scholarly journals Mental Hospitals in India in the 21st century: transformation and relevance

2016 ◽  
Vol 26 (1) ◽  
pp. 10-15 ◽  
Author(s):  
P. Murthy ◽  
M. Isaac ◽  
H. Dabholkar
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Hospital ◽  
Limited Resources ◽  
Community Interventions ◽  
Mental Hospitals ◽  
The Family ◽  
The World ◽  
Community Facilities

Mental hospitals in India, as elsewhere in the world, have played an important role in the care of persons with mental illness. Since their inception, they have both been decried for gross violations of human rights and dignity as well as lauded as places of refuge and care for persons turned away by the communities. In a country where community interventions for mental health care are still fragmentary, the mental hospital still continues to be a relevant and legitimate locus of care along with other limited resources available for the care of persons with mental illness outside of the family. In India, positive changes in the infrastructure and resourcing of mental hospitals, reductions in involuntary admissions and improvements in facilities have largely occurred through judicial interventions. Recent pilot interventions for rehabilitation of long-stay patients point towards the need to develop rehabilitation and community facilities for persons with severe mental illness.

Psychiatry without Asylums: Origins and Prospects in Italy

1983 ◽  
Vol 13 (1) ◽  
pp. 119-129 ◽  
Author(s):  
Paolo Crepet ◽  
Giovanni De Plato
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Hospital ◽  
Institutional Reform ◽  
Mental Hospitals ◽  
The World ◽  
Private Citizens

In 1978, Italy became the first country in the world to pass a law eliminating mental hospitals and replacing them with services in the community. This victory was in large part due to the foresight and commitment of psychiatrist Franco Basaglia and his colleagues, whose work showed how psychiatric assistance could be realized in practice without asylums and without force and violence. This article analyzes why the anti-institutional reform took place in Italy when it did, and reviews twenty years of reform activity involving an alliance between democratic mental health professionals, politicians, workers' organizations, and private citizens. Although the reform gives psychiatry the opportunity to transform itself into a science of liberation, conservative political and scientific forces are attempting to maintain the logic of the asylum and replace the mental hospital with other institutions which continue to practice segregation in a decentralized form. The outcome of this radical experiment in creating a nonrepressive psychiatry remains uncertain.

Do we still need mental hospitals?

1997 ◽  
Vol 6 (S1) ◽  
pp. 29-48
Author(s):  
Lorenzo Burti
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Hospital ◽  
Psychiatric Care ◽  
Multidisciplinary Teams ◽  
The Past ◽  
Mental Hospitals ◽  
Custodial Care

“The debate is over” claimed a heading in a newspaper on the 1991 Amsterdam WHO conference ‘Changing mental health care in the cities of Europe’: “After half a century of debate of the issue of deinstitutionalisation the question is not any more if we should close the large mental hospitals, but what follows the closure and how to develop adequate community mental health care which replaces the functions of the mental hospital” (Gersons & Burns, 1992).These ‘functions’ have actually secured the long-lasting success of the mental hospital which has been in the past and, to a certain extent, still is in a number of countries, the cornerstone of psychiatric care. It incorporates all the functions of a psychiatric system in a single, usually isolated facility, including crisis intervention, evaluation, treatment, aftercare, long-term custodial care, rehabilitation, etc. In order to phase down the mental hospital these functions have to be supplemented by newly established, discrete services disseminated in the community. The process is clearly a complex one, since it implies a transition from a system of care provided only in mental hospitals under medical direction, to one that is comprehensive in scope, community-orientated, and staffed by multidisciplinary teams.

scholarly journals Family Centeredness in Mental Health: A Concept Analysis

2020 ◽  
Vol 2 (1) ◽  
pp. 48-70
Author(s):  
Iril Panes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Health Care Providers ◽  
Concept Analysis ◽  
Care Providers ◽  
Open Communication ◽  
Entire Family ◽  
The Family ◽  
Family Centeredness

Background: Mental illness affects the entire family structure. The family members are the main provider of care that results in caregiving burden. Thus, the care given should encompass the entire family system, termed as family centeredness. Purpose: This study clarifies the concept of "family centeredness" in mental health to enhance individual and family cares living amid mental illness. Methods: This research employed Walker and Avant's method of Concept Analysis. Literature was reviewed, and the characteristics that appeared repeatedly were noted and categorized. Data were mapped according to its definition, antecedents, attributes, and consequences. Results: Three key defining attributes were identified: (a) A mutual, collaborative partnership between the patient, family and health care providers based on knowledge exchange, open communication and cooperation; (b) A supportive, professional relationship/bond/engagement among health care providers, patient and family characterized by empathy, understanding, respect and empowerment; and (c) Individualized care wherein the process is defined by the family is supported, enabling the opportunity to choose, control over decisions and empowerment. Conclusion: The result of the study clearly defines family centeredness as a health care approach in mental health that acknowledges the patient and family as the experts on themselves, involves families as collaborative partners in all aspects of services and decisions about care through mutually beneficial supportive partnerships with health care providers; to help patients make progress towards recovery.

