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Are mental health services for children distributed according to needs?

https://arctichealth.org/en/permalink/ahliterature185538
Source
Can J Psychiatry. 2003 Apr;48(3):176-86
Publication Type
Article
Date
Apr-2003
Author
Régis Blais
Jean-Jacques Breton
Mylène Fournier
Marie St-Georges
Claude Berthiaume
Author Affiliation
Department of Health Administration, Groupe de recherche interdisciplinaire en santé, Université de Montreal, CP 6128, succursale Centre-ville, Montreal, QC H3C 3J7. regis.blais@umontreal.ca
Source
Can J Psychiatry. 2003 Apr;48(3):176-86
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child Health Services - manpower - supply & distribution - utilization
Health Resources - supply & distribution
Health services needs and demand
Hospitalization - statistics & numerical data
Humans
Mental Disorders - epidemiology - psychology - rehabilitation
Mental Health Services - manpower - supply & distribution - utilization
Quebec - epidemiology
Regional Health Planning
Abstract
The purpose of this study was twofold: 1) to determine whether publicly funded mental health services and resources available in 4 large regions in the province of Quebec were distributed according to the mental health needs of children aged 6 to 14 years and 2) to assess whether the variations in mental health services and resources across the 4 regions had changed over a 5-year period.
Indicators of need according to the child's parent (presence of mental disorder, measure of adaptation, and perception of need for help) from an epidemiologic survey of 2400 noninstitutionalized children were compared with both in-school and community professional resources and with physician and hospital services in 1992-1993. Resource and service data were also collected for 1997-1998. Resource and service data came from professional colleges and government administrative databases.
No significant regional differences were found for need indicators, but there were large discrepancies in mental health resources and services in 1992-1993. Differences in professional resources were largest for special education teachers in the school system and for psychiatrists in the community. The regional differences in resources and services were as large in 1997-1998 as they were in 1992-1993.
Despite universal health care in Quebec and a government mental health policy stressing equity of access, the available mental health resources for children aged 6 to 14 years are not distributed across regions according to needs. More evidence-based planning is required, specifically using epidemiologic survey data, to match resources to needs and to monitor changes over time.
PubMed ID
12728742 View in PubMed
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The association between self-reported mental health status and alcohol and drug abstinence 5 years post-assessment for an addiction disorder in U.S. and Swedish samples.

https://arctichealth.org/en/permalink/ahliterature112582
Source
J Addict Dis. 2013;32(2):180-93
Publication Type
Article
Date
2013
Author
Sarah Trocchio
Deborah Chassler
Jessica Storbjörk
Kevin Delucchi
Jane Witbrodt
Lena Lundgren
Author Affiliation
Center for Addictions Research and Services, Boston University School of Social Work, Boston, MA, USA. stroc@bu.edu
Source
J Addict Dis. 2013;32(2):180-93
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcoholism - epidemiology - psychology - rehabilitation
Anxiety Disorders - epidemiology - psychology - rehabilitation
Comorbidity
Cross-Cultural Comparison
Female
Follow-Up Studies
Hospitalization - statistics & numerical data
Humans
Likelihood Functions
Logistic Models
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Mental health
Middle Aged
Prognosis
Recurrence
Rehabilitation, Vocational - psychology
Risk factors
Self-Assessment
Social Support
Substance-Related Disorders - epidemiology - psychology - rehabilitation
Sweden
Temperance - psychology
United States
Young Adult
Abstract
This study compared whether self-reported mental health status was associated with likelihood of being abstinent from alcohol and drugs five years after baseline assessment for an addiction disorder in two representative samples; one from Sweden (n = 469) and one from the US (n = 667). Self-reported mental health status was measured through the ASI score of mental health symptoms and history of inpatient and/or outpatient treatment. Through logistic regression modeling the study controlled for demographic characteristics including age, gender, employment status and social network connection with individuals who do not use alcohol/drugs. For both the US and Swedish samples employment status and having a social network that does not use alcohol and drugs were associated with being likely to be abstinent from alcohol and drugs five years after initial assessment. For the US sample only, individuals who reported symptoms of anxiety were 50% more likely not to be abstinent from alcohol and drugs at follow-up. For the Swedish sample, current mental health status was not significantly associated with abstinence. However, reporting a lifetime history of inpatient psychiatric treatment at the baseline assessment was significantly associated with not being abstinent at 5 years post assessment; those with a lifetime history of inpatient mental health treatment were 47% less likely to report abstinence. While specific variables differ across Sweden and the US, psychiatric comorbid status, employment and social network are each associated with drug and alcohol abstinence cross-nationally.
Notes
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PubMed ID
23815425 View in PubMed
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Chronic patients in psychiatric institutions: psychopathology, level of functioning and need for care.

