Full Text Available 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 cases aged more than 18 years visiting outpatient of psychiatric department and diagnosed as a case of mental illness for at least a year were included. Instruments used were self-developed proforma and Multidimensional Scale of Perceived Social Support. Interview technique was used to collect the data. Results: Majority (60% of the patients perceive social support from family, 28% of the patients perceive social support from significant others. Regression analysis showed that the perceived social support is influenced by employment status, type of family one lives in and physical illness. It is not influenced by gender, subjective financial status and frequency of hospitalization. Conclusion: Perceived social support is influenced by employment status, type of family one lives in and physical illness. Majority (60% of the patients perceive social support from family.
... the same time. For example, you may have depression and a substance use disorder. Complications Mental illness is a leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include: ...
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.
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
Ritchie, Sarah; Muldoon, Laura
To determine whether patients with serious mental illness (SMI) are receiving preventive care for cardiovascular disease at the same rate as those without SMI in an interprofessional practice with a mandate to care for persons with barriers to access to the health care system. Quality improvement exercise using a case-matched retrospective chart review. Somerset West Community Health Centre in downtown Ottawa, Ont. All patients with SMI were adult, current primary care patients from the Somerset West Community Health Centre with a recorded diagnosis of SMI (bipolar affective disorder, schizophrenia, or other psychosis) during the 2-year period from June 1, 2013, to May 31, 2015. Two control patients (current primary care patients without SMI and matched for age and sex) were randomly chosen for each patient with SMI. They had at least 1 record in their electronic chart during the 2-year study period of measurement of blood pressure, weight, body mass index, smoking status, lipid screening results, or diabetes screening results. Prevention score was calculated as the number of preventive tests documented out of the possible 6. Secondary measures included age, sex, comorbidities (diabetes, hypertension, or hyperlipidemia), mental illness diagnosis, involvement of a psychiatrist, and involvement of a mental health case worker. Patients with SMI had higher rates of diabetes, hypertension, and dyslipidemia. Screening rates for the 6 outcome measures were very similar between patients with and without SMI. Patients with SMI who were under the care of a psychiatrist or who had a case worker had more complete screening results than those who had neither provider. As expected, patients with SMI had higher rates of metabolic comorbidities than control patients had. Screening rates for cardiovascular risk factors were similar in the 2 groups. Involvement of mental health case workers and psychiatrists in the patients' care might be linked to more complete preventive screening
Arvaniti, Aikaterini; Samakouri, Maria; Kalamara, Eleni; Bochtsou, Valentini; Bikos, Constantinos; Livaditis, Miltos
Stereotypes and prejudices against patients with mental illness are widespread in many societies. The aim of the present study is to investigate such attitudes among the staff and medical students, including employees and trainees, in a general university hospital. Six hundred individuals (361 employees, 231 students) completed the following questionnaires: Level of Contact Report (LCR), Authoritarianism Scale (AS), and Opinion about Mental Illness (OMI), a scale yielding five factors (social discrimination, social restriction, social care, social integration, and aetiology). Multivariate linear regression models were applied in order to search for the simultaneous effect of many variables on the scores of OMI factors. An important part of the sample held negative attitudes especially concerning social discrimination and restriction of the patients. Women, older and less educated staff, nursing staff, and people scoring higher on authoritarianism were more prejudiced. Higher scores on familiarity were associated with less negative attitudes. The results indicate the need to develop sensitisation and training programs considering mental health topics among health service employees.
Hanson, Mark D.; Johnson, Samantha; Niec, Anne; Pietrantonio, Anna Marie; High, Bradley; MacMillan, Harriet; Eva, Kevin W.
Objective: Adolescent mental illness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may provide a stigma-reduction strategy. This article reports an investigation of this hypothetical…
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, ...
... News & Events About Us Home > Health Information Share Statistics Research shows that mental illnesses are common in ... of mental illnesses, such as suicide and disability. Statistics Top ı cs Mental Illness Any Anxiety Disorder ...
Hendrie, Hugh C; Lindgren, Donald; Hay, Donald P; Lane, Kathleen A; Gao, Sujuan; Purnell, Christianna; Munger, Stephanie; Smith, Faye; Dickens, Jeanne; Boustani, Malaz A; Callahan, Christopher M
Patients with serious mental illness are living longer. Yet, there remain few studies that focus on healthcare utilization and its relationship with comorbidities in these elderly mentally ill patients. Comparative study. Information on demographics, comorbidities, and healthcare utilization was taken from an electronic medical record system. Wishard Health Services senior care and community mental health clinics. Patients age 65 years and older-255 patients with serious mental illness (schizophrenia, major recurrent depression, and bipolar illness) attending a mental health clinic and a representative sample of 533 nondemented patients without serious mental illness attending primary care clinics. Patients having serious mental illness had significantly higher rates of medical emergency department visits (p = 0.0027) and significantly longer lengths of medical hospitalizations (p mentally ill group (p seriously mentally ill. The differences in healthcare utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population requiring an integrated model of healthcare. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. 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.
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
Bailey, Elizabeth A; Wirtalla, Christopher; Sharoky, Catherine E; Kelz, Rachel R
Patients with mental health disorders have worse medical outcomes and experience excess mortality compared with those without a mental health comorbidity. This study aimed to evaluate the relationship between mental health comorbidities and surgical outcomes. This retrospective cohort study used the National Inpatient Sample (2009-2011) to select patients who underwent one of the 4 most common general surgery procedures (cholecystectomy and common duct exploration, colorectal resection, excision and lysis of peritoneal adhesions, and appendectomy). Patients with a concurrent mental health diagnosis were identified. Multivariable logistic regression examined outcomes, including prolonged length of stay, in-hospital mortality, and postoperative complications. Of the 579,851 patients included, 38,702 patients (6.7%) had a mental health diagnosis. Mood disorders were most prevalent (58.7%), followed by substance abuse (23.8%). After adjustment for confounders, including sex, race, number of comorbidities, admission status, open operations, insurance, and income quartile, we found that having a mental health diagnosis conferred a 40% greater odds of including prolonged length of stay (OR 1.41, P mental health diagnosis cohort. General surgery patients with comorbid mental disease experience a greater incidence of postoperative complications and longer hospitalizations. Recognizing these disparate outcomes is the first step in understanding how to optimize care for this frequently marginalized population. Copyright © 2017 Elsevier Inc. All rights reserved.
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 < 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53% v. 3.4%, p < 0.001). Compared to the general population, patients with SMI are at substantially increased risk of 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.
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.
Rayan, Ahmad; Mahroum, Maryam Husnee; Khasawneh, Aws
This study aims to assess the correlates of stigma toward mental illness among patients diagnosed with major depressive disorder (MDD). One hundred and sixty one Jordanian outpatients suffering from MDD completed the study. Participants completed the demographic questionnaire, the Center for Epidemiological Studies for the intensity of depression, and the Devaluation-Discrimination Scale to assess stigma. Participants reported a moderate level of perceived stigma toward mental illness. Age, perceived pain, the number of relapses, and severity of depressive symptoms were significantly correlated with stigma toward mental illness among the study sample. The severity of depressive symptoms was the strongest correlate of stigma toward mental illness. Factors associated with stigma toward mental illness should be carefully considered when implementing anti-stigma programs for patients. © 2017 Wiley Periodicals, Inc.
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
Atzema, Clare L.; Schull, Michael J.; Kurdyak, Paul; Menezes, Natasja M.; Wilton, Andrew S.; Vermuelen, Marian J.; Austin, Peter C.
Background: It has been suggested that patients with mental illness wait longer for care than other patients in the emergency department. We determined wait times for patients with and without mental health diagnoses during crowded and noncrowded periods in the emergency department. Methods: We conducted a population-based retrospective cohort analysis of adults seen in 155 emergency departments in Ontario between April 2007 and March 2009. We compared wait times and triage scores for patients with mental illness to those for all other patients who presented to the emergency department during the study period. Results: The patients with mental illness (n = 51 381) received higher priority triage scores than other patients, regardless of crowding. The time to assessment by a physician was longer overall for patients with mental illness than for other patients (median 82, interquartile range [IQR] 41–147 min v. median 75 [IQR 36–140] min; p < 0.001). The median time from the decision to admit the patient to hospital to ward transfer was markedly shorter for patients with mental illness than for other patients (median 74 [IQR 15–215] min v. median 152 [IQR 45–605] min; p < 0.001). After adjustment for other variables, patients with mental illness waited 10 minutes longer to see a physician compared with other patients during noncrowded periods (95% confidence interval [CI] 8 to 11), but they waited significantly less time than other patients as crowding increased (mild crowding: −14 [95% CI −12 to −15] min; moderate crowding: −38 [95% CI −35 to −42] min; severe crowding: −48 [95% CI −39 to −56] min; p < 0.001). Interpretation: Patients with mental illness were triaged appropriately in Ontario’s emergency departments. These patients waited less time than other patients to see a physician under crowded conditions and only slightly longer under noncrowded conditions. PMID:23148052
Noblett, Joanne E; Lawrence, Robert; Smith, Jared G
What are the attitudes of general hospital doctors toward patients with comorbid mental illness? Do certain characteristics of the health professional related to attitude valence to patients with comorbid mental illness? An anonymous questionnaire was sent out to a cohort of doctors working in three General Hospitals in South West London. The questionnaire included vignettes to assess the respondents' attitudes toward eight patients presenting with a physical compliant with different clinical histories, including depression, schizophrenia, personality disorder, diabetes, and criminal behavior. A total of 52 participants completed the questionnaire; 40 females and 12 males. Across all domains, the most positive attitudes were held toward patients without a diagnosis of mental illness. The least positive attitudes were toward patients with schizophrenia, personality disorder, and those classified as "criminals," and negative attitudes relating to the unpredictability of patients was identified in these categories. There was no statistically significant difference in attitudes depending on age or level of training. However, female participants tended to endorse more positive attitudinal responses, most clearly toward patients with depression and heroin addiction. Negative attitudes of doctors were identified toward certain mental illness diagnoses and are likely to contribute the physical health disparity between patients with and without a comorbid mental illness. This raises the question as to how these attitudes can be changed in order to improve the parity of physical health care between patient with and without mental illness. © The Author(s) 2015.
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.
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.
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.
Latalova, Klara; Kamaradova, Dana; Prasko, Jan
The aims of this paper are to review data on the prevalence and correlates of violent victimization of persons with severe mental illness, to critically evaluate the literature, and to explore possible approaches for future research. PubMed/MEDLINE and PsycINFO databases were searched using several terms related to severe mental illness in successive combinations with terms describing victimization. The searches identified 34 studies. Nine epidemiological studies indicate that patients with severe mental illness are more likely to be violently victimized than other community members. Young age, comorbid substance use, and homelessness are risk factors for victimization. Victimized patients are more likely to engage in violent behavior than other members of the community. Violent victimization of persons with severe mental illness has long-term adverse consequences for the course of their illness, and further impairs the quality of lives of patients and their families. Victimization of persons with severe mental illness is a serious medical and social problem. Prevention and management of victimization should become a part of routine clinical care for patients with severe mental illness.
Freidl, M; Lang, T; Scherer, M
It is well established that the general public has devaluating attitudes towards psychiatric patients. In order to avoid rejection, many of these patients develop coping strategies, such as withdrawal and concealing their treatment history. These efforts are in themselves stressing, which might have negative consequences for the course of the disorder. It is not clear, however, how many and which patients do actually perceive the public's stereotype as threatening and, therefore, expect rejection. Ninety psychiatric patients and a sample of 1042 persons of the Austrian general population were asked whether they agreed with five devaluating statements about mental patients contained in a questionnaire developed by Link et al. Matched pairs comparisons and multiple logistic regression were employed in order to find out whether patients agreed with these statements to the same extent as the general population did. For the statements that most people believe that psychiatric patients are "less intelligent", "less trustworthy" and "taken less seriously", patients thought significantly less often than the general population that most people devalue mental patients. For two statements ("personal failure", "think less of") no difference was found. It seems that some psychiatric patients are less convinced than the general population that most people devalue psychiatric patients in specific respects; these patients might fear rejection less than other patients do. Those who actually fear rejection might need antistigma assistance more urgently than the first group.
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.
Thom, Robyn P; Farrell, Helen M
Stigma associated with mental illness-a public health crisis-is perpetuated by the language used to describe and document it. Psychiatric pathology and how it can be perceived among clinicians contribute to the marginalization of patients, which exacerbates their vulnerability. Clinical documentation of mental illness has long been mired in pejorative language that perpetuates negative assumptions about those with mental illness. Although patients have the legal right to view their health record, sharing mental health notes with patients remains a sensitive issue, largely due to clinicians' fears that review of this content might cause harm, specifically psychiatric destabilization. However, the ethical principles of justice, beneficence, and autonomy as well as nonmaleficence must be considered by clinicians in determining when and how to share psychiatric details from a health record with their patients. © 2017 American Medical Association. All Rights Reserved.
Levin, Kfir; Bradley, Graham L; Duffy, Amanda
This study examined whether attitudes toward euthanasia vary with type of illness and with the source of the desire to end the patient's life. The study used a 3 (illness type: cancer, schizophrenia, depression) × 2 (euthanasia type: patient-initiated, family-initiated) between-groups experimental design. An online questionnaire was administered to 324 employees and students from a Australian public university following random assignment of participants to one of the six vignette-based conditions. Attitudes toward euthanasia were more positive for patients with a physical illness than a mental illness. For a patient with cancer or depression, but not schizophrenia, approval was greater for patient-, than, family-, initiated euthanasia. Relationships between illness type and attitudes were mediated by perceptions of patient autonomy and illness controllability. Findings have implications for debate, practices, and legislation regarding euthanasia.
Nubia Hernández de Cadena
Full Text Available It is of common knowledge, that mentally ill patients are frequently subjected to physical and mental abuse. However, there is little information about this topic. Patients with mental disorders may be subjected to physical, sexual, psychological, and economical, as well as, negligence abuse by folks and people from community, due to fact, of prejudice towards people with mental disorders. Therefore abuse in all forms, constitutes an additional stressor event and changes prognosis of preexistent disorder. Diagnosis of abuse is a complex process and it is necessary a full clinical history, including physical and mental evaluation.
Huang, Yao-Hui; Lin, Yao-Yu; Lee, Shih-Kai; Lee, Ming-Feng; Lin, Ching-Lan Esther
The ideology of recovery addresses the autonomy of patients with mental illness and their ability to reconstruct a normal life. Empirical knowledge of this process of recovery and related factors remains unclear. To assess the process of recovery and related factors in patients with mental illness. This cross-sectional, correlational study was conducted on a convenience sample in a psychiatric hospital. Two-hundred and fifty patients with mental illness were recruited and were assessed using 3 instruments: Questionnaire about the Process of Recovery (QPR), Perceived Psychiatric Stigma Scale (PPSS), and Personal and Social Performance Scale (PSP). Data were analyzed using descriptive statistics, χ 2 , analysis of variance, and multiple linear regression analysis. Most of the participants were male, middle-aged, unmarried, educated to the senior high school level, employed, receiving home-care treatment, and diagnosed with schizophrenia. Those who were unemployed, living in a community rehabilitative house, and living in the community, respectively, earned relatively higher recovery scores (p mental illness. Community psychiatric nurses should provide care to help employed patients adapt to stresses in the workplace, strengthen their stigma-coping strategies, and promote public awareness of mental health issues by increasing public knowledge and acceptance of mental illness in order to minimize patient-perceived stigma and facilitate their recovery.
Mahmoud, Sahar; Zaki, Rania A.
This study was a comparative study aiming to assess the extent of internalized stigma of mental illness among patients with schizophrenia & identify stigma as perceived by family members caring schizophrenic patients. The study was conducted in two settings 1st clinic was outpatient clinic for psychiatric patient affiliated to Abbasia…
Barke, Antonia; Nyarko, Seth; Klecha, Dorothee
Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. A convenience sample of 403 participants (210 men, mean age 32.4±12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9±11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes.
The purpose of the study was to develop a grounded theory about individuals' perception of the situation of being a psychiatric patient. Thirty-five inpatients (19 males, 16 females), ages 18 to 68, in two psychiatric units of an urban, public facility were interviewed on a biweekly basis from admission to discharge. Data were analyzed using the constant comparative method, and the data indicated that participants used the basic social process of managing self-worth to deal with the stigmatizing social predicament of being a mental patient. Events occurring before admission that shaped their responses were substance abuse, medication noncompliance, and the lack of social capital, which led to norm violations and subsequent hospitalization. Six attribution categories emerged: problem, disease, crisis, punishment, ordination, and violation. Findings support the need for professionals to improve their practice by acknowledging the effects of patients' subjective assessments on their response to hospitalization and by placing more emphasis on assisting patients to deal with the stigmatizing effects of a psychiatric diagnosis.
Looijmans, Anne; Jorg, Frederike; Schoevers, Robert A.; Bruggeman, Richard; Stolk, Ronald P.; Corpeleijn, Eva
Background: Severe mentally ill (SMI) patients have a reduced life expectancy of 13-30 years compared to the general population, largely due to an increased risk of cardiovascular mortality. Unhealthy lifestyle behaviours in SMI patients contribute to this increased risk. The obesogenic living
de Mooij, Liselotte D.; Kikkert, Martijn; Lommerse, Nick M.; Theunissen, Jan; de Koning, Mariken B.; de Haan, Lieuwe; Beekman, Aartjan T. F.; Duurkoop, Pim W. R. A.; Dekker, Jack J. M.
Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. This study describes patterns of changes in the residential and care settings of SMI patients and explores associations between
James, Caryl C A B; Peltzer, Karl
The aim of this study was to investigate traditional and alternative therapy for mental illness in Jamaica: patients' conceptions and practitioners' attitudes. The sample included 60 psychiatric patients selected from Ward 21 at the University of the West Indies, Kingston as well as Princess Margaret outpatient clinic, and 30 Afro-centric psychiatric nurses, psychiatrist and clinical psychologists from Kingston and St. Thomas, Jamaica. Patients were interviewed with the Short Explanatory Model Interview (SEMI) and practitioners completed a self administered questionnaire on attitudes towards traditional and alternative medicine. 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 these patients. In case for those who also sought traditional medicine, they were more inclined to feel pleased about their interaction and the treatment they received. Results from western trained practitioners found that although they acknowledged that traditional medicine plays a major role in the treatment of mental illness among psychiatric patients the treatment was not advantageous. For the most part when all three traditional approaches were examined alternative medicine seemed more favourable than traditional healing and traditional herbal treatment. There is a need to develop models of collaboration that promote a workable relationship between the two healing systems in treating mental illness.
Lai, Jiun-Yang; Huang, Tiao-Lai
The purpose of the present study was to investigate the prevalence, distribution of psychiatric diagnoses, and treatment responses of patients with post-partum mental illness at an emergency unit at Chang Gung Memorial Hospital at Kaohsiung in Taiwan. During a 1 year period a total of 636 Taiwanese women received psychiatric consultation on their visits to the emergency room. Fifteen of these were noted to have post-partum mental illnesses. All subjects were followed up for a minimum of 3-6 months. The prevalence of patients with post-partum mental illness at an emergency unit at Chang Gung Memorial Hospital at Kaohsiung was 2.4% (15/636). The distribution of psychiatric diagnoses according to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria included eight cases of major depressive disorders (53.3%), three cases of bipolar I disorder (20%), three cases of schizophrenia (20%), and one case of psychotic disorder due to a general medical condition (6.7%). Four subjects manifested catatonic features. Of these four, three had complete remission in catatonic symptoms after receiving intramuscular injection of lorazepam. The fourth subject died of multiple medical diseases. The treatment results suggest that most of the clinical presentations in patients with post-partum mental illness could be relieved by antipsychotics, mood stabilizers or antidepressants. In addition, it was found that intramuscular injection of lorazepam was also effective in patients with catatonic features and post-partum depression or psychosis.
Bauer, Michael; Glenn, Tasha; Monteith, Scott; Bauer, Rita; Whybrow, Peter C; Geddes, John
The digital revolution in medicine not only offers exciting new directions for the treatment of mental illness, but also presents challenges to patient privacy and security. Changes in medicine are part of the complex digital economy based on creating value from analysis of behavioral data acquired by the tracking of daily digital activities. Without an understanding of the digital economy, recommending the use of technology to patients with mental illness can inadvertently lead to harm. Behavioral data are sold in the secondary data market, combined with other data from many sources, and used in algorithms that automatically classify people. These classifications are used in commerce and government, may be discriminatory, and result in non-medical harm to patients with mental illness. There is also potential for medical harm related to poor quality online information, self-diagnosis and self-treatment, passive monitoring, and the use of unvalidated smartphone apps. The goal of this paper is to increase awareness and foster discussion of the new ethical issues. To maximize the potential of technology to help patients with mental illness, physicians need education about the digital economy, and patients need help understanding the appropriate use and limitations of online websites and smartphone apps.
Penney, Stephanie R; Prosser, Aaron; Simpson, Alexander I F
Developmental typologies regarding age of onset of violence and offending have not routinely taken account of the role of serious mental illness (SMI), and whether age of onset of offending in relation to onset of illness impacts on the manifestation of offending over the life course. To test whether forensic psychiatric patients can be classified according to age of onset of SMI and offending, and, if so, whether subtypes differ by sex. Details of all 511 patients enrolled into a large forensic mental health service in Ontario, Canada, in 2011 or 2012 were collected from records. A latent profile analysis supported a 2-class solution in both men and women. External validation of the classes demonstrated that those with a younger age onset of serious mental illness and offending were characterised by higher levels of static risk factors and criminogenic need than those whose involvement in both mental health and criminal justice systems was delayed to later life. Our findings present a new perspective on life course trajectories of offenders with SMI. While analyses identified just two distinct age-of-onset groups, in both the illness preceded the offending. The fact that our sample was entirely drawn from those hospitalised may have introduced a selection bias for those whose illness precedes offending, but findings underscore the complexity and level of need among those with a younger age of onset. Copyright © 2018 John Wiley & Sons, Ltd. Copyright © 2018 John Wiley & Sons, Ltd.
Jun, Won Hee; Lee, Eun Ju; Park, Jeong Soon
To investigate the effects of a suicide prevention programme on the levels of depression, self-esteem, suicidal ideation and spirituality in patients with mental illness. Instances of suicide have significant correlations with depression, low self-esteem, suicidal ideation and a low level of spirituality in the victims. Therefore, addressing depression, low self-esteem and suicidal ideation as suicide risk factors and increasing levels of spirituality can constitute an effective programme to prevent suicide among patients with mental illness. The study was a quasi-experimental study with a nonequivalent control group, nonsynchronised design. The study sample consisted of 45 patients with mental illness who had been admitted to the psychiatric unit in a university hospital in South Korea. The patients were assigned to control and experimental groups of 23 and 22 members, respectively. The suicide prevention programme was conducted with the experimental group over four weeks and included eight sessions (two per week). The control group received only routine treatments in the hospital. The experimental group that participated in the programme had significantly decreased mean scores for depression and suicidal ideation compared with the control group. However, there were no significant differences in the mean scores for self-esteem and spirituality between the groups. The suicide prevention programme might be usefully applied as a nursing intervention for patients hospitalised in psychiatric wards or clinics where the goals are to decrease depression and suicidal ideation. Typical treatments for hospitalised patients with mental illness are not enough to prevent suicide. Intervention for suicide prevention needs to apply an integrated approach. The suicide prevention programme using an integrated approach is more effective in reducing depression and suicidal ideation in patients with mental illness than applying routine treatments in the hospital. © 2013 John Wiley
People with serious mental illness who are overweight or obese can benefit from taking part in a fitness program called InSHAPE where they receive help with fitness, weight loss, and even grocery shopping on a budget.
Jochems, E.C.; van Dam, A.; Duivenvoorden, H.J.; Scheffer, S.C.M.; van der Feltz-Cornelis, C.M.; Mulder, N.L.
The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model
van Hasselt, F. M.; Oud, M. J. T.; Loonen, A. J. M.
ObjectiveHealth care for the physical health of patients with severe mental illness (SMI) needs to be improved. Therefore, we aimed to develop policy recommendations to improve this physical health care in the Netherlands based on consensus (general agreement) between the major stakeholders. MethodA
Conclusion: Despite the small size and selective nature of the sample, the nurses' negative attitude toward the mentally-ill patients provides useful baseline data for further large-scale studies and underscores the need for psychoeducation of different health care professionals, including nurses.
Mar 1, 2009 ... Awareness of mental illness as a significant cause of morbidity is increasing ... of disability throughout the world, 5 are psychiatric illnesses.2 ... war of 1967 - 1970. ... illness, and the treatment that they first employed, with their.
Hassan, Mohamed Basil; Hodge, David O.
Background Children diagnosed with some forms of strabismus were recently found to have an increased risk of developing mental illness by early adulthood. The purpose of this case-controlled study was to determine if adults with non-paralytic forms of strabismus are similarly at an elevated risk for developing mental illness. Methods The medical records of all patients diagnosed as adults (≥ 19 years of age) with convergence insufficiency (CI, n=118), divergence insufficiency (DI, n=80), and small angle hypertropia (HT, n=99) from January 1, 1985, through December 31, 2004, were retrospectively reviewed. Each case was compared with a sex- and birthdate-matched non-strabismic control. The medical records were reviewed for mental health diagnoses, including inpatient and outpatient encounters, psychiatric ER visits, and medication use. Results Mental health disorders were diagnosed in 65 (55.1%) patients with CI compared to 54 (45.8%) controls (p=0.15), in 51 (63.8%) patients with DI compared to 42 (52.5%) controls (p=0.15), and in 63 (63.6%) patients with HT compared to 57 (57.6%) controls (p=0.38). CI patients were not more likely to have mental health disorders than their controls (p=0.15). Mental health hospitalizations (p=0.02), psychiatric medication use (p=0.04), and unspecified anxiety disorders (p=0.03) were higher in DI patients compared to controls. HT patients were found to have more generalized anxiety disorders (p=0.003) than controls. Conclusions Adults with some forms of strabismus (DI and HT) appear to have an increased risk of mental illness and its comorbidities, compared to age- and gender-matched non-strabismic controls. PMID:26559866
Stiekema, Anna Petronella Maria
Many patients with severe mental illness experience difficulties with adapting to the impact of their illness and with developing new meaning and purpose in life. This process of adapting to the consequences of the illness is called recovery. Patients in residential facilities often have stagnated
Nyboe, Lene; Lund, H
Background: Physical inactivity is an independent risk factor for cardiovascular diseases and Type 2 diabetes, both being highly prevalent in patients with severe mental illness. Though physical activity has become an important issue in psychiatric treatment and rehabilitation in the past decade......, systematic evaluations of physical activity level in psychiatric populations could be more disseminated. Aim: The primary aim of the study was to investigate the physical activity level of psychiatric patients in comparison with healthy controls. Methods: Patients with severe mental illness (n =47......) and a group of healthy controls (n =28) matched on sex and age reported their physical activity level using the Physical Activity Scale (PAS). PAS was administered as an interview in relation to patients and as a questionnaire in relation to healthy controls. Results: Patients had statistically significant...
De Herdt, Amber; Knapen, Jan; Vancampfort, Davy; De Hert, Marc; Brunner, Emanuel; Probst, Michel
Social anxiety (SA) is a frequent comorbid condition in patients with mental illness. However, no data exist regarding SA in physical activity (PA) situations. The aim of the present study was to measure the level of self-reported SA in PA participation in patients with mental illness compared to healthy controls. Six hundred ninety-three patients with mental illness and 2,888 controls aged between 18 and 65 years completed the Physical Activity and Sport Anxiety Scale (PASAS). Group and gender differences in PASAS scores were tested by ANOVA and Scheffé's post hoc test. After controlling for gender (P mental illness reported higher levels of SA in PA situations compared to healthy control subjects. Health professionals should consider SA when trying to improve outcome and adherence of patients with mental illness to PA interventions. © 2013 Wiley Periodicals, Inc.
Erdner, A; Magnusson, A
The aim of the study was to describe psychiatric caregivers' perceptions of self-esteem and activities for patients with long-term mental illness. The study design used a qualitative approach, based on an open lifeworld perspective. A total of 13 caregivers at four psychiatric hospital units in a large Swedish city were interviewed about their views on patients' physical activity and/or other pastimes, as well as their self-esteem and its bearing on the patients' well-being. According to the caregivers, it is up to the patients themselves to decide what they wish to occupy themselves with. In the same time the caregivers' opinions are that patients have difficulties to occupy themselves. The caregivers believe that patients' disability is based in a lack of self-esteem, commitment and capacity to realize their wishes. The caregivers in this study argue that activities are valuable for self-esteem and physical health of people with long-term mental illness. The caregivers consider that it is the patient's responsibility to initiate their needs of activities. This means that the caregivers do not use their knowledge about the importance of activities for the patient's health. Search terms: activity, caregivers, mental illness. © 2011 Blackwell Publishing.
Full Text Available Abstract Awareness of the importance of maintaining physical health for patients with severe mental illnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbidity. These patients present higher vulnerability to cardiovascular risk factors based on several issues, such as genetic predisposition to certain pathologies, poor eating habits and sedentary lifestyles, high proportions of smokers and drug abusers, less access to regular health care services, and potential adverse events during pharmacological treatment. Nevertheless, there is ample scientific evidence supporting the benefits of lifestyle interventions based on diet and exercise designed to minimize and reduce the negative impact of these risk factors on the physical health of patients with severe mental illnesses.
Chacón, Fernando; Mora, Fernando; Gervás-Ríos, Alicia; Gilaberte, Inmaculada
Awareness of the importance of maintaining physical health for patients with severe mental illnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbidity. These patients present higher vulnerability to cardiovascular risk factors based on several issues, such as genetic predisposition to certain pathologies, poor eating habits and sedentary lifestyles, high proportions of smokers and drug abusers, less access to regular health care services, and potential adverse events during pharmacological treatment. Nevertheless, there is ample scientific evidence supporting the benefits of lifestyle interventions based on diet and exercise designed to minimize and reduce the negative impact of these risk factors on the physical health of patients with severe mental illnesses.
Miguélez, Marta; Merlani, Paolo; Gigon, Fabienne; Verdon, Mélanie; Annoni, Jean-Marie; Ricou, Bara
Following treatment in an ICU, up to 70% of chronically critically ill patients present neurocognitive impairment that can have negative effects on their quality of life, daily activities, and return to work. The Mini Mental State Examination is a simple, widely used tool for neurocognitive assessment. Although of interest when evaluating ICU patients, the current version is restricted to patients who are able to speak. This study aimed to evaluate the feasibility of a visual, multiple-choice Mini Mental State Examination for ICU patients who are unable to speak. The multiple-choice Mini Mental State Examination and the standard Mini Mental State Examination were compared across three different speaking populations. The interrater and intrarater reliabilities of the multiple-choice Mini Mental State Examination were tested on both intubated and tracheostomized ICU patients. Mixed 36-bed ICU and neuropsychology department in a university hospital. Twenty-six healthy volunteers, 20 neurological patients, 46 ICU patients able to speak, and 30 intubated or tracheostomized ICU patients. None. Multiple-choice Mini Mental State Examination results correlated satisfactorily with standard Mini Mental State Examination results in all three speaking groups: healthy volunteers: intraclass correlation coefficient = 0.43 (95% CI, -0.18 to 0.62); neurology patients: 0.90 (95% CI, 0.82-0.95); and ICU patients able to speak: 0.86 (95% CI, 0.70-0.92). The interrater and intrarater reliabilities were good (0.95 [0.87-0.98] and 0.94 [0.31-0.99], respectively). In all populations, a Bland-Altman analysis showed systematically higher scores using the multiple-choice Mini Mental State Examination. Administration of the multiple-choice Mini Mental State Examination to ICU patients was straightforward and produced exploitable results comparable to those of the standard Mini Mental State Examination. It should be of interest for the assessment and monitoring of the neurocognitive
G Jonsson; M Y H Moosa; F Y Jeenah
Aim. The aim of the study was to determine knowledge, attitudes and personal beliefs regarding HIV and AIDS in a group of mentally ill patients attending outpatient clinics in Soweto, Johannesburg. Method. All patients attending four randomly chosen clinics in Soweto were invited to complete a self-administered questionnaire after obtaining informed written consent. The 63-item questionnaire, developed from others specifically for this study, included questions on socio-demographic and c...
Chac?n, Fernando; Mora, Fernando; Gerv?s-R?os, Alicia; Gilaberte, Inmaculada
Abstract Awareness of the importance of maintaining physical health for patients with severe mental illnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbi...
Full Text Available Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from psychoanalysis and the old, holistic tradition of Hippocratic medicine. Holistic medicine during the last decade has developed its philosophical positions and is today an independent, medical system seemingly capable of curing mentally ill patients at the cost of a few thousand Euros with no side effects and with lasting value for the patient. The problem is that very few studies have tested the effect of holistic medicine on mentally ill patients. Another problem is that the effect of holistic medicine must be documented in a way that respects this school's philosophical integrity, allowing for subjective assessment of patient benefit and using the patient as his/her own control, as placebo control cannot be used in placebo-only treatment. As the existing data are strongly in favor of using holistic medicine, which seems to be safer, more efficient, and cheaper, it is recommended that clinical holistic medicine also be used as treatment for mental illness. More research and funding is needed to develop scientific holistic medicine.
Ventegodt, Søren; Kandel, Isack; Merrick, Joav
Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from psychoanalysis and the old, holistic tradition of Hippocratic medicine. Holistic medicine during the last decade has developed its philosophical positions and is today an independent, medical system seemingly capable of curing mentally ill patients at the cost of a few thousand Euros with no side effects and with lasting value for the patient. The problem is that very few studies have tested the effect of holistic medicine on mentally ill patients. Another problem is that the effect of holistic medicine must be documented in a way that respects this school's philosophical integrity, allowing for subjective assessment of patient benefit and using the patient as his/her own control, as placebo control cannot be used in placebo-only treatment. As the existing data are strongly in favor of using holistic medicine, which seems to be safer, more efficient, and cheaper, it is recommended that clinical holistic medicine also be used as treatment for mental illness. More research and funding is needed to develop scientific holistic medicine.
Aug 3, 2017 ... Objective: To explore the different attitudes and beliefs amongst relatives of patients having schizophrenia ... across racial and socioeconomic factors. ... the beliefs about schizophrenia, also among health .... Schizophrenic people should not be living with people and spend money like other family members.
Kreyenbuhl, Julie; Leith, Jaclyn; Medoff, Deborah R.; Fang, LiJuan; Dickerson, Faith B.; Brown, Clayton H.; Goldberg, Richard W.; Potts, Wendy; Dixon, Lisa B.
Inadequate self-management of chronic medical conditions like Type 2 diabetes may play a role in the poor health status of individuals with serious mental illnesses. We compared adherence to hypoglycemic medications and blood glucose control between 44 diabetes patients with a serious mental illness and 30 patients without a psychiatric illness. The two groups did not differ in their ability to manage a complex medication regimen as assessed by a performance-based measure of medication management capacity. However, significantly fewer patients with a mental illness self-reported nonadherence to their hypoglycemic regimens compared to those without a mental illness. Although individuals with mental illnesses also had better control of blood glucose, this metabolic parameter was not correlated with adherence to hypoglycemic medications in either patient group. The experience of managing a chronic mental illness may confer advantages to individuals with serious mental illnesses in the self-care of co-occurring medical conditions like Type 2 diabetes. PMID:21459458
Overton, Stacy L.; Medina, Sondra L.
Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…
Frati, Paola; Gulino, Matteo; Mancarella, Paola; Cecchi, Rossana; Ferracuti, Stefano
A year after Mario Monicelli's suicide, the death of another famous person in Italy, Lucio Magri, reawakened the Italian debate on social, ethical and juridical issues in end-of-life decisions. Unlike Monicelli, Lucio Magri decided to end his own life in Switzerland with the help of a physician because his mental illness rendered his life unbearable. Both Monicelli and Magri suffered from a severe depression. The authors analyze the ethical issues regarding the right to die for mentally ill patients and neurological disabled patients, discussing the decision-making autonomy in persons suffering from severe depression. The role of the psychiatry in the management of end-of-life decision requests is considered along with pros and cons of suicide prevention and rationale suicide. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Larsen, Jens I; Andersen, Ulla A; Becker, Thomas
Objective: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...... 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...... 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.Results:Incidence rate ratios were increased for both CVD, DM and overweight in both F2 and F3 in all cultures (Western...
