scholarly journals A Comparison of Participants in Two Community-Based Programs: Assisted Outpatient Treatment and a Mental Health Court

2018 ◽  
Vol 69 (9) ◽  
pp. 1001-1006
Author(s):  
Natalie Bonfine ◽  
Christian Ritter ◽  
Jennifer L. S. Teller ◽  
Mark R. Munetz
Keyword(s):  
Mental Health ◽  
Outpatient Treatment ◽  
Mental Health Court ◽  
Community Based ◽  
Assisted Outpatient Treatment ◽  
Community Based Programs

Deinstitutionalization and Increased Arrest Rates among the Mentally Disordered

1987 ◽  
Vol 15 (1) ◽  
pp. 117-127 ◽  
Author(s):  
Mark R. Pogrebin ◽  
Eric D. Poole
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Community Based ◽  
Arrest Rates ◽  
Mental Patients ◽  
Mentally Disordered ◽  
Police Decision Making ◽  
Community Based Programs ◽  
Criminal Histories ◽  
Mental Health Programs

Policies of deinstitutionalization, together with a general tightening of civil commitment laws and inadequate funding for community-based programs, have resulted in an increase of mentally ill people on the streets. Growing numbers of former mental patients and individuals whose bizarre behavior might have landed them in a state hospital bed a few years ago are now being arrested and ending up in jail. Four key areas––deinstitutionalization, police decision making, decline of mental health programs, and criminal histories of mental patients—are examined with respect to the shifting of mentally disordered persons from the mental health system to the criminal justice system.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominently addressing major social determinants of health and multimorbid substance use disorders.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominantly addressing major social determinants of health and multimorbid substance use disorders.

scholarly journals “It’s More Than Just Exercise”: Tailored Exercise at a Community-Based Activity Center as a Liminal Space along the Road to Mental Health Recovery and Citizenship

2021 ◽  
Vol 18 (19) ◽  
pp. 10516
Author(s):  
Kjersti Karoline Danielsen ◽  
May Helena Øydna ◽  
Sofia Strömmer ◽  
Kenneth Haugjord
Keyword(s):  
Mental Health ◽  
Poor Mental Health ◽  
Safe Space ◽  
Mental Health Recovery ◽  
Liminal Space ◽  
Community Based ◽  
The Road ◽  
Community Based Programs ◽  
Activity Center ◽  
Mental Health Challenges

Mental health care policies call for health-promoting and recovery-oriented interventions, as well as community-based programs supporting healthier habits. The purpose of this study was to explore how individuals facing mental health challenges experienced participating in tailored exercise at a community-based activity center, and what role tailored exercise could play in supporting an individual’s process of recovery. Data were collected through in-depth interviews with nine adults experiencing poor mental health who engaged in exercise at the activity center. Interviews were audio-recorded, transcribed verbatim and analyzed using systematic text condensation. Participants spoke about the community-based program being a safe space where they could “come as they are” (Theme 1). Taking part in the program was “more than just exercise” and allowed them to connect with others (Theme 2). The experiences they gained from exercise also helped with other areas in life and provided them with a safe space to build their confidence towards the “transition back to the outside” (Theme 3). We summarized the findings into one overall theme: “inside vs. outside”. In conclusion, a community-based activity center acted as a liminal space that aided mental health recovery by allowing participants to feel safe, accepted and supported, as well as experience citizenship. The findings highlight the need to treat mental health challenges as a contextual phenomenon and creating arenas for community and citizenship in society.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0%) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made more extensive use of mental health outpatient and inpatient care. Conclusions Almost one-fifth of VHA mental health patients receive specialized community-based services addressing, most prominently, major social determinants of health and multimorbid substance use disorders.

scholarly journals Low Cost Community Health Interventions to Address the Mental Health Crisis Arising From Greece’s Financial Austerity Measures

2014 ◽  
Vol 4 (2) ◽  
pp. 28-31
Author(s):  
Eleni Styliani Ramphos ◽  
Raywat Deonandan
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Low Cost ◽  
Work Force ◽  
Health Interventions ◽  
Social Spending ◽  
Mental Health Crisis ◽  
Community Based ◽  
Health Crisis ◽  
Community Based Programs

In response to the European financial crisis of 2008-2009, Greece reduced funding for social spending as part of its austerity program, which may have reversed past progress in Greece’s mental health system. Significant increases in depression and suicide rates coincided with the start of the crisis. A slower economic recovery may result from the combination of a less productive work force and out-migration of mental health professionals. In order to alleviate the detrimental effects of this crisis, mental health crisis training, as well as low cost community-based programs should be prioritized in Greece. 

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