https://arctichealth.org/en/permalink/ahliterature72602
Source
Acta Psychiatr Scand. 1998 Jan;97(1):55-61
Publication Type
Article
Date
Jan-1998
Author
T. Ruud
E W Martinsen
S. Friis
Author Affiliation
Nordfjordeid Psychiatric Center, Norway.
Source
Acta Psychiatr Scand. 1998 Jan;97(1):55-61
Date
Jan-1998
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - classification - psychology
Adult
Aged
Aged, 80 and over
Chronic Disease
Deinstitutionalization - statistics & numerical data
Female
Geriatric Assessment - statistics & numerical data
Health Services Needs and Demand - statistics & numerical data
Humans
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Norway - epidemiology
Patient Discharge - statistics & numerical data
Prognosis
Psychiatric Status Rating Scales - statistics & numerical data
Psychometrics
Psychotic Disorders - epidemiology - rehabilitation
Schizophrenia - epidemiology - rehabilitation
Abstract
A total of 107 chronic in-patients in a catchment area of 106,000 inhabitants were rated for psychopathology on the Brief Psychiatric Rating Scale expanded version (BPRS-E), for level of functioning on the Rehabilitation Evaluation Hall And Baker (REHAB), and for geriatric problems on the Geriatric Rating Scale (GRS). The results showed low levels of severe psychopathology and low to moderate levels of functioning, indicating that the main obstacle to community placement was the lack of functioning. Global assessment by ward nurses with regard to the future level of care needed divided the patients into three categories: 40 patients in need of a psychiatric nursing home, 30 patients in need of a general nursing home, and 37 patients who could potentially be discharged to apartments with community support. This study indicates that the REHAB may help to identify patients who are potential candidates for community placement, while the BPRS-E may help to identify patients who are still in need of care in a psychiatric institution.
Notes
Comment In: Acta Psychiatr Scand. 1998 Nov;98(5):427-89845184
PubMed ID
9504704 View in PubMed
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[Community services and quality of life: a study of the impact in a remote region].

https://arctichealth.org/en/permalink/ahliterature222996
Source
Can J Psychiatry. 1992 Oct;37(8):553-63
Publication Type
Article
Date
Oct-1992
Author
C. Mercier
R. Tempier
C. Renaud
Author Affiliation
Département de psychiatrie, Université McGill, Montréal, Québec.
Source
Can J Psychiatry. 1992 Oct;37(8):553-63
Date
Oct-1992
Language
French
Publication Type
Article
Keywords
Adult
Aged
Chronic Disease
Cohort Studies
Community Mental Health Services - supply & distribution - utilization
Cross-Sectional Studies
Female
Health Services Accessibility - statistics & numerical data
Humans
Incidence
Longitudinal Studies
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Patient Care Team - utilization
Quality of Life
Quebec - epidemiology
Rural Health - statistics & numerical data
Social Support
Urban Health - statistics & numerical data
Abstract
This longitudinal study with a matched comparison group was conducted in Abitibi, an area in North-West Quebec. Its goal was to observe the impact of community support services on the quality of life of long term psychiatric patients living in a remote area. A cohort of 47 subjects, living in a small town with a comprehensive network of community support services, was compared with a similar group living in a neighbouring city with only outpatient services. The satisfaction with life domains scale developed by Andrews and Withey and adapted by Baker and Intagliata was used at four times during the study. According to the results, the subjective perception of the quality of life in the two groups is comparable, even though the objective conditions are less favorable for the group participating in the community support program. The highest ratings were given to the place of residence, the neighborhood and its commodities; the lowest ratings were given to their love life and financial situation. One can observe a stability of the measures of quality of life over time and for the two groups. The perceptions of the sample living in a remote area are much more favorable than the ones of a comparable group living in the Montreal area. These results are discussed in a double perspective: the role of community support services in the daily life of people who are having severe and persistent problems of mental health, and the interest of measures of quality of life.
PubMed ID
1423157 View in PubMed
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Determinants of health-related quality of life of opiate users at entry to low-threshold methadone programs.