scholarly journals One dose of Architecture, taken daily: Building for Mental Health in New Zealand

2021 ◽  
Author(s):  
◽  
Rebecca McLaughlan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
New Zealand ◽  
Mentally Ill ◽  
Mental Hospital ◽  
Institutional Care ◽  
Hospital Design ◽  
Mental Hospitals ◽  
History Of ◽  
The Government

<p>Thousands of New Zealanders were treated in the nation’s mental hospitals in the late nineteenth and twentieth centuries. Existing research has examined this history of institutionalisation from the perspectives of policy, psychiatric medicine and nursing culture, but to date little has been written about the built fabric of this type of institutional care. This dissertation asks what does the architectural approach taken to Seacliff Asylum (1878-84), Kingseat Hospital (1927-40) and Cherry Farm Hospital (1943-71) indicate about official attitudes to mental illness in New Zealand. Architecture was thought to be capable of performing a curative role in the treatment of mental illness; the administrators of New Zealand’s mental hospitals stated this belief publically in various press releases and reports to the government between 1878 and 1957. This dissertation examines Seacliff, Kingseat and Cherry Farm against current thought regarding the treatment of mental illness and against best architectural practice in mental hospital design.   While these three institutions were the jewels in the crown of New Zealand’s mental hospital network, only Kingseat could be considered an exemplary hospital of its time. The compromises that occurred in the construction of Seacliff, Kingseat and Cherry Farm hospitals indicate that meeting the needs of the mentally ill was only one of a number of agendas that were addressed by the officials involved in the design of these institutions. Many of these agendas were peripheral to the delivery of mental health care, such as the political desire for colonial propaganda and professional concerns of marginalisation, and conflicted with the attainment of ideal environments for the treatment of mental illness. The needs of the mentally ill were a low priority for successive New Zealand governments who exhibited a reluctance to spend taxpayer funds on patients who were not considered curable. The architects and medical advisors involved in the design of these facilities did attempt to meet the needs of these patients; however, they were limited by a design and procurement process that elevated political and operational concerns over the curative potential of these hospitals.   This dissertation also examines the role of individuals in the design of these institutions. Architect Robert Lawson was reproached for deficiencies in the curative potential of Seacliff Asylum. Similarly, medical administrator Theodore Gray has received criticism for limiting the development of New Zealand’s wider network of mental hospital care. This dissertation establishes that Lawson and Gray deserve greater recognition for their relative contributions to the architecture created, within New Zealand, for the treatment of mental illness.</p>

scholarly journals Young Adults and Their Families Living With Mental Illness: Evaluation of the Usefulness of Family-Centered Support Conversations in Community Mental Health care Settings

2020 ◽  
Vol 26 (4) ◽  
pp. 302-314
Author(s):  
Lisbeth Kjelsrud Aass ◽  
Hege Skundberg-Kletthagen ◽  
Agneta Schrøder ◽  
Øyfrid Larsen Moen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Young Adults ◽  
Community Mental Health ◽  
Everyday Life ◽  
Community Mental Health Care ◽  
Family Nursing ◽  
The Family ◽  
Family Centered

The aim of this study was to evaluate the usefulness of Family-Centered Support Conversations (FCSC) offered in community mental health care in Norway to young adults and their families experiencing mental illness. The FCSC is a family nursing intervention based on the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model and is focused on how family members can be supportive to each other, how to identify strengths and resources of the family, and how to share and reflect on the experiences of everyday life together while living with mental illness. Interviews were conducted with young adults and their family members in Norway who had received the FCSC intervention and were analyzed using phenomenography. Two descriptive categories were identified: “Facilitating the sharing of reflections about everyday life” and “Possibility of change in everyday life.” The family nursing conversations about family structure and function in the context of mental illness allowed families to find new meanings and possibilities in everyday life. Health care professionals can play an important role in facilitating a safe environment for young adults and their families to talk openly about the experience of living with and managing mental illness.

scholarly journals Family care for persons with severe mental illness: experiences and perspectives of caregivers in Uganda

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
F. Verity ◽  
A. Turiho ◽  
B. B. Mutamba ◽  
D. Cappo
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Low Income ◽  
Mental Hospital ◽  
Belief Systems ◽  
Hospital Readmissions ◽  
Family Care ◽  
The Family ◽  
The Impact

