Societal abuse refers to the disadvantages that a group experience as a result of unjust social structures. People with mental illness are among the most marginalized, oppressed, devalued and stigmatized populations in our society. They experience a range of societal abuses, including barriers to health care, lack of employment, difficulty accessing and maintaining adequate housing, and discrimination. Nurses are in a unique position to address social inequity and societal abuse as advocates for health and well-being. The author addresses the impact of societal abuse and presents ways in which nurses can advocate for people with mental illness. PMID:19583050
This paper reviews issues in the provision of services to individuals who are mentally ill chemical abusers and addicted (MICAA). Introductory material defines this population and notes that these people are frequently ineligible for services aimed at either mental illness or chemical abuse alone. Service provisions within the psychiatric/mental…
Stanley D. Rosenberg; Robert E. Drake; Kim Mueser
Sexual abuse in childhood is increasingly recognized as an important etiologic component in a number of psychiatric disorders. One-quarter to one-third of all female children suffer sexual abuse before their eighteenth birthday, and at least one half of women with severe mental illness acknowledge such events. An even higher percentage of a particularly vulnerable group, dually diagnosed homeless women, appear
Andres R. Schneeberger; Kristina H. Muenzenmaier; Joseph Battaglia; Dorothy Castille; Bruce G. Link
People with severe mental illness (SMI) report high rates of traumatic experiences. This study analyzes data collected from 183 people diagnosed with SMI on reports of childhood trauma, head injuries, and emergency room (ER) services. More than half the cohort (56.7%) reported 3 to 7 cooccurring categories of childhood abuse (CAB). People who reported 6 and 7 categories of CAB
Morris, Sylvia K.; Schinke, Steven P.
Reviews treatment needs of dual diagnosed, substance abusing and mentally ill mothers. Suggests treatment strategies and programmatic options for serving and meeting needs of these mothers and their children. Devotes particular attention to residential and continuing care services and skills-based interventions for target clients. Concludes with…
The current article outlines a comprehensive approach to evidence-based social work practice, and applies it to persons with severe and persistent mental illness 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
De Leon, G; Sacks, S; Staines, G; McKendrick, K
This paper is one of a series reporting on a clinical field trial evaluating the efficacy of the modified therapeutic community (TC) approach for the treatment of homeless mentally ill chemical abusers (MICAs). The social and psychological characteristics of the treatment sample were described in an earlier paper; the purpose of the present report was to categorize subtypes of homeless MICA clients to predict with greater accuracy their treatability in modified TCs. An index that consistently correlated with treatment-relevant variables was identified for each of three dimensions; Homelessness (residential instability), Mental Illness (current severity), and Substance Abuse (current substance abuse/dependence diagnosis). These indices yielded distributions that captured the variability in the sample with respect to a number of variables, including drug use, criminality, human immunodeficiency virus (HIV) risk (sexual behavior), psychological status, and motivation. Bivariate and multivariate analyses showed that the indices were not strongly related to demographic variables such as race/ethnicity, age, or gender, but were significantly associated with baseline drug use, criminal activity, HIV risk (sexual behavior), psychological symptoms, and motivation and readiness. These findings indicate that, even among those admitted to residential treatment for substance abuse, homeless MICA clients are not homogeneous; rather, subgroup differences emerge among the indices of homelessness, mental illness, and substance abuse. The efficacy of treatment in modified TCs for these subgroups will be assessed in subsequent papers examining the relationships among the three indices, client retention, and outcomes during and subsequent to residential treatment. PMID:10473011
Anna Wiencrot; Angela Nannini; Susan E. Manning; Joan Kennelly
Mental illness (MI), substance abuse (SA), and intentional injury (II) are known individual risk factors for adverse pregnancy\\u000a outcomes. Their combined association with preterm birth (PTB) and low birth weight (LBW) remains relatively unexplored. We\\u000a examined hospital utilization for the co-occurrence of II and MI or SA in pregnant women in Massachusetts and assessed their\\u000a interactive association with PTB and
Robert M. Malow; Jessy G. Dévieux; Ligia Martinez; Fred Peipman; Barbara A. Lucenko; Seth C. Kalichman
Epidemiological studies in the United States estimate HIV seroprevalence rates ranging between 4% and 23% for serious mentally ill 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
Christina S. Meade; Trace S. Kershaw; Nathan B. Hansen; Kathleen J. Sikkema
The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately\\u000a high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood\\u000a abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving\\u000a community mental health
Subica, Andrew M
Trauma and posttraumatic stress disorder (PTSD) frequently co-occur with serious mental illness, yet the unique mental and physical health influences of childhood physical abuse (CPA), childhood sexual abuse (CSA), and forced sexual trauma on individuals with serious mental illness remain unevaluated. The present study of 172 individuals with serious mental illness investigated the adverse effects of CPA, CSA, and forced sexual trauma on severity of PTSD and depression, and overall mental and physical health functioning. Data analysis consisted of chi-square tests, independent t tests, bivariate odds ratios, and linear regressions. Prevalence of CPA (44.8%), CSA (29.1%), and forced sexual trauma (33.1%) were elevated, and nearly one third of participants (31.4%) reported clinical PTSD. Participants exposed to CSA or forced sexual trauma evidenced bivariate ORs ranging from 4.13 to 7.02 for PTSD, 2.44 to 2.50 for major depression, and 2.14 to 2.31 for serious physical illness/disability. Sexual trauma exposure associated with heightened PTSD and depression, and reduced mental and physical health functioning, with CSA uniquely predicting PTSD, depression, and physical health difficulties. CPA less significantly affected these clinical domains. Sexual traumas have profound negative effects on mental and physical health outcomes among individuals with serious mental illness; increased screening and treatment of sexual traumas is needed. PMID:24115301
The Substance Abuse and Mental Health Services Administration Home Newsroom Site Map Contact Us SAMHSA Search Search All SAMHSA Data ... SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities. “Talk. They ...
Brown, Vivian B.; And Others
The special needs of young adults with concurrent mental health and substance abuse problems are discussed. This article presents federal initiatives and research findings, and describes state-of-the-art approaches to treatment and rehabilitation. Strategies for training mental health professionals to diagnose and treat dually disabled persons are…
Rosen, Marc I; McMahon, Thomas J; Lin, HaiQun; Rosenheck, Robert A
Objectives To determine whether receipt of social supplemental security income (SSI) or Social Security disability income (SSDI) disability payments is associated with increased drug and alcohol use. Data Sources/Study Setting Secondary analysis of data from 6,199 participants in the Access to Community Care and Effective Social Supports and Services demonstration for the homeless mentally ill. Design Observational, 12-month, cohort study completed over 4 years. Substance abuse and other outcomes were compared between the participants who did not receive SSI or SSDI during the 12-month study, those newly awarded benefits, and those without benefits throughout the 12 months. Data Collection Methods Social Security administrative records were used to corroborate Social Security benefit status. Drug and alcohol use were measured by self-report and clinician ratings. Principal Findings Participants who did not receive benefits significantly reduced their substance use over time. In generalized estimating equations models that adjusted for potentially confounding covariates, participants who newly received Social Security benefits showed no greater drug use than those without benefits but had significantly more days housed and fewer days employed. Participants whose benefits antedated the demonstration and continued during the 12 months had more clinician-rated drug use over time than those without benefits. Conclusions In this vulnerable population, participants with newly awarded benefits did not have any different drug use changes than those without benefits, and had relatively more days housed. The hypothesis that Social Security benefits facilitate drug use was not supported by longitudinal data in this high-risk population. PMID:16430606
Padgett, Deborah K.; Smith, Bikki Tran; Tiderington, Emmy
Objective This paper addresses how consumers with dual diagnosis, who were formerly homeless but are now living in supportive housing, understand their recovery from substance abuse (i.e., substance abuse or dependence). Specifically, this study examined: What can be learned about substance abuse recovery from consumers considered to be doing well; how past substance abuse fits into their present-day narratives; and how (if at all) policies of harm reduction versus abstinence are regarded as affecting recovery efforts. Methods As part of a federally-funded qualitative study, 38 individuals who met criteria for having achieved a measure of success in mental health recovery were purposively sampled from two supportive housing agencies – one using a harm reduction and the other an abstinence model. Researchers conducted in-depth interviews and used case study analysis, the latter including the development of case summaries and data matrices, to focus on substance abuse recovery in the larger context of participants’ lives. Results Recovery from substance abuse was depicted as occurring either through discrete decisions or gradual processes; achieving recovery was distinct from maintaining recovery. Emergent themes related to achievement included: (a) pivotal events and people (b) maturation, and (c) institutionalization. Central themes to maintaining recovery were: (a) housing, (b) self-help, and (c) the influence of significant others. Conclusions These findings capture a complex picture of overcoming substance abuse that largely took place outside of formal treatment and was heavily dependent on broader contexts. Equally important is that consumers themselves did not necessarily view substance abuse recovery as a defining feature of their life story. Indeed, recovery from substance abuse was seen as overcoming one adversity among many others during their troubled life courses. PMID:22962547
Zhuo, Yue; Bradizza, Clara M; Maisto, Stephen A
The interrelationships between severe mental illness, substance use, and aggression are of longstanding importance with implications for community treatment programs, treatment research and public policy. Through the analysis of longitudinal data collected from 278 patients over a 6-month period following admission to an outpatient dual diagnosis treatment program, this study examined the association between dual diagnosis treatment attendance and subsequent aggression among individuals diagnosed with both a severe mental illness and a substance use disorder. We also tested substance use and psychiatric symptoms as mediators of this treatment-aggression relationship. The results of structural equation modeling analyses indicated that dual diagnosis treatment was associated with lower levels of subsequent aggression. Mediational analyses indicated that greater treatment involvement was associated with reduced substance use, which was associated with lower levels of aggression; thus, substance use was found to mediate the relationship between dual diagnosis treatment and aggression. Surprisingly, severity of psychiatric symptoms did not predict later aggression. These findings suggest that targeting substance use reduction in treatment may have the additional benefit of reducing the risk of later aggression among dual diagnosis patients. PMID:25124261
Background There is a long history of certain medical conditions being associated with stigma, stereotypes, and negative attitudes. Research has shown that such attitudes can have a detrimental effect on patients presenting with stigmatised medical conditions and can even flow on to impact their family. The objective of this study was to measure the attitudes of undergraduate students enrolled in six different health-related courses at Monash University toward patients with intellectual disability, substance abuse, and acute mental illness. Methods A convenience sample of undergraduate students enrolled in six health-related courses in first, second and third years at Monash University were surveyed. The Medical Condition Regard Scale - a valid and reliable, self-report measure of attitudes - was administered to students along with a brief demographic form. Mean scores, t-tests, and ANOVA were used to analyse student attitudes. Ethics approval was granted. Results 548 students participated. Statistically significant differences were found between the courses (p = 0.05), year of the course (p = 0.09), and gender (p = 0.04) for the medical condition of intellectual disability. There was no statistically significant difference between the courses, year of the course, gender, and age group for substance abuse or acute mental illness conditions. Conclusion The findings suggest that students in undergraduate health-related courses, as a group, have a strong regard for patients with intellectual disability and some regard for patients with acute mental illness, but not for patients presenting with substance abuse problems. PMID:20964840
Chandra, Prabha S.; Carey, Michael P.; Carey, Kate B.; Shalinianant; Thomas, Tinku
Research from the west indicates that women living with a psychiatric disorder are particularly vulnerable to sexual coercion and abuse. However, there have been no published reports of sexual abuse among female psychiatric patients in India. This exploratory study sought (1) to determine the prevalence of sexual coercion in a representative sample of female psychiatric patients in India, (2) to identify clinical and sociodemographic correlates of sexual coercion, (3) to clarify the association between sexual coercion and human immunodeficiency virus (HIV)-related risk behaviour, and (4) to determine whether self-report of sexual coercion from these patients was recorded in their medical charts. Consecutive female inpatient admissions (N = 146) to a large psychiatric hospital in southern India were assessed using a structured interview and standardized measures. During structured clinical interviews, sexual coercion was reported by 30% of the 146 women. The most commonly reported experience was sexual intercourse involving threatened or actual physical force (reported by 14% of women), and the most commonly identified perpetrator was the woman's husband or intimate partner (15%), or a person in a position of authority in their community (10%). Women with a history of abuse were more likely to report HIV-related sexual behaviour (p < .001). In contrast to the 30% of women who reported sexual coercion during interviews, only 3.5% of the medical records contained this information. Thus, sexual coercion is a serious and prevalent concern among female Indian psychiatric patients, but is rarely reported in medical charts. Increased screening and reporting are indicated, as are sexual abuse prevention and treatment programs. PMID:12764708
Bouis, Stephanie; Reif, Susan; Whetten, Kathryn; Scovil, Janet; Murray, Andrea; Swartz, Marvin
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…
Singer, Mark I.; Kola, Lenore A.; Biegel, David E.
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…
Wood, Steven R.; Buttaro, Anthony, Jr.
Using hierarchical logistic regression with a nationally representative sample of state prisoners ("n" = 12,504), we found inmates with dual severe psychiatric and substance abuse disorders to be at higher risk of being assaulted and to assault others in prison than nonmentally ill inmates. Dually disordered inmates may be "importing"…
Overton, Stacy L.; Medina, Sondra L.
Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…
Deborah K. Padgett; Leyla Gulcur; Sam Tsemberis
The literature on homeless adults with severe mental illness 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
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. Mental illness 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 mental illness. Key Words: Agency • alchemy • behaviour • cause • chemistry • dignity PMID:11579183
Robert E. Drake; Arthur I. Alterman; Stanley R. Rosenberg
Severe mental illness is frequently complicated by substance use disorder. Approximately half of the severely mentally ill patients treated in acute care psychiatric settings have abused one or more of these substances. Despite the high rate of comorbidity, substance use disorders are generally not detected in acute care psychiatric settings, leading to incorrect diagnoses and ineffective treatments. The reasons for
Wolff, Nancy; Frueh, B Christopher; Shi, Jing; Schumann, Brooke E
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 mental illness, 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
Booth, Brad D; Gulati, Sanjiv
Transinstitutionalization (ie, the criminalization of those with mental illness) is relevant to individuals committing sexual offenses. Mental illness 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
Lewis, Valerie A; Colla, Carrie H; Tierney, Katherine; Van Citters, Arica D; Fisher, Elliott S; Meara, Ellen
Accountable care organizations (ACOs) may be well positioned to increase the focus on managing behavioral health conditions (mental health and substance abuse) through the integration of behavioral health treatment and primary care. We used a mixed-methods research design to examine the extent to which ACOs are clinically, organizationally, and financially integrating behavioral health care and primary care. We used data from 257 respondents to the National Survey of Accountable Care Organizations, a nationally representative survey of ACOs. The data were supplemented with semistructured, in-depth interviews with clinical leaders at sixteen ACOs purposively sampled to represent the spectrum of behavioral health integration. We found that most ACOs hold responsibility for some behavioral health care costs, and 42 percent include behavioral health specialists among their providers. However, integration of behavioral health care and primary care remains low, with most ACOs pursuing traditional fragmented approaches to physical and behavioral health care and only a minority implementing innovative models. Contract design and contextual factors appear to influence the extent to which ACOs integrate behavioral health care. Nevertheless, the ACO model has the potential to create opportunities for improving behavioral health care and integrating it with primary care. PMID:25288427
Poreddi, Vijayalakshmi; BIrudu, Raju; Thimmaiah, Rohini; Math, Suresh Bada
Background: Despite of growing evidence of mental disorders in developing countries, research on mental health literacy is limited from India. Aim: To examine mental health literacy among caregivers of persons with mental illness Materials and Methods: A cross-sectional descriptive survey was carried out among 161 randomly selected caregivers of persons with mental illness at outpatient department of a tertiary care centre. Data was collected through face to face interview using a structured questionnaire. Results: Regarding the causes of mental illness, a majority agreed that genetic inheritance (69%), substance abuse (64%) and brain disease (59.6%) are main factors for developing mental illness. Although more than two-thirds agreed that anyone could suffer from mental illness, 61.5% also agreed that people with mental health problems are largely to blame for their condition. The majority of the participants also agreed that mentally ill are not able to maintain friendships (45.9%), are dangerous (54%), and not capable to work (59.1%). Just over half (55.9%) of the participants would not want people to know if they had a mental illness and nearly half of them also expressed that they would feel ashamed if a family member had a mental illness. Conclusion: Based on the findings of the present study researchers suggest that there is an urgent need to educate and change the attitudes of caregivers through mental health literacy programs specifically designed for them.
Bruce G. Link; Lawrence H. Yang; Jo C. Phelan; Pamela Y. Collins
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
Murphy, Gillian; Peters, Kathleen; Wilkes, Lesley; Jackson, Debra
In this paper, we present A Dynamic Cycle of Familial Mental Illness; an innovative framework, which considers family members' experiences and responses to mental illness. There is an acknowledged discourse noting parental experiences of mental illness alongside a growing body of knowledge acknowledging children's needs while living with parental mental illness. However, there is a paucity of literature that makes reference to the concept of familial mental illness and the cyclic interface of parental and child distress and symptoms. The model is supported by published research studies from several differing disciplines to demonstrate the relationship between parent and child experiences and to synthesise the published short- and longer-term possible impact of familial mental illness. An extensive search of the literature using recognised search engines, keywords and phrases has been undertaken, to generate an appropriate literature base for this work. This literature demonstrates how a child's possible emotional distancing as a response to parental mental illness could increase parental distress. A Dynamic Cycle of Familial Mental Illness adopts the underpinning philosophy of a Stress Vulnerability Model of Mental Illness, which assumes that predisposing factors and increased stress for a parent may have possible links to exacerbation of parental mental distress and symptomology. We advocate for further research of familial mental illness, and argue for a family approach to mental health assessment and treatment in mainstream health and social care sectors. PMID:25426750
Aileen B. Rothbard; Bentson H. McFarland; David L. Shern; Joseph P. Morrisey; H. Stephen Leff; A. Michael Wylie
and Introduction Abstract The rapid enrollment of Medicaid clients in private sector managed care plans has prompted considerable debate among consumers and policymakers about the extent that private sector techniques are transferable to vulnerable populations, such as persons with serious mental illness. Concern about these issues and the lack of empiric data to inform policy choices led the Substance Abuse
A reformed mental health system that does not support the family adequately only spreads the burden of suffering. The evolution of a more sophisticated and precise biological understanding of mental illness has enlarged the limits of what is possible for family members to undertake. When families are well supported, the mentally ill do better. The federal government can lead through
Weber, Linda R.; Wimmer, Sharon
This brief factsheet presents information on mental illness in mentally retarded persons. The most prevalent disorders found in this population are schizophrenia, organic brain syndrome, adjustment disorders, personality disorders, depression, and behavioral problems. Few standardized methods of assessment exist for the diagnosis of mental illness…
Afifi, Tracie O.; MacMillan, Harriet L.; Boyle, Michael; Taillieu, Tamara; Cheung, Kristene; Sareen, Jitender
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. PMID:24756625
Bishop, B. W.
This article discusses the importance of archiving state commission papers, documenting the formation of public policy, and allowing the public access to an organized collection of the data gathered by the Florida Commission on Mental Health and Substance Abuse. Florida's citizens with mental illnesses or substance abuse disorders face a myriad of…
Beth R. Hinden; Kathleen Biebel; Joanne Nicholson; Alexis D. Henry; Lawrence Stier
Citation: Hinden, B., Biebel, K., Nicholson, J., Henry, A., & Stier, L. (2002) Steps toward evidence-based practices for parents with mental illness 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 mental illness and their families by identifying
O'Keefe, Maureen L.
Largely the result of prison officials needing to safely and efficiently manage a volatile inmate population, administrative segregation or supermax facilities are criticized as violating basic human needs, particularly for mentally ill inmates. The present study compared Colorado offenders with mental illness (OMIs) to nonOMIs in segregated and…
Ursula M Read; Edward Adiibokah; Solomon Nyame
BACKGROUND: The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill 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.
The Substance Abuse and Mental Health Services Administration was established in 1992 and "leads Federal efforts to treat mental illnesses by promoting mental health and by preventing the development or worsening of mental illness 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.
Wilson, Amy Blank; Farkas, Kathleen; Ishler, Karen J; Gearhart, Michael; Morgan, Robert; Ashe, Melinda
The purpose of this study was to extend the investigation of criminal thinking of persons with mental illness beyond prison and community settings to a jail setting. Participants consisted of 122 individuals incarcerated in a county jail who were diagnosed with a severe mental illness, including schizophrenia spectrum and major mood disorders. Results indicated that people with mental illness in this sample of jail inmates presented with thinking styles that support a criminal lifestyle, and have criminal thinking styles that follow a pattern that is very similar to a sample of prison inmates with serious mental illness. These findings support the need for therapeutic programs for justice-involved persons with serious mental illness to develop a multipronged treatment approach that integrates interventions for individuals' criminal thinking and antisocial attitudes with treatment for their mental illness and substance abuse issues. PMID:24707911
Warner, R; Taylor, D; Wright, J; Sloat, A; Springett, G; Arnold, S; Weinberg, H
Substance use among a random sample of mentally ill, community-based patients was examined. Current use was found to have declined substantially from a high lifetime prevalence, and a family history of substance abuse was associated with moderate to heavy use. No association was found between heavy substance use and elevated psychopathology, hospitalization, or medication noncompliance. Hospital admissions and some symptoms were less prevalent among users preferring marijuana. PMID:8147425
California provides numerous pathways by which people with mental illness can qualify for a state-level firearm prohibition. The state's involuntary detention for psychiatric treatment, or "5150" (CA W&I Code 5150) process, is often cited as one potential mechanism for reducing violence by dangerous people, though its use is limited to people whose dangerousness is due to a mental illness. Additionally, California has taken legislative steps to prohibit firearm ownership among other people who have an increased risk of violence, regardless of whether or not mental illness is a factor. This article compares the California firearm ownership disqualification system for mental illness with the federal system and those of other states, examines the strengths and weaknesses of this system, and reviews alternatives. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25899250
... 153704.html Mental Illness Afflicts Many Juveniles in Jail Problems more common among girls than boys, study ... the general population, a new study finds. Juvenile inmates also have longer hospital stays, which suggests they ...
... to misdiagnosis, likely due to differing cultural or religious beliefs or language barriers with caregivers. For anyone ... of adults living with mental illness. An evidencebased practice taught by trained NAMI family members who have ...
Elkington, Katherine S.; Hackler, Dusty; Walsh, Tracy A.; Latack, Jessica A.; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.
The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (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…
Kessler, Ronald C.; Galea, Sandro; Jones, Russell T.; Parker, Holly A.
OBJECTIVE: To estimate the impact of Hurricane Katrina on mental illness 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 who lived in the same area before the hurricane. Identical questions were asked about mental illness and suicidality. The post-Katrina survey also assessed several dimensions of personal growth that resulted from the trauma (for example, increased closeness to a loved one, increased religiosity). Outcome measures used were the K6 screening scale of serious mental illness and mild-moderate mental illness and questions about suicidal ideation, plans and attempts. FINDINGS: Respondents to the post-Katrina survey had a significantly higher estimated prevalence of serious mental illness than respondents to the earlier survey (11.3% after Katrina versus 6.1% before; chi(2)1= 10.9; P < 0.001) and mild-moderate mental illness (19.9% after Katrina versus 9.7% before; chi(2)1 = 22.5; P < 0.001). Among respondents estimated to have mental illness, though, the prevalence of suicidal ideation and plans was significantly lower in the post-Katrina survey (suicidal ideation 0.7% after Katrina versus 8.4% before; chi(2)1 = 13.1; P < 0.001; plans for suicide 0.4% after Katrina versus 3.6% before; chi(2)1 = 6.0; P = 0.014). This lower conditional prevalence of suicidality was strongly related to two dimensions of personal growth after the trauma (faith in one's own ability to rebuild one's life, and realization of inner strength), without which between-survey differences in suicidality were insignificant. CONCLUSION: Despite the estimated prevalence of mental illness doubling after Hurricane Katrina, the prevalence of suicidality was unexpectedly low. The role of post-traumatic personal growth in ameliorating the effects of trauma-related mental illness on suicidality warrants further investigation. PMID:17242828
Chen, Fang-pei; Ying-Chi Lai, Grace; Yang, Lawrence
Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person’s participation in networks due to mental illness stigma, especially in Chinese-immigrant communities where social networks (the guanxi network) has specific social-cultural significance. This study focused on mental illness 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 mental illness 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 mental illness 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 mental illness. However, disclosing mental illness may damage a person's participation in networks due to mental illness stigma, especially in Chinese immigrant communities where social networks (the guanxi network) have specific social-cultural significance. This study focused on mental illness 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 mental illness 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 mental illness disclosure among Chinese immigrants were discussed. PMID:23647389
Lumley, V A; Miltenberger, R G
The problem of sexual abuse among persons with mental retardation, skills for preventing sexual abuse, and methods for assessing prevention skills were discussed. Because very little research on teaching sexual abuse prevention skills exists, research on abduction prevention programs for persons with mental retardation as well as on sexual abuse prevention programs for children, was reviewed. Suggestions for future research in the area of sexual abuse prevention for persons with mental retardation were discussed. PMID:9083603
Gold, Azgad; Appelbaum, Paul S
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 mental illness 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 mental illness. PMID:21724780
Headquartered in Arlington, Virginia, the National Alliance for the Mentally Ill (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.
Larson, Jon E.; Corrigan, Patrick
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 mental illness stigma experienced by family members. Research indicates this type of stigma…
Gove, Walter R.; Johnson, Marilyn
Gove suggests higher rates of mental illness among women can be linked to their societal role, particularly marital role. Johnson calls for examination of relationship between sex roles and emotional problems. Gove replies that Johnson's response is ideological, but they are in agreement on many issues. (HLM)
...2013-07-01 2013-07-01 false Mentally ill inmates. 541.6 Section 541.6 Judicial...Inmate Discipline Program § 541.6 Mentally ill inmates. If it appears you are mentally ill at any stage of the discipline process,...
...2014-07-01 2014-07-01 false Mentally ill inmates. 541.6 Section 541.6 Judicial...Inmate Discipline Program § 541.6 Mentally ill inmates. If it appears you are mentally ill at any stage of the discipline process,...
...2012-07-01 2012-07-01 false Mentally ill inmates. 541.6 Section 541.6 Judicial...Inmate Discipline Program § 541.6 Mentally ill inmates. If it appears you are mentally ill at any stage of the discipline process,...
...2011-07-01 2011-07-01 false Mentally ill inmates. 541.6 Section 541.6 Judicial...Inmate Discipline Program § 541.6 Mentally ill inmates. If it appears you are mentally ill at any stage of the discipline process,...
James K. Morrison; Gregory D. Hanson
To determine the current degree of acceptance of an antimedical approach to mental illness, a survey was conducted of attitudes toward mental illness among various mental health professionals (20 psychiatrists, 23 psychiatric nurses, 16 psychologists, and 25 social workers) and mental patients (41 outpatients with a history of psychiatric hospitalization and 20 outpatients with no similar history) in a community
Lumley, Vicki A.; Miltenberger, Raymond G.
Discusses sexual abuse among persons with mental retardation, skills for preventing sexual abuse, and methods for assessing prevention skills. Reviews research on abduction prevention programs for persons with mental retardation and on sexual abuse prevention programs for children, and makes suggestions for future research. (Author/CR)
Varshney, Upkar; Vetter, Ron
Medication adherence has been studied for some time; however most research has focused on able-bodied patients or the elderly living independently. What has not been studied nearly as much is medication adherence for people with psychiatric or mental illnesses. In this paper, we present a framework that includes the specific challenges in medication adherence for patients with mental illness, algorithms and protocols for evaluating adherence, and some on-going work in developing effective solutions. The architectural framework and associated algorithms leverage the context-aware computing capabilities available on many mobile devices. The system is designed to be able to collect and offer situation-aware information on medication use and adherence for healthcare professionals and other designated persons. PMID:23366355
Wesselmann, Eric D; Day, Magin; Graziano, William G; Doherty, Eileen F
Research demonstrates that social support facilitates recovery from a mental illness. Stigma negatively impacts the social support available to persons with mental illness (PWMIs). We investigated how religious beliefs about mental illness influenced the types of social support individuals would be willing to give PWMIs. Christian participants indicated their denominational affiliation and their religious beliefs about mental illness. We then asked participants to imagine a situation in which their friend had depression. Participants indicated their willingness to give secular and spiritual social support (e.g., secular: recommending medication; spiritual: recommending prayer). Christians' beliefs that mental illness results from immorality/sinfulness and that mental illnesses have spiritual causes/treatments both predicted preference for giving spiritual social support. Evangelical Christians endorsed more beliefs that mental illnesses have spiritual causes/treatments than Mainline Protestant and Roman Catholic Christians, and they endorsed more preference for giving spiritual social support than Roman Catholic Christians. PMID:26151166
Nawková, Lucie; Nawka, Alexander; Adámková, Tereza; Rukavina, Tea Vukuši?; Holcnerová, Petra; Kuzman, Martina Rojni?; Jovanovi?, Nikolina; Brborovi?, Ognjen; Bednárová, Bibiána; Zuchová, Svetlana; Miovský, Michal; Raboch, Ji?í
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 mental illness. 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. The authors used content analysis methods to achieve quantitative and qualitative objectives. More than half of all articles contained negative statements reflecting stigma toward persons with mental illness. 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, in the association of aggressive behavior with persons with mental illness, 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. On the basis of the authors' findings, practical recommendations for journalists can be tailored specifically for each country. PMID:21707410
Eris F. Perese
Roadblocks to recovery of individuals with severe mental illness include stigma, poverty, and victimization. Stigma cre- ates barriers to accessing safe housing, employment, and community integration. Poverty decreases ability to meet needs and increases risk for victimization. Victimization occurs as direct violence, exploitation, neglect, and abuse by care providers. It results in worsening of psychiatric disorders, increased need for care,
Eileen M. Furey; Jill J. Niesen
All allegations of sexual abuse of adults with mental retardation by other adults with mental retardation over a five year\\u000a period were examined. There were 72 cases substantiated with a total of 49 perpetrators. In all 72 cases, sexual abuse of\\u000a one adult with mental retardation by another occurred; however, the perpetrator was deemed culpable in 31 cases, abuse and
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.
Bovina, I. B.; Panov, M. S.
The study of mental diseases and the mentally ill is, no doubt, the job of psychiatry and clinical psychology. However, social psychology has also made a substantial contribution to research in this field in the past few decades. In this study, the authors describe and analyze the content and structure of representations of the mentally ill among…
Hartman, Leah I.; Michel, Natalie M.; Winter, Ariella; Young, Rebecca E.; Flett, Gordon L.; Goldberg, Joel O.
Despite the prevalence of mental health problems, society continues to stigmatize and discriminate against people with mental illness and in particular, schizophrenia. Among the negative consequences of stigma, is that some individuals with mental illness internalize negative stereotypes about themselves, referred to as self-stigma, which is…
Deborah Bybee; Carol T. Mowbray; Daphna Oyserman; Lisa Lewandowski
In thepost-deinstitutionalization era, everyday community functioning is an important aspect of assessment and treatment of individuals with serious mental illness. The current study focuses on correlates of community functioning among 332 low-income mothers with serious mental illness. Results revealed significant relationships between everyday functioning and a number of demographic, psychiatric, contextual, and mental health treatment variables. Current psychiatric symptoms accounted
Stephen J. Bartels; Frederic C. Blow; Aricca D. Van Citters; Laurie M. Brockmann
Objectives: The goal of this article is to provide a comprehensive critical review of studies reporting the prevalence, characteristics, outcomes, and service utilization associated with comorbid substance abuse and mental illness in older age.Methods: We searched the Medline and PsycINFO databases using combinations of the keywords ‘Dual diagnosis,’ ‘Elderly,’ and ‘Older.’ We included English-language reports presenting quantitative data on the
Alvidrez, Jennifer; Kaiser, Dawn; Havassy, Barbara E
Substance use disorders have serious negative consequences for severely mentally ill (SMI) adults, but many do not receive adequate substance abuse treatment. As part of a larger project on access barriers to substance abuse treatment for SMI clients, this qualitative study examined two potential client-level barriers to treatment: minimization of drug problems and perceived acceptability of drug use to reduce psychiatric symptoms. Open-ended interviews about drug use were conducted with 24 SMI adults with substance use problems. The majority of respondents identified drug use as a major problem in their lives. Respondents were aware of the impact of drugs on psychiatric symptoms, and most believed that the negative effects of drug use outweighed any short-term benefits. Nearly all respondents believed it was not acceptable for SMI adults to use drugs except marijuana. Contrary to findings in the literature that SMI adults deny or minimize drug problems, most respondents acknowledged the seriousness of their drug use, were aware of the negative effects of drug use on their psychiatric symptoms, and endorsed abstinence as the optimal treatment goal. These findings have implications for substance abuse treatment for SMI clients, particularly interventions that emphasize education about drug use as a way to increase motivation for treatment. PMID:15559681
O'Hare, Thomas; Shen, Ce; Sherrer, Margaret
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 mental illness. 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
This article reviews dominant media portrayals of mental illness, the mentally ill and mental health interventions, and examines what social, emotional and treatment-related effects these may have. Studies consistently show that both entertainment and news media provide overwhelmingly dramatic and distorted images of mental illness that emphasise dangerousness, criminality and unpredictability. They also model negative reactions to the mentally ill, including fear, rejection, derision and ridicule. The consequences of negative media images for people who have a mental illness are profound. They impair self-esteem, help-seeking behaviours, medication adherence and overall recovery. Mental health advocates blame the media for promoting stigma and discrimination toward people with a mental illness. However, the media may also be an important ally in challenging public prejudices, initiating public debate, and projecting positive, human interest stories about people who live with mental illness. Media lobbying and press liaison should take on a central role for mental health professionals, not only as a way of speaking out for patients who may not be able to speak out for themselves, but as a means of improving public education and awareness. Also, given the consistency of research findings in this field, it may now be time to shift attention away from further cataloguing of media representations of mental illness to the more challenging prospect of how to use the media to improve the life chances and recovery possibilities for the one in four people living with mental disorders. PMID:16478286
... false Ongoing medical and mental health care for sexual abuse victims...115.83 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.283 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.83 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.383 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.383 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.283 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.83 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.283 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
... false Ongoing medical and mental health care for sexual abuse victims...115.383 Ongoing medical and mental health care for sexual abuse victims...facility shall offer medical and mental health evaluation and, as...
