Rustin, Terry A
Artwork and psychiatric disorders are often linked. Accomplished artists with psychiatric disorders express themselves and their emotional distress through their works, and art therapists use the visual arts to help clients understand their problems and cope with them. There have been a number of psychiatric patients with no previous art training who produced artwork that many consider museum-worthy (Art Brut, or Outsider Art.) For the past two years, I have used artwork in another way: to better understand my clients and their psychiatric disorders. Presented here are paintings I have made about the mental illness experience of some of my clients, all well known to me through their therapy. It is a form of visual psychodrama, in which I reverse roles with the client through the paintings. My goal has been to experience the stresses felt by my clients so that I can understand them better. The paintings have served as a point of embarkation for therapy sessions, as a means of clarifying a client's experience, and as a way to show clients that their therapist is attending to what they say. Countertransference undoubtedly plays a role in my choice of clients and their portrayals, but the intent is to help me better understand the clients' experiences.Included here are images of some of these paintings with a short psychiatric history of the client about whom they were made. Accompanying each one are responses from the clients upon viewing "their" paintings, and a discussion of the client's psychiatric disorder. Making these paintings has helped me understand better the feelings of isolation, rejection, loss, and alienation that many of my clients experience every day. In turn, they tell me that viewing the paintings is an intense experience for them as well. As an outsider artist, I must leave it to the viewer to determine whether or not these paintings qualify as "art."
Cohen, C I; Thompson, K S
Mainstream psychiatry conceptualizes people who are homeless and mentally ill as distinct from other homeless persons because it is thought that their status stems from their mental disorder and the poor implementation of deinstitutionalization. The authors believe this dichotomy is illusory. They present data indicating that recent socioeconomic and political shifts contributed greatly to homelessness among all groups, regardless of mental illness; that those with and without mental illness have similar biographical and demographic profiles; that high levels of mental distress are common to all homeless persons; and that few mentally ill homeless persons require involuntary hospitalization. This perspective suggests novel responses that de-emphasize clinical solutions and focus on empowerment, consumerism, entitlement, community-level interventions, and closer alliances with other advocates for the homeless.
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... to situations and to people Alcohol or drug abuse Major changes in eating habits Sex drive changes Excessive anger, hostility or violence Suicidal thinking Sometimes symptoms of a mental health disorder appear as physical ... on Drug Abuse. http://www.drugabuse.gov/publications/principles-drug-addiction- ...
Magli, Erica; Buizza, Chiara; Pioli, Rosaria
Many knowledges on the mental disease that the community possesses are turning out of information disclosed from the media. It's common in the press to connect actions of violence and murders to the mental diseases. For this reason, the reader is induced to infer that murders and other violent actions are more frequent in people who have suffered from mentally ill, than in the general population. The mystifying impression provided by media accrues from the fact that these reports are rarely compensated from positive reports. Objective of the present study is to characterize the type of information concerning mental illness diffused from the local daily paper "Giornale di Brescia" in the year 2001. The results show that many articles connote negatively the mental disease. The journalistic sensationalism, denounced facing the speech of the prejudgment in the comparisons of the mentally ill people, seems to still remain, in the considered year of publication, one unchanging tendency.
In Great Britain 1-2 million people may be homeless. Most homeless people are men, but about 10-25% are women, of whom about half are accompanied by children. Significant mental illness is present in 30-50% of the homeless: functional psychoses predominate; acute distress and personality dysfunction are also prevalent. Co-morbidity of mental illness and substance abuse occurs in 20%, and physical morbidity rates exceed those of domiciled populations. The homeless mentally ill also have many social needs. Pathways to homelessness are complex; deinstitutionalization may be only one possible cause of the increase in the number of homeless people. There is much recent research estimating the extent of mental illness and the characteristics of selected subgroups of accessible homeless people. The evaluation of potential service solutions has received less attention. This review outlines the research, highlights current views on the definition and classification of homeless populations, and offers some guidelines on avenues which need to be explored.
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.
Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.
Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.
Hare-Mustin, Rachel T.; Garvine, Richard
Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)
R K Mahto
Full Text Available Background: In developing countries like India, there are evidences that stigma associated with mental illness is increasing. As in parts of the developing world, with advancement of urbanization and rapid industrialization, people tend to react in a very peculiar and biased way when they confront a mentally ill person. Materials and Methods: The present study aimed to find out students′ opinion about mental illness. A total of 100 students (50 male and 50 female from Ranchi University were purposively recruited for the study, and the 51-item Opinion about Mental Illness (OMI Scale was administered. Results: Majority of the students were from Hindu families, of whom 42 (84% were males and 38 (68% were females. With regard to OMI scale, the item, viz., ′The law should allow a woman to divorce her husband as soon as he has been confined in mental hospital with a severe mental illness′, both male (46% and female (56% students were neutral (significant at 0.014, P < 0.05. Conclusion: Overall no significant level of difference emerged between male and female students with regard to opinion about mental illness.
This chapter is concerned with the profile of symptoms, illnesses, and diseases (further referred to as 'morbidity') presented to primary care doctors. It is important to acknowledge that morbidity presented to primary care doctors is only a small part of all morbidity perceived by people in the
... that participate with your plan. Mental Health and Addiction Insurance Help : This website from the U.S. Department ... in the Health & Education section. The website is mobile and print-friendly. Printed ... eastern time, M-F Phone: 1-866-615-6464 TTY: 1-301-443- ...
Petersen, Kirsten Schultz; Friis, Vivi Soegaard; Haxholm, Birthe Lodahl
Mental health services strive to implement a recovery-oriented approach to rehabilitation. Little is known about service users' perception of the recovery approach. The aim is to explore the service user's perspectives on facilitators and barriers associated with recovery. Twelve residents living...
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 recruite...
Schoenfeld, Timothy J; Cameron, Heather A
Several lines of evidence suggest that adult neurogenesis, the production of new neurons in adulthood, may play a role in psychiatric disorders, including depression, anxiety, and schizophrenia. Medications and other treatments for mental disorders often promote the proliferation of new neurons; the time course for maturation and integration of new neurons in circuitry parallels the delayed efficacy of psychiatric therapies; adverse and beneficial experiences similarly affect development of mental illness and neurogenesis; and ablation of new neurons in adulthood alters the behavioral impact of drugs in animal models. At present, the links between adult neurogenesis and depression seem stronger than those suggesting a relationship between new neurons and anxiety or schizophrenia. Yet, even in the case of depression there is currently no direct evidence for a causative role. This article reviews the data relating adult neurogenesis to mental illness and discusses where research needs to head in the future. PMID:25178407
A number of prominent writers on the concept of mental illness/disease are committed to accounts which involve rejecting certain plausible widely held beliefs, namely: that it is part of the meaning of illness that it is bad for its possessor, so the concept of illness is essentially evaluative; that if a person has a mental illness, ...
Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet
For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations.
Sullivan, G; Burnam, A; Koegel, P
Persons with mental illness are over-represented among the homeless relative to the general population, and mental illness is most likely one of many vulnerabilities that confer risk for homelessness. This paper elucidates the pathways to homelessness for persons with mental illness by comparing and contrasting groups of mentally ill homeless persons, non-mentally ill homeless persons, and housed mentally ill persons drawn from RAND's Course of Homelessness (COH) study and the Epidemiological Catchment Area (ECA) survey. Homeless persons share childhood histories of economic and social disadvantage. The mentally ill homeless appear to have a "double dose" of disadvantage: poverty with the addition of childhood family instability and violence. Among the mentally ill homeless, those who became homeless prior to becoming mentally ill have the highest levels of disadvantage and disruption; while those who become homeless after becoming ill have an especially high prevalence of alcohol dependence. Mental illness may play a role in initiating homelessness for some, but is unlikely in and of itself to be a sufficient risk factor for homelessness. In addition to outreach and treatment programs for adult mentally ill homeless persons, emphasis should be placed on interventions with children and on addressing more pervasive causes of homelessness.
National Inst. of Mental Health (DHHS), Rockville, MD.
Many former mental patients see their biggest problem in resuming community life to be their inability to be accepted by other people. The National Institute of Mental Health has worked to remove the stigma associated with mental illness and research has unraveled many of the mysteries about the origins of mental illness. Deinstitutionalization,…
Kim, M-C; Lee, T-K
The authors report stereotactically created lesioning by radiofrequency or Cyberknife radiosurgery for patients with mental illness. Since 1993, thirty-eight patients have undergone stereotactic psychosurgery for medically intractable mental illnesses. Two patients had aggressive behavior. Twenty-five patients suffered from Obsessive-Compulsive Disorder (OCD) and ten patients had depression. Another patient suffered from atypical psychosis. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior. Limbic leucotomy or anterior cingulotomy was done for OCD and subcaudate tractotomy with or without cingulotomy was done for depression. In twenty-three patients, the lesions were made by a radiofrequency (RF) lesion generator. In fifteen cases, the lesions were made with CyberKnife Radiosurgery (CKRS). The Overt Aggression Scale (OAS) declined from 8 to 2 with clinical improvement during follow up period. With long-term follow up (meaning 57 months) in 25 OCDs, the mean Yale Brown Obsessive Compulsive Score (YBOCS) declined from 34 to 13 (n = 25). The Hamilton Depression scale (HAMD) for ten patients with depression declined from 38.5 to 10.5 (n = 10). There was no operative mortality and no significant morbidity except one case with transient urinary incontinence. Authors suggest that stereotactic psychosurgery by RF and CKRS could be a safe and effective means of treating some medically intractable mental illnesses.
Kim, M.-C.; Lee, T.-K.
The authors report stereotactically created lesioning by radiofrequency or Cyberknife radiosurgery for patients with mental illness. Since 1993, thirty-eight patients have undergone stereotactic psychosurgery for medically intractable mental illnesses. Two patients had aggressive behavior. Twenty-five patients suffered from Obsessive-Compulsive Disorder (OCD) and ten patients had depression. Another patient suffered from atypical psychosis. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior. Limbic leucotomy or anterior cingulotomy was done for CCD and subcaudate tractotomy with or without cingulotomy was done for depression. In twenty-three patients, the lesions were made by a radiofrequency (RF) lesion generator. In fifteen cases, the lesions were made with Cyberknife Radiosurgery (CKRS). The Overt Aggression Scale (OAS) declined from 8 to 2 with clinical improvement during follow up period. With long-term follow up (meaning 57 months) in 25 OCDs, the mean Yale Brown Obsessive Compulsive Score (YBOCS) declined from 34 to 13 (n = 25). The Hamilton Depression scale (HAMD) for ten patients with depression declined from 38.5 to 10.5 (n = 10). There was no operative mortality and no significant morbidity except one case with transient urinary incontinence. Authors suggest that stereotactic psychosurgery by RF and CKRS could be a safe and effective means of treating some medically intractable mental illnesses. (author)
Mental illness is prevalent among the homeless population and the rate of mentally ill homeless individuals has increased since deinstitutionalization. There is little information about homeless population mental health and access to mental healthcare. This study sought to describe the mental health status and utilization of mental healthcare services among homeless individuals in Mississippi. This is a cross-sectional study with 3,375 adults participants. There were 58% males, 42% females, 4...
Full Text Available Mental illness is prevalent among the homeless population and the rate of mentally ill homeless individuals has increased since deinstitutionalization. There is little information about homeless population mental health and access to mental healthcare. This study sought to describe the mental health status and utilization of mental healthcare services among homeless individuals in Mississippi. This is a cross-sectional study with 3,375 adults participants. There were 58% males, 42% females, 45% Caucasian, 54% African Americans, and 1% other minorities (Asian, Indian, and Pacific Islander at intake into Mississippi United to End Homelessness' (MUTEH Homeless Management Information System (HMIS program. The data was collected during the initial screening of homeless individuals. The screening documented mental illness and utilization of healthcare. Frequency tables and Chi-SQ was used to test the relationship between mental illness and utilization of mental healthcare among the homeless in Mississippi. The result of the analysis revealed that 83% of the chronically homeless individual had a mental illness, and 78% of the chronically homeless participants were not receiving mental healthcare. Mental health services were successful in connecting mentally ill homeless individuals to mental healthcare in lieu of institutionalization. However, chronically homeless mentally ill individuals struggle with obtaining appropriate care.
Aoki, Yuta; Malcolm, Estelle; Yamaguchi, Sosei; Thornicroft, Graham; Henderson, Claire
Mass media depictions of people with mental illness have a strong influence on public attitudes, to the extent that changes in these depictions can reduce public stigmatization of people with such illness. Journalists' mental health may influence their depiction of those with mental illness, but little is known about this. To investigate mental illness among journalists in five key areas: (1) journalists' mental health status; (2) journalists' personal attitudes towards mental illness; (3) attitudes and support journalists expect or have experienced from colleagues when they have a mental health problem; (4) effect of journalism's professional culture on the course of mental illness; and (5) effect of journalism's professional culture on mass media depictions of people with mental illness. We performed a systematic screening of MEDLINE, PsycINFO, EMBASE, Web of Science and the Cochrane Library regarding the study aims. We identified 19, 12, seven and four studies for aims 1, 2, 3, and 4, respectively. No articles were found for aim 5. The prevalence of post-traumatic stress disorder (PTSD) among journalists is higher than that among the general population. Journalists have positive personal attitudes towards mental illness, but there are perceived workplace disincentives to disclose mental health problems.
Watson, Amy C.; Fulambarker, Anjali; Kondrat, David C.; Holley, Lynn C.; Kranke, Derrick; Wilkins, Brittany T.; Stromwall, Layne K.; Eack, Shaun M.
Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice…
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…
... this was quite challenging. Conclusion. The necessity for formal bodies to develop routes for collaboration between healthcare professionals and traditional healers was brought to the fore. So, too, was the need to incorporate indigenous theory and knowledge into mainstream definitions and approaches to mental illness.
This book highlights a broad range of issues on mental health and illness in large cities. It presents the epidemiology of mental disorders in cities, cultural issues of urban mental health care, and community care in large cities and urban slums. It also includes chapters on homelessness, crime...
Lawson, Andrea; Fouts, Gregory
To examine the prevalence of verbalizations about mental illness in the animated feature films of The Walt Disney Company (TWDC). We discuss the results within the context of children's repeated exposure to popular animated movies and their learning of labels and stereotypes associated with mental illness. We recommend further research on this topic. We coded 34 animated feature films produced by TWDC for mental illness references (for example, "crazy" or "nuts"). We developed a coding manual to systematize the content analysis, to ensure accuracy of the data, and to ascertain intercoder reliability. Most of the films (that is, 85%) contain verbal references to mental illness, with an average of 4.6 references per film. The references were mainly used to set apart and denigrate the characters to whom they referred. Twenty-one percent of the principal characters were referred to as mentally ill. We discuss the contributions and limitations of the study. The findings have implications for child viewers in terms of their potentially learning prejudicial attitudes and distancing behaviours toward individuals perceived as being mentally ill. To further verify this connection, an assessment of the incidence of Disney film exposure and attitudes toward people with a mental illness, using a sample of school-aged children, is needed.
Babić, Dragan; Babić, Romana; Vasilj, Ivan; Avdibegović, Esmina
The stigmatization of mentally ill patients has negative labelling, marginalization and exclusion of people simply because they have a mental illness. Stigma has negative consequences for the individual and his family, as well as for psychiatry as a profession and the entire community. Stigma weakens the mentally ill, reinforcing a sense of alienation, which has negative consequences on the course of the illness. The media can inform the public about the treatment of mentally ill patients by conveying correct information, who can then act positively towards improving the quality of treatment. Stigma and self-stigma create a feeling of low self-esteem and fear of rejection, due to which mentally ill people avoid the media and very rarely speak publicly about their illness. The realization of information rights is very delicate and it is reflected through two opposing but substantially equivalent human rights: 1. Right to information, 2. Right to privacy. Which of the two rights will get advantage depends on the circumstances of each case and journalism ethics. The relationship of psychiatry with the media and especially the media with psychiatry must be extremely correct and professional, based on facts, and not on the pursuit of media sensationalism. The media can significantly reduce the current level of stigmatization of the mentally ill by adequate and correct reports, and thereby facilitate their role in family and society. Lack of knowledge and understanding of mental illness contributes to stigmatization. Education of patients, their families and journalists is crucial if we want to better understand people with mental illness and reduce stigma.
Lamb, H R
Progress in alleviating the plight of the homeless mentally ill has been very slow and disappointing. After reviewing the needs of the homeless mentally ill, the author makes recommendations for immediate action. Extensive case management services should be implemented rather than simply discussed. All incompetent and/or dangerous or gravely disabled homeless mentally ill persons should be brought to hospitals, involuntarily if necessary. Cost-effective alternatives to hospitals with varying degrees of structure should be provided. Involuntary mechanisms such as conservatorship and outpatient commitment should be used when needed. The emphasis should be on timely transfer to acceptable treatment and living situations rather than waiting for the ideal.
Gilman, Sander L
Today electrotherapy has reappeared as a therapy of choice for the treatment of depression and other forms of mental illness. It had de facto vanished from allopathic medicine from the 1920s to the end of the century. The debates about electrotherapy mirror the question of whether mental illness was somatic and to be treated by somatic means or psychological to be treated with psychotherapy. Sigmund Freud's move from an advocate to an opponent of electrotherapy is exemplary for a shift in attitude and the decline of electrotherapy. With the re-somaticization of mental illness over the past decades has come the reappearance of somatic therapies such as electrotherapy.
S K Padhy
Full Text Available Media has a complex interrelationship with mental illnesses. This narrative review takes a look at the various ways in which media and mental illnesses interact. Relevant scientific literature and electronic databases were searched, including Pubmed and GoogleScholar, to identify studies, viewpoints and recommendations using keywords related to media and mental illnesses. This review discusses both the positive and the negative portrayals of mental illnesses through the media. The portrayal of mental health professionals and psychiatric treatment is also discussed. The theories explaining the relationship of how media influences the attitudes and behavior are discussed. Media has also been suggested to be a risk factor for the genesis or exacerbation of mental illnesses like eating disorders and substance use disorders. The potential use of media to understand the psychopathology and plight of those with psychiatric disorders is referred to. The manner in which media can be used as a tool for change to reduce the stigma surrounding mental illnesses is explored.
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…
Gilman, Sander L.
Abstract Today electrotherapy has reappeared as a therapy of choice for the treatment of depression and other forms of mental illness. It had de facto vanished from allopathic medicine from the 1920s to the end of the century. The debates about electrotherapy mirror the question of whether mental illness was somatic and to be treated by somatic means or psychological to be treated with psychotherapy. Sigmund Freud's move from an advocate to an opponent of electrothera...
Women are particularly vulnerable in the peripartum period for either developing a mental illness or suffering symptom exacerbation. These illnesses are often experienced covertly, however, and women may not seek out professional help, even though their symptoms may be seriously affecting their well-being and parenting. This article provides an…
Thoits, Peggy A.
The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mental illness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions…
An indication of the failure of the mental health system in this country is reflected in the increasingly visible homeless population, many of whom suffer from some form of untreated mental illness. Public policy priorities have shifted from proactive, treatment-oriented policies to reactive, punitive institutionalization. The…
Purpose: Mental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies…
Eliany Nazaré Oliveira; Maria Salete Bessa Jorge
The reflection tries to make explicit the existing interfaces between violence and mental illness, more specifically, inwomen experiencing daily mistreatment. Violence weakens women’s mental health. Psychological consequences of abuse are even more serious than their physical effects. Abuse suffering often destroys woman’s self esteem and exposes her to much higher risk of suffering mental disorders, including depression, post-traumatic stress, tendency towards suicide and consumption of drug...
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…
Aggarwal, Anuj K.; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H.
Objectives: Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us…
National Association of State Mental Health Program Directors, Washington, DC.
Reported were the results of a survey on the sterilization of the mentally ill and the mentally retarded. Thirty-three states responded to the survey. It was found that 17 states have a sterilization statute, but the existence of the statute was explained not to mean that the procedure was used. Sixteen states responded that they did not have a…
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. PsycINFO Database Record (c) 2013 APA, all
This book highlights a broad range of issues on mental health and illness in large cities. It presents the epidemiology of mental disorders in cities, cultural issues of urban mental health care, and community care in large cities and urban slums. It also includes chapters on homelessness, crime...... and racism - problems that are increasingly prevalent in many cities world wide. Finally, it looks at the increasing challenges of mental disorders in rapidly growing cities. The book is aimed at an international audience and includes contributions from clinicians and researchers worldwide....
Vendsborg, Per; Nordentoft, Merete; Lindhardt, Anne
Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care...... or social care. The myth of dangerousness is out of proportion and the media is to blame as they most often mention persons with mental illnesses as dangerous. Many countries make a great effort to reduce stigma and this is also under planning in Denmark.......Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care...
Bandana Pokharel; Anupama Pokharel
Introduction: Social support is the perception that one is cared for, has assistance available from significant others and its benefit is by buffering stress by influencing the ability to adjust and live with illness. Social support can uplift the quality and subjective wellbeing of people. The objective of this study was to examine the perceived social support and factors influencing it among mentally ill patients. Methods: A descriptive cross-sectional study was carried out. Ninety cas...
Vendsborg, Per; Nordentoft, Merete; Lindhardt, Anne
Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care...... or social care. The myth of dangerousness is out of proportion and the media is to blame as they most often mention persons with mental illnesses as dangerous. Many countries make a great effort to reduce stigma and this is also under planning in Denmark....
Schaefer, Nicole J.; Stefancic, Ana
Mentally ill offenders represent a substantial proportion of jail and prison inmates. Despite the fact that confining mentally ill offenders can and often will exacerbate their mental illness, the quality of mental health services available to them remains poor and insufficient. Up to date, only a few cities and counties have considered a more…
Rowe, David C.; Elam, Patricia
Siblings are far more likely to be different than alike in personality and psychopathology. Different genes and different environmental experiences can account for why one sibling becomes mentally ill and another is not affected. Environmental experiences play a much greater role in sibling differentiation than has been previously recognized.…
Rife, J C; First, R J; Greenlee, R W; Miller, L D; Feichter, M A
This article reports the findings of a National Institute of Mental Health (NIMH) services demonstration project that used a mobile case management team to serve homeless mentally ill clients. The project examined three issues: (1) factors associated with client engagement in case management, (2) clients' perceptions of how case management affected their quality of life, and (3) significant differences between clients who remained engaged in case management services and those who discontinued involvement. The results indicated that clients who received more frequent case management contact, had higher assessed independent living skills, were older, were less likely to be substance abusers, and had experienced fewer periods of homelessness and fewer prior psychiatric hospitalizations were more likely to remain engaged in case management services. After six months of case management, clients perceived significant improvement in their global well-being, living situation, use of leisure time, finances, and physical health. Implications for providing case management services to homeless mentally ill people are presented.
Aggarwal, Anuj K; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H
Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us (MIAU)," would reduce stigma of mental illness. In 2010 and 2011, students completed voluntary pre- and post-MIAU surveys measuring attitudes regarding mental illness in relation to MIAU. Also, in 2011, the authors categorized topics mentioned in student responses to an open-ended, free-response question on the course final examination. Of 298 enrolled students, 250 submitted surveys that were matched pre- and post-intervention. Participants in the curriculum showed a significant difference in Social Distance, indicating an increased willingness to interact with individuals with mental illness, and a significant difference in the Mental Illness: Clinicians' Attitudes (MICA) score representing a stronger agreement with positive statements regarding mental illness. The non-participants' scores showed no changes in measures from pre- to post. Respondents most frequently reported that the neuroscience course prepared them to be a physician because it taught about compassion and the importance of treating the whole patient. The results indicate that participation in MIAU leads to a decrease in stigmatization of mental illness and a greater sense of compassion among UCSF medical students. This finding is consistent with previous research suggesting social and cognitive congruence among peers and peer-teachers can result in meaningful learning experiences. MIAU may represent a sustainable model to supplement current systems to promote well-being of medical trainees.
Kidd, Jacquie Dianne; Finlayson, Mary P
Many nurses are burned out, exhausted and have a high intent to leave their jobs. These factors, when experienced over a period of time, are consistent with the development of mental illness. This study takes a collective autoethnographical approach to mental illness in the nursing workplace by focusing on the stories of nurses who have experienced mental illness in clinical practice. It highlights three ways in which nursing and mental illness are connected; the nurse who is vulnerable to mental illness prior to entering the profession, the nurse who develops mental illness that is independent of her work but is nevertheless impacted by it, and the nurse who develops mental illness as a result of her work and/or role. This paper explores the hyphenated lives and bullying these nurses experience, and recommends strategies that the profession, employing organisations, and individuals can adopt to reduce nurses' progression from stress to distress and mental illness.
, the Act's statutory requirements relating to the informed consent to participation in clinical research by mentally ill children and adolescents in South Africa are examined. The necessity of doing clinical research in mentally ill children and ...
Reviews the history of the problem of deinstitutionalization of the mentally ill to community settings, outlines characteristics of the homeless mentally ill, and discusses steps to create a more responsive clinical network to cope with the problem. (Author/KS)
Objectives: To determine the prevalence and sociodemographic correlates for mental illness among inmates at Lusaka Central Prison, Zambia. Design: Cross sectional study. Main outcome measure: Mental illness. Results: Of the 206 inmates in Lusaka, 63.1% had current mental illness. Among the factors considered in the ...
Corrigan, Patrick W
Two approaches have emerged to deal with the stigma of mental illness: normalcy, where people with mental illness are framed as 'just like everyone else'; and solidarity, where the public agrees to stand with those with mental illness regardless of their symptoms. Pros and cons of each approach are considered. © The Royal College of Psychiatrists 2016.
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.
Knaak, Stephanie; Mantler, Ed; Szeto, Andrew
Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-b...
In the wake of the Stoneman Douglas School shooting, Republican and Democratic leaders-like the American electorate they represent-remain sharply divided in their responses to gun violence. They are united in their condemnation of these mass shootings, but they disagree about whether stricter or looser gun control laws are the answer. Those on the right side of the political aisle suggest that the issue is one of mental illness rather than gun control. Conversely, those who are more liberal or progressive in their political learnings are quick to condemn attempts to reframe the issue of mass shootings as a mental health problem. Both sides are wrong. Mass shootings are indeed partially a mental health problem, albeit one poorly addressed by our current laws and policies. But the solution to mass shootings also needs to consider strategies that may reduce gun violence in general. © 2018 The Hastings Center.
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.
Frazier, S H
The homeless mentally ill represent a pivotal and urgent challenge to the mental health field in the 1980s. Those homeless who have extended histories of psychiatric hospitalization stand as harsh reminders of the failures of deinstitutionalization, while young mentally ill homeless adults who never have been treated as inpatients testify to the gaps and unrealized promises of community-based care under deinstitutionalization. Homelessness and mental illness are social and clinical problems, ...
North, C S; Smith, E M; Pollio, D E; Spitznagel, E L
The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is
Benders-Hadi, Nikole; Barber, Mary; Alexander, Mary Jane
This study aimed to determine the prevalence of motherhood among inpatient females at a large state psychiatric hospital in suburban New York, as well as develop an understanding of the characteristics and needs of this unique population. Data on motherhood status was gathered from October 2010 through April 2011 via medical records. Data on custody status, frequency of contacts with children, and effect of mental illness on parenting was assessed through patient surveys and focus groups. 38.5 % of female inpatients were found to be mothers, almost half of whom reported at least weekly contact with children despite their inpatient status. The majority of identified mothers reported having maintained custody of their minor children and expressed great pride at being primary caretakers for their children, yet also emphasized the challenging effects of stigma associated with mental illness and parenting. A significant proportion of women at this psychiatric hospital were found to be mothers. Although acknowledged by some clinicians at the individual level, motherhood appears to remain a forgotten role systemically. Determining motherhood status and recognizing the varied roles our patients have is one more way mental health providers can model and promote recovery-oriented care.
Fletcher, Richard J; Maharaj, O'Neil N; Fletcher Watson, Chloe H; May, Chris; Skeates, Nigel; Gruenert, Stefan
A significant proportion of fathers living with their natural, adopted, step or foster children experience mental illness. Psychiatric illness among fathers can have a devastating impact on children's wellbeing, and even milder forms of paternal mental illness can have serious developmental effects on children. While several pathways linking paternal mental illness with poor child outcomes have been identified, fathers' impaired parenting is an important, potentially malleable factor. Clinicians can assist fathers with mental illness and their families by proactively inquiring about children and by exploring fathering-focused psychological support.
illness are widespread among the general public. However, little is known about the attitudes of undergraduates to mental illness. Purpose. To compare the attitudes towards mental illness among undergraduates enrolled in nursing courses v. those enrolled in Bachelor of Business Management (BBM) courses. Methods.
Sangeeta, S J; Mathew, K J
Understanding and perceptions about mental illness vary among individuals based on their experience with the illness or their contact with the people affected by it. These may be further influenced by the individuals' sociocultural background. This study aimed to understand the differences in the beliefs about, understanding of, and explanations for mental illness between different population groups of Jharkhand, India. During July 2014 to February 2016, we recruited the following 3 groups of individuals aged between 18 and 60 years: individuals with mental illness (group 1, n = 240), relatives of individuals with mental illness (group 2, n = 240), and the general public (group 3, n = 240). Qualitative and quantitative findings were combined in this study, and participants were asked about their beliefs about, understanding of, and explanations about mental illness. Individuals with mental illness and their relatives shared similar beliefs whereas the general public held a different opinion in various domains. There were significant differences among all groups in their understanding of various aspects of mental illnesses including the definition, causes, signs and symptoms, treatment, and outcomes. Individuals' perception towards different aspects of mental illness varies, despite they are sharing the same sociocultural milieu. Differences in beliefs, understanding, and explanations may lead to conflicts in treatment goals and expectations, and hamper the intervention strategies that promote mental health and patient care. Focused strategies to develop uniformity in beliefs and explanations about various aspects of mental illness may help to develop collaboration with different community groups that may in turn help in developing effective interventions and treatment.
Frierson, Richard L; Boyd, Mary S; Harper, Angela
As the number of state mental hospital beds declines, persons with persistent mental illness are increasingly encountered by those working in the legal system. Attorneys may have little experience in working with this population. This research involved a 32-item written survey of the 492 members of the criminal bar in South Carolina. Demographic variables were surveyed, and attorneys were asked to define two common terms describing mental illnesses (delusion and psychosis) and the legal criteria for verdicts of not guilty by reason of insanity and guilty but mentally ill. They were also asked to identify the most severe mental illness (schizophrenia). Attitudes about these verdicts and about working with defendants who are mentally ill were also surveyed. Results indicate that attorneys are fairly knowledgeable about mental illness, but not verdicts involving mental illness, particularly the verdict of guilty but mentally ill. Most attorneys prefer to work with clients who do not have mental illness. However, as they become more experienced interacting with defendants who are affected by mental illness, they become more knowledgeable and are more willing to defend them. A large majority believe that their law school education about mental illness was inadequate. When comparing attorney occupations, public defenders were the most knowledgeable about mental illness and mental health defenses, followed by prosecutors and private defense attorneys. Judges were the least knowledgeable group. © 2015 American Academy of Psychiatry and the Law.
Ramasubramanian, Chellamuthu; Mohandoss, Anusa Arunachalam; Namasivayam, Rajesh Kannan
The employment status of mentally ill patients is a reflection of their productivity, control of illness besides providing therapeutic benefits and integration into mainstream society. Owing to the associated stigma, self-reporting of mental illness (SRMI) often is rare. Census exercise of India in 2011 provides an insight of SRMI and employment status of such people. This study was undertaken to consider the role of gender, age group, and place on the employment status of SRMI. Frequency of SRMI, age group, gender, and employment status was gathered from Indian 2011 census sources. Descriptive statistics and logistic regression were employed. P ≤ 0.05 was taken as significant. Majority (68.6%) of the SRMI people resides in rural areas, in the economically productive age group of 15-59 years (75.88%) and often males (57.51%). Of the SRMI as reported in the data, 78.62% were not employed while 2.4% of them were currently employed. The employability frequency distributions of SMRIs were statistically different in terms of area, age group, and gender with significance. Although the mental illness data of 2011 census was rejected by mental health professionals citing discrepancy and underestimating of the prevalence of mental illness, it provides a robust estimate of the employability, self-reporting tendency of mental illness. The association of the factors provides a unique insight into SRMIs in India. Understanding the interplay of factors may yield robust estimates and clues for policy framers to formulate employment-related policies for employment opportunities for mentally ill patients.
Full Text Available Introduction: The employment status of mentally ill patients is a reflection of their productivity, control of illness besides providing therapeutic benefits and integration into mainstream society. Owing to the associated stigma, self-reporting of mental illness (SRMI often is rare. Census exercise of India in 2011 provides an insight of SRMI and employment status of such people. This study was undertaken to consider the role of gender, age group, and place on the employment status of SRMI. Methodology: Frequency of SRMI, age group, gender, and employment status was gathered from Indian 2011 census sources. Descriptive statistics and logistic regression were employed. P≤ 0.05 was taken as significant. Results: Majority (68.6% of the SRMI people resides in rural areas, in the economically productive age group of 15–59 years (75.88% and often males (57.51%. Of the SRMI as reported in the data, 78.62% were not employed while 2.4% of them were currently employed. The employability frequency distributions of SMRIs were statistically different in terms of area, age group, and gender with significance. Discussion: Although the mental illness data of 2011 census was rejected by mental health professionals citing discrepancy and underestimating of the prevalence of mental illness, it provides a robust estimate of the employability, self-reporting tendency of mental illness. The association of the factors provides a unique insight into SRMIs in India. Conclusion: Understanding the interplay of factors may yield robust estimates and clues for policy framers to formulate employment-related policies for employment opportunities for mentally ill patients.
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…
Maranzan, K. Amanda
A number of initiatives are aimed at reducing mental illness stigma, yet stigma remains a problem in the general population. A focus on stigma reduction with students is particularly relevant, as students often hold negative attitudes toward mental illness, have regular contact with persons experiencing mental health difficulties, and because…
Background. Mental health literacy on the part of medical practitioners is an important component of mental healthcare. General practitioners (GPs) are typically the first doctors consulted by a person who is ill. Exploration of their perceptions regarding mental illness, aetiological issues and treatment is important. Objective.
Belcher, John R.
Studied homeless mentally ill patients who had been released into the community. Discusses mentally ill clients' rights to self-determination versus immediate survival needs and the potential mental restoration that could be provided through commitment to a psychiatric hospital. Presents two case studies. (Author/ABL)
Corrigan, Patrick W.
Stigma can greatly exacerbate the experience of mental illness. Diagnostic classification frequently used by clinical social workers may intensify this stigma by enhancing the public's sense of "groupness" and "differentness" when perceiving people with mental illness. The homogeneity assumed by stereotypes may lead mental health professionals and…
Moulden, Heather M; Marshall, Liam E
There is evidence showing an increasing prevalence of mental illness in those in conflict with the law. However, there are many factors affecting the detection, treatment, and management of criminals who are mentally ill. Sex offenders with major mental illness present many challenges to those providing treatment and management services. For example, it is important to consider whether sexually offensive behavior is the cause of criminal behavior or whether it is reflective of an antisocial orientation. Recent evidence suggests it may help better understand and inform risk assessment and management. This paper will review the literature on mental illness among sexual offenders, present a typology to aid in the assessment, treatment, and management of sexual offender with mental illness, and highlight important considerations when providing treatment to sexual offenders with mental illness.
Frazier, S H
The homeless mentally ill represent a pivotal and urgent challenge to the mental health field in the 1980s. Those homeless who have extended histories of psychiatric hospitalization stand as harsh reminders of the failures of deinstitutionalization, while young mentally ill homeless adults who never have been treated as inpatients testify to the gaps and unrealized promises of community-based care under deinstitutionalization. Homelessness and mental illness are social and clinical problems, respectively, distinct in some ways but intertwined in others. Some of the factors that contribute to homelessness--such as economic deprivations, a dearth of low-cost housing, discontinuities in social service systems, and radical changes in the composition of American families--are felt particularly keenly by many persons who are mentally ill. And symptoms of mental disorders, in turn, frequently impede an individual's capacities to cope with those, as well as other, stressors. Developing appropriate and effective responses to the needs of homeless people who are mentally ill requires precise definition and identification of the target population, innovations in the mental health service system, encouragement of those who staff it to work with homeless mentally ill patients, and public education. Ultimately, however, fundamental answers will be found in an improved understanding of severe mental illness, enhanced treatment capacities, and greater attention to the rehabilitative needs of mentally ill persons.
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.
Richter, D; Hoffmann, H
People with severe mental illness (SMI) have a high risk of living socially excluded from the mainstream society. Policy initiatives and health systems aim to improve the social situation of people who suffer from mental health disabilities. The aim of this study was to explore the extent of social exclusion (employment and income, social network and social activities, health problems) of people with SMI in Switzerland. Data from the Swiss Health Survey 2012 were used to compare the social exclusion magnitude of people with SMI with those suffering from severe physical illness, common mental illness and the general population. With the exception of Instrumental Activities of Daily Living, we found a gradient of social exclusion that showed people with SMI to be more excluded than the comparison groups. Loneliness and poverty were widespread among people with SMI. Logistic regression analyses on each individual exclusion indicator revealed that people with SMI and people with severe physical illness were similarly excluded on many indicators, whereas people with common mental illness and the general population were much more socially included. In contrast to political and health system goals, many people with SMI suffer from social exclusion. Social policy and clinical support should increase the efforts to counter exclusionary trends, especially in terms of loneliness and poverty.
Peterson, A L
WHAT IS KNOWN ON THE SUBJECT?: Stigma involves connecting individuals with a particular label to negative characteristics; this is based not on the stigmatized condition itself, but cultural reactions to it. Stigma exists towards nurses with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a first-person account of experiencing stigma as a nurse with a mental illness. This paper incorporates the existing literature to offer a broader cultural perspective on the experiences of a nurse with a mental illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses are likely to encounter a nurse with a mental illness at some point in their practice. Nurses' reactions towards colleagues with mental illness can have significant implications for those colleague(s)' wellbeing. Nurses with mental illness will have to navigate their person and professional journey while giving consideration to the attitudes of their nursing peers and leaders. Limited research has been done on the stigma faced by nurses with mental illness from their nursing peers. Mental illness is not generally considered acceptable within the context of nursing culture, so when nurses do experience mental illness, their experiences in a professional context may be influenced by stereotypes, particularly those relating to dangerousness. Using autoethnography as a research method, the author examines her own subjective experiences of stigma as a nurse with a mental illness, and draws upon existing literature on stigma, deviance and the phenomenon of mental illness in nurses to analyse broader cultural implications for nursing. Assessment of suitability to return to work arises throughout the narratives, and consideration is given to the way that risk assessment by nursing leaders is impacted by negative stereotypes that surround mental illness. © 2017 John Wiley & Sons Ltd.
Seidman, L J; Caplan, B B; Tolomiczenko, G S; Turner, W M; Penk, W E; Schutt, R K; Goldfinger, S M
Because little data are available on the neuropsychological functioning of severely and persistently mentally ill (SPMI) persons who are homeless, our primary goal was to describe accurately and extensively the general neuropsychological functioning of a large group of such homeless individuals. In addition, we have sought to examine the relationship between some neuropsychological functions and demographic, illness, and clinical state measures in this population. A 5-hour neuropsychological test battery was administered to 116 SPMI homeless individuals. Neuropsychological, diagnostic, substance abuse, clinical, and psychopathology data were obtained in a standardized manner. SPMI homeless individuals were significantly impaired on a wide range of neuropsychological functions. Specific test performances were most significantly related to precursor variables (level of education and parental socioeconomic status) and state variables (level of psychosis and anticholinergic medication dose). Gender and substance abuse had significant effects limited to sustained attention. Neuropsychological performance was impaired in this sample of homeless SPMI persons. Further research, using profile analysis to directly compare groups composed of homeless persons without psychiatric illness or demographically matched persons of comparable psychiatric status who are not homeless will help clarify the role of homelessness and psychosis on neuropsychological function.
Filipa Alexandra Lourenço Campos
Full Text Available Background Peer support is a mutual aid system based on the belief that someone who faced/overcome adversity can provide support, encouragement and guidance to those who experience similar situations. Objective To conduct a systematic review that describes this concept and characterizes peer supporters, its practice and efficacy. Method Research on ISI Web of Science, EBSCO Psychology and Behavioral Sciences Collection and Medline databases (from 2001 to December 2013 was conducted using as keywords “mental illness”, “mental health”, “psychiatric disability”, “mental health services”, combined with “peer support”, “mutual support”, “self-help groups”, “consumers as providers”, “peer-run services”, “peer-run programs” and “social support”. Results We found 1,566 articles and the application of both the exclusion (studies with children, teenagers and elderly people; disease in comorbidity; peer support associated to physical illnesses or family members/caregivers and the inclusion criteria (full text scientific papers, peer support or similar groups directed for schizophrenia, depression, bipolar or psychotic disorders lead to 165 documents, where 22 were excluded due to repetition and 31 to incomplete text. We analyzed 112 documents, identifying as main peer support categories: characterization, peer supporter, practices and efficacy. Discussion Despite an increasing interest about this topic, there is no consensus, suggesting realizing more studies.
Stefanovics, Elina A; He, Hongbo; Cavalcanti, Maria; Neto, Helio; Ofori-Atta, Angelo; Leddy, Meaghan; Ighodaro, Adesuwa; Rosenheck, Robert
This study examines the intercorrelation of measures reflecting beliefs about and attitudes toward people with mental illness in a sample of health professionals (N = 902) from five countries: Brazil, China, Ghana, Nigeria, and the United States, and, more specifically, the association of beliefs in supernatural as contrasted with biopsychosocial causes of mental illness. Factor analysis of a 43-item questionnaire identified four factors favoring a) socializing with people with mental illness; b) normalizing their roles in society; c) belief in supernatural causes of mental illness (e.g., witchcraft, curses); and d) belief in biopsychosocial causes of mental illness. Unexpectedly, a hypothesized negative association between belief in supernatural and biopsychosocial causation of mental illness was not found. Belief in the biopsychosocial causation was weakly associated with less stigmatized attitudes towards socializing and normalized roles.
