Paradigm 8: Community Care Is Destigmatizing

2013 ◽  
Author(s):  
Heather Stuart ◽  
Julio Arboleda-Flórez ◽  
Norman Sartorius
Keyword(s):  
Mental Illness ◽  
Community Care ◽  
Social Stigma ◽  
Safety Net ◽  
Poor Quality ◽  
Community Services ◽  
Negative Consequences ◽  
Health Movement ◽  
Community Mental Health Movement

Chapter 9 addresses how there have been many negative consequences for people with a mental illness as a result of the rapid deinstitutionalization of mental hospitals without appropriate community services to provide a safety net. These have included criminalization, increased stigmatization, social exclusion, poor quality of care, and poorer health outcomes. It covers how these problems challenge the notion that the community mental health movement has been a destigmatizing force leading to greater social participation for people with a mental illness. Because they are now more visible, and often less supported by treatment systems, people with a mental illness living in the community may be at greater risk of experiencing social stigma.

Body dysmorphic disorder

2020 ◽  
pp. 1031-1042
Author(s):  
Megan M. Kelly ◽  
Katharine A. Phillips
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Suicidal Ideation ◽  
Functional Impairment ◽  
Clinical Characteristics ◽  
Body Dysmorphic Disorder ◽  
Psychosocial Interventions ◽  
Poor Quality ◽  
Clinical Settings

Body dysmorphic disorder (BDD) is a common and unusually severe mental illness, characterized by distressing or impairing preoccupations with non-existent or slight defects in one’s physical appearance, as well as compulsive behaviours, that aim to examine, improve, hide, or obtain reassurance about the perceived defects. BDD is associated with poor quality of life and marked functional impairment, as well as high rates of suicidal ideation and behaviours. Although BDD is often under-recognized in clinical settings, both pharmacotherapy and psychosocial interventions are effective at reducing BDD symptoms and distress. This chapter presents information on the phenomenology, clinical characteristics, diagnosis, epidemiology, pathogenesis, course, and treatment of BDD.

scholarly journals Leprosy review

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Lehlohonolo Makhakhe
Keyword(s):  
Negative Impact ◽  
Social Stigma ◽  
Medical Science ◽  
Poor Quality ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Multiple Organs ◽  
Immunodeficiency Virus ◽  
Significant Negative Impact

Leprosy (Hansen’s disease) can affect multiple organs and body structures. Skin signs are typically observed in the early phase of the disease, hence being the first identifiable signs to propel clinical suspicion. Leprosy predominantly affects the skin and peripheral nerves. The disease has been documented many centuries preceding the biblical era. Over many decades, the classification of Hansen’s disease has changed as modern medical science evolved. Patients with leprosy are usually subjected to discrimination, rejection from society and can suffer from social stigma, poor quality of life (QoL), low self-esteem and permanent disfigurements. Studies have shown that leprosy has a significant negative impact on the patients’ QoL. Leprosy is often not suspected by practicing clinicians because it is no longer emphasised in the medical curricula. In modern years, attention has gradually shifted from leprosy to tuberculosis (TB) and human immunodeficiency virus (HIV).

scholarly journals Einkarekstur eða ríkisrekstur í heilsugæslu: Samanburður á kostnaði og ánægju með þjónustu

2018 ◽  
Vol 14 (2) ◽  
pp. 69-84
Author(s):  
Héðinn Sigurðsson ◽  
Sunna Gestsdóttir ◽  
Sigríður Halldórsdóttir ◽  
Kristjan G. Guðmundsson
Keyword(s):  
Health Care ◽  
Consumer Satisfaction ◽  
Low Cost ◽  
Safety Net ◽  
Community Services ◽  
Quality Of Services ◽  
Private Health Care ◽  
The Cost ◽  
Health Care Centers

The organization of health care is one of the most complex present day challenges. Like other countries that run socialized health care systems, Icelanders face the question of the role of private enterprise in health care. The objective of this study was two-fold: to compare the cost of 17 private and state-run health care centers in the metropolitan area, and to compare consumer satisfaction related to these. At the beginning of Icelandic settlement, there were statutory laws decreeing that community services should be provided for those in need. By the Health Care Act in 1973, the Icelandic health care system fell under the Nordic welfare society with equal access and a tight safety net. The results show that the private health care centers had a low cost per work unit, but not the lowest. Four to seven state run health care centers had less expenditure per patient than the private centers. The cost of each doctor’s position was highest in one of the private clinics. Patient satisfaction surveys showed that there is no difference in the quality of services between these two different operating modes. A conclusion can be drawn from this study that it is not clear whether private health care improves the use of public funds or increases the quality of services.