Kopera, Maciej; Suszek, Hubert; Bonar, Erin; Myszka, Maciej; Gmaj, Bart?omiej; Ilgen, Mark; Wojnar, Marcin
The study investigated explicit and implicit attitudes towards people with mental illness among medical students (non-professionals) with no previous contact with mentally ill patients and psychiatrists and psychotherapists (professionals) who had at least 2 years of professional contact with mentally ill patients. Explicit attitudes where assessed by self-report. Implicit attitudes were measured with the Go/No-Go Association Task, a variant of the Implicit Association Test that does not require the use of a comparison category. Compared to non-professionals, mental health professionals reported significantly higher approach emotions than non-professionals towards people with mental illness, showed a lesser tendency to discriminate against them, and held less restrictive attitudes. Both groups reported negative implicit attitudes towards mentally ill. Results suggest that both non-professionals and professionals display ambivalent attitudes towards people with mental illness and that professional, long-term contact with people with mental illness does not necessarily modify negative implicit attitudes. PMID:25535045
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...
Philip T. Yanos; David Roe; Paul H. Lysaker
The impact of the experience and diagnosis of mental illness 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 mental illness. The present article proposes a theoretically
SALLY JOY MACKAIN; KIM T. MUESER
Despite evidence supporting the utility of teaching people with severe mental illness how to manage their psychiatric disorders more effectively in collaboration with others, little is known about the use of such programs in criminal justice settings. This article provides an overview of the background, principles, and empirical basis for teaching illness self-management strategies to persons with severe mental illness,
Blanca M. Ramos; Bonnie E. Carlson; Louise-Anne McNutt
This study examined the relationship between lifetime abuse and mental health among 126 African American women and 365 White women from a primary health care setting who participated in a telephone interview as part of a larger study. Seven types of childhood and adult intimate partner abuse were measured. Consistent with hypotheses, (1) lifetime abuse was associated with elevated levels
Angela Fertig; Arati Dahal
This paper examines the relationship between individuals’ mental health status and their spending behavior. Compared to individuals without mental health problems, individuals with mental health problems may have higher discount rates and derive greater utility from spending (commonly referred to as ‘retail therapy’). These characteristics suggest that individuals with mental illnesses will purchase goods and services that give immediate enjoyment,
Arthur, Carlotta M; Whitley, Rob
Causal attributions are a key factor in explanatory models of illness; however, little research on causal attributions of mental illness has been conducted in developing nations in the Caribbean, including Jamaica. Explanatory models of mental illness may be important in understanding illness experience and be a crucial factor in mental health service seeking and utilization. We explored causal attributions of mental illness in Jamaica by conducting 20 focus groups, including 16 community samples, 2 patient samples, and 2 samples of caregivers of patients, with a total of 159 participants. The 5 most commonly endorsed causal attributions of mental illness are discussed: (a) drug-related causes, including ganja (marijuana); (b) biological causes, such as chemical imbalance, familial transmission, and "blood"; (c) psychological causes, including stress and thinking too much; (d) social causes, such as relationship problems and job loss; and (e) spiritual or religious causes, including Obeah. PMID:25406259
Examines the incidence of substance use and mental illness among jail inmates by analyzing differences and similarities in demographic characteristics and detention status in a sample of 5,785 subjects. Significant associations were found between membership in one of the substance use and/or mental illness categories and variables reflecting…
Shabana Kabeer; Maqbool Uddin Shaikh
In this paper an attempt is made to describe the relationship between cyber crime and mental illness. It will create awareness among people about cyber crimes and criminality due to mental illness. Computers and the internet make many actions easier for us. They also make many unlawful activities easier for criminals such as the sharing of, copy right infringement, stock
Seed, Mary St. John; Higgins, Sally
Recent research on temperament and attachment theory highlights the importance of early intervention to helping children develop secure attachments and prevent mental illnesses. A mental illness curriculum for nursing students should integrate concepts from psychiatry and public health to prepare community-based for participation in intervention.…
D. Lehmkuhl; G. Bosch; I. Steinhart
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 mentally ill 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 mentally ill in such homes and
Riley, John M.; Fellin, Phillip A.
Taking as indisputable the relationship between poverty and mental illness, this paper examines the effect which the War on Poverty could have upon mental illness. Community Action Centers are the specific focus, with their potential for serving low income clients with emotional problems, and functioning as case finders and referral sources for…
Gregg J. Gagliardi; David Lovell; Paul D. Peterson; Ron Jemelka
Little research has focused on assessing the risk of mentally ill offenders (MIOs) released from state prisons. Here we report findings for 333 mentally ill offenders released from Washington State prisons. Logistic regression identified sets of variables that forecasted felony and violent reconviction as accurately as state-of-the-art risk assessment instruments. Sums of simple recoded versions of these variables predicted reoffense
Phelan Ruth; Lee Lana; Howe Deb; Walter Garry
Objective: To describe a pilot group programme for parents with a mental illness that was developed and implemented on the NSW Central Coast.Conclusions: The Parenting and Mental Illness Group Program is a 6week group programme that is followed by four weekly, individual home visits. Data from the Eyberg Child Behaviour Inventory and Parenting Scale suggest the programme produced positive outcomes
O'Hara, Michael W; Wisner, Katherine L
Perinatal mental illness 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
Glied, Sherry; Frank, Richard G
The debate about addressing mental illness and violence often ignores key facts. Many people experience mental illnesses, 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
Elkington, Katherine S; Hackler, Dusty; Walsh, Tracy A; Latack, Jessica A; McKinnon, Karen; Borges, Cristiane; Wright, Eric R; Wainberg, Milton L
The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (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 in-depth interviews with N=20 youth with mental illness (MI) (55% male, 16-24 years, 75% Latino) from 4 psychiatric outpatient clinics in New York City. We conducted a thematic analysis to investigate shared experiences of MI stigma and its impact on youth's sexual or romantic relationships and associated behaviors. Our analysis revealed four main themes: 1) societal perceptions of those with MI as partners (societal stigma); 2) individual experiences of stigma within relationships (individual level); 3) internalized stigma of self as a partner (social-psychological processes); and 4) managing a stigmatized identity, of which some of the behaviors directly placed them at increased risk for HIV. We found that just under half of the sample (n=9/20) endorsed all themes, including engaging in HIV/STI sexual risk behaviors as a method to manage a stigmatize identity, which suggests that MI stigma and sexual risk may be linked. We discuss differences by gender and diagnosis. Findings provide new information for providers and researchers to address on the role of stigma experiences in the romantic and sexual behavior of youth in psychiatric treatment. Implications for stigma and HIV/STI prevention interventions are discussed. PMID:25477706
Stephanie E Urigwe
One of the major challenges in treating mental illness in Nigeria is that the health care facilities and mental health care professionals are not enough in number or well equipped to handle the burden of mental illness. There are several barriers to treatment for individual Nigerians which include the following: such as the lack of understanding of the root causes
Nevid, Jeffrey S.; Morrison, James
The study was an attempt to construct an attitude scale to measure the radical psychosocial or libertarian position about "mental illness" and mental health practices. The factor analysis defined four scale factors: mental illness mythology, antimedical model, social deviance control, and anti-coercive treatment. (Author)
In this work, some of the most important instruments used to measure attitudes toward mental illness were analysed. A revision of different experimental investigations which studied attitudes toward mental illness among general public, mental health professionals and patients and their relatives was made. Some of the strategies applied to change…
Tzouvara, V; Papadopoulos, C
Mental illness stigma negatively affects the lives of individuals with mental health disorders. Studies have indicated that the type and degree of stigma significantly varies across cultures. This study aimed to add to this body of knowledge by examining the prevalence and the type of mental illness stigma among individuals who identified themselves as Greek. It also examined the influence of a range of potential within-culture stigma moderating factors, including levels of previous experience with mental illness and mental illness knowledge. A cross-sectional quantitative design was employed, and 111 participants living in England and Greece were sampled through the snowball sampling technique. Stigma prevalence was measured using the 'Community Attitudes to Mental Illness' questionnaire. The findings revealed that participants showed a high degree of sympathy for people with mental illness but also considered them to be inferior and of a lower social class, and needing strict societal control. Higher stigma was significantly associated with being educated in England (instead of Greece), higher religiosity, lower knowledge levels and lower levels personal experience of mental illness. Targeted antistigma campaigns specifically tailored for the Greek culture are required in order to help reduce stigmatizing attitudes. PMID:24646410
Wei, Wenhui; Sambamoorthi, Usha; Crystal, Stephen; Findley, Patricia A.
Objective To estimate the rates of mental illness among Medicaid beneficiaries with traumatic brain injury (TBI) and associated Medicaid-paid expenditures. Design Retrospective claims-based calendar year data. Setting Claims data. Participants Medicaid recipients with diagnosed TBI and mental illness who received Medicaid services in 4 states in 1995. Interventions Not applicable. Main Outcome Measures Annual expenditures for total, inpatient, and noninpatient services, as derived from Medicaid personal summary files. Mental illness and TBI were identified by using International Classification of Diseases, 9th Revision, Clinical Modification codes recorded in Medicaid claims. Results Of a total of 493,663 Medicaid recipients, 3641 (0.7%) were diagnosed with TBI in the 4 states. Significant demographic and racial differences were found in the rates of TBI; 18% of patients with TBI were diagnosed with serious mental illness. People with TBI in the age group 40 to 49 years were more likely to have a mental disorder. There were significant differences in estimated total, inpatient, and noninpatient expenditures between those with and without mental illness. In general, those with serious mental illness had higher Medicaid-paid expenditures than those without any mental illness. Conclusions Psychiatric comorbidity in TBI increases the overall expenditures in this population. This increased cost is an important consideration in programming for those with TBI. PMID:15895335
Min, Jung-Ah; Lee, Chang-Uk
Mental health is essential for individual and public health. To improve mental health, promotion, prevention, and the treatment of disease are required. These three kinds of interventions are interrelated but independent from one another. Although separate efforts for mental health promotion and prevention are needed as well as the public need of mental health promotion and well-being, psychiatrists usually are not accustomed to mental health promotion and prevention. This review introduces an overview of the concept, subjects according to target populations, and various intervention strategies for mental health promotion and prevention of mental illnesses. Based on literatures to date, understanding of developmental psychology, lifestyle medicine, and biopsychosocial contributors of mental health with a macroscopic perspective might help to practice mental health promotion and illness prevention. PMID:24474978
Drossman, Douglas A
Our understanding of the relationship of abuse and trauma history with gastrointestinal (GI) disorders has evolved over the last three decades. Although previously seen within a psychiatric context, ongoing studies continue to show that abuse can have multiple effects on GI symptoms, patient illness behaviors, and clinical outcomes. The prevalence of abuse history is greater among those who have more severe symptoms and who are seen in referral settings. Although abuse history may be present across all diagnostic categories, more severe abuse seems to occur in patients with functional GI disorders. The pathophysiological features that explain this association relate to stress-mediated brain-gut dysfunction and can range from altered stress-induced mucosal immune function to impaired ability of the central nervous system to downregulate incoming visceral or somatic afferent signals. For gastroenterologists and other health-care providers, it is important to understand when to inquire about an abuse history and what to do with that information. This is particularly relevant, as the data indicate that having a co-morbid abuse history leads to adverse health outcomes. Finally, there is growing evidence that centrally targeted interventions may have palliative effects on reducing symptoms, altering brain-gut dysregulation and structure, and improving the clinical outcome. This presentation tracks the history of our understanding of the effect of abuse and trauma on GI illness, provides the scientific rationale for this association, and offers guidelines as to when and how to inquire about this information and implement proper care for the patient. PMID:21139573
Grant Title: POSTDOCTORAL FELLOWSHIP IN MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES (MHSAS) Funding Opportunity Number: NA Agency/Department: American Psychological Association (APA), Substance Abuse and Mental health and substance abuse services and research. Release and Expiration: NA Application Deadline
Read, Ursula M; Adiibokah, Edward; Nyame, Solomon
Background The Global Movement for Mental Health has brought renewed attention to the neglect of people with mental illness within health policy worldwide. The maltreatment of the mentally ill 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 mental illness and their families. Methods This research forms part of a longitudinal anthropological study of people with severe mental illness in rural Ghana. Visits were made to over 40 households with a family member with mental illness, as well as churches, shrines, hospitals and clinics. Ethnographic methods included observation, conversation, semi-structured interviews and focus group discussions with people with mental illness, carers, healers, health workers and community members. Results Chaining and beating of the mentally ill 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 mental illness were embedded within spiritual and moral perspectives and such treatment provoked little sanction at the local level. Families struggled to provide care for severely mentally ill 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 mentally ill in their facilities. Conclusion Efforts to promote the human rights of those with mental illness must engage with the experiences of mental illness 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 mental illness within rural communities, as well as family members and healers, may have greater potential to effect change in the treatment of the mentally ill than legislation or investment in services alone. PMID:19825191
Reynolds, K. Michael; Dziegielewski, Sophia F.; Sharp, Chris
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 mentally ill are placed when they are no longer in a treatment facility. With the abundance of offenders with mental health…
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 mental illness and a second about possible links between media images and the…
Blank, Michael B; Himelhoch, Seth; Walkup, James; Eisenberg, Marlene M
There has been a general recognition of a syndemic that includes HIV/AIDS and serve mental illnesses including schizophrenia, major depression, bipolar disorder, post-traumatic stress disorder, and others. The pathophysiology and direction of effects between severe mental illness 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 mental illness. Further, we describe the need for better treatments for "triply diagnosed persons"; those with HIV, mental illness, 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 mental illness 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
Kelly, Brendan D
Up to one in four individuals in the US meet the diagnostic criteria for a mental illness in any given year and a significant proportion have severe or recurring illnesses (e.g. schizophrenia). Despite this prevalence, mental health services remain poorly funded, mental illness remains misunderstood and individuals with recurring illness are constrained to live lives characterized by isolation, under-employment, stigma and denial of rights. Here I examine the idea that this situation is attributable, at least in part, to the ways in which the freedom and power of the mentally ill are undermined by a range of factors, including: (i) dispersion of political power amongst interest groups, which, combined with the relatively wide distribution of the 'interest' of mental illness, has the paradoxical result that mental health interest groups do not command political power proportional to the number affected; (ii) systematic exclusion of the mentally ill from full participation in civic, social and political life (structural violence), resulting in a lack of emphasis on mental health on political agendas and the exclusion of certain policy options as possible responses and (iii) difficulties the mentally ill may experience recognizing or articulating their own needs the absence of effective health-care systems, and the absence of knowledge about alternative systems. I argue that the enhancement of individual agency is central to efforts to address this power gap, including: (i) rights-based approaches, involving the enhancement of national mental health legislation, improvement of advocacy, empowerment and guardianship processes and development of governance, accountability and quality procedures in mental health services; (ii) approaches based on enhancing direct political participation, including voter-registration programmes and development of larger, more effective interest groups and (iii) additional approaches, including increasing accountability throughout services, recognizing the effects of socio-political change on the context of care and adapting the concept of 'soft power' to strengthen advocacy programmes. PMID:16781034
Corner, Emily; Gill, Paul
We test whether significant differences in mental illness exist in a matched sample of lone- and group-based terrorists. We then test whether there are distinct behavioral differences between lone-actor terrorists with and without mental illness. We then stratify our sample across a range of diagnoses and again test whether significant differences exist. We conduct a series of bivariate, multivariate, and multinomial statistical tests using a unique dataset of 119 lone-actor terrorists and a matched sample of group-based terrorists. The odds of a lone-actor terrorist having a mental illness is 13.49 times higher than the odds of a group actor having a mental illness. Lone actors who were mentally ill were 18.07 times more likely to have a spouse or partner who was involved in a wider movement than those without a history of mental illness. Those with a mental illness were more likely to have a proximate upcoming life change, more likely to have been a recent victim of prejudice, and experienced proximate and chronic stress. The results identify behaviors and traits that security agencies can utilize to monitor and prevent lone-actor terrorism events. The correlated behaviors provide an image of how risk can crystalize within the individual offender and that our understanding of lone-actor terrorism should be multivariate in nature. PMID:25133916
Aragonès, Enric; López-Muntaner, Judit; Ceruelo, Santiago; Basora, Josep
Because the media influences society's perceptions of reality, the treatment of mental illness in the news can have an effect on the societal stigma related to it. This study aimed to analyze the content and form of news items related to mental illness in Spanish newspapers in order to understand their role in propagating or attenuating stereotypes, prejudices, and stigma. The authors conducted a cross-sectional descriptive study on the basis of a review of news items related to mental illness appearing in the Spanish print media. A sample was taken from articles published on the subject in the 20 Spanish newspapers with the widest circulations over the course of the year 2010. Formal elements and content were analyzed by means of a structured evaluation system. The authors analyzed 695 news items. The content of 47.9% (n = 333) of the articles was not strictly related to mental illness, but rather clinical or psychiatric terms were used metaphorically, and frequently in a pejorative sense. The remaining 52.1% (n = 362) consisted of news items related specifically to mental illness. Of these, news items linking mental illness to danger were the most common (178 texts, 49.2%), specifically those associating mental illness with violent crime (130 texts, 35.9%) or a danger to others (126 texts, 34.8%). The results confirm the hypothesis that the press treats mental illness in a manner that encourages stigmatization. The authors appeal to the press's responsibility to society and advocate an active role in reducing the stigma towards mental illness. PMID:24708534
Sandra J. Tanenbaum
Evidence-based practice (EBP), a derivative of evidence-based medicine (EBM), is ascendant in the United States’ mental health\\u000a system; the findings of randomized controlled trials and other experimental research are widely considered authoritative in\\u000a mental health practice and policy. The concept of recovery from mental illness is similarly pervasive in mental health programming\\u000a and advocacy, and it emphasizes consumer expertise and
Baker, Chris I.
Treatment Research in Mental Illness: Improving the Nation's Public Mental Health Care through NIMH Funded Interventions Research Report of the National Advisory Mental Health Council's Workgroup on Clinical Trials EXECUTIVE SUMMARY The mission of the National Institute of Mental Health (NIMH
Gerben J. Westerhof; Corey L. M. Keyes
Mental health has long been defined as the absence of psychopathologies, such as depression and anxiety. The absence of mental\\u000a illness, however, is a minimal outcome from a psychological perspective on lifespan development. This article therefore focuses\\u000a on mental illness as well as on three core components of positive mental health: feelings of happiness and satisfaction with\\u000a life (emotional well-being),
Poreddi, Vijayalakshmi; Thimmaiah, Rohini; Math, Suresh Bada
Background: Globally, people with mental illness frequently encounter stigma, prejudice, and discrimination by public and health care professionals. Research related to medical students’ attitudes toward people with mental illness is limited from India. Aim: The aim was to assess and compare the attitudes toward people with mental illness among medical students’. Materials and Methods: A cross-sectional descriptive study design was carried out among medical students, who were exposed (n = 115) and not exposed (n = 61) to psychiatry training using self-reporting questionnaire. Results: Our findings showed improvement in students’ attitudes after exposure to psychiatry in benevolent (t = 2.510, P < 0.013) and stigmatization (t = 2.656, P < 0.009) domains. Further, gender, residence, and contact with mental illness were the factors that found to be influencing students’ attitudes toward mental illness. Conclusion: The findings of the present study suggest that psychiatric education proved to be effective in changing the attitudes of medical students toward mental illness to a certain extent. However, there is an urgent need to review the current curriculum to prepare undergraduate medical students to provide holistic care to the people with mental health problems.
Bignall, Whitney J Raglin; Jacquez, Farrah; Vaughn, Lisa M
Although the prevalence of mental illness is similar across ethnic groups, a large disparity exists in the utilization of services. Mental health attributions, causal beliefs regarding the etiology of mental illness, may contribute to this disparity. To understand mental health attributions across diverse ethnic backgrounds, we conducted focus groups with African American (n = 8; 24 %), Asian American (n = 6; 18 %), Latino/Hispanic (n = 9; 26 %), and White (n = 11; 32 %) participants. We solicited attributions about 19 mental health disorders, each representing major sub-categories of the DSM-IV. Using a grounded theory approach, participant responses were categorized into 12 themes: Biological, Normalization, Personal Characteristic, Personal Choice, Just World, Spiritual, Family, Social Other, Environment, Trauma, Stress, and Diagnosis. Results indicate that ethnic minorities are more likely than Whites to mention spirituality and normalization causes. Understanding ethnic minority mental health attributions is critical to promote treatment-seeking behaviors and inform culturally responsive community-based mental health services. PMID:25536943
Oliva-Moreno, Juan; López-Bastida, Julio; Montejo-González, Angel Luis; Osuna-Guerrero, Rubén; Duque-González, Beatriz
Mental illness affects a large number of people in the world, seriously impairing their quality of life and resulting in high socioeconomic costs for health care systems and society. Our aim is to estimate the socioeconomic impact of mental illness in Spain for the year 2002, including health care resources, informal care and loss of labour productivity. A prevalence-based approach was used to estimate direct medical costs, direct non-medical costs, and loss of labour productivity. The total costs of mental illness have been estimated at 7,019 million euros. Direct medical costs represented 39.6% of the total costs and 7.3% of total public healthcare expenditure in Spain. Informal care costs represented 17.7% of the total costs. Loss of labour productivity accounted for 42.7% of total costs. In conclusion, the costs of mental illness in Spain make a considerable economic impact from a societal perspective. PMID:19031056
Metzl, Jonathan M; MacLeish, Kenneth T
Four assumptions frequently arise in the aftermath of mass shootings in the United States: (1) that mental illness causes gun violence, (2) that psychiatric diagnosis can predict gun crime, (3) that shootings represent the deranged acts of mentally ill loners, and (4) that gun control "won't prevent" another Newtown (Connecticut school mass shooting). Each of these statements is certainly true in particular instances. Yet, as we show, notions of mental illness that emerge in relation to mass shootings frequently reflect larger cultural stereotypes and anxieties about matters such as race/ethnicity, social class, and politics. These issues become obscured when mass shootings come to stand in for all gun crime, and when "mentally ill" ceases to be a medical designation and becomes a sign of violent threat. PMID:25496006
New Hampshire, University of
: DEMOGRAPHICS Sex Male Female Ethnicity Asian 1.6% African American 1.2% Caucasian 94.1% Hispanic 2% American. Having been mentally ill carries with it a burden of shame. I believe that individuals diagnosed
Bartholomew, Nicole R; Morgan, Robert D
The relationship between mental illness, violence, and criminal behavior is complex, and involves a multifaceted interaction of biological, psychological, and social processes. In this article, we review the emerging research that examines the neurobiological and psychological factors that distinguish between persons with mental illness who do and who do not engage in crime and violence. Additionally, a novel model for understanding the interaction between mental illness and criminalness is proposed. (As defined by Morgan and colleagues, criminalness is defined as behavior that breaks laws and social conventions and/or violates the rights and wellbeing of others.) Stemming from this model and outlined research, we argue that management and treatment approaches should target the co-occurring domains of mental illness and criminalness to improve criminal and psychiatric outcomes. Specifically, we discuss and propose effective housing (management) and biopsychosocial intervention strategies for improving outcomes. PMID:25953043
Older adults are susceptible to the same mental afflictions that affect other age groups; depression, anxiety disorders, schizophrenia, and other illnesses affect all adult age groups to varying degrees. Yet despite recent ...
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Sledge, William H; Lazar, Susan G
While it is known that psychiatric illness and subclinical psychiatric illness can be very disabling, their impact on workers' productivity has been little appreciated or appropriately addressed. Complex variables are involved in fashioning an appropriate policy to ameliorate the impact of mental illness on productivity including the identification of effective treatments and potential negative effects of controlling patients' access to them. The cost-effectiveness of such treatments is considered from the differing perspectives and goals of the various stakeholders involved, including employers, insurers, and workers with psychiatric illness. Depression in workers leads to significant absenteeism, "presenteeism" (diminished capacity due to illness while still present at work), and significantly increased medical expenses in addition to the costs of psychiatric care. In addition to the specific usefulness of psychotropic medication, there are a variety of studies on the cost-effectiveness of different psychotherapeutic treatments that improve health and productivity in psychiatrically ill workers. Research indicates the usefulness of approaches including employee assistance programs, specialized cognitive-behavioral treatments, and brief and longer term psychodynamic interventions. It is clear that substance abuse disorders and especially depression and subsyndromal depression have a profound negative effect on work productivity and increases in medical visits and expenses. The current system of mental health care suffers from ignorance of the negative effects of psychiatric illness in workers, from a lack of subtle awareness of which treatments are most appropriate for which diagnoses and from the reluctance by payers to invest in them. Access to evidence-based appropriate treatment can improve the negative impact on productivity as well as workers' health. This article considers these issues and argues for a role of psychotherapy in the treatment of mental illness and substance abuse from the perspective of worker productivity. PMID:25211435
Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.
Few investigators studying alcohol abuse among individuals with a severe mental illness (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…
Amy C. Watson; Emeline Otey; Anne L. Westbrook; April L. Gardner; Theodore A. Lamb; Patrick W. Corrigan; Wayne S. Fenton
The field test of The Science of Mental Illness curriculum supplement for middle school (grades 6–8) children provided an opportunity to assess knowledge and attitudes about mental illness in more than 1,500 middle school students throughout the United States and to evaluate the impact of an educational intervention on stigma-related attitudes. Two primary questions were examined: (1) what are the
Ibrahim Puteh; M Marthoenis; Harry Minas
Background Physical restraint and confinement of the mentally ill (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 mentally ill in the province from restraint and to provide appropriate\\u000a medical treatment and care. The aim of the paper
Wilkerson, Hal Dennis
the mentally ill. Methodological problems in both studies are discussed as they relate to tV&e inconsistency of the present study's findings and those of previous researchers (Farina & Hsgelauer, 1975; Latorre, 1975; Nowacki & Poe, 197$), Implications... of attitudes toward the mentally ill. Of the many variables investigated. , sex seemingly has not been studied thoroughly, though several recent studies have focused directly on its importance (Farina, Ec Hagelauer, 1975; LaTorre, 1975). Htill...
... other mental disorders, such as depression, anxiety, or schizophrenia. It is therefore not surprising that population surveys ... other than substance use disorders, such as depression, schizophrenia, anxiety, and mania. The terms “dual diagnosis,” “mentally ...
Richard L. Hough; Henry Tarke; Virginia Renker; Patricia Shields; Jeff Glatstein
Are the unstable residential and personal lives of homeless mentally ill (HMI) individuals so difficult as to preclude their inclusion in rigorous, longitudinal research protocols? The continued presence of HMI individuals in U.S. society has prompted the mental health research community to reconsider the question of whether clinical trial and demonstration research protocols are feasible with this population. This article
Molinari, Victor A.; Merritt, Stacy S.; Mills, Whitney L.; Chiriboga, David A.; Conboy, Ann; Hyer, Kathryn; Becker, Marion A.
This study examined how the mental health needs of nursing home (NH) residents with serious mental illness (SMI) are addressed. Data were collected from three sources: interviews with 84 SMI stakeholders; surveys of 206 NH staff members; and focus groups at two psychiatry specialty NHs. Four common themes emerged: placement of older adults with…
Mary E. Barber
Very little has been written about lesbians, gay men, and bisexual people (LGBs) with severe mental illness (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
Charbonneau, David D.
Yesterday, the Surgeon General's office issued a comprehensive new report on Mental Illness 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 mental illness 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 mentally ill. Citing stigmas, ignorance of the efficacy of treatment, and a health insurance system that does not accord the same coverage (or respect) to mental illnesses 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."
Ennals, Priscilla; Fossey, Ellie M; Harvey, Carol A; Killackey, Eóin
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, mental illness frequently disrupts secondary or tertiary education, and resulting lower educational attainment contributes to reduced lifetime employment and earning potential. Yet, supporting people with mental illnesses 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 mental ill health, less is known about the best ways to enable people with mental illness 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 mental illness to reengage in education so as to improve their educational outcomes and career prospects. PMID:23857720
Awareness of the importance of maintaining physical health for patients with severe mental illnesses 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 mental illnesses. PMID:21929761
Yang, Lawrence H.; Link, Bruce G.; Phelan, Jo C.
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 mental illness less favorably than mental illness 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 mental illness. Methods We utilized data from a 2003 national telephone survey designed to measure how public perceptions of mental illness 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 mental illness should be examined relative to other social, moral, and religious attributions common in Chinese culture. PMID:21079911
There has been a tendency by some social scientists and the media to claim that in advanced western societies like Britain and the US mental illness has been increasing and mental well-being declining over the period since the Second World War. In this paper I consider the evidence that is invoked in making such claims, along with the counter-evidence. In order to assess the evidence it is essential to take account of the different ways mental illness and mental well-being are measured and the definitions the measures embed. I argue that when the findings from studies using similar measures at different points in time are compared, there is little evidence of consistent secular increases in mental illness or declines in mental well-being. I suggest that such claims are encouraged by two main factors: first and most importantly, the major changes that have occurred in the official boundaries of mental disorder over the post-war period, which have also changed the ideas and perceptions of professionals and the public about mental health and illness; and second, the ready way in which data on mental health and illness can be used to support criticism of certain features of present-day society. PMID:22591824
Ostler, Teresa; Bahar, Ozge Sensoy; Jessee, Allison
This study examined the mentalization capabilities of children exposed to parental methamphetamine abuse in relation to symptom underreporting, mental health, and behavioral outcomes. Twenty-six school-aged children in foster care participated in this study. Mentalization was assessed using the My Family Stories Interview (MFSI), a semi-structured interview in which children recalled family stories about a happy, sad or scary and fun time. An established scale of the Trauma Symptom Checklist for Children (TSCC), a self-report measure, provided information on children's symptom underreporting. The Child Behavior Checklist (CBCL), completed by the children's foster caregivers, assessed children's mental health and behavioral outcomes. Children with higher mentalization were significantly less prone to underreport symptoms. These children had fewer mental health problems and were rated by their foster caregivers as more socially competent. The findings underscore that mentalization could be an important protective factor for children who have experienced parental substance abuse. PMID:20473793
C. E. Fraser; K. B. Smith; F. Judd; J. S. Humphreys; L. J. Fragar; A. Henderson
Background: Farmers experience one of the highest rates of suicide of any industry and there is growing evidence that those involved in farming are at higher risk of developing mental health problems. This article provides an overview of the literature examining mental health issues experienced by farming populations in the United Kingdom, Europe, Australia, Canada and the United States and
Amy A. Mericle; Cherie Martin; Deni Carise; Meghan Love
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
Shor, Ron; Kalivatz, Zvi; Amir, Yael; Aldor, Roy; Lipot, Marc
Parents with mental illness face many parenting related challenges that are exacerbated by the lack of services focusing on these needs. A study was conducted with 35 persons who participated in a group for parents with mental illness in Israel in order to examine the parenting related concerns the participants might bring up in a group modality, and the therapeutic factors in the group process. The findings illuminate the centrality of the parenting role in the participants lives and the value of the group modality as a tool enabling the participants to reveal their vulnerabilities. The therapeutic factors at work in the group, such as, imparting information, interpersonal learning, socialization techniques helped them deal with the difficulties of fulfilling their parenting roles at the same time they cope with their own mental illness. PMID:24962269
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 Mental Illness 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 mental illness" 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 mental illness 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 mental illness. 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
Wilkerson, Hal Dennis
SEX AS A FACTOR IN ATTITUDES TOWARD THE MENTALLY ILL A Thesis by HAL DENNIS WILKERSON Submitted to the Graduate College of Texas ASM University in partial fulfillment of the requirement for the degree of MASTER OF SCIENCE May 1976 Major... Subject: Psychology SEX AS A FACTOR IN ATTITUDES TOWARD THE MENTALLy ILL A Thesis by Hal Dennis Wilkerson Approved as to style and content by: (Chairman of Committee) (Head of Department) (Member) Hem'b e r ) May 1976 ABSTHACT Sex As A Factor...
Apu T. Chakraborty; Kwame J. McKenzie; Shakoor Hajat; Stephen A. Stansfeld
Purpose The difference in risk of mental illness 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 mental illness in an ethnic\\u000a minority group.\\u000a \\u000a \\u000a \\u000a \\u000a Methods We
Krameddine, Yasmeen I.; Silverstone, Peter H.