Yanos, Philip T; Roe, David; Lysaker, Paul H
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 driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.
Full Text Available The work of early pioneers like Dorothea Dix was instrumental in the establishment of institutions dedicated especially for the care of the mentally ill. Originally from the United States, she became acquainted with the idea of humane treatment of the mentally ill during her visit to England. After her return to the United States, she conducted a statewide investigation of care for the insane poor in Massachusetts and began to extensively lobby for reforms and establishment of more state-funded institutions for the care of mentally ill. Her efforts led to setting up of several mental health institutions, which became the cornerstone of care of psychiatrically ill, and for training of mental health care providers. Though subsequently, the hegemony of the institutions was challenged, and the era of deinstitutionalization was ushered in, the work of Dorothea Dix is important as it vouched for humane care of patients with mental illnesses.
Drury, Lin J
This qualitative longitudinal study documents the experiences of 60 people who are homeless and mentally ill from their state mental hospital discharge through their first two years in community housing. The study explores the personal, cultural, and environmental contexts of life for adults who are homeless and mentally ill and examines the interaction between an individual's needs and community resources. The research identifies forces that perpetuate homelessness and traces the struggles that people who are homeless and mentally ill encounter during the transition from the streets to stable housing. The findings describe a culturally based pattern of mutual avoidance between homeless mentally ill clients and caregivers, which limits delivery of services to the population. Recommendations include development of alternative systems of care delivery, expansion of educational experiences with underserved populations, and increased funding for service or research with people who are homeless and mentally ill.
Ecker, John; Cherner, Rebecca; Rae, Jennifer; Czechowski, Konrad
The current article reviews the literature on sexuality among individuals with a severe mental illness (SMI) who have experienced homelessness, a topic that has received little attention in the research literature, particularly from a community psychology perspective. The review begins with a synthesis of the literature on SMI and sexuality, followed by a review of the available literature on SMI, homelessness, and sexuality. It concludes with an interpretation of the findings using community psychology values and principles. The findings highlight the importance of intimate relationships to recovery for many individuals with an SMI who have experienced homelessness. Policy implications for homeless shelters and housing interventions are discussed. © Society for Community Research and Action 2017.
Lêda Maria de Vargas Rebello
Full Text Available Com base em uma reportagem publicada recentemente sobre a tríade seca/fome/doença mental, cuja idéia central é a de que a miséria decorrente possa estar provocando distúrbios comportamentais na população nordestina atingida, buscamos refletir sobre o que essa suposta 'loucura' poderia estar representando para esse grupo de pessoas. Procuramos fazer uma leitura que envolvesse várias disciplinas e que ultrapassasse as explicações meramente causais, levando em conta que os transtornos relatados teriam significação a partir da articulação de elementos cognitivos, afetivos e experienciais, calcados nas relações sociais e culturais dos indivíduos. Nessa perspectiva, o discurso vai assumindo outras interpretações, mostrando que a enfermidade é um processo singular de construção.Based on a recently-published article on the triad of drought, hunger, and mental illness, in which the main idea is that destitution may be leading to behavioral disorders in the drought-plagued population of the Brazilian Northeast, we reflect on what this so-called "madness" may represent for this group of people. We attempt to analyze the issue from various disciplinary perspectives, going beyond merely causal explanations and taking into account that the reported disorders entail meanings following the articulation of cognitive, affective, and experiential elements founded on the social and cultural relations of individuals. From this point of view, the respective discourse assumes other interpretations, showing that illness is a singular process of construction.
Larkings, Josephine S; Brown, Patricia M
Viewing mental illness as an 'illness like any other' and promoting biogenetic causes have been explored as a stigma-reduction strategy. The relationship between causal beliefs and mental illness stigma has been researched extensively in the general public, but has gained less attention in more clinically-relevant populations (i.e. people with mental illness and mental health professionals). A systematic review examining whether endorsing biogenetic causes decreases mental illness stigma in people with mental illness and mental health professionals was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Multiple databases were searched, and studies that explored the relationship between biogenetic causal beliefs and mental illness stigma in people with mental illness or mental health professionals were considered. Studies were included if they focussed on depression, schizophrenia, or mental illness in general, were in English, and had adult participants. The search identified 11 journal articles reporting on 15 studies, which were included in this review. Of these, only two provided evidence that endorsing biogenetic causes was associated with less mental illness stigma in people with mental illness or mental health professionals. The majority of studies in the present review (n = 10) found that biogenetic causal beliefs were associated with increased stigma or negative attitudes towards mental illness. The present review highlights the lack of research exploring the impacts of endorsing biogenetic causes in people with mental illness and mental health professionals. Clinical implications associated with these results are discussed, and suggestions are made for further research that examines the relationship between causal beliefs and treatment variables. © 2017 Australian College of Mental Health Nurses Inc.
Millner, Uma Chandrika; Rogers, Erna Sally; Bloch, Philippe; Costa, William; Pritchett, Sharon; Woods, Tracy
Current vocational services for adults with serious mental illness remain largely atheoretical and disconnected from mainstream vocational psychology research and practice. This study explored the perspectives on work of adults with serious mental illness, compared perspectives of young and older adults, and assessed these perspectives for the applicability of a well-established theory of vocational psychology. A national sample of 76 individuals with mental illness engaged in the workforce completed a semistructured questionnaire. We applied the principles of a participatory approach to consensual qualitative research methodology in the study design and data analysis. Results yielded a large number of categories, which clustered under domains representative of the primary constructs of social cognitive career theory (SCCT; Lent, 2013). These domains included the antecedents of self-efficacy, namely, personal accomplishments, vicarious learning, social persuasion, and physical or emotional states as well as additional constructs of outcome expectations, personal goals, and contextual barriers. The SCCT model will likely provide a useful framework to bridge the gap between career development theory and vocational services for individuals with mental illness. (c) 2015 APA, all rights reserved).
The study revealed that there were significant differences between men and women in the perception of mental illness. Stigmatisation and gender discrimination among People Living with Mental Illness (PLWMI) should be eradicated through government actions, advocacy and education. Keywords: Gender differentials ...
Background: Success in the treatment of the mentally-ill is suggested by patient's level of functioning. This study is to determine the highest overall level of functioning among the mentally-ill patients on follow-up at the University of Benin Teaching Hospital. Methods: Patients were picked consecutively as they presented at ...
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.…
Derby, John K.
This dissertation critically examines mental illness discourses through the intersecting disciplinary lenses of art education and disability studies. Research from multiple disciplines is compared and theorized to uncover the ways in which discourses, or language systems, have oppressively constructed and represented "mental illness." To establish…
Results: Of 387 respondents, 60.2% had diagnosable current mental illness and 16.3% had had one disorder in their lifetime. Of the diagnosable current mental illnesses, 29.7% were Psychosis; 5.4% Major depressive episode; 5.6% Anxiety disorders; 3.6% mixed. Anxiety-Depression; and 3.9% Suicidality. In terms of ...
Markos, Patricia A.; Baron, Heather Lyn; Allen, Daniel N.
This article describes a unique population within the homeless community--women who are homeless and mentally ill. Homelessness prevalence and etiology data are presented, followed by a general discussion of how mental illness affects people who are homeless. The article provides an overview of women who are homeless, focusing on those who are…
The study found that factors like heredity, witchcraft, sorcery and disregard of cultural norms were found to be some of the causes of mental illness. In some cases, mental illness was interpreted as an invitation to some people by their ancestors to become traditional healers. The study also found that traditional healers follow ...
stating that mentally ill individuals should not have children in order to avoid heredity handicaps, with which a lower percentage agreed. Conclusions Poor knowledge and stigmatization of mental illness still exist among undergraduate students in Nigeria. While exposure to a course in abnormal psychology was effective in ...
Objective: There is no documented evidence in Kenya on relatives' perceptions of economic and behavioural effects of the mentally ill patients and their coping mechanisms. To document what relatives of mentally ill patients perceive to be the economic effects of the patients on the family and how they are affected by and ...
Workman Arts, a Toronto-based theatre and visual arts company with a 20-year history, provides a rich site for re-imagining stigmatised representations of mental illness. Writing and performing against a long tradition of representing people with mental illnesses as incoherent speakers and visually different, company members seek to re-imagine…
Objective: Public attitudes toward mental illness in two widely disparate cultures, Canada and Cameroon, were compared using ... Method: 120 respondents rated POSHA–MI(e) items relating to mental illness on 1-9 equal appearing interval scales: 30 in English ... sacrificing, perhaps, some of the face validity inherent in.
The demographic form elicited information on five aspects of the participants' background: age, family's monthly income, place of residence, and history of personal contact with mental illness. Questionnaires. The Attitude Scale for Mental Illness (ASMI) is a valid and reliable self-report that measures respondents' ...
In this paper I provide an account of the metaphysical foundations of mental illness in terms of a realism debate. I motivate the importance of such metaphysical analysis as a means of avoiding some intractable problems that beset discussion of the concept of mental illness. I apply aspects of the framework developed by ...
Witteman, C.L.M.; Bolks, L.; Hutschemaekers, G.J.M.
Background: It has been suggested that illness perceptions in mental health are related to treatment outcomes. Aims: We aimed to develop a short generic questionnaire to assess clients' problem perceptions in mental health, congruent with the Illness Perception Questionnaire (IPQ) for somatic
Bhumika T Venkatesh
Full Text Available Background: Stigma associated with mental illnesses is one of the principal causes for mentally ill people not receiving adequate mental health care and treatment. The study was conducted to assess the extent of stigma associated with mental illness and knowledge of mental illness among the community. Materials and Methods: Community-based, cross-sectional study was conducted among 445 respondents from Udupi district; the community attitude toward the mentally ill (CAMI scale was used to assess stigma. The probability proportional to sampling size technique was adopted to select the wards/blocks. Household from blocks/wards were selected using convenience sampling. Self- administered semi-structured questionnaire was used to collect the information. Data was analyzed using the software SPSS version 15. Results: Of the total 445 respondents, the prevalence of stigma toward mentally ill people was 74.61% (95% confidence interval, 0.7057, 0.7866. The prevalence of stigma was high under all the four domains of CAMI scale. High prevalence of stigma was seen among females and people with higher income. Conclusions: The overall prevalence of stigma toward PWMI was found to be high. The stigma toward PWMI was associated with gender with respect to AU, BE and CMHI. Hence, the study suggests that there is a strong need to eliminate stigma associated with mental illness to improve the mental health status of the region.
Oranye, Nelson Ositadimma; Arumugam, Utharas; Ahmad, Nora; Arumugam, Marian E
Introductio n: In Malaysia, nurses form a significant part of the clinical mental health team, but the current level of training in mental health results in suboptimal nursing care delivery. For this study 220 registered nurses and medical assistants working with the mentally ill completed a structured questionnaire. The purpose of this study was to explore perceived competence in mental healthcare and the training needs of nurses working with mentally ill patients in inpatient mental healthcare facilities. The skills perceived as important for practicing in mental health varied among the nurse participants. Post basic training in mental health was significantly related to perceived competence in patient mental state assessment (p=0.036), risk assessment for suicide (p=0.024), violence (p=0.044) and self-harm (p=0.013). There is little emphasis on psychosocial skills in current post basic mental health training in Malaysia.
Adjorlolo, Samuel; Abdul-Nasiru, Inusah; Chan, Heng Choon Oliver; Bambi, Laryea Efua
Mental health professionals' attitudes toward offenders with mental illness have significant implications for the quality of care and treatment rendered, making it imperative for these professionals to be aware of their attitudes. Yet, this topical issue has received little research attention. Consequently, the present study investigates attitudes toward offenders with mental illness (insanity acquittees) in a sample of 113 registered mental health nurses in Ghana. Using a cross-sectional survey and self-report methodology, the participants respond to measures of attitudes toward offenders with mental illness, attitudes toward mental illness, conviction proneness, and criminal blameworthiness. The results show that mental health nurses who reportedly practiced for a longer duration (6 years and above) were more likely to be unsympathetic, while the male nurses who were aged 30 years and above were more likely to hold offenders with mental illness strictly liable for their offenses. Importantly, the nurses' scores in conviction proneness and criminal blameworthiness significantly predict negative attitudes toward the offenders even after controlling for their attitudes toward mental illness. Yet, when the nurses' conviction proneness and criminal blameworthiness were held constant, their attitudes toward mental illness failed to predict attitudes toward the offenders. This initial finding implies that the nurses' views regarding criminal blameworthiness and conviction may be more influential in understanding their attitudes toward offenders with mental illness relative to their attitudes toward mental illness.
Doran, Christopher M; Kinchin, Irina
Objective To examine the impact and cost associated with mental illness. Methods A rapid review of the literature from Australia, New Zealand, UK and Canada was undertaken. The review included literature pertaining to the cost-of-illness and impact of mental illness as well as any modelling studies. Included studies were categorised according to impact on education, labour force engagement, earlier retirement or welfare dependency. The well-accepted Drummond 10-point economic appraisal checklist was used to assess the quality of the studies. Results A total of 45 methodologically diverse studies were included. The studies highlight the significant burden mental illness places on all facets of society, including individuals, families, workplaces and the wider economy. Mental illness results in a greater chance of leaving school early, a lower probability of gaining full-time employment and a reduced quality of life. Research from Canada suggests that the total economic costs associated with mental illness will increase six-fold over the next 30 years with costs likely to exceed A$2.8 trillion (based on 2015 Australian dollars). Conclusions Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions. What is known about the topic? Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy. What does this paper add? This review provides a summary of the economic impact and cost of mental illness. The included literature highlights the significant burden mental illness places on individuals, families, workplaces, society and the economy in general. The review identified several areas for improvement. For example, only
National Institute of Mental Health (NIMH), 2009
Research shows that half of all lifetime cases of mental illness begin by age 14. Scientists are discovering that changes in the body leading to mental illness may start much earlier, before any symptoms appear. Through greater understanding of when and how fast specific areas of children's brains develop, we are learning more about the early…
This 60 second public service announcement is based on the February 2013 CDC Vital Signs report, which shows that cigarette smoking is a serious problem among adults with mental illness. More needs to be done to help adults with mental illness quit smoking and make mental health facilities tobacco-free. Created: 2/5/2013 by Centers for Disease Control and Prevention (CDC). Date Released: 2/5/2013.
McCloughen, Andrea; Foster, Kim; Marabong, Nikka; Miu, David; Fethney, Judith
Comorbid physical health conditions, commonly associated with mental illness, contribute to increased morbidity and reduced life expectancy. The trajectory to poorer health begins with the onset of mental illness. For young people with mental illness, health risk behaviours and poor physical health can progress to adulthood with long-term detrimental impacts. Using a cross-sectional survey design, self-reported health risk behaviours were gathered from 56 young (16-25 years) Australians who had been hospitalised for mental illness and taking psychotropic medication. Smoking, alcohol use, minimal physical activity, and lack of primary health care were evident. While these behaviours are typical of many young people, those with mental illness have substantially increased vulnerability to poor health and reduced life expectancy. Priority needs to be given to targeted health promotion strategies for young people with mental illness to modify their risky long-term health behaviours and improve morbidity and mortality outcomes. Nurses in mental health settings play a vital role in promoting young peoples' well-being and preventing poorer physical health outcomes. Implementation of a cardiometabolic health nurse role in inpatient settings for young people with mental illness could facilitate prevention and early intervention for health risk behaviours.
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. © 2014 John Wiley & Sons Ltd.
Wilson, C; Nairn, R; Coverdale, J; Panapa, A
There is a dearth of studies examining how dangerousness is constructed in media depictions of mentally ill individuals who are frequently portrayed as acting violently. The aim of the present study was to identify the contribution of diverse technical, semiotic and discursive resources utilised in portraying a character with a mental illness in a prime-time drama as dangerous. Discourse analytic techniques, involving systematic, repeated, critical viewings, were applied to a single program drawn from a sample of prime-time television drama episodes touching on mental illness. Nine devices (appearance, music and sound effects, lighting, language, intercutting, jump-cutting, point of view shots, horror conventions and intertextuality) were identified as contributing to the signified dangerousness of person receiving care in the community for a mental illness. These techniques combine in signifying mental illness and a person suffering from it as dangerous. The findings suggest that mental health professionals working to reduce the stigma of mental illness need to have a reasonably sophisticated understanding of the practices and priorities of television production if they are to collaborate effectively with producers to create dramas that convey more human and sympathetic understandings of mental illness or to combat the negative effects of such portrayals.
Eack, Shaun M.; Newhill, Christina E.
Racial disparities in mental health outcomes have been widely documented in noninstitutionalized community psychiatric samples, but few studies have specifically examined the effects of race among individuals with the most severe mental illnesses. A sample of 925 individuals hospitalized for severe mental illness was followed for a year after…
Westerhof, Gerben Johan; Keyes, Cory L.M.
Mental health has long been defined as the absence of psychopathologies, such as depression and anxiety. The absence of mental illness, however, is a minimal outcome from a psychological perspective on lifespan development. This article therefore focuses on mental illness as well as on three core
Bland, R C
To examine the morbidity produced by mental disorders, to project changes in morbidity likely to be produced by demographic and economic change, and to review the possible role of psychiatry in the health care system. Using prevalence data for psychiatric disorders and population projections, this paper presents the likely changes in morbidity over the next 20 years. A review of social and economic information indicates changes in social attitudes and their effects on mental health. This paper examines the determinants of health and how they are likely to change and explores some possible directions for changes in health care delivery. Psychiatric disorders have been greatly underestimated as a cause of disability but account for 5 of the 10 leading causes of disability and 47.2% of all years lived with a disability (YLD) in developed countries. By 2016, there will be significant changes in the distribution and type of psychiatric disorders seen in the population, with cases of dementia almost doubling. Most of the population growth will be in the older age-groups, who will be well informed and will demand high standards of service. The gap between rich and poor will increase, and the results of childhood poverty and abuse will become more apparent. The disadvantaged, including many mentally ill, will suffer deprivation as disability payments decline, but youth unemployment will improve, possibly reducing crime rates. Forced early retirements will decline. Alternative medicine will make inroads into health care. A crisis in subsidized accommodation for the elderly can be anticipated, which perhaps will lead to reopening institutions that are currently being closed or to developing new forms of care. As the baby boomers pass 50 years of age and begin consuming health care services, governments will revise plans and eligibility for services; users will pay for services more directly. Psychiatry is very vulnerable to minor changes in health care schemes and will
Vigo, Daniel; Thornicroft, Graham; Atun, Rifat
We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness. Copyright © 2016 Elsevier Ltd. All rights reserved.
Salzer, Mark S; Brusilovskiy, Eugene; Townley, Greg
A broad range of estimates of recovery among previously institutionalized persons has been reported, but no current, community-based national estimate of recovery from serious mental illness exists. This study reports recovery rate results, based on a remission definition, and explores related demographic factors. A national, geographically stratified, and random cross-sectional survey conducted from September 2014 to December 2015 resulted in responses from more than 41,000 individuals. Lifetime prevalence of serious mental illness was assessed by asking about receipt of a diagnosis (major depression, bipolar disorder, manic depression, and schizophrenia or schizoaffective disorder) and hospitalization and impairment associated with the diagnosis. Recovery was determined by asking about impairments over the past 12 months. Almost 17% reported receiving one of the diagnoses in their lifetime, 6% had a lifetime rate of a serious mental illness, and nearly 4% continued to experience interference associated with serious mental illness. One-third of those with a lifetime serious mental illness reported having been in remission for at least the past 12 months. Recovery rates were low until age 32 and then progressively increased. Lifetime estimates of diagnosed illness and current prevalence of serious mental illness are consistent with previous research. Results indicate that recovery is possible and is associated with age. Further research is needed to understand factors that promote recovery, and sustained evaluation efforts using similar parsimonious approaches may be useful in conducting timely assessments of national and local mental health policies.
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.
Ditchman, Nicole; Werner, Shirli; Kosyluk, Kristin; Jones, Nev; Elg, Brianna; Corrigan, Patrick W
Individuals with intellectual disabilities (ID) and individuals with mental illness are consistently found to be among the most socially excluded populations and continue to face substantial health, housing, and employment disparities due to stigma. Although this has spurred extensive research efforts and theoretical advancements in the study of stigma toward mental illness, the stigma of ID has received only limited attention. In this article we explore the application of mental illness stigma research for ID. We carefully reviewed the existing research on mental illness stigma as a foundation for a parallel summary of the empirical literature on attitudes and stigma related to ID. Based on our review, there has not been a systematic approach to the study of stigma toward ID. However, multilevel conceptual models of stigma have received much attention in the mental illness literature. These models have been used to inform targeted interventions and have application to the study of the stigma process for individuals with ID. Nonetheless, there are indeed key differences between-as well as substantial variability within-the ID and mental illness populations that must be considered. Stigma is an issue of social justice impacting the lives of individuals with ID, yet there remains virtually no systematic framework applied to the understanding of the stigma process for this group. Future research can draw on the stigma models developed in the mental illness literature to guide more rigorous research efforts and ultimately the development of effective, multilevel stigma-change strategies for ID.
Okamura, Tsuyoshi; Takeshima, Tadashi; Tachimori, Hisateru; Takiwaki, Ken; Matoba, Yuki; Awata, Shuichi
Japan has the largest number of psychiatric beds in the world and has been in the process of deinstitutionalization since 2004. The majority of psychiatric inpatients are elderly long-term patients, who are at risk of homelessness after they are discharged. There is little information about homeless people with mental illnesses in Japan, and the aim of this study was to describe characteristics of people with a mental illness in homeless shelters in Tokyo. A face-to-face survey was conducted from December 2012 to March 2013 by the staff of a nonprofit organization (NPO) that helps socially isolated persons. Of the 1,056 people who received help during the study period, 684 completed the survey. Eighteen percent of the 684 survey participants had a mental illness. Of the 210 individuals who lived in shelters, one-third had a mental illness. The mean age of shelter users with mental illness was 64.9; they tended to be referred from hospitals, and their mental well-being was poorer than other NPO service users in the study. Among the service users with mental illness, those living in shelters were older than those living in the community and more likely to have a history of trouble with alcohol, poor family relationships, and impaired instrumental activities of daily living. Unmet mental health needs were noted among discharged hospital patients living in Tokyo homeless shelters. An integrated and community-based support system with more effective health care delivery, including critical time interventions, is needed.
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.
Koh, Eugen; Shrimpton, Bradley
Exhibitions of art by people with experience of mental illness are increasingly being staged to improve awareness of mental health issues in the general community and to counter the stigma of mental illness. However, few exhibitions have incorporated research to ascertain their actual effectiveness. This paper reports the results of a study that considered the responses of 10,000 people after they viewed exhibitions of art produced by people with experience of mental illness. These works were selected from the Cunningham Dax Collection, one of the world's most extensive collection of artworks by people with experience of mental illness and/or psychological trauma. More than 90% of respondents agreed with three propositions that the exhibitions helped them: (1) gain a better understanding of mental illness; (2) gain a more sympathetic understanding of the suffering of people with mental illness; and (3) appreciate the ability and creativity of people with mental illness. The results suggest that exhibitions can successfully promote mental health literacy and contribute to positive attitudes towards people with experience of mental illness. This paper explores these findings and raises questions about how the presentation of artworks in an exhibition influences their effectiveness in mental health promotion.
Hastrup, Lene H; Van Den Berg, Bernard; Gyrd-Hansen, Dorte
This study investigates a possible added subjective burden among informal caregivers to care recipients with a mental illness or a combination of mental and somatic illnesses compared with caregivers to care recipients with a somatic illness. The study also investigates the subjective caregiver burden by caregivers' characteristics and objective burden. The association between subjective caregiver burden and socio-demographic factors, objective burden, and health-related quality of life was analyzed in a population of 865 Dutch informal caregivers, using multiple linear regression analysis. Controlling for other factors in the analysis, we found that caring for a recipient with mental illness or a combination of mental and somatic illness was associated with an extra subjective caregiver burden (measured by Caregiver Strain Index). Objective burden, in terms of more than 50 hours of care provision per week, less than three years of caregiving, or living together with the care recipients was associated with higher subjective caregiver burden. Other factors associated with higher subjective caregiver burden were being partners or a child of care recipient, having a paid job, a low health-related quality of life (EQ-5D), or having an illness. This study suggests that caregivers to care recipients with a mental and especially a combination of mental and somatic illnesses have a higher subjective caregiver burden compared with caregivers to care recipients with a somatic illness. Because the study is not representative of all caregivers, more research focusing on identifying and contacting informal caregivers is needed to confirm the result.
Sandra M Flynn
Full Text Available Most child victims of homicide are killed by a parent or step-parent. This large population study provides a contemporary and detailed description of filicide perpetrators. We examined the relationship between filicide and mental illness at the time of the offence, and care received from mental health services in the past.All filicide and filicide-suicide cases in England and Wales (1997-2006 were drawn from a national index of homicide perpetrators. Data on people in contact with mental health services were obtained via a questionnaire from mental health teams. Additional clinical information was collected from psychiatric reports.6144 people were convicted of homicide, 297 were filicides, and 45 cases were filicide-suicides. 195 (66% perpetrators were fathers. Mothers were more likely than fathers to have a history of mental disorder (66% v 27% and symptoms at the time of the offence (53% v 23%, most often affective disorder. 17% of mothers had schizophrenia or other delusional disorders. Overall 8% had schizophrenia. 37% were mentally ill at the time of the offence. 20% had previously been in contact with mental health services, 12% within a year of the offence.In the majority of cases, mental illness was not a feature of filicide. However, young mothers and parents with severe mental illness, especially affective and personality disorder who are providing care for children, require careful monitoring by mental health and other support services. Identifying risk factors for filicide requires further research.
Full Text Available 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.
Yang, Albert C; Tsai, Shih-Jen
A defining but elusive feature of the human brain is its astonishing complexity. This complexity arises from the interaction of numerous neuronal circuits that operate over a wide range of temporal and spatial scales, enabling the brain to adapt to the constantly changing environment and to perform various amazing mental functions. In mentally ill patients, such adaptability is often impaired, leading to either ordered or random patterns of behavior. Quantification and classification of these abnormal human behaviors exhibited during mental illness is one of the major challenges of contemporary psychiatric medicine. In the past few decades, attempts have been made to apply concepts adopted from complexity science to better understand complex human behavior. Although considerable effort has been devoted to studying the abnormal dynamic processes involved in mental illness, unfortunately, the primary features of complexity science are typically presented in a form suitable for mathematicians, physicists, and engineers; thus, they are difficult for practicing psychiatrists or neuroscientists to comprehend. Therefore, this paper introduces recent applications of methods derived from complexity science for examining mental illness. We propose that mental illness is loss of brain complexity and the complexity of mental illness can be studied under a general framework by quantifying the order and randomness of dynamic macroscopic human behavior and microscopic neuronal activity. Additionally, substantial effort is required to identify the link between macroscopic behaviors and microscopic changes in the neuronal dynamics within the brain. Copyright © 2012 Elsevier Inc. All rights reserved.
Wiechers, Ilse R; Karel, Michele J; Hoff, Rani; Karlin, Bradley E
National data from Veterans Health Administration (VHA) electronic medical records were used to examine rates of mental illness and service use among older veterans since mental health care transformation efforts were implemented in 2005. Data were extracted from VHA electronic medical records for each fiscal year from 2005 through 2013 for veterans ages 65 and older. Among those receiving any health care services, the number and proportion treated for a confirmed mental illness and the utilization of non-mental health care services were identified. In 2013, 2.6 million older veterans utilized services in VHA, 14% of whom had a confirmed mental illness, which was a 57% increase from 2005. Older veterans with confirmed mental illness accounted for a sizable and growing proportion of non-mental health service utilization. Preparing the workforce to address the mental health needs of older veterans and nonveterans is essential.
Full Text Available People with mental illness are more likely to have serious coexisting physical health problems than the general population. Although lifestyle and genetics may contribute independent risks of cardiovascular dysfunction in schizophrenia and other serious mental illness, antipsychotic treatment also represents an important contributor to risk of cardiovascular disorder, particularly for certain drugs and for vulnerable patients. Mental health professionals and other health care provider must give emphasis to recognize the clinical signposts indicating mental health related cardiovascular problems to forestall progression to type II diabetes, cardiovascular events and premature death.
U.S. Department of Health & Human Services — The National Database for Clinical Trials Related to Mental Illness (NDCT) is an extensible informatics platform for relevant data at all levels of biological and...
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.
... Evidence shows that there has been direct tobacco marketing to people with mental illness and other vulnerable ... Associate Director for Communications (OADC) Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs ...
Rr Dian Tristiana
Conclusion: Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.
Vigo, Daniel; Thornicroft, Graham; Atun, Rifat
We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from as...
Avhandling (doktorgrad) - Norges idrettshøgskole, 2017 There is increasing evidence for physical activity having a positive impact on physical and mental health, as well as on illness symptoms in individuals with severe mental illness (SMI). However, individuals with SMI experience several barriers related to physical activity that makes it difficult for them to take advantage of the benefits associated with physical activity. One barrier consistently reported to impede physical activity i...
Robson , Anthony ,
International audience; Diet, lifestyle and environment do not just affect a person's health, they also determine the health of their children and possibly the health of their grandchildren. Mental ill health is an epidemic worldwide because of the combined effect of the modern diet and a sedentary lifestyle. Primary prevention of mental ill health starts, crucially, with optimal adult nutrition before the inception of pregnancy, includes breastfeeding, and continues throughout the life of th...
Bachrach, L L
Program development for chronic mentally ill women is emerging in a climate where more general concerns relating to women's health and mental health are increasingly being examined. Although in the past the special needs of chronic mentally ill women have received scant attention in the professional literature, there is evidence today of a growing commitment to serving this population. The author traces the emergence and legitimation of three specific issues--homelessness, skills training, and family planning--that reflect the complexity of program development for this population. As specific issues in service delivery to chronic mentally ill women come to the fore and move toward relevant solutions, we may anticipate a sharpening of planning concepts. Both male and female chronic mental patients stand to benefit from these developments.
Mikhail A. Nekrasov
Full Text Available Background: Mental illness (MI markedly affects a person’s daily living and leads to disability, reduced duration of active life and, finally, tremendous economic losses incurred by the state and society. Moreover, it has an adverse impact on the patient’s immediate social surroundings. The aim of the research was to study various aspects of mentally ill patients’ daily living and their social environment in order to optimize psychosocial rehabilitation programs and therapies. Methods: One thousand forty two mentally ill people and 580 persons from their social environment participated in an anonymous social survey. The survey was carried out using specially developed structured questionnaires. The results showed that MI changes the quality of life of mentally ill people (MIP: impaired well-being (84.4%, curbing of interests (36.0%, increased emotional sensitivity (39.0%, low self-esteem (75.4%, problems in family relations (78.0%, dramatic loss of sexual activity (72.3%, and in 75.8% patients – stigmatizing effect of their MI. The presence of a mentally-ill member in a family significantly affected the life and inner world of people close to that member, and modified their professional activity (38.8%, daily living (56.8% and emotional state (36.2%. Conclusion: To improve application of psychosocial rehabilitation methods, an attempt was made to conduct a comprehensive medical and social study of the mentally ill and their social environment.
Shapiro, Samuel; Rotter, Merrill
Although studies have examined portrayals of mental illness in the mass media, little attention has been paid to such portrayals in video games. In this descriptive study, the fifty highest-selling video games in each year from 2011 to 2013 were surveyed through application of search terms to the Wikia search engine, with subsequent review of relevant footage on YouTube. Depiction categories were then assigned based on the extent of portrayal and qualitative characteristics compared against mental illness stereotypes in cinema. Twenty-three of the 96 surveyed games depicted at least one character with mental illness. Forty-two characters were identified as portraying mental illness, with most characters classified under a "homicidal maniac" stereotype, although many characters did not clearly reflect cinema stereotypes and were subcategorized based on the shared traits. Video games contain frequent and varied portrayals of mental illness, with depictions most commonly linking mental illness to dangerous and violent behaviors. © 2016 American Academy of Forensic Sciences.
Pathare, Soumitra; Nardodkar, Renuka; Shields, Laura; Bunders, Joske F G; Sagade, Jaya
Section 5(ii) of The Hindu Marriage Act, 1955 (HMA) states that under certain circumstances, mental illness is accepted as a ground for the annulment of marriage, while Section 13(1) (iii) states that mental illness is a ground for divorce. There is little data on how this provision is used and applied in matrimonial petitions. This paper assesses judicial practices in divorce cases, exploring the extent to which gender and the diagnosis of mental illness affect the decision to grant annulment or divorce. The paper analyses judgments related to annulment and divorce at the Family Court in Pune and at the High Courts in India. In the Family Court at Pune, 85% of the cases were filed by husbands, who alleged that their spouse was mentally ill. Medical evidence of mental illness was presented in only 36% of the cases and in many cases, divorce/nullity was granted even in the absence of medical evidence. In 14% of the cases, nullity/divorce was granted even when both spouses were not present. Of the Family Court cases reaching the High Court, 95% were filed by male petitioners. The High Courts reversed the lower courts' judgments in 50% of the cases. Our analysis highlights the need for standardised guidelines for lower courts on what constitutes adequate medical proof of mental illness when hearing a petition related to nullity or divorce under HMA. It also provides a critical review of Section 5(ii) of HMA.
Invariably the mentally ill person encounters rejectionand humiliation that are in some way tantamount to a "second illness." The combination either disrupts or puts beyond reach the usual personal and social life stages of marriage, family life, raising children, sexual relationships, the choice of treatment, affordable housing, ...
Venville, Annie; Street, Annette F.
Vocational Education and Training (VET) students experiencing mental illness have been described as one of the most vulnerable student groups in the Australian post-secondary sector. This vulnerability can be attributed to the impacts of illness, the oft-reported experiences of stigma and discrimination, and low educational outcomes. There is…
Stiawa, Maja; Kilian, Reinhold
Social Networks of Children with Mentally Ill Parents Mental illness of parents can be a load situation for children. Supporting social relations might be an important source in such a situation. Social relations can be shown by social network analysis. Studies about social networks and mental health indicate differences regarding structure and potential for support when compared with social networks of healthy individuals. If and how mental illness of parents has an impact on their children's network is widely unknown. This systematic review shows methods and results of studies about social networks of children with mentally ill parents. By systematic search in electronic databases as well as manual search, two studies were found who met the target criteria. Both studies were conducted in the USA. Results of studies indicate that parental mental illness affects the state of mental health and social networks of children. Symptomatology of children changed due to perceived social support of network contacts. Impact of social support and strong network contacts seems to depend on age of children and the family situation. That's why support offers should be adapt to children's age. Focusing on social networks as potential resource for support and needs of the family affected seems appropriate during treatment.
Yim, Larina Chi-Lap; Leung, Henry Chi-Ming; Chan, Wai Chi; Lam, Marco Ho-Bun; Lim, Vivian Wai-Man
This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I) and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists. The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18%) of the subjects initially selected were too ill to give consent to join the study. The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals.
Larina Chi-Lap Yim
Full Text Available This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists.The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18% of the subjects initially selected were too ill to give consent to join the study.The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals.
Chan, Wai Chi; Lam, Marco Ho-Bun; Lim, Vivian Wai-Man
Metholodogy This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I) and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists. Findings The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18%) of the subjects initially selected were too ill to give consent to join the study. Conclusion The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals. PMID:26484889
Background: Mental illness is a psychological, emotional and mental health problems that affects the physical, behavioral and occupational functioning of an individual. The understand of the signs and symptoms of the disorder in a typical setting and by ordinary people or even among the literate is often difficulty; talk more ...
Generalised anxiety disorder (n=9) and adjustment disorder (n=3) were also common. Conclusion: Mental disorders were fairly common among women with infertility. Physicians should screen for this co-morbid disorder in women presenting with infertility problems. Key words: Infertility, mental illness, women, developing ...
most common forms of mental illness include anxiety disorders, depressive disorders and schizophrenia. Among the major mental disorders are hose that can be classified under the following categories viz: substance use disorders, Alzheimer's disease, disorders of childhood and adolescence eating disorder, Epilepsy etc.
Liu, C.-H.; Meeuwesen, L.; van Wesel, F.; Ingleby, D.
Purpose - The purpose of this paper is to test the widely held assumption that underutilisation of mental health services by Chinese living in western countries is due to their different beliefs regarding mental illness. Design/methodology/approach - Qualitative data were analysed from in-depth
Liu, C.-H.; Meeuwesen, L.; van Wesel, F.; Ingleby, D.
Purpose – The purpose of this paper is to test the widely held assumption that underutilisation of mental health services by Chinese living in western countries is due to their different beliefs regarding mental illness. Design/methodology/approach – Qualitative data were analysed from in-depth
Mendelsohn, Colin P; Kirby, Dianne P; Castle, David J
We aimed to review research on smoking and mental illness and provide evidence-based guidelines for psychiatrists to help smoking patients quit. We undertook a narrative review of the literature with a special focus on the Australian context. Although one in three people with mental illness smoke tobacco, smoking is often neglected in psychiatric practice. Smoking is a significant contributor to the health gap between people with mental illness and the general population. Smokers with mental illness are motivated to quit and are able to do so, albeit with lower quit rates. Quitting can lead to substantial improvements in mental wellbeing and physical health and does not exacerbate pre-existing mental illness. Psychiatrists should advise all smokers to quit and provide counselling, medication and support, based on the 5As framework. Approved pharmacotherapy - nicotine replacement therapy, varenicline and bupropion - is recommended for nicotine-dependent smokers. Smoking induces the metabolism of certain psychotropic drugs such as clozapine and olanzapine and dose reductions may be necessary after cessation. Psychiatrists have a duty of care to identify the smoking status of their patients and to provide evidence-based support to quit. © The Royal Australian and New Zealand College of Psychiatrists 2014.
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
Schomerus, G; Angermeyer, M C; Baumeister, S E; Stolzenburg, S; Link, B G; Phelan, J C
A core component of stigma is being set apart as a distinct, dichotomously different kind of person. We examine whether information on a continuum from mental health to mental illness reduces stigma. Online survey experiment in a quota sample matching the German population for age, gender and region (n=1679). Participants randomly received information on either (1) a continuum, (2) a strict dichotomy of mental health and mental illness, or (3) no information. We elicited continuity beliefs and stigma toward a person with schizophrenia or depression. The continuum intervention decreased perceived difference by 0.19 standard deviations (SD, Pmental illness can be improved by providing information on a mental health-mental illness continuum. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Aghukwa Nkereuwem Chikaodiri
Full Text Available A few months from the time of this survey, the nearly completed inpatient psychiatric facility within the Aminu Kano Teaching Hospital’s complex would be ready for admissions. Understanding the health workers’ level of experience of mental illness and their likely behavioural responses towards people with psychiatric illness, therefore, should be a good baseline to understanding their likely reactions towards admitting such patients within a general hospital setting. The study, which used a pre-tested and adapted attribution questionnaire, was prospective and cross-sectional. Randomly selected health workers in Aminu Kano Teaching Hospital had their level of familiarity and attributions towards psychiatric patients assessed. The respondents showed a high level of experience with mental illness, with more than 3 in 5 of them having watched movies on mental illness before. More than half of them held positive (favorable attributions towards persons with mental illness on nine of the ten assessed attribution factors. Almost all held negative (unfavourable opinion towards intimate relationships with such persons. Attribution factors, “Responsibility, “Anger”, “Dangerousness”, “Fear” and “Segregation” were significantly related to the respondents’ level of education (P less than 0.05. Marital status of the respondents related significantly to “Pity” and “Avoidance” factors (P less than 0.05. Having watched movies on mental illness significantly related to “Responsibility” and “Fear” factors (P less than 0.05. Programs designed to improve the health workers mental health literacy, and increased positive professional contacts with mentally ill persons on treatment, would further enhance their perceived positive attributions towards them.
... Your child's doctor or mental health provider will work with your child to determine if he or she has a ... or mental health provider to determine what might work best for your child, including the risks or benefits of specific medications. ...
Ben Natan, Merav; Drori, Tal; Hochman, Ohad
This study examined public perception of stigmas relating to mental illness six months after a reform, which integrated mental health care into primary care in Israel. The results reveal that the public feels uncomfortable seeking referral to mental health services through the public health system, with Arab Israelis and men expressing lower levels of comfort than did Jewish Israelis. The current reform has not solved the issue of public stigma regarding mental health care. The study suggests that the current reforms must be accompanied over time with appropriate public education regarding mental illness. Copyright © 2017 Elsevier Inc. All rights reserved.
Fletcher, Erica Hua
This article argues humans should not be defined strictly at their physical boundaries with clear distinctions between anatomical bodies, mental states, and the rest of the world. Rather, diverse mental states, which are often diagnosed as "mental illness," take shape within greater environmental forces and flows, including those that are constructed online. Drawing from a multi-sited ethnography of The Icarus Project, a radical mental health community, the author situates online narratives written by two of its members within posthuman emotional ecologies in which the exchange of ideas online affects mental states in a profound way. These narratives can be seen as a new type of psychiatric resistance based in new technologies, one that "uncivilizes" mental illness by searching for alternative frameworks and metaphors to understand lived experiences with mental distress. This ethnographic perspective differs significantly from traditional bio-psychiatric models and interventions and can offer both patients and mental healthcare providers with an alternative language to frame mental health.
Tuffin, A; Tuffin, K; Watson, S
Talk about mental health and mental illness was examined using Potter and Wetherell's system of discourse analysis. Participants were 8 health coordinators (teachers) from a range of New Zealand secondary schools. They were interviewed on the topics of mental health and mental illness. Verbatim transcripts from the interviews were analyzed, and three mental health and illness linguistic resources were identified: a mental health as illness resource, a mental well-being resource, and a mental illness resource. Each resource was examined, and the practical consequences of this language use was discussed in relation to the role of teachers as frontline mental health professionals.
Loon, L.M.A. van; Ven, M.O.M. van de; Doesum, K.T.M. van; Hosman, C.M.H.; Witteman, C.L.M.
