufferers are often widely perceived to be dangerous or unpredictable. Reinforcement of these popular myths through the media can perpetuate the stigma surrounding mentalillness, precipitating shame, self-blame, and secrecy, all of which discourage affected individuals from seeking treatment. Efforts aimed at countering stigma in mentalillness are faced with the challenge of centuries of discrimination and must, therefore, replace existing stereotypes with coverage of positive outcomes, as a first step in achieving the daunting task of overcoming these negative stereotypes. Long-term anti-stigma campaigns that encompass human-rights-based, normalization, and educational approaches are needed. The involvement of the media is essential for success, but, in order for the media to be used effectively, its motivations and limitations must first be recognized and understood. PMID:17288505
OBJECTIVE Mentalillness stigma remains a significant barrier to treatment. However, the recent increase in the medical and non-medical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students’ attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (i.e., attitudes towards mentalillness and beliefs about the efficacy of psychiatric medications). METHOD Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcohol Screening Test, Drug Abuse Screening Test, Day’s MentalIllness Stigma Scale, Attitudes Toward Psychiatric Medication Scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on campus or through online classes. RESULTS Results showed high rates of psychiatric medication misuse when compared to rates of medical use. Participants reported believing that the majority of students who use prescription psychotropics do so non-medically. In addition, less-stigmatized attitudes toward mentalillness were correlated with both increased beliefs about the treatability of mentalillness and increased misuse of psychiatric medications. Conversely, more stigmatized beliefs were associated with negative views toward psychiatric medication, as well as decreased likelihood of abuse. CONCLUSION Results suggest the need for improved education regarding the nature of mentalillness, the appropriate use of psychiatric medications, and the potential consequences associated with abuse of these potent drugs.
There is an increasing number of severely mentallyill persons in the criminal justice system. This article first discusses the criminalization of persons with severe mentalillness and its causes, the role of the police and mental health, and the treatment of mentallyill offenders and its difficulties. The authors then offer recommendations to reduce criminalization by increased coordination between
H. Richard Lamb; Linda E. Weinberger; Bruce H. Gross
Mentallyill offenders represent a substantial proportion of jail and prison inmates. Despite the fact that confining mentallyill offenders can and often will exacerbate their mentalillness, the quality of mental health services available to them remains poor and insufficient. Up to date, only a few cities and counties have considered a more…
Should a murderer be allowed to inherit the victim's estate? The question dates from biblical times, but most jurisdictions today have statutes in place that bar inheritance by convicted murderers. However, a special problem arises when the killer has a severe mentalillness and has been found not guilty by reason of insanity. Should such people, who have not been convicted of a crime, be permitted to collect their inheritance? Jurisdictions vary in their responses, with the rules reflecting a mix of practical and moral considerations influenced by different perspectives about what determines the behavior of persons with mentalillness. PMID:21724780
Persons with a mentalillness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care or social care. The myth of dangerousness is out of proportion and the media is to blame as they most often mention persons with mentalillnesses as dangerous. Many countries make a great effort to reduce stigma and this is also under planning in Denmark. PMID:21501561
Vendsborg, Per; Nordentoft, Merete; Lindhardt, Anne
This article will examine baseline assessment data from consecutive admissions to the MISSION Program, a transitional case management program for homeless veterans, to better understand the differences across military service eras that impact the psychosocial treatment needs of homeless, mentallyill, substance-abusing veterans. In all, 373 homeless veterans with a co-occurring mentalillness and substance abuse disorder received the Structured
Anna Kline; Lanora Callahan; Mark Butler; Lauren St. Hill; Miklos F. Losonczy; David A. Smelson
Throughout history, most societies have strongly believed that mental disorder is linked with violence. The earliest recorded account is found in a dialog written by Plato. William Shakespeare wrote of such a connection in The Taming of the Shrew and Henr...
...2013-07-01 false Ongoing medical and mental health care for sexual abuse victims and abusers...Community Confinement Facilities Medical and Mental Care Â§ 115.283 Ongoing medical and mental health care for sexual abuse victims and...
The combined problems of substance abuse, mentalillness, and homelessness among the urban poor represent a major public health issue. The study evaluated 340 patients attending a cocaine day treatment program that integrates peer leadership and professional supervision. Thirty-six percent of the sample had a major mentalillness, and 39 percent were homeless. Sixty-nine percent achieved an acceptable final urine toxicology status, and the median number of program visits was 46. Homelessness, a longer history of cocaine use, and a diagnosis of schizophrenia were associated with positive treatment outcomes. The results support the feasibility of a cocaine abuse treatment model combining professional and peer leadership. PMID:9550249
Stigmatization is a common problem to overcome for people suffering from chronic diseases. It usually follows infectious diseases, disabilities and mental disorders. In our study we explained basic concepts concerning stigma, particularly health-related one, and then we presented the most important socio-demographic factors influencing attitudes towards mentallyill people exemplifying them by scientific literature on mentalillness stigma. Profession, frequency of contact with mentallyill persons, level of mental health literacy, own experience, education level, culture-related factors, overall value orientation, gender and age are the most relevant factors which influence perception of people suffering from mental disorders. A review of surveys on dependencies between those factors and attitudes towards mentallyill people and tendencies to stigmatize with mentalillness was presented. Mental health literacy is the most easily modifiable factor among all the presented here. Majority of campaigns concerning change of attitude towards mentallyill people consist in enhancement of mental health awareness in society. PMID:19388546
Headquartered in Arlington, Virginia, the National Alliance for the MentallyIll (NAMI) sponsors a broad range of public outreach projects and research studies dedicated to providing a more nuanced and multi-faceted understanding of the immense complexity of the many mental health issues that affect millions of persons each day. Within the Find Support section of the site, individuals can learn about local branches of NAMI, learn about support networks for young people dealing with mental health issues, and the presence of NAMI on college campuses. The public policy section of the site is quite strong, as visitors to this area can learn about policy news and alerts about mental health issues, download resource materials about assisting those grappling with mental health afflictions, and read Issue Spotlights that deal with a host of subjects such as managed care, Medicaid, parity, and confidentiality.
A step-by-step guide is presented to assist planning authorities in northwest Illinois communities in the preparation of comprehensive mental health and developmental disabilities plans. The concepts and methods of planning presented are those needed to d...
In 1972, a federal court reinforced the deinstitutionalization of state psychiatric hospitals when they held that people with mentalillness have a constitutional right to treatment (Wyatt v. Stickney, 1972). Although many states released patients and closed hospitals in response to this decision, they neglected to provide adequate community-based treatment resulting in the unintended reinstitutionalization of this population into our
Rates of HIV infection, STDs, and sexual and drug-use risk behaviors are high among people with severe mentalillness. Clinicians often are in the best position to connect psychiatric patients to the particular HIV-related services they need. These may include prevention interventions, risk assessment, antibody test counseling, and medical care. This review article describes the AIDS epidemic and its underpinnings
The benefits of new knowledge on the psychobiology and neuropsychology of serious mentalillnesses have been slow to impact on psychiatric rehabilitation technology. A literature review reveals that, at least in the case of schizophrenia, enough is known about neurobiological deficits and their impact on neurocognitive functioning to justify a more informed approach to psychiatric rehabilitation. Essential elements for a
Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mentalillness stigma experienced by family members. Research indicates this type of stigma…
Siblings are far more likely to be different than alike in personality and psychopathology. Different genes and different environmental experiences can account for why one sibling becomes mentallyill and another is not affected. Environmental experiences play a much greater role in sibling differentiation than has been previously recognized.…
Reviews the history of the problem of deinstitutionalization of the mentallyill to community settings, outlines characteristics of the homeless mentallyill, and discusses steps to create a more responsive clinical network to cope with the problem. (Author/KS)
The problem of mentallyill offenders is discussed in this report. Mentallyill offenders are described as generally not violent, with their behavior resulting in charges such as shoplifting, vagrancy, and trespassing. Factors increasing the number of mentallyill offenders are discussed, including the inability of families and communities to…
The vast majority of mentallyill offenders are not violent, although their illness necessarily manifests itself in ways that society often finds unacceptable. The number of mentallyill offenders is growing because needed mental health care is not available to those who are no longer hospitalized due to the deinstitutionalization movement and the…
Psychometric properties of a brief self-report measure of personal loss for adults coping with psychiatric disability are examined. The Personal Loss from MentalIllness Scale (PLMI) is a 20-item measure that assesses overall perceptions and four interrelated aspects of personal loss from mentalillness. Using a sample of 158 adults with serious mentalillness, the PLMI was found to have
Catherine H. Stein; Dryw O. Dworsky; Russell E. Phillips III; Marcia G. Hunt
Current health policies emphasize partnership between professional groups, between agencies and with users, to ensure more integrated health and social care services. However, a number of reasons have been consistently identified as inhibiting interprofessional working. Among the many factors identified are poor communication, conflicting power relations and role confusion, and these present immense challenges to those who wish to offer interprofessional education and training opportunities. East Gloucestershire NHS Trust worked in partnership with the University of Gloucestershire (formerly the Cheltenham and Gloucester College of Higher Education) to overcome these problems and deliver an important postqualifying interprofessional training for those working with people with serious mentalillness - the Thorn-based 'Diploma in Integrated Approaches to Serious MentalIllness'. This collaborative initiative represents a good model by which practitioners of all disciplines can be trained to a high standard and meet the requirements of the National Service Framework for Mental Health. This paper describes the initiative and identifies the extent to which the course has, by mirroring the practice it is seeking to generate, 'pulled together' to ensure interprofessional, intersectoral and professional/user collaboration. The key challenges associated with interprofessional working (with people with serious mentalillness and with others) and with course implementation and how these were met are discussed and further opportunities are identified. PMID:12060376
Investigates the relationship between college undergraduate students' (N=102) beliefs about the definition of mentalillness and their tolerance toward individuals with mentalillnesses. Results show that students with broad and inclusive definitions of mentalillness had more benevolent, less authoritarian, and less socially restrictive attitudes…
Definitions of the physical, sexual, and psychological abuse of children were assessed in a sample of mental health and legal professionals. Forty-eight social workers and 33 attorneys rated 39 items describing various parental behaviors that were potentially abusive. The results indicated that: (a) severity ratings were highest for sexual abuse, followed by physical and emotional abuse; (b) the social workers
Lori Isman Greene; David S. Glenwick; Kathleen M. Schiaffino
Even in the era of the internet, printed media are still among the most frequently identified sources of mental health information. Many studies have shown that this information is frequently negative and contributes to stigmatization of people with mentalillness. This international comparative study describes the content of media messages about mental health/illness in terms of stigma in three central European countries. The study sample comprised all articles pertaining to the topic of mental health/illness (N=450) identified during five week-long periods in 2007 chosen from the six most widely read newspapers and magazines in each country. Content analysis methods were used to achieve quantitative as well as qualitative objectives. More than half of all articles contained negative statements reflecting stigma towards persons with mentalillness. Substance abuse disorders are the most frequent mental conditions covered in all three countries (22%) and psychotic disorders are the most stigmatized. Countries significantly differ in length of articles, the association of aggressive behavior with persons with mentalillness, and in the use of a sensationalized style of writing. Coverage of mental health/illness issues differs to some extent across countries, but is generally of poor quality. Based on our findings, practical recommendations for journalists can be tailored specifically for each country.
Objective To estimate the impact of Hurricane Katrina on mentalillness and suicidality by comparing results of a post-Katrina survey with those of an earlier survey. Methods The National Comorbidity Survey-Replication, conducted between February 2001 and February 2003, interviewed 826 adults in the Census Divisions later affected by Hurricane Katrina. The post-Katrina survey interviewed a new sample of 1043 adults
Ronald C. Kessler; Russell T. Jones; Holly A. Parker
1.The history of pharmacotherapy of mentalillness can be divided into three periods.2.Introduction of morphine, potassium bromide, chloral hydrate, hyoscine, paraldehyde, etc., during the second half of the 19th century (first period), led to the replacement of physical restraint by pharmacological means in behavior control.3.Introduction of nicotinic acid, penicillin, thiamine, etc., during the first half of the 20th century (second
This article documents the physical health burdens of participants in a large, federally funded cross-site study of specialized services for women with histories of trauma (physical or sexual abuse) and co-occurring substance abuse and mental health disorders. Nearly half of the 2729 women in the study (48%) reported serious physical illnesses that frequently limited their daily life activities or required
Mary Jo Larson; Lisa Miller; Marion Becker; Erin Richardson; Nina Kammerer; Jennifer Thom; Joanne Gampel; Andrea Savage
Cultural religious beliefs influence perceptions of mentalillness, and any clinician interested in treating mentallyill people and their families must consider these beliefs so that he or she can develop culturally specific interventions. This article reports on the results of interviews with African American experts, mentallyill persons, and nurses caring for the mentallyill. A case study is used to illustrate the influence of southern religious beliefs on perceptions of mentalillness and the behaviors of people who are mentallyill. Although many issues are considered in this analysis (i.e., ethnicity, geographic location, and religion), it is the influence of three religious traditions in the South--voodoo, slave religion, and evangelical Protestantism--that takes precedence in the analysis. Mental health professionals, especially psychiatric nurses, will find this information helpful when assisting hospitalized patients. PMID:10808829
Whereas some research suggests that acknowledgment of the role of biogenetic factors in mentalillness could reduce mentalillness stigma by diminishing perceived responsibility, other research has cautioned that emphasizing biogenetic aspects of mentalillness could produce the impression that mentalillness is a stable, intrinsic aspect of a person (“genetic essentialism”), increasing the desire for social distance. We assessed genetic and neurobiological causal attributions about mentalillness among 85 people with serious mentalillness and 50 members of the public. The perceived responsibility of persons with mentalillness for their condition, as well as fear and social distance, were assessed by self-report. Automatic associations between MentalIllness and Guilt and between Self and Guilt were measured by the Brief Implicit Association Test. Among the general public, endorsement of biogenetic models was associated with less perceived responsibility, but also greater social distance. Among people with mentalillness, endorsement of genetic models had only negative correlates: greater explicit fear and stronger implicit self-guilt associations. Genetic models may have unexpected negative consequences for implicit self-concept and explicit attitudes of people with serious mentalillness. An exclusive focus on genetic models may therefore be problematic for clinical practice and anti-stigma initiatives.
Rusch, Nicolas; Todd, Andrew R.; Bodenhausen, Galen V.; Corrigan, Patrick W.
Congress established the Substance Abuse and Mental Health Services Administration (SAMHSA) in 1992 to "target effectively substance abuse and mental health services to the people most in need." SAMHSA also administers a number of block grant programs and data collection activities. On their homepage, visitors can get started by clicking on the "Data" link at the top of the page and reading through the "What We Are Doing" section. Here interested parties will find highlights of recent reports, state-level data on these topics, and a series of mental health statistics reports. The top of their homepage contains additional sections of interest, including "Grants", "Publications", "Data", and "Newsroom". Visitors should also take a look at the "Featured Resource", which is also on the homepage. In addition, many of the site's materials are available in Spanish. Visitors can follow SAMHSA on various social networks including Facebook YouTube, and Twitter, and they can also sign up for their mailing list if they wish to keep up with this valuable organization.
Background Mental fitness for work is the ability of workers to perform their work without risks for themselves or others. Mental fitness was a neglected area of practice and research. Mentalill health at work seems to be rising as a cause of disablement. Psychiatrists who may have had no experience in relating mental health to working conditions are increasingly being asked to undertake these examinations. This research was done to explore the relationship of mentalill health and fitness to work and to recognize the differences between fit and unfit mentallyill patients. Methods This study was cross sectional one. All cases referred to Al-Amal complex for assessment of mental fitness during a period of 12 months were included. Data collected included demographic and clinical characteristics, characteristics of the work environment and data about performance at work. All data was subjected to statistical analysis. Results Total number of cases was 116, the mean age was 34.5 ± 1.4. Females were 35.3% of cases. The highly educated patients constitute 50.8% of cases. The decision of the committee was fit for regular work for 52.5%, unfit for 19.8% and modified work for 27.7%. The decision was appreciated only by 29.3% of cases. There were significant differences between fit, unfit and modified work groups. The fit group had higher level of education, less duration of illness, and better performance at work. Patients of the modified work group had more physical hazards in work environment and had more work shift and more frequent diagnosis of substance abuse. The unfit group had more duration of illness, more frequent hospitalizations, less productivity, and more diagnosis of schizophrenia. Conclusion There are many factors affecting the mental fitness the most important are the characteristics of work environment and the most serious is the overall safety of patient to self and others. A lot of ethical and legal issues should be kept in mind during such assessment as patient's rights, society's rights, and the laws applied to unfit people.
The National Alliance for the MentallyIll (NAMI) was conceived a decade ago in the tradition of self-organized parents' groups for handicapped and chronically ill children. The character of the organization and its rapid growth are thought to be due to its clear identity as a “mentalillness” group, its control and direction by parents and relatives of people suffering
Stigma can greatly exacerbate the experience of mentalillness. Diagnostic classification frequently used by clinical social workers may intensify this stigma by enhancing the public's sense of "groupness" and "differentness" when perceiving people with mentalillness. The homogeneity assumed by stereotypes may lead mental health professionals and…
Despite the prevalence of mental health problems, society continues to stigmatize and discriminate against people with mentalillness and in particular, schizophrenia. Among the negative consequences of stigma, is that some individuals with mentalillness internalize negative stereotypes about themselves, referred to as self-stigma, which is…
Hartman, Leah I.; Michel, Natalie M.; Winter, Ariella; Young, Rebecca E.; Flett, Gordon L.; Goldberg, Joel O.
The escalating mentallyill population in prisons has created unique challenges for correctional systems, Colorado being no exception with 25% of its incarcerated population having mental health needs. This study examined correctional offenders with mentalillness (OMIs) and found a growing number of OMIs in Colorado's prison system. Not only is…
BACKGROUND: Many studies have been carried out that focus on mental patients' access to care for their mentalillness, but very few pay attention on these same patients' access to care for their physical diseases. Acute appendicitis is a common surgical emergency. Our population-based study was to test for any possible association between mentalillness and perforated appendicitis. We hypothesized
Living with a parent with mentalillness may expose a child to a degree of risk of abuse and neglect. Consequently, both adult mental health services and children's services share a responsibility for safeguarding children and promoting their welfare. However, there is evidence in England that these services do not work together very effectively. Interagency training for social workers and
John Carpenter; Demi Patsios; Eszter Szilassy; Simon Hackett
This study aimed to determine the prevalence of motherhood among inpatient females at a large state psychiatric hospital in suburban New York, as well as develop an understanding of the characteristics and needs of this unique population. Data on motherhood status was gathered from October 2010 through April 2011 via medical records. Data on custody status, frequency of contacts with children, and effect of mentalillness on parenting was assessed through patient surveys and focus groups. 38.5 % of female inpatients were found to be mothers, almost half of whom reported at least weekly contact with children despite their inpatient status. The majority of identified mothers reported having maintained custody of their minor children and expressed great pride at being primary caretakers for their children, yet also emphasized the challenging effects of stigma associated with mentalillness and parenting. A significant proportion of women at this psychiatric hospital were found to be mothers. Although acknowledged by some clinicians at the individual level, motherhood appears to remain a forgotten role systemically. Determining motherhood status and recognizing the varied roles our patients have is one more way mental health providers can model and promote recovery-oriented care. PMID:22576070
Benders-Hadi, Nikole; Barber, Mary; Alexander, Mary Jane
We examined associations among six forms of common lifetime traumatic/adverse events and lifetime suicide attempts while controlling for gender, psychiatric symptoms, self-injury, and substance use in 371 community mental health clients with severe mentalillness. Most clients (88.1 %) reported at least one traumatic event, and more than half had attempted suicide at least once. Regression revealed that three factors were significantly associated with lifetime suicide attempts: lifetime self-injurious behaviors, lifetime physical abuse, and alcohol use. Having been physically abused appears to be uniquely associated with lifetime suicide attempts when other key risk factors are controlled. Limitations include the cross-sectional design. PMID:24282033
The author explores the process of how homeless mentallyill persons become involved with the criminal justice system. The unique demands of homelessness and chronic mentalillness were specifically examined in this naturalistically based study. The author concludes that a combination of severe mentalillness, a tendency to decompensate in a nonstructured environment, and an inability or unwillingness to follow
The Substance Abuse and Mental Health Data Archive (SAMHDA) is an initiative of the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA) of the United States Department of Health and Human Services. The goal of the archive is to provide re...
The treatment system for the chronically mentallyill in New Jersey's Bergen and Passaic counties was studied. Questionnaires were completed by community mental health agencies and by social service directors at two psychiatric hospitals. Information was ...
... state and community leaders Helping mental health and tobacco control programs to work together to reduce tobacco use ... and tobacco-free campuses. Supporting sustained, evidence-based tobacco control programs. By people with mentalillness Deciding to ...
On April 2, 1990, an event occurred that had major potential for the betterment of the circumstances of mentallyill persons in the criminal justice system. A national collection of mental health, correctional, and law enforcement professionals were joine...
... people with mentalillness are not violent, not criminal and not dangerous." In the study, the researchers ... disorder. The study participants were interviewed about their criminal history and mental health symptoms, covering an average ...
The aim of this study was to explore the use of photovoice as an innovative methodology for understanding aspects of the mentalillness experience. Applied ethnographic methods were used to examine 15 photographs and accompanying narratives from a mentalillness photovoice exhibit. Analysis occurred within and across cases, resulting in individual case studies and a thematic description of the narratives. Suffering, stigma, and loss of identity were found at the center of this rendering of mentalillness experience. The findings suggest that a photovoice project offers a useful lens from which to examine experiences associated with living with mentalillness. PMID:19216984
Fleming, John; Mahoney, Jane; Carlson, Elizabeth; Engebretson, Joan
The impact of the experience and diagnosis of mentalillness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mentalillness. The present article proposes a theoretically
This article examines the specific experiences of women in prison, focusing on previous (and continuing) physical and mentalabuse, the consequent health care requirements of women prisoners, the policy response and the availability of suitable health care in prisons across the EU. It draws from an extensive review of the literature on women prisoners across Europe that was part of an on-going European Project funded by the DAPHNE programme of the European Commission, entitled 'DAPHNE Strong'. It also uses the field research from the project collected via surveys and in-depth interviews with key personnel in organisations that work with women prisoners or ex-prisoners and staff with a strategic overview of activity from the ministries of justice, police, prison service and women's support organisations. There are probably many more women prisoners with a history of domestic abuse than is officially recognised. Many of the women prison population who have experienced violence and abuse mask this by problematic drug or alcohol use as well as self-injury. These are key areas that training for prison staff needs to address. The availability of services for this group of women is inconsistent within and between countries of the EU. The political will to address the situation of women in prison, as distinct from the norms applied to men, is variable and it seems to take the determined efforts of active lobby groups to make inroads into an area of latent inertia. PMID:23642339
Background There is an increasing probability that the psychiatrist will, willingly or not, come into contact with mentallyill offenders in the course of their practice. There are increasing rates of violence, substance abuse and other psychiatric disorders that are of legal importance. Therefore, the aim of this work was to investigate the rates of different mental disorders in 100 court reports and to investigate the characteristics of mentallyill offenders. Methods All cases referred from different departments of the legal system to the forensic committee for assessment of legal accountability over 13-months duration were included. A specially designed form was prepared for data collection. Cases were classified into five groups: murder, robbery, financial offences, violent and simple offences and a group for other offences. Data were subjected to statistical analysis and comparisons between different groups of subjects were performed by analysis of variance (ANOVA). Results Men constituted 93% of cases. In all, 73% of offenders were younger than 40 years old. Schizophrenia cases made up 13% of the total, substance related cases constituted 56% and amphetamine cases alone made up 21%; 10% of cases were antisocial personality disorders, and 51% of cases were classified as having a low education level. Unemployment was found in 34% of cases. The final decision of the forensic committee was full responsibility in 46% of cases and partial responsibility in 11% of cases, with 33% considered non-responsible. A total of 58% of cases had had contact with psychiatric healthcare prior to the offence and in 9% of cases contact had been in the previous 12 weeks. A history of similar offences was found in 32% of cases. In all, 14% of the offences were murders, 8% were sexual crimes, and 31% were violent/simple crimes. Conclusions The ability of the legal system to detect cases was good, while the ability of the healthcare system to predict crimes and offences was weak, as 58% of cases had had previous contact with the healthcare system previously. Substance abuse, especially amphetamine abuse, played an important role.
This study compared parental psychiatric symptom severity, and the absence or presence of severe substance abuse, as predictors of contact with minor children for a representative sample of adults with diagnoses of serious mentalillness (N = 45). Child contact and psychiatric symptom severity were measured during regularly scheduled 6-month research interviews over a total 30-month period following each participant’s entry into the project. Severe substance abuse was documented as present or absent for the 6-month interval preceding each interview. Results revealed that incidence of severe substance abuse was repeatedly associated with less frequent parent-child contact, even after controlling for psychiatric symptoms, diagnosis, gender, age, ethnicity, and socioeconomic status. Neither psychiatric diagnosis nor symptom severity predicted frequency of child contact when substance abuse was taken into account. Mental health agencies offering parenting classes for adults with serious mentalillness should incorporate substance use interventions to reduce loss of child custody and strengthen parent-child relationships.