Ajak Manguak Agau
Full Text Available Background: Schizophrenia is a mental disease with inability to differentiate real from unreal. In many African cultures a traditional view on mental disease results in stigma, negative attitudes, and ignorance of the patient and their symptoms. Objective: To explore the different attitudes and beliefs amongst relatives of patients having schizophrenia. Method: Cross-sectional survey among relatives of patients with schizophrenia treated at Butabika Mental Hospital, Kampala, Uganda. Results: A total of 44 were included. 30% believed schizophrenia to be a brain disease, 32% thought the cause was supernatural. The majority (80% thought that schizophrenia can be treated and preferably in hospitals (91%; 66% felt the best way to reduce schizophrenia was to pray to God, and many stated that being with the patients (73% or letting them be part of the community (80% was good ways of helping the patients. Conclusion: Beliefs about supernatural causes of schizophrenia and stigmatizing are still present in Uganda. However among participants many had positive attitude towards letting the patients be part of community. Education of the communities could be a way of improving the awareness of mental disorders and the role that the community play in recovery from mental illness.
Ventriglio, Antonio; Borelli, Albacenzina; Bellomo, Antonello; Lepore, Alberto
PurposeThis epidemiologic study tested an hypothesized association between the year of birth of persons with major mental illnesses and solar activity over the past century. MethodsWe collected data on diagnoses and birthdates of psychiatric patients born between 1926 and 1975 (N = 1954) in south Italy for comparison to yearly solar activity as registered by the International Observatories. ResultsWe found a strong inverse correlation between high solar activity (HSA) and incidence of schizophrenia and bipolar disorder in a 20-year period whereas the incidence of non-affective/non-psychotic disorders was moderately associated with HSA in the same period. ConclusionsInterpretation of the observed correlations between HSA during years of birth and the incidence of mental illnesses remains unclear, but the findings encourage further study.
Lin, Susan Y
Literature about experiences of mental illness among ethnic minority has tended to focus on first-generation migrants. This study fills that gap by exploring experiences among highly acculturated Chinese-American patients with mental illness. Twenty-nine participants completed semi-structured interviews based on Kleinman's explanatory model, which were audio-taped, transcribed and coded for qualitative analysis. Beliefs about the causes of mental illness included biological factors, head trauma and personal losses. Issues relating to stigma and shame were also discussed. Highly acculturated ethnic minority patients may ascribe to a biomedical model at the same time as ascribing to culture-specific beliefs.
Kim, Woo Jung; Song, Youn Joo; Ryu, Hyun-Sook; Ryu, Vin; Kim, Jae Min; Ha, Ra Yeon; Lee, Su Jin; Namkoong, Kee; Ha, Kyooseob; Cho, Hyun-Sang
We aimed to examine internalized stigma of patients with mental illness in Korea and identify the contributing factors to internalized stigma among socio-demographic, clinical, and psychosocial variables using a cross-sectional study design. A total of 160 patients were recruited from a university mental hospital. We collected socio-demographic data, clinical variables and administered self-report scales to measure internalized stigma and levels of self-esteem, hopelessness, social support, and social conflict. Internalized stigma was identified in 8.1% of patients in our sample. High internalized stigma was independently predicted by low self-esteem, high hopelessness, and high social conflict among the psychosocial variables. Our finding suggests that simple psychoeducation only for insight gaining cannot improve internalized stigma. To manage internalized stigma in mentally ill patients, it is needed to promote hope and self-esteem. We also suggest that a relevant psychosocial intervention, such as developing coping skills for social conflict with family, can help patients overcome their internalized stigma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Arat, Seher; Verschueren, Patrick; De Langhe, Ellen; Smith, Vanessa; Vanthuyne, Marie; Diya, Luwis; Van den Heede, Koen; Blockmans, Daniel; De Keyser, Filip; Houssiau, Frédéric A; Westhovens, René
The aim of the present study was to evaluate the association between illness perceptions and the ability to cope with physical and mental health problems in a large cohort of systemic sclerosis (SSc) patients. This was a cross-sectional study in 217 systemic sclerosis patients from the Belgian Systemic Sclerosis Cohort. Illness perception and coping were measured by the Revised Illness Perception Questionnaire and a coping questionnaire--the Coping Orientation of Problem Experience inventory (COPE). Physical and mental health-related quality of life was measured by the 36-item short-form health survey (SF-36), as were disease activity and several severity parameters. The relationship between illness perceptions and the ability to cope with physical/mental health problems was examined using multiple linear regression analysis. According to LeRoy's classification, 49 patients had limited SSc (lSSc), 129 had limited cutaneous SSc (lcSSc) and 39 had diffuse cutaneous SSc (dcSSc). Median disease duration was five years and the modified Rodnan skin score was 4. Good physical health was significantly associated with the lcSSc subtype and low disease activity (p consequences' and strong 'illness identity' correlated with poor physical health (p mental health was associated with low illness identity scores and low 'emotional response' scores (p mental health compared with the illness perception items. Illness representations contribute more than classical disease characteristics to physical and mental health. Copyright © 2011 John Wiley & Sons, Ltd.
Shelby, Sarah R; Labott, Susan; Stout, Rebecca A
Although bariatric surgery has become a recognized treatment for obesity, its utility among patients with severe psychiatric disorders has not been extensively studied. A few studies have reported similar weight loss outcomes in these patients, but psychiatric status after bariatric surgery has been studied only minimally, and it is unknown if exacerbation of the mental illness affects weight loss. The aim of this study was to shed greater light on the issue of serious mental illness and bariatric surgery. Specifically, do patients with a diagnosis of schizophrenia, bipolar I, and bipolar II have poorer weight loss outcomes postbariatric surgery than the general bariatric surgery population? Also, do patients with these diagnoses experience an exacerbation of psychiatric symptoms after bariatric surgery, and if so, is the exacerbation of these disorders linked to poorer weight loss results? Midwest university medical center. A medical record review of approximately 1500 bariatric patients in a Midwest university medical center was conducted to identify those patients with diagnoses of schizophrenia, bipolar I, and bipolar II. Information was gathered on bariatric surgery outcomes and changes in psychiatric status postsurgery. Eighteen patients were identified as undergoing bariatric surgery and having a diagnosis of schizophrenia, bipolar I, or bipolar II. Weight loss in this group was significant and comparable to expected outcomes of absolute weight lost, changes in body mass index, and percentage excess weight loss for patients in the typical bariatric population. Postsurgery psychiatric status was known on 10 patients. All 10 patients experienced some exacerbation of psychiatric problems yet weight loss outcomes were still as expected. Bariatric surgery is a viable obesity treatment option for patients with schizophrenia, bipolar I, and bipolar II disorders. Symptom exacerbations occurred postsurgery, although it is not clear if these were due to the surgery or
Lindenmayer, Jean-Pierre; Khan, Anzalee; Wance, Deborah; Maccabee, Neta; Kaushik, Sashank; Kaushik, Saurabh
Obesity is increasing at an alarming rate in the United States, as is the obesity rate in patients with schizophrenia. Our study retrospectively evaluated the effectiveness of the Solutions for Wellness and Team Solutions programs, 2 structured educational patient programs, and evaluated the effects on obesity and other metabolic markers in a large, naturalistic inpatient sample. Between September 18, 2006, and September 15, 2007, 275 inpatients with DSM-IV-TR-diagnosed chronic mental illness admitted to a tertiary care psychiatric facility were included in the 36-week comprehensive and manualized educational program for healthy lifestyles for patients with chronic mental illness incorporating psychoeducational small-group curricula. Patients were tested before and after each of three 12-week group periods by 30 knowledge-assessment questions, and metabolic markers were recorded at baseline, midpoint, and endpoint. Of the 275 included inpatients, 50.5% completed more than 5 modules, 20.4% completed less than or equal to 2 or fewer modules, and 5.1% completed all 11 modules. Significant increases in scores were observed for 7 of the 11 modules in the knowledge assessments (P /=30 (indicating obesity) at the start of the program. There was a significant mean weight loss of 4.88 lb (P = .035) together with a significant decrease in mean BMI (P = .045). Patients with diabetes showed a reduction in mean weight of 5.98 lb. Significant reductions were observed in glucose and triglyceride levels (both P values (r = 0.56, P = .001). We found that a structured wellness program using a psychoeducational curriculum can be successfully implemented in a large, naturalistic psychiatric setting with unselected, chronically mentally ill inpatients. Results may help both clinicians and hospital managers to implement similar programs or to include successful components in existing programs for psychiatric patients. Copyright 2009 Physicians Postgraduate Press, Inc.
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.
Full Text Available In many health conditions, stigma is receiving increasing attention. Public stigmatization toward mental illness can affect particularly the patients and family memberships to help seeking behavior and treatment. These stigmatized persons in the society are deprived of rights and benefits. In this paper, reasons and consequences of stigma associated with mental illness are reviewed and combat against mental illnesses originated stigma are discussed. [TAF Prev Med Bull 2010; 9(1.000: 71-78
Koenders, Jitske F; de Mooij, Liselotte D; Dekker, Jack M; Kikkert, Martijn
Research suggests that patients with a severe mental illness (SMI) are among the most social excluded in society. However, comparisons of social network composition and relationship satisfaction between SMI patients and a control group are rare. Our aim was to compare differences in size, satisfaction and composition of the social network between patients with SMI and a control group. Potential sociodemographic and clinical risk factors in relation to social network size in SMI patients were explored. The sample consisted of a control group ( N = 949) and SMI patients ( N = 211) who were under treatment in Dutch mental health care institutions. In these groups, network size, relationship satisfaction, sociodemographic and clinical (patients only) characteristics were assessed. Social network size was 2.5 times lower in SMI patients, which was also reflected in a lower relationship satisfaction. The composition of the social network of SMI patients differs from that of controls: patients' network seems to consist of a smaller part of friends. Different risk factors were associated with the impoverishment of the social network of family, friends and acquaintances of patients with SMI. SMI patients have very small networks compared to controls. This may be a problem, given the ongoing emphasis on outpatient treatment of SMI patients and self-dependence. This outcome advocates for more attention to social isolation of SMI patients and involvement of family in the treatment and aftercare of SMI patients.
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.
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)
Full Text Available Abstract Background The risk of cardiovascular disease is increased in patients with severe mental illness (SMI dramatically reducing life expectancy. Method A real world pragmatic service evaluation of a Well-Being Support Program (WSP was conducted. This was a four-session package delivered over a one-year period by mental health practitioners that had received additional training in providing physical health assessment and intervention. Patients' physical health was screened and appropriate one-to-one and group intervention was offered. Results 212 mental health practitioners were trained in the WSP and 782 patients were enrolled on the program. The majority of our sample was overweight or obese; 66% had a Body Mass Index (BMI >25. Lifestyle risk factors for cardiovascular disease (CVD were common and the patients had low self esteem. The average number of formally recorded well-being sessions attended was 2.10. Just under a quarter of those patients enrolled in the program completed. The only cardiovascular risk factor that significantly altered in patients that completed the program was BMI. The qualitative feedback about the program was largely positive. Conclusions The need to intervene to enhance the physical health of people with SMI is beyond doubt. Maintaining patient engagement in a physical health improvement program is challenging. Regular comprehensive physical health monitoring is necessary to establish the benefit of intervention and increase life expectancy and well-being in this population.
Groenier Klaas H
Full Text Available Abstract Background Patients with severe mental illness (SMI experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. Methods A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. Results 186 general practitioners distributed over urban areas (49%, urbanised rural areas (38% and rural areas (15% of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices. GPs also saw their role as giving support and information to the patient's family. However, they felt a need for recognition of their competencies when working with mental health care specialists. Conclusion GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.
Oud, Marian J T; Schuling, Jan; Slooff, Cees J; Groenier, Klaas H; Dekker, Janny H; Meyboom-de Jong, Betty
Patients with severe mental illness (SMI) experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. 186 general practitioners distributed over urban areas (49%), urbanised rural areas (38%) and rural areas (15%) of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices.GPs also saw their role as giving support and information to the patient's family.However, they felt a need for recognition of their competencies when working with mental health care specialists. GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.
Full Text Available Older patients with comorbid mental illness are shown to receive less appropriate care for their medical conditions. This study analyzed Medicare patients hospitalized for acute myocardial infarction (AMI and determined whether those with comorbid mental illness were more likely to present to hospitals with lower quality of AMI care.Retrospective analyses of Medicare claims in 2008. Hospital quality was measured using the five "Hospital Compare" process indicators (aspirin at admission/discharge, beta-blocker at admission/discharge, and angiotension-converting enzyme inhibitor or angiotension receptor blocker for left ventricular dysfunction. Multinomial logit model determined the association of mental illness with admission to low-quality hospitals (rank of the composite process score 90(th percentile, compared to admissions to other hospitals with medium quality. Multivariate analyses further determined the effects of hospital type and mental diagnosis on outcomes.Among all AMI admissions to 2,845 hospitals, 41,044 out of 287,881 patients were diagnosed with mental illness. Mental illness predicted a higher likelihood of admission to low-quality hospitals (unadjusted rate 2.9% vs. 2.0%; adjusted odds ratio [OR]1.25, 95% confidence interval [CI] 1.17-1.34, p<0.01, and an equal likelihood to high-quality hospitals (unadjusted rate 9.8% vs. 10.3%; adjusted OR 0.97, 95% CI 0.93-1.01, p = 0.11. Both lower hospital quality and mental diagnosis predicted higher rates of 30-day readmission, 30-day mortality, and 1-year mortality.Among Medicare myocardial infarction patients, comorbid mental illness was associated with an increased risk for admission to lower-quality hospitals. Both lower hospital quality and mental illness predicted worse post-AMI outcomes.
Helu-Brown, Paula; Aranda, Maria
The sexual health and behavior and the intimate relationships of patients diagnosed with a serious mental illness (SMI) have been described as ongoing and often ignored concerns in mental health treatment. Evidence-based psychosocial interventions have emerged as effective complimentary approaches to address symptoms of SMI in conjunction with psychopharmacology, yet rarely do they address sexual concerns in a targeted manner. This systematic review explores the scope and efficacy of psychosocial interventions designed to address sexual health and behavior and intimate relationship concerns in patients with SMI. The search was conducted in four targeted databases and identified 967 articles with four of those meeting inclusion criteria for this review. The data extracted included setting, study sample, study design, outcome measures, data analysis, and results. The measures utilized in the studies assess mental and sexual health-related outcomes. All four studies reported an improvement in sexual and mental health outcomes. Given the lack of psychosocial approaches and culturally sensitive adaptations, this review highlights a gap in literature that should be addressed, particularly emphasizing their combined treatment with psychotropic medication and efficacy testing with diverse populations. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
The strange behavior of emperor Gaius has been the subject of debate for many historians. Some charge him with madness and attribute it to his illness in A.D. 37, whereas others believe it occurred later, or else had nothing to do with his sickness.We have no real evidence to reconstruct his mental state. Therefore speculations about madness are fruitless, as they can't be proven. Also, his madness belongs to a discourse which originates mainly from the senatorial narrative that sought to discredit him through any means possible. Thus, his acts should be seen from other angles, and the search for "mad Caligula" abandoned.
Full Text Available Introduction: Family members often play a vital role as caregivers in the lives of individuals with schizophrenia. Results of the studies showed that family invironment is the most important determinint of patients outcomes like as quality of life, relapse, adherence. This study aimed to determine the effect of group psychoeducational programme on attitude towards mental illness in families of patients with schizophrenia. Methods: In this quasi-experimental study, 74 families who have schizophrenic patients hospitalized in psychiatric wards during sampling were selected by convenience sampling method. Then the sample was randomly assigned to experimental and control groups. The families of experimental group received 8 continuous 90-minute 3 times a week psychoeducational sessions. Family attitude towards mental illness was measured using the questionnaire of Opinion about Mental Illnesses (OMI before and after intervention. Data analysis was conducted using 2 test, independent t-test, and paired t-test on SPSS software version 13. Results: The results showed that majority of the families had negative attitude towards mental illness (88.90%. In addition, the results showed that there was significant difference between different dimensions of attitude towards mental illness before and after psychoeducation in the experimental group. The mean score of families' post-test in the experimental group increased compared to control group 108.86 (14.9, vs. 88.86 (7.5. Conclusion: The results of this study indicate that psychoeducation improves family attitude towards mental illness. Training methods like group psych education for the families of mental patients can be effective on their attitudes towards mental illness.
Rezakhani Moghaddam, Hamed; Nadrian, Haidar; Abbagolizadeh, Nategh; Babazadeh, Towhid; Aghemiri, Mehran; Fathipour, Asaad
Our aim in this cross-sectional study was to investigate mental health-ill health differences in disease severity and its sociodemographic biobehavioral predictors among patients with knee osteoarthritis (OA). Applying convenient sampling, 180 patients with knee OA in Tabriz, Iran, were recruited to participate in completing a three-section questionnaire (SF-12, Lequesne Algofunctional Index and Self-Management Behaviors Scale). Separate hierarchical multiple linear regressions were performed with OA severity as dependent variable: one for OA patients with positive mental health and other for OA patients with mental disorders symptoms. Among the patients with positive mental health, but not those with symptoms of mental disorder, pain management, duration of OA, physical activity management, living alone, and level of education were significant predictors of disease severity. Health care providers with a better understanding on the determinants of disease severity by mental health status may identify vulnerable patients and develop targeted interventions to foster disease management behaviors among OA patients.
Vasudev, Kamini; Thakkar, Pratish B; Mitcheson, Nicola
Patients with severe mental illness (SMI) treated with antipsychotic medication are at increased risk of metabolic side-effects like weight gain, diabetes mellitus and dyslipidaemia. This study aims to examine the feasibility of maintaining a physical health monitoring sheet in patients' records and its impact on physical health of patients with SMI, over a period of one year. A physical health monitoring sheet was introduced in all the patients' records on a 15-bedded male medium secure forensic psychiatric rehabilitation unit, as a prompt to regularly monitor physical health parameters. An audit cycle was completed over a one year period. The data between baseline and re-audit were compared. At baseline, 80 per cent of the patients were identified as smokers, 80 per cent had increased body mass index (BMI) and 87 per cent had raised cardiovascular risk over the next ten years. Appropriate interventions were offered to address the risks. At re-audit, the physical health monitoring sheets were up to date in 100 per cent of patients' records. The serum lipids and cardiovascular risk over the next ten years reduced over time. No significant change was noted on the parameters including BMI, central obesity, high blood pressure and smoking status. This was a pilot study and was limited by the small sample size, male gender only and the specific nature of the ward. There is a need for improved access to physical health care in long-stay psychiatric settings. A more robust lifestyle modification programme is required to positively influence the physical health parameters in this cohort of patients. Introduction of a physical health monitoring sheet in patients' records led to regular screening of cardiovascular risks and subsequent increased prescribing of hypolipidaemic agents in individuals with severe mental illness.
Göhner, Wiebke; Dietsche, Christine; Fuchs, Reinhard
The objective of the study was to evaluate whether a motivational-volitional intervention program offered in addition to an existing sport program during stationary treatment is capable of establishing a post-stationary increase in physical activity in persons with mental illness. N=112 in-patients were initially randomly assigned to the control group (CG; standard rehabilitation) or intervention group (IG; standard rehabilitation plus intervention). Assessments were conducted at four measurement points. At 6 months follow up, the level of exercise in the IG was 95 min/week higher than in the CG (p=.02). The participants of the IG were able to increase their level of goal intention until 6 months follow up (t2: p=.03; t4: p=.005); levels of self-efficacy of the IG increased during intervention (t2: p=.001). Changes in volitional aspects were significant over time (t1-t3), but not specifically for the IG. The intervention was effective at increasing the level of physical activity in patients with mental illness who were initially minimally active. Our results suggest that it could be of great use to place the emphasis of a physical activity-enhancing intervention on its motivational effect since volitional aspects are already taken into sufficient account in standard rehabilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Bajor, Laura A; Gunzler, Douglas; Einstadter, Douglas; Thomas, Charles; McCormick, Richard; Perzynski, Adam T; Kanuch, Stephanie W; Cassidy, Kristin A; Dawson, Neal V; Sajatovic, Martha
While previous work has demonstrated elevation of both comorbid anxiety disorders and diabetes mellitus type II in individuals with serious mental illness, little is known regarding the impact of comorbid anxiety on diabetes mellitus type II outcomes in serious mental illness populations. We analyzed baseline data from patients with serious mental illness and diabetes mellitus type II to examine relationships between comorbid anxiety, glucose control as measured by hemoglobin A1c score, and overall illness burden. Using baseline data from an ongoing prospective treatment study involving 157 individuals with serious mental illness and diabetes mellitus type II, we compared individuals with and without a comorbid anxiety disorder and compared hemoglobin A1c levels between these groups to assess the relationship between anxiety and management of diabetes mellitus type II. We conducted a similar analysis using cumulative number of anxiety diagnoses as a proxy for anxiety load. Finally, we searched for associations between anxiety and overall medical illness burden as measured by Charlson score. Anxiety disorders were seen in 33.1% (N=52) of individuals with serious mental illness and diabetes mellitus type II and were associated with increased severity of depressive symptoms and decreased function. Hemoglobin A1c levels were not significantly different in those with or without anxiety, and having multiple anxiety disorders was not associated with differences in diabetes mellitus type II control. However, depressive symptoms were significantly associated with higher hemoglobin A1c levels. Neither comorbid anxiety nor anxiety load was significantly associated with overall medical burden. One in three people with serious mental illness and diabetes mellitus type II had anxiety. Depressive symptoms were significantly associated with Hb1Ac levels while anxiety symptoms had no relation to hemoglobin A1c; this is consistent with previously published work. More studies are
Full Text Available Aim. The aim of the study was to determine knowledge, attitudes and personal beliefs regarding HIV and AIDS in a group of mentally ill patients attending outpatient clinics in Soweto, Johannesburg. Method. All patients attending four randomly chosen clinics in Soweto were invited to complete a self-administered questionnaire after obtaining informed written consent. The 63-item questionnaire, developed from others specifically for this study, included questions on socio-demographic and clinical characteristics; knowledge on how HIV is acquired and spread; attitudes and beliefs regarding HIV and AIDS; and condom usage. The statements in the knowledge sections were used to calculate a composite score, which if greater than or equal to 75% was defined as ‘adequate knowledge’. Results. A total of 1 151 patients with mental illness participated in the study. The mean age was 41.9 years (standard deviation 11.6 and the majority were males (50%; single (55%, and had achieved only a secondary level of education (53.3%. Overall, most of the study population did not believe in the myths surrounding the spread and acquisition of HIV and AIDS. There were however, significant associations between a low level of education and the belief that HIV is acquired from mosquito bites (odds ratio (OR 1.61; 95% CI 1.19 - 2.18; p=0.002 and through masturbation or body rubbing (OR 1.76; 95% CI 1.34 - 2.33; p=0.000. Although more than 90% of the patients were aware of the facts regarding the spread of HIV, approximately 40% did not believe that one could acquire HIV through a single sexual encounter. The composite scoring for knowledge showed that less than half the patients had adequate knowledge of HIV/AIDS. This was significantly associated with gender and level of education: females were 1.6 times (p
Jochems, Eline C; van Dam, Arno; Duivenvoorden, Hugo J; Scheffer, Sylvia C M; van der Feltz-Cornelis, Christina M; Mulder, Niels L
The present study assessed motivation for engaging in treatment as rated by clinicians (n = 57) and patients with severe mental illness (SMI, n = 294) using measures based on three different motivation theories. Questionnaires were derived from self-determination theory, the transtheoretical model and the integral model of treatment motivation. It was investigated to which extent clinicians of patients with SMI were able to estimate their patient's perspective on motivation for engaging in treatment, to which extent they agreed on the patient's motivation and which factors were associated with estimation and agreement on treatment motivation. It was found that clinicians were poorly to moderately capable of estimating their patient's type of motivation and readiness for change. Further, agreement on the level of motivation between patients and clinicians was moderate. These findings were consistent across diagnostic groups (psychotic and personality disorders). A higher quality therapeutic relationship was generally associated with higher clinician-rated motivation. The patient's ethnicity and socially desirable responding were factors that differentiated between scales of different motivation theories. It is concluded that patients with SMI and their clinicians have different perceptions on the patient's motivation for engaging in psychiatric treatment, regardless of the theoretical framework that is used to measure motivation. The findings imply that a negotiated approach is needed where both perceptions of clinicians and patients on motivation for treatment are considered to ensure effective mental health interventions. Copyright © 2015 John Wiley & Sons, Ltd. Clinicians show poor to moderate capability in estimating how patients perceive their motivation for engaging in treatment, especially so when the patient's motives revolve around feelings of shame and guilt. Clinicians generally give higher motivation ratings for patients where they experience a
Bressington, Daniel T; Mui, Jolene; Cheung, Eric F C; Petch, Joel; Clark, Allan B; Gray, Richard
Background: Patients with severe mental illness are at increased risk of developing metabolic disorders. The risk of metabolic syndrome in the Hong Kong general population is lower than that observed in western countries; however the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong is unknown. Method: This cross-sectional study aimed to estimate the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong and to identify the rela...
Dornan, Julieanne; Kennedy, Miriam; Garland, Jackie; Rutledge, Emer; Kennedy, Harry G
Decision making ability can change with time, depending on mental or physical health. Little is known about the factors that determine this change and the relationship of capacity to time. As a pilot for studies using functional mental capacities as an outcome measure, we sought to quantify this relationship measuring change over time using competence assessment tools, and rating scales for symptoms and global function. We assessed 37 inpatients in a secure psychiatric hospital. All patients met the diagnostic and statistical manual of mental disorders-fourth edition and International classification of diseases, 10th edition criteria for an Axis 1 mental illness, all with psychosis. Patients were interviewed twice a mean of 323 days apart (median 176 days range 17-1221 days). The MacArthur competence assessment tools for consent to treatment (MacCAT-T) and fitness to plead (MacCAT-FP) were used to quantify functional capacity along with the Positive and Negative Syndrome Scale (PANSS) and global assessment of function (GAF) scale. A comparison was also made between those patients prescribed clozapine in comparison to other antipsychotics. The number judged by treating psychiatrists to lack capacity either to make a treatment choice or to plead in court fell from 35 to 8%. Change was greatest for those admitted within the previous 9 months. The measures of capacity improved between time 1 and time 2 for both consent to treatment and fitness to plead. The measures of capacity improved with positive symptoms within the PANSS and with GAF scores. Those with shorter lengths of stay at baseline had the greatest improvements in the MacCAT-FP scores. Effect sizes were medium or large (0.3-0.7+). As expected, patients prescribed clozapine had larger changes in functional mental capacities and larger effect sizes than those prescribed other psychotropics. The results show a strong relationship between the clinicians' assessment of capacity and structured rating scales. We
Kluit, M.J. van der; Goossens, P.J.J.
An estimated 40% of patients in general health care settings suffer from a comorbid mental illness. A literature review was conducted to elucidate the factors underlying the different attitudes of nurses in general health care toward the nursing care of these patients. Although lack of knowledge,
Steele, Leah S; Durbin, Anna; Sibley, Lyn M; Glazier, Richard
In Ontario, Canada, the patient-centred medical home is a model of primary care delivery that includes 3 model types of interest for this study: enhanced fee-for-service, blended capitation, and team-based blended capitation. All 3 models involve rostering of patients and have similar practice requirements but differ in method of physician reimbursement, with the blended capitation models incorporating adjustments for age and sex, but not case mix, of rostered patients. We evaluated the extent to which persons with mental illness were included in physicians' total practices (as rostered and non-rostered patients) and were included on physicians' rosters across types of medical homes in Ontario. Using population-based administrative data, we considered 3 groups of patients: those with psychotic or bipolar diagnoses, those with other mental health diagnoses, and those with no mental health diagnoses. We modelled the prevalence of mental health diagnoses and the proportion of patients with such diagnoses who were rostered across the 3 medical home model types, controlling for demographic characteristics and case mix. Compared with enhanced fee-for-service practices, and relative to patients without mental illness, the proportions of patients with psychosis or bipolar disorders were not different in blended capitation and team-based blended capitation practices (rate ratio [RR] 0.91, 95% confidence interval [CI] 0.82-1.01; RR 1.06, 95% CI 0.96-1.17, respectively). However, there were fewer patients with other mental illnesses (RR 0.94, 95% CI 0.90-0.99; RR 0.89, 95% CI 0.85-0.94, respectively). Compared with expected proportions, practices based on both capitation models were significantly less likely than enhanced fee-for-service practices to roster patients with psychosis or bipolar disorders (for blended capitation, RR 0.92, 95% CI 0.90-0.93; for team-based capitation, RR 0.92, 95% CI 0.88-0.93) and also patients with other mental illnesses (for blended capitation
There is a high prevalence of mental disorders in the community population of older adults, especially in medical treatment facilities. Therefore, clinicians who treat geriatric patients cannot neglect the psychiatric vulnerability of the elderly population. The fragility of psychological functioning of the elderly is caused not only by psychological contributors, such as various kinds of experiences of loss, but also by biological factors such as decreases in neurotransmitters and in the number of neurons. Another point geriatric clinicians should pay attention to is the powerful mind-body connection in the elderly. Recent psychoneuroimmunological research demonstrates that depression or other types of emotional stress damages the immune system, which can induce some physical diseases. This is especially true for the elderly, who have weakened cell-mediated immune function and are more susceptible to influence by the damaged immune function caused by such psychiatric dysfunction. Also, depression in the elderly can often lead to malnutrition or dehydration, which can induce various kinds of physical illness. On the other hand, physical illness in the elderly can induce depression, because of the psychological vulnerability of the elderly. Due to the strong mind-body connection in the elderly, the availability of psychiatric care is essential. When providing psychiatric care for the elderly, the clinician should attend to all symptoms, not minimizing the importance of biological treatment, while also trying to support the elderly patients psychologically through acceptance of their need for interdependency and respect for their narcissism.
Mario A Brondani
Full Text Available To explore the ways in which stigma is experienced in healthcare and dental settings by patients with a history of addiction and mental illness.Audio-recorded, semi-structured interviews with a purposefully selected convenience sample of residents from two community treatment centres in Vancouver, Canada were conducted. The interview guide contained questions about experiences while seeking health and dental care and was based on an existing framework of labeling, stereotyping, exclusion, discrimination, and power imbalance. Interviews were transcribed verbatim for coding and thematic analysis.Twenty-five participants between 23 and 67 years of age were interviewed; 17 were males. Most had a self-reported history of depression combined with use of alcohol and crack-cocaine; most of them only sought dental care for emergency purposes. Textual analysis of more than 300 pages of transcribed interviews revealed that participants perceived stigma when they were negatively stereotyped as 'unworthy', labeled as 'different', excluded from the decision-making process, discriminated against, 'treated unfairly', and felt powerless when interacting in the heath and dental care systems. Conversely, positive experiences were characterized by empathy, reassurance and good communication, which were empowering for patients.When associated with stigma, mental illness and addictions have negative implications for accessing health and dental care. From our participants' perspectives, it seems that the lack of understanding about their life conditions by the healthcare professionals was the origin of stigma. We suggest that an increased social awareness of these health issues be enhanced among current and future health and dental care professionals to help improve care experiences for this marginalized population.
Full Text Available People with serious mental illness (SMI have a higher incidence of type 2 diabetes mellitus (T2DM and shorter life span due to medical health problems. The chronic care model (CCM has been used to improve care of patients with T2DM. One clinical organization that provided primary care to patients with SMI had excellent diabetes outcomes but did not have information on how they achieved those outcomes. Thus, we conducted a pilot study chart review for 30 patients with T2DM and SMI to determine how well the clinic’s system aligned with the overall CCM components and which components correlated with diabetes control. We also evaluated use of the CCM using the Assessment of Chronic Illness Care provider survey. Results showed that the clinic had an overall basic implementation level of the CCM, which allows opportunity for improvement. Two elements of the CCM were correlated with hemoglobin A 1C and both were in an unexpected direction: self-management support in the variable of percentage of visits that included patient-specific goal-setting ( r s = .52; P = .004 and delivery system design in the variable of number of nurse practitioner visits per study period ( r s = .43; P = .02. These findings suggest that the clinic may have made more concentrated efforts to manage diabetes for patients who were not in good diabetes control. Providers noted the influence of SMI and social service organization support on these patients’ clinical outcomes. The findings will be reexamined after a fuller implementation of the CCM to further improve management in this population.
Whenever partial knowledge is considered absolute and turned into ideological and dogmatic conceptions, the risk increases that the conditions for the people involved might become dangerous. This will be illustrated by casuistic examples of consequences of one-sided psychiatric conceptions such as social, biological, and psychological ideas about the treatment and care of the mentally ill. Present perspectives of an integrative model, i.e., an advanced bio-psycho-social conception about evidence-based characteristics on the social, psychological, and molecular-genetic level, require that all of these dimensions should be considered in order to personalize and thereby improve the care and treatment of the mentally ill.
van Hasselt, Fenneke M.; Oud, Marian J. T.; Loonen, Anton J. M.
Background: Patients with severe mental illness (SMI) experience more physical comorbidity than the general population. Multiple factors, including inadequate seeking of healthcare and health care related factors such as lack of collaboration, underlie this undesirable situation. To improve this
de Mooij, Liselotte D; Kikkert, Martijn; Lommerse, Nick M; Theunissen, Jan; de Koning, Mariken B; de Haan, Lieuwe; Beekman, Aartjan T F; Duurkoop, Pim W R A; Dekker, Jack J M
Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. This study describes patterns of changes in the residential and care settings of SMI patients and explores associations between these changes, sociodemographics, and clinical characteristics. From January 2006 to January 2012, all data relating to changes in residential and/or care setting by SMI patients (N = 262) were collected from electronic case files. Data covering psychopathology, substance use, and medication adherence were assessed in 2006. There were more changes in the residential than in the care setting. In 6 years, only 22% of our sample did not move, 23% changed residence once, 19% twice, 10% three times, and 26% four or more times. Substance use predicted changes of care and/or residential setting and rehospitalisation. The severity of negative symptoms predicted rehospitalisation and duration of hospitalisation. Disorganisation symptoms predicted the duration of hospitalisation. A majority of patients with SMI changed residential and/or care settings several times in 6 years. Patients with substance use or severe negative and disorganisation symptoms may need more intensive and customised treatment. Further research is needed to investigate prevention programmes for highly-frequent movers.
Fernández-Mondragón, Susana; Adan, Ana
Dual diagnosis (DD) is the coexistence of a substance use disorder (SUD) and severe mental illness (SMI). The aim of this study is to determine for the first time if a specific personality pattern exists for DD patients compared to those who only have SUD or SMI. The sample was composed of 102 male, 34 patients in each group (DD, SUD and SMI). DD and SMI groups included 20 schizophrenic and 14 depressed patients respectively. Cloninger's TCI-R was administered together with a structured interview of sociodemographic and clinical characteristics. All the temperament dimensions and Self-directedness provided differences among groups. The DD and SUD showed significant higher scores in Novelty Seeking regarding SMI, whereas for Harm Avoidance the SUD subjects scored lower with respect to the DD and SMI group. Persistence was significant lower for the DD and SMI groups compared to the SUD patients. The DD obtained low significant scores in Reward Dependence in relation to the SUD and Self-directedness in relation to the SUD and SMI. Our data highlight the presence of a different personality profiles among DD, SUD and SMI disorders. Taking into account the patients' personality can benefit the clinical course and minimize the DD impact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available The present review seeks to identify and analyze qualitative studies that examined experiences of children whose parents have a mental illness. This study reported that children whose parents have a mental illness had some common experiences. These experiences may have negative effects on children’s coping skills, resilience to tough living conditions and ability to maintain their mental health. In spite of these negative conditions, some of these children have much more self-confidence, resilience and independence because of inner development and early maturation. Some effective intervention programs are needed to promote information to children and other family members about mental illness, coping behaviors. Availability of such psychiatric services and nation-wide programs with professionals to deal with these problems should be organized properly to increase quality of life of these children. Furthermore, qualitative researches that explore the experiences of children whose parents with mental illness should also be conducted in our country.