scholarly journals Newspaper Articles Related to the Not Criminally Responsible on Account of Mental Disorder (NCRMD) Designation: A Comparative Analysis

2017 ◽  
Vol 62 (10) ◽  
pp. 697-701 ◽  
Author(s):  
Rob Whitley ◽  
JiaWei Wang ◽  
Victoria Carmichael ◽  
Ruth Wellen
Keyword(s):  
Mental Illness ◽  
Quality Of Care ◽  
Mental Disorder ◽  
Poor Quality ◽  
Major Theme ◽  
Not Criminally Responsible ◽  
The Media ◽  
Negative Tone ◽  
Newspaper Articles

Objective: The not criminally responsible on account of mental disorder (NCRMD) designation remains widely misunderstood by the public. Such misunderstandings may also be reflected in the media. As such, the aim of this study is to conduct a preliminary examination of the tone and content of recent Canadian newspaper articles where NCRMD is a major theme, comparing these to generic articles about mental illness. Methods: Articles about mental illness were gathered from major Canadian newspapers. These were then divided into two categories: 1) articles where NCRMD was a major theme and 2) articles where NCRMD was not a major theme. Articles were then coded for the presence or absence of 1) a negative tone, 2) stigmatising tone/content, 3) recovery/rehabilitation as a theme, and 4) shortage of resources/poor quality of care as a theme. Results: The retrieval strategy resulted in 940 articles. Fourteen percent ( n = 131) of all articles had NCRMD as a major theme. In comparison to generic articles about mental illness, articles with NCRMD as a major theme were significantly more likely to have a negative tone ( P < 0.001) and stigmatising tone/content ( P < 0.001) and significantly less likely to have recovery/rehabilitation ( P < 0.001) or shortage of resources/poor quality of care as a theme ( P < 0.001). Conclusions: Articles with NCRMD as a theme were overwhelmingly negative and almost never focused on recovery or rehabilitation, in stark comparison to generic articles about mental illness.

scholarly journals Multimorbidity, Mental Illness, and Quality of Care: Preventable Hospitalizations among Medicare Beneficiaries

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Mayank Ajmera ◽  
Tricia Lee Wilkins ◽  
Patricia A. Findley ◽  
Usha Sambamoorthi
Keyword(s):  
Mental Illness ◽  
Quality Of Care ◽  
Poor Quality ◽  
Medicare Beneficiaries ◽  
Medicare Current Beneficiary Survey ◽  
Preventable Hospitalizations ◽  
Significant Difference ◽  
Logistic Regressions ◽  
Ambulatory Care Sensitive Hospitalizations

Background. Individuals with multimorbidity are vulnerable to poor quality of care due to issues related to care coordination. Ambulatory care sensitive hospitalizations (ACSHs) are widely accepted quality indicators because they can be avoided by timely, appropriate, and high-quality outpatient care. Objective. To examine the association between multimorbidity, mental illness, and ACSH. Study Design. We used a longitudinal panel design with data from multiple years (2000–2005) of Medicare Current Beneficiary Survey. Individuals were categorized into three groups: (1) multimorbidity with mental illness (MM/MI); (2) MM/no MI; (3) no MM. Multivariable logistic regressions were used to analyze the association between multimorbidity and ACSH. Results. Any ACSH rates varied from 10.8% in MM/MI group to 8.8% in MM/No MI group. Likelihood of any ACSH was higher among beneficiaries with MM/MI (AOR = 1.62; 95% CI = 1.14, 2.30) and MM (AOR = 1.54; 95% CI = 1.12, 2.11) compared to beneficiaries without multimorbidity. There was no statistically significant difference in likelihood of ACSH between MM/MI and MM/No MI groups. Conclusion. Multimorbidity (with or without MI) had an independent and significant association with any ACSH. However, presence of mental illness alone was not associated with poor quality of care as measured by ACSH.

scholarly journals Healthcare Providers’ Knowledge and Current Practice of Pain Assessment and Management: How Much Progress Have We Made?