Children of parents with mental illness have an elevated risk of developing a range of mental health and psychosocial problems. Yet many of these children remain mentally healthy. The present study aimed to get insight into factors that protect these children from developing internalizing and
Kliewer, Stephen P.; McNally Melissa; Trippany, Robyn L.
Deinstitutionalization has had a significant impact on the mental health system, including the client, the agency, and the counselor. For clients with serious mental illness, learning to live in a community setting poses challenges that are often difficult to overcome. Community mental health agencies must respond to these specific needs, thus…
Van Loon, L. M. A.; Van De Ven, M. O. M.; Van Doesum, K. T. M.; Hosman, C. M. H.; Witteman, C. L. M.
Background: Children of parents with mental illness have an elevated risk of developing a range of mental health and psychosocial problems. Yet many of these children remain mentally healthy. Objective: The present study aimed to get insight into factors that protect these children from developing internalizing and externalizing problems. Methods:…
Full Text Available Similar to the general public, mental health professionals sometimes also have negative attitudes towards individuals with mental illness; which could ultimately affect the quality of care received by the patients. This study aims to explore attitudes to mental illness among mental health professionals in Singapore; make comparisons with the general population; and investigate the significant correlates.A cross-sectional design was used. Eligible participants were recruited from the Institute of Mental Health, Singapore. Attitudes to mental illness among the mental health professionals were measured using an adapted 26-item Attitudes to Mental Illness questionnaire (AMI. An earlier study amongst the general population in Singapore had used the same tool; however, factor analysis suggested a 20-item, 4-factor structure (AMI-SG was the best fit. This 4-factor structure was applied among the current sample of mental health professionals to allow comparisons between the professionals and the general population. Data were collected through an online survey tool 'Questionpro' from February to April 2016, and 379 participants were included in the current analysis. Attitudes to mental illness among these professionals were compared to those of the general population, which were captured as part of a national study conducted from March 2014 to April 2015.The 20-item, 4-factor structure AMI-SG derived from the general population was applicable among the mental health professionals in Singapore. Compared to the general population, mental health professionals had significantly more positive attitudes to mental illness; however their scores on 'social distancing' did not differ from the general population. Indian ethnicity was negatively associated with 'social distancing' and 'social restrictiveness' among the professionals; while higher education was negatively related to 'prejudice and misconception'. Compared to nurses, doctors showed significantly more
Khanna, Priya; Clifton, Andrew V; Banks, David; Tosh, Graeme E
People with a serious mental illness are more likely to smoke more and to be more dependent smokers than the general population. This may be due to a wide range of factors that could include a common aetiology to both smoking and the illness, self medication, smoking to alleviate adverse effects of medications, boredom in the existing environment, or a combination of these factors. It is important to undertake this review to facilitate improvements in both the health and safety of people with serious mental illness who smoke, and to reduce the overall burden of costs (both financial and health) to the smoker and, eventually, to the taxpayer. To review the effects of smoking cessation advice for people with serious mental illness. We searched the Cochrane Schizophrenia Group Specialized Trials Register up to 2 April 2015, which is based on regular searches of CENTRAL, BIOSIS, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and trial registries. We also undertook unsystematic searches of a sample of the component databases (BNI, CINHAL, EMBASE, MEDLINE, and PsycINFO), up to 2 April 2015, and searched references of all identified studies We planned to include all randomised controlled trials (RCTs) that focussed on smoking cessation advice versus standard care or comparing smoking cessation advice with other more focussed methods of delivering care or information. The review authors (PK, AC, and DB) independently screened search results but did not identify any trials that fulfilled the inclusion criteria of this review. We did not identify any RCTs that evaluated advice regarding smoking cessation for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to smokers with serious mental illness is possible. People with serious mental illness are more likely to smoke than the general population. Yet we could not find any high quality evidence to guide the smoking cessation advice healthcare professionals pass onto
WonPat-Borja, Ahtoy J; Yang, Lawrence H; Link, Bruce G; Phelan, Jo C
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. 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. 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. 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.
Schoonover, Julie; Lipkin, Samuel; Javid, Munazza; Rosen, Anna; Solanki, Mehul; Shah, Sandip; Katz, Craig L
Despite the significant toll of mental illness on the Indian population, resources for patients often are scarce, especially in rural areas. Traditional healing has a long history in India and is still widely used, including for mental illnesses. However, its use has rarely been studied systematically. The aim of this study was to determine the perspective of patients, their families, and healthy community members toward faith healing for mental illness, including the type of interventions received, perceptions of its efficacy, and overall satisfaction with the process. We also sought to explore the range of care received in the community and investigate possibilities for enhancing mental health treatment in rural Gujarat. We interviewed 49 individuals in July 2013 at Dhiraj General Hospital and in 8 villages surrounding Vadodara. A structured qualitative interview elicited attitudes toward faith healing for mental illnesses and other diseases. Qualitative analysis was performed on the completed data set using grounded theory methodology. Subjects treated by both a doctor and a healer reported they overwhelmingly would recommend a doctor over a healer. Almost all who were treated with medication recognized an improvement in their condition. Many subjects felt that traditional healing can be beneficial and believed that patients should initially go to a healer for their problems. Many also felt that healers are not effective for mental illness or are dishonest and should not be used. Subjects were largely dissatisfied with their experiences with traditional healers, but healing is still an incredibly common first-line practice in Gujarat. Because healers are such integral parts of their communities and so commonly sought out, collaboration between faith healers and medical practitioners would hold significant promise as a means to benefit patients. This partnership could improve access to care and decrease the burden of mental illness experienced by patients and
Padayachee, Priyanka; Laher, Sumaya
Conceptualisations of mental illness are not universally applicable, as culture shapes the expression, perceptions and treatment preferences thereof. By focusing on the perceptions of Hindu psychologists regarding mental illness, this study aimed to provide a deeper understanding of the impact that religious beliefs have on such conceptualisations. Semi-structured interviews were conducted with six Hindu psychologists around the Johannesburg area, South Africa. Responses were analysed using thematic content analysis. From the findings, it was evident that religion plays a critical role in the understanding and treatment of mental illness. Hindu beliefs around psychological disturbances were salient. Additionally, it was found that a tension existed between psychologists' awareness of the influential function of religion, particularly amongst collectivistic communities such as the Hindu community, and their occupational understandings and practices, which are deeply rooted in Western thought. Furthermore, it was suggested that the fear of stigma prevented Hindu clients from reaping the benefits of seeking help from culturally competent psychologists.
Simpson, Alexander I F; McKenna, Brian; Moskowitz, Andrew; Skipworth, Jeremy; Barry-Walsh, Justin
Homicides by mentally ill persons have led to political concerns about deinstitutionalisation. To provide accurate information about the contribution of mental illness to homicide rates. Retrospective study of homicide in New Zealand from 1970 to 2000, using data from government sources. 'Mentally abnormal homicide'perpetrators were defined as those found unfitto stand trial, not guilty by reason of insanity, convicted and sentenced to psychiatric committal, or convicted of infanticide. Group and time trends were analysed. Mentally abnormal homicides constituted 8.7% of the 1498 homicides. The annual rate of such homicides was 1.3 per million population, static over the period. Total homicides increased by over 6% per year from 1970 to 1990, then declined from 1990 to 2000. The percentage of all homicides committed by the mentally abnormal group fell from 19.5% in 1970 to 5.0% in 2000. Ten percent of perpetrators had been admitted to hospital during the month before the offence; 28.6% had had no prior contact with mental health services. Victims were most commonly known to the perpetrator (74%). Deinstitutionalisation appears not to be associated with an increased risk of homicide by people who are mentally ill.
Oates, Jennifer; Drey, Nicholas; Jones, Julia
The effects of mental health nurses' own experience of mental illness or being a carer have rarely been researched beyond the workplace setting. This study aimed to explore how the experience of mental illness affects mental health nurses' lives outside of and inside work. A sample of 26 mental health nurses with personal experience of mental illness took part in semistructured interviews. Data were analysed thematically using a six-phase approach. The analysis revealed the broad context of nurses' experiences of mental illness according to three interwoven themes: mental illness as part of family life; experience of accessing services; and life interwoven with mental illness. Participants typically described personal and familial experience of mental illness across their life course, with multiple causes and consequences. The findings suggest that nurses' lives outside of work should be taken into account when considering the impact of their personal experience of mental illness. Similarly being a nurse influences how mental illness is experienced. Treatment of nurses with mental illness should account for their nursing expertise whilst recognizing that the context for nurses' mental illness could be much broader than the effect of workplace stress. © 2018 Australian College of Mental Health Nurses Inc.
Full Text Available Background: Knowledge of family members or caregivers regarding mental illness plays a vital role in treatment for persons with mental illnesses. There are limited numbers of standardised tool that measure the existing knowledge of family members regarding mental illness. The present study aimed to develop a valid and reliable tool to assess the knowledge of family members regarding mental illness. Methods: A 46-item questionnaire was structured following the scientific tool development steps. Six domains, namely basic information, need of treatment, medication administration, side-effects and management, consequences of non-adherence, and psychosocial treatment were included in the tool. Content validity of the questionnaire was established by accepting more than 80% validity index for each item. To test the reliability, questionnaire was applied to 100 family members of persons with mental illnesses. Results: Statistical analyses showed good internal consistency by Chronbach’s alpha (r=0.831 and Spearman Brown-Proficiency formula (r=0.88. Score of all the six individual domains were significantly correlated with the total score of the tool indicating acceptable sensitivity. Significant correlation was found among the score of domains indicating good construct validity of the structured questionnaire. Conclusion: The constructed questionnaire can be used in research studies of related field by considering its acceptable psychometric properties.
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. Copyright © 2012 Elsevier Ltd. All rights reserved.
Li, Jie; Li, Juan; Huang, Yuanguang; Thornicroft, Graham
In order to reduce the huge treatment gap in mental health, WHO has called for integrating mental health into primary care. The purposes of this study are to provide a training course to improve the community mental health staff's knowledge of mental health and reduce stigma related to mental illness, as well as to evaluate the impact of this training on knowledge and stigma. The training intervention was a one day course for community mental health staff in Guangzhou, China. Evaluation questionnaires were given before and after the training session. Mental health knowledge was assessed using two vignettes. Stigma was evaluated by the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS). A total of 99 community mental health staff from eight regions in Guangzhou, China were recruited for the study. The training course did not lead to a significant improvement of participants' levels of mental health knowledge. The mean score of MICA decreased from 47.92 ± 8.63 to 43.53 ± 9.61 after the training (t = 6.64, P training course is an effective way to improve community mental health staff's attitudes toward people with mental illness in the short term, as well as to lessen the social distance between staff and people with mental illness.
The aim of this article is to review the literature on the relationship between homeless and serious mental illness. For both concepts there are different definitions, which will be promptly worked according to the analysis. The study of this issue, particularly outside the scope of our country just highlights the lack of information about this topic in our country. In addition, the following work aims to discuss the relationship between homeless and serious mental illness, as well as a new perspective of work with respect to this issue.
Transitioning to adulthood is challenging for young people who have a mental illness or substance use disorder, especially those who are transitioning from institutional care. For young people with serious mental illnesses to succeed in the adult world, they need more than treatment.These youth need to be truly integrated into their communities. They need jobs that offer skills, dignity, independence, and peers. They need a responsible and caring older adult who can help them to make better choices, learn from their mistakes, and applaud their successes, no matter how small. Community providers can create these opportunities through their own programs or appropriate community collaborations.
Faulkner, L R; Cutler, D L; Krohn, D D; Factor, R M; Goldfinger, S M; Goldman, C R; Lamb, H R; Lefley, H; Minkoff, K; Schwartz, S R
In this paper a group of knowledgeable individuals with expertise in psychiatric education present their recommendations for a basic psychiatric residency curriculum concerning the chronically mentally ill. The proposed curriculum consists of knowledge, skill, and attitude educational objectives, as well as clinical experiences, faculty supervision, didactics and seminars, and evaluation mechanisms. Recommendations are also made concerning changes in the Accreditation Council for Graduate Medical Education's Special Requirements for Residency Training in Psychiatry, which would require residency programs to place more emphasis on training to meet the needs of the chronically mentally ill. Obstacles to the implementation of the proposed recommendations are presented and possible solutions are discussed.
Bullenkamp, Jens; Voges, Burkhard
Outpatients with chronic mental illness living in therapeutic residential facilities in Mannheim, Germany (N=110) responded to an opinion poll to determine their voting preferences for the 2002 federal election to the Bundestag. The poll found that the outpatients were significantly more likely than the general population in Mannheim to prefer left-wing parties (78 percent compared with 56 percent). This finding is in contrast to earlier reports; however, it seems to better reflect common beliefs about the political preferences of this population. In conclusion, persons with chronic mental illness seem to prefer political parties that they believe will best serve their perceived specific interests.
, attitudes and behaviour that ... and quality of life of those who suffer from mental disorders.14,25,26 There is much evidence to ..... to seep through some of the stories that they told, and the remarks that they made. For example, the above ...
Wilk, Ruta J.
Examines the issue of involuntary outpatient commitment, and its implications for social workers working in the health system. Describes a nationwide movement to establish a new system of involuntary outpatient commitment to address the failure of deinstitutionalization, mandating mental health treatment in the community for persons ineligible for…
King, Robert; Neilsen, Philip; White, Emma
There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mental illness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well-received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mental illness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Evan Hy Einstein
Full Text Available Objective: This preliminary study examined the differences between what was taught during a formal medical education and medical students’ and psychiatry residents’ conceptions of notions regarding the causes and determinants of mental illness. Methods: The authors surveyed 74 medical students and 11 residents via convenience sampling. The survey contained 18 statements which were rated twice based on truthfulness in terms of a participant’s formal education and conception, respectively. Descriptive statistics and a Wilcoxon signed rank test determined differences between education and conception. Results: Results showed that students were less likely to perceive a neurotransmitter imbalance to cause mental illness, as opposed to what was emphasized during a formal medical education. Students and residents also understood the importance of factors such as systemic racism and socioeconomic status in the development of mental illness, which were factors that did not receive heavy emphasis during medical education. Furthermore, students and residents believed that not only did mental illnesses have nonuniform pathologies, but that the Diagnostic and Statistical Manual of Mental Disorders also had the propensity to sometimes arbitrarily categorize individuals with potentially negative consequences. Conclusions: If these notions are therefore part of students’ and residents’ conceptions, as well as documented in the literature, then it seems appropriate for medical education to be further developed to emphasize these ideas.
Rowe, M; Hoge, M A; Fisk, D
The key elements of a systems integration approach to delivery of human services are reviewed in terms of their application to services for mentally ill homeless persons. The example of a mental health outreach project illustrates the service- and systems-integrating influences of clinical case management with this population, and the ability of a "bottom-up" street-level approach to improve coordination and service accessibility for clients in general is discussed.
Caregivers of mental patients experience both subjective and ... Key words: Mental illness; Caregivers; Kenya. Received: 26-11-2007 .... Education level. None. 21 (12.0). -. Primary. 61 (34.9). 37 (35.6). Secondary. 69 (39.4). 59 (56.7). Tertiary/college. 19 (10.9). 8 (7.7). Unspecified. 5 (2.9). 3 (2.8). Table II: Economic Status ...
Smith, Allison L.; Cashwell, Craig S.
The authors explored attitudes toward adults with mental illness. Results suggest that mental health trainees and professionals had less stigmatizing attitudes than did non-mental-health trainees and professionals. Professionals receiving supervision had higher mean scores on the Benevolence subscale than did professionals who were not receiving…
Graham, Annette L; Brooker, Joanne; Hasking, Penelope; Clarke, David; Meadows, Graham
The distribution of mental illness information is a crucial element of mental health promotion initiatives. We assessed the receipt and perceived helpfulness of such information in Australia. Data from the Australian National Survey of Mental Health and Wellbeing indicated that, during the year prior to the survey, 33.7% of Australians received mental illness information; of these, 51.2% found it helpful. Among people with a mental disorder, 46.1% received information; of these, 67.4% found it helpful. Non-English speakers and the socially disadvantaged were less likely to receive mental illness information. Older and less educated respondents were less likely to both receive mental illness information and find it helpful. Mental health service users were more likely to receive mental illness information perceived as helpful than those who had not accessed such services. Better targeted information interventions are required to ensure those most likely to benefit receive mental illness-related information.
The growing old of patients levels and reduces the affective impact of the mental diseases in the way of leucotomia (Muller). The author considers this problem of these patient's destiny. The fact of sending them to retreat-home may recreate new-focus of segregation. The chimiotherapy becomes illusory when treating old people (iatrogene pseudo-dementia. Irreversible tertiary effect of the medical treatments). The old psychotic dies more peacefully than the old person who has become psychotical late in life with a kind of serenity which evokes a bonze's wisdom, identification pattern for the young people. Is schizophrenia a chronic disease or is it made chronic by our society? Is there an analogy between the residual mental automatism and the Far-Eastern extasis?
van Hasselt, Fenneke M; Oud, Marian J T; Loonen, Anton J M
Patients with severe mental illness have an accumulation of risk factors for physical diseases like cardiovascular diseases, metabolic syndrome, diabetes mellitus and COPD. These patients receive suboptimal care in the Netherlands. A major barrier to optimal care is the lack of collaboration between mental health professionals and general practitioners. An improvement could be made if all medical professionals actively supported these high-risk patients in taking adequate care of their health needs. This improvement can only be made if general practitioners and mental health professionals collaborate in a timely and structured manner.
Holley, Lynn C; Tavassoli, Kyoko Y; Stromwall, Layne K
People with mental illnesses (PWMI) who are of color and/or lesbian, gay, or bisexual (LGB) experience mental health disparities, including within mental health treatment programs (MHTPs). Informed by a critical framework with attention to intersectionality and microaggressions, this qualitative study asked 20 PWMI and family members who also are of color and/or LGB whether they had experienced mental illness discrimination in MHTPs, a possible factor in disparities. We also asked participants about aspects of MHTPs that supported recovery. Participants reported that they were ignored/not listened to, not viewed as complex individuals, experienced condescension/lack of respect and violations of privacy or other rights, and were presumed to lack intelligence. In addition, identifying mental illness discrimination was complex due to intersections of identities. Despite these perceptions of discrimination, participants described supportive aspects of MHTPs. Implications for practice and research are offered.
Objective: The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other ...
Hopper, K; Jost, J; Hay, T; Welber, S; Haugland, G
Research on homelessness among persons with severe mental illness tends to focus on aspects of demand, such as risk factors or structural and economic forces. The authors address the complementary role of supply factors, arguing that "solutions" to residential instability-typically, a series of institutional placements alternating with shelter stays-effectively perpetuate homelessness among some persons with severe mental illness. Thirty-six consecutive applicants for shelter in Westchester County, New York, in the first half of 1995 who were judged to be severely mentally ill by intake workers were interviewed using a modified life chart format. Detailed narrative histories were constructed and reviewed with the subjects. Twenty of the 36 subjects had spent a mean of 59 percent of the last five years in institutions and shelters. Analysis of the residential histories of the 36 subjects revealed that shelters functioned in four distinctive ways in their lives: as part of a more extended institutional circuit, as a temporary source of transitional housing, as a surrogate for exhausted support from kin, and as a haphazard resource in essentially nomadic lives. The first pattern dominated in this group. Shelters and other custodial institutions have acquired hybrid functions that effectively substitute for more stable and appropriate housing for some persons with severe mental illness.
Mar 1, 2013 ... [27,28] Mentally ill children and adolescents may have difficulties in relation to each of the above. For example, any of the developmental disorders – such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorders or intellectual disability – may impair cognitive and decision-making skills.
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…
Rüsch, Nicolas; Corrigan, Patrick W; Todd, Andrew R; Bodenhausen, Galen V
People with mental illness often internalize negative stereotypes, resulting in self-stigma and low self-esteem ("People with mental illness are bad and therefore I am bad, too"). Despite strong evidence for self-stigma's negative impact as assessed by self-report measures, it is unclear whether self-stigma operates in an automatic, implicit manner, potentially outside conscious awareness and control. We therefore assessed (i) negative implicit attitudes toward mental illness and (ii) low implicit self-esteem using 2 Brief Implicit Association Tests in 85 people with mental illness. Implicit self-stigma was operationalized as the product of both implicit measures. Explicit self-stigma and quality of life were assessed by self-report. Greater implicit and explicit self-stigma independently predicted lower quality of life after controlling for depressive symptoms, diagnosis, and demographic variables. Our results suggest that implicit self-stigma is a measurable construct and is associated with negative outcomes. Attempts to reduce self-stigma should take implicit processes into account.
Result: In Canada (and in the USA), attitudes were generally more positive and less socially stigmatizing toward mental illness than in Cameroon. Differences between countries were much larger than differences between language groups. Conclusion: Consistent with other research, beliefs and reactions of the public ...
Danser, Helen Lisanby
The manual is intended to assist the rehabilitation professional in planning services for persons with disabilities, such as long-term mental illness, which require treatment with medication, especially psychotropic medications. The compilation of data groups similar medications together and includes such information as purpose of medication, side…
Additionally, 30 matched, monolingual English, American respondents were included as a ... Results of this field test of the POSHA–MI(e), documenting differences in public attitudes toward mental illness in two divergent cultures, support its further .... things (e.g., lead a normal life or work in jobs requiring good judgment); (f) ...
This paper meets at the crossroads of personal experience and public policy. The personal is the experience of learning as described by five TAFE students with a mental illness. The public policy context is the increased political pressure on Australia's major vocational training providers to increase workforce participation of people with mental…
Margolis, Gary J.; Shtull, Penny R.
Campus police officers are often among the initial contacts for behavioral incidents involving people with mental illness. Their training and access to resources influence decisions to direct the individual to support services and/or through campus disciplinary processes and/or the criminal justice system. Over the past decade, there has been an…
Fernando, Sunera Mayanthi; Deane, Frank P; McLeod, Hamish J
Stigmatizing attitudes towards mental illness can impede help-seeking and adversely affect treatment outcomes, especially if such attitudes are endorsed by medical personnel. In order to help identify targets for anti-stigma interventions, we comprehensively examined negative attitudes towards mental illness displayed by Sri Lankan doctors and medical students and compared these with equivalent UK and other international data. A self-report questionnaire originally developed in the UK was completed by medical students (n = 574) and doctors (n = 74) from a teaching hospital in Colombo. The questions assessed the presence and intensity of stigmatizing attitudes towards patients with schizophrenia, depression, panic disorder, dementia and drug and alcohol addiction. The study revealed higher levels of stigma towards patients with depression, alcohol and drug addiction in this Sri Lankan sample compared to UK data but attitudes towards schizophrenia were less stigmatized in Sri Lanka. Blaming attitudes were consistently high across diagnoses in the Sri Lankan sample. Sri Lankan medical students displayed more negative attitudes than doctors (P addiction, followed by, alcohol addiction, schizophrenia, depression, panic disorder and dementia. Sri Lankan doctors and undergraduates endorse stigmatizing attitudes towards mental illnesses and are especially prone to see patients as blameworthy. As such attitudes are likely to affect the engagement of patients in treatment and specific interventions that modify negative attitudes towards people with mental illnesses are needed. Ensuring that medical students have contact with recovered patients in community psychiatry settings may be one way of decreasing stigmatizing attitudes.
This study was designed to find out the attitude of people in Ekiti State Nigeria, towards epilepsy and mental illness in terms of work opportunities and marriage options and to examine whether the level of education, gender and religious affiliation would affect people's attitude towards person with these disorders.
Objective: To determine the burden of mental illness in the family/caregiver and the community. Design: A cross-sectional descriptive study. Setting: Rehabilitation centres, community day centres, resettlement villages and in the community in three provinces (Harare, Bulawayo and Masvingo), Zimbabwe. Subjects: A sample ...
INTRODUCTION. Prevalence and Socio-Demographic Correlates for. Mental Illness Among Inmates at Lusaka Central. Prison, Zambia. 1. 2*. Mweene Tembalami Nseluke , S Siziya. 1 Clinical Care Department, Chainama Hills College Hospital, Lusaka, Zambia. 2 Public Health Unit, Clinical Sciences Department, School of ...
Waggoner, Elizabeth A.; Howard, Richard; Markos, Patricia A.
This article presents an ethical analysis of the important issues surrounding the involuntary institutionalization of people who are homeless and mentally ill (HMI) in the United States. The legal, economic, and moral implications of state-sponsored involuntary institutionalization of people who are HMI are considered. An ethical decision-making…
Van Hasselt, Fenneke M.; Oud, Marian J. T.; Krabbe, Paul F. M.; Postma, Maarten J.; Loonen, A.J.M.
Background: Patients with severe mental illness (SMI) experience a 13-to 30-year reduction in life expectancy compared with the general population. The majority of these deaths can be attributed to somatic health problems. The risk on somatic health problems is partly increased due to a reduced
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…
Introduction: Labelling remains one of the forms of public stigma experienced by persons with mental illness and this has its attendant consequences not only for the individual sufferer but also for the family members/care-givers and the society as a whole. In a bid to avoid labelling and other forms of public stigma there is a ...
Banks, Andrae; Fields, Lashawnda; O'Dwyer, Curtis; Scott, Marquisha Lawrence; Joe, Sean
Objective: To examine randomized controlled trials (RCTs) for treatment evidence for Black male adolescents suffering from comorbid mental illness and diabetes mellitus. Method: A review of the studies published in English-language journals was conducted. Results: We found no RCT focused on Black males with diabetes mellitus Type 2 (DMT2).…
Gorenstein, Ethan E.
Debate over the existence of mental illness may be abandoned if its two components (first, the conceptual status of psychological variables determining deviance and second, society's response to individuals exhibiting certain behaviors) are disentangled. Disagreement actually centers around professional prerogatives and the legal/ethical status of…
Results indicate that among psychiatric patients more than a third expressed the belief that the overall cause of their mental illness was as a result of supernatural factors. In general, the majority of patients felt that their perception of their problems did not concur with the western practitioner, which in turn caused distress for ...
Bunn, William; Terpstra, Jan
Objective: The authors address the issue of cultivating medical students' empathy for the mentally ill by examining medical student empathy pre- and postsimulated auditory hallucination experience. Methods: At the University of Utah, 150 medical students participated in this study during their 6-week psychiatry rotation. The Jefferson Scale of…
Sarteschi, Christine M
A case of an attempted mass shooting at a large psychiatric hospital in the United States by a 30-year-old male with severe mental illness, somatic delusions, and exceptional access to healthcare professionals is reported. Six persons were shot, one died at the scene, and the shooter was then killed by the police. Data were gathered from court documents and media accounts. An analysis of the shooter's psychiatric history, his interactions with healthcare professionals, and communications prior to the shooting suggest a rare form of mass murder, a random attack by a documented psychotic and delusional individual suffering with somatic delusions. Despite his being psychotic, the killer planned the attack and made a direct threat 1 month prior to the shootings. This case highlights problems with the healthcare system, indicating that it might be ill equipped to appropriately deal with severe mental illness. © 2015 American Academy of Forensic Sciences.
The three main conditions that are associated with childbirth are the maternity blues, postnatal depression and post-partum psychosis. The prevalence of the blues, which are mild, transient and very common disturbances of postnatal mood, does not appear in a major way to be related to environmental, social or cultural factors. Postnatal depression, which has a predominantly psychosocial etiology, surprisingly does not appear to vary in incidence across different cultures in the few studies reported that permit direct comparisons. There is also no good evidence for or against the theory that postnatal depression is partly the consequence of the customs and rituals that traditionally mark the transition to parenthood being stripped away in developed Western societies. However, the lack of relevant research and limitations of method severely restrict any conclusions that can be drawn. There is much firmer evidence for a consistent incidence of post-partum psychosis across cultural and ethnic divides; this observation, together with clinical data and historical evidence of an unchanging incidence rate during the past 150 years, points to a primarily endogenous etiology for the psychoses, which may be triggered by the physiology of childbirth. The transcultural approach to postnatal psychiatric disorders provides a unique opportunity not only to test hypotheses about social and cultural contributions to the etiology of psychotic and non-psychotic reactions to childbirth, but also an opportunity to study the ways in which social factors can influence the evolution of psychopathology. It is also possible that in some cultures the family and social milieu may play a major part in buffering infants from the adverse effects of maternal postnatal illness, but the evidence is anecdotal. Systematic research across cultures will lead to better recognition of maternal illness as well as to better prevention and management.
Kamkar, Mohammad Zaman; Sanagoo, Akram; Zargarani, Fatemeh; Jouybari, Leila; Marjani, Abdoljalal
Background: Metabolic syndrome is commonly associated with cardiovascular diseases and psychiatric mental illness. Hence, we aimed to assess the metabolic syndrome among severe mental illness (SMI). Materials and Methods: The study included 267 patients who were referred to the psychiatric unit at 5th Azar Education Hospital of Golestan University of Medical Sciences in Gorgan, Iran. Results: The mean waist circumference, systolic and diastolic blood pressure, triglyceride and fasting blood glucose levels were significantly higher in the SMI with metabolic syndrome, but the high density lipoprotein (HDL)-cholesterol was significantly lower. The prevalence of metabolic syndrome in SMI patients was 20.60%. There were significant differences in the mean of waist circumference, systolic (except for women) and diastolic blood pressure, triglyceride, HDL-cholesterol and fasting blood glucose in men and women with metabolic syndrome when compared with subjects without metabolic syndrome. The prevalence of metabolic syndrome in SMI women was higher than men. The most age distribution was in range of 30-39 years old. The most prevalence of metabolic syndrome was in age groups 50-59 years old. The prevalence of metabolic syndrome was increased from 30 to 59 years old. Conclusion: The prevalence of metabolic syndrome in patients with SMI in Gorgan is almost similar to those observed in Asian countries. The prevalence of metabolic syndrome was lower than western countries. These observations may be due to cultural differences in the region. It should be mention that the families of mental illness subjects in our country believe that their patients must be cared better than people without mental illness. These findings of this study suggest that mental illness patients are at risk of metabolic syndrome. According to our results, risk factors such as age and gender differences may play an important role in the presence of metabolic syndrome. In our country, women do less
Pinals, Debra A; Anacker, Lisa
Gun violence and mental illness is a major area of media attention, especially because highly publicized mass shootings seem to have become more commonly reported in the press. Gun access also is undergoing a highly politicized debate in the United States. It is important for mental health practitioners to understand the background and context of laws related to firearms access, and to understand data related to risk of suicide and violence toward others caused by gun violence among persons with mental illness. In addition, clinically driven risk assessments with specific inquiry related to firearms can be important for identifying individuals for whom firearm-focused clinical risk mitigation may be warranted. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available In Byzantium mentally ill persons were stigmatized, despite the fact that they could live normally. This stigma consisted a very serious problem not only for the patients themselves, but also for their families.Through the legislation of the Byzantine Emperor Justinian and also the Leo's VI the Wise (9th – 10th A.C. legislation, mental illness was a main health cause of divorce and it concerned both males and females.During these years men were treated different than women, which had to wait five years in order to get a divorce. On the opposite men had to wait only three years to get a divorce for the cause of mentally retarded wife.
Anthony, Kathleen Hope
The intent of this study was to learn how consumers experience helping partnerships that assist them in recovery to inform families, professionals, and peers about meaningful actions and strategies that promote the healing process. In-depth interviews were conducted with a purposeful sample of 10 individuals who had a self-reported diagnosis of severe mental illness. Using the phenomenological research process, helping partnerships and how they develop were described. Six key themes emerged from the data and included Networks of Helping Partnerships, Teaching-Learning, Spirituality, Creative Drive, Time, and Medication Adherence. Characteristics and behaviors of helping partners were identified, as well as structures that promoted their development. Educating the public, consumers, and mental health professionals about how to promote recovery, the role of spirituality and creativity, the benefits of medication and therapy, and the impact of learning on progressing through recovery can go a long way toward eliminating the mystery and fear associated with mental illness.
Del Olmo-Romero, Francisco; González-Blanco, María; Sarró, Salvador; Grácio, Jaime; Martín-Carrasco, Manuel; Martinez-Cabezón, Ana C; Perna, Giampaolo; Pomarol-Clotet, Edith; Varandas, Pedro; Ballesteros-Rodríguez, Javier; Rebolleda-Gil, Carlos; Vanni, Giovanna; González-Fraile, Eduardo
Research shows that personnel working in mental health facilities may share some of the societal prejudices towards mental illness. This might result in stigmatizing behaviours towards people suffering from mental disorders, undermining the quality of their care. To describe and compare attitudes towards mental illness across a sample of professionals working in a wide range of mental health facilities in Spain, Portugal and Italy. We administered a survey to personnel including two questionnaires related to stigmatizing attitudes: The Community Attitudes toward the Mentally Ill (CAMI) and the Attribution Questionnaire (AQ-27). Data were compared according to professional category, work setting and country. 34.06% (1525) professionals of the surveyed population responded adequately. Psychologists and social therapists had the most positive attitudes, and nursing assistants the most negative, on most factors of CAMI and AQ-27. Community staff had more positive attitudes than hospital-based professionals in most factors on CAMI and in discriminatory responses on AQ-27. Globally, mental health professionals showed a positive attitude towards mental illness, but also a relative support to coercive treatments. There are differences in attitudes modulated by professional category and setting. Results can guide preventive strategies, particularly for the hospital-based and nursing staff.
Covarrubias, Irene; Han, Meekyung
In this study, the attitudes toward and beliefs about serious mental illness (SMI) held by a group of graduate social work students in the northwestern United States were examined. Mental health stigma was examined with relation to the following factors: participants' level of social contact with SMI populations, adherence to stereotypes about SMI…
Levine, Irene S.; Rog, Debra J.
Recent research suggests that approximately one-third of homeless single adults suffer from severe mental illnesses. Discusses federal initiatives undertaken by the National Institutes of Mental Health (NIMH) to encourage research and improve services for this subgroup. Describes the target population, NIMH research findings, and current mental…
Viron, Mark; Bello, Iruma; Freudenreich, Oliver; Shtasel, Derri
Specialized transitional shelters are available in various cities to provide assistance to homeless individuals with serious mental illness. Little is known about the population using such shelters. The authors conducted a retrospective chart review to collect demographic, social, and clinical data of residents in a state-operated mental health transitional shelter in Massachusetts. A total of 74 subjects were included. Schizophrenia-spectrum disorders were present in 67.6 % of the sample and mood disorders in 35.1 %. Substance use disorders were documented in 44.6 %. Chronic medical illness (mostly hypertension, dyslipidemia, asthma, and diabetes) was found in 82.4 %. The co-occurrence of a psychiatric and substance use disorder and chronic medical illness was found in 36.5 %. The majority (75.7 %) of patients had a history of legal charges. Homeless individuals with serious mental illness served by specialized transitional shelters represent a population with complex psychiatric, medical and social needs.
Full Text Available This article describes experiences in implementing a community mental health and development project in a rural district in southern India, including the position of persons with mental illness when the project was initiated, the challenges the faced and the strategies that were developed to overcome these challenges. The authors conclude that when services are locally available, persons with mental illness can be treated and rehabilitated within their own community. They can live with dignity and their rights are respected. There is a great need for inclusion of persons with mental illness in the existing developmental activities and in disabled persons’ organizations.doi 10.5463/DCID.v22i2.58
Rayan, Ahmad; Fawaz, Mirna
The purpose of this study was to examine cultural misconceptions about mental illness and how they are associated with the public stigma against mental illness among Lebanese university students. A sample of 203 participants completed the study. Data about cultural misconceptions, attitudes about mental illness, and public stigma of mental illness were obtained. The researchers examined the mean difference in public stigma according to cultural beliefs about mental illness. The majority of students believe that mental health professionals have inadequate knowledge and expertise to treat mental disorders. Various cultural misconceptions about mental illness were reported. Public stigma significantly differed based on these cultural misconceptions. Psychiatric nurses should play a vital role in reshaping the inappropriate cultural view about mental illness. © 2017 Wiley Periodicals, Inc.
Ali, Mana K; Hack, Samantha M; Brown, Clayton H; Medoff, Deborah; Fang, Lijuan; Klingaman, Elizabeth A; Park, Stephanie G; Dixon, Lisa B; Kreyenbuhl, Julie A
Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI. Participants were Veterans who had an SMI being treated at two Veteran Affairs outpatient mental health clinics by a psychiatrist or nurse practitioner. Participants completed the Behavior and Symptom Identification Scale (BASIS-24), Mental Health Recovery Measure, and patient-report Scale to Assess the Therapeutic Relationship (STAR-P) which includes three subscales: positive collaboration, positive clinician input, and non-supportive clinician input. Regression analyses were used to determine interactive effects of race, psychosis severity, and therapeutic alliance variables. The sample was 226 Veterans (50% black, 50% white). Black participants were slightly older (p mental health recovery (p mental health recovery orientation for black participants. Conversely, for white participants, positive collaboration had little effect on the negative relationship between psychosis severity and mental health recovery orientation. Increased levels of psychosis may inhibit patients' perceptions of their ability to recover from SMI. However, for black participants, positive collaboration with mental health providers may moderate the effects of psychotic symptomatology.
Schrank, B; Brownell, T; Tylee, A; Slade, M
This paper reviews the literature on positive psychology with a special focus on people with mental illness. It describes the characteristics, critiques, and roots of positive psychology and positive psychotherapy, and summarises the existing evidence on positive psychotherapy. Positive psychology aims to refocus psychological research and practice on the positive aspects of experience, strengths, and resources. Despite a number of conceptual and applied research challenges, the field has rapidly developed since its introduction at the turn of the century. Today positive psychology serves as an umbrella term to accommodate research investigating positive emotions and other positive aspects such as creativity, optimism, resilience, empathy, compassion, humour, and life satisfaction. Positive psychotherapy is a therapeutic intervention that evolved from this research. It shows promising results for reducing depression and increasing well-being in healthy people and those with depression. Positive psychology and positive psychotherapy are increasingly being applied in mental health settings, but research evidence involving people with severe mental illness is still scarce. The focus on strengths and resources in positive psychology and positive psychotherapy may be a promising way to support recovery in people with mental illness, such as depression, substance abuse disorders, and psychosis. More research is needed to adapt and establish these approaches and provide an evidence base for their application.
Oduguwa, Adeola Oluwafunmilayo; Adedokun, Babatunde; Omigbodun, Olayinka Olusola
Stigmatizing attitudes and discriminatory behaviour towards persons with mental illness are known to start in childhood. In Nigeria, it is not unusual to see children taunting persons with mental illness. This behaviour continues into adulthood as evidenced by the day-to-day occurrences in the community of negative attitudes and social distance from persons with mental illness. School-based interventions for pupils have been found to increase knowledge about mental illness. Children are recognised as potential agents of change bringing in new ways of thinking. This study determined the effect of a 3-day mental health training for school pupils in Southwest Nigeria, on the perceptions of and social distance towards persons with mental illness. A total of 205 school pupils drawn from two administrative wards were randomly assigned to control and experimental groups. The mean age of the pupils was 14.91 years (±1.3). The pupils in the intervention group received a 5-h mental health training session spaced out over 3-days. Apart from didactic lectures, case history presentations and discussions and role-play were part the training. Outcome measures were rated using a knowledge, attitude and social distance questionnaire at baseline, immediately following the training for both group and 3-week post intervention for the intervention group. A Student Evaluation Form was administered to evaluate the pupils' assessment of the training programme. Frequencies, Chi square statistics, paired t test were used to analyse the data received. At immediate post-intervention, the intervention group had a significantly higher mean knowledge score compared to controls, 21.1 vs. 22.0; p = 0.097 to 26.1 vs 22.0; p training was useful to them. Multiple contacts and mixed-method training sessions produced a positive and sustained change in knowledge of and attitude towards persons with mental illness in school pupils in Nigeria.
Vogel, Marc; Frank, Anastasia; Choi, Fiona; Strehlau, Verena; Nikoo, Nooshin; Nikoo, Mohammadali; Hwang, Stephen W; Somers, Julian; Krausz, Michael R; Schütz, Christian G
Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons with mental illness in the At Home/Chez Soi study. Cross-sectional data from a randomized controlled trial on homelessness and mental health. Data collected between 2009 and 2013 in three Canadian cities. One thousand two hundred eighty-seven homeless persons with mental illness. Data on chronic pain and utilization of prescribed and nonprescribed interventions was assessed using a chronic pain screening instrument. Mental illness was diagnosed with the Mini-International Neuropsychiatric Interview. Forty-three percent reported moderate to severe chronic pain, interfering with general daily activities (80%), sleep (78%), and social interactions (61%). Multivariate analysis indicated that increasing age and diagnoses of major depressive disorder, mood disorder with psychotic features, panic disorder, and post-traumatic stress disorder (PTSD) were independent predictors of chronic pain. Chronic pain was further associated with increased suicidality. Among participants reporting chronic pain, 64% had sought medical treatment and 56% treated pain with prescribed drugs, while 38% used illicit drugs for pain relief. Chronic pain is very common among homeless persons with mental illness and affects activities of daily living. Clinicians treating this population should be aware of the common connections between chronic pain, depression, panic disorder, PTSD, and substance use. While the data indicate the contribution of chronic pain to complex treatment needs, they also indicate a clear treatment gap. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Murphy, Suzanne; Irving, Claire B; Adams, Clive E; Driver, Ron
Background A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. Objectives To review the effects of crisis intervention models for anyone with serious mental illness experiencing an acute episode, compared with ‘standard care’. Search methods We updated the 1998, 2003 and 2006 searches with a search of the Cochrane Schizophrenia Group’s Register of trials (2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE, and PsycINFO. Selection criteria We included all randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. Data collection and analysis We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early from a trial had no improvement. Main results Three new studies have been found since the last review in 2006 to add to the five studies already included in this review. None of the previously included studies investigated crisis intervention alone; all used a form of home care for acutely ill people, which included elements of crisis intervention. However, one of the new studies focuses purely on crisis intervention as provided by Crisis Resolution Home Teams within the UK; the two other new studies investigated crisis houses i.e. residential alternatives to hospitalisation providing home-like environments. Crisis intervention appears to reduce repeat admissions to hospital after the initial ‘index’ crises investigated in the included studies, this was particularly so for mobile crisis teams supporting patients in their own homes. Crisis intervention reduces the number of people leaving the study early, reduces family burden, is a more
The stigma associated with schizophrenia is pervasive, both in the community and among healthcare workers, and forms a real barrier to optimal recovery from the illness. The negative consequences of stigma include discrimination in housing, education and employment, and increased feelings of hopelessness in people with schizophrenia. Health professionals have a responsibility to improve their own attitudes and behaviour towards people with schizophrenia so they do not contribute to the stigma. Educational campaigns aimed at people in the community and media personnel could help to demystify mental illness and reduce the portrayal of offensive stereotypes of people with schizophrenia.
Paterson, Andrea; Craig, Rebecca T.
The increasing presence of the mentally ill among the nation's homeless is the topic of this report. The problems presented by deinstitutionalization are discussed, including: (1) the homeless mentally ill as a disruptive element of society; (2) mentally ill persons who shuttle between the hospital and the community; (3) young chronic patients who…
This article shares the author's experience in dealing with her child who has a mental illness. The author hopes that other teachers and school administrators would find her experience helpful when dealing with mentally ill children. The author describes the first steps to learning with a child with a mental illness.
About one-quarter of homeless Americans have serious mental illnesses. This review synthesizes research findings on the cost-effectiveness of services for this population and their relevance for policy and practice. Service interventions for seriously mentally ill homeless people were grouped into three overlapping categories: 1) outreach, 2) case management, and 3) housing placement and transition to mainstream services. Data were reviewed both from experimental studies with high internal validity and from observational studies, which better reflect typical community practice. In most studies, specialized interventions are associated with significantly improved outcomes, most consistently in the housing domain, but also in mental health status and quality of life. These programs are also associated with increased use of many types of health service and housing assistance, resulting in increased costs in most cases. The value of these programs to the public thus depends on whether their greater effectiveness is deemed to be worth their additional cost. Innovative programs for seriously mentally ill homeless people are effective and are also likely to increase costs in many cases. Their value ultimately depends on the moral and political value society places on caring for its least-well-off members.
Witteman, Cilia; Bolks, Lisabeth; Hutschemaekers, Giel
It has been suggested that illness perceptions in mental health are related to treatment outcomes. We aimed to develop a short generic questionnaire to assess clients' problem perceptions in mental health, congruent with the Illness Perception Questionnaire (IPQ) for somatic health. We adapted the IPQ-R (Moss-Morris, R., Weinman, J., Petrie, K.J., Horne, R., Cameron, L.D., & Buick, D. ( 2002 ). Psychology and Health, 17, 1-16) to psychological complaints, in particular the IPQ-R's scales that assess clients' perceptions of what their problem actually is and what its causes are. We administered our adapted instrument, the IPQ-MH, to large groups of mental health clients, and subsequently performed psychometric analyses over the scores. The identity scale of the IPQ-MH differentiates different clients; the structure scale of the IPQ-MH replicates that of the original IPQ-R; the cause scale reliably measures clients' attributions of causes to their mental problems. We conclude that our IPQ-MH can reliably assess clients' mental health problem perceptions. © 2011 Informa UK, Ltd.
Cotton, Sue; Butselaar, Felicity
The aim of the study was to evaluate a novel outdoor adventure camping program for individuals with mental illness. The program was developed by YMCA Victoria in partnership with Sport and Recreation Victoria, and mental health service agencies. Orygen Youth Health Research Centre conducted the program evaluation. One hundred and eight individuals from mental health services across Victoria participated in 12 camps. Five camps targeted young people between the ages of 18 and 25 years. Seven camps were run for adults 26 years and older. Participants were assessed at baseline, end of camp, and four weeks following the camp in terms of self-esteem, mastery, and social connectedness. Quality of life was assessed at baseline and four weeks post-camp. Participants demonstrated significant improvements in mastery, self-esteem and social connectedness from baseline to end of the camp; however, these improvements were not sustained by the four-week follow-up. We have demonstrated that utilizing the expertise of mental health services and a community recreation provider can benefit individuals experiencing mental illness. More research is required with respect to how to sustain these benefits over the longer term.
Nurjannah, I; Mills, J; Park, T; Usher, K
The mentally ill are vulnerable to human rights violations, particularly in Indonesia, where shackling is widespread. The aim of this study was to understand the provision of mental health care in Indonesia, thereby identifying ways to improve care and better support carers. Grounded theory methods were used. Study participants included health professionals, non-health professionals and individuals living with a mental disorder who were well at the time (n = 49). Data were collected through interviews conducted in 2011 and 2012. The core category of this grounded theory is 'connecting care' a term coined by the authors to describe a model of care that involves health professionals and non-health professionals, such as family members. Four main factors influence care-providers' decision-making: competence, willingness, available resources and compliance with institutional policy. Health professionals are influenced most strongly by institutional policy when deciding whether to accept or shift responsibility to provide care. Non-health professionals base their decisions largely on personal circumstances. Jointly-made decisions can be matched or unmatched. Unmatched decisions can result in forced provision of care, increasing risks of human rights violations. Generalization of this grounded theory is difficult as the research was conducted in two provinces of Indonesia. Institutional policy was important in the process of connecting care for the mentally ill in Indonesia and needs to be underpinned by legislation to protect human rights. Strengthening mental health legislation in Indonesia will allow nurses to connect care more effectively. © 2014 International Council of Nurses.
Burnard, P; Naiyapatana, W; Lloyd, G
This paper reports some of the findings of an ethnographic study carried out in Thailand over a 2-year period. Interviews were conducted with three clinical nurses, three student nurses, 14 nurse educators, one psychiatrist, one Buddhist monk and two lay people (n = 24) about their views of mental health and mental health care in Thailand. Data (comprising field notes and interview transcripts) were analysed with the aid of Atlas.ti. Data were also collected through observation and conversation. This paper reports only the findings from the interviews. Findings emerged under the following headings: Causes of mental illness; Status of the mentally ill; Karma; Merit making; Kwan; Treatment and care; Reasons for becoming a mental health nurse. A range of causes, including the effects of ghosts and spirits, were identified under the first heading. The stigma of mental illness was noted under the second. Karma and merit making are Buddhist concepts and were discussed by many respondents as was the animist concept of kwan. Treatment and care seemed to include both 'modern' and 'traditional' approaches. These findings are discussed and some tentative 'rules' that appear to exist within the culture are mooted. The study is descriptive in nature and the findings cannot be generalized; however, it is hoped that they go some way to illuminate aspects of Thai culture as they relate to the mental health and mental health nursing fields.
Maranzan, K Amanda
Mental illness stigma is a common problem in healthcare students and professionals in addition to the general public. Stigma is associated with numerous negative outcomes and hence there is an urgent need to address it. This article explores the potential for interprofessional education (IPE) to emerge as a strategy to reduce mental illness stigma amongst healthcare students and professionals. Most anti-stigma strategies use a combination of knowledge and contact (with a person with lived experience) to change attitudes towards mental illness. Not surprisingly interprofessional educators are well acquainted with theory and learning approaches for attitude change as they are already used in IPE to address learners' attitudes and perceptions of themselves, other professions, and/or teamwork. This article, through an analysis of IPE pedagogy and learning methods, identifies opportunities to address mental illness stigma with application of the conditions that facilitate stigma reduction. The goal of this article is to raise awareness of the issue of mental illness stigma amongst healthcare students and professionals and to highlight interprofessional education as an untapped opportunity for change.
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. Copyright © 2014 Elsevier Ltd. All rights reserved.
In many countries, there continue to be conflicting opinions and mechanisms regarding the appropriateness of treatment and/or punishment for mentally ill individuals who commit crimes. The general population is concerned with public safety and often finds it difficult to accept the possibility that a mentally ill individual who commits a crime can be hospitalized and eventually discharged, sometimes after a relatively short time. In most countries the options of incarceration and hospitalization are available in concert. In some, incarceration occurs before hospitalization. In others, hospitalization is first, followed by a prison term. An additional option could be "treatment years." The court would determine the number of years of treatment required, according to the crime. This dilemma has no unequivocal solution. The goal is to reach a balance between the right of the patient to treatment and the responsibility of the courts to ensure public safety.
Mowbray, C T; Bybee, D; Cohen, E
Presented descriptive data on a group of homeless, mentally ill individuals (N = 108) served by a two-site demonstration project, funded by NIMH. Comparing results with those from other studies of this population produced some differences and some similarities. Cluster analysis techniques were applied to the data, producing a 4-group solution. Data validating the cluster solution are presented. It is suggested that the cluster results provide a more meaningful and useful method of understanding the descriptive data. Results suggest that while the population of individuals served as homeless and mentally ill is quite heterogeneous, many have well-developed functioning skills--only one cluster, making up 35.2% of the sample, fits the stereotype of the aggressive, psychotic individual with skill deficits in many areas. Further discussion is presented concerning the implications of the cluster analysis results for demonstrating contextual effects and thus better interpreting research results from other studies and assisting in future services planning.
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…
Bould, Helen; Koupil, Ilona; Dalman, Christina; DeStavola, Bianca; Lewis, Glyn; Magnusson, Cecilia
To investigate which parental mental illnesses are associated with eating disorders in their offspring. We used data from a record-linkage cohort study of 158,679 children aged 12-24 years at the end of follow-up, resident in Stockholm County from 2001 to 2007, to investigate whether different parental mental illnesses are risk factors for eating disorders in their offspring. The outcome measure was diagnosis of any eating disorder, either from an ICD or DSM-IV code, or inferred from an appointment at a specialist eating disorder clinic. Mental illness in parents is a risk factor for eating disorders in female offspring (Adjusted Hazard Ratio (AHR) 1.57 (95% CI 1.42, 1.92), p eating disorders is increased if there is a parental diagnosis of bipolar affective disorder (AHR 2.28 (95% CI 1.39, 3.72), p = 0.004), personality disorder (AHR 1.57 (95% CI 1.01, 2.44), p = 0.043) or anxiety/depression (AHR 1.57 (95% CI 1.32, 1.86), p disorder (AHR 1.25 (95% CI 0.74, 2.13), p = 0.40). There is no support for a relationship between parental substance misuse and eating disorders in children (AHR 1.08 (95% CI 0.82, 1.43), p = 0.57). Parental mental illness, specifically parental anxiety, depression, bipolar affective disorder, and personality disorders, are risk factors for eating disorders in their offspring. © 2014 Wiley Periodicals, Inc.
Larsen, Maja; Nordentoft, Merete
A systematic review of the literature shows that it is possible to reduce homelessness among mentally ill homeless persons, partly by offering access to housing and partly by providing intensive care through Assertive Community Treatment. Assertive Community Treatment can, to some extent, decrease psychiatric symptoms and increase quality of life. It is evident that by offering housing, homelessness may be reduced, but the comparison of independent housing and group living did not reveal big differences.
Full Text Available Severe mental illness 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 severe mental illness. Multiple lines of evidence suggest that the roles of genetic and environmental 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 severe mental illness and the heritability gap between twin and molecular heritability estimates. Sons and daughters of parents with severe mental illness 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 BDNF and stressful life events triggering bipolar depressive episodes. The first systematic search for gene-environment interactions has found that a polymorphism in CTNNA3 may sensitise 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.
Hean, Sarah; Ødegård, Atle; Willumsen, Elisabeth
Purpose Interprofessional collaboration is necessary when supporting mentally ill offenders but little is understood of these interactions. The purpose of this paper is to explore prison officers' perceptions of current and desirable levels of interprofessional collaboration (relational coordination (RC)) to understand how collaboration between these systems can be improved. Design/methodology/approach Gittell's RC scale was administered to prison officers within the Norwegian prison system ( n=160) using an adaptation of the instrument in which actual and desired levels of RC are evaluated. This differentiates between prison officers' expectations of optimum levels of collaboration with other professional groups, dependent on the role function and codependence, vs actual levels of collaboration. Findings Prison officers reported different RC levels across professional groups, the lowest being with specialist mental health staff and prison doctors and highest with nurses, social workers and other prison officers. Significant differences between desired and actual RC levels suggest expertise of primary care staff is insufficient, as prison officers request much greater contact with mental health specialists when dealing with the mentally ill offender. Originality/value The paper contributes to limited literature on collaborative practice between prison and health care professionals. It questions the advisability of enforcing care pathways that promote the lowest level of effective care in the prison system and suggest ways in which mental health specialists might be better integrated into the prison system. It contributes to the continued debate on how mental health services should be integrated into the prison system, suggesting that the current import model used in Norway and other countries, may not be conducive to generating the close professional relationships required between mental health and prison staff.
Bissland, James H.; Munger, Richard
Efforts to foster mental health care in society have always been hampered by the stigma attached to mental illness. To identify differential patterns of attitude hierarchies among people who live in or provide mental health services in a typical urban area, 54 adults participated in a Q methodology study of their attitudes toward mental illness.…
Kozloff, Nicole; Adair, Carol E; Palma Lazgare, Luis I; Poremski, Daniel; Cheung, Amy H; Sandu, Rebeca; Stergiopoulos, Vicky
"Housing First" has been shown to improve housing stability in homeless individuals with mental illness, but had not been empirically tested in homeless youth. We aimed to evaluate the effect of "Housing First" on housing stability in homeless youth aged 18 to 24 years participating in At Home/Chez Soi, a 24-month randomized trial of "Housing First" in 5 Canadian cities. Homeless individuals with mental illness were randomized to receive "Housing First" (combined with assertive community treatment or intensive case management depending on their level of need) or treatment as usual. We defined our primary outcome, housing stability, as the percent of days stably housed as a proportion of days for which residence data were available. Of 2148 participants who completed baseline interviews and were randomized, 7% (n = 156) were youth aged 18 to 24 years; 87 received "Housing First" and 69 received treatment as usual. In an adjusted analysis, youth in "Housing First" were stably housed a mean of 437 of 645 (65%) days for which data were available compared with youth in treatment as usual, who were stably housed a mean of 189 of 582 (31%) days for which data were available, resulting in an adjusted mean difference of 34% (95% confidence interval, 24%-45%; P < .001). "Housing First" was associated with improved housing stability in homeless youth with mental illness. Future research should explore whether adaptations of the model for youth yield additional improvements in housing stability and other outcomes. Copyright © 2016 by the American Academy of Pediatrics.
The painting of the mentally ill has fascinated artists and their public throughout the 20th century. Yet the psychologically as well as art-historically interesting topic can be traced back over a long period in the history of Western culture. Aristotle emphasizes that all men who create great works, such as artists, philosophers, poets and politicians, are prone to melancholy, that excess of black gall which is characteristic of artists and depressive. Although Plato distinguished between creative and clinical mania, the topos of "genius and madness" prevails up to our century. The cult of melancholy is taken up bei Marsilio Ficino and becomes fashionable among the artists of the 16th and 17th centuries. During the Romantic period of the early 19th century the psychologically unstable or even sick intellectual and artist becomes the focus of attention. Artistic madness is glorified in an almost mystical fashion. However, disillusionment was soon to follow. Schopenhauer, Lombroso and many physicians stress the close relationship between genius and madness. However, they judge madness to be merely morbid and negative. During the 20th century the artists of the avantgarde show much interest in psychoanalysis and in the art of the mentally ill. The rise of National Socialism brought about a drastic break in the appraisal of the art of the mentally ill, which today is an acknowledged factor in contemporary art.
Glover, Crystal M; Ferron, Joelle C; Whitley, Rob
Lack of exercise is a risk factor for various negative health outcomes. Some research suggests people with severe mental illnesses are less likely to engage in exercise than the general population. The purpose of this report is to document, analyze, and understand self-identified barriers to exercise that may be especially specific to people living with serious mental illnesses. Producing such knowledge can assist in the development of effective interventions. Thirty-one people with serious mental illnesses participated in in-depth one-on-one interviews to discuss health behaviors in general and exercise more specifically. The authors then engaged in thematic analysis of data to identify common barriers to exercise. Participants reported psychiatric medication side effects, symptoms related to SMI, and physical comorbidities as barriers. Clinicians should incorporate physical health goals as a part of treatment planning. Agencies also can play a role in increasing exercise through the implementation of programs. PsycINFO Database Record (c) 2013 APA, all rights reserved
McGinty, Emma Elizabeth; Webster, Daniel W; Barry, Colleen L
In response to recent mass shootings, policy makers have proposed multiple policies to prevent persons with serious mental illness from having guns. The political debate about these proposals is often uninformed by research. To address this gap, this review article summarizes the research related to gun restriction policies that focus on serious mental illness. Gun restriction policies were identified by researching the THOMAS legislative database, state legislative databases, prior review articles, and the news media. PubMed, PsycINFO, and Web of Science databases were searched for publications between 1970 and 2013 that addressed the relationship between serious mental illness and violence, the effectiveness of gun policies focused on serious mental illness, the potential for such policies to exacerbate negative public attitudes, and the potential for gun restriction policies to deter mental health treatment seeking. Limited research suggests that federal law restricting gun possession by persons with serious mental illness may prevent gun violence from this population. Promotion of policies to prevent persons with serious mental illness from having guns does not seem to exacerbate negative public attitudes toward this group. Little is known about how restricting gun possession among persons with serious mental illness affects suicide risk or mental health treatment seeking. Future studies should examine how gun restriction policies for serious mental illness affect suicide, how such policies are implemented by states, how persons with serious mental illness perceive policies that restrict their possession of guns, and how gun restriction policies influence mental health treatment seeking among persons with serious mental illness.
Conclusion: Attribution of depressive and anxiety symptoms appeared to be more likely to influence help-seeking behaviors than attitudes toward mental illness. Enhancing public mental health literacy toward depression may help facilitate help-seeking in response to potential mental illness.
Kasprow, W J; Rosenheck, R
This study directly compared mortality risk in homeless and nonhomeless mentally ill veterans and compared mortality rates in these groups with the general U.S. population. The study used a retrospective cohort design to assess mortality over a 9-year period in homeless (N = 6,714) and nonhomeless (N = 1,715) male veterans who were treated by Department of Veterans Affairs specialized mental health programs. The study showed that mortality rates in all homeless members of the cohort were significantly higher than the general U.S. population. Relative to nonhomeless cohort members, significant increases in mortality risk were observed in cohort members who at baseline were age 45 to 54 and had been homeless 1 year or less (RR = 1.55, 95% CI = 1.02, 2.36) and those age 55 and older who had been homeless 1 year or less (RR = 1.83, 95% CI = 1.33, 2.52). Similar, but nonsignificant trends were observed in cohort members who had been homeless more than 1 year at baseline. Additionally, medical problems at baseline and history of prior hospitalization for alcohol problems elevated mortality risk. Employment at baseline and minority group membership reduced mortality risk. The study suggests that mentally ill veterans served by specialized VA mental health programs are at elevated risk of mortality, relative to the general population. Homelessness increases this risk, particularly in older veterans, and this difference does not abate after entry into a health care system.
Studies of employee assistance program (EAP) clinical use across multiple industries and multiple EAP delivery models range from highs greater than 5% to lows of less than 1 %. Despite the range in utilization, the rates of employee behaviors that indicate a behavioral health issue are significantly higher, suggesting far too little use of EAPs overall. Studies of the costs to an employer for an employee with a mental health issue are as high as 37% lost annual productivity. EAPs have attempted to raise utilization through a variety of efforts, with mixed results. Most EAP utilization initiatives fail to address the impact of stigma, misunderstandings about mental illness and the reluctance of many employees to seek counseling as an option for better management of stress, work-life balance and overall mental wellness. For both employers and EAPs, addressing the impact of stigma and perceptions of mental illness is costly, requiring greater direct employee engagement and education. However, it is a more effective means of increasing EAP use than current practices and, ultimately, can result in significantly higher net gains in productivity while reducing employers' direct costs.
Stoklosa, Hanni; MacGibbon, Marti; Stoklosa, Joseph
This article reviews an emergency department-based clinical vignette of a trafficked patient with co-occurring pregnancy-related, mental health, and substance use disorder issues. The authors, including a survivor of human trafficking, draw on their backgrounds in addiction care, human trafficking, emergency medicine, and psychiatry to review the literature on relevant general health and mental health consequences of trafficking and propose an approach to the clinical complexities this case presents. In their discussion, the authors explicate the deleterious role of implicit bias and diagnostic overshadowing in trafficked patients with co-occurring addiction and mental illness. Finally, the authors propose a trauma-informed, multidisciplinary response to potentially trafficked patients. © 2017 American Medical Association. All Rights Reserved.
Full Text Available BACKGROUND: The current investigation examined the psychometric properties of the Internalized Stigma of Mental Illness (ISMI scale in a sample of patients with mental illness. In addition to the internal consistency, test-retest reliability, and concurrent validity that previous studies have tested for the ISMI, we extended the evaluation to its construct validity and measurement invariance using confirmatory factor analysis (CFA. METHODS: Three hundred forty-seven participants completed two questionnaires (i.e., the ISMI and the Depression and Somatic Symptoms Scale [DSSS], and 162 filled out the ISMI again after 50.23±31.18 days. RESULTS: The results of this study confirmed the frame structure of the ISMI; however, the Stigma Resistance subscale in the ISMI seemed weak. In addition, internal consistency, test-retest reliability, and concurrent validity were all satisfactory for all subscales and the total score of the ISMI, except for Stigma Resistance (α = 0.66; ICC = 0.52, and r = 0.02 to 0.06 with DSSS. Therefore, we hypothesize that Stigma Resistance is a new concept rather than a concept in internalized stigma. The acceptable fit indices supported the measurement invariance of the ISMI across time, and suggested that people with mental illness interpret the ISMI items the same at different times. CONCLUSION: The clinical implication of our finding is that clinicians, when they design interventions, may want to use the valid and reliable ISMI without the Stigma Resistance subscale to evaluate the internalized stigma of people with mental illness.
Ribe, Anette Riisgaard; Vestergaard, Mogens; Katon, Wayne
OBJECTIVE: Persons with severe mental illness die 15-20 years earlier on average than persons without severe mental illness. Although infection is one of the leading overall causes of death, no studies have evaluated whether persons with severe mental illness have a higher mortality after infection...... than those without. METHOD: The authors studied mortality rate ratios and cumulative mortality proportions after an admission for infection for persons with severe mental illness compared with persons without severe mental illness by linking data from Danish national registries. RESULTS: The cohort...... consisted of all persons hospitalized for infection during the period 1995-2011 in Denmark (N=806,835), of whom 11,343 persons had severe mental illness. Within 30 days after an infection, 1,052 (9.3%) persons with a history of severe mental illness and 58,683 (7.4%) persons without a history of severe...
Erik M. Lund
Full Text Available Biases against the mentally ill are historically and cross-culturally pervasive, suggesting they may have an evolutionary basis. The prevailing view is that people seek to distance themselves from the mentally ill because they are perceived as dangerous, violent, and incompetent. However, because of similarities between sickness behaviors and symptoms of some mental disorders, it was hypothesized that mental illness stigma could be partially explained as a function of behavioral immune system biases designed to avoid potential sources of contagion. In two experiments, it was found that mental illness was implicitly associated more with disease than danger. In Experiment 1, this implicit association was exacerbated among people who have had their biological immune system activated by a recent illness. In Experiment 2, experimentally priming disease salience increased implicit association between mental illness and disease. Implications for the evolutionary origins of prejudice and the prevention of mental illness stigma are discussed.
Sheldon, C T; Aubry, T D; Arboleda-Florez, J; Wasylenki, D; Goering, P N
The following study evaluates the complex association between legal involvement and mental illness. It describes a population of consumers of community mental health programs, comparing those with legal involvement to those without legal involvement, on a number of demographic, clinical and social indicators. It is a secondary analysis of data collected in studies making up the Community Mental Health Evaluation Initiative (CMHEI) in the province of Ontario, Canada. Legal involvement was a significant issue among community mental health program consumers; about one in five consumers had at least some contact with the legal system in the preceding nine months. Legally involved consumers were more likely to be in receipt of social assistance and be unstably housed than those legally uninvolved. However, there were no significant differences between legally involved and uninvolved consumers with respect to severity of symptomatology, current medication use or number of hospitalization days in the past 9 months. A predictive model compared the differential impact of clinical and social determinants upon legal involvement. Analyses failed to uncover a significant relationship between severity of psychiatric symptomatology and legal involvement. Significant predictors of legal involvement included gender, race, drug use as well as housing instability, and receipt of social assistance. Legal involvement was attributable to factors other than the severity of mental illness; these results challenge assumptions that the most symptomatically severe consumers are most at risk of legal involvement. Accordingly, the rate of legal involvement in a sample of community mental health program users must be considered in a broad context, with particular emphasis on social disadvantage.
Anoshiravani, Arash; Saynina, Olga; Chamberlain, Lisa; Goldstein, Benjamin A; Huffman, Lynne C; Wang, N Ewen; Wise, Paul H
Objective To describe inpatient hospitalization patterns among detained and non-detained youth in a large, total population of hospitalized adolescents in California. Methods We examined the unmasked California Office of Statewide Health Planning and Development Patient Discharge Dataset from 1997-2011. We considered hospitalized youth aged 11-18 years “detained” if admitted to California hospitals from detention, transferred from hospital to detention, or both. We compared discharge diagnoses and length of stay (LOS) between detained youth and their non-detained counterparts in the general population. Results There were 11,367 hospitalizations for detained youth. Hospitalizations differed for detained versus non-detained youth: 63% of all detained youth had a primary diagnosis of mental health disorder (compared to 19.8% of non-detained youth). Detained girls were disproportionately affected, with 74% hospitalized for a primary mental health diagnosis. Detained youth hospitalized for mental health disorder had an increased median LOS compared to non-detained inpatient youth with mental illness (≥6 days versus 5 days, respectively). This group difference was heightened in the presence of minority status, public insurance, and concurrent substance abuse. Hospitalized detained youth discharged to chemical dependency treatment facilities had the longest hospital stays (≥43 days). Conclusions Detained juvenile offenders are hospitalized for very different reasons than the general adolescent population. Mental illness, often with comorbid substance abuse, requiring long inpatient stays, represents the major cause for hospitalization. These findings underscore the urgent need for effective, well-coordinated mental health services for youth before, during, and after detention. PMID:26208862
Moore, D.; Drey, N.; Ayers, S.
BACKGROUND: Perinatal mental illness is a global health concern; however, many women with the illness do not get the treatment they need to recover. Interventions that reduce the stigma around perinatal mental illness have the potential to enable women to disclose their symptoms to health care providers and consequently access treatment. There are many online forums for perinatal mental illness and thousands of women use them. Preliminary research suggests that online forums may promote help-...
Bigelow, D A; Sladen-Dew, N; Russell, J S
Over the past twenty years, GVMHS has been the single organization taking ultimate responsibility for the seriously mentally ill throughout the city. It uses central coordination coupled with community-based teams and partnership programs with other agencies to strike a useful balance between integration and flexibility. GVMHS's mission throughout that time has been to provide everyday community support, networking, case management, rehabilitation, and counseling services to as many seriously mentally ill persons with concomitant disabilities as possible. To carry out that mission, GVMHS has developed some innovative solutions for the problems of community support--problems such as psychiatric emergencies, crises, community demands for service outside the mandate, and workload management. GVMHS has also developed dual-diagnosis, multicultural, multiagency case coordination for the multiproblem client (Buckley and Bigelow, 1992), specialized family and child programs, and specialized geriatric programs. This has all been possible only because financial support is available on an ongoing basis at a level adequate to provide good, dependable services. GVMHS has been proven an effective service in a number of studies (Bigelow and Beiser, 1978; Beiser, Shore, Peters, and Tatum, 1985). It has also demonstrated good cost-efficiency (Bigelow and McFarland, 1989) and abundant innovation and adaptation to emerging challenges (Bigelow, McFarland, Russell, and Sladen-Dew, 1990). It has proven that dedicated, well-trained professionals working at the community level will work hard and smart and that an agency and its staff will stick to the mandate of serving people with serious mental illnesses and disabilities even under pressure to do otherwise. The intriguing thing is that this productivity is not driven by competition, incentives, or threat: none of these factors presses upon the Greater Vancouver Mental Health Services Society from without and none is built in. The
Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A; Pratt, Sarah I; Bartels, Stephen J
Young adulthood represents a critical time to address elevated obesity rates and the risk of early mortality, particularly among people with serious mental illness. Few studies have assessed the benefits of lifestyle interventions targeting weight loss among these young adults. This study examined the impact of the 12-month In SHAPE lifestyle intervention on weight loss and fitness among overweight and obese young adults with serious mental illness (ages 21-30) compared with participants over age 30. Data were combined from three trials of the 12-month In SHAPE program delivered through community mental health centers. In SHAPE includes weekly fitness trainer meetings, a gym membership, and nutrition education. Primary outcomes were weight loss and change in fitness at 12 months. Participants (N=194) had a schizophrenia spectrum disorder (53%) or a mood disorder (47%). The overall sample achieved significant weight loss and improved fitness; differences between young adults (N=29) and participants over age 30 (N=165) were not significant. An important finding was that 42% of young adults achieved clinically significant reductions in cardiovascular risk, defined as ≥5% weight loss or improved fitness (>50-m increase on the 6-Minute Walk Test), compared with 54% of adults over age 30 (a nonsignificant difference between age groups). Among persons enrolled in a lifestyle intervention, overweight and obese young adults experienced benefits comparable with those of adults over age 30. Young adults with serious mental illness face high risk of gaining weight, but a meaningful proportion of these individuals can achieve clinically significant cardiovascular risk reduction, thus highlighting the need to promote lifestyle intervention participation in this group.
Rüger, Heiko; Löffler, Isabel; Ochsmann, Elke; Alsmann, Christine; Letzel, Stephan; Münster, Eva
In Germany, over-indebtedness of private households has been steadily increasing and is currently estimated to affect about 3 million private households. It is almost unknown in the German-speaking part, to what extent financial strain due to excessive debts is accompanied by mental health problems in affected persons. A cross-sectional study including over-indebted persons was conducted between July 2006 and March 2007 in Rhineland-Palatinate by an anonymously filled-in questionnaire of clients of debt counselling services. Altogether 666 persons (51% women) aged between 18-79 years took part (participation rate: 35.5%). 40% of the collective reported a current mental disorder. Especially persons experiencing over-indebtedness as a threat and cannot rely on a functioning social network are in danger of experiencing mental illnesses. When treating mental illnesses, the financial situation of the diseased person should be taken into account and the support of debt counselling services should be used at an early stage. Georg Thieme Verlag KG Stuttgart-New York.
Opare-Henaku, Annabella; Utsey, Shawn O
Mental illness is a culturally laden phenomenon, and different cultures have unique ways of constructing mental illness. In this study, conceptions of mental illness were explored among 30 participants of Akan descent in Ghana through individual and group interviews. Participants demonstrated a wide range of knowledge on mental illness indicating that poor self-care, deficits in social functioning, and disordered behaviors are the cardinal features of mental illness. The data revealed that Akan cultural beliefs influenced notions of etiology of mental illness and care of the mentally ill. While participants recognized the role of multiple factors such as genetics, substance abuse, daily hassles (for example, concerns about basic needs such as food, clothing, and shelter), and trauma in the cause of mental illness, the predominant belief was that mental illness is a retributive and/or a spiritual illness. This belief encourages pluralistic health-seeking behaviors: use of hospitals, prayer camps, herbalists, and traditional healers. The implications of these findings for public health education on mental illness, and clinical training and practice are discussed.
Bennett, J; Stennett, R
There is longstanding evidence of nurses demonstrating negative attitudes towards people with mental illness. Student nurses' fear or discomfort with mentally ill patients results in poorer outcomes for patients and students' dissatisfaction with their experience of mental health nursing. There is evidence of negative attitudes towards mental illness in the Jamaican society; however, no studies have explored whether these attitudes are held by nursing students. The aim of the study was to examine the attitudes of nursing students towards mental illness. A questionnaire survey was conducted with a convenience sample of 143 third-year nursing students who were enrolled in a baccalaureate programme. Data were collected using the Attitudes Towards Acute Mental Health Scale (ATAMHS). A response rate of 71% was achieved for the survey. The findings indicated that the student nurses held an overall negative attitude towards mental illness, with a general perception that mentally ill people are dangerous. The student nurses were divided in their opinions in a number of areas, suggesting a possible conflict of opinions. Negative attitudes towards mental illness impact client outcomes and the career choices made by nurses. This study provides baseline data within the Jamaican context that adds to the evidence on nursing students' attitude to mental illness. Further research is needed to explore whether nursing education and clinical experience enables student nurses in Jamaica to develop a more positive attitude towards mental illness and mental health nursing and whether cultural factors contribute to negative attitudes. © 2015 John Wiley & Sons Ltd.
Ali, Mana K.; Hack, Samantha M.; Brown, Clayton H.; Medoff, Deborah; Fang, Lijuan; Klingaman, Elizabeth; Park, Stephanie G.; Dixon, Lisa B.; Kreyenbuhl, Julie A.
Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI. Participants were Veterans who had an SMI being treated at two Veteran Affairs outpatient mental health clinics by a psychiatrist or nurse practitioner. Participants completed the Behavior and Symptom Identification Scale (BASIS-24), Mental Health Recovery Measure, and patient-report Scale to Assess the Therapeutic Relationship (STAR-P) which includes three subscales: positive collaboration, positive clinician input, and non-supportive clinician input. Regression analyses were used to determine interactive effects of race, psychosis severity, and therapeutic alliance variables. The sample was 226 Veterans (50% black, 50% white). Black participants were slightly older (p < .05), had higher baseline psychosis (p < .05), higher mental health recovery (p < .05), and perceived less non-supportive clinician input (p < .01) than white participants. Regression analyses indicated a significant three-way interaction among race, psychosis, and positive collaboration (p < .01). Greater positive collaboration attenuated the negative effect of higher levels of psychosis on mental health recovery orientation for black participants. Conversely, for white participants, positive collaboration had little effect on the negative relationship between psychosis severity and mental health recovery orientation. Increased levels of psychosis may inhibit patients’ perceptions of their ability to recover from SMI. However, for black participants, positive collaboration with mental health providers may moderate
Wahl, Otto; Aroesty-Cohen, Eli
A large body of research has documented public attitudes toward people with mental illness. The current attitudes of the people who provide services to those with psychiatric disorders are important to understand, as well. The authors review what studies over the past 5 years reveal about the attitudes of psychiatric professionals. Empirical…
Flèche, Sarah; Layard, Richard
Studies of deprivation usually ignore mental illness. This paper uses household panel data from the USA, Australia, Britain and Germany to broaden the analysis. We ask first how many of those in the lowest levels of life-satisfaction suffer from unemployment, poverty, physical ill health, and mental illness. The largest proportion suffers from mental illness. Multiple regression shows that mental illness is not highly correlated with poverty or unemployment, and that it contributes more to explaining the presence of misery than is explained by either poverty or unemployment. This holds both with and without fixed effects.
Ogloff, James R P; Talevski, Diana; Lemphers, Anthea; Wood, Melisa; Simmons, Melanie
Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Hanafiah, Ainul Nadhirah; Van, Bortel Tine
Background Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and ?stigma?. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public a...
Haeyen, S.W.; Hooren, S. van; Veld, W.M. van der; Hutschemaekers, G.J.M.
The distinction between mental health and mental illness has long been the subject of debate, especially in the last decade where there has been a shift in focus in mental health care from symptom reduction to the improvement of positive mental health. Art therapists have been influenced by this
Mar 1, 2009 ... illnesses account for 11.5% of the global burden of disease – a figure that is projected to increase to 15% by 2020. Worldwide,. 340 million people suffer from mental illnesses, with the majority living in the developing world.3. In Nigeria, the prevalence of mental illness is reported at 20%.4. With a population ...
Moore, Donna; Ayers, Susan; Drey, Nicholas
This study aimed to develop and validate a scale to measure perceived stigma for perinatal mental illness in women. Stigma is one of the most frequently cited barriers to seeking treatment and many women with perinatal mental illness fail to get the treatment they need. However, there is no psychometric scale that measures how women may experience the unique aspects of perinatal mental illness stigma. A draft scale of 30 items was developed from a literature review. Women with perinatal mental illness (n = 279) were recruited to complete the City Mental Illness Stigma Scale. Concurrent validity was measured using the Internalised Stigma of Mental Illness Scale. Factor analysis was used to create the final scale. The final 15-item City Mental Illness Stigma Scale has a three-factor structure: perceived external stigma, internal stigma and disclosure stigma. The scale accounted for 54% of the variance and had good internal reliability and concurrent validity. The City Mental Illness Stigma Scale appears to be a valid measure which provides a potentially useful tool for clinical practice and research in stigma and perinatal mental illness, including assessing the prevalence and characteristics of stigma. This research can be used to inform interventions to reduce or address the stigma experienced by some women with perinatal mental illness.
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.
Appel, Philip W; Tsemberis, Sam; Joseph, Herman; Stefancic, Ana; Lambert-Wacey, Dawn
The Housing First approach used by Pathways to Housing, Inc., was used to enhance residential independence and treatment retention of homeless, seriously mentally ill methadone patients. The Keeping Home project first secured scattered-site apartments and assertive community treatment services and then addressed patients' service needs. Three years post-implementation, methadone treatment retention for 31 Keeping Home patients versus 30 comparison participants (drawn from an administrative database) was 51.6% vs. 20% (p < .02); apartment/independent housing retention was 67.7% vs. 3% or 13% (both p's < .01). Although results firmly support Keeping Home, future research needs to address study's possible database limitations.
Westergård-Nielsen, Niels Chr.; Agerbo, Esben; Eriksson, Tor Viking
after hospital treatment is about 35% lower for cases than for controls and varies somewhat depending on diagnosis. On average, those who keep their jobs have 20% lower earnings compared to a control group. We use longitudinal data from labour market registers covering a 5% sample of the Danish adult......This paper investigates the effect of severe mental illness on the capacity to hold a job and to earn an income. We find that the employment rate is reduced with about 1/3 during the development of the disease. Hospital admission seems to stabilize employment for all diagnoses. The employment rate...
The legal and ethical debate surrounding the right of mentally ill patients to refuse life saving medical treatment is one area in the spectrum of patient rights that the medical community has failed to fully explore. To better investigate this concept, it is important to first focus on the history of the right to refuse treatment for all patients. Case studies then explore arguments on both sides of the issue, and focus discussion on the inadequacies of the current standards, a need for further study and universal testing principles in order to provide all patients with the rights they deserve.
Malley, Sharon M; Dattilo, John; Gast, David
Single-subject multiple probe designs were employed in two studies with 5 young adults who had a dual diagnosis of mental retardation and mental illness. Our aim was to determine effects of instruction designed to teach visual arts activity skills and promote personal expressiveness on acquisition, maintenance, and generalization of these skills and behaviors associated with these persons' mental health. In Study 1, a 5-second constant time delay procedure was used to teach three chosen art activities. In Study 2, an instructional package was used to promote personally expressive behaviors. After learning the skills in Study 1, participants in Study 2 displayed improvement in occurrence of behaviors associated with mental illness and increases in personally expressive behaviors.
Annamalai, Aniyizhai; Singh, Noreen; O’Malley, Stephanie S.
Smoking rates in people with serious mental illness (SMI) are disproportionately high compared to the general population. It is a leading contributor to the early mortality in this population. Smoking cessation rates are low in this group, though patients are motivated to quit. Unfortunately, health care providers do not always prioritize smoking cessation for this population. This review provides an overview of prevalence rates, biological effects that maintain smoking, and evidence-based treatments for smoking cessation in SMI. In addition, objective and qualitative data from a chart review of 78 patients with SMI prescribed smoking cessation treatment at one community mental health center are described. Of these, 30 (38.5 percent) were found to either quit (16/78) or reduce (14/78) smoking. Varenicline appeared to be particularly effective. Review of the literature and results of this study suggest that smoking cessation pharmacotherapies are effective for SMI patients and should be offered to those who smoke. PMID:26339210
Ikwuka, Ugo; Galbraith, Niall; Nyatanga, Lovemore
Understanding of mental illness in sub-Saharan Africa has remained under-researched in spite of the high and increasing neuropsychiatric burden of disease in the region. This study investigated the causal beliefs that the Igbo people of south-eastern Nigeria hold about schizophrenia, with a view to establishing the extent to which the population makes psychosocial, biological and supernatural attributions. Multi-stage sampling was used to select participants (N = 200) to which questionnaires were administered. Mean comparison of the three causal models revealed a significant endorsement of supernatural causation. Logistic regressions revealed significant contributions of old age and female gender to supernatural attribution; old age, high education and Catholic religious denomination to psychosocial attributions; and high education to biological attributions. It is hoped that the findings would enlighten, augment literature and enhance mental health care service delivery.