Vijayalakshmi, Poreddi; Reddemma, Konduru; Math, Suresh Bada
Individuals with mental illness commonly experience human rights violations while seeking to meet their basic needs. There is lack of research in developing countries on gender-related differences in human rights needs. This study investigated gender differences in perceived human rights needs at the family and community levels in individuals with mental illness in India. This descriptive study surveyed 100 asymptomatic individuals with mental illness at a tertiary care center. Subject selection employed a random sampling method. Data were collected using face-to-face interviews based on a structured needs assessment questionnaire. Data were analyzed and interpreted using descriptive and inferential statistics. Subjects enjoyed a satisfactory level of fulfillment in the physical dimension of human rights needs, which included food, housing, and clothing. Men expressed lower satisfaction than women with perceived human rights needs fulfillment in the emotional dimension. This included fear of family members (χ = 9.419, p human rights needs fulfillment in social and ethical dimensions. The former included freedom to leave the home (χ = 11.277, p human rights needs of people with mental illness and that legislation must be strengthened to meet the human rights needs of this disadvantaged population.
People suffering from mental illness are among the most disadvantaged groups in ... privacy and anti-discrimination law to protect people with disabilities. .... the imaginations of the young and explain that understanding the brain is the last ... because there has been so much bad teaching and inadequate treatment over the.
Full Text Available There is a surge of cardiovascular disease (CVD in Africa. CVD is the leading cause of mortality among patients with severe mental illness (SMI in developed countries, with little evidence from the African context.To determine the prevalence and risk factors for MetS among South African patients with SMI.In a cross sectional study, individuals with SMI treated with antipsychotics and a control group without a mental illness, matched for age, gender and ethnicity were evaluated for MetS using the 2009 Joint Interim statement (JIS criteria.Of the 276 study group subjects, 65.9% were male, 84.1% black African, 9.1% white, 5.4% of Indian descent and 1.5% coloured (mixed race with a mean age of 34.7 years (±12.5. Schizophrenia was the most common diagnosis (73.2% and 40% were taking first generation antipsychotics. The prevalence of MetS was 23.2% (M: 15.4%, F: 38.3% in the study group and 19.9% (M: 11.9%, F: 36.3% in the control group (p = 0.4. MetS prevalence was significantly higher in study subjects over 55 years compared to controls (p = 0.03. Increased waist circumference (p< 0.001 and low high density lipoprotein (HDL cholesterol (p = 0.003 were significantly more prevalent in study subjects compared to controls. In study subjects, risk factors associated with MetS included age (OR: 1.09, 95% CI 1.06-1.12, p < 0.001, female gender (OR: 2.19, 95% CI 1.06-4.55, p = 0.035 and Indian descent (OR: 5.84, 95% CI 1.66-20.52, p = 0.006 but not class of antipsychotic (p = 0.26.The overall MetS prevalence was not increased in patients with SMI compared to controls; however, the higher prevalence of the individual components (HDL cholesterol and waist circumference suggests an increased risk for CVD, especially in patients over 55 years.
Franz, Michael; Lujić, Claudia; Koch, Eckhardt; Wüsten, Bernd; Yürük, Nergüz; Gallhofer, Bernd
Knowledge about culture- and migration-specific characteristics of subjective illness beliefs in Turkish patients is necessary for adequate treatment. Analysis of subjective illness beliefs in Turkish patients (F3; F4; n = 79) in comparison to matched Germans (n = 79) using a modified version of the Illness Perception Questionnaire IPQ-R. Differences were explored by t-tests and chi(2)-tests. Turkish patients believed significantly stronger in a chronical timeline of illness and in negative illness consequences, while German patients believed significantly stronger in treatment control and personal control. Turkish patients more often mentioned external causes of their disease compared to Germans. The results provide explanations of the deficient health care situation for Turkish migrants in Germany.
Wan Kasim, Syarifah Hafizah; Midin, Marhani; Abu Bakar, Abdul Kadir; Sidi, Hatta; Nik Jaafar, Nik Ruzyanei; Das, Srijit
This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI). A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment. The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (phistory of working and getting a preferred job were significant predictors of successful employment. Copyright © 2014 Elsevier Inc. All rights reserved.
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)
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…
Freidl, M; Spitzl, S Piralic; Prause, W; Zimprich, F; Lehner-Baumgartner, Eva; Baumgartner, C; Aigner, M
The aim of this study was to survey the attitudes of 101 consecutive in- and out-patients with epileptic, dissociative or somatoform pain disorders (mean age: 43 [+/-11] years; 58% female) from either the Department of Psychiatry or Neurology toward anticipated mental illness stigma. The patients were administered a modified 12-item version of Links Stigma Questionnaire. Nearly 60% of all 101 patients believe that "most people" would not allow a mental patient "to take care of their children", "most young women" would be "reluctant to date a man" who has been treated for a mental illness and "most employers would pass over" the application of a psychiatric patient in favour of another applicant. Fifty five percent of the respondents assume that "most people think less of a person who has been in a mental hospital" and over a half of all patients interviewed assert that the general population thinks that psychiatric patients are "less intelligent, less trustworthy and that their opinion is taken less seriously by others". Gender, age and education had no influence on the overall results. There is a high stigmatisation concerning psychiatry even in patients with epilepsy and somatoform/dissociative symptoms with psychiatric comorbidity. Fear of being stigmatized is more pronounced among somatoform pain patients as compared to patients suffering from epileptic or dissocative disorders, with particular reference to close personal relationships.
Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie
Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.
Furimsky, Ivana; Cheung, Amy H; Dewa, Carolyn S; Zipursky, Robert B
Recruitment and retention of research participants is often the most labor-intensive and difficult component of clinical trials. Poor recruitment and retention frequently pose as a major barrier in the successful completion of clinical trials. In fact, many studies are prematurely terminated, or their findings questioned due to low recruitment and retention rates. The conduct of clinical trials involving youth with a first episode of mental illness comes with additional challenges in recruitment and retention including barriers associated with engagement and family involvement. To develop effective early interventions for first episode mental illness, it is necessary to develop strategies to enhance recruitment and retention in this patient population. This article presents the recruitment and retention challenges experienced in two clinical trials: one involving participants experiencing a first episode of depression and one involving participants experiencing a first episode psychosis. Challenges with recruitment and retention are identified and reviewed at both the patient level and clinician level. Strategies that were implemented to enhance recruitment and retention in these two studies are also discussed. Finally, ethical issues to consider when implementing these strategies are also highlighted.
Botha-Scheepers, S; Riyazi, N; Kroon, H M; Scharloo, M; Houwing-Duistermaat, J J; Slagboom, E; Rosendaal, F R; Breedveld, F C; Kloppenburg, M
Using the International Classification of Functioning, Disability and Health as framework, we evaluated modifying effects of illness perceptions and mental health on the association between impairments in body structures and functions due to osteoarthritis (OA) and limitation in activities in the lower extremities. Self-reported limitation in activities was assessed by the Western Ontario and McMaster Universities OA index (WOMAC) function subscale in 316 patients with knee or hip pain or evidence of OA on knee or hip radiographs. Body structures and functions were evaluated during clinical and radiological assessments. Illness perceptions and mental health were assessed with the revised Illness Perception Questionnaire (IPQ-R) and the mental component summary score of the RAND 36-item Health Survey, respectively. For each patient an expected WOMAC function score was calculated, using an equation based on a multivariate model of the association of body structures and functions with limitation in activities. The median (interquartile) self-reported WOMAC function score was 22.2 (9.6-43.5). Ninety-one patients reported more and 120 patients reported less limitation in activities than expected. Patients with lumbar spine degeneration, physical or exercise therapy and high IPQ-R identity, consequences and chronic timeline scores had an increased risk to report more limitation in activities than the expected range. Low IPQ-R identity, consequences and emotional representation scores and better mental health were associated with reporting less limitation in activities than the expected range. Illness perceptions and mental health modify the association between self-reported limitation in activities and calculated limitation in activities based on impairments in body structures and functions due to OA.
Stumbo, Scott P; Yarborough, Bobbi Jo H; Yarborough, Micah T; Green, Carla A
Individuals with mental illnesses have higher morbidity rates and reduced life expectancy compared to the general population. Understanding how patients and providers perceive the need for prevention, as well as the barriers and beliefs that may contribute to insufficient care, are important for improving service delivery tailored to this population. Cross-sectional; mixed methods. An integrated health system and a network of federally qualified health centers and safety net clinics. Interviews (n = 30) and surveys (n = 249) with primary care providers. Interviews (n = 158) and surveys (n = 160) with patients diagnosed with schizophrenia, bipolar, anxiety, or major depressive disorders. Semi-structured interviews and surveys. Thematic analysis for qualitative data; frequencies for quantitative data. More than half (n = 131, 53%) of clinicians believed patients with mental illnesses care less about preventive care than the general population, yet 88% (n = 139) of patients reported interest in improving health. Most providers (n = 216, 88%) lacked confidence that patients with mental illnesses would follow preventive recommendations; 82% (n = 129) of patients reported they would try to change lifestyles if their doctor recommended. Clinicians explained that their perception of patients' chaotic lives and lack of interest in preventive care contributed to their fatalistic attitudes on care delivery to this population. Clinicians and patients agreed on substantial need for additional support for behavior changes. Clinicians reported providing informational support by keeping messages simple; patients reported a desire for more detailed information on reasons to complete preventive care. Patients also detailed the need for assistive and tangible support to manage behavioral health changes. Our results suggest a few clinical changes could help patients complete preventive care recommendations and improve health behaviors: improving clinician-patient collaboration on
Full Text Available Whenever partial knowledge is considered absolute and turned into ideological and dogmatic conceptions, the risk increases that the conditions for the people involved might become dangerous. This will be illustrated by casuistic examples of consequences of one-sided psychiatric conceptions such as social, biological, and psychological ideas about the treatment and care of the mentally ill. Present perspectives of an integrative model, i.e. the bio-psycho-social conception about specific interactions between the social environment and individual characteristics on both the psychological and molecular-genetic level, require that all of these dimensions should be considered in order to personalize and thereby improve the care and treatment of the mentally ill.
Latalova, Klara; Kamaradova, Dana; Prasko, Jan
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 d...
Lucca, J M; Ramesh, M; Parthasarathi, G; Ram, D
In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients. A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD)-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). Of the 400 patients, 172 (43%) were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001), number of drugs (P = 0.002), family income (P = 0.013), and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32%) and disease-related factors (31%). The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.
J M Lucca
Full Text Available Background: In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients. Materials and Methods: A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS. Results: Of the 400 patients, 172 (43% were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001, number of drugs (P = 0.002, family income (P = 0.013, and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32% and disease-related factors (31%. Conclusion: The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.
... local university health centers for their psychiatry or psychology departments. You can also go to the website ... may face different mental health issues than the general public. For resources for both service members and ...
Haliko, Shannon; Downs, Julie; Mohan, Deepika; Arnold, Robert; Barnato, Amber E
Variation in the intensity of acute care treatment at the end of life is influenced more strongly by hospital and provider characteristics than patient preferences. We sought to describe physicians' mental models (i.e., thought processes) when encountering a simulated critically and terminally ill older patient, and to compare those models based on whether their treatment plan was patient preference-concordant or preference-discordant. Seventy-three hospital-based physicians from 3 academic medical centers engaged in a simulated patient encounter and completed a mental model interview while watching the video recording of their encounter. We used an "expert" model to code the interviews. We then used Kruskal-Wallis tests to compare the weighted mental model themes of physicians who provided preference-concordant treatment with those who provided preference-discordant treatment. Sixty-six (90%) physicians provided preference-concordant treatment and 7 (10%) provided preference-discordant treatment (i.e., they intubated the patient). Physicians who intubated the patient were more likely to emphasize the reversible and emergent nature of the patient situation (z = -2.111, P = 0.035), their own comfort (z = -2.764, P = 0.006), and rarely focused on explicit patient preferences (z = 2.380, P = 0.017). Post-decisional interviewing with audio/video prompting may induce hindsight bias. The expert model has not yet been validated and may not be exhaustive. The small sample size limits generalizability and power. Hospital-based physicians providing preference-discordant used a different mental model for decision making for a critically and terminally ill simulated case. These differences may offer targets for future interventions to promote preference-concordant care for seriously ill patients.
Iglay, Kristy; Santorelli, Melissa L; Hirshfield, Kim M; Williams, Jill M; Rhoads, George G; Lin, Yong; Demissie, Kitaw
Purpose Limited data are available on the survival of patients with breast cancer with preexisting mental illness, and elderly women are of special interest because they experience the highest incidence of breast cancer. Therefore, we compared all-cause and breast cancer-specific mortality for elderly patients with breast cancer with and without mental illness. Methods A retrospective cohort study was conducted by using SEER-Medicare data, including 19,028 women ≥ 68 years of age who were diagnosed with stage I to IIIa breast cancer in the United States from 2005 to 2007. Patients were classified as having severe mental illness if an International Classification of Diseases, Ninth Edition, Clinical Modification code for bipolar disorder, schizophrenia, or other psychotic disorder was recorded on at least one inpatient or two outpatient claims during the 3 years before breast cancer diagnosis. Patients were followed for up to 5 years after breast cancer diagnosis to assess survival outcomes, which were then compared with those of patients without mental illness. Results Nearly 3% of patients had preexisting severe mental illness. We observed a two-fold increase in the all-cause mortality hazard between patients with severe mental illness compared with those without mental illness after adjusting for age, income, race, ethnicity, geographic location, and marital status (adjusted hazard ratio, 2.19; 95% CI, 1.84 to 2.60). A 20% increase in breast cancer-specific mortality hazard was observed, but the association was not significant (adjusted hazard ratio, 1.20; 95% CI, 0.82 to 1.74). Patients with severe mental illness were more likely to be diagnosed with advanced breast cancer and aggressive tumor characteristics. They also had increased tobacco use and more comorbidities. Conclusion Patients with severe mental illness may need assistance with coordinating medical services.
Batra, Sonal; Baker, Ross A; Wang, Tao; Forma, Felicia; DiBiasi, Faith; Peters-Strickland, Timothy
As the capabilities and reach of technology have expanded, there is an accompanying proliferation of digital technologies developed for use in the care of patients with mental illness. The objective of this review was to systematically search published literature to identify currently available health technologies and their intended uses for patients with serious mental illness. The Medline, Embase, and BIOSIS Previews electronic databases were searched to identify peer-reviewed English language articles that reported the use of digital, mobile, and other advanced technology in patients with schizophrenia/schizoaffective disorder, bipolar disorder, and major depressive disorder. Eligible studies were systematically reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eighteen studies that met the inclusion criteria were identified. Digital health technologies (DHTs) assessed in the selected studies included mobile applications (apps), digital medicine, digital personal health records, and an electronic pill container. Smartphone apps accounted for the largest share of DHTs. The intended uses of DHTs could be broadly classified as monitoring to gain a better understanding of illness, clinical assessment, and intervention. Overall, studies indicated high usability/feasibility and efficacy/effectiveness, with several reporting validity against established clinical scales. Users were generally engaged with the DHT, and mobile assessments were deemed helpful in monitoring disease symptoms. Rapidly proliferating digital technologies seem to be feasible for short-term use in patients with serious mental illness; nevertheless, long-term effectiveness data from naturalistic studies will help demonstrate their usefulness and facilitate their adoption and integration into the mental health-care system.
... increased risk of cardiovascular disease, diabetes, stroke, and Alzheimer’s disease, for example. Research also suggests that people with depression are at higher risk for osteoporosis relative to others. The reasons are not yet clear. One factor with some of these illnesses is that many ...
Design of the Lifestyle Interventions for severe mentally ill Outpatients in the Netherlands (LION) trial; a cluster randomised controlled study of a multidimensional web tool intervention to improve cardiometabolic health in patients with severe mental illness
Looijmans, Anne; Jorg, Frederike; Bruggeman, Richard; Schoevers, Robert; Corpeleijn, Eva
Background: The cardiometabolic health of persons with a severe mental illness (SMI) is alarming with obesity rates of 45-55% and diabetes type 2 rates of 10-15%. Unhealthy lifestyle behaviours play a large role in this. Despite the multidisciplinary guideline for SMI patients recommending to
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...
Queri, S; Spörrle, M
In Germany, customer surveys in the field of rehabilitation meanwhile are of high political relevance - particularly since the Deutsche Rentenversicherung (German Pension Insurance) has defined customer judgements as a significant outcome parameter. Both the theoretical conceptualization and the empirical data available suggest that customer satisfaction is a construct widely dependent on subjective factors, which has only little reference to the reality of treatment. In the Herzogsägmühle Rehabilitation Centre a detailed customer survey (rehabilitants with mental illness) was carried out for the first time in 2007 in the framework of internal quality management. Data analysis was to yield new knowledge concerning the validity of subjective patient-related outcome parameters as well as relative to the content dimensioning regarding satisfaction and quality judgments in this specific sample. A Centre-specific questionnaire was constructed taking into account existing empirical data and theoretical considerations concerning the relevant content dimensions of customer satisfaction. Forty-six mostly male rehabilitants with an average age of 25 were interviewed. The majority of the interviewees had been diagnosed as having a schizophrenic or an affective disorder. The data obtained was submitted to a predominantly explorative data analysis, also testing various hypotheses. The results show that the rehabilitants' judgements are differentiated and that the expected positive bias was restricted to a few areas. Also it could be shown that treatment satisfaction and quality evaluations present different content dimensions. While satisfaction depends on the evaluation of treatment efficacy, the quality judgement is dependent on evaluation of the professional skills of the staff involved. CONCLUSION/CONSEQUENCES: In particular the quality judgments of the rehabilitants are important in both internal and external (by the cost carriers) quality management assurance. Both
Hatch, Ainslie; Hoffman, Julia E; Ross, Ruth; Docherty, John P
Digital technology is increasingly being used to enhance health care in various areas of medicine. In the area of serious mental illness, it is important to understand the special characteristics of target users that may influence motivation and competence to use digital health tools, as well as the resources and training necessary for these patients to facilitate the use of this technology. The aim of this study was to conduct a quantitative expert consensus survey to identify key characteristics of target users (patients and health care professionals), barriers and facilitators for appropriate use, and resources needed to optimize the use of digital health tools in patients with serious mental illness. A panel of 40 experts in digital behavioral health who met the participation criteria completed a 19-question survey, rating predefined responses on a 9-point Likert scale. Consensus was determined using a chi-square test of score distributions across three ranges (1-3, 4-6, 7-9). Categorical ratings of first, second, or third line were designated based on the lowest category into which the CI of the mean ratings fell, with a boundary >6.5 for first line. Here, we report experts' responses to nine questions (265 options) that focused on (1) user characteristics that would promote or hinder the use of digital health tools, (2) potential benefits or motivators and barriers or unintended consequences of digital health tool use, and (3) support and training for patients and health care professionals. Among patient characteristics most likely to promote use of digital health tools, experts endorsed interest in using state-of-the-art technology, availability of necessary resources, good occupational functioning, and perception of the tool as beneficial. Certain disease-associated signs and symptoms (eg, more severe symptoms, substance abuse problems, and a chaotic living situation) were considered likely to make it difficult for patients to use digital health tools
Full Text Available Sonal Batra,1 Ross A Baker,2 Tao Wang,3 Felicia Forma,4 Faith DiBiasi,3 Timothy Peters-Strickland5 1Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, 2Global Medical Affairs, Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ, 3Medical Affairs, Otsuka Pharmaceutical Development and Commercialization Inc., Rockville, MD, 4Health Economics and Outcomes Management, 5Global Clinical Development, Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ, USA Background: As the capabilities and reach of technology have expanded, there is an accompanying proliferation of digital technologies developed for use in the care of patients with mental illness. The objective of this review was to systematically search published literature to identify currently available health technologies and their intended uses for patients with serious mental illness.Materials and methods: The Medline, Embase, and BIOSIS Previews electronic databases were searched to identify peer-reviewed English language articles that reported the use of digital, mobile, and other advanced technology in patients with schizophrenia/schizoaffective disorder, bipolar disorder, and major depressive disorder. Eligible studies were systematically reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines.Results: Eighteen studies that met the inclusion criteria were identified. Digital health technologies (DHTs assessed in the selected studies included mobile applications (apps, digital medicine, digital personal health records, and an electronic pill container. Smartphone apps accounted for the largest share of DHTs. The intended uses of DHTs could be broadly classified as monitoring to gain a better understanding of illness, clinical assessment, and intervention. Overall, studies indicated high usability/feasibility and efficacy/effectiveness, with several reporting validity
Richard, Aline; Mascherek, Anna C; Schwappach, David L B
Background: Patient safety in mental healthcare has not attracted great attention yet, although the burden and the prevalence of mental diseases are high. The risk of errors with potential for harm of patients, such as aggression against self and others or non-drug treatment errors is particularly high in this vulnerable group. Aim: To develop priority topics and strategies for action to foster patient safety in mental healthcare. Method: The Swiss patient safety foundation together with experts conducted round table discussions and a Delphi questionnaire to define topics along the treatment pathway, and to prioritise these topics. Finally, fields of action were developed. Results: An action plan was developed including the definition and prioritization of 9 topics where errors may occur. A global rating task revealed errors concerning diagnostics and structural errors as most important. This led to the development of 4 fields of action (awareness raising, research, implementation, and education and training) including practice-oriented potential starting points to enhance patient safety. Conclusions: The action plan highlights issues of high concern for patient safety in mental healthcare. It serves as a starting point for the development of strategies for action as well as of concrete activities.
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
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
Chiu, Maria; Lebenbaum, Michael; Newman, Alice M; Zaheer, Juveria; Kurdyak, Paul
Little is known about the sociocultural determinants of mental illness at hospital presentation. Our objective was to examine ethnic differences in illness severity at hospital admission among Chinese, South Asian, and the general population living in Ontario, Canada. We conducted a large, population-based, cross-sectional study of psychiatric inpatients aged from 19 to 105 years who were discharged between 2006 and 2014. A total of 133,588 patients were classified as Chinese (n = 2,582), South Asian (n = 2,452), or the reference group (n = 128,554) using a validated surnames algorithm (specificity: 99.7%). Diagnoses were based on DSM-IV criteria. We examined the association between ethnicity and 4 measures of disease severity: involuntary admissions, aggressive behaviors, and the number and frequency of positive symptoms (ie, hallucinations, command hallucinations, delusions, and abnormal thought process) (Positive Symptoms Scale, Resident Assessment Instrument-Mental Health [RAI-MH]). After adjusting for sociodemographic characteristics, immigration status, and discharge diagnosis, Chinese patients had greater odds of involuntary admissions (odds ratio [OR] = 1.79; 95% CI, 1.64-1.95) and exhibiting severe aggressive behaviors (OR = 1.36; 95% CI, 1.23-1.51) and ≥ 3 positive symptoms (OR = 1.39; 95% CI, 1.24-1.56) compared to the general population. South Asian ethnicity was also an independent predictor of most illness severity measures. The association between Chinese ethnicity and illness severity was consistent across sex, diagnostic and immigrant categories, and first-episode hospitalization. Chinese and South Asian ethnicities are independent predictors of illness severity at hospital presentation. Understanding the role of patient, family, and health system factors in determining the threshold for hospitalization is an important future step in informing culturally specific care for these large and growing populations worldwide. © Copyright 2016 Physicians
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 ...
Hatfield, Agnes B.
Utilizing the conceptual framework of coping theory, 30 family care-givers of mentally ill family members were interviewed to determine the relationship between coping effectiveness and such variables as patient characteristics, factors of the care-givers life situation, and the availability and adequacy of community supports. Care-givers were…
... how you can help. By Mayo Clinic Staff Mental illness in children can be hard for parents to ... help they need. Understand the warning signs of mental illness in children and how you can help your ...
Bersani, Giuseppe; Prevete, Elisabeth
Literature is quite poor about the clinical effects of novel psychoactive substances (NPS) and the long-term consequences of NPS use in psychiatric patients. Consequently, it is of the greatest interest to examine which effects NPS can exert in patients with previous severe mental illness (SMI), such as psychotic patients. The aim of this work was a comprehensive review about NPS use in patients with SMI. We searched Medline or PubMed for relevant English-language citations and reviews describing relationships between NPS use and mental disorders, as well as for the main groups of substances and associated psychiatric manifestations. All studies reporting single case or case series of patients were selected. The NPS use in patients with SMI is probably underestimated. The one existing systematic review considers only 14 studies, 12 of which are case reports. Most clinical results report acute symptom exacerbation of preexisting psychosis. Paranoid, mood, and aggression symptoms occur more frequently. NPS use could modify clinical features of SMI, but these conclusions cannot be generalizable. More evidence is needed to establish the causal and effective connection between NPS use and course of illness, type of psychiatric symptoms, and outcome of treatment in terms of adherence or response. Copyright © 2017 John Wiley & Sons, Ltd.
De Hert, Marc; Correll, Christoph U.; Bobes, Julio; Cetkovich-Bakmas, Marcelo; Cohen, Dan; Asai, Itsuo; Detraux, Johan; Gautam, Shiv; Moeller, Hans-Jurgen; Ndetei, David M.; Newcomer, John W.; Uwakwe, Richard; Leucht, Stefan
The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic
da Rocha Neto, Helio Gomes; Rosenheck, Robert A; Stefanovics, Elina A; Cavalcanti, Maria Tavares
The authors evaluated whether a psychiatric clerkship reduces stigmatized attitudes towards people with mental illness among medical students. A 56-item questionnaire was used to assess the attitudes of medical students towards patients with mental illness and their beliefs about its causes before and after their participation in their psychiatric clerkship at a major medical school in Rio de Janeiro. Exploratory factor analysis identified four factors, reflecting "social acceptance of people with mental illness," "normalizing roles for people with mental illness in society," "non-belief in supernatural causes for mental illness," and "belief in bio-psychosocial causes for mental illness." Analysis of variance was used to evaluate changes in these factors before and after the clerkship. One significant difference was identified with a higher score on the factor representing social acceptance after as compared to before the clerkship (p = 0.0074). No significant differences were observed on the other factors. Participation in a psychiatric clerkship was associated with greater social acceptance but not with improvement on other attitudinal factors. This may reflect ceiling effects in responses before the clerkship concerning supernatural and bio-psychosocial beliefs about causes of mental illness that left little room for change.
Woodhead, Charlotte; Ashworth, Mark; Broadbent, Matthew; Callard, Felicity; Hotopf, Matthew; Schofield, Peter; Soncul, Murat; Stewart, Robert J; Henderson, Max J
Suboptimal treatment of cardiovascular diseases (CVD) among patients with severe mental illness (SMI) may contribute to physical health disparities. To identify SMI characteristics associated with meeting CVD treatment and prevention guidelines. Population-based electronic health record database linkage between primary care and the sole provider of secondary mental health care services in south east London, UK. Cardiovascular disease prevalence, risk factor recording, and Quality and Outcomes Framework (QOF) clinical target achievement were compared among 4056 primary care patients with SMI whose records were linked to secondary healthcare records and 270 669 patients without SMI who were not known to secondary care psychiatric services, using multivariate logistic regression modelling. Data available from secondary care records were then used to identify SMI characteristics associated with QOF clinical target achievement. Patients with SMI and with coronary heart disease and heart failure experienced reduced prescribing of beta blockers and angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB). A diagnosis of schizophrenia, being identified with any indicator of risk or illness severity, and being prescribed with depot injectable antipsychotic medication was associated with the lowest likelihood of prescribing. Linking primary and secondary care data allows the identification of patients with SMI most at risk of undertreatment for physical health problems. © British Journal of General Practice 2016.
Contrary to current theoretical debates on father roll and collective father representations, only few empirical studies have so far been done on the topic of fatherhood of psychiatric patients. The study at hand investigates the paternity rate, the frequency by which fathers actually live together with their children and other aspects commonly associated with fatherhood, of a cohort consisting of men who had been under psychiatric treatment. 222-male patients who had been under psychiatric treatment in the first quarter of 2005 were recruited for a survey on variables relevant to paternity. In addition to a descriptive statistical analysis a subgroup classification of fatherhood-variables associated with other independent variables, i. e. primary diagnosis, severity of disease, migration background, relationship status and age was performed using the multivariate statistical methods of Exhaustive CHAID-analysis. In total, of the 222 Patients we recruited for this study 74 (33,3 %) were fathers. Of these, 44 were fathers to an underage child. 31 of these men actually lived in the same household as their child. The Exhaustive CHAID analysis was able to display different associations between the independent variables and the varied dependent aspects of fatherhood. Here, the independent variables "relationship status", "primary diagnosis" and "migration background" showed to be important. A paternity rate of approximately one third demonstrates the relevance of this subject matter. Specific options for treatment, support and therapy, which include the mothers of the patient's children and, where applicable, take their migrant background into consideration, need to be established. © Georg Thieme Verlag KG Stuttgart · New York.
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.
Brown, Kaylene; Bradley, Loretta J.
Each year, an estimated 50 million Americans will experience a mental disorder while only one fourth of them will seek mental health services. Contends that this disparity results from the stigma attached to mental illness. Proposes that counselors must educate the general public about the misconceptions of mental illness and advocate for parity…
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.
... is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first. People experiencing a mental health ...
Garrido, Melissa M; Prigerson, Holly G; Neupane, Suvam; Penrod, Joan D; Johnson, Christopher E; Boockvar, Kenneth S
Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted. To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses. Design, Subjects, and Measurements: This was a retrospective study of 11,286 veterans hospitalized in a Veterans Health Administration acute care facility in fiscal year 2011 with diagnoses of advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, and/or advanced HIV/AIDS. Prevalent and incident mental illness diagnoses during and before hospitalization and rates of psychotherapy and psychotropic use among patients with incident depression and anxiety were measured. At least one-quarter of the patients in our sample had a mental illness or substance use disorder. The most common diagnoses at hospitalization were depression (11.4%), followed by alcohol abuse or dependence (5.5%), and post-traumatic stress disorder (4.9%). Of the 831 patients with incident past-year depression and 258 with incident past-year anxiety, nearly two-thirds received at least some psychotherapy or guideline-concordant medication within 90 days of diagnosis. Of 191 patients with incident depression and 47 with incident anxiety at time of hospitalization, fewer than half received mental healthcare before discharge. Many veterans hospitalized with serious physical illnesses have comorbid mental illnesses and may benefit from depression and anxiety treatment.
Franx, G.C.; Kroon, H.; Grimshaw, J.; Drake, R.; Grol, R.P.T.M.; Wensing, M.J.P.
OBJECTIVE: To provide a comprehensive overview of the research on organizational changes aimed at improving health care for patients with severe mental illness and to learn lessons for mental health practice from the results. METHOD: We searched for systematic literature reviews published in English
Cheon, Bobby K; Chiao, Joan Y
Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one's reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one's attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness.
Mulder, Cornelis L; Jochems, E; Kortrijk, H E
Lack of motivation for treatment makes a subgroup of patients with severe mental illness (SMI) difficult to engage in psychiatric treatment. Such difficult-to-engage patients may also be the most in need of treatment. We hypothesized that the level of psychosocial problems would be inversely related to motivation for treatment. Cross-sectional study in two independent samples. The first sample (n = 294) included SMI patients who participated in a randomized controlled trial and were assessed using the Health of the Nation Outcome Scales (HoNOS) and self-rated and clinician-rated motivation-for-treatment scales. The second sample (n = 1,170) included SMI patients who were treated in Assertive Outreach Teams and were routinely assessed with the HoNOS and a motivation-for-treatment scale. In both samples, patients also self-rated their quality of life. In both samples, patients with HoNOS scores of 16 and higher had lower motivation scores on all motivation scales than patients with lower HoNOS scores, and also a lower quality of life. A motivation paradox seems inherent to this association between higher psychosocial problems levels, less motivation for treatment, and lower quality of life. Such a paradox has clinical relevance, as it may provide an ethical basis for outreach services which aim to engage marginally motivated SMI patients with severe psychosocial problems into mental health care.
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.
Pelletier, Jean-François; Lesage, Alain; Boisvert, Christine; Denis, Frédéric; Bonin, Jean-Pierre; Kisely, Steve
Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses. A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition. Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants
Drukker, M; van Os, J; Sytema, S; Driessen, G; Visser, E; Delespaul, P
Previous work suggests that the Dutch variant of assertive community treatment (ACT), known as Function ACT (FACT), may be effective in increasing symptomatic remission rates when replacing a system of hospital-based care and separate community-based facilities. FACT guidelines propose a different pattern of psychiatric service consumption compared to traditional services, which should result in different costing parameters than care as usual (CAU). South-Limburg FACT patients, identified through the local psychiatric case register, were matched with patients from a non-FACT control region in the North of the Netherlands (NN). Matching was accomplished using propensity scoring including, among others, total and outpatient care consumption. Assessment, as an important ingredient of FACT, was the point of departure of the present analysis. FACT patients, compared to CAU, had five more outpatient contacts after the index date. Cost-effectiveness was difficult to assess. Implementation of FACT results in measurable changes in mental health care use.
Gowda, Guru S; Gopika, G; Kumar, Channaveerachari Naveen; Manjunatha, Narayana; Yadav, Ravi; Srinivas, Dwarakanath; Dawn, Bharath Rose; Math, Suresh Bada
Homeless Mentally Ill (HMI) patients represent a unique global problem and pose a challenge in treatment, management and rehabilitation services. There is sparse data on HMI patients in India. The objective of this paper is to study the clinical outcome and rehabilitation of HMI patients. We performed a retrospective chart review of 'HMI' patients from 1st January 2002 to 31st December 2015, who were admitted under Department of Psychiatry at National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Clinical outcomes were analysed by descriptive statistics and predictors of family reintegration were analysed by logistic regression model. Seventy-eight HMI (unknown) patients were admitted in fourteen years period. 64(82%) were improved at discharge, 40(51.3%) were reintegrated to the family; 15(19.2%) were sent to state home for women, and 17(21.8%) were sent to Non-Governmental Organization (NGO)/Rehabilitation Centre and 6 (7.8%) required multispecialty care in general hospital or absconded from the hospital during inpatient care. The logistic regression model showed that mental retardation (B=-2.204, P=0.002) was negatively correlated with family reintegration and clinical improvement at discharge (B=2.373, P=family reintegration. In our study majority of HMI patients improved at the time of discharge. Family reintegration was possible in about half of HMI patients after treatment. Mental retardation and clinical improvement are important predictors of family reintegration of HMI patients. Copyright © 2017 Elsevier B.V. All rights reserved.
Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P
Poor adherence to medication treatment can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article concerning assessment of adherence are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey contained 39 questions (521 options) that asked about defining nonadherence, extent of adherence problems in schizophrenia and bipolar disorder, risk factors for nonadherence, assessment methods, and interventions for specific types of adherence problems. The survey was completed by 41 (85%) of the 48 experts to whom it was sent. When evaluating adherence, the experts considered it important to assess both behavior and attitude, although they considered actual behavior most important. They also noted the importance of distinguishing patients who are not willing to take medication from those who are willing but not able to take their medication as prescribed due to forgetfulness, misunderstanding of instructions, or financial or environmental problems, since this will affect the type of intervention needed. Although self- and physician report are most commonly used to clinically assess adherence, they are often inaccurate and may underestimate nonadherence. The experts believe that more accurate information will be obtained by asking about any problems patients are having or anticipate having taking medication rather than if they have been taking their medication; They also recommended speaking with family or caregivers, if the patient gives permission, as well as using more objective measures (e.g., pill counts, pharmacy records, smart pill containers if available, and, when appropriate, medication plasma levels). Use of a validated self-report scale may also help improve accuracy. For patients who appear adherent to medication, the experts recommended monthly assessments for
Kluit, M.J. van der; Goossens, P.J.J.; Leeuw, J.R.