There have been repeated instances of police forces having violent, sometimes fatal, interactions with individuals with mental illness. Police forces are frequently first responders to those with mental illness. Despite this, training police in how to best interact with individuals who have a mental illness has been poorly studied. The present article reviews the literature examining mental illness training programs delivered to law-enforcement officers. Some of the key findings are the benefits of training utilizing realistic “hands-on” scenarios, which focus primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. Current issues in training police officers are firstly the tendency for organizations to provide training without proper outcome measures of effectiveness, secondly the focus of training is on changing attitudes although there is little evidence to demonstrate this relates to behavioral change, and thirdly the belief that a mental health training program given on a single occasion is sufficient to improve interactions over the longer-term. Future police training needs to address these issues. PMID:25642196
Teresa Ostler; Ozge Sensoy Bahar; Allison Jessee
This study examined the mentalization capabilities of children exposed to parental methamphetamine abuse in relation to symptom underreporting, mental health, and behavioral outcomes. Twenty-six school-aged children in foster care participated in this study. Mentalization was assessed using the My Family Stories Interview (MFSI), a semi-structured interview in which children recalled family stories about a happy, sad or scary and fun
O'Leary, Patrick; Coohey, Carol; Easton, Scott D.
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…
Whitley, Rob; Campbell, Rosalyn Denise
Evidence suggests that people with a severe mental illness still suffer high levels of stigma and discrimination. However little is known about how people with a severe mental illness 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 mental illness. 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 mental illness 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
Cloyes, Kristin G.
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 mentally ill 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. PMID:17673111
C. Nageotte; G. Sullivan; N. Duan; P. L. Camp
Medication non-compliance, a pervasive problem among persons with serious, chronic mental illness, 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
Sugaya, Luisa; Hasin, Deborah S; Olfson, Mark; Lin, Keng-Han; Grant, Bridget F; Blanco, Carlos
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
Drawing from a conceptual framework which hypothesizes a temporal sequence for persons who are in psychological distress, this paper focuses on two problems faced by chronically mentally ill (CMI) Hispanics in need of clinical services: (1) barriers in seeking follow-up clinical services upon discharge from a psychiatric hospital; and (2) barriers…
Elkington, Katherine S.; Hackler, Dusty; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.
This research explores the experiences of mental illness 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…
Barney, Steve T.; Corser, Grant C.; White, Lynn H.
Stigmas toward those who have mental illnesses 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…
In an effort to inform junior and senior high school students about mental illness, 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,…
Paolo del Vecchio; Larry Fricks; J. Rock Johnson
The essential elements of well being and health include an adequate income from meaningful employment, healthful diet, comfortable and safe housing, and good health. Well being also includes being able to improve one's life through education and the building of good relationships. The absence of these elements is faced by people who have experienced mental illness, and thus, in addition
Schulman, Eveline D.
This monograph is an international overview of available information about the current status of rehabilitation efforts for the mentally ill. It served as a springboard for discussion at the Special Interest Group session at the Fourteenth World Congress of Rehabilitation International in Winnipeg, Canada, on June, 1980. The first part of the…
Argues for an organized scheme that considers the human rights of people with mental illness in a way that focuses attention on primary rights. The theory of primary rights emphasizes: life, liberty, and security of persons; the right to an adequate standard of living; all human beings being free and equal in dignity and rights; and conditional…
March, John S.
Objective: Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mental illnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy…
Berman, Dene S.; Fry, Patricia Brown
The notion that student teachers are less accepting of mentally ill than of normal students was investigated. The hypothesis was supported. Implications for revealing potentially stigmatizing information about mental illness to teachers were discussed. (Author)
...2014-07-01 false Presumptive eligibility for psychosis and mental illness other than psychosis. 17.109 Section 17.109 Pensions... § 17.109 Presumptive eligibility for psychosis and mental illness other than...
Riedel-Heller, Steffi G; Gühne, Uta; Weinmann, Stefan; Becker, Thomas
Severe mental illness is associated with long-lasting symptoms and various impairments including individual, social and occupational aspects. The S3 guideline on psychosocial therapies in severe mental illness of the Germany Society for Psychiatry, Psychotherapy and Neurology (DGPPN) offers recommendations for psychosocial interventions. This paper emphasizes specific characteristics of the S3 guidelines on psychosocial therapies in severe mental illness and summarizes the primary results. Areas of future mental health service research are identified. PMID:23143829
Corrigan, Patrick W; Watson, Amy C; Warpinski, Amy C; Gracia, Gabriela
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 mental illness 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 mental illness, 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 mental illness 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 mental illness 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
Hanson, Mark D.; Johnson, Samantha; Niec, Anne; Pietrantonio, Anna Marie; High, Bradley; MacMillan, Harriet; Eva, Kevin W.
Objective: Adolescent mental illness 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…
Francis, Catherine; Pirkis, Jane; Blood, R. Warwick; Dunt, David; Burgess, Philip; Morley, Belinda; Stewart, Andrew
This study describes Australian media portrayal of mental illnesses, focusing on depression. A random sample of 1,123 items was selected for analysis from a pool of 13,389 nonfictional media items about mental illness collected between March 2000 and February 2001. Depression was portrayed more frequently than other mental illnesses. Items about…
The apparently large genetic contribution to the aetiology of mental illness presents a formidable puzzle. Unlike common physical disorders, mental illness usually has an onset early in the reproductive age and is associated with substantial reproductive disadvantage. Therefore, genetic variants associated with vulnerability to mental illness should be under strong negative selection pressure and be eliminated from the genetic pool
The purpose of this dissertation is to critically examine the attitudes of health care professionals' attitudes towards individuals with severe mental illness. Severe mental illnesses (SMI) are major social and public health issues in the United States and Canada. Severe mental illness may include individuals with a diagnosis of schizophrenia, major depression, bipolar disorder, mood disorders, and some of the
The long-awaited Mental Health Law of China was passed on 26 October 2012 and took effect on 1 May 2013. Being the first national legislation on mental health, it establishes a basic legal framework to regulate mental health practice and recognizes the fundamental rights of persons with mental disorders. This article focuses on the system of involuntary detention and treatment of the mentally ill under the new law, which is expected to prevent the so-called "Being misidentified as mentally disordered" cases in China. A systematic examination of the new system demonstrates that the Mental Health Law of China implicitly holds two problematic assumptions and does not provide adequate protection of the fundamental rights of the involuntary patients. Administrative enactments and further national legislative efforts are needed to remedy these flaws in the new law. PMID:24630738
This paper explores the conceptual knowledge base underpinning 'mental illness type behaviour' and offers a sociological and philosophical perspective. The role of values in concepts of health and illness is presented as widespread not only within psychiatry, but also in regard to general/physical health. The controversial nature of the psychiatric enterprise is believed to be due to the lack of consensus regarding notions of mental health and mental illness. Psychiatry is presented as a form of social control, akin to the legal system, dictated by moral norms. These are presented as value-loaded and maintained in accordance with the dictates of particular interest groups. Social control concepts are explored and Freud's psychodynamic model is presented as a legitimate model that incorporates a meaningful concept of 'illness'. No theory, though, is presented as value-free. Psychiatry is thus presented as being socially and politically constructed. The implication for health care professionals is presented as that of trying to liberate professional work from the narrow responsibility of the 'individual', whilst also trying to create a more democratic enterprise. PMID:1791257
Nandy, S; Chalmers-Watson, C; Gantley, M; Underwood, M
BACKGROUND: Mild depression and anxiety are common problems in general practice. They can be managed by the general practitioner (GP) alone or referred. Previous quantitative studies have shown a large variation between GPs in terms of referral behaviour. The reasons for this variation are not fully understood. AIM: To describe and analyse GP's decision-making processes when considering who should be treating patients with minor mental illness, using a qualitative method. DESIGN OF STUDY: A qualitative interview study. SETTING: Twenty-three GPs in east London and Essex. METHOD: Subjects were chosen using a purposive sampling strategy and participated in one-to-one semi-structured interviews. A grounded theory approach was used for analysis. RESULTS: Two distinct referral strategies were identified--the 'containment' and the 'conduit' approaches. In addition, referrals were found to be of two types--proactive 'referrals to' and reactive 'referrals away'; for minor mental illness the 'referrals away' were found to predominate. Emotive as well as rational responses informed GP decision making on referral. CONCLUSIONS: Explanations of the variation in referral rates need to recognise the emotive responses of individual GPs to minor mental illness. The contribution of guidelines, which assume consistently rational responses to illness, may therefore be limited. PMID:11407051
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 mental illness. 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 mental illness 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 mental illness 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
Seth C. Kalichman; Mary E. Craig; Diane R. Follingstad
The prevalence and effects of child abuse have been reported in numerous studies. Although mandatory reporting laws require professionals to report suspected cases of child abuse, studies have indicated that large percentages of mental health professionals report selectively. The present study investigates professionals' tendency to report and attribution of responsibility for child abuse. One-hundred and one mental health clinicians working
In the wake of the December 2012 mass shooting at an elementary school in Newtown, Connecticut, the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce of the U.S. House of Representatives held a hearing on the Substance Abuse and Mental Health Services Administration (SAMHSA) and its role in caring for people with severe mental illness. The author was among those who testified at the hearing. In this Open Forum she raises points made in that hearing-for example, that in embracing the recovery model and certain evidence-based practices, SAMHSA has been derelict in its duty to attend to the sickest individuals, those with chronic psychosis. She calls on the agency to embrace and promote a more balanced and pragmatic agenda. PMID:25179186
B. Christopher Frueh; Anouk L. Grubaugh; Karen J. Cusack; Jon D. Elhai
Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mental illnesses (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 health care. Yet few public-sector mental health agencies routinely provide
Stovall, Gavin; Craig, Robert J.
This study found that, although the mental representations of 20 sexually abused and 20 physically abused females (ages 7-12) did not differ, the internal images of the abused groups differed from images of 20 nonabused but distressed children. Thus it is abuse, and not simply family distress, that results in impaired object relations. (Author/JDD)
Freedman, David; Woods, George W
This paper briefly reviews the social science on "neighborhood effects" as an independent force in shaping poor outcomes, specifically mental illness and criminal behavior, before discussing the implications of that research for understanding the relationship between neighborhoods, race and class. Neighborhood effects research has proliferated in recent years with extensive attention again being focused on the social context of family and individual development and life course. Moreover, recent work has suggested the need to consider the developmental effects of neighborhoods that persist across life-span. This paper will focus specifically on mental illness and criminal behavior as outcomes for understanding neighborhood effects, but will also consider what the structural causes of individual behavior and functioning mean for clinical assessment, especially forensic assessment. PMID:25250101
Freedman, David; Woods, George W.
This paper briefly reviews the social science on “neighborhood effects” as an independent force in shaping poor outcomes, specifically mental illness and criminal behavior, before discussing the implications of that research for understanding the relationship between neighborhoods, race and class. Neighborhood effects research has proliferated in recent years with extensive attention again being focused on the social context of family and individual development and life course. Moreover, recent work has suggested the need to consider the developmental effects of neighborhoods that persist across life-span. This paper will focus specifically on mental illness and criminal behavior as outcomes for understanding neighborhood effects, but will also consider what the structural causes of individual behavior and functioning mean for clinical assessment, especially forensic assessment. PMID:25250101
Department of Human Services Division of Substance Abuse and Mental Health (DSAMH) I. Internal Scan will likely need other medical services beyond just substance abuse and mental health issues complex mental health issues, and some service expectations may be shifted to DSAMH. Baby boomers are also
Saloner, Brendan; Lê Cook, Benjamin
The Affordable Care Act (ACA) required that insurers allow people ages 19-25 to remain as dependents on their parents' health insurance beginning in 2010. Using data from the 2008-12 National Survey of Drug Use and Health, we examined the impact of the ACA dependent coverage provision on people ages 18-25 with possible mental health or substance use disorders. We found that after implementation of the ACA provision, among people ages 18-25 with possible mental health disorders, mental health treatment increased by 5.3 percentage points relative to a comparison group of similar people ages 26-35. Smaller, but consistent, effects were found among all young adults, not only those with possible illnesses. For people using mental health treatment, uninsured visits declined by 12.4 percentage points, and visits paid by private insurance increased by 12.9 percentage points. We observed no changes in mental health treatment setting. Outcomes related to substance abuse treatment did not change during the study period. The dependent coverage provision can contribute to a broader strategy for improving behavioral health treatment for young adults. PMID:25092845
Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rusch, Nicolas
Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. 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…
Sloat, Lisa M; Frierson, Richard L
We begin with a brief overview of the Not Guilty by Reason of Insanity (NGRI) and Guilty but Mentally Ill (GBMI) verdicts in the United States and then report on a study of qualified jurors (n=96) in which we examined jurors' understanding and attitudes about mental illness verdicts and the disposition of mentally ill defendants. Results indicate that although the jury pool was highly educated, only 4.2 percent of jurors could correctly identify both the definitions and dispositions of defendants found NGRI and GBMI. Jurors with lower educational levels were less likely to identify the dispositional outcome of a GBMI verdict (p<.05). Eighty-four percent of respondents believed that juries should be informed of dispositional outcome before deciding a verdict. Also, 68.4 percent of jurors erroneously believed that a defendant found GBMI could not receive the death penalty. Among jurors who correctly identified the definition of GBMI, those with lower educational levels were more punitive in their attitudes toward disposition of the GBMI defendants, believing they should eventually be sent to prison (p<.05). PMID:15985664
Nicolaidis, Christina; McFarland, Bentson; Curry, MaryAnn; Gerrity, Martha
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. PMID:19687174
Ulibarri, Monica D; Ulloa, Emilio C; Salazar, Marissa
This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18-34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues. PMID:25635897
Mowbray, C T; Oyserman, D; Bybee, D; MacFarlane, P; Rueda-Riedle, A
Individuals with a severe mental illness now have greater opportunities to pursue normal adult roles, including parenting. The research reported involved 379 women carrying out parenting responsibilities, recruited from the public mental health system in an urban area. The sample displayed great heterogeneity in educational levels, number of children, number of fathers for their children, and family living arrangements, except that most women were very poor. These women faced many significant stresses: living alone with their children, significant child behavior problems, and financial worries. Still, most of the women endorsed the significance of motherhood in their lives. Inattention by most mental health providers to parenting issues leaves many important needs unmet and is likely to have adverse consequences for these women and their children. Implications for psychosocial rehabilitation practice are discussed. PMID:11769977
Gehart, Diane R
In 2004, the U.S. Department of Health and Human Services issued a consensus statement on mental health recovery based on the New Freedom Commission's recommendation that public mental health organizations adopt a "recovery" approach to severe and persistent mental illness, including services to those dually diagnosed with mental health and substance abuse issues. By formally adopting and promoting a recovery orientation to severe mental illness, the United States followed suit with other first-world nations that have also adopted this approach based on two decades of research by the World Health Organization. This movement represents a significant paradigm shift in the treatment of severe mental health, a shift that is more closely aligned with the nonpathologizing and strength-based traditions in marriage and family therapy. Furthermore, the recovery movement is the first consumer-led movement to have a transformational effect on professional practice, thus a watershed moment for the field. Part I of this article introduces family therapists to the concept of mental health recovery, providing an overview of its history, key concepts, and practice implications. Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. PMID:22804463
... Find a Local MHA Affiliate Substance Abuse and Mental Health Services Administraton (SAMHSA) Phone 800-789-2647 National Institute of Mental Health (NIMH) Information Resources and Inquiries Branch Phone ...
The relationship between social class and mental illness stigma has received little attention in recent years. At the same time, the concept of mental health literacy (MHL) has become an increasingly popular way to frame knowledge and understanding...
... violence or abuse • Mental illness, dependency, family dysfunction • Economic pressures, personal stress • Longstanding personality traits (bad temper, ... 14 domestic elder abuse incidents comes to the attention of authorities. We do know that we must ...
Carla Lewis; Bruce D. Johnson; Andrew Golub; Eloise Dunlap
This study attempts to better understand a limited segment of the drug-abusing population, especially individuals who repeatedly use crack and other drugs. This article addresses the methodological strategies and underlying paradigms informing the recruitment of hard-to-reach and ill-defined subpopulations of crack abusers and noncrack drug abusers. Subjects were recruited from diverse social contexts: streets or communities where most drug users
Maskey, Robin; Shakya, Dhana Ratna; Sharma, Sanjib Kumar; Karki, Prahlad; Lavaju, Poonam; Baranwal, Jouslin Kishore
Diabetes Mellitus (DM) and psychiatric illness are related in many ways by prevalence, burden, course, and outcome. Co-morbid mental illness may play a role in determining the complication in diabetic patients. This study was conducted in 2010 among consecutive diabetic out-patients diagnosed as per American Diabetes Association (ADA) guidelines 2009, of age above 14 years, to compare the complications in diabetic patients with or without mental illness. Diabetic neuropathies, cardiovascular complications, and morbid obesity were among the complications significantly more among diabetic patients with mental illness (GHQ-12 ? 2) than without mental illness (GHQ-12 ? 2). PMID:24251198
Atilola, Olayinka; Olayiwola, Funmilayo
This study examines the modes of framing mental illness in the Yoruba genre of Nigerian movies. All Yoruba films on display in a convenient sample of movie rental shops in Ibadan (Nigeria) were sampled for content. Of the 103 films studied, 27 (26.2%) contained scenes depicting mental illness. Psychotic symptoms were the most commonly depicted, while effective treatments were mostly depicted as taking place in unorthodox settings. The most commonly depicted aetiology of mental illness was sorcery and enchantment by witches and wizards, as well as other supernatural forces. Scenes of mental illness are common in Nigerian movies and these depictions-though reflecting the popular explanatory models of Yoruba-speaking Nigerians about mental illness- may impede utilization of mental health care services and ongoing efforts to reduce psychiatry stigma in this region. Efforts to reduce stigma and improve service utilization should engage the film industry. PMID:23670966
Nover, Cynthia Helen
Individuals with serious mental illness are at increased risk of developing secondary physical illnesses because of lifestyle and psychiatric treatment-related factors. Many individuals with mental illness participate in primary care clinics, such as Placer County Community Clinic (PCCC), which provides primary care and medication-only psychiatric services to low-income county residents. This qualitative study describes an augmented care program provided to this population at PCCC and explores participant experiences with that program. The augmented program consisted of a full-time social worker and part-time registered nurse working as a team to coordinate care between providers, and provide psychosocial education and illness management support. Previous studies have demonstrated that similar programs result in improved clinical outcomes for people with mental illness but have largely not included perspectives of participants in these pilot programs. This article includes participant reports about medical service needs, barriers, and beneficial elements of the augmented program. Medical service needs included the need to provide input in treatment and to be personally valued. Barriers ranged from doubts about provider qualifications to concerns about medication. Elements of the augmented care program that participants found beneficial were those involving care coordination, social support, and weight management support. PMID:23947541
Davison, Joanna; Huntington, Annette
Sexuality is a complex and fundamental aspect of a person's health and mental well-being, yet mental health professionals generally seem reluctant to discuss sexuality related issues and few research studies have specifically explored the sexuality of women with enduring mental illness. The aim of this qualitative research was to gain a deeper understanding about the sexuality experiences of this group of women. Eight women were interviewed individually, and then together as a focus group. Working from a feminist theoretical perspective, the interview transcripts were analysed thematically. All the women considered sexuality an essential component of their identity. However, powerful interlocking systems controlled and influenced how the women expressed their sexuality, often marginalizing, and positioning them as 'Other', and rendering their sexuality hidden and unseen. The experiences of this group of women highlight the need for mental health professionals to recognize sexuality as an important aspect of a person's care and recovery, and to create a culture that is supportive of a person's sexuality and sexual expression. Incorporating sexuality related issues into clinical practice offers mental health professionals a significant opportunity to make a positive difference. PMID:20618524
Marriage is a consensual and contractual relationship recognized by law. In India, there is a tremendous social and cultural pressure to marry. It is of paramount importance to discuss the relationship between marriage and mental illness in Indian scenario as marriage is perceived to be a panacea to mental illness by many. This review aims to explore whether marriage contributes to mental-health problems; whether it has a protective role; what effect it has on pre-existing mental illnesses and its outcome in major mental illnesses. PMID:23858261
Stuhlmiller, Cynthia M.
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 mental illness as consumers and students came to know, trust, and count on each other in order to succeed…
David Lawrence; Francis Mitrou; Stephen R Zubrick
BACKGROUND: Smoking has been associated with a range of mental disorders including schizophrenia, anxiety disorders and depression. People with mental illness have high rates of morbidity and mortality from smoking related illnesses such as cardiovascular disease, respiratory diseases and cancer. As many people who meet diagnostic criteria for mental disorders do not seek treatment for these conditions, we sought to
Seligman, Martin E P
Susan Nolen-Hoeksema's life work concerned rumination, gender differences in depression, and the "transdiagnostic" processes in mental illness. The articles in this special section expand on these themes. Her work on transdiagnostic processes leads us to consider that the real mental illnesses are not the congeries of symptoms in the Diagnostic and Statistical Manual of Mental Disorders, but these processes themselves. PMID:24661153
Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep
Background: Reducing stigma associated with mental illness 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 mental illness, as compared with…
Mowbray, Carol; Oyserman, Daphna; Bybee, Deborah; MacFarlane, Peter
Examines the effects of mental illness on parenting in a sample of women with serious mental illness. Diagnosis had a small but significant effect on parenting attitudes and behaviors. However, current symptoms mediated the effects of diagnosis and chronicity on parenting stress, and current symptomatology and community functioning partially…
Loue, Sana; Sajatovic, Martha; Mendez, Nancy
Latinos, and Puerto Ricans in particular, have been disproportionately impacted by HIV/AIDS. Severe mental illness (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 mental illness (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 mental illness, 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. PMID:21327967
Sajatovic, Martha; Mendez, Nancy
Latinos, and Puerto Ricans in particular, have been disproportionately impacted by HIV/AIDS. Severe mental illness (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 mental illness (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 mental illness, 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. PMID:21327967
Cáceda, Ricardo; Nemeroff, Charles B; Harvey, Philip D
A commonality of patients with major psychiatric disorders is their propensity to make poor decisions, which is intimately related to poor real-life outcomes. The authors reviewed the literature on decision making as applied to severe psychiatric disorders, with particular focus on advances in cognitive neuroscience. Deficits in reward sensitivity, avoidance learning, and temporal discounting are reported in depression. Besides abnormalities in hedonic capacity, other cognitive distortions required for flexible control of behavior occur in patients with bipolar disorder and schizophrenia. A conceptual framework of abnormal decision making in mental illness could generate targeted interventions to improve quality of life and clinical outcomes. PMID:24599051
Hyman, S. E.
Many of the comfortable and relatively simple models of the nature of mental disorders, their causes and their neural substrates now appear quite frayed. Gone is the idea that symptom clusters, course of illness, family history and treatment response would coalesce in a simple way to yield valid diagnoses. Also too simple was the concept, born of early pharmacological successes, that abnormal levels of one or more neurotransmitters would satisfactorily explain the pathogenesis of depression or schizophrenia. Gone is the notion that there is a single gene that causes any mental disorder or determines any behavioural variant. The concept of the causative gene has been replaced by that of genetic complexity, in which multiple genes act in concert with non-genetic factors to produce a risk of mental disorder. Discoveries in genetics and neuroscience can be expected to lead to better models that provide improved representation of the complexity of the brain and behaviour and the development of both. There are likely to be profound implications for clinical practice. The complex genetics of risk should reinvigorate research on the epidemiology and classification of mental disorders and explain the complex patterns of disease transmission within families. Knowledge of the timing of the expression of risk genes during brain development and of their function should not only contribute to an understanding of gene action and the pathophysiology of disease but should also help to direct the search for modifiable environmental risk factors that convert risk into illness. The function of risk genes can only become comprehensible in the context of advances at the molecular, cellular and systems levels in neuroscience and the behavioural sciences. Genetics should yield new therapies aimed not just at symptoms but also at pathogenic processes, thus permitting the targeting of specific therapies to individual patients. PMID:10885164
Sam Davis; Cape Town
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 mental illness resting on contestable psychiatric dogma. Specifically, the disease model of mental illness reproduced in the policy allows the desires,
Hyler, S E; Gabbard, G O; Schneider, I
The portrayal of mentally ill persons in movies and television programs has an important and underestimated influence on public perceptions of their condition and care. Movie stereotypes that contribute to the stigmatization of mentally ill persons include the mental patient as rebellious free spirit, homicidal maniac, seductress, enlightened member of society, narcissistic parasite, and zoo specimen. The authors suggest that mental health professionals can fight this source of stigma by increasing their collaboration with patient advocacy groups in monitoring negative portrayals of mentally ill people, using public information campaigns such as Mental Illness Awareness Week to call attention to the process of stigmatization, and supporting accurate dramatic and documentary depictions of mental illness. PMID:1959896
Sheri D. Weiser; William R. Wolfe; David R. Bangsberg
People with depression and other mental illness comprise a growing proportion of individuals living with HIV in the United\\u000a States; at the same time, the prevalence of HIV among mentally ill individuals is at least seven times higher than in the\\u000a general population. Individuals with mental illness are particularly vulnerable to infection with HIV because of several factors,\\u000a including the
Antonia Barke; Seth Nyarko; Dorothee Klecha
Purpose Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the\\u000a stigma connected to mental illness 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 mental illness in Ghana. Even less is known about the
Blank, Michael; Eisenberg, Marlene
The public health literature demonstrates disturbingly high HIV risk for persons with a serious mental illness (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. PMID:23673886
evidence based practices for working with people in recovery Elements of ROSC 1. Person Centered 2RECOVERY Definition In 2005 The Substance Abuse and Mental Health Services Administration (SAMHSA and community support Definition In 2005 The Substance Abuse and Mental Health Services Administration (SAMHSA
Balsam, Kimberly F.; Lehavot, Keren; Beadnell, Blair; Circo, Elizabeth
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…
Santhosh, Lekshmi; Meriwether, Margaret; Saucedo, Catherine; Reyes, Reason; Cheng, Christine; Clark, Brian; Tipperman, Doug; Schroeder, Steven A
Smoking is a major contributor to premature mortality among people with mental illness and substance abuse. Historically, the Substance Abuse and Mental Health Services Administration (SAMHSA) did not include smoking cessation in its mission. We describe the development of a unique partnership between SAMHSA and the University of California, San Francisco's Smoking Cessation Leadership Center. Starting with an educational summit in Virginia in 2007, it progressed to a jointly sponsored "100 Pioneers for Smoking Cessation" campaign that provided grants and technical assistance to organizations promoting cessation. By 2013, the partnership established 7 "Leadership Academies," state-level multidisciplinary collaboratives of organizations focused on cessation. This academic-public partnership increased tobacco quit attempts, improved collaboration across multiple agencies, and raised awareness about tobacco use in vulnerable populations. PMID:24625143
Seng, Julia S.; Sperlich, Mickey; Low, Lisa Kane
Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed. PMID:18984507
Deborah J. Rinehart; Marion A. Becker; Pamela R. Buckley; Kathy Dailey; Charles S. Reichardt; Carla Graeber; Nancy R. VanDeMark; Ellen Brown
This analysis examined data from mothers at 2 of the 9 sites participating in Substance Abuse and Mental Health Services Administration's (SAMHSA's) national Women Co-occurring Disorders and Violence Study (WCDVS). According to previous literature, it was hypothesized that women in the WCDVS would be at high risk of perpetrating child abuse. This research examined mothers' potential for physical child abuse
Prochaska, Judith J.; Grana, Rachel A.
Background We examined electronic cigarette (EC) use, correlates of use, and associated changes in smoking behavior among smokers with serious mental illness in a clinical trial. Methods Adult smokers were recruited during acute psychiatric hospitalization (N?=?956, 73% enrollment among approached smokers) in the San Francisco Bay Area between 2009–2013. At baseline, participants averaged 17 (SD?=?10) cigarettes per day for 19 (SD?=?14) years; 24% intended to quit smoking in the next month. Analyses examined frequency and correlates of EC use reported over the 18-month trial and changes in smoking behavior by EC use status. Findings EC use was 11% overall, and by year of enrollment, increased from 0% in 2009 to 25% in 2013. In multiple logistic regression, the likelihood of EC use was significantly greater with each additional year of recruitment, for those aged 18–26, and for those in the preparation versus precontemplation stage of change, and unlikely among Hispanic participants. EC use was unrelated to gender, psychiatric diagnosis, and measures of tobacco dependence at baseline. Further, over the 18-month trial, EC use was not associated with changes in smoking status or, among continued smokers, with reductions in cigarettes per day. Interpretation Within a clinical trial with smokers with serious mental illness, EC use increased over time, particularly among younger adults and those intending to quit tobacco. EC use was unrelated to changes in smoking. The findings are of clinical interest and warrant further study. PMID:25419703
Stuber, Jennifer P.; Rocha, Anita; Christian, Ann; Link, Bruce G.
Objectives The authors compared attitudes of the U.S. general public and of mental health professionals about the competence and perceived dangerousness of people with mental health problems and the desire for social distance from them. Factors related to negative attitudes and the desire for social distance also were examined. Methods Vignettes describing individuals meeting DSM-IV criteria for major depression and schizophrenia were included in the 2006 General Social Survey (GSS) and a 2009 study of mental health professionals, and responses were descriptively compared (GSS, N=397 responses to depression vignette, N=373 responses to schizophrenia vignette; 731 mental health professionals responded to both vignettes). Regression analyses examined whether demographic and provider characteristics were associated with perceptions of less competence and perceived dangerousness of the vignette character and with respondents’ desire for social distance. Results Compared with the American public, mental health professionals had significantly more positive attitudes toward people with mental health problems. However, some providers’ conceptions about the dangerousness of people with schizophrenia and provider desire for social distance from clients in work and personal situations were concerning. Younger age, self-identifying as non-Hispanic white, being female, having at least a four-year college degree, being familiar with mental illness, and certain job titles and more years of experience in the mental health field were predictive of more positive conceptions. Conclusions Although mental health professionals held more positive attitudes than the general public about people with mental health problems, strong stereotypes persisted in both groups, especially concerning schizophrenia. This study identified several demographic and provider characteristics that can inform intervention strategies in both groups. PMID:24430508
Crowther, Ruth; Marshall, Max; Bond, Gary R; Huxley, Peter
Background Unemployment rates are high amongst people with severe mental illness, yet surveys show that most want to work. Vocational rehabilitation services exist to help mentally ill people find work. Traditionally, these services have offered a period of preparation (Pre-vocational Training), before trying to place clients in competitive (i.e. open) employment. More recently, some services have begun placing clients in competitive employment immediately whilst providing on-the-job support (Supported Employment). It is unclear which approach is most effective. Objectives To assess the effects of Pre-vocational Training and Supported Employment (for people with severe mental illness) against each other and against standard care (in hospital or community). In addition, to assess the effects of: (a) special varieties of Pre-vocational Training (Clubhouse model) and Supported Employment (Individual Placement and Support model); and (b) techniques for enhancing either approach, for example payment or psychological intervention. Search methods Searches were undertaken of CINAHL (1982-1998), The Cochrane Library (Issue 2, 1999), EMBASE (1980-1998), MEDLINE (1966-1998) and PsycLIT (1887-1998). Reference lists of eligible studies and reviews were inspected and researchers in the field were approached to identify unpublished studies. Selection criteria Randomised controlled trials of approaches to vocational rehabilitation for people with severe mental illness. Data collection and analysis Included trials were reliably selected by a team of two raters. Data were extracted separately by two reviewers and cross-checked. Authors of trials were contacted for additional information. Relative risks (RR) and 95% confidence intervals (CI) of homogeneous dichotomous data were calculated. A random effects model was used for heterogeneous dichotomous data. Continuous data were presented in tables (there were insufficient continuous data for formal meta-analysis). A sensitivity analysis was performed, excluding poorer quality trials. Main results Eighteen randomised controlled trials of reasonable quality were identified. The main finding was that on the primary outcome (number in competitive employment) Supported Employment was significantly more effective than Pre-vocational Training; for example, at 18 months 34% of people in Supported Employment were employed versus 12% in Pre-vocational Training (RR random effects (unemployment) 0.76 95% CI 0.64 to 0.89, NNT 4.5). Clients in Supported Employment also earned more and worked more hours per month than those in Pre-vocational Training. There was no evidence that Pre-vocational Training was more effective in helping clients to obtain competitive employment than standard community care. Authors’ conclusions Supported employment is more effective than Pre-vocational Training in helping severely mentally ill people to obtain competitive employment. There is no clear evidence that Pre-vocational Training is effective. PMID:11406069
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 mental illness, and tests elements of this thorough critical review of recent UK literature relating to public attitudes towards, and media representations, of
Leahy, Marie A.
More than five million children in the United States have a parent suffering from a severe mental illness and these children have specific experiences and needs, particularly in school. Children of mentally ill parents are at greater risk of being neglected and of developing psychological, social, emotional, and behavioral problems. They often…
Charles Gillispie; W. Sweetwater
This article describes how poetry therapy principles and techniques, such as the isoprinciple and the collaborative poem, are applicable to adult education for the mentally ill. The author describes how these techniques were applied during a semester-long writing workshop conducted at a day-treatment programme for mentally ill adults. Samples of student-generated poems are included.