https://arctichealth.org/en/permalink/ahliterature170213
Source
Eur Addict Res. 2006;12(2):74-82
Publication Type
Article
Date
2006
Author
Peggy Millson
Laurel Challacombe
Paul J Villeneuve
Carol J Strike
Benedikt Fischer
Ted Myers
Ron Shore
Shaun Hopkins
Author Affiliation
Department of Public Health Sciences, University of Toronto, Toronto, Canada. p.millson@utoronto.ca
Source
Eur Addict Res. 2006;12(2):74-82
Date
2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child Abuse - psychology - statistics & numerical data
Child Abuse, Sexual - psychology - statistics & numerical data
Cocaine-Related Disorders - epidemiology - psychology - rehabilitation
Comorbidity
Female
Health Status Indicators
Humans
Hypnotics and Sedatives
Longitudinal Studies
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Methadone - administration & dosage
Middle Aged
Ontario
Opioid-Related Disorders - epidemiology - psychology - rehabilitation
Patient Acceptance of Health Care
Quality of Life - psychology
Questionnaires
Recurrence
Retreatment
Statistics as Topic
Substance Abuse, Intravenous - epidemiology - psychology - rehabilitation
Tranquilizing Agents
Treatment Outcome
Abstract
The aim of this study was to conduct an exploratory analysis of factors associated with poor health-related quality of life (HRQOL) among opiate users at entry to low-threshold methadone treatment.
The SF-36 questionnaire was administered to 145 opiate users at enrollment into low-threshold methadone maintenance programs. ANOVA and correlational analyses were performed to investigate the determinants of poor physical and mental composite summary scales (PCS and MCS) of the SF-36 among opiate users. Stepwise regression methods were also employed to fit PCS and MCS multivariate models.
Age, employment status, chronic medical conditions, hospitalization, emotional abuse, sexual abuse and age at first injection episode were significantly associated with PCS. Mental health problems, sexual abuse, physical abuse, the use of sedatives, the use of cocaine, the number of days of cocaine use, sedative use and multiple substance use in the past month were significantly associated with MCS. The variances in the MCS and PCS were not readily explained by any one factor.
The multiplicity of factors influencing HRQOL of opiate users suggests the need for a range of services within the context of a methadone program, addressing primary medical care needs as well as treatment for both mental health problems and abuse issues.
PubMed ID
16543742 View in PubMed
Less detail

Drug trajectories among youth undergoing treatment: the influence of psychological problems and delinquency.