In rehabilitation centers, many patients suffer a comorbid mental illness. Nurses have different attitudes toward these patients. A cross-sectional, questionnaire-based study among nurses in Dutch rehabilitation centers was undertaken to clarify the factors that underlie attitudes toward patients
Lin, K M; Inui, T S; Kleinman, A M; Womack, W M
This descriptive study employed semistructured interviewing and questionnaire administration to delineate the sociocultural determinants of the help-seeking process in 48 psychiatric patients. The help-seeking process is considered in two stages. The first stage starts from the recognition of initial symptoms and ends in the first contact with a mental health professional. The second stage is defined as that time between the first contact and actual participation in a planned treatment program. In both stages, patients typically go through phases of lay consultation, nonpsychiatric professional consultation, and referral. The multiple steps which are usually involved in help seeking often result in significant delay of both mental health contact and treatment. The help-seeking process was found to correlate strongly with ethnicity. Both Asians and Blacks showed more extended family involvement, and the involvement of key family members tended to be persistent and intensive in Asians. Ethnicity was also associated with the length of delay, with Asians showing the longest delay and Caucasians the least. These ethnic differences were also reflected in help-seeking pathway assignment using Lin's criteria. Although modernity and parochialism, as measured by the level of modernization and the cohesiveness of the social network system of the subjects, were also found to be correlated with delay, they appeared to exert an influence independent from that of ethnicity.
Kopera, Maciej; Suszek, Hubert; Bonar, Erin; Myszka, Maciej; Gmaj, Bart?omiej; Ilgen, Mark; Wojnar, Marcin
The study investigated explicit and implicit attitudes towards people with mental illness among medical students (non-professionals) with no previous contact with mentally ill patients and psychiatrists and psychotherapists (professionals) who had at least 2?years of professional contact with mentally ill patients. Explicit attitudes where assessed by self-report. Implicit attitudes were measured with the Go/No-Go Association Task, a variant of the Implicit Association Test that does not requ...
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.
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.
Roberts, Laura Weiss
There are many tasks ahead in the area of ethics and mental illness research. We face unknown challenges in psychiatric genetics projects, studies of psychopharmacological interventions in children, controversial scientific designs (e.g., symptom challenge, medication-free interval), and cross-disciplinary research incorporating goals and methods of health services, epidemiology, and social and behavioral science endeavors. Boundaries between innovative clinical practices and research-related experimentation will become increasingly difficult to distinguish, as will the roles between clinicians, clinical researchers, and basic scientists. Moreover, the institutions and systems in which research occurs are being rapidly and radically revised, raising new questions about oversight responsibilities and standards. Our ability to identify and respond to the ethical questions arising in this uncharted territory will depend on our willingness to self-reflect, to integrate the observations and insights of the past century, to think with great clarity, and to anticipate novel ethical problems that keep company with scientific advancements. It will also depend on data. Empirical study of ethical dimensions of human research is essential to anchor and attune the intuitions and theoretical constructs that we develop. Science and ethics have changed over the past 100 years, as they will over the next century. It is ironic that the ethical acceptability of psychiatric research is so much in question at this time, when it holds so much promise for advancing our understanding of mental illness and its treatment. The tension between the duty to protect vulnerable individuals and the duty to perform human science will continue to grow, as long as ethics and science are seen as separable, opposing forces with different aims championed by different heroes. The profession of psychiatry is poised to move toward a new, more coherent research ethics paradigm in which scientific and
Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P
Poor adherence to medication can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey (39 questions, 521 options) on adherence problems in schizophrenia and bipolar disorder was completed by 41 experts in 2008. This article first reviews the literature on interventions aimed at improving adherence. It then presents the experts' recommendations for targeting factors that can contribute to nonadherence and relates them to the literature. The following psychosocial/programmatic and pharmacologic interventions were rated first line for specific problems that can lead to nonadherence: ongoing symptom/ side-effect monitoring for persistent symptoms or side effects; services targeting logistic problems; medication monitoring/environmental supports (e.g., Cognitive Adaptation Training, assertive community treatment) for lack of routines or cognitive deficits; and adjusting the dose or switching to a different oral antipsychotic for persistent side effects (also high second-line for persistent symptoms). Among pharmacologic interventions, the experts gave high second-line ratings to switching to a long-acting antipsychotic when lack of insight, substance use, persistent symptoms, logistic problems, lack of routines, or lack of family/ social support interfere with adherence and to simplifying the treatment regimen when logistic problems, lack of routines, cognitive deficits, or lack of family/social support interfere with adherence. Psychosocial/programmatic interventions that received high second-line ratings in a number of situations included medication monitoring/environmental supports, patient psychoeducation, more frequent and/or longer visits if possible, cognitive behavioral therapy (CBT), family-focused therapy
Cheon, Bobby K.; Chiao, Joan Y.
Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one’s reactions to mental illness remains unknown. Here we compared implicit and expli...
Shin, Jinah K; Shortridge-Baggett, Lillie M; Sachmechi, Issac; Barron, Charles; Chiu, Ya-Lin; Bajracharya, Bhavana; Bang, Heejung
Various methods for diabetes risk assessment have been developed over a decade, but they were not evaluated in patients with mental illness. This study examined the feasibility and utility of a self-assessment score for type 2 diabetes mellitus (DM2) risk among patients with mental illness. DM2 risk was assessed by patients with mental illness as well as clinicians via a self-assessment questionnaire, and the resulting scores were compared to each other as well as with actual diagnosis. Of 100 patients, nine patients were newly revealed to have DM2 and 34 patients have pre-DM2. Patients tended to underreport risk factors - obesity and physical activity - so perceived to have lower risk. Sensitivity of the self-assessment score was different when used by patients and by clinicians despite correlation coefficient of 0.82. Based on positive predictive values, we may expect one out of two patients who have high scores actually have DM2 or pre-DM2. Also, the discrimination capability was reasonably high (AUC=0.79), comparable to its performance observed in general populations. The self-assessment score has potential as a simple and adjunct tool to identify a high risk group of DM2/pre-DM2 among persons with mental illness, especially, when used together with health care providers. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Stefanakis, Zacharias; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N
The present study aimed to investigate possible differences in family environment among patients experiencing their First Episode of Psychosis (FEP), chronic patients and controls. Family cohesion and flexibility (FACES-IV) and psychological distress (GHQ-28) were evaluated in families of 50 FEP and 50 chronic patients, as well as 50 controls, whereas expressed emotion (FQ) and family burden (FBS) were assessed in families of FEP and chronic patients. Multivariable linear regression analysis, adjusted for confounders, indicated impaired cohesion and flexibility for families of FEP patients compared to controls, and lower scores for families of chronic patients compared to those of FEP patients. Caregivers of chronic patients scored significantly higher in criticism, and reported higher burden and psychological distress than those of FEP patients. Our findings suggest that unbalanced levels of cohesion and flexibility, high criticism and burden appeared to be the outcome of psychosis and not risk factors triggering the onset of the illness. Furthermore, emotional over-involvement both in terms of positive (i.e. concern) and negative behaviors (i.e. overprotection) is prevalent in Greek families. Psychoeducational interventions from the early stages of the illness should be considered to promote caregivers' awareness regarding the patients' illness, which in turn, may ameliorate dysfunctional family interactions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Available The personalised nature of mental illness obscures from general view the intolerable burden of private and public distress that people with serious mental illness carry. Invariably the mentally ill person encounters rejection and 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, transportation, education and gainful employment. As a result of their lack of financial and social support and their experience of rejection from society, persons with mental illness tend to neglect themselves and their diet, and frequently delay seeking treatment. Against this background, this contribution critically focuses on the human rights that influence the mentally ill patient in South African medical law. Specific attention is paid to the relevance and meaning of sections 9 (the equality clause, 27 (access to health care services, 30 and 31 (language, culture and religion of the Constitution of the Republic of South Africa, 1996.
Design of the Lifestyle Interventions for severe mentally ill Outpatients in the Netherlands (LION) trial; a cluster randomised controlled study of a multidimensional web tool intervention to improve cardiometabolic health in patients with severe mental illness.
Looijmans, Anne; Jörg, Frederike; Bruggeman, Richard; Schoevers, Robert; Corpeleijn, Eva
The cardiometabolic health of persons with a severe mental illness (SMI) is alarming with obesity rates of 45-55% and diabetes type 2 rates of 10-15%. Unhealthy lifestyle behaviours play a large role in this. Despite the multidisciplinary guideline for SMI patients recommending to monitor and address patients' lifestyle, most mental health care professionals have limited lifestyle-related knowledge and skills, and (lifestyle) treatment protocols are lacking. Evidence-based practical lifestyle tools may support both patients and staff in improving patients' lifestyle. This paper describes the Lifestyle Interventions for severe mentally ill Outpatients in the Netherlands (LION) trial, to investigate whether a multidimensional lifestyle intervention using a web tool can be effective in improving cardiometabolic health in SMI patients. The LION study is a 12-month pragmatic single-blind multi-site cluster randomised controlled trial. 21 Flexible Assertive Community Treatment (ACT) teams and eight sheltered living teams of five mental health organizations in the Netherlands are invited to participate. Per team, nurses are trained in motivational interviewing and use of the multidimensional web tool, covering lifestyle behaviour awareness, lifestyle knowledge, motivation and goal setting. Nurses coach patients to change their lifestyle using the web tool, motivational interviewing and stages-of-change techniques during biweekly sessions in a) assessing current lifestyle behaviour using the traffic light method (healthy behaviours colour green, unhealthy behaviours colour red), b) creating a lifestyle plan with maximum three attainable lifestyle goals and c) discussing the lifestyle plan regularly. The study population is SMI patients and statistical inference is on patient level using multilevel analyses. Primary outcome is waist circumference and other cardiometabolic risk factors after six and twelve months intervention, which are measured as part of routine outcome
Alegria, Margarita; Drake, Robert E; Kang, Hyeon-Ah; Metcalfe, Justin; Liu, Jingchen; DiMarzio, Karissa; Ali, Naomi
Social determinants of health, such as poverty and minority background, severely disadvantage many people with mental disorders. A variety of innovative federal, state, and local programs have combined social services with mental health interventions. To explore the potential effects of such supports for addressing poverty and disadvantage on mental health outcomes, we simulated improvements in three social determinants-education, employment, and income. We used two large data sets: one from the National Institute of Mental Health that contained information about people with common mental disorders such as anxiety and depression, and another from the Social Security Administration that contained information about people who were disabled due to severe mental disorders such as schizophrenia and bipolar disorder. Our simulations showed that increasing employment was significantly correlated with improvements in mental health outcomes, while increasing education and income produced weak or nonsignificant correlations. In general, minority groups as well as the majority group of non-Latino whites improved in the desired outcomes. We recommend that health policy leaders, state and federal agencies, and insurers provide evidence-based employment services as a standard treatment for people with mental disorders. Project HOPE—The People-to-People Health Foundation, Inc.
Decision making ability can change with time, depending on mental or physical health. Little is known about the factors that determine this change and the relationship of capacity to time. As a pilot for studies using functional mental capacities as an outcome measure, we sought to quantify this relationship measuring change over time using competence assessment tools, and rating scales for symptoms and global function.
Lin, Wei-Chen; Winkelman, John W
Sleep complaints are commonly encountered in psychiatric clinics. Underlying medical disorders or sleep disorders need to be identified and treated to optimize treatment of the mental illness. Excessive daytime sleepiness, which is the main symptom of obstructive sleep apnea (OSA), overlaps with those of many severe mental illnesses. Medication side effects or the disorder itself maybe account for daytime sleepiness but comorbid OSA is a possibility that should not be overlooked. The diagnosis of OSA is straightforward but treatment compliance is problematic in psychiatric patients. This article summarizes studies concerning comorbid OSA in patients with severe mental illness and includes suggestions for future investigations.
Oexle, N; Ajdacic-Gross, V; Kilian, R; Müller, M; Rodgers, S; Xu, Z; Rössler, W; Rüsch, N
Whether the public stigma associated with mental illness negatively affects an individual, largely depends on whether the person has been labelled 'mentally ill'. For labelled individuals concealing mental illness is a common strategy to cope with mental illness stigma, despite secrecy's potential negative consequences. In addition, initial evidence points to a link between stigma and suicidality, but quantitative data from community samples are lacking. Based on previous literature about mental illness stigma and suicidality, as well as about the potential influence of labelling processes and secrecy, a theory-driven model linking perceived mental illness stigma and suicidal ideation by a mediation of secrecy and hopelessness was established. This model was tested separately among labelled and unlabelled persons using data derived from a Swiss cross-sectional population-based study. A large community sample of people with elevated psychiatric symptoms was examined by interviews and self-report, collecting information on perceived stigma, secrecy, hopelessness and suicidal ideation. Participants who had ever used mental health services were considered as labelled 'mentally ill'. A descriptive analysis, stratified logistic regression models and a path analysis testing a three-path mediation effect were conducted. While no significant differences between labelled and unlabelled participants were observed regarding perceived stigma and secrecy, labelled individuals reported significantly higher frequencies of suicidal ideation and feelings of hopelessness. More perceived stigma was associated with suicidal ideation among labelled, but not among unlabelled individuals. In the path analysis, this link was mediated by increased secrecy and hopelessness. Results from this study indicate that among persons labelled 'mentally ill', mental illness stigma is a contributor to suicidal ideation. One explanation for this association is the relation perceived stigma has with
Shefer, Guy; Henderson, Claire; Howard, Louise M; Murray, Joanna; Thornicroft, Graham
We conducted a qualitative study in the Emergency Departments (EDs) of four hospitals in order to investigate the perceived scope and causes of 'diagnostic overshadowing'--the misattribution of physical symptoms to mental illness--and other challenges involved in the diagnostic process of people with mental illness who present in EDs with physical symptoms. Eighteen doctors and twenty-one nurses working in EDs and psychiatric liaisons teams in four general hospitals in the UK were interviewed. Interviewees were asked about cases in which mental illness interfered with diagnosis of physical problems and about other aspects of the diagnostic process. Interviews were transcribed and analysed thematically. Interviewees reported various scenarios in which mental illness or factors related to it led to misdiagnosis or delayed treatment with various degrees of seriousness. Direct factors which may lead to misattribution in this regard are complex presentations or aspects related to poor communication or challenging behaviour of the patient. Background factors are the crowded nature of the ED environment, time pressures and targets and stigmatising attitudes held by a minority of staff. The existence of psychiatric liaison team covering the ED twenty-four hours a day, seven days a week, can help reduce the risk of misdiagnosis of people with mental illness who present with physical symptoms. However, procedures used by emergency and psychiatric liaison staff require fuller operationalization to reduce disagreement over where responsibilities lie.
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…
Seeman, Neil; Tang, Sabrina; Brown, Adalsteinn D; Ing, Alton
To obtain rapid and reproducible opinions that address mental illness stigma around the world. Random global Web users were exposed to brief questions, asking whether they interacted daily with someone with mental illness, whether they believed that mental illness was associated with violence, whether it was similar to physical illness, and whether it could be overcome. Over a period of 1.7 years, 596,712 respondents from 229 countries completed the online survey. The response rate was 54.3%. China had the highest proportion of respondents in daily contact with a person with mental illness. In developed countries, 7% to 8% of respondents endorsed the statement that individuals with mental illness were more violent than others, in contrast to 15% or 16% in developing countries. While 45% to 51% of respondents from developed countries believed that mental illness was similar to physical illness, only 7% believed that mental illness could be overcome. To test for reproducibility, 21 repeats of the same questions were asked monthly in India for 21 months. Each time, 10.1 ± 0.11% s.e., of respondents endorsed the statement that persons who suffer from mental illness are more violent than others, indicating strong reproducibility of response. This study shows that surveys of constructs such as stigma towards mental illness can be carried out rapidly and repeatedly across the globe, so that the impact of policy interventions can be readily measured. The method engages English speakers only, mainly young, educated males. Copyright © 2015 Elsevier B.V. All rights reserved.
Mousa, Marwa Abd El-Gawad Ahmed
Empathy is an ability and skill that can be learned and developed through appropriate education and practice. While the importance of nurses' empathy is widely acknowledged, little is known about the impact of passing through the psychiatric nursing and mental health educational experience at the Faculty of Nursing, Alexandria University on…
Ringer, Agnes; Holen, Mari
This article examines how discourses on mental illness are negotiated in mental health practice and their implications for the subjective experiences of psychiatric patients. Based on a Foucauldian analysis of ethnographic data from two mental health institutions in Denmark--an outpatient clinic and an inpatient ward--this article identifies three discourses in the institutions: the instability discourse, the discourse of "really ill," and the lack of insight discourse. This article indicates that patients were required to develop a finely tuned and precise sense of the discourses and ways to appear in front of professionals if they wished to have a say in their treatment. We suggest that the extent to which an individual patient was positioned as ill seemed to rely more on his or her ability to navigate the discourses and the psychiatric setting than on any objective diagnostic criteria. Thus, we argue that illness discourses in mental health practice are not just materialized as static biomedical understandings, but are complex and diverse--and have implications for patients' possibilities to understand themselves and become understandable to professionals. © The Author(s) 2015.
Deenik, Jeroen; Kruisdijk, Frank; Tenback, Diederik; Braakman-Jansen, Annemarie; Taal, Erik; Hopman-Rock, Marijke; Beekman, Aartjan; Tak, Erwin; Hendriksen, Ingrid; van Harten, Peter
Background: Increasing physical activity in patients with severe mental illness is believed to have positive effects on physical health, psychiatric symptoms and as well quality of life. Till now, little is known about the relationship between physical activity and quality of life in long-term
Ghane, S.; Kolk, A.M.; Emmelkamp, P.M.G.
Background: Explanatory models (EMs) refer to patients’ causal attributions of illness and have been shown to affect treatment preference and outcome. Reliable and valid assessment of EMs may be hindered by interviewer and respondent disparities on certain demographic characteristics, such as
Markwort, Ilka; Schmitz-Buhl, Mario; Christiansen, Hanna; Gouzoulis-Mayfrank, Euphrosyne
Offsprings of psychiatric patients are burdened and they are at risk of developing a mental disorder themselves. All admissions in a psychiatric hospital within a period of 6 months were screened for parenthood of underaged children. They were given standardized questionnaires for child behavior (SDQ), parenting behavior and subjective need for help in parenting. 21.5 % (N = 439) of the patients had underaged children, 194 patients participated in the study. They considered their children as having more psychological/behavioral problems than a control group (N = 97). Patients with personality or affective disorders and patients with a high level of psychiatric comorbidity rated their children most problematic. Although patients did not differ from controls in the evaluation of their parenting style, they expressed a higher need for help in parenting. Parenting and education issues need to be considered in the treatment of mentally ill patients. Effective support could be a relief for families and help to prevent mental disorders in offsprings. © Georg Thieme Verlag KG Stuttgart · New York.
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.
Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.
Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of…
Lauritzen, Camilla; Kolmannskog, Anne Berit; Iversen, Anette Christine
Previous research has shown a link between parental mental illness and adverse development in their offspring. In Norway, it is mandatory for health professionals to identify if patients in adult mental health services have children, and subsequently to provide support for the children. An important tool to detect if families are affected by parental mental illness and to assess if there is a need for further intervention is the Family Assessment Conversation. Family Assessment Conversations is potentially a powerful tool for communication with families affected by parental mental illness because it facilitates early identification of children at risk of various adversities due to the family situation. Additionally the tool may initiate processes that enable children and parents to cope with the situation when a parent becomes seriously ill. Little is however known about how the mental health practitioners use the family assessment form in conversations, and to what extent they record relevant information in the electronic patient journals. The main aim of the study was to provide information about the existing practice within mental health services for adults in terms of parental mental illness and family assessment conversations. The project is a retrospective journal review. The data base consists of relevant journal data from 734 patients aged 20-60 years admitted. In total, 159 recordings of family assessment conversations were discovered. The main result in this study was that many of the questions in the family assessment form lacked documented responses and assessments from the healthcare professionals. Only 17% of the participants had been assessed with the total family assessment form. Additionally, there was a lack of documentation about whether or not the children had been informed in a large proportion of the assessment forms (31%). A total of 55% say that the child has not been informed. This implies that there is still a long way to go in order to
Background: In many cultures and countries, mental and physical disorders have been found to occur concurrently with more than mere chance phenomena. Such co-morbidity increases poor outcome for both disorders and results in high mortality and health care costs. Studies in Nigeria along this line seem scanty.
MEDICAL LAW: A DISCUSSION OF SECTIONS 9; 27; 30 AND 31 OF THE .... Reconciliation Commission that are of relevance to psychiatry. ..... liberty because of a mental disorder, the state owes a duty to provide him or her with reasonable ...
Nilsson, Karin; Gustafson, Lars; Hultberg, Björn
Background: Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) is regarded as a sensitive marker of cardiovascular disease. Vascular disease plays an important role in cognitive impairment. Method: In 447 elderly patients with mental illness, serum NT-proBNP level and the presence or absence of vascular disease according to the medical record were used to categorize patients in different subgroups of vascular disease. Results and Conclusion: Patients with vascular disease and elevated...
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.
Lauveng, Arnhild; Tveiten, Sidsel; Ekeland, Tor-Johan; Torleif, Ruud
Recent research suggests that a basic anomaly in self-experience may be a core factor in patients with severe mental illnesses. Given the importance of sense of self, the traditional treatment of symptoms might not be the most effective for these groups of patients. This qualitative study examines how differences in social environmental conditions, organized as education or treatment, might affect personal development in patients with severe mental illness. A qualitative hermeneutical design was used. Data were collected through qualitative interviews. Informants included 14 patients in psychiatric treatment and 15 students at schools for adults with mental illness. Most informants were interviewed on two occasions, 6-8 months apart, totaling 47 interviews. All participants had been diagnosed with severe mental illness with pronounced impact on daily functioning (most often psychoses or personality disorders) for a minimum of 2 years. Findings and interpretations showed that the students experienced a supportive environment focused mostly on education. They described personal and enduring development in areas such as capacity for relationships, regulation of symptoms, subjective well-being, and integration in society. The patients experienced an environment focused more on treatment of their illness and less on personal development and interests. They described little development, much loneliness, a poor quality of life, an objectifying attitude of themselves and others, and hopelessness. Even if more research is needed, findings indicate that for this group of patients, problems may be closely related to identity development. Therefore, instead of solemnly focusing on specific symptoms, it might be more effective to support patients' personal and social development by offering intensive and lasting social environmental conditions. This includes stable and mutual relationships, intrinsically motivated activities, and an environment that supports personal choices
Druss, Benjamin G; Singh, Manasvini; von Esenwein, Silke A; Glick, Gretl E; Tapscott, Stephanie; Tucker, Sherry Jenkins; Lally, Cathy A; Sterling, Evelina W
Individuals with serious mental illnesses have high rates of general medical comorbidity and challenges in managing these conditions. A growing workforce of certified peer specialists is available to help these individuals more effectively manage their health and health care. However, few studies have examined the effectiveness of peer-led programs for self-management of general medical conditions for this population. This randomized study enrolled 400 participants with a serious mental illness and one or more chronic general medical conditions across three community mental health clinics. Participants were randomly assigned to the Health and Recovery Peer (HARP) program, a self-management program for general medical conditions led by certified peer specialists (N=198), or to usual care (N=202). Assessments were conducted at baseline and three and six months. At six months, participants in the intervention group demonstrated a significant differential improvement in the primary study outcome, health-related quality of life. Specifically, compared with the usual care group, intervention participants had greater improvement in the Short-Form Health Survey physical component summary (an increase of 2.7 versus 1.4 points, p=.046) and mental component summary (4.6 versus 2.5 points, p=.039). Significantly greater six-month improvements in mental health recovery were seen for the intervention group (p=.02), but no other between-group differences in secondary outcome measures were significant. The HARP program was associated with improved physical health- and mental health-related quality of life among individuals with serious mental illness and comorbid general medical conditions, suggesting the potential benefits of more widespread dissemination of peer-led disease self-management in this population.
[The Effects of Auditory Hallucination Simulation on Empathy, Knowledge, Social Distance, and Attitudes Toward Patients With Mental Illness Among Undergraduate Students: A Systemic Review and Meta-Analysis].
Lee, Ming-Feng; Lin, Ching-Lan Esther
The negative attitudes of the general public toward mental illness frequently influence the integration of mental illness patients into the community. Auditory hallucination simulation may be considered as a creative teaching strategy to improve the attitudes of learners toward mental illness. However, the empirical effects of auditory hallucination simulation to change the negative attitudes toward mental illness remains uncertain. To compare and analyze, using a systematic review and meta-analysis, the effectiveness of auditory hallucination simulation in improving empathy, knowledge, social distance, and attitudes toward mental illness in undergraduates. A search using the keywords "auditory hallucination" and "simulation" and the 4 outcome indicators of empathy, knowledge, social distance, and attitudes toward mental illness was conducted to identify related articles published between 2008 and 2016 in 6 Chinese and English electronic databases, including Cochrane Library, EBSCO-CINAHL, MEDLINE, PsycINFO, PubMed, and Airiti Library. Research quality was appraised using the Modified Jadad Scale (MJS), the Oxford Centre for Evidence-Based Medicine Level of Evidence (OCEBM LoE), and the Cochrane Risk of Bias tool. Eleven studies were recruited, and 7 studies with sufficient data were included in the meta-analysis. The meta-analysis showed that hallucination simulation significantly improved the empathy and knowledge of participants, with respective effect sizes of 0.63 (95% CI [0.21, 1.05]) and 0.69 (95% CI [0.43-0.94]). However, this intervention also increased social distance, with an effect size of 0.60 (95% CI [0.01, 1.19]), and did not change attitudes toward mental illness significantly, with an effect size of 0.33 (95% CI [-0.11, 0.77]). Auditory hallucination simulation is an effective teaching strategy for improving the empathy and knowledge of undergraduates. However, related evidence for the effects of social distance and attitudes toward mental illness
Favazza, A R
Healing of mental illness through religious practices was a key element of early Christianity. In the early twentieth century such healing was associated with blue-collar and rural Fundamentalists, but religious healing practices have gained widespread acceptance by many middle-class, conservative Christian groups. "Evil demons" are now equated with envy, pride, avarice, hatred, and obsessions with alcohol and gambling. Many psychotherapeutic techniques of modern Christian healers appear to be rediscoveries of psychoanalytic insights expressed in religious metaphors. Most responsible healers encourage clients to seek medical and psychiatric help, especially for serious mental disorders. Psychiatrists need not share patients' religious beliefs, but for treatment to be effective these beliefs must be understood and respected.
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.
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.
Schene, A. H.; van Wijngaarden, B.
Members of Ypsilon, a Dutch family organization for relatives of patients with schizophrenia or chronic psychosis, were surveyed to determine whether patients whose families were involved in the organization were representative of all patients with schizophrenia in the Netherlands and whether
To determine the magnitude and pattern of aggressive behaviour among psychiatric in-patients and identity associated socio-demographic and clinical factors. The studywas cross-sectional in design. Among patients admitted to theNeuro-psychiatricHospital, Aro (and its Lantoro annex), Abeokuta between January 1 to ...
Azman, Azlinda; Jamir Singh, Paramjit Singh; Sulaiman, Jamalludin
Mental illness is a disease that affects millions of people every year. It not only causes stress to the mentally ill patients, but also for the family members who provide them the care. The family caregivers, therefore need some form of coping strategies in dealing with their mentally ill family members. This qualitative study aims at identifying and analysing the coping strategies adopted by the family caregivers in dealing with their mentally ill family members. A total of 15 family caregivers from the state of Kedah, Malaysia participated in the face-to-face semi structured interview. The study findings identified an array of coping strategies used by the family caregivers, including religious coping, emotional coping, acceptance, becoming engaged in leisure activities, and the use of traditional healing to help them cope with their mentally ill members. Suggestions and conclusions: Study suggests that the family caregivers should engage themselves in social support groups to learn about and obtain the positive coping strategies used by other caregivers who have similar experiences in caring for the mentally ill. Study also suggests that they should get appropriate training from the mental health professionals in order to enhance the caregivers' coping skills.
Full Text Available Background: This study was designed to examine the attitude of nonpsychiatric health professionals about mental illness in urban multispeciality tertiary care setting. Aim: To assess attitude toward mental illness among urban nonpsychiatric health professionals. Materials and Methods: A cross-sectional study design was used. A pretested, semistructured questionnaire was administered to 222 medical and paramedical staff at two tertiary care hospitals at Chandigarh. Results: There is an increased awareness of mental illness especially in military subjects. Literacy was associated with a positive attitude toward mental illness. Health care givers commonly fail to ask about the emotional well being of their patients. Many saw referral to psychiatrist as a form of punishment. There is uniform desire for more knowledge about psychiatric disorders in medical and paramedical staff. Conclusions: This study demonstrates the need for educational programs aimed at demystifying mental illness. A better understanding of mental disorders among the nonpsychiatric medical professional would help to allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization toward such persons.
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…
their illness on the one side, and widespread stigma and discrimination on the other. Evidence from North America and paralleling findings from research in Western Europe suggest that stigma and discrimination are major problems in the community, with negative attitudes and behaviour towards people with mental illness ...
Avdibegović, Esmina; Hasanović, Mevludin
Stigma and recovery "from" and "in" mental illness are associated in many various ways. While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion, in the same time stigma reduces opportunities, reduces self-esteem and self-efficacy, reduces the belief in own abilities and contributes to social exclusion through discrimination. The recovery of a person with mental illness means to get and keep hope, to understand their own possibilities and impossibilities, active living, to be autonomous, to have a social identity and to give meaning and purpose of our own lives. The care system, recovery-oriented, provides help and support to people with mental disorders in his/her recovery, which contributes to reduction of self-stigma, to the elimination of stigmatizing attitudes and beliefs in mental health services which consequently may have a positive reflection in reducing the stigma of mental illness in the community. It is important to look at the stigma and recovery from the perspective of individual experience of each person with a mental illness in the process of recovery. A support to the recovery concept and the development of a recovery-oriented system of care should be one of the key segments of any strategy to combat the stigma of mental illness. Also, the cultural and the social stigma aspects of stigma would be taken into account in the developing of the recovery concept and on the recovery-oriented care system.
Kjeldsen, Lene Juel; Hansen, Per Sveistrup; Kristensen, Anne Mette Fisker
by clinical pharmacists to support the implementation of screening of MeS at a psychiatric ward. Methods: The study was conducted at the psychiatric ward, Odense University Hospital. In 2008, clinical guidelines for systematic screening and prevention of metabolic risk were developed and implemented...... by passive dissemination (PD) followed by a period of active implementation (AI). AI contained outreach visits by clinical pharmacists on a weekly basis. Patients with affective disorder or schizophrenia were included. The study was designed as a before-and-after study, and electronic patient charts were...... pharmacists significantly improved the use of the screening sheet...
Caruso, Rosangela; Grassi, Luigi; Biancosino, Bruno; Marmai, Luciana; Bonatti, Luciano; Moscara, Maria; Rigatelli, Marco; Carr, Catherine; Priebe, Stefan
Group therapies are routinely provided for patients with severe mental illness. The factors important to the group experience of patients are still poorly understood and are rarely measured. To support further research and practice, we aimed to develop a questionnaire that captures how patients experience groups within a community mental health context. An initial pool of 39 items was conceptually generated to assess different aspects of group experiences. Items were completed by 166 patients with severe mental illness attending group therapies in community mental health services in Italy. Patients with different psychiatric diagnoses who attended at least 5 group sessions were included. An exploratory factor analysis was used to identify different dimensions of group experiences and to reduce the number of items for each dimension. The resulting questionnaire has five subscales: 1) sharing of emotions and experiences, 2) cognitive improvement, 3) group learning, 4) difficulties in open expression and 5) relationships. Each subscale has 4 items. The scale and sub-scales have good internal consistency. The Ferrara Group Experiences Scale is conceptually derived and assesses dimensions of group experience that are theoretically and practically relevant. It is brief, easy to use and has good psychometric properties. After further validation, the scale may be used for research into patient experiences across different group therapy modalities and for evaluation in routine care.
Objective: This study reviews conceptual and methodological issues of needs for care among people with severe mental illness (SMI) and presents data on their prevalence, correlates and consequences for mental health care. Method: Focus is on the definition of the concept of need as what people can
Owiti, John A; Palinski, Andrea; Ajaz, Ali; Ascoli, Micol; De Jongh, Bertine; Bhui, Kamaldeep S
Cultural variations in perceptions of mental distress are important issues for healthcare. They can affect communication between patients and professionals and may be a root cause for misdiagnosis, patient disengagement, and disparities in access, outcomes and overall experiences of treatment by patients. Taking into account patients' explanatory models (EMs) of mental distress is fundamental to patient-centred care, and improved outcomes. This paper reports on the outcomes from the Cultural Consultation Service, commissioned in an inner-city London borough. We used a narrative-based ethnographic method of assessment, in which community mental health patients referred for a cultural consultation were interviewed using Barts Explanatory Model Inventory and Checklist (BEMI) to assess the EMs of their mental distress. Patients mainly attributed the causes and consequences of their mental distress to emotional and psychological factors, which were inextricably linked to existing social concerns and interpersonal issues. Desired solutions mainly focused on treatment, social, and systemic interventions. We found that using BEMI could contribute to a comprehensive assessment in routine care and can be used by professionals within a short timeframe and with minimal training. Ethnographic assessment method captures patients' EMs and illness experiences, opening the way for patient-centred interventions and potentially better outcomes and experiences.
Ventegodt, Søren; Kandel, Isack; Merrick, Joav
Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from p...
Shuel, Francis; White, Jacquie; Jones, Martin; Gray, Richard
The physical health of people with serious mental illness is a cause of growing concern to clinicians. Life expectancy in this population may be reduced by up to 25 years and patients often live with considerable physical morbidity that can dramatically reduce quality of life and contribute to social exclusion. This study sought to determine whether the serious mental illness health improvement profile [HIP], facilitated by mental health nurses [MHNs], has the clinical potential to identify physical morbidity and inform future evidence-based care. Retrospective documentation audit and qualitative evaluation of patients' and clinicians' views about the use of the HIP in practice. A nurse-led outpatient medication management clinic, for community adult patients with serious mental illness in Scotland. 31 Community patients with serious mental illness seen in the clinic by 2 MHNs trained to use the HIP. All 31 patients, 9 MHNs, 4 consultant psychiatrists and 12 general practitioners [GPs] (primary care physicians) participated in the qualitative evaluation. A retrospective documentation audit of case notes for all patients where the HIP had been implemented. Semi-structured interviews with patients and their secondary care clinicians. Postal survey of GPs. 189 Physical health issues were identified (mean 6.1 per patient). Items most frequently flagged 'red', suggesting that intervention was required, were body mass index [BMI] (n=24), breast self-examination (n=23), waist circumference (n=21), pulse (n=14) and diet (n=13). Some rates of physical health problems observed were broadly similar to those reported in studies of patients receiving antipsychotics in primary care but much lower than those reported in epidemiological studies. Individualised care was planned and delivered with each patient based on the profile. 28 discreet interventions that included providing advice, promoting health behavioural change, performing an electrocardiogram and making a referral to
Strid, Catharina; Andersson, Claes; Forsell, Yvonne; Öjehagen, Agneta; Lundh, Lars-Gunnar
Mental ill-health has become a large health problem and it is important for caregivers to provide effective treatment alternatives. REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances. The study comprised 879 patients with mental ill-health taking part in the REGASSA study. Data were collected by Interactive Voice Response (IVR), a computerized, automated telephone technique. The treatments were compared at baseline, twice during treatment, at the end of treatment and at three follow-ups after treatment. Measures used were the Outcome Questionnaire-45, the short versions of the Perceived Stress Scale, and the Karolinska Sleep Questionnaire. Linear mixed models showed that the patients in ICBT and PE had better results than in TAU on psychological functioning and sleep disturbances, p effect sizes. On stress there were no differences; all groups made improvements. Women had stronger effects than men. More patients recovered on psychological functioning (OQ-45) in ICBT and PE than in TAU. Internet-based cognitive behaviour therapy and PE proved to be effective treatment alternatives for patients with mild-to-moderate mental ill-health in improving psychological functioning, stress, and sleep disturbances and could be useful alternatives in primary care. Internet-based cognitive behaviour therapy and physical exercise proved to be effective treatment alternatives for mental ill-health patients in primary care. Automated techniques (Interactive Voice Response) could be useful for following treatment course in large groups of patients in the health care. It is important to use measures that capture different
Grover, Sandeep; Avasthi, Ajit; Shah, Sandip; Lakdawala, Bhavesh; Chakraborty, Kaustav; Nebhinani, Naresh; Kallivayalil, Roy Abraham; Dalal, Pranob K.; Sinha, Vishal; Khairkar, Praveen; Mukerjee, Divya G.; Thara, R.; Behere, Prakash; Chauhan, Nidhi; Thirunavukarasu, M.