Michelle D. Sherman; Richard A. Carothers
Family intervention for serious mental illness is known to be highly efficacious in reducing patient relapse, improving social functioning, enhancing caregivers’ knowledge of mental illness, and ultimately reducing overall costs of care. However, very few families receive services. The reasons for this gap between empirical findings and program implementation are complex and not yet fully understood. Prochaska and DiClemente’s Readiness
Price, James H; Thompson, Amy J; Khubchandani, Jagdish; Wiblishauser, Michael
Firearms injuries place a unique burden on America in terms of lives lost (31,000/year), disability (70,000 nonfatal injuries/year), and economic costs ($174 billion in 2010). The purpose of this study was to examine psychiatric residency directors' perceptions of firearm access issues of the mentally ill. In late Fall 2012 and early Spring of 2013, a three-wave mailing was used to survey the membership of the American Association of Directors of Psychiatric Residency Training (N = 129). Due to the homogenous small sample size descriptive statistics were calculated to describe the responses. A total of 72 (56 %) directors responded. Almost 1 in 4 (23.6 %) thought that access to firearms by the seriously mentally ill should not be prohibited. The majority (91.7 %) supported closing the background check loophole. The majority (54.2 %) also believed that singling out the mentally ill as a group of "banned purchasers" adds to the stigma of the mentally ill (54.2 %) but a plurality (44.4 %) did not believe reporting the mentally ill to authorities would result in the mentally ill avoiding treatment. The current method of reducing access by the mentally ill to firearms is perceived by psychiatric residency directors as ineffective and burdensome to the mentally ill. PMID:23996614
Kendra, Matthew S.; Cattaneo, Lauren B.; Mohr, Jonathan J.
Abnormal psychology instructors often use traditional and personal methods to educate students about and improve student attitudes toward mental illness and professional help-seeking. Data from abnormal psychology students (N = 190) were used to determine if and how students' attitudes toward mental illness and professional help-seeking attitudes…
Celia Janet Boritz Wintz
The movement of the management of mental illness to community settings has provided an opportunity for persons with serious mental illness to engage in sexual activities, which often results in pregnancy. The need for psychotropic medication during pregnancy and lactation must be weighted against the possible teratogenic organic and behavioral effects of these drugs. A review of the literature presents
Celia Janet Boritz Wintz
The movement of the management of mental illness to community settings has provided an opportunity for persons with serious mental illness to engage in sexual activities, which often results in pregnancy. The need for psychotropic medication during pregnancy and lactation must be weighted against the possible teratogenic organic and behavioral effects of these drugs. A review of the literature presents
Tamara B. George
The care meanings, expressions, and experiences of those with a chronic mental illness living in the community were explored with use of Leininger's Theory of Culture Care Diversity and Universality and the Sunrise Model. Results indicate that people with chronic mental illness have identifiable values, norms, and lifeways that set them apart from the dominant culture. Cultural and social structure
Carol Kennedy; Pamela Salsberry; Jennie Nickel; Chantal Hunt; Esther Chipps
BACKGROUND: Clients with severe mental illness are known to have higher morbidity than the general population, but little is known about their perception of disease burden. OBJECTIVE: This study examined the disease burden in a cohort of community-dwelling persons diagnosed with severe mental illness. STUDY DESIGN: This was a descriptive study that included: interviews, measures of blood pressure, height and
This paper reviews the current English?language literature on police and mentally ill offenders in Europe, including the UK. Opportunities are being lost at the first point of contact of people with mental illness (PMI) with the police, to divert them to treatment. Nevertheless a number of promising programs in the UK, notably those in London, Birmingham, and Belfast (Northern Ireland)
CHANCE 11 Beginnings Schizophrenia is among the most debilitating of mental illnesses (NARSAD 2003, and personal effects. The National Institute of Mental Health estimates that schizophrenia is responsible for 2 offer relief of some symptoms, schizophrenia remains an incurable, lifelong illness and most patients
Objectives. We examined whether there were high levels of mental illness among displaced New Orleans, LA, residents in the fall of 2006, 1 year after Hurricane Katrina. Methods. We used data from the Displaced New Orleans Residents Pilot Study, which measured the prevalence of probable mild or moderate and serious mental illness among a representative sample of people who resided in New Orleans at the time of the hurricane, including people who evacuated the city and did not return. We also analyzed disparities in mental illness by race, education, and income. Results. We found high rates of mental illness in our sample and major disparities in mental illness by race, education, and income. Severe damage to or destruction of an individual's home was a major covariate of mental illness. Conclusions. The prevalence of mental illness remained high in the year following Hurricane Katrina, in contrast to the pattern found after other disasters. Economic losses and displacement may account for this finding as well as the disparity in mental illness between Blacks and Whites. PMID:19890178
Frank X. Acosta
This study examines pretherapy expectations for psychotherapists and definitions of mental illness among 44 Mexican American and 48 Anglo American outpatients. Patients' expectations for therapist behaviors, expectations for time in therapy, and definitions for concepts of mental illness were measured on three scales. Both Mexican Americans and Anglo Americans were found to primarily expect a therapist who would engage them
Richard Warner; Paul Polak
In order to evaluate the extent to which economic factors influence the life choices of people with mental illness, we interviewed 50 mentally ill people living in Boulder, Colorado. Subjects experience significant financial disincentives to work. The average total cash and noncash income of part-time employed subjects ($1,028 a month) is only modestly higher than that of unemployed subjects ($929
David E. Biegel; Robert D. Shafran; Jeffrey A. Johnsen
Objective: Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasian family caregivers. Three hypotheses were tested in a multivariate model which included need, enabling and predisposing variables utilizing
Alix M. McLearen; Nancy L. Ryba
Most researchers conclude that from six to fifteen percent of jail detainees meet the diagnostic criteria for severe mental illnesses including schizophrenia, bipolar disorder, and major depressive disorder. Although legal and professional standards mandate screening for mental illness in jails, few procedures exist that can be completed within the limited time constraints under which jails function. This study compares the
Boo, Su-Lyn; Loong, Jaymee; Ng, Wai-Sheng
This is a preliminary qualitative study, using a basic interpretive approach, to investigate the work experiences of people with mental illness in Malaysia. Six females and four males (aged 30-70) from a residential home for the mentally ill participated in semi-structured interviews. Three inter-relating themes emerged, namely the experience of…
Amini, Homayoun; Majdzadeh, Reza; Eftekhar-Ardebili, Hasan; Shabani, Amir; Davari-Ashtiani, Rozita
The study aimed to assess medical students' attitudes toward mental illness following a 4-week psychiatry clerkship. All fifth-year medical students from three academic centers in Tehran were asked to participate in the study. They completed the questionnaire on the last day of their 4-week psychiatry clerkship. A self-administered questionnaire was used to examine participants' Attitudes Toward Mental Illness (ATMI). One hundred and sixty eight students completed the questionnaires (88.9% response rate). In general, the students had favorable attitudes toward mental illness at the end of their clerkship, with mean (± SD) ATMI total score of 78.6 (± 8.1) (neutral score, 66.0). The students showed the most favorable opinion (95.2%) about Category 5 (stereotypic attitude toward people with mental illness) whilst they revealed the least favorable opinion (64.3%) regarding Category 1 (social relations with people affected by mental illness). In addition, the students thought that movies were on the top of influential media on shaping the attitudes toward mental illness. Overall, most of Iranian medical students had generally favorable attitudes toward people with mental illness at the end of their clerkship. Therefore, it may be expected next generation of medical doctors show more favorable attitude toward mental illness. PMID:23878611
Mowbray, Carol T.; Bybee, Deborah; Oyserman, Daphna; MacFarlane, Peter; Bowersox, Nicholas
Children of parents with mental illness are at risk of psychiatric and behavioral problems. Few studies have investigated the psychosocial outcomes of these children in adulthood or the parental psychiatric history variables that predict resilience. From a sample of 379 mothers with serious mental illnesses, 157 women who had at least one adult…
Gerald V. OBrien; Melinda S. Brown
Although persons who are diagnosed with a mental illness are potentially protected from employment discrimination by the Americans With Disabilities Act (ADA) of 1990, a rather perplexing set of questions arises when attempting to delineate exactly which such workers are accorded protection against discrimination. This article considers the status of persons with mental illness within the context of the ADA,
Grant Title: MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES FELLOWSHIP Funding Opportunity Number: NA and Mental Health Services Administration (SAMHSA). Area of Research: Fellowship aimed at those pursuing doctoral degrees in clinical, counseling, and school psychology, or other mental health services areas
Swanson, Jeffrey W; Felthous, Alan R
Firearm violence is a top-tier public health problem in the U.S., killing 33,563 and injuring an additional 81,396 people in 2012 (Centers for Disease Control and Prevention, CDC, ). Given constitutional protection and the cultural entrenchment of private gun ownership in the U.S., it is likely that guns will remain widely accessible - and largely unrestricted - for the foreseeable future. Therefore, most policies and laws intended to reduce firearm violence focus selectively on preventing "dangerous people" from having access to guns. That is a formidable challenge. How do we think productively about guns and mental illness in this context, and about the role of law in lessening the toll of gun violence? Copyright © 2015 John Wiley & Sons, Ltd. PMID:25874748
Caputo, Nicole Mossing; Rouner, Donna
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 mental illness. 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
Serra, Anne-Laure; von Gunten, Armin; Mosimann, Urs; Favrat, Bernard
Fitness to drive in elderly drivers is most commonly discussed with a focus on cognitive impairment. Therefore, this article is focussing on mental illness and the use of psychotropic drugs in elderly drivers, which can both interfere with fitness to drive. Based on a detailed literature review and on clinical judgement, we propose signposts and "red flags" to judge the individual risks. Health professionals dealing with elderly patients should in particular be aware of the dangers related to cumulative risks and need to inform the patients appropriately. For medico-legal reasons the information provided to patients must be written down in the medical record. Individual counselling is important as fitness to drive is a complex topic. PMID:24834622
Sajatovic, Martha; Dawson, Neal V.; Perzynski, Adam T.; Blixen, Carol E.; Bialko, Christopher S.; McKibbin, Christine L.; Bauer, Mark S.; Seeholzer, Eileen L.; Kaiser, Denise; Fuentes-Casiano, Edna
Diabetes and obesity among patients with serious mental illness are common. Use of second-generation antipsychotics compounds risk, and widely prevalent unhealthy behaviors further contribute to negative outcomes. This column describes Targeted Training in Illness Management, a group-based psychosocial treatment that blends psychoeducation, problem identification, goal setting, and behavioral modeling and reinforcement. The intervention has been adapted to the primary care setting and is targeted at individuals with serious mental illness and diabetes. A key feature of the intervention is the use of peer educators with serious mental illness and diabetes to teach and model self-management. Promising results from a 16-week trial are reported. PMID:21885575
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 mental illness and socioeconomic status might be jointly associated with smoking behaviour. We set out to examine the relationship between mental illness, 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 mental illness, 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 mental illness 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 mental illness 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 mental illness and smoking is not explained by the association between mental illness 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. PMID:23663362
Helene L. Provencher; Corey L. M. Keyes
Purpose – The purpose of this paper is to propose that the study, and the promotion, of recovery can be augmented by adopting the model of mental health as a complete state. Design\\/methodology\\/approach – A literature review of the last two decades was undertaken and pathways to complete mental health in recovery are proposed. Findings – More work is needed
Bode, C O; Odelola, M A; Odiachi, R O
Child abuse and neglect are a global phenomenon often symptomatic of underlying psychosocial family problems, which may represent a transferred aggression from one or both disturbed parents onto the child. Although the scope has been widely explored in Africa, little has been written on children presenting with surgical lesions. We report 31 children abused by their parents on accounts of frustrations engendered by the children's surgical conditions in Lagos. 26 (83.9%) of these children had major congenital defects while only 5 (16.1%) had acquired lesions. The commonest form of abuse was child abandonment, seen in 9 (29%) of cases. Neglect was recorded in 7 (23%) cases while 2 children were mutilated because of surgical lesions. Three patients were starved, 3 children with colostomy were evicted by landlords while 2 were locked up by parents out of shame. One child died of infanticide. Reasons for abuse included financial constraints, hopelessness and shame associated with grotesque lesions, broken homes and maternal pregnancy. Doctors and nurses engaged in the care of gross congenital anomalies and other major surgical lesions should anticipate this problem and evolve appropriate strategies to deal with it. The social worker should be involved early enough in the management. Provision of adequate social safety nets, affordable medical care and specific legal protection for children will curtail this ugly trend in our society. PMID:11768025
Harry Minas; Ruzanna Zamzam; Marhani Midin; Alex Cohen
Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings\\u000a by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose\\u000a of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent
Carol T. Mowbray; Deborah Bybee; Daphna Oyserman; Paula Allen-Meares; Peter Macfarlane; Tamera Hart-Johnson
Children of parents with mental illness are an at-risk population according to research on psychiatric outcomes using White, middle-class samples of depressed parents and infants and preschool children.The current study expands this evidence byexploringwithin-group heterogeneity across psychosocial outcomes, in a racially diverse, low-income sample of adolescent children of mothers with mental illness (N = 166). Using measures of mental health,
Barry, Colleen L.; Ridgely, M. Susan
A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than…
Morrissey, J P; Goldman, H H
Three major cycles of reform in public mental health care in the United States--the moral treatment, mental hygiene, and community mental health movements--are described as a basis for assessing the shifting boundaries between the mental health, social welfare, and criminal justice systems. Historical forces that led to the transinstitutionalization of the mentally ill from almshouses to the state mental hospitals in the nineteenth and twentieth centuries have now been reversed in the aftermath of recent deinstitutionalization policies. Evidence is suggestive that the mentally ill are also being caught up in the criminal justice system, a circumstance reminiscent of pre-asylum conditions in the early nineteenth century. These trends shape the current mental health service delivery system and the agenda for policy-relevant research on issues involving the legal and mental health fields. PMID:10300755
Schutt, Russell K.; Goldfinger, Stephen M.
Previous research on housing loss among severely mentally ill persons who have been placed in housing after being homeless has been largely atheoretical and has yielded inconsistent results. We develop a theory of housing loss based on identifying fundamental causes—problems in motives, means and social situation—and test these influences in a longitudinal, randomized comparison of housing alternatives. As hypothesized, individuals were more likely to lose housing if they had a history of alcohol or drug abuse, desired strongly to live independently contrary to clinician recommendations, or were African Americans placed in independent housing. Deficits in daily functioning did not explain these influences, but contributed to risk of housing loss. Our results demonstrate the importance of substance abuse, the value of distinguishing support preferences from support needs, and the necessity of explaining effects of race within a social context and thus should help to improve comparative research. PMID:20161654
Cabassa, Leopoldo J.
Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public’s stigma toward mental disorders, (2) summarize stigma findings focused on the public’s stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental disorders and advance research in this area. Public stigma of mental illness in the U.S. was widespread. Findings can inform interventions to reduce the public’s stigma of mental illness. PMID:22833051
Tracey Peter; Lance W Roberts; Jennifer Dengate
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 mental illness. This new paradigm argues that mental health should be regarded as
Sullivan, Greer; Vasterling, Jennifer J; Han, Xiaotong; Tharp, Andra Teten; Davis, Teri; Deitch, Elizabeth A; Constans, Joseph I
To investigate predisaster mental illness as a risk factor of poor postdisaster mental health outcomes, veterans with (n = 249) and without (n = 250) preexisting mental illness 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 mental illness compared with those without preexisting mental illness. Among those with preexisting PTSD, the odds of screening positive for any new mental illness 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 mental illnesses, particularly PTSD, should be considered a high-risk group for poor outcomes after a disaster. PMID:23364127
Hans Schanda; Thomas Stompe; Gerhard Ortwein-Swoboda
During the last decades of the 20th century, general mental healthcare underwent fundamental changes in all countries of the Western world. Despite all doubtless improvements for the majority of the mentally ill, many countries report on a substantial increase of admissions of mentally disordered offenders to forensic hospitals. Possible relations between these findings and the introduction of psychiatry reforms are
Craig, Rebecca T.
The mental health policies of the past 20 years and the evidence of unserved populations suffering from serious mental illness constitute a public health crisis. Currently there are at least 3,000,000 people in the United States suffering from mental disorders. A fully developed continuum of care is needed to respond effectively to the diverse…
Paul Vincent Greenall; Lorna Jellicoe-Jones
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 mentally ill and what treatment implications this might raise. Several men
Bowser, Benjamin P.
The field of mental health has had difficulty in developing an adequate conceptualization of racism as a mental health problem. Based on conventional classifications of mental illness, racism might be described as a functional disorder. The racist, however, appears quite normal except for a paranoid disorder in the area of racial relations. The…
Grandparenting in the 21st Century Problems such as substance abuse, catastrophic illness, teen sex than when you were rearing your children. Even the news and commercials may speak of things you are open to all people without regard to race, color, sex, disability, religion, age, or national origi
Hepworth, I; McGowan, L
This literature review examines the extent to which mental health professionals enquire about childhood sexual abuse during routine mental health assessments in acute mental health settings. Five electronic databases were searched for papers which explored the nature of enquiry about childhood sexual abuse by mental health professionals. The literature was searched between December 2008 and March 2010, with an update in October 2011. Of the 332 papers identified, 54 papers were selected as potentially relevant and data extraction was performed. Eleven studies met the inclusion criteria. Eleven studies were identified that either examined the prevalence of childhood sexual abuse enquiry documented in medical records, or directly asked mental health professionals about their own practice in relation to this subject. The studies found that while many professionals acknowledged the importance of enquiry, there was little evidence of widespread routine enquiry during mental health assessments in acute settings. Mental health professionals do not routinely enquire about childhood sexual abuse during mental health assessment in acute mental health settings. Service providers may have to consider incorporating mandatory enquiry into mental health assessments. PMID:22702227
Background It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. Methods This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n?=?364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. Results In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Conclusions Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. Trials registration This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374. PMID:24726046
David Carless; Kitrina Douglas
ObjectivesIt has been suggested that mental illness threatens identity and sense of self when one's personal story is displaced by dominant illness narratives focussing on deficit and dysfunction. One role of therapy, therefore, is to allow individuals to re-story their life in a more positive way which facilitates the reconstruction of a meaningful identity and sense of self. This research
William A. Anthony
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 mental illness is the vision that will guide the
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. PMID:24708777
Newman, Michael K.
A study identified and analyzed the learning preferences of 17 seriously and chronically mentally ill adults participating in the rehabilitative psychosocial therapy program at the Toxaway Church Site of the Anderson Mental Health Center. Staff perceived as boring and unfocused the traditional treatment approach that relied mainly upon…
Henry, David; And Others
Attitudes of 340 staff members in 120 community living programs for people with mental retardation, mental illness, and dual diagnosis were assessed using the Community Living Attitudes Scale, a measure of attitudes toward inclusion. Findings identified attitudinal differences toward inclusion between managers and staff and between those working…
Tobin, Joseph Jay; And Others
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 mental illness, focusing particularly on the unique challenges and pressures of being a refugee. Covered in the individual units are the following topics: psychological…
Edinger, Jennifer; Boulter, Sandra
The mentally ill are overrepresented in the statistics of individuals killed or injured by police and it is understandable that police would seek a weapon, such as a TASER, that is less lethal than a firearm. However, it appears that use of TASERs is not without risk, especially in certain groups, including the mentally ill. The risk of injury to vulnerable people with a mental illness from TASER weapons must be weighed against the risk that escalation to lethal force may cause if a person with an acute mental illness requires restraint. When police officers are carrying out their duties under mental health legislation it is recommended that TASERs be used only when an individual is imminently likely to sustain or to cause grievous bodily harm. This article recommends changes to the Western Australian Police TASER training programs and proposes mandatory medical assessments after the use of TASER restraint. PMID:21528742
... in place. More progress can be achieved: By mental health professionals Asking their patients if they use tobacco; ... in people trying to quit using tobacco. By mental health facilities Including quitting treatments as part of mental ...
Peter D. Friedmann; Jeffrey A. Alexander; Thomas A. D’Aunno
Primary care and mental health services improve drug abuse treatment clients’ health and treatment outcomes. To examine the association between clients’ access to these services and the characteristics of drug treatment organizations, we analyze data from a national survey of the unit directors and clinical supervisors of 618 outpatient drug abuse treatment programs in 1995 (88% response rate). In multivariate
services, through evidence-based practices, to individuals and families who live in permanent housingRecovery National and Regional Resources Substance Abuse and Mental Health Services Administration to carry-out voucher programs for substance abuse clinical treatment and recovery support services. Goal
Hickson, Linda; Khemka, Ishita; Golden, Harriet; Chatzistyli, Aikaterini
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…
Diaz, Naelys; Horton, Eloise G.; McIlveen, John; Weiner, Michael; Nelson, Jenniffer
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…
Martha A. Jessup; Suzanne L. Dibble
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
Ostler, Teresa; Haight, Wendy; Black, James; Choi, Ga-Young; Kingery, Linda; Sheridan, Kathryn
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…
Muralidharan, Anjana; Lucksted, Alicia; Medoff, Deborah; Fang, Li Juan; Dixon, Lisa
To distinguish the impact of mental illness stigma from that of other negative caregiving experiences, this study examined the unique relationships between stigma and caregiver/family functioning. Adult relatives (n?=?437) of individuals with mental illness completed questionnaires regarding caregiving experiences, distress, empowerment, and family functioning, as part of a larger study. Regression analyses examined the relationship between stigma and caregiver/family variables, while controlling for other negative caregiving experiences. Stigma was uniquely associated with caregiver distress, empowerment, and family functioning. Mental illness stigma is a potent source of distress for families and an important target of family services. PMID:25168187
Background Employment is associated with better quality of life and wellbeing in people with mental illness. Unemployment is associated with greater levels of psychological illness and is viewed as a core part of the social exclusion faced by people with mental illness. Social Firms offer paid employment to people with mental illness but are under-investigated in the UK. The aims of this phase of the Social Firms A Route to Recovery (SoFARR) project were to describe the availability and spread of Social Firms across the UK, to outline the range of opportunities Social Firms offer people with severe mental illness and to understand the extent to which they are employed within these firms. Method A UK national survey of Social Firms, other social enterprises and supported businesses was completed to understand the extent to which they provide paid employment for the mentally ill. A study-specific questionnaire was developed. It covered two broad areas asking employers about the nature of the Social Firm itself and about the employees with mental illness working there. Results We obtained returns from 76 Social Firms and social enterprises / supported businesses employing 692 people with mental illness. Forty per cent of Social Firms were in the south of England, 24% in the North and the Midlands, 18% in Scotland and 18% in Wales. Other social enterprises/supported businesses were similarly distributed. Trading activities were confined mainly to manufacturing, service industry, recycling, horticulture and catering. The number of employees with mental illness working in Social Firms and other social enterprises/supported businesses was small (median of 3 and 6.5 respectively). Over 50% employed people with schizophrenia or bipolar disorder, though the greatest proportion of employees with mental illness had depression or anxiety. Over two thirds of Social Firms liaised with mental health services and over a quarter received funding from the NHS or a mental health charity. Most workers with mental illness in Social Firms had been employed for over 2 years. Conclusions Social Firms have significant potential to be a viable addition to Individual Placement and Support (IPS), supporting recovery orientated services for people with the full range of mental disorders. They are currently an underdeveloped sector in the UK. PMID:23844779
Perron, Amélie; Holmes, Dave
The concepts of discourse, subjectivity and power allow for innovative explorations in nursing research. Discourse take many different forms and may be maintained, transmitted, even imposed, in various ways. Nursing practice makes possible many discursive spaces where discourses intersect. Using a Foucauldian perspective, were explored the ways in which forensic psychiatric nurses construct the subjectivity of mentally ill inmates. Progress notes and individual interviews constitute discursive spaces within which nurses construct patients' subjectivities. Progress notes provide a written (and permanent) form of discourse, while interviews set the space for a more fluid and contextual form of discourse. We identified five types of subjectivities - the (in)visible patient, the patient as risk, the deviant patient, the disturbed patient and the disciplined patient. These subjectivities were rooted in various types of discourses circulating in the selected setting. Despite the multiple discursive dimensions of forensic psychiatric nursing, progress notes remain the main formal source of information regarding nursing care even though it is not representative of the care provided nor is it representative of nurses' complex discursive practices in corrections. PMID:21790870
Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J
Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care. PMID:15379386
Mc Lellan, A T; Woody, G E; O'Brien, C P
The origin of the psychiatric illnesses observed in drug abusers is often unclear. This study examines the causal relation between drug abuse and specific psychiatric disorders. Fifty-one male veterans first seen in 1972, who were admitted at least once per year for six consecutive years for inpatient drug-abuse treatment, underwent psychiatric assessments at each admission. Eleven men mainly used stimulants, 14 depressants, and 26 opiates. Initial psychiatric examinations showed low symptom levels in all groups but no statistically significant differences among them. By the end of six years, five of the stimulant users had psychoses, and eight of the depressant users had serious depression. The narcotics users showed no change in psychopathology. Differences between the groups were significant at the 0.01 level. These changes were not due to acute toxic reactions, but our data suggest that abuse of particular drugs has a major role in the development of specific psychiatric illnesses. The possibility that different preexisting personality disorders lead to different kinds of drug abuse cannot be excluded. PMID:41182
Latalova, Klara; Kamaradova, Dana; Prasko, Jan
The aims of this paper are to review data on the prevalence and correlates of violent victimization of persons with severe mental illness, to critically evaluate the literature, and to explore possible approaches for future research. PubMed/MEDLINE and PsycINFO databases were searched using several terms related to severe mental illness in successive combinations with terms describing victimization. The searches identified 34 studies. Nine epidemiological studies indicate that patients with severe mental illness are more likely to be violently victimized than other community members. Young age, comorbid substance use, and homelessness are risk factors for victimization. Victimized patients are more likely to engage in violent behavior than other members of the community. Violent victimization of persons with severe mental illness has long-term adverse consequences for the course of their illness, and further impairs the quality of lives of patients and their families. Victimization of persons with severe mental illness is a serious medical and social problem. Prevention and management of victimization should become a part of routine clinical care for patients with severe mental illness. PMID:25336958
Latalova, Klara; Kamaradova, Dana; Prasko, Jan
The aims of this paper are to review data on the prevalence and correlates of violent victimization of persons with severe mental illness, to critically evaluate the literature, and to explore possible approaches for future research. PubMed/MEDLINE and PsycINFO databases were searched using several terms related to severe mental illness in successive combinations with terms describing victimization. The searches identified 34 studies. Nine epidemiological studies indicate that patients with severe mental illness are more likely to be violently victimized than other community members. Young age, comorbid substance use, and homelessness are risk factors for victimization. Victimized patients are more likely to engage in violent behavior than other members of the community. Violent victimization of persons with severe mental illness has long-term adverse consequences for the course of their illness, and further impairs the quality of lives of patients and their families. Victimization of persons with severe mental illness is a serious medical and social problem. Prevention and management of victimization should become a part of routine clinical care for patients with severe mental illness. PMID:25336958
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
Pera, S Barbera; Dailliet, A
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 mentally ill at large. The concept of mental illness 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
abuse treatment facilities collected from the 2011 National Survey of Substance Abuse Treatment Services (N-SSATS) provides the basis for conducting a series of confirmatory factor analyses (CFA). In addition, interviews with 21 senior managers of mental...
Ward, Earlise; Wiltshire, Jacqueline C.; Detry, Michelle A.; Brown, R. L.
Background Although research focused on African Americans with mental illness has been increasing, few researchers have addressed gender and age differences in beliefs, attitudes, and coping. Objective To examine African Americans' beliefs about mental illness, attitudes toward seeking mental health services, preferred coping behaviors, and whether these variables differ by gender and age. Method An exploratory, cross-sectional survey design was used. Participants were 272 community-dwelling African Americans aged 25-72 years. Data analysis included descriptive statistics and general linear regression models. Results Depression was the most common mental illness and there were no gender differences in prevalence. Both men and women believed they knew some of the symptoms and causal factors of mental illness. Their attitudes suggested they are not very open to acknowledging psychological problems, are very concerned about stigma associated with mental illness, and are somewhat open to seeking mental health services, but they prefer religious coping. Significant gender and age differences were evident in attitudes and preferred coping. Discussion Our findings have implications for gender and age-specific psychoeducation interventions and future research. For instance, psychoeducation or community awareness programs designed to increase openness to psychological problems and reducing stigma are needed. Also, exploration of partnerships between faith-based organizations and mental health services could be helpful to African Americans. PMID:23328705
The relationship between social class and mental illness stigma has received little attention in recent years. At the same time, the concept of mental health literacy has become an increasingly popular way of framing knowledge and understanding of mental health issues. British Social Attitudes survey data present an opportunity to unpack the relationships between these concepts and social class, an important task given continuing mental health inequalities. Regression analyses were undertaken which centred on depression and schizophrenia vignettes, with an asthma vignette used for comparison. The National Statistics Socio-economic Classification, education and income were used as indicators of class. A number of interesting findings emerged. Overall, class variables showed a stronger relationship with mental health literacy than stigma. The relationship was gendered such that women with higher levels of education, especially those with a degree, had the lowest levels of stigma and highest levels of mental health literacy. Interestingly, class showed more of an association with stigma for the asthma vignette than it did for both the depression and schizophrenia vignettes, suggesting that mental illness stigma needs to be contextualised alongside physical illness stigma. Education emerged as the key indicator of class, followed by the National Statistics Socio-economic Classification, with income effects being marginal. These findings have implications for targeting health promotion campaigns and increasing service use in order to reduce mental health inequalities. PMID:25323051
Brown, Michael H.
States that the techniques of mental imagery can help adult survivors of childhood sexual abuse access the inner wisdom necessary to identify, understand, and creatively address issues from the past and develop new and healthier patterns of thinking and behaving. Documents the innovative ways psychosynthesis uses mental imagery with this client…
Robert E. Drake; Carolyn Mercer-McFadden; Kim T. Mueser; Gregory J. McHugo; Gary R. Bond
Patients with severe mental disorders such as schizophrenia and co-occurring substance use disorders traditionally received treatments for their two disorders from two different sets of clinicians in parallel treatment systems. Dissatisfaction with this clinical tradition led to the development of integrated treatment models in which the same clinicians or teams of clinicians provide substance abuse treatment and mental health treatment
Corrigan, Patrick W; Watson, Amy C; Warpinski, Amy C; Gracia, Gabriela
This study examined how two types of public education programs influenced how the public perceived persons with mental illness, their potential for violence, and the stigma of mental illness. A total of 161 participants were randomly assigned to one of three programs: one that aimed to combat stigma, one that highlighted the association between violence and psychiatric disorders, and a control group. Participants who completed the education-about-violence program were significantly more likely to report attitudes related to fear and dangerousness, to endorse services that coerced persons into treatment and treated them in segregated areas, to avoid persons with mental illness in social situations, and to be reluctant to help persons with mental illness. PMID:15128968
Brown, Sarah Mills
Major mental illness is now recognised as one of the leading causes of adult morbidity. Of the adult onset psychiatric disorders, the functional psychoses (schizophrenia, bipolar disorder and recurrent major depression) ...
Corelli, T B; Hoag, M J; Howell, R J
Childhood sexual abuse is prevalent in our society today. Over the last 30 years, mental health professionals have become increasingly involved in the assessment and treatment of adults who were sexually abused as children. The emergence of the phenomenon of recovered memories has divided both families and mental health professionals. The current debate over repressed memory as well as the prominent theories in this area are discussed. Recent legal developments of repressed memory litigation are discussed along with examples of legal cases that are most relevant to mental health professionals today. PMID:9148881
Johnson, Kurt D.; Whitbeck, Les B.; Hoyt, Dan R.
