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)     

Strategies for maintaining optimal wellness in the chronic mentally ill

TOPIC: Ways the chronic mentally ill avoid loss of control and the importance of both the therapeutic environment and the nurse-patient relationship in helping them do this. PURPOSE: To examine the strategies people with chronic mental illness use to prevent loss of control and maintain health, and ways nurses can help with this process. SOURCE: Findings from a previously published study of seven chronically mentally ill clients in a rural day-treatment center. CONCLUSIONS: Four properties related to the core variable of "preventing loss of control" are relationships, feelings, good attitude, and functional activity. These properties must be examined within the context of the therapeutic environment as well as the nurse-patient relationship.     

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.     

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)     

The status of the mentally ill in Jewish law

The Jewish law goes into great detail discussing the status of the mentally ill. There are many aspects to this question over and above the legal aspects of such a person's rights, obligations, doing business, etc. What is the Halachic approach to a mentally ill person in general? Is this person subject to the code of Jewish law the same as the normal Jew? Should we make an effort to help this type of person fulfil the commandments and prevent him or her from transgressing them or perhaps since such a person is incapable of controlling his or her behaviour, there is no purpose in these efforts? Marriage and divorce are other serious issues to which the Jewish law gives special attention in this context. Marriage must be entered into by a rational and judicious person or the act will not be valid. A very serious problem arises when a husband is mentally ill and due to that halachically cannot divorce his wife and she remains an Agunah. The situation is more complicated as the definition of mentally ill encompasses a broader spectrum of cases. Which psychiatric disorders come under the definition of a mentally ill person who is unable to control his or her behaviour? Which symptoms attest the inability of a person to enter into marriage or to grant a divorce? The Talmud discusses these matters in several places and the Halacha bases its rulings on their conclusions.     

Loss of control and the chronic mentally ill in a rural day-treatment center

The bioartificial pancreas was designed to incorporate islet tissues and a selectively permiable membrane that isolates islets from the immune system of the recipient. The efficacy of agarose, a nontoxic polysaccharide, has been evaluated as a material of microcapsules to prevent allo- and xenograft rejection in rodents. The aim of this study is to demonstrate the possibility of the agarose microcapsule containing allo-islets as a bioartificial pancreas in canine model. In vitro viability of islets was determined by glucose challenge during perifusion experiments (n = 4). Insulin secretion from both encapsulated (enc.) and non-encapsulated (non-enc.) canine islets rose from initial basal levels of 0.09 (encap.), 0.07 (non-encap.) to the peak of 0.2 (encap.), 0.1 (non-encap.) in microU/islet/min after 5 minutes, then decreased to the basal level when the glucose challenge was discontinued. Auto-transplantation was performed in two dogs to evaluated in vivo viability and biocompatibility of encapsulated islets implanted into the splenic sinus by venouse reflux. Two weeks after auto-transplantation, the plasma insulin levels in the splenic vein and artery of two dogs were assayed. In the first dog, serum insulin level was 1 microU/ml both in the vein and the artery and increased, after glucagon (1.0 mg) injection, to levels of 9 microU/ml in the vein, but still kept 1 microU/ml in artery, as well as in the second one. Histological and electron-microscopical examination of the spleen revealed that encapsulated islets remained morphologically intact and the surface of agarose capsules showed no significant adherence of fibroblasts and inflammatory cells. Functional efficacy of the microencapsulated islets was determined using five totally-pancreatectomized diabetic dogs as recipients without immunosuppression. Defined quantity of microencapsulated islets from outbred mongrel donors were grafted through the catheter into omental tissue of the pancreatectomized recipients. All dogs had various degrees of reduced insulin requirements. In three of five recipients, the average fasting glucose values were controlled under 120 mg/dl for 28, 42, 49 days without exogenous insulin, which received totally 4.3 x 10(3), 7.3 x 10(3) and 1.0 x 10(4) (IE/kg) of microencapsulated islets, respectively. In conclusion, the present study indicates that the agarose-based microencapsulated islets can function in large diabetic animals, resulting in the independence of exogenous insulin therapy for prolonged periods without the need for immunosuppression.     

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)     

Outreach interventions for the homeless mentally ill

There has been a steady rise in the number of homeless mentally ill in Britain. This article reviews the scale of the problem and identifies the need for change within mental health services in order to address this challenge. It is argued that mainstream psychiatric services need to become more diverse and open in their approach to this potentially isolated group of users. The authors suggest that this could be achieved by embracing assertive outreach interventions. Innovative projects using a range of care providers, including voluntary workers, past users of the service and professional mental health workers, are discussed as an alternative framework to traditional services. In conclusion, the article highlights some of the professional and social implications for psychiatric nurses and mental health practice.     

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)     

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)     

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)     

The Behavioral Expectations Scale: Assessment of expectations for interaction with the mentally ill.

Describes the development and evaluation of a behaviorally specific expectation scale to facilitate investigations of behavior-expectation effects in social interactions with the mentally ill. Data indicate that the 21-item true-false scale may be useful in further studies of the role of expectation in attitudes toward the behavior of persons labeled "mentally ill." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The dimensions of stigma: The social situation of the mentally ill person and the male homosexual.

Conducted 2 studies to test the assumptions that stigmatizing labels not only lead observers to perceive more deviance but also lead the labeled individual to behave more deviantly. Study 1 employed videotape, varying the amount of actual deviance and the mental-illness labeling of the target. Since the 80 female undergraduate Ss were forced to attend to actual behaviors, perhaps that is why labeling did not affect perceptions of deviance or attitudes toward the target. In Study 2, 40 members of a gay liberation organization were led to believe that their sexual orientation had been disclosed to an examiner. A battery of tests including Rotter's Incomplete Sentences Blank, Wechsler Memory Scale, and Nowlis Mood Adjective Check List were used in both studies. Belief that they had been labeled did affect Ss' cognitive performance, but it had no disruptive interpersonal effects. Findings highlight the need for more specificity in describing the effects of stigmatizing labels. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative study of long-term mortality in the mentally ill

The mortality in mental illness has been studied after an average follow-up period of 3-4 decades in a material of 5661 former in-patients of the Psychiatric University Hospital of Lausanne (Switzerland), from which 3520 probands were dead at the date of reference. By use of an improved method, the calculations showed in all diagnostic groups, and generally more marked in women than in men, a 1,34 to 9,72 times higher mortality than in the general population, increasing in the following order: head injuries, psychogenic and psychopathic disorders, manic syndromes, schizophrenia, depressions, mental retardation, alcoholisme, other psychosis, epilepsy, general paralysis, other cerebro-organic conditions. Several possible explanations of these results are discussed.     

The nurse's role as patient advocate for mentally ill people

The recent report of the Confidential Inquiry into Homicides and Suicides by Mentally Ill People (the Boyd report) compiled for the government, and the imminent publication of the Mental Health Patient's Charter, highlight national concern over the provision of care for this group of people. This article examines some of the dilemmas facing mental health nurses when caring for patients under detention orders and evaluates guidelines and recommendations which can aid the nurse in providing appropriate care.     

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)