Review of Treating the Long-Term Mentally Ill: Beyond Deinstitutionalization.

1983 ◽  
Vol 28 (9) ◽  
pp. 727-728
Author(s):  
Oscar A. Barbarin
Keyword(s):  
Mentally Ill

Counselling the Relatives of the Long-Term Adult Mentally Ill

1989 ◽  
Vol 154 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Liz Kuipers ◽  
Brigid MacCarthy ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage
Keyword(s):  
Family Relationships ◽  
Mentally Ill ◽  
Expressed Emotion ◽  
Realistic Model ◽  
Education Session ◽  
Term Care ◽  
Interactive Education ◽  
Severely Mentally Ill ◽  
Group Facilitators

A psychosocial intervention is described geared to the needs of carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion (EE) and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EE and improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill.

The DEMoBinc Study in Portugal: Development and First Results

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Cardoso ◽  
C. Coelho ◽  
J. Caldas de Almeida
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Residential Care ◽  
Mental Health Professionals ◽  
Mentally Ill ◽  
Physical Restraint ◽  
National Literature ◽  
Standards Of Care ◽  
Delphi Exercise

The DEMoBinc study's main objective is to develop an instrument for assessing the living conditions, the quality of care, and the human rights of long-term mentally ill patients in psychiatric and social residential care. It started on March 2007, with 11 centres and 10 countries participating.The Portuguese centre has carried out a national literature review of mental health legislation, standards of care related with residential care for mental patients, and mandatory procedures for physical restraint and seclusion.A three-round Delphi exercise with four groups of experts - advocates, mental health professionals, service users, and carers - was also developed. In the first round the participants were asked to state the ten more important components of care helping recovery in institutional care for the long-term mentally ill. The results were sent back to be rated for their importance on a 5-point scale. Finally, the participants were asked to confirm or change their own scores in comparison with the calculated group median. Between twelve and 18 participants by group were contacted, and the overall rate of participation was 73%.A pilot study using the first draft of the DEMoBinc instrument was done, and refinement of the instrument is being carried out in twenty institutions and will be completed during the next months.The results of the Portuguese centre on the national literature review, the Delphi exercise, and the first phase refinement of the DEMoBinc instrument will be presented and discussed.

Compliance versus adherence in serious and persistent mental illness

2010 ◽  
Vol 17 (1) ◽  
pp. 77-85 ◽  
Author(s):  
Paula K Vuckovich
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Psychiatric Nurses ◽  
Ethical Implications ◽  
Persistent Mental Illness ◽  
Term Basis ◽  
Nursing Literature ◽  
Compliance Versus ◽  
The Ideal

Failure to follow prescribed treatment has devastating consequences for those who are seriously and persistently mentally ill. Nurses, therefore, try to get clients to take psychotropic medication on a long-term basis. The goal is either compliance or adherence. Although current nursing literature has abandoned the term compliance because of its implications of coercion, in psychiatric nursing practice with patients suffering from serious long-term mental illness compliance and adherence are in fact different goals. The ideal goal is adherence, which requires the patient to be an active participant in the team. This goal is consistent with nurses’ ethical values, but for such patients this is frequently unrealistic. If the person is severely psychotic, treatment may be involuntary and the goal compliance. Psychiatric nurses participate in involuntary treatment and thus should acknowledge the ethical implications of compliance as a goal and not obscure the issue by calling compliance adherence.

scholarly journals A cross-sectional evaluation of a community-orientated mental health service

1995 ◽  
Vol 19 (3) ◽  
pp. 151-154
Author(s):  
Jon Spear ◽  
Andrew Cole ◽  
Jan Scott
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Community Mental Health Services ◽  
Cross Sectional ◽  
Neurotic Disorders ◽  
Community Psychiatric ◽  
Severely Mentally Ill ◽  
Acute Distress ◽  
To Receive

Community mental health services have been criticised for seeing those with minor psychiatric disorders at the expense of those with severe and long-term illness. We report a cross-sectional evaluation of a UK service based entirely within the community. Most patients in contact with the service (66%) had a psychotic disorder or an affective disorder. Patients with greater impairment were likely to receive more intensive treatment. Only 20% of the community psychiatric nurse (CPN) case load focused on acute distress and neurotic disorders. Within this service careful operational planning and maintaining CPNs within the secondary care system appear to be critical factors in achieving the goal of giving priority to the severely mentally ill.

scholarly journals Scottish rehabilitation services: eight year follow-up

1993 ◽  
Vol 17 (6) ◽  
pp. 341-344
Author(s):  
Robin G. McCreadie ◽  
Douglas J. Williamson ◽  
Lesley J. Robertson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mentally Ill ◽  
Support Services ◽  
Psychiatric Rehabilitation ◽  
Rehabilitation Services ◽  
Local Authorities

A survey of Scottish psychiatric rehabilitation and support services, carried out in 1983 (McCreadie et al, 1985), found that although there were wide between-hospital differences, the National Health Service in Scotland was making considerable efforts to provide services for the long-term mentally ill. However, services provided by local authorities were seriously deficient.

Punishing paupers? Control, discipline and mental health in the Southwell workhouse (1836–71)

Rural History ◽  
2019 ◽  
Vol 30 (02) ◽  
pp. 161-180 ◽  
Author(s):  
Paul Carter ◽  
Jeff James ◽  
Steve King
Keyword(s):  
Mental Health ◽  
Local Government ◽  
Small Group ◽  
Mentally Ill ◽  
Poor Law ◽  
National Archives ◽  
The Way

AbstractThis article focuses on the way that staff and guardians in the rural Nottinghamshire workhouse of Southwell sought to exert control and containment over pauper inmates. Fusing together local and central records for the period 1834–71, including locally held punishment books and correspondence at The National Archives, Kew (TNA), we argue that the notional power of the workhouse authorities was heavily shaded. Most paupers most of the time did not find their behaviour heavily and clumsily controlled. Rather, staff focused their attention in terms of detecting and punishing disorderly behaviour on a small group of long-term and often mentally ill paupers whose actions might create enmities or spiral into larger conflicts and dissent in the workhouse setting. Both inmates and those under threat of workhouse admission would have seen or heard about punishment of ‘the usual characters’. This has important implications for how we understand the intent and experience of the New Poor Law up to the formation of the Local Government Board (LGB) in 1871.

Expressed Emotion in Staff Working with the Long-Term Adult Mentally Ill

1992 ◽  
Vol 161 (6) ◽  
pp. 802-808 ◽  
Author(s):  
E. Moore ◽  
R. A. Ball ◽  
L. Kuipers
Keyword(s):  
Staff Training ◽  
Mentally Ill ◽  
General Health ◽  
Expressed Emotion ◽  
Patient Characteristics ◽  
Disabled Patients ◽  
Patient Relationships ◽  
The Relationship ◽  
Work Events

Staff-patient relationships in long-term settings were examined in 35 staff and 61 patients. Measures were also taken of the staff's general health, their coping style in relation to work events, and job satisfaction. A range of ratings of EE was evident in staff descriptions of patients under their care. Strain and criticism in the relationship were not associated with identified stressors in the workplace, or the general health of the carer. When patients were grouped according to high-EE and low-EE interviews, there were no significant differences in their symptoms. Criticism was associated with other patient characteristics, including aggressive and attention-seeking behaviour, underactivity, and limited social interaction. The findings have implications for staff training and for the maintenance of optimal staff-patient relationships in services supporting severely disabled patients.

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