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Khawla Nuseir ◽  
Manal Kassab ◽  
Basima Almomani
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Treatment Guidelines ◽  
Healthcare Providers ◽  
Poor Quality ◽  
Negative Consequences ◽  
Significant Difference ◽  
Level Of Knowledge ◽  
Insufficient Knowledge

Context. Despite improvement in pain management and availability of clinical treatment guidelines, patients in Jordan are still suffering from pain. Negative consequences of undertreated pain are being recognized as a reason for further illnesses and poor quality of life. Healthcare providers (HCPs) are responsible for relieving pain of their patients.Objective. To evaluate the knowledge and attitudes of HCPs toward pain management in Jordan.Methods. A 16-item questionnaire with agree or disagree options was given to 662 HCPs in seven hospitals in Jordan who volunteered to participate in the study. Following data collection, the responses were coded and entered into SPSS.Results. There was a statistically significant difference (p<0.004) in percentage scores between physicians (36%) and pharmacists (36%) versus nurses (24%). The level of knowledge was the best among physicians, followed by pharmacists specifically in the area of cancer pain management. Nurses scored the lowest for knowledge of pain assessment and management among HCPs. However, HCPs overall scores indicated insufficient knowledge specifically in relation to pain assessment and management among children.

Homicides by people with mental illness: myth and reality

1999 ◽  
Vol 174 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Pamela J. Taylor ◽  
John Gunn
Keyword(s):  
Mental Illness ◽  
Substance Misuse ◽  
Community Care ◽  
Care Model ◽  
Home Office ◽  
High Profile ◽  
People With Mental Illness ◽  
Annual Decline ◽  
Criminal Statistics

BackgroundTragic and high-profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed.AimsTo consider whether such homicides have become more frequent as psychiatric services have changed.MethodData were extracted from Home Office-generated criminal statistics for England and Wales between 1957 and 1995 and subjected to trends analysis.ResultsThere was little fluctuation in numbers of people with a mental illness committing criminal homicide over the 38 years studied, and a 3% annual decline in their contribution to the official statistics.ConclusionsThere are many reasons for improving the resources and quality of care for people with a mental disorder, but there is no evidence that it is anything but stigmatising to claim that their living in the community is a dangerous experiment that should be reversed. There appears to be some case for specially focused improvement of services for people with a personality disorder and/or substance misuse.

scholarly journals Towards community care: Qatar's rapidly evolving mental health landscape

2021 ◽  
pp. 1-3
Author(s):  
Barry Solaiman ◽  
Suhaila Ghuloum
Keyword(s):  
Mental Health ◽  
Community Care ◽  
Social Stigma ◽  
Mental Healthcare ◽  
Community Services ◽  
The Past ◽  
Significant Attention

An undercurrent of change is occurring in Qatar's approach towards mental healthcare. In the past 5 years, significant attention has been given to community care initiatives. There is much progress to be made, but the provision of psychiatric support outside of hospitals, the launch of several community services and the tackling of the associated social stigma represent a marked step away from the norm that has usually pervaded in the region. This article analyses these changes and identifies the challenges that remain.

scholarly journals The quality of semi-finished steel

2019 ◽  
pp. 102-107
Author(s):  
A. G. Anisovich
Keyword(s):  
Oil And Gas ◽  
Cold Treatment ◽  
Oil And Gas Industry ◽  
Poor Quality ◽  
Negative Consequences ◽  
Gas Industry ◽  
Finished Steel ◽  
Quality Of Delivery ◽  
Free Cementite

The article deals with the quality of structural steel supplied by metallurgical enterprises. It is shown that the pipes made of steel 20, used in the oil and gas industry, contain structurally free cementite in the structure, often in the form of a grid (points 4 and 5 according to GOST 5640–68). This structure is the cause of faulty production: the subsequent cold treatment pressure formed sags on the surface of the product, and there is a violation of the continuity of the material up to the formation of through cracks. Formation of structurally-free cementite in steel 40KHN2MA with structure of the top bainite which was formed at violation of regulations of heat treatment of a semi-finished product is also found. When nitriding with heating to 490 ° C and holding at this temperature, there was a decay of bainite with the formation of tertiary cementite along the grain boundaries. Discussed the possibility of culling the poor quality of delivery at the consumer. It is also noted that many enterprises have now abolished entrance control, which has the most negative consequences both in terms of product quality and safety, especially in the oil and gas industry.

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