Projection and Introjection

2014 ◽  
Author(s):  
R.D. Hinshelwood
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
Mental Hospital ◽  
Community Care ◽  
Moral Agent ◽  
Ethical Principles ◽  
Organizational Dynamics ◽  
Dynamic Approach ◽  
Personal Functioning

Psychiatry straddles a medical approach to the mentally ill, and a dynamic approach to the experiences of severely disturbed people. One consequence of this is that ethical principles apply in different ways. The understanding of processes known as introjection, projection, and splitting seriously disrupt the functioning of a person and his ability to make adequate, responsible decisions. Severe mental illness can be regarded as the disruption of a moral agent, and in a sense treatment has to focus on the resumption of those functions that enable the person to take responsibility again. This chapter explores the ethics of the person’s loss of his personal functioning. Paternalism does not have a free rein, and needs to be carefully used as it supplants autonomy. Over-extended paternalistic care leads to excessive depletion of the patient, and was apparent in the old mental hospital as it still is in contemporary community care as specific organizational dynamics.

scholarly journals Management aspects of care for the homeless mentally ill

1996 ◽  
Vol 2 (4) ◽  
pp. 158-165 ◽  
Author(s):  
P. Timms
Keyword(s):  
Mental Illness ◽  
Inner City ◽  
Severe Mental Illness ◽  
Social Service ◽  
Mentally Ill ◽  
Economically Disadvantaged ◽  
High Unemployment ◽  
People With Mental Illness ◽  
Homeless Mentally Ill ◽  
The Continuum

People with mental illness have always been marginalised and economically disadvantaged. Warner (1987) has shown that this is particularly true in times of high unemployment. Poor inner-city areas have excessive rates of severe mental illness, usually without the health, housing and social service provisions necessary to deal with them (Faris & Dunham, 1959). The majority of those who suffer major mental illness live in impoverished circumstances somewhere along the continuum of poverty. Homelessness, however defined, is the extreme and most marginalised end of this continuum, and it is here that we find disproportionate numbers of the mentally ill.

scholarly journals Severe persistent mental illness

1992 ◽  
Vol 16 (12) ◽  
pp. 743-745 ◽  
Author(s):  
Peter F. Liddle
Keyword(s):  
Mental Illness ◽  
Mental Hospital ◽  
Community Care ◽  
Community Setting ◽  
Detailed Examination ◽  
Mental Illnesses ◽  
Persistent Mental Illness ◽  
Realistic Appraisal

Many patients with persistent mental illnesses enjoy a better life in a community setting than would be possible in a long stay mental hospital. Furthermore, the available evidence indicates that most such patients get better while living in the community. Unfortunately, community care has not served all patients well. Much of the difficulty can be attributed to lack of resources. However, there is also a tendency by planners to underestimate the severity of patients' disabilities. A realistic appraisal demands a detailed examination of the problems of patients whose needs have not been met by community care. One important issue is that of patients who fall through the net of community care and another is that of patients who have not but nonetheless have not survived in the community. This paper addresses the question of the needs of this latter group.

scholarly journals Dual Diagnosis as a Tool for Therapists and Social Workers

2017 ◽  
Vol 3 (3) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Severe Mental Illness ◽  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Psychoactive Substances

The problem of dual diagnosis described as the first in Poland Lehmann in 1993. He noticed that for people with dual diagnosis is needed different diagnostic and therapeutic-specific approach and that social services (Lehman, 2000; Le hman 1993; Lehman, Myers 1994). Clinical experience suggests the need for a clear separation of this group of patients from both patients and the mentally ill odwykowo. T HAT approach allows to carry out homogeneous diagnostic psychiatric patients. Such ayodrębnienie It is dictated by the difficulties of diagnostic and therapeutic (Siegfried 1998; Sciacca 1991; Lehman, 1998). One clinical term for such a diverse group of patients do not permit a homogeneous diagnostic tests and determine the needs, problems and medical treatment and social services. Interest in this group of patients is not only due to cognitive reasons, but also due to the increasing number of people with dual diagnosis, more effective treatment and social assistance. Another reason is the rapidly growing number of people with PD. This group represents a challenge for physicians, social workers (Crome, Myton 2004; Lehman 2000; Alaja, Sepia1998).Clinical studies confirm the phenomenon of interactivity in which a mentally ill person is at high risk of developing mood-dependent dependence, particularly alcohol and those who are at high risk for mental illness (Lehman 2000).Dual diagnosis is the term defining the clinical coexistence in the same person from one side of a mental disorder, and disorders related to psychoactive substances, mostly drugs and / or alcohol (Abel-Saleh 2004; Crome, Myton 2004). The population of patients with dual diagnosis is large and varies widely in type and severity of the mental illness, the type of psychoactive agents and specific disorders resulting from the adoption of psychoactive substances, psychological and social skills which is obtained support and other factors (Lehman 1996; Ridgely 1987), such as schizophrenia. Severe mental illness (severe mental illness) as a concept which takes into account the clinical diagnosis (diagnosis) the degree of impairment of (disability) and duration of disorder (duration). This criterion includes serious mental breakdowns such as schizophrenia, bipolar affective disorder, depression. These disorders seriously impair people-to-people contact, self-care. Treatment of people with dual diagnosis is a problem because it results from the combination of two extremely different ways of dealing with mental illness and addiction.

