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[A union basis of values stigmatize the mentally ill--there is a need for ethical analysis].

https://arctichealth.org/en/permalink/ahliterature183328
Source
Ugeskr Laeger. 2003 Sep 15;165(38):3639-41; author reply 3641
Publication Type
Article
Date
Sep-15-2003

Being a psychiatric patient in the community--reclassified as the stigmatized "other".

https://arctichealth.org/en/permalink/ahliterature192014
Source
Scand J Public Health. 2001 Dec;29(4):248-55
Publication Type
Article
Date
Dec-2001
Author
J. Thesen
Author Affiliation
Department of Public Health and Primary Health Care, University of Bergen, Norway. Janecke.Thesen@isf.uib.no
Source
Scand J Public Health. 2001 Dec;29(4):248-55
Date
Dec-2001
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Attitude to Health
Caregivers - education
Community Mental Health Services - manpower - standards
Deinstitutionalization
Humans
Interview, Psychological
Loneliness
Mentally Ill Persons - psychology
Norway
Prejudice
Professional-Patient Relations
Rural Population
Self Concept
Social Isolation
Stereotyping
Abstract
To explore the experiences of psychiatric patients living in six rural communities in Norway from a primary care perspective.
A "Knowledge workshop" (KW) was designed. It was a special kind of meeting between users of services for people with mental illness and service providers. The process and outcome were documented on flipcharts and audiotape and analysed by a qualitative method.
A main statement was constructed in order to capture the essence of meaning in the 10 main themes identified in the analysis. The statement is mainly about the process and state of being reclassified as a stigmatized "other", with serious consequences for both self-esteem and public esteem. The consequences include isolation and loneliness, low self-esteem, no paid work, lack of money, discrimination, and harassment. Other consequences include altered behaviour from others, lack of necessary conditions for empowerment, and the danger of becoming visible as mentally ill. Attitudinal change is called for.
Although the stigma of mental illness is a wellknown and much discussed fact, it has so far not really been included in the professional knowledge base. It is still practically absent from discussions of quality of care. In order for services to be relevant to people who need them, professionals can no longer ignore issues that are of major importance for users. Stigma must thus be included in the conceptual thinking about serving people with mental illness. The inclusion of stigma as an issue for quality of care could be a fruitful way forward.
PubMed ID
11775780 View in PubMed
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Changes in attitudes towards mental disorders and psychiatric treatment 1976-2014 in a Swedish population.

https://arctichealth.org/en/permalink/ahliterature274492
Source
Nord J Psychiatry. 2016;70(1):38-44
Publication Type
Article
Date
2016
Author
Helia Faghir Mirnezami
Lars Jacobsson
Anette Edin-Liljegren
Source
Nord J Psychiatry. 2016;70(1):38-44
Date
2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude to Health
Female
Follow-Up Studies
Health Knowledge, Attitudes, Practice
Humans
Male
Mental Disorders - etiology - psychology - therapy
Mentally Ill Persons - psychology
Middle Aged
Psychotherapy
Psychotropic Drugs - therapeutic use
Public Opinion
Social Stigma
Sweden
Violence - psychology
Young Adult
Abstract
Mental illness has always been subject to stigma and discrimination. There are a number of studies on public attitudes towards people with mental illness. Long-term studies, however, examining changes over time are scarce.
The aim of this study was to examine potential changes concerning attitudes between 1976 and 2014 in Vilhelmina, a community in northern Sweden.
A postal questionnaire was sent out to a random sample of 500 adults aged 18-70 years. The same questionnaire has previously been used in 1976 and 2003.
The attitudes towards people with mental illness have not generally become more positive over the years. In 2014 almost a quarter of the population still think that "people with mental illness commit violentX acts more than others". Even more people in 2014 than in 1976 agree to the statement that "mental illness harms the reputation more than a physical disease" (77.2% versus 52.8%). People with low educational level have more negative views than people with higher education. Younger respondents,
PubMed ID
26051607 View in PubMed
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Changes in inpatient and postdischarge suicide rates in a nationwide cohort of Danish psychiatric inpatients, 1998-2005.

