Spain

2020 ◽  
pp. 147-160
Author(s):  
Victor Aparicio Basauri
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Psychiatric Hospitals ◽  
Psychiatric Reform ◽  
The Relationship ◽  
Critical Movement

This chapter analyses the influence of Franco Basaglia and the organization ‘Psichiatria Democrática’ on the Spanish critical movements. These movements appeared in 1971 and were organized through a clandestine group known as the ‘Psychiatric Coordinator’. This organization linked professionals (mainly young psychiatrists) who had initiated innovative experiences in various psychiatric hospitals. These developments generated conflict when opposing the norms of the dictatorship. From 1975, and especially after the approval of the 1978 Constitution, the critical movement was a force for change in mental health structures in Spain, through the established organization, the Spanish Association of Neuropsychiatry. This effort made it possible to generate the psychiatric reform in 1985 that advocated community mental health and deinstitutionalization policies. Franco Basaglia began his contacts with the Spanish critical professionals in 1970, and the relationship was maintained periodically until 1980, the year of his death.

scholarly journals Community treatment orders and antipsychotic long-acting injections

2009 ◽  
Vol 195 (S52) ◽  
pp. s57-s62 ◽  
Author(s):  
Tim J. Lambert ◽  
Bruce S. Singh ◽  
Maxine X. Patel
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Legal Framework ◽  
Community Treatment ◽  
Mental Health Clinics ◽  
Health Clinics ◽  
Community Mental Health Clinics ◽  
Long Acting ◽  
The Relationship ◽  
Treatment Order

BackgroundThe community treatment order (CTO) is the legal framework by which people in the community are compelled to accept treatment. Both antipsychotic long-acting injections (LAIs) and CTOs are used to address treatment non-adherence.AimsTo investigate the relationship between CTOs and LAI use in patients with schizophrenia.MethodPrescribing, demographic and CTO data were collected for patients from four community mental health clinics in Melbourne, Australia, in 1998 and 2002.ResultsAgainst a background of increasing use of oral second-generation antipsychotic (SGA) medication and decreasing use of LAIs, the rates of CTO implementation doubled from 13% to 26% of patients with schizophrenia between 1998 and 2002. Proportionally more patients with a CTO are prescribed LAIs rather than oral SGAs.ConclusionsThe relationship between receiving an LAI and being subject to a CTO is significant, and reflects the consideration given to enhancing adherence in a community mental health setting.

scholarly journals “Caring for a Crisis”: Care and Control in Community Mental Health

2022 ◽  
Vol 12 ◽  
Author(s):  
Christien Muusse ◽  
Hans Kroon ◽  
Cornelis Lambert Mulder ◽  
Jeannette Pols
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Open Door Policy ◽  
Mental Health Team ◽  
Psychiatric Crisis ◽  
Crisis Care ◽  
Specific Care ◽  
And Control ◽  
Psychiatric Beds ◽  
The Relationship

In the debate on coercion in psychiatry, care and control are often juxtaposed. In this article we argue that this dichotomy is not useful to describe the more complex ways service users, care professionals and the specific care setting interrelate in a community mental health team (CMHT). Using the ethnographic approach of empirical ethics, we contrast the ways in which control and care go together in situations of a psychiatric crisis in two CMHT's: one in Trieste (Italy) and one in Utrecht (the Netherlands). The Dutch and Italian CMHT's are interesting to compare, because they differ with regard to the way community care is organized, the amount of coercive measures, the number of psychiatric beds, and the fact that Trieste applies an open door policy in all care settings. Contrasting the two teams can teach us how in situations of psychiatric crisis control and care interrelate in different choreographies. We use the term choreography as a metaphor to encapsulate the idea of a crisis situation as a set of coordinated actions from different actors in time and space. This provides two choreographies of handling a crisis in different ways. We argue that applying a strict boundary between care and control hinders the use of the relationship between caregiver and patient in care.

scholarly journals Decision Making in Psychiatric Reform: A Case Study of the Czech Experience

2019 ◽  
Vol 13 (2) ◽  
pp. 15-27
Author(s):  
Christopher G. Hudson ◽  
Eva Dragomirecka
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Community Mental Health ◽  
Planning Process ◽  
The United States ◽  
Soviet Bloc ◽  
Case Study Methodology ◽  
Psychiatric Reform ◽  
Trade Offs

Abstract This study examines the initial impact of a broadly participatory planning process in the Czech Republic during 2016–2017, aimed at both reducing inpatient care and expanding community mental health systems, on policy and programmatic decision making. A central focus of the study involves the trade-offs between and efforts to integrate shared decision making with evidence-based planning methods within the context of a national psychiatric reform strategy, particularly one involving a former Soviet bloc state. Given the uniqueness of the Czech experience, an exploratory case study methodology is used, one involving ten interviews with key informants and examination of a wide variety of documents. Results include the development of broad new decision and oversight structures, and the initial implementation of community mental health services. The nation faces some of the same trade-offs found elsewhere, such as in the United States, between an inclusive participatory process, and one that systematically incorporates empirical rational and evidence and best practices within bounded parameters. Implications for new psychiatric deinstitutionalization initiatives are identified, including development of a national mental health authority, a professional workforce, new funding strategies, multi-level service coordination, mechanisms to assure transparency, among others.

scholarly journals Social determinants for health (mental): evaluating a non-governmental experience from the perspective of actors involved

2014 ◽  
Vol 17 (suppl 2) ◽  
pp. 126-135 ◽  
Author(s):  
Maria Lucia Magalhães Bosi ◽  
Anna Karynne da Silva Melo ◽  
Liliane Brandão Carvalho ◽  
Veronica Morais Ximenes ◽  
Maria Gabriela Curubeto Godoy
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Social Inclusion ◽  
Methodological Approach ◽  
Multidimensional Analysis ◽  
Determinants Of Health ◽  
Environmental Behaviors ◽  
Psychiatric Reform ◽  
The Social ◽  
The Relationship

INTRODUCTION: The Brazilian Psychiatric Reform, an ongoing process, and its developments involve the construction of new ways of seeing the subject in illness, establishing the mental health field in a new way of understanding the social determinants that reflect in the deinstitutionalization and social inclusion. OBJECTIVE: This study, multidimensional analysis of the relationship between social determinants and deinstitutionalization in mental health focusing on a community movement in Northeast Brazil, whose proposed work is subjective and psychosocial dimensions, aims to explore and analyze how the experiences in course of the Movement highlights the importance of social determinants, the perspective of professionals. METHODS: The methodological approach outlined in the qualitative approach in the form of case studies, employing techniques such as interviews and focus groups. The categorization of analytical information was built from the relationship established between a model based on the constituent dimensions of the psychiatric reform, covering different planes, namely epistemological, healthcare, legal and socio-political, and social determinants of health - living conditions, and work environment, community networks and support, economic, cultural and environmental behaviors and lifestyles. RESULTS: The results show emphasis on the social subject, making the processing and knowledge of professionals, adding new ways to produce health; dialogue with multiple stakeholders, building autonomy, participative management, concern for professionalization; reorganizing the work process; appreciation of the everyday activities that weave and; invention of a new social site, among other elements in close interface with the determinants of health. CONCLUSION: These elements indicate that care practices woven into the daily life of the Movement involve the disassembling the traditional model of mental health care, stimulating new forms of citizenship, thus contributing to the institutionalization and promoting equality of income, social cohesion and participation policy for the promotion and protection of health.

scholarly journals Labyrinths of nursing training and the Brazilian National Mental Health Policy

2020 ◽  
Vol 73 (suppl 1) ◽  
Author(s):  
Juliana Jesus Baião ◽  
João Fernando Marcolan
Keyword(s):  
Mental Health ◽  
Mental Health Policy ◽  
Psychiatric Hospitals ◽  
Educational Institutions ◽  
Exploratory Research ◽  
Public And Private ◽  
Psychiatric Reform ◽  
Treatment Practice ◽  
Undergraduate Nursing ◽  
National Mental Health

ABSTRACT Objective: to analyze the training of nurses from public and private educational institutions of the city of São Paulo from the perspective of the Brazilian Psychiatric Reform. Methods: a qualitative, descriptive-exploratory research, using as methodological framework documentary analysis of the pedagogical projects of the participating institutions and content analysis of the interviews carried out with mental health professors. Results: it was identified that most mental health courses had insufficient workload for adequate training; theory emphasized the study of mental disorders and drug treatment; practice, in some schools, was carried out in psychiatric hospitals. There were problems that interfered with the quality of the education offered. Final considerations: educational institutions still did not offer training in undergraduate nursing from the perspective of the Brazilian Psychiatric Reform.

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