Aim: To assess the health-care needs of the patients with severe mental disorders. Materials and Methods: Patients with the diagnosis of a severe mental disorder (schizophrenia and related psychotic disorders, bipolar disorder, recurrent depressive disorder, major depressive disorder and obsessive compulsive disorder) were assessed using Camberwell Assessment of Need-Research version (CAN-R) Scale and indigenously designed Supplementary Needs Assessment Scale (SNAS). Results: The study includ...
Stolzenburg, Susanne; Freitag, Simone; Evans-Lacko, Sara; Muehlan, Holger; Schmidt, Silke; Schomerus, Georg
The aim of this study was to investigate whether personal stigma decreases self-identification as having a mental illness in individuals with untreated mental health problems. We interviewed 207 persons with a currently untreated mental health problem as confirmed by a structured diagnostic interview. Measures included symptom appraisal, self-identification as having a mental illness (SELFI), self-labeling (open-ended question on the nature of their problem) stigma-related variables (explicit and implicit), as well as sociodemographics, current symptom severity, and previous treatment. Support for discrimination and implicit stigmatizing attitude were both associated with lower likelihood of self-identification. More social distance and support for discrimination were associated with less self-labeling. Previous treatment was the strongest predictor of symptom appraisal, SELFI, and self-labeling. Destigmatizing mental illness could increase awareness of personal mental health problems, potentially leading to lower rates of untreated mental illness.
Lauritzen, Camilla; Reedtz, Charlotte; Martinussen, Monica; vanDoesum, Karin
Children of parents with a mental illness are at risk of developing mental health problems themselves (Beardslee, Versage & Gladstone, 1998; Hosman, van Doesum, & van Santvoort, 2009; Reupert & Maybery, 2007). In order to prevent children of mentally ill parents from developing serious problems, it is therefore beneficial to include a child perspective in the treatment of mentally ill parents by identifying the children of patients, and supporting patients in their parenting role. Norwegia...
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…
Mattejat, Fritz; Remschmidt, Helmut
The children of mentally ill parents have a higher risk of developing mental illnesses themselves over the course of their lives. This known risk must be taken into account in the practical provision of health care. Selective literature review. The increased psychiatric risk for children of mentally ill parents is due partly to genetic influences and partly to an impairment of the parent-child interaction because of the parent's illness. Furthermore, adverse factors are more frequent in these families, as well as a higher risk for child abuse. Genetic and psychosocial factors interact with one another. For example, genetic factors moderate environmental effects; that is, the effect of adverse environmental factors depends on the genetic substrate. Preventive measures for children of mentally ill parents urgently need improvement. In this article, positively evaluated programs of preventive measures are discussed. Essential prerequisites for success include appropriate, specialized treatment of the parental illness, psychoeducative measures, and special support (e.g. self-help groups) as indicated by the family's particular needs.
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
Work is a major determinant of mental health and a socially integrating force. To be excluded from the workforce creates material deprivation, erodes self-confidence, creates a sense of isolation and marginalization and is a key risk factor for mental disability. This review summarizes recent evidence pertaining to employment-related stigma and discrimination experienced by people with mental disabilities. A broad understanding of the stigmatization process is adopted, which includes cognitive, attitudinal, behavioural and structural disadvantages. Stigma is both a proximate and a distal cause of employment inequity for people with a mental disability who experience direct discrimination because of prejudicial attitudes from employers and workmates and indirect discrimination owing to historical patterns of disadvantage, structural disincentives against competitive employment and generalized policy neglect. Against this background, modern mental health rehabilitation models and legislative philosophies, which focus on citizenship rights and full social participation, are to be welcomed. Yet, recent findings demonstrate that the legislation remains vulnerable to the very prejudicial attitudes they are intended to abate. Research conducted during the past year continues to highlight multiple attitudinal and structural barriers that prevent people with mental disabilities from becoming active participants in the competitive labour market.
Kristofferzon, Marja-Leena; Engström, Maria; Nilsson, Annika
The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status. The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS. The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL. Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.
Zeyne Alves Pires Scherer
Full Text Available Abordagens alternativas no manejo da doença mental têm surgido no mundo inteiro com ênfase nos modelos extra-hospitalares, comunitários. Pouco se fala das pessoas cronicamente internadas. O objetivo da presente revisão da literatura foi levantar o que os estudiosos têm proposto na última década no que se refere ao trabalho com doentes mentais crônicos internados. Os artigos e textos encontrados foram divididos nos tópicos: características dos doentes crônicos internados, opinião destes sobre a internação e sugestões para melhorar a prática. Como conclusão, os autores propõem uma melhor avaliação com estudos sérios sobre esta clientela, a realidade que a cerca e as possibilidades de intervenção.Abordajes alternativos en el manejo de la enfermedad mental han surgido en el mundo entero con énfasis en los modelos extra-hospitalarios, comunitarios. Poco se habla de las personas crónicamente internadas. El objetivo de la presente revisión de la literatura fue levantar lo que los estudiosos han propuesto en la última década acerca del trabajo con enfermos mentales crónicos internados. Los artículos y textos encontrados fueron divididos en los tópicos: características de los enfermos crónicos internados, opinión de los mismos sobre la internación y sugerencias para mejorar la práctica. Como conclusión, los autores proponen una mejor evaluación con estudios serios sobre esta clientela, la realidad que la circunda y las posibilidades de intervención.Alternative approaches to manage mental illness have arisen all over the world with emphasis on outpatient community models. Little is said about chronically hospitalized patients. The purpose of this literature review was to access what researchers have proposed in the past decade concerning the work with chronic mentally ill inpatients. The articles found were divided in topics: characteristics of chronic mentally ill inpatients, their opinion about hospitalization and
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....
Wundsam, Kerstin; Pitschel-Walz, Gabi; Leucht, Stefan; Kissling, Werner
Contact with police officers due to schizophrenia and resort to violence in such interactions is a common occurrence and represents a source for stigmatisation of mentally ill people. Aim of this project was to establish a program for police officers to reduce that stigma. The seminar was developed by a German anti-stigma organisation in cooperation with sociology teachers of the Bavarian police academy. Evaluations focussed on the police officers "social distance" and "negative stereotypes" towards mentally ill people. The personal contact between officers and the referees (patients, relatives, professionals) was the core of the seminar. Results of a debriefing after the pilot-project was overall positive. Evaluations in the renewal years showed significant improvement within the scale "social distance" (p stigma interventions.
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.
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...
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 ...
Gold, Azgad; Appelbaum, Paul S
Should a murderer be allowed to inherit the victim's estate? The question dates from biblical times, but most jurisdictions today have statutes in place that bar inheritance by convicted murderers. However, a special problem arises when the killer has a severe mental illness and has been found not guilty by reason of insanity. Should such people, who have not been convicted of a crime, be permitted to collect their inheritance? Jurisdictions vary in their responses, with the rules reflecting a mix of practical and moral considerations influenced by different perspectives about what determines the behavior of persons with mental illness.
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....
Hipes, Crosby; Lucas, Jeffrey; Phelan, Jo C; White, Richard C
Mental illness labels are accompanied by devaluation and discrimination. We extend research on reactions to mental illness by utilizing a field experiment (N = 635) to test effects of mental illness labels on labor market discrimination. This study involved sending fictitious applications to job listings, some applications indicating a history of mental illness and some indicating a history of physical injury. In line with research indicating that mental illness leads to stigma, we predicted fewer callbacks to candidates with mental illness. We also predicted relatively fewer callbacks for applicants with mental illness when the jobs involved a greater likelihood for interpersonal contact with the employer. Results showed significant discrimination against applicants with mental illness, but did not indicate an effect of potential proximity to the employer. This contributes a valuable finding in a natural setting to research on labor market discrimination towards people with mental illness. Copyright © 2015 Elsevier Inc. All rights reserved.
Deenik, Jeroen; Kruisdijk, Frank; Tenback, Diederik; Braakman-Jansen, Annemarie; Taal, Erik; Hopman-Rock, Marijke; Beekman, Aartjan; Tak, Erwin; Hendriksen, Ingrid; van Harten, Peter
Increasing physical activity in patients with severe mental illness is believed to have positive effects on physical health, psychiatric symptoms and as well quality of life. Till now, little is known about the relationship between physical activity and quality of life in long-term hospitalized patients with severe mental illness and knowledge of the determinants of behavioural change is lacking. The purpose of this study was to elucidate the relationship between objectively measured physical activity and quality of life, and explore modifiable psychological determinants of change in physical activity in long-term hospitalized patients with severe mental illness. In 184 inpatients, physical activity was measured using an accelerometer (ActiGraph GTX+). Quality of life was assessed by EuroQol-5D and WHOQol-Bref. Attitude and perceived self-efficacy towards physical activity were collected using the Physical Activity Enjoyment Scale and the Multidimensional Self Efficacy Questionnaire, respectively. Patient and disease characteristics were derived retrospectively from electronic patient records. Associations and potential predictors were analysed using hierarchical regression. Physical activity was positively related with and a predictor of all quality of life outcomes except on the environmental domain, independent of patient and disease characteristics. However, non-linear relationships showed that most improvement in quality of life lies in the change from sedentary to light activity. Attitude and self-efficacy were not related to physical activity. Physical activity is positively associated with quality of life, especially for patients in the lower spectrum of physical activity. An association between attitude and self-efficacy and physical activity was absent. Therefore, results suggest the need of alternative, more integrated and (peer-)supported interventions to structurally improve physical activity in this inpatient population. Slight changes from sedentary
DE HERT, MARC; CORRELL, CHRISTOPH U.; BOBES, JULIO; CETKOVICH-BAKMAS, MARCELO; COHEN, DAN; ASAI, ITSUO; DETRAUX, JOHAN; GAUTAM, SHIV; MÖLLER, HANS-JURGEN; NDETEI, DAVID M.; NEWCOMER, JOHN W.; UWAKWE, RICHARD; LEUCHT, STEFAN
The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic treatment and disparities in health care access, utilization and provision that contribute to these poor physical health outcomes. We searched MEDLINE (1966 – August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates. Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI. It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases. Moreover, there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases. Lifestyle factors, relatively easy to measure, are barely considered for screening; baseline testing of numerous important physical parameters is insufficiently performed. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains to be improved for individuals with SMI. PMID:21379357
Welch, Lisa C; Litman, Heather J; Borba, Christina P C; Vincenzi, Brenda; Henderson, David C
To determine whether physician's attitudes toward patients with comorbid mental illness affect management of a chronic disease. A total of 256 primary care physicians interviewed in 2010. This randomized factorial experiment entailed physicians observing video vignettes of patient-actors with poorly controlled diabetes. Patients were balanced across age, gender, race, and comorbidity (schizophrenia with bizarre or normal affect, depression, eczema). Physicians completed structured and semistructured interviews plus chart notes about clinical management and attitudes. Physicians reported more negative attitudes for patients with schizophrenia with bizarre affect (SBA). There were few differences in clinical decisions measured quantitatively or in charting, but qualitative data revealed less trust of patients with SBA as reporters, with more reliance on sources other than engaging the patient in care. Physicians often alerted colleagues about SBA, thereby shaping expectations before interactions occurred. Results are consistent with common stereotypes about people with serious mental illness. Vignettes did not include intentional indication of unreliable reporting or danger. Reducing health care disparities requires attention to subtle aspects of managing patients--particularly those with atypical affect--as seemingly slight differences could engender disparate patient experiences over time. © Health Research and Educational Trust.
Alonso, L; Jeffrey, W D
Santeria, a religious system that blends African and Catholic beliefs, is practiced by many Cuban Americans. One aspect of this system is the belief in spirit possession. Basic santeria beliefs and rituals, including the fiesta santera (a gathering at which some participants may become possessed), are briefly described, and four cases in which the patients' belief in possession played a role in their mental illness are presented. The belief in possession can complicate the diagnosis and treatment of mental illness, but it should not be considered a culture-bound syndrome. Rather, it may be a nonspecific symptom of a variety of mental illnesses and should be evaluated in the context of the patient's overall belief system and ability to carry out usual activities.
Schrank, Beate; Moran, Katherine; Borghi, Cristiana; Priebe, Stefan
There are well-established risks for parents with severe mental illness (i.e. psychotic and bipolar disorders), both for their children and themselves. Interventions to help parents fulfil their role should therefore be a public health objective, but their implementation needs to be underpinned by research evidence. This systematic review determines what is known about the nature and effectiveness of interventions for parents with severe mental illness. We conducted a narrative synthesis of controlled and uncontrolled studies reporting interventions for this patient group after the post-natal period (i.e. after the child has turned 1 year old). Eighteen publications reported data from 15 studies. All but two studies were rated as low quality studies. Interventions included home visiting programmes, complex community programmes, residential treatments, and online interventions. Interventions targeted diverse areas, with parenting skills and understanding the impact of mental illness on parenting most frequently addressed. Both parent and child-related outcomes improved, but children were only assessed via observers and follow-up times were short. Interventions were diverse with respect to their nature and effectiveness. Future interventions should combine different intervention strategies to target multiple areas in a flexible manner. The addition of positively focussed and resource-oriented components should be investigated. Trials should include direct assessments of both parents and children, outcomes that are relevant from a public health perspective, and establish the long-term effects ideally until children have reached 18 years of age.
Rüsch, Nicolas; Todd, Andrew R.; Bodenhausen, Galen V.; Corrigan, Patrick W.
Whereas some research suggests that acknowledgment of the role of biogenetic factors in mental illness could reduce mental illness stigma by diminishing perceived responsibility, other research has cautioned that emphasizing biogenetic aspects of mental illness could produce the impression that mental illness is a stable, intrinsic aspect of a person (“genetic essentialism”), increasing the desire for social distance. We assessed genetic and neurobiological causal attributions about mental il...
Lauritzen, Camilla; Reedtz, Charlotte; Van Doesum, Karin TM; Martinussen, Monica
Background: Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. Methods: The design w...
Pickard, Ben S; Hollox, Edward J; Malloy, M Pat; Porteous, David J; Blackwood, Douglas H R; Armour, John A L; Muir, Walter J
Cryptic structural abnormalities within the subtelomeric regions of chromosomes have been the focus of much recent research because of their discovery in a percentage of people with mental retardation (UK terminology: learning disability). These studies focused on subjects (largely children) with various severities of intellectual impairment with or without additional physical clinical features such as dysmorphisms. However it is well established that prevalence of schizophrenia is around three times greater in those with mild mental retardation. The rates of bipolar disorder and major depressive disorder have also been reported as increased in people with mental retardation. We describe here a screen for telomeric abnormalities in a cohort of 69 patients in which mental retardation co-exists with severe psychiatric illness. We have applied two techniques, subtelomeric fluorescence in situ hybridisation (FISH) and multiplex amplifiable probe hybridisation (MAPH) to detect abnormalities in the patient group. A subtelomeric deletion was discovered involving loss of 4q in a patient with co-morbid schizoaffective disorder and mental retardation. The precise region of loss has been defined allowing us to identify genes that may contribute to the clinical phenotype through hemizygosity. Interestingly, the region of 4q loss exactly matches that linked to bipolar affective disorder in a large multiply affected Australian kindred.
Blackwood Douglas HR
Full Text Available Abstract Background Cryptic structural abnormalities within the subtelomeric regions of chromosomes have been the focus of much recent research because of their discovery in a percentage of people with mental retardation (UK terminology: learning disability. These studies focused on subjects (largely children with various severities of intellectual impairment with or without additional physical clinical features such as dysmorphisms. However it is well established that prevalence of schizophrenia is around three times greater in those with mild mental retardation. The rates of bipolar disorder and major depressive disorder have also been reported as increased in people with mental retardation. We describe here a screen for telomeric abnormalities in a cohort of 69 patients in which mental retardation co-exists with severe psychiatric illness. Methods We have applied two techniques, subtelomeric fluorescence in situ hybridisation (FISH and multiplex amplifiable probe hybridisation (MAPH to detect abnormalities in the patient group. Results A subtelomeric deletion was discovered involving loss of 4q in a patient with co-morbid schizoaffective disorder and mental retardation. Conclusion The precise region of loss has been defined allowing us to identify genes that may contribute to the clinical phenotype through hemizygosity. Interestingly, the region of 4q loss exactly matches that linked to bipolar affective disorder in a large multiply affected Australian kindred.
Jochems, Eline C; Mulder, Cornelis L; van Dam, Arno; Duivenvoorden, Hugo J; Scheffer, Sylvia C M; van der Spek, Willem; van der Feltz-Cornelis, Christina M
Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients' motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients' treatment motivation upon the patients' TE. The primary outcome is the patients' TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment engagement and clinical outcomes. The
Prevalence of mental distress and associated factors among caregivers of patients with severe mental illness in the outpatient unit of Amanuel Hospital, Addis Ababa, Ethiopia, 2013: Cross-sectional study.
Sintayehu, Mezinew; Mulat, Haregwoin; Yohannis, Zegeye; Adera, Tewodros; Fekade, Maereg
Caregivers like family members or other relatives are central and provide not only practical help and personal care but also give emotional support, and they are suffering from plenty of challengeable tasks. These, eventually, cast out family caregivers into multidimensional problems prominently for mental distress like depression, anxiety, sleep problem and somatic disorder which are followed by physiologic changes and impaired health habits that ultimately lead to illness and possibly to death. Numerous studies demonstrate that mental distress of caregivers are two times compared to general populations. Despite it was not uncommon to observe manifestations of caregivers' mental distress, yet there was no study on this area. Therefore, this study was intended to assess the prevalence of mental distress and associated factors among the caregivers of persons with severe mental illness in the out patients unit of Amanuel Hospital, Ethiopia. Institutional based cross sectional study was conducted from May 1 to 31, 2013 at Amanuel Hospital, Addis Ababa, Ethiopia. Systematic random sampling technique with "k" interval of 13 was employed to withdraw a total of 423 participants from study population. Five psychiatric nurses carried out interview by using standardized and validated Self Reported Questionnaire (SRQ 20). Descriptive statistics, binary and multivariate logistic regression analysis were conducted. This study revealed that the overall prevalence of mental distress was found to be 221(56.7 %). The factors like missed social support, two or more times admission of patient, care giving for psychotic patient, being farmer and being female were found to be predictors for mental distress of caregivers with this [AOR 95 % CI = 9.523(5.002, 18.132)], 3.293(1.474, 3.3560), 2.007(1.109, 3.634), 2.245(1.129, 4.463) and 3.170(1.843, 5.454)] respectively. In this respect the study observed that there was a higher level of mental distress experienced by caregivers of
Larson, Jon E.; Corrigan, Patrick
Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…
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.…
Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep
Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…
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.
This paper examines how an understanding of systematic findings about creative processes involved in art, literature, and science can be applied to the effective treatment of mental illness. These findings and applications are illustrated by particular reference to the work of the poet Sylvia Plath and the treatment of a patient who aspired to become a writer.
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
sufferers of mental illness in Nigeria, span the social, psychological, and economic .... from the ground to eat, that schizophrenia will remain incurable. .... Figure 1: Household coping strategies for the mentally ill. Strategies aimed at Health care ...
, 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 ...
... Families Become an APA Member Learn More Explore APA Psychiatrists Residents & Medical Students Patients & Families About APA ... Psychiatric News Message from President APA Blogs Join APA General Members Residents and Fellows Medical Students International ...
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...
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.
Full Text Available Background: Serum N-terminal pro-brain natriuretic peptide (NT-proBNP is regarded as a sensitive marker of cardiovascular disease. Vascular disease plays an important role in cognitive impairment. Method: In 447 elderly patients with mental illness, serum NT-proBNP level and the presence or absence of vascular disease according to the medical record were used to categorize patients in different subgroups of vascular disease. Results and Conclusion: Patients with vascular disease and elevated serum NT-proBNP level had a lower cognition level, shorter survival time, lower renal function and a higher percentage of pathological brain imaging than patients with vascular disease and normal NT-proBNP level. Thus, elevated serum NT-proBNP level might be helpful to detect patients who have a more severe cardiovascular disease.
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.
Background: Female infertility is highly co-morbid with mental illness. In Nigeria, very few studies have been conducted to determine the pattern of mental illness among women with infertility. We aimed to determine the pattern of mental illness in a sample of women with female infertility as well as its associated correlates.
Murphy, Neil A; Fatoye, Francis; Wibberley, Christopher
Negative stereotypes presented in the media may contribute to the stigma associated with mental illness. People's attitudes towards the mentally ill are initially influenced and subsequently maintained in part by the frequent media presentation of negative stereotypes of mental illness. This could result in social rejection of individuals with mental illnesses. To explore how four main U.K. national newspapers reported on mental health/mental illness stories over a 10-year period. This study utilised content analysis to identify words, themes and trends of representation related to the mentally ill in articles from the four newspapers. The findings indicated that there was an increase in the number of articles related to mental health/illness over the time of the study. The rate of increase was far greater than that for the increase in the total number of articles carried in the press over this time period. It was also identified that pejorative terms were used, in a number of the articles, to describe the mentally ill person. Many of the newspaper reports highlighted the need for protection of the general public from the mentally ill, and that the mentally ill were in some way different to the general public. In particular, both the words "violence" and "drugs" were linked to mental health/mental illness in these articles.
Stoltz, Peter; Skärsäter, Ingela; Willman, Ania
This article reports on commissioned research funded by the Swedish Council of Technology Assessment in Health Care (SBU) and the Swedish Nursing Society (SSF). The objective was to review computer-based education programs. However, as the review produced insufficient evidence of effectiveness, the publication was withheld due to a previous incident where such evidence was misunderstood by Swedish policy and health care decision makers. This article highlights the concept of evidence with regard to the consequences of insufficient evidence of effectiveness being mistaken for evidence of no effectiveness. The aim is also to present a systematic review evaluating a computer-based education program for patients suffering from severe mental illness. Systematic database searches in Medline, CINAHL, PsycINFO and the Cochrane Library identified a total of 131 potentially relevant references. Thereafter, 27 references were retrieved as full-text documents, of which 5 were finally included and co-reviewed by two independent researchers. The review found no decisive evidence of effectiveness regarding computer-based education programs designed to assist persons suffering from severe mental illness. Failing to see the difference between insufficient evidence and evidence of no effectiveness may have unexpected consequences. As a result, practice may be misguided and treatments withheld, which at worse may have harmful consequences for patients. In the end, it is of utmost importance that researchers do good quality research by ensuring statistical power and quality of outcome measurement. For example, this review of computer-based education programs could have revealed effective ways of dealing with severe mental illness if the studies included had been conducted using more sophisticated designs.
Pompili, Enrico; Carlone, Cristiano; Silvestrini, Cristiana; Nicolò, Giuseppe
Aggression is a behaviour with evolutionary origins, but in today’s society it is often both destructive and maladaptive. Increase of aggressive behaviour has been observed in a number of serious mental illnesses, and it represents a clinical challenge for mental healthcare provider. These phenomena can lead to harmful behaviours, including violence, thus representing a serious public health concern. Aggression is often a reason for psychiatric hospitalization, and it often leads to prolonged hospital stays, suffering by patients and their victims, and increased stigmatization. Moreover, it has an effect on healthcare use and costs in terms of longer length of stay, more readmissions and higher drug use. In this review, based on a selective search of 2010-2016 pertinent literature on PubMed, we analyze and summarize information from original articles, reviews, and book chapters about aggression and psychiatric disorders, discussing neurobiological basis and therapy of aggressive behaviour. A great challenge has been revealed regarding the neurobiology of aggression, and an integration of this body of knowledge will ultimately improve clinical diagnostics and therapeutic interventions. The great heterogeneity of aggressive behaviour still hampers our understanding of its causal mechanisms. Still, over the past years, the identification of specific subtypes of aggression has released possibilities for new and individualized treatment approaches. Neuroimaging studies may help to further elucidate the interrelationship between neurocognitive functioning, personality traits, and antisocial and violent behaviour. Recent studies point toward manipulable neurobehavioral targets and suggest that cognitive, pharmacological, neuromodulatory, and neurofeedback treatment approaches can be developed to ameliorate urgency and aggression in schizophrenia. These combined approaches could improve treatment efficacy. As current pharmacological and therapeutic interventions are
Sun, Gwo-Ching; Hsu, Mei-Chi
Child-to-parent violence is an often hidden serious problem for parental caregivers of mentally ill adult children who experience violence toward them. To date, the comprehensive dyadic parent-adult child intervention to manage child-to-parent violence is scarce. To evaluate the effect of Child- and Parent-focused Violence Program, an adjunctive intervention involved with both violent adult children with mental illness and their victimized biological parent (parent-adult child dyads) on violence management. Open-label randomized controlled trial. A psychiatric ward in a teaching hospital and two mental hospitals in Southern Taiwan. Sixty-nine patients aged ≥20 years, with thought or mood disorders, having violent behavior in the past 6 months toward their biological parent of either gender were recruited. The violent patients' victimized biological parents who had a major and ongoing role in provision of care to these patients, living together with and being assaulted by their violent children were also recruited. The parent-adult child dyads were selected. The intervention was carried out from 2011 to 2013. The parent-adult child dyads were randomly assigned to either the experimental group (36 dyads), which received Child- and Parent-focused Violence Intervention Program, or to the control group (33 dyads), which received only routine psychiatric care. The intervention included two individualized sessions for each patient and parent, separately, and 2 conjoint sessions for each parental-child dyad for a total of 6 sessions. Each session lasted for at least 60-min. Data collection was conducted at 3 different time frames: pre-treatment, post-treatment, and treatment follow-up (one month after the completion of the intervention). Occurrence of violence prior to intervention was comparable between two groups: 88.9% (n=32) parents in the experimental group versus 93.9% (n=31) in the control group experienced verbal attack, and 50% (n=18) versus 48.5% (n=16
Walter, Charles Thomas
This dissertation demonstrates how patients' mental illness treatment careers depend on the change and/or stability among differing levels of social structure. Theorists of the mental illness career tend to ignore the role that higher levels of social structural change have on individuals' mental illness career. Researchers using an organizational perspective tend to focus on the organizational environment but ignore the treatment process from the individual's point of view. Both perspectives...
Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W
Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. This review aims to clarify the concept of mental illness stigma and discuss consequences for individuals with mental illness. After a conceptual overview of stigma we discuss two leading concepts of mental illness stigma and consequences of stigma, focussing on self-stigma/empowerment and fear of stigma as a barrier to using health services. Finally, we discuss three main strategies to reduce stigma -- protest, education, and contact -- and give examples of current anti-stigma campaigns. Well-designed anti-stigma initiatives will help to diminish negative consequences of mental illness stigma.
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.
Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona
This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.
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.
Rowan, Kathleen; Shippee, Nathan D
This study used nationally representative household survey data to examine the association between mental illness and experiences with usual care providers and health plans among persons with public or private insurance (N=25,176). Data were from the 2004-2012 Medical Expenditure Panel Surveys. Mental illness was assessed with symptom scales of serious psychological distress and depression at two time points, and persons were categorized by whether mental illness was episodic or persistent over time. Questions about experiences with providers (four questions) and plans (five questions) were based on the Consumer Assessment of Healthcare Providers and Systems survey. Rates of problems with plans and providers were reported for each category of mental illness, and multivariate regression was used to examine the association of problems with mental illness. Rates of problems with health plans were high, specifically for treatment approvals, finding information, and customer service, and were higher among persons with mental illness. Rates of problems with providers were lower than problems with plans, but persons with mental illness were more likely to report problems, specifically that doctors do not explain treatment options, respect treatment choices, or seek participation in decisions. Persons with mental illness reported experiencing more clinical and administrative problems at their usual source of care, although the reasons were not clear. Efforts by plans to improve health care before and after the clinical encounter and by providers to design treatments in line with patient preferences may improve experiences for all patients and particularly for those with mental illness.
Tungpunkom, Patraporn; Maayan, Nicola; Soares-Weiser, Karla
Background Most people with schizophrenia have a cyclical pattern of illness characterised by remission and relapses. The illness can reduce the ability of self-care and functioning and can lead to the illness becoming disabling. Life skills programmes, emphasising the needs associated with independent functioning, are often a part of the rehabilitation process. These programmes have been developed to enhance independent living and quality of life for people with schizophrenia. Objectives To review the effects of life skills programmes compared with standard care or other comparable therapies for people with chronic mental health problems. Search methods We searched the Cochrane Schizophrenia Group Trials Register (June 2010). We supplemented this process with handsearching and scrutiny of references. We inspected references of all included studies for further trials. Selection criteria We included all relevant randomised or quasi-randomised controlled trials for life skills programmes versus other comparable therapies or standard care involving people with serious mental illnesses. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis, based on a random-effects model. For continuous data, we calculated mean differences (MD), again based on a random-effects model. Main results We included seven randomised controlled trials with a total of 483 participants. These evaluated life skills programmes versus standard care, or support group. We found no significant difference in life skills performance between people given life skills training and standard care (1 RCT, n = 32, MD −1.10; 95% CI −7.82 to 5.62). Life skills training did not improve or worsen study retention (5 RCTs, n = 345, RR 1.16; 95% CI 0.40 to 3.36). We found no significant difference in PANSS positive, negative or total scores between life skills intervention and
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
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.
Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W
Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. We aim to clarify the concept of mental illness stigma and discuss important consequences for people with mental illness. A search of scientific literature on mental illness stigma was conducted with a focus on conceptually relevant empirical studies. After giving a conceptual overview of stigma, we elaborate on the consequences of stigma, focussing on self-stigma/empowerment, coping behaviour, fear of stigma as a barrier to using health services, and on structural discrimination. Main strategies to reduce stigma -- protest, education, and contact -- are discussed. Stigma is of central importance to persons with mental illness, both to how they experience their illness and its consequences and whether they use available health services. Well-designed anti-stigma initiatives will help to diminish the impact of mental illness stigma.
Ritter, Kristina; Chaudhry, Haroon R; Aigner, Martin; Zitterl, Werner; Stompe, Thomas
Subjective health beliefs are representations about pathogenesis, course and treatment options of psychic as well as somatic illnesses. They are important for a psychotherapeutic interaction as well as for a stable drug adherence. However, it remains unclear whether these representations are primarily affected by the cultural background or by an individual's specific illness experiences, a question of increasing importance in our era of globalized migration. The study sample consisted of 203 Austrians (125 with schizophrenia, 78 with obsessivecompulsive disorder) and 190 Pakistanis (120 with schizophrenia, 70 with obsessive-compulsive disorder). All patients completed the "Causal Explanations of Mental Disorders" (CEMD), a 41-item self-rating questionnaire. Pakistani patients reported magic-religious oriented mental health beliefs more frequently. In contrast, Austrians' beliefs are more often in line with the bio-psychosocial explanations of Western medicine. Concerning mental health beliefs the cultural background seems to be more important than the subjective experience with a distinctive mental disorder. Although the subjective experience is of importance for the shape of illnessspecific cognitions, mental health beliefs are primarily caused by the patients' socio-cultural origin. It is a challenge for psychiatry to improve the co-operation with culture-anthropology and other social sciences.
Cosh, S.; Zentner, N.; Ay, E.; Loos, S.; Slade, Mike; Maj, Mario; Salzano, A.; Berecz, R.; Glaub, T.; Munk-Jørgensen, Povl; Krogsgaard Bording, M.; Rössler, Wulf; Kawohl, Wolfram; Puschner, Bernd
Objective: This study aims to explore relationships between preferred and experienced clinical decision making with service use, and associated costs, by people with severe mental illness.\\ud Methods: Prospective observational study of mental healthcare in six European countries: Germany, UK, Italy Hungary, Denmark and Switzerland. Patients (N = 588) and treating clinicians (N = 213) reported preferred and experienced decision making at baseline using the Clinical Decision Making Style Scale ...
Rüsch, Nicolas; Todd, Andrew R; Bodenhausen, Galen V; Corrigan, Patrick W
Whereas some research suggests that acknowledgment of the role of biogenetic factors in mental illness could reduce mental illness stigma by diminishing perceived responsibility, other research has cautioned that emphasizing biogenetic aspects of mental illness could produce the impression that mental illness is a stable, intrinsic aspect of a person ("genetic essentialism"), increasing the desire for social distance. We assessed genetic and neurobiological causal attributions about mental illness among 85 people with serious mental illness and 50 members of the public. The perceived responsibility of persons with mental illness for their condition, as well as fear and social distance, was assessed by self-report. Automatic associations between Mental Illness and Guilt and between Self and Guilt were measured by the Brief Implicit Association Test. Among the general public, endorsement of biogenetic models was associated with not only less perceived responsibility, but also greater social distance. Among people with mental illness, endorsement of genetic models had only negative correlates: greater explicit fear and stronger implicit self-guilt associations. Genetic models may have unexpected negative consequences for implicit self-concept and explicit attitudes of people with serious mental illness. An exclusive focus on genetic models may therefore be problematic for clinical practice and anti-stigma initiatives. Copyright © 2009 Elsevier Ltd. All rights reserved.
Jochems Eline C
Full Text Available Abstract Background Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1 to determine whether a feedback intervention based on the patients’ motivation for treatment is effective at improving treatment engagement (TE of severe mentally ill patients in outpatient psychiatric treatment, 2 to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM and TE in this patient population and 3 to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. Methods/design The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients’ treatment motivation upon the patients’ TE. The primary outcome is the patients’ TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. Discussion The current study can provide important insights regarding motivational processes and the way in which motivation
Background Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients’ motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and possible mechanisms regarding treatment motivation (TM) and TE in this patient population and 3) to determine which of three theories of motivation is most plausible for the dynamics of TM and TE in this population. Methods/design The Motivation and Treatment Engagement Intervention Trial (MotivaTe-IT) is a multi-center cluster randomized trial investigating the effectiveness of feedback generated by clinicians regarding their patients’ treatment motivation upon the patients’ TE. The primary outcome is the patients’ TE. Secondary outcomes are TM, psychosocial functioning and quality of life. Patients whose clinicians generate monthly motivation feedback (additional to treatment as usual) will be compared to patients who receive treatment as usual. An estimated 350 patients, aged 18 to 65 years, with psychotic disorders and/or severe personality disorders will be recruited from outpatient community mental health care. The randomization will be performed by a computerized randomization program, with an allocation ratio of 1:1 (team vs. team or clinician vs. clinician) and patients, but not clinicians, will be blind to treatment allocation at baseline assessment. Due to the nature of the trial, follow-up assessment can not be blinded. Discussion The current study can provide important insights regarding motivational processes and the way in which motivation influences the treatment
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.
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.
Soderstrom, Irina R.
Prisons are increasingly being filled with inmates who suffer from mental illness. This paper examines the prevalence of mental illness in American jails and prisons, the duty government and society has to provide appropriate mental health treatment, and the implications for inmate safety, costs, recidivism, and community reintegration if…
Comorbid substance use in adolescents with mental illness is often an indicator of poor treatment outcome. This study aims to determine the prevalence of, and associated risk factors for, substance use in adolescents with mental illness attending a mental health service. Data was collected from hospital records of 162 ...