Jones, Danson; Macias, Rosemarie Lillianne; Gold, Paul B.; Barreira, Paul; Fisher, William
This handbook for attorneys represents part of an effort to improve legal representation for criminal defendants with mentalillness. The handbook was developed and reviewed by both mental health professionals and attorneys experienced in criminal and mental health law. However, it is not a comprehensive guide on mental health law or on how to…
Background: Unemployment remains a major conse- quence of schizophrenia and other severe mentalill- nesses. This study assesses the effectiveness of the Indi- vidual Placement and Support model of supportive employment relative to usual psychosocial rehabilita- tion services for improving employment among inner- city patients with these disorders. Methods: Two hundred nineteen outpatients with se- vere mentalillnesses, 75% with
Anthony F. Lehman; Richard Goldberg; Lisa B. Dixon; Scot McNary; Leticia Postrado; Ann Hackman; Karen McDonnell
This article describes a unique population within the homeless community--women who are homeless and mentallyill. Homelessness prevalence and etiology data are presented, followed by a general discussion of how mentalillness affects people who are homeless. The article provides an overview of women who are homeless, focusing on those who are…
Markos, Patricia A.; Baron, Heather Lyn; Allen, Daniel N.
BACKGROUND: Adults aged 65 and older with severe mentalillnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mentalillnesses patients, no special form of it is available for the elderly.
In South Africa, a substantial burden is placed on families living with people with mentalillnesses. The aim of this study was to identify resilience factors in families living in an underprivileged area, caring for people with mentalillnesses. Data was obtained from family representatives (N=34) using semistructured interviews and a set of…
This dissertation critically examines mentalillness discourses through the intersecting disciplinary lenses of art education and disability studies. Research from multiple disciplines is compared and theorized to uncover the ways in which discourses, or language systems, have oppressively constructed and represented "mentalillness." To establish…
Having taken into account the advantages and disadvantages of all the investigations hitherto carried out in the German Federal Republic into the prevalence of the mentallyill and handicapped in geriatric nursing and old people's homes, we conducted our own research project using our own investigatory method. This involved the detailed recording of the mentallyill in such homes and
Police encounters are believed to be particularly dangerous for people with mentalillness and police officers. Despite widespread concern among advocates, researchers, and police professionals, little is known about the details of these interactions, including the occurrence of injuries. In the current study, we explore injuries to people with mentalillness and officers to determine the extent to which situational
Workman Arts, a Toronto-based theatre and visual arts company with a 20-year history, provides a rich site for re-imagining stigmatised representations of mentalillness. Writing and performing against a long tradition of representing people with mentalillnesses as incoherent speakers and visually different, company members seek to re-imagine…
The 10 components of a career development curriculum for mentallyill individuals are intended to achieve 3 goals: (1) job readiness (reality of work, integration of mentalillness and employment, on-the-job behavior); (2) career decision making (self-assessment, occupational information, career choice); and (3) getting and keeping employment (job…
Mentalillness has a catastrophic impact on the family, subjecting its members to severe burden and life stress. In addition, families are often implicated in the origins of the illness by themselves, society, and mental health professionals. New alliances with clinicians are helping to support and destigmatize these families. (AF)
This study explores how mentalillness shapes transitions to marriage among unwed mothers using augmented data from the Fragile Families and Child Wellbeing study (N = 2,351). We estimate proportional hazard models to assess the effects of mentalillness on the likelihood of marriage over a 5-year period following a nonmarital birth. Diagnosed…
The chronic mentallyill experience substantially higher rates of HIV infection than the general population. This paper examines the problems which confront the chronic mentallyill and society at large. Discussed are the questions of whether or not psychiatric patients should be excepted, due to their cognitive and behavioral impairments, from…
Perinatal mentalillness is a significant complication of pregnancy and the postpartum period. These disorders include depression, anxiety disorders, and postpartum psychosis, which usually manifests as bipolar disorder. Perinatal depression and anxiety are common, with prevalence rates for major and minor depression up to almost 20% during pregnancy and the first 3 months postpartum. Postpartum blues are a common but lesser manifestation of postpartum affective disturbance. Perinatal psychiatric disorders impair a woman's function and are associated with suboptimal development of her offspring. Risk factors include past history of depression, anxiety, or bipolar disorder, as well psychosocial factors, such as ongoing conflict with the partner, poor social support, and ongoing stressful life events. Early symptoms of depression, anxiety, and mania can be detected through screening in pregnancy and the postpartum period. Early detection and effective management of perinatal psychiatric disorders are critical for the welfare of women and their offspring. PMID:24140480
This study examined medication decision making by 84 persons with serious mentalillness, specifically examining relationships among perceived coercion, decisional capacity, preferences for involvement and actual participation, and the outcomes of medication adherence and QoL. Multiple and logistic regression analysis were used in this cross-sectional, descriptive study, controlling for demographic, socio-economic and utilization variables. Appreciation was positively related to medication adherence behaviors for the past six months. Females, older individuals and those living independently were more likely to have taken all their medications over the past six months. Neither client participation, preference, nor preference-participation agreement was found to be associated with better medication adherence or QoL.
Grief is a key reaction experienced by many relatives of persons with serious mentalillness. Parents, spouses, and children may endure great longing for the quality of their former relationship with the ill person, as well as grief over dashed hopes and aspirations. The author describes a format for grief therapy for relatives of persons with serious mentalillness that is based on four tasks of mourning: making the loss real, expressing overt and latent affect, accommodating to the loss through relationships other than that with the mentallyill person. Grief therapy is a potentially appropriate complement to existing approaches for family members, such as psychoeducation. PMID:8726492
The debate about addressing mentalillness and violence often ignores key facts. Many people experience mentalillnesses, so having had a diagnosed illness is not a very specific predictor of violent behavior. This means that many proposed policy approaches, from expanded screening to more institutionalization, are unlikely to be effective. Expanded access to effective treatments, although desirable, will have only modest impacts on violence rates. Most people with mental health problems do not commit violent acts, and most violent acts are not committed by people with diagnosed mental disorders. PMID:24328636
Many people seeking help from the mental health system have histories of childhood trauma from sexual and physical abuse. Little literature is available for counselors, mental health workers, and other professionals on the topic of specialized therapy for abuse survivors. Counselors have a crucial role in helping these clients heal and recover.…
The study was an attempt to construct an attitude scale to measure the radical psychosocial or libertarian position about "mentalillness" and mental health practices. The factor analysis defined four scale factors: mentalillness mythology, antimedical model, social deviance control, and anti-coercive treatment. (Author)
Racial disparities in mental health outcomes have been widely documented in noninstitutionalized community psychiatric samples, but few studies have specifically examined the effects of race among individuals with the most severe mentalillnesses. A sample of 925 individuals hospitalized for severe mentalillness was followed for a year after…
Research shows that half of all lifetime cases of mentalillness begin by age 14. Scientists are discovering that changes in the body leading to mentalillness may start much earlier, before any symptoms appear. Through greater understanding of when and how fast specific areas of children's brains develop, we are learning more about the early…
We evaluate the influence of housing, services, and individual characteristics on housing loss among formerly homeless mentallyill persons who participated in a five-site (4-city) study in the U.S. Housing and service availability were manipulated within randomized experimental designs and substance abuse and other covariates were measured with a common protocol. Findings indicate that housing availability was the primary predictor of subsequent ability to avoid homelessness, while enhanced services reduced the risk of homelessness if housing was also available. Substance abuse increased the risk of housing loss in some conditions in some projects, but specific findings differed between projects and with respect to time spent in shelters and on the streets. We identify implications for research on homeless persons with mentalillness that spans different national and local contexts and involves diverse ethnic groups.
Hough, Richard L.; Goldfinger, Stephen M.; Lehman, Anthony F.; Shern, David L.; Valencia, Elie; Wood, Patricia A.
Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mentalillness within health policy worldwide. The maltreatment of the mentallyill in many low-income countries is widely reported within psychiatric hospitals, informal healing centres, and family homes. International agencies have called for the development of legislation and policy to address these abuses. However such initiatives exemplify a top-down approach to promoting human rights which historically has had limited impact at the level of those living with mentalillness and their families. Methods This research forms part of a longitudinal anthropological study of people with severe mentalillness in rural Ghana. Visits were made to over 40 households with a family member with mentalillness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mentalillness, carers, healers, health workers and community members. Results Chaining and beating of the mentallyill was found to be commonplace in homes and treatment centres in the communities studied, as well as with-holding of food ('fasting'). However responses to mentalillness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentallyill relatives with very little support from formal health services. Psychiatric services were difficult to access, particularly in rural communities, and also seen to have limitations in their effectiveness. Traditional and faith healers remained highly popular despite the routine maltreatment of the mentallyill in their facilities. Conclusion Efforts to promote the human rights of those with mentalillness must engage with the experiences of mentalillness within communities affected in order to grasp how these may underpin the use of practices such as mechanical restraint. Interventions which operate at the local level with those living with mentalillness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentallyill than legislation or investment in services alone.
In this paper, the author discusses an exercise she uses requiring students to view a popular film that portrays a particular mental disorder or a character with a mental disorder. Students analyze the film and write two papers, one about the sociological model of mentalillness and a second about possible links between media images and the…
For several reasons including the failures of deinstitutionalization, the inadequacy of community resources, and poor coordination among service agencies, the needs of people with long-term mentalillness living in the community have not been adequately met. Yet recent changes in the mental health care treatment system have sustained the shift in the locus of mental health care from inpatient settings
Historically, the policy of deinstitutionalization has resulted in the closing of many federal and state mental health facilities. This has caused many criminal justice professionals and social workers to question where the mentallyill are placed when they are no longer in a treatment facility. With the abundance of offenders with mental health…
Reynolds, K. Michael; Dziegielewski, Sophia F.; Sharp, Chris
There has been a general recognition of a syndemic that includes HIV/AIDS and serve mentalillnesses including schizophrenia, major depression, bipolar disorder, post-traumatic stress disorder, and others. The pathophysiology and direction of effects between severe mentalillness and HIV infection is less clear however, and relatively little work has been done on prevention and treatment for people with these complex, co-occurring conditions. Here we present the most recent work that has been published on HIV and mentalillness. Further, we describe the need for better treatments for "triply diagnosed persons"; those with HIV, mentalillness, and substance abuse and dependence. Finally, we describe the potential drug-drug interactions between psychotropic medications and anti-retrovirals, and the need for better treatment guidelines in this area. We describe one example of an individually tailored intervention for persons with serious mentalillness and HIV (PATH+) that shows that integrated community-based treatments using advanced practice nurses (APNs) as health navigators can be successful in improving health-related quality of life and reducing the burden of disease in these persons. PMID:24158425
Blank, Michael B; Himelhoch, Seth; Walkup, James; Eisenberg, Marlene M
Homeless mentallyill (HMI) persons are a highly vulnerable and socially disadvantaged population, deprived of even the basic minimal human rights. Data on HMI in India is scarce. This retrospective chart review aimed to evaluate socio-demographic, socio-cultural and clinical profile of HMI patients, and to study reasons of homelessness and outcome related variables in these patients. One hundred and forty homeless persons were admitted to the department of psychiatry of a north Indian medical university from February 2005 to July 2011. Of these, one hundred and twenty-seven (90.7%) had psychiatric illness and six had only intellectual disabilities. The majority of HMI persons were illiterate/minimally literate, adult, male, and from low socioeconomic and rural backgrounds. Most of the patients (55.7%) had more than one psychiatric diagnosis. HMI had considerably high rates of co-morbid substance abuse (44.3%), intellectual disabilities (38.6%) and physical problems (75.4%). Most (84.3%) were mentallyill before leaving home and 54.3% left home themselves due to the illness. Most HMI responded to the treatment. After treatment of mentalillness, it was possible to reintegrate about 70% of the patients into their families. Families were willing to accept and support them. Untreated/inadequately treated mentalillness was the most common reason for homelessness. Easily accessible treatment and rehabilitation facilities at low cost can improve the plight of such patients. Further research in this area is required. PMID:24011688
Tripathi, A; Nischal, A; Dalal, P K; Agarwal, V; Agarwal, M; Trivedi, J K; Gupta, B; Arya, A
Background: Supported housing, integrating clinical and housing services, is a widely advocated intervention for homeless people with mentalillness. In 1992, the US De- partment of Housing and Urban Development (HUD) and the US Department of Veterans Affairs (VA) established the HUD-VA Supported Housing (HUD-VASH) program. Methods: Homeless veterans with psychiatric and\\/or sub- stance abuse disorders or both (N=460) were
Robert Rosenheck; Wesley Kasprow; Linda Frisman; Wen Liu-Mares
Background The stigma against people with mentalillness is a major barrier to help-seeking in young people for mental health problems. The objective of this study was to investigate the extent of stigma in relation to treatment avoidance in 14 year-old school students in England in relation to how they refer to people with mentalillness. Methods This is a qualitative, cross-sectional study. The data were gathered as part of the baseline assessment for an intervention study intended to reduce stigma among 14 year old school students. The participating schools were two grammar (selective) schools and three comprehensive (non-selective) schools. At the start of the lesson, the students were asked 'What sorts of words or phrases might you use to describe someone who experiences mental health problems?' Words and terms used to refer to mentalillness were enumerated. Using the grounded theory approach, words and terms were grouped in terms of their denotative and connotative meanings. Labels were then derived to capture the key themes attached by the students to the concepts of mentalillness. The frequencies of occurrence for each word were also tabulated. Results 400 of the 472 participating students (85%) provided 250 words and terms to describe a person with mentalillness. Five themes were identified from the data. The first theme called 'popular derogatory terms' (116 items) accounted for nearly half of the words examined. The second theme occurred less often and was described as 'negative emotional state' (61 items). The third theme demonstrated the confusion of young people between physical disabilities, learning difficulties and mental health problems (38 items). The use of psychiatric diagnoses (15 items) and terms related to violence (9 items) were unexpectedly uncommon. Conclusion Our findings suggest the hypothesis that help-seeking by mentallyill young people may be improved by interventions that address both their lack of factual information about mentalillness, and those which reduce their strong negative emotional reactions towards people with mentalillness.
...2013-07-01 false Ongoing medical and mental health care for sexual abuse victims and abusers...Standards for Adult Prisons and Jails Medical and Mental Care Â§ 115.83 Ongoing medical and mental health care for sexual abuse victims and...
...2013-07-01 false Ongoing medical and mental health care for sexual abuse victims and abusers...Standards for Juvenile Facilities Medical and Mental Care Â§ 115.383 Ongoing medical and mental health care for sexual abuse victims and...
Although some research has examined negative automatic aspects of attitudes toward mentalillness via relatively indirect measures among Western samples, it is unclear whether negative attitudes can be automatically activated in individuals from non-Western countries. This study attempted to validate results from Western samples with Chinese college students. We first examined the three-component model of implicit stigma (negative cognition, negative affect, and discriminatory tendencies) toward mentalillness with the Single Category Implicit Association Test (SC-IAT). We also explored the relationship between explicit and implicit stigma among 56 Chinese university college students. In the three separate SC-IATs and the combined SC-IAT, automatic associations between mentalillness and negative descriptors were stronger relative to those with positive descriptors and the implicit effect of cognitive and affective SC-IATs were significant. Explicit and implicit measures of stigma toward mentalillness were unrelated. In our sample, women's overall attitudes toward mentalillness were more negative than men's were, but no gender differences were found for explicit measures. These findings suggested that implicit stigma toward mentalillness exists in Chinese students, and provide some support for the three-component model of implicit stigma toward mentalillness. Future studies that focus on automatic components of stigmatization and stigma-reduction in China are warranted. PMID:23029366
The convergence of HIV, substance abuse (SA), and mentalillness (MI) represents a distinctive challenge to health care providers, policy makers, and researchers. Previous research with the mentallyill and substance-abusing populations has demonstrated high rates of psychiatric and general medical comorbidity. Additionally, persons living with HIV/AIDS have dramatically elevated rates of MI and other physical comorbidities. This pattern of co-occurring conditions has been described as a syndemic. Syndemic health problems occur when linked health problems involving 2 or more afflictions interact synergistically and contribute to the excess burden of disease in a population. Evidence for syndemics arises when health-related problems cluster by person, place, or time. This article describes a research agenda for beginning to understand the complex relations among MI, SA, and HIV and outlines a research agenda for the Social and Behavioral Science Research Network in these areas. PMID:18301129
Walkup, James; Blank, Michael B; Gonzalez, Jeffrey S; Safren, Steven; Schwartz, Rebecca; Brown, Larry; Wilson, Ira; Knowlton, Amy; Lombard, Frank; Grossman, Cynthia; Lyda, Karen; Schumacher, Joseph E
1. People with mentalillness must know that mentalillness does not mean they can no longer lead full lives. Role models--successful people who have mentalillness--are needed. 2. There is a great danger in labeling a person as an illness. Once people believe they are an illness, there is no one left inside to take a stand toward the illness; they give up control and others take responsibility for them. 3. "High functioning" and "low functioning" are not attributes that exist inside a person. They are value judgments that are put on a person. There are no high-functioning or low-functioning people. There are people whose contribution we are able to see and value and there are those whose gifts we have failed to see and have failed to value. PMID:8487230
Single-subject multiple probe designs were employed in two studies with 5 young adults who had mental retardation and mentalillness. After learning visual arts activity skills in Study 1 and personally expressive behaviors in Study 2, participants displayed improvement in behaviors associated with mentalillness and increases in expressive…
OBJECTIVE: To identify the number of people in the United States with untreated serious mentalillness (SMI) and the reasons for their lack of treatment. DATA SOURCE/STUDY DESIGN: The National Comorbidity Survey; cross-sectional, nationally representative household survey. DATA COLLECTION: An operationalization of the SMI definition set forth in the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act identified individuals with SMI in the 12 months prior to the interview. The presence of SMI then was related to the use of mental health services in the past 12 months. PRINCIPAL FINDINGS: Of the 6.2 percent of respondents who had SMI in the year prior to interview, fewer than 40 percent received stable treatment. Young adults and those living in nonrural areas were more likely to have unmet needs for treatment. The majority of those who received no treatment felt that they did not have an emotional problem requiring treatment. Among those who did recognize this need, 52 percent reported situational barriers, 46 percent reported financial barriers, and 45 percent reported perceived lack of effectiveness as reasons for not seeking treatment. The most commonly reported reason both for failing to seek treatment (72 percent) and for treatment dropout (58 percent) was wanting to solve the problem on their own. CONCLUSIONS: Although changes in the financing of services are important, they are unlikely by themselves to eradicate unmet need for treatment of SMI. Efforts to increase both self-recognition of need for treatment and the patient centeredness of care also are needed.
Kessler, R C; Berglund, P A; Bruce, M L; Koch, J R; Laska, E M; Leaf, P J; Manderscheid, R W; Rosenheck, R A; Walters, E E; Wang, P S
In this descriptive study, we analyzed data collected from multiple state agencies on 95 persons with severe mentalillness who were convicted of murder in Indiana between 1990 and 2002. Subjects were predominantly suffering from a mood disorder, were white and male with a high school education or equivalent, were living in stabilized housing, and, to a lesser degree, were involved in significant intimate and familial relationships. Rage or anger, overwhelmingly directed toward intimate or familial relations by the use of a firearm or sharp object, was the most frequently mentioned motive for murder. Most of those studied had been raised in households with significant family dysfunction, had extensive histories of substance abuse and criminality, and had received little treatment for their mental and substance use disorders. Findings are contextualized and compared with similarly descriptive studies of nonlethal violence and persons with a mentalillness; hospitalized, schizophrenic and psychotic murderers; and homicide offenders outside the United States. PMID:18354127
Matejkowski, Jason C; Cullen, Sara W; Solomon, Phyllis L
Few investigators studying alcohol abuse among individuals with a severe mentalillness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of…
Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.
This study compared parental psychiatric symptom severity, and the absence or presence of severe substance abuse, as predictors of contact with minor children for a representative sample of adults with diagnoses of serious mentalillness (N = 45). Child contact and psychiatric symptom severity were measured during regularly scheduled 6-month research interviews over a total 30-month period following each participant's entry into
Danson Jones; Rosemarie Lillianne Macias; Paul B. Gold; Paul Barreira; William Fisher
The information-motivation-behavioral skills (IMB) model (Fisher & Fisher, 1992) was used as the theoretical framework for predicting unprotected sexual behavior among substance abusing men and women diagnosed with serious mentalillnesses (n = 320; 150 men and 170 women, primarily of minority ethnicity). In a structural equation model, gender, HIV transmission knowledge, and motivational variables of pro-condom norms and attitudes,
Seth Kalichman; Robert Malow; Jessy Dévieux; Judith A. Stein; Fred Piedman
Although violent victimization is highly prevalent among men and women with serious mentalillness (SMI; e.g., schizophrenia, bipolar disorder), future research in this area may be impeded by controversy concerning the ability of individuals with SMI to report traumatic events reliably. This article presents the results of a study exploring the temporal consistency of reports of childhood sexual abuse, adult
Lisa A. Goodman; Kim M. Thompson; Kevin Weinfurt; Susan Corl; Pat Acker; Kim T. Mueser; Stanley D. Rosenberg
... Only 2.6 percent of these acts of violence occurred at school or the workplace. Meanwhile, a higher percentage of these adults with mentalillness were the victim of violence. The study showed that nearly 31 percent were ...
... MentalIllness to Blame for 10 Percent of Kids' Hospitalizations: Study Shortage of psychiatrists, psychologists makes it ... problem, a new study finds. Most of these kids suffer from depression, bipolar disorder or psychosis. Unfortunately, ...
A multi-method, ethnographically-centered approach was used to understand how homeless individuals whom service providers label mentallyill collude in their own management and surmount their marginality. Field observations from five nontraditional progra...
Our objective was to compare the physical health status of adult prisoners with and without a mentalillness. Mentalillness was diagnosed in a sample of 557 Australian prisoners using the Composite International Diagnostic Interview (CIDI). Physical health measures included self-reported chronic health conditions, recent health complaints and symptoms, self-assessed health using the Short-Form 36 Health Survey (SF-36), and markers
\\u000a The effects of stigmatisation upon people with mentalillness are common and profoundly socially excluding, and so constitute\\u000a unethical barriers to full social participation. This chapter will therefore discuss the ethical dimension of stigma by defining\\u000a terms, discussing the existing literature on stigma related to mentalillness, considering global patterns of stigma, and\\u000a examining stigma and human rights within psychiatric
Background Physical restraint and confinement of the mentallyill (called pasung in Indonesia) is common in Aceh. In early 2010, the local government initiated a program called Aceh Free Pasung 2010. The main goal of the program is to release the mentallyill in the province from restraint and to provide appropriate\\u000a medical treatment and care. The aim of the paper
The formation, structure, and goals of an open-ended psychoeducational support group for people with serious and persistent mentalillnesses are described, differentiating psychoeducation from psychotherapy, and professional from peer-led support groups. Major goals are to provide education for illness management and help members combat social…
One factor thought to contribute to the underutilization of mental health services, especially among rural Americans, is the stigma attached to mentalillness and the associated help seeking process. This study investigated the effects of an instructional unit on mentalillness and related issues on rural adolescents' concept of mentalillness and…
Public security officers are the first to be called upon to restore order where an incident has been precipitated by a person with mentalillness. The paper introduces the steps followed by the officers in handling the case. Problems related to mental health legislation, guardianship, medical services, and policing practices are examined. Since there are not yet comprehensive policies and
Yesterday, the Surgeon General's office issued a comprehensive new report on MentalIllness in America, the first report of its kind in terms of scope and source. According to the report's findings, one in five Americans experiences a mentalillness in any given year and half experience a mental disorder at some time in their lives. But the report's most compelling language was reserved for the obstacles to effective treatment of the mentallyill. Citing stigmas, ignorance of the efficacy of treatment, and a health insurance system that does not accord the same coverage (or respect) to mentalillnesses as it does to physical ones, the report calls for an expansion in the supply of mental health services and, specifically, an increase in the number of mental health professionals caring for children and adolescents. Michael M. Faenza, president of the National Mental Health Association, said the report could be a turning point, if it improves access to services, or "it could be meaningless, if Congress and state legislators do not have the backbone and the political will to act on it."
Very little has been written about lesbians, gay men, and bisexual people (LGBs) with severe mentalillness (SMI). In general, LGBs with SMI have the same mental health needs as their heterosexual counterparts. However, there is a need for some basic understanding and confronting potential bias among health practitioners. Although specialized services for lesbian, gay, bisexual, and transgender (LGBT) people
This paper meets at the crossroads of personal experience and public policy. The personal is the experience of learning as described by five TAFE students with a mentalillness. The public policy context is the increased political pressure on Australia's major vocational training providers to increase workforce participation of people with mental…
Describes a special curriculum that combines religious studies and social science resources to offer a better understanding and acceptance of persons suffering from long-term mental disorders. Utilizes recent scientific research and sacred texts to investigate biological causes of mentalillness and the ensuing cultural stigmatization. (MJP)
People with mental health problems experience many different types of stigma. This article explores the attitudes and beliefs of the general public towards people with mentalillness, and the lived experiences and feelings of service users and their relatives. PMID:22866515
The authors surveyed a random sample of 1,200 NASW members in post-master's practice in mental health to identify their attitudes toward practice with people with severe mentalillness. Contrary to the literature that claims social workers have abandoned vulnerable populations or have negative attitudes toward this population, the authors found…
Background Latinos in the United States have been identified as a high-risk group for depression, anxiety, and substance abuse. HIV\\/AIDS\\u000a has disproportionately impacted Latinos. Review findings suggest that HIV-risk behaviors among persons with severe mental\\u000a illness (SMI) are influenced by a multitude of factors including psychiatric illness, cognitive-behavioral factors, substance\\u000a use, childhood abuse, and social relationships.\\u000a \\u000a \\u000a \\u000a \\u000a Objective To examine the impact of
Emily Lenore Goldman Heaphy; Sana Loue; Martha Sajatovic; Daniel J. Tisch
Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mentalillness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender.
... should comorbid conditions be treated? Glossary References NIDA Publications By Audience By Drug of Abuse By Drug ... of national interest. View all ?Research Reports Featured Publication Drugs, Brains, and Behavior - The Science of Addiction ...
Objective To date, there is no systematic analysis of mental health laws and their implementation across the People’s Republic of China. This article aims to describe and analyze current legal frameworks for voluntary and involuntary admissions of mentallyill patients in the five cities of China that currently have municipal mental health regulations. Methods Information on the legislation and practice of involuntary admission in the five cities was gathered and assessed using the “WHO Checklist on Mental Health Legislation.” The checklist was completed for each city by a group of psychiatrists trained in mental health legislation. Results Although the mental health regulations in these five cities cover the basic principles needed to meet international standards of mental health legislation, some defects in the legislation remain. In particular, these regulations lack detail in specifying procedures for dealing with admission and treatment and lack oversight and review mechanisms and procedures for appeal of involuntary admission and treatment. Conclusions A more comprehensive and enforceable national mental health act is needed in order to ensure the rights of persons suffering mentalillness in terms of admission and treatment procedures. In addition, more research is needed to understand how the current municipal regulations of mental health services in these cities are implemented in routine practice.
Shao, Yang; Xie, Bin; Good, Mary-Jo DelVecchio; Good, Byron J.
Awareness of the importance of maintaining physical health for patients with severe mentalillnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbidity. These patients present higher vulnerability to cardiovascular risk factors based on several issues, such as genetic predisposition to certain pathologies, poor eating habits and sedentary lifestyles, high proportions of smokers and drug abusers, less access to regular health care services, and potential adverse events during pharmacological treatment. Nevertheless, there is ample scientific evidence supporting the benefits of lifestyle interventions based on diet and exercise designed to minimize and reduce the negative impact of these risk factors on the physical health of patients with severe mentalillnesses.
The purpose of this study was that of defining psychiatric profiles among veterans based on a structured interview of 3,595 individuals administered by outreach mental health clinicians to individuals who were presently or recently homeless. The interview included ratings of presence or absence of current psychiatric disorders; alcoholism, drug abuse, psychosis, mood disorders, personality disorders, PTSD, and adjustment disorders. We
Gerald Goldstein; James F. Luther; Aaron M. Jacoby; Gretchen L. Haas; Adam J. Gordon
Education is recognized in many sectors of society as essential for empowerment and better lives, and postsecondary education is increasingly a prerequisite for many occupations. Given its onset in late adolescence and early adulthood, mentalillness frequently disrupts secondary or tertiary education, and resulting lower educational attainment contributes to reduced lifetime employment and earning potential. Yet, supporting people with mentalillnesses to pursue postsecondary education offers pathways to vocational qualifications and more diverse opportunities for employment and career advancement. While substantial efforts have been made to develop evidence-based interventions to improve employment outcomes for people with mentalill health, less is known about the best ways to enable people with mentalillness to successfully return to study and to pursue their educational goals. This paper briefly discusses supported education, an approach designed to provide pathways and supports for reengagement in education; it highlights the potential of modeling educational support on Individual Placement and Support principles used in supported employment programs; and calls for greater efforts in research and practice to enable youth or adults with mentalillness to reengage in education so as to improve their educational outcomes and career prospects. PMID:23857720
Ennals, Priscilla; Fossey, Ellie M; Harvey, Carol A; Killackey, Eóin
Background The increasing interest in the genetic causes of mental disorders may exacerbate existing stigma if negative beliefs about a genetic illness are generally accepted. China’s history of policy-level eugenics and genetic discrimination in the workplace suggests that Chinese communities will view genetic mentalillness less favorably than mentalillness with non-genetic causes. The aim of this study is to identify differences between Chinese Americans and European Americans in eugenic beliefs and stigma toward people with genetic mentalillness. Methods We utilized data from a 2003 national telephone survey designed to measure how public perceptions of mentalillness differ if the illness is described as genetic. The Chinese American (n = 42) and European American (n = 428) subsamples were analyzed to compare their support of eugenic belief items and measures of stigma. Results Chinese Americans endorsed all four eugenic statements more strongly than European Americans. Ethnicity significantly moderated the relationship between genetic attribution and three out of five stigma outcomes; however, genetic attribution actually appeared to be de-stigmatizing for Chinese Americans while it increased stigma or made no difference for European Americans. Conclusions Our findings show that while Chinese Americans hold more eugenic beliefs than European Americans, these attributions do not have the same effect on stigma as they do in Western cultures. These results suggest that future anti-stigma efforts must focus on eugenic attitudes as well as cultural beliefs for Chinese Americans, and that the effects of genetic attributions for mentalillness should be examined relative to other social, moral, and religious attributions common in Chinese culture.
There are many factors that contribute to the poor physical health of people with severe mentalillness (SMI), including lifestyle factors and medication side effects. However, there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes. These inequalities have been attributed to a combination of factors including systemic issues, such as the separation of mental health services from other medical services, healthcare provider issues including the pervasive stigma associated with mentalillness, and consequences of mentalillness and side effects of its treatment. A number of solutions have been proposed. To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services. The health care sector could be targeted for programmes aimed at reducing the stigma of mentalillness. The cognitive deficits and other consequences of SMI could be addressed through the provision of healthcare skills training to people with SMI or by the use of peer supporters. Population health and health promotion approaches could be developed and targeted at this population, by integrating health promotion activities across domains of interest. To date there have only been small-scale trials to evaluate these ideas suggesting that a range of models may have benefit. More work is needed to build the evidence base in this area.
The authors explored attitudes toward adults with mentalillness. Results suggest that mental health trainees and professionals had less stigmatizing attitudes than did non-mental-health trainees and professionals. Professionals receiving supervision had higher mean scores on the Benevolence subscale than did professionals who were not receiving…
Objective: Counselor detection of co-occurring disorders is critical to ensuring that clients with mental disorders entering substance abuse treatment receive appropriate care. This study sought to: (1) examine correspondence between client-reported psychiatric symptoms and client and counselor ratings of need for mental health treatment, and (2) explore client- and program-level characteristics associated with client and counselor underrating. Methods: Psychiatric symptoms
Amy A. Mericle; Cherie Martin; Deni Carise; Meghan Love
... officials to place a much higher priority on mental health. Findings from the study were released online May 23 in the journal World Psychiatry . SOURCE: University of Oxford, news release, May 22, 2014 HealthDay ...
... make sure the medication is working. Children need treatment plans tailored to their individual problems and needs. Q. What medications are used for which kinds of childhood mental disorders? A. Psychotropic medications include stimulants, antidepressants, anti- ...
Conceptualisations of mentalillness are not universally applicable, as culture shapes the expression, perceptions and treatment preferences thereof. By focusing on the perceptions of Hindu psychologists regarding mentalillness, this study aimed to provide a deeper understanding of the impact that religious beliefs have on such conceptualisations. Semi-structured interviews were conducted with six Hindu psychologists around the Johannesburg area, South Africa. Responses were analysed using thematic content analysis. From the findings, it was evident that religion plays a critical role in the understanding and treatment of mentalillness. Hindu beliefs around psychological disturbances were salient. Additionally, it was found that a tension existed between psychologists' awareness of the influential function of religion, particularly amongst collectivistic communities such as the Hindu community, and their occupational understandings and practices, which are deeply rooted in Western thought. Furthermore, it was suggested that the fear of stigma prevented Hindu clients from reaping the benefits of seeking help from culturally competent psychologists. PMID:23054478
A substantial body of evidence supports the role of exercise interventions for people with a mentalillness. However, much of this literature is conducted using outpatient and community-based populations. We undertook a systematic review examining the effect of exercise interventions on the health of people hospitalized with depression, schizophrenia, bipolar disorder, or anxiety disorders. Eight studies met our inclusion criteria. Several studies show positive health outcomes from short-term and long-term interventions for people hospitalized due to depression. Although positive, the evidence for inpatients with schizophrenia, bipolar disorder, or anxiety disorders is substantially less. There is an urgent need to address the paucity of literature in this area, in particular the optimal dose and delivery of exercise for people hospitalized as a result of mentalillness. Standardization of reporting exercise programme variables, the assessment of mentalillness, and the reporting of adverse events must accompany future studies. PMID:24119136
Santeria, a religious system that blends African and Catholic beliefs, is practiced by many Cuban Americans. One aspect of this system is the belief in spirit possession. Basic santeria beliefs and rituals, including the fiesta santera (a gathering at which some participants may become possessed), are briefly described, and four cases in which the patients' belief in possession played a role in their mentalillness are presented. The belief in possession can complicate the diagnosis and treatment of mentalillness, but it should not be considered a culture-bound syndrome. Rather, it may be a nonspecific symptom of a variety of mentalillnesses and should be evaluated in the context of the patient's overall belief system and ability to carry out usual activities. PMID:3224955
The World Psychiatric Association promotes global anti-stigma programs. However, evaluation research is crucial to developing effective programs. The present study examined the effects of a lecture on mental health on public attitudes towards mentalillness. Subjects were recruited from individuals employed by private companies and the government. Attitudes towards mentalillness were measured using the MentalIllness and Disorder Understanding
Researchers have demonstrated that mentalillness stigma is both prevalent in our society and has serious negative consequences for mentallyill persons and their friends and family (Corrigan, 2004a). One of the ways researchers have found to reduce mental health stigma is through contact with persons with mentalillness (Corrigan et al., 2002; Desforges et al., 1991; Schulze, Richter-Werling, &
Examines the evidence for the speculation that mentallyill persons who would previously have been treated within mental hospitals are now processed through the criminal justice system and constitute an ever-increasing proportion of the jail population. Three factors underlie this speculation: the increase in mentallyill persons residing in the community, police handling of the mentallyill, and evidence that
We compared provider diagnosis of mentalillness as noted in a chart audit to an indication of mentalillness using the Revised Symptom Checklist (SCL-90R). We identified cases of correct diagnoses, over-diagnoses, and missed diagnoses of mentalillness by examining mental functioning (using the SF-36). Providers over diagnosed mentalillness in 23% of the cases and missed a diagnosis in
Operated by a private research firm under contract to the Center for Mental Health Services (CMHS) of the U.S. Department of Health and Human Services, the National Resource Center on Homelessness and MentalIllness serves as a clearinghouse for technical assistance and research information. Included here are comprehensive, well-annotated national listings of organizations concerned with mental health, housing and homelessness, as well as housing-related technical assistance resources. The site also provides an "extensive bibliographic database on homelessness and mentalillness" broken down by subject; a listing of research monographs and papers commissioned by the center, some of which may be accessed online; an annotated directory of online resources; information about technical assistance given by the Center to professionals in the field; and selected posted articles from issues of Access, a periodic information letter to the field.
This qualitative study examined three stigma reduction interventions against mentalillness stigma: education, video, and contact. Undergraduates (N = 69) in three introductory psychology classes from a small, Catholic, liberal arts university in the northeast United States participated. Responses to two open-ended questions revealed common negative and stereotypical themes associated with mentalillness. The benefits of supplementing traditional social distance measures with a qualitative approach, as well as the importance of considering a social developmental approach to stigma education are discussed. PMID:24010560
Purpose The difference in risk of mentalillness in UK ethnic minorities may be related to a balance between specific risk factors\\u000a such as racial discrimination and mediating factors such as social support. We investigated whether social support from friends\\u000a or relatives reduces the cross-sectional association between perceived racism and the risk of mentalillness in an ethnic\\u000a minority group.\\u000a \\u000a \\u000a \\u000a \\u000a Methods We
Apu T. Chakraborty; Kwame J. McKenzie; Shakoor Hajat; Stephen A. Stansfeld
The relationship between childhood abuse and adult mental and physical health problems is well documented. Over the lifespan of victims of child abuse, social, psychological and biological consequences of abuse interact in complex ways. A biopsychosocial model is applied to the experiences of adult victims of child abuse to make sense of the complex and varied impacts of child abuse.
This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who…
This paper focuses on nine overlapping topics dealing with improving mental health and substance abuse services for adolescents and their families. Depending on the state of knowledge of each topic, the authors either highlight the importance of the area or offer a specific position statement. It is intended that these statements be reviewed for possible endorsement by the American College
Robert M. Friedman; Barbara J. Burns; Lenore Behar
A mental health, alcohol, and drug abuse (MHADA) needs assessment study was conducted from July 1979 through May 1980 in southern New Jersey. Study goals were to determine the prevalence of MHADA problems among the service area's population, to evaluate t...
Reports on a 33-item questionnaire based on Alexander G. Zaphiris's conceptualization of the terminology of sexual mistreatment. Results indicate that mental health counselors (N=300) who encountered sexual abuse, incest, and sexual exploitation agreed with Zaphiris's conceptualization but did not use this system of classification in actual…
Freet, Mary A.; Scalise, Joseph J.; Ginter, Earl J.
OBJECTIVE Community integration is integral to recovery for individuals with severe mentalillness. This study explored the integration of individuals with severe mentalillness into mental health and non-mental health communities and associations with mental health service intensity. METHODS Thirty-three ethnically diverse participants with severe mentalillness were categorized in high-intensity (N=18) or low-intensity (N=15) mental health service groups. Community integration was assessed with measures of involvement in community activities, social capital resources, social support, social network maps, and subjective integration. RESULTS Although participants rated themselves as being more integrated into the mental health community, their social networks and social capital were primarily derived from the non-mental health community. The high-intensity group had a higher proportion of members from the mental health community in their networks and had less overall social capital resources than the low-intensity group. CONCLUSIONS The findings suggest opportunities and possible incongruities in the experience of community integration. PMID:24733579
Pahwa, Rohini; Bromley, Elizabeth; Brekke, Benjamin; Gabrielian, Sonya; Braslow, Joel T; Brekke, John S
Evidence suggests that people with a severe mentalillness still suffer high levels of stigma and discrimination. However little is known about how people with a severe mentalillness manage such stigma. As such, the overall aim of this study is to document and analyze behavioral and psychological strategies of stigma management and control in a sample of people in recovery from a severe mentalillness. To meet this aim, we conducted a five-year (2008-2012) qualitative longitudinal study in Washington D.C. Participants were recruited from small-scale congregate housing units ('recovery communities') for people in recovery, provided by a public mental health agency. We conducted regular focus groups at these communities, augmented by in-depth participant observation. Analysis was propelled by the grounded theory approach. A key finding of this study is that stigma and discrimination were not perceived as commonly experienced problems by participants. Instead, stigma and discrimination were perceived as omnipresent potential problems to which participants remained eternally vigilant, taking various preventive measures. Most notable among these measures was a concerted and self-conscious effort to behave and look 'normal'; through dress, appearance, conduct and demeanor. In this endeavor, participants possessed and deployed a considered degree of agency to prevent, avoid or preempt stigma and discrimination. These efforts appeared to have a strong semiotic dimension, as participants reported their developing 'normality' (and increased agentic power) was tangible proof of their ongoing recovery. Participants also routinely discussed severe mentalillness in normative terms, noting its similarity to physical illnesses such as diabetes, or to generic mental health problems experienced by all. These behavioral and psychological strategies of normalization appeared to be consolidated within the recovery communities, which provided physical shelter and highly-valued peer support. This fostered participants' ability to face and embrace the outside world with confidence, pride and dignity. PMID:24602965
The October 2002 issue of Archives of Psychiatric Nursing reported on the design of a prison-based mental health program implemented during the mid 1990s. The aim of this program was to reduce debilitating symptoms and promote coping skills, thereby enhancing both the functional status and clinical management of mentallyill prisoners. This article presents a qualitative study of the same program conducted in 2001?2003, and describes critical issues facing mental health providers, correctional officers, and prisoners involved in this program today. Of key interest is how subsequent developments have eroded the original focus of the program.
Prior to the second world war, most persons confined in insane asylums were regarded as legally incompetent and had guardians appointed for them. Today, most persons confined in mental hospitals (or treated involuntarily, committed to outpatient treatment) are, in law, competent; nevertheless, in fact, they are treated as if they were incompetent. Should the goal of mental health policy be providing better psychiatric services to more and more people, or the reduction and ultimate elimination of the number of persons in the population treated as mentallyill?
This study characterizes adults who report being physically abused during childhood, and examines associations of reported type and frequency of abuse with adult mental health. Data were derived from the 2000-2001 and 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the U.S. population. Weighted means, frequencies, and odds ratios of sociodemographic correlates and prevalence of psychiatric disorders were computed. Logistic regression models were used to examine the strength of associations between child physical abuse and adult psychiatric disorders adjusted for sociodemographic characteristics, other childhood adversities, and comorbid psychiatric disorders. Child physical abuse was reported by 8% of the sample and was frequently accompanied by other childhood adversities. Child physical abuse was associated with significantly increased adjusted odds ratios (AORs) of a broad range of DSM-IV psychiatric disorders (AOR = 1.16-2.28), especially attention-deficit hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder. A dose-response relationship was observed between frequency of abuse and several adult psychiatric disorder groups; higher frequencies of assault were significantly associated with increasing adjusted odds. The long-lasting deleterious effects of child physical abuse underscore the urgency of developing public health policies aimed at early recognition and prevention. PMID:22806701
In this study, the attitudes toward and beliefs about serious mentalillness (SMI) held by a group of graduate social work students in the northwestern United States were examined. Mental health stigma was examined with relation to the following factors: participants' level of social contact with SMI populations, adherence to stereotypes about SMI…
This qualitative study explores strategies used by mental health providers (N = 17) to address substance use problems among seriously mentallyill (SMI) clients and their perspectives on barriers to treatment and how treatment can be improved. Providers identified numerous strategies. yet these were countered with perceptions of multiple obstacles, leaving them frustrated, helpless, and hopeless about their clients' substance
Amy A. Mericle; Jennifer Alvidrez; Barbara E. Havassy
Excesses associated with deinstitutionalization during the 1970s provided a legacy of homelessness, revolving door rehospitalization, and gridlock in metropolitan hospital emergency rooms. To allow for the seriously and persistently mentallyill to move planfully into community life, caregivers must utilize new and improved care models. One option is the HMO capitation model being tested in the Monroe\\/Livingston County Mental Health
This study examines the impact of mental health services on arrests of offenders with a serious mentalIllness (SMI) by assessing changes in associations between receipt of outpatient and emergency room\\/inpatient services and arrests one, two, and three quarters later. A variety of data sets were used for identifying 3,769 offenders who were in the Pinellas County Florida jail between
Robert J. Constantine; John Robst; Ross Andel; Gregory Teague
Objective To evaluate the impact of a mental health elective on pharmacy students' perceptions and stigmatizing views of mentalillness. Design An elective was designed that featured an advanced overview of psychopharmacology; student training in motivational interviewing; a presentation by the National Alliance on MentalIllness (NAMI) local chapter; introduction to pharmacy collaborations with peer support specialists, social workers, and psychiatrists; mock patient counseling sessions; and a required psychiatric patient interview at a local community mental health center. Assessment A survey instrument with 17 Likert-scale items was constructed to measure 2 distinct areas: social distance and stigmatizing views. The survey instrument was administered at the beginning and end of the spring 2010 semester to pharmacy students enrolled in the mental health elective course and to a control group of pharmacy students enrolled in an unrelated clinical elective. The course had a positive impact on pharmacy students' perceptions of mentalillnesses. Students' social distance and stigmatizing views of mentalillnesses improved, while no significant change in views occurred among students in the control group. Conclusion Advanced training in psychiatric medicine and exposure to mental health care are vital to prepare pharmacy students to provide unbiased, patient-centered care to this population.
Medication non-compliance, a pervasive problem among persons with serious, chronic mentalillness, has been linked to increased inpatient resources use in public mental health systems. The objective of this analysis was to determine which factors are associated with medication compliance in this population so that more appropriate screening and intervention programs can be designed. Using knowledge gained from clinical research
Attitudes towards mental patients influence the treatment they receive and decisions of policymakers. It is important to modify attitudes of students who may work with them. Psychopathology course students (45 visited a mental institution, 56 volunteered in it, and 12 neither) and 53 introductory psychology students participated in this study. Benevolence, mental hygiene etiology and interpersonal etiology (opinions about mentalillness scale) improved from beginning to end of year. Working proved more important than visiting or studying. Visiting increased social restrictiveness. Therefore, a small amount of exposure (a visit) can be detrimental. These results point to the possible superiority of prolonged, intimate exposure, on an equal basis, in changing attitudes towards mental health patients. PMID:15259629
Debate over the existence of mentalillness may be abandoned if its two components (first, the conceptual status of psychological variables determining deviance and second, society's response to individuals exhibiting certain behaviors) are disentangled. Disagreement actually centers around professional prerogatives and the legal/ethical status of…
In an effort to inform junior and senior high school students about mentalillness, this document provides educators with an annotated bibliography of young adult fiction and a set of supporting activities. Included in the bibliography are nearly 100 current fiction titles, grouped according to the following topics: anorexia, drugs and alcohol,…
This research explores the experiences of mentalillness stigma in 24 youth (58.3% male, 13-24 years, 75% Latino) in psychiatric outpatient treatment. Using Link and Phelan's (2001) model of stigmatization, we conducted thematic analysis of the interview texts, examining experiences of stigma at individual and structural levels, in addition to the…
Elkington, Katherine S.; Hackler, Dusty; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.
The data presented in the report on mentalillness in nursing homes are from the 1985 National Nursing Home Survey (NNHS). The Survey reports that 65.3 percent of all current nursing home residents (or 974,300 persons) had at least one condition that can ...
Stigmas toward those who have mentalillnesses are wide-spread and detrimental to the health and well-being of those suffering from these debilitating conditions, and to society as a whole. Stigma-reducing programs are plentiful but many are only marginally effective. In this paper we describe and evaluate a course in Psychopathology that included…
Barney, Steve T.; Corser, Grant C.; White, Lynn H.
Campus police officers are often among the initial contacts for behavioral incidents involving people with mentalillness. Their training and access to resources influence decisions to direct the individual to support services and/or through campus disciplinary processes and/or the criminal justice system. Over the past decade, there has been an…
Although medical research involving the use of persons with mentalillness is critically important, in order for the research to be ethical and legal there are certain considerations and restrictions which should be immediately readdressed in order to insure that the welfare of these vulnerable research subjects is protected, and their best interests are assured. A brief historical examination of
Transferring the care of mentallyill patients to the community is not a new initiative. The first comprehensive Hospital Plan by the Department of Health and Social Security (DHSS, 1962) recognized and recommended that areas of health care which did not need to take place in hospital should be carried out in the community. Some 30 years later, this transition is taking place. This transition has not been a smooth process and in certain cases it has failed. The public image of mentalillness has played a significant role in delaying the transfer of care to the community, although this is not the sole hindering factor. Poor liaison between health and social services, closure of hospitals before development of community facilities, inadequate community support and resources, and sensationalized media coverage have all been cited. Community care of mentallyill patients is a reality and it has been demonstrated that it can be well planned and properly funded (Faugier, 1993). Rather than dwelling on the shortcomings surrounding the implementation of community care, the way forward is to learn from mistakes and to identify means of increasing public acceptance of people suffering from mentalillness. PMID:8717828
Drawing on modified labeling theory and the reflected appraisals process and using longitudinal data from 129 mothers and their adult children with schizophrenia, we estimate models of the effects of mothers' stigmatized identity appraisals of their mentallyill children on reflected and self-appraisals, and how appraisals affect outcomes…
Markowitz, Fred E.; Angell, Beth; Greenberg, Jan S.
Objective: Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mentalillnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy…
This study investigated how people with persistent mentalillness who work or study, attend a community?based activity centre or have no regular activities, experience and describe the meaningfulness of their daily occupations. Data were gathered from 102 randomly selected individuals who were interviewed regarding their daily occupations and perceived meaningfulness using a ‘yesterday activity diary’. Content analysis revealed five main
In this study, the paths between two prejudicial atti- tudes (authoritarianism and benevolence) and a proxy measure of behavioral discrimination (social distance) were examined in a sample drawn from the general public Moreover, the effects of two person variables (familiarity with mentalillness and ethnicity) on prej- udice were examined in the path analysis. One hun- dred fifty-one research participants
Patrick W. Corrigan; Annette Backs Edwards; Amy Qreen; Sarah Lickey Thwart; David L. Perm
Concern has been expressed that negative attitudes toward people with mentalillnesses begin to develop early in childhood. This study examines one of the possible sources of learning of such negative attitudes--children's television programs. Two hundred sixty-nine (269) hours of children's television programming were videotaped, viewed, and…
Our paper provides an overview of current stigma discourse, the origins and nature of the stigma associated with mentalillnesses, stigmatization by health providers, and approaches to stigma reduction. This is a narrative review focusing on seminal works from the social and psychological literature, with selected qualitative and quantitative studies and international policy documents to highlight key points. Stigma discourse has increasingly moved toward a human rights model that views stigma as a form of social oppression resulting from a complex sociopolitical process that exploits and entrenches the power imbalance between people who stigmatize and those who are stigmatized. People who have a mentalillness have identified mental health and health providers as key contributors to the stigmatization process and worthy targets of antistigma interventions. Six approaches to stigma reduction are described: education, protest, contact-based education, legislative reform, advocacy, and stigma self-management. Stigma denigrates the value of people who have a mentalillness and the social and professional support systems designed to support them. It creates inequities in funding and service delivery that undermine recovery and full social participation. Mental health professionals have often been identified as part of the problem, but they can redress this situation by becoming important partners in antistigma work. PMID:22854027
This study examined the integration of two evidence-based practices for adults with severe mentalillness: Assertive community\\u000a treatment (ACT) and illness management and recovery (IMR) with peer specialists as IMR practitioners. Two of four ACT teams\\u000a were randomly assigned to implement IMR. Over 2 years, the ACT–IMR teams achieved moderate fidelity to the IMR model, but\\u000a low penetration rates: 47 (25.7%)
Michelle P. SalyersAlan; Alan B. McGuire; Angela L. Rollins; Gary R. Bond; Kim T. Mueser; Veronica R. Macy
Life goals and the opportunities that define them are impaired by the stigma of mentalillness. Three kinds of stigma may act as barriers to personal aspirations: public stigma, self-stigma, and label avoidance. Challenging mentalillness stigm is essential in helping individuals accomplish recovery-related goals. Public stigma may be changed through protest, education, and contact. Self-stigma can be addressed by fostering group identity, changing the perceived legitimacy of stigma through cognitive rehabilitation, and making strategic decisions about disclosing one's mental health history. Stigma change for label avoidance is not as well understood but may include the education and contact approaches used for public stigma. Evidence-based approaches to stigma change need to be substantiated by rigorous investigations. PMID:18251351
Background Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries. Aims To examine one central aspect of illness burden, the association of serious mentalillness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Method The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mentalillness were estimated. Results Respondents with serious mentalillness earned on average a third less than median earnings, with no significant between-country differences (?2(9) = 5.5–8.1, P = 0.52–0.79). These losses are equivalent to 0.3–0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations. Conclusions These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.
Levinson, Daphna; Lakoma, Matthew D.; Petukhova, Maria; Schoenbaum, Michael; Zaslavsky, Alan M.; Angermeyer, Matthias; Borges, Guilherme; Bruffaerts, Ronny; de Girolamo, Giovanni; de Graaf, Ron; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Karam, Aimee N.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Browne, Mark Oakley; Okoliyski, Michail; Posada-Villa, Jose; Sagar, Rajesh; Viana, Maria Carmen; Williams, David R.; Kessler, Ronald C.
Specialized transitional shelters are available in various cities to provide assistance to homeless individuals with serious mentalillness. Little is known about the population using such shelters. The authors conducted a retrospective chart review to collect demographic, social, and clinical data of residents in a state-operated mental health transitional shelter in Massachusetts. A total of 74 subjects were included. Schizophrenia-spectrum disorders were present in 67.6 % of the sample and mood disorders in 35.1 %. Substance use disorders were documented in 44.6 %. Chronic medical illness (mostly hypertension, dyslipidemia, asthma, and diabetes) was found in 82.4 %. The co-occurrence of a psychiatric and substance use disorder and chronic medical illness was found in 36.5 %. The majority (75.7 %) of patients had a history of legal charges. Homeless individuals with serious mentalillness served by specialized transitional shelters represent a population with complex psychiatric, medical and social needs. PMID:23703373
The present qualitative study examined the personal accounts, elicited via semi-structured interview, of nine United States military veterans with serious mentalillness to describe their knowledge, attitudes, and beliefs about psychiatric genetics, genetic testing and counseling for mentalillness. The aim of the research was to elucidate issues from the perspective of adults with mentalillness that may inform the education and training of mental health providers on basic genetic counseling. Findings suggest that participants had some basic knowledge about genetics, were interested in psychiatric genetic testing, and had an awareness of both positive and negative aspects of genetic test results. Participants tended to have overly optimistic ideas about current advances in psychiatric genetics and were motivated to undergo genetic testing for the good of their families and to benefit society. Implications of findings for research and practice are discussed. PMID:21394471
Potokar, Danielle N; Stein, Catherine H; Darrah, Olivia A; Taylor, Brent C; Sponheim, Scott R
This study tests a social psychological model (Skitka & Tetlock, 1992). Journal of Experimental Social Psychology, 28, 491-522; . Journal of Personality & Social Psychology, 65, 1205-1223 stating that policy maker decisions regarding the allocation of resources to mental health services are influenced by their attitudes towards people with mentalillness and treatment efficacy. Fifty four individuals participated in a larger study of education about mental health stigma. Participants completed various measures of resource allocation preferences for mandated treatment and rehabilitation services, attributions about people with mentalillness, and factors that influence allocation preferences including perceived treatment efficacy. Results showed significant attitudinal correlates with resource allocation preferences for mandated treatment, but no correlates to rehabilitation services. In particular, people who pity people with mentalillness as well as those that endorse coercive and segregated treatments, were more likely to rate resource allocation to mandated care as important. Perceived treatment efficacy was also positively associated with resource allocation preferences for mandated treatment. A separate behavioral measure that involved donating money to NAMI was found to be inversely associated with blaming people for their mentalillness and not being willing to help them. Implications of these findings on strategies that seek to increase resources for mental health programs are discussed. PMID:15453083
Large numbers of individuals in U.S. prisons meet DSM criteria for severe psychiatric disorder. These individuals also have co-occurring personality and substance abuse disorders, medical conditions, and histories of exposure to social pathologies. Based on nine months of ethnographic fieldwork in a U.S. prison, focusing on staff narratives, I utilize interpretivist and constructivist perspectives to analyze how mental health clinicians construct psychiatric disorder among inmates. Discrete categorization of disorders may be confounded by the clinical co-morbidities of inmates and the prison context. Incarcerated individuals’ responses to the institutional context substantially inform mental health staffs’ illness construction and the prison itself is identified as an etiological agent for disordered behaviors. In addition, diagnostic processes are found to be indeterminate, contested, and shaped by interactions with staff. Analysis of illness construction reveals that what is at stake for clinicians is not only provision of appropriate treatment, but also mandates for the safety and security of the institution. Enmeshed in these mandates, prison mental health becomes a particular local form of psychiatric knowledge. This paper contributes to anthropological approaches to mental disorder by demonstrating how local contexts mediate psychiatric knowledge and contribute to the limited ethnographic record of prisons.
Background The current investigation examined the psychometric properties of the Internalized Stigma of MentalIllness (ISMI) scale in a sample of patients with mentalillness. In addition to the internal consistency, test-retest reliability, and concurrent validity that previous studies have tested for the ISMI, we extended the evaluation to its construct validity and measurement invariance using confirmatory factor analysis (CFA). Methods Three hundred forty-seven participants completed two questionnaires (i.e., the ISMI and the Depression and Somatic Symptoms Scale [DSSS]), and 162 filled out the ISMI again after 50.23±31.18 days. Results The results of this study confirmed the frame structure of the ISMI; however, the Stigma Resistance subscale in the ISMI seemed weak. In addition, internal consistency, test-retest reliability, and concurrent validity were all satisfactory for all subscales and the total score of the ISMI, except for Stigma Resistance (??=?0.66; ICC?=?0.52, and r?=?0.02 to 0.06 with DSSS). Therefore, we hypothesize that Stigma Resistance is a new concept rather than a concept in internalized stigma. The acceptable fit indices supported the measurement invariance of the ISMI across time, and suggested that people with mentalillness interpret the ISMI items the same at different times. Conclusion The clinical implication of our finding is that clinicians, when they design interventions, may want to use the valid and reliable ISMI without the Stigma Resistance subscale to evaluate the internalized stigma of people with mentalillness.
Objective: Adolescent mentalillness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may provide a stigma-reduction strategy. This article reports an investigation of this hypothetical…
Hanson, Mark D.; Johnson, Samantha; Niec, Anne; Pietrantonio, Anna Marie; High, Bradley; MacMillan, Harriet; Eva, Kevin W.
A growing body of literature on the subjective experiences of people with severe mentalillness (SMI) reveals the importance of the experience of self. The current study explored how the course of SMI is related to individuals' subjective experience of self. Bimonthly, comprehensive, semi-structured interviews with 43 people who had been discharged from psychiatric hospitalization were conducted over a 1-year period. Qualitative analysis of the data revealed mutual influences between the experience of self and illness over time. Conceptual and clinical implications of the relation between self and illness are discussed. PMID:16422276
Sexual abuse in the mentally retarded population has often been under-reported and children and youth with such a handicap are at a greater risk of becoming victims. This article reviews the problem of sexual abuse among children and youth with mental retardation and attempts to explain why they are particularly vulnerable. The prevalence of sexual abuse can be as many
According to the modified labeling theory of mentalillness, when an individual is diagnosed with a mentalillness, cultural ideas associated with the mentallyill become personally relevant and foster negative self-feelings. We explore the way that psychiatric diagnosis shapes this process. Specifically, we examine if and how psychiatric…
Reports on results of Community Attitudes Toward MentallyIll questionnaire given to undergraduates. Significant differences emerged on subscales based ranking of primary source of information about mentalillness. Results do not imply causality but rather that electronic media is powerful mechanism for spreading the stigma of mentalillness.…
Granello, Darcy Haag; Pauley, Pamela S.; Carmichael, Ann
This guide provides curriculum lessons for the upper elementary school student that put a human face on mentalillness and confront myths passed on from one generation to the next. One in five children will be affected by mentalillness at some point in their lives. The goal of these lessons is help students understand that severe mentalillnesses…
Previous inattention to the specific circumstances of homeless mentallyill individuals in general hospital settings is discussed. Homeless mentallyill individuals who presented for emergency psychiatric care in a public general hospital setting exhibited distinctive patterns of service utilization and showed evidence of being a uniquely disabled, rootless, and impoverished subgroup of mentallyill individuals. The characteristics of homeless users
Leona L. Bachrach; Jose M. Santiago; Michael R. Berren
This guide contains all of the information, support and tools that community members need to implement "Talking About MentalIllness" in their community--an awareness program proven to be effective in bringing about positive change in young people's knowledge about mentalillness, and in reducing stigma that surrounds mentalillness. The program…
Title: Interpersonal contact and the stigma of mentalillness: A review of the literature Background. Stigmatization of mentalillness is widespread in Western societies (Crisp et al., 2001) and other cultures (Chung et al., 2001). Furthermore, researchers have found that stigma is detrimental to the well being of persons with a mentalillness (Wahl, 1999), potentially resulting in decreased life
The use of psychiatric hospitalization for mentalillness has evolved through Modernity. In the last century, indefinite and involuntary committal was a widespread practice but has now become an extraordinary and short-term therapeutic recourse. Even though law experts, doctors and other mental health professionals agree on the benefits of this shift, in practice there are disagreements rooted in the shortcomings of health service providers. The current medical and legal criteria for hospitalization of patients with mental disorders should move away from the concept of endangerment and embrace therapeutic procedures and social care. New contemporary challenges, such as drugs and violence, require the implementation of a social strategy that is more comprehensive than medical treatment. This article presents a series of case studies describing the circumstances that led to the hospitalization of mental health patients, mostly in the city of Buenos Aires. PMID:22091456
Context/Background: Epidemiological data have long been considered essential for documenting incidence of disability and planning services. India has been conducting census operations for a long time, and this information may be relevant in the current context. Aims: To document the prevalence of insanity, and discussions about treatment and disability arising out of mentalillness in India (1850-1950). Settings and Design: The material used was located at the British Library and the Wellcome Library, London; the Teen Murti Library, Delhi, and web-based archives. Materials and Methods: We have retrieved and summarized the coverage of psychiatric illness in previous census reports from the 19th and 20th century. Statistical Analysis: None, this relies upon historical archives and documents. Results and Conclusions: Differences in incidence and prevalence of insanity, as well as biological and psycho-social factors in the causation, and outcomes, of mentalillness are all discussed in these census reports. Comparisons are often drawn to other countries and cultures, and impressions drawn about these differences and similarities. Similar concerns persist to this day. Disabilities and mentalillness were not enumerated since the census of 1941 and have been restored only recently, and this lacuna has hampered planning in the post-Independence era. As we debate policy and plan interventions using contemporary census data, it may be useful to remind ourselves of the issues, then and now.
The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mentalillness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although meta-analytic results are based on a small sample of available studies, results suggest interventions with offenders with mentalillness effectively reduced symptoms of distress, improving offender’s ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mentalillness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted.
Morgan, Robert D.; Flora, David B.; Kroner, Daryl G.; Mills, Jeremy F.; Varghese, Femina; Steffan, Jarrod S.
The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mentalillness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although meta-analytic results are based on a small sample of available studies, results suggest interventions with offenders with mentalillness effectively reduced symptoms of distress, improving offender's ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mentalillness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted. PMID:22471384
Morgan, Robert D; Flora, David B; Kroner, Daryl G; Mills, Jeremy F; Varghese, Femina; Steffan, Jarrod S
Efforts to foster mental health care in society have always been hampered by the stigma attached to mentalillness. To identify differential patterns of attitude hierarchies among people who live in or provide mental health services in a typical urban area, 54 adults participated in a Q methodology study of their attitudes toward mentalillness.…
This paper reports part of the results of a study of hope in mentalillness. The focus of this paper is on the mental health worker's role in fostering and maintaining a sense of hope in people with serious mentalillness. Six experienced mental health workers report on the strategies they use to foster and maintain hope in their clients;
"Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" reviews theory and research on stigma and mental health with a focus on the stigmatization of mentalillness in the family when either a child or a parent has a mentalillness.…
Research and Training Center on Family Support and Children's Mental Health, 2005
Contents: Scope and magnitude of the problem; The criminalization of the mentallyill; The stresses of confinement; Mental health problems of jail inmates; Provision of mental health services in jails; Indications for transfer to a hospital; Follow-up ser...
BACKGROUND: Disparities among African Americans and Whites with severe mentalillness have been identified in numerous studies. Yet it remains unknown if disparities are associated with race or other vulnerabilities common to this population. OBJECTIVES: This study used the Behavioral Model for Vulnerable Populations to examine mental health service utilization among 155 African Americans and Whites with severe mentalillness
Michelle DeCoux Hampton; Linda Chafetz; Mary C. White
"SAMHSA News" is the national newsletter of the Substance Abuse and Mental Health Services Administration. Published six times a year (bimonthly) by SAMHSA's Office of Communications, SAMHSA News contains information about the latest substance abuse and mental health treatment and prevention practices, recent statistics on mental health and…
Background Interpersonal trauma exposure and trauma-related disorders in people with severe mentalillness (SMI) are often not recognized in clinical practice. Objective To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods We conducted a systematic review of four databases (1980–2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%), sexual abuse 37% (range 24–49%), and posttraumatic stress disorder (PTSD) 30% (range 20–47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.
Mauritz, Maria W.; Goossens, Peter J. J.; Draijer, Nel; van Achterberg, Theo
A consortium of social services agencies developed a comprehensive community mental health services program for homeless mentallyill offenders in Portland, Oregon. Residential services were provided in a single-room-occupancy hotel. Forty-seven clients were accepted for the program, 38 actually entered the program, and 14 graduated--that is, attained sobriety and were placed in community housing. Problems complicating program implementation included differing philosophical approaches of key agencies, staff turnover, and financial shortfalls. Many potential clients were not accepted into the program because of recent violence or potential violence; some clients were expelled or reincarcerated because of violent behavior. PMID:7712258
The study examined the flow of a state mental health agency's case-managed clients into its forensic mental health court clinic systems for evaluation of competency to stand trial (CST) for a criminal offense. An analysis of merged encounter data from the case management and court clinic systems revealed that roughly 2% of the case-managed population were referred to court clinics for evaluation of CST during a 1-year period, but that these 2% represented roughly one eighth of that year's court clinic evaluees. The likelihood of this involvement was higher for males, African-Americans, and Latinos, and for persons with a history of substance abuse, and also was associated with higher levels of previous hospitalization. In addition, CST evaluees were more likely to be non-White, male, and uninsured than were case-managed evaluees. These data indicate that demographic characteristics, substance abuse, and lack of insurance are potential risk factors for forensic and, by inference, criminal justice system involvement among persons with mentalillness. PMID:11254069
Fisher, W H; Packer, I K; Grisso, T; McDermeit, M; Brown, J M
Medication noncompliance contributes significantly to recurrence of symptoms and readmission to the hospital of schizophrenic patients. The purpose of this study was to determine factors identified by patients, family members, and nurses for patients' noncompliance. The Health Belief Model provided a theoretical framework. The sample consisted of 11 triads with a noncompliant schizophrenic patient, a family member, and a primary nurse in each triad. A structured interview was developed to assess stated reasons for noncompliance and factors relating to the patient's illness, medication practices, stressors, life-style, and support systems. Results showed that many patients stated they did not need medication or needed less than the amount prescribed. Family members and nurses agreed that the majority of patients did not believe that they needed medication. When asked if they thought they had a mentalillness, most patients denied that they were ill. Other stated reasons for noncompliance were drug/alcohol use, and, for one patient, medication side effects. Additional findings were patients' low self-esteem; lack of knowledge about medications; inability to identify stressors in patients' lives; inability to identify early symptoms of relapse; patients' need for support from families; and families' stress from patients' abusive, unpredictable behavior. Use of the Health Belief Model is appropriate to study noncompliance in mentallyill patients if perception of illness threat is assessed. Conclusions were that patients and families could benefit from more knowledge of schizophrenia and its treatment, more awareness of stressors and signs of relapse, and improved mutual problem solving. Studies are needed to assess the effects of patients' denial of illness, denial of need for medication, and self-image/self-esteem on medication noncompliance. PMID:1399520
Proceedings from a conference on health and mental health agency roles in the identification and treatment of spouse abuse are presented. Introductory remarks discuss spouse abuse as a family, social, and public health problem and as a reflection of socie...
Research on families dealing with mentalillness has considered either positive or negative aspects of intergenerational family relationships. The current study extends this work by using intergenerational ambivalence theory to examine aging mothers' contradictory expectations toward adult daughters who are mentallyill. This study focuses on interviews obtained from a sample of 22 mothers aged 52-90 who expressed considerable sociological ambivalence in relation to their grown daughters. Four strategies of managing ambivalence are identified: excusing behaviors, reducing expectations, adjusting help-giving, and confronting. The implications are that practitioners should be aware of intergenerational ambivalence, help aging parents identify their ambivalence management strategies, and assess the extent to which these strategies are adaptive. Future research directions in this area are also discussed. PMID:21686064
Suicide prevention efforts are a major focus of psychiatry residency training. Residents are taught to identify suicide risk factors, monitor for suicidal ideation, and develop crisis stabilization plans for patients at risk for self harm. In contrast, training and support for dealing with suicide completion is often lacking. Although suicide remains a predictable outcome for many patients with severe mentalillness, this topic may be avoided or reviewed only with residents who are directly affected by patient suicide. The purpose of this paper is to present a psychiatry resident's experience of dealing with a patient suicide and identify obstacles to developing this aspect of training. Options for "preventative" training in helping trainees deal with this unfortunate outcome of mentalillness will be reviewed. PMID:14535611
There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mentalillness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well-received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mentalillness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority. PMID:23211053
This review intends to determine the extent to which a serious mentalillness (SMI) interferes with reproductive health (RH).\\u000a The primary focus is the question of whether or not, women with SMI are at high risk for sexually transmitted infections,\\u000a female cancer, unwanted pregnancies, and sexual dysfunction. Eighty-four original studies published 1971–2008 are identified\\u000a through database, journal and Internet searches
The present study examined messages about mentalillness in 14 contemporary Christian self-help bestsellers. Content analysis revealed that most texts focused upon depression. Categories of textual units included Underlying Assumptions Regarding Depression, Representations of Depression, Roots\\/Causes\\/Reasons for Depression, and Christian Responses to Depression. Demonic influence was the most frequently cited reason for depression. Other reasons included negative cognitions, failure as
Self-stigma can undermine self-esteem and self-efficacy of people with serious mentalillness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with…
Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rusch, Nicolas
Background There is ample evidence that both intimate-partner violence (IPV) and childhood abuse adversely affect the physical and mental health of adult women over the long term. Objective The authors assessed the associations between abuse, symptoms, and mental health utilization. Method The authors performed a cross-sectional survey of 380 adult female, internal-medicine patients. Results Although both IPV and childhood abuse were associated with depressive and physical symptoms, IPV was independently associated with physical symptoms, and childhood abuse was independently associated with depression. Women with a history of childhood abuse had higher odds, whereas women with IPV had lower odds, of receiving care from mental health providers. Conclusion IPV and childhood abuse may have different effects on women’s symptoms and mental health utilization.
In a historic effort to reduce the stigma of mentalillness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mentalillness and in the individual experience of stigma. We examined the context, planning, programming, and evaluation of this effort. PMID:23488486
Clark, Wayne; Welch, Stephanie N; Berry, Sandra H; Collentine, Ann M; Collins, Rebecca; Lebron, Dorthy; Shearer, Amy L
Objective The World Health Organization Quality of Life (WHOQOL-100) questionnaire is a generic quality of life (QoL) measurement tool used in various cultural and social settings and across different patient and healthy populations. The present study examines the psychometric properties of the Greek version, with an emphasis on the ability of the instrument to capture QoL differences between mentallyill, physically ill and healthy individuals. Methods A total of 425 Caucasian participants were tested, as to form 3 groups: (a) 124 psychiatric patients (schizophrenia n = 87, alcohol abuse/dependence n = 37), (b) 234 patients with physical illness (hypertension n = 139, cancer n = 95), and (c) 67 healthy control individuals. Results Confirmatory factor analysis was performed indicating that a four-factor model can provide an adequate instrument structure for the participating groups (GFI 0.92). Additionally, internal consistency of the instrument was shown to be acceptable, with Cronbach's ? values ranging from 0.78 to 0.90 regarding the four -domain model, and from 0.40 to 0.90 regarding the six-domain one. Evidence based on Pearson's r and Independent samples t-test indicated satisfactory test/retest reliability, as well as good convergent validity tested with the General Health Questionnaire (GHQ-28) and the Life Satisfaction Inventory (LSI). Furthermore, using Independent samples t-test and one-way ANOVA, the instrument demonstrated good discriminatory ability between healthy, mentallyill and physically ill participants, as well as within the distinct patient groups of schizophrenic, alcohol dependent, hypertensive and cancer patients. Healthy individuals reported significantly higher QoL, particularly in the physical health domain and in the overall QoL/health facet. Mentallyill participants were distinctively differentiated from physically ill in several domains, with the greatest difference and reduction observed in the social relationships domain and in the overall QoL/health facet. Within the four distinct patient groups, alcohol abuse/dependence patients were found to report the most seriously compromised QoL in most domains, while hypertensive and cancer patients did not report extensive and significant differences at the domain level. However, significant differences between patient groups were observed at the facet level. For example, regarding the physical domain, physically ill participants reported more compromised scores in the pain/discomfort facet, while mentallyill participants in the facets of energy/fatigue, daily living activities and dependence on medication. Conclusion The findings of the study indicate that the Greek version of WHOQOL-100 provided satisfactory psychometric properties supporting its use within general and pathological populations and in the context of national and crosscultural QoL measurement.
Ginieri-Coccossis, Maria; Triantafillou, Eugenia; Tomaras, Vlasis; Liappas, Ioannis A; Christodoulou, George N; Papadimitriou, George N
This article describes a study undertaken to determine the prevalence of human immunodeficiency virus (HIV) infection and risk factors associated with HIV infection in a chronically mentallyill population. Patients were eligible for inclusion in the survey at their first outpatient or inpatient admission to a Maryland state psychiatric hospital between August 1990 and July 1991. Demographic and risk behavior information was collected, and unlinked HIV antibody testing was performed on blood specimens drawn for routine clinical purposes. Of 533 patients surveyed, 31 patients (5.8%) were infected with HIV. The prevalence of HIV infection was 36.4% among female patients reporting intravenous drug use and 14.5% among their male counterparts. The prevalence of HIV infection among homeless patients was 10.1%; 88.9% of those HIV infected also reported intravenous drug use. On admission, 90% of patients reported no knowledge of their HIV antibody status; 4.1% of these patients were HIV infected. The data confirmed the risk of HIV infection in this population of chronically mentallyill individuals. Risk reduction programs designed specifically for individuals with chronic mentalillness need to be developed.
Self-stigma can undermine self-esteem and self-efficacy of people with serious mentalillness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mentalillness completed measures of coming out (called the Coming Out with MentalIllness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person’s quality of life are discussed.
Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rusch, Nicolas
Objectives Mentalillness is prevalent among nursing home residents, but staff are not well trained to deal with it. This research evaluated an Internet mentalillness training program designed for certified direct care workers i.e., Nurse Aides (NAs). Pilot research was also conducted to explore effects and acceptance of the same program with a sample of Licensed Health Professionals (LHPs). Design Trial 1: Pre-post randomized treatment and control design for NAs; Trial 2: Quasi-experimental pre-post within-subjects design for LHPs. Setting Both studies were conducted on the Internet. Participants Trial 1: N=62 NAs; Trial 2: N=16 LHPs Intervention Internet-based behavioral skills training and knowledge building, using video modeling with mastery learning instructional design. Measurements Video situations testing and assessment of psycho-social constructs associated with behavior change; follow-up interviews with a sample of treatment NAs. Results Trial 1: MANCOVA analysis showed positive results (p=.003) for knowledge, attitudes, self efficacy, and behavioral intention, with medium-large effect sizes. The training was well received by the users. Trial 2: Paired t-tests showed significant effects on five of six outcome measures, with medium-large effect sizes, and it was well received by the LHP sample. Conclusions Internet training can be an effective approach to help staff work with residents with mentalillness. In this research, it showed significant positive effects and was well received by NAs and by LHPs.
Irvine, A. Blair; Billow, Molly B.; Bourgeois, Michelle; Seeley, John R.
This study examines the impact of mental health services on arrests of offenders with a serious mentalIllness (SMI) by assessing\\u000a changes in associations between receipt of outpatient and emergency room\\/inpatient services and arrests one, two, and three\\u000a quarters later. A variety of data sets were used for identifying 3,769 offenders who were in the Pinellas County Florida jail\\u000a between
Robert J. Constantine; John Robst; Ross Andel; Gregory Teague
OBJECTIVES The objectives of the systematic review were to estimate the prevalence and correlates of criminal behavior, contacts with the criminal justice system, and victimization among homeless adults with severe mentalillness. METHODS MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Web of Science were searched for published empirical investigations of prevalence and correlates of criminal behavior, contacts with the justice system, and episodes of victimization in the target population. RESULTS The search yielded 21 studies. Fifteen examined prevalence of contacts with the criminal justice system; lifetime arrest rates ranged between 62.9% and 90.0%, lifetime conviction rates ranged between 28.1% and 80.0%, and lifetime incarceration rates ranged between 48.0% and 67.0%. Four studies examined self-reported criminal behavior, with 12-month rates ranging from 17.0% to 32.0%. Six studies examined the prevalence of victimization, with lifetime rates ranging between 73.7% and 87.0%. Significant correlates of criminal behavior and contacts with the justice system included criminal history, high perceived need for medical services, high intensity of mental health service use, young age, male gender, substance use, protracted homelessness, type of homelessness (street or shelter), and history of conduct disorder. Significant correlates of victimization included female gender, history of child abuse, and depression. CONCLUSIONS Rates of criminal behavior, contacts with the criminal justice system, and victimization among homeless adults with severe mentalillness are higher than among housed adults with severe mentalillness. PMID:24535245
Roy, Laurence; Crocker, Anne G; Nicholls, Tonia L; Latimer, Eric A; Ayllon, Andrea Reyes
Background In high income countries, over the last three decades, the length of hospital stays for people with serious mentalillness has reduced drastically. Some argue that this reduction has led to revolving door admissions and worsening mental health outcomes despite apparent cost savings, whilst others suggest longer stays may be more harmful by institutionalising people to hospital care. Objectives To determine the clinical and service outcomes of planned short stay admission policies versus a long or standard stay for people with serious mentalillnesses. Search methods We searched the Cochrane Schizophrenia Group’s register of trials (July 2007). Selection criteria We included all randomised trials comparing planned short with long/standard hospital stays for people with serious mentalillnesses. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a fixed effects model. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. For continuous data, we calculated fixed effects weighted mean differences (WMD). Main results We included six relevant trials. We found no significant difference in hospital readmissions between planned short stays and standard care at one year (n=651, 4 RCTs, RR 1.26 CI 1.0 to 1.6). Short hospital stay did not confer any benefit in terms of ’loss to follow up compared with standard care (n=453, 3 RCTs, RR 0.87 CI 0.7 to 1.1). There were no significant differences for the outcome of ’leaving hospital prematurely’ (n=229, 2 RCTs, RR 0.77 CI 0.3 to 1.8). More post-discharge day care was given to participants in the short stay group (n=247, 1 RCT, RR 4.52 CI 2.7 to 7.5, NNH 3 CI 2 to 6) and people from the short stay groups were more likely to be employed at two years (n=330, 2 RCTs, RR 0.61 CI 0.5 to 0.8, NNT 5 CI 4 to 8). Economic data were few but, once discharged, costs may be more for those allocated to an initial short stay. Authors’ conclusions The effects of hospital care and the length of stay is important for mental health policy. We found limited data, although outcomes do suggest that a planned short stay policy does not encourage a ’revolving door’ pattern of admission and disjointed care for people with serious mentalillness. More large, well-designed and reported trials are justified.
The roles of the mental health professional in child abuse and neglect identification, treatment, and prevention are delineated. Specifically, the manual focuses on why mental health professionals should be involved in the child protection system, how to ...
J. W. Lauer I. S. Lourie M. K. Salus D. D. Broadhurst
Background Adults aged 65 and older with severe mentalillnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mentalillnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. Methods We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. Discussion This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mentalillnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. Trial Registration The Netherlands National Trial Register NTR1620
...with mentalillness requires specialized...for the State mental health authority...program for mentalillness as defined in...history and physical examination...history and physical examination...designate the mental health professionals...diagnosis of mentalillness and...
...with mentalillness requires specialized...for the State mental health authority...program for mentalillness as defined in...history and physical examination...history and physical examination...designate the mental health professionals...diagnosis of mentalillness and...
The authors review the evolution of the treatments for persons with severe mentalillnesses over the past 40 years in three areas: pharmacological and other somatic treatments, psychosomatic treatments, and rehabilitation. Current treatments are based on a much stronger evidence base, are more patient-centered, and are more likely to target autonomy and recovery.
Robert E. Drake; Alan I. Green; Kim T. Mueser; Howard H. Goldman
Realization that families are providing a major portion of the care for people with a severe and persistent mentalillness has led to attempts to form an alliance with such families. Many professionals are aware that there is much cognitive distance between families and the professional community. Bridging this gap requires knowledge of the subjective experience of families. This paper
This paper deals with the technical development of an attitude-scale technique and with some of the substantive results obtained using this technique. The first section describes the methodological research and the most recent version of the attitude toward mentalillness scale. A total of six new types of attitude items were generated from…
A large body of research has documented public attitudes toward people with mentalillness. The current attitudes of the people who provide services to those with psychiatric disorders are important to understand, as well. The authors review what studies over the past 5 years reveal about the attitudes of psychiatric professionals. Empirical…
... Evaluating whether an individual with mentalillness requires specialized services... Evaluating whether an individual with mentalillness requires specialized services...and process requirements for the State mental health authority, which is...
This article examines the historical and contextual factors that are related to the growing numbers of persons with mentalillness who are processed through the criminal justice system. The paper discuss five major mental health and criminal justice policies that frame the challenges associated with the mentallyill in the criminal justice system: deinstitutionalization (a shift in the locus of
Social work principles of strengths, empowerment, and consumer-centered care for persons with mentalillness are currently being adapted to broader contexts. This article presents study findings on practice wisdom about custodial parents with mentalillness, a potentially increasing group of consumers in light of mental health reform. The research…
Women with severe and persistent mentalillness (e.g., schizophrenia, bipolar disorder) are at enhanced risk for sexual coercion and several resulting sexual health complications. We examine the prevalence and types of sexual coercion encountered by women with severe and persistent mentalillness and provide recommendations for interventions to reduce the prevalence of sexual coercion. Mental health professionals working with this
Lance S Weinhardt; Nicole L Bickham; Michael P Carey
Family services and intervention for persons with mentalillness is crucial in mental health services. In this paper, the writer attempts to describe family intervention and services for persons with mentalillness in the People's Republic of China. Family intervention and services like home-based care, guardianship network, family counseling, and…
Describes an outdoor adventure camp to help mental health consumers and nursing students explore the issues of mental health and illness through experiential and perceived risk challenges. Evaluation data reveals a breakdown in the stigma of mentalillness as consumers and students came to know, trust, and count on each other in order to succeed…
Background. Conduct disorder (CD) prior to age 15 has been associated with an increased risk of aggressive behaviour and crime among men with schizophrenia. The present study aimed to replicate and extend this finding in a clinical sample of severely mentallyill men and women. Method. We examined a cohort of in-patients with severe mentalillness in one mental health
Background: Reducing stigma associated with mentalillness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mentalillness, as compared with…
The notion of recovery has been embraced by key stakeholders across Canada and elsewhere. This has led to a proliferation of definitions, models, and research on recovery, making it vitally important to examine the data to disentangle the evidence from the rhetoric. In this paper, first we ask, what do people living with severe mentalillness (SMI) say about recovery in autobiographical accounts? Second, what do they say about recovery in qualitative studies? Third, from what we have uncovered about recovery, can we learn anything from quantitative studies about proportions of people leading lives of recovery? Finally, can we identify interventions and approaches that may be consistent or inconsistent with the grounded notions of recovery unearthed in this paper? We found that people with mentalillness frequently state that recovery is a journey, characterized by a growing sense of agency and autonomy, as well as greater participation in normative activities, such as employment, education, and community life. However, the evidence suggests that most people with SMI still live in a manner inconsistent with recovery; for example, their unemployment rate is over 80%, and they are disproportionately vulnerable to homelessness, stigma, and victimization. Research stemming from rehabilitation science suggests that recovery can be enhanced by various evidence-based services, such as supported employment, as well as by clinical approaches, such as shared decision making and peer support. But these are not routinely available. As such, significant systemic changes are necessary to truly create a recovery-oriented mental health system. PMID:25007276
Since the recent shootings in Tucson, Arizona; Aurora, Colorado; and Newtown, Connecticut, there has been an ever-increasing state and national debate regarding gun control. All 3 shootings involved an alleged shooter who attended college, and in hindsight, evidence of a mentalillness was potentially present in these individuals while in school. What appears to be different about the current round of debate is that both pro-gun control and anti-gun control advocates are focusing on mentallyill individuals, early detection of mentalillness during school years, and the interactions of such individuals with physicians and the mental health system as a way to solve gun violence. This raises multiple questions for our profession about the apparent increase in these types of events, dangerousness in mentallyill individuals, when to intervene (voluntary vs involuntary), and what role physicians should play in the debate and ongoing prevention. As is evident from the historic Tarasoff court case, physicians and mental health professionals often have new regulations/duties, changes in the physician-patient relationship, and increased liability resulting from high-profile events such as these. Given that in many ways the prediction of who will actually commit a violent act is difficult to determine with accuracy, physicians need to be cautious with how the current gun debate evolves not only for ourselves (eg, increased liability, becoming de facto agents of the state) but for our patients as well (eg, increased stigma, erosion of civil liberties, and changes in the physician-patient relationship). We provide examples of potential troublesome legislation and suggestions on what can be done to improve safety for our patients and for the public. PMID:24138962
Hall, Ryan Chaloner Winton; Friedman, Susan Hatters
Latinos, and Puerto Ricans in particular, have been disproportionately impacted by HIV/AIDS. Severe mentalillness (SMI) is associated with an increase in HIV risk. Relatively little research has focused on the role of SMI among Puerto Rican injection drug users (IDUs) and non-IDUs in susceptibility to and transmission of HIV and there are few published reports on HIV risk among Latina SMI. We conducted a longitudinal mixed methods study with 53 Puerto Rican women with schizophrenia, bipolar disorder, or major depression to examine the cultural context of HIV risk and HIV knowledge, beliefs, and behaviors among a larger study with Puerto Rican and Mexican women with serious mentalillness (SMI). There was a high prevalence of past and current substance use and a high prevalence of substance use-associated HIV risk behaviors, such as unprotected sexual relations with an IDU. The violence associated with substance use frequently increased participants’ HIV risk. Choice of substance of abuse depended on cost, availability, and use within the individual participant's network. Participants attributed their substance use to the need to relieve symptoms associated with their mentalillness, ameliorate unpleasant feelings, and deaden emotional pain. HIV prevention interventions for poorer Puerto Rican women with SMI must target the individuals themselves and others within their networks if the women are to be supported in their efforts to reduce substance use-related risk. The content of any intervention must address past and current trauma and its relationship to substance use and HIV risk, as well as strategies to prevent HIV transmission.
An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses ("abuses") of the concept of recovery: recovery is the latest model; recovery does not apply to "my" patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship. PMID:24497237
Objective Community integration is recognized as a crucial component of recovery from serious mentalillness. Although the construct of community integration can be measured with structured instruments, little is known about the subjective and experiential meaning of community and community involvement for persons with serious mentalillness. Methods In 2010, 30 individuals with serious mentalillness treated in two public mental health clinics completed semistructured interviews that elicited the places and people that they associate with the experience of community and the larger meaning of community in their lives. Results Participants described four experiences as integral to their concepts of community: receiving help, minimizing risk, avoiding stigma, and giving back. Participants looked for communities that provide reliable support, and they described the need to manage community contact in order to protect themselves and others from their symptoms and from discrimination. Most participants experienced communities centered on mental health treatment or mentallyill peers as providing opportunities for positive engagement. Conclusions The experience of having a serious mentalillness shapes preferences for and perceptions of community in pervasive ways. Participants describe community involvement not as a means to move away from illness experiences and identities but as a process that is substantially influenced by them. Mental health communities may help individuals with serious mentalillness to both manage their illness and recognize and enjoy a sense of community. The findings indicate the need for further research on the relationship between community integration and outcome in serious mentalillness.
Bromley, Elizabeth; Gabrielian, Sonya; Brekke, Benjamin; Pahwa, Rohini; Daly, Kathleen A.; Brekke, John S.; Braslow, Joel T.
This study sought to understand the experience of “hitting bottom” from the perspective of 32 mothers with serious mentalillness. Secondary narrative analysis of 173 stories about experiences related to hitting bottom were identified. Enactment of their perceived mothering roles and responsibilities was compromised when confronted by the worst of illness. Subsequent to women's descent to bottom was their need for a timely and safe exit from bottom. An intense experience in bottom further jeopardized their parenting and treatment self-determination and, for some, their potential for survival. The results suggest that prevention of bottom is feasible with early assessment of the diverse issues contributing to mothers' vulnerabilities. Interventions to lessen their pain may circumvent bottom experiences. Healing necessitates purposeful approaches to minimize the private and public trauma of bottom experiences, nurture growth towards a future, and establish resources to actualize such a life.
The causes of psychological illness in Irish people have been identified with colonial rule and the catastrophic conditions deriving from famine in the nineteenth century. In particular, the scourge of unremitting emigration, resulting from famine, has formed a background against which speculative theories of inferiority, alienation and mentalillness have been constructed. In particular, the long standing idea that Irish people exhibit higher rates of schizophrenia, both in Ireland and abroad, is discussed. Contemporary studies which suggest that these elevated rates do not correspond to international diagnostic criteria for schizophrenia are introduced. Rather, these enhanced rates may reflect a malaise which resembles schizophrenia but which is really a product of historical dispossession. The importance of these factors is underscored by the previous neglect of Irish people, considered as an ethnic minority, as well as the particular distaste which many Irish people display towards such a notion. PMID:9807368
The causes of psychological illness in Irish people have been identified with colonial rule and the catastrophic conditions deriving from famine in the nineteenth century. In particular, the scourge of unremitting emigration, resulting from famine, has formed a background against which speculative theories of inferiority, alienation and mentalillness have been constructed. In particular, the long standing idea that Irish people exhibit higher rates of schizophrenia, both in Ireland and abroad, is discussed. Contemporary studies which suggest that these elevated rates do not correspond to international diagnostic criteria for schizophrenia are introduced. Rather, these enhanced rates may reflect a malaise which resembles schizophrenia but which is really a product of historical dispossession. The importance of these factors is underscored by the previous neglect of Irish people, considered as an ethnic minority, as well as the particular distaste which many Irish people display towards such a notion. PMID:10076286
Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mentalillnesses (SMI). The treatment of psychotic symptoms usually takes precedence in the care of adults with SMI. Such oversight is problematic in that PTSD in SMI populations is common (19%-43%), contributes a significant illness burden, and hinders mental…
Frueh, B. Christopher; Grubaugh, Anouk L.; Cusack, Karen J.; Elhai, Jon D.
Objective: Prior research has established that lesbian, gay, and bisexual (LGB) people experience higher rates of childhood abuse than heterosexuals. However, there has been little research on the mental health impact of these experiences or how race/ethnicity might influence prevalence and mental health impact of childhood abuse in this…
Balsam, Kimberly F.; Lehavot, Keren; Beadnell, Blair; Circo, Elizabeth
To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…
...2013-07-01 false Medical and mental health screenings; history of sexual abuse. 115.81 Section 115.81 Judicial...Care Â§ 115.81 Medical and mental health screenings; history of sexual abuse. (a) If the screening pursuant...
...2013-07-01 false Medical and mental health screenings; history of sexual abuse. 115.381 Section 115.381 Judicial...Care Â§ 115.381 Medical and mental health screenings; history of sexual abuse. (a) If the screening pursuant...
Whereas physical sport activity is generally considered a health benefit, extreme exercise may be harmful. Of particular concern in this regard is the considerable variation between doctors in the primary care setting and those working within the sports setting around the diagnosis and treatment of athletes presenting with similar symptoms. Known risk factors for athletes are herein presented to raise awareness of the negative side of sport and to bring attention to the psychological outcomes and needs of athletes. The need for research into the incidence and aetiology of mentalillness within elite level sport is also raised. PMID:22297587
OBJECTIVES: This study examined injection drug use among homeless men and women with severe mentalillness in two sites. METHODS: The data were drawn from related clinical trials conducted in Baltimore (101 men, 49 women) and Boston (85 men, 33 women). RESULTS: The percentages of homeless men with a history of injection drug use were 26% in Baltimore and 16% in Boston; the corresponding rates among homeless women were 8% and 6%. CONCLUSIONS: Taken together, these and previous results suggest high lifetime prevalences of injection drug use-and associated risks of HIV transmission-in this elusive population.
Susser, E; Betne, P; Valencia, E; Goldfinger, S M; Lehman, A F
The Housing First approach used by Pathways to Housing, Inc., was used to enhance residential independence and treatment retention of homeless, seriously mentallyill methadone patients. The Keeping Home project first secured scattered-site apartments and assertive community treatment services and then addressed patients' service needs. Three years post-implementation, methadone treatment retention for 31 Keeping Home patients versus 30 comparison participants (drawn from an administrative database) was 51.6% vs. 20% (p < .02); apartment/independent housing retention was 67.7% vs. 3% or 13% (both p's < .01). Although results firmly support Keeping Home, future research needs to address study's possible database limitations. PMID:22873188
Appel, Philip W; Tsemberis, Sam; Joseph, Herman; Stefancic, Ana; Lambert-Wacey, Dawn
Structuring their daily life is an important problem for many individuals with chronic mental disorder. Therefore day structuring services are considered as constituent parts of modern mental healthcare systems. In this paper the theoretical and empirical basis for the implementation and evaluation of day structuring services will be discussed from a social science perspective. Recent work in the field of cultural sociology shows that the social framework of everyday behaviour in modern societies provides a great variety of opportunities to create and practice individual lifestyles. The potential to take advantage of these opportunities is related to individual competencies and resources. The few existing qualitative studies on the everyday behaviour of individuals with chronic mental disorders in the community reveal that increased freedom of choice is often combined with an objective or subjective lack of resources and competencies to make use of this variety of opportunities. Therefore, beyond providing a structure for daily life, day structuring services should help empower individuals with chronic mental disorder to make their choices among behavioural alternatives bearing in mind both illness-related limitations and their strengths and resources. PMID:19085403
Children of parents with a mentalillness have been identified as vulnerable to experiencing a variety of psychosocial effects arising from the impact of parental mentalillness. Many children do not however, experience difficulties as a result of their parent's mentalillness and are able to thrive despite what may be an adverse situation. Until recently there has been a lack of adequate service provision in Australia for these children and their families. Recent government initiatives have led to greater awareness and recognition of the needs of children whose parents have a mentalillness, and key principles and actions have been developed to assist health services to adequately care for them. The aim of this paper is to overview the risk and protective factors that may impact on the psychosocial health children of parents with a mentalillness, and provide me strategies that nurses in a range of health settings may use to assist families where parents have a mentalillness. PMID:15729799
Foster, Kim; O'Brien, Louise; McAllister, Margaret
Increasingly, US prisoners diagnosed with mentalillness are housed in control units, the most restrictive form of confinement in the US prison system. This situation has led to intense debate over the legal, ethical and clinical status of mentalillness. This is a semiotic struggle with profound effects, yet most related work treats mentalillness as a neutral, individual variable. Few analyses locate mentalillness within a larger sociopolitical context. Fewer still focus on discursive practice. None critically analyze the accounts of control unit prisoners, who talk about extreme marginality and risk for victimization. This paper has two aims: (i) to develop a systematic method of analysis that accounts for signification as discourse-in-action; and (ii) to show how prisoners' signification of mentalillness articulates agency through and against marginalizing discourse. Political discourse analysis demonstrates how control unit prisoners with psychiatric diagnoses signify mentalillness, and articulate safer identifications in the process. PMID:17718746
Mentallyill people may face barriers to receiving elective surgical procedures as a result of societal stigma and the cognitive, behavioral, and interpersonal deficits associated with mentalillness. Using data from a cohort of elderly Medicare beneficiaries in 2007, we examined whether the mentallyill have less access than people without mentalillness to several common procedures that are typically not for emergencies and are performed at the discretion of the provider and the patient. Results suggest that Medicare patients with mentalillness are 30-70 percent less likely than others to receive these "referral-sensitive" surgical procedures. Those who did undergo an elective procedure generally experienced poorer outcomes both in the hospital and after discharge. Efforts to improve access to and outcomes of nonpsychiatric care for mentallyill patients are warranted. PMID:21734205
Li, Yue; Cai, Xueya; Du, Hang; Glance, Laurent G; Lyness, Jeffrey M; Cram, Peter; Mukamel, Dana B
Older persons with severe mentalillness (SMI) are prone to the development of multiple physical illnesses, which are often poorly recognized and treated and which can threaten the quality of their lives, diminish their ability to live in the community, and lead to premature mortality. To address this issue, the Illness Management and Recovery (IMR) program, a standardized program for
Kim T. Mueser; Stephen J. Bartels; Meghan Santos; Sarah I. Pratt; Erik G. Riera
The public health literature demonstrates disturbingly high HIV risk for persons with a serious mentalillness (SMI), who are concurrently co-morbid for substance abuse (SA). Many HIV positives have not been tested, and therefore do not know their status, but for individuals who are triply diagnosed, adherence to HIV treatment results in meaningful reductions in viral loads and CD4 counts. Barriers to treatment compliance are reviewed, low threshold/low intensity community based interventions are discussed, and preliminary evidence is presented for the efficacy of the Intervention Cascade, defined as an integrated intervention delivered by specially trained nurses who individualize a treatment compliance intervention in real time as an adaptive response to demand characteristics of the individual.
This paper examines the South African Mental Health Care Act, focussing on its ideological and theoretical underpinnings. It argues that the Act is flawed not only through clear textual inconsistencies, but further, as a consequence of its view of mentalillness resting on contestable psychiatric dogma. Specifically, the disease model of mentalillness reproduced in the policy allows the desires,
The primary care physician has a vital role in documenting and preventing sexual abuse among the mentally retarded populations in our community. Since the current national trend is to integrate citizens with mental retardation into the community away from institutionalized care, it is essential that all physicians have a basic understanding of the unique medical and legal ramifications of their clinical diagnoses. As the legal arena is currently revising laws concerning rights of sexual consent among the mentally retarded, it is essential that determinations of mental competency follow national standards in order to delineate clearly any instance of sexual abuse. Clinical documentation of sexual abuse and sexually transmitted disease is an important part of a routine examination since many such individuals are indeed sexually active. Legal codes adjudicating sexual abuse cases of the mentally retarded often offer scant protection and vague terminology. Thus, medical documentation and physician competency rulings form a solid foundation for future work toward legal recourse for the abused.
Purpose Stigma is a frequent accompaniment of mentalillness leading to a number of detrimental consequences. Most research into the\\u000a stigma connected to mentalillness was conducted in the developed world. So far, few data exist on countries in sub-Saharan\\u000a Africa and no data have been published on population attitudes towards mentalillness in Ghana. Even less is known about the
The important role that religious beliefs may have on perceptions of mentalillness cannot be ignored. Many religions including\\u000a Islam advocate witchcraft and spirit possession—all of which are thought to influence the behaviour of a person so as to resemble\\u000a that of a mentallyill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness\\u000a in
... and symptoms of FASD are similar to various mental health disorders. In many cases, the signs and symptoms of an FASD go unrecognized or are misdiagnosed as a mentalillness or brain injury. Individuals with an FASD ...
The appropriateness of nursing homes for individuals with serious mentalillness remains a controversial issue in long-term care policy more than a decade since the landmark U.S. Supreme Court Olmstead decision in 1999, which affirmed the rights of persons with disabilities to live in their communities. Using national nursing home Minimum Data Set assessments from 2005, the authors compared the demographic, clinical, and functional characteristics of persons with and without serious mentalillness newly admitted to nursing homes. They found that newly admitted people with serious mentalillness were younger and more likely to become long-stay residents than those admitted with other conditions despite a higher proportion of residents with serious mentalillness, including the elderly, classified as low-care status. The most substantial and clinically significant difference for rates of low-care status 90 days after initial admission are for persons younger than 65 with serious mentalillness versus those younger than 65 without serious mentalillness (33% vs. 8.5%, or 3.9 times greater). There is a notable difference in low-care status between persons aged 65 and older with serious mentalillness and those aged 65 and older without serious mentalillness (14% vs. 6.6%, or 2.1 times greater). These results suggest that a substantial number of adults with serious mentalillness residing in nursing homes may have the functional capacity to live in less restrictive environments.
Aschbrenner, Kelly; Grabowski, David C.; Cai, Shubing; Bartels, Stephen J.; Mor, Vincent
Objective It is often assumed that individual stigmatizing attitudes toward the mentallyill are linked to stigmatizing attitudes in\\u000a the social milieu and that both, individual and social stigmatizing attitudes are major barriers to mental health treatment\\u000a seeking. This study aims to examine these assumptions.\\u000a \\u000a \\u000a \\u000a \\u000a Method Data from the 2005–2006 Eurobarometer general population survey (N = 29,248) are used to examine the association of
Khat has been used as a stimulant plant in many parts of Africa and the Arabian Peninsula for centuries. Its current use among particular migrant communities in Europe and elsewhere has caused alarm among policy makers and health care professionals. In the United Kingdom, the debate over the psychiatric and social implications of khat use has led to a demand for stricter legal control of this stimulant plant. This paper (a) provides a historical overview of khat use, and (b) reviews the evidence for the existence of a causal link between khat use and mentalillness. To do so, we undertook a detailed search of social and medical science databases for case reports, qualitative and quantitative articles on khat use and mentalillness from 1945 to 2006. The validity and reliability of the studies that met our inclusion criteria were examined. Lastly, although highlighting health concerns about khat use we suggest that the debate about this popular drug in migrant populations carries elements of a 'moral panic'. There is a need for improved research on khat use and its possible association with psychiatric disorders. PMID:17544193
Warfa, Nasir; Klein, Axel; Bhui, Kamaldeep; Leavey, Gerard; Craig, Tom; Alfred Stansfeld, Stephen
In this article I describe the unique caring and caretaking relationship between a mentallyill person and the nonprofessional caretaker in his or her life. Stressing the perspective of the caretaker, I call this relationship "being there" for the mentallyill person. I collected the data through in-depth interviews and used a descriptive phenomenological approach to unveil the general structure of the experience. Eight constituents emerged as central to the general structure of this experience: (a) accepting the changed other and grieving the loss of who the other once was; (b) taking action in challenging circumstances; (c) recognizing the ongoing, never-ending, and sometimes unpredictable nature of the experience; (d) feeling isolated; (e) having ambiguity of the heart; (f) experiencing the tension of waiting; (g) knowing the other well; and (h) caring for the other. Knowledge gained from the study findings will help health care professionals understand and support people who are in this experience from a more caring paradigm. PMID:19843963
Public tolerance of, and non-discrimination towards, people with mental health problems are key factors on which success in achieving the goal of community-based mental health care depends. This paper revisits Thomas Scheff' s (1966) sociological theory of mentalillness, and tests elements of this thorough critical review of recent UK literature relating to public attitudes towards, and media representations, of
Explores the relationships of caregivers of mentallyill people with professional mental health providers since the introduction of community-based services. Respondents perceived mental health workers to be professional, friendly, respectful and positive in outlook. However they indicated dissatisfaction with accessibility, communication about…
Mentalillness is listed as a child protection concern for a number of families reported to child protection agencies in Australia. Parents with mental health problems are more vulnerable, as are their children, to having parenting and child welfare concerns. Studies undertaken in the Melbourne Children's Court (Victoria) have found that the children of parents with mental health problems comprise
The apparently large genetic contribution to the aetiology of mentalillness presents a formidable puzzle. Unlike common physical disorders, mentalillness usually has an onset early in the reproductive age and is associated with substantial reproductive disadvantage. Therefore, genetic variants associated with vulnerability to mentalillness should be under strong negative selection pressure and be eliminated from the genetic pool through natural selection. Still, mental disorders are common and twin studies indicate a strong genetic contribution to their aetiology. Several theories have been advanced to explain the paradox of high heritability and reproductive disadvantage associated with the same common phenotype, but none provides a satisfactory explanation for all types of mentalillness. At the same time, identification of the molecular substrate underlying the large genetic contribution to the aetiology of mentalillness is proving more difficult than expected. The quest for genetic variants associated with vulnerability to mentalillness is predicated upon the common disease/common variant (CDCV) hypothesis. On the basis of a summary of evidence, it is concluded that the CDCV hypothesis is untenable for most types of mentalillness. An alternative evolution-informed framework is proposed, which suggests that gene-environment interactions and rare genetic variants constitute most of the genetic contribution to mentalillness. Common mentalillness with mild reproductive disadvantage is likely to have a large contribution from interactions between common genetic variants and environmental exposures. Severe mentalillness that confers strong reproductive disadvantage is likely to have a large and pleiotropic contribution from rare variants of recent origin. This framework points to a need for a paradigm change in genetic research to enable major progress in elucidating the aetiology of mentalillness. PMID:19704409
Mentallyill people may face barriers to receiving elective surgical procedures due to societal stigma, and the cognitive, behavioral, and interpersonal deficits associated with metal illness. Using data from a cohort of elderly Medicare beneficiaries in 2007, we examined whether the mentallyill have less access than persons without mentalillness to several common procedures that are typically non-emergent and performed at the discretion of the provider and patient. Results suggest that Medicare patients with mentalillness are between 30 and 70 percent less likely to receive these “referral-sensitive” surgical procedures. Those who did undergo an elective procedure generally experienced poorer outcomes both in the hospital and after discharge. Efforts to improve the access and outcomes of nonpsychiatric care for mentallyill patients are warranted.
Li, Yue; Cai, Xueya; Du, Hang; Glance, Laurent G.; Lyness, Jeffrey M.; Cram, Peter; Mukamel, Dana B.
The present study applied the common sense model (i.e., cause, controllability, timeline, consequences, and illness coherence) to understand public attitudes toward mentalillness and help-seeking intention and to examine the mediating role of perceived controllability between causal attributions with public attitudes and help seeking. Based on a randomized household sample of 941 Chinese community adults in Hong Kong, results of the structural equation modeling demonstrated that people who endorsed cultural lay beliefs tended to perceive the course of mentalillness as less controllable, whereas those with psychosocial attributions see its course as more controllable. The more people perceived the course of mentalillness as less controllable, more chronic, and incomprehensible, the lower was their acceptance and the greater was mentalillness stigma. Furthermore, those who perceived mentalillness with dire consequences were more likely to feel greater stigma and social distance. Conversely, when people were more accepting, they were more likely to seek help for psychological services and felt a shorter social distance. The common sense model provides a multidimensional framework in understanding public's mentalillness perceptions and stigma. Not only should biopsychosocial determinants of mentalillness be advocated to the public, cultural myths toward mentalillness must be debunked. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24826933
Mak, Winnie W S; Chong, Eddie S K; Wong, Celia C Y
The media are often identified as partially responsible for increasing the stigma of mentalillness through their negatively focused representations. For many years, training programs have educated journalists on how to report on mentalillness to reduce stigma. This purpose of this study was to evaluate the benefits of reading a positive, neutral or a negative journalism article that discusses mentalillness. Consenting adult participants were randomly assigned to read one of three published articles about recovery from mentalillness, a dysfunctional public mental health system, or dental hygiene. The participants completed measures immediately before and after the intervention; the measures administered evaluated stigmatizing and affirming attitudes toward people with mentalillness. Public stigma was assessed using the nine-item Attribution Questionnaire and the Stigma Through Knowledge Test (STKT). The STKT is a measure of mentalillness stigma less susceptible to the impact of social desirability. Affirming attitudes represent public perceptions about recovery, empowerment, and self-determination, indicated as important to accepting and including people with psychiatric disabilities into society. Significant differences were observed between the articles on recovery and dysfunctional public mental health system, as well as the control condition, on the measures of stigma and affirming attitudes. The recovery article reduced stigma and increased affirming attitudes, whereas the dysfunctional public mental health system article increased stigma and decreased affirming attitudes. Not all journalistic stories have positive effects on attitudes about mentalillness. PMID:23407209
Corrigan, Patrick W; Powell, Karina J; Michaels, Patrick J
Objective Limited data are available on how older adults access public mental health systems. This study examines how uninsured or publicly insured older adults with severe mentalillness in San Diego County initially accessed the public mental health system, as well as their subsequent use of public mental health services, as compared to younger adults. Methods Data from San Diego County, 2002–2006, was used to examine how older adults initially accessed the public mental health system, and their utilization over the subsequent 90 days. Multivariate regression models were used to control for demographic and clinical characteristics. Results Older adults (age 60+) were more likely to access the public mental health system through the Psychiatric Emergency Response Team (PERT), a combined law-enforcement and psychiatric service that responds to psychiatric related 911 calls. Older adults were also less likely to receive follow-up care. This lower rate of follow-up was due to both the initial site of service – and an associated lower rate of follow-up among PERT clients – as well as a lower rate of follow-up among older adult clients initiating services in other sectors. Conclusions This paper suggests two areas for intervention that would improve access to care for older adults: improving linkages and referrals between PERT and outpatient providers; and additional efforts to retain older adults at outpatient programs.
For a significant number of people suffering from severe mentalillness (SMI) prevention of suicide is a prerequisite for their recovery. This review summarises and interprets risk/protective factors for suicide in the context of schizophrenia and bipolar disorder, thereby enabling evidence-based suicide risk assessment and management. A history of self-harm greatly increases suicide risk among people with schizophrenia or bipolar disorder. Suicide prevention for patients with SMI necessitates constant vigilance by (mental) health and social care professionals in contact with them, particularly those with a history of self-harm, males, young people, those near illness onset, people with a family history of suicidal behaviour (especially suicide), victims of childhood abuse, those challenged by recent adverse life events (notably interpersonal conflict), people with aggressive/impulsive personality features, and those who have expressed hopelessness. Research suggests that suicide risk associated with SMI should be reduced by early intervention, restricting access to lethal means, improvement of treatment adherence, treating more patients with clozapine and lithium, assertive outreach, treating psychiatric comorbidity (depression, alcohol/drug misuse, etc.), 24-hour crisis care, timely (compulsory) hospitalization (sufficient bed provision imperative), improving psychiatric inpatient ward safety, lowering the risk of absconding from wards, appropriate use of electroconvulsive therapy, intensive follow-up postdischarge, and improving access to psychological/psychosocial interventions, notably cognitive behavioural therapy. The clinical interview is the optimum method of suicide risk assessment and locally developed risk assessment tools should not be used. Evidence-based suicide risk assessment/management within primary care and secondary mental health services warrants recurrent, mandatory training. PMID:24547607
Since 2001, the National Drug Abuse Treatment Clinical Trials Network (CTN) has worked to put the results of its trials into the hands of community treatment programs, in large part through its participation in the National Institute on Drug Abuse—Substance Abuse and Mental Health Services Administration Blending Initiative and its close involvement with the Center for Substance Abuse Treatment's Addiction
Steve Martino; Gregory S. Brigham; Christine Higgins; Steve Gallon; Thomas E. Freese; Lonnetta M. Albright; Eric G. Hulsey; Laurie Krom; Susan A. Storti; Harold Perl; Cathrine D. Nugent; Denise Pintello; Timothy P. Condon
The percentage of people with mental retardation in the general population is estimated at about 2.3%, with adolescence (15-20 years) constituting the development period during which a peak in rates of mental retardation is observed. The increased prevalence of adolescence may be explained from the fact that the specified requirements of the school initially, and society later, inevitably lead to comparative evaluation of the teen with mental retardation in relation to peers, thus making mental retardation more apparent. Adolescents with mental retardation face a number of physical and psychological needs which are not often distinguishable and as a consequence undergo the deterioration of their already burdened quality of life. In particular, mental health problems occur 3 to 4 times more often in adolescents with mental retardation compared with adolescents of the general population. This review presents the most recent epidemiological findings regarding the correlation between behavioral disorders, substance use and the possible comorbidity in adolescents with intellectual disability, both at community level and residential care level. Epidemiological data indicate that behavioral disorders are among the most common types of psychopathology in mentally retarded adolescents with the severity and symptoms varying depending on the personal characteristics of each adolescent. Regarding substance use, the available data show that the rates of substance use (alcohol, smoking, illicit drugs) are lower in this specific population group but the differences over the last years tend to be eliminated. Finally, according to the few surveys that were examined referring to the comorbidity of behavioral disorders and substance use in adolescents with intellectual disability, the results were contradictory. Specifically, while behavioral disorders continued to be one of the most common types of psychopathology, the related substances disorders indicated lower rates compared to normal intelligence adolescents with behavioral disorders. Risk factors that increase the chances of developing either simple or more complicated types of psychopathology in adolescents with mental retardation have been found to be based on individual, family and social levels. On the other hand, the individual characteristics of adolescents (intellectual level, attention capacity, understandable linguistic expression, overall progress until adolescence), the existence of a supportive family environment and the presence of social support and awareness through the creation of special counseling, education and medical services, are the most important protective factors which contribute to the prevention of several forms of psychopathology in adolescents with mental retardation. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Intellectual Disability, Behavioral disorders, Adolescents, Mental Retardation, Learning disabilities, Developmental Disabilities, Disruptive behaviour disorders, Conduct disorder, Substance Abuse, Substance Misuse, Oppositional defiant disorder, Alcohol and illicit drug use, Smoking Use, Young people, Teenagers, Youths. PMID:25035183
We introduce "stigma sentiments" as a way to operationalize the cultural conceptions of the mentallyill. Stigma sentiments are the evaluation, potency, and activity (EPA) associated with the cultural category "a mentallyill person." We find consistent support for the validity of the evaluation and potency components as measures of these…
This guide contains all of the information, support and tools teachers will need to implement "Talking about MentalIllness" in their classroom--an awareness program that has been proven to bring about positive change in students' knowledge and attitudes about mentalillness. The program supports teachers in four essential ways: it outlines the…
Children of mentallyill parents are often vulnerable, partly because they may not receive adequate nurturing and partly because they feel stigmatized by their parents' disabilities. The author recommends use in treatment of several children's books that show realistic, positive role models of children coping with parental mentalillness. PMID:4064794
Background: The assertive community treatment (ACT) model for people with severe mentalillness was origi- nally designed to be provided continuously without ter- mination. This study evaluated postdischarge changes in health status and service use associated with the time- limited provision of ACT to homeless people with se- vere mentalillness. Methods: Clients in the fourth annual cohort of the
Morbidity and mortality due to physical illness is extremely high in the population of persons with serious mentalillness. The purpose of this study was to examine the impact on psychiatric and physical outcomes through enhancing a standard Program of Assertive Community Treatment (PACT) with Advanced Practice Psychiatric Mental Health Nurses (APNs) and stabilized consumer peer providers (NPACT). In a
This article draws attention to the issue of parental severe mentalillness and the ethical and clinical implications for counselors who work with this population. Parents with mentalillness face a multitude of life challenges including, but not limited to, parenting difficulties, medication and hospitalization, custody and placement of their…
Social cognitive models of stigma define the relationship among: signals that suggest a person is mentallyill, stigmatizing attitudes about the person with mentalillness, affective reactions to the stigmatizing attitude, and behavior responses to these attitudes and emotions. The Prairie State Stigma Studies were a set of investigations completed over the past five years examining stigma from the perspective
This is a preliminary qualitative study, using a basic interpretive approach, to investigate the work experiences of people with mentalillness in Malaysia. Six females and four males (aged 30-70) from a residential home for the mentallyill participated in semi-structured interviews. Three inter-relating themes emerged, namely the experience of…
This thesis is an accumulation of two and a half years of research. The premise was to see if the variables of level of education, level of contact with persons with mentalillness, and type of majors (used as independent variables) were related to the concepts of individuals with mentalillness being dangerous, having poor social skills, and being incurable
Objective: Children of mothers with mentalillness are at risk for multiple untoward outcomes, including child maltreatment and foster care placement. The purpose of this analysis was to determine the association between maternal mentalillness and children's long term safety and stability. Methods: A multi-sector administrative dataset from the…
Of all the different types of disability, mentalillness can be particularly disruptive to education and training outcomes. In this report, the authors explore the factors contributing to successful course completion for students with a mentalillness. The authors especially focus on the role of disclosure and the reasons why students choose to…
Abnormal psychology instructors often use traditional and personal methods to educate students about and improve student attitudes toward mentalillness and professional help-seeking. Data from abnormal psychology students (N = 190) were used to determine if and how students' attitudes toward mentalillness and professional help-seeking attitudes…
Kendra, Matthew S.; Cattaneo, Lauren B.; Mohr, Jonathan J.
This study employs a phenomenological hermeneutic approach to analyse narratives written by mainland Chinese people who care for a family member with serious mentalillness. Locating culture at the centre of the analysis, the study explicates and explores the salient themes and subthemes in texts that were originally published in a monthly psychoeducational newsletter. Analysis reveals that mentalillness constitutes
The need for a more responsive service system for people who are both mentallyill and homeless is a salient concern in America today. Preliminary research was conducted to examine how homeless mentallyill persons are processed by the currently organized network of human services in the nation's capital. Data were gathered in the summer of 1985…
Research on mentalillness in relation to social problems such as crime, unemployment, and homelessness often ignores the broader social context in which mentalillness is embedded. Policy, research, and practice will be improved if greater attention is given to social context. The authors critically analyze the approach used in much of the psychiatric services literature to infer links between
Jeffrey Draine; Mark S. Salzer; Dennis P. Culhane; Trevor R. Hadley
Family caregivers are confronted with the often arduous task of attending to the needs of their mentallyill relatives and have become increasingly prominent in society following the Australian deinstitutionalisation movement. The discourse pertaining to the experiences of mentalillness caregivers is particularly negative and is largely generated from international research. While other aspects of the caregiving experience have been
A number of data sets can be used to estimate the size of the nursing home population with mentalillness; however, estimates vary because of differences in data collection. The 2004 National Nursing Home Survey (NNHS) estimates that 6.8 percent of nursing home residents had a primary diagnosis of mentalillness in that year (6.0 percent of those 65 and
As the United States has engaged in record levels of incarceration, there has been a concomitant rise in the number of persons incarcerated afflicted with severe mentalillness (SMI) including schizophrenia, bipolar disorder, and major depression. Legislation aimed at diverting SMI persons away from incarceration and toward treatment has been recently developed. This paper reviews the MentallyIll Offender Treatment
The Crisis Intervention Team (CIT) model is a specialized police response program for people in a mentalillness crisis. We analyzed 2174 CIT officers' reports from one community, which were completed during a five year period. These officers' reports described interactions with people presumed to be in a mentalillness crisis. We used hierarchical logistic and multinomial regression analyses to
Christian Ritter; Jennifer L. S. Teller; Kristen Marcussen; Mark R. Munetz; Brent Teasdale
This study is to identify culturally relevant treatment methods and to assess the effects of family psychoeducational intervention for Korean Americans who had a family member with mentalillness. 48 Korean Americans with children with mentalillness were randomly assigned to either an experimental group program that provided culturally sensitive…
The number of mentallyill inmates in the criminal justice system has increased dramatically. This article evaluates the prevalence and causes of mentalillness in the criminal justice system and describes the inadequate care that is provided, the effects of imprisonment, and the problem of rehabilitation. (Contains 4 notes.)
In this article, a comprehensive pain management program on an inpatient psychiatric unit is described. Traditional pain management methods ofpatient education and active participation in rehabilitation are modified to be efficacious with a seriously mentallyill patient population. Specific assessment, planning, implementation, and evaluation strategies for pain management in the mentallyill are outlined. To illustrate the pain program, a
Diane Pavalonis; Michele DeCarr; Michael S. Shutty
Background The context of the study is the increased assessment and treatment of persons with mentalillness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mentalillness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mentalillness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mentalillness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mentalillness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mentalillness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mentalillness were common. Those responding to the mentalillness vignette (N = 356) gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298). Conclusions Results support the view that, in the Malaysian setting, patients with mentalillness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented through survey method is required to support these conclusions.
Background This study was designed to examine the knowledge, attitude and beliefs about causes, manifestations and treatment of mentalillness among adults in a rural community in northern Nigeria. Methods A cross sectional study design was used. A pre-tested, semi-structured questionnaire was administered to 250 adults residing in Karfi village, northern Nigeria. Results The most common symptoms proffered by respondents as manifestations of mentalillness included aggression/destructiveness (22.0%), loquaciousness (21.2%), eccentric behavior (16.1%) and wandering (13.3%). Drug misuse including alcohol, cannabis, and other street drugs was identified in 34.3% of the responses as a major cause of mentalillness, followed by divine wrath/ God's will (19%), and magic/spirit possession (18.0%). About 46% of respondents preferred orthodox medical care for the mentally sick while 34% were more inclined to spiritual healing. Almost half of the respondents harbored negative feelings towards the mentallyill. Literate respondents were seven times more likely to exhibit positive feelings towards the mentallyill as compared to non-literate subjects (OR = 7.6, 95% confidence interval = 3.8–15.1). Conclusions Our study demonstrates the need for community educational programs in Nigeria aimed at demystifying mentalillness. A better understanding of mental disorders among the public would allay fear and mistrust about mentallyill persons in the community as well as lessen stigmatization towards such persons.
Kabir, Mohammed; Iliyasu, Zubair; Abubakar, Isa S; Aliyu, Muktar H
Policies and guidelines from across the international community are attempting to galvanise action to address the unacceptably high morbidity and mortality rates amongst people with a serious mentalillness (SMI). Primary care has a pivotal role to play in translating policy into evidence based practice in conjunction with other providers of health care services. This paper explores the current and potential of role of primary care providers in delivering health care to people with SMI. A review of research in the following key areas of primary health care provision is provided: access, screening and preventative care, routine monitoring and follow-up, diagnosis and delivery of treatments in accordance with guidelines and delivery of interventions. There is undoubtedly a need for further research to establish the effectiveness of primary care interventions and the organisation of services. Equally, understanding how primary care services can deliver high quality care and promoting effective working at the interface with other services must be priorities. PMID:25007733
This study examined the narrative effects of familiarity, transportation, whether a story is factual or fiction, and perceived realism on the stigmatizing behavior of social distancing behavior. A sample of N?=?137 participants watched a commercial movie about mentalillness. Genre was manipulated to determine whether fiction or nonfiction impacted social distancing behavior. Although there was no effect of the genre manipulation, transportation was found to have a relationship with social distancing, with the more relevant the participants found the story, the lower they demonstrated social distancing behavior. How much participants identified with the main character was found to have a partial mediating effect between perceived story relevance and social distancing behavior. PMID:21516556
Empirical studies of violence and mentalillness have used many different methods. Current state-of-the-art methods gather information from both subject and collateral interviews as well as official records. Typically these sources are treated as additive. Any report of a violent incident from any source is treated as true and all reported incidents are added to generate estimates of frequency. This paper presents a new statistical technique that uses the level of agreement between the sources of data to adjust those estimates. The evidence suggests that, although the additive technique for using multiple sources correctly estimates how many people are involved, it substantially underestimates the number of incidents. The new technique substantially reduces both false negatives and false positives. PMID:17203412
Lidz, Charles W; Banks, Steven; Simon, Lorna; Schubert, Carol; Mulvey, Edward P
There is now a relatively good understanding of the broad range of direct and indirect effects of humor and laughter on perceptions, attitudes, judgments and emotions, which can potentially benefit the physical and psychological state. This article presents a review and discussion of the use of humor and laughter in treating people with serious mentalillness, distinguishing between clinical papers on individual and group psychotherapy, and empirical research reports describing humor and laughter interventions. In spite of the exponential growth of the field over the last 30 years, I conclude that empirical studies are still lacking, the studies that do exist have major methodological shortcomings, and the field is in dire need of further investigation.
OBJECTIVE. To identify the subjective quality of life in people with chronic mental health problems who were in non-residential community mental health services, and to investigate factors affecting their quality of life after the illness. METHODS. People with mentalillness (n = 105) were recruited. They were assessed with the self-rated Hong Kong Chinese version of the World Health Organization Quality of Life Brief questionnaire. RESULTS. The participants had lower total quality-of-life and the 4 domain scores of the questionnaire than the general population. They were particularly dissatisfied with their financial situation. Duration of illness was positively correlated with subjective quality-of-life variables while age at onset of the mentalillness was negatively correlated with subjective quality of life, in particular the physical health, psychological health, and environmental domains. CONCLUSION. This study highlighted the significance of duration and age at onset of illness in subjective quality of life of people with mentalillness. A longitudinal study to test the causal relationships between these factors and the quality of life in people with mentalillness is recommended. PMID:24986198
Background Recent years have seen a number of attempts to reduce the stigma related to mentalillness; the media can play a significant role in perpetuating this stigma. This paper analyses trends in newspaper coverage of mentalillness in the UK between 1992-2008 across a range of psychiatric diagnoses. Methods A content analysis was performed on a sample of articles (n = 1361) about mentalillness in a range of UK newspapers in 1992, 2000, and 2008. Results There was a significant proportional reduction in negative articles about mentalillness between 1992 and 2008, and a significant increase in articles explaining psychiatric disorders. Coverage improved for depression but remained largely negative for schizophrenia. Conclusions Newspaper coverage of mentalillness became less stigmatising overall in the 1990s and 2000s, but this was not true for all diagnoses.
This study examined the extent to which a criminal history is associated with the use of various mental health services as well as related service use predictors among people with serious mentalillness (SMI). Data were obtained from the National Comorbidity Survey Replication. The sample consisted of 1,588 adults with SMI, including major depressive disorder (n = 1,398) and bipolar disorder (n = 190). Chi square tests were conducted to compare respondent characteristics based upon the presence/absence of a criminal history. Logistic regression analyses were conducted to examine various mental health services usage among respondents while controlling for predisposing, enabling, and need factors. Approximately 30 % of respondents reported a criminal history. Those with a criminal history were more likely to use specialty mental health services (OR = 1.42, p < 0.05). Findings suggest that the criminal justice system may be serving as a substantial referrer to mental health services or that there is higher morbidity among people with SMI who have been justice involved. PMID:23783440
Background High rates of smoking and lower rates of smoking cessation are known to be associated with common mental disorders such as anxiety and depression, and with individual and community measures of socioeconomic status. It is not known to what extent mentalillness and socioeconomic status might be jointly associated with smoking behaviour. We set out to examine the relationship between mentalillness, measures of socioeconomic disadvantage and both current smoking and smoking cessation rates. Methods We used data from the 2007 Australian National Survey of Mental Health and Wellbeing to examine the relationship between mentalillness, socioeconomic status and both current smoking and smoking cessation. We used cross-classified tables and logistic regression to examine the relationship between psychosocial and sociodemographic predictors and current smoking. We also used proportional hazards regression to examine the relationship between the factors and smoking cessation. Results Both mentalillness and socioeconomic status were independently associated with current smoking and with lower likelihood of smoking cessation, with gradients in smoking by mental health status being observed within levels of socioeconomic indicators and vice versa. Having a mentalillness in the past 12 months was the most prevalent factor strongly associated with smoking, affecting 20.0% of the population, associated with increased current smoking (OR 2.43; 95% CI: 1.97-3.01) and reduced likelihood of smoking cessation (HR: 0.77; 95% CI: 0.65-0.91). Conclusions The association between mentalillness and smoking is not explained by the association between mentalillness and socioeconomic status. There are strong socioeconomic and psychosocial gradients in both current smoking and smoking cessation. Incorporating knowledge of the other adverse factors in smokers’ lives may increase the penetration of tobacco control interventions in population groups that have historically benefitted less from these activities.