scholarly journals Dual Diagnosis as a Tool for Therapists and Social Workers

2017 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Severe Mental Illness ◽  
Social Workers ◽  
Social Services ◽  
Dual Diagnosis ◽  
Mentally Ill ◽  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Psychoactive Substances

The problem of dual diagnosis described as the first in Poland Lehmann in 1993. He noticed that for people with dual diagnosis is needed different diagnostic and therapeutic-specific approach and that social services (Lehman, 2000; Le hman 1993; Lehman, Myers 1994). Clinical experience suggests the need for a clear separation of this group of patients from both patients and the mentally ill odwykowo. T HAT approach allows to carry out homogeneous diagnostic psychiatric patients. Such ayodrębnienie It is dictated by the difficulties of diagnostic and therapeutic (Siegfried 1998; Sciacca 1991; Lehman, 1998). One clinical term for such a diverse group of patients do not permit a homogeneous diagnostic tests and determine the needs, problems and medical treatment and social services. Interest in this group of patients is not only due to cognitive reasons, but also due to the increasing number of people with dual diagnosis, more effective treatment and social assistance. Another reason is the rapidly growing number of people with PD. This group represents a challenge for physicians, social workers (Crome, Myton 2004; Lehman 2000; Alaja, Sepia1998).Clinical studies confirm the phenomenon of interactivity in which a mentally ill person is at high risk of developing mood-dependent dependence, particularly alcohol and those who are at high risk for mental illness (Lehman 2000).Dual diagnosis is the term defining the clinical coexistence in the same person from one side of a mental disorder, and disorders related to psychoactive substances, mostly drugs and / or alcohol (Abel-Saleh 2004; Crome, Myton 2004). The population of patients with dual diagnosis is large and varies widely in type and severity of the mental illness, the type of psychoactive agents and specific disorders resulting from the adoption of psychoactive substances, psychological and social skills which is obtained support and other factors (Lehman 1996; Ridgely 1987), such as schizophrenia. Severe mental illness (severe mental illness) as a concept which takes into account the clinical diagnosis (diagnosis) the degree of impairment of (disability) and duration of disorder (duration). This criterion includes serious mental breakdowns such as schizophrenia, bipolar affective disorder, depression. These disorders seriously impair people-to-people contact, self-care. Treatment of people with dual diagnosis is a problem because it results from the combination of two extremely different ways of dealing with mental illness and addiction.

When Non-Compliance Carries the Day: Evaluating the Effectiveness of an Employment Program for the Severely Mentally Ill

2021 ◽  
pp. 0193841X2110496
Author(s):  
Alberto Martini ◽  
Enrico Rettore ◽  
Gian Paolo Barbetta ◽  
Fabio Sandrolini
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
Mental Disease ◽  
Empirical Studies ◽  
Experimental Period ◽  
Employment Rate ◽  
Severely Mentally Ill ◽  
Employment Rates ◽  
The Impact

