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Background: Cultural beliefs significantly shape societal attitudes toward mental illness, and these social attitudes profoundly impact help-seeking behaviors. Therefore, it is important to focus on understanding and addressing these social behaviors. Aim: This study aimed to evaluate the effect of chronic mental illness interpretations based on culture and religious beliefs on non-medical help-seeking behaviors among patients in Türkiye. Methods: The study was conducted from September to October 2023 using an inductive qualitative approach. In-depth face-to-face interviews were carried out with individuals diagnosed with chronic mental illness and their relatives, registered in a state-owned Community Mental Health Center (CMHC) in Türkiye. Using purposive sampling, 13 individuals who met the criteria were interviewed. Thematic analysis was used to identify themes. Results: Three main themes and eight sub-themes were identified, including the reasons for seeking non-medical help (psychological challenges, subjective norms, physical requirements), factors contributing to seeking non-medical help (predisposing factors, enabling factors, and myths), and reflections on the benefits of non-medical practices (perceived physical benefits, perceived psychological benefits). Conclusions: It was concluded that individuals with chronic mental illness and their relatives living in the Eastern Anatolia Region of Türkiye engaged in non-medical help-seeking behaviors and mostly turned to traditional religious practices. Culture and religious beliefs emerged as primary factors leading patients to seek non-medical treatment approaches. Consequently, there is a perceived need to explore non-medical alternative methods across various mental health settings and with diverse samples in future research endeavors.

Background: Cultural beliefs significantly shape societal attitudes toward mental illness, and these social attitudes profoundly impact help-seeking behaviors. Therefore, it is important to focus on understanding and addressing these social behaviors. Aim: This study aimed to evaluate the effect of chronic mental illness interpretations based on culture and religious beliefs on non-medical help-seeking behaviors among patients in Türkiye. Methods: The study was conducted from September to October 2023 using an inductive qualitative approach. In-depth face-to-face interviews were carried out with individuals diagnosed with chronic mental illness and their relatives, registered in a state-owned Community Mental Health Center (CMHC) in Türkiye. Using purposive sampling, 13 individuals who met the criteria were interviewed. Thematic analysis was used to identify themes. Results: Three main themes and eight sub-themes were identified, including the reasons for seeking non-medical help (psychological challenges, subjective norms, physical requirements), factors contributing to seeking non-medical help (predisposing factors, enabling factors, and myths), and reflections on the benefits of non-medical practices (perceived physical benefits, perceived psychological benefits). Conclusions: It was concluded that individuals with chronic mental illness and their relatives living in the Eastern Anatolia Region of Türkiye engaged in non-medical help-seeking behaviors and mostly turned to traditional religious practices. Culture and religious beliefs emerged as primary factors leading patients to seek non-medical treatment approaches. Consequently, there is a perceived need to explore non-medical alternative methods across various mental health settings and with diverse samples in future research endeavors. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to examine the relationship between perceived social support, insight, and treatment adherence in patients with schizophrenia and bipolar disorder. Materials and Methods: This study was conducted with 110 individuals, including 55 bipolar and 55 schizophrenia patients, who had been hospitalized in our clinic in the last 1 year and were in remission. Participants were administered a sociodemographic and clinical data form, Young Mania Rating Scale (YMDÖ), Clinical Global Impression Scale (CGI), Three Components of Insight Rating Scale (IÜBDÖ), Morisky Treatment Compliance Scale (MTUÖ) and Multidimensional Perceived Social Support Scale (MSPSS). Results: The mean age was 40.47±12.96 for bipolar patients and 40.45±11.71 for schizophrenics. Perceived family, friend, significant others support, and total support was found to be higher (p=0.000, p=0.000, p=0.004, p=0.000, respectively) of bipolar patients, and the highest support was perceived from family, followed by friends and significant people. Although the groups did not differ in terms of treatment adherence (p=0.083), the insight score was significantly higher in bipolar patients (p=0.001). Groups were evaluated with hierarchical regression analysis in terms of factors affecting perceived social support. Gender, years of education, insight, and treatment adherence were found to be predictive of social support (p=0.04, p=0.01, p

