Experiences of Case Managers Who Provide Residential Services to People with Mental Disorders Living in Independent Housing

Family members are important to the well-being of their relatives with substance use disorders or co-occurring substance use and mental disorders. Many caregivers experience high levels of burden, negatively impacting their capacity to provide support to their ill family member. The Andersen health care utilization model (Andersen & Newman, 1973, 2005) was used to identify the impact of predisposing, enabling, and need factors hypothesized to predict caregivers’ likelihood of asking for help and support with their caregiving role. The sample include 82 women recruited from outpatient or inpatient substance abuse treatment centers and 82 family caregivers nominated by these women. Findings showed that almost half of caregivers were unlikely to ask for help. Multiple regression analysis found that two need variables were statistically significant predictors of caregivers’ likelihood to ask for help. Caregivers who had higher subject burden (worry) and caregivers who provided more assistance with daily living were more likely to ask for help. It is suggested that case managers assess the amount of worried family caregivers’ experience because their worries may provide the motivation to ask for help or to participate in help when it is offered to them.

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DSM-IV-TR Axes-I and II mental disorders in a representative and referred sample of unemployed youths – Results from a psychiatric liaison service in a job centre

European Psychiatry ◽

10.1016/j.eurpsy.2013.06.001 ◽

2014 ◽

Vol 29 (4) ◽

pp. 239-245 ◽

Cited By ~ 13

Author(s):

V. Reissner ◽

B. Mühe ◽

S. Wellenbrock ◽

O. Kuhnigk ◽

B. Kis ◽

...

Keyword(s):

Mental Disorders ◽

Health Service ◽

Clinical Sample ◽

Case Managers ◽

Urban Region ◽

Service Utilisation ◽

Clinical Interviews ◽

Axis I ◽

Dsm Iv ◽

Substance Related Disorders

AbstractObjectives:Increased levels of anxiety, depression and alcohol abuse are associated with unemployment. This study compares both DSM-IV-TR Axis-I and Axis-II mental disorders between a representative and a referred sample of unemployed youths aged 16.0 to 24.9.Methods:One hundred subjects were randomly recruited on the premises of the vocational services centre in the urban region of Essen, Germany (representative sample, RS). One hundred and sixty-five subjects constituting the ‘clinical sample’ (CS) were preselected and referred by case managers to the on-site psychiatric liaison service. Structured Clinical Interviews for DSM-IV (SCID-I and -II), measures of psychopathology and health service utilization were administered.Results:Ninety-eight percent and 43% of CS and RS subjects fulfilled DSM-IV criteria for mental disorders. Mood-, anxiety- and substance-related disorders were the most common Axis-I disorders in both samples. Personality disorders were diagnosed significantly more frequently in the CS. Despite the more severe psychopathology in subjects with mental disorders from the CS compared to the RS, no differences were found for recent mental health service utilisation.Conclusion:Because the sample of unemployed youths referred by case managers was significantly more disturbed in psychiatric terms, such a pre-selection is deemed useful in conjunction with a psychiatric liaison service on the premise of a job centre.

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Promoting appropriate health care in Europe - the case of psychiatry

European Psychiatry ◽

10.1016/s0924-9338(09)70503-6 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

