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)     

Clinical and treatment correlates of access to Section 8 certificates for homeless mentally ill persons

OBJECTIVE: The study assessed how clients' housing preference and other variables were related to the acquisition of Section 8 certificates, facilitating independent living, for homeless persons with severe mental illness who were being served by an experimental assertive community treatment team. METHODS: For 77 clients, demographic and clinical differences between receivers and nonreceivers of certificates were examined, and correlates of time from referral to the team to completion of the Section 8 application were analyzed. Reasons clients did not receive certificates and housing outcomes were summarized in relation to client preference. RESULTS: The 34 clients who received certificates (44 percent) had significantly less psychopathology after three months than did nonreceivers and tended to have affective disorders rather than schizophrenia. Of the 43 nonreceivers, the two largest groups were 19 clients who did not want certificates and ten clients who wanted certificates but whom staff considered unable to live safely in an unsupervised apartment. The mean +/- SD length of time for application for a certificate was 5.7 +/- 5.8 months. Longer time to apply was significantly associated with having schizophrenia, having the team as a representative payee, and showing increased psychotic symptoms at referral and at three months. CONCLUSIONS: The study suggests that it is possible to honor the housing preferences of the majority of homeless persons with severe mental illness if adequate resources are provided. However, staff may view persons who have schizophrenia and more symptoms as needing more supervision than those clients prefer. Homeless mentally ill persons may also take longer than more symptomatic persons to pursue independent living through a Section 8 certificate.     

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)     

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.     

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)     

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)     

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)     

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)     

Recruitment and retention of homeless mentally ill participants in research.

Are the unstable residential and personal lives of homeless mentally ill (HMI ) individuals so difficult as to preclude their inclusion in rigorous, longitudinal research protocols? The continued presence of HMI individuals in U.S. society has prompted the mental health research community to reconsider the question of whether clinical trial and demonstration research protocols are feasible with this population. This article briefly examines the existing research literature on recruitment and retention rates in recent studies of this population and, in more detail, the specific strategies used by researchers to recruit and retain HMI individuals as research participants. In general, with sufficient resources and the persistent use of existing strategies for recruitment and retention, HMI individuals can be successfully studied over time. Finally, to demonstrate this potential, the recruitment and retention strategies of the San Diego McKinney Homeless Mentally Ill Demonstration Research Program are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

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)     

Physician's attitudes toward the ill aged and nursing homes

A survey of physicians in private practice (exclusive of pediatricians) was conducted in a medium sized suburban city in the New York metropolitan area, to determine whether physicians' attitudes toward the ill aged and nursing homes were predictors of the quality of medical care available to area nursing home patients. Questionnaires were circulated to 302 practitioners. Of the 28 percent who responded, 32 percent were psychiatrists, 15 percent primary care physicians and 8 percent orthopedists. Physicians felt competent to manage the ill aged, although 50 percent had had no significant degree of exposure to geriatric medicine in their medical education, and 70 percent of the primary care group had had none. Primary care and older physicians were more likely to treat patients in nursing homes. Almost 40 percent viewed the nursing home as a place to die. Although 85 percent studied that physicians should be involved in the nursing home displacement process, only 21 percent believed that they continued to be in charge of their patients after placement. The findings demonstrate generalized medical disinterest in the care of ill aged patients in institutions. The persons responsible for awarding government grants and those involved in planning medical school curricula should pay more attention to the needs of the chronically ill aged.     

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)     

Review of Madness and government: Who cares for the mentally ill?.

Reviews the book, Madness and government: Who cares for the mentally ill? by Emory A. Foley and Steven S. Sharfstein (1983). This book is a fascinating factual account of the struggle to develop community intervention alternatives to the 100-year domination of the state hospital system in the United States. It is the story of the efforts of "Washington's Noble Conspirators," who struggled for more than 20 years after World War II to expand the amount of federal support of medical research, to get federal money into the care of people with mental disorders, and to obtain federal support for the training of mental health personnel and research into the whole area of mental health. (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)