ABSTRACT 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 medical services. In addition, formal services on reservation were preferred to off reservation services. To better serve the mental health and substance abuse treatment needs of American Indians, traditional informal services should be incorporated into the current medical model. PMID:17143732
Laura L. Otto-Salaj; Timothy G. Heckman; L. Yvonne Stevenson; Jeffrey A. Kelly
A number of studies have established high human immunodeficiency virus (HIV) seroprevalence among severely mentally ill men and women living in large urban areas. Much less research has characterized the patterns of risk behavior that contribute to elevated vulnerability to HIV\\/AIDS among the mentally ill, as well as psychological, situational, and gender-related influences on risk in this population. One-hundred thirty-four
John Sylvestre; Geoffrey Nelson; Annabelle Sabloff; Sarah Peddle
This article contrasts values associated with the delivery of housing programs for people with serious mental illness with\\u000a the typical topics pertaining to housing that are studied by researchers. Six values were identified through a search and\\u000a content analysis of the literature on housing for people with serious mental illness. A second review of the literature was\\u000a conducted to identify
Jayakody, Kaushadh; Gibson, Roger Carl; Kumar, Ajit; Gunadasa, Shalmini
Background Medication used for acute aggression in psychiatry must have rapid onset of effect, low frequency of administration and low levels of adverse effects. Zuclopenthixol acetate is said to have these properties. Objectives To estimate the clinical effects of zuclopenthixol acetate for the management of acute aggression or violence thought to be due to serious mental illnesses, in comparison to other drugs used to treat similar conditions. Search methods We searched the Cochrane Schizophrenia’s Group Trials Register (July 2011). We supplemented this by citation searching and personal contact with authors and relevant pharmaceutical companies. Selection criteria All randomised clinical trials involving people thought to have serious mental illnesses comparing zuclopenthixol acetate with other drugs. Data collection and analysis Two review authors extracted and cross-checked data independently. We calculated fixed-effect relative risks (RR) and 95% confidence intervals (CI) for dichotomous data. We analysed by intention-to-treat. We used mean differences (MD) for continuous variables. Main results We found no data for the primary outcome, tranquillisation. Compared with haloperidol, zuclopenthixol acetate was no more sedating at two hours (n = 40, 1 RCT, RR 0.60, 95% CI 0.27 to 1.34). People given zuclopenthixol acetate were not at reduced risk of being given supplementary antipsychotics (n = 134, 3 RCTs, RR 1.49, 95% CI 0.97 to 2.30) although additional use of benzodiazepines was less (n = 50, 1 RCT, RR 0.03, 95% CI 0.00 to 0.47). People given zuclopenthixol acetate had fewer injections over seven days compared with those allocated to haloperidol IM (n = 70, 1 RCT, RR 0.39, 95% CI 0.18 to 0.84, NNT 4, CI 3 to 14). We found no data on more episodes of aggression or harm to self or others. One trial (n = 148) reported no significant difference in adverse effects for people receiving zuclopenthixol acetate compared with those allocated haloperidol at one, three and six days (RR 0.74, 95% CI 0.43 to 1.27). Compared with haloperidol or clotiapine, people allocated zuclopenthixol did not seem to be at more risk of a range of movement disorders (< 20%). Three studies found no difference in the proportion of people getting blurred vision/dry mouth (n = 192, 2 RCTs, RR at 24 hours 0.90, 95% CI 0.48 to 1.70). Similarly, dizziness was equally infrequent for those allocated zuclopenthixol acetate compared with haloperidol (n = 192, 2 RCTs, RR at 24 hours 1.15, 95% CI 0.46 to 2.88). There was no difference between treatments for leaving the study before completion (n = 522, RR 0.85, 95% CI 0.31 to 2.31). One study reported no difference in adverse effects and outcome scores, when high dose (50-100 mg/injection) zuclopenthixol acetate was compared with low dose (25-50 mg/injection) zuclopenthixol acetate. Authors’ conclusions Recommendations on the use of zuclopenthixol acetate for the management of psychiatric emergencies in preference to ‘standard’ treatment have to be viewed with caution. Most of the small trials present important methodological flaws and findings are poorly reported. This review did not find any suggestion that zuclopenthixol acetate is more or less effective in controlling aggressive acute psychosis, or in preventing adverse effects than intramuscular haloperidol, and neither seemed to have a rapid onset of action. Use of zuclopenthixol acetate may result in less numerous coercive injections and low doses of the drug may be as effective as higher doses. Well-conducted pragmatic randomised controlled trials are needed. PMID:22513898
Simoni-Wastila, Linda; Zuckerman, Ilene H; Shaffer, Thomas; Blanchette, Christopher M; Stuart, Bruce
Objective To describe the extent of drug coverage among severely mentally ill Medicare beneficiaries and to determine whether and to what extent discontinuities in prescription drug coverage influence the use of medications used to treat serious mental health conditions. Data Source 1997–2001 Medicare Current Beneficiary Surveys. Study Design We use a zero-inflated negative binomial model to estimate: (1) the probability of not receiving any mental health drug and (2) the number of medications received, adjusting for age, race, income, census region, health status, and comorbidity. Severe mental illness is defined using inpatient and outpatient claims with ICD-9 codes of schizophrenia, other psychotic disorders, bipolar disorders, and major depression. Mental health medications include antidepressants, antipsychotics, mood stabilizers, anxiolytic/sedative-hypnotics, and stimulants. Prescription drug coverage is assessed as full coverage (0 percent discontinuities), no coverage (100 percent discontinuities), or as discontinuous coverage, measured as 1–25, 26–50, and 51–99 percent of time without coverage. Data Collection/Extraction Methods We constructed three 3-year longitudinal cohorts of severely mentally ill Medicare beneficiaries residing in the community (n = 901). Principal Findings Severely mentally ill Medicare beneficiaries with drug coverage discontinuities are more likely than their continuously insured peers not to receive medications used to treat mental health disorders, with the most significant impact seen in the probability of receiving any psychiatric medications. Analysis of two therapeutic classes—antidepressants and antipsychotics—revealed varying impacts of drug gaps on both probability of any drug use, as well as number of medications received among users. Conclusions Severely mentally ill Medicare beneficiaries may be particularly vulnerable to the Medicare Part D drug benefit design and, as such, warrant close evaluation and monitoring to insure adequate access to and utilization of medications used to manage mental illness. PMID:18370965
Carroll, Anne; Reichman, Nancy E.; Corman, Hope
The objective of this study was to assess the extent to which maternal prenatal mental illness is associated with mothers’ health insurance status 12–18 months after giving birth. The sample consisted of 2,956 urban, mostly unwed, mothers who gave birth in 20 large U.S. cities between 1998 and 2000 and participated in the Fragile Families and Child Wellbeing birth cohort study. Multinomial logistic regression models were used to assess associations between maternal prenatal mental illness and whether the mother had private, public, or no insurance one year after the birth. Covariates included the mother’s and child’s physical health status, the father’s physical and mental health status, and numerous other maternal, paternal, and family characteristics. Potential mediating factors were explored. The results showed that mothers with prenatal diagnosed mental illness were almost half as likely as those without mental illness diagnoses to have private insurance (vs. no insurance) one year after the birth. Among mothers who did not have a subsequent pregnancy, those with prenatal mental illness were less likely than those without mental illness diagnoses to have public insurance than to be uninsured. Screening positive for depression or anxiety at one year decreased the likelihood that the mother had either type of insurance. Policies to improve private mental health care coverage and public mental health services among mothers with young children may yield both private and social benefits. Encounters with the health care and social service systems experienced by pregnant and postpartum women present opportunities for connecting mothers to needed mental health services and facilitating their maintenance of health insurance. PMID:18989764
The author sets three objectives: to determine the status of sexuality in pedagogical institutions; to examine the means used to control sexuality; and to trace a global interpretation of the links between sexuality and the institution. The development of the asylum saw the appearance of moral treatment which sought to promote certain social values and to repress those behaviours such as sexual activity which opposed the fundamental bourgeois social virtues. These notions were presented in the guise of an ethical standard and a normative scientific current (eg. sexuality is a symptom to be eliminated; it is a cause of insanity.) Now, while no longer attacked in the institution, sexuality is nonetheless perceived as lacking any inherent value and is worthwhile only in terms of its therapeutic utility* The same phenomenon is observable in the school. To illustrate the second point the author analyses the phenomenon of masturbation. The 18th century saw masturbation cited as the cause of insanity and numerous physical disorders. Viewed as a diversion of the child's natural forms, and as bringing into question the substitutive educational system, masturbation was excluded from the school of the period. At present, masturbation is permitted but there is no recognition of the child's free enjoyment. Instead a system of exercises has been developped which permit the child greater body control. This masturbation has become a therapeutic technique to obtain a normative level of pleasure.Touching on the third point, the author states that society regulates sexual life with a complex normative system in order to incorporate it within an identification with sexual institutions and no longer with judicial sanctions. Applying this analysis to the situation of the mentally ill, the author argues that the latter's sexuality is socially normalized by the definition and utilisation of illegal areas where it's actualization is permitted. PMID:17093652
The review deals with present problems of protecting mentally ill patients who are incompetent to give informed consent to participating in clinical research, and of assessment of the capacity to consent. 1. Clinical trials of drugs on efficacy and safety in incompetent patients are ethically justified and legally admissible if the investigational drug can be expected to exert a direct potential individual benefit and if such trials will be performed under defined criteria to protect these vulnerable patients. In Germany it is questionable how far these prescriptions of the German Drug Law (AMG) are transferable to other than drug research. 2. Research with no direct potential individual benefit or only a group-specific benefit in incompetent patients is controversially discussed. However, it may be ethically justified as an exception, and is in Germany legally admissible only in minors, but not in adults. 3. However, internationally there exists a wide range of legal regulations, terms, interpretations, and practices of research with vulnerable persons. In the past years a shift seems to have developed from normatively oriented discussions to more empirically based investigations. Especially vague but clinically relevant terms in protection declarations or guidelines have been better specified, put in concrete form by anchor examples, and empirically studied. 4. In general the criteria of protecting the dignity and, even if impaired, the autonomy of incompetent patients as subjects for research appear to guarantee a high standard of protection. However, the application of these criteria must be improved by practicable procedures. This is valid particularly for the assessment of the basic criterion whether a patient is capable of consenting or not. 5. Open Questions are formulated as need of research. PMID:18633585
Severe mental illness (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
Cook, J A; Lefley, H P; Pickett, S A; Cohler, B J
Family burden reported by parents of offspring with severe mental illness was examined to determine whether burden increases with age. Older parents were troubled by cognitive dimensions of burden, while younger parents were distressed by their offspring's behavior, suggesting that interventions should vary according to parents' age as well as developmental stage of their child's illness. PMID:7977666
Henry VI, King of England, at age 19 founded Eton College and King's College, Cambridge. At 31 he had a sudden, dramatic mental illness in which he was mute and unresponsive. Before, he had been paranoid, grandiose, and indecisive. After, he was apathetic with deterioration of ability, drive, interest and self-care, and hallucinations and religious delusions. This illness, which is
Amy C. Watson; Melissa Schaefer Morabito; Jeffrey Draine; Victor Ottati
The large numbers of people with mental illness 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
Matthew Johnsen; Laura Samberg; Robert Calsyn; Margaret Blasinsky; Wendy Landow; Howard Goldman
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 mental illness. We describe theimplementation of case
Carol T. Mowbray; Lisa Lewandowski; Deborah Bybee; Daphna Oyserman
Children who have a parent diagnosed with a mental illness are at risk of psychiatric and behavioral problems; yet, these children do not necessarily receive needed services. Research has investigated correlates of child mental health service use, but not for these high-risk children. This study is part of an NIMH-funded, longitudinal investigation and describes child problems, service use, and predictors
Adelson, Rachel K.
A content analysis was performed on six mass-audience women's magazines to determine frequency of coverage of specific mental disorders and to see how fair and complete mental illness coverage was in the magazines. The six magazines analyzed were "Family Circle,""McCalls,""Good Housekeeping,""Cosmopolitan,""Glamour," and "Seventeen." The contents…
DeSocio, Janiece; Stember, Lisa; Schrinsky, Joanne
A mental health education program designed by school nurses for children ages 10-12 was developed in 2000-2001 and expanded with broader distribution in 2004-2005. Six classroom sessions, each 45 minutes in length, provided information and activities to increase children's awareness of mental health and illness. Education program content included…
Ronald E. Hellman; Eileen Klein
This paper reports on The LGBT Affirmative Program of South Beach Psychiatric Center, a public sector mental health program in New York State for lesbian, gay, bisexual, and transgender (LGBT) individuals with major mental illness. The program began in 1996 and has provided services to over 200 individuals as of June, 2004. Systemic and cultural factors influencing program development are
William C. Torrey; Robert E. Drake; Lisa Dixon; Barbara J. Burns; Laurie Flynn; A. John Rush; Robin E. Clark; Dale Klatzker
Extensive empirical research, summarized in several reviews and codified in practice guidelines, recommendations, and algorithms, demonstrates that several pharmacological and psychosocial interventions are effective in improving the lives of persons with severe mental illnesses. Yet the practices validated by research are not widely offered in routine mental health practice settings. As part of an effort to promote the implementation of
Acosta, Frank X.
Notes similarities and differences of pretherapy expectations for psychotherapists, length of time in therapy, and definitions of mental illness among 44 Mexican American and 48 Anglo American low income out-patients at an East Los Angeles mental health clinic. (SB)
Paterson, Andrea; Rhubright, Ellen
Housing is a critical component of community care for people with long-term mental illness. Without a place to live, the best mental health treatment and the most sophisticated rehabilitation services cannot be effective. The first phase of the deinstitutionalization movement, releasing large numbers of patients from the state hospitals and…
Darlene M. OConnor; Faith C. Little; Richard H. McManus
This article reviews key federal Medicaid policies affecting older adults with serious, long-term mental illness: (a) the Medicaid exclusion of coverage for Institutions for Mental Diseases, (b) the Preadmission Screening and Resident Review Process, and (c) the Medicaid Home and Community Based Services waiver policy. Documenting the incentives and restrictions in these policies provides an historical context for understanding the
Corfman, Eunice, Ed.
Science Monographs, published by the National Institute of Mental Health, are book-length, integrative state-of-the-art reviews, critical evaluations of findings, or program assessments of current research on topics related to the NIMH mandate. This set of articles concentrate on mental illness in the family. "Depression and Low-Income,…
Reardon, Claudia L; Factor, Robert M
Sport psychiatry focuses on diagnosis and treatment of psychiatric illness in athletes in addition to utilization of psychological approaches to enhance performance. As this field and its research base are relatively new, clinicians often deliver psychiatric care to athletes without a full understanding of the diagnostic and therapeutic issues unique to this population. In this systematic review, we discuss published findings relating to psychiatric diagnosis and medical treatment of mental illness in athletes. There have been several studies looking at the prevalence of some psychiatric disorders in various athlete populations. Eating disorders and substance abuse are the most studied of these disorders and appear to be common problems in athletes. However, to provide informed understanding and treatment, we especially need more research on overtraining syndrome, bipolar disorder, suicidality, anxiety disorders, attention-deficit hyperactivity disorder (ADHD) and psychosis in athletes. Research is needed in the areas of prevalence, risk factors, prognosis and the unique experiences facing athletes with any of these disorders. Additionally, there have not been any large, systematic studies on the use of psychotropic medications in athletes. Small studies suggest that some medications may either be performance enhancing or detrimental to performance, but we need larger studies with rigorous methodology. Higher level athletes suffering from psychiatric symptoms often have reservations about taking medications with unknown performance and safety effects, and methodological issues with the current literature database preclude any definitive conclusions on performance effects of psychiatric medications. We need many more, higher quality studies on the use by athletes of antidepressants, mood stabilizers, anxiolytics, stimulants and other ADHD medications, sedative-hypnotics and antipsychotics. Such studies should utilize sensitive performance measures and involve longer term use of psychotropic medications. Furthermore, study subjects should include athletes who actually have the psychiatric disorder for which the medication is proposed, and should include more women. PMID:20942511
... Dual Diagnosis: Adolescents with Co-occurring Brain Disorders & Substance Abuse Disorders Adolescents are often referred to treatment for ... do model programs for treating mental illness and substance abuse look like? There is a growing number of ...
Richman, J A; Rospenda, K M; Nawyn, S J; Flaherty, J A; Fendrich, M; Drum, M L; Johnson, T P
OBJECTIVES: This study hypothesized that interpersonal workplace stressors involving sexual harassment and generalized workplace abuse are highly prevalent and significantly linked with mental health outcomes including symptomatic distress, the use and abuse of alcohol, and other drug use. METHODS: Employees in 4 university occupational groups (faculty, student, clerical, and service workers; n = 2492) were surveyed by means of a mailed self-report instrument. Cross-tabular and ordinary least squares and logistic regression analyses examined the prevalence of harassment and abuse and their association with mental health status. RESULTS: The data show high rates of harassment and abuse. Among faculty, females were subjected to higher rates; among clerical and service workers, males were subjected to higher rates. Male and female clerical and service workers experienced higher levels of particularly severe mistreatment. Generalized abuse was more prevalent than harassment for all groups. Both harassment and abuse were significantly linked to most mental health outcomes for men and women. CONCLUSIONS: Interpersonally abusive workplace dynamics constitute a significant public health problem that merits increased intervention and prevention strategies. PMID:10076485
Morano, Jamie P.
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. PMID:15014610
Background Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. Methods The design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker’s knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. Results The results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice. Conclusion The main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant. PMID:24507566
McGinty, Emma E; Frattaroli, Shannon; Appelbaum, Paul S; Bonnie, Richard J; Grilley, Anna; Horwitz, Joshua; Swanson, Jeffrey W; Webster, Daniel W
Recent mass shootings have prompted a national dialogue around mental illness and gun policy. To advance an evidence-informed policy agenda on this controversial issue, we formed a consortium of national gun violence prevention and mental health experts. The consortium agreed on a guiding principle for future policy recommendations: restricting firearm access on the basis of certain dangerous behaviors is supported by the evidence; restricting access on the basis of mental illness diagnoses is not. We describe the group's process and recommendations. PMID:25211757
Brandon, Nicholas J.; Sawa, Akira
Recent advances in our understanding of the underlying genetic architecture of psychiatric disorders, has blown away “old” diagnostic boundaries defined by currently used diagnostic manuals. The DISC1 gene was originally discovered at the breakpoint of an inherited chromosomal translocation, which segregates with major mental illnesses. Many biological studies have indicated the role of DISC1 in early neurodevelopment and synaptic regulation. Given the additional insight that DISC1 is thought to drive a range of endophenotypes, which underlie major mental conditions, the biology of DISC1 may provide a hint on constructing new diagnostic categories for mental illnesses with more meaningful biological foundation. PMID:22095064
Bourgeois, M; Khaleff, M; Labrousse, D
A religious Sect (Jéhovah witness), its mental patients, its doctor and its psychiatrists. The authors study religious sects, specially Jéhovoah witness. Such 15 mentally ill patients among this group have been treated at the psychiatric clinic. The fact that they are members of a community, sharing the same religious faith, and having in common severe rules of life, is considered as having a pathogenic or beneficial effect. One of them, physician, explain their opinion of mental illness : they believe in biological factors and discard any psychotherapeutic mean. PMID:1163915
Saira Nawaz; Rochelle Frounfelker; Joelle C. Ferron; Elizabeth A. Carpenter-Song; Kristin Davis; Mary F. Brunette
Objective: Most people with severe mental illness do not use evidence-based smoking cessation treatment. Ethnic and racial identification among people with severe mental illness may add complexity to their participation in smoking cessation interventions. The purpose of this qualitative study was to explore smoking and smoking cessation attitudes, beliefs and behaviors among three race\\/ethnicity groups of smokers with severe mental
Saira Nawaz; Rochelle Frounfelker; Joelle C. Ferron; Elizabeth A. Carpenter-Song; Kristin Davis; Mary F. Brunette
Objective: Most people with severe mental illness do not use evidence-based smoking cessation treatments. Ethnic and racial identification among people with severe mental illness may add complexity to their participation in smoking cessation interventions. The purpose of this qualitative study was to explore smoking and smoking cessation attitudes, beliefs, and behaviors among three race\\/ethnicity groups of smokers with severe mental
Evins, A Eden; Cather, Corinne; Laffer, Alexandra
Addiction to tobacco-derived nicotine remains highly prevalent in the United States, with 18% using daily, and 53% of those with serious mental illness using daily. While smokers with serious mental illness have been excluded from most large nicotine-dependence treatment studies, a growing evidence base is available to guide clinicians in assisting their patients with psychiatric illness to quit smoking. The aim of this review is to present the evidence on safety and efficacy of smoking cessation interventions for those with serious mental illness. Smokers with schizophrenia spectrum disorders should receive varenicline or bupropion with or without nicotine replacement therapy in combination with behavioral treatment. Although more research is needed, preliminary evidence suggests that varenicline in combination with behavioral support is efficacious and well tolerated for smoking cessation for those with bipolar disorder and major depressive disorder. Controlled trials have found no evidence that in patients with serious mental illness, the use of pharmacotherapeutic cessation aids worsens psychiatric symptoms or increases the rate of psychiatric adverse events. Converging evidence indicates that a majority of smokers with serious mental illness want to quit smoking and that available pharmacotherapeutic cessation aids combined with behavioral support are both effective for, and well tolerated by, these smokers. PMID:25747922
Quinn, Diane M.; Williams, Michelle K.; Weisz, Bradley M.
Objective Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future, and how anticipation of stigma, in turn predicts greater stigma internalization. Method Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers. Results Correlational analyses indicated that more experiences of discrimination due to one’s mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma. Conclusion and Implications for Practice Experiences of discrimination over the lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma. PMID:25844910
Gühne, Uta; Weinmann, Stefan; Arnold, Katrin; Becker, Thomas; Riedel-Heller, Steffi G
The burden of severe and persistent mental illness is high. Beside somatic treatment and psychotherapeutic interventions, treatment options for patients with severe mental illness also include psychosocial interventions. This paper summarizes the results of a number of systematic literature searches on psychosocial interventions for people with severe mental illness. Based on this evidence appraisal, recommendations for the treatment of people with severe mental illness were formulated and published in the evidence-based guideline series of the German Society for Psychiatry, Psychotherapy and Neurology (DGPPN) as an evidence-based consensus guideline ("S3 guideline"). Recommendations were strongly based on study results, but used consensus processes to consider external validity and transferability of the recommended practices to the German mental healthcare system. A distinction is made between system-level interventions (multidisciplinary team-based psychiatric community care, case management, vocational rehabilitation and participation in work life and residential care interventions) and single psychosocial interventions (psychoeducation, social skills training, arts therapies, occupational therapy and exercise therapy). There is good evidence for the efficacy of the majority of psychosocial interventions in the target group. The best available evidence exists for multidisciplinary team-based psychiatric community care, family psychoeducation, social skills training and supported employment. The present guideline offers an important opportunity to further improve health services for people with severe mental illness in Germany. Moreover, the guideline highlights areas for further research. PMID:25384674
Castellow, Jennifer; Kloos, Bret; Townley, Greg
This paper argues that the experience of homelessness is inherently traumatic and thus has the potential to affect the manifestation of mental illness. The experiences related to being homeless might act as specific and unique sources of vulnerability. This study included 424 people diagnosed with serious mental illnesses living in supported housing programs in South Carolina. Three hierarchical regression analyses measuring the impact of homelessness on three types of outcomes revealed the following: (1) ever experiencing homelessness as well as the amount of time spent homeless were related to higher levels of psychiatric distress, (2) ever experiencing homelessness was related to higher levels of reported alcohol use, and (3) total amount of time spent homeless was related to lower perceived recovery from mental illness. These findings suggest that experiencing homelessness might contribute to psychosocial vulnerability to negative mental health outcomes. Future investigations examining this concept of risk and vulnerability as a result of homelessness are in order. PMID:25566947
Islam, F; Campbell, R A
Mental health stigma in Muslim communities may be partly due to a commonly held belief among some Muslims about the supernatural causes of mental illness (i.e. jinn-possession brought on by one's sinful life). A thematic analysis was carried out on four English translations and the Arabic text of the Qur'an to explore whether the connection between jinn-possession and insanity exists within the Muslim holy book. No connection between spirit-possession and madness or mental illness was found. Pagans taunted and labelled people as jinn-possessed only to ostracize and scapegoat. Linking the labelling of people as jinn-possession to a pagan practice may be used to educate Muslims, so they can reassess their community's stigma towards the mentally ill. PMID:22688386
Gostin, Lawrence O
Despite countless promises for a better life by national commissions, governments and the international community, there has evolved a vicious cycle of neglect, abandonment, indignity, cruel and inhuman treatment, and punishment of persons with mental illness. This shameful history of benign, and sometimes malignant, neglect of persons with mental illness is well understood, with the deep stigma and unredressed discrimination, the deplorable living conditions, and the physical and social barriers preventing their integration and full participation in society. The maltreatment of this vulnerable population has been reinforced by the hurtful stereotypes of incompetency and dangerousness. The belief that persons with mental illness are uniformly dangerous is an equally harmful myth. It provides policy makers with an ostensible justification to exercise control over persons with mental illness, even if they have not committed a violent offence. However, research demonstrates that the class of persons with most mental illnesses is no more dangerous than other populations, and that the vast majority of violence is committed by persons without mental illness. This article will show how this vulnerable population has been unconscionably treated. First, the gross violations of human rights that have occurred, and continue to occur, in 'old' psychiatric institutions will be examined. The deinstitutionalization movement, however, resulted in new places of confinement for this population, such as jails, prisons and homeless shelters. The second part of this paper will explore the new realities of criminal confinement of persons with mental illness. As we will see, incarceration of this vulnerable population in the criminal justice system has caused enormous suffering. If Dostoyevsky was correct that the 'degree of civilization... can be judged by entering its prisons', then by that measure, we are a deeply uncivilized society. PMID:18555496
Ellen Hoxmark; Mary Nivison; Rolf Wynn
BACKGROUND: Mental distress measured by the HSCL-10 is used as an indicator of psychiatric disorders in population studies, where a higher level of mental distress has been shown to be related to demographic factors such as living conditions and level of education. The first aim of the study was to explore whether mental distress could be a valuable concept in
Gehart, Diane R.
In 2004, the U.S. Department of Health and Human Services issued a consensus statement on mental health recovery based on the New Freedom Commission's recommendation that public mental health organizations adopt a "recovery" approach to severe and persistent mental illness, including services to those dually diagnosed with mental health and…
Eileen A. Graessle
Despite the great need for occupational therapists in mental health care, fewer and fewer therapists practice in this area. Many factors may be involved in a search for explanations of this documented trend, especially when studying occupational therapy students actively weighing the decision of which practice area to pursue. Instructor influence and prior structured experience with mental health may be
Widom, Cathy Spatz; Brzustowicz, Linda M.
Background Studies have examined the interaction of MAOA genotype with childhood maltreatment in relation to depressive symptomatology and alcohol abuse with conflicting findings. Both high and low activity allele combinations have been shown to be protective for maltreated children with direction of findings varying by study methodology and participant’s sex. Methods Participants in a prospective cohort design study involving court substantiated cases of child abuse and neglect and a matched comparison group were followed up into adulthood and interviewed (N = 802). Eighty-two percent consented to provide blood, 631 gave permission for DNA extraction and analyses, and 575 were included in the final sample. This sample included male, female, White, and Non-White (primarily Black) participants. Symptoms of dysthymia, major depression and alcohol abuse were assessed using the NIMH Diagnostic Interview Schedule-III-R. Results Significant three-way interactions, MAOA genotype by abuse by sex, predicted dysthymic symptoms. Low-activity MAOA genotype buffered against symptoms of dysthymia in physically abused and multiply maltreated women. Significant three-way interactions, MAOA genotype by sexual abuse by race, predicted all outcomes. Low-activity MAOA genotype buffered against symptoms of dysthymia, major depressive disorder and alcohol abuse for sexually abused White participants. The high-activity genotype was protective in the Non-White sexually abused group. Conclusions This prospective study provides evidence that MAOA interacts with child maltreatment to predict mental health outcomes. Reasons for sex differences and race findings are discussed. PMID:22030358
Prins, Seth J.
Objective People with mental illnesses are understood to be overrepresented in the U.S. criminal justice system, and estimates of the prevalence of mental illnesses in corrections settings are crucial for planning and implementing preventive and diversionary policies and programs. Despite consistent scholarly attention, two federal self-report surveys are typically cited, and these may not represent the extent of relevant data. This systematic review identifies studies that assess the prevalence of mental illnesses in U.S. state prisons, in order to develop a broader picture of prison prevalence and identify methodological challenges to obtaining accurate and consistent estimates. Methods Medline, PsycInfo, the National Criminal Justice Reference Service, Social Services Abstracts, Social Work Abstracts, and Sociological Abstracts were searched. Studies were included if they were published between 1989 and 2013; focused on U.S. state prisons; reported prevalence of diagnoses/symptoms of DSM Axis I disorders; and identified screening/assessment strategies. Results Twenty-eight articles met inclusion criteria. Estimates of current and lifetime prevalence of mental illnesses varied widely; however, the range of prevalence estimates for particular disorders was much greater—and tended to be higher—in prisons than community samples. Conclusions Operationalizations of mental illnesses, sampling strategies, and case ascertainment strategies likely contributed to inconsistency in findings. Other reasons for study heterogeneity are discussed, and implications for public health are explored. PMID:24686574
Dalky, Heyam F
Family stigma is well documented in the research literature; however, it has only been recently that efforts have been undertaken to discuss the perception of stigma as reported by Arab families of relatives with mental illness. This clinical paper aims to identify families' perception of stigma related to mental illness, and to compare Arab families' approaches with various aspects of caring from different countries. Further, this paper discusses, in-depth, specific areas related to families' perceptions of stigma: What impacts does stigma perception have on those families and on their relatives' care outcomes and what are coping strategies are used to handle stigma and its impacts in such countries? This paper emphasizes that chronic mental illness contributes the most to families' perception of stigma. In this study, Arab families perceived the experience of caring for a family member with a mental illness with fear, loss, embarrassment, and disgrace of family reputations. Further, secrecy, isolation, despair, and helplessness were reported the most among different family groups in Jordan and Morocco. This paper reminds us that cultural norms and beliefs shape family members' perception of coping and their ability to manage caring for relatives with mental illnesses. Thus, more studies are needed concerning coping and management strategies that are culturally relevant. This could eventually guide the establishment of stigma reduction initiatives and expand understanding of stigma from different cultural perspectives. PMID:22757601
Poreddi, Vijayalakshmi; Ramachandra; Thimmaiah, Rohini; Math, Suresh Bada
Background: Globally women confront manifold violations of human rights and women with poverty and mental illness are doubly disadvantaged. Aim: The aim was to examine the influence of poverty in meeting human rights needs among recovered women with mental illness at family and community level. Materials and Methods: This was a descriptive study carried out among randomly selected (n = 100) recovered women with mental illness at a tertiary care center. Data were collected through face-to-face interview using structured needs assessment questionnaire. Results: Our findings revealed that below poverty line (BPL) participants were not satisfied in meeting their physical needs such as “access to safe drinking water” (?2 = 8.994, P < 0.02), “served in the same utensils” (?2 = 13.648, P < 0.00), had adequate food (?2 = 11.025, P < 0.02), and allowed to use toilet facilities (?2 = 13.565, P < 0.00). The human rights needs in emotional dimension, that is, afraid of family members (?2 = 8.233, P < 0.04) and hurt by bad words (?2 = 9.014, P < 0.02) were rated higher in above poverty line (APL) participants. Similarly, 88.9% of women from APL group expressed that they were discriminated and exploited by the community members (?2 = 17.490, P < 0.00). More than three-fourths of BPL participants (76.1%) believed that there were wondering homeless mentally ill in their community (?2 = 11.848, P < 0.01). Conclusion: There is an urgent need to implement social welfare programs to provide employment opportunities, disability allowance, housing and other social security for women with mental illness. Further, mental health professionals play an essential role in educating the family and public regarding human rights of people with mental illness.
Lytsy, Per; Larsson, Kjerstin; Anderzén, Ingrid
Mental illness and pain are common causes of long-term sick absence and major difficulties in vocational rehabilitation. The aim of this study was to investigate health in a group of women with pain or mental illness who had exhausted their days of sickness benefit. This cross-sectional study uses baseline data from 355 women on long-term sick leave participating in controlled intervention studies aiming at returning to work. The study population filled in a written questionnaire with questions of self-rated health and sleep quality and validated indexes of mental health, satisfaction with life and general self-efficacy. Clinical psychiatric screening was performed on 230 individuals. The study population had a mean age of 48.8 years (SD 8.4), with an average time on sick leave of 7.8 years (SD 3.2). Self-rated health and sleep quality was poor compared with other populations. In all, 80.1% had at least one psychiatric diagnosis according to the psychiatric screening, and the average numbers of psychiatric diagnoses were 2.2 (SD 1.9). Foreign-born women showed significantly higher levels of mental illness, poorer self-rated health and sleep quality and lower self-efficacy and life satisfaction than native Swedish women. Women with long sick leave because of mental illness and/or pain have poor self-rated health and sleep quality, high prevalence of mental illness and low self-efficacy and life satisfaction. Psychiatric screening suggests more extensive mental illness than what was stated on the sick leave certificates. The health of foreign-born women seems to be worse than that of native Swedish women. PMID:25203749
Botella, Cristina; Moragrega, Inés; Baños, R; García-Palacios, Azucena
Mental health care represents over a third of the cost of health care to all EU nations and in US is estimated to be around the 2'5% of the gross national product. It additionally results in further costs to the economy in lost productivity. Depression and Stress related disorders are the most common mental illnesses and the prevention of depression and suicide is one of the 5 central focus points in the European Pact for Mental Health and Well Being. While other mental illnesses may benefit in the long term, Depression and Stress will be the focal point mental illnesses mentioned in OPTIMI. Currently the main treatments for mental illness are pharmacological and evidence based Cognitive Behavioral Therapy (CBT). CBT comprises a set of therapist and patient processes whose format allows for the whole treatment process to be computerized and personalized, Computerised CBT (CCBT). OPTIMI will try to improve the state of the art by monitoring stress and poor coping behavior in high risk population, and by developing tools to perform prediction through early identification of the onset of depression. The main goal of OPTIMI is to improve CCBT programs in order to enhance both efficacy and therapeutic effectiveness. The presentation will outline the main goals the project is aiming and its clinical rationale. PMID:21335767
Kiesler, C A; Simpkins, C G; Morton, T L
Data from a 1980 discharge survey of general hospitals were analyzed to determine the prevalence of cases with coexisting diagnoses of mental and substance abuse disorders. Twelve percent of total cases (or 208,000 episodes) had dual diagnoses, a proportion similar to that found in another analysis of 1985 data. Of these cases, 55.5 percent had a primary diagnosis of an alcohol or drug disorder, most commonly alcohol- or drug-induced organic brain syndrome. Thirty-four percent of cases with a primary diagnosis of mental disorder had depressive neurosis, 24 percent had psychosis, and 19 percent had personality disorder. An additional 18.9 percent of all cases had two or more mental or substance abuse disorders. Dual-diagnosis cases had a shorter mean hospital stay than cases with mental disorder only. PMID:1904835
Miltenberger, R G; Roberts, J A; Ellingson, S; Galensky, T; Rapp, J T; Long, E S; Lumley, V A
Previous research has shown that behavioral skills training to teach sexual abuse prevention skills to women with mental retardation results in skill acquisition but poor generalization. In this investigation we evaluated procedures for enhancing generalization following training. Five women with mental retardation received 10 behavioral skills training sessions followed by in situ training when the skills did not fully generalize. Behavioral skills training resulted in skill acquisition and in situ training produced generalized responding during naturalistic assessments. PMID:10513032
Dawn E. Peleikis; Arnstein Mykletun; Alv A. Dahl
Purpose. – This study from Norway examines mental health status of women with child sexual abuse (CSA) who formerly had outpatient psychotherapy for anxiety disorders and\\/or depression. The relative contributions of CSA and other family background risk factors (FBRF) to aspects of mental health status are also explored.Subjects. – At a mean of 5.1 years after outpatient psychotherapy, 56 female outpatients
Shor, Ron; Shalev, Anat
Participating in physical activities could be essential for reducing the multiple risk factors for health problems that persons with severe mental illness (SMI) may suffer. However, people with SMI are significantly less active than the general population. To develop knowledge about factors related to the perceived barriers hindering this population's participation in physical activities and the benefits this participation would have, a study was conducted in Israel with 86 people with mental illness living in community mental health facilities prior to their participation in a health promotion program. A mixed method was implemented and included: a scale designed to measure participants' perceptions of the barriers to and benefits of involvement in physical activities; instruments focusing on bio-psycho-social factors that may affect the level of barriers experienced; and personal interviews. The findings revealed high ranking for accessibility barriers hindering the participation in physical activities. Bio-psycho-social factors stemming from the participants' mental health, such as level of depression, were correlated with higher ranking of accessibility barriers. Bio-psycho-social factors reflecting positive mental health and health, such as positive appraisal of body weight, were correlated with lower ranking of accessibility barriers. Other barriers may include organizational and broader systemic barriers in the mental health facilities where the participants reside. These findings illuminate the need to consider the unique challenges that persons with mental illness may face in any attempt to advance their involvement in physical activity. PMID:25204451
Wolfe, Barbara; Song, Jieun; Greenberg, Jan S.; Mailick, Marsha R.
