scholarly journals Management aspects of care for the homeless mentally ill

1996 ◽  
Vol 2 (4) ◽  
pp. 158-165 ◽  
Author(s):  
P. Timms

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.

2007 ◽  
Vol 191 (4) ◽  
pp. 343-350 ◽  
Author(s):  
Sheilagh Hodgins ◽  
Jane Alderton ◽  
Adrian Cree ◽  
Andrew Aboud ◽  
Timothy Mak

BackgroundSevere mental illness is associated with increased risk of aggressive behaviour, crime and victimisation. Mental health policy does not acknowledge this evidence. The number of forensic beds has risen dramatically.AimsTo examine the prevalence of aggressive behaviour, victimisation and criminality among people receiving in-patient treatment for severe mental illness in an inner-city area.MethodSelf-reports of aggressive behaviour and victimisation and criminal records were collected for 205 in-patients with severe mental illness.ResultsIn the preceding 6 months 49% of the men and 39% of the women had engaged in aggressive behaviour and 57% of the men and 48% of the women had been victims of assault; 47% of the men and 17% of the women had been convicted of at least one violent crime.ConclusionsAggressive behaviour and victimisation are common among severely mentally ill people requiring hospitalisation in the inner city. Rates of violent crime are higher than in the general population.


2009 ◽  
Vol 19 (1) ◽  
pp. 52-68 ◽  
Author(s):  
Elizabeth Young

Four published memoirs refute culturally dominant ideas about severe mental illness as personal weakness, as something shameful, and as a condition that necessarily leads to isolation and disenfranchisement. The narrative structure and content of the memoirs reveal that people’s experience differs from the hegemonic discourse: while narrating symptoms, diagnosis, treatment, and acceptance of the illness, all four authors present themselves as accomplished, self-possessed, and socially integrated. Their memoirs, and the act of narrating their experiences with mental illness, challenge the established cultural discourse of mental illness as limitation. The narratives help change that discourse and our social attitudes toward people with mental illness.


1992 ◽  
Vol 22 (4) ◽  
pp. 1027-1034 ◽  
Author(s):  
Lorna I. Hogg ◽  
Max Marshall

SynopsisHostels for the homeless contain many who are disabled by chronic mental illness but have little access to rehabilitation services. One approach to solving this problem might be to measure the needs of hostel residents in a standardized way and use this information as a basis for planning interventions. This study attempted to use the MRC Needs for Care Assessment Schedule to measure the needs of 46 mentally ill residents of Oxford hostels. It aimed to determine if a standardized assessment could be used in these difficult settings and if the needs it identified could form a useful basis for planning future interventions. Although it was possible to use the schedule, and although the pattern of need identified appeared broadly to reflect conditions in the hostels, it was not felt that the information produced was of sufficient quality to assist in planning services. The authors postulate that underlying this deficiency is the failure of the schedule to take sufficient account of the views of staff and residents.


2009 ◽  
Vol 194 (3) ◽  
pp. 278-284 ◽  
Author(s):  
Nisha Mehta ◽  
Aliya Kassam ◽  
Morven Leese ◽  
Georgia Butler ◽  
Graham Thornicroft

BackgroundUnderstanding trends in public attitudes towards people with mental illness informs the assessment of ongoing severity of stigma and evaluation of anti-stigma campaigns.AimsTo analyse trends in public attitudes towards people with mental illness in England and Scotland using Department of Health Attitudes to Mental Illness Surveys, 1994–2003.MethodWe analysed trends in attitudes for 2000 respondents in each survey year (6000 respondents in 1996 and 1997) using quota sampling methods and the adapted Community Attitudes Toward the Mentally Ill scale.ResultsComparing 2000 and 2003, there was significant deterioration for 17/25 items in England and for 4/25 items in Scotland. Neither country showed significant improvements in items between 2000 and 2003.ConclusionsPublic attitudes towards people with mental illness in England and Scotland became less positive during 1994–2003, especially in 2000–2003, and to a greater extent in England. The results are consistent with early positive effects for the ‘see me’ anti-stigma campaign in Scotland.


2017 ◽  
Vol 3 (3) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow

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.


2017 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Andrzej Lipczyński ◽  
Jarosław Kinal ◽  
Institute of Sociology University of Rzeszow

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.


2021 ◽  
pp. 0193841X2110496
Author(s):  
Alberto Martini ◽  
Enrico Rettore ◽  
Gian Paolo Barbetta ◽  
Fabio Sandrolini

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


2021 ◽  
pp. 000486742110422
Author(s):  
Jisu Choi ◽  
Josh Price ◽  
Samuel Ryder ◽  
Dan Siskind ◽  
Marco Solmi ◽  
...  

Objective: Psychiatric patients have increased rates of comorbid physical illness. There are less data on dental disease, especially decay, despite risk factors including lifestyle and psychotropic side effects such as xerostomia. We therefore undertook an umbrella review of all meta-analyses on the association between mental illness and oral health. Methods: We searched PubMed, MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Embase and CINAHL. Articles were independently assessed. Outcomes were caries, periodontal disease, erosion, and partial or total tooth loss (edentulism), measured where possible with standardised measures such as the mean number of decayed, missing and filled teeth or surfaces. Quality was assessed in line with National Institutes of Health guidelines. Results: We identified 11 meta-analyses. The most information and strongest association was between dental decay and severe mental illness or substance use, as well as erosion and eating disorders. Depressive, anxiety and eating disorders were also associated with caries, but the datasets were small. People with severe mental illness had nearly three times the odds of having lost all their teeth than the general community (odds ratio = 2.81, 95% confidence interval = [1.73, 4.57]) and those with depression between 1.17 and 1.32. Findings for periodontal disease were more equivocal, possibly because of study heterogeneity. Conclusion: Mental health clinicians should screen for oral diseases when treating those with mental illness and facilitate referral to affordable dental clinics when indicated. Prevention should be a priority, including the promotion of dental care, as well as the management of xerostomia when psychopharmacologic agents are prescribed.


Author(s):  
Norman Sartorius

People with mental illness are usually characterized by the unpredictability of their behaviour: this feature is central to the concept of ‘mentally ill’ and has found its expression in words such as ‘alien’ (describing a person whose behaviour is different and unpredictable) or ‘alienist’ (as a description of a psychiatrist who deals with mentally ill people). Unpredictability is the very basis of stigma: individuals with mental illness are separated from other people by their key characteristic of being different, alien, unpredictable—and therefore funny, dangerous, not belonging. The consequence of this fact for the fight against stigmatization is that a key element of work must be the education of parents, teachers, and others who influence the development of children in order that these children become adults who accept the notion that people with mental illness are similar to themselves (and to other people who do not have the illness) and that it is the illness that makes them different. Interventions against stigmatization must therefore begin not with the onset of illness or with the first encounter with a mentally ill person but with the concept formation—hence, early in life. Parents and teachers are, of course, not the only ones who influence children and the formation of concepts; media and other sources of information must participate in these efforts. The chapter also describes some of the measures that have been shown, in the course of several major studies in recent years, to be effective in reducing stigma.


1999 ◽  
Vol 5 (3) ◽  
pp. 76 ◽  
Author(s):  
Sue Booth

The purpose of this paper is to outline some methodological considerations for researchers working with vulnerable, transient, hard-to-reach populations. The research has been developed from reflecting on planning a study to examine the food and nutrition issues for homeless young people in inner city Adelaide. Homelessness is discussed as an example, however, many of the points are transferable to other 'hidden' or hard-to-reach populations. This applies particularly to those whose lives can be characterised by stigmatisation and powerlessness, for example, people with mental illness, sex workers, drug users/dealers, or transsexuals; that is, many groups which are relatively 'invisible' on a daily basis.


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