This article explores the importance of assessing and improving the quality of life for individuals with chronic mental illness. It emphasizes the need for a person-centered approach and interdisciplinary collaboration in developing customized interventions. The article discusses various research studies on topics such as depression among science students during the Covid-19 pandemic, the impact of employment programs on the quality of life for people with psychiatric disorders, the relationship between creativity and mental illness, and the effectiveness of electro-acupuncture in treating post-stroke depression. It also discusses a systematic review and meta-analysis on Moyamoya disease and psychiatric manifestations, highlighting the most common symptoms and providing guidelines for treatment. The article concludes by emphasizing the importance of addressing factors often overlooked in the treatment of chronic mental illness, such as depression, physical health, lifestyle behaviors, and technology-aided interventions. [Extracted from the article]

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Introduction: This study analyzes the effect of telemedicine use on healthcare utilization and medical spending for patients with chronic mental illness. Methods: Using the IBM MarketScan Research database from 2009 to 2018, this study examined the timing of users’ first telemedicine use and identified similar periods for non-users by using random forest and random forest proximity matching. A difference-in-differences approach, which tests whether there are differences in the study outcomes before and after the actual/predicted first use among the treated group (users) compared with the control group (non-users), was then used to assess the impact of telemedicine. Analyses were done in 2021. Results: Comparing users with non-users after matching suggested that telemedicine use both increases the number of overall outpatient visits (0.461; 95% CI=0.280, 0.642; p

Background: Psychiatric disorders are a type of illness in which people suffer from emotional problems that affect all aspects of a person's life. Numerous studies have examined the effectiveness of third-generation cognitive and behavioral therapies on improving the performance of the mentally ill. Nevertheless, the main question is whether the new therapies, including positive psychology- based skills, affect the self-efficacy and awareness of these patients? Aims: This study aimed to investigate the effectiveness of positive psychology skills on self-efficacy, problem solving, and mindfulness in chronically mentally ill patients. Methods: This was a quasi-experimental study with a pretest-posttest design with a control group The statistical population consisted of all chronic male mental patients attending the center overnight in Roozbeh mental patients in Zahedan in 1399Thirty patients were selected by convenience sampling method and randomly assigned to experimental (n=15) and control (n=15) Experimental group (positive psychology Quailiam,2003) received eight 90-minute sessions (biweekly). The control group received no intervention. The measurement instruments used in the study were the Self-Efficacy Questionnaire for Coping with Chesney Problems (2003) and the Mindfulness in Sports Questionnaire. The data obtained from the questionnaires were analyzed in two sections descriptively and inferentially using tests (multivariate and univariate covariance). Results: The results of the analysis of covariance showed that the skills training based on Positive Psychology is effective on "self-efficacy in coping with problems" and "mindfulness in exercise" of chronically mentally ill people (p

Abstract Background The psychosocial rehabilitation of an individual with mental illness is an evidence-based approach to reducing the burden of the illness and the associated stigma globally. Specifically, in Africa, it has promising scope for African life and the African economy. Psychosocial rehabilitation is described as a set of approaches that aim to assist an individual in achieving restoration from a state of dependency caused by schizophrenia to a state of being an independent decision-maker. However, there seems to be a dearth of literature and implementation of psychosocial rehabilitation in Africa. Therefore, it is necessary to map studies on how psychosocial rehabilitation is conducted for people living in Africa with the most chronic form of mental illness, schizophrenia. Methods This study will adopt the Arksey and O’Malley scoping review framework to search and compile relevant studies. This process will involve three steps: title screening, to be performed solely by the principal investigator, followed by abstract and full-text screening, to be performed independently by two reviewers (the principal investigator and co-investigator). Rayyan QCRI, a systematic reviews web app, will be used for tracking the screening records, and data charting form will be used to extract basic data of included studies. The risk of bias in the articles identified for screening will be assessed by the Mixed Method Appraisal Tool (MMAT). Finally, the content analysis of the screened studies will be performed with NVivo. Expected outcome This study has the likelihood of revealing a research gap in psychosocial rehabilitation approaches and methods. The review results will constitute part of the available evidence that the researchers aim to adopt in the broader part of the project, which aims to develop implementation strategies for the psychosocial rehabilitation of chronic mental illnesses, specifically schizophrenia, in Sub-Sahara Africa. The implementation process also encompasses disseminating the findings of this review to stakeholders, which will enhance their knowledge of the current state of Sub-Saharan Africa and may stimulate support for the implementation of rehabilitation strategies.

