Search

This paper provides a summary of issues related to psychosocial and mental health programs for children, adolescents and families following the end of the conflict and mass displacement of Kosovar Albanians from Kosovo in 1999. The authors discuss the impact of war on children and families, their needs, and the recovery programs implemented by local and international agencies and institutions. A review of psychosocial programs within various service systems, including education, health, social services and mental health services, describes the challenges, successes and failures of creating a comprehensive, accessible system of care in an environment characterized by weak institutional and professional capacity, a relatively weak regulatory framework, and a plethora of actors, many with their own agendas and varying levels of expertise. The paper concludes that a public mental health approach is most effective when implemented within a continuum of care that provides a range of services for children, adolescents, and their families, ranging from public education to clinical psychiatric care. [ABSTRACT FROM AUTHOR]

Changes to professional work now ensure that social care and health care workers should be accountable to service users, and not only to their professional colleagues. This paper seeks to explore how this may eventually be realised in new working relationships that will profoundly affect mental health social work. These changes are driven by factors that ate external to the social work profession-in policy initiatives that introduce measures of performance that incorporate the service user in both evaluating and planning services, in efforts to build new relationships, and ill a breakdown of barriers between social work practitioner's and service manager's. While these changes are sometimes likely to be resisted by practitioners and service users alike, the demands of policy makers for a new professional accountability to service users can be used to pave the way for effective dialogue. The paper outlines the steps necessary to build confidence among both service users and service providers. This requires sensitive management and leadership. It also requires that action demonstrably follows from such dialogue. The paper uses evidence from Community Mental Health Teams in Swansea, over a three-year period, to demonstrate how the policy and management imperatives faced by service providers can be reconciled with the expressed desires of mental health service users. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to discuss the role of the social work profession in the mental health service arena. It analyzes the changing mental health environment and the challenges lacing social work. It stresses that the profession must adapt to the dramatic changes that have been taking place since the advent of deinstitutionalization and the need for community care for mentally ill persons. Historical analysis of the social work profession shows that its involvement in the mental health field has started during the early stages of the development of the profession. Psychiatric social work has been considered a prestigious area of practice within the profession. Historically, social workers in the mental health field rarely challenged the dominance of the psychiatric profession. This position seems to have restrained social work from providing its full potential contribution to this field of practice and to the population it served. Assessment of the continuing problems and current issues of the mental health system shows the potential central role of social work in this area. However, changes must take place in the practice of social workers in the mental health service system, as well as in the education and training of social workers. The paper discusses factors that facilitate or hinder the profession from appropriately adapting to the current service needs of the mentally ill persons, their families and communities, providing quality mental health and social services to this population and society as well. [ABSTRACT FROM AUTHOR]

The article offers information on the mental health policy of South Africa. The policy was initially formulated in 1997. The components of the policy are advocacy, promotion, prevention, treatment and rehabilitation. The White Paper for the Transformation of the Health System in South Africa (1997) sets out the policy direction for the development and transformation of mental heath services.

In all aspects of health and mental health care-the emergency room, the outpatient clinic, inpatient facilities, rehab centers, nursing homes, and hospices-social workers interact with patients from many different cultures. This paper will introduce an assessment tool for health care professionals to advance understanding of culturally diverse patients and their families. [ABSTRACT FROM AUTHOR]

This paper reports on The LGBT Affirmative Program South Beach Psychiatric Center, a public sector mental health program in New York State for lesbian, gay, bisexual, and transgender (LGBT) individuals with major mental illness. The program began in 1996 and has provided services to over 200 individuals as of June, 2004. Systemic and cultural factors influencing program development are described. Evolution of the program components are summarized. A survey sampling psychiatric patients/clients who attended the program in May, 2000 demonstrated a high level of satisfaction with the services offered. The program is viewed as an important resource to the clinic and the community. [ABSTRACT FROM AUTHOR]