Background: Mental disease is increasing worldwide and people who suffer from it show lower employment rates and lower earnings. Various approaches have been tried to increase the employment rate of people with mental disease. In the US, empirical studies show that individual placement and support(IPS)—a rapid transition to the job market, with some external assistance—is effective in increasing the employment rate of the mentally ill. Europe lacks such evidence. Purpose: The study assesses the impact of an IPS-like program undertaken in Italy on the employment rate of people with severe mental illness. Methods: The analysis is based on a RCT that tests whether offering people with severe mental illness the support of a “job coach” increases their chances of being employed. Moreover, using a battery of tests—one of which is made available by the RCT itself—we show that the large non-compliance with the protocol showed by the RCT is ignorable. This motivates estimating the impact of carrying out a traineeship during the experimental period on employment using non-experimental methods. Results and Conclusions: The study finds that the availability of a coach boosts the patients’ chances of finding a traineeship during the experimental period; moreover, undertaking a traineeship almost doubles the likelihood of being at work one year later. JEL CODES: J78, J48, J38

Confronting 60 Minutes’ “Imminent Danger”: The Evidence on Schizophrenia and Psychotropic Medications, Violence, and Forced Orders to Treat

2014 ◽  
Vol 16 (1) ◽  
pp. 51-62 ◽  
Author(s):  
Toby T. Watson
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
The United States ◽  
Psychotropic Medications ◽  
Television Show ◽  
Imminent Danger ◽  
The World

Recently, considerable attention has been given to individuals labeled “mentally ill,” with the possibility that they too often go untreated with psychotropic medications and in turn, commit disproportionally higher rates of violence. The world-known television show60 Minutesbroadcasted a special on this topic in the United States on September 29, 2013; however, they created a disturbingly inaccurate picture of those who suffer with what some label as “mental illness.” There are decades of peer-reviewed research demonstrating that individuals diagnosed with severe mental illness, labeledschizophrenia,and given psychotropic medications are in fact less likely to recover from their disorder and more likely to be rehospitalized. Additionally, although mental health commitments, often calledforced orders to treat,are quite common and now being supported more so due to such programming, the research on mental health commitments has not shown they are actually effective.

The Community's Tolerance of the Mentally Ill

1993 ◽  
Vol 162 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Ian F. Brockington ◽  
Peter Hall ◽  
Jenny Levings ◽  
Christopher Murphy
Keyword(s):  
Mental Illness ◽  
Factor Analysis ◽  
Mentally Ill ◽  
Mental Hospital ◽  
Community Based ◽  
Mental Hospitals ◽  
Main Components

A survey of attitudes to mental illness was conducted in a quota sample of about 2000 subjects in Malvern and Bromsgrove. Factor analysis showed three main components – benevolence, authoritarianism, and fear of the mentally ill. Residents of Bromsgrove, which is served by a traditional mental hospital, were slightly more tolerant than those living in Malvern, which has a community-based service, and has seen the closure of two mental hospitals in its vicinity during the last 10 years. The main demographic determinants of tolerance are age, education, occupation, and acquaintance with the mentally ill.

Coping with the Dual Demands of Severe Mental Illness and Parenting: The Parents' Perspective

2003 ◽  
Vol 84 (1) ◽  
pp. 109-118 ◽  
Author(s):  
Barry J. Ackerson
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Interpersonal Relationships ◽  
Mentally Ill ◽  
Role Reversal ◽  
Future Research ◽  
Single Parenthood ◽  
Sources Of Support ◽  
Boundary Issues

The experience of parenthood by individuals with severe mental illness has not been well studied. Research on mentally ill parents has focused on their pathology and the potential risk for their children without considering the parents' perspective. This qualitative study used interviews to explore how these parents coped with the dual demands of parenthood and their illness. Participants included individuals whose children are now young adults as well as those with younger children. Themes that emerged were problems with diagnosis and treatment, stigma, chaotic interpersonal relationships, the strain of single parenthood, custody issues, relationship with children, social support, and pride in being a parent. Follow-up interviews focused on the themes of relationship with children, strain of single parenthood, and sources of support. Relationship with children contained three specific topics: discipline, boundary issues, and role reversal. Implications for practice are discussed along with recommendations for future research involving other family members.

scholarly journals Collecting suicide statistics for the severely mentally ill

1996 ◽  
Vol 20 (8) ◽  
pp. 461-462 ◽  
Author(s):  
Riadh T. Abed
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
National Level ◽  
District Level ◽  
Department Of Health ◽  
Severely Mentally Ill ◽  
Year 2000

Since the Health of the Nation government document (Department of Health, 1992) set the target for the reduction of suicide in the severely mentally ill by 33% by the year 2000 it has become necessary to collect the suicide data for this population of patients at district and national level. There are a range of problems concerning the definition and identification of patients with severe mental illness as well as problems concerning the compilation of suicide data for this population at district level.

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