https://arctichealth.org/en/permalink/ahliterature108741
Source
J Adolesc. 2013 Aug;36(4):705-16
Publication Type
Article
Date
Aug-2013
Author
Natacha Brunelle
Karine Bertrand
Isabelle Beaudoin
Cinthia Ledoux
Annie Gendron
Catherine Arseneault
Author Affiliation
Université du Québec à Trois-Rivières, Department of Special Education, P.O. Box 500, Trois-Rivières, QC, Canada G9A 5H7. natacha.brunelle@uqtr.ca
Source
J Adolesc. 2013 Aug;36(4):705-16
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Child Abuse - psychology - statistics & numerical data
Child Abuse, Sexual - psychology - statistics & numerical data
Combined Modality Therapy
Comorbidity
Educational Status
Family Characteristics
Female
Humans
Interview, Psychological
Juvenile Delinquency - psychology - rehabilitation - statistics & numerical data
Longitudinal Studies
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Personality Assessment - statistics & numerical data
Psychometrics
Quebec
Substance Abuse Treatment Centers
Substance-Related Disorders - epidemiology - psychology - rehabilitation
Abstract
Previous research has documented associations of addiction with delinquency and psychological problems. However, few studies have evaluated their influence on adolescent's drug use trajectories. The current study aims to examine the influence of these factors on the recovery trajectories of 199 youths aged 15.6 years on average admitted to inpatient and outpatient addiction treatment centers, followed up three and six months later. Results indicate that youth who show higher severity of drug abuse exhibit greater improvement than youth with a lower severity of drug abuse at the onset of treatment. Although psychological problems were associated with baseline drug use, they did not influence drug use trajectory over time. Only delinquency influenced the recovery trajectories of these youth. Results suggest that a high level of delinquency can have a significant effect on the drug recovery process of adolescents and that interventions should attempt to reduce both drug use and delinquency.
PubMed ID
23849665 View in PubMed
Less detail
Source
Can J Psychiatry. 1991 Dec;36(10):743-5
Publication Type
Article
Date
Dec-1991
Author
K M Boydell
S A Malcolmson
K. Sikerbol
Author Affiliation
Department of Psychiatry, University of Toronto, Ontario.
Source
Can J Psychiatry. 1991 Dec;36(10):743-5
Date
Dec-1991
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adult
Aftercare - utilization
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Follow-Up Studies
Health Services Needs and Demand - statistics & numerical data
Humans
Incidence
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Ontario - epidemiology
Patient Compliance - psychology
Patient Discharge - statistics & numerical data
Patient Readmission - statistics & numerical data
Abstract
The process and outcome of discharge planning were examined at a large provincial psychiatric hospital. Two hundred patients were studied to determine whether or not they received services from the agencies to which they were referred after discharge. In addition, patients who were rehospitalized within three months of discharge were identified in order to determine whether they differed from the rest of the cohort. Eighty-three percent of the patients for whom referrals were made sought help from at least one aftercare service or community agency, suggesting that there is considerably more aftercare in the community than has previously been documented. The implications of these findings for treatment, research and policy planning are discussed.
PubMed ID
1665100 View in PubMed
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Early treatment of women with alcohol addiction (EWA): a comprehensive evaluation and outcome study. I. Patterns of psychiatric comorbidity at intake.

https://arctichealth.org/en/permalink/ahliterature11472
Source
Addiction. 1995 Jan;90(1):101-9
Publication Type
Article
Date
Jan-1995
Author
B. Haver
L. Dahlgren
Author Affiliation
Stiftelsen Bergensklinikkene, Bergen, Norway.
Source
Addiction. 1995 Jan;90(1):101-9
Date
Jan-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcoholism - epidemiology - psychology - rehabilitation
Combined Modality Therapy
Comorbidity
Female
Follow-Up Studies
Humans
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Norway - epidemiology
Research Support, Non-U.S. Gov't
Abstract
This paper deals with psychiatric comorbidity among 60 women problem drinkers treated in a specialized women-only treatment programme (EWA) at Karolinska Hospital, Stockholm, Sweden. The programme attracts women who have not been previously treated for alcohol problems. The methods used were structured interviews (SCID-I and SCID-II) applied at least 10 days after the start of treatment. All but two of the women had a definite alcohol dependence according to the DSM-III-R, and a majority (60%) also fulfilled the criteria for at least one psychiatric disorder during their lifetime. However, only 23% had a personality disorder (PD), and all subjects with a PD also had at least one Axis I disorder. The most common disorders were mood disorders (48%) and anxiety disorders (38%). However, alcohol dependence developed without definite pre-existing psychiatric disorders among a substantial proportion of the women (40%). It remains to be seen whether and how psychiatric disturbances among female problem drinkers affect treatment compliance and long-term outcome.
PubMed ID
7888968 View in PubMed
Less detail