The growing literature about psychotherapy with LGBT clients rarely addresses serious mental illnesses or mental health care settings such as inpatient, psychosocial rehabilitation, day programs, or residential care. Nor does much of existing literature address the public mental health system. In 1997, the federal Center for Mental Health Services (part of Substance Abuse and Mental Health Services Administration and the federal Department of Health and Human Services) commissioned a review of current knowledge regarding the experiences, needs, and recommendations of LGBT people with serious mental illnesses. This article offers a summary of that multi-year project. Using qualitative methods and analysis, this study combines information from archival sources, published and unpublished literature, and key informant interviews to highlight questions and themes important to the welfare of lesbian, gay, bisexual and transgender (LGBT) people receiving public/community mental health services. This paper raises issues about the experiences and needs of these populations that would benefit from further investigation, to help pique further inquiry, and to suggest constructive interim steps. [ABSTRACT FROM AUTHOR]

In recent years many countries have embarked on various types of health and mental health reform. These reforms have in large part been driven by governments' concerns for cost containment which has, in turn, been driven by an increasing process of global marketization and the need to control national deficits. A critical issue in these reforms is the increased emphasis on the use of "market mechanisms" in the delivery of health and mental health services. This paper uses a policy analysis framework to compare recent developments in the mental health sector in Canada, the United States, Britain and Australia. The common framework to be used for this will focus on: the defining characteristics of the society; legislative mandate; sectorial location (within or separate from health sector); funding streams; organising values of the system; locus of service delivery; service technologies; the role of social work; interprofessional dynamics; the role of consumers; and evaluation of outcomes at multiple levels. This analysis provides an opportunity to explore similarities and differences in mental system reform and in particular identify the challenges for social work in the field of mental health in the 21st century. [ABSTRACT FROM AUTHOR]

This chapter discusses the methods used by the author in studying the Peper Harow residential community for teenagers with behavioral problems. This study's main objective has been to demonstrate the psychological and functional changes that have occurred within the ex-residents since they arrived at Peper Harow. It would be helpful to know exactlywhat and how much change resulted from the ex-residents experiences at Peper Harow. While listening to ex-residents over the years, it became increasingly clear that their comments about Peper Harow were more than simply reminiscent. Both thoughtful criticism or spontaneous comments offered important insights into what actually influenced them and brought about change. As an exceptionally articulate group, it became clear that what they could say might also be of particular use to those who work with children and young people and to those who make social policy, for the views of the consumers of care or treatment, especially children and young people, are rarely heard when policy is being developed. However, the existence of a group of mature adults, all of whom had reached the usual age for raising families, all of whom had shared a similar residential therapeutic experience up to twenty-five years earlier, provided a quite unusual perspective from which the experience they had received could be evaluated. None of the previous books and published professional papers about the objects and processes of Peper Harow have focused on the way that residents or ex-residents experienced their stay. Nevertheless, although their anecdotal descriptions of Peper Harow may alone have been enlightening, it was felt that their views could be even more persuasive if their comments were presented in a more empirical form. Perhaps criteria could be applied to measure how real the ex-residents' perceived change was.

An approach to multi-family group therapy for utilization in social work practice is outlined. Professional help is combined with peer and non peer help within and across families to attain the goal of altered interaction patterns within families. Consideration also is given to the development of the multi-family therapy group as an entity. The patterns of interaction in the multi-family therapy group, were investigated. A case study of a closed time-limited group was developed with a practitioner-researcher design. The data collection utilized structured observation and audio-tape recordings. The data were analyzed qualitatively. The approach to multi-family group therapy described in this paper was developed through the writer's experience as a practitioner nonresidential multi-family therapy groups located in mental health and in pediatric settings. A child or an adolescent was the identified client. The writer also has used the knowledge gained from the empirical research which she conducted into this modality. [ABSTRACT FROM AUTHOR]

This paper describes a training project for work with Southeast Asian refugees using an integrated family systems approach. The author has found using a model integrating a structural, strategic, life cycle and Milan systemic therapy helpful at three levels of the project work: consulting with agencies serving the population, training students for this work, and intervening clinically with the refugees themselves. [ABSTRACT FROM AUTHOR]