Background: Adult children of chronically mentally ill parents are prone to behavioural, emotional, and psychological problems compared to children and teenagers in the general community. Purpose: To gain an understanding of adult children’s experiences with a parent living with a chronic mental illness in Giyani, Limpopo Province, South Africa. Design and methods: A qualitative exploratory, descriptive research design was utilised. Ten purposefully sampled adult children with a parent living with a chronic mental illness participated in the study. Data were collected using in-depth phenomenological interviews. Data were analysed utilising Tesch’s open-coding method. Results: Adult children experienced having a parent living with a chronic mental illness as a difficult and painful journey filled with confusion. The support and lack of support they received from people around them. They ultimately accepted their situation based on the realisation their parent has a chronic mental illness. Conclusion: Based on the findings, it is recommended that healthcare professionals should promote individuals’ mental health and well-being through the provision of mental health education, facilitation of a reduction in mental health stigma in communities, and fostering resilience among adult children with a parent living with a chronic mental illness. The facilitation of support and acceptance of their parent’s mental status is also vital for these individuals. Collaboration between families with parental mental illness, the community, social services, mental health services and other relevant organisations and stakeholders were highlighted in supporting these families to achieve better outcomes.

Introduction People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population. Objectives The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health in accordance with best practice guidelines. Methods Patients were invited to attend the metabolic clinic. The following areas were examined: Personal and family history of cardiovascular disease, diet, exercise, smoking. Mental state examination, waist circumference, BP, pulse, ECG and BMI. Laboratory tests including U+E, LFTs, HbA1c, Lipid profile and other tests as appropriate such as serum lithium. AIMS scale, HoNOS and WHOQOL-BREF scales as additional indicators of global health. Results A total of 80 patients attended during 3.5 years of clinic. Mean age was 54.9 years (SD:13.81) at first contact and 45% were females. Mean years in the service was 19.66 (SD:11.54) and mean number of previous hospital admissions was 4.4 (SD:5.63). Metabolic syndrome was present in 42% at first assessment and 20% had at least one new physical abnormality identified during the clinic. A statistically significant difference was found for the psychological domain of the WHOQOL-BREF and the HoNOs particularly at third assessment. (β=4.64, Wald x2=7.38, df:1, p=0.007, CI:1.3-8.1, β =-.889, Wald x2=4.08, df:1, p=0.043, CI: -1.752 to-.026) respectively. Conclusions The results show a high prevalence of physical health conditions in this cohort, some of which represent a new diagnosis. This implicates better allocation of existing resources for screening and early detection, and potential to run joint clinics with primary care. Disclosure No significant relationships.