Full Text Available Background. Mental illness is an important public health issue worldwide; stigmatisation and negative attitudes towards people with mental illness are widespread among the general public. However, little is known about the attitudes of undergraduates to mental illness. Purpose. To compare the attitudes towards mental illness among undergraduates enrolled in nursing courses v. those enrolled in Bachelor of Business Management (BBM courses. Methods. A cross-sectional descriptive design was adopted for the present study. A total of 268 undergraduates were selected to complete the Attitude Scale for Mental Illness (ASMI and the Opinions about Mental Illness in the Chinese Community (OMICC questionnaires. Results. We found significant differences between the number of nursing and BBM students who agreed with statements posed by the questionnaires, e.g., that they would move out of their community if a mental health facility was established there (χ2=16.503, p<0.002, that they were not afraid of treated mentally ill people (χ2=15.279, p<0.004, and that people with mental illness tend to be violent (χ2=14.215, p<0.007 and dangerous (χ2=17.808, p<0.001. Nursing students disagreed that people with mental illness are easily identified (χ2=30.094, p<0.000, have a lower IQ (χ2=70.689, p<0.000 and should not have children (χ2=24.531, p<0.000. Nursing students were more benevolent than BBM students, as they agreed that people with mental illness can hold a job (χ2=49.992, p<0.000 and can return to their former position (χ2=11.596, p<0.021, that everyone faces the possibility of becoming mentally ill (χ2=38.726, p<0.000, and that one should not laugh at the mentally ill (χ2=17.407, p<0.002. Nursing students held less pessimistic attitudes, as they felt that the mentally ill should receive the same pay for the same job (χ2=10.669, p<0.031 and that the public are prejudiced towards people with mental illness (χ2=17.604, p<0.001. Conclusion
Hall, Ryan Chaloner Winton; Friedman, Susan Hatters
Since the recent shootings in Tucson, Arizona; Aurora, Colorado; and Newtown, Connecticut, there has been an ever-increasing state and national debate regarding gun control. All 3 shootings involved an alleged shooter who attended college, and in hindsight, evidence of a mental illness was potentially present in these individuals while in school. What appears to be different about the current round of debate is that both pro-gun control and anti-gun control advocates are focusing on mentally ill individuals, early detection of mental illness during school years, and the interactions of such individuals with physicians and the mental health system as a way to solve gun violence. This raises multiple questions for our profession about the apparent increase in these types of events, dangerousness in mentally ill individuals, when to intervene (voluntary vs involuntary), and what role physicians should play in the debate and ongoing prevention. As is evident from the historic Tarasoff court case, physicians and mental health professionals often have new regulations/duties, changes in the physician-patient relationship, and increased liability resulting from high-profile events such as these. Given that in many ways the prediction of who will actually commit a violent act is difficult to determine with accuracy, physicians need to be cautious with how the current gun debate evolves not only for ourselves (eg, increased liability, becoming de facto agents of the state) but for our patients as well (eg, increased stigma, erosion of civil liberties, and changes in the physician-patient relationship). We provide examples of potential troublesome legislation and suggestions on what can be done to improve safety for our patients and for the public. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Broadbent, Marc; Creaton, Anne; Moxham, Lorna; Dwyer, Trudy
The aim of this paper is to examine the use of mental health triage scales in Australian emergency departments (EDs) and to explore the use of the Australasian Triage Scale (ATS) with existing mental health triage scales. Since the introduction of mainstreaming and deinstitutionalisation in Australian mental health care, the number of clients presenting to Australian EDs has been increasing. It has become apparent that the lack of mental health descriptors in existing triage scales diminishes the ability of ED triage staff to accurately assess clients with a mental illness. In response to this, specialised mental health triage scales have been developed and introduced into practice. Concurrently, mental health descriptors have been incorporated into the ATS used across Australian EDs. A review of English language literature was conducted. The data bases Proquest, Synergy and CINAHL were searched using the key words 'emergency department', 'triage', 'mental health' and again using the term 'emergency mental health triage'. There is a paucity of literature surrounding the use of mental health triage scales in Australian EDs; 18 articles were found to be directly relevant to the subject matter. Currently clients with a mental illness presenting to the ED may be triaged against one of four mental health triage scales. Research has shown that the mental health descriptors in the ATS are not as reliable as a specialised mental health triage scale. This has implications for clinical practice on two levels. First, it affects the initial triage assessment in the ED and the ability for mental health clinicians to respond in a timely manner and this will have an impact on clinical outcomes. Second, the use of the mental health triage criteria in the ATS may misrepresent ED workloads and affect data pertaining to ED performance.
Full Text Available Background. Sixty-eight per cent of women and 57% of men with mental illness are parents. There is increasing evidence of adverse psychosocial impact of parental mental illness on their children. However, among children whose parents have mental illness, the potential contribution of the children’s beliefs about mental illness to their own emotional distress is still poorly understood. Aim. To explore among children whose parents have serious mental illness, the relationship between the children’s beliefs about mental illness and their own depressive symptoms. Methodology. We conducted an interview-administered questionnaire survey of 67 Nigerian children whose parents were psychiatric inpatients. The children’s beliefs about mental illness were explored with five questions – two of which embedded threat-related beliefs. Their depressive symptoms were assessed with the Short Mood and Feelings Questionnaire (SMFQ (Cronbach alpha 0.91. Based on stigma theory, we hypothesised that among this cohort, the children who hold threat-related beliefs about people with mental illness would report statistically significantly more depressive symptoms than those without similar beliefs. Results. The mean age (standard deviation (SD of the children was 13.3 (2.8 years, and 38% were males. Twenty-four per cent of the children believed mental illness is infectious. In line with our hypothesis, those holding this belief had statistically significantly more depressive symptoms compared with those without similar beliefs (p=0.001. Fifty-seven per cent of the children believed that people with mental illness are dangerous. However, contrary to our hypothesis, this belief was not associated with increased depressive symptoms (p=0.2. Multiple regression showed that statistically significant predictors of increased emotional symptoms were ‘belief that mental illness is infectious’ and younger age. The model explained 39.8% of the variance in SMFQ
Pearce, Michelle J; Medoff, Deborah; Lawrence, Ryan E; Dixon, Lisa
This cross-sectional study investigated the use of religious coping strategies among family members of adults with serious mental illness. A sample of 436 individuals caring for a family member with serious mental illness were recruited into a randomized clinical trial for the National Alliance on Mental Illness Family to Family Education Program. Relationships are reported between religious coping and caregiving, care recipient, and mental health services outcomes. Religious coping was associated with more objective caregiving burden, greater care recipient need, less mental health knowledge, and less receipt of mental health services after adjusting for non-religious types of coping. At the same time, religious coping was associated with a positive caregiving experience and greater religious support. Religious coping plays an important role for many caregivers of persons with serious mental illness. Caregivers who use more religious coping may have an especially high need for mental health education and mental health services.
Babalola, Olufemi; Gormez, Vahdet; Alwan, Nisreen A; Johnstone, Paul; Sampson, Stephanie
In high-income countries, over the last three decades, the length of hospital stays for people with serious mental illness has reduced drastically although considerable variation remains. In lower-income countries this variation may be greater. Some argue that reduction in hospital stay leads to 'revolving door admissions' and worsening mental health outcomes despite apparent cost savings, whilst others suggest longer stays may be more harmful by institutionalising people to hospital care. To evaluate the effect of short stay/brief admission hospital care with long stay/standard in-patient care in people with serious mental illness. We searched the Cochrane Schizophrenia Group's register of trials, July 2007 and updated this search in May 2012. We included all randomised controlled trials comparing planned short/brief with long/standard hospital stays for people with serious mental illnesses. We extracted data independently. For dichotomous data we calculated risk ratios (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based using a fixed-effect model. For continuous data, had we identified such data, we planned to calculate fixed-effect mean differences (MD). We assessed risk of bias for included studies and rated quality of evidence using GRADE. We included six relevant trials undertaken between 1969 and 1980. We found no significant difference in death (n = 175, 1 RCT, RR in the longer term 0.42, CI 0.10 to 1.83, very low quality evidence). In the long term, there was no difference in improvement of mental state (n = 61, 1 RCT, RR 3.39, CI 0.76 to 15.02, very low quality evidence). There was no difference in readmission to hospital (n = 651, 4 RCTs, RR by the long term 1.26, CI 1.00 to 1.57, low quality evidence). Data for leaving the study prematurely by the longer term showed no difference (n = 229, 2 RCTs, (RR 0.77, CI 0.34 to 1.77, low quality evidence). There was a significant difference favouring short stay (P = 0.01) in numbers
Full Text Available Mental illness is a major public health concern in Canada and also globally. According to the World Health Organization, five of the top ten disabilities worldwide are mental health disorders. Within Canada, one in five individuals is living with mental illness each year. Currently, there are 6.7 million Canadians living with mental illness and over 1 million Canadian youth living with mental illness. Police are frequently the first responders to situations in the community involving people with mental illness, and police services are increasingly aware of the need to provide officers with additional training and strategies for effectively interacting with these citizens. This study examined the effectiveness of four online, interactive video-based simulations designed to educate police officers about mental illness and strategies for interacting with people with mental illness. The simulations were created through the efforts of a unique partnership involving a police service, a mental health facility and two postsecondary institutions. Frontline police officers from Ontario were divided into one of three groups (simulation, face to face, control. Using a pre- and post-test questionnaire, the groups were compared on their level of knowledge and understanding of mental illness. In addition, focus groups explored the impact of the simulations on officers’ level of confidence in engaging with individuals with mental illness and officers’ perceptions of the simulations’ ease of use and level of realism. The study’s findings determined that the simulations were just as effective as face-to-face learning, and the officers reported the simulations were easy to use and reflected real-life scenarios they had encountered on the job. As mental health continues to be a major public concern, not only in Canada but also globally, interactive simulations may provide an effective and affordable education resource not only for police officers but for
Bromley, Elizabeth; Gabrielian, Sonya; Brekke, Benjamin; Pahwa, Rohini; Daly, Kathleen A.; Brekke, John S.; Braslow, Joel T.
Objective Community integration is recognized as a crucial component of recovery from serious mental illness. Although the construct of community integration can be measured with structured instruments, little is known about the subjective and experiential meaning of community and community involvement for persons with serious mental illness. Methods In 2010, 30 individuals with serious mental illness treated in two public mental health clinics completed semistructured interviews that elicited the places and people that they associate with the experience of community and the larger meaning of community in their lives. Results Participants described four experiences as integral to their concepts of community: receiving help, minimizing risk, avoiding stigma, and giving back. Participants looked for communities that provide reliable support, and they described the need to manage community contact in order to protect themselves and others from their symptoms and from discrimination. Most participants experienced communities centered on mental health treatment or mentally ill peers as providing opportunities for positive engagement. Conclusions The experience of having a serious mental illness shapes preferences for and perceptions of community in pervasive ways. Participants describe community involvement not as a means to move away from illness experiences and identities but as a process that is substantially influenced by them. Mental health communities may help individuals with serious mental illness to both manage their illness and recognize and enjoy a sense of community. The findings indicate the need for further research on the relationship between community integration and outcome in serious mental illness. PMID:23545784
Cloyes, Kristin Gates
Increasingly, US prisoners diagnosed with mental illness are housed in control units, the most restrictive form of confinement in the US prison system. This situation has led to intense debate over the legal, ethical and clinical status of mental illness. This is a semiotic struggle with profound effects, yet most related work treats mental illness as a neutral, individual variable. Few analyses locate mental illness within a larger sociopolitical context. Fewer still focus on discursive practice. None critically analyze the accounts of control unit prisoners, who talk about extreme marginality and risk for victimization. This paper has two aims: (i) to develop a systematic method of analysis that accounts for signification as discourse-in-action; and (ii) to show how prisoners' signification of mental illness articulates agency through and against marginalizing discourse. Political discourse analysis demonstrates how control unit prisoners with psychiatric diagnoses signify mental illness, and articulate safer identifications in the process.
Newton, L; Rosen, A; Tennant, C; Hobbs, C; Lapsley, H M; Tribe, K
Deinstitutionalisation of seriously mentally ill people in the developed world, including Australia, has occurred since the middle of this century. Evaluation of the effects of this change on the lives of individuals is of paramount importance to ensure that policies are acceptable and effective. Increasingly, multifaceted studies are considered essential for comprehensive health research. The qualitative aspect of this study complements the clinical and economic components. An ethnographic approach enabled contextual, qualitative data to be gathered from within the social world of 47 hospital residents as they moved to the community. A social anthropologist acting explicitly as a participant observer undertook fieldwork over two and a half years both pre- and post-discharge. Qualitative data were collected, stored and analysed separately from quantitative and economic data. Ethnographic findings generally supported and, in many cases, mirrored clinical results. Of the total cohort of 47 patients transferred to the community, the 40 who continue to live outside of hospital all reported a preference for community living. The importance of freedom and simple liberties cannot be underestimated as factors that enabled this resilient group of people to work creatively through difficult periods. Properly planned and resourced deinstitutionalisation not only maintains people with a prolonged mental illness outside of hospital, it also enhances their quality of life. Subjective descriptive material focusing on personal experiences adds meaning to quantitative research data allowing health professionals to more fully understand the implications of health policy on the lives of individuals.
Hallett, Nutmeg; Rees, Helen
People with serious mental illness (SMI) are at risk of dying many years earlier than the general population. Providing an effective, cost-efficient healthcare service requires a holistic approach, and improving the physical health of people with SMI should be integral to all healthcare roles. It is important for nurses to identify and understand the barriers that people with SMI may experience when accessing physical healthcare. A range of factors contribute to reduced life expectancy, including lifestyle factors, symptoms of mental illness and the side effects of medications. This article discusses four areas of health that commonly affect people with SMI: metabolic syndrome, smoking, oral health and sexual health. Metabolic syndrome is a cluster of risk factors that increase an individual's risk of cardiovascular disease, stroke and type 2 diabetes mellitus. Smoking is increasingly prevalent in people with SMI, with rates remaining steady despite a decline in smoking rates nationally. Oral health and sexual health can negatively affect the physical health and well-being of people with SMI; however, these aspects of health are often neglected. This article identifies ways that nurses in all practice settings can use health promotion, assessment and treatment to improve the physical health of people with SMI in relation to these four areas.
Östman, Margareta; Björkman, Ann-Christine
This paper seeks to investigate the impact of mental illness on the sexuality of patients with a schizophrenic disorder who live in the community in a long-term relationship with a partner. We conducted qualitative, in-depth interviews with five such patients who were in treatment at a psychiatric outpatient clinic, and three of their partners. The data were analyzed by thematic analysis and identified the following areas of concern: relationships outweigh sexuality; uncertainties about one’s sexual capacity; the dwindling of sexual fantasies, feelings of desire, and satisfaction; and, a lack of communication and support in sexual matters. Both patients and partners reported feeling overlooked by psychiatric services as sexual beings. They also expressed dissatisfaction with a patient-therapist treatment model that excluded their partners. Our findings indicate that dysfunctional sexuality affects both patients suffering from severe mental illness and their partners. Patients and partners deplore the lack of opportunity to discuss questions related to their sexuality and long-term relationships with psychiatric clinicians. Sexual problems arising from, or exacerbated by, schizophrenia require supportive services, whether in the form of general, psychiatric, or couples therapy.
Judith J Prochaska
Full Text Available 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.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.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.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.
Full Text Available Epidemiological studies suggest that prenatal exposure to different types of viral or bacterial infections may be associated with similar outcomes; i.e., an increased risk of mental illness disorders in the offspring. Infections arising from various causes have similar debilitating effects in later life, suggesting that the exact pathogen may not be the critical factor in determining the neurological and cognitive outcome in the offspring. Instead, it is thought that response of the innate immune system, specifically the increased production of inflammatory cytokines, may be the critical mediator in altering fetal brain development pre-disposing the offspring to mental illness disorders later in life. Inflammatory cytokines are essential for normal brain development. Factors such as the site of cytokine production, a change in balance between anti- and pro- inflammatory cytokines, placental transfer of cytokines, the effects of cytokines on glial cells, and the effects of glucocorticoids are important when evaluating the impact of maternal infection on fetal brain development. Although it is clear that cytokines are altered in the fetal brain following maternal infection, further evidence is required to determine if cytokines are the critical factor that alters the trajectory of brain development, subsequently leading to postnatal behavioural and neurological abnormalities.
Peisah, Carmelle; Brodaty, Henry; Bridger, Marie
(i) To raise awareness about the vulnerability of mentally ill older persons to abuse by others seeking to gain by marriage; (ii) to outline key legal cases from common law countries; and (iii) to provide guidelines for health care professionals who encounter this issue in practice. We present two cases: the first case involved an 87-year-old widower who married his carer--50 years his junior--in a religious ceremony while hypomanic. The second case involved an 82-year-old widow with moderate dementia who married her boarder, the marriage subsequently being found void in the Family Court of Australia on the basis that her consent was not real because she was incapable of understanding the nature and effect of the marriage ceremony. Abuse by marriage may be of a psychological, sexual, social or financial nature.Older people with impaired judgement and inability to appraise others due to mental illness may be persuaded to execute legal documents such as marriage certificates. Health care professionals may have a role in the identification and management of this kind of abuse. There are legal means to address this problem ranging from guardianship and financial management to family law court applications to seek a decree of nullity/invalidity of the marriage.
Janoušková, Miroslava; Weissová, Aneta; Formánek, Tomáš; Pasz, Jiří; Bankovská Motlová, Lucie
Medical school curriculum contributes to future doctors' attitude formation towards people with mental illness. The purpose of this study was to compare stigmatizing attitudes between medical students and faculty, analyse stigmatizing attitudes among students from different years of study and identify factors predicting stigma. A cross-sectional study with the use of scales measuring attitudes and social distance was designed. Online questionnaires were distributed to all students and teachers at a medical faculty in the Czech Republic. The response rate was 32.1% ( n = 308) among students and 26.7% ( n = 149) among teachers. Teachers had a greater prevalence of stigmatizing attitudes than students. Increased tolerant attitudes in students were detected after the fourth year, that is, following introduction to psychiatry. Preferred specialization in psychiatry and attending two psychiatry courses predicted more tolerant attitudes. Among both students and teachers, men possessed more stigmatizing attitudes towards people with mental illness. Age was an important predictor of stigmatizing attitudes among teachers. Educators should pay closer attention to the role of medical psychology and communication training implementation, which may be beneficial to improving skills and increasing medical students' self-esteem and feeling of competence throughout their psychiatry rotation.
van Hasselt, F.; Loonen, Antonius
Objective: Patients with severe mental illness (SMI) suffer from more somatic illness than the general population. Possible causes are side effects of neuropsychiatric medication, genetic vulnerability, insufficient health care and lifestyle. This co-morbidity is potentially reversible and augments
Cutler, D L
We have discussed the problems of the new young chronic patients, deinstitutionalized old chronic patients now living in the community, and some of the groups of hard to place patients. We have talked about problems with community barriers, staff training, a spectrum of facilities, and we have looked at what new sorts of facilities may need to be developed. It seems clear that we have not yet developed a spectrum which can deal with all varieties of the chronically mentally ill. Pepper (1985) has suggested a different, more ideal spectrum of housing particularly suited to the young adult chronic patient. These include crisis residences, supervised 14-bed residences, growth house for 14 beds; support house for 14 beds; supervised apartments (satellite apartments), 14 beds; supportive apartments, 14 beds; (these have less intensive staffing than supervised ones); open community living; and residential congregate care for adults (RCCAs). These RCCAs are large facilities located either in old state hospitals or nursing homes which are primarily oriented towards the homeless mentally ill. According to Pepper, if a program can plan a spectrum of housing situations in the immediate catchment area, it can then actually meet the specific needs of each patient with a specific sort of residential facility. The challenge for community residences is certainly much greater than a decade ago and, with the homeless mentally ill population continuing to grow (Bachrach, 1985), one might be tempted to regard our present situation as one of crisis proportions. Clearly, there is little doubt that a need exists for a wide spectrum of living situations to be made available to the deinstitutionalized or never institutionalized young adult chronic patient. Yet very few incentives exist for those who would try to meet this challenge. To do this effectively will undoubtedly require the development of sizeable amounts of public funding through existing and new channels to provide support for
Full Text Available Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan.Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences.Results. Response rate was 81% (527/650 respondents. Mean age was 20.98 years. Most of the students (331, 62.8% had an urban background and studied Social Sciences (238, 45.2%. Four hundred and eighteen respondents (79.3% considered religion very important and most respondents considered psychiatrists (334, 63.4% and spiritual leaders (72, 13.7% to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1% considered black magic to be a cause of mental illness. Only 215 (41% respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p < .05.Conclusion. Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can
Ward, Earlise C.; Heidrich, Susan M.
We examined African American women's representations/beliefs about mental illness, preferred coping behaviors if faced with mental illness, whether perceived stigma was associated with treatment-seeking, and if so, whether it was related to beliefs and coping preference, and whether these variables differed by age group. Participants were 185 community-dwelling African American women 25 to 85 years of age. Results indicated the women believed that mental illness is caused by several factors, ...
Marienfeld, Carla; Rosenheck, Robert A
Comorbidity and co-prescription patterns of people with serious mental illness in methadone maintenance may complicate their treatment and have not been studied. The goal of this study was to examine the care and characteristics of people with serious mental illness in methadone maintenance treatment nationally in the Veterans Health Administration (VHA). Using national VHA data from FY2012, bivariate and multiple logistic regression analyses were used to compare veterans in methadone maintenance treatment wo had a serious mental illness (schizophrenia, bipolar disorder, or major affective disorder) to patients in methadone maintenance treatment without serious mental illness and patients with serious mental illness who were not in methadone maintenance treatment. Only a small fraction of patients with serious mental illness were receiving methadone maintenance treatment (0.65%), but a relatively large proportion in methadone maintenance treatment had a serious mental illness (33.2%). Compared to patients without serious mental illness, patients with serious mental illness in methadone maintenance treatment were more likely to have been homeless, to have had a recent psychiatric hospitalization, to be over 50% disabled, and to have had more fills for more classes of psychotropic drugs. Compared to other patients with serious mental illness, patients with serious mental illness in methadone maintenance treatment were more likely to have a drug abuse diagnosis and to reside in large urban areas. One-third of patients in methadone maintenance treatment have serious mental illness and more frequent psychiatric comorbidity, and they are more likely to use psychiatric and general health services and fill more types of psychiatric prescriptions. Further study and clinical awareness of potential drug-drug interactions in this high medication and service using population are needed.
Nishio, Akihiro; Yamamoto, Mayumi; Horita, Ryo; Sado, Tadahiro; Ueki, Hirofumi; Watanabe, Takahiro; Uehara, Ryosuke; Shioiri, Toshiki
Background While the prevalence of mental illness or cognitive disability is higher among homeless people than the general population in Western countries, few studies have investigated its prevalence in Japan or other Asian countries. The present study conducted a survey to comprehensively assess prevalence of mental illness, cognitive disability, and their overlap among homeless individuals living in Nagoya, Japan. Methods Participants were 114 homeless individuals. Mental illness was diagn...
ABSTRACT: This quantitative study investigated the attitudes toward the mentally ill in professionals working in Ndera neuropsychiatric hospital. The research questions explored were centered on the attitudes of directly involved and supportive professionals toward mentally ill clients and also on the difference between the attitudes of directly involved and supportive professionals toward mentally ill clients and demographic variables. The purpose of this study was to determine whether...
Dardas, L A; Simmons, L A
The stigma of mental illness varies significantly from culture to culture and from person to person. To date, little is known about how mental illness stigma manifests within the Arab community. This study aimed at bringing clarity to the concept of 'mental illness stigma' as it applies to Arab families. Nursing's holistic and patient-centered approach is integral to helping Arab patients and their families appropriately incorporate individual values, beliefs, and cultural perspectives into treatment plans. This study establishes a scientific alert for professionals at all levels to avoid making false generalizations about a specific culture that are not based on specific research findings from that culture. Accessing mental health services is a critical step towards reducing the burden of mental illness. The stigma of mental illness is one of the most common reasons for not seeking mental health care leading to negative health consequences and undue suffering for many individuals and their families. Stigma is embedded in its social context. What may be considered acceptable in one society may be considered unacceptable and open to stigmatization in other societies. Arabs have a shared set of values, beliefs, and traditions that are substantially different from those of Westerners. Further, in most Arab countries, formal mental health resources are scarce and people with mental illness experience the compounded disadvantages of poverty and illness stigma. To date, little is known about how mental illness stigma manifests within the Arab community making it difficult to design and test interventions that support Arab individuals with mental illness and their families in treatment seeking and adherence. Using Rodger's concept analysis method, we examined how 'mental illness stigma' operates within an Arab context as a first step towards elucidating culturally competent approaches to treatment. This analysis provides a foundation for future work in the areas of mental
Appelbaum, Paul S; Swanson, Jeffrey W
This column describes federal and state laws to restrict access to firearms among people with mental illness. The contribution to public safety of these laws is likely to be small because only 3%-5% of violent acts are attributable to serious mental illness, and most do not involve guns. The categories of persons with mental illnesses targeted by the laws may not be at higher risk of violence than other subgroups in this population. The laws may deter people from seeking treatment for fear of losing the right to possess firearms and may reinforce stereotypes of persons with mental illnesses as dangerous.
Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert
Stigma among health care providers toward people with mental illness is a worldwide problem. This study at a large US university examined medical student attitudes toward mental illness and its causes, and whether student attitudes change as they progress in their education. An electronic questionnaire focusing on attitudes toward people with mental illness, causes of mental illness, and treatment efficacy was used to survey medical students at all levels of training. Exploratory factor analysis was used to establish attitudinal factors, and analysis of variance was used to identify differences in student attitudes among these factors. Independent-samples t tests were used to assess attitudes toward efficacy of treatments for six common psychiatric and medical conditions. The study response rate was 42.6 % (n = 289). Exploratory factor analysis identified three factors reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Stages of student education did not differ across these factors. Students who had completed the psychiatry clerkship were more likely to believe that anxiety disorders and diabetes could be treated effectively. Students reporting personal experiences with mental illness showed significantly more social acceptance, and people born outside the USA were more likely to endorse supernatural causes of mental illness. Sociocultural influences and personal experience with mental illness have a greater effect than medical education on attitudes toward people with mental illness. Psychiatric education appears to have a small but significant effect on student attitudes regarding treatment efficacy.
Swanson, Jeffrey W.; McGinty, E. Elizabeth; Fazel, Seena; Mays, Vickie M.
Purpose This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders. Methods Research concerning public attitudes toward persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiologic and clinical studies of violence and mental illness and of the accuracy of psychiatrists' risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented. Results Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiologic studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms–related fatalities. Conclusions Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiologic data concerning risk to improve the effectiveness, feasibility, and fairness of policy initiatives. PMID:24861430
Swanson, Jeffrey W; McGinty, E Elizabeth; Fazel, Seena; Mays, Vickie M
This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders. Research concerning public attitudes toward persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiologic and clinical studies of violence and mental illness and of the accuracy of psychiatrists' risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented. Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiologic studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms-related fatalities. Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiologic data concerning risk to improve the effectiveness, feasibility, and fairness of policy initiatives. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Fone, David Lawrence; Dunstan, Frank David John; John, Ann; Lloyd, Keith
Background The relationship between the Mental Illness Needs Index (MINI) and the common mental disorders is not known.\\ud \\ud Aims To investigate associations between the small-area MINI score and common mental disorder at individual level.\\ud \\ud Method Mental health status was measured using the Mental Health Inventory of the Short Form 36 instrument (SF–36). Data from the Caerphilly Health and Social Needs population survey were analysed in multilevel models of 10 653 individuals aged 18–...
Ben-Zeev, Dror; Corrigan, Patrick W; Britt, Thomas W; Langford, Linda
Many service members do not utilize the available services designed to assist them in coping with post-traumatic stress disorder and other mental health problems that emerge during active duty. In the current paper, we discuss the possible role stigma plays in the underutilization of treatments in the military, and attempt to transfer a well-articulated framework for understanding stigma and stigma-change in civilian populations to the military context. The literature was searched for papers reviewing negative beliefs about mental illness and fears of stigmatization and underutilization of treatments, especially as relevant to service members. We explain how public stigma, self stigma, and label avoidance may emerge as barriers to care seeking and service participation in soldiers, and propose approaches/strategies for change. We then discuss a number of recent applications of these approaches in both civilian and military initiatives. Stigma-change programs specifically created by/for the military that integrate components of education and direct contact with respected peers or veterans who have coped with mental health problems may have great utility at both the early stages of military training and later, when soldiers return from theatres of operation.
Huys, Quentin J M; Roiser, Jonathan P
Computational Psychiatry aims to describe the relationship between the brain's neurobiology, its environment and mental symptoms in computational terms. In so doing, it may improve psychiatric classification and the diagnosis and treatment of mental illness. It can unite many levels of description in a mechanistic and rigorous fashion, while avoiding biological reductionism and artificial categorisation. We describe how computational models of cognition can infer the current state of the environment and weigh up future actions, and how these models provide new perspectives on two example disorders, depression and schizophrenia. Reinforcement learning describes how the brain can choose and value courses of actions according to their long-term future value. Some depressive symptoms may result from aberrant valuations, which could arise from prior beliefs about the loss of agency (‘helplessness’), or from an inability to inhibit the mental exploration of aversive events. Predictive coding explains how the brain might perform Bayesian inference about the state of its environment by combining sensory data with prior beliefs, each weighted according to their certainty (or precision). Several cortical abnormalities in schizophrenia might reduce precision at higher levels of the inferential hierarchy, biasing inference towards sensory data and away from prior beliefs. We discuss whether striatal hyperdopaminergia might have an adaptive function in this context, and also how reinforcement learning and incentive salience models may shed light on the disorder. Finally, we review some of Computational Psychiatry's applications to neurological disorders, such as Parkinson's disease, and some pitfalls to avoid when applying its methods. PMID:26157034
Minas, H; Zamzam, R; Midin, M; Cohen, A
Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours...
Full Text Available HIV/AIDS is among the leading causes of morbidity and mortality in world. There are more than 35 million people living with HIV/AIDS in the world. Although the annual incidence of HIV infection is decreasing globally, HIV prevalence is rising due to development of more effective treatment and higher survival. Iran suffers from concentrated HIV epidemics among injecting and non-injecting drug users. There are more than 27 thousand registered cases of HIV infection and it is estimated that there are above seventy eight thousand cases in the country. Regarding the burden of disease, it is projected that HIV/AIDS will have the highest growth during the next 10 years. The outcome of this epidemics will be determined by human behavior. HIV, psychiatric disorders and substance use disorders are closely correlated and are accompanied by similar risk factors. They also share common consequences such as stigma and discrimination. Correlation of psychiatric disorders, as one of the most influential determinants of our behavior, and HIV/AIDS infection is reviewed in this narrative article. Psychiatric disorders are associated with greater risk of HIV acquisition. Substance use disorders, both injecting and non-injecting, as well as severe mental illnesses put the individual at higher risk of acquiring HIV infection. Impaired judgment, diminished inhibition and control over behaviors, lack of insight and poor self-care have been proposed as the underlying mechanisms. On the other hand, HIV infection may put the individual at greater risk of developing a mental illness. Coping with a chronic and life-threatening illness, fear of stigma and discrimination, CNS invasion of the virus as well as the adverse neuropsychiatric side effects of anti-retroviral medications may all contribute to establishment of a psychiatric disorder. Although there exists a bi-directional correlation between mental health problems and HIV/AIDS infection, this reciprocity goes beyond
Dunham, A; Kinnear, D; Allan, L; Smiley, E; Cooper, S-A
People with intellectual disabilities face a much greater burden and earlier onset of physical and mental ill-health than the general adult population. Physical-mental comorbidity has been shown to result in poorer outcomes in the general population, but little is known about this relationship in adults with intellectual disabilities. To identify whether physical ill-health is associated with mental ill-health in adults with intellectual disabilities and whether the extent of physical multi-morbidity can predict the likelihood of mental ill-health. To identify any associations between types of physical ill-health and mental ill-health. A total of 1023 adults with intellectual disabilities underwent comprehensive health assessments. Binary logistic regressions were undertaken to establish any association between the independent variables: total number of physical health conditions, physical conditions by International Classification of Disease-10 chapter and specific physical health conditions; and the dependent variables: problem behaviours, mental disorders of any type. All regressions were adjusted for age, gender, level of intellectual disabilities, living arrangements, neighbourhood deprivation and Down syndrome. The extent of physical multi-morbidity was not associated with mental ill-health in adults with intellectual disabilities as only 0.8% of the sample had no physical conditions. Endocrine disease increased the risk of problem behaviours [odds ratio (OR): 1.22, 95% confidence interval (CI): 1.02-1.47], respiratory disease reduced the risk of problem behaviours (OR: 0.73, 95% CI: 0.54-0.99) and mental ill-health of any type (OR: 0.73, 95% CI: 0.58-0.92), and musculoskeletal disease reduced the risk of mental ill-health of any type (OR: 0.84, 95% CI: 0.73-0.98). Ischaemic heart disease increased the risk of problem behaviours approximately threefold (OR: 3.29, 95% CI: 1.02-10.60). The extent of physical multi-morbidity in the population with intellectual
Donovan, Rob; Jalleh, Geoffrey; Robinson, Katy; Lin, Chad
To determine the impact of the Act-Belong-Commit mental health promotion campaign on people with a diagnosed mental illness or who had sought professional help for a mental health problem in the previous 12 months. In 2013 and 2014, 1,200 adults in Western Australia were interviewed by telephone. The questionnaire measured campaign reach, impact on beliefs about mental health and mental illness and behavioural impact. Campaign impact on changing the way respondents thought about mental health was significantly higher among those with a mental illness or who had sought help (41.4% vs 24.2%; pmental health as a result of their exposure to the campaign (20.5% vs 8.7%; pmental illness or who recently sought help to take steps of their own to enhance their mental health. © 2015 Public Health Association of Australia.
This work is a study of perceptions toward mental illness among respondents from the city of Chihuahua in Mexico. A non-probability sample of forty-seven respondents was taken during a two-week stay in the summer of 1985. To tap respondents' perceptions of mental illness, vignettes characterizing people normally thought to have symptoms of mental illness were employed. The study reveals that men and women perceive mental illness differently. In three out of four vignettes, women perceive mental disorder than men. It is argued that the reason for the disparity in perceptions between the sexes is the result of the sexual differentiation that exists in Mexico. With regard to whom the respondents would refer the person for help, the majority of the respondents recommended that, whether or not the person in the vignette is characterized as mentally ill or simply "sick", the person should seek professional help.
Smith, Thomas E; Easter, Alison; Pollock, Michele; Pope, Leah Gogel; Wisdom, Jennifer P
This study sought to describe reasons for disengagement from services and practical guidelines to enhance engagement among individuals with serious mental illness and high need for treatment. Qualitative interviews were conducted with 56 individuals with serious mental illness and 25 providers recruited from a larger project that used administrative data to identify individuals with serious mental illness who had disengaged from care. Individuals with serious mental illness and providers described reasons for disengagement and effective provider engagement strategies. Individuals with serious mental illness and providers differed in reported reasons for disengagement. Reasons reported by individuals with serious mental illness included services that were not relevant to their needs, inability to trust providers, and a belief that they were not ill. Providers cited lack of insight, stigma, and language and cultural barriers as common reasons for disengagement. Strategies for increasing engagement were grouped into a framework of acceptable, accessible, and available services. Acceptable services reflect a partnership model that fosters support and instills hope; accessible services minimize barriers related to transportation and intake procedures; and available services address recovery needs in addition to treatment of general medical and psychiatric problems. Individuals with serious mental illness and providers often do not agree on reasons for seeking care. The framework of acceptable, accessible, and available services identifies opportunities for providers to adjust practices and maximize engagement in services among individuals with serious mental illness who are in high need of treatment.
Davoren, Mary; Fitzpatrick, Mary; Caddow, Fintan; Caddow, Martin; O'Neill, Conor; O'Neill, Helen; Kennedy, Harry G
Older prisoners are the fastest growing group of prisoners in most countries. They have high rates of physical and psychiatric co-morbidity, compared to community dwelling older persons and also compared with other prisoner groups. Very high rates of mental illness have been found in remand (pre-trial) prisoners when compared with other prisoner groups; however to date there have been no studies examining older male and female remand prisoners. A retrospective chart review was conducted of all remands, to a male and a female prison, over a six and half-year period. Demographic data were collected pertaining to psychiatric and medical diagnoses and seriousness of offending. We found rising numbers of older prisoners amongst male remand prisoners. Older remand prisoners had very high rates of affective disorder and alcohol misuse. They had rates of psychotic illnesses and deliberate self-harm comparable to younger remand prisoners. High rates of vulnerability were found among older prisoners and older prisoners had a greater need for general medical and psychiatric services than younger prisoners. We also found comparable offending patterns with younger prisoners and high rates of sexual offending among the older male prisoner group. Given the ageing population of many countries it is likely the numbers of older prisoners will continue to grow and given their high levels of both physical and psychiatric illness this will have implications for future service delivery.
Full Text Available The prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada.Data collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421. A modified version of the U.S. Department of Agriculture's Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity.The prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95-0.99, less than high school completion (aOR = 0.57; 95% CI: 0.35-0.93, needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00-2.72, subjective mental health (aOR = 0.97; 95% CI: 0.96-0.99, having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16-4.36, HIV/AIDS (aOR = 4.20; 95% CI: 1.36-12.96, heart disease (aOR = 0.39; 95% CI: 0.16-0.97 and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01-2.68.The prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed.
Parpouchi, Milad; Moniruzzaman, Akm; Russolillo, Angela; Somers, Julian M
The prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada. Data collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421). A modified version of the U.S. Department of Agriculture's Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity. The prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95-0.99), less than high school completion (aOR = 0.57; 95% CI: 0.35-0.93), needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00-2.72), subjective mental health (aOR = 0.97; 95% CI: 0.96-0.99), having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16-4.36), HIV/AIDS (aOR = 4.20; 95% CI: 1.36-12.96), heart disease (aOR = 0.39; 95% CI: 0.16-0.97) and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01-2.68). The prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed.
Zolezzi, Monica; Bensmail, Nawal; Zahrah, Farah; Khaled, Salma Mawfek; El-Gaili, Tayseer
Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students' beliefs, attitudes, and help-seeking and treatment preferences). A total of 282 students completed the survey. The majority of the participating students were females (59.3%), non-Qataris (64.3%), and enrolled in science-based colleges (62.7%). Beliefs reflecting poor mental health literacy, such as "medications to treat mental illness can cause addiction", "mental illness is not like any other illness", or that "mental illness is a punishment from God", were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively). Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%), that people with mental illness are dangerous (65.7%), and that they would not marry someone with a mental illness (88.9%). Additionally, 33.6% of students indicated they would be ashamed to mention if someone in their family or they themself, had a mental illness. A vast majority of students (86.3%) indicated to prefer family and friend's support as treatment options. Significant differences in KAB about
Full Text Available In this article I oppose the current account of autonomy and informed consent in bioethics through criticising the four underlying prejudices of an objectivistic, dualistic, rationalistic and individualistic misunderstanding of the will. With special regard to the case of patients with dementia I argue for the thesis that the principle of autonomy, as moral principles in general, has unconditional and universal validity, but has to be applied differently in the face of specific situations and circumstances by means of the power of judgment (Urteilskraft. As the philosophical resp. anthropological basis of my argument I develop a broad understanding of the will in an Aristotelian and phenomenological sense. The practical consequences of my thesis consist in the ethical requirement of equal respect for the will of mentally ill patients.
Edgerton, R B
The publication of The Quest for Therapy in Lower Zaire (University of California Press) by John M. Janzen (with the collaboration of William Arkinstall), and African Therapeutic Systems (Crossroads Press), edited by Z. A. Ademuwagun, John A. A. Ayoade, Ira E. Harrison and Dennis M. Warren, calls attention to recent research findings which indicate that mentally ill persons, particularly schizophrenics, may recover more rapidly and fully in non-industrialized societies than they do in industrialized ones. The books by Janzen and Ademuwagen et al. will be examined as contributions to a growing body of information on native African therapeutic practices. Evidence relating to the apparently benign course of psychosis in Africa will be examined, and various explanations for this pattern will be evaluated. Finally, some guidelines for future research will be suggested.
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.
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.
Fischer, Sean N; Shinn, Marybeth; Shrout, Patrick; Tsemberis, Sam
This study examined whether street homelessness, sheltered homelessness, and the severity of psychological symptoms predicted non-violent and violent crime among 207 mentally ill participants who were homeless at baseline. Participants were interviewed at 9 time points over 4 years. Hierarchical linear modeling (HLM) was used to examine whether changes in homelessness status and symptom severity predicted changes in criminal activity over time. Results indicated that homelessness both on the streets and in shelters and psychological symptom severity predicted increases in non-violent crime. Sheltered homelessness and symptom severity predicted increases in violent crime, although street homelessness did not. A separate mediational analysis with 181 participants showed that the relationship between diagnosis of a psychotic disorder and both non-violent and violent criminal activity was partially mediated through the severity of psychotic symptoms. Implications for research and intervention are discussed.
Larsen, Jens Ivar; Andersen, Ulla A; Becker, Thomas
different geographical areas - Asia (Japan), Africa (Nigeria) and Western Europe (Switzerland, Germany and Denmark) - and to search for possible transcultural differences in these correlations, which would also reflect the differences between low-income areas in Africa (Nigeria) and high-income areas...... in Europe and Japan.Method:Patients with International Classification of Diseases (ICD-10) F2 diseases (schizophrenia spectrum disorders) and F3 diseases (affective disorders) admitted to one Nigerian, one Japanese, two Swiss, two German and six Danish centres during 1 year were included. Physical diseases...... Europe, Nigeria and Japan) within the same ranges (however, the Japanese results should be interpreted conservatively owing to the limited sample size). Overweight among the mentally ill were marked in Nigeria. A parallelism of the incidence of overweight, CVD and diabetes with the occurrence...
Larsen, Jens I; Andersen, Ulla A; Becker, Thomas; Bickel, Graziella G; Bork, Bernhard; Cordes, Joachim; Frasch, Karel; Jacobsen, Bent A; Jensen, Signe O Wallenstein; Kilian, Reinhold; Lauber, Christoph; Mogensen, Birthe; Nielsen, Jørgen A; Rössler, Wulf; Tsuchiya, Kenji J; Uwakwe, Richard; Munk-Jørgensen, Povl
People with psychiatric diseases have a severely increased risk for physical morbidity and premature death from physical diseases. The aims of the study were to investigate the occurrence of cardiovascular diseases (CVD), diabetes (DM) and obesity in schizophrenia and depression in three different geographical areas - Asia (Japan), Africa (Nigeria) and Western Europe (Switzerland, Germany and Denmark) - and to search for possible transcultural differences in these correlations, which would also reflect the differences between low-income areas in Africa (Nigeria) and high-income areas in Europe and Japan. Patients with International Classification of Diseases (ICD-10) F2 diseases (schizophrenia spectrum disorders) and F3 diseases (affective disorders) admitted to one Nigerian, one Japanese, two Swiss, two German and six Danish centres during 1 year were included. Physical diseases in accordance with ICD-10 were also registered. Psychiatric and physical comorbidity were calculated and standardized rate ratio incidences of background populations were our primary measures. Incidence rate ratios were increased for both CVD, DM and overweight in both F2 and F3 in all cultures (Western Europe, Nigeria and Japan) within the same ranges (however, the Japanese results should be interpreted conservatively owing to the limited sample size). Overweight among the mentally ill were marked in Nigeria. A parallelism of the incidence of overweight, CVD and diabetes with the occurrence in background populations was seen and was most marked in overweight. Overweight, CVD and DM were increased in schizophrenia spectrum disorders and affective disorders in all three cultures investigated (Western Europe, Nigeria and Japan). Lifestyle diseases were also seen in Nigeria and Japan. The results from this study indicate that cultural background might be seen as an important factor in dealing with lifestyle diseases among people with a severe mental illness, as it is in the general population.