This paper describes the basis for the reform in mental health care system in Israel as presented in the report of the Netanyahu Commission (State Commission for Investigation of Functioning and Efficiency of the Health Care System in Israel, 1990) and the report of the State Comptroller's office (State Comptroller, 1991). These reports pointed to seven major problem areas in the mental health care system: (1) segregation of mental health and general health care systems, (2) variations in availability of services across the country, (3) conflict of interests within Ministry of Health which provides services and oversight, (4) overuse of hospital based care and under use of community based care, (5) reliance on hospitals for custodial care, (6) lack of appreciation of mental health service needs of non-severely mentally ill, and (7) lack of regional service planning. The article describes these problems and the proposed solutions. [ABSTRACT FROM AUTHOR]

The article presents notes on references of each chapters discussed in the book "From the Mental Patient to the Person." In the chapter titled "Introduction," several scientist have written papers on the "moral careers" of mental patients; historical collection of mad people's writings; views of "patients" are beset by theoretical difficulties; mental patients are but the constructs of medicine and their perspectives thereby contaminated; detailed ethnography of ex-mental patients in the community; a video-educational package which attempts to give voice to the experiences of people with a history of schizophrenic illness. Various perspectives of consumers of mental health services within a professional framework are available from the work conducted by World Health Organization. In the seventh chapter "The Person Predicament," scientists have discussed about the lives of people with schizophrenia, which are shaped by political, economic and labor market forces and the homeless mentally ill in the United States.

Soldiers returning from combat military operations are at risk for developing a range of psychological problems. One way to facilitate the identification of these atrisk soldiers is to have them complete a psychological screening survey. Such a survey can be used to link soldiers reporting psychological problems with appropriate mental health services. The challenge of developing such a screen is to ensure that it is valid, short, and easy to administer. The US Army Medical Research Unit-Europe has been at the forefront of developing a valid psychological screen for use with soldiers at post-deployment. Research conducted prior to 2004 showed that screening needed to include five domains: post-traumatic stress disorder, depression, alcohol problems, anger, and relationship problems. Blind validation studies conducted in 2004 led to the selection of scale items and cut-offs for each domain resulting in an effective short screen with good sensitivity and specificity values. Finally, the question of when to conduct psychological screening at post-deployment has also been addressed through a comparison of prevalence estimates at immediate reintegration and three months post-deployment. Future research will examine scale refinement and the use of sleep problem questions in subsequent screening efforts. [ABSTRACT FROM AUTHOR]

Ninety-four staff from a regionally based mental health service and associated health and human services completed a two-day workshop introducing dialectical behaviour therapy, with a smaller number also undertaking advanced training. Survey and focus group data were collected on participants' demographics, attitudes, knowledge and experience of working with persons with this disorder, prior to and at one-month and six-months following completion of the introductory workshops. Quantitative and qualitative findings indicated that involvement in the training program was a positive experience for the majority of participants, with knowledge regarding detection and treatment and staff attitudes toward consumers being improved following exposure to the principles and practice of dialectial behaviour therapy. Discourse analysis of the focus group interview data pre- and post-training indicated a significant shift in the meanings staff associate with borderline personality disorder, with a pervasive therapeutic pessimism being displaced by more optimistic understandings and outlooks. Improved therapeutic outlook is likely to have positive implications for staff engagement with service users with borderline personality disorder. While this article provides a brief overview of the findings of the survey, the main purpose is to report the findings of the focus group interviews. [ABSTRACT FROM AUTHOR]

The article focuses on the experiences of the emergency mental health service of the Ministry of Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters in giving emergency psychological help to victims of terrorist acts. An emergency situation has special challenges and an emergency psychological help can be divided into three stages. It presents examples of work on rendering emergency psychological assistance and suggests several priorities when responding to emergency cases.

The article discusses the need of community resources such as psychosocial programs for children affected by war. As expressed in the Convention of Child's Right, caregivers and other adults are responsible of protecting the children and ensuring them a quality life. The main components of the programs involve social networks, security, and religious activities. The role of mental health workers involve enhancing the psychosocial climate and activating resources in basic social structures important for children's lives.