M. Musalek

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Health Care ◽

Early Recognition ◽

Case Managers ◽

Mental Illnesses ◽

Prevention Measures ◽

Clinical Experiences ◽

Heath Care

Nowadays different professions are involved in mental heath care in Europe, e.g. general practitioners, psychiatrists, psychologists, psychotherapists, social-workers, case-managers, prevention specialists, health ministry bureaucrats etc. As mental health represents a weak concept with vague and ambiguous definitions and delimitations it remains quite unclear who should be responsible for mental health today and in the future. In the last decades psychiatrists gained high expertise in treating mental disorders (e.g. psychopharmacological, psychotherapeutic and social measures) but lost terrain in mental health matters because of a lack of interest in such questions leading to the hardly acceptable contemporary situation that professionals without any psychopathological knowledge and without clinical experiences in mental illnesses as well as in the various transitional states between mental health and disordered health have taken the leading positions in the field of mental health care. Of course, the main tasks of psychiatry are to diagnose and to treat mental disorders, but as the prognosis of mental disorders and the treatment efficacy highly depend on the time of recognizing the disorder (the earlier the recognition of a mental disorders and the earlier the start of therapy the better the treatment out-come and prognosis) early recognition of mental disorders and prevention measures (esp. secondary and tertiary prevention) have to become core fields of psychiatry. Therefore psychiatry cannot any longer restrict itself to the treatment of severe mental disorders but has to take again a crucial role in future mental health care system in cooperation with other mental health stake-holders. This implies that future training programs for psychiatrists have to take into account such considerations and have to include beside usual fields of interests (e.g. psychopathology, neurosciences, psychopharmacology, psychotherapy, medical humanities, etc.) also topics like early recognition, transitional states and prevention of mental disorders as regular parts.

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Employment effects of a multidisciplinary health assessment for mentally ill persons – A quasi-randomised controlled trial

Scandinavian Journal of Public Health ◽

10.1177/1403494817723458 ◽

2017 ◽

Vol 46 (3) ◽

pp. 389-399 ◽

Cited By ~ 2

Author(s):

Jan Høgelund ◽

Lene Falgaard Eplov

Keyword(s):

Mental Disorders ◽

Case Management ◽

Sick Leave ◽

Return To Work ◽

Health Assessment ◽

Case Managers ◽

Control Group ◽

Work Duration ◽

Study Population ◽

Work Effect

Aim: Relatively little is known about the effectiveness of return-to-work interventions for employees sick-listed with mental disorders, and the results of the literature are contradictory. This study evaluated the return-to-work effect of a multidisciplinary health assessment for persons sick-listed with mental disorders. Methods: The study population consisted of 244 persons who were allocated to the treatment and control groups based on their birth year. In addition to the usual case management, the treatment group ( n = 83) was assessed by a team consisting of a case manager, a psychiatrist, and a job coach. The control group ( n = 99) received the usual case management. We used unique register data to code outcome variables (sick-leave duration and return-to-work duration). Results: The multidisciplinary treatment had no statistically significant effect on the sick-leave duration (HR = 1.05; 95% CI 0.74–1.43) or the return-to-work duration (HR = 0.94; 95% CI 0.65–1.35). Subgroup analyses showed that the treatment effect did not systematically depend on age, education or severity of the mental disorder. We found no signs of systematic dropout from the study population or of imbalanced data. We found an insignificant tendency indicating that control-group case managers may have learned about the intervention from treatment case managers ( p = 0.31). Conclusions: This study showed no return-to-work effect of a multidisciplinary assessment of sick-listed individuals with mental disorders. Together with the sparse and inconclusive findings of the literature, this finding suggests that further research is needed for disentangling the elements that constitute an effective intervention.

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Reductionist thinking and animal models in neuropsychiatric research

Behavioral and Brain Sciences ◽

10.1017/s0140525x18001231 ◽

2019 ◽

Vol 42 ◽

Cited By ~ 1

Author(s):

Nicole M. Baran

Keyword(s):

Animal Models ◽

Mental Disorders ◽

Environmental Factors ◽

Neuropsychiatric Disorders ◽

Model Organisms ◽

Developmental Genetic ◽

Term Study ◽

Genetic And Environmental Factors ◽

Mechanisms Of Plasticity

AbstractReductionist thinking in neuroscience is manifest in the widespread use of animal models of neuropsychiatric disorders. Broader investigations of diverse behaviors in non-model organisms and longer-term study of the mechanisms of plasticity will yield fundamental insights into the neurobiological, developmental, genetic, and environmental factors contributing to the “massively multifactorial system networks” which go awry in mental disorders.