Before the appearance of specific psychotic symptoms, most individuals experience a period of prodromal symptoms associated with severe mentalillness. Early intervention during this pre-psychotic phase may improve treatment outcomes, alter the natural course of disease, and prevent or delay mental disease onset. This paper aimed to synthesize four screening strategies (genetic high-risk populations selected by family history with mentalillness, finding ultra-high-risk population, the close-in strategy, and the pre-psychotic phase by assessing basic symptoms); two intervention dimensions (psychosocial interventions and antipsychotic medicine); discussions of ethnic issues; and three Taiwanese nurses' roles (the role of assessment for screening, the role of development for screening tools, and the role of preventive intervention providers) to attain early diagnoses and prevention of mentalillness. This article provides more information to advanced Taiwanese mental health nurses responsible to promote /s enhance the health of patients with prodromes of severe mentalillness. PMID:23729347
Stigmatization of mentalillness is a widespread phenomenon even among health professionals. To explore the origins of this inappropriate attitude, medical students at the beginning and in the end of their studies were examined with self-report measures of social distance towards mentallyill persons, beliefs about etiology of mental disorders, valuation of psychotherapy and the personality features empathy and narcissism. While the students' attitudes turn out to be unrelated to the personality features, significant differences between the two groups were found indicating that distance towards mentallyill patients in the medical role and ambivalence about the etiological factors of mental disorders are stronger pronounced in the end of the studies compared to the beginning. These findings underline the need to prepare medical students better for contacts with mentallyill patients. PMID:22334088
Objective: Present study was conducted to explore the relationship between parental psychological abuse toward their children and mental health problems in adolescence. Method: Three hundred participants age range 13-17 years, (57% boys and 43% girls) participated in the study from both public and private high schools of Lahore. Psychological maltreatment experience scale (PMES) and Youth Self-Report(YSR) were used for assessment and diagnosis. Results: Findings revealed that psychological abuse by parents significantly related with mental health problems in adolescents, for mother abuse (r= .24 to.67, p< .05) and father abuse (r= .20 to.70, p< .05). Adolescents who perceived their parents as more abusive exhibited greater problems. Regression analysis indicated that hypothesized factors of parental psychological abuse predicted the mental health problems in adolescents (contributed from 10% to 49% of variance). Conclusion: Psychological abuse by parents is related with mental health problems in adolescents. These findings will contribute to a better understanding of non-injurious psychological abuse and its impact on adolescents. Findings of the study can be used to bring the attention of parents, public and professionals’ towards damaging effects of psychological abuse on adolescents
The Crisis intervention team model (CIT) is possibly the most well known and widely adopted model to improve police response\\u000a to persons with mentalillness. A primary goal of CIT programs is to divert individuals with mentalillness from the criminal\\u000a justice system to mental health services. In this paper we examine the effectiveness of fielding CIT trained and supported
Amy C. Watson; Victor C. Ottati; Melissa Morabito; Jeffrey Draine; Amy N. Kerr; Beth Angell
Multi-sensory stimulation provided in a Snoezelen room is being used increasingly for individuals with mental retardation and mentalillness to facilitate relaxation, provide enjoyment, and inhibit behavioral challenges. We observed aggressive and self-injurious behavior in three groups of 15 individuals with severe or profound mental retardation and mentalillness before, during, and after being in a Snoezelen room. All participants
Nirbhay N Singh; Giulio E Lancioni; Alan S. W Winton; Enrique J Molina; Monica Sage; Stephen Brown; Jop Groeneweg
In the conventional paradigm, mental health and illness exist on a single continuum where the emphasis is on the presence or absence of pathological outcomes. By contrast, a new theoretical framework recognizes and promotes a dual continua model where mental health is no longer the absence of mentalillness. This new paradigm argues that mental health should be regarded as
This study examined the files of 11 men from a regional forensic service who committed acts of sexual violence in the context of a mental disorder. The aim was to identify what factors other than a mental disorder may be relevant when considering acts of sexual violence by the mentallyill and what treatment implications this might raise. Several men
The data of a sociological survey of 1042 mentallyill patients are presented. The aim of the investigation was to study different aspects of daily functioning of patients with mental diseases. It has been shown that the negative consequences of mental disease are seen at every level (professional, family and social) of daily functioning. PMID:24662345
To investigate predisaster mentalillness as a risk factor of poor postdisaster mental health outcomes, veterans with (n = 249) and without (n = 250) preexisting mentalillness residing in the Gulf Coast during Hurricane Katrina were surveyed after Katrina and screened for posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder, and panic. Logistic regression examined the association between preexisting mental disorders and positive screens after the hurricane, adjusting for demographics and exposure to hurricane-related stressors. The odds of screening positive for any new mental disorder were 6.8 times greater for those with preexisting mentalillness compared with those without preexisting mentalillness. Among those with preexisting PTSD, the odds of screening positive for any new mentalillness were 11.9 times greater; among those with schizophrenia, 9.1 times greater; and among those with affective disorders, 4.4 times greater. Persons with preexisting mentalillnesses, particularly PTSD, should be considered a high-risk group for poor outcomes after a disaster. PMID:23364127
Sullivan, Greer; Vasterling, Jennifer J; Han, Xiaotong; Tharp, Andra Teten; Davis, Teri; Deitch, Elizabeth A; Constans, Joseph I
Objective: The authors examined the prevalence of and risk factors for homeless- ness among all patients treated for serious mentalillnesses in a large public mental health system in a 1-year period. The use of public mental health services among homeless persons was also examined. Method: The study included 10,340 per- sons treated for schizophrenia, bipolar disorder, or major depression
David P. Folsom; William Hawthorne; Anne Bailey; Richard Hough; Dilip V. Jeste
In order to assess the prevalence of mental health and substance abuse among youth in one state's juvenile justice facilities, a survey was conducted of 40 Tennessee facilities. A total of 1215 youth were being held on the \\
Louise Barnes; Deborah Bennett; Charlotte Bryson; Sita Diehl; Trish Hayes; Craig Anne; Liz Ledbetter; Pam McCain; Linda O'Neal; Patti Orten; Nancy Reed; Adriane Sheffield; Debrah Stafford; Pat Wade
The report examines the implementation of legislative requirements that states set aside a percentage of their Alcohol, Drug Abuse and Mental Health Services Block Grant funds for services to targeted populations. These funds are to be used specifically f...
Background Although research has established the profound effects that intimate partner abuse can have on postpartum mental health, little is known regarding how this association may change as a function of the timing and type of abuse. This study examined associations of psychological, physical and sexual abuse experienced as adults before and during pregnancy with symptoms of postpartum mental health problems in a non-clinical sample of women. Methods English-speaking mothers aged 18 years and older in the metropolitan area of a large, Western Canadian city were recruited to participate in a study of women’s health after pregnancy. The study was advertised in hospitals, local newspapers, community venues, and relevant websites. One-hundred women completed standardized, self-report questionnaires during semi-structured interviews conducted by female research assistants at approximately 2 months postpartum. In addition to questions about their general health and well-being, participants answered questions about their experiences of intimate partner abuse and about their mental health during the postpartum period. Results Almost two-thirds (61.0%) of women reported postpartum mental health symptoms above normal levels, with 47.0% reporting symptoms at moderate or higher levels. The majority reported some form of intimate partner abuse before pregnancy (84.0%) and more than two-thirds (70.0%), during pregnancy; however, the abuse was typically minor in nature. Multivariate models revealed that women who experienced intimate partner abuse—whether before or during pregnancy—reported higher levels of postpartum mental health problems; however, associations differed as a function of the timing and type of abuse, as well as specific mental health symptoms. Multivariate models also showed that as the number of types of intimate partner abuse experienced increased, so did the negative effects on postpartum mental health. Conclusions Results of this study provide further evidence that intimate partner abuse is a risk factor for postpartum mental health problems. They also underscore the complex risks and needs associated with intimate partner abuse among postpartum women and support the use of integrated approaches to treating postpartum mental health problems. Future efforts should focus on the extent to which strategies designed to reduce intimate partner abuse also improve postpartum mental health and vice versus.
Background Thousands of people whose aggression is thought due to serious mentalillness are secluded or restrained every day. Without\\u000a fair testing these techniques will continue to be used outside of a rigorous evidence base. With such coercive treatment this\\u000a leaves all concerned vulnerable to abuse and criticism. This paper presents the protocol for a randomised trial comparing\\u000a seclusion with restraints
Gisele Huf; Evandro SF Coutinho; Marco AV Ferreira; Silvana Ferreira; Flavia Mello; Clive E Adams
Purposes: Attitudes toward mentalillness and patients with mentalillness influence the treatment they receive and decisions of policy makers. The purposes of this study were to assess Jordanian nursing students' attitudes towards mentalillness, and to assess the effectiveness of teaching and contact on changing nursing students' attitudes about…
A cross-national survey was conducted among 358 recently homeless young people in Melbourne and Los Angeles. Drug dependence and mentalillness were assessed at baseline, 6 and 12 months. At each time point, participants were classified as no condition, drug dependent, having a mentalillness or dual condition. Low levels of drug dependence or mentalillness or both were reported
Doreen Rosenthal; Shelley Mallett; Lyle Gurrin; Norweeta Milburn; Mary Jane Rotheram-Borus
he implementation of deinstitutional- ization in the 1960s and 1970s, and the increasing ascendance of the com- munity support system concept and the practice of psychiatric rehabilitation in the 1980s, have laid the foundation for a new 1990s vision of service delivery for people who have men- tal illness. Recovery from mentalillness is the vision that will guide the
Explores effect of child abuse reporting on counselor-client relationship, mental health profession, and child protective services system. Uses ecological systems approach in exploration of interventions needed to help resolve child abuse reporting dilemma. Within ecosystems framework, discusses ethical guidelines and policymaking for reporting…
Objective: This case-based, mixed-methods study was undertaken to understand the perspectives and mental health needs of rural children exposed to parental methamphetamine abuse. Method: Participants were 23 children involved with a state child protective agency because of parental methamphetamine abuse. A semistructured interview provided…
Objective: To examine the child protection process in cases of severe physical abuse, to compare characteristics of the families with risk factors previously reported in the published literature, and to develop recommendations about the use of mental health professionals in such cases.Method: Reviewers examined 30 case records of severely physically abused children under age 5, nominated by child protection workers
Barbara V Miller; Barry R Fox; Lloyd Garcia-Beckwith
The purpose of this study was to examine the individual characteristics and mental health factors of dysthymic and nondysthymic substance abusers. Out of a total of 1,209 medical records reviewed to select cases of dysthymic and nondysthymic substance abusers attending a community drug treatment program, 183 medical records were selected, 48% of…
In a survey exploring the reliability and validity of a screening tool, we explored the substance abuse and mental health issues among 371 elders; 74 were sexual minorities. Analyses by age group indicated that elders 55–64 years had significantly more problems with substance abuse, posttraumatic stress disorder (PTSD), depression, anxiety, and suicidal thoughts compared to those 65 and older. Bisexuals
Thirty-six women with mental retardation were divided into two groups on the basis of whether they had a documented history of abuse during the preceding 5 years. The women with this history were more likely than the women with no documented history of abuse to be employing passive/avoidant decision-making strategies, reporting higher levels of…
This staff training manual, the second volume of a three-volume set of materials for use in training paraprofessional refugee workers, deals with the life cycle, mental health, and mentalillness, focusing particularly on the unique challenges and pressures of being a refugee. Covered in the individual units are the following topics: psychological…
The AIDS epidemic in South Africa is among the fastest growing in the world. While much of the population is at risk for infection, marginalized groups such as women with severe mentalillness (SMI) are often neglected in prevention efforts. A qualitative study of mental health care providers' perceptions of HIV risk and sexuality among women with SMI was conducted
Objectives: To discuss the findings and the various judgements of the courts in the case of Presland v Hunter Area Health Service and to consider the liability of psychiatrists and mental health services for failing to admit or detain patients with mentalillness.Conclusion: In a highly controversial and sometimes misreported decision, the NSW Supreme Court on 21 August 2003 entered
...Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...you will be examined by mental health staff. (a) Competency...evidence presented by mental health staff. (b) Responsibility...evidence presented by mental health...
The purpose of this study was to examine the national practices of psychotherapy services for male offenders with mentalillness\\u000a (OMI) in state correctional facilities. Participants consisted of 230 correctional mental health service providers from 165\\u000a state correctional facilities. Results indicated that mental health professionals provided a variety of services to OMI that\\u000a can be conceptualized by six goals considered
...the State mental health authority, which...services program for mentalillness as defined...symptoms or mimic mentalillness. (3...description of current attitudes and overt behaviors...Self-monitoring of health status, self-administering...may designate the mental health...
...the State mental health authority, which...services program for mentalillness as defined...symptoms or mimic mentalillness. (3...description of current attitudes and overt behaviors...Self-monitoring of health status, self-administering...may designate the mental health...
All the studies performed in many industrialized countries have shown that the mortality-rates of mentally-ill patients are higher than expected, despite of a recent trend indicating a diminishing difference by comparison with control-groups (review in Corten et al). In France, the works by Casadebaig and Quemada focused on the mortality-rates of psychiatric in-patients from 1968 to 1982 cannot unfortunately be performed nowadays because of an administrative change in the nation-wide death-registration. This is the main reason for the purpose of a longitudinal study on this topic for the next years in our country. The chief goals are concerned with public health and with analytical epidemiology: defining the Standardized Mortality Ratios (SMR) globally and by cause of death for the most typical clinical groups. Methodology and feasibility. The main methodological issues have to be examined first before implementation. Theoretically, one should wait that a multicentric longitudinal survey could be representative of the whole population of french mentally in and out-patients. Actually, this study will be more likely performed with collaborative centers agreeing for data-collection; and secondly, it will be necessary to control that these collaborative centers do not differ significantly from the other public psychiatry-departments for the main variables that may influence the mortality-rates. The definition of cases and their identification will be done according to the International Classification of Disorders (ICD) considering its ninth and tenth revision. This research also needs to include a large number of patients because of statistical constraints.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1600890
Guillaud-Bataille, J M; Quemada, N; Casadebaig, F; Gausset, M F; Terra, J L
Previous inattention to the specific circumstances of homeless mentallyill individuals in general hospital settings is discussed. Homeless mentallyill individuals who presented for emergency psychiatric care in a public general hospital setting exhibited distinctive patterns of service utilization and showed evidence of being a uniquely disabled, rootless, and impoverished subgroup of mentallyill individuals. The characteristics of homeless users of general hospital psychiatric services may provide some important clues to system-wide deficits in community-based care for the members of this population. PMID:2257725
This paper explores the decontextualization of mentalillness in psychiatric drug advertisements. Taking the portrayal of work in several drug advertisements which appeared in the American Journal of Psychiatry* as the object of our analysis, we show how these ads tend to individualize mentalillness and its treatment by failing to consider the social realities that contribute to or, in some way, affect mentalillness. We conclude with a discussion of how such ads distort debate over treatment options and legitimize existing social relations and attitudes. PMID:2031203
Programs to teach sexual abuse prevention skills to persons with mental retardation have rarely been evaluated empirically, and typical evaluations are limited to assessment of the participants' knowledge rather than their performance of specific skills. In the present study, 6 adult women with mental retardation were trained in sexual abuse prevention, and performance was assessed using four separate measures: pretests and posttests of knowledge, verbal report, role play, and naturalistic probes. All women learned the skills but failed to exhibit them to criterion during the probes. We discuss the implications for further training and assessment of sexual abuse prevention skills.
Lumley, V A; Miltenberger, R G; Long, E S; Rapp, J T; Roberts, J A
Programs to teach sexual abuse prevention skills to persons with mental retardation have rarely been evaluated empirically, and typical evaluations are limited to assessment of the participants' knowledge rather than their performance of specific skills. In the present study, 6 adult women with mental retardation were trained in sexual abuse prevention, and performance was assessed using four separate measures: pretests and posttests of knowledge, verbal report, role play, and naturalistic probes. All women learned the skills but failed to exhibit them to criterion during the probes. We discuss the implications for further training and assessment of sexual abuse prevention skills. PMID:9532753
Lumley, V A; Miltenberger, R G; Long, E S; Rapp, J T; Roberts, J A
In a survey exploring the reliability and validity of a screening tool, we explored the substance abuse and mental health issues among 371 elders; 74 were sexual minorities. Analyses by age group indicated that elders 55-64 years had significantly more problems with substance abuse, posttraumatic stress disorder (PTSD), depression, anxiety, and suicidal thoughts compared to those 65 and older. Bisexuals reported significantly greater problems with depression, anxiety, and suicidality than either heterosexual or lesbian or gay elders. Mental health and substance abuse treatment utilization was low among all elders with problems. Implications for assessment, access to care, and group-specific services delivery are discussed. PMID:22587357
Perceived legitimacy of discrimination shapes reactions to mentalillness stigma among stigmatized individuals. We assessed deliberately endorsed versus automatic shame-related reactions to mentalillness as predictors of change in perceived legitimacy of discrimination over six months among 75 people with mentalillness. Automatically activated shame-related associations with mentalillness were measured using the Brief Implicit Association Test, deliberately endorsed beliefs via self-report. Controlling for depression and perceived stigma, stronger baseline automatic shame-related associations, but not deliberately endorsed beliefs, predicted higher perceived legitimacy of discrimination after six months. Automatically activated shame reactions may increase vulnerability to mentalillness stigma.
Rusch, Nicolas; Todd, Andrew R.; Bodenhausen, Galen V.; Olschewski, Manfred; Corrigan, Patrick W.
Introduction Many genetic studies have indicated that DISC1 is not merely “disrupted-in-schizophrenia,” but is more generally implicated in various brain dysfunctions associated with aberrant neurodevelopment and intracellular signaling pathways. Thus, the DISC1 gene is mildly associated with a variety of brain disorders, including schizophrenia, mood disorders, and autism. This novel concept fits with the results from biological studies of DISC1, which include cell and animal models. Areas covered We review the molecular structure and functions of DISC1, particularly those in conjunction with its important interactors. Functions of these interacting proteins are also introduced under the concept of the “DISC1 interactome.” Finally, we discuss how the DISC1 interactome can provide potential therapeutic targets for mentalillnesses. Expert opinion Modulation of DISC1 stability and post-transcriptional modifications may be key targets to address DISC1-related pathology. In addition, modulation of DISC1 interactors and the mechanisms of their interactions with DISC1 may also provide drug targets. Disc1 rodent models can subsequently be used as templates for in vivo validations of compounds designed for DISC1 and its interacting proteins. Furthermore, these rodents will serve as genetic models for schizophrenia and related conditions, especially in conjunction with their pathologies during the neurodevelopmental trajectory.
Objective To estimate the effect of a nursing home’s share of residents with a serious mentalillness (SMI) on the quality of care. Data Sources Secondary nursing home-level data over the period 2000 through 2008 obtained from the Minimum Data Set, OSCAR, and Medicare claims. Study Design We employ an instrumental variables approach to address the potential endogeneity of the share of SMI residents in nursing homes in a model including nursing home and year fixed effects. Principal Findings An increase in the share of SMI nursing home residents positively affected the hospitalization rate among non-SMI residents and negatively affected staffing skill mix and level. We did not observe a statistically significant effect on inspection-based health deficiencies or the hospitalization rate for SMI residents. Conclusions Across the majority of indicators, a greater SMI share resulted in lower nursing home quality. Given the increased prevalence of nursing home residents with SMI, policymakers and providers will need to adjust practices in the context of this new patient population. Reforms may include more stringent preadmission screening, new regulations, reimbursement changes, and increased reporting and oversight.
Grabowski, David C.; Intrator, Orna; Cai, Shubing; Mor, Vincent
Several national bodies have proposed using mobile technology to improve mental health services. But rates of current use and interest in using technology to enhance services among individuals with serious mentalillness are uncertain. The authors surveyed 1,592 individuals with serious mentalillness regarding their use of mobile devices and interest in using mobile technologies to enhance mental health services. Seventy-two percent of survey respondents reported currently owning a mobile device, a rate approximately 12 % lower than the general adult population. The most common uses were for talking, followed by texting, and internet activities. Both mobile device users and nonusers expressed interest in future mobile services. PMID:22648635
Ben-Zeev, Dror; Davis, Kristin E; Kaiser, Susan; Krzsos, Izabela; Drake, Robert E
People with mental retardation have experienced increasing levels of freedom and access to community living over the past 40 years. This has included access to alcohol, illicit drugs and the potential for developing substance abuse and related problems. The manner in which people with mental retardation have handled this access has been recognized since the de ? institutionalization era began. Despite this
This study examines factors that influence preferences between traditional cultural and western mental health and substance use associated care among American Indians from the northern Midwest. Personal interviews were conducted with 865 parents\\/caretakers of tribally enrolled youth concerning their preferences for traditional\\/cultural and formal healthcare for mental health or substance abuse problems. Adults strongly preferred traditional informal services to formal
Melissa L. Walls; Kurt D. Johnson; Les B. Whitbeck; Dan R. Hoyt
Relatives of those suffering from severe mentalillness experience multiple challenges and a complex life situation. The aim of this study was to describe life-sharing experiences from the perspective of relatives of someone with severe mentalillness. A qualitative, descriptive study was performed, and interviews were carried out with eighteen relatives of persons with severe mentalillness. A phenomenographic analysis, according to the steps described by Dahlgren and Fallsberg, was used to describe the relatives' conceptions of their situation. The findings show that the experiences of these relatives can be summarized in one main category: 'The art of balancing between multiple concerns'. Two descriptive categories emerged: 'Making choices on behalf of others and oneself' and 'Constantly struggling between opposing feelings and between reflections'. Relatives report that they have to manoeuvre between different ways to act and to prioritize between different wishes and needs. In addition, they face a wide range of strong feelings and they search for hope and meaning. Relatives of someone with severe mentalillness have to balance multiple concerns, which induce ethical dilemmas. They felt love, compassion or sense of duty towards the mentallyill person. The changeable situation made it difficult for the relatives to establish a balance in their lives. To be able to prioritize some private time was important. Relatives need own support and sufficient follow-up of the mentallyill next of kin from the mental health services. PMID:22583154
Weimand, Bente M; Hall-Lord, Marie Louise; Sällström, Christina; Hedelin, Birgitta
In this study, the attitudes toward and beliefs about serious mentalillness (SMI) held by a group of graduate social work students in the northwestern United States were examined. Mental health stigma was examined with relation to the following factors:participants'level of social contact with SMI populations, adherence to stereotypes about SMI populations, belief in the ability to recover from SMI, and the belief that SMI defines an individual's identity. Measures used to identify mental health stigma included the desire for social distance and restrictions with relation to the SMI population. Survey results from 71 graduate social work students found that a significant number of participants who engaged in friendships with SMI-diagnosed individuals had less desire for social distance from and restrictions toward SMI populations. Participants who indicated that they believed in stereotypes of dangerousness and believed that SMI defines an individual's identity were more likely to express desire for both social distance and restrictions. Implications for social work and further research on the matter are discussed. PMID:22308664
Dental fear is a barrier to receiving dental care, particularly for those patients who also suffer from mentalillnesses. The current study examined United States dental professionals’ perceptions of dental fear experienced by patients with mentalillness, and frequency of sedation of patients with and without mentalillness. Dentists and dental staff members (n = 187) completed a survey about their experiences in treating patients with mentalillness. More participants agreed (79.8%) than disagreed (20.2%) that patients with mentalillness have more anxiety regarding dental treatment (p < .001) than dental patients without mentalillness. Further, significantly more participants reported mentallyill patients’ anxiety is “possibly” or “definitely” a barrier to both receiving (96.8%; p < .001) and providing (76.9%; p < .01) dental treatment. Despite reporting more fear in these patients, there were no significant differences in frequency of sedation procedures between those with and without mentalillness, regardless of type of sedation (p’s > .05). This lack of difference in sedation for mentallyill patients suggests hesitancy on the part of dental providers to sedate patients with mentalillness and highlights a lack of clinical guidelines for this population in the US. Suggestions are given for the assessment and clinical management of patients with mentalillness.
Heaton, Lisa J.; Hyatt, Halee A.; Huggins, Kimberly Hanson; Milgrom, Peter
The present study analysed the characteristics of homicide in internees according to the Social Defence system in Belgium. The Social Defence system was inaugurated in 1930, following the ideas of Adolphe Prins, a Belgian specialist in the criminal law. The Social Defence system concerns those offenders who are considered as mentallyill at large. The concept of mentalillness encompasses the classical notion of "dementia" but also those people with mental unbalance as personality disordered offenders and mentally retarded persons. In the present study, we considered all those internees who committed a homicide or a homicide attempt and whose cases were examined by the review board between September 1998 and June 2000. We collected 99 cases and studied the age at the time of the offence (mean: 32.2 years), their diagnoses, the status of victims. These 99 murderers committed 111 "facts", a fact being a murder or murder attempt on one or several person(s) without arrest between the different phases of the commitment. These facts provoked 132 victims (72 men and 60 women); 61.36 % deceased. There was no significant difference in the characteristics of homicide versus homicide attempt. The results showed that, in our population, 59.6 % of the patients endorsed a diagnosis of psychosis (37 cases of paranoid schizophrenia, 2 schizophrenias of other types, 7 schizo-affective disorders, 1 autistic disorder, and 12 delusional disorders). Other axis I disorders were 3 intermittent explosive disorders, 2 major depressive disorders, 2 paraphilias and 1 bipolar disorder. The 32 offenders with no axis I major mental diseases presented such diagnoses, alone or comorbid, as antisocial personality disorder (n = 17), borderline personality disorder (n = 8), paranoid personality disorder (n = 4), and schizoid personality disorder (n = 2), 14 were mentally retarded and 5 presented a cerebral damage or an epilepsy. The age of the offender at the first homicide was not significantly different between the different diagnoses: group 1 : schizophrenia-type group (29.63 years) ; group 2 : comorbid diagnoses of schizophrenia and cluster B personality disorder (31.64 years) ; group 3 : cluster B personality disordered people (without psychosis) (27.90 years) ; and group 4 : the mixed group of residual diagnoses (32.63 years). Only the persons with a delusional disorder (group 5) significantly committed their homicide at an older age (47,06 year). We found no significant differences between group 2 (54.55 %), 3 (69.23 %), and 4 (50 %) in the proportion of offenders having substance problems. The group 1 (schizophrenia-type without comorbid personality disorder) presented significantly less problems with substances (13.83 %) than the three former groups. The group 5 (20.0 % prevalence) exhibited only a significant difference with group 3. We distinguished instrumental and emotional violence. Instrumental violence was more represented in the facts committed by group 2, 3 and 4 versus group 5. Group 1 differed also significantly from groups 2 and 3. The status of the victim(s) was divided in: 1) members of the family; 2) specifically known persons (outside the family); 3) specifically chosen victims (chosen, searched or followed because of their status, gender, profession, social role); 4) opportunity victims (victims present at the time and having sufficient characteristics to be attacked, e.g. being a woman, suspected to have some money); and 5) accidental victims. We demonstrated in our sample that victims of murderers in their family or specifically known were more frequently victims of pure psychotic offenders (groups 1 + 5) than of offenders of the mixed group (groups 2, 3 and 4) (21.97% vs 10.61%; 16,67% vs 13.64 %, respectively). On the contrary, specifically chosen (2.27 % vs 8.33 %) and opportunity victims (3.03 % vs 11.36 %) were more frequently attacked by the "mixed group". Accidental murders were almost only committed by psychotics (10.61 % vs 0.76 %), often in the context of a spree murder. In conclusion, we
This multi-site study addressed critical gaps in the literature by assessing the prevalence of serious mentalillness (SMI), posttraumatic stress disorder (PTSD), and substance use disorders (SUD) in women in jail and pathways to offending for women with ...
Medication Guide Antidepressant Medicines, Depression and other Serious MentalIllnesses, and Suicidal Thoughts or Actions Read the Medication Guide that comes with you or your family member’s antidepressant medicine. This Medication Guide is ...
The Permanent Housing component of the Supportive Housing Program, the Department's principal program to meet the needs of homeless people with disabilities, was established to offer homeless people with disabilities, including mentalillness, an assuranc...
Y. I. Wong T. R. Hadley D. P. Culhane S. R. Poulin M. R. Davis
Stigma against mentalillness is a complex construct with affective, cognitive, and behavioral components. Beyond its symbolic value, federal law can only directly address one component of stigma: discrimination. This article reviews three landmark antidiscrimination laws that expanded protections over time for individuals with mentalillness. Despite these legislative advances, protections are still not uniform for all subpopulations with mentalillness. Furthermore, multiple components of stigma (e.g., prejudice) are beyond the reach of legislation, as demonstrated by the phenomenon of label avoidance; individuals may not seek protection from discrimination because of fear of the stigma that may ensue after disclosing their mentalillness. To yield the greatest improvements, antidiscrimination laws must be coupled with antistigma programs that directly address other components of stigma.
Cummings, Janet R.; Lucas, Stephen M.; Druss, Benjamin G.
Persuasive empirical support exists for a positive association between serious mentalillness (SMI) and rates of violence; a great deal of support is also present for the clinical impression that psychotic symptoms sometimes motivate \\
This report has three objectives: (1) to demonstrate the need for prevention-oriented approaches to end homelessness among people who have serious mentalillnesses; (2) to make recommendations regarding State-level strategies to strengthen prevention effo...
Prior research has established an association between deployment and family violence, with insufficient evidence to identify when such violence occurs in relation to deployment and identification of mentalillness in ADSM. This project will use: (1) longi...
Prior research has established an association between deployment and family violence, with insufficient evidence to identify when such violence occurs in relation to deployment and identification of mentalillness in ADSM. This project will use: (1) longi...
Prior research has established an association between deployment and family violence, with insufficient evidence to identify when such violence occurs in relation to deployment and identification of mentalillness in ADSM. This project will use: 1) longit...
OBJECTIVE The study compared delays in seeking general medical care among adults with serious mentalillness and a general population sample. Associations of delays with health status and use of emergency department services among individuals with serious mentalillness were also assessed. METHODS Data for 271 persons with serious mentalillness (clinic sample) and 40,016 participants in the National Health Interview Survey (NHIS sample) were compared. RESULTS Fifty-three percent of the clinic sample and 13% of the NHIS sample reported delays, most because of difficulties accessing services. In the clinic sample, delays were associated with receipt of routine care at a public clinic, rather than a physician's office; more severe depressive symptoms; and functional difficulties. Delays were also associated with poorer health status and use of emergency department services. CONCLUSIONS Integration of services as envisioned in the Affordable Care Act and targeted case management may reduce delays among individuals with serious mentalillness. PMID:24733659
Acute secondary care settings are complex environments that offer a range of challenges for healthcare staff. These challenges can be exacerbated when patients present with a co-morbid mentalillness. This article is a systematic review of the literature that has investigated the challenges imposed on health professionals working in acute secondary care settings where they care for patients who experience co-morbid physical and mentalillnesses. A systematic search of the bibliographic databases was conducted and a total of 25 articles were included in this review. A number of challenges were identified including experience of fear, negative attitudes, poor mental health literacy, being positive and optimistic in providing care as a profession and environmental factors. Health professionals working in acute secondary care settings require organisational support and training in mental health care. Acute secondary care environments conducive to providing holistic care to patients experiencing mentalillness co-morbidity are required. PMID:25072334
People from culturally and linguistically diverse (CALD) backgrounds hold attitudes, values and beliefs surrounding health, illness and mental health issues that are not fully in harmony with Western approaches to health care. In particular, mental health services do not adequately meet the specific needs of CALD communities, a situation that is a violation of sound health care access and rights. A number of damning government reports highlight the inadequacies of the system. CALD groups that experience mentalillness have the problem of dual vulnerabilities. They are disadvantaged on at least two fronts: The marginalization and stigmatization associated with mentalillness and the access and utilization of services. This paper reviews the context of mental health service delivery in Australia. There is agreement that the needs of these people are only marginally being met at best despite individual and collective efforts to address the issue. PMID:23181368
This study investigated the extent to which mentalillness and substance use hospitalization rates were related to the supply\\u000a of psychiatric treatment services. Supply variables, notably the per capita rate of psychiatrists, primary care physicians,\\u000a and specialty units, were strongly related to mentalillness and substance use hospitalization rates to acute care hospitals\\u000a across 114 small geographic areas in Iowa.
Michael S. Hendryx; Marta E. Urdaneta; Tyrone Borders
Background The stigma of mentalillness among medical students is a prevalent concern that has far reaching negative consequences. Attempts to combat this stigma through educational initiatives have had mixed results. This study examined the impact of a one-time contact-based educational intervention on the stigma of mentalillness among medical students and compared this with a multimodal undergraduate psychiatry course at the University of Calgary, Canada that integrates contact-based educational strategies. Attitudes towards mentalillness were compared with those towards type 2 diabetes mellitus (T2DM). Method A cluster-randomized trial design was used to evaluate the impact of contact-based educational interventions delivered at two points in time. The impact was assessed by collecting data at 4 time points using the Opening Minds Scale for Health Care Providers (OMS-HC) to assess changes in stigma. Results Baseline surveys were completed by 62% (n=111) of students before the start of the course and post-intervention ratings were available from 90 of these. Stigma scores for both groups were significantly reduced upon course completion (p < 0.0001), but were not significantly changed following the one-time contact based educational intervention in the primary analysis. Student confidence in working with people with a mentalillness and interest in a psychiatric career was increased at the end of the course. Stigma towards mentalillness remained greater than for T2DM at all time points. Conclusions Psychiatric education can decrease the stigma of mentalillness and increase student confidence. However, one-time, contact-based educational interventions require further evaluation in this context. The key components are postulated to be contact, knowledge and attention to process, where attending to the student’s internal experience of working with people with mentalillness is an integral factor in modulating perceptions of mentalillness and a psychiatric career.
The author discusses the quote from Mill's On Liberty that is often cited by libertarians in opposition to involuntary commitment of the mentallyill. This quote has been taken out of context; other statements in the document indicate that Mill excluded from his libertarian credo those "without the ordinary amount of understanding," i.e., those people who would now be considered mentallyill. PMID:335904
Objective: This cross-sectional mortality linkage study describes the prevalence of specific fatal disease and injury conditions in an adult population with serious mentalillness. The large sample of decedents and the use of multiple-cause-of-death data yield new clinical details relevant to those caring for persons with serious mentalillness. Meth- ods: Age-adjusted frequency distributions and years of potential life lost
The aims of this study were to examine gender differences in symptoms, functioning, substance use problems and substance use correlates in patients with serious mentalillness. The current study is cross-sectional, and data were collected using the Health of the Nation Outcome Scales for Severe MentalIllness (HoNOS-SMI) questionnaire. The questionnaire was completed by the patients' therapists. The study included
Turid Møller Olsø; Camilla Buch Gudde; Elin Wullum; Olav M. Linaker
The aims of this study were to examine gender differences in symptoms, functioning, substance use problems and substance use correlates in patients with serious mentalillness. The current study is cross-sectional, and data were collected using the Health of the Nation Outcome Scales for Severe MentalIllness (HoNOS-SMI) questionnaire. The questionnaire was completed by the patients' therapists. The study included
Turid Møller Olsø; Camilla Buch Gudde; Elin Wullum; Olav M. Linaker
Background Studies among adults show an association between abuse and Body Mass Index (BMI) status. When an aberrant BMI status as a consequence of abuse is already prevalent in adolescence, early detection and treatment of abuse might prevent these adolescents from developing serious weight problems and other long-term social, emotional and physical problems in adulthood. Therefore, this study investigated the prevalence of physical, sexual and mentalabuse among adolescents and examined the association of these abuse subtypes with BMI status. Methods In total, data of 51,856 secondary school students aged 13–16 who had completed a questionnaire on health, well-being and lifestyle were used. BMI was classified into four categories, underweight, normal weight, overweight and obesity. Adolescents reported if they had ever been physically, sexually or mentallyabused. Crude and adjusted General Estimation Equation (GEE) analyses were performed to investigate the association between abuse subtypes and BMI status. Analyses were adjusted for ethnicity and parental communication, and stratified for gender and educational level. Results Eighteen percent of the adolescents reported mentalabuse, 7% reported sexual abuse, and 6% reported physical abuse. For underweight, overweight and obese adolescents these percentages were 17%, 25%, and 44%; 7%, 8%, and 16%; and 6%, 8%, 18% respectively. For the entire population, all these subtypes of abuse were associated with being overweight and obese (OR=3.67, 1.79 and 1.50) and all but sexual abuse were associated with underweight (OR=1.21 and 1.12). Stratified analyses showed that physical and sexual abuse were significantly associated with obesity among boys (OR=1.77 and 2.49) and among vocational school students (OR=1.60 and 1.69), and with underweight among girls (OR=1.26 and 0.83). Conclusion Mentalabuse was reported by almost half of the obese adolescents and associated with underweight, overweight and obesity. Longitudinal analyses are recommended to explore the causality of and the mechanisms explaining this association between abuse and overweight.
Stigma and discrimination have been identified as important obstacles to the integration of people with mentalillness in society. In efforts to reduce stigma and discrimination, health professionals play an important role as they have frequent contact with and responsibility for treatment and rehabilitation of consumers. The aim of the present study was to investigate attitudes towards mentalillness and people with mentalillness among nursing staff working in psychiatric or somatic care. The sample consisted of 120 registered or assistant nurses who were interviewed about intimacy with mentalillness and attitudes about seven different mentalillnesses. The results showed that nursing staff in somatic care, to a higher degree than nursing staff in mental health, reported more negative attitudes with regard to people with schizophrenia as being more dangerous and unpredictable. In contrast, professional experience, intimacy with mentalillness and type of care organization were found to be more associated with attitudes to specific mentalillnesses concerning the prospect of improvement with treatment and the prospect of recovery. In conclusion, attitudes among nursing staff are in several respects comparable with public opinions about mentalillness and mentallyill persons. In order to elucidate if negative attitudes about dangerousness and unpredictability of persons with specific mentalillnesses are associated with realistic experiences or with prejudices further studies with a qualitative design are suggested. PMID:18489686
Background There has been a substantial increase in research on mentalillness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mentalillness stigma, prejudice and discrimination experienced by people who have personal experience of mentalillness. We will identify measures used, their characteristics and psychometric properties. Method A narrative literature review of survey measures of mentalillness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results 57 studies were included in the review. 14 survey measures of mentalillness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mentalillness stigma which is most appropriate to their purpose.
Many programs for offenders with mentalillness (OMIs) seem to assume that serious mentalillness directly causes criminal justice involvement. To help evaluate this assumption, we assessed a matched sample of 221 parolees with and without mentalillness and then followed them for over 1 year to track recidivism. First, compared with their relatively healthy counterparts, OMIs were equally likely to be rearrested, but were more likely to return to prison custody. Second, beyond risk factors unique to mentalillness (e.g., acute symptoms; operationalized with part of the Historical-Clinical-Risk Management-20; Webster, Douglas, Eaves, & Hart, 1997), OMIs also had significantly more general risk factors for recidivism (e.g., antisocial pattern; operationalized with the Level of Service/Case Management Inventory; Andrews, Bonta, & Wormith, 2004) than offenders without mentalillness. Third, these general risk factors significantly predicted recidivism, with no incremental utility added by risk factors unique to mentalillness. Implications for broadening the policy model to explicitly target general risk factors for recidivism such as antisocial traits are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24377913
Skeem, Jennifer L; Winter, Eliza; Kennealy, Patrick J; Louden, Jennifer Eno; Tatar, Joseph R
After the democratization of South Africa in 1994, the health-care system was reorganized in accordance with the primary health-care philosophy advocated by the World Health Organization. This was accompanied by a process of deinstitutionalization of mental health-care services, which has led families to become the main providers of care to individuals with mentalillness. This study explores the experiences of informal family caregivers of persons with mentalillness in a rural area in South Africa. Data were collected through eight individual semistructured interviews of informal caregivers who cared for relatives with mentalillness and collect medications monthly at a community clinic in the Makhuduthamaga local municipality in Limpopo, South Africa. A qualitative research design was used, which was explorative, descriptive, and contextual. The data analysis revealed four major themes: (i) experiences of providing for physiological/physical needs; (ii) experiences of providing for emotional needs; (iii) experiences of providing for security needs; and (iv) experiences associated with the medical health-care programme. The study revealed that the experiences of family caregivers were conceptualized negatively, although the interview questions were intentionally neutral. This is believed to be due to the cultural explanatory models of mentalillness prevalent in this region of South Africa. It is suggested that to increase compliance with medication, reduce relapse, and mitigate stigma associated mentalillness, medical professionals need to incorporate aspects of cultural explanatory models into their explanations of the causes of illness. PMID:19740145
Mavundla, Thandisizwe R; Toth, Ferenc; Mphelane, Makua L
Severe mentalillness (SMI) is a broad category that includes schizophrenia, bipolar disorder, and severe depression. Both genetic disposition and environmental exposures play important roles in the development of SMI. Multiple lines of evidence suggest that the roles of genetic and environmental factors depend on each other. Gene–environment interactions may underlie the paradox of strong environmental factors for highly heritable disorders, the low estimates of shared environmental influences in twin studies of SMI, and the heritability gap between twin and molecular heritability estimates. Sons and daughters of parents with SMI are more vulnerable to the effects of prenatal and postnatal environmental exposures, suggesting that the expression of genetic liability depends on environment. In the last decade, gene–environment interactions involving specific molecular variants in candidate genes have been identified. Replicated findings include an interaction between a polymorphism in the AKT1 gene and cannabis use in the development of psychosis and an interaction between the length polymorphism of the serotonin transporter gene and childhood maltreatment in the development of persistent depressive disorder. Bipolar disorder has been underinvestigated, with only a single study showing an interaction between a functional polymorphism in the BDNF gene and stressful life events triggering bipolar depressive episodes. The first systematic search for gene–environment interactions has found that a polymorphism in CTNNA3 may sensitize the developing brain to the pathogenic effect of cytomegalovirus in utero, leading to schizophrenia in adulthood. Strategies for genome-wide investigations will likely include coordination between epidemiological and genetic research efforts, systematic assessment of multiple environmental factors in large samples, and prioritization of genetic variants.
Severe mentalillness (SMI) is a broad category that includes schizophrenia, bipolar disorder, and severe depression. Both genetic disposition and environmental exposures play important roles in the development of SMI. Multiple lines of evidence suggest that the roles of genetic and environmental factors depend on each other. Gene-environment interactions may underlie the paradox of strong environmental factors for highly heritable disorders, the low estimates of shared environmental influences in twin studies of SMI, and the heritability gap between twin and molecular heritability estimates. Sons and daughters of parents with SMI are more vulnerable to the effects of prenatal and postnatal environmental exposures, suggesting that the expression of genetic liability depends on environment. In the last decade, gene-environment interactions involving specific molecular variants in candidate genes have been identified. Replicated findings include an interaction between a polymorphism in the AKT1 gene and cannabis use in the development of psychosis and an interaction between the length polymorphism of the serotonin transporter gene and childhood maltreatment in the development of persistent depressive disorder. Bipolar disorder has been underinvestigated, with only a single study showing an interaction between a functional polymorphism in the BDNF gene and stressful life events triggering bipolar depressive episodes. The first systematic search for gene-environment interactions has found that a polymorphism in CTNNA3 may sensitize the developing brain to the pathogenic effect of cytomegalovirus in utero, leading to schizophrenia in adulthood. Strategies for genome-wide investigations will likely include coordination between epidemiological and genetic research efforts, systematic assessment of multiple environmental factors in large samples, and prioritization of genetic variants. PMID:24860514
OBJECTIVE Information is limited concerning the role of religious and spiritual advisors in providing help to people with mentalillnesses in Singapore. This study examined that role, as well as the satisfaction with and the perceived effectiveness of the services provided, among people with mental health problems. METHODS Data were collected as part of a nationally representative household survey of residents 18 years and older in Singapore. The Composite International Diagnostic Interview, version 3.0, was used to diagnose mentalillness as well as to collect information about the mental health services respondents had sought. RESULTS A total of 6,616 respondents completed the survey; in the overall sample, 1.5% reported seeking help from religious or spiritual advisors. This rate increased to 6.6% among those with at least one mentalillness, with the prevalence being higher among respondents with lifetime dysthymia, generalized anxiety disorder, or bipolar disorder. Sociodemographic correlates associated with a lower likelihood of consultation with a religious or spiritual advisor included reporting "other" race-ethnicity as well as faith in Buddhism, Hinduism, or Islam. Most respondents who sought help from a religious or spiritual advisor in the last 12 months were satisfied with the help they received, and about half reported it to be very useful. CONCLUSIONS Religious and spiritual advisors are an important source of help for people with mentalillness, and a majority of respondents with a mentalillness were satisfied with the support they received from these sources. PMID:23903293
A training programme for rehabilitation of people with mentalillness is presented, designed particularly for schizophrenic patients who need occupational rehabilitation. The training goal is to connect aspects of the schizophrenic disorder with vocational issues. It is aimed at supporting the participants in developing a realistic and appropriate vocational perspective in line with their illness related restrictions and current vocational possibilities, seeking to find out the individual's optimal ability to take stress so as to avoid over- or understimulation in vocational respects. The ZERA training has been developed for implementation in different medical and vocational rehabilitation settings for persons with mentalillness. An initial control-group study was carried out to evaluate the effectiveness of this group training approach, and preliminary results have revealed changes in the experimental group in accordance with the objectives of the training and encourage further research. PMID:11253751
Culture may particularly influence community attitudes towards mentalillness, when the illness itself is shaped by a cultural context. To explore the influence of culture-specific, religious symptoms on Orthodox Jewish community attitudes, the authors compared the attitudes of 169 Orthodox Jews, who randomly viewed one of two vignettes describing…
Pirutinsky, Steven; Rosmarin, David H.; Pargament, Kenneth I.
This study sought to identify the psychiatric, physical, and social services needs experienced by older adults with severe mentalillness (SMI) and to examine factors influencing their experience of need and service provision adequacy. Seventy-five older adults with SMI were recruited from a community mental health center to participate in the…
This report is an analysis of five ethnic groups in New York City (Jews, blacks, Puerto Ricans, Italians, and Irish), and makes correlations between ethnicity, social class and mentalillness. It estimates the extent to which five indicators of health in area populations account for variation in rates of mental hospitalization for men and women…
This article describes the critical ingredients of the assertive community treatment (ACT) model for people with severe mentalillness and then reviews the evidence regarding its effectiveness and cost effectiveness. ACT is an intensive mental health program model in which a multidisciplinary team of professionals serves patients who do not readily use clinic-based services, but who are often at high
Gary R. Bond; Robert E. Drake; Kim T. Mueser; Eric Latimer
Psychiatric community-based services are being developed in Malaysia currently to ensure more comprehensive mental health care to especially patients with severe mentalillness. Assertive Community Treatment (ACT) as one of the earliest component of community-based services has been observed to be useful and able to provide favourable outcomes in this group of patients. Though the paradigm shift has gradually occurred
Background: Mentally retarded and chronic mentallyill are being certified using IQ Assessment and Indian Disability Evaluation and Assessment Scale (IDEAS). They have been granted various benefits including monthly pension, from Ministry of Social Welfare, Government of India. The monthly pension appears to be the strongest reason for seeking certification and applying for government benefits. The caregivers appear to have only partial information and awareness about the remaining schemes. Objective: The study aims to assess the severity of disability in the mentally retarded and mentallyill who are certified for disability benefits, as well as to assess the trends of utilization of disability benefits over a 3 year period. Materials and Methods: This was a retrospective, file review based study of certificates of patients certified for mental disability in the period of January 2006 to December 2008. Certificates of a total of 1794 mentally retarded and 285 mentallyill were reviewed. The data regarding utilization of disability benefits was assessed. Results: Patients from rural areas did not avail any benefits other than the disability pension. Among MentallyIll, Schizophrenia accounted for highest certifications. Males had higher disability compared to females, and Dementia showed highest disability as per IDEAS. Conclusion: Though initial hurdles due to disability measurement have been crossed, disability benefits are still elusive to the vast majority of the disabled. Proper awareness and education will help in reducing the stigma and in the effective utilization of benefits.
Kashyap, Kartik; Thunga, Ravish; Rao, Arun K.; Balamurali, N. P.
Summary New Zealand legislation allows for the involuntary outpatient treatment of people with serious mentalillness. This study examines the views of service users, family mem- bers and mental health professionals (MHPs) about the impact of this regime. Semi- structured interviews were completed with forty-two service users, twenty-seven family members and ninety MHPs, with recent experience of the regime. Participants
The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mentalillness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…
Relationship Enhancement (RE) therapy can be a useful intervention for adolescents with serious mentalillness and their family members. This article reviews the basic concepts and effectiveness of RE therapy and illustrates how it is implemented. Presents a case example and discusses implications for research and mental health counseling.…
Accordino, Michael P.; Keat, Donald B., II; Guerney, Bernard G., Jr.
Probation and parole officers supervise a disproportionate amount of offenders with mentalillness. Many causes contribute to this over-representation ranging from deinstitutionalization, to co-occurring disorders, to homelessness. It appears there may be a lack of training specifically for probation and parole officers on the topic of mental…
Estimates of the prevalence of serious mentalillness (SMI) provide a measure of the population with the most severe mental health problems and indicate those persons who are most in need of treatment. SMI is defined in this report as having at some time ...
Drawing on the stress paradigm and using data from the Duke Mental Health Study, this paper investigates the links between violence by and against persons with severe mentalillness and their caregivers' financial burden (e.g., number of financial contributions and perceived financial strain). In addition to violence, substance use and medication…
Educating and recruiting practitioners to work in community-based settings with persons with serious mentalillness has become a national health personpower issue, particularly in underserved rural areas. This study was conceived in order to obtain a better basis for curriculum development and recruitment strategies. Graduate and undergraduate social work students, representing the greatest pool of mental health practitioners, were surveyed
Explores the effects of maternal psychiatric symptoms and community functioning on child outcomes in a diverse sample of seriously mentallyill women caring for their teenaged children. In hierarchical multiple regression, for youth depression, we find effects for parenting style and maternal mental health; for youth anxiety and efficacy, effects…
Explores impact of national policies affecting income maintenance, health, transportation, education, employment, and housing of chronically mentallyill people in rural areas. Suggests policies rendered deinstitutionalization and rural community placement difficult. Reveals interlocking policy environment that warrants widening of mental health…
The large numbers of people with mentalillness in jails and prisons has fueled policy concern in all domains of the justice system. This includes police practice, where initial decisions to involve persons in the justice system or divert them to mental health services are made. One approach to focus police response in these situations is the implementation of Crisis
Amy C. Watson; Melissa Schaefer Morabito; Jeffrey Draine; Victor Ottati
Persons who are homeless and mentally illpresent unique challenges to service providers and humanservice systems. In vivo case management approaches suchas assertive community treatment (ACT) have shown promise in engaging this population. This paperexplores case management models employed within theACCESS program, a five year, 18-site demonstrationprogram enriching services for homeless persons with serious mentalillness. We describe theimplementation of case
Matthew Johnsen; Laura Samberg; Robert Calsyn; Margaret Blasinsky; Wendy Landow; Howard Goldman
This study tests three hypotheses concerning types of individuals who are likely to be excluded from a community for mentalillness. An “exclusion index” is developed, based on the ratio of involuntary to voluntary commitments to mental hospitals with high ratios indicating high rejection or low community tolerance of deviance. The patient sample consists of 14,304 first admissions to the
Objective: Interview data collected from 275 clients with severe mentalillnesses are used to test the construct and criterion validity of the Posttraumatic Stress Disorder Symptom Scale (PSS). Method: First, exploratory and con- firmatory factor analyses are used to test whether the scale reflects the posttraumatic stress disorder (PTSD) symp- tom criteria of the Diagnostic and Statistical Manual of Mental