Background: The psychosocial rehabilitation of an individual with mental illness is an evidence-based approach to reducing the burden of the illness and the associated stigma globally. Specifically, in Africa, it has promising scope for African life and the African economy. Psychosocial rehabilitation is described as a set of approaches that aim to assist an individual in achieving restoration from a state of dependency caused by schizophrenia to a state of being an independent decision-maker. However, there seems to be a dearth of literature and implementation of psychosocial rehabilitation in Africa. Therefore, it is necessary to map studies on how psychosocial rehabilitation is conducted for people living in Africa with the most chronic form of mental illness, schizophrenia. Methods: This study will adopt the Arksey and O'Malley scoping review framework to search and compile relevant studies. This process will involve three steps: title screening, to be performed solely by the principal investigator, followed by abstract and full-text screening, to be performed independently by two reviewers (the principal investigator and co-investigator). Rayyan QCRI, a systematic reviews web app, will be used for tracking the screening records, and data charting form will be used to extract basic data of included studies. The risk of bias in the articles identified for screening will be assessed by the Mixed Method Appraisal Tool (MMAT). Finally, the content analysis of the screened studies will be performed with NVivo. Expected outcome: This study has the likelihood of revealing a research gap in psychosocial rehabilitation approaches and methods. The review results will constitute part of the available evidence that the researchers aim to adopt in the broader part of the project, which aims to develop implementation strategies for the psychosocial rehabilitation of chronic mental illnesses, specifically schizophrenia, in Sub-Sahara Africa. The implementation process also encompasses disseminating the findings of this review to stakeholders, which will enhance their knowledge of the current state of Sub-Saharan Africa and may stimulate support for the implementation of rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Background: Patriarchy exposes women to various forms of discrimination and oppression. Women are more often blamed for mental illness, which can result in social isolation and stigma. Method: Case Study. Results: Psycho-social intervention aided in empowering women by giving them voices to speak as well as by utilizing their strengths and available community resources to develop a sense of self-efficacy, coping strategies, and support system. Conclusion: Women with chronic mental illness have unique needs and challenges. Mentally ill women face sexual coercion in childhood or adulthood. The factors related to help-seeking in the context of abuse were family reactions, social support, and stigma. Our findings highlight the need to conduct risk assessments and provide community-based and coordinated services during follow-up visits.

Introduction: Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life. However, such psychosocial rehabilitation centers are limited in India. Aims: The present study assesses psychosocial rehabilitation centers (of urban day-care and rural residential rehabilitation center) operated by Ashadeep Charitable Foundation, a civil service organization and its effect on health outcomes of patients living with chronic mental illness. Materials and Methods: Records of 170 cases were retrieved for secondary analysis of demographic information, diagnosis, duration of stay, and health outcomes. Results: Rehabilitation activities included yoga, light physical exercises, group discussion, training for daily living skills, social skills, life skills, vocational training, individual, and family counseling. In addition, extensive outreach activities, mental health camps were also integral part of the rehabilitation activities. Patients who have accessed rehabilitation services were diagnosed with schizophrenia, psychosis, bipolar disorder, depression, and intellectual disability. The average duration of rehabilitation of patients (other than persons with intellectual disability) was ranged from three to four months. Out of those rehabilitated, 69% of them were successfully re-integrated with the family. Conclusion: Combination of pharmacological and psychosocial interventions are effective for re-integrate patients with mental illness to the family. This model of community-based rehabilitation has potential for scale-up.

David W Morris,1 Subroto Ghose,1,2 Ella Williams,1,2 Kevin Brown,1,2 Fuad Khan1,2 1Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA; 2Department of Psychiatry, Parkland Memorial Hospital, Dallas, TX, USA Introduction: Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED. Methods: Data from ED visits of patients who were admitted to the Parkland Memorial Hospital ED (the community hospital for Dallas County, TX, USA) with a psychiatric complaint more than once within a 30-day period were evaluated (n=202). A 50-item readmission survey was used to collect information on demographic and clinical factors associated with 30-day readmission, as well as to identify quality improvement opportunities by assessing related moderating factors. An analysis of acute readmission visits (occurring within 3 days of previous discharge) was also performed. Results: Patients readmitted to the ED commonly present with a combination of acute psychiatric symptoms, substance use (especially in the case of acute readmission), and violent or suicidal behavior. The vast majority of cases reviewed found that readmitted patients had difficulties coordinating care outside the ED. A number of moderating factors were identified and targeted for quality improvement including additional support for filling prescriptions, transportation, communication with family and outside providers, drug and alcohol treatment, intensive case management, and housing. Conclusion: Many of the resources necessary to reduce psychiatric patient visits to hospital EDs are available within the community. There is no formal method of integrating and insuring the continuity of community services that may reduce the demand for psychiatric and related services in the ED. While agreements between community service providers may be challenging and require considerable vigilance to maintain equitable agreements between parties, this route of improving efficiency may be the only available method, given the current and projected patient care needs. Keywords: chronic mental illness, psychiatric readmission, emergency psychiatry, public mental health