Factors associated with homicide recidivism in a 13-year sample of homicide offenders in Finland.

https://arctichealth.org/en/permalink/ahliterature212284
Source
Psychiatr Serv. 1996 Apr;47(4):403-6
Publication Type
Article
Date
Apr-1996
Author
M. Eronen
P. Hakola
J. Tiihonen
Author Affiliation
Department of Forensic Psychiatry, University of Kuopio, Niuvanniemi Hospital, Finland.
Source
Psychiatr Serv. 1996 Apr;47(4):403-6
Date
Apr-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcoholism - epidemiology - psychology - rehabilitation
Cross-Sectional Studies
Female
Finland - epidemiology
Homicide - psychology - statistics & numerical data
Humans
Incidence
Insanity Defense
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Odds Ratio
Recurrence
Risk factors
Treatment Outcome
Abstract
Data on persons known to have committed homicide during a 13-year period were studied to determine factors associated with increased risk of repeating homicide.
Between 1981 and 1993, a total of 1,649 homicides were committed in Finland. In 1,089 cases (66 percent), the offenders received an exhaustive forensic psychiatric examination. Data from reports of these examinations were analyzed to determine whether mental disorder and other factors were associated with homicide recidivism.
Thirty-six homicide recidivists were identified. Twenty-four were alcoholics, 23 had a personality disorder, in most cases combined with alcoholism, four had schizophrenia, and two had major depression. Homicidal behavior was ten times more likely in men who had committed a previous homicide than in the general male population. Alcoholism increased the odds ratio of additional homicidal behavior in male homicide offenders about 13 times, and schizophrenia increased the odds ratio more than 25 times. During their first year after release from prison, male homicide offenders were about 250 times more likely to commit homicide than members of the general male population.
The data suggest that mentally abnormal offenders are overrepresented among homicide recidivists in Finland. The risk of repeat homicide appears to be very high during the first year after release from prison.
PubMed ID
8689372 View in PubMed
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Gender differences among clients of a case management program for the homeless.

https://arctichealth.org/en/permalink/ahliterature224394
Source
Hosp Community Psychiatry. 1992 Feb;43(2):160-5
Publication Type
Article
Date
Feb-1992
Author
P. Goering
D. Wasylenki
M S Onge
D. Paduchak
W. Lancee
Author Affiliation
Health Systems Research Unit, Clarke Institute of Psychiatry, Toronto, Ontario, Canada.
Source
Hosp Community Psychiatry. 1992 Feb;43(2):160-5
Date
Feb-1992
Language
English
Publication Type
Article
Keywords
Adult
Aged
Community Mental Health Services - utilization
Cross-Sectional Studies
Disability Evaluation
Female
Follow-Up Studies
Homeless Persons - psychology - statistics & numerical data
Humans
Incidence
Male
Managed Care Programs - utilization
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Ontario - epidemiology
Psychiatric Status Rating Scales
Psychotic Disorders - epidemiology - psychology - rehabilitation
Rehabilitation, Vocational - utilization
Sex Factors
Abstract
Differences between 24 female and 35 male clients were assessed at entry into an intensive case management program serving homeless shelter residents and again nine months later. Both men and women were socially isolated, with small social networks and severe deficits in social functioning. Histories of homelessness were similar for both genders, and there were no gender differences in psychopathology at baseline or follow-up. At entry into the program women had higher levels of social skills, larger and more supportive networks, and better housing conditions than men, but these differences disappeared after the subjects spent nine months in the program. Inadequate living conditions may have contributed to the more negative initial picture for men. Although there were more similarities than differences between the men and women in this sample, more research on gender differences is needed to design and evaluate programs for homeless mentally ill persons.
PubMed ID
1572613 View in PubMed
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32 records – page 1 of 4.