Developmental disabilities and severe mental illness are costly to the affected individual and frequently to their family as well. Little studied are their nondisabled siblings. Here we examine major life course outcomes (education, employment, and marriage) of these siblings in adulthood using data from the Wisconsin Longitudinal Study. Our sample comprises 113 individuals with developmental disabilities and 337 of their nondisabled siblings; 97 individuals with mental illness and 235 of their nondisabled siblings; and 17,126 unaffected comparison group members. We find that siblings of individuals with mental illness have less education and less employment than the unaffected comparison group, whereas those who have a sibling with developmental disabilities had normative patterns of education and employment, but less marriage and more divorce. Robustness tests incorporating genetic data do not change the conclusions based on the nongenetic analyses. PMID:24607704
Bengtsson-Tops, A; Hansson, L
The aim of this Swedish study was to describe landlords' experiences of having tenants suffering from severe mental illness. Sixteen landlords working in private and public housing agencies participated in open in-depth interviews. Data were subjected to a thematic latent content analysis. The results showed that having tenants with severe mental illness entails being confronted with various difficult circumstances, ranging from mismanagement of apartments to sensitivity among neighbours as well as issues regarding provocative behaviour. It involved providing assistance that was far beyond their professional obligations and to be neglected by the community-based psychiatric service system when in need of help. In order to support landlords and to prevent evictions of individuals with severe mental illness, community-based psychiatric services need to be more pro-active in their attempts to achieve collaboration with the parties at hand. PMID:23361470
Richard D. Lennox
Over the past several years, outcome assessment has crossed the boundaries of basic evaluation research to reach an audience not historically interested in treatment effectiveness per se. Payers, who have traditionally accepted mental health treatment as advertised, are increasingly demanding empirical evidence of mental health treatment effectiveness, requiring examination of a widening range of outcome measures. Full-course evaluation that once
Rosemarie Kobau; Colleen DiIorio; Daniel Chapman; Paolo Delvecchio
The purpose of this study was to test a brief instrument to monitor the U.S. public’s attitudes about mental illness. A SAMHSA\\u000a and CDC-led panel reached consensus through an iterative process to identify generic, multidimensional measures to test using\\u000a a representative sample of 5,251 adults. Exploratory factor analysis revealed two subscales (Negative Stereotypes [? = 0.66];\\u000a Recovery and Outcomes [? = 0.69]). Confirmatory factor
Patterson, Michelle Louise; Moniruzzaman, Akm; Frankish, Charles James; Somers, Julian M
Objectives It is well documented that early-learning problems and poor academic achievement adversely impact child development and a wide range of adult outcomes; however, these indicators have received scant attention among homeless adults. This study examines self-reported learning disabilities (LD) in childhood as predictors of duration of homelessness, mental and substance use disorders, physical health, and service utilisation in a sample of homeless adults with current mental illness. Design This study was conducted using the baseline sample from a randomised controlled trial (RCT). Setting Participants were sampled from the community in Vancouver, British Columbia. Participants The total sample included 497 adult participants who met criteria for absolute homelessness or precarious housing and a current mental disorder based on a structured diagnostic interview. Learning disabilities in childhood were assessed by asking adult participants whether they thought they had an LD in childhood and if anyone had told them they had an LD. Only participants who responded positively to both questions (n=133) were included in the analyses. Outcome measures Primary outcomes include current mental disorders, substance use disorders, physical health, service utilisation and duration of homelessness. Results In multivariable regression models, self-reported LD during childhood independently predicted self-reported educational attainment and lifetime duration of homelessness as well as a range of mental health, physical health and substance use problems, but did not predict reported health or justice service utilisation. Conclusions Childhood learning problems are overrepresented among homeless adults with complex comorbidities and long histories of homelessness. Our findings are consistent with a growing body of literature indicating that adverse childhood events are potent risk factors for a number of adult health and psychiatric problems, including substance abuse. Trials registration number This trial has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374. PMID:23175737
Michelle R. Munson; Jerry E. Floersch; Lisa Townsend
The present study describes how adolescents perceive their mood disorders (MD; e.g., acute vs. chronic) and their attitudes\\u000a toward mental health services. The study also explores the relationships between demographics, clinical characteristics, perceptions\\u000a of illness and attitudes. Finally, we examine the psychometric properties of the Illness Perception Questionnaire-Revised\\u000a (Moss-Morris et al. in Psychology & Health 17(1):1–16, 2002). Seventy adolescents were
Whenever partial knowledge is considered absolute and turned into ideological and dogmatic conceptions, the risk increases that the conditions for the people involved might become dangerous. This will be illustrated by casuistic examples of consequences of one-sided psychiatric conceptions such as social, biological, and psychological ideas about the treatment and care of the mentally ill. Present perspectives of an integrative model, i.e., an advanced bio-psycho-social conception about evidence-based characteristics on the social, psychological, and molecular-genetic level, require that all of these dimensions should be considered in order to personalize and thereby improve the care and treatment of the mentally ill. PMID:23720646
Objective Work is often a desired goal for people with mental illness, as expressed by both themselves and their relatives. This study\\u000a investigated the importance of work status, everyday activities and objective life indices for subjective quality of life,\\u000a with a special focus on quality of life domains.\\u000a \\u000a \\u000a \\u000a Method The sample consisted of 103 individuals with severe mental illness in Sweden, a
Eack, Shaun M.; Newhill, Christina E.; Watson, Amy C.
Social work students (n = 60) in a master’s-level course on severe mental illness participated in a quasi-experimental study examining the degree to which increased knowledge about and contact with individuals with schizophrenia during the course would impact their attitudes toward people with the disorder. Results revealed significant improvement in student knowledge and general attitudes after the course, and indicated that increased knowledge about schizophrenia was only related to general attitudinal improvement when accompanied by increased personal social contact. Implications for education on severe mental illnesses, and value and attitude development in social work education are discussed PMID:24465119
Lee, Sing; Tsang, Adley; Huang, Yue-qin; He, Yan-ling; Liu, Zhao-rui; Zhang, Ming-yuan; Shen, Yu-cun; Kessler, Ronald C
To evaluate individual-level and societal-level losses of income associated with serious mental illness in metropolitan China, a multi-stage probability survey was administered to adults aged 18-70 years in Beijing and Shanghai. We used data to estimate individual-level expected earnings from a model that included information about the respondents' education level, marital status, age, and gender. Expected earnings were compared to observed earnings among respondents with mental illness and serious disability. The result shows that the 12-month prevalence of such serious mental illness was 0.6%. Its impact on earnings was significant in the total sample and was higher for males (76% of gender-specific expected salary was lost) than for females (32%). When projected to societal level, the annual impact was estimated to be 466 million Renminbi (RMB 8.27=USD 1), less than 0.2% of the gross domestic product (GDP) of the two cities. Serious mental illness was associated with a substantial decrease in individual-level earnings, but the burden that resulted from societal-level loss of earnings was not large enough to help drive mental health policy and programs in China. PMID:20493555
Winstanley, Erin L.; Steinwachs, Donald M.; Stitzer, Maxine L.; Fishman, Marc J.
The purpose of this study is to identify factors associated with adolescent alcohol or drug (AOD) abuse/dependence, mental health and co-occurring problems, as well as factors associated with access to treatment. This is a secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2000. The 12-month prevalence rate of…
Dorfman, Sharon L.
Programs and services that prevent substance abuse and mental health disorders have the potential to lessen an enormous burden of suffering and to reduce both the cost of future treatment and lost productivity at work and home. The availability and accessibility of these interventions to Americans whose health care is provided by managed care…
Busch, Denise; Svanum, Soren
Surveyed 55 psychiatric/mental health nursing programs to assess training in substance abuse. Results indicated that, although virtually all programs offered some course work and clinical experience, the modal amount of course work was five percent of a three credit course. Specific clinical training was offered but rarely chosen. (JAC)
Reviews the sparse literature concerning the mental health of American Indian and Alaska Native women. Suggests research into various sources of stress experienced by Native women and related to drug and alcohol abuse. Discusses coping mechanisms and the particular stress factors affecting professional Native women. (SV)
Lumley, Vicki A.; Miltenberger, Raymond G.; Long, Ethan S.; Rapp, John T.; Roberts, Jennifer A.
Six adult women with mental retardation were trained in sexual abuse prevention, and performance was assessed using four separate measures: pretest and posttests of knowledge, verbal report, role play, and naturalistic probes. All learned the skills but failed to exhibit them to criterion during the probes. (Author/CR)
Joshi, Mohit; Vankar, GK
Inahalant abuse is of increasing interest in India. The age of onset is typically during adolescence. Gasoline inhalant use is rarely reported in adolescents with intellectual deficit. We report a case of petrol dependence in a 10-year-old child with mental retardation. Possible effect of petrol huffing on behavior and cognition is discussed. PMID:25733844
Robert E. Drake; Carolyn Mercer-McFadden; Kim T. Mueser; Qregory J. McHugo; Qary R. Bond
Patients with severe mental disorders such as schizo- phrenia and co-occurring substance use disorders tra- ditionally received treatments for their two disorders from two different sets of clinicians in parallel treat- ment systems. Dissatisfaction with this clinical tradi- tion led to the development of integrated treatment models in which the same clinicians or teams of clini- cians provide substance abuse
Hani Hamed Dessoki
Objective: To detect differences in attitudes towards psychiatric illness, regarding its nature, cause, different ways of therapy, possibility of cure and the effect on the society in two areas from different socioeconomic classes in Egypt. Method: A survey study using self administered questionnaire, to detect culture differences between students of Cairo and Beni Suef universities \\
Mentally ill individuals have always smoked at high rates and continue to do so, despite public health efforts to encourage smoking cessation. In the last half century, the tobacco industry became interested in this connection, and conducted and supported psychiatric and basic science research on the mental health implications of smoking, long before most mental health professionals outside the industry investigated this issue. Initially, representatives of tobacco industry research organizations supported genetics and psychosomatic research to try to disprove findings that smoking causes lung cancer. Tobacco industry research leaders engaged with investigators because of shared priorities and interests in the brain effects of nicotine. By the 1980s, collaborative funding programs and individual company research and development teams engaged in intramural and extramural basic science studies on the neuropharmacology of nicotine. When mental health researchers outside the industry became interested in the issue of the mentally ill and smoking in the mid-1990s, they increasingly explained it in terms of a disease of nicotine addiction. Both the idea that smoking/nicotine does something positive for the mentally ill and the conclusion that it is the result of nicotine dependence have the potential to support corporate agendas (tobacco or pharmaceutical). PMID:21596723
Adshead, Stephanie; Collier, Elizabeth; Kennedy, Sarah
The aim of this literature review is to explore whether mental health nurses are being appropriately prepared to care for learning disabled patients who also suffer from mental ill health. A systematic approach was adopted in order to identify relevant literature for review on the topic. Five electronic databases were searched; CINAHL, Medline, ERIC, PubMed and Scopus. Searches were limited to the years 2001-2013. A total of 13 articles were identified as relevant to the topic area for review. Three main themes were identified relating to (a) attitudes (b) practice and (c) education. There appears to be a lack of research that directly addresses this issue and the existing literature suggests that there are considerable deficits in the ability of mental health nurses to be able to provide appropriate care for those with both a learning disability and mental ill health. The findings of this review would suggest that this topic area is in urgent need of further investigation and research. Further research into this area of practice could possibly help to inform education regarding this subject at pre-registration and post qualifying levels, which could therefore in turn, improve the delivery of mental health nursing care to this particular client group. PMID:25662482
Jenkins, Rachel; McDaid, David; Nikiforov, Alexey; Potasheva, Angelina; Watkins, Jonathan; Lancashire, Stuart; Samyshkin, Yevgeniy; Huxley, Peter; Atun, Rifat
Long-established Medico-Social Expert Commissions (MSECs) play a pivotal role in the Russian mental health system. They act as gatekeepers to pensions, rehabilitation, and employment services. This column describes their role in encouraging or impeding the social inclusion of people with mental illness, drawing on findings of a three-year project in Sverdlovsk Oblast. In Russia the emphasis remains on medical aspects of treatment, without adequate consideration of social and occupational rehabilitation. Links with local employment services are weak. To promote social inclusion, steps must be taken to encourage and facilitate cooperation and collaboration between the MSECs, employment services, and medical services. PMID:20194396
Riebschleger, Joanne; Scheid, Jeanette; Luz, Clare; Mickus, Maureen; Liszewski, Christine; Eaton, Monaca
Objective: This descriptive study explored the extent that medical education curriculum guidelines contained content about the experiences and needs of family members of people with serious mental illness. Methods: Key family-focused-literature themes about the experiences and needs of families of individuals with mental illness were drawn from a…
Linda S. Kahn; Chester H. Fox; Julie Krause-Kelly; Diane E. Berdine; Renee B. Cadzow
Little is known about screening mammography rates among women diagnosed with mental illness–even though some studies have suggested that this population might be particularly vulnerable to breast cancer. The purpose of this pilot study was to identify facilitators and barriers to mammography among women diagnosed with mental illness and\\/or substance use disorders. Four focus groups were conducted, with a total
Stanley D. Rosenberg; Robert E. Drake; George L. Wolford; Kim T. Mueser; Thomas E. Oxman; Robert M. Vidaver; Karen L. Carrieri; Ravindra Luckoor
Objective: Despite high rates of co-occurring substance use disorder in people with severe mental illness, substance use disorder is often undetected in acute-care psychiatric settings. Because underdetection is related to the failure of traditional screening instruments with this population, the authors developed a new screen for detection of substance use disorder in people with severe mental illness. Method: On the
Amanda N. Barczyk; Jane Arnold Lincove
Mental illness is the country's leading cause of disability. However, approximately 60 percent of individuals with serious mental illness (SMI) are not receiving stable, ongoing treatment (Carper, 2005). One approach to combat this problem is to actively involve consumers in their treatment. Personal assistance services (PAS) assist individuals with disabilities with their daily living activities, and some, such as cash
Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Molina, Enrique J.; Sage, Monica; Brown, Stephen; Groeneweg, Jop
Multi-sensory stimulation provided in a Snoezelen room is being used increasingly for individuals with mental retardation and mental illness 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…
Spangler, Arthur Stephenson, Jr.
Although Community Mental Health Centers (CMHCs) are mandated to serve all clients requiring mental health services including those who are mentally retarded, it appears that many CMHCs have no programs designed to address the needs of the retarded. This paper describes a financially sound outpatient program which provides psychological and…
Andrew R. Payton
In this article, I argue that the relationships among mental health, disorder, and distress are a key source of conflict in the sociology of mental health and that the features of the conflict have the potential to call into question much of the accumulated scientific knowledge on mental health. To address this issue, I attempt to empirically assess three competing
Kuno, Eri; Koizumi, Naoru; Rothbard, Aileen B.; Greenwald, Joel
An institutional-based care system in mental health has been replaced by a network of community-based services with different levels of structure and support. This poses both an opportunity and a challenge to provide appropriate and effective care to persons with serious mental illnesses. This paper describes a simulation-based approach for mental health system planning, focused on hospital and residential service components that can be used as a decision support tool. A key feature of this approach is the ability to represent the current service configuration of psychiatric care and the client flow pattern within that framework. The strength of the simulation model is to help mental health service managers and planners visualize the interconnected nature of client flow in their mental health system and understand possible impacts of changes in arrival rates, service times, and bed capacity on overall system performance. The planning model will assist state mental health agencies to respond to requirements of the Olmstead decision to ensure that individuals with serious mental illness receive care in the least restrictive setting. Future plans for refining the model and its application to other service systems is discussed. PMID:16193999
Ruedrich, S L; Wadle, C V; Sallach, H S; Hahn, R K; Menolascino, F J
The authors administered a 1-mg dexamethasone suppression test (DST) to 85 institutionalized adults with mild to profound mental retardation after screening to exclude false-positive nonsuppression. Thirty-one (36%) of these subjects had baseline hypercortisolemia, which was significantly correlated with age, symptoms, and "modified" DSM-III criteria for major depressive disorder. Twenty (24%) of the 85 subjects were nonsuppressors (5 micrograms/dl) after testing; nonsuppression was significantly related to age, female sex, level of retardation, symptoms, and "modified" DSM-III criteria for major depressive disorder (sensitivity 41%, specificity 81%). First-order partial correlations maintained significant relationships between age and severity of retardation but not sex. Mental retardation itself did not appear to invalidate the DST. PMID:3578569
As recent cases of mass murder at Utoya Island in Norway, and in the United States (US) at Virginia Tech, Virginia; Tucson, Arizona; Aurora, Colorado; and Newtown, Connecticut all illustrate, acts of extreme violence involving high powered weapons and committed by persons with a presumed or confirmed mental illness tend to arouse intense public and political debates about the efficacy of firearm regulation and control. Following these tragedies, in the US at least, various law reform measures have been proposed and in some cases implemented designed principally to make it more difficult for mentally ill persons to gain access to firearms. In this article it is contended that measures like these are at best tinkering with the margins of gun control and also have the tendency to reinforce the stigma and discrimination experienced by persons with a mental illness, while perpetuating stereotypes of them as dangerous to themselves and others. Despite these limitations, and while firearm regulation policies and practices vary widely across the globe, most nations still seek in some way to limit access to guns by persons with a mental illness. This article explores in more detail how such policies and practices have been applied in the Australian State of New South Wales and the lessons to be learned elsewhere from this experience. PMID:24768212
Rutman, Irvin D.; Baron, Richard C.; Hadley, Trevor R.
This monograph examines issues in the field of psychosocial/psychiatric rehabilitation (PSR) services for people with serious mental illness, placed in the context of a debate within the field about trends toward managed behavioral health care companies. Four main issues are addressed: (1) the degree to which managed behavioral health care…
Mantry, D.; Cooper, S. -A.; Smiley, E.; Morrison, J.; Allan, L.; Williamson, A.; Finlayson, J.; Jackson, A.
Background: While there is considerable literature on adults with Down syndrome who have dementia, there is little published on the epidemiology of other types of mental ill-health in this population. Method: Longitudinal cohort study of adults with Down syndrome who received detailed psychiatric assessment (n = 186 at the first time point; n =…
Melville, Craig A.; Cooper, Sally-Ann; Morrison, Jill; Smiley, Elita; Allan, Linda; Jackson, Alison; Finlayson, Janet; Mantry, Dipali
The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem…
Bond, Gary R.; Salyers, Michelle P.; Dincin, Jerry; Drake, Robert; Becker, Deborah R.; Fraser, Virginia V.; Haines, Michael
The authors compared 2 approaches to vocational rehabilitation for individuals with severe mental illness: the individual placement and support (IPS) model of supported employment and the diversified placement approach (DPA), which emphasizes work readiness and offers a range of vocational options, including agency-run businesses and…
Mueser, Kim T.; Clark, Robin E.; Haines, Michael; Drake, Robert E.; McHugo, Gregory J.; Bond, Gary R.; Essock, Susan M.; Becker, Deborah R.; Wolfe, Rosemarie
The authors compared 3 approaches to vocational rehabilitation for severe mental illness (SMI): the individual placement and support (IPS) model of supported employment, a psychosocial rehabilitation (PSR) program, and standard services. Two hundred four unemployed clients (46% African American, 30% Latino) with SMI were randomly assigned to IPS,…
Lemon, Sherry; Reveal, Marge
A survey of 138 dental hygiene programs gathered information on didactic and clinical experiences for preparing students to treat patients with mental illnesses. Although most curricula addressed the issue, inadequate time was allotted. Over half did not provide oral care to these patients; few felt the community's need was met. (MSE)
Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Adkins, Angela D.; Wahler, Robert G.; Sabaawi, Mohamed; Singh, Judy
Verbal and physical aggression are risk factors for community placement of individuals with serious and persistent mental illness. Depending on the motivations involved, treatment typically consists of psychotropic medications and psychosocial interventions, including contingency management procedures and anger management training. Effects of a…
Media representation of mental illness has received growing research attention within a variety of academic disciplines. Cultural and media studies have often dominated in this research and discussion. More recently healthcare professionals have become interested in this debate, yet despite the importance of this subject only a selection of papers have been published in professional journals relating to nursing and
Koons, Cedar R.; Chapman, Alexander L.; Betts, Bette B.; O'Rourke, Beth; Morse, Nesha; Robins, Clive J.
Twelve vocational rehabilitation clients with severe mental illness received a comprehensive adaptation of dialectical behavior therapy (DBT) delivered in a group format. Treatment consisted of 2 hours of standard DBT skills training per week and 90 minutes of diary card review, chain analysis, and behavioral rehearsal. Participants were selected…
Brian M Ross; Jennifer Seguin; Lee E Sieswerda
BACKGROUND: A growing number of observational and epidemiological studies have suggested that mental illness, in particular mood disorders, is associated with reduced dietary intake and\\/or cellular abundance of omega-3 polyunsaturated fatty acids (PUFA). This has prompted researchers to test the efficacy of omega-3 PUFA in a range of different psychiatric disorders. We have critically reviewed the double blind placebo controlled
Eack, Shaun M.; Newhill, Christina E.; Watson, Amy C.
Social work students (N=60) in a master's-level course on severe mental illness participated in a quasi-experimental study examining the degree to which increased knowledge about and contact with individuals with schizophrenia during the course would impact their attitudes toward people with the disorder. Results revealed significant improvement…
McKinney, Kathleen G.
This study examined whether a new student organization, Active Minds, aimed at increasing awareness of "mental illness" and reducing stigma had an impact on students' stigma and willingness to seek psychological help. Three classes were recruited to become involved in the organization. In a pretest/posttest design, stigma and willingness to seek…
RENANAH K. LEHNER; CYNTHIA A. DOPKE; KENNETH COHEN; KATHERINE EDSTROM; MICHAEL MASLAR; NANCY B. SLAGG; DANIEL YOHANNA
Despite the availability of a broad array of efficacious pharmacological and psychosocial treatments for individuals with serious mental illness, treatment nonadherence remains a major obstacle to recovery. The current article reviewed research on the effects of interventions specifically designed to enhance outpatient treatment adherence with this population. To locate articles, we conducted computer searches of the PsycInfo and Medline databases
NIDRR Consensus Statment, 1992
A 1992 conference on strategies to secure and maintain employment for person with long-term mental illness brought together providers, consumers, family members, researches, and others to develop as complete an overview as possible of the current state of knowledge in the field. This booklet summarizes findings from the conference. There were many…
Mary Ann Camann
Persons with mental illness often have poor access to both health promotion and primary care services. Consequently, they are at greater risk for earlier mortality, and comorbid health problems that ultimately impact their community rehabilitation. The “To Your Health” program is a health promotion program, based on the states of change model that was implemented as part of a clubhouse
Mary Molewyk Doornbos
Although the family plays a major role in the care of young adults with serious and persistent mental illness, there has been limited research on the impact of these ongoing caregiving responsibilities on the health of the family unit itself. The specific objective of the study was to explore the relationship of family stressors, family coping, family perception of the
Kim T. Mueser; William C. Torrey; David Lynde; Patricia Singer; Robert E. Drake
Persons with severe mental illnesses (SMI) often lack access to effective treatments. The authors describe the Implementing Evidence-Based Practices (EBPs) Project, designed to increase access for people with SMI to empirically supported interventions. The EBP Project aims to improve access through development of standardized implementation packages, created in collaboration with different stakeholders, including clinicians, consumers, family members, clinical supervisors, program
Swartz, James A.; Lurigio, Arthur J.
Past studies of the mediating effects of substance use on the criminal justice involvement of the mentally ill have tended to focus on a single disorder, schizophrenia, and on violent crimes. This study examined the generality of the relationships among psychiatric disorders, substance use, and arrests for violent, nonviolent, and drug-related…
Kawamura, Ai; Tanioka, Tetsuya; Tada, Toshiko; King, Beth; Locsin, Rozzano C
Long-term hospitalization is a problem for psychiatric care in Japan. The purpose of this research was to clarify the demands placed on public health nurses' (PHN) involved in the discharge of long-term inpatients (LIPs) with mental illness, and their lack of support. A questionnaire was mailed to 516 health centers, and 112 health centers replied. The response rate was 21.7 percent. The mail survey questionnaire was based on original questionnaire developed by the authors. Significant differences were found among collaborative agencies selected as essential for the discharge support project for the LIPs with mental illness. These differences were evident in the following question items on insufficiency of support: "Incompatibility with the policy of the public health center on discharge support"; "Opposition to discharge of a LIPs with mental illness by hospital staff"; and "Shortage of PHN in charge of the discharge support project for the LIPs with mental illness". It was clarified that the discharge support project required not only the involvement of health and medical welfare personnel but also the cooperation of local human resources such as local residents, neighbor associations, social workers, real-estate agencies and others. PMID:23614912
Christopher G. Hudson
This study tests several hypotheses about the underlying causal structure of the inverse correlation between socioeconomic status (SES) and mental illness. It does this through the analysis of a longitudinal statewide database on acute psychiatric hospitalization in Massachusetts for the fiscal years 1994-2000 as well as supplemental census data. The modeling strategy used techniques of structural equation modeling and found
Mary E Plomondon; P Michael Ho; Li Wang; Gwendolyn T Greiner; James H Shore; Joseph T Sakai; Stephan D Fihn; John S Rumsfeld
BACKGROUND: Severe mental illness (SMI) has been associated with more medical co-morbidity and less cardiovascular procedure use for older patients with myocardial infarction. However, it is unknown whether SMI is associated with increased long term mortality risk among patients presenting with acute coronary syndromes (ACS). We tested the hypothesis that SMI is associated with higher one-year mortality following ACS hospitalization.
Mowbray, Carol T.; Bybee, Deborah; Oyserman, Daphna; Allen -Meares, Paula; MacFarlane, Peter; Hart-Johnson, Tamera
Children of parents with mental illness are an at-risk population according to research on psychiatric outcomes using White, middle-class samples of depressed parents and infants and preschool children. The current study expands this evidence by exploring within-group heterogeneity across psychosocial outcomes, in a racially diverse, low-income…
Lisa A. Mistler; Mary F. Brunette; Joelle C. Ferron; Douglas Ziedonis
Objective: People with severe mental illness (e.g., schizophrenia and severe mood disorders) are more likely to smoke tobacco and less likely to quit than the general population. Current recommendations for treatment combine evidence-based medications and behavioral interventions tailored to each individual's needs. One way to individualize treatment is through shared decision making, in which the patient and the provider negotiate
Length of treatment delay and cultural-familial correlates were studied in a group of 62 Asian-American patients with severe mental illness, and 40 of their relatives. Contrary to prior findings of long treatment delay among Asian Americans, this cohort reported relatively low levels of stigma and shame and relatively short delay between onset of psychiatric symptoms and inception of treatment. Higher
Kristin Davis; Mary Brunette; Vanessa Vorhies; Joelle Ferron; Rob Whitley
Background: This qualitative paper describes perceptions of smoking risk and ways of thinking about risk for 31 persons with a Severe Mental Illness (SMI). Research has shown that many people with SMI want to quit smoking, and, like many other disadvantaged groups, make many quit attempts.Aim: The authors undertook a qualitative study to explore views and experiences about smoking and
This article examines a model of service delivery for homeless mentally ill women, a combined day center and shelter program. Using data from participant observation and in-depth interviews with 21 clients, four patterns of day center and shelter use are delineated. Overall, few women from the day center make the transition to the shelter, and then to permanent housing and
Janki Shankar; Fran Collyer
This study examined the role of several factors in shaping the employment outcomes of people with mental illness who were interested in gaining open employment and participated in a community based vocational rehabilitation program to achieve this goal. The majority of the study respondents had a diagnosis of schizophrenia. The work history, work competence and social networks of the respondents
Carol J. Van Dongen
The purposes of this research were to examine first the relationship between work status and quality of life and self-esteem in persons with severe, persistent mental illness and secondly, the relationship between (a) demographic characteristics, attitudes toward psychotropic medications, and perceptions of the meaning of work and (b) quality of life and self-esteem in working and nonworking persons with severe
Gazizova, D.; Puri, B. K.; Singh, I.; Dhaliwal, R.
Background: Previous studies in adults with intellectual disabilities (ID) have reported a higher prevalence of obesity than in the general population, and a trend to an increase in the prevalence of excess weight. However, little information is available on body weight status and lipids levels of adults with ID and co-existing mental illness. The…
Nicholas J. Brandon; Akira Sawa
Recent advances in our understanding of the underlying genetic architecture of psychiatric disorders has blown away the diagnostic boundaries that are defined by currently used diagnostic manuals. The disrupted in schizophrenia 1 (DISC1) gene was originally discovered at the breakpoint of an inherited chromosomal translocation, which segregates with major mental illnesses. In addition, many biological studies have indicated a role
Stephen J. Bartels; Brent Forester; Kim T. Mueser; Keith M. Miles; Aricca R. Dums; Sarah I. Pratt; Anjana Sengupta; Christine Littlefield; Sheryl O'Hurley; Patricia White; Lois Perkins
This report describes a combined skills training (ST) and health management (HM) intervention for older adults with severe mental illness (SMI) and one-year pilot study outcomes. Findings are reported for twelve older persons with SMI (age 60+) who received ST+HM and twelve who received only HM. ST addressed interpersonal and independent living skills. HM included promotion of preventive health care.
Randolph, Mary E.; Pinkerton, Steven D.; Somlai, Anton M.; Kelly, Jeffrey A.; McAuliffe, Timothy L.; Gibson, Richard H.; Hackl, Kristin
Seriously mentally ill women at risk for HIV infection (n = 96) participated in structured interviews assessing sexual and substance-use behavior over a 3-month period. The majority of the women (63.5%) did not use condoms. Consistent with the theory of reasoned action, attitudes toward condom use and perceived social norms about safer sex were…
Eleanor E. Yurkovich; Izetta Lattergrass
Discrepancies in definitions of health exist. These discrepancies, if not acknowledged, create major communication gaps between health-care professionals and their clients, which interferes with the provision of culturally responsive care. The purpose of this study was to understand how Native American Indians experiencing persistent mental illness (PMI) define\\/describe being healthy and being unhealthy. Grounded theory design was used in conducting
Merriman, S.; Haw, C.; Kirk, J.; Stubbs, J.
Coronary heart disease (CHD) is a major cause of morbidity and mortality in the UK. The aim of this study was to screen inpatients with mild or borderline intellectual disability, many of whom also have mental illness, for risk factors for CHD. Participants were interviewed, measured and had blood samples taken. Of the 53 participants, 20 (37.7%)…
Brunette, Mary F.; Ferron, Joelle C.; Devitt, Timothy; Geiger, Pamela; Martin, Wendy M.; Pratt, Sarah; Santos, Meghan; McHugo, Gregory J.