Background: Patriarchy exposes women to various forms of discrimination and oppression. Women are more often blamed for mental illness, which can result in social isolation and stigma. Method: Case Study. Results: Psycho-social intervention aided in empowering women by giving them voices to speak as well as by utilizing their strengths and available community resources to develop a sense of self-efficacy, coping strategies, and support system. Conclusion: Women with chronic mental illness have unique needs and challenges. Mentally ill women face sexual coercion in childhood or adulthood. The factors related to help-seeking in the context of abuse were family reactions, social support, and stigma. Our findings highlight the need to conduct risk assessments and provide community-based and coordinated services during follow-up visits. [ABSTRACT FROM AUTHOR]

The spiral phenomenon of homelessness and mental ill-health are major growing epidemic in both developed and developing countries. Viewing from a socio-economic-political dimension, homelessness and mental ill-health cause detrimental effects on the individuals' lives as well as the nation-building process. The condition of women seems to be complex, as the gender perspectives are often described in terms of patriarchy and powerlessness. The bi-directionality of mental illness and homelessness creates a vicious cycle, and many women seem to end up in shelter care homes. The scenario of homeless women with chronic mental illness reflects the lack of community-based rehabilitation efforts and gender-sensitive policy level initiatives.

Introduction: Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life. However, such psychosocial rehabilitation centers are limited in India. Aims: The present study assesses psychosocial rehabilitation centers (of urban day-care and rural residential rehabilitation center) operated by Ashadeep Charitable Foundation, a civil service organization and its effect on health outcomes of patients living with chronic mental illness. Materials and Methods: Records of 170 cases were retrieved for secondary analysis of demographic information, diagnosis, duration of stay, and health outcomes. Results: Rehabilitation activities included yoga, light physical exercises, group discussion, training for daily living skills, social skills, life skills, vocational training, individual, and family counseling. In addition, extensive outreach activities, mental health camps were also integral part of the rehabilitation activities. Patients who have accessed rehabilitation services were diagnosed with schizophrenia, psychosis, bipolar disorder, depression, and intellectual disability. The average duration of rehabilitation of patients (other than persons with intellectual disability) was ranged from three to four months. Out of those rehabilitated, 69% of them were successfully re-integrated with the family. Conclusion: Combination of pharmacological and psychosocial interventions are effective for re-integrate patients with mental illness to the family. This model of community-based rehabilitation has potential for scale-up. [ABSTRACT FROM AUTHOR]

Background: Chronic mental illnesses like Schizophrenia, Bipolar Affective Disorder, Depression, Alcoholism have a negative impact on the quality of life and affect the reasons for living in such patients. This study was done to find out how the quality of life affects the reasons for living in such chronic patients. Aim: To study the Quality of life and Reasons for living in patients suffering from chronic mental illness. Materials and methods: 60 patients suffering from chronic mental illness were selected as subjects. WHO Quality of Life - BREF scale and Reasons for Living inventory are used in this study. SPSS software was used for statistical analysis. Results: Mean RFL score for Males was 151.52. Mean RFL score for females was 133.28. Strong Positive Co-relation was seen between RFL and Quality of life Domains with significant p-values (<0.05). Conclusion: Females have more Fear of Suicide and Psychological domain in quality of life whereas, Males have more Reasons for Living, Survival and Coping Beliefs, Responsibility to Family, Child Related Concerns, Fear of Social Disapproval, Moral Objections, Physical health, Social relationships and environmental domains. [ABSTRACT FROM AUTHOR]

Background: Intrapersonal, interpersonal, social and economic factors associated with chronic mental illness influence mothers' parenting abilities which in turn influence childhood mental health. Aim: The aim of the study was to explore and describe the parenting experiences of mothers with a chronic mental illness. Methods: An explorative, descriptive and qualitative research design was used. Ten participants were purposively sampled until saturation occurred. Data was collected using in-depth individual interviews and a content analysis was carried out. Results: Mothers with a chronic mental illness experienced various challenges and expressed their family support needs. Conclusion: A family-centred approach to mental healthcare, treatment and rehabilitation is proposed.