Training counselors or psychosocial workers in areas of armed conflict, requires an explicit vision on the relationship between theoretical knowledge, practical knowledge and counselling. This article describes how, with minimal means, a training of trainers for counsellors or psychosocial workers can be put together. The basic principles are discussed, and the training is described as an interactive process in which both the participants and the trainer develop their expertise. [ABSTRACT FROM AUTHOR]

The article focuses on practical aspects of providing psychiatric treatment to older Americans in office-based psychiatric private practices. The author discusses the mechanics of the process of treatment. One important focuses of community-based psychiatric ambulatory care is the need to create relationships with other community services and providers of care and assistance.

This chapter considers the role of the volunteer and approaches this from a number of viewpoints. It recognizes that the lay volunteer brings the fundamental qualities of a human being, such as empathy, awareness and humanity, unfettered by the need for the acquiring of clinical knowledge and experience. There is arguably, therefore, a greater motivational interest in volunteers in contrast to that of the highly trained specialist. However, it will be clear that the roles of the volunteer and professionals are entirely complementary and will result in a better overall service for those who need intervention of this nature. Selection, training and supervision are prerequisites for an effective volunteer workforce and therefore the potential for most communities across the cultures to establish a suicide prevention programme is discussed. The need for collaboration, locally, nationally and internationally, in order for a preventive strategy to be effective in reducing the rate of suicide, is a theme throughout this chapter. It draws on the international experience of the authors, who work professionally in the voluntary sector in suicide prevention as well as being volunteers in suicide prevention agencies. [ABSTRACT FROM AUTHOR]

This chapter briefly reviews different psychological approaches to suicidal behaviour. It begins with psychodynamic models and shows how early researchers developed and elaborated the intrapsychic concepts of suicidal behaviour proposed by Freud, to include external environmental factors. Personality variables that have been associated with suicidal behaviour are then examined, focusing particularly on impulsivity, which has been found to be associated with suicidal behaviour in both research and clinical settings. We review the work on dichotomous thinking and cognitive rigidity and show how these factors influence problem solving in suicidal individuals. Recent research has investigated the psychological processes underlying problem solving and how this is related to suicidal behaviour, We discuss this work and show how memory biases and a sense of hopelessness can have an impact on the way interpersonal problem situations are approached. Drawing together the threads of this contemporary, research leads us to describe a recent model of suicidal behaviour. The ‘cry of pain’ model sees suicidal behaviour as an attempt to escape from a feeling of entrapment, These individuals believe they cannot escape from an external situation or from their own inner turmoil, and that there is no prospect of rescue. This model provides us with a framework for understanding the psychological research and shows how psychology can create a bridge between research on social and biological factors. [ABSTRACT FROM AUTHOR]

This chapter examines the social history of the state mental hospital, including its emergence and institutionalization in the nineteenth century; its critique by sociologists and other observers in the period just after World War II; and its deinstitutionalization in the past half-century. The chapter next discusses the consequences of deinstitutionalization.

This chapter reviews themes from research on mental health services and systems. It explores research on access and obstacles to care, systematic problems that may limit the distribution and use of mental health services. It then summarizes national data on mental health service utilization according to the various types of organizations within and beyond the specialty mental health sector.

This chapter traces the theoretical and empirical work describing the process of coping with mental illness and the patterns of using different systems of care. As the health care system is fundamentally transformed, understanding how individuals respond to mental illness, what pathways they travel, and what factors shape their trajectories requires a step backward to reevaluate what is known about service use and where further research is needed.

The chapter discusses the role of the social worker in addressing HIV ethical issues in the mental health setting. General practice guidelines for addressing ethical issues are presented. The duty of the social worker to protect clients is explained. A discussion of a situation wherein the social worker is faced with the task of determining the capacity of his or her client to make decisions on his or her own behalf is offered.

The article provides information about multidisciplinary team in the case of the elderly psychiatrically ill. The author reviews the role and effect of this teamwork in the management of delirium in dementia found insufficient data for the development of evidence-based guidelines. Teamwork involves allowing the patient and carer to participate in the process.

The article examines the significance of early detection in the management of dementia. Studies by B. Cooper and H. Bickel indicate some of the advantages of early detection, including the gap between those receiving specialist psychiatric care and the total volume of morbidity in a general population, reversibility of some conditions detected as dementia, and the use early detection as a preliminary not to curative treatment but to reduce disability and delay institutional care.