Many people learn about smoking cessation through information on the Internet. Whether people with severe mental illnesses, who have very high rates of smoking, are able to use currently available websites about smoking cessation is unknown. The study reported here assessed whether four smoking cessation websites met usability guidelines and…
Tom Burns; Jocelyn Catty; Thomas Becker; Angelo Fioritti; Martin Knapp; Christoph Lauber; Wulf Rössler; Toma Tomov; Jooske van Busschbach; Sarah White
Methods 312 patients with severe mental illness were randomly assigned in six European centres to receive IPS (n=156) or vocational services (n=156). Patients were followed up for 18 months. The primary outcome was the diff erence between the proportions of people entering competitive employment in the two groups. The heterogeneity of IPS eff ectiveness was explored with prospective meta-analyses to
Richardson, Meg; Cobham, Vanessa; Murray, Judith; McDermott, Brett
Research indicates that parents and other family members often grieve their child or relative's mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in "Am J Psychiatry" 151(8):1137-1139, 1994; Davis and Schultz in "Soc Sci Med" 46(3):369-379, 1998; Jones…
Christopher G. Hudson
Objectives: Epidemiological surveys have revealed dramatic declines in the prevalence of serious mental illness (SMI) as adults age. Analyses of these datasets have not determined whether this is attributable, on one hand, to declining incidence, shorter duration of condition, and lesser severity with age, or on the other hand, confounding variables and methodological biases. This study, thus, aims to test
Jo C. Phelan; Rosangely Cruz-rojas; Marian Reiff
An increased emphasis on biological causes of mental illness has been viewed as having the potential to significantly reduce stigma. From this perspective, the current genetics revolution can be seen as a source of hope with regard to reducing stigma. However, theory and empirical research suggest that biological attributions may have complex effects for stigma, reducing it along some dimensions
Kim T. Mueser; Stanley D. Rosenberg; Lisa A. Goodman; Susan L. Trumbetta
Traumatic life events, as defined by DSM-IV, are common among persons with severe mental illnesses (SMI) such as schizophrenia. Limited evidence suggests concomitantly high rates of posttraumatic stress disorder (PTSD) in this population. However, conceptual models do not exist for understanding the interactions between trauma, PTSD, and SMI. We propose a model, which is an extension of the stress-vulnerability model,
O'Hare, Thomas; Shen, Ce; Sherrer, Margaret
Trauma and Posttraumatic Stress Disorder (PTSD) are more common in severe mental illnesses (SMI) clients than in the general population, yet brief screens for detecting probable PTSD in SMI clients are nonexistent. In a two-part study, the authors used correlation analysis and receiver operating characteristics (ROC) analysis to develop and…
Nages Nagaratnam; Mary Lewis-Jones
As a measure of community awareness, this study examined the predictive properties of the diagnoses in referral communications for mental illness and dementia in elderly people. The patients were referred to the Aged Care Assessment Team from diversified sources over an 18-month period, the referral initiators being the general practitioner (GP), community nurse, family and others. There were 90 patients
John M. Riley; Phillip A. Fellin
Based on a 2-year study of Office of Economic Opportunity (OEO) programs in a large urban center, this paper examines the potential of Community Action Centers for serving low-income clients with emotional problems. The processing, referral and follow-up patterns of the indigenous counseling staff are described. Strategies for mental health agencies are developed for enhancing their links with these programs
González-Guarda, Rosa M; Florom-Smith, Aubrey L.; Thomas, Tainayah
Hispanics are disproportionately affected by substance abuse, HIV infection, intimate partner violence, and mental health conditions. To address health disparities among Hispanics and other vulnerable groups, it is necessary to understand the complex interactions between health conditions clustering together (e.g., substance abuse, intimate partner violence, and HIV) and the social ecology in which these conditions exist. A syndemic orientation, a consideration of clustering epidemics and common individual, relationship, cultural, and socioenvironmental factors linking these conditions, may be helpful in developing comprehensive models that expand our ability to understand and address health disparities. The purpose of this paper is to introduce a Syndemic Model of Substance Abuse, Intimate Partner Violence, HIV Infection, and Mental Health among Hispanics, and provide evidence from the research literature to support the central relationships and risk and protective factors (i.e., potential links between conditions) depicted by the model. The development and evaluation of interventions aimed at the prevention of substance abuse, intimate partner violence, HIV/AIDS, and mental health problems as a syndemic affecting Hispanics is urgently needed. Public health nurses can initiate this endeavor with the guidance of a Syndemic Model. PMID:21736615
Ritter, Christian; Teller, Jennifer L S; Marcussen, Kristen; Munetz, Mark R; Teasdale, Brent
The Crisis Intervention Team (CIT) model is a specialized police response program for people in a mental illness 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 mental illness crisis. We used hierarchical logistic and multinomial regression analyses to compare transport to treatment to either transport to jail or no transport by how the calls were dispatched. The results revealed that both dispatch codes and officers' on-scene assessments influenced transport decisions. Specifically, calls dispatched as suspected suicide were more likely to be transported to treatment than calls dispatched as mental disturbance. Furthermore, calls dispatched as calls for assistance, disturbance, suspicious person, assault, suspicion of a crime, and to meet a citizen were all less likely than mental disturbance calls to result in transportation to treatment. Officer assessments of the use of substances, being off medications, signs and symptoms of mental or physical illness, and violence to self or others were associated with the likelihood of being transported to treatment. These results build on previous work that demonstrated differences in transport decisions between CIT trained and non-CIT trained officers. PMID:21138782
Ekeland, Tor-Johan; Bergem, Randi
Integration and normalization are goals within the community-based care of people with mental illness. The implementation of this care policy has led to increased contact between people with mental illness and so-called normal people and society at large. But we know little about how this change affects the former patients' identity and experience of stigma and stereotyping. This study is based on qualitative interviews with people with mental illness (N=15) living in rural communities in four different municipalities. The focus in the study is on the informants' subjective experiences and the results show that they adapt in different ways, depending on how they negotiate their identity. Those who accept their role as "mental patients" seem to have easier access to services, they experience less stigmatization and fewer conflicts with their surroundings than those who oppose the patient role. Seem from our informants' perspectives there seems to be a simple definition of integration: Being integrated is feeling accepted as yourself. Some implications for policy and mental health services are discussed. PMID:16532380
Objective A relatively new approach to addressing tobacco use in mental health settings is the involvement of consumers or peers, defined as other individuals with mental health conditions, as service providers. This review examines the literature describing peer delivered supports for tobacco cessation for adults with serious mental illness. Methods The authors conducted a review of online databases to identify reports of tobacco cessation interventions in which peers play a key role in the provision of services to help other adults with serious mental illness to reduce or quit using tobacco. Results Our review yielded reports of four tobacco cessation interventions for persons with serious mental illness that include peer providers. The roles of peers in these interventions include that of co-leaders of an educational smoking cessation group, individual counselors as part of a multi-faceted tobacco treatment program, and as outreach tobacco cessation advocates. Conclusions The roles of peers in these interventions are promising; however, more detail about the selection and experience of the peer providers, as well as the services they deliver in tobacco cessation interventions, would be helpful. In addition, rigorous research is needed to evaluate the impact of peer providers on reducing tobacco use in this population. PMID:22904697
Peterson, Jillian K; Skeem, Jennifer; Kennealy, Patrick; Bray, Beth; Zvonkovic, Andrea
Although offenders with mental illness are overrepresented in the criminal justice system, psychiatric symptoms relate weakly to criminal behavior at the group level. In this study of 143 offenders with mental illness, we use data from intensive interviews and record reviews to examine how often and how consistently symptoms lead directly to criminal behavior. First, crimes rarely were directly motivated by symptoms, particularly when the definition of symptoms excluded externalizing features that are not unique to Axis I illness. Specifically, of the 429 crimes coded, 4% related directly to psychosis, 3% related directly to depression, and 10% related directly to bipolar disorder (including impulsivity). Second, within offenders, crimes varied in the degree to which they were directly motivated by symptoms. These findings suggest that programs will be most effective in reducing recidivism if they expand beyond psychiatric symptoms to address strong variable risk factors for crime like antisocial traits. PMID:24730388
Jones, Danson; Harvey, John; Giza, Debra; Rodican, Charles; Barreira, Paul J.; Macias, Cathaleene
Nearly a fourth (22%) of the participants within a research sample of 148 individuals with serious mental illness reported the death of a loved one as a significant loss, and two thirds of these deaths involved the loss of one or both parents. The key determinant of the severity and duration of grief in response to the death of a parent was whether or not there were extenuating circumstances that complicated the death event, such as co-residence with the deceased at the time of death or a lack of regular social contact with anyone other than the deceased. In all instances of severe or prolonged grief, there was no preparation for the parental death, either through preparatory counseling or practical plans for funeral arrangements, financial repercussions, life-style changes, or residential relocation. Mental health agencies serving people with serious mental illness should begin to incorporate financial and emotional preparation for parental deaths and bereavement counseling as essential services. PMID:20011621
Del'Guidice, Thomas; Beaulieu, Jean-Martin
Mental illnesses such as bipolar disorders, ADHD, depression and schizophrenia are a major public health concern worldwide. While several pharmacological agents acting on monoamine neurotransmission are used for the management of these disorders, the ultimate molecular mechanisms responsible for their therapeutic effects and their relationships to disease etiology are still poorly understood. Here we provide an overview of recent advances on the involvement of the signaling molecules Akt and glycogen synthase kinase-3 (GSK3) in the regulation of behavior by the monoamine neurotransmitters dopamine and serotonin (5-HT). We also examine the possible participation of these signaling molecules to the effects of antipsychotics, antidepressant and lithium and their contribution to mental disorders. Regulation of Akt and GSK3 by monoamine neurotransmitters may provide a better understanding of mental illnesses leading to new therapeutic approaches having better efficacy. PMID:20619169
Mignon, Sylvia I; Holmes, William M
Substance abuse and mental health problems among Native Americans are associated with a variety of general health, social, and economic problems. This current study examined Native American grandparents who are raising their grandchildren and found that a child, parent, or grandparent had an alcohol or drug problem in 36% of families. Substance abuse on the part of a parent was correlated with the reasons grandparents were raising their grandchildren. Native American grandparents raising grandchildren cope with a variety of challenges and receive little state-funded assistance or help from others. PMID:23967883
Perry, Brea L; Pescosolido, Bernice A
In response to health problems, individuals may strategically activate their social network ties to help manage crisis and uncertainty. While it is well-established that social relationships provide a crucial safety net, little is known about who is chosen to help during an episode of illness. Guided by the Network Episode Model, two aspects of consulting others in the face of mental illness are considered. First, we ask who activates ties, and what kinds of ties and networks they attempt to leverage for discussing health matters. Second, we ask about the utility of activating health-focused network ties. Specifically, we examine the consequences of network activation at time of entry into treatment for individuals' quality of life, social satisfaction, ability to perform social roles, and mental health functioning nearly one year later. Using interview data from the longitudinal Indianapolis Network Mental Health Study (INMHS, N = 171), we focus on a sample of new patients with serious mental illness and a group with less severe disorders who are experiencing their first contact with the mental health treatment system. Three findings stand out. First, our results reveal the nature of agency in illness response. Whether under a rational choice or habitus logic, individuals appear to evaluate support needs, identifying the best possible matches among a larger group of potential health discussants. These include members of the core network and those with prior mental health experiences. Second, selective activation processes have implications for recovery. Those who secure adequate network resources report better outcomes than those who injudiciously activate network ties. Individuals who activate weaker relationships and those who are unsupportive of medical care experience poorer functioning, limited success in fulfilling social roles, and lower social satisfaction and quality of life later on. Third, the evidence suggests that social networks matter above and beyond the influence of any particular individual or relationship. People whose networks can be characterized as having a pro-medical culture report better recovery outcomes. PMID:24525260
Nowotny, Kathryn M; Belknap, Joanne; Lynch, Shannon; DeHart, Dana
Recent research has documented the unusually high rates of incarcerated women's serious mental illness (SMI) and substance use disorders (SUD). Complicating these high rates is the high comorbidity of SMI with SUD and trauma histories. Yet, incarcerated women have significantly less access to treatment and health services while incarcerated than men. We used data from a multi-site, multi-method project funded by the Bureau of Justice Assistance (2011-2012) to determine the risk profile of women in jail (n = 491) with a current co-occurring SMI (i.e., major depressive disorder, bipolar disorder, schizophrenia spectrum disorder) and SUD (i.e., abuse, dependence). The study spanned multiple geographic regions, and structured diagnostic interviews were used to understand better the women that comprised this vulnerable population. One-in-five of the women had a current co-occurring disorder (CCOD). The findings revealed that significantly more women with a CCOD had been exposed to violence and were exposed to drugs at a younger age. Further, about one-third of women with a CCOD had received no treatment from a health care professional in the past year, demonstrating a substantial unmet need. We conclude that investing in mental and behavioral health care in jails is critical to the health and safety of women as well as the communities to which they return. PMID:25204664
Feinson, Marjorie C; Meir, Adi
Although childhood abuse is an established risk factor for mental health problems in adulthood, there is relatively little empirical evidence concerning intervening factors that may mitigate the risk. One potentially protective factor is religiosity. A unique opportunity to explore religiosity's relevance exists with a community-based sample of adult Jewish women that includes sizable subsamples of both rigorously devout ultra-Orthodox (Haredi) and nonreligious Secular Jews. A global measure of any childhood abuse (ACA) includes sexual, physical, and/or emotional abuse. Mental health is assessed with the Brief Symptom Inventory (BSI distress) and a single item reflecting unresolved anger about the past. Predictors of distress severity are examined with separate hierarchical regressions for each religious observance (RO) group. Despite being located at opposite ends of the religiosity spectrum, several surprising similarities emerge including no significant RO group differences in distress among abuse survivors. Moreover, ACA emerges as the strongest predictor of BSI distress within both groups and regressions explain similar amounts of variance. In contrast, two important differences emerge regarding unresolved anger and any recent abuse (ARA). Anger makes a strong contribution to explaining Haredi distress severity, less so for Secular respondents (6.1% vs. 2.9% respectively) while ARA is significant only for Haredi respondents. These initial findings suggest that abusive traumas in childhood may seriously compromise religiosity's potentially protective role. Broadening the research agenda to focus on resilient survivors would expand our understanding of healing resources-both within and outside of a religious framework. Moreover, a better understanding of unresolved anger would likely enhance interventions with greater potential for mitigating the suffering of those abused in childhood. PMID:25015236
Drake, Robert E.; Skinner, Jonathan S.; Bond, Gary R.; Goldman, Howard H.
Social Security Administration disability programs are expensive, growing, and headed toward bankruptcy. People with psychiatric disabilities now constitute the largest and most rapidly expanding subgroup of program beneficiaries. Evidence-based supported employment is a well-defined, rigorously tested service model that helps people with psychiatric disabilities obtain and succeed in competitive employment. Providing evidence-based supported employment and mental health services to this population could reduce the growing rates of disability and enable those already disabled to contribute positively to the workforce and to their own welfare, at little or no cost (and, depending on assumptions, a possible savings) to the government. PMID:19414885
Lynn Ahlgrim-Delzell; James R Dudley
Objective: The purpose is to explore differences in confirmed, unconfirmed, and false allegations of abuse made by consumers with mental retardation in regards to type of abuse and perpetrator.Method: Interviews were conducted with 1,220 people with mental retardation who were part of a class action lawsuit in North Carolina. A content analysis of abuse allegations was performed. Frequencies of responses
Corrigan, Patrick W; Bink, Andrea B; Fokuo, J Konadu; Schmidt, Annie
Social desirability can influence reports of stigma change in that subscribing to stigmatizing attitudes might pose a threat to personal beliefs of open-mindedness, while endorsing difference might not be as troubling. A measure is needed that assesses stigma change but is less susceptible to desirability effects. This study examined the psychometrics of various assessments of perceived difference from a person with mental illness. A total of 460 participants were recruited online using Amazon's Mechanical Turk. Four measures of difference, the Likert Scale of Difference, Semantic Differential: Similar-Different Scale, Semantic Differential: Mental Illness versus Other Illness scale, and Cause of Perceived Difference Scale were compared to measures of stereotypes, affirming attitudes, and care seeking. A vignette describing a person with mental illness anchored the Difference Scale and a measure of stereotype. Results showed that measures of difference yielded significantly higher endorsements than measures of stereotypes; the Semantic Differential Scale: Similar-Different was endorsed at a higher rate than other difference scales. Difference scores were positively related to stereotypes and inversely related to affirming attitudes. Difference was also found to influence empowerment separate from, and in addition to stereotype. These results suggest a new domain as an efficient and sensitive measure of stigma change. PMID:25660735
Sidhom, Emad; Abdelfattah, Ahmed; Carter, Julie M.; El-Dosoky, Ahmed; El-Islam, Mohamed Fakhr
The present study is concerned with the stigma of mental illness. It examines the subjective element of the experience of stigma among a sample of in-patients with different mental disorders. The sample was taken from consecutive admissions of in-patients meeting International Classification of Diseases, 10th revision (ICD-10) criteria for mental disorders who had capacity to decide on participation in the study and were willing to respond to the structured interview. The study was undertaken in an Egyptian private psychiatric hospital. The structured clinical interview included aspects of the emotional, behavioral, and cognitive effects of having a psychiatric diagnosis on in-patients with various diagnostic labels in an Egyptian psychiatric hospital. It also studied whether this effect changes with specific disorders, total duration of illness, or sociodemographic variables as gender, age, or educational level. The study illustrated the core items of stigmatization attached to the diagnosis of mental illness (1), which more than half of the participants responded affirmatively. The study aimed to explore the most prevailing aspects of stigma or social disadvantage; hoping that this may offer a preliminary guide for clinicians to address these issues in their practice. PMID:25505426
Li, Yue; Glance, Laurent G; Cai, Xueya; Mukamel, Dana B
Context Patients with mental disorders show higher burden of coronary heart disease, and may face special safety issues during in-hospital cardiac care. Objectives To compare the postoperative complication rate between patients with and without mental disorders undergoing isolated coronary artery bypass graft (CABG) surgery. Design, Setting, and Patients Retrospective analyses of New York state hospital claims between 1997 and 2004 (N=135,701). Complications were defined using the Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ PSI). Principal Findings Mental disorders were significantly associated with higher anesthesia complications (adjusted odds ratio [AOR]=6.44, p<.001), decubitus ulcer (AOR=1.42, p=.006), postoperative hip fracture (AOR=3.29, p<.001), and overall complication rate representing nine PSIs (AOR=1.27, p<.001). Conclusions Mentally ill patients undergoing CABG surgery are more likely to experience potentially preventable complications and injuries. The mechanism underlying this observation warrants further study. PMID:18665856
Pamela J. Grace; Sara T. Fry; Gary S. Schultz
Background: The ethics and human rights issues experienced by psychiatric-mental health and substance-abuse registered nurses (P-MH and SA RNs) and how disturbed they are by the issues are not known. Objective: The purpose of this study was to identify the frequency of ethics and human rights issues experienced by P-MH and SA RNs and how disturbing the issues are to
Christine M. Sarteschi; Michael G. Vaughn
Studies of women offenders with respect to the continuing salience of two co-occurring and pernicious characteristics—mental health (including traumatic experiences) and substance abuse (including HIV)—were reviewed. Findings indicated that research on these interrelated phenomena bears directly on a population that has been historically understudied and poorly serviced. As findings on women offenders are inadequately integrated and lack conceptual direction, a
Pinto-Foltz, Melissa D.; Logsdon, M. Cynthia; Myers, John A.
The purpose of this school-based cluster-randomized trial was to determine the initial acceptability, feasibility, and efficacy of an existing community-based intervention, In Our Own Voice, in a sample of US adolescent girls aged 13–17 years (n=156). In Our Own Voice is a knowledge-contact intervention that provides knowledge about mental illness to improve mental health literacy and facilitates intergroup contact with persons with mental illness as a means to reduce mental illness stigma. This longitudinal study was set in two public high schools located in a southern urban community of the U.S. Outcomes included measures of mental illness stigma and mental health literacy. Findings support the acceptability and feasibility of the intervention for adolescents who enrolled in the study. Findings to support the efficacy of In Our Own Voice to reduce stigma and improve mental health literacy are mixed. The intervention did not reduce mental illness stigma or improve mental health literacy at one week follow up. The intervention did not reduce mental illness stigma at 4 and 8 weeks follow up. The intervention did improve mental health literacy at 4 and 8 weeks follow up. Previous studies have assessed the preliminary efficacy In Our Own Voice among young adults; rarely has In Our Own Voice been investigated longitudinally and with adolescents in the United States. This study provides initial data on the effects of In Our Own Voice for this population and can be used to further adapt the intervention for adolescents. PMID:21624729
Hayes, Richard D.; Chang, Chin-Kuo; Fernandes, Andrea C.; Begum, Aysha; To, David; Broadbent, Matthew; Hotopf, Matthew; Stewart, Robert
Background Serious mental illness can affect many aspects of an individual’s ability to function in daily life. The aim of this investigation was to determine if the environmental and functional status of people with serious mental illness contribute to the high mortality risk observed in this patient group. Methods We identified cases of schizophrenia, schizoaffective and bipolar disorder aged ?15 years in a large secondary mental healthcare case register linked to national mortality tracing. We modelled the effect of activities of daily living (ADLs), living conditions, occupational and recreational activities and relationship factors (Health of the Nation Outcome Scale [HoNOS] subscales) on all-cause mortality over a 4-year observation period (2007–10) using Cox regression. Results We identified 6,880 SMI cases (242 deaths) in the observation period. ADL impairment was associated with an increased risk of all-cause mortality (adjusted HR 1.9; 95% CI 1.3–2.8; p?=?0.001, p for trend across ADL categories?=?0.001) after controlling for a broad range of covariates (including demographic factors, physical health, mental health symptoms and behaviours, socio-economic status and mental health service contact). No associations were found for the other three exposures. Stratification by age indicated that ADLs were most strongly associated with mortality in the youngest (15 to <35 years) and oldest (?55 years) groups. Conclusions Functional impairment in people with serious mental illness diagnoses is a marker of increased mortality risk, possibly in younger age groups as a marker of negative symptomatology. PMID:22970266
Carless, David; Douglas, Kitrina
Social support is important for people experiencing serious mental illness and is also important during the initiation and maintenance of exercise. In this article we draw on interpretive research into the experiences of 11 men with serious mental illness to explore four dimensions of social support both for and through exercise. Our findings suggest that informational, tangible, esteem, and emotional support were both provided for and given by participants through exercise. We conclude that experiences of both receiving and giving diverse forms of support in this way are significant for some people living with and recovering from serious mental illness. PMID:18979324
The growing literature about psychotherapy with LGBT clients rarely addresses serious mental illnesses or mental health care settings such as inpatient, psychosocial rehabilitation, day programs, or residential care. Nor does much of existing literature address the public mental health system. In 1997, the federal Center for Mental Health Services (part of Substance Abuse and Mental Health Services Administration and the
Jacquie White; Richard J Gray; Louise Swift; Garry R Barton; Martin Jones
Background The serious mental illness Health Improvement Profile [HIP] is a brief pragmatic tool, which enables mental health nurses\\u000a to work together with patients to screen physical health and take evidence-based action when variables are identified to be\\u000a at risk. Piloting has demonstrated clinical utility and acceptability.\\u000a \\u000a \\u000a \\u000a \\u000a Methods\\/Design A single blind parallel group cluster randomised controlled trial with secondary economic analysis and
Williams, Jill M; Ziedonis, Douglas
Tobacco dependence among individuals with a mental illness or an addiction is a tremendous problem that goes largely ignored. Studies of genetics, neuroimaging, and nicotinic receptors support a neurobiological link between tobacco use and alcohol dependence, drug dependence, schizophrenia, depression, attention-deficit hyperactivity disorder (ADHD), and anxiety disorders. This paper summarizes the recent literature on this topic and discusses how treatment for tobacco can no longer be ignored in mental-health and addiction-treatment settings. More research is needed as well as a national organized effort to address tobacco in this large segment of smokers. PMID:15236808
Winer, Rachel A; Morris-Patterson, Amrie; Smart, Ynolde; Bijan, Inci; Katz, Craig L
Saint Vincent and the Grenadines (SVG) is an Eastern Caribbean country with limited inpatient and outpatient resources to meet the country's mental health needs. In preparation for integrating mental health care into the primary care setting, we assessed knowledge of and attitudes toward mental illness among primary care providers in SVG. From October 24-November 11, 2011, we visited a convenience sample of District Health Centers in SVG. We gave a multiple-choice-answer, self-administered questionnaire to primary care providers and then administered a structured interview. Survey responses were analyzed for frequencies and interview transcripts qualitatively analyzed for major themes. We completed 53 surveys and interviews representing all nine SVG Health Districts. Results demonstrated a provider population with basic, but inadequate, knowledge of mental illness diagnosis and treatment. Results also revealed a curious and interested group of providers who felt mental illness should be a health priority and were willing and eager to receive further mental health training. Providers suggested strengthening resources in existing district clinics, providing additional staff training sessions, establishing positions with a dual health and mental health role, instituting annual mental health screening examinations, and creating weekly mental health clinics. Integrating mental health care into primary care necessitates involvement of primary care staff during the planning stages, and this study initiates an intensive effort to do so in SVG. Results have led to the development of a "mental health check-up" tool, which we hope will improve access to mental health care in this community. PMID:23378041
Challapallisri, Vaishnavi; Dempster, Lloyd V.
Background: Wide prevalence of mental illness has been documented in South India; however, the magnitude of stigma is unclear. Aims: The aim was to investigate the magnitude of stigma prevalent among medical professionals in Hyderabad, India. Materials and Methods: A prospective survey of seven common psychiatric disorders for eight specified perceptions was conducted. Responses of 226 out of 250 (90%) doctors were analyzed. Results: Significant overall negative perception (P < 0.001), with drug addiction (52.8%) and alcoholism (48.2%) eliciting most negative perceptions (Chi-square: P <0.05) was observed. Significant negative perceptions were also seen among married doctors and those with < 10 years experience. Even though, there was no overall difference based on gender (P = 0.242), more females had significant negative perception toward eating disorders, depression, dementia, alcoholism and schizophrenic patients (P ? 0.05). Conclusions: This study revealed negative attitude of doctors toward mentally ill and highlighted the gender difference in perceptions.
Frati, Paola; Gulino, Matteo; Mancarella, Paola; Cecchi, Rossana; Ferracuti, Stefano
A year after Mario Monicelli's suicide, the death of another famous person in Italy, Lucio Magri, reawakened the Italian debate on social, ethical and juridical issues in end-of-life decisions. Unlike Monicelli, Lucio Magri decided to end his own life in Switzerland with the help of a physician because his mental illness rendered his life unbearable. Both Monicelli and Magri suffered from a severe depression. The authors analyze the ethical issues regarding the right to die for mentally ill patients and neurological disabled patients, discussing the decision-making autonomy in persons suffering from severe depression. The role of the psychiatry in the management of end-of-life decision requests is considered along with pros and cons of suicide prevention and rationale suicide. PMID:24365684
Mizuno, Eriko; Iwasaki, Misuzu; Sakai, Ikue; Kamizawa, Naotoshi
This qualitative study explored experiences of recovery from severe mental illness based on semi-structured interviews with sixteen persons diagnosed with schizophrenia spectrum disorders using psychiatric rehabilitation facilities. The participants' transcripts revealed two major themes: (1) ongoing efforts to live better and (2) inconsistent self-acceptance as a person living with a mental illness. The participants were aware of their responsibility to live with integrity. They all had hopes and goals, were able to respond to social cues, and considered what they could do independently. They wanted to be recognized as people who adapted successfully in society while inconsistently perceiving themselves as either sick or healthy. It is necessary to examine approaches that support the identities of persons who have been treated for schizophrenia and allow them to live comfortable within their communities. PMID:25858206
Ralevski, Elizabeth; Gianoli, Mayumi O; McCarthy, Elissa; Petrakis, Ismene
Quality of life is negatively impacted by diagnosis of mental illness. Those with mental illness report problems in physical, psychological, cognitive, social, and occupational functioning. This study was designed to examine changes in quality of life in veterans with dual diagnoses. All veterans participated in a treatment study designed to treat alcohol dependence with naltrexone, disulfiram, and the combination of naltrexone/disulfiram or placebo for 12 weeks. Quality of life was assessed before treatment and at the end of treatment. Quality of life improved for all veterans and the improvement was more significant for those who abstained from alcohol throughout treatment. Severity of psychiatric symptom was associated with worse quality of life. This study demonstrates the importance of addressing social functioning in veterans with dual diagnosis. PMID:23890764
Ventriglio, Antonio; Borelli, Albacenzina; Bellomo, Antonello; Lepore, Alberto
PurposeThis epidemiologic study tested an hypothesized association between the year of birth of persons with major mental illnesses and solar activity over the past century. MethodsWe collected data on diagnoses and birthdates of psychiatric patients born between 1926 and 1975 (N = 1954) in south Italy for comparison to yearly solar activity as registered by the International Observatories. ResultsWe found a strong inverse correlation between high solar activity (HSA) and incidence of schizophrenia and bipolar disorder in a 20-year period whereas the incidence of non-affective/non-psychotic disorders was moderately associated with HSA in the same period. ConclusionsInterpretation of the observed correlations between HSA during years of birth and the incidence of mental illnesses remains unclear, but the findings encourage further study.
Cheryl Irmiter; John F. McCarthy; Kristen L. Barry; Soheil Soliman; Frederic C. Blow
Patterns of reinstitutionalization following psychiatric hospitalization for individuals with serious mental illnesses (SMI)\\u000a vary by medical and psychiatric health care settings. This report presents rates of reinstitutionalization across care settings\\u000a for 35,527 patients following psychiatric discharge in the Department of Veterans Affairs (VA) health system, a national health\\u000a care system. Over a 7-year follow-up period, 30,417 patients (86%) were reinstitutionalized.
Jacques BaillargeonJoseph; Joseph V. Penn; Kevin Knight; Amy Jo Harzke; Gwen Baillargeon; Emilie A. Becker
This study examined whether the presence of a comorbid substance use disorder increased the risk of criminal recidivism and\\u000a reincarceration in prison inmates with a severe mental illness. Our analyses of more than 61,000 Texas prison inmates showed\\u000a that those with a co-occurring psychiatric and substance use disorder exhibited a substantially higher risk of multiple incarcerations\\u000a over a 6-year period
Background: There is often a lack of agreement on how to understand mental illness in low-income countries and support those experiencing it. This article explores the debate on beliefs and the implications for how society responds.Material: Semi-structured interviews were undertaken with 80 family carers across four sites in Ghana to explore the themes of beliefs, attitudes, carer burden and support.Discussion
Sana Loue; Martha Sajatovic; Nancy Mendez
Latinos, and Puerto Ricans in particular, have been disproportionately impacted by HIV\\/AIDS. Severe mental illness (SMI) is\\u000a associated with an increase in HIV risk. Relatively little research has focused on the role of SMI among Puerto Rican injection\\u000a drug users (IDUs) and non-IDUs in susceptibility to and transmission of HIV and there are few published reports on HIV risk\\u000a among
Cynthia K Crews; Kieu O Vu; Arthur J Davidson; Lori A Crane; Philip S Mehler; John F Steiner
The objective of this study was to determine the prevalence of self-reported podiatric impairments and their effect on health status in persons with severe mental illness. A sample of psychiatric outpatients (N=309) underwent interviews assessing medical conditions and health status with the Medical Outcomes Study Short Form-36 (SF-36). Podiatric health was assessed using nine items from the National Health Interview
Harriet P. Lefley
Research findings on family psychoeducation as evidence-based treatment for serious mental illnesses and benefits for families of peer-led family education groups are presented. Because major psychiatric disorders frequently are long term with episodic crises, caregivers have ongoing needs for support to enhance time-limited interventions. This article describes a continuous psychoeducational family support group that gives prolonged assistance and also helps
Peterson, Marilyn Strachan; Urquiza, Anthony J.
This manual is intended to provide mental health professionals with the information needed in the evaluation and treatment of maltreated children and their families. An introductory chapter briefly considers the roles of the various mental health disciplines in child abuse intervention, including psychiatry, psychology, clinical social work,…
Lucksted, Alicia; Drapalski, Amy L
In October 2013, we brought together 30 researchers in the area of mental illness self-stigma to discuss the current state of the field and to identify future priorities ("Reducing Internalized Stigma of Mental Illness: Mapping Future Directions," Baltimore Maryland). These included the differences between and relationships among self-stigma and related constructs; exploring models or theories of the development, maintenance, and amelioration of self-stigma; validating new and existing measures of self-stigma with a variety of populations; and advancing strategies and programs designed to prevent, reduce, or eliminate self-stigma. That small working meeting was the impetus for this special issue. A call for papers was circulated widely, and final authors include both conference attendees and others. The resulting articles push forward our knowledge about and inquiry into the effects and dynamics of internalized stigma associated with mental illness as well as potential avenues and strategies for intervening to reduce it. (PsycINFO Database Record PMID:26075527
Hunt, Glenn E; Siegfried, Nandi; Morley, Kirsten; Sitharthan, Thiagarajan; Cleary, Michelle
Over 50% of people with a severe mental illness also use illicit drugs and/or alcohol at hazardous levels. This review is based on the findings of 32 randomized controlled trials which assessed the effectiveness of psychosocial interventions, offered either as one-off treatments or as an integrated or nonintegrated program, to reduce substance use by people with a severe mental illness. The findings showed that there was no consistent evidence to support any one psychosocial treatment over another. Differences across trials with regard to outcome measures, sample characteristics, type of mental illness and substance used, settings, levels of adherence to treatment guidelines, and standard care all made pooling results difficult. More quality trials are required that adhere to proper randomization methods; use clinically valuable, reliable, and validated measurement scales; and clearly report data, including retention in treatment, relapse, and abstinence rates. Future trials of this quality will allow a more thorough assessment of the efficacy of psychosocial interventions for reducing substance use in this challenging population. PMID:24179148
Crowther, Ruth E; Marshall, Max; Bond, Gary R; Huxley, Peter
Objective To determine the most effective way of helping people with severe mental illness to obtain competitive employment—that is, a job paid at the market rate, and for which anyone can apply. Design Systematic review. Participants Eligible studies were randomised controlled trials comparing prevocational training or supported employment (for people with severe mental illness) with each other or with standard community care. Outcome measures The primary outcome was number of subjects in competitive employment. Secondary outcomes were other employment outcomes, clinical outcomes, and costs. Results Eleven trials met the inclusion criteria. Five (1204 subjects) compared prevocational training with standard community care, one (256 subjects) compared supported employment with standard community care, and five (484 subjects) compared supported employment with prevocational training. Subjects in supported employment were more likely to be in competitive employment than those who received prevocational training at 4, 6, 9, 12, 15, and 18 months (for example, 34% v 12% at 12 months; number needed to treat 4.45, 95% confidence interval 3.37 to 6.59). This effect was still present, although at a reduced level, after a sensitivity analysis that retained only the highest quality trials (31% v 12%; 5.3, 3.6 to 10.4). People in supported employment earned more and worked more hours per month than those who had had prevocational training. Conclusion Supported employment is more effective than prevocational training at helping people with severe mental illness obtain competitive employment. PMID:11159616
Chan, Kevin K. S.; Mak, Winnie W. S.