The spiral phenomenon of homelessness and mental ill-health are major growing epidemic in both developed and developing countries. Viewing from a socio-economic-political dimension, homelessness and mental ill-health cause detrimental effects on the individuals' lives as well as the nation-building process. The condition of women seems to be complex, as the gender perspectives are often described in terms of patriarchy and powerlessness. The bi-directionality of mental illness and homelessness creates a vicious cycle, and many women seem to end up in shelter care homes. The scenario of homeless women with chronic mental illness reflects the lack of community-based rehabilitation efforts and gender-sensitive policy level initiatives. [ABSTRACT FROM AUTHOR]

Background: Intrapersonal, interpersonal, social and economic factors associated with chronic mental illness influence mothers' parenting abilities which in turn influence childhood mental health. Aim: The aim of the study was to explore and describe the parenting experiences of mothers with a chronic mental illness. Methods: An explorative, descriptive and qualitative research design was used. Ten participants were purposively sampled until saturation occurred. Data was collected using indepth individual interviews and a content analysis was carried out. Results: Mothers with a chronic mental illness experienced various challenges and expressed their family support needs. Conclusion: A family-centred approach to mental healthcare, treatment and rehabilitation is proposed. [ABSTRACT FROM AUTHOR]

Major depressive disorder, bipolar I disorder and schizophrenia are chronic conditions, and adults who have these diagnoses often benefit from mental health treatment throughout their lives. The recent fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included changes to many diagnoses. Consequently, counselors need to understand the changes and revise their diagnostic practices accordingly. Changes affect new clients being diagnosed for the first time as well as long-term clients who were initially diagnosed many years ago. This manuscript provides an explanation of changes to major depressive disorder, bipolar I disorder and schizophrenia. Case examples illustrate implications for counselors who work with clients who have these three serious and chronic mental illnesses. Counselors, following best practice guidelines and the American Counseling Association's ethical mandate, can take advantage of this opportunity to ensure that clients understand their mental health conditions and that documented diagnoses are accurate and thorough. [ABSTRACT FROM AUTHOR]

Aim: This study explored the associations of personal, disease, family, and social factors with quality of life (QoL) in patients with two common types of chronic mental illness (CMI) living in Kaohsiung City, Taiwan. Methods: Using a convenience sample and a cross-sectional design, 714 patients (50.1% male, 49.9% female) with CMI (72.1% schizophrenia and 27.9% affective disorder) and their caregivers were recruited. Demographic information was collected via the following questionnaires: 12-Item Short-Form Health Survey (SF-12), five-item Brief Symptom Rating Scale (BSRS-5), Caregiver Burden Scale, and Clinical Global Impressions (CGI-S) Scale. Pearson correlations and hierarchical regression analyses were used to predict QoL. Results: Disease factors accounted for 17-50% of the change in variance. Predictors of low mental subscale scores included the following: high psychological distress and high family burden as well as a history of suicide attempts, negative caregiver attitudes, and living away from home. Disease factors also explained the greatest variance in the physical subscales. Predictors of low physical subscale scores included the following: high psychological distress, age, unemployment, a history of suicide attempts, high family burden, and living alone. Conclusions: Disease factors were the most important predictors of QoL in patients with CMI. Family factors were more important than social factors on the mental subscales. Differential relationships were also found for the other two dimensions. Together, these results indicate that a wide range of factors improve the QoL in patients with CMI. [ABSTRACT FROM AUTHOR]