... putting these recommendations in place. By state and community leaders Helping mental health and tobacco control programs to work together to ... With Mental Illness On Other Web Sites The Community Guide: Reducing Tobacco Use and ... Administration) SAMHSA: Smoking & Mental Illness SAMHSA: Smoking & ...
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.
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…
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…
Painter, Janelle M; Brignone, Emily; Gilmore, Amanda K; Lehavot, Keren; Fargo, Jamison; Suo, Ying; Simpson, Tracy; Carter, Marjorie E; Blais, Rebecca K; Gundlapalli, Adi V
Severe mental illness (SMI) and substance use disorders (SUD) are among the more chronic and costly mental health conditions treated in the Department of Veterans Affairs (VA). Service use patterns of returning veterans with SMI and SUD have received little attention. We examined gender differences in the utilization of VA services among a national sample of Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) VA patients with SMI, SUD, and their comorbidity (SMI/SUD) in their first year of established VA care (N = 24,166). Outpatient services and acute-residential stays were modeled using negative binomial and logistic regression, respectively. Among all diagnostic categories, men used outpatient services less often than did women, including primary care (adjusted rate ratio [ARR] = .71, 95% confidence interval CI [.68, .74]), mental health (ARR = .85, 95% CI [.80, .91]), and addiction (ARR = .91, 95% CI [.83, .99]) services. For emergency department (ED) and psychiatric inpatient services, gender interacted significantly with diagnosis. The combination of SMI/SUD compared to either SMI or SUD conferred greater risk of ED utilization among men than women (adjusted odds ratio [AOR] = 2.09, 95% CI [1.24, 3.51], and 1.95, 95% CI [1.17, 3.26], respectively). SMI versus SUD conferred greater risk of psychiatric inpatient utilization among men than women (AOR = 1.83, 95% CI [1.43, 2.34]). Our findings point to gender differences in outpatient and acute service utilization among OEF/OIF/OND VA patients with some of the more chronic and costly mental health conditions. Further investigation of health care utilization patterns is needed to understand factors driving these gender differences to ensure that veterans have appropriate access to the services they need. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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.
Maher, Erin J; Kroska, Amy
We examine the determinants of patients' accounts of their own mental illness. In particular, we examine the factors that affect the likelihood of attributing one's own mental illness to controllable factors rather than non-controllable factors. Our quantitative measure of attributional control is derived from the coding of in-depth interviews with people with severe mental illness seeking treatment for the first time (N = 144). We find that those who occupy positions of social disadvantage (particularly African-American males and those who receive public assistance) are less likely to attribute their illness to controllable sources, suggesting that personal mental illness attributions are systematically related to a person's social location. We outline the significance of these findings for research on the psychological consequences of mental illness attributions.
Carson, Nicholas J; Vesper, Andrew; Chen, Chih-Nan; Lê Cook, Benjamin
Outpatient follow-up after hospitalization for mental health reasons is an important indicator of quality of health systems. Differences among racial-ethnic minority groups in the quality of service use during this period are understudied. This study assessed the quality of outpatient treatment episodes following inpatient psychiatric treatment among blacks, whites, and Latinos in the United States. The Medical Expenditure Panel Survey (2004-2010) was used to identify adults with any inpatient psychiatric treatment (N=339). Logistic regression models were used to estimate predictors of any outpatient follow-up or the beginning of adequate outpatient follow-up within seven or 30 days following discharge. Predicted disparities were calculated after adjustment for clinical need variables but not for socioeconomic characteristics, consistent with the Institute of Medicine definition of health care disparities as differences that are unrelated to clinical appropriateness, need, or patient preference. Rates of follow-up were generally low, particularly rates of adequate treatment (<26%). Outpatient treatment prior to inpatient care was a strong predictor of all measures of follow-up. After adjustment for need and socioeconomic status, the analyses showed that blacks were less likely than whites to receive any treatment or begin adequate follow-up within 30 days of discharge. Poor integration of follow-up treatment in the continuum of psychiatric care leaves many individuals, particularly blacks, with poor-quality treatment. Culturally appropriate interventions that link individuals in inpatient settings to outpatient follow-up are needed to reduce racial-ethnic disparities in outpatient mental health treatment following acute treatment.
Wright, Christine A; Osborn, David PJ; Nazareth, Irwin; King, Michael B
Background People with severe mental illness (SMI) are at increased risk of developing coronary heart disease (CHD) and there is growing emphasis on the need to monitor their physical health. However, there is little consensus on how services for the primary prevention of CHD should be organised for this patient group. We explored the views of people with SMI and health professionals from primary care and community mental health teams (CMHTs) on how best to provide these services. Methods In-depth interviews were conducted with a purposive sample of patients with SMI (n = 31) and staff from primary care (n = 10) and community mental health teams (n = 25) in North Central London. Transcripts of the qualitative interviews were analysed using a 'framework' approach to identify the main themes in opinions regarding various service models. Results Cardiovascular risk factors in people with SMI were of concern to participants. However, there was some disagreement about the best way to deliver appropriate care. Although staff felt that primary care should take responsibility for risk factor screening and management, patients favoured CHD screening in their CMHT. Problems with both approaches were identified. These included a lack of familiarity in general practice with SMI and antipsychotic side effects and poor communication of physical health issues to the CMHT. Lack of knowledge regarding CHD risk factor screening and difficulties in interpreting screening results and implementing appropriate interventions exist in secondary care. Conclusion Management of physical health care for people with SMI requires complex solutions that cross the primary-secondary care interface. The views expressed by our participants suggest that neither primary nor secondary care services on their own can provide a comprehensive service for all patients. The increased risk of CHD associated with SMI and antipsychotic medications requires flexible solutions with clear lines of responsibility
Full Text Available Abstract Background People with severe mental illness (SMI are at increased risk of developing coronary heart disease (CHD and there is growing emphasis on the need to monitor their physical health. However, there is little consensus on how services for the primary prevention of CHD should be organised for this patient group. We explored the views of people with SMI and health professionals from primary care and community mental health teams (CMHTs on how best to provide these services. Methods In-depth interviews were conducted with a purposive sample of patients with SMI (n = 31 and staff from primary care (n = 10 and community mental health teams (n = 25 in North Central London. Transcripts of the qualitative interviews were analysed using a 'framework' approach to identify the main themes in opinions regarding various service models. Results Cardiovascular risk factors in people with SMI were of concern to participants. However, there was some disagreement about the best way to deliver appropriate care. Although staff felt that primary care should take responsibility for risk factor screening and management, patients favoured CHD screening in their CMHT. Problems with both approaches were identified. These included a lack of familiarity in general practice with SMI and antipsychotic side effects and poor communication of physical health issues to the CMHT. Lack of knowledge regarding CHD risk factor screening and difficulties in interpreting screening results and implementing appropriate interventions exist in secondary care. Conclusion Management of physical health care for people with SMI requires complex solutions that cross the primary-secondary care interface. The views expressed by our participants suggest that neither primary nor secondary care services on their own can provide a comprehensive service for all patients. The increased risk of CHD associated with SMI and antipsychotic medications requires flexible solutions with clear
Full Text Available Introduction. This paper deals with medicolegal aspects of the hospital treatment of patients suffering from severe mental disorders and who are prone to violent behavior, dangerous to self and others. Violent acts in this study were defined as deliberate and nonconsensual acts of actual, attempted or threatened harm to a person or persons, and classified into categories of any type of violence, physical violence and nonphysical violence, which is in accordance with approaches used in other risk assessment researches. Outline of Cases. The authors present four cases of mentally ill inpatients whose violent behavior toward self or other persons resulted in self-destruction and physical aggression against other persons. The presented cases involved: 1 selfinjury in a patient with acute organic mental disorder after jumping through a hospital window, 2 suicide by drowning of a patient with acute mental disorder after escaping from intensive care unit, 3 suicide in a depressive patient after escaping from a low-security psychiatry unit, 4 physical violence against body and life of other persons in a patient with chronic mental disorder. Conclusion. The presented cases are considered to be rare in clinical practice and risk of violent behavior and the consequent danger of mentally ill inpatients may be efficiently predicted and prevented with appropriate hospital management based on 1 repeated escalation of violent behavior and 2 protection of the patient and others. Hence, if the physician, in order to prevent harmful consequences, does not apply all the necessary measures, including appropriate diagnostic and therapeutic procedures, as well as treatment in an adequate setting, such act is against the Criminal Law of the Republic of Serbia which sanctions physician's negligence. Also, according to the Law on Obligations of the Republic of Serbia this presents a legal ground for damage claim and the requirement of liability for nonmaterial damage
Pölkki, Pirjo; Ervast, Sari-Anne; Huupponen, Marika
This paper examines the needs and stress reactions of children of mentally ill parents, as well as coping and resilience. The study is based on the interviews of six 9-11 years old children and narratives of seventeen female grown up children of mentally ill parents. The younger and older children of the mentally ill parents had not been informed about their parent's illness. The illness of the parent aroused a variety of emotions in them. The children used both practical problem solving and emotional coping mechanisms. Informal social support was available to them but seldom from the public services. It is recommended that professionals in mental health and child welfare services clarify their roles when working with mentally ill parents. The best interest of the child and the parenting they need should be carefully assessed. Open care measures should be offered to families early enough to prevent serious child welfare and mental problems.
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.
Oduguwa, Adeola Oluwafunmilayo; Adedokun, Babatunde; Omigbodun, Olayinka Olusola
Background 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. Childre...
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.
Luciene Simões Spadini
studying the comprehension of mental illness of patients and their families, we conducted a bibliographical study of articles in Brazilian periodicals, theses and dissertations in the period between 1993 and 2003. The identification of the sources was done through the automated search systems Latin American Literature on Health Sciences (LILACS and the University of São Paulo's Bibliographic Data Bank On-line Global Catalog (DEDALUS. Nineteen papers were selected and four categories identified: family difficulty in the relationship with the patient; prejudice and stigma; organic/biological explanation for the illness; and fear and pain of insanity. Most of the papers show that, regarding assistance, there is a need for support and expansion of the public health system in order to meet the demands. It is believed that the number of publications is small considering the importance of the problem, showing the need for new research.
Ackerman, Marra G; Shapiro, Peter A; Coe, Austin; Trivedi, Meghna S; Crew, Katherine D
We evaluated whether mental illness is a barrier to genetic counseling for hereditary breast and ovarian cancer (HBOC) in multiethnic breast cancer patients. We conducted a retrospective analysis of 308 women with newly diagnosed breast cancer and eligible for HBOC genetic testing seen in the breast clinic of an academic, urban medical center from 2007 to 2015. Uptake of genetic services and history of mental health disorder (MHD), defined as a psychiatric diagnosis or treatment with an antidepressant, mood stabilizer, anxiolytic, or antipsychotic medication, were ascertained by medical chart review. The mean age at breast cancer diagnosis was 56 years, with 44% non-Hispanic whites, 37% Hispanics, and 15% non-Hispanic blacks. Ninety-nine (32%) women met study criteria for MHD, 73% had a genetics referral, 57% had genetic counseling, and 54% completed BRCA testing. Uptake of genetic counseling services did not differ by race/ethnicity or presence of MHD. In multivariable analysis, younger age at diagnosis, Ashkenazi Jewish heritage, and family history of breast cancer were associated with HBOC genetic counseling. A relatively high proportion of breast cancer patients eligible for HBOC genetic testing were referred to a genetic counselor and referral status did not vary by MHD or race/ethnicity. © 2017 Wiley Periodicals, Inc.
Full Text Available Dawn I Velligan,1 Martha Sajatovic,2 Ainslie Hatch,3 Pavel Kramata,4 John P Docherty3 1Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, 2Departments of Psychiatry and Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, 3Medical Affairs, ODH, Inc., Princeton, NJ, 4C4 MedSolutions LLC, Yardley, PA, USA Background: Antipsychotic medication reduces the severity of serious mental illness (SMI and improves patient outcomes only when medicines were taken as prescribed. Nonadherence to the treatment of SMI increases the risk of relapse and hospitalization and reduces the quality of life. It is necessary to understand the factors influencing nonadherence to medication in order to identify appropriate interventions. This systematic review assessed the published evidence on modifiable reasons for nonadherence to antipsychotic medication in patients with SMI. Methods: Articles published between January 1, 2005, and September 10, 2015, were searched on MEDLINE through PubMed. Abstracts were independently screened by 2 randomly assigned authors for inclusion, and disagreement was resolved by another author. Selected full-text articles were divided among all authors for review. Results: A qualitative analysis of data from 36 articles identified 11 categories of reasons for nonadherence. Poor insight was identified as a reason for nonadherence in 55.6% (20/36 of studies, followed by substance abuse (36.1%, 13/36, a negative attitude toward medication (30.5%, 11/36, medication side effects (27.8%, 10/36, and cognitive impairments (13.4%, 7/36. A key reason directly associated with intentional nonadherence was a negative attitude toward medication, a mediator of effects of insight and therapeutic alliance. Substance abuse was the only reason consistently associated with unintentional nonadherence, regardless of type and stage of SMI. Discussion: Although adherence research is inherently biased
Chisholm, Katharine; Patterson, Paul; Greenfield, Sheila; Turner, Erin; Birchwood, Max
Understanding how adolescents perceive mental illness is important for clinicians wishing to improve engagement, and for the development of educational programmes and health-behaviour directed policies. The current research aimed to develop a preliminary model of how adolescents perceive mental illness and construct their understanding of mental health. Forty-six participants aged 11-18 from six schools in Birmingham, UK, took part in one of 12 group interviews. A thematic analysis highlighted a dual perception of mental illness. Adolescents discussed stereotypes and extreme examples of illness, but also displayed an insightful understanding of mental distress which had developed through participants' own experiences. Participants attempted to reconcile and negotiate these conflicting perceptions by creating distinctions between concepts of 'craziness' and 'normality', and reported experiencing negative emotions relating to both perceptions of illness. The findings suggest that once media stereotypes have been acknowledged, adolescents demonstrate a relatively sophisticated understanding of mental illness, although one which differed at times from the diagnostic medical model of mental illness. Focusing on individual symptoms, prevalence rates and prior contact adolescents have had with individuals with mental illnesses provides a framework to discuss mental health and ill-health with adolescents. John Wiley & Sons Australia, Ltd.
Maria W. Mauritz
Full Text Available Background: In the Netherlands, most patients with severe mental illness (SMI receive flexible assertive community treatment (FACT provided by multidisciplinary community mental health teams. SMI patients with comorbid posttraumatic stress disorder (PTSD are sometimes offered evidence-based trauma-focused treatment like eye movement desensitization reprocessing or prolonged exposure. There is a large amount of evidence for the effectiveness of narrative exposure therapy (NET within various vulnerable patient groups with repeated interpersonal trauma. Some FACT-teams provide NET for patients with comorbid PTSD, which is promising, but has not been specifically studied in SMI patients. Objectives: The primary aim is to evaluate NET in SMI patients with comorbid PTSD associated with repeated interpersonal trauma to get insight into whether (1 PTSD and dissociative symptoms changes and (2 changes occur in the present SMI symptoms, care needs, quality of life, global functioning, and care consumption. The second aim is to gain insight into patients’ experiences with NET and to identify influencing factors on treatment results. Methods: This study will have a mixed methods convergent design consisting of quantitative repeated measures and qualitative semi-structured in-depth interviews based on Grounded Theory. The study population will include adult SMI outpatients (n=25 with comorbid PTSD and receiving NET. The quantitative study parameters will be existence and severity of PTSD, dissociative, and SMI symptoms; care needs; quality of life; global functioning; and care consumption. In a longitudinal analysis, outcomes will be analyzed using mixed models to estimate the difference in means between baseline and repeated measurements. The qualitative study parameters will be experiences with NET and perceived factors for success or failure. Integration of quantitative and qualitative results will be focused on interpreting how qualitative results
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.
Rational and reality-congruent unconscious processes facilitate adaptive functioning and have implications for mental illness and psychotherapy. With this knowledge, psychotherapists can more effectively guide interventions to improve mental health.
Trofimova, Irina; Christiansen, Julie
Studies of temperament profiles in patients with mental disorders mostly focus on emotionality-related traits, although mental illness symptoms include emotional and nonemotional aspects of behavioral regulation. This study investigates relationships between 12 temperament traits (9 nonemotionality and 3 emotionality related) measured by the Structure of Temperament Questionnaire and four groups of clinical symptoms (depression, anxiety, antisociality, and dominance-mania) measured by the Personality Assessment Inventory. The study further examines age differences in relationships among clinical symptoms and temperament traits. Intake records of 335 outpatients and clients divided into four age groups (18-25, 26-45, 46-65, and 66-85) showed no significant age differences on depression scales; however, the youngest group had significantly higher scores on Anxiety, Antisocial Behavior, Dominance, and Thought Disorders scales. Correlations between Personality Assessment Inventory and Structure of Temperament Questionnaire scales were consistent with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, descriptors showing strong concurrent validity. Several age differences on temperament scales are also reported. Results show the benefits of differentiation between physical, social-verbal, and mental aspects of activities, as well as differentiation between dynamical, orientational, and energetic aspects in studying mental illness and temperament. © The Author(s) 2016.
Carrieri, Daniele; Briscoe, Simon; Jackson, Mark; Mattick, Karen; Papoutsi, Chrysanthi; Pearson, Mark; Wong, Geoffrey
Mental ill-health is prevalent across all groups of health professionals and this is of great concern in many countries. In the UK, the mental health of the National Health Service (NHS) workforce is a major healthcare issue, leading to presenteeism, absenteeism and loss of staff from the workforce. Most interventions targeting doctors aim to increase their 'productivity' and 'resilience', placing responsibility for good mental health with doctors themselves and neglecting the organisational and structural contexts that may have a detrimental effect on doctors' well-being. There is a need for approaches that are sensitive to the contextual complexities of mental ill-health in doctors, and that do not treat doctors as a uniform body, but allow distinctions to account for particular characteristics, such as specialty, career stage and different working environments. Our project aims to understand how, why and in what contexts support interventions can be designed to minimise the incidence of doctors' mental ill-health. We will conduct a realist review-a form of theory-driven interpretative systematic review-of interventions, drawing on diverse literature sources. The review will iteratively progress through five steps: (1) locate existing theories; (2) search for evidence; (3) select articles; (4) extract and organise data and (5) synthesise evidence and draw conclusions. The analysis will summarise how, why and in what circumstances doctors' mental ill-health is likely to develop and what can remediate the situation. Throughout the project, we will also engage iteratively with diverse stakeholders in order to produce actionable theory. Ethical approval is not required for our review. Our dissemination strategy will be participatory. Tailored outputs will be targeted to: policy makers; NHS employers and healthcare leaders; team leaders; support organisations; doctors experiencing mental ill-health, their families and colleagues. CRD42017069870. © Article author
Briscoe, Simon; Jackson, Mark; Mattick, Karen; Papoutsi, Chrysanthi; Pearson, Mark; Wong, Geoffrey
Introduction Mental ill-health is prevalent across all groups of health professionals and this is of great concern in many countries. In the UK, the mental health of the National Health Service (NHS) workforce is a major healthcare issue, leading to presenteeism, absenteeism and loss of staff from the workforce. Most interventions targeting doctors aim to increase their ‘productivity’ and ‘resilience’, placing responsibility for good mental health with doctors themselves and neglecting the organisational and structural contexts that may have a detrimental effect on doctors’ well-being. There is a need for approaches that are sensitive to the contextual complexities of mental ill-health in doctors, and that do not treat doctors as a uniform body, but allow distinctions to account for particular characteristics, such as specialty, career stage and different working environments. Methods and analysis Our project aims to understand how, why and in what contexts support interventions can be designed to minimise the incidence of doctors’ mental ill-health. We will conduct a realist review—a form of theory-driven interpretative systematic review—of interventions, drawing on diverse literature sources. The review will iteratively progress through five steps: (1) locate existing theories; (2) search for evidence; (3) select articles; (4) extract and organise data and (5) synthesise evidence and draw conclusions. The analysis will summarise how, why and in what circumstances doctors’ mental ill-health is likely to develop and what can remediate the situation. Throughout the project, we will also engage iteratively with diverse stakeholders in order to produce actionable theory. Ethics and dissemination Ethical approval is not required for our review. Our dissemination strategy will be participatory. Tailored outputs will be targeted to: policy makers; NHS employers and healthcare leaders; team leaders; support organisations; doctors experiencing mental ill
Mulder Niels CL
Full Text Available Abstract Background Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. Methods We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.. If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. Discussion This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects
Stobbe, Jolanda; Mulder, Niels C L; Roosenschoon, Bert-Jan; Depla, Marja; Kroon, Hans
Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. The Netherlands National Trial Register NTR1620.
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.
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.
Farmer, A E; Griffiths, H
GPs and psychiatrists from South Wales were asked to make decisions based on the information included in each of 16 vignettes describing depressed and anxious subjects. This information contained randomly assigned sex, psychiatric label, good and bad psychosocial context and age as well as eight different severity ratings of depression and anxiety symptoms. Our results showed that both GPs and psychiatrists were influenced in their decision making by the severity of the illness, but that GPs alone were also strongly influenced by the presence of male sex and by the presence of a psychiatric label. Good or bad psychosocial context had no influence on the GPs' referral decision, and previous experience in psychiatry or other vocational training had no detectable effect, but this may be because of the sample size.
The use of a Cumulative Needs for Care Monitor for individual treatment v. care as usual for patients diagnosed with severe mental illness, a cost-effectiveness analysis from the health care perspective
Drukker, M.; Joore, M.; van Os, J.; Sytema, S.; Driessen, G.; Bak, M.; Delespaul, Ph.
Aims. To study the systematic assessment of need for care and clinical parameters for use in treatment plans in patients diagnosed with severe mental illness. Methods. The Cumulative Needs for Care Monitor (CNCM) includes various validated instruments, such as the Camberwell Assessment of Need. A
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.
Jorm, Anthony; Sawyer, Michael; Gillett, Joy
Australian Rotary Health (ARH) was established in 1981 with the goal of supporting family health research in Australia. Since 2000, ARH has supported research relevant to mental health and mental illness. This article describes the early history of the fund, the reasons for the move to mental illness research, some examples of research projects that have had a beneficial impact and the branching out into mental health community awareness raising and stigma reduction. ARH has emerged as a major non-government supporter of mental illness research. It has also effectively engaged Rotary clubs at a local level to increase community awareness of mental illness and to reduce stigma.
Bondesson, E; Larrosa Pardo, F; Stigmar, K; Ringqvist, Å; Petersson, I F; Jöud, A; Schelin, M E C
Pain from various locations in the body and mental illness are common and the comorbidity between the two is well-known although the temporal relationship remains to be determined. Our aim was to follow patients over time to study if pain (here dorsalgia/abdominal pain) or fibromyalgia lead to an increased risk of developing mental illness (here depression/anxiety) and/or the reverse, that is whether patients with mental illness have an increased risk to develop pain or fibromyalgia, compared to the rest of the population. This prospective cohort study used the Skåne Healthcare Register, covering all care in the region of Skåne, southern Sweden (population ~1.3 million). The cohort included healthcare consultations in primary care, outpatient specialized care and inpatient care between 2007 and 2016 for all patients without prior registered diagnosis of mental illness or pain, aged 18 or older (n = 504,365). The incidence rate ratio (IRR) for developing mental illness after pain was 2.18 (95% CI = 2.14-2.22) compared to without pain. IRR for developing pain after mental illness was 2.02 (95% CI = 1.98-2.06) compared to without mental illness. Corresponding IRR for developing mental illness after fibromyalgia was 4.05 (95% CI = 3.58-4.59) and for developing fibromyalgia after mental illness 5.54 (95% CI = 4.99-6.16). This study shows a bidirectional influence of similar magnitude of pain and mental illness, respectively. In monitoring patients with pain or mental illness, a focus on both conditions is thus important to develop appropriate, targeted interventions and may increase the likelihood of improved outcomes. We followed a population-based cohort over a period of 10 years, including incident cases of both exposure and outcome and found a bidirectional relationship between pain and mental illness. Clinicians need to pay attention on both conditions, in patients seeking care due to mental illness or pain. © 2018 European Pain Federation - EFIC®.
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.
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.
De Hert, Marc; Cohen, Dan; Bobes, Julio; Cetkovich-Bakmas, Marcelo; Leucht, Stefan; Ndetei, David M.; Newcomer, John W.; Uwakwe, Richard; Asai, Itsuo; Moeller, Hans-Jurgen; Gautam, Shiv; Detraux, Johan; Correll, Christoph U.
Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in
This article is based on a study that investigated the notions of mental illness by Vhavenda traditional healers in Limpopo Province, South Africa. Specifically, the aim of the researchers was to understand and describe these traditional healers' representations of the causes of mental illness, including the diagnostic and ...
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 ...
I pay particular attention to characterising Szasz's account of mental illness as that of an anti-realist error-theory and present ways in which a realist may counter such a position. Ultimately I argue that in order to hold a realist position on mental illness one would have to adopt some form of realism towards values, such as ...
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…
Vasudev, Kamini; Martindale, Brian V
Aim People with severe mental illness are at higher risk of physical health problems. Guidelines recommend annual monitoring. An audit cycle was completed on individuals with severe mental illness under the care of an early interventions in psychosis (EIP) service to evaluate and improve physical health monitoring practice.
Shelef, Assaf; Mazeh, Doron; Berger, Uri; Baruch, Yehuda; Barak, Yoram
Electroconvulsive therapy (ECT) is a highly effective treatment for patients with severe mental illness (SMI). Maintenance ECT (M-ECT) is required for many elderly patients experiencing severe recurrent forms of mood disorders, whereas M-ECT for schizophrenia patients is a poorly studied treatment. We report on the outcomes in aged patients with SMI: schizophrenia and severe affective disorders treated by M-ECT of varying duration to prevent relapse after a successful course of acute ECT. The study measured the effectiveness of M-ECT in preventing hospital readmissions and reducing admission days. A retrospective chart review of 42 consecutive patients comparing the number and length of psychiatric admissions before and after the start of M-ECT was used. We analyzed diagnoses, previous ECT treatments, number of ECT treatments, and number and length of psychiatric admissions before and after M-ECT. Mean age in our sample was 71.5 (6.9) years. Twenty-two (52%) patients experienced severe affective disorders and 20 (48%) experienced schizophrenia. Patients were administered 92.8 (85.9) M-ECT treatments. Average duration of the M-ECT course was 34 (29.8) months. There were on average 1.88 admissions before M-ECT and only 0.38 admissions in the M-ECT period (P < 0.001). Duration of mean hospitalization stay decreased from 215.9 to 12.4 days during the M-ECT (P < 0.01). Our findings suggest that acute ECT followed by M-ECT is highly effective in selected elderly patients with SMIs.
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.
DE HERT, MARC; COHEN, DAN; BOBES, JULIO; CETKOVICH-BAKMAS, MARCELO; LEUCHT, STEFAN; M. NDETEI, DAVID; W. NEWCOMER, JOHN; UWAKWE, RICHARD; ASAI, ITSUO; MÖLLER, HANS-JURGEN; GAUTAM, SHIV; DETRAUX, JOHAN; U. CORRELL, CHRISTOPH
Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in developed countries. Moreover, specific patient, provider, treatment and system factors act as barriers to the recognition and to the management of physical diseases in people with SMI. Psychiatrists can play a pivotal role in the improvement of the physical health of these patients by expanding their task from clinical psychiatric care to the monitoring and treatment of crucial physical parameters. At a system level, actions are not easy to realize, especially for developing countries. However, at an individual level, even simple and very basic monitoring and treatment actions, undertaken by the treating clinician, can already improve the problem of suboptimal medical care in this population. Adhering to monitoring and treatment guidelines will result in a substantial enhancement of physical health outcomes. Furthermore, psychiatrists can help educate and motivate people with SMI to address their suboptimal lifestyle, including smoking, unhealthy diet and lack of exercise. The adoption of the recommendations presented in this paper across health care systems throughout the world will contribute to a significant improvement in the medical and related psychiatric health outcomes of patients with SMI. PMID:21633691
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.
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
Theoretical neuroscience, which characterizes neural mechanisms using mathematical and computational models, is highly relevant to central problems in the philosophy of psychiatry. These models can help to solve the explanation problem of causally connecting neural processes with the behaviors and experiences found in mental illnesses. Such explanations will also be useful for generating better classifications and treatments of psychiatric disorders. The result should help to eliminate concerns that mental illnesses such as depression and schizophrenia are not objectively real. A philosophical approach to mental illness based on neuroscience need not neglect the inherently social and historical nature of mental phenomena.
Full Text Available Abstract Background Compared with the general population, individuals with severe mental illness (SMI have increased prevalence rates of obesity and greater risk for cardiovascular disease. This study aimed to investigate the effects of a long term nutritional intervention on body weight, body fat and cardiovascular risk factors in a large number of patients with SMI. Methods Nine hundred and eighty-nine patients with a mean ± S.D age of 40 ± 11.7 yrs participated in a 9 mo nutritional intervention which provided personalised dietetic treatment and lifestyle counselling every two weeks. Patients had an average body mass index (BMI of 34.3 ± 7.1 kg.m-2 and body weight (BW of 94.9 ± 21.7 kg. Fasted blood samples were collected for the measurement of glucose, total cholesterol, triglycerides and HDL- cholesterol. All measurements were undertaken at baseline and at 3 mo, 6 mo and 9 mo of the nutritional intervention. Results Four hundred and twenty-three patients of 989 total patients' cases (42.8% dropped out within the first 3 months. Two hundred eighty-five completed 6 months of the program and 145 completed the entire 9 month nutritional intervention. There were progressive statistically significant reductions in mean weight, fat mass, waist and BMI throughout the duration of monitoring (p -2 (p Conclusion The nutritional intervention produced significant reductions in body weight, body fat and improved the cardiometabolic profile in patients with SMI. These findings indicate the importance of weight-reducing nutritional intervention in decreasing the cardiovascular risk in patients with SMI.
Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn
This paper reports two studies that investigated children's conceptions of mental illness using a naive theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing…
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.
Green, Charee E; Mojtabai, Ramin; Cullen, Bernadette A; Spivak, Amethyst; Mitchell, Melissa; Spivak, Stanislav
This study explored the association of exposure to direct-to-consumer advertising (DTCA) with medication nonadherence among individuals with serious mental disorders. Results of an anonymous survey administered at an inner-city mental health clinic were examined by using logistic regression. Nonadherence was defined as not taking prescribed medications for at least two out of seven days. Of 246 respondents, 48% reported DTCA exposure and 43% reported nonadherence. Sixty-one percent of those exposed to DTCA reported nonadherence, compared with 26% of those not exposed (adjusted odds ratio=4.96, 95% confidence interval=2.64-9.33, preporting nonadherence, 59% reported changing medication-taking behaviors or stopping prescribed medications because of side effect information in advertisements. Only a minority communicated with providers before becoming nonadherent. This study found an association between self-report of DTCA exposure and self-reported nonadherence. These results support further research on DTCA as a possible risk factor for nonadherence.
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
Kapungwe, A; Cooper, S; Mwanza, J; Mwape, L; Sikwese, A; Kakuma, R; Lund, C; Flisher, A J
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 low-income African countries. This is the first in-depth study on mental illness stigma in Zambia. Fifty semi-structured interviews and 6 focus group discussions were conducted with key stakeholders drawn from 3 districts in Zambia (Lusaka, Kabwe and Sinazongwe). Transcripts were analyzed using a grounded theory approach. Mental illness stigma and discrimination is pervasive across Zambian society, prevailing within the general community, amongst family members, amid general and mental health care providers, and at the level of government. Such stigma appears to be fuelled by misunderstandings of mental illness aetiology; fears of contagion and the perceived dangerousness of people with mental illness; and associations between HIV/AIDS and mental illness. Strategies suggested for reducing stigma and discrimination in Zambia included education campaigns, the transformation of mental health policy and legislation and expanding the social and economic opportunities of the mentally ill. In Zambia, as in many other low-income African countries, very little attention is devoted to addressing the negative beliefs and behaviours surrounding mental illness, despite the devastating costs that ensue. The results from this study underscore the need for greater commitment from governments and policy-makers in African countries to start prioritizing mental illness stigma as a major public health and development issue.
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…
Fox, C; Buchanan-Barrow, E; Barrett, M
This study aimed to investigate children's thinking about mental illness by employing a well-established framework of adult illness understanding. The study adopted a semistructured interview technique and a card selection task to assess children's responses to causes, consequences, timeline and curability of the different types of mental illness. The children were aged between 5 and 11 years. Results indicated a developmental trend in the children's thinking about mental illness; there was an increase in the children's understanding of the causes, consequences, curability and timeline of mental illness with age. The older children demonstrated a more sophisticated and accurate thinking about mental illness compared with the younger children, who tended to rely on a medical model in order to comprehend novel mental illnesses. Furthermore, the girls exhibited more compassion, showing greater social acceptance compared with the boys. The Leventhal model provides a useful framework within which to investigate children's knowledge and understanding of mental illness. Limitations of the study and implications for future research are discussed.
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
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.
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.
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.
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.
Schools are in a key position not only to identify mental health concerns early but to address issues of stigma that prevent both children and their parents from seeking help with mental illness. Stigma associated with mental illness perpetuates isolative behavior and poor engagement within the academic community. Programs within schools that address mental health issues and support open communication with families can reduce the pain and isolation that is often the experience of youth with undiagnosed and untreated mental and emotional disorders. © 2014 The Author(s).
Full Text Available Mental illness has very close and intimate relationship with societal factors and components. There have been many theoretical postulations that come from time to time to explain this relationship. Mental disorder has definite aetiological association with various socio-cultural and economic factors, and ideal interventions of mental disorders should include equal appraisal to biological, psychological, and social aspects.
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
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…
Nevid, Jeffrey S.; Morrison, James
The study was an attempt to construct an attitude scale to measure the radical psychosocial or libertarian position about "mental illness" and mental health practices. The factor analysis defined four scale factors: mental illness mythology, antimedical model, social deviance control, and anti-coercive treatment. (Author)
Outpatient chronic hemodialysis facilities often serve large populations of patients in an open and sometimes fast-paced environment. Any sizeable group of people will contain a sample of mental illnesses -and the end-stage renal disease diagnosis can be accompanied by co-occurring or comorbid mental illness. Thus, it is important for professional teams to be able to effectively manage related issues arising in the dialysis clinic. Guided by Medicare mandates, dialysis clinics all employ a masters level social worker to respond to the myriad psychosocial needs of this population; MSWs are trained to recognize the signs and symptoms of mental illnesses, and can help guide the team response.
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.
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.
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.
Full Text Available Although some research has examined negative automatic aspects of attitudes toward mental illness via relatively indirect measures among Western samples, it is unclear whether negative attitudes can be automatically activated in individuals from non-Western countries. This study attempted to validate results from Western samples with Chinese college students. We first examined the three-component model of implicit stigma (negative cognition, negative affect, and discriminatory tendencies toward mental illness with the Single Category Implicit Association Test (SC-IAT. We also explored the relationship between explicit and implicit stigma among 56 Chinese university college students. In the three separate SC-IATs and the combined SC-IAT, automatic associations between mental illness and negative descriptors were stronger relative to those with positive descriptors and the implicit effect of cognitive and affective SC-IATs were significant. Explicit and implicit measures of stigma toward mental illness were unrelated. In our sample, women's overall attitudes toward mental illness were more negative than men's were, but no gender differences were found for explicit measures. These findings suggested that implicit stigma toward mental illness exists in Chinese students, and provide some support for the three-component model of implicit stigma toward mental illness. Future studies that focus on automatic components of stigmatization and stigma-reduction in China are warranted.
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.
Full Text Available The authors demonstrate the behaviour of police towards mentally ill individuals de lege lata and de lege ferenda. For this, they use an analysis of the existing Protection and Advocacy for the Mentally Ill Act, the draft of the new law which regulates that area, examples from practice, statistical data and the viewpoints of the legal and medical professions. This article points out the most frequent application of police powers when dealing with mentally ill persons and certain quandaries about the practice of admitting mentally ill persons into psychiatric institutions when they are a danger to themselves and others, that is, in the case of providing help to health workers dealing with mentally ill persons. Statistical data for the area of the Republic of Croatia point to a slight trend in the increase of police interventions over the last five years and also in the professional police approach towards such individuals. In conclusion, the coordinated activity of all services dealing with mentally ill persons is proposed as are additional education and the specialisation of police officials dealing with such persons. Furthermore, the need for balance between the necessity to protect the rights of mentally ill persons and the protection of rights and the security of the surroundings in which such persons live and the security of the entire community are pointed out.
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.
Gonzales, Lauren; Davidoff, Kristin C; Nadal, Kevin L; Yanos, Philip T
Microaggressions are subtle verbal or behavioral communications of disparaging messages to people based upon membership in a socially marginalized group. Their negative impact has been demonstrated for racial/ethnic groups, gender, sexual orientation, and physical disability, but currently no research exists on microaggressions as experienced by persons with mental illnesses. Qualitative data were gathered from 4 focus groups with 2 samples: adult mental health consumers in an assertive community treatment program and college students with mental illness diagnoses. Focus group transcripts were then analyzed using an open coding approach (Strauss & Corbin, 1990) to identify hierarchical themes and categories. Five major themes were identified, including invalidation, assumption of inferiority, fear of mental illness, shaming of mental illness, and second class citizen. Perpetrators of microaggressions were most commonly identified as being close friends, family members, and authority figures. Importantly, participants reported experiencing more overt discrimination experiences than subtle microaggression experiences. Reported negative outcomes related to microaggression experiences included isolation, negative emotions, and treatment nonadherence. Reported consequences of microaggressions have important implications for mental health treatment, especially as perpetrators were reported to include treatment providers and were usually unaware of such negative social exchanges. Loss of social support reported by participants and the frequent occurrence of microaggressions within close relationships implies these experiences could contribute to internalization of stigmatizing attitudes toward mental illness. Directions for future research include an investigation of motivation and reasoning behind perpetration of microaggressions against persons with mental illnesses. (c) 2015 APA, all rights reserved).
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.
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
McLean, C S; Greer, K; Scott, J; Beck, J C
Support and education groups for the families of the mentally ill have been in existence for at least 20 years. The authors describe a group treatment program established in 1979 for parents of chronically mentally ill individuals living in the community. The goal was to help parents become less overprotective, critical, and hostile so that clients would relapse less frequently and improve their social functioning during their time in the community. The groups provided parents with information and support. Some of the results of the groups include the implementation of new hospital procedures, more effective parenting, and a parent-initiated alliance on behalf of the mentally ill in the locality.
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.
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...
Flynn, Sandra M; Shaw, Jenny J; Abel, Kathryn M
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.
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.
Juel, Anette; Kristiansen, Christina Blanner; Madsen, Nikolaj Juul
BACKGROUND: Patients with co-existence of psychiatric disorders and substance use have an increased risk of premature death. This is attributable to a higher prevalence of physical comorbidities and a lifestyle related to substance use. Furthermore, they experience low quality-of-life (QoL). Stud...
Murphy, Suzanne M; Irving, Claire B; Adams, Clive E; Waqar, Muhammad
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. To review the effects of crisis-intervention models for anyone with serious mental illness experiencing an acute episode compared to the standard care they would normally receive. If possible, to compare the effects of mobile crisis teams visiting patients' homes with crisis units based in home-like residential houses. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. There is no language, time, document type, or publication status limitations for inclusion of records in the register. This search was undertaken in 1998 and then updated 2003, 2006, 2010 and September 29, 2014. We included all randomised controlled trials of crisis-intervention models versus standard care for people with severe mental illnesses that met our inclusion criteria. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assessed risk of bias for included studies and used GRADE to create a 'Summary of findings' table. The update search September 2014 found no further new studies for inclusion, the number of studies included in this review remains eight with a total of 1144 participants. Our main outcomes of interest are hospital use, global state, mental state, quality of life, participant satisfaction and family burden. With the exception of mental state, it was not possible to pool data for these outcomes.Crisis intervention may reduce repeat admissions to hospital (excluding index admissions) at six months (1 RCT, n = 369, RR 0.75 CI 0.50 to 1.13, high quality evidence), but does appear to reduce family burden (at six months: 1 RCT, n = 120, RR 0.34 CI 0.20 to 0.59, low quality evidence), improve
Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.
Nash, Sara Siris; Kent, Laura K; Muskin, Philip R
This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.
Social Sciences, University of Ado Ekiti, Ekiti State, P.M.B. 5363 Ekiti. State, Nigeria ... Nigeria, towards epilepsy and mental illness in terms of work opportunities .... have a negative impact in the management of epilepsy (Nbuko et al, 2003).
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...
of Business Management (BBM) courses. Methods. A cross-sectional descriptive design was adopted for the present study. A total of 268 ... combat discrimination, and potentially enhance the promotion of human rights for the mentally ill.
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.
Bignall, Whitney J Raglin; Jacquez, Farrah; Vaughn, Lisa M
Although the prevalence of mental illness is similar across ethnic groups, a large disparity exists in the utilization of services. Mental health attributions, causal beliefs regarding the etiology of mental illness, may contribute to this disparity. To understand mental health attributions across diverse ethnic backgrounds, we conducted focus groups with African American (n = 8; 24 %), Asian American (n = 6; 18 %), Latino/Hispanic (n = 9; 26 %), and White (n = 11; 32 %) participants. We solicited attributions about 19 mental health disorders, each representing major sub-categories of the DSM-IV. Using a grounded theory approach, participant responses were categorized into 12 themes: Biological, Normalization, Personal Characteristic, Personal Choice, Just World, Spiritual, Family, Social Other, Environment, Trauma, Stress, and Diagnosis. Results indicate that ethnic minorities are more likely than Whites to mention spirituality and normalization causes. Understanding ethnic minority mental health attributions is critical to promote treatment-seeking behaviors and inform culturally responsive community-based mental health services.
Concepts of mental health and care according to mentally-ill patients and their relatives Concepciones sobre enfermedad mental y atención según enfermos mentales y sus familiares Concepções sobre doença mental e assistência segundo doentes mentais e seus familiares
Vera Lucia Mendiondo Osinaga
Full Text Available This study aimed at 1 identifying social, demographic and clinical characteristics of mentally-ill patients and their relatives and 2 analyzing their conceptions concerning mental illness and psychiatric care. The Attitude Measurement Scale (AMS was used. Quantitative and qualitative analyses of the data were carried out. The 104 study subjects comprised 35 patients and 69 relatives (n=104. The Mann-Whitney Test was used for comparing the opinions of patients X relatives and the Wilcoxon Test for comparing Concept and Care. There was homogeneity in the distribution of the subjects' scores for both Concept and Care. No questions stood out or were concentrated in either group. The subjects' profile shows the transition from asylum care to innovative experiences, although there is still a concentration of drug treatments and dependence on the psychiatric institution.Este estudio tuvo como objetivo: 1 identificar las características socio-demográficas y clínicas de los enfermos mentales y sus familiares y 2 analizar sus concepciones sobre enfermedad mental y asistencia psiquiátrica. Se aplicó la Escala de Medida de Opinión (EMO. Fueron realizadas análisis cuantitativos y cualitativos de los datos. Los 104 sujetos incluyen 35 portadores y 69 familiares (n=104. Las pruebas estadísticas fueron el Test de Mann-Whitney comparando dos poblaciones independientes (Portadores X Familiares, y el Test de Wilcoxon, comparando dos poblaciones relacionadas (Concepto y Asistencia. Hubo homogeneidad en la distribución de los escores de los sujetos tanto para Concepto como para Atención. Por lo tanto, no hubo cuestiones sobresalientes o concentradas en ninguno de los dos grupos estudiados. El perfil de los sujetos retrata la transición de la atención manicomial para experiencias innovadoras, aún todavía hay la concentración de los tratamientos medicamentosos y la dependencia de la institución psiquiátrica.Este estudo objetivou: 1 identificar as
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...
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...
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.
St Louis, K O; Roberts, P M
Public attitudes toward mental illness in two widely disparate cultures, Canada and Cameroon, were compared using an experimental version of a survey instrument, the Public Opinion Survey of Human Attributes-Mental Illness or POSHA-MI(e). 120 respondents rated POSHA-MI(e) items relating to mental illness on 1-9 equal appearing interval scales: 30 in English and 30 in French in both Cameroon and Canada. Additionally, 30 matched, monolingual English, American respondents were included as a comparison group. 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. Consistent with other research, beliefs and reactions of the public regarding mental illness reflect stigma, especially in Cameroon. Cultural influences on these public attitudes are more likely important than language influences. 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 development.
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.
illness, particularly the young generation and college-going students. ... the attitudes and beliefs about people with mental illness among .... totally agree = 4, totally agree = 5) based on their feelings towards ... tend to be violent (χ2=14.215, p<0.007) and dangerous (χ2=17.808, ..... disabled persons through fieldwork.
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…
Çelik Ince, S; Partlak Günüşen, N; Serçe, Ö
. A thematic analysis was used to evaluate the interviews. Four main themes were determined. (1) The barriers to physical healthcare theme included barriers related to patients, illness and treatment, barriers related to patients' caregivers, barriers related to health professionals and barriers related to the healthcare system. (2) The physical healthcare practices theme included common physical health problems and current nursing practices. (3) Motivators theme included the desire to see positive changes in a patient, receiving positive feedback, feeling useful and happy, having a sense of conscience and feeling satisfied with their profession. (4) The needs for better physical healthcare theme included the nurses' recommendations for better physical health care. Mental health nurses believe that the physical health care provided to individuals with mental illness is not adequate. Many barriers to providing care for physical health, such as having psychiatric symptoms that are not seen as a priority by patients and health personnel, were determined. Mental health nurses should integrate physical healthcare practices into their routine care. In addition, mental health nurses' knowledge and skills about physical health care should be improved. © 2018 John Wiley & Sons Ltd.
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.
Jung, Wook; Choi, Eunkyung; Yu, Jaehak; Park, Doo-Heum; Ryu, Seung-Ho; Ha, Jee Hyun
Prejudice and negative attitudes toward mental illness are major obstacles in the rehabilitation and functional recovery of patients. The objective of this study was to evaluate the attitudes of health-related personnel toward mentally ill patients in a local urban community in South Korea. In total, 401 participants (men, 132; women, 269; mean age, 37.3 ± 9.5 years) were recruited. The participants were health-related personnel in a district of Seoul, who were recruited from three different workplaces: a local administration office, a public health center, and a community welfare center. Sociodemographic data were gathered, and the community attitudes toward the mentally ill (CAMI) inventory were administered. Comparisons of the CAMI subscales were conducted among participants using statistical analysis. Community welfare center workers showed more authoritarianism and social restriction and less community mental health ideology than the other two groups. Among the demographic variables, a shorter working career, higher education, female gender, and younger age were also related to a more negative attitude toward mentally ill patients. Community health-related personnel who have contact with patients with mental illness should be encouraged to have a fair, hospitable, and open-minded attitude. It is advisable for these workers to receive interventions such as regular educational programs early in their careers.
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
Çelik Ince, Sevecen; Partlak Günüşen, Neslihan
The aim of this study is to determine the views and habits of the individuals with mental illness on physical activities and nutrition behaviors. This study was carried out descriptive qualitative method. The sample of the study consisted of 15 individuals with mental illness. The data were collected with Socio-Demographic Information Form and Semi-Structured Interview Form and analyzed by content analysis. Four main themes emerged as the result of the analysis of the data. These themes are the barriers, facilitators, habits, and the needs. Mental health nurses should be aware of the barriers of individuals with mental illness. It is recommended that mental health nurses make interventions to encourage patients to have physical activity and healthy eating. © 2018 Wiley Periodicals, Inc.
Mar 1, 2013 ... permissible in minors be stated in terms of well-defined risk standards. Finally, the ... The assessment of a mentally ill child's or adolescent's capacity to consent to ... 'mental healthcare' may include research; furthermore its repeated ..... Clinical response and risk of reported suicidal ideation and suicide ...
Chen, Sylvia Xiaohua; Mak, Winnie W. S.
In the present study, the authors examined the contributions of cultural beliefs about the etiology of mental illness to the seeking of help from mental health professionals among college students in 4 cultural groups, European Americans, Chinese Americans, Hong Kong Chinese, and Mainland Chinese. Group differences were found in help-seeking…
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 ...
investigations of public attitudes, whether from cross-cultural ... toward mental illness internationally ... in the context of different attitudes toward other human .... the impression that the study was not only a study of mental ... translation, and has experience in translating and editing ...... University students' perceptions of.
Naughton, Michael F A; Maybery, Darryl J; Goodyear, Melinda
Nearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co-occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross-sectional study design was employed involving a case record review and clinician-completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co-occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family-focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent. © 2017 Australian College of Mental Health Nurses Inc.
Podogrodzka-Niell, Magdalena; Tyszkowska, Magdalena
Persons with mental disorders often experience stigmatization. There is a number of social factors that may affect the process of recovery and at the same time, in certain circumstances, could be a source of stigma. Mentally ill may find strength in themselves to fight against the disease or the opposite - can internalize the negative attitudes of the society and become self-stigmatized. The patient's family, on the one hand, is often the only source of social support, on the other hand, can experience a destructive influence of courtesy-stigma. Mentally ill have to face social reluctance which is reinforced by stereotypical media coverage of mental disorders. The social network of patients is poor and often limited to a family system. Negative views about persons diagnosed with mental illness are most visible in the labour market. Patients experience many types of discrimination at work,have lower employment rates and lower mean wages than healthy ones. Structural discrimination is a form of stigma which is revealed in underfunded and inefficient system of mental health care. All the social factors mentioned above are necessary for recovery (positive stimulation of functioning), but can also increase stigma and become a significant barrier in the recovery of psychiatric patients. This paper highlights the complex and ambiguous nature of the relationship between social factors and the recovery of the mentally ill basing on the data from the literature.
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.
Gladstone, Brenda M; Boydell, Katherine M; Seeman, Mary V; McKeever, Patricia D
This paper provides a review of published qualitative research on children's experiences of parental mental illness. We undertook a comprehensive search of Medical Literature Analysis and Retrieval System Online, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts and Applied Social Sciences Index and Abstracts databases, as well as citation searches in Web of Science and manual searches of other relevant journals and reference lists of primary papers. Although 20 studies met the search criteria, only 10 focused exclusively on children's descriptions of their experience--the remainder elicited adults' perspectives on children's experiences of parental mental illnesses. Findings are organized under three themes: the impact of illness on children's daily life, how children cope with their experiences and how children understand mental illness. Despite references to pervasive knowledge gaps in the literature, significant information has been accumulated about children's experiences of parental mental illness. Considerable variability in research findings and tensions remain unresolved. For example, evidence is mixed as to children's knowledge and understanding of mental illnesses and how best to deploy resources to help them acquire optimal information. Furthermore, children's desire to be recognized as important to their parents' well-being conflicted with adults' perceptions that children should be protected from too much responsibility. Nevertheless, the cumulative evidence remains a key reason for advocating for psychoeducation and peer-support group interventions for children, which are endorsed by child and adult study participants alike. © 2011 Blackwell Publishing Asia Pty Ltd.
McDowell, Caitlin; Fossey, Ellie
Disability discrimination legislation means that employees with a disability or mental illness are legally entitled to reasonable workplace accommodations that enable them to work effectively and safely. This scoping review aims to investigate the types of workplace accommodations provided for people with mental illness, and their costs and benefits. A literature search was conducted using five electronic databases. Peer reviewed research articles published between 1993 and June 2013 were included in this scoping review and their quality was assessed. Opinion papers, reports, and case descriptions were excluded. Nine studies explored workplace accommodations for people with mental illness. The most commonly reported work-related accommodations were flexible scheduling/reduced hours, modified training and supervision, and modified job duties/descriptions. The least common type of accommodation was physical modification to the workplace. For employees with persistent mental illness who were accessing a supported employment agency, the majority of accommodations related to support from the job coach or employment specialist, such as facilitating communication with the employer during hiring or on the job. The quality of the studies varied considerably and the benefits of the accommodations are not yet well documented. There is limited evidence that a larger number of workplace accommodations are associated with longer job tenure. Workplace accommodations appear to be important to support employees with mental illness, but more accessible information about how disability discrimination legislation applies to this population is needed. Future research should address the implementation and effectiveness of mental health-related workplace accommodations.
Kidd, Sean A; Howison, Meg; Pilling, Merrick; Ross, Lori E; McKenzie, Kwame
There is increasing attention to diversity in psychiatric services and widespread recognition of the mental health implications of stigma for individuals from sexual or gender minority groups. However, these areas remain markedly underdeveloped in the area of severe mental illness. The aim of this review was to map out the existing base of knowledge in these areas to help inform future research, practice, and policy directions. A review of the literature was conducted to answer the following question: What factors and strategies need to be considered when developing services for individuals from sexual or gender minority groups who are experiencing severe mental illness? A comprehensive search of MEDLINE, PsycINFO, and Google Scholar was completed by using Arksey and O'Malley's methodological framework for scoping reviews. A total of 27 publications were identified for review. Mental health services research indicated generally lower levels of service satisfaction among lesbian, gay, bisexual, transgender, and transsexual (LGBT) individuals and minimal evidence regarding specific interventions. Descriptive research suggested an increased risk of severe mental illness in LGBT populations, an association between this increased risk and discrimination, and the potential benefit of cultivating spaces where individuals can be "out" in all aspects of themselves. There is a pressing need for research into interventions for LGBT populations with severe mental illness as well as descriptive studies to inform efforts to reduce illness morbidity linked to discrimination.
Protocol for the effect evaluation of Individual Placement and Support (IPS): a randomized controlled multicenter trial of IPS versus treatment as usual for patients with moderate to severe mental illness in Norway.
Sveinsdottir, Vigdis; Løvvik, Camilla; Fyhn, Tonje; Monstad, Karin; Ludvigsen, Kari; Øverland, Simon; Reme, Silje Endresen
Roughly one third of disability pensions in Norway are issued for mental and behavioral disorders, and vocational rehabilitation offered to this group has traditionally been dominated by train-and-place approaches with assisted or sheltered employment. Based on a more innovative place-and-train approach, Individual Placement and Support (IPS) involves supported employment in real-life competitive work settings, and has shown great promise for patients with severe mental illness. The study is a multicenter Randomized Controlled Trial (RCT) of IPS in a Norwegian context, involving an effect evaluation, a process evaluation, and a cost/benefit analysis. IPS will be compared to high quality treatment as usual (TAU), with labor market participation and educational activity at 12 months post inclusion as the primary outcome. The primary outcome will be measured using register data, and the project will also include complete follow-up up to 4 years after inclusion for long-term outcome data. Secondary outcomes include mental health status, disability and quality of life, collected through survey questionnaires at baseline, and after 6 and 12 months. Participants will include patients undergoing treatment for moderate to severe mental illness who are either unemployed or on sickness or social benefits. The estimated total sample size of 400-500 will be randomly assigned to the interventions. To be eligible, participants must have an expressed desire to work, and sufficient Norwegian reading and writing skills to fill out the questionnaires. The Effect Evaluation of Individual Placement and Support (IPS) will be one of the largest randomized controlled trials to date investigating the effectiveness of IPS on competitive employment, and the first study to evaluate the effectiveness of IPS for patients with moderate to severe mental illness within a Norwegian context. Clinicaltrials.gov: NCT01964092 . Registered October 16th, 2013.
Konrad, Jana; Loos, Sabine; Neumann, Petra
with severe mental illness across Europe over a measurement period of one year. METHODS: Self-ratings of the HA by 588 people with severe mental illness who participated in a multicentre European study (CEDAR; ISRCTN75841675) were examined using latent class analysis. RESULTS: Four main patterns of alliance...... of life. CONCLUSIONS: Results support findings from psychotherapy research about a predominantly stable course of the helping alliance in patients with severe mental illness over time. Implications for research and practice indicate to turn the attention to subgroups with noticeable courses.......PURPOSE: The helping alliance (HA) between patient and therapist has been studied in detail in psychotherapy research, but less is known about the HA in long-term community mental health care. The aim of this study was to identify typical courses of the HA and their predictors in a sample of people...
Stanton, Robert; Happell, Brenda
A substantial body of evidence supports the role of exercise interventions for people with a mental illness. However, much of this literature is conducted using outpatient and community-based populations. We undertook a systematic review examining the effect of exercise interventions on the health of people hospitalized with depression, schizophrenia, bipolar disorder, or anxiety disorders. Eight studies met our inclusion criteria. Several studies show positive health outcomes from short-term and long-term interventions for people hospitalized due to depression. Although positive, the evidence for inpatients with schizophrenia, bipolar disorder, or anxiety disorders is substantially less. There is an urgent need to address the paucity of literature in this area, in particular the optimal dose and delivery of exercise for people hospitalized as a result of mental illness. Standardization of reporting exercise programme variables, the assessment of mental illness, and the reporting of adverse events must accompany future studies. © 2013 Australian College of Mental Health Nurses Inc.
The current study aimed to measure the stress levels of family caregivers of individuals with mental illness and compare their stress levels according to the diagnosis and other sociodemographic characteristics. The sample comprised 310 family caregivers of individuals with mental illness in Jordan. Family caregivers completed a demographic checklist and the Arabic version of the Perceived Stress Scale 10-Item (PSS-10) questionnaire. A significant difference was found in PSS-10 levels among family caregivers according to gender, diagnosis of their family member, and time since diagnosis. Female caregivers reported significantly higher stress levels than male caregivers. Family members of individuals with schizophrenia reported the highest stress levels (p family caregivers and time since diagnosis. Investigating stress levels in family members of individuals with mental illness may be helpful when designing interventions to reduce such stress. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 30-35.]. Copyright 2017, SLACK Incorporated.
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.
Jakobsen, Lars; Terkelsen, Christian J; Christiansen, Evald H
The mechanisms behind the increased mortality in patients with acute myocardial infarction and co-existing severe mental illness (SMI) compared with non-SMI patients remain unclear. We studied 12,102 patients with ST-elevation myocardial infarction treated with primary percutaneous coronary...
This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.
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 physical activity intervention programming in hospital settings, which may contribute to decreasing the chronic disease burden and improve the psychological wellbeing in adults with mental illness. © 2015 Australian College of Mental Health Nurses Inc.
Arun Kumar Agnihotri
This study was initiated to explore the attitude towards mental illness among medical ... keep social distance against the mentally ill, however these students have tendency to feel that mentally ..... stigma and its consequences: evidence from a.
Evans-Lacko, S.; Brohan, E.; Mojtabai, R.; Thornicroft, G.
Background. Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems...
Fisher, David; Coleman, Karen J; Arterburn, David E; Fischer, Heidi; Yamamoto, Ayae; Young, Deborah R; Sherwood, Nancy E; Trinacty, Connie Mah; Lewis, Kristina H
To compare bariatric surgery outcomes according to preoperative mental illness category. Electronic health record data from several US healthcare systems were used to compare outcomes of four groups of patients who underwent bariatric surgery in 2012 and 2013. These included the following: people with (1) no mental illness, (2) mild-to-moderate depression or anxiety, (3) severe depression or anxiety, and (4) bipolar, psychosis, or schizophrenia spectrum disorders. Groups were compared on weight loss trajectory using generalized estimating equations using B-spline bases and on all-cause emergency department visits and hospital days using zero-inflated Poisson and negative binomial regression up to 2 years after surgery. Models were adjusted for demographic and health covariates, including baseline healthcare use. Among 8,192 patients, mean age was 44.3 (10.7) years, 79.9% were female, and 45.6% were white. Fifty-seven percent had preoperative mental illness. There were no differences between groups for weight loss, but patients with preoperative severe depression or anxiety or bipolar, psychosis, or schizophrenia spectrum disorders had higher follow-up levels of emergency department visits and hospital days compared to those with no mental illness. In this multicenter study, mental illness was not associated with differential weight loss after bariatric surgery, but additional research could focus on reducing acute care use among these patients. © 2017 The Obesity Society.
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.
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…
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
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:…
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.
Gold, S J
Despite their impressive progress in adapting to American life, many Vietnamese still suffer from wartime experiences, culture shock, the loss of loved ones, and economic hardship. Although this trauma creates substantial mental health needs, culture, experience, and the complexity of the American resettlement system often block obtaining assistance. Vietnamese mental health needs are best understood in terms of the family unit, which is extended, collectivistic, and patriarchal. Many refugees suffer from broken family status. They also experience role reversals wherein the increased social and economic power of women and children (versus men and adults) disrupts the traditional family ethos. Finally, cultural conflicts often make communication between practitioners and clients difficult and obscure central issues in mental health treatment. Rather than treating symptoms alone, mental health workers should acknowledge the cultural, familial, and historical context of Vietnamese refugees.
Lauber, Christoph; Nordt, Carlos; Falcato, Luis; Rössler, Wulf
When identifying ways to reduce stigmatization because of mental illness it is crucial to understand contributing factors. Social distance-the willingness to engage in relationships of varying intimacy with a person--is an indicator of public attitudes toward persons with mental illness. Multiple linear regression analysis of the results of a vignette-based opinion survey conducted on a representative population sample in Switzerland (n = 594). The level of social distance increases if situations imply 'social closeness.' The vignette describing a person with schizophrenia, attitudes to general aspects of mental health (lay helping, community psychiatry), emotions toward those affected, and the attitude toward consequences of mental illness (medical treatment, medication side effects, negative sanctions, e.g. withdrawal of the driver license) were found to predict social distance. Demographic factors such as age, gender, and the cultural background influence social distance. The explained variance (R2) is 44.8%. Social distance is a multifaceted concept influenced by, e.g., socio-economic and cultural factors, but also by the respondent's general attitude toward (mental) health issues. These results suggest that more knowledge about mental illnesses, especially schizophrenia, may increase social distance. The findings presented here may help to focus anti-stigma campaigns not only on transmission of knowledge, but on integrating different approaches.
Wang, Li; Zhang, Zhiguo; Yan, Qiuli; Lu, Jie; Gao, Baoyin; Zhao, Yanlin; Pang, Yu
Although the prevalence of tuberculosis has decreased significantly over the past decades, the certain populations with mental illness are at increased risk for tuberculosis infection and transmission. However, no studies have examined the performance of different laboratory examination methods among people with severe mental illness in China. In this study, we firstly performed a retrospective study to evaluate the feasibility of three routine laboratory methods, including sputum microscopy, solid culture and GeneXpert, to diagnose tuberculosis patients with mental illness. During August 2010 and March 2013, a total of 251 TB patients based on clinical and radiographic criteria with severe mental illness were enrolled in this study. The majority of patients was homeless (97/251, 38.6%), and the other 62 (24.7%) and 92 (36.7%) were from urban and rural region, respectively. The most frequently diagnosed mental illness was schizophrenia, accounting for 84.1% (211/251) of patients available for analysis. In addition, the laboratory received 753 sputum samples collected from these 251 TB patients, of which 76.0% (572/753) of samples were classified as salivary sputum, which were unqualified for microscopy and culture. When the test results were analyzed by patients, the positive numbers of TB patients detected by sputum microscopy, solid culture and GeneXpert were 3 (1.2%), 5 (2.0%) and 5 (2.0%), respectively. In conclusion, our findings reveal that the current laboratory examinations based on sputum samples seem not to be suitable for the diagnosis of active TB in the persons with severe mental illness. The products using a non-invasive specimen such as urine deserve further evaluation, which may generate benefit for the early diagnosis of TB in this special population.
Lauritzen, Camilla; Reedtz, Charlotte; Van Doesum, Karin T M; Martinussen, Monica
Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. The design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker's knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. The results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice. The main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant.
Evans-Lacko, S; Brohan, E; Mojtabai, R; Thornicroft, G
Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.
O'Brien, S; McFarland, J; Kealy, B; Pullela, A; Saunders, J; Cullen, W; Meagher, D
There is increasing interest in the application of recovery principles in mental health services. We studied the implementation of a programme of intensive case management (ICM) emphasizing recovery principles in a community mental health service in Ireland. Eighty service attenders with severe and enduring illness characterized by significant ongoing disability were randomized into (1) a group receiving a programme of ICM and (2) a group receiving treatment as usual (TAU). Groups were compared before and after the programme for general psychopathology using the Brief Psychiatric Rating Scale (BPRS) (clinician rated) and How are You? scale (self-rated). The Functional Analysis of Care Environments (FACE) scale provided assessment of multiple functional domains. The overall group (mean age 44.5 ± 13.2 years; 60% male) had mean total Health of the Nation Outcome Scale (HoNOS) scale scores of 10.5 ± 4.6, with problems in social functioning especially prominent (mean social subscale score 5.0 ± 2.7). The ICM group were younger (p recovery principles resulted in significant improvement across psychopathological and functional domains. Improvements were linked to enhanced engagement with structured daily activities. Recovery-oriented practices can be integrated into existing mental health services and provided alongside traditional models of care.
Jyoti Srivastava, Indira Sharma, Anuradha Khanna
Full Text Available Background: Domestic violence against women is the most pervasive human rights violation in the world today. According to UNiTE to End Violence against Women (2009 by UN Women, In the United States, one-third of women murdered each year are killed by intimate partners. In South Africa, a woman is killed every 6 hours by an intimate partner. The Objective: To assess the magnitude and causes of domestic violence with mental illness & normal women. Material & Methods: The sample of study comprised of 50 women with mental illness and 50 normal women. Mental illness patients diagnosed according to with Axis one psychiatric Disorder DSM IV-TR, who were selected from the Psychiatry OPD and ward of the S.S. Hospital, BHU and normal women were be selected from the accompany with patients of Sir Sunder Lal Hospital. The patients were assessed on the structured questionnaire on Domestic Violence. Results – The domestic violence present in married women with mental illness was 72% and normal women were 36%. Perceived causes of domestic violence in married women with mental illness were more compared to those with normal women. The health care personnel should be given an opportunity to update their knowledge regarding domestic violence and there is need education for domestic violence and cessation, so that they can help the women to protect/prevent domestic violence.
Paraskevoulakou, Alexia; Vrettou, Kassiani; Pikouli, Katerina; Triantafillou, Evgenia; Lykou, Anastasia; Economou, Marina
Since evaluation regarding the impact of mental illness related internalized stigma is scarce, there is a great need for psychometric instruments which could contribute to understanding its adverse effects among Greek patients with severe mental illness. The Brief Internalized Stigma of Mental Illness (ISMI) scale is one of the most widely used measures designed to assess the subjective experience of stigma related to mental illness. The present study aimed to investigate the psychometric properties of the Greek version of the Brief ISMI scale. In addition to presenting psychometric findings, we explored the relationship of the Greek version of the Brief ISMI subscales with indicators of self-esteem and quality of life. 272 outpatients (108 males, 164 females) meeting the DSM-IV TR criteria for severe mental disorder (schizophrenia, bipolar disorder, major depression) completed the Brief ISMI, the RSES and the WHOQOL-BREF scales. Patients reported age and educational level. A retest was conducted with 124 patients. The Chronbach's alpha coefficient was 0 0.83. The test-retest reliability coefficients varied from 0.81 to 0.91, indicating substantial agreement. The ICC was for the total score 0.83 and for the two factors, 0.69 and 0.77 respectively. Factor analysis provided strong evidence for a two factor model. Factors 1 and 2 were named respectively "how others view me" and "how I view myself". They were negatively correlated with both RSES and WHOQOL-BREF scales, as well as with educational level. Factor 2 was significantly associated with the type of diagnosis. The Greek version of the Brief ISMI scale can be used as a reliable and valid tool for assessing mental illness related internalized stigma among Greek patients with severe mental illness.
Girma, Eshetu; Möller-Leimkühler, Anne Maria; Dehning, Sandra; Mueller, Norbert; Tesfaye, Markos; Froeschl, Guenter
In addition to economic and material burdens, caregivers of people with mental illness are exposed to psychosocial challenges. Self-stigma is among the psychological challenges that can be exacerbated by intrinsic and/or extrinsic factors. Caregivers' self-stigma can negatively influence the patients' treatment and rehabilitation process. The objective of this study was to measure the level and correlates of self-stigma among caregivers of people with mental illness. An interviewer-administered cross-sectional study was conducted in the Jimma University Specialized Hospital Psychiatry Clinic in Ethiopia on a sample of 422 caregivers. Data were collected by trained nurses working in the clinic using a pretested questionnaire. Multivariate linear regression was performed to identify the correlates of self-stigma among caregivers of people with mental illness. The majority (70.38%) of the caregivers were male. On a scale of 0 to 15, with 0 being low and 15 being high, the average self-stigmatizing attitude score was 4.68 (±4.11). A statistically significant difference in mean self-stigma score was found between urban and rural respondents (t=3.95, PSelf-stigma of caregivers showed significant positive correlation with perceived signs of mental illness (r=0.18, Pself-stigma was perceived supernatural explanation of mental illness (standardized β=0.22, Pself-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers' self-stigma may negatively influence patients' treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness.
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.
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.
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.
Swinson, Nicola; Flynn, Sandra M; While, David; Roscoe, Alison; Kapur, Navneet; Appleby, Louis; Shaw, Jenny
The rise in homicides by those with serious mental illness is of concern, although this increase may not be continuing. To examine rates of mental illness among homicide perpetrators. A national consecutive case series of homicide perpetrators in England and Wales from 1997 to 2006. Rates of mental disorder were based on data from psychiatric reports, contact with psychiatric services, diminished responsibility verdict and hospital disposal. Of the 5884 homicides notified to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness between 1997 and 2006, the number of homicide perpetrators with schizophrenia increased at a rate of 4% per year, those with psychotic symptoms at the time of the offence increased by 6% per year. The number of verdicts of diminished responsibility decreased but no change was found in the number of perpetrators receiving a hospital order disposal. The likeliest explanation for the rise in homicide by people with psychosis is the misuse of drugs and/or alcohol, which our data show increased at a similar magnitude to homicides by those with psychotic symptoms. However, we are unable to demonstrate a causal association. Although the Poisson regression provides evidence of an upward trend in homicide by people with serious mental illness between 1997 and 2006, the number of homicides fell in the final 2 years of data collection, so these findings should be treated with caution. There appears to be a concomitant increase in drug misuse over the period, which may account for this rise in homicide. However, an increase in the number of people in contact with mental health services may suggest that access to mental health services is improving. Previous studies have used court verdicts such as diminished responsibility as a proxy measure of mental disorder. Our data indicate that this does not reflect accurately the prevalence of mental disorder in this population.
Wong, M G P; Poole, C J M; Agius, R
Clinicians may be asked whether mental ill-health has been caused by work but there is no guidance on how this judgement should be made. To seek a consensus on the factors that should be considered and how they should be sought when attributing mental ill-health to work. A three-round Delphi study involving expert academics, occupational physicians, psychiatrists and psychologists. We deemed consensus had been reached when 66% or more of the experts were in agreement. Of 54 invited experts, 35 (65%) took part in the first round, 30 of these 35 (86%) in the second and 29 of these 30 (97%) in the final round. Consensus was reached for 11 workplace stressors: high job strain; effort-reward imbalance; major trauma; interpersonal conflict; inadequate support; role ambiguity; person-job mismatch; organizational injustice; organizational culture; work scheduling and threats to job security. Seven personal factors were identified as being important: previous mental illness; personality traits of neuroticism; adverse life events or social circumstances; resilience; a family history of mental illness and secondary gain. The worker, manager and co-workers were thought to be the most useful sources of workplace information. Consensus was reached for a definition of occupational mental illness but not for a threshold of work-relatedness. The attribution of mental ill-health to work is complex and involves the consideration of both workplace stressors and personal factors of vulnerability. Clinical consultation with an occupational physician who is familiar with the workplace is central to the process. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Friedman, Susan Hatters; McEwan, Miranda V
Despite a limited empirical literature, parental mental illness is often cited as a major risk factor for violence against children. However, mental illness that is adequately treated would not be expected to lead to increased violence risk. This study compared incidents of violence toward children perpetrated by parents who were newly discharged from inpatient psychiatric treatment with violence perpetrated by other parents in the same communities to determine whether parents with treated mental illness had an elevated risk of child abuse perpetration. A secondary analysis of data from the MacArthur Violence Risk Assessment Study was conducted. Violence toward children reported by parents and by collateral informants at the initial ten-week follow-up interview was analyzed for two groups: study participants discharged from inpatient psychiatric facilities and parents in the community matched by neighborhood. Of the 416 parents in the participant group, 20 (5%) committed violence toward a child in the ten weeks after discharge, compared with 41 (14%) of the 299 parents in the comparison group. In the participant group, diagnostic categories of parents who committed violence toward a child were as follows: serious mental illness only (8% of whom were violent), substance use disorder only (3%), both serious mental illness and substance use disorder (4%), and another issue (7%). This study found that parents with treated serious mental illness were not at higher risk than other parents in their community of perpetrating violence toward children. Parents who were admitted to an acute psychiatric facility and treated appeared to be at lower risk of being violent toward children than other parents in their community.