Galvez, Juan Francisco; Thommi, Sairah; Ghaemi, S Nassir
There is growing interest to understand the role of positive psychological features on the outcomes of medical illnesses. Unfortunately this topic is less studied in relation to mental health, and almost completely neglected in relation to one of the most common severe psychiatric illnesses, bipolar disorder. Certain specific psychological characteristics, that are generally viewed as valuable and beneficial morally or socially, may grow out of the experience of having this affective disorder. We describe the sources, research and impact of these positive psychological traits in the lives of persons with bipolar disorder based on the few published literature available to date. These include, but are not limited to: spirituality, empathy, creativity, realism, and resilience. After an extensive search in the literature, we found 81 articles that involve descriptions of positive psychological characteristics of bipolar disorder. We found evidence for enhancement of the five above positive psychological traits in persons with bipolar disorder. Bipolar disorder is associated with the positive psychological traits of spirituality, empathy, creativity, realism, and resilience. Clinical and research attention to preserving and enhancing these traits may improve outcomes in bipolar disorder. © 2010 Elsevier B.V. All rights reserved.
Martell, D A; Rosner, R; Harmon, R B
The study aimed to estimate the prevalence of homelessness among mentally disordered offenders entering the criminal justice and forensic mental health systems, to compare base rates of arrest for violent and nonviolent criminal charges among homeless and domiciled persons with mental illness, and to examine patterns in the categories of victims chosen by these two groups. The authors analyzed data from structured psychiatric interviews and criminal and psychiatric records of 77 homeless defendants and 107 domiciled defendants referred for psychiatric examination by the criminal and supreme courts in Manhattan over a six-month period. Mentally disordered defendants had 40 times the rate of homelessness found in the general population, and 21 times the rate in the population of mentally ill persons in the city. The overall rate of criminal offenses was 35 times higher in the homeless mentally ill population than in the domiciled mentally ill population. The rate of violent crimes was 40 times higher and the rate of nonviolent crimes 27 times higher in the homeless population. Homeless defendants were significantly more likely to have been charged with victimizing strangers. Homeless mentally ill persons appear to be grossly overrepresented among mentally disordered defendants entering the criminal justice and forensic mental health systems and to have a higher base rate of arrest for both violent and nonviolent crimes than domiciled mentally ill persons.
Glozah, Franklin N; Pevalin, David J
Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.
Lipskaya-Velikovsky, Lena; Elgerisi, Dikla; Easterbrook, Adam; Ratzon, Navah Z
Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.
Michaels, Patrick J; Corrigan, Patrick W
For persons with mental illness, stigma diminishes employment and independent living opportunities as well as participation in psychiatric care. Public stigma interventions have sought to ameliorate these consequences. Evaluation of anti-stigma programs' impact is typically accomplished with self-report questionnaires. However, cultural mores encourage endorsement of answers that are socially preferred rather than one's true belief. This problem, social desirability, has been circumvented through development of faux knowledge tests (KTs) (i.e., Error-Choice Tests); written to assess prejudice. Our KT uses error-choice test methodology to assess stigmatizing attitudes. Test content was derived from review of typical KTs for façade reinforcement. Answer endorsement suggests bias or stigma; such determinations were based on the empirical literature. KT psychometrics were examined in samples of college students, community members and mental health providers and consumers. Test-retest reliability ranged from fair (0.50) to good (0.70). Construct validity analyses of public stigma indicated a positive relationship with the Attribution Questionnaire and inverse relationships with Self-Determination and Empowerment Scales. No significant relationships were observed with self-stigma measures (recovery, empowerment). This psychometric evaluation study suggests that a self-administered questionnaire may circumvent social desirability and have merit as a stigma measurement tool.
Leung, Lucinda B; Yoon, Jean; Escarce, José J; Post, Edward P; Wells, Kenneth B; Sugar, Catherine A; Yano, Elizabeth M; Rubenstein, Lisa V
Primary care-mental health integration (PC-MHI) aims to increase access to general mental health specialty (MHS) care for primary care patients thereby decreasing referrals to non-primary care-based MHS services. It remains unclear whether new patterns of usage of MHS services reflect good mental health care. This study examined the relationship between primary care clinic engagement in PC-MHI and use of different MHS services. This was a retrospective longitudinal cohort study of 66,638 primary care patients with mental illnesses in 29 Southern California Veterans Affairs clinics (2008-2013). Regression models used clinic PC-MHI engagement (proportion of all primary care clinic patients who received PC-MHI services) to predict relative rates of general MHS visits and more specialized MHS visits (for example, visits for serious mental illness services), after adjustment for year and clinic fixed effects, other clinic interventions, and patient characteristics. Patients were commonly diagnosed as having depression (35%), anxiety (36%), and posttraumatic stress disorder (22%). For every 1 percentage point increase in a clinic's PC-MHI engagement rate, patients at the clinic had 1.2% fewer general MHS visits per year (pPrimary care clinics with greater engagement in PC-MHI showed reduced general MHS use rates, particularly for patients with depression, without accompanying reductions in use of more specialized MHS services.
Sharma, Indira; Tripathi, C B; Pathak, Abhishek
The institution of marriage in Hindus is regulated by the prevailing social norms and the Hindu Marriage Act (HMA), 1955. Married women with mental illness are heavily discriminated. This paper examines the social and legal aspects of Hindu marriage in women with mental illness. The HMA, 1955 lays down the conditions for a Hindu marriage and also provides matrimonial reliefs: Nullity of marriage, restitution of conjugal rights, judicial separation and divorce. The application of the provisions of HMA in the setting mental illness is difficult and challenging. There is a wide gap between the legislative provisions of HMA, and societal value systems and attitudes towards marriage in Indian society. Societal norms are powerful and often override the legal provisions. The disparities are most glaring in the setting of mental illness in women. This is a reflection of social stigma for mental illness and patriarchal attitude towards women. Concerted efforts are needed to bridge the gap between the legislative provisions of HMA and societal value systems and attitudes toward marriage. Awareness programs regarding the nature and types of mental illness, advances in treatment and information about good outcome of severe mental illness will be helpful. Improvement in moral and religious values will overcome to some extent the negative attitudes and patriarchal mind set toward married women with mental illness.
This paper discusses provider-initiated HIV counselling and testing (PICT) and some of the ethical dilemmas associated with it, on the basis that PICT may be used to increase the number of mentally ill persons tested for HIV. The authors conclude that PICT should be promoted to all psychiatric admissions and mentally ill ...
Spiegelhoff, Sarah F.; Ahia, C. Emmanuel
This article draws attention to the issue of parental severe mental illness and the ethical and clinical implications for counselors who work with this population. Parents with mental illness face a multitude of life challenges including, but not limited to, parenting difficulties, medication and hospitalization, custody and placement of their…
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
Brandt, Anna L. S.
The number of mentally ill inmates in the criminal justice system has increased dramatically. This article evaluates the prevalence and causes of mental illness in the criminal justice system and describes the inadequate care that is provided, the effects of imprisonment, and the problem of rehabilitation. (Contains 4 notes.)
HUMAN RIGHTS THAT INFLUENCE THE MENTALLY ILL PATIENT IN SOUTH. AFRICAN MEDICAL LAW: A DISCUSSION OF SECTIONS 9; 27; 30 AND 31 OF. THE CONSTITUTION*. M Swanepoel**. 1. Introduction. People suffering from mental illness are among the most disadvantaged groups in society. They suffer ...
The purpose of this note is to discuss legal aspects with regard to mentally ill offenders with specific reference to the defence raised as a result of mental illness. In order to fully understand this defence it is important to provide a clinical background on what forensic psychiatry is. It is also necessary to define certain clinical ...
Different studies show different attitudes towards mental illness among medical students. This study was initiated to explore the attitude towards mental illness among medical students in a medical college of Manipur. A cross-sectional selfadministered questionnaire-based study was conducted among medical students in ...
Dockett, Kathleen H.
The need for a more responsive service system for people who are both mentally ill and homeless is a salient concern in America today. Preliminary research was conducted to examine how homeless mentally ill persons are processed by the currently organized network of human services in the nation's capital. Data were gathered in the summer of 1985…
O. F. Pironkova
For respondents with higher education and high social status were characterized by a more humanistic and tolerant practices of interaction with the mentally ill against the possibility of hiddennegativities attitude towards the mentally ill, which is reflected in social practices bypassing the declared position.
The author discusses the quote from Mill's On Liberty that is often cited by libertarians in opposition to involuntary commitment of the mentally ill. This quote has been taken out of context; other statements in the document indicate that Mill excluded from his libertarian credo those "without the ordinary amount of understanding," i.e., those people who would now be considered mentally ill.
Kohl, Patricia L.; Jonson-Reid, Melissa; Drake, Brett
Objective: Children of mothers with mental illness are at risk for multiple untoward outcomes, including child maltreatment and foster care placement. The purpose of this analysis was to determine the association between maternal mental illness and children's long term safety and stability. Methods: A multi-sector administrative dataset from the…
Horwitz, Allan V.; And Others
Examined role of adult siblings in caregiving for severely mentally ill using data from 109 siblings named by patients released from mental hospitals and 24-hour crisis care facilities. Results indicated that greater patient need, positive attitudes toward ill sibling, and other role involvements were major factors influencing sibling caregiving.…
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…
...; Presumptive Eligibility for Psychosis and Other Mental Illness AGENCY: Department of Veterans Affairs. ACTION... psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis within two years after service and within two years after the end of the Persian...
...; Presumptive Eligibility for Psychosis and Other Mental Illness AGENCY: Department of Veterans Affairs. ACTION... care eligibility for veterans of certain wars and conflicts who developed psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis...
Kroska, Amy; Harkness, Sarah K.
We introduce "stigma sentiments" as a way to operationalize the cultural conceptions of the mentally ill. Stigma sentiments are the evaluation, potency, and activity (EPA) associated with the cultural category "a mentally ill person." We find consistent support for the validity of the evaluation and potency components as measures of these…
The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital ... The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective antistigma psycho-educational programme.
Adams, Rick A; Huys, Quentin J M; Roiser, Jonathan P
Computational Psychiatry aims to describe the relationship between the brain's neurobiology, its environment and mental symptoms in computational terms. In so doing, it may improve psychiatric classification and the diagnosis and treatment of mental illness. It can unite many levels of description in a mechanistic and rigorous fashion, while avoiding biological reductionism and artificial categorisation. We describe how computational models of cognition can infer the current state of the environment and weigh up future actions, and how these models provide new perspectives on two example disorders, depression and schizophrenia. Reinforcement learning describes how the brain can choose and value courses of actions according to their long-term future value. Some depressive symptoms may result from aberrant valuations, which could arise from prior beliefs about the loss of agency ('helplessness'), or from an inability to inhibit the mental exploration of aversive events. Predictive coding explains how the brain might perform Bayesian inference about the state of its environment by combining sensory data with prior beliefs, each weighted according to their certainty (or precision). Several cortical abnormalities in schizophrenia might reduce precision at higher levels of the inferential hierarchy, biasing inference towards sensory data and away from prior beliefs. We discuss whether striatal hyperdopaminergia might have an adaptive function in this context, and also how reinforcement learning and incentive salience models may shed light on the disorder. Finally, we review some of Computational Psychiatry's applications to neurological disorders, such as Parkinson's disease, and some pitfalls to avoid when applying its methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Full Text Available Abstract Background There is an increasing probability that the psychiatrist will, willingly or not, come into contact with mentally ill offenders in the course of their practice. There are increasing rates of violence, substance abuse and other psychiatric disorders that are of legal importance. Therefore, the aim of this work was to investigate the rates of different mental disorders in 100 court reports and to investigate the characteristics of mentally ill offenders. Methods All cases referred from different departments of the legal system to the forensic committee for assessment of legal accountability over 13-months duration were included. A specially designed form was prepared for data collection. Cases were classified into five groups: murder, robbery, financial offences, violent and simple offences and a group for other offences. Data were subjected to statistical analysis and comparisons between different groups of subjects were performed by analysis of variance (ANOVA. Results Men constituted 93% of cases. In all, 73% of offenders were younger than 40 years old. Schizophrenia cases made up 13% of the total, substance related cases constituted 56% and amphetamine cases alone made up 21%; 10% of cases were antisocial personality disorders, and 51% of cases were classified as having a low education level. Unemployment was found in 34% of cases. The final decision of the forensic committee was full responsibility in 46% of cases and partial responsibility in 11% of cases, with 33% considered non-responsible. A total of 58% of cases had had contact with psychiatric healthcare prior to the offence and in 9% of cases contact had been in the previous 12 weeks. A history of similar offences was found in 32% of cases. In all, 14% of the offences were murders, 8% were sexual crimes, and 31% were violent/simple crimes. Conclusions The ability of the legal system to detect cases was good, while the ability of the healthcare system to predict
Minas, Harry; Zamzam, Ruzanna; Midin, Marhani; Cohen, Alex
The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356) gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298). Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented through survey method is required to support these conclusions.
Full Text Available Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356 gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298. Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented
Whitley, Rob; Berry, Sarah
Much research suggests that the general public relies on the popular media as a primary source of information about mental illness. We assessed the broad content of articles relating to mental illness in major Canadian newspapers over a 6-year period. We also sought to assess if such content has changed over time. We conducted a retrospective analysis of Canadian newspaper coverage from 2005 to 2010. Research assistants used a standardized guide to code 11 263 newspaper articles that mention the terms mental health, mental illness, schizophrenia, or schizophrenic. Once the articles were coded, descriptive statistics were produced for overarching themes and time trend analyses from 2005 to 2010. Danger, violence, and criminality were direct themes in 40% of newspaper articles. Treatment for a mental illness was discussed in only 19% of newspaper articles, and in only 18% was recovery or rehabilitation a significant theme. Eighty-three per cent of articles coded lacked a quotation from someone with a mental illness. We did not observe any significant changes over time from 2005 to 2010 in any domain measured. There is scope for more balanced, accurate, and informative coverage of mental health issues in Canada. Newspaper articles infrequently reflect the common realities of mental illness phenomenology, course, and outcome. Currently, clinicians may direct patients and family members to other resources for more comprehensive and accurate information about mental illness.
Full Text Available Abstract Background This study was designed to examine the knowledge, attitude and beliefs about causes, manifestations and treatment of mental illness among adults in a rural community in northern Nigeria. Methods A cross sectional study design was used. A pre-tested, semi-structured questionnaire was administered to 250 adults residing in Karfi village, northern Nigeria. Results The most common symptoms proffered by respondents as manifestations of mental illness included aggression/destructiveness (22.0%, loquaciousness (21.2%, eccentric behavior (16.1% and wandering (13.3%. Drug misuse including alcohol, cannabis, and other street drugs was identified in 34.3% of the responses as a major cause of mental illness, followed by divine wrath/ God's will (19%, and magic/spirit possession (18.0%. About 46% of respondents preferred orthodox medical care for the mentally sick while 34% were more inclined to spiritual healing. Almost half of the respondents harbored negative feelings towards the mentally ill. Literate respondents were seven times more likely to exhibit positive feelings towards the mentally ill as compared to non-literate subjects (OR = 7.6, 95% confidence interval = 3.8–15.1. Conclusions Our study demonstrates the need for community educational programs in Nigeria aimed at demystifying mental illness. A better understanding of mental disorders among the public would allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization towards such persons.
Hanafiah, Ainul Nadhirah; Van Bortel, Tine
Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and 'stigma'. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public attitudes towards mental illness but little to none from the standpoint of mental health professionals. In Malaysia, this research on stigma is particularly limited. Therefore, the state of stigma and discrimination of people with mental illness was investigated from the perspectives of mental health professionals in Malaysia. In-depth, face-to-face, semi-structured interviews were conducted with 15 mental health professionals from both government and private sectors including psychiatrists, psychologists and counsellors. The interviews were approximately 45-minutes long. The data was subsequently analysed using the basic thematic approach. Seven principal themes, each with their own sub-themes, emerged from the analysis of 'stigma of mental illness' from mental health professionals' point of view, including: (1) main perpetrators, (2) types of mental illness carrying stigma, (3) demography and geography of stigma, (4) manifestations of stigma, (5) impacts of stigma, (6) causes of stigma and (7) proposed initiatives to tackle stigma. Stigma of mental illness is widespread in Malaysia. This is most evident amongst people suffering from conditions such as schizophrenia, bipolar disorder and depression. Stigma manifests itself most often in forms of labelling, rejection, social exclusion and in employment. Family, friends and workplace staff are reported to be the main perpetrators of discriminatory conducts. According to the perspectives of the mental health professionals, implications of
Balogh, Robert; Lin, Elizabeth; Dobranowski, Kristin; Selick, Avra; Wilton, Andrew S; Lunsky, Yona
Early hospital readmissions within 30 days of discharge are common and costly. This research describes predictors of all-cause, 30-day hospital readmissions among persons with intellectual and developmental disabilities (IDD), a group known to experience high rates of hospitalization. A cohort of 66,484 adults with IDD from Ontario, Canada, was used to create two subgroups: individuals with IDD only and those with IDD and mental illness. The rates of hospital readmission were determined and contrasted with a comparison subgroup of people without IDD who have mental illness. Compared with those with mental illness only, individuals with IDD and mental illness were 1.7 times more likely to experience a hospital readmission within 30 days. Predictors of their readmission rates included being a young adult and having high morbidity levels. The high rate of hospital readmission suggests that individuals with IDD and mental illness need attention regarding discharge planning and outpatient follow-up.
Stanton, Simon; Rosenbaum, Simon; Kalucy, Megan; Reaburn, Peter; Happell, Brenda
Mental illness affects the lives of a significant number of Australians. In addition to pharmacological and psychological interventions, exercise has demonstrated benefits for people with mental illness including symptom reduction, improved cardiovascular risk profile and improved physical capacity. Unfortunately, evidence shows that clinician-delivered exercise advice is not routinely offered. This is despite patient acceptability for exercise. This article summarises the recent evidence supporting the prescription of exercise for people with mental illness and offers a model incorporating basic exercise prescription, and referral pathways for specialised advice. Current exercise prescription patterns for people with mental illness may not meet patient expectations; therefore, clinicians should consider exercise referral schemes to increase the accessibility of interventions for people with a mental illness.
Novak, Lan; Švab, Vesna
Background: Little research was done on the influence of antipsychotics’ side effects on stigma of mental illness. An overview of studies shows that people with mental illness state that because of medication side effects they feel discriminated in the field of employment, observe worsening of family relations and tend to skip or discontinue their regular medication. It is difficult to discriminate between stigmatizing effects of antipsychotics and other stigma related factors such as illness...
Ordan, Revital; Shor, Ron; Liebergall-Wischnitzer, Michal; Noble, Lawrence; Noble, Anita
To examine professional stigma and attitudes of parenthood towards postpartum women with severe mental illness and the association between postpartum nurses' attitudes and nursing interventions that promote motherhood. Stigma and attitudes towards parenthood of women with severe mental illness may influence nurses' clinical practices. Cross-sectional, mixed methods. The Stigma among Health Professionals towards People with Severe Mental Illness, Attitudes towards Parenthood among People with Severe Mental Illness and Nursing Interventions that Promote Becoming a Mother Questionnaires were used in the study, as well as qualitative analysis. Sixty-one postpartum nurses participated in the study. Increased stigma was associated with an increase in negative attitudes towards parenthood among people with severe mental illness, in general, and towards their parenthood skills, in particular. Postpartum nurses reported a decrease in nursing interventions and a therapeutic nurse-client relationship that fosters mother's empowerment. Themes that emerged from the qualitative analysis were postpartum nurse's perceptions of inadequacy, difficulty of postpartum nurses taking responsibility for managing women with severe mental illness and a paternalistic approach to these women, rather than empowerment, regarding infant care. Nurses providing care to postpartum women with severe mental illness and their infants may provide fewer routine postpartum interventions due to professional stigma and negative attitudes concerning parenting skills. Nurses should provide individualised, tailored care that allows women with severe mental illness to become a mother to the best of her ability. Not all women with severe mental illness are capable of caring for themselves and/or their baby. Nurses should provide individualised, tailored care that allows the women with severe mental illness to become a mother to the best of her ability. © 2017 John Wiley & Sons Ltd.
The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness. A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent loss of housing and continued homelessness. The responses of participants who had mental illness, defined both broadly and narrowly, were compared with responses of those who were not mentally ill. The broad definition of mental illness was based on a set of criteria proposed by NSHAPC investigators. The narrow definition included past psychiatric hospitalization in addition to the NSHAPC criteria. A total of 1,620 participants (56 percent) met the broad definition of mental illness, and 639 (22 percent) met the narrow definition; 1,345 participants (44 percent) did not meet any of these criteria and were categorized as not having a mental illness. Few differences in reasons for the most recent loss of housing were noted between the participants with and without mental illness. Both groups attributed their continued homelessness mostly to insufficient income, unemployment, and lack of suitable housing. Homeless persons with mental illness mostly report the same reasons for loss of housing and continued homelessness as those who do not have a mental illness. This finding supports the view that structural solutions, such as wider availability of low-cost housing and income support, would reduce the risk of homelessness among persons with mental illness, as among other vulnerable social groups.
Molinari, Victor; Hobday, John V; Roker, Rosalyn; Kunik, Mark E; Kane, Rosalie; Kaas, Merrie J; Mehrotra, Chandra; Williams, Christine L; Robbins, Joyce C; Dobbs, Debra
Certified nurse assistants (CNAs) spend the most staff time with nursing home residents, yet they receive little training in addressing the mental health needs of residents with serious mental illness (SMI). Forty CNAs from four long-term-care facilities took the online interactive CARES- ® Serious Mental Illness ™ training consisting of two modules guided by the Recovery Movement philosophy of care. Responses from pre-post testing, Likert-type items, and open-ended questions indicated that CNAs gained information, changed their perspectives, and had more confidence in dealing with SMI. Although there were minor concerns regarding length, clarity of content, and technical issues, CNAs found the online format acceptable and easy to use, and many said they would recommend the training. CARES Serious Mental Illness online training appears to be a viable way of helping CNAs address the mental health needs of long term care residents. Additional testing on CARES Serious Mental Illness is planned.
Neumann, Eva; Obliers, Rainer; Albus, Christian
Stigmatization of mental illness is a widespread phenomenon even among health professionals. To explore the origins of this inappropriate attitude, medical students at the beginning and in the end of their studies were examined with self-report measures of social distance towards mentally ill persons, beliefs about etiology of mental disorders, valuation of psychotherapy and the personality features empathy and narcissism. While the students' attitudes turn out to be unrelated to the personality features, significant differences between the two groups were found indicating that distance towards mentally ill patients in the medical role and ambivalence about the etiological factors of mental disorders are stronger pronounced in the end of the studies compared to the beginning. These findings underline the need to prepare medical students better for contacts with mentally ill patients. © Georg Thieme Verlag KG Stuttgart · New York.
Catanesi, Roberto; Rocca, Gabriele; Candelli, Chiara; Carabellese, Felice
Matricide is one of the rarest of reported murders and has always been considered one of the most abhorrent crimes. Psychiatric investigations as to why a son might murder his mother yield indications of a high rate of mental illness, primarily psychotic disorders, in perpetrators. In an attempt to gain an in-depth understanding of the role of the mother-son bond in the etiology of matricide by mentally disordered sons, this article presents a qualitative study of nine cases of matricide examined at two Italian Forensic Psychiatry Departments between 2005 and 2010 and retrospective analysis of forensic psychiatry reports on the offenders. Most matricides suffered from psychotic disorders, especially schizophrenia. Nevertheless, not all the perpetrators had psychotic symptoms at the time of the crime. A "pathologic" mother-son bond was found in all cases. However, mental illness is not the only variable related to matricide and, taken alone, is not enough to explain the crime. Several factors in the history of the mother and son need to be probed, especially how their relationship developed over the years. The peculiar dynamics of the mother-son relationship and the unique personalities and life experiences of both subjects are the real key to cases of matricide. © The Author(s) 2014.
Full Text Available Klara Latalova,1,2 Dana Kamaradova,1,2 Jan Prasko1,2 1Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic; 2Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic Abstract: 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. Keywords: victimization, violence, severe mental illness, schizophrenia, bipolar disorder
Calogero, Samantha; Caley, Charles F
To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
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.
1. With deinstitutionalization and changes in legal rights of patients, care of patients with severe mental illness has shifted from a hospital-based to a community-centered system. 2. Families often serve as an extension of the mental health system, providing important case management functions such as assessment, monitoring, crisis management, and advocacy. 3. Symbolic interactionism provides a framework for understanding the role of meaning in individual and family responses to the disruption of life that results from severe mental illness.
This podcast is based on the February 2013 CDC Vital Signs report, which shows that cigarette smoking is a serious problem among adults with mental illness. More needs to be done to help adults with mental illness quit smoking and make mental health facilities tobacco-free. Created: 2/5/2013 by Centers for Disease Control and Prevention (CDC). Date Released: 2/5/2013.
Stanton, R; Reaburn, P; Happell, B
Exercise is valuable in the treatment of mental illness, yet personal and organizational barriers limit widespread implementation by nurses in mental health settings. Using a self-report questionnaire, we sought to identify how often nurses prescribe exercise and their level of agreement with previously identified barriers to exercise prescription and participation for mental health consumers. Nurses disagree that many of the previously identified barriers should impede exercise prescription for people with mental illness. Nurses agree that many of the barriers expressed by mental health consumers might prevent exercise participation. Our study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness; however, it is limited to a small sample. Confirmation of these findings in larger, geographically and professionally diverse groups is needed. Evidence is mounting for the efficacy of exercise in the treatment of people with mental illness. Nurses working in mental health settings are well placed to provide exercise advice for people with mental illness. However, quantitative examinations of the barriers to exercise prescription experienced by nurses, or their views regarding the barriers to exercise participation experienced by people with mental illness, are lacking. In this study, 34 nurses completed the Exercise in Mental Illness Questionnaire-Health Professionals Version (EMIQ-HP). This survey examined the frequency of exercise prescription and the level of agreement with statements regarding barriers to exercise prescription for, and exercise participation by, people with mental illness. The level of agreement scores for statements for each section was summed, with a higher score indicating a higher level of agreement. Nurses disagree with many of the barriers to exercise prescription presented in the literature. The level of agreement scores did not differ between nurses who prescribe exercise 'Always
Baillargeon, Jacques; Hoge, Stephen K; Penn, Joseph V
The purpose of the paper is to discuss the formidable challenges to community reentry and reintegration faced by U.S. prison inmates with serious mental illness and to describe various strategies for improving transitional services for these individuals. We review epidemiologic data supporting the high prevalence of severe mental illness in U.S. prisons as well as the historical factors underlying the criminalization of the mentally ill. The importance and challenges of providing adequate psychiatric care for mentally ill prisoners during their incarceration are discussed. We also review the numerous psychosocial and economic challenges confronting these individuals upon their release from prison, such as unemployment and vulnerability to homelessness, as well as specific barriers they may encounter in attempting to access community-based mental health services. We follow with a discussion of some of the more promising strategies for improving the transition of the mentally ill from prison to the community. In the final sections, we review the evidence for a relationship between serious mental illness and recidivism and briefly discuss emerging alternatives to incarceration of the mentally ill.
Thomas, Melanie; James, Monique; Vittinghoff, Eric; Creasman, Jennifer M; Schillinger, Dean; Mangurian, Christina
This study examined mammogram screening rates among women with severe mental illness by using a socioecological framework. Because it has been shown that people with severe mental illness receive less preventive health care overall, the analysis included psychosocial predictors of mammogram screening rates in a cohort of women with severe mental illness. This retrospective cohort study (N=14,651) used existing statewide data for women ages 48-67 in California with Medicaid insurance who received treatment in the specialty mental health care system. The primary outcome of interest was evidence of breast cancer screening via mammogram. The associations of each predictor of interest with mammogram screening were evaluated by using Poisson models with robust standard errors. Across all demographic and diagnostic categories, rates of breast cancer screening in this cohort of women with severe mental illness fell below the national average. Only 26.3% (3,859/14,651) of women in the cohort received breast cancer screening in the past year. This study replicated previous findings that women with schizophrenia spectrum disorder and those with a comorbid substance use disorder are less likely to receive screening than those with other types of mental illness. In this cohort of women with severe mental illness, evidence of nonpsychiatric health care utilization was strongly associated with breast cancer screening (adjusted risk ratio=3.30, 95% confidence interval=2.61-4.16, pmental illness, such as targeted outreach to population subsets and colocation of primary care services in mental health treatment settings.
The over-representation of people with mental illness in the criminal justice system highlights the need for legislative reform and the implementation of programs breaking the cycle of mental illness, poverty, unemployment and substance abuse across Australia. Whilst there is no inherent association between mental illness and crime, there is a…
Lateef Olutoyin Oluwole
Full Text Available Background: The power of the modern mass media is not limited to its ability to communicate information and entertain but derives primarily from its ability to define situations, thereby enabling it to construct social reality. Stigma is related to negative stereotyping and prejudicial attitudes that in turn lead to discriminatory practices. Aims: The study sought to know the perceptions of and attitudes of mass communication students towards mental illness and the mentally ill. Settings and Design: The study population comprised of final year Diploma students of Mass Communication of a foremost tertiary institution in Nigeria. Methods and Material: The World Psychiatric Association questionnaire measuring attitudes towards Schizophrenia was modified and administered to the students. Results: Study also showed only one-fifth of all respondents had contact with either an advert or a promotion about mental illness. About three-quarter (74.1% of those who had come in contact with information on mental illness had done so through audiovisuals including television and radio. More than half of the students ranked environmental factors foremost among causes of mental illness. Majority of the students (85.9% would definitely not marry someone with mental illness. Conclusions: The enormous potential and influence the media has on mental health issues would require that mental health professionals provide great input into the enlightenment program for these young and mental health-naïve potential image makers.
Zhao, Sai; Sampson, Stephanie; Xia, Jun; Jayaram, Mahesh B
Those with serious/severe mental illness, especially schizophrenia and schizophrenic-like disorders, often have little to no insight regarding the presence of their illness. Psychoeducation may be defined as the education of a person with a psychiatric disorder regarding the symptoms, treatments, and prognosis of that illness. Brief psychoeducation is a short period of psychoeducation; although what constitutes 'brief psychoeducation' can vary. A previous systematic review has shown that the median length of psychoeducation is around 12 weeks. In this current systematic review, we defined 'brief psychoeducation' as programmes of 10 sessions or less. To assess the efficacy of brief psychoeducational interventions as a means of helping severely mentally ill people when added to 'standard' care, compared with the efficacy of standard care alone.The secondary objective is to investigate whether there is evidence that a particular kind (individual/ family/group) of brief psychoeducational intervention is superior to others. We searched the Cochrane Schizophrenia Group register September 2013 using the phrase:[*Psychoeducat* in interventions of STUDY]. Reference lists of included studies were also inspected for further relevant studies. We also contacted authors of included study for further information regarding further data or details of any unpublished trials. All relevant randomised controlled trials (RCTs) comparing brief psychoeducation with any other intervention for treatment of people with severe mental illness. If a trial was described as 'double blind' but implied randomisation, we entered such trials in a sensitivity analysis. At least two review authors extracted data independently from included papers. We contacted authors of trials for additional and missing data. We calculated risk ratios (RR) and 95% confidence intervals (CI) of homogeneous dichotomous data. For continuous data, we calculated the mean difference (MD), again with 95% CIs. We used a fixed
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
Naslund, John A; Aschbrenner, Kelly A; McHugo, Gregory J; Unützer, Jürgen; Marsch, Lisa A; Bartels, Stephen J
Social media holds promise for expanding the reach of mental health services, especially for young people who frequently use these popular platforms. We surveyed social media users who self-identified as having a mental illness to learn about their use of social media for mental health and to identify opportunities to augment existing mental health services. We asked 240 Twitter users who self-identified in their profile as having a mental illness to participate in an online survey. The survey was in English and inquired about participants' mental health condition, use of social media for mental health and interest in accessing mental health programs delivered through social media. Respondents from 10 countries completed 135 surveys. Most respondents were from the United States (54%), Canada (22%) and the United Kingdom (17%) and reported a psychiatric diagnosis of either schizophrenia spectrum disorder (27%), bipolar disorder (25%), major depressive disorder (16%) or depression (20%). Young adults age ≤35 (46%) were more likely to use Instagram (P = .002), Snapchat (P social media (P social media, especially to promote overall health and wellbeing (72%) and for coping with mental health symptoms (90%). This exploratory study demonstrates the feasibility of reaching social media users with mental illness and can inform efforts to leverage social media to make evidence-based mental health services more widely available to those in need. © 2017 John Wiley & Sons Australia, Ltd.
Collier, Elizabeth; Grant, Maria J
To illuminate long-term experiences of mental illness from both research and autobiographical accounts. A literature review of English-language papers, 1950-2014, relating to the experience of long-term mental illness indexed in AgeInfo, AMED, ASSIA, British Nursing Index (BNI), CINAHL, MEDLINE, PsycEXTRA, and PsychINFO. Twenty-five research papers and nine autobiographic accounts met the review criteria. Thematic analysis revealed nine themes: fear, explanation seeking, stigma, disability, coping strategies, control, support, change and learning, and life history. Specific gaps of note relate to age differences, acknowledgement of longevity of mental illnesses, and different cultural perspectives. Research Implications: There is an absence of longitudinal studies focused on experiences of long-term mental illness. The considerable length-of-time implicated in the experiences suggests that more individual life experience rather than illness focused studies are needed, enabling a holistic understanding. This includes studies from cultures other than the Western world. Greater transparency is needed in justifying age inclusions or passive exclusion of older peoples' perspectives. Knowledge of long-term mental illness experiences is of great importance to mental health practitioners. Evidence-based services cannot be provided if we do not have an holistic understanding of long-term mental illness. Social Implications: This review questions our ability to provide effective support for those experiencing long-term mental illness, in particular older people and different cultural perspectives. There appear to be no literature reviews that focus on the individual experience of long-term mental illness. It highlights the surprisingly small number of research studies available to inform mental health practitioners.
To report on the analysis of the concept of the stigma of mental illness within the Haitian American community. Mental illness is a highly stigmatized condition within certain communities making it challenging for individuals to seek effective treatment. The consequences of such stigma can have lifelong corollaries for the individuals, the families and the communities. The concept of stigma is not fully developed in nursing; clarity of the concept of stigma of mental illness is still needed in the nursing literature. In order to assist patients in accessing mental health services, the concept of stigma must first be clarified. The method used for this concept analysis was that of Walker and Avant. Five attributes were identified, creating the following definition: labelling, stereotype, negative attitude, emotional response, and discrimination. The antecedents for stigma of mental illness are lack of knowledge about mental illness, emotional state and cultural beliefs and values. The origins of stigmatization of mental illness among Haitian Americans need to be understood. Mental health illnesses are stigmatized within the Haitian culture, which presents as a barrier to accessing help for many Haitian American women suffering from mental illness. The defining attributes can be used to develop tools to help clinicians identify patients being stigmatized. Once stigma is recognized, nurses can develop strategies and policies that can mitigate the effects of stigmatization of mental illness among this patient population. Further research is essential to examine the ways in which this concept impacts the Haitian American community, as well as effective strategies to help minimize its effects. © 2016 International Council of Nurses.
Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J
Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.
Losinski, Mickey; Maag, John W.; Katsiyannis, Antonis
Mental health in children and adults has always been a controversial topic, however, recent mass shootings in schools have heightened the concern of many and raise questions for how to interact with the mentally ill. Schools, have the capacity to be one of the key stakeholders in delivering services to students with mental health concerns,…
Doori Song; Hyun-Ji Lim; Yoo Jin Chung
Some believe that stigma is the worst side effect of the people who have mental illness. Mental illness researchers have focused on the influence of mass media on the stigmatization of the people with mental illness. However, no studies have investigated the effects of the interactive media, such as blogs, on the stigmatization of mentally ill people, even though the media have a significant influence on people in all areas of life. The purpose of this study is to investi...
Afzelius, M; Plantin, L; Östman, M
WHAT IS KNOWN ON THE SUBJECT?: Coping with parental mental illness in families can be challenging for both children and parents. Providing evidence-based family interventions to families where a parent has a mental illness can enhance the relationships in the family. Although psychiatric research has shown that evidence-based family interventions may improve the communication and understanding of parental mental illness, there is a lack in this area of research from an everyday clinical context. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Our study reinforces the fact that parents with mental illnesses are searching for support from psychiatric services in order to talk to their children about their illness. The finding that under-age children comply when they are told by their parents to join an intervention in psychiatric services supporting the family is something not observed earlier in research. This study once more illuminates the fact that partners of a person with parental mental illness are seldom, in an obvious way, included in family support interventions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric services, and especially mental health nurses, have an important task in providing families with parental mental illness with support concerning communication with their children and in including the "healthy" partner in family support interventions. Introduction Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method Five families with children aged 10-12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both
Cohen, D; Winstanley, S J; Greene, G
Understanding of doctors' attitudes towards disclosing their own mental illness has improved but assumptions are still made. To investigate doctors' attitudes to disclosing mental illness and the obstacles and enablers to seeking support. An anonymous, UK-wide online survey of doctors with and without a history of mental illness. The main outcome measure was likelihood of workplace disclosure of mental illness. In total, 1954 doctors responded and 60% had experienced mental illness. There was a discrepancy between how doctors think they might behave and how they actually behaved when experiencing mental illness. Younger doctors were least likely to disclose, as were trainees. There were multiple obstacles which varied across age and training grade. For all doctors, regardless of role, this study found that what they think they would do is different to what they actually do when they become unwell. Trainees, staff and associate speciality doctors and locums appeared most vulnerable, being reluctant to disclose mental ill health. Doctors continued to have concerns about disclosure and a lack of care pathways was evident. Concerns about being labelled, confidentiality and not understanding the support structures available were identified as key obstacles to disclosure. Addressing obstacles and enablers is imperative to shape future interventions. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: email@example.com.
Jahn, Danielle R; Muralidharan, Anjana; Drapalski, Amy L; Brown, Clayton H; Fang, Li Juan; Lucksted, Alicia
Individuals with serious mental illness and veterans are two populations at elevated risk for suicide; however, research has not examined whether veterans with serious mental illness may be at higher suicide risk than nonveterans with serious mental illness. Additionally, overlapping risk factors for suicide in these populations may account for differences in suicide-related outcomes between these groups. Therefore, the aim of this study was to identify differences in death ideation and suicide ideation among veterans and nonveterans with serious mental illness. We also aimed to explore these effects after adjusting for potentially shared risk factors. We found that veterans with serious mental illness reported death ideation and suicide ideation more than twice as often as nonveterans with serious mental illness. After adjusting for demographic, psychiatric, and theory-driven risk factors, the effect of veteran status on death ideation remained significant, though the effect on suicide ideation was no longer significant. Depressive and psychotic symptoms were significant predictors of death ideation; depressive symptoms and hostility were significant predictors of suicide ideation. Clinicians should particularly monitor death ideation and suicide ideation in veterans with serious mental illness, as well as associated clinical risk factors such as depression, psychotic symptoms, and hostility. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Vila-Badia, Regina; Martínez-Zambrano, Francisco; Arenas, Otilia; Casas-Anguera, Emma; García-Morales, Esther; Villellas, Raúl; Martín, José Ramón; Pérez-Franco, María Belén; Valduciel, Tamara; Casellas, Diana; García-Franco, Mar; Miguel, Jose; Balsera, Joaquim; Pascual, Gemma; Julia, Eugènia; Ochoa, Susana
To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness (CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness.
McGinty, Emma E; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L
The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995-2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media's continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses. Project HOPE—The People-to-People Health Foundation, Inc.
McGinty, Emma E.; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L.
The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995–2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media’s continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses. PMID:27269031
Newman, Daniel; O'Reilly, Pauline; Lee, Siew Hwa; Kennedy, Catriona
Background Interviews are widely used in qualitative research to collect data. However, little has been written about interviewing people with severe mental illness (SMI). Aim To report and analyse an experience of addressing the ethical and practical challenges of interviewing people with SMI. Discussion Semi-structured interviews were conducted as part of a doctoral study to explore how service users and healthcare professionals built relationships with each other. Conclusion Although interviewing participants with SMI was challenging, rich data illustrating their experiences were gathered. Careful planning around ethical considerations, such as obtaining informed consent, was required to maximise the opportunities to gather in-depth information during the interviews. The relationship established between researcher and the participants assisted with sensitive disclosures and allowed participants to tell their stories. Implications for research This paper provides strategies to help guide researchers planning interviews with vulnerable populations, including those with SMI. These strategies include how to discuss sensitive issues and promote engagement. Listening to participants' life stories is an intense experience, requiring support for the interviewer to stay neutral during interviews. It is also important to be aware of the differences between the roles of nurse and nurse researcher before undertaking in-depth qualitative interviews, particularly with vulnerable participants.
Fleury, Marie-Josée; Grenier, Guy
In the context of reforms in the field of disability, this study documents the trajectories and mechanisms of support for young people with mental illness or intellectual disability or pervasive developmental disorders, during the teen-adult life transition period; andfactorsfostering or impeding this transition for their maintenance in an everyday environment, particularly in SESSAD (special education and home care service) and the SAMSAH/ SPAC (medico-social support for adults with disabilities/support services in social life). This study was conducted in the French department of Seine-et-Marne. It was supported by a mixed call for tenders, in which 77 respondents (professionals, families and users), and 26 organizations were consulted. The study shows that few young adults in SAMSAH/SPAC programmes are derived from SESSAD, and they encounter major difficulties living in an everyday environment, particularly during the transition period. Clinical or socio-economic factors related to the profiles of users or healthcare service organization facilitate or hinder the inclusion of young people in an everyday environment. Support for users was also often limited to followup over a suboptimal period, and was hampered by insufficient networking within the regional healthcare system. On the other hand, empowerment of users and their optimal inclusion in an everyday environment, as founding principles of the reform, constitute major action priorities for healthcare structures. Strengthening services for young people (16-25 years), including integration strategies, is recommended in order to establish an integrated network of services in the field of disability.
Leijdesdorff, S.M.J.; Doesum, K.T.M. van; Popma, A.; Klaassen, R.M.C.; Amelsvoort, T.A.M.J. van
Purpose of review: Children of parents with a mental illness and/or addiction are at high risk for developing a mental illness themselves. Parental mental illness is highly prevalent leading to a serious number of children at high risk. The aim of this review is to give an up-to-date overview of
Full Text Available Mental illness in the university student population has come under increased scrutiny in recent years. Students with mental illness are understandably highly reluctant to disclose their condition to others due to fear of prejudice, “not blending in,” and a strong desire to appear self-reliant. This study considered whether disclosure to university support services, with all its perceived risks, had academic benefits for students with mental illness. Preliminary evidence was found that, for those students with mental illness who registered with the University’s Disability Support Service for assistance, academic achievement was significantly higher on average in the year following their joining the service. Academic retention for these students was comparable to their university peers. A number of recommendations are discussed that could accommodate for students’ learning needs, thereby benefitting those experiencing mental health difficulties.
Lyons, Zaza; Laugharne, Jonathan; Laugharne, Richard; Appiah-Poku, John
Stigma towards mental illness has been found to impact adversely on medical students' attitudes towards psychiatry. This study aimed to assess the impact of stigma among final year students at the University of Science and Technology in Kumasi, Ghana, and the University of Western Australia. A 28-item "Attitudes and stigma towards mental health" questionnaire was distributed to final year students at both universities. There was a significant difference in questionnaire scores, with Australian students showing more positive attitudes towards mental illness and lower levels of stigma compared with Ghanaian students. Stigmatization was expressed by Australian and Ghanaian students. A combination of medical school experiences and wider societal and cultural beliefs could be responsible for students' attitudes towards mental illness. Educators can develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students' attitudes towards psychiatry as a discipline and mental illness in general.
Mental illnesses have long been perceived as the exclusive consequence of abnormalities in neuronal functioning. Until recently, the role of glial cells in the pathophysiology of mental diseases has largely been overlooked. However recently, multiple lines of evidence suggest more diverse and significant functions of glia with behavior-altering effects. The newly ascribed roles of astrocytes, oligodendrocytes and microglia have led to their examination in brain pathology and mental illnesses. Indeed, abnormalities in glial function, structure and density have been observed in postmortem brain studies of subjects diagnosed with mental illnesses. In this review, we discuss the newly identified functions of glia and highlight the findings of glial abnormalities in psychiatric disorders. We discuss these preclinical and clinical findings implicating the involvement of glial cells in mental illnesses with the perspective that these cells may represent a new target for treatment.
Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw
This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis. Patients were classified as having no mental illness, anxiety, depression, anxiety and depression, or severe mental illness (bipolar disorder, schizophrenia, and other psychotic disorder). Multivariable binomial regression was used to assess the association between mental illness and delays of ≥60 and ≥90 days after adjustment for confounders. Patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition (RR 1.11; 95% CI 1.00, 1.23), and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis (RR 1.36; 95% CI 1.06, 1.74). Patients with any mental illness experienced an increased risk for adjuvant chemotherapy delay of ≥90 days from last operation (RR 1.13; 95% CI 1.01, 1.26) and each category of mental illness, except depression, showed a non-significant trend for this association. Breast cancer patients with mental illness should be closely managed by a cross-functional care team, including a psychiatrist, a primary care physician, and an oncologist, to ensure adequate care is received within an appropriate timeframe.
Raymond J. Gibbons
Full Text Available Objectives. The current study investigated mental health literacy in an Australian sample to examine sex differences in the identification of and attitudes towards various aspects of mental illness.Method. An online questionnaire was completed by 373 participants (M = 34.87 years. Participants were randomly assigned either a male or female version of a vignette depicting an individual exhibiting the symptoms of one of three types of mental illness (depression, anxiety, or psychosis and asked to answer questions relating to aspects of mental health literacy.Results. Males exhibited poorer mental health literacy skills compared to females. Males were less likely to correctly identify the type of mental illness, more likely to rate symptoms as less serious, to perceive the individual as having greater personal control over such symptoms, and less likely to endorse the need for treatment for anxiety or psychosis.Conclusion. Generally, the sample was relatively proficient at correctly identifying mental illness but overall males displayed poorer mental health literacy skills than females.
Nordentoft, Merete; Krogh, Jesper; Krogholm, Kirstine Suszkiewicz
A significant share of the excess mortality among people suffering from mental illness is due to unhealthy lifestyles. Obesity, smoking, unhealthy diets and sedentary behaviour is twice as frequent among people with mental illness, but the willingness to improve lifestyle is as high as in healthy...... people. Based on a review of the literature we conclude that it is possible for people with mental illness to change their lifestyle, but they encounter a number of barriers to lifestyle changes, including their symptoms, adverse drug effects and their life situations....
Full Text Available This study explored the social situation of homeless people with mental illness living on the streets of Hillbrow, Johannesburg, with the view to facilitating action in terms of support services. Data were collected via interviews and observations from three groups: homeless persons with suspected mental illness, homeless people and service providers. The research focused on reasons for homelessness; health and living conditions; relationships between homeless persons and those with mental illness; survival strategies; and services utilised. Results were presented to all stakeholders and a forum was established to enable the findings to be taken forward.
Morgan, Leslie A; Perez, Rosa; Frankowski, Ann Christine; Nemec, Mary; Bennett, Colleen R
An unknown number of mentally ill elders in the U.S. receive care in assisted living [AL], along with persons facing physical or cognitive challenges. While dementia is familiar in AL, our data indicate that neither staff nor residents are prepared to work or live with the mentally ill. Challenges are created for professionals, since these residents bring diverse needs. Daily inter-resident interactions are also disrupted or stressful. Qualitative data describe the impacts on quality of resident life as well as care and management dilemmas identified within five assisted living settings having varying presence of mental illness among residents.
Apollonio, D E; Malone, R E
To describe the tobacco industry's relationships with and influence on homeless and mentally ill smokers and organisations providing services to them. Analysis of internal tobacco industry documents and journal articles. The tobacco industry has marketed cigarettes to the homeless and seriously mentally ill, part of its "downscale" market, and has developed relationships with homeless shelters and advocacy groups, gaining positive media coverage and political support. Tobacco control advocates and public health organisations should consider how to target programmes to homeless and seriously mentally ill individuals. Education of service providers about tobacco industry efforts to cultivate this market may help in reducing smoking in these populations.
Cunningham, Colleen; Peters, Kathleen; Mannix, Judy
People with severe mental illness have a higher prevalence of co-morbid physical diseases and a significantly reduced life expectancy when compared with people in the general population. This article explores the literature published between 2002 and 2012 in order to identify causes of poor physical health in those with severe mental illness and discusses interventions that may be implemented to enhance health outcomes for this group. The causes of poor physical health in those with severe mental illness are difficult to address. However, existing literature does identify some interventions that can potentially provide the basis for practice change.
Fokuo, J Konadu; Goldrick, Virginia; Rossetti, Jeanette; Wahlstrom, Carol; Kocurek, Carla; Larson, Jonathon; Corrigan, Patrick
Stigma is defined as endorsing prejudicial attitudes about mental illness leading to discriminatory behaviors. It undermines the quality of medical care received by people with mental illness. Research suggests contact based interventions are effective in reducing stigma and increasing positive attitudes towards people with mental illness. This paper describes the development of a consumer led student-nurse mentoring program as part of nursing student education. People with lived mental health experience would mentor student nurses regarding the harmful effects of stigma and the beneficial outcomes of affirming attitudes. Seventy members of stakeholder groups (people with lived mental health experience and student nurses) participated in focus groups. Qualitative analyses revealed themes across stakeholder groups regarding: perceived mental health stigma from nurses, ways to reduce stigma, target message for the mentorship program, characteristics of mentors and logistics in developing such a program within the student nurse curricula.
Devlin, J M; O'Brien, L M
This paper explores the psychosocial consequences of parental mental illness for child mental health and the implications for mental health nursing. The literature on risk and vulnerability to psychosocial disorder, resilience, child protection, disorder prevention and epidemiological data are reviewed. Based upon a health promotion approach, a model for mental health nursing advocacy for families of adult consumers is proposed as an effective means of preventing disorder in subsequent generations.
Çelik Ince, S; Partlak Günüşen, N; Serçe, Ö
Individuals with mental illness have significantly higher mortality and morbidity than the general population due to physical illnesses. Mental health nurses play a key role in providing care for common physical problems and protecting and promoting healthy lifestyles. Little is known from previous studies in the international literature about the attitudes, behaviours and thoughts of mental health nurses on providing physical health care. Mental health nurses mostly focus on the existing physical health problems of individuals with mental illness. However, mental health nurses do not include practices of disease prevention and physical health promotion for individuals with mental illness. The desire to see positive changes in individuals with mental illness, receiving positive feedback, feeling useful and happy, and feeling satisfied with their profession motivate mental health nurses in terms of providing physical health care. The knowledge and skill required of mental health nurses to provide physical health care need to be increased. Institutions should employ expert nurses who are able to guide mental health nurses to provide physical health care. It is important to provide adequate physical infrastructure and human resources to provide better physical health care in mental health services. Background Mental health nurses play an important role in improving the physical health of individuals with mental illnesses. However, there are limited studies of their attitudes and practices about physical health. Therefore, there is a need for qualitative studies to clarify the issue. The aim of this study was to determine mental health nurses' opinions about physical health care for individuals with mental illness. This study was carried out in Turkey. A qualitative descriptive approach was taken in the study. The sample consisted of twelve mental health nurses selected by purposeful sampling. In-depth interviews were conducted using a semi-structured interview format
Full Text Available Background: There are few studies in Indian context on factors affecting generalized help-seeking behaviors in the relatives of persons with mental illness. Hence, the present study was undertaken. Materials and Methods: This is a cross-sectional, purposive sampling, comparative study. Sociodemographic profile, illness details, treatment, compliance, reactions to mental illness scale, and cope inventory scores were compared between the low and high help-seeking groups on General Help-seeking Questionnaire divided on the lower 25th and upper 75th quartiles, respectively, for the groups. The data were statistically analyzed on SPSS-17. Results: Out of a total of 100 patients, 25 and 28 subjects in the low and high help-seeking groups, respectively, were included in the study. In the low help-seeking group, drug compliance was good and caregivers' education level was higher compared to the high help-seeking group. High help-seeking group was characterized by higher scores of hope and compassion on reactions to mental illness scale and the coping mechanisms of humor, denial, use of instrumental and emotional support, acceptance, and planning were frequently used. Conclusions: There is a need to develop awareness about mental illness in the general population and improve the available social support systems to the patients with mental illness and their family members. The help-seeking behaviors could be improved by training the personnel at primary health centers about the treatment of mental illness and importance of drug compliance and regular follow-up.
Solomon, P; Draine, J
Many family members experience a profound sense of loss when a relative becomes mentally ill. The adjustment to this loss is similar to grief as a response to death. The extent of this grief may be explained by personal characteristics of family members, the severity of the illness, and the extent of social support available. A family member's emotional response to a relative's mental illness may be exacerbated by increases in both objective and subjective burden. While grief among families with a seriously mentally ill relative is the emotional response to reflecting on the loss of an emotionally healthy relative, burden reflects the present state of responsibility for the ill relative, expressed in both subjective and objective terms. In this study, family member characteristics, social support, objective burden and subjective burden contributed to explaining expressed grief among 225 family members of seriously mentally ill individuals. Mental health and family support professionals are encouraged to recognize the grief response in family members with a mentally ill relative.
Ally, Yaseen; Laher, Sumaya
The important role that religious beliefs may have on perceptions of mental illness cannot be ignored. Many religions including Islam advocate witchcraft and spirit possession--all of which are thought to influence the behaviour of a person so as to resemble that of a mentally ill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness in terms of their understanding of the distinctions between the two, the aetiologies and the treatments thereof. Six Muslim Healers in the Johannesburg community were interviewed and thematic content analysis was used to analyse the data. From the results it is clear that the faith healers were aware of the distinction between mental and spiritual illnesses. It was also apparent that Islam has a clear taxonomy that distinguishes illness and the causes thereof. Treatments are then advised accordingly. Thus this paper argues that the predominant Western view of the aetiology and understanding of mental illness needs to acknowledge the various culturally inclined taxonomies of mental illness so as to better understand and aid clients.
Mossman, D; Perlin, M L
Homeless mentally ill persons are highly visible subjects of ongoing public discussion and potent symbols of a host of contemporary social problems. They present psychiatry with a scientific challenge that calls for further elucidation of the sources of their mental illness and for fashioning possible solutions to their problems. They also present a moral challenge that requires psychiatrists to acknowledge the cultural, political, legal, and economic context of the mental problems of the homeless in the course of deciding what should be done to help them. H. Richard Lamb has proposed a program of aggressive outreach and psychiatric hospitalization for the homeless mentally ill. The authors believe that his proposal misconstrues the problems and needs of homeless mentally ill individuals; it would also needlessly infringe upon their freedom, further stigmatize them, and probably not help them. The authors offer an alternative understanding of the plight of the homeless mentally ill which places their problems within a larger context of social trends and domestic issues that society has been reluctant to confront. Psychiatrists can help the homeless mentally ill by championing their liberty rights and by focusing public discourse on the broad national need for improved access to medical and psychiatric care.
Hine, Rochelle Helena; Maybery, Darryl; Goodyear, Melinda Jane
Social connection is a fundamental human need, but challenging for individuals with characteristics that are socially stigmatized. Parenting with mental illness presents obstacles, as well as opportunities, for connection. In the present study, we examined connectedness within a personal recovery paradigm for rural mothers with a mental illness. In-depth interviews with 17 mothers with a mental illness, utilizing constructivist grounded theory, resulted in six categories of meaning, including 'yearning for connection', 'connecting intensely', 'encountering rejection and exclusion', 'choosing isolation', 'being known', and 'finding peers/helping others'. Women expressed a strong desire for connection, but for many, prior experiences of trauma and rejection created barriers to the development of trust, preventing some women from seeking opportunities for connection. Connectedness to self and significant others, and a broader life meaning and purpose can support and expedite personal recovery from mental illness for rural women. However the factors that contribute to the mental illness might also inhibit the development of trust needed to attain social connection. Increasing connectedness in mothers with mental illness is a complex endeavour requiring concerted focus as distinct from other service-delivery goals. The perinatal period could be a key time for intervention. © 2017 Australian College of Mental Health Nurses Inc.
Salize, H J; Horst, A; Dillmann-Lange, C; Killmann, U; Stern, G; Wolf, I; Henn, F; Rössler, W
Besides pronounced deficiencies in psychiatric research concerning homeless mentally ill in Germany, studies concerned with the quality of life of homeless mentally ill were missing until now. This study reveals in a representative sample of 102 homeless people from the City of Mannheim, Germany that--compared to the homeless without psychiatric disorders of the sample--the mentally ill homeless (prevalence 68.6%) have significantly different subjective views of their quality of life regarding the items "state of health", "physical capabilities" and "support from others". The differences were even stronger if the homeless mentally ill were compared to a group of non-homeless mentally ill schizophrenic patients (n = 104), cared for in the City's well-equipped community care services. Community care patients reported a significantly better quality of life in respect of 11 items. These results were seen as a success of the concept of community-based mental health care. The consequences for improving care strategies for homeless mentally ill are discussed.
Gulati, Prannay; Das, Subhash; Chavan, B. S.
Context: Attitude of fresh graduates toward psychiatric patients is important to bridge the treatment gap due to mental illness. Psychiatry as a subject has been neglected in the undergraduates of MBBS. Aims: (1) To compare the attitude of medical students and interns in a medical college toward mental illness and psychiatry. (2) To assess the impact of psychiatric training on attitude toward the mentally ill person and mental illness. Settings and Design: Cross-sectional, single assessment study conducted at a tertiary hospital. Subjects and Methods: Participants consisted of medical students of 1st and 2nd year who didn’t have any exposure to psychiatry and interns, who had completed their compulsory 2 week clinical posting in psychiatry. Participants were individually administered sociodemographic proforma, General Health Questionnaire-12 (GHQ-12), opinion about mental illness (OMI) scale, and attitude to psychiatry-29 (ATP-29) scale. Statistical Analysis: Standard descriptive statistics (mean, percentage), Chi-square test. Results: A total of 135 participants formed the study sample, with 48, 47, and 40 participants from 1st year, 2nd year and interns, respectively. Mean GHQ score was 14.03 for the entire sample. There was better outlook of interns toward psychiatry and patients with mental disorders in comparison to fresh graduate students in some areas. Overall, negative attitude toward mental illness and psychiatry was reflected. Conclusions: Exposure to psychiatry as per the current curriculum seems to have a limited influence in bringing a positive change in OMI and psychiatry. PMID:25316938
Benston, Elizabeth A
This systematic review analyzed the best available research in the United States on permanent supportive housing programs for homeless individuals with mental illness and the effect of these programs on housing status and mental health. It updates older and broader reviews that included weaker studies or those that did not analyze permanent housing as an input and housing and mental health as primary outcomes. The literature search (1980-2013) yielded 14 studies (randomized controlled trials and quasi-experimental studies). The studies found that a majority of participants placed in experimental housing programs with case management support remained in housing for at least one year or experienced more days housed than homeless relative to a comparison group. Although this finding is in line with previous literature reviews on permanent supportive housing, this analysis found limitations in each of the 14 reviewed studies, such as attrition, selection and response bias, imprecise definitions and implementation of housing programs, and a lack of appropriate controls. Only three of the reviewed studies reported using a housing fidelity assessment tool to test whether the housing intervention was faithful to theoretical standards, and conceptions and implementation of housing varied widely across studies, threatening internal and external validity. Pitfalls in the best available studies on permanent supportive housing programs in the United States limit the ability of research to inform the policy goal of ending chronic homelessness and demonstrate a need for further experimental research upon which to make funding and policy decisions, especially in light of prioritized federal funds.
Frajo-Apor, Beatrice; Pardeller, Silvia; Kemmler, Georg; Hofer, Alex
Emotional Intelligence (EI) and resilience may be considered as prerequisites for mental health professionals caring for patients with serious mental illness (SMI), since they are often exposed to severe emotional stress during daily work. Accordingly, this cross-sectional study assessed both EI and resilience and their interrelationship in 61 individuals belonging to an assertive outreach team for patients suffering from SMI compared 61 control subjects without healthcare-related working conditions. EI was assessed by means of the German version of the Mayer-Salovey-Caruso-Emotional-Intelligence Test (MSCEIT), resilience was assessed using the German version of the Resilience Scale. Both groups showed an average level of EI in all categories of the MSCEIT and indicated high levels of resilience. They did not differ significantly from each other, neither in terms of EI nor resilience. Correlation analysis revealed a positive association between EI and resilience, albeit small in magnitude. Our results suggest that mental health professionals are not more resilient and therefore not more 'protected' from stressors than the general population. Though this finding warrants cautious interpretation, the positive correlation between EI and resilience suggests that EI may be a potential target for education and training in order to strengthen resilience even in healthy individuals and vice versa.
Hutchinson, Susan L; Fenton, Lara
There is merit in understanding how recreation-oriented programs for adults living with mental illness address barriers to participation and how programming is structured to create safe and inclusive environments, resulting in programming that amplifies the benefits of recreation for mental well-being. Following an environmental scan of programs targeting adults living with mental illness in Canada, ten coordinators in community mental health settings were interviewed. Four themes were constructed to reflect characteristics deemed to be 'promising practices' related to recreation-oriented programming: (a) barriers and solutions to individual participation, (b) characteristics of welcoming and supportive environments, (c) leadership characteristics, and (d) program characteristics.
Riebschleger, Joanne; Grové, Christine; Cavanaugh, Daniel; Costello, Shane
Millions of children have a parent with a mental illness (COPMI). These children are at higher risk of acquiring behavioural, developmental and emotional difficulties. Most children, including COPMI, have low levels of mental health literacy (MHL), meaning they do not have accurate, non-stigmatized information. There is limited knowledge about what kind of MHL content should be delivered to children. The aim of this exploratory study is to identify the knowledge content needed for general population children and COPMI to increase their MHL. A second aim is to explore content for emerging children's MHL scales. Researchers created and analyzed a literature review database. Thematic analysis yielded five main mental health knowledge themes for children: (1) attaining an overview of mental illness and recovery; (2) reducing mental health stigma; (3) building developmental resiliencies; (4) increasing help-seeking capacities; and (5) identifying risk factors for mental illness. COPMI appeared to need the same kind of MHL knowledge content, but with extra family-contextual content such as dealing with stigma experiences, managing stress, and communicating about parental mental illness. There is a need for MHL programs, validated scales, and research on what works for prevention and early intervention with COPMI children.
Riebschleger, Joanne; Grové, Christine; Cavanaugh, Daniel
Millions of children have a parent with a mental illness (COPMI). These children are at higher risk of acquiring behavioural, developmental and emotional difficulties. Most children, including COPMI, have low levels of mental health literacy (MHL), meaning they do not have accurate, non-stigmatized information. There is limited knowledge about what kind of MHL content should be delivered to children. The aim of this exploratory study is to identify the knowledge content needed for general population children and COPMI to increase their MHL. A second aim is to explore content for emerging children’s MHL scales. Researchers created and analyzed a literature review database. Thematic analysis yielded five main mental health knowledge themes for children: (1) attaining an overview of mental illness and recovery; (2) reducing mental health stigma; (3) building developmental resiliencies; (4) increasing help-seeking capacities; and (5) identifying risk factors for mental illness. COPMI appeared to need the same kind of MHL knowledge content, but with extra family-contextual content such as dealing with stigma experiences, managing stress, and communicating about parental mental illness. There is a need for MHL programs, validated scales, and research on what works for prevention and early intervention with COPMI children. PMID:29072587
Full Text Available Millions of children have a parent with a mental illness (COPMI. These children are at higher risk of acquiring behavioural, developmental and emotional difficulties. Most children, including COPMI, have low levels of mental health literacy (MHL, meaning they do not have accurate, non-stigmatized information. There is limited knowledge about what kind of MHL content should be delivered to children. The aim of this exploratory study is to identify the knowledge content needed for general population children and COPMI to increase their MHL. A second aim is to explore content for emerging children’s MHL scales. Researchers created and analyzed a literature review database. Thematic analysis yielded five main mental health knowledge themes for children: (1 attaining an overview of mental illness and recovery; (2 reducing mental health stigma; (3 building developmental resiliencies; (4 increasing help-seeking capacities; and (5 identifying risk factors for mental illness. COPMI appeared to need the same kind of MHL knowledge content, but with extra family-contextual content such as dealing with stigma experiences, managing stress, and communicating about parental mental illness. There is a need for MHL programs, validated scales, and research on what works for prevention and early intervention with COPMI children.
Full Text Available Abstract Background Early recognition of the signs and symptoms of mental health disorders is important because early intervention is critical to restoring the mental as well as the physical and the social health of an individual. This study sought to investigate patterns of treatment seeking behavior and associated factors for mental illness. Methods A quantitative, institution-based cross sectional study was conducted among 384 psychiatric patients at Jimma University Specialized Hospital (JUSH located in Jimma, Ethiopia from March to April 2010. Data was collected using a pretested WHO encounter format by trained psychiatric nurses. Data was analyzed using SPSS V.16. Result Major depression disorder 186 (48.4%, schizophrenia 55 (14.3% and other psychotic disorders 47 (12.2% were the most common diagnoses given to the respondents. The median duration of symptoms of mental illness before contact to modern mental health service was 52.1 weeks. The main sources of information for the help sought by the patients were found to be family 126 (32.8% and other patients 75 (19.5%. Over a third of the patients 135 (35.2%, came directly to JUSH. Half of the patients sought traditional treatment from either a religious healer 116 (30.2% or an herbalist 77 (20.1% before they came to the hospital. The most common explanations given for the cause of the mental illness were spiritual possession 198 (51.6% and evil eye 61 (15.9%, whereas 73 (19.0% of the respondents said they did not know the cause of mental illnesses. Nearly all of the respondents 379 (98.7% believed that mental illness can be cured with modern treatment. Individuals who presented with abdominal pain and headache were more likely to seek care earlier. Being in the age group 31-40 years had significant statistical association with delayed treatment seeking behavior. Conclusions There is significant delay in modern psychiatric treatment seeking in the majority of the cases. Traditional healers
Khalifeh, H; Moran, P; Borschmann, R; Dean, K; Hart, C; Hogg, J; Osborn, D; Johnson, S; Howard, L M
Domestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population. Three hundred and three randomly recruited psychiatric patients, in contact with community services for ⩾ 1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey. Past-year domestic violence was reported by 27% v. 9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7-4.0], and by 13% v. 5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0-2.8). Past-year sexual violence was reported by 10% v. 2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4-5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63% v. 35%, p domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.
Ward, Earlise C; Wiltshire, Jacqueline C; Detry, Michelle A; Brown, Roger L
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. The aim of this study was to examine African Americans' beliefs about mental illness, attitudes toward seeking mental health services, and preferred coping behaviors and whether these variables differ by gender and age. 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. Depression was the most common mental illness, and there were no gender differences in prevalence. Both men and women believed that 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. 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 reduce stigma are needed. Also, exploration of partnerships between faith-based organizations and mental health services could be helpful to African Americans.
Jun 6, 2011 ... experienced previous abortions p=0.028. Conclusion: Women with severe mental illness particularly ... for the patients, children and family which may include hostility, stigma, relapse, treatment failure, ..... our setting, cultural and religious institutions with pervasive influence make marriage and parenthood.
Negative attitudes of patients with severe mental illness towards their own group presenta serious problem. Actions are needed to improve their identification and reduce theperceived need for exclusion from their group
Illman, Sarah C; Spence, Sandy; O'Campo, Patricia J; Kirsh, Bonnie H
The nature of occupational engagement for homeless people living with mental illnesses is not well understood, and there are few studies to date that examine the occupational lives of these individuals. This research study seeks to understand how this group of individuals engages in occupations. The central question is "What is the nature of occupational engagement by homeless adults living with mental illnesses in Toronto?" A constant comparative method of analysis was used in a secondary analysis of 60 interviews with homeless adults experiencing mental illness. Four themes emerged that describe the nature of occupational engagement for this group: occupations as enjoyment, occupations as survival/risk, occupations as passing time, and occupations as self-management. Implications. This research informs occupational therapy interventions aimed at optimizing engagement, health, and well-being for homeless adults living with mental illnesses.
Lehman, A F; Kernan, E; DeForge, B R; Dixon, L
This study assessed the relationship between homelessness and specific quality-of-life problems for persons with severe and persistent mental illness. The objective and subjective quality of life of 106 homeless persons with severe mental illness who lived on the streets or in shelters in Baltimore was compared with that of 146 domiciled persons with severe mental illness who lived in the community. Objective and subjective quality of life of the homeless subjects was clearly worse than that of the domiciled group in the areas of living situation, family and social relations, employment, daily activities, and legal and safety problems. Homeless subjects were also less likely to have federal disability entitlements. Poorer quality of life is associated with homelessness among persons with severe mental illness. Their quality of life may be improved by efforts to increase their access to disability entitlements and treatment services and to help them develop supportive social networks.
... are more than 200 classified forms of mental illness. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, ...
Full Text Available We studied the structure and content of social representations of the mentally ill people among the various professional groups of young people. This study involved 60 people aged 20 to 30 years (50% of respondents were girls, 50% were boys, specializing in psychology, law and journalism. We used semi-structured interview, associative method with elements of ranking and emotional attitude, and drawing techniques. We tested the following hypotheses: 1 the social representations of the mentally ill people contain elements with negative valence in all investigated occupational groups of young people; 2 social representations of the mentally ill people are based on such constructs as "otherness"; treatment (hospital, pills, experts; disease (synonyms, names of diseases, symptoms; the attitude of society; 3 social representations of the mentally ill people of lawyers and journalists are simpler and more consistent than those of psychologists. These hypotheses were supported by the empirical results
Dunkle, Ruth E; Ingersoll-Dayton, Berit; Chadiha, Letha A
This article discusses, from the grandmother's perspective, the ways in which support is exchanged in families coping with serious mental illness. A strengths perspective was utilized to identify ways in which family members help each other. Employing a qualitative approach, this study focuses on interviews obtained from a sample of 22 aging mothers, aged 52-90, who are in contact with their daughters who have a mental illness. Grandmothers provided several kinds of support to their mentally ill adult daughters and to their grandchildren, who also supported the aging mother in numerous ways. As social workers seek to assist individuals with mental illness, it is important to assess the existing strengths of their intergenerational family context.
Kelly, B D
The history of institutional care for individuals with intellectual disability is under-researched, complex and troubling. To explore the experiences of women who may have had intellectual disability and/or mental illness and were admitted to forensic psychiatric care in early twentieth-century Ireland. All female case records at the Central Mental Hospital, Dublin from 1910 to 1948 (n = 42) were studied for evidence of possible intellectual disability and a series of five cases is presented in detail. These committals occurred in the context of adverse social conditions, over-crowding in asylums and a belief that rates of mental illness were rising. Particular challenges included diagnostic issues (especially in relation to intellectual disability), adjustment to asylum environments, mental illness and physical ill-health. The institutional experiences of individuals with intellectual disability represents an important area for further historical research, using larger and more varied forensic populations.
Hallion, Madeleine; Taylor, Amanda; Roberts, Rachel
Sibling relationships have lifelong significance and childhood chronic illness and disability can have considerable impacts on healthy siblings, influencing development into adulthood. Research has not yet assessed well-being in this population using measures of both mental health and mental illness. Thus, this study assessed well-being in a comprehensive manner using the complete mental health (CMH) model. Participants (N = 144) included both adult siblings of those with chronic illness or disability and adults with healthy siblings. Measures of positive social, psychological and emotional well-being were used to assess mental health and a measure of depression, anxiety, and stress was used to assess mental illness. A high proportion of participants, both with and without siblings with a chronic illness or disability, were experiencing symptoms of mental illness, accompanied by high wellbeing. This indicates that many participants fit into the struggling category of the CMH model. The present research highlights the need for early intervention services to ensure that siblings of those with a chronic illness or disability are well supported in developing strengths, as well as managing difficulties. Results also indicate that targeting students in mental health promotion is important to encourage participation in services. Implications for rehabilitation Siblings of those with a chronic illness or disability need to be included in assessments in order to understand the experience of the family unit. It is important for families and clinicians to be aware of the needs of healthy siblings and encourage them to interact with support services in order to maximise and maintain well-being. Skills-based support could be beneficial, particularly for providing caregivers with strategies to meet the needs of both their child with a chronic illness or disability and their healthy children.
Corrigan, Patrick W.; Pickett, Susan; Schmidt, Annie; Stellon, Edward; Hantke, Erin; Kraus, Dana; Dubke, Rachel
Homeless African Americans with serious mental illness experience higher rates of morbidity and mortality than adults with severe mental illness alone. Peer navigators, individuals with similar lived experiences, may help these individuals navigate the healthcare system to improve healthcare utilization. This study examined whether the Peer Navigator Program (PNP) improved scheduling and achieving healthcare appointments compared to treatment as usual (TAU) over the course of 12 months, inclu...
Aakre, Jennifer M; Medoff, Deborah R; Dixon, Lisa B; Kreyenbuhl, Julie A
Jennifer M Aakre,1 Deborah R Medoff,1,2 Lisa B Dixon,1,2 Julie A Kreyenbuhl1,21VA Capitol Healthcare Network Mental Illness Research, Education, and Clinical Center, Baltimore VA Medical Center, 2Division of Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USABackground: This study compared the beliefs held by individuals with coexisting serious mental illness and type 2 diabetes regarding the necessity and risks of taking antipsychotic ve...
Background The stigma of mental illness among medical students is a prevalent concern that has far reaching negative consequences. Attempts to combat this stigma through educational initiatives have had mixed results. This study examined the impact of a one-time contact-based educational intervention on the stigma of mental illness among medical students and compared this with a multimodal undergraduate psychiatry course at the University of Calgary, Canada that integrates contact-based educational strategies. Attitudes towards mental illness were compared with those towards type 2 diabetes mellitus (T2DM). Method A cluster-randomized trial design was used to evaluate the impact of contact-based educational interventions delivered at two points in time. The impact was assessed by collecting data at 4 time points using the Opening Minds Scale for Health Care Providers (OMS-HC) to assess changes in stigma. Results Baseline surveys were completed by 62% (n=111) of students before the start of the course and post-intervention ratings were available from 90 of these. Stigma scores for both groups were significantly reduced upon course completion (p mental illness and interest in a psychiatric career was increased at the end of the course. Stigma towards mental illness remained greater than for T2DM at all time points. Conclusions Psychiatric education can decrease the stigma of mental illness and increase student confidence. However, one-time, contact-based educational interventions require further evaluation in this context. The key components are postulated to be contact, knowledge and attention to process, where attending to the student’s internal experience of working with people with mental illness is an integral factor in modulating perceptions of mental illness and a psychiatric career. PMID:24156397
Lee, Minhwa; Seo, Mikyung
This study is based on the contact hypothesis that contact with mental illness is the most effective anti-stigma strategy. This study aims to analyze which form of contact can most effectively decrease the dangerousness and social distance associated with schizophrenia, depression and alcoholism. In total, 573 Korean adults ( M age = 43.71 years, standard deviation ( SD) = 13.41; 54.1% male, 45.9% female) were surveyed about randomly assigned vignettes of schizophrenia, depression and alcoholism. The participants were questioned on the dangerousness and social distance associated with the assigned vignette, as well as direct and indirect contact experience with the mental illness. Two-way analysis of variance (ANOVA) was used to determine the main effect and interaction effect that the type of mental illness and contact experience have on the two dependent variables (dangerousness and social distance). The findings show that the type of mental illness has a significant main effect on dangerousness and social distance, but contact type only has a significant main effect on social distance. Moreover, the two independent variables (mental illness subtype and contact experience) have an interaction effect on two dependent variables (dangerousness and social distance). Therefore, the anti-stigma effect of contact varies according to the type of mental illness. Our findings suggest that appropriate anti-stigma strategies are required for each type of mental illness. Considering that opportunities for direct contact with persons with mental illness are highly limited, it is necessary to actively utilize indirect contact.
Apollonio, D; Malone, R
Objectives: To describe the tobacco industry’s relationships with and influence on homeless and mentally ill smokers and organisations providing services to them. Methods: Analysis of internal tobacco industry documents and journal articles. Results: The tobacco industry has marketed cigarettes to the homeless and seriously mentally ill, part of its "downscale" market, and has developed relationships with homeless shelters and advocacy groups, gaining positive media coverage...
Lateef Olutoyin Oluwole; Adetunji Obadeji; Mobolaji Usman Dada
Background: The power of the modern mass media is not limited to its ability to communicate information and entertain but derives primarily from its ability to define situations, thereby enabling it to construct social reality. Stigma is related to negative stereotyping and prejudicial attitudes that in turn lead to discriminatory practices. Aims: The study sought to know the perceptions of and attitudes of mass communication students towards mental illness and the mentally ill. Settings and ...
Waegemakers Schiff, Jeannette; Schiff, Rebecca; Schneider, Barbara
A rich body of literature attests to the importance of affordable accommodation and support services necessary, appropriate, and acceptable to persons disabled by a mental illness. However, there is a little which provides a means for housing and service planners to determine the gap between available supportive housing and need. Such understandings are needed to prepare strategies and develop the resources needed to accommodate persons with a disabling mental illness in the community. While ...
Teh, Jen Lee; King, David; Watson, Bernadette; Liu, Shuang
People with mental illness (PWMI) often internalise negative beliefs (self-stigma) or anticipate external sources of stigma (perceived stigma). This study examines how the two types of stigma affect the willingness to communicate for help – such communication is a vital aspect of good patient care and treatment outcome. Seventy-two participants from different ethnic backgrounds who had experienced mental illness responded to an online survey about their level of agreement with statements refl...
Zolezzi, Monica; Bensmail, Nawal; Zahrah, Farah; Khaled, Salma Mawfek; El-Gaili, Tayseer
Monica Zolezzi,1,2 Nawal Bensmail,2 Farah Zahrah,2 Salma Mawfek Khaled,3 Tayseer El-Gaili4 1Clinical Pharmacy and Practice, 2College of Pharmacy, 3Research Unit, Social and Economic Survey Research Institute, 4Student Counseling Center, Qatar University, Doha, Qatar Background: Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among re...
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. © The Author(s) 2014.
Lee, Samantha; Waters, Flavie; Briffa, Kathy; Fary, Robyn E
How do mental health professionals perceive the role of physiotherapists in the care of people with severe and persistent mental illness, and what factors do they perceive as influencing access to physiotherapy services? How do people with severe and persistent mental illness understand the potential role of physiotherapy in their healthcare, and what factors do they perceive as influencing access to physiotherapy services? Qualitative study. Twenty-four mental health professionals and 35 people with severe and persistent mental illness. Interview schedules were developed to explore participants' understanding of physiotherapy, as well as barriers and enablers to service access. Focus groups and interviews were conducted for each group of participants. Transcripts were analysed using an inductive approach to derive key themes. Both the mental health professionals and the people with severe and persistent mental illness expressed a limited understanding of the role and relevance of physiotherapy for physical health in mental healthcare. Common barriers to service access were cost, transport and lack of motivation. Likewise, enablers of reduced cost, provision of transport and education about physiotherapy to improve their understanding were identified. The health system structure and perceived lack of mental health knowledge by physiotherapists influenced referrals from mental health professionals. Consequently, education in mental health for physiotherapists and integration of the service within mental health were identified as potential enablers to physiotherapy access. Limited understanding about physiotherapy and its relevance to physical health in mental healthcare among mental health professionals and people with severe and persistent mental illness was found to be a key factor influencing service access. Limited physiotherapy presence and advocacy within mental health were also highlighted. There is a need for greater understanding about physiotherapy among
Papageorgiou, Alexia; Loke, Yoon K; Fromage, Michelle
Research evidence suggests that both mental health professionals and people with severe mental health illness such as schizophrenia or schizoaffective disorder find it difficult to communicate with each other effectively about symptoms, treatments and their side effects so that they reach a shared understanding about diagnosis, prognosis and treatment. Effective use of communication skills in mental health interactions could be associated with increased patient satisfaction and adherence to treatment. To review the effectiveness of communication skills training for mental health professionals who work with people with severe mental illness. We searched the Cochrane Schizophrenia Trials Register (latest search 17 February, 2016) which is compiled by systematic searches of major resources (including AMED, BIOSIS, CINAHL, Embase, MEDLINE, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings. There are no language, date, document type, or publication status limitations for inclusion of records into the register. All relevant randomised clinical trials (RCTs) that focused on communication skills training (CST) for mental health professionals who work with people with severe mental illness compared with those who received standard or no training. We sought a number of primary (patient adherence to treatment and attendance at scheduled appointments as well as mental health professionals' satisfaction with the training programme) and secondary outcomes (patients' global state, service use, mental state, patient satisfaction, social functioning, quality of life). RCTs where the unit of randomisation was by cluster (e.g. healthcare facility) were also eligible for inclusion. We included one trial that met our inclusion criteria and reported useable data. We independently selected studies, quality assessed them and extracted data. For binary outcomes, we planned to calculate standard
Full Text Available Monica Zolezzi,1,2 Nawal Bensmail,2 Farah Zahrah,2 Salma Mawfek Khaled,3 Tayseer El-Gaili4 1Clinical Pharmacy and Practice, 2College of Pharmacy, 3Research Unit, Social and Economic Survey Research Institute, 4Student Counseling Center, Qatar University, Doha, Qatar Background: Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. Methods: A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students’ beliefs, attitudes, and help-seeking and treatment preferences. Results: A total of 282 students completed the survey. The majority of the participating students were females (59.3%, non-Qataris (64.3%, and enrolled in science-based colleges (62.7%. Beliefs reflecting poor mental health literacy, such as “medications to treat mental illness can cause addiction”, “mental illness is not like any other illness”, or that “mental illness is a punishment from God”, were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively. Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%, that people with mental illness are dangerous (65.7%, and that they would not marry
Razali, S M; Khan, U A; Hasanah, C I
The concept of aetiology of mental illness in 134 Malay patients was investigated by means of a 20-item checklist. About 53% of the patients attributed their illnesses to supernatural agents. Witchcraft and possession by evil spirits were regarded as common causes of illness. The number of patients who believed in supernatural causes of their mental illness was significantly higher among those who had consulted bomohs (Malay traditional healers) than among those who had not consulted them. The belief that mental illness is caused by supernatural agents is firmly held by bomohs, who reinforce this notion in those who seek their advice. Belief in supernatural causes of mental illness was not significantly associated with age, gender, level of education or occupation of the patients. Patients who believed in supernatural causes of mental illness were also found to show poor drug compliance, and the number of such patients at 6 months follow-up was significantly lower than the corresponding figure for those who did not believe in supernatural causes. The importance of understanding the patients' cultural background when treating psychiatric patients is highlighted.
Blomqvist, Marjut; Sandgren, Anna; Carlsson, Ing-Marie; Jormfeldt, Henrika
It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness. © 2017 Australian College of Mental Health Nurses Inc.
Draine, Jeffrey; Salzer, Mark S; Culhane, Dennis P; Hadley, Trevor R
Research on mental illness in relation to social problems such as crime, unemployment, and homelessness often ignores the broader social context in which mental illness is embedded. Policy, research, and practice will be improved if greater attention is given to social context. The authors critically analyze the approach used in much of the psychiatric services literature to infer links between mental illness and social problems. They compare these studies with studies that have been more validly conceptualized to account for social context. With this broader perspective, the impact of mental illness on crime, unemployment, and homelessness appears to be much smaller than that implied by much of the psychiatric services literature. Poverty moderates the relationship between serious mental illness and social problems. Factors related to poverty include lack of education, problems with employment, substance abuse, and a low likelihood of prosocial attachments. This relationship is often complicated and is not amenable to simple explanations. Research and policy that take this complexity into account may lead to greater effectiveness in interventions for persons with serious mental illness.
Poremski, Daniel; Whitley, Rob; Latimer, Eric
The rate of unemployment among homeless people is estimated to exceed 80%. A high prevalence of mental illness partially explains this figure, but few studies about the relationship between employment and homelessness have focused on homeless people with mental illness. The present study explores the self-reported barriers to employment in a sample of individuals with mental illness when they were homeless. A sample of 27 individuals with mental illness and recent experiences of homelessness, who had expressed an interest in working, participated in semi-structured qualitative interviews. Inductive analysis was used to identify barriers to employment. The prominent barriers include: (1) current substance abuse, (2) having a criminal record, (3) work-impeding shelter practices, and (4) difficulties obtaining adequate psychiatric care. Individuals who have been homeless and have a mental illness report facing specific barriers associated with mental illness, homelessness, or the interaction between the two. Additional research should explore how supported housing and employment interventions can be tailored to effectively serve this group.
Background There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. Method A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose. PMID:20338040
Full Text Available Abstract Background There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. Method A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose.
Bella, Mónica E; Vilarrodona, Hugo
Literature suggests that general beliefs towards mental illnesses are strongly correlated to the social behavior towards people who suffer them. to explore beliefs and attitudes towards mental illnesses in children and adolescents and associate them to bioethics. exploratory, prospective and quantitative study. A questionnaire was administered to parents-tutors of children-adolescents with mental disorders, and to healthcare professionals of the Hospital de Niños de la Santísima Trinidad Córdoba (Argentina). Data processing was performed by means of frequency analysis. 68.5% of parents-tutors and 51.8% of healthcare professionals answered that mental illnesses are never considered like any other illness. Diagnose and treatment is perceived as a stigma by 25.9% of healthcare professionals. For 88.1% of parents-tutors and 9.8% of healthcare professionals, children and adolescents with mental illnesses are never dangerous. 77.1% of parents and 18.4% of professionals stated that people are never afraid of children-adolescents with MI. 42.8% of children-adolescents were excluded from school and 28.5% from family activities. mental illness during childhood entails a stigma that compromises development, equal opportunity and human rights.
Stanton, Robert; Rosenbaum, Simon; Lederman, Oscar; Happell, Brenda
Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. To examine the way in which Australian AEPs prescribe exercise for people with mental illness. Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.
Martin, M S; Maddocks, E; Chen, Y; Gilman, S E; Colman, I
Food insecurity is associated with elevated risk of mental illness. This risk may be further compounded by stressful life events and by social isolation. This study investigated whether the risk of mental illness is higher among individuals experiencing food insecurity along with greater stress and social isolation. Cross-sectional self-report survey data from the 2009-10 Canadian Community Health Survey (N = 100,401). We estimated prevalence differences of the risk of self-reported mental illness associated with food insecurity alone and in combination with stressful life events and social isolation. Sensitivity analyses were conducted on a sub-sample who completed a structured diagnostic interview. Overall, the prevalence of mental illness was 18.4% [95% CI 16.7-20.1] higher for women and 13.5% higher [95% CI 11.9, 15.2] for men in severely food insecure households compared to those reporting food security. The increased risk of mental illness associated with food insecurity was more pronounced among females and those reporting higher stress and social isolation. Individuals reporting food insecurity are at increased risk of mental illness. This increased risk is further exacerbated in high stress and socially isolated environments. Policies, clinical and public health interventions must address broader constellations of risks that exist when food insecurity is present. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Pirutinsky, Steven; Rosmarin, David H.; Pargament, Kenneth I.
Culture may particularly influence community attitudes towards mental illness, when the illness itself is shaped by a cultural context. To explore the influence of culture-specific, religious symptoms on Orthodox Jewish community attitudes, the authors compared the attitudes of 169 Orthodox Jews, who randomly viewed one of two vignettes describing…
Ayoub, Aimina; Fraser, William D; Low, Nancy; Arbour, Laura; Healy-Profitós, Jessica; Auger, Nathalie
We sought to determine the relationship between maternal mental illness and the risk of having an infant with a central nervous system defect. We analyzed a cohort of 654,882 women aged less than 20 years between 1989 and 2013 who later delivered a live born infant in any hospital in Quebec, Canada. The primary exposure was mental illness during pregnancy or hospitalization for mental illness before pregnancy. The outcomes were neural and non-neural tube defects of the central nervous system in any offspring. We computed risk ratios (RR) and 95% confidence intervals (CI) for the association between mental disorders and risk of central nervous system defects in log-binomial regression models adjusted for age at delivery, total parity, comorbidity, socioeconomic deprivation, place of residence, and time period. Maternal mental illness was associated with an increased risk of nervous system defects in offspring (RR 1.76, 95% CI 1.64-1.89). Hospitalization for any mental disorder was more strongly associated with non-neural tube (RR 1.84, 95% CI 1.71-1.99) than neural tube defects (RR 1.31, 95% CI 1.08-1.59). Women at greater risk of nervous system defects in offspring tended to be diagnosed with multiple mental disorders, have more than one hospitalization for mental disease, or be 17 or older at first hospitalization. A history of mental illness is associated with central nervous system defects in offspring. Women hospitalized for mental illness may merit counseling at first symptoms to prevent central nervous system defects at pregnancy.
Pusey-Murray, Andrea; Miller, Paul
The findings reported here form part of a larger research project that examined non-compliance with medication among the mentally ill patients attending public clinics in a specific parish in Jamaica. The aim of the research was to explore the perceptions of caregivers about caring for the mentally ill at two outpatient psychiatric clinics. Caregivers involved in looking after their relatives with mental illness played a vital role in mental health promotion. This study sought to examine the ...
Brockelman, Karin F; Scheyett, Anna M
Universities across the country struggle with the legal and ethical dilemmas of how to respond when a student shows symptoms of serious mental illness. This mixed-method study provides information on faculty knowledge of mental health problems in students, their use of available accommodations and strategies, and their willingness to accept psychiatric advance directives (PADs) as helpful interventions for managing student crises. Participants were 168 faculty members at a large, public, Southern university. A web-based survey was used to collect quantitative self-report data as well as qualitative data in the form of open-ended questions. Quantitative data are presented with descriptive statistics. Qualitative data were analyzed using thematic analysis. The majority of faculty surveyed have an overall supportive stance and are willing to provide accommodations to students with a mental illness. The most common advantage faculty see in a PAD is support of student autonomy and choice, and the primary concern voiced about PADs is that students with mental illness will have poor judgment regarding the contents of the PADs they create. PADs may be effective recovery tools to help university students with mental illnesses manage crises and attain stability and academic success. For PADs to be effective, university faculty and administration will need to understand mental illnesses, the strategies students need to manage mental health crises, and how PADs can play a role in supporting students. (c) 2015 APA, all rights reserved).
Rönngren, Ylva; Björk, Annette; Audulv, Åsa; Enmarker, Ingela; Kristiansen, Lisbeth; Haage, David
Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention. © 2017 Australian College of Mental Health Nurses Inc.
Singh, Gaurav; Shah, Nilima; Mehta, Ritambhara
There are estimated 400,000 wandering mentally ill persons in India, found in poor physical state wandering on streets and railway stations; mainly treated either by government run Hospitals for Mental Health (HMH) or Psychiatry units of a Government Medical College (GMC). They require psychosocial rehabilitation along with treatment. To study the presentation, clinical profile and rehabilitative outcome of wandering mentally ill admitted in government psychiatric care facilities. The objective was to establish them as a distinct psychiatric inpatient population requiring special attention. The study was a chart review of all wandering mentally ill patients institutionalized during a period of two years in two distinct government facilities. Additionally, clinical staff was interviewed for cross checking the data and for eliciting problems faced in management. The discharged patients were contacted to assess the present status. Forty seven patients in HMH and 35 patients in GMC were studied. Wandering mentally ill patients were brought to mental health facility by helping person (30) and police (23). Majority of them (61) were picked up from streets and railway station. Most of them (56) belonged to mentally ill constitutes a unique patient population with specific challenges different from other inpatients in management and rehabilitation. Provisions to take care of this most vulnerable group of the society and mechanisms to watch for their continuous implementation are required.
Eno Louden, Jennifer; Manchak, Sarah M
Mental health treatment adherence is often required for offenders with mental illness supervised on probation and parole. However, research on offenders with mental illness has largely overlooked cultural and ethnic responsivity factors that may affect adherence to treatment. Latinos are a quickly growing subgroup of offenders whose social networks differ in meaningful ways from European Americans' (e.g., size, composition, centrality of family). Social networks are known to relate to both clinical and criminal justice outcomes for offenders with mental illness, and there are features of nonoffender Latinos' social networks that suggest that findings distilled from work with non-Latino offenders may not apply to them. The present study examined the social networks of 86 Latino probationers with serious mental illness to (a) describe the size and composition of these networks and (b) to determine which factors of social networks are related to treatment adherence. The authors found that Latino offenders' social networks are small (∼6 individuals), consisting primarily of family and professionals such as treatment providers and probation officers. Supportive relationships with nonprofessionals and treatment providers was related to lower likelihood of missing treatment appointments, whereas social control and pressure from family and friends to attend treatment was not related to treatment adherence. Findings are discussed within the context of improved practices for community corrections and mental health agencies in working with Latino offenders with mental illness. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Hoffner, Cynthia A; Cohen, Elizabeth L
This study of responses to the TV series Monk, about a detective with obsessive-compulsive disorder, examines perceptions and behaviors related to mental illness. A total of 172 respondents completed an online survey. A parasocial bond with Monk was associated with lower stereotypes of mental illness and less social distance. Predictors and outcomes of perceived influence of the series on self and others were also examined. Perceived (positive) influence of the series on others' attitudes was predicted by respondents' favorable evaluation of the series's depiction of mental illness, as well as greater perceived exposure to and favorable evaluations among family and friends. Perceived influence on others also was associated with greater willingness to disclose mental health treatment, but only among people without personal or family experience with mental illness. In contrast, perceived influence of the series on self was predicted only by respondents' own evaluations of the series, and was related to willingness to seek mental health treatment-but only among those who had personally dealt with mental illness.
McGinty, Emma; Pescosolido, Bernice; Kennedy-Hendricks, Alene; Barry, Colleen L
Despite the high burden and poor rates of treatment associated with mental illness and substance use disorders, public support for allocating resources to improving treatment for these disorders is low. A growing body of research suggests that effective policy communication strategies can increase public support for policies benefiting people with these conditions. In October 2015, the Center for Mental Health and Addiction Policy Research at Johns Hopkins University convened an expert forum to identify what is currently known about the effectiveness of such policy communication strategies and produce recommendations for future research. One of the key conclusions of the forum was that communication strategies using personal narratives to engage audiences have the potential to increase public support for policies benefiting persons with mental illness or substance use disorders. Specifically, narratives combining personal stories with depictions of structural barriers to mental illness and substance use disorder treatment can increase the public's willingness to invest in the treatment system. Depictions of mental illness and violence significantly increase public stigma toward people with mental illness and are no more effective in increasing willingness to invest in mental health services than nonstigmatizing messages about structural barriers to treatment. Future research should prioritize development and evaluation of communication strategies to increase public support for evidence-based substance use disorder policies, including harm reduction policies-such as needle exchange programs-and policies expanding treatment.
Fraser, Sarah J; Chapman, Justin J; Brown, Wendy J; Whiteford, Harvey A; Burton, Nicola W
The life expectancy of adults with mental illness is worse than that of the general population and is largely due to poor physical health status. Physical activity has been consistently recommended for the prevention and management of many chronic physical health conditions and can also have benefits for mental health. This cross sectional study assessed the attitudes towards and preferences for physical activity among inpatient adults with mental illness, and differences by distress and gender. Self-report questionnaires were completed by 101 patients. Findings indicated that inpatient adults with mental illness are interested in doing physical activity while in hospital, primarily to maintain good physical health and improve emotional wellbeing. Fewer than half of participants agreed that physical activity has benefits for serious mental illness. Participants indicated a preference for walking and physical activity that can be done alone, at a fixed time and with a set routine and format. Major barriers were fatigue and lack of motivation. Females were more likely than males to prefer activities done with others of the same gender (P = 0.001) and at the same level of ability (P mental illness. © 2015 Australian College of Mental Health Nurses Inc.
Economou, M; Louki, E; Charitsi, M; Alexiou, T; Patelakis, A; Christakaki, A; Papadimitriou, G N
The media seem to have played a prominent role in shaping the contemporary social image of people with mental illness, by perpetuating the stigma attached to it. Worldwide, a vast amount of research findings converge to the stigmatizing representation of people with mental illness by the media, with reference to the dominant stereotype of violence. The present study aims to explore the representations of mental illness in the Greek Press using a quantitative and qualitative approach. Potential changes in the media portrayal of mental illness during the last decade are also being examined: findings are compared to those of a previous research that took place in 2001, following the same methodology. The sample consisted of press articles referring to mental illness, that were indexed daily from the Greek newspapers during the period July-November 2011. The items were categorized into thematic categories and further analyzed taking in account the use of stigmatizing vocabulary, the reproduction of common myths concerning mental illness, the overall valence of each article (stigmatizing, neutral or anti-stigmatizing) towards people with mental illness, as well as the contextual implications conveyed in the use of psychiatric terms as a metaphor. The largest thematic category that emerged from the sample was that referring to the repercussions of the economic crisis to mental health, followed by the category of articles where psychiatric terms are used as a metaphor. The comparisons made between 2001 and 2011 revealed an improved representation of mental illness in terms of stigma, especially regarding schizophrenia. The public expression of stigma has decreased, with fewer stigmatizing articles and notably more neutral in valence articles. The findings of this study suggest a decline of the media propensity for emotionally charged descriptions and a shift towards objective journalism regarding mental illness. This is most likely to be attributed to the anti
Although power differentials which enable the components of stigma to unfold have been identified, literature that demonstrates the gendered disparities in stigmatization is scarce. Using a gender-based framework, this paper aims first at understanding the gendered social cues which produce the stigma in mental illness enacted by the general population. Second, it highlights the influence of gender on the everyday experiences of a severe and persistent mental illness and the related stigmatization. Results are drawn from a combination of ethnographic and qualitative methods including a field ethnography of two health centres, one psychiatric hospital, and participants' households and neighbourhoods, two group discussions with members of the general population participating in gender-specific social support groups (N = 12 women/5 men), and illness narratives of men and women with a severe and persistent mental illness (N = 22), which was conducted from May to August 2006 in a poor, urban district of Peru. It is argued that in a society like that of Peru where gender roles are segregated into specific social and economic fields, gendered expectations shape both the experience of a severe and persistent mental illness and the stigmatization of people with such a mental illness in a gender-specific way. Not only do gender inequalities create the conditions leading to a power differential which enables stigmatization to unfold, but stigma is constructed as much around gendered-defined social roles as it is enacted in distinct social spheres for men and women with a severe and persistent mental illness. The gendered experience of stigmatization must, therefore, be fully understood in order to design more effective interventions that would challenge stereotypical perceptions and discriminatory practices, and reduce their effect on the everyday life of the mentally ill in Peru. Copyright © 2010 Elsevier Ltd. All rights reserved.
Noblett, J; Caffrey, A; Deb, T; Khan, A; Lagunes-Cordoba, E; Gale-Grant, O; Henderson, C
Explore the experiences of liaison psychiatry professionals, to gain a greater understanding of the quality of care patients with mental illness receive in the general hospital setting; the factors that affect the quality of care; and their insights on interventions that could improve care. A survey questionnaire and qualitative in depth interviews were used to collect data. Data collection took place at the Royal College of Psychiatrists Faculty of Liaison Psychiatry Annual conference. Qualitative analysis was done using thematic analysis. Areas of concern in the quality of care of patients with co-morbid mental illness included 'diagnostic overshadowing', 'poor communication with patient', 'patient dignity not respected' and 'delay in investigation or treatment'. Eleven contributing factors were identified, the two most frequently mentioned were 'stigmatising attitudes of staff towards patients with co-morbid mental illness' and 'complex diagnosis'. The general overview of care was positive with areas for improvement highlighted. Interventions suggested included 'formal education' and 'changing the liaison psychiatry team'. The cases discussed highlighted several areas where the quality of care received by patients with co-morbid mental illness is lacking, the consequences of which could be contributing to physical health disparities. It was acknowledged that it is the dual responsibility of both the general hospital staff and liaison staff in improving care. Copyright © 2017 Elsevier Inc. All rights reserved.
Adewuya, Abiodun O; Makanjuola, Roger O A
It had been claimed that stigma and social distance are less severe in African countries, although not enough research had been done to confirm this. Most of the studies had focussed on the general community, and specific population groups had been neglected. The aims of this study are to examine the level of social distance of students in a Nigerian university towards people with mental illness and to assess the possible socio-demographic variables involved. This is to enable the development of appropriate mental health educational and stigma-reducing programmes. A modified version of Bogardus Social Distance Scale was used to assess the desire for social distance towards people with mental illness amongst 1,668 students of a Nigerian federal university. Socio-demographic details were also obtained. The social distances increased with the level of intimacy required in the relationship and were higher than those from the western culture, with 65.1% of the respondents categorised as having high social distance towards the mentally ill people. The predictors of high social distance towards the mentally ill include female gender [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.69-2.60], studying a non-medical course (OR 4.65, 95% CI 3.01-7.19) and not having a family member with mental illness (OR 6.73, 95% CI 4.34-10.44). Social distance towards the mentally ill is higher amongst Nigerian university students than expected. This challenges the notion that stigma and negative attitude towards the mentally ill are less severe in Africa than in western cultures. There are needs for intensive public awareness, effective stigma-reducing educational programmes and more research in this area.
Currently in the United States, there are far more mentally ill individuals in jails and prisons than in mental hospitals or other treatment facilities. Stigma toward this population presents as a major barrier to eradicating this indictment, yet research has shown that education can help to reduce stigma and, in turn, possibly decreasing the…
Kaier, Emily; Cromer, Lisa DeMarni; Johnson, Mitchell D.; Strunk, Kathleen; Davis, Joanne L.
Stigma related to mental health and its treatment can thwart help-seeking. The current study assessed college athletes' personal and perceived public mental illness stigma and compared this to nonathlete students. Athletes (N = 304) were National Collegiate Athletic Association (NCAA) Division I athletes representing 16 teams. Results indicated…
Happell, Brenda; Wilson, Karen; Platania-Phung, Chris; Stanton, Robert
Shortened life expectancy of people with mental illness is now widely known and the focus of research and policy activity. To date, research has primarily reflected perspectives of health professionals with limited attention to the views and opinions of those most closely affected. The voice of carers is particularly minimal, despite policy stipulating carer participation is required for mental health services. To present views and opinions of carers regarding physical health of the people they care for. Qualitative exploratory. Two focus groups and one individual interview were conducted with 13 people identifying as carers of a person with mental illness. Research was conducted in the Australian Capital Territory. Data analysis was based on the thematic framework of Braun and Clarke. Two main themes were interaction between physical and mental health; and, carers' own physical and mental health. Participants described the impact of mental illness and its treatments on physical health, including their own. Carers are acknowledged as crucial for the delivery of high quality mental health services. Therefore they have an important role to play in addressing the poor physical health of people with mental illness. Hearing their views and opinions is essential.
Drost, Louisa M.; Schippers, Gerard M.
From epidemiologic research, we know that children of parents with a mental illness (COPMI) have an elevated risk of developing a serious mental disorder. Aside from studies based on risk and resilience, there has been little research on the children's own perceptions. The aim of this study was to
Holmes, Alana; Silvestri, Robert
Staff at campus-based counselling and disability centres in 15 of Ontario's 24 community colleges completed 3,536 surveys on 1,964 individual students querying the presence of mental illness and academic challenges as reported by students accessing these services. Survey data were analyzed to determine prevalence rates of mental disorders and…
Parrott, F.R.; Macinnes, D.I.; Parrott, J.
Background: Research into parenting and mental illness seldom includes forensic mental health service users, despite its relevance to therapeutic, family work and risk management. Aims: This study aimed to understand the experiences of parents and the variety of parenting roles maintained during
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,…
Barnard, Jordan D.
Given that there is evidence that college student-athletes may be at risk for psychological disturbances (Pinkerton, Hintz, & Barrow, 1989), and possibly underutilizing college mental health services (Watson & Kissinger, 2007), the purpose of this study was to examine attitudes toward mental illness and help seeking among college…
Oyserman, Daphna; Bybee, Deborah; Mowbray, Carol
Explores the effects of maternal psychiatric symptoms and community functioning on child outcomes in a diverse sample of seriously mentally ill women caring for their teenaged children. In hierarchical multiple regression, for youth depression, we find effects for parenting style and maternal mental health; for youth anxiety and efficacy, effects…
O'Hare, Thomas; Sherrer, Margaret V.; LaButti, Annamaria; Emrick, Kelly
Objective/Method: The use of brief, reliable, valid, and practical measures of substance use is critical for conducting individual assessments and program evaluation for integrated mental health-substance abuse services for persons with serious mental illness. This investigation examines the internal consistency reliability, concurrent validity,…
Roberts, Laura Weiss; Kim, Jane Paik
Ethical controversy surrounds clinical research involving seriously ill participants. While many stakeholders have opinions, the extent to which protocol volunteers themselves see human research as ethically acceptable has not been documented. To address this gap of knowledge, authors sought to assess views of healthy and ill clinical research volunteers regarding the ethical acceptability of human studies involving individuals who are ill or are potentially vulnerable. Surveys and semi-structured interviews were used to query clinical research protocol participants and a comparison group of healthy individuals. A total of 179 respondents participated in this study: 150 in protocols (60 mentally ill, 43 physically ill, and 47 healthy clinical research protocol participants) and 29 healthy individuals not enrolled in protocols. Main outcome measures included responses regarding ethical acceptability of clinical research when it presents significant burdens and risks, involves people with serious mental and physical illness, or enrolls people with other potential vulnerabilities in the research situation. Respondents expressed decreasing levels of acceptance of participation in research that posed burdens of increasing severity. Participation in protocols with possibly life-threatening consequences was perceived as least acceptable (mean = 1.82, sd = 1.29). Research on serious illnesses, including HIV, cancer, schizophrenia, depression, and post-traumatic stress disorder, was seen as ethically acceptable across respondent groups (range of means = [4.0, 4.7]). Mentally ill volunteers expressed levels of ethical acceptability for physical illness research and mental illness research as acceptable and similar, while physically ill volunteers expressed greater ethical acceptability for physical illness research than for mental illness research. Mentally ill, physically ill, and healthy participants expressed neutral to favorable perspectives regarding the ethical
Boyd, Jennifer E; Zeiss, Antonette; Reddy, Shilpa; Skinner, Stephanie
Anecdotal reports and first-person accounts by psychologists, psychiatrists, social workers, and nurses with lived experience of mental illness ("prosumers") indicate that they can be effective in these roles, but little is known about the extent, nature, or contributions of this group. Competently functioning prosumers are in a unique position to increase hope for recovery and reduce stigma and discrimination across the mental health field, to the ultimate benefit of consumers. The study surveyed a convenience sample of 77 prosumers working for the Veterans Health Administration (VHA). We present descriptive productivity metrics such as publications, presentations, funding, initiating and leading programs, training and supervising other clinicians, and performing community work outside VHA. Very few have asked for accommodations at work. Two thirds have not disclosed their lived experience to any of their patients. On average, respondents have disclosed to only 16% of their colleagues, and about one third have not disclosed to any of their colleagues. Qualitative data show that participants see their lived experience as an asset, whether or not they disclose it. They advocate being conscientious about self-care to remain work-ready. Although the group sees many advantages to being open about their lived experience, and many are proud to stand up and be counted, others cite reasons to be cautious about disclosure. It is hoped that this survey will provide inspiration and encouragement to mental health workers with lived experience and that it will help foster a welcoming and inclusive work environment for this capable group of colleagues. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Teasdale, Scott B; Latimer, Geogina; Byron, Annette; Schuldt, Vanessa; Pizzinga, Josephine; Plain, Janice; Buttenshaw, Kerryn; Forsyth, Adrienne; Parker, Elizabeth; Soh, Nerissa
This article aims to draw mental health clinicians' attention to the connections between nutrition and mental health, and the roles that Accredited Practising Dietitians play in improving mental and physical health through dietary change. Selective narrative review. Unhealthy dietary practices are common in high prevalence and severe mental illness. Epidemiological evidence demonstrates that nutrients and dietary patterns impact on mental health. In addition, poor physical health is well documented in people with mental illness and the greatest contributor to the mortality gap. Dietary intervention studies demonstrate improved mental and physical health outcomes. Accredited Practising Dietitians translate nutrition science into practical advice to improve the nutritional status of patients with mental illness, and prevent and manage comorbidities in a variety of care settings. Medical Nutrition Therapy offers opportunities to improve the physical and mental health of people living with mental illness.
Modernisation of mental health services has been a government priority in recent years with new legislation, increased funding and investment and service reforms. The National Service Framework (NSF) for Mental Health defines national standards to meet the mental healthcare needs of adults up to the age of 65. This article considers standards two and three of the NSF regarding access to primary care services for people with a mental health problem. It discusses whether these standards consider homeless people, who continue to experience significant problems gaining equal access to health care.
Full Text Available The article examines the legal requirements relating to the informed consent of mentally ill persons to participation in clinical research in South Africa. First, the juridical basis of informed consent in South African law is outlined; and second, the requirements for lawful consent developed in South African common law and case law are presented. Finally, the article deliberates upon the requirements for the participation of mentally ill persons in research as laid down by the Mental Health Care Act and its regulations, the National Health Act and its (draft regulations, and the South African Constitution.
Matsea, Thabisa Coleen
Stigma is a contributing factor to non-help-seeking behavior and social isolation of mental health-care users. The study examined social workers' perspective regarding strategies that can be implemented to destigmatize mental illness in South Africa. A qualitative study method was adopted. Data were sourced through focus group discussions with social work students and telephone interviews with social workers working in hospitals. Data were analyzed using a thematic approach. Active involvement, education, and awareness campaigns, creating opportunities for improved well-being and constant support, were identified as relevant strategies. Given that stigma is multidimensional, various strategies are important if mental illness is to be destigmatized.
Brousseau, Ruth Tebbets
Foundations are often criticized for their short attention spans and inability to continue funding the toughest social problems. Homelessness among people with mental illnesses is considered among the most intractable of social issues. This paper explores the role of permanent supportive housing in reducing homelessness among the mentally ill; the role of the Corporation for Supportive Housing in developing, authenticating, and disseminating its model; and its long-term funding relationship with the Conrad N. Hilton Foundation, which has facilitated this trajectory. The paper tells the story of how long-term funding, strategically used, is making inroads into this serious mental health problem.
Moore, Donna; Ayers, Susan
Many women with postnatal mental illness do not get the treatment they need and this is often because stigma prevents disclosure. The purpose of this study was to explore online social support for postnatal mental illness, how women experience stigma and potential disadvantages of using Internet forums. Interviews were conducted with fifteen participants who had suffered postnatal mental illness and had used forums. Systematic thematic analysis identified common themes in relation to social support, stigma and disadvantages of using forums. Most women felt they benefited from visiting forums by developing a shared understanding and discourse about their illness. Findings suggest future research should investigate if women benefit from using online social support provided by forums, if use challenges stigma and further explore potential concerns about using forums.
Dalum, Helle Stentoft; Korsbek, Lisa; Mikkelsen, John Hagel
mental illness in facilitating recovery. Illness Management and Recovery (IMR) is a curriculum-based psychosocial intervention designed as structured program with a recovery-oriented approach. The aim of IMR is to rehabilitate people with severe mental illnesses by helping them acquire knowledge...... is a randomised, assessor-blinded, multi-centre, clinical trial of the IMR program compared with treatment as usual for 200 participants diagnosed with schizophrenia or bipolar disorder under the care of two community mental health centres in the Capital Region of Denmark. The primary outcome is level...... and skills in managing their illness and achieve personal recovery goals. Previous randomised clinical trials indicate that IMR can be implemented with a good effect and a high fidelity though further trials are crucial to demonstrate the potential effectiveness of IMR. Methods/Design: The trial design...
Bachrach, L L
Although extensive research on the homeless mentally ill population has been conducted, existing studies have failed to answer three important questions: the prevalence of chronic mental illness among homeless persons, whether deinstitutionalization has precipitated increased homelessness in this population, and what kinds of services should be offered. The author suggests that future research will require clearer definition of the terms used in discussing this population and calls for increased federal direction in making policies to respond to their problems, especially the problems of those who are geographically mobile. Successful service planning must address the full array of disabilities experienced by homeless mentally ill persons, including psychiatric symptoms, secondary responses to the experience of illness, and disabilities resulting from stigma and lack of societal opportunity.
Oram, Siân; Flynn, Sandra Marie; Shaw, Jenny; Appleby, Louis; Howard, Louise Michele
Approximately 10% of convicted homicide perpetrators in England and Wales have symptoms of mental illness at the time of homicide. The prevalence among perpetrators of adult domestic homicide is unclear. The study was a consecutive case series of all convicted adult domestic homicide perpetrators in England and Wales between 1997 and 2008. Sociodemographic, clinical, and offense characteristics were gathered from the United Kingdom Home Office, the Police National Computer, psychiatric court reports, and, for psychiatric patients, questionnaires completed by supervising clinicians. A total of 1,180 perpetrators were convicted of intimate partner homicide, and 251 were convicted of homicide of an adult family member. Fourteen percent of perpetrators of intimate partner homicide and 23% of perpetrators of adult family homicide had been in contact with mental health services in the year before the offense; 20% of intimate partner homicide perpetrators and 34% of adult family homicide perpetrators had symptoms of mental illness at the time of offense. Perpetrators with symptoms of mental illness at the time of offense were less likely than perpetrators without symptoms to have previous violence convictions or history of alcohol abuse. A significant minority of adult domestic homicide perpetrators had symptoms of mental illness at the time of the homicide. Most perpetrators, including those with mental illnesses, were not in contact with mental health services in the year before the offense. Risk reduction could be achieved through initiatives that encourage individuals with mental health problems to access mental health services and that develop closer interagency working, including between mental health services, police, social services, and domestic violence services.
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
Domino, Marisa E; Wells, Rebecca; Morrissey, Joseph P
Primary care-based medical homes are rapidly disseminating through populations with chronic illnesses. Little is known about how these models affect the patterns of care for persons with severe mental illness who typically receive much of their care from mental health specialists. This study examined whether enrollment in a primary care medical home alters the patterns of care for Medicaid enrollees with severe mental illness. The authors conducted a retrospective secondary data analysis of medication adherence, outpatient and emergency department visits, and screening services used by adult Medicaid enrollees with diagnoses of schizophrenia (N=7,228), bipolar disorder (N=13,406), or major depression (N=45,000) as recorded in North Carolina Medicaid claims from 2004-2007. Participants not enrolled in a medical home (control group) were matched by propensity score to medical home participants on the basis of demographic characteristics and comorbidities. Those dually enrolled in Medicare were excluded. Results indicate that medical home enrollees had greater use of both primary and specialty mental health care, better medication adherence, and reduced use of the emergency department. Better rates of preventive lipid and cancer screening were found only for persons with major depression. Enrollment in a medical home was associated with substantial changes in patterns of care among persons with severe mental illness. These changes were associated with only a modest set of incentives, suggesting that medical homes can have large multiplier effects in primary care of persons with severe mental illness.
Yuan, Qi; Abdin, Edimansyah; Picco, Louisa; Vaingankar, Janhavi Ajit; Shahwan, Shazana; Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Shafie, Saleha; Tay, Jenny; Chong, Siow Ann; Subramaniam, Mythily
Background Public attitudes to mental illness could influence how the public interact with, provide opportunities for, and help people with mental illness. Aims This study aims to explore the underlying factors of the Attitudes to Mental Illness questionnaire among the general population in Singapore and the socio-demographic correlates of each factor. Methods From March 2014 to April 2015, a nation-wide cross-sectional survey on mental health literacy with 3,006 participants was conducted in Singapore. Results Factor analysis revealed a 4-factor structure for the Attitudes to Mental Illness questionnaire among the Singapore general population, namely social distancing, tolerance/support for community care, social restrictiveness, and prejudice and misconception. Older age, male gender, lower education and socio-economic status were associated with more negative attitudes towards the mentally ill. Chinese showed more negative attitudes than Indians and Malays (except for prejudice and misconception). Conclusions There is a need for culture-specific interventions, and the associated factors identified in this study should be considered for future attitude campaigns. PMID:27893796
du Toit, Elsa; Jordaan, Esme; Niehaus, Dana; Koen, Liezl; Leppanen, Jukka
Pregnant women in general are at an increased risk of experiencing symptoms of mental illness, and those living in a developing country are even more vulnerable. Research points towards a causal relationship between unplanned pregnancy and perinatal mental illness and suggests that pregnancy planning can aid in reducing the negative impact of mental illness on a woman, her unborn baby, and the rest of the family. In this quantitative, descriptive study, we investigated both socio-demographic factors and variables relating to mental illness itself that may place women at an increased risk of experiencing unplanned pregnancy. Data was gathered at two maternal mental health clinics in Cape Town by means of semi-structured interviews. Univariate analyses of the data revealed five independent key risk factors for unplanned pregnancy: lower levels of education, unmarried status, belonging to the Colored ethnic population, substance use, and having a history of two or more suicide attempts. Some of these factors overlap with findings of similar studies, but others are unique to the specific population (women with mental illness within a developing country). Screening of women based on these risk predictors may pave the way for early interventions and reduce the incidence of unplanned pregnancy and the negative consequences thereof in the South African population.
Despite recent prosperity in the U.S., homelessness is still a widespread social problem. It is estimated that 25% of homeless persons have a serious mental illness. This article will review the literature evaluating prevention services and specialized outreach, treatment, and housing programs designed to reduce homelessness for individuals who are mentally ill. Although these interventions have been helpful in addressing the complex needs of the homeless mentally ill, it is difficult to measure how they have improved outcomes. It is even more challenging to determine whether the programs are cost-effective. Since public resources are used to maintain services for the homeless mentally ill, policy-makers must be informed about whether the best outcomes are achieved at the lowest possible cost. Following a discussion of the successes of the individual programs and the challenges they confront, several important questions are identified related to improving the efficiency of these programs. Although the establishment of such programs indicates that progress has been made toward alleviating the burdens facing people who are homeless and mentally ill, collaboration among all stakeholders-especially between the mental health community and consumer advocates-needs to be further enhanced. New research can be conducted in a way that improves how information is evaluated and used.
Carpiniello, Bernardo; Girau, Roberta; Orrù, Maria Germana
Media reports related to people suffering from mental illness appear to deal prevalently with acts of violence and crimes. The present study focused on all newspaper reports relating to homicides, suicide, and other acts of violence, in an attempt to ascertain whether a different pattern emerged in some Italian newspapers in describing deeds committed by the mentally ill. All articles published over a six-month period in the two main national and two main regional newspapers relating to homicides, suicides, and other acts of violence were selected. A comparison of reports regarding events attributed to mentally ill people was performed according to quantitative parameters. 2279 articles were considered; 54% regarded homicides, 8.2% suicides and attempted suicides, 2.1% homicides/suicides; the remaining 35.8% regarded other acts of violence. A significantly higher number of words, accompanying photos and a more stigmatizing language were used in reporting deeds when attributed to mentally ill people. An excessive emphasis on deeds related to a psychopathological condition still emerged in media reports, almost as though acts of violence committed by the mentally insane should be viewed in a different light. These findings support the hypothesis that media portrayal mirrors the enduring stereotype of "diversity" of the mentally ill.
Lo, Celia C; Cheng, Tyrone C
Before abating, the recession of the first decade of this century doubled the US unemployment rate. High unemployment is conceptualized as a stressor having serious effects on individuals' mental health. Data from surveys administered repeatedly over 15 years (1997-2011) described changes over time in the prevalence of chronic mental illness among US adults. The data allowed us to pinpoint changes characterizing the White majority--but not Black, Hispanic, or Asian minorities--and to ask whether such changes were attributable to economic conditions (measured via national unemployment rates). We combined 1.5 decades' worth of National Health Interview Survey data in one secondary analysis. We took social structural and demographic factors into account and let adjusted probability of chronic mental illness indicate prevalence of chronic mental illness We observed, as a general trend, that chronic mental illness probability increased as the unemployment rate rose. A greater increase in probability was observed for Blacks than Whites, notably during 2007-2011, the heart of the recession Our results confirmed that structural risk posed by the recent recession and by vulnerability to the recession's effects was differentially linked to Blacks. This led to the group's high probability of chronic mental illness, observed even when individual-level social structural and demographic factors were controlled. Future research should specify the particular kinds of vulnerability that created the additional disadvantage experienced by Black respondents.
Gabbidon, Jheanell; Farrelly, Simone; Hatch, Stephani L; Henderson, Claire; Williams, Paul; Bhugra, Dinesh; Dockery, Lisa; Lassman, Francesca; Thornicroft, Graham; Clement, Sarah
This study assessed participants' experienced discrimination and their causal attributions, particularly to mental illness or race-ethnicity. In a cross-sectional study, 202 service users with severe mental illnesses were interviewed to assess their reported experiences of discrimination. The Major Experiences of Discrimination Scale assessed major experiences of discrimination and their recency and frequency across 12 life domains and perceived reasons (attributions). The Everyday Experiences of Discrimination Scale assessed ten types of everyday discrimination and attributions for these experiences. Most participants (88%) reported discrimination in at least one life domain, and 94% reported ever experiencing everyday discrimination. The most common areas of major discrimination were mental health care (44%), neighbors (42%), police (33%), employment (31%), and general medical care (31%). The most common attributions for major discrimination were mental illness (57%), race-ethnicity (24%), education or income (20%), or appearance (19%). Almost half (47%) attributed experiences of major discrimination to two or more causes. No differences were found between racial-ethnic groups in overall experienced discrimination or in main attributions to mental illness. However, compared with the mixed and white groups, participants in the black group were most likely to endorse race-ethnicity as a main attribution (pethnic groups, and discrimination based on race-ethnicity was prevalent for the mixed and black groups. There is a need for antidiscrimination strategies that combine efforts to reduce the experience of discrimination attributed to mental illness and to race-ethnicity for racial-ethnic minority groups.
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” (χ2 = 8.994, P rights needs in emotional dimension, that is, afraid of family members (χ2 = 8.233, P women from APL group expressed that they were discriminated and exploited by the community members (χ2 = 17.490, P 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. PMID:26124524
Schafer, Tim; Wood, Steve; Williams, Rena
This paper reports on a survey of attitudes to mental illness that was completed with a cohort of pre-registration nurses in 2007 in a large university in Essex. The background literature highlights the effects of attitudes on stigma, disadvantage and discrimination and presents a brief review of the literature on cultural variations in attitudes. It also briefly reviews the attitudes of health professionals to mental illness. A survey using the Community Attitudes to Mental Illness questionnaire was completed and ethnicity proved to be an important factor in accounting for variations in attitudes to mental illness. The Black and Black British group displayed less positive attitudes across all nursing branches when compared to the white group. The differences raised questions about how best nurse training can prepare nurses to practice in culturally sensitive ways that acknowledge the beliefs of patients whilst avoiding stereotyping and discrimination. Personal contact with someone with mental illness was also found to be a significant factor and the importance of user involvement in training is discussed. The paper concludes with some recommendations for nurse training that include greater use of teaching strategies that challenge beliefs and assumptions and promote a commitment to multicultural mental health practice. Copyright © 2010 Elsevier Ltd. All rights reserved.
Maura, Jessica; Weisman de Mamani, Amy
Mounting evidence indicates that there are mental health disparities in the United States that disadvantage racial/ethnic minorities in medical and mental health settings. Less is known, however, about how these findings apply to a particularly vulnerable population, individuals with severe mental illness (SMI). The aim of this paper is to (1) provide a critical review of the literature on racial/ethnic disparities in mental health care among individuals with SMI; (2) identify factors which may contribute to the observed disparities; and (3) generate recommendations on how best to address these disparities. Specifically, this article provides an in-depth review of sociocultural factors that may contribute to differences in treatment engagement and rates of attrition from treatment among racial/ethnic minorities with SMI who present at medical and mental health facilities. This review is followed by a discussion of specific strategies that may promote engagement in mental health services and therefore reduce racial/ethnic disparities in SMI.
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.
Rozel, John S; Mulvey, Edward P
The United States has substantially higher levels of firearm violence than most other developed countries. Firearm violence is a significant and preventable public health crisis. Mental illness is a weak risk factor for violence despite popular misconceptions reflected in the media and policy. That said, mental health professionals play a critical role in assessing their patients for violence risk, counseling about firearm safety, and guiding the creation of rational and evidence-based public policy that can be effective in mitigating violence risk without unnecessarily stigmatizing people with mental illness. This article summarizes existing evidence about the interplay among mental illness, violence, and firearms, with particular attention paid to the role of active symptoms, addiction, victimization, and psychosocial risk factors. The social and legal context of firearm ownership is discussed as a preface to exploring practical, evidence-driven, and behaviorally informed policy recommendations for mitigating firearm violence risk.