Seeking to align psychiatric practice with general medicine following the inauguration of the National Health Service, psychiatric hospitals in post-war Britain deployed new treatments designed to induce somatic change, such as ECT, leucotomy and sedatives. Advocates of these treatments, often grouped together under the term 'physical therapies', expressed relief that the social problems encountered by patients could now be interpreted as symptomatic of underlying biological malfunction rather than as a cause of disorder that required treatment. Drawing on the British Journal of Psychiatric Social Work, this article analyses the critique articulated by psychiatric social workers based within hospitals who sought to facilitate the social reintegration of patients following treatment. It explores the development of 'psychiatric social treatment', an approach devised by psychiatric social workers to meet the needs of people with enduring mental health problems in hospital and community settings that sought to alleviate distress and improve social functioning by changing an individual's social environment and interpersonal relationships. 'Physical' and 'social' models of psychiatric treatment, this article argues, contested not only the aetiology of mental illness but also the nature of care, treatment and cure. [ABSTRACT FROM AUTHOR]

Objective. To evaluate Hurricane Katrina’s impact on patients with pre-existing chronic pain. Design. Review of literature about Hurricane Katrina and chronic pain or pain management and a qualitative interview of all identified patients enrolled in a behavioral pain management program. Setting. Southeast Louisiana Veterans Healthcare System, Mental Health Service Line. Subjects. In total, 42 of the 53 (79%) veterans enrolled in a chronic pain program prior to Hurricane Katrina were able to be contacted and evaluated with interviews and a review of their available medical records. Outcome Measures. Major impediments and facilitative factors in delivering pain management services were identified. Conclusions. Health care planning for large-scale emergencies must take into the need for prompt continuation of pain management services in patients with chronic pre-existing pain. Coordination between emergency clinics and pain management specialists, as well as the availability of electronic medical records, is an important factor in continuing established pain management services after a regional disaster. [ABSTRACT FROM AUTHOR]

A systematic policy for treatment and management of chronic psychiatric patients in South Korea was begun with the passage of the Mental Health Act in 1995. The mentally ill patients who were previously separated from the society now have opportunities to live in local communities under medication with the help of rehabilitation facilities. This study aims to understand how mentally ill patients deal with their new medical environment. An autobiographic narrative analysis is methodically applied in order to link the social and the individual levels. Autobiographic narratives of illness show how the patient's self-identity is formed and further developed according to the chronic conditions of his illness and the continual learning from experiences. In regard to the construction of self-identity, two aspects should be taken into consideration: First, medication is absolutely necessary before patients can leave the hospital and participate in rehabilitation programs. Secondly, social integration is usually evaluated by the return of the patient into a normal biographical stage. It turns out that medication deprives the patients of control over their emotions, their bodies. Furthermore, their social environments — including family, friends and the labor market — work against them. Under these circumstances, mentally ill patients are liable to adhere to their own interpretation of mental illness, and what they experience is far different from the expectations of experts in the field. The new mental health environment also contributes to the formation of patient communities. As a result, chronic psychiatric patients are able to build their own subculture and to see themselves through their own eyes. Further studies are needed to explore whether and to what extent the ongoing improvement of social conditions for mentally ill patients has an impact on autobiographic narratives and self-identity construction. [ABSTRACT FROM AUTHOR]

This paper presents a cross-sectional survey of subjective quality of life in a sample of 40 Italian patients with disabling mental disorders living in the community. The patients self-rated their quality of life by the Satisfaction with Life Domains Scale. They were satisfied in relation to basic needs, such as housing, food or clothing and appreciated to some extent the services received, but were very unhappy about their income and their intimate sexual relationships. This Italian sample appeared less satisfied than most samples of people with severe mental disorders investigated by the same instrument in other countries. This may be related to the high level of psychopathology and disability shown by patients for whom survival in the community is in itself an achievement. However, lack of money and poor sexual life are common concerns of long-term mentally ill. How to address such problems is a major challenge for community psychiatric services. [ABSTRACT FROM AUTHOR]