Mental health needs of the chronically mentally ill elderly.

The treatment histories and current social, financial, and clinical status of 111 chronically mentally ill (CMI) persons over the age of 60 were examined. Information was obtained from Ss, family, mental health records, and mental health professionals familiar with Ss. Psychiatric symptoms were observed in 74% of Ss. Many Ss experienced long periods without acute episodes of illness. Recurring episodes eventually appeared in most Ss, however, and ongoing deficits in daily functioning and social contacts were prototypical. Two thirds of the Ss were living in the community, relying heavily on family contacts; the rest lived primarily in nursing homes (23.4%) or psychiatric hospitals (7.2%). Social support was the best predictor of level of functioning. Findings suggest that failure of CMI elderly to use mental health services is not due to lack of need. Mental health services currently do not appear to be meeting the needs of this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues of special concern to chronically mentally ill women.

Discusses sex differences with respect to the treatment of chronically mentally ill women and suggests that attention to these areas will aid understanding of their disorders and enhance the quality of their existence. The lives of chronically mentally ill women in relation to marital and family roles, other instrumental roles, social and sexual roles, rape and sexual exploitation, and physical health are described. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antecedents and consequences of psychology training with the chronically mentally ill: A case example.

Training programs to prepare psychologists for careers with persons with chronic mental disorders are rare, although the future demand for these skills will increase. If psychology training is to expand in this area, information about what attracts individuals to these programs, areas of training that are beneficial, and how training affects careers is needed. Results of the current study indicate trainees have a long-term outlook regarding training benefits and value practical experience in psychosocial treatment. Training helps participants obtain their choice of employment. Salary benefits were reported. Once employed, participants were able to make use of their skills despite identified obstacles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a public policy on the chronic mentally ill patient

This paper outlines the problems posed by the chronic mentally ill, which have become a national disgrace. The historical background of deinstitutionalization is reviewed, issues critical to an understanding of the problems of the chronic mental patient are examined, solutions are suggested, and a public policy on the chronic mental patient is proposed.     

Private-sector care for chronically mentally ill individuals: The more things change, the more they stay the same.

Two profit-making industries, nursing homes and board-and-care homes, care for about one million chronic mental patients. This care is primarily custodial and probably not very different from the care patients received in the public sector prior to deinstitutionalization. Moreover, certain characteristics of privately owned facilities encourage poor patient care so as to maximize profit. The problem could be ameliorated if chronic mental patients were strong and informed consumers or if the public sector strongly regulated proprietary care. However, neither of these two conditions now hold. Perhaps the apparent difficulties in significantly improving care for chronically mentally ill individuals despite seemingly major changes in policy reflect a fundamental problem in overall social policy—a reluctance to care for chronically indigent individuals of all kinds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The criminalization of the mentally ill.

Comments on the contribution of L. A. Teplin (see record 1985-12217-001) who discussed issues relating to the incarceration of the mentally ill. Although the present author agrees with Teplin's conclusions and recommendations, he asserts that the logic of the argument presented was not convincing. Teplin does not include the role of the magistrate in discussing the process through which mentally ill people end up in jail, and she thus lacks a comprehensive viewpoint. No direct data were presented to support the conclusion that the criminalization of the mentally ill is a result of inadequate funding for the mental health system. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building bridges: Psychologists and families of the mentally ill.

Describes problems faced by families of the mentally ill, particularly since the caregiving system in the US provides only incomplete solutions. Psychologists have provided important support to family members coping with seriously mentally ill relatives; however, psychology's response has been incomplete. Families have helped themselves in the initiation in 1979 of the National Alliance for the Mentally Ill (NAMI), an advocacy and education organization that originated as a network of mutual support groups. The history of communication between NAMI and the American Psychological Association (APA) is outlined. The need for "building bridges" between psychologists and families of the mentally ill resulted in 2 conferences between APA and NAMI. Other steps to enhance communication between psychologists and these families are listed, including communication with legislatures and the general public about public policy agendas on mental health services and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Private foundations in health affairs: A case study of the development of a national initiative for the chronically mentally ill.

Although the role of private foundations in health affairs has changed as philanthropic resources have become dwarfed by rapidly escalating government expenditures, foundations have continued to be influential by strategically targeting their resources. The authors describe how large foundations make decisions about funding priorities, using the development of the Robert Wood Johnson Foundation's Program for the Chronically Mentally Ill as an example. This program seeks to develop centralized urban mental health authorities offering a continuum of mental health and social services, housing, and vocational rehabilitation. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of infection with HIV among the seriously mentally ill: Review of research and implications for practice.

The authors review the research literature for estimates of the prevalence of HIV infection among the seriously mentally ill. Data from nine studies suggest that 4%–23% of the seriously mentally ill have been infected with the virus that causes AIDS. Men have been infected at a higher rate than have women, but this gender difference is less pronounced than that found in the general population. Because most of these blinded seroprevalence studies have been conducted in New York City, the representativeness of these results remains unknown. Nonetheless, the findings call attention to the need for enhanced HIV-related services for the seriously mentally ill. The authors provide screening and counseling guidelines for practitioners who work with seriously mentally ill clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community-based care for the mentally ill: Simple justice.

Discusses problems associated with community-based treatment for the mentally ill and describes a new federal policy initiative to improve services to this group. Features of the Comprehensive Mental Health Service Act of 1986 (Pub. L. 99-660) are described, including specifications for its implementation, its initial outcome, and roles for psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mentally ill witch in textbooks of abnormal psychology: Current status and implications of a fallacy.

The psychopathological interpretation of demonology, witchcraft, and possession states that demonology replaced psychiatric knowledge and practice in the Middle Ages and that the mentally ill were subsequently misidentified as witches and demoniacs. This model has been discredited, but its persistence is demonstrated by an examination of 20 textbooks in abnormal psychology published between 1978 and 1981. Almost all authors endorsed at least 1 aspect of the psychopathological interpretation, and only 3 books included contradictory opinions. Textbooks that presented the psychiatric model seem to have derived it primarily from G. Zilboorg (1935), and there is also evidence of unreferenced internal borrowing among textbooks. Authors generally ignored prominent historical and anthropological research on witchcraft and possession; they also gave minimal attention to more recent, socioculturally oriented histories of psychiatry and to critiques of the older psychiatric paradigm. It is concluded that these results are at least partly due to clinical psychologists' identification with psychiatrists' efforts at self-validation and self-justification. (94 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The chronically ill child in the school.

Focuses on the school attendance and performance problems encountered by chronically ill children (CIC), from the point of their re-entry after diagnosis or treatment. CIC exhibit school related problems, reflected in psychological well being, interaction with peers, academic performance, and higher absenteeism. Inability to attend school may lead to decreased self esteem and hopelessness about the future. Specific aspects of the illness or its treatment, the child's emotional response to the illness, prolonged absence, and learning problems may influence school functioning. Attitudes of parents, teachers, other school personnel and the health care team, and inability of the school to provide necessary daily health care services seriously affect successful school re-entry. School psychologists play an important role in maximizing CIC's success in school, as they prospectively monitor their educational functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Labeling the mentally ill and the attribution of personal traits.

Data from 900 community college students indicate that labeling, including both the labels themselves and the labelers, has no significant independent effect on the attributes imputed to a labeled individual, although it may produce some effects in interaction with other variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The stereotype of the mentally ill

The objective of the submitted work was to obtain a more accurate picture of lay ideas on mentally ill people in seven selected population groups--two classes from a school for health workers, two classes of general secondary schools, participants of a training course for nurses organized by the church, employees of the law court and prosecution and patients of a psychiatric hospital/a total of 181 respondents. The respondents were asked to give at least 5 expressions characterizing a mentally sick person or lunatic. A total of 948 statements, incl. 450 different ones, were obtained. The statements were divided into four categories, depending whether they expressed a favourable or unfavourable quality, the need of assistance, protection or sympathy or whether they were neutral. The author assessed the ratio of categories by groups of respondents, repeatedly used expressions and qualities described in the statements. With the exception of the from of pupils of an extension course for health workers, where the majority were statements expressing the need of assistance, in the remaining groups more than half the expressions were unfavourable, in five the difference was statistically significant. The difference between students from the school for health workers and students from general secondary schools was significant only as regards the number of favourable replies from those in the extension course the difference was a smaller number of unfavourable replies. Against expectations, adverse ideas were recorded in the group of subjects training for nursing. Employees of the law court and prosecution used most frequently adverse expressions and made the smallest number of statements expressing the necessity of assistance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Commentary on sexual orientation: Research and social policy implications.

This commentary evaluated the methodology and conclusions reached in the 12 articles of the special issue on sexual orientation and human development as these pertained to 3 questions: Have homosexual persons chosen their sexual orientation, or are they born that way? What psychological risks are unique to the mental health and well-being of lesbian and gay youths? What are the effects, harmful and beneficial, of being raised by homosexual parents? Social policy implications of alternative answers to these questions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client as colleague: Therapeutic contracting with the seriously mentally ill.

This article introduces the therapeutic contracting program as a comprehensive treatment system for persons with serious mental illness. Therapeutic contracting offers a promising framework for integrating medical, psychological, and social therapies in a manner that fosters clients' active involvement in treatment. This article outlines a multistage therapy program that mobilizes clients' adaptational resources through environmental interventions, structured goal-setting exercises, and skills-building experiences. Data illustrate the effectiveness of therapeutic contracting for (a) securing clients' treatment compliance, (b) promoting positive clinical outcomes, and (c) reducing overall treatment costs. The therapeutic contracting model is discussed as a potential vehicle for expanding the professional role of psychologists in psychiatric settings, particularly in areas of clinical and administrative decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The criminalization of the mentally ill: Speculation in search of data.

Examines the evidence for the speculation that mentally ill persons who would previously have been treated within mental hospitals are now processed through the criminal justice system and constitute an ever-increasing proportion of the jail population. Three factors underlie this speculation: the increase in mentally ill persons residing in the community, police handling of the mentally ill, and evidence that persons thought to be dangerous are among the most unwanted clients of mental health agencies. Three types of research are explored: archival studies, investigations of police decision making, and studies of the prevalence of mental disorder among jail detainees. It is concluded that the research literature, albeit methodologically flawed, offers at least modest support for the contention that the mentally ill are being processed through the criminal justice system. (81 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Criminalizing mental disorder: The comparative arrest rate of the mentally ill.

Notes that there has been a great deal of speculation that mentally ill persons are being processed through the criminal justice system rather than the mental health system. To date, this thesis has been based more on intuition than on empirical research. Data from a study of 1,382 police–citizen encounters are presented that suggest that the mentally ill are indeed being criminalized. Specifically, it was found that, for similar offenses, mentally disordered citizens had a significantly greater chance of being arrested than non-mentally-disordered persons. This finding has public policy implications for the basic tenets of the community mental health movement, as well as for optimal functioning of the criminal justice system. Several public policy modifications are suggested. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists and families of the severely mentally ill: The role of family consultation.

Notes that, at present, families find themselves playing an integral role in the caretaking of mentally ill individuals, and are in need of supportive family counseling. Psychologists are in an ideal position to consult to families and staff; however, curricular revisions are needed to educate and train psychologists for this task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)