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.
Hsiao, Fei-Hsiu; Klimidis, Steven; Minas, Harry I; Tan, Eng S
This paper reports a study of (a) popular conceptions of mental illness throughout history, (b) how current social and cultural knowledge about mental illness influences Chinese-Australian patients' and caregivers' understanding of mental illness and the consequences of this for explaining and labelling patients' problems. According to traditional Chinese cultural knowledge about health and illness, Chinese people believe that psychotic illness is the only type of mental illness, and that non-psychotic illness is a physical illness. Regarding patients' problems as not being due to mental illness may result in delaying use of Western mental health services. Data collection took place in 2001. Twenty-eight Chinese-Australian patients with mental illness and their caregivers were interviewed at home, drawing on Kleinman's explanatory model and studies of cultural transmission. Interviews were tape-recorded and transcribed, and analysed for plots and themes. Chinese-Australians combined traditional knowledge with Western medical knowledge to develop their own labels for various kinds of mental disorders, including 'mental illness', 'physical illness', 'normal problems of living' and 'psychological problems'. As they learnt more about Western conceptions of psychology and psychiatry, their understanding of some disorders changed. What was previously ascribed to non-mental disorders was often re-labelled as 'mental illness' or 'psychological problems'. Educational programmes aimed at introducing Chinese immigrants to counselling and other psychiatric services could be made more effective if designers gave greater consideration to Chinese understanding of mental illness.
Neeleman, J; Oldehinkel, AJ; Ormel, J
Background: Episode duration in non-psychotic mental illness is associated with personal characteristics of patients, like age or personality. Part of these links may be mediated by life change, a predictor of episode duration in its own right. Methods: In 170 primary care patients who suffered 4171
Dickerson, Faith B.; Brown, Clayton H.; Daumit, Gail L.; LiJuan, Fang; Goldberg, Richard W.; Wohlheiter, Karen; Dixon, Lisa B.
We examined indices of the health of persons with serious mental illness. A sample of 100 adults with schizophrenia and 100 with major mood disorder were recruited from randomly selected outpatients who were receiving community-based psychiatric treatment. Participants were surveyed about health indicators using items from the National Health and Nutrition Examination Study III and the National Health Interview Survey. Their responses were compared with those of matched samples from the general population surveys. A total of 1% of persons with serious mental illness, compared with 10% from the general population sample, met criteria for all 5 of selected health indicators: nonsmoker, exercise that meets recommended standards, good dentition, absence of obesity, and absence of serious medical co-occurring illness. Within the mentally ill group, educational level, but not a diagnosis of schizophrenia versus mood disorder, was independently associated with a composite measure of health behaviors. We conclude that an examination of multiple health indicators may be used to measure overall health status in persons with serious mental illness. PMID:16469943
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.
Tang, Lili; Fritzsche, Kurt; Leonhart, Rainer; Pang, Ying; Li, Jinjiang; Song, Lili; Fischer, Irmela; Koch, Maike; Wuensch, Alexander; Mewes, Ricarda; Schaefert, Rainer
To evaluate the relationship between quality of life (QOL) and physical as well as psychological variables in Chinese breast cancer patients. This multicenter cross-sectional study enrolled 254 Chinese breast cancer patients in different stages and treatment phases. They answered standard instruments assessing QOL (EORTC), somatic symptom severity (PHQ-15), depression (PHQ-9), anxiety (GAD-7), health-related anxiety (WI-7), illness perception (BIPQ), and sense of coherence (SOC-9). Canonical correlation was applied to identify the strongest correlates between the physical, emotional and social QOL scales and the physical and psychological variables. In our sample, a low global QOL was significantly associated with the following physical and psychological variables: symptom-related disability (Karnofsky Index) (r = .211, p illness perception (r = -.411, p illness perception, and low sense of coherence showed the strongest correlations with low physical, emotional and social functioning. The first three significant canonical correlations between these two sets of variables were .78, .56, and .45. QOL in Chinese breast cancer patients is strongly associated with psychological factors. Our results suggest that Chinese physicians and nurses should incorporate these factors into their care for women with breast cancer to improve patients' QOL.
Simpson, C J; Hyde, C E; Faragher, E B
The quality of life of chronically mentally ill patients in acute wards in a district general hospital, a hostel ward and group homes was compared. Within the spectrum of care of these patients, the severity of psychopathology corresponded to their placement. Analysis, including adjustments for the influence of psychopathology, showed differences between the three types of facility. Although differences existed between all types of care, residents in group homes and the hostel ward shared more similarities in quality of life than those in the district general hospital. Problems of caring for the chronically mentally ill on acute wards are highlighted.
Thornicroft, Amalia; Goulden, Robert; Shefer, Guy; Rhydderch, Danielle; Rose, Diana; Williams, Paul; Thornicroft, Graham; Henderson, Claire
Better newspaper coverage of mental health-related issues is a target for the Time to Change (TTC) anti-stigma programme in England, whose population impact may be influenced by how far concurrent media coverage perpetuates stigma and discrimination. To compare English newspaper coverage of mental health-related topics each year of the TTC social marketing campaign (2009-2011) with baseline coverage in 2008. Content analysis was performed on articles in 27 local and national newspapers on two randomly chosen days each month. There was a significant increase in the proportion of anti-stigmatising articles between 2008 and 2011. There was no concomitant proportional decrease in stigmatising articles, and the contribution of mixed or neutral elements decreased. These findings provide promising results on improvements in press reporting of mental illness during the TTC programme in 2009-2011, and a basis for guidance to newspaper journalists and editors on reporting mental illness.
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.
Full Text Available There have been repeated instances of police forces having violent, sometimes fatal, interactions with individuals with mental illness. Police forces are frequently first responders to those with mental illness. Despite this, training police in how to best interact with individuals who have a mental illness has been poorly studied. The present article reviews the literature examining mental illness training programs delivered to law enforcement officers. Some of the key findings are the benefits of training utilizing realistic hands-on scenarios, which focus primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. Current issues in training police officers are firstly the tendency for organizations to provide training without proper outcome measures of effectiveness, secondly the focus of training is on changing attitudes although there is little evidence to demonstrate this relates to behavioural change, and thirdly the belief that a mental health training program given on a single occasion is sufficient to improve interactions over the longer-term. Future police training needs to address these issues.
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.
Einstein, Evan Hy; Klepacz, Lidia
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. 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 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. 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.
Madathumkovilakath, Neethu Bhaskaran; Kizhakkeppattu, Sindhu; Thekekunnath, Saleem; Kazhungil, Firoz
Aggression is one of the chief determinants of caregiver burden in severe mental illnesses. Clinical and treatment implications of aggression in mental illness are predominantly studied in perspectives of mental health care professionals. Coping style of caregivers towards aggression of persons with mental illness is understudied. So we studied coping strategies used by caregivers of patients with severe mental illness towards aggressive behaviors of patients and relationship between aggressive behavior and coping strategies. We assessed two hundreds and seventy caregivers of patients with severe mental illness attending outpatient psychiatry department using Modified Overt Aggression Scale and the Ways of Coping Scale - revised. 95.6% of the caregivers perceived verbal aggression followed by aggression against property (67%), auto aggression (33.7%) and physical aggression (25.6%). The study revealed that adaptive coping strategies - planful problem solving and seeking social support were used by 40% each of caregivers to deal with aggressive behavior. Only 4.4% of caregivers resorted to escape avoidance which is maladaptive coping strategy. Though adaptive strategies were used by caregivers these were not used in appropriate situations. Physical aggression and aggression against property were not significantly associated with planful problem solving (r = 0.105; p = 0.08 and r = 0.110; p = 0.07 respectively). But verbal aggression, aggression against property and physical aggression were associated with escape avoidance (r = 0.152; p = 0.01 and r = 0.168; p = 0.01 and r = 0.23; p = mental illness is maladaptive with respect to aggression. Coping skills training would play a major role to address this issue. Copyright © 2018 Elsevier B.V. All rights reserved.
Pahwa, Rohini; Kriegel, Liat
As different facets of community integration as well as psychological and social integration are important dimensions of recovery for individuals with serious mental illness (SMI). The primary aim of the study was to explore psychological integration for individuals with SMI into the mental health and mainstream (i.e., non-mental health) communities and its association with their social integration into both communities. The study used self-report and egocentric social network data from 60 individuals with SMI receiving community-based mental health services. The primary findings indicated that social integration connected to service providers was associated with psychological integration in both mental health and mainstream communities. Our data suggest that in addition to providing services, providers are doing something meaningful to impact their clients' lives well beyond mental health services. The study supports a bifurcated conceptualization of psychological integration and provides a more complex understanding of the community integration concept.
Wu, Heng; Zhao, Xudong; Fritzsche, Kurt; Salm, Florian; Leonhart, Rainer; Jing, Wei; Yang, Jianzhong; Schaefert, Rainer
In western countries, negative illness perceptions are associated with poor health status and affect health outcomes in primary care populations. The aim of this study is to examine the relationship between illness perception and mental and physical health status in general hospital outpatients in China. This multicentre, cross-sectional study analysed a total of 281 consecutive patients from four general hospital outpatient departments of internal medicine and traditional Chinese medicine in Beijing and Kunming. The patients answered questionnaires concerning illness perception (Brief-IPQ), somatic symptom severity (Patient Health Questionnaire-15), illness behaviour (Scale for the Assessment of Illness Behaviour), emotional distress (Hospital Anxiety and Depression Scale) and health-related quality of life (Twelve-Item Short Form Health Survey). Negative illness perception, especially negative emotional reactions, perceived illness consequences, encumbering illness concerns, and strong illness identity were significantly associated with high emotional distress, impairing illness consequences, and a low mental and physical quality of life. Using a multiple linear regression model, five strongest correlates of negative illness perception were high anxiety, seeking diagnosis verification, low mental and physical quality of life and high somatic symptom severity. The variance explained by this model was 35%. Chinese general hospital outpatients showed associations between negative illness perceptions and poor mental and physical health status that were similar to those of primary care patients in western countries. The main difference was that no association with perceived illness control was found in Chinese patients. Chinese physicians should be sensitised to their patients' negative illness perceptions and should focus on helping patients cope with uncertainty and anxiety by providing an understandable illness model and increasing control beliefs.
Kramp, Peter; Gabrielsen, Gorm
Introduction: Over the past 40 years, a marked deinstitutionalisation in favour of social and community psychiatry has taken place in many countries. During this same period of time, there has been an increase in the number of mentally ill criminals. The purpose of this study is to analyse...... the correlations between the reorganization of the psychiatric treatment system, the growing number of forensic patients and the increase in serious crime, homicide, arson and violence associated with the mentally ill. Materials and methods: Using registers and other data sources, we estimated the annual positive......: The study is based on historical data, but the results are still valid. We have used two sets of data firstly the number of forensic patients and, secondly the reported number of crimes associated with the mentally ill. The uniformity of the results leads us to consider them for certain: That the decreasing...
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.
Bruins, Jojanneke; Pijnenborg, Marieke Gh; Bartels-Velthuis, Agna A; Visser, Ellen; van den Heuvel, Edwin R; Bruggeman, Richard; Jörg, Frederike
Objective: In the general population cannabis use is associated with better cardiometabolic outcomes. Patients with severe mental illness frequently use cannabis, but also present increased cardiometabolic risk factors. We explore the association between cannabis use and cardiometabolic risk factors
Bruins, J.; Pijnenborg, M.G.H.M.; Bartels-Velthuis, A.A.; Visser, E.; Van Den Heuvel, E.R.; Bruggeman, R.; Jörg, F.
Objective: In the general population cannabis use is associated with better cardiometabolic outcomes. Patients with severe mental illness frequently use cannabis, but also present increased cardiometabolic risk factors. We explore the association between cannabis use and cardiometabolic risk factors
Goldberg, Richard W; Dickerson, Faith; Lucksted, Alicia; Brown, Clayton H; Weber, Elyssa; Tenhula, Wendy N; Kreyenbuhl, Julie; Dixon, Lisa B
Individuals with serious mental illness have elevated rates of comorbid chronic general medical conditions and may benefit from interventions designed to support illness self-management. This study examined the effectiveness of a modified version of the Chronic Disease Self-Management Program called Living Well for individuals with serious mental illness. A total of 63 mental health consumers with serious mental illness and at least one concurrent chronic general medical condition were randomly assigned to receive the 13-session peer-cofacilitated Living Well intervention or usual care. Participants were evaluated on attitudinal, behavioral, and functional outcomes at baseline, at the end of the intervention, and at a two-month follow-up. Living Well participants showed significant postintervention improvements across a range of attitudinal (self-efficacy and patient activation), behavioral (illness self-management techniques), and functional (physical and emotional well-being and general health functioning) outcomes. Although attenuation of effect was observed for most outcomes at two months postintervention, evidence was found of continued improvement in general self-management behaviors (use of action planning, brainstorming, and problem-solving). Continued advantage was found for the Living Well group in other areas, such as health-related locus of control and reports of healthy eating and physical activity. Receipt of Living Well was associated with a notable decrease in use of the emergency room for medical care, although the between-group difference was not statistically significant. Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.
Lund, Crick; Myer, Landon; Stein, Dan J; Williams, David R; Flisher, Alan J
Little is known regarding the links between mental disorder and lost income in low- and middle-income countries. The purpose of this study was to investigate the association between mental disorder and lost income in the first nationally representative psychiatric epidemiology survey in South Africa. A probability sample of South African adults was administered the World Health Organization Composite International Diagnostic Interview schedule to assess the presence of mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, version IV. The presence of severe depression or anxiety disorders was associated with a significant reduction in earnings in the previous 12 months among both employed and unemployed South African adults (p = 0.0043). In simulations of costs to individuals, the mean estimated lost income associated with severe depression and anxiety disorders was $4,798 per adult per year, after adjustment for age, gender, substance abuse, education, marital status, and household size. Projections of total annual cost to South Africans living with these disorders in lost earnings, extrapolated from the sample, were $3.6 billion. These data indicate either that mental illness has a major economic impact, through the effect of disability and stigma on earnings, or that people in lower income groups are at increased risk of mental illness. The indirect costs of severe depression and anxiety disorders stand in stark contrast with the direct costs of treatment in South Africa, as illustrated by annual government spending on mental health services, amounting to an estimated $59 million for adults. The findings of this study support the economic argument for investing in mental health care as a means of mitigating indirect costs of mental illness.
Full Text Available People with severe mental illnesses die early from cardiovascular disease. Evidence is lacking regarding effective primary care based interventions to tackle this problem.To identify current procedures for, barriers to, and facilitators of the delivery of primary care based interventions for lowering cardiovascular risk for people with severe mental illnesses.75 GPs, practice nurses, service users, community mental health staff and carers in UK GP practice or community mental health settings were interviewed in 14 focus groups which were audio-recorded, transcribed and analysed using Framework Analysis.Five barriers to delivering primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses were identified by the groups: negative perceptions of people with severe mental illnesses amongst some health professionals, difficulties accessing GP and community-based services, difficulties in managing a healthy lifestyle, not attending appointments, and a lack of awareness of increased cardiovascular risk in people with severe mental illnesses by some health professionals. Identified facilitators included involving supportive others, improving patient engagement with services, continuity of care, providing positive feedback in consultations and goal setting.We identified a range of factors which can be incorporated in to the design, delivery and evaluation of services to reduce cardiovascular risk for people with severe mental illnesses in primary care. The next step is determining the clinical and cost effectiveness of primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses, and evaluating the most important components of such interventions.
Burton, Alexandra; Osborn, David; Atkins, Lou; Michie, Susan; Gray, Ben; Stevenson, Fiona; Gilbert, Hazel; Walters, Kate
People with severe mental illnesses die early from cardiovascular disease. Evidence is lacking regarding effective primary care based interventions to tackle this problem. To identify current procedures for, barriers to, and facilitators of the delivery of primary care based interventions for lowering cardiovascular risk for people with severe mental illnesses. 75 GPs, practice nurses, service users, community mental health staff and carers in UK GP practice or community mental health settings were interviewed in 14 focus groups which were audio-recorded, transcribed and analysed using Framework Analysis. Five barriers to delivering primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses were identified by the groups: negative perceptions of people with severe mental illnesses amongst some health professionals, difficulties accessing GP and community-based services, difficulties in managing a healthy lifestyle, not attending appointments, and a lack of awareness of increased cardiovascular risk in people with severe mental illnesses by some health professionals. Identified facilitators included involving supportive others, improving patient engagement with services, continuity of care, providing positive feedback in consultations and goal setting. We identified a range of factors which can be incorporated in to the design, delivery and evaluation of services to reduce cardiovascular risk for people with severe mental illnesses in primary care. The next step is determining the clinical and cost effectiveness of primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses, and evaluating the most important components of such interventions.
Zhuang, Xiao Yu; Wong, Daniel Fu Keung; Cheng, Chi-Wei; Pan, Shu-Man
Few studies have been performed to explore mental health literacy and stigmatising attitudes towards mental illness and their relationships with causal beliefs about mental illness among Chinese people in Taiwan. Using a comparative approach, this study attempted to compare the mental health literacy and stigmatising attitudes of Taiwanese Chinese with those found among Australian and Japanese participants in other studies and to explore how mental health literacy and stigmatising attitudes relate to different perceptions of causes of mental illness. A convenience sample of 287 participants completed a battery of standardised questionnaires. A much lower percentage of Taiwanese people than Australians could correctly identify depression and schizophrenia. The Taiwanese respondents rated psychiatrists and clinical psychologists as more helpful than social workers and general practitioners (GPs) and expressed more uncertainty about the usefulness of certain medications when compared to the Australian and Japanese samples. Interestingly, Taiwanese Chinese hold similarly high levels of stigma towards schizophrenia, but lower levels of stigma towards depression when compared to the Japanese respondents. Taiwanese respondents who have higher levels of mental health literacy about schizophrenia were less willing to interact with people with schizophrenia than those with lower levels of mental health literacy. This study underlines the need for public education programmes to improve knowledge of various mental illnesses and to reduce stigmatising attitudes among Taiwanese Chinese. The aforementioned socially and culturally driven beliefs must be taken into consideration so that culturally relevant education programmes can be developed.
Prior to the second world war, most persons confined in insane asylums were regarded as legally incompetent and had guardians appointed for them. Today, most persons confined in mental hospitals (or treated involuntarily, committed to outpatient treatment) are, in law, competent; nevertheless, in fact, they are treated as if they were incompetent. Should the goal of mental health policy be providing better psychiatric services to more and more people, or the reduction and ultimate elimination of the number of persons in the population treated as mentally ill?
Full Text Available Abstract Background Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi. Methods A cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”. Results 210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%. This was closely followed by brain disease (92.8%, spirit possession (82.8% and psychological trauma (76.1%. There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample. Conclusions Our study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue.
The topic of rational suicide is often approached with some trepidation by mental health professionals. Suicide prevention strategies are more likely to be seen as the domain of psychiatry and a wealth of psychiatric literature is devoted to identifying and managing suicide risk. Whether or not suicide can be deemed permissible is ostensibly linked to discussions of autonomy and mental capacity, and UK legislation directs that a patient's wishes must be respected with regard to treatment refusal where decisional capacity is intact. In the context of the care and treatment of those with physical disorders, extreme and untreatable physical suffering is likely to be accepted as rational grounds for suicide, where the person possesses cognitive coherence and an ability to realistically appreciate the consequences of his or her actions. In the case of those with serious mental disorder, the grounds for accepting that suicide is rational are however less clear-cut. Serious mental illness is typically conceived of as a coercive pressure which prevents rational deliberation and as such, the suicides of those with serious mental illness are considered to be substantially non-voluntary acts arising from constitutive irrationality. Therefore, where an appropriate clinician judges that a person with serious mental disorder is non-autonomous, suicide prevention is likely to be thought legally and morally justified. There are arguably, two questionable assumptions in the position that psychiatry adopts: Firstly, that psychogenic pain is in some way less real than physical pain and secondly, that mental illness invariably means that a desire to die is irrational and inauthentic. If it can be shown that some people with serious mental illness can be rational with regard to suicide and that psychological pain is of equal significance as physical suffering, then it may be possible to conclude that some persons with serious mental illness should not by definition be excluded from the
Barney, Steve T.; Corser, Grant C.; White, Lynn H.
Stigmas toward those who have mental illnesses are wide-spread and detrimental to the health and well-being of those suffering from these debilitating conditions, and to society as a whole. Stigma-reducing programs are plentiful but many are only marginally effective. In this paper we describe and evaluate a course in Psychopathology that included…
Schene, A. H.; Tessler, R. C.; Gamache, G. M.
The consequences of psychiatric disorders for family members, usually called family or caregiver burden, have been studied during the last 4 decades. During this period a variety of instruments have been developed to measure the impact of mental illness on family members, but not all instruments
Schulman, Eveline D.
This monograph is an international overview of available information about the current status of rehabilitation efforts for the mentally ill. It served as a springboard for discussion at the Special Interest Group session at the Fourteenth World Congress of Rehabilitation International in Winnipeg, Canada, on June, 1980. The first part of the…
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 ...
Young, Daniel Kim-Wan; Ng, Petrus Y. N.; Pan, Jia-Yan; Cheng, Daphne
Purpose: This study aims to translate and test the reliability and validity of the Internalized Stigma of Mental Illness-Cantonese (ISMI-C). Methods: The original English version of ISMI is translated into the ISMI-C by going through forward and backward translation procedure. A cross-sectional research design is adopted that involved 295…
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 ...
Alberta Learning, Edmonton.
This resource manual is designed to assist Alberta teachers in the identification and education of students with emotional disorders and/or mental illnesses. It takes a comprehensive look at six emotional disorders. The first section focuses on eating disorders. It describes the characteristics and symptoms of anorexia nervosa, bulimia nervosa,…
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.
Kaufman, James C.
Two studies involving a total of 2149 writers and other eminent individuals found that female poets were significantly more likely to suffer from mental illness than female fiction writers, than male writers of any type, or than eminent individuals in other fields. This finding has been dubbed the "Sylvia Plath" effect. (Contains…
Identifying social labels for mental illness in a Nigerian university: the overt problem of public ... Methods: The study was a Focus Group Discussion that took place in the University of Ibadan. ... Support: A partial bursary was received from the John D. and Catherine T. McArthur Foundation, ... AJOL African Journals Online.
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…
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…
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).…
Westergård-Nielsen, Niels Chr.; Agerbo, Esben; Eriksson, Tor Viking
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...
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…
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…
Markowitz, Fred E.; Angell, Beth; Greenberg, Jan S.
Drawing on modified labeling theory and the reflected appraisals process and using longitudinal data from 129 mothers and their adult children with schizophrenia, we estimate models of the effects of mothers' stigmatized identity appraisals of their mentally ill children on reflected and self-appraisals, and how appraisals affect outcomes…
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…
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 changing knowledge, there were still some aspects of stigma that were not amenable to education. Nigerian Journal of Psychiatry Vol.
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.
Chiles, Catherine; Stefanovics, Elina; Rosenheck, Robert
Stigma towards people with mental illness remains a burden for patients and healthcare providers. This study at a large US university examined the attitudes of psychiatry residents and fellows towards mental illness and its causes, and whether their attitudes differed from the medical student attitudes previously studied utilizing the same survey method. An electronic questionnaire examining attitudes toward people with mental illness, causes of mental Illness, and treatment efficacy was used to survey the attitudes of psychiatry residents and fellows. Exploratory factor analysis derived from the authors' medical student survey was used to examine attitudinal factors. The study response rate was 54.2% (n = 94). Factor analysis employed three factors previously identified reflecting social acceptance of mental illness, belief in supernatural causes, and belief in biopsychosocial causes. Residents and fellows reporting more personal experiences with mental illness, both as a group and when compared with medical students, were significantly more willing to socialize with the mentally ill. Respondents who had more professional (work) experience other than medical school or post-graduate training were less likely to believe in supernatural causes of mental illness. Female residents and fellows were more willing to socialize with the mentally ill, and were less likely to believe in supernatural causes for mental illness than their male counterparts. In our study, increased social acceptance of the mentally ill relates to having personal experiences, advanced training in psychiatry, and female gender. Both professional experiences outside of training and female gender reduced the belief in supernatural causes.
Rüsch, Nicolas; Evans-Lacko, Sara; Thornicroft, Graham
'Mental illness' is a common label. However, the general public may or may not consider various conditions, ranging from major psychiatric disorders to stress, as mental illnesses. It is unclear how such public views affect attitudes towards people with mental illness and reactions to one's own potential mental illness, e.g. in terms of help-seeking or disclosure. In representative English population surveys the classification of six conditions (schizophrenia, bipolar disorder, depression, drug addiction, stress, grief) as a mental illness was assessed as well as attitudes towards, and contact with, people with mental illness, intentions to disclose a mental illness and to seek treatment. A factor analysis of how strongly respondents perceived the six conditions as a mental illness yielded two factors: (i) major psychiatric disorders and (ii) stress- and behaviour-related conditions including drug addiction. In regression analyses, higher scores on the first, but not the second, factor predicted less perceived responsibility of people with mental illness for their actions, and more support for a neurobiological illness model and help-seeking. Classifying stress-related/behaviour-related conditions as mental illnesses, as well as not referring to major psychiatric disorders as mental illnesses, was associated with more negative attitudes and increased social distance, but also with stronger intentions to disclose a mental illness to an employer. Negative attitudes and social distance were also related to ethnic minority status and lower social grade. Referring to major psychiatric disorders as mental illnesses may reflect higher mental health literacy, better attitudes towards people with mental illness and help-seeking. A broader concept of mental illness could, although increasing negative attitudes, facilitate disclosure in the workplace. Public views on what is a mental illness may have context-dependent effects and should be taken into account in anti
Wainberg, Milton L; Cournos, Francine; Wall, Melanie M; Norcini Pala, Andrea; Mann, Claudio Gruber; Pinto, Diana; Pinho, Veronica; McKinnon, Karen
The majority of people in psychiatric care worldwide are sexually active, and studies have revealed sharply elevated rates of HIV infection in that group compared with the general population. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, and stigma experiences related to sexuality among people in psychiatric outpatient care. Sexually active adults attending 8 public outpatient psychiatric clinics in Rio de Janeiro (N = 641) were interviewed for psychiatric diagnosis and stigma experiences. Stigma mechanisms well-established in the literature but not previously examined in relation to sexuality were measured with the Mental Illness Sex Stigma Questionnaire, a 27-item interview about stigma in sexual situations and activities. Experiences of stigma were reported by a majority of participants for 48% of questionnaire items. Most people reported supportive attitudes toward their sexuality from providers and family members. Those with severe mental illness diagnoses showed greater stigma on individual discrimination and structural stigma mechanisms than did those with nonsevere mental illness diagnoses, whereas there was no difference on the social psychological processes (internalized stigma) mechanism. Regardless of diagnosis or gender, a majority of participants devalued themselves as sexual partners. Adults in psychiatric outpatient care frequently reported stigma experiences related to aspects of their sexual lives. From the perspectives of both HIV prevention and recovery from mental illness, examinations of the consequences of stigma in the sexual lives of people in psychiatric care and improving their measurement would have wide applicability. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
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.
Pihkala, Heljä; Sandlund, Mikael; Cederström, Anita
Beardslee's family intervention (FI) is a family-based intervention to prevent psychiatric problems for children of mentally ill parents. The parents' experiences are of importance in family-based interventions. Twenty five parents were interviewed about their experiences of FI. Data were analysed by qualitative methods. Confidence and security in the professionals and in FI as a method were prerequisites for initiating communication about the parents' mental illness with the children. FI provides a solid base for an alliance with the parents and might be a practicable method when parenthood and children are discussed with psychiatric patients.
Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri
The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
Reisner, Andrew D; Piel, Jennifer; Makey, Miller
Forensic evaluators often assess patients who lack insight into their mental illnesses. This lack of insight can have a significant impact on the defendant's ability to make legal strategy decisions that rely on their acceptance of their mental illness. In this article, the relationship between refusing an insanity plea and competency to stand trial will be explored in the context of defendants who lack insight into their mental illness. The authors argue that an adequate competency assessment should take into account the defendant's ability to consider his available pleas rationally. Such evaluations may have the effect of negating the necessity of a Frendak inquiry in those jurisdictions that can impose the insanity defense on defendants.
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.
Loon, L.M.A. van; Ven, M.O.M. van de; Doesum, K.T.M. van; Witteman, C.L.M.; Hosman, C.M.H.
Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent-child interaction and
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…
A doença mental vivida por um paciente psiquiátrico: suas percepções La enfermedad mental vivida por un paciente psiquiatrico: sus percepciones The mental illness experienced by a psichiatric patient: their perceptions
Antonia Regina Ferreira Furegato
.We carried out a series of interactions with a mental patient and his relatives, who received the necessary information. Nurses from NUPRI (Núcleo de Pesquisas das Relações Interpessoais worked with 15 recorded interviews that aimed get to know perceptions about the disease. Data were processed using ALCESTE software. We obtained a file with 139,843 characters, correlating subjects' attitudes with their fear. ALCESTE selected 5 classes: the accident in childhood; the consequences; adolescent relations; disease and hospitalization; current activities. We observed the impact of culture and group rules on the subject's identity dynamics, who constructed his reality on the basis of happenings that determined his life history. The disease joins the conflicts that are legitimized by the family's and the health system's attitudes, mediations between altered and the meaning given to the disease.
Buizza, Chiara; Pioli, Rosaria; Ponteri, Marco; Vittorielli, Michela; Corradi, Angela; Minicuci, Nadia; Rossi, Giuseppe
To assess the association between socio-demographic characteristics and community attitudes towards mentally ill people. We assessed a sample of 280 subjects, stratified for sex and age, which has identified using the electoral registers of Brescia. A letter was sent to everyone in order to introduce the future potential study participant to the topics of the public attitudes towards mental illness and it included an invitation to take part in the study. After, 280 subjects were contacted by telephone. Finally, 174 persons, who expressed their willingness to collaborate, were visited by a team of four trained interviewers. The instruments used were: a semi-structured interview; the Community Attitudes to the Mentally Ill (CAMI) inventory, which is composed by 40 statements, concerning the degree of acceptance of mental health services and mentally ill patients in the community; and the Fear and Behavioural Intentions (FABI) inventory, which is composed by 10 items, concerning fears and behavioural intentions towards mentally ill people. 106 subjects refused to participate. Factor analysis of the CAMI revealed three components Physical distance and fear, Social isolation and Social responsibility and tolerance. Factor 1 is associated with: people >61 years old; people being divorced/widowed/living separated; people who haven't participated in social or volunteer activities. Factor 2 is associated with: people > 41 years old; people being schooled at a level that's higher than elementary level; unemployed people. Factor 3 doesn't present any associations. The results of this study outline the need to: a) promote interventions focused to improve the general attitude towards people with mental illness; b) to favour specific actions in order to prevent or eliminate prejudices in subgroups of the population.
Murphy, Andrea L; Gardner, David M
Community pharmacists are accessible health care professionals who are increasingly offering weight management programs. People living with serious mental illness have markedly higher rates of obesity and associated illness outcomes than the general population, providing pharmacists who are interested in offering weight management services with an identifiable patient subgroup with increased health needs. Issues with stigma within obesity and mental illness care are prevalent and can lead to inequities and reduced quality of care. We conducted a scoping review to map and characterize the available information from published and grey literature sources regarding community pharmacists and weight bias towards obese people with lived experience of mental illness. A staged approach to the scoping review was used. Six articles and 6 websites were abstracted after we removed duplicates and applied our inclusion and exclusion criteria. The published studies that we found indicated that pharmacists and pharmacy students do demonstrate implicit and explicit weight bias. Very limited research is available regarding weight bias in pharmacists and stigma towards people with obesity, and we found no information on these phenomena relating to people with lived experience of mental illness. Investigations are needed to characterize the extent and nature of anti-fat bias and attitudes by pharmacists and the consequences of these attitudes for patient care.
Pasmatzi, E; Koulierakis, G; Giaglis, G
The way that the social stigma of mental illness is related with the self-stigma, which in turn affects self-esteem and self-efficacy of mental patients was investigated. A sample of 66 patients in the Adult Psychiatric Clinic of the Thessaloniki General Hospital "G. Papanikolaou" was participated in this descriptive association study, with cross-sectional comparisons. The sample comprised of patients who were hospitalized or visited the Clinic as out-patients during the period that the study was undertaken. A tool for measuring the basic demographic, social and clinical characteristics of the participants was designed and used. Additionally, the Self-Stigma of Mental Illness Scale, SSMIS, Rosenberg's Self-Esteem Scale, RSE and the General Self-Efficacy Sherer Scale, GSESH were used for measuring self-stigma, self-esteem and self-efficacy respectively. Results showed that self-esteem and self-efficacy were highly associated with each another. Self-esteem and self-efficacy co varied. Greater self-stigma was associated with lower self-esteem and selfefficacy confirming the power of this relationship which is connected with patients' psychological empowerment and acts as mediator between patients' self-categorization as "mentally ill" and their self-esteem and self-efficacy. Additionally, a mild negative association between self-esteem, self-efficacy and age was found while higher educational level was associated with greater selfefficacy. Greater self-stigma along with lower educational level were the most significant predictors of both self-esteem and self-efficacy of mental patients, as shown by regression analysis. Some of our results, such as the percentage of low self-esteem (30.3%), were different from previous relevant data (9.1-24%), probably due to differences in sample's cultural characteristics and composition, research tools used, and the degree of mentally ill patients' reaction to social stigma perception. Despite its methodological limitations, the
Trachsel, Manuel; Irwin, Scott A; Biller-Andorno, Nikola; Hoff, Paul; Riese, Florian
BACKGROUND: As a significant proportion of patients receiving palliative care suffer from states of anxiety, depression, delirium, or other mental symptoms, psychiatry and palliative care already collaborate closely in the palliative care of medical conditions. Despite this well-established involvement of psychiatrists in palliative care, psychiatry does not currently explicitly provide palliative care for patients with mental illness outside the context of terminal medical illness. DISCUSSI...
Lacey, Melanie; Paolini, Stefania; Hanlon, Mary-Claire; Melville, Jessica; Galletly, Cherrie; Campbell, Linda E
Research demonstrates that people living with serious mental illness (SMI) contend with widespread public stigma; however, little is known about the specific experiences of stigma that mothers, and in particular fathers, with SMI encounter as parents. This study aimed to explore and compare the experiences of stigma for mothers and fathers with SMI inferred not only by living with a mental illness but also potential compounding gender effects, and the associated impact of stigma on parenting. Telephone surveys were conducted with 93 participants with SMI who previously identified as parents in the Second Australian National Survey of Psychosis. Results indicated that mothers were more likely than fathers to perceive and internalise stigma associated with their mental illness. Conversely, fathers were more inclined to perceive stigma relating to their gender and to hold stigmatising attitudes towards others. Mental illness and gender stigma predicted poorer self-reported parenting experiences for both mothers and fathers. These findings may assist in tailoring interventions for mothers and fathers with SMI. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.