https://arctichealth.org/en/permalink/ahliterature105250
Source
J Clin Psychiatry. 2013 Dec;74(12):e1190-4
Publication Type
Article
Date
Dec-2013
Author
Trine Madsen
Merete Nordentoft
Author Affiliation
Psychiatric Center Copenhagen, Copenhagen University Hospital, Bispebjerg Bakke 23, Bldg 13A, 2400 Copenhagen, Denmark trine.madsen@regionh.dk.
Source
J Clin Psychiatry. 2013 Dec;74(12):e1190-4
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Denmark - epidemiology
Female
Hospitalization - statistics & numerical data
Hospitals, Psychiatric - statistics & numerical data
Humans
Incidence
Inpatients - psychology - statistics & numerical data
Longitudinal Studies
Male
Mental Disorders - epidemiology - psychology - therapy
Mentally Ill Persons - psychology - statistics & numerical data
Middle Aged
Outpatients - psychology - statistics & numerical data
Patient Discharge - statistics & numerical data
Proportional Hazards Models
Risk factors
Suicide - prevention & control - psychology - statistics & numerical data
Abstract
A reduction in the number of inpatient beds as well as shorter admissions have aroused concern that tendencies to deinstitutionalize may increase the suicide rate for psychiatric patients who have been hospitalized. One study indicates that a decreasing inpatient suicide rate may actually reflect a transfer to an increasing postdischarge suicide rate; however, uncertainties exist about this transfer, since it is not well studied. The objectives of this study were to estimate adjusted changes over time in suicide rates among psychiatric inpatients and recently discharged psychiatric patients and to estimate changes in these rates by gender and diagnosis.
Data on all psychiatric patients admitted from 1998 through 2005 in Denmark were extracted from the Danish Psychiatric Central Register and merged with information from the Danish Cause of Death Register. Calendar year was applied as an independent continuous variable in Cox survival analyses modeling the hazard of suicide during inpatient treatment and during the 3-month postdischarge period. Analyses were adjusted for sex, age, educational status, primary diagnosis, and previous suicide attempt.
The overall inpatient suicide rate declined in psychiatric patients admitted from 1998 through 2005 (hazard ratio [HR] = 0.93 [95% CI, 0.88-0.99]), particularly among women (HR = 0.87 [95% CI, 0.79-0.96]). The overall rate of suicide in the 3-month postdischarge period also declined significantly (HR = 0.94 [95% CI, 0.91-0.98]), which was explained mostly by a falling rate among men (HR = 0.94 [95% CI, 0.90-0.98]) as well as among patients who were discharged with a diagnosis of schizophrenia (HR = 0.90 [95% CI, 0.83-0.99]).
Although our results show a decreasing trend in suicide rates, the sizes of the rates emphasize that focus on suicide in mental health care settings must continue and be improved, as the rates are still very high.
PubMed ID
24434107 View in PubMed
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Clients' perceptions of client-nurse relationships in local authority psychiatric services: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature71106
Source
Int J Ment Health Nurs. 2004 Mar;13(1):9-17
Publication Type
Article
Date
Mar-2004
Author
Ulrica Hörberg
David Brunt
Asa Axelsson
Author Affiliation
School of Social and Health Sciences, Halmstad University, Halmstad, Sweden. ulrica.horberg@ivosa.vxu.se
Source
Int J Ment Health Nurs. 2004 Mar;13(1):9-17
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude to Health
Community Mental Health Services - organization & administration
Female
Health Care Reform
Humans
Male
Mentally Ill Persons - psychology
Middle Aged
Nurse-Patient Relations
Psychiatric Nursing - methods
Sweden
Abstract
The Mental Health Care reform in Sweden aimed, among other things, to improve the possibilities for persons with mental illnesses to experience companionship and participation in society. The aim of the study was to describe how persons suffering from mental illness perceive their relationships with nursing staff in local authority psychiatric services. Data were collected through semi-structured recorded interviews with 17 strategically chosen clients. A qualitative approach inspired by phenomenography was used to analyse the data. The analysis resulted in four main categories and 13 subcategories. The main categories were: security, companionship, confirmation and development.
PubMed ID
15009374 View in PubMed
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Concurrent validity and clinical utility of the HCR-20V3 compared with the HCR-20 in forensic mental health nursing: similar tools but improved method.

https://arctichealth.org/en/permalink/ahliterature264821
Source
J Forensic Nurs. 2014 Oct-Dec;10(4):234-42
Publication Type
Article
Author
Stål Bjørkly
Gunnar Eidhammer
Lars Erik Selmer
Source
J Forensic Nurs. 2014 Oct-Dec;10(4):234-42
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Forensic Nursing
Forensic Psychiatry
Humans
Mentally Ill Persons - psychology
Norway
Psychiatric Nursing
Risk Assessment - methods
Risk Management
Violence - psychology
Abstract
The main scope of this small-scale investigation was to compare clinical application of the HCR-20V3 with its predecessor, the HCR-20. To explore concurrent validity, two experienced nurses assessed 20 forensic mental health service patients with the tools. Estimates of internal consistency for the HCR-20 and the HCR-20V3 were calculated by Cronbach's alpha for two levels of measurement: the H-, C-, and R-scales and the total sum scores. We found moderate (C-scale) to good (H- and R- scales and aggregate scores) estimates of internal consistency and significant differences for the two versions of the HCR. This finding indicates that the two versions reflect common underlying dimensions and that there still appears to be differences between V2 and V3 ratings for the same patients. A case from forensic mental health was used to illustrate similarities and differences in assessment results between the two HCR-20 versions. The case illustration depicts clinical use of the HCR-20V3 and application of two structured nursing interventions pertaining to the risk management part of the tool. According to our experience, Version 3 is superior to Version 2 concerning: (a) item clarity; (b) the distinction between presence and relevance of risk factors; (c) the integration of risk formulation and risk scenario; and (d) the explicit demand to construct a risk management plan as part of the standard assessment procedure.
PubMed ID
25411814 View in PubMed
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Consideration of the influence of place on access to employment for persons with serious mental illness in northeastern Ontario.

https://arctichealth.org/en/permalink/ahliterature122182
Source
Rural Remote Health. 2012;12:2034
Publication Type
Article
Date
2012
Author
K L Rebeiro Gruhl
C. Kauppi
P. Montgomery
S. James
Author Affiliation
Community Mental Health and Addictions Program, Health Sciences North, Sudbury, Ontario, Canada. krebeiro@persona.ca
Source
Rural Remote Health. 2012;12:2034
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Community-Based Participatory Research
Educational Status
Employment - statistics & numerical data
Employment, Supported - methods - psychology - statistics & numerical data
Female
Financing, Government - methods - statistics & numerical data
Health Status Disparities
Humans
Male
Mental Disorders - diagnosis - psychology
Mentally Ill Persons - psychology - statistics & numerical data
Middle Aged
Ontario
Organizational Case Studies
Questionnaires
Rehabilitation, Vocational - psychology - statistics & numerical data
Research Design
Residence Characteristics
Rural Population - statistics & numerical data
Social Class
Urban Population - statistics & numerical data
Abstract
Despite increasing attention to employment within the mental health sector, reports indicate that people with serious mental illness (SMI) continue to experience limited employment success in the province of Ontario, Canada. Research specifies that people with SMI who live in rural places are less likely than those living in urban centers to have access to satisfactory employment services or to become gainfully employed. The objective of this study was to examine access to employment from the perspectives of people with SMI, mental health and vocational service providers, and decision-makers, and to explore whether place influenced their access to work in northeastern Ontario.
A qualitative case study using community-based participatory research methods was chosen to examine the experience of access to competitive employment in two northeastern Ontario communities. The cases selected for study were two geographic areas in northeastern Ontario which provided best-practice, mental health services to persons with SMI. Community-based site partners advertised and recruited participants, and a consumer advisory provided input on key stakeholders, questions, findings and the study action plan. The study findings were informed by individual and group interviews conducted with 46 individuals who resided in both rural and urban settings in the case communities, and feedback from 49 participants who attended town hall forums for presentation of study findings and development of an action plan. The qualitative data was supported by a secondary data source reporting on the employment outcomes of 4112 people with SMI who received disability income support and who resided in the case communities. Qualitative data were analyzed inductively, and categories and themes were developed. Findings were member checked with all informants and town hall participants in each case community.
This article draws on the findings of a larger study and reports on the influence of place to the low employment success experienced by people with SMI who reside in the case communities; 91.3% of those receiving disability income support are unemployed, and rural residents experience higher levels of unemployment than those in urban places. Place was found to influence access to employment in five ways: by limited access to employment support services in rural places, and to recommended ratios in urban places; by the use of different models and practices that were inconsistent with best practices for people with SMI; by the lack of a plan for the implementation of employment services in the case communities; by limited use of the available, dedicated vocational resources for employment purposes; and by inadequate supports provided to persons with SMI who wish to enter the workforce. The results also underscore how people with SMI continue to be perceived negatively regarding their capacity for employment. Such stereotypical attitudes additionally contributed to employment marginalization of people with SMI from the workforce, especially in rural communities.
The study highlights the influence of geography and human resources to the implementation of best practice employment services and supports for persons with SMI. Important policy implications include the need to consider place when implementing evidence-based practices in places where geography, distance and human health resources limit the communities' capacity to successfully do so. The study also underscores the need to build community capacity for supported employment, especially in rural places, in order to improve the participation of people with SMI in employment, and subsequently, to help shift the communities' thinking about their capacity for work.
PubMed ID
22839731 View in PubMed
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Considering the care of the suicidal client and the case for 'engagement and inspiring hope' or 'observations'.

https://arctichealth.org/en/permalink/ahliterature188316
Source
J Psychiatr Ment Health Nurs. 2002 Oct;9(5):611-21
Publication Type
Article
Date
Oct-2002
Author
J R Cutcliffe
P. Barker
Author Affiliation
Faculty of Nursing, University of Alberta, Edmonton, Canada.
Source
J Psychiatr Ment Health Nurs. 2002 Oct;9(5):611-21
Date
Oct-2002
Language
English
Publication Type
Article
Keywords
Canada
Community Mental Health Services
England
Ethics, Nursing
Humans
Mentally Ill Persons - psychology
Models, Nursing
Nurse's Role
Nurse-Patient Relations
Nursing Assessment
Practice Guidelines as Topic
Psychiatric Nursing - methods
Suicide
Abstract
Psychiatric/mental health (P/MH) nursing has rightly been described as a 'broad church', and one that contains many contested matters and areas of differing opinion. One such contested matter is that of the appropriate care for the person who is at risk of suicide. Recent, albeit limited, debate of this issue has taken place, and the literature, such as it is, indicates two principal (though linked) positions. These can be summarized as the 'engagement and hope inspiration' position and the 'observations' position. Given the P/MH nurse's unique position in providing 24-hour, day-to-day care to suicidal clients and the growing problem of suicide within people who suffer from mental health problems, it is both necessary and perhaps timely to consider this debate in more detail. Accordingly, this paper considers the debate regarding care for suicidal mental health care clients. First, the paper briefly describes the historical policy context of care for the suicidal client. Next, it focuses on 'observations' and concludes that there is a range of well-established, empirically based problems or drawbacks to this approach. Following this, it focuses on 'engagement, inspiring hope' and points out the key processes of engagement: forming a relationship, a human-human connection, conveying acceptance and tolerance, and hearing and understanding. The value and importance of these most fundamental of interpersonal processes is described and alluded to throughout the limited research into care of the suicidal client. The paper then describes the range of criticisms that have been levelled at the engagement-inspiring hope approach and considers these criticisms in more detail. As a result of this detailed examination, the paper then reiterates the need to replace 'observations' with 'engagement-hope inspiration' as the principal approach to caring for suicidal mental health clients.
PubMed ID
12358715 View in PubMed
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Cross-validation of the Self-Appraisal Questionnaire with a maximum-security psychiatric population.

https://arctichealth.org/en/permalink/ahliterature183071
Source
J Interpers Violence. 2003 Nov;18(11):1325-34
Publication Type
Article
Date
Nov-2003
Author
David B Villeneuve
Neil Oliver
Wagdy Loza
Author Affiliation
Collins Bay Institution, Kingston, Ontario, Canada.
Source
J Interpers Violence. 2003 Nov;18(11):1325-34
Date
Nov-2003
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cross-Sectional Studies
Forensic Psychiatry - methods
Hospitals, Psychiatric
Humans
Male
Mentally Ill Persons - psychology
Middle Aged
Psychometrics
Questionnaires - standards
Recurrence - prevention & control
Reproducibility of Results
Risk Assessment - methods
Self-Assessment
Sex Offenses - psychology
Young Adult
Abstract
The Self-Appraisal Questionnaire (SAQ) is a 72-item, self-report measure designed to predict recidivism, supervision violations, and related behaviors among nonmentally disordered Canadian federal offenders. In the present article, the authors demonstrate that the SAQ maintains satisfactory predictive validity on cross-validation with a high-risk correctional psychiatric sample.
PubMed ID
19774768 View in PubMed
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55 records – page 1 of 6.