As habitual self-stigma can have a tremendous negative impact on people with mental illness, it is of paramount importance to identify its risk factors. The present study aims to examine the potential contributory role of attentional bias in habitual self-stigma. People with mental illness having strong (n = 47) and weak (n = 47) habitual self-stigma completed a computerized emotional Stroop task which included stigma-related, positive, and non-affective words as stimuli. The strong habit group was found to exhibit faster color-naming of stigma-related words (compared to non-affective words), whereas the weak habit group showed no difference in the speed of response to different stimuli. These findings suggest that people with stronger habitual self-stigma may be more able to ignore the semantic meaning of stigma-related words and focus on the color-naming task. Moreover, people with stronger habitual self-stigma may have greater attentional avoidance of stigma-related material. The present study is the first to demonstrate a specific relationship between habitual self-stigma and biased processing of stigma-related information. In order to further determine the role and the nature of attentional bias in habitual self-stigma, future research should employ a broader range of experimental paradigms and measurement techniques to examine stigma-related attentional bias in people with mental illness. PMID:26177536
Mueser, Kim T; Gottlieb, Jennifer D; Xie, Haiyi; Lu, Weili; Yanos, Philip T; Rosenberg, Stanley D; Silverstein, Steven M; Duva, Stephanie Marcello; Minsky, Shula; Wolfe, Rosemarie S; McHugo, Gregory J
Background A cognitive-behavioural therapy (CBT) programme designed for post-traumatic stress disorder (PTSD) in people with severe mental illness, including breathing retraining, education and cognitive restructuring, was shown to be more effective than usual services. Aims To evaluate the incremental benefit of adding cognitive restructuring to the breathing retraining and education components of the CBT programme (trial registration: clinicaltrials.gov identifier: NCT00494650). Method In all, 201 people with severe mental illness and PTSD were randomised to 12- to 16-session CBT or a 3-session brief treatment programme (breathing retraining and education). The primary outcome was PTSD symptom severity. Secondary outcomes were PTSD diagnosis, other symptoms, functioning and quality of life. Results There was greater improvement in PTSD symptoms and functioning in the CBT group than in the brief treatment group, with both groups improving on other outcomes and effects maintained 1-year post-treatment. Conclusions Cognitive restructuring has a significant impact beyond breathing retraining and education in the CBT programme, reducing PTSD symptoms and improving functioning in people with severe mental illness. PMID:25858178
Michael C. Singer
Gays and lesbians with major mental illness often spend their lives within the public mental health system, in which the existence of gay-affirmative programs is a rarity. This potentially alienating situation is often exacerbated by gaps in the training of psychodynamic clinicians that leave important issues of sexuality unexplored in most programs' core curricula. The Lesbian, Gay, Bisexual and Transgender
Grenville Rose; Ivan Beale; John Malone; Judi Higgin; Melanie Whiticker; Loren Brener
A significant proportion of people with mental illness are thought to have co-occurring problematic substance use but there is little published information available and that which is published can be contradictory and vary according to a number of factors. Additionally, the stigma surrounding co-occurrence is little understood and an exploration of attitudes would benefit mental health service design and delivery.
Illness in southern Africa In Botswana, depression is highly prevalent among people living with HIV . Evidence suggests that mental illness is a significant problem in similar settings across southern Africa transmissions. However, alcohol abuse is significant risk factor for HIV acquisition in southern Africa21
Lee, Grace; Mizgalewicz, Ania; Borgelt, Emily; Illes, Judy
Background According to the World Health Organization, mental illness is one of the leading causes of disability worldwide. The first onset of mental illness usually occurs during childhood or adolescence, with nearly 12 million diagnosed cases in the United States alone. NeuroimagingNeuroimaging and genetic testingGenetic testing have been invaluable in research on behavioral, affective, and attentional disorders, particularly with their potential predictive capabilities, and ability to improve diagnosis and to decrease the associated burdens of disease. The present study focused specifically the perspectives of mental healthMental health providers on the role of neuroimagingNeuroimaging and genetic testingGenetic testing in clinical practice with children and adolescents. Methods We interviewed 38 psychiatrists, psychologists, and allied mental health professionals who work primarily with youth about their receptivity toward either the use of neuroimagingNeuroimaging or genetic testingGenetic testing . Interviews probed the role they foresee for these modalities for prediction, diagnosis, treatment planning, and the benefits and risks they anticipate. Results Practitioners anticipated three major benefits associated with clinical introduction of imaging and genetic testingGenetic testing in the mental healthMental health care for youth: (1) improved understanding of the brain and mental illness, (2) more accurate diagnosis than available through conventional clinical examination, and (3) legitimization of treatment plans. They also perceived three major risks: (1) misuse or misinterpretation of the imaging or genetic data, (2) potential adverse impacts on employment and insurance as adolescents reach adulthood, and (3) infringements on self-esteem or self-motivation. Limitations The nature of the interview questions focused on the future of neuroimagingNeuroimaging and genetic testingGenetic testing research in the context of clinical neuroscience. Therefore, the responses from interview participants are based on anticipated rather than actual experience. Conclusions Continued expansion of brain imagingBrain imaging and genetic testingGenetic testing into clinical care will require a delicate balance of brain biology and respect for autonomy in the still-evolving cognitive and affective world of young individuals. PMID:25056008
Bitonte, Robert A.
Medical students experience higher rates of mental illness than the general population. With competition rising for success in medical school, and residency, increasing incidence of distress are leading this population to experience higher rates of thoughts of dropping out of school, and even suicide. Since many stigmas deter medical students from receiving mental health counseling, such as the perceived inability to handle the stresses of medical school, and the potential lack of competitiveness for residencies if reported, prevention of mental illness may be a better course to take in reducing prevalence in this population. Regular exercise has demonstrated a positive effect on not only promoting physical health, but also mental health. Exercise encourages a healthy mood, positive self esteem, and better cognition, while decreasing the chances of depression, anxiety, and burnout. Implementing exercise time into medical school curriculums, just like the basic sciences, albeit for less time in the day, could provide a feasible way to ensure that all students are taking time to partake in this important activity for their well being. Though medical schools are rigid with attempts to make changes in their curriculum, thirty minutes a day, three to five times a week of exercise of the students’ choice not only is more cost effective than counseling, but it also reduces the chances that they will experience burnout, which if left untreated could transcend into a compromised training experience. PMID:25553235
Watson, Amy C; Morabito, Melissa Schaefer; Draine, Jeffrey; Ottati, Victor
The large numbers of people with mental illness 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 Intervention Teams (CIT). The CIT model is being implemented widely, with over 400 programs currently operating. While the limited evidence on CIT effectiveness is promising, research on CIT is limited in scope and conceptualization-much of it focusing on officer characteristics and training. In this paper we review the literature on CIT and present a conceptual model of police response to persons with mental illness that accounts for officer, organizational, mental health system and community level factors likely to influence implementation and effectiveness of CIT and other approaches. By moving our conceptualizations and research in this area to new levels of specificity, we may contribute more to effectiveness research on these interventions. PMID:18632154
Kloos, Bret; Townley, Greg
The present study examined the relationships between how research participants experienced their neighborhood, their neighborhood social climate, and psychological well-being. Participants (n = 525) were residents of supported housing programs who used mental health services at one of 17 community mental health centers in South Carolina. Hierarchical regression and mediation analyses were employed to answer research questions. Results suggest that neighbor relations, perceptions of neighborhood safety, and neighborhood satisfaction were significantly associated with perceptions of neighborhood social climate; and neighborhood social climate accounted for a significant amount of the variance in psychiatric distress. Of particular interest, perceptions of neighborhood social climate fully mediated the relationship between the specific reported neighborhood experiences and psychiatric distress. These findings have implications for interventions and policy aimed at promoting integration of individuals with serious mental illness into community settings. PMID:20680675
Jim E. Banta; Elaine H. Morrato; Scott W. Lee; Mark G. Haviland
Background Serious mental illness often is associated with an increased risk of diabetes and sub-optimal diabetes care.\\u000a \\u000a \\u000a \\u000a Objective To examine diabetes prevalence and care among Medicaid patients from one county mental health system.\\u000a \\u000a \\u000a \\u000a Design Retrospective cohort study combining county records and 12 months of state Medicaid claims.\\u000a \\u000a \\u000a \\u000a Subjects Patients ages 18 to 59 receiving mental health services between November 1 and 14, 2004.\\u000a \\u000a \\u000a \\u000a Measurements Dependent
Perron, Amelie; Rudge, Trudy; Holmes, Dave
The concept of citizenship is becoming more and more prominent in specific fields, such as psychiatry/mental health, where it is constituted as a solution to the issues of exclusion, discrimination, and poverty often endured by the mentally ill. We argue that such discourse of citizenship represents a break in the history of psychiatry and constitutes a powerful strategy to counter the effects of equally powerful psychiatric labelling. However, we call into question the emancipatory promise of a citizenship agenda. Foucault's concept of governmentality is helpful in understanding the production of the citizen subject, its location within the 'art of government', as well as the ethical and political implications of citizenship in the context of mental health. PMID:20415962
Michael T. Compton; Dana Hankerson-Dyson; Beth Broussard
The public's level of mental health literacy remains low, despite growing access to information regarding mental illnesses. Because few measures exist to assess the level of knowledge of mental illnesses in lay samples, the Multiple-Choice Knowledge of Mental Illnesses Test (MC-KOMIT) was developed, initially for use in a study involving police officers, some of whom received 40h of training focused
McMartin, Seanna E.; Kingsbury, Mila; Dykxhoorn, Jennifer; Colman, Ian
Background: Existing research and media reports convey conflicting impressions of trends in the prevalence of mental illness. We sought to investigate trends in the prevalence of symptoms of mental illness in a large population-based cohort of Canadian children and adolescents. Methods: We obtained population-based data from the National Longitudinal Survey of Children and Youth. Every 2 years, participants completed self-reported measures of mental illness indicators, including conduct disorder, hyperactivity, indirect aggression, suicidal behaviour, and depression and anxiety. We analyzed trends in mean scores over time using linear regression. Results: We evaluated 11 725 participants aged 10–11 years from cycles 1 (1994/95) through 6 (2004/05), 10 574 aged 12–13 years from cycles 2 (1996/97) through 7 (2006/07), and 9835 aged 14–15 years from cycles 3 (1998/99) through 8 (2008/09). The distribution of scores on depression and anxiety, conduct and indirect aggression scales remained stable or showed small decreases over time for participants of all ages. The mean hyperactivity score increased over time in participants aged 10–11 years (change per 2-year cycle: 0.16, 95% CI 0.02 to 0.12) and those aged 12–13 years (0.13, 95% CI 0.09 to 0.18). Over time, fewer participants aged 12–13 years (0.40% per cycle, 95% CI ?0.78 to ?0.07) and aged 14–15 years (0.56% per cycle, 95% CI ?0.91 to ?0.23) reported attempting suicide in the previous 12 months. Interpretation: With the exception of hyperactivity, the prevalence of symptoms of mental illness in Canadian children and adolescents has remained relatively stable from 1994/95 to 2008/09. Conflicting reports of escalating rates of mental illness in Canada may be explained by differing methodologies between studies, an increase in treatment-seeking behaviour, or changes in diagnostic criteria or practices. PMID:25367419
Ilan Harpaz-Rotem; Robert A. Rosenheck; Rani Desai
In recent years a number of reports have documented an increase in the number of homeless families in the US. Using a sample of 195 mothers who were veterans of the US armed forces we assessed the association of maternal homelessness and clinical status, with measures of children’s mental health, school enrolment and attendance. Although maternal homelessness had no significant
Pinals, Debra A; Appelbaum, Paul S; Bonnie, Richard; Fisher, Carl E; Gold, Liza H; Lee, Li-Wen
The American Psychiatric Association, ("APA"), with more than 36,000 members at present, is the Nation's leading organization of physicians who specialize in psychiatry. APA provides for education and advocacy and develops policy through Position Statements. It promotes enhanced knowledge of particular topics relevant to psychiatric practice and patient care through Resource Documents. Since 1993, the APA has developed various positions and resource materials related to firearms and mental illness, incorporating evolving themes as new issues emerge. This paper reflects the APA's 2014 Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services. PMID:26095100
Cherry, Andrew L.
Treatments for people with the co-occurring disorders of mental illness and substance use (abuse or dependence) have been evolving and improving since the mid 1980s. During this period substance abuse treatment programs reported between 50 and 75% of the people they served also had a mental health problem. At the same time, mental health programs…
Little is known about the factors that increase the risk for enacted mental illness stigma (i.e. rejection, devaluation and exclusion) as perceived by the stigmatized person. This is particularly true for the population of adolescents diagnosed with a mental illness. The aim of this study was to address this question and examine select social and clinical factors that predict enacted stigma (self-reported) with research that follows eighty American adolescents for 6 months following a first psychiatric hospitalization. Drawing on social identity theory, and research on stigma-threatening environments, social group identification and social support, this study tested four hypotheses: affiliation or identification with higher status and lower status peers predicts more and less stigma respectively (H1); a greater and more supportive social network, and more perceived family support predict less stigma (H2); greater severity of internalizing and externalizing symptoms predicts more stigma (H3); and poorer school functioning predicts more stigma (H4). Results indicated that about 70% of adolescents reported experiencing enacted stigma (at 6 months); disrespect or devaluation was more common than outright social rejection. Using OLS regression analyses, the results provided partial support for H1, H3 and H4, while H2 was not supported. The baseline factors found to be most predictive of enacted stigma ratings at 6-months were: affiliating with more friends with mental health problems, identifying with the 'populars' peer group, higher internalizing symptom ratings, and self-reported disciplinary problems at school. These four factors remained significant when controlling for initial enacted stigma ratings, pointing to their importance in determining changes in social stigma experiences in the follow-up period. They also remained significant when controlling for perceived public stigma ratings at follow-up, indicating that the findings were not due to generalized perceptions of stigma of youth with mental illness. PMID:24695363
Draine, Jeffrey; Wilson, Amy Blank; Pogorzelski, Wendy
Intervention at the intersection of the mental health and criminal justice systems has followed a small set of service models with limited success and a narrow impact on the quality of treatment available to people with mental illness who experience arrest, court processing, incarceration, and release. In reviewing research on police, court, and…
Herman, Daniel B.
Professional social workers and other mental health providers have for many years been involved in delivering treatment and support services focused on the needs of adults with severe mental illnesses living in the community. While some models have evolved largely through practice experience, others have developed through research paradigms in…
Dow A. Wieman; Robert A. Dorwart
This article compares public and privatized approaches to managed behavioral health care for persons with serious mental illness in Massachusetts. Data from the Department of Mental Health (DMH) for 247 patients receiving care managed by DMH and 312 in a Medicaid carve-out were compared. Repeated measures multivariate analysis of variance models were used to examine adjusted changes in number of
The present study was designed to examine the relationship between self-stigma and quality of life over a one year time period for 71 people with mental illness who were receiving compulsory community mental health treatment. It was hypothesized that, over time, self-stigma would have the direct effect of eroding quality of life among people with…
Loya, Fred; Reddy, Radhika; Hinshaw, Stephen P.
Previous research has established that Asian Americans use mental health services less frequently and hold poorer attitudes toward psychological counseling than Caucasians. The authors directly tested whether stigmatizing beliefs regarding mental illness might explain such differential attitudes toward counseling in a South Asian and Caucasian…
Barbara Dickey; Howard H. Goldman
Revenue sources for mental health care for the chronically mentally ill are fragmented, and services limited. What services are provided are frequently underfunded, and gaps in the “safety net” undermine a continuum of care. Given this situation, what can local units of government do to leverage multiple funding streams in a way that makes optimal use of scarce resources? The
Yin-Ling Irene Wong; Sungeun Lee; Phyllis L. Solomon
This study examines mechanisms of structural leverage in supported independent living (SIL) for persons with severe mental illness and their relationship with discontinuance of program participation among SIL residents. The investigation employed program-level and consumer-level data available in an urban public mental health system. Findings indicate that housing leverage was a universal feature in SIL programs, with a high level
Paul B. Gold; Neil Meisler; Alberto B. Santos; Mark A. Carnemolla; Olivia H. Williams
Urban-based randomized clinical trials of integrated sup- ported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited,
Crews, Cynthia K; Vu, Kieu O; Davidson, Arthur J; Crane, Lori A; Mehler, Philip S; Steiner, John F
The objective of this study was to determine the prevalence of self-reported podiatric impairments and their effect on health status in persons with severe mental illness. A sample of psychiatric outpatients (N=309) underwent interviews assessing medical conditions and health status with the Medical Outcomes Study Short Form-36 (SF-36). Podiatric health was assessed using nine items from the National Health Interview Survey (NHIS). Eighty percent of patients reported at least one podiatric problem. The most common problems were foot pain (48%), nail disorders (35%) and corns/calluses (28%). Prevalence rates were 4-11 times higher than those reported by the general population in the 1990 NHIS. The total number of podiatric problems was inversely related to eight self-reported health status domains and both summary SF-36 scores (all P<==.0001). After controlling for sociodemographic factors, psychiatric illness and medical conditions, the total number of podiatric limitations remained significantly associated with lower patient ratings in four of the eight SF-36 domains and both summary scores. We concluded that persons with severe and persistent mental illness have markedly elevated rates of podiatric problems when compared to the general population group. These problems are associated with worsened self-perceived health status. Addressing podiatric health may be a successful way to improve the overall health of this population. PMID:15121351
Shor, Ron; Shalev, Anat
Hospitalization of persons with mental illness may cause their family members to experience multiple stressors that stem from the hospitalization as well as from the duties of helping him or her. However, providing support services in psychiatric hospitals for family members has received only limited attention. To change this situation, mental health professionals in a psychiatric hospital in Israel developed an innovative family-centered practice model, the Family Members' Support and Consultation (FMSC) service center. We examined the significance to family members of the services they received from the FMSC service center in a study that included 20 caregivers. Ten participated in 2 focus groups of 5 participants each; 10 were interviewed personally. We implemented a thematic analysis to analyze the data. According to the participants, the staff of the FMSC service center provided support services that helped them cope with the stressors and difficulties they experienced within the context of the psychiatric hospital. The participants emphasized the significance of the immediacy and accessibility of support provided, as well as the positive effects of systemic interventions aimed at changing the relationships between family members and systems in the psychiatric hospital. Our findings show the importance of integrating a service that focuses on the needs of family members of persons with mental illness within a psychiatric hospital. PMID:25485823
Angell, Beth; Matthews, Elizabeth; Barrenger, Stacey; Watson, Amy C; Draine, Jeffrey
Linking prisoners with mental illness with treatment following release is critical to preventing recidivism, but little research exists to inform efforts to engage them effectively. This presentation compares the engagement process in two model programs, each representing an evidence-based practice for mental health which has been adapted to the context of prison reentry. One model, Forensic Assertive Community Treatment (FACT), emphasizes a long-term wrap-around approach that seeks to maximize continuity of care by concentrating all services within one interdisciplinary team; the other, Critical Time Intervention (CTI), is a time-limited intervention that promotes linkages to outside services and bolsters natural support systems. To compare engagement practices, we analyze data from two qualitative studies, each conducted in a newly developed treatment program serving prisoners with mental illness being discharged from prisons to urban communities. Findings show that the working relationship in reentry services exhibits unique features and is furthered in both programs by the use of practitioner strategies of engagement, including tangible assistance, methods of interacting with consumers, and encouragement of service use via third parties such as families and parole officers. Nevertheless, each program exhibited distinct cultures and rituals of reentry that were associated with fundamental differences in philosophy and differences in resources available to each program. PMID:24650496
Yang, Suzanne; Kadouri, Alane; Révah-Lévy, Anne; Mulvey, Edward P; Falissard, Bruno
Once convicted, the perpetrator of serious crime embarks upon a new journey: the challenge of adjusting to long-term imprisonment. Prisoners' views of incarceration and the meaning of this experience may affect their later adjustment to life in the community. On the basis of brief narrative responses collected during an epidemiological survey of the psychological health of prisoners in France, this study examined the impact of incarceration on psychological state in a group of 59 inmates serving long sentences. Qualitative content analysis and computer-assisted linguistic analysis (using ALCESTE software) were performed on the textual data of open responses to three standard questions. Using a combination of these two approaches, seven categories of the subjective experience of prisoners in the sample were identified: the Outside World, Others, Punishment, Time, Affects and Impulses, Self-Concept, and Speech. Further qualitative analyses were then performed to compare the responses of Severely Mentally Ill (SMI) subjects and subjects with no psychiatric disorder. These analyses revealed contrasting attitudes towards incarceration. SMI subjects spoke in more hostile and persecutory terms about their experience in prison, attributing suffering to external circumstances, while subjects with no psychiatric disorder evoked similar themes, but with an introspective attitude. The themes evoked by mentally ill individuals in our sample suggest that their reactions to the prison environment arise in part from aspects of their psychiatric symptoms, and this may have relevance to future mental health policy and practices in criminal corrections. PMID:19619895
Steigman, Pamela J; Pickett, Susan A; Diehl, Sita M; Fox, Anthony; Grey, Dennis D; Shipley, Patricia; Cook, Judith A
Depression has been shown to moderate the effects of physical illness self-management (ISM) programs. We attempted to replicate these findings for a mental ISM intervention. Outpatients with serious mental illness (N = 428) from eight Tennessee communities were randomly assigned to receive a peer-led self-management intervention called Building Recovery of Individual Dreams and Goals Through Education and Support or services as usual. Psychiatric symptoms were assessed with the Brief Symptom Inventory; the outcome of personal empowerment was measured by the Empowerment Scale. Intent-to-treat analysis using mixed-effects random regression found significant interaction effects between study condition and three moderating symptom profiles. Empowerment was greater for the intervention participants with high levels of depressive symptoms, anxiety symptoms, and general symptom distress than for the experimental participants with low symptom levels and the control subjects with high or low levels of symptoms. These results shed light on how mental ISM programs operate and ways these can be improved. PMID:24566504
Petter Tinghög; Tomas Hemmingsson; Ingvar Lundberg
Background Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the\\u000a association between immigrant status and mental illness can be explained by a different distribution of known risk factors\\u000a for impaired mental health between groups of immigrants and persons born in Sweden.\\u000a \\u000a \\u000a \\u000a Methods The study is based on data from the
Lorig, Kate; Ritter, Philip L; Pifer, Carolyn; Werner, Pamela
Evaluation of evidence-based interventions in new settings and new populations is the hallmark of successful translation. We evaluated the Chronic Disease Self-Management Program in persons with serious mental illness who were receiving care through Michigan Community Mental Health Services (N = 139). At 6-months, participants demonstrated improvements in health indicators (fatigue, quality of life, sleep, depression, health distress, and days health bad) and health behaviors (medical adherence and communication with doctor). The program was successfully administrated in a "real world" setting and continues to be used. In addition, the program appears to be an effective resource for people with serious mental illness. PMID:23748554
Horwitz, A V; Reinhard, S C
The policy of community care for the seriously mentally ill increases the caregiving duties and resulting burden on families with members who have a mental illness. Ethnicity is one factor that might have an important impact on the caregiving duties family members perform and the burden that results from these duties. This study uses interviews with 78 parents and 70 siblings of patients scheduled for imminent release from a state mental hospital. The findings indicate that Black and White parents have equivalent caregiving duties, but White parents report substantially more caregiver burden. Black siblings report more caregiving duties than White siblings but report less caregiver burden. These ethnic differences remain after controls for income, gender, age, diagnosis, perceived stigma, and coresidence. The results indicate that ethnicity can be a critical factor affecting levels of informal caretaking for persons with serious mental illnesses. PMID:9113139
Mueser, K T; McGurk, S R
The individual placement and supported (IPS) model of supported employment is the most empirically validated model of vocational rehabilitation for persons with schizophrenia or another serious mental illness. Over 18 randomized controlled trials have been conducted throughout the world demonstrating the effectiveness of supported employment at improving competitive work compared to other vocational programs: IPS supported employment is defined by the following principles: 1) inclusion of all clients who want to work; 2) integration of vocational and clinical services; 3) focus on competitive employment; 4) rapid job search and no required prevocational skills training; 5) job development by the employment specialist; 6) attention to client preferences about desired work and disclosure of mental illness to prospective employers; 7) benefits counseling; and 8) follow-along supports after a job is obtained. Supported employment has been successfully implemented in a wide range of cultural and clinical populations, although challenges to implementation are also encountered. Common challenges are related to problems such as the failure to access technical assistance, system issues, negative beliefs and attitudes of providers, funding restrictions, and poor leadership. These challenges can be overcome by tapping expertise in IPS supported employment, including standardized and tested models of training and consultation. Efforts are underway to increase the efficiency of training methods for supported employment and the overall program, and to improve its effectiveness for those clients who do not benefit. Progress in IPS supported employment offers people with a serious mental illness realistic hope for achieving their work goals, and taking greater control over their lives. PMID:24929974
A predictive medicine program allows disease and illness including mental illness to be predicted using tools created to identify the presence of accelerated aging (a.k.a. disease) in electrical and mechanical equipment. When illness and disease can be predicted, actions can be taken so that the illness and disease can be prevented and eliminated. A predictive medicine program uses the same tools and practices from a prognostic and health management program to process biological and engineering diagnostic data provided in analog telemetry during prelaunch readiness and space exploration missions. The biological and engineering diagnostic data necessary to predict illness and disease is collected from the pre-launch spaceflight readiness activities and during space flight for the ground crew to perform a prognostic analysis on the results from a diagnostic analysis. The diagnostic, biological data provided in telemetry is converted to prognostic (predictive) data using the predictive algorithms. Predictive algorithms demodulate telemetry behavior. They illustrate the presence of accelerated aging/disease in normal appearing systems that function normally. Mental illness can predicted using biological diagnostic measurements provided in CCSDS telemetry from a spacecraft such as the ISS or from a manned spacecraft in deep space. The measurements used to predict mental illness include biological and engineering data from an astronaut's circadian and ultranian rhythms. This data originates deep in the brain that is also damaged from the long-term exposure to cortisol and adrenaline anytime the body's fight or flight response is activated. This paper defines the brain's FOFR; the diagnostic, biological and engineering measurements needed to predict mental illness, identifies the predictive algorithms necessary to process the behavior in CCSDS analog telemetry to predict and thus prevent mental illness from occurring on human spaceflight missions.
Baumgartner, Joy Noel; Herman, Daniel B.
Objective This exploratory study examined the impact of critical time intervention (CTI), a time-limited care coordination model, on community integration among formerly homeless adults with severe mental illness after discharge from inpatient psychiatric treatment. Methods Data were from a randomized trial that enrolled 150 participants, 95 of whom completed 18-month outcome measures. Relationships between two components of community integration (social and physical) and demographic characteristics, symptom ratings, housing status, and treatment condition were examined. Results Neither assignment to CTI nor housing stability was associated with integration outcomes. General and negative symptoms were inversely associated with both physical and social integration. Conclusions Although CTI and similar community support models may improve housing stability and reduce rehospitalization, they may not, by themselves, improve community integration. Future studies should focus on improving measurement of community integration so that it can be effectively studied as an important outcome of mental health interventions for this population. PMID:22549529
Hanrahan, Nancy P.; Rolin-Kenny, Donna; Roman, June; Kumar, Aparna; Aiken, Linda; Blank, Michael
People with a serious mental illness (SMI) along with HIV have complex health conditions. This population also has high rates of poverty, difficulty in sustaining regular housing, and limited supportive networks. Typically, the combination of psychotropic and HIV medication regimens is complicated, changes frequently, and requires coordination among multiple providers. Furthermore, fragmented and divided primary health care and mental health care systems present substantial barriers for these individuals and for the public health nurses who care for them. In this paper, we present “real world” case studies of individuals with SMI and HIV and the self-care management strategies used by nurses to address medication and treatment management, build interpersonal skills, and develop sustainable health networks. The case studies can be used for quality improvement discussions among practicing public health nurses and for instructing nursing students in a self-care management approach. PMID:22399840
Raskin, A; Mghir, R; Peszke, M; York, D
The objective of this study was to develop a psychoeducational program for caregivers of the chronically mentally ill residing in community residencies. An evaluative component was added to determine how well the program was received by caregivers and what impact the program had on the residents. A total of 20 caregivers and 63 residents participated in the program. In general, the psychoeducational program was well received by the caregivers. They especially liked the mental health component and opportunity to meet and interact with other caregivers. There was a significant drop in hospital admissions following the program. There was also improvement in a number of quality of life activities such as trips to the local coffee shop and mall. PMID:9693867
de Pierrefeu, I; Charbonneau, C
Many different types of vocational programs (services) exist to help people with severe mental disorders (e.g., schizophrenia) integrate the regular labor market: sheltered workshops, social enterprises, and supported employment programs to name a few. Each type of vocational services has its specificities: on one hand, some of them are following the "train and place" approach. For example, sheltered workshops offer to people with a severe mental illness a training during a long period of, with a small proportion obtaining competitive employment. On the other hand, other programs adopt the "place and train" philosophy, such as supported employment programs, in which employment specialists help people obtain a competitive job as fast as possible with no requested training. This article presents two original vocational services, the Messidor's sheltered workshops in France and the Accès-Cible SMT supported employment program in Quebec, following an "hybrid" approach including both philosophies "place and train" and "train and place". More particularly, they are both aiming at competitive employment on the regular labor market for people with a severe mental illness, with a different length of training. Messidor consists of a sheltered workplace for people with a severe mental illness in France, using this time of transition in the workshops as a tool to obtain a competitive job. Thanks to three key factors, Messidor succeeds in placing many of their workers in the French regular labor market: (1) Workers with severe mental disorders work on tasks and workplaces similar to those in regular labor market; (2) Messidor's managers have small teams (5-7 persons) that offer a nearby and personalized management to workers; (3) Each worker is followed by a Messidor's employment counsellor, to build together a working plan and put in place work strategies to obtain a competitive job. This "double management" seems to be a key ingredient of this support as it promotes some success in getting a job as well as in developing some recovery effects. Accès-Cible SMT located in Montreal (Quebec, Canada) is also an interesting "hybrid" program since people with severe mental disorders can be supported by a counsellor, with a short period of training (a 28-week program with 6 steps) before integrating the regular labor market. The philosophy of Accès-Cible SMT is to consider their clients as normal persons more than as patients, and its objective is mainly to restore confidence and self-esteem of the person by putting emphasis on their professional skills. Meetings in groups, practicums in the workplace, and the utilization of job search strategies are essential ingredients of Accès-Cible SMT, which are also efficient tools to develop a better empowerment of the person. Indeed, the common ingredients/elements of these two vocational services, Messidor and Accès-Cible SMT, seem to be the development of empowerment for people with severe mental disorders. The scientific literature supports that empowerment is one of the key factors of recovery for people with a mental illness, a recovery process that can be illustrated by their work integration in the regular labor market as a final goal. PMID:24930724
Rapp, C A; Shera, W; Kisthardt, W
Research concerning the care and treatment of people with severe mental illness has not been consonant with the well-established emphasis on consumer empowerment in social work and the psychiatric rehabilitation field. This article provides a set of research strategies that would help bridge the gap. We argue that research should amplify "the voice of the consumer" by attending to the context of research, the vantage point, the process of formulating research questions, the selection of interventions to be tested, the selection of outcomes and measures, and the dissemination of research results. PMID:8256144
Cummings, Sherry M; Kropf, Nancy P
Caregivers of older persons with severe mental illness (SMI) contend with the double challenge of providing assistance related to both the psychiatric condition and older age of their family member. Study explored factors influencing negative psychological outcomes experienced by caregivers (n = 96) of older adults with SMI. One-quarter of caregivers scored at or above the clinical point for depression. Low income, care recipient gender, poor health, problems dealing with care recipient's symptoms and the interaction of health and problems dealing with symptoms were associated with higher rates of depression. Implications for service provision and future research are discussed. PMID:25357014