Abstract Background In low-income settings with limited social protection supports, by necessity, families are a key resource for care and support. Paradoxically, the quality of family care for people living with Severe Mental Illness (PLSMI) has been linked to support for recovery, hospital overstay and preventable hospital readmissions. This study explored the care experiences of family members of PLSMI with patients at the national mental hospital in Kampala, Uganda, a low income country. This study was undertaken to inform the development of YouBelongHome (YBH), a community mental health intervention implemented by YouBelong Uganda (YBU), a registered NGO in Uganda. Methods Qualitative data was analysed from 10 focus groups with carers of ready to discharge patients on convalescent wards in Butabika National Referral Mental Hospital (BNRMH), Kampala. This is a subset of data from a mixed methods baseline study for YouBelong Uganda, undertaken in 2017 to explore hospital readmissions and community supports for PLSMI from the Wakiso and Kampala districts, Uganda. Results Three interrelated themes emerge in the qualitative analysis: a range of direct, practical care provided by the caregiver of the PLSMI, emotional family dynamics, and the social and cultural context of care. The family care giving role is multidimensional, challenging, and changing. It includes protection of the PLSMI from harm and abuse, in the context of stigma and discrimination, and challenging behaviours that may result from poor access to and use of evidence-based medicines. There is reliance on traditional healers and faith healers reflecting alternative belief systems and health seeking behaviour rather than medicalised care. Transport to attend health facilities impedes access to help outside the family care system. Underpinning these experiences is the impact of low economic resources. Conclusions Family support can be a key resource and an active agent in mental health recovery for PLSMI in Uganda. Implementing practical family-oriented mental health interventions necessitates a culturally aware practice. This should be based in understandings of dynamic family relationships, cultural understanding of severe mental illness that places it in a spiritual context, different family forms, caregiving practices and challenges as well as community attitudes. In the Ugandan context, limited (mental) health system infrastructure and access to medications and service access impediments, such as economic and transport barriers, accentuate these complexities.

scholarly journals One dose of Architecture, taken daily: Building for Mental Health in New Zealand

2021 ◽  
Author(s):  
◽  
Rebecca McLaughlan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
New Zealand ◽  
Mentally Ill ◽  
Mental Hospital ◽  
Institutional Care ◽  
Hospital Design ◽  
Mental Hospitals ◽  
History Of ◽  
The Government

<p>Thousands of New Zealanders were treated in the nation’s mental hospitals in the late nineteenth and twentieth centuries. Existing research has examined this history of institutionalisation from the perspectives of policy, psychiatric medicine and nursing culture, but to date little has been written about the built fabric of this type of institutional care. This dissertation asks what does the architectural approach taken to Seacliff Asylum (1878-84), Kingseat Hospital (1927-40) and Cherry Farm Hospital (1943-71) indicate about official attitudes to mental illness in New Zealand. Architecture was thought to be capable of performing a curative role in the treatment of mental illness; the administrators of New Zealand’s mental hospitals stated this belief publically in various press releases and reports to the government between 1878 and 1957. This dissertation examines Seacliff, Kingseat and Cherry Farm against current thought regarding the treatment of mental illness and against best architectural practice in mental hospital design.   While these three institutions were the jewels in the crown of New Zealand’s mental hospital network, only Kingseat could be considered an exemplary hospital of its time. The compromises that occurred in the construction of Seacliff, Kingseat and Cherry Farm hospitals indicate that meeting the needs of the mentally ill was only one of a number of agendas that were addressed by the officials involved in the design of these institutions. Many of these agendas were peripheral to the delivery of mental health care, such as the political desire for colonial propaganda and professional concerns of marginalisation, and conflicted with the attainment of ideal environments for the treatment of mental illness. The needs of the mentally ill were a low priority for successive New Zealand governments who exhibited a reluctance to spend taxpayer funds on patients who were not considered curable. The architects and medical advisors involved in the design of these facilities did attempt to meet the needs of these patients; however, they were limited by a design and procurement process that elevated political and operational concerns over the curative potential of these hospitals.   This dissertation also examines the role of individuals in the design of these institutions. Architect Robert Lawson was reproached for deficiencies in the curative potential of Seacliff Asylum. Similarly, medical administrator Theodore Gray has received criticism for limiting the development of New Zealand’s wider network of mental hospital care. This dissertation establishes that Lawson and Gray deserve greater recognition for their relative contributions to the architecture created, within New Zealand, for the treatment of mental illness.</p>

A Tribute to the Late William J. Curran

1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
United Nations ◽  
Mental Health Care ◽  
Harvard University ◽  
Legal Medicine ◽  
General Assembly ◽  
International Institute ◽  
University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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