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Assessing Mental and Behavioral Disorder Impairment: Overview of Sixth Edition Approaches

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2008.novdec01 ◽

2008 ◽

Vol 13 (6) ◽

pp. 1-7

Author(s):

Norma Leclair ◽

Steve Leclair ◽

Robert Barth

Keyword(s):

Mental Disorders ◽

Behavioral Disorders ◽

Psychotic Disorders ◽

Behavioral Disorder ◽

Behavioral Impairment ◽

Central Nervous System Damage ◽

Brain Functioning ◽

Sixth Edition ◽

Diagnostic And Statistical Manual ◽

Mental And Behavioral Disorders

Abstract Chapter 14, Mental and Behavioral Disorders, in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, defines a process for assessing permanent impairment, including providing numeric ratings, for persons with specific mental and behavioral disorders. These mental disorders are limited to mood disorders, anxiety disorders, and psychotic disorders, and this chapter focuses on the evaluation of brain functioning and its effects on behavior in the absence of evident traumatic or disease-related objective central nervous system damage. This article poses and answers questions about the sixth edition. For example, this is the first since the second edition (1984) that provides a numeric impairment rating, and this edition establishes a standard, uniform template to translate human trauma or disease into a percentage of whole person impairment. Persons who conduct independent mental and behavioral evaluation using this chapter should be trained in psychiatry or psychology; other users should be experienced in psychiatric or psychological evaluations and should have expertise in the diagnosis and treatment of mental and behavioral disorders. The critical first step in determining a mental or behavioral impairment rating is to document the existence of a definitive diagnosis based on the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The article also enumerates the psychiatric disorders that are considered ratable in the sixth edition, addresses use of the sixth edition during independent medical evaluations, and answers additional questions.

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Prevalence of mental disorders in household-members of patients with inflammatory bowel disease

Gastroenterology ◽

10.1016/s0016-5085(01)82021-7 ◽

2001 ◽

Vol 120 (5) ◽

pp. A407-A407

Author(s):

M VERGARA ◽

F CASELLAS ◽

X BADIA ◽

J MALAGELADA

Keyword(s):

Inflammatory Bowel Disease ◽

Mental Disorders ◽

Bowel Disease ◽

Inflammatory Bowel ◽

Household Members

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When Mental Disorders Suspected, Tools Abound

Pediatric News ◽

10.1016/s0031-398x(06)71380-7 ◽

2006 ◽

Vol 40 (10) ◽

pp. 24-25

Author(s):

KERRI WACHTER

Keyword(s):

Mental Disorders

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Malfunctional Reorganization in the Developing Limbo-Prefrontal System in Animals: Implications for Human Psychoses?

Zeitschrift für Neuropsychologie ◽

10.1024//1016-264x.12.1.8 ◽

2001 ◽

Vol 12 (1) ◽

pp. 8-14

Author(s):

Gertraud Teuchert-Noodt ◽

Ralf R. Dawirs

Keyword(s):

Prefrontal Cortex ◽

Mental Disorders ◽

Dentate Gyrus ◽

Cognitive Functions ◽

Experimental Approach ◽

Regulatory Mechanisms ◽

Hippocampal Dentate Gyrus ◽

Non Invasive ◽

Invasive Method ◽

Activity Dependent

Abstract: Neuroplasticity research in connection with mental disorders has recently bridged the gap between basic neurobiology and applied neuropsychology. A non-invasive method in the gerbil (Meriones unguiculus) - the restricted versus enriched breading and the systemically applied single methamphetamine dose - offers an experimental approach to investigate psychoses. Acts of intervening affirm an activity dependent malfunctional reorganization in the prefrontal cortex and in the hippocampal dentate gyrus and reveal the dopamine position as being critical for the disruption of interactions between the areas concerned. From the extent of plasticity effects the probability and risk of psycho-cognitive development may be derived. Advance may be expected from insights into regulatory mechanisms of neurogenesis in the hippocampal dentate gyrus which is obviously to meet the necessary requirements to promote psycho-cognitive functions/malfunctions via the limbo-prefrontal circuit.

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Angststörungen – von der ICD-10 zur ICD-11

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000768 ◽

2020 ◽

pp. 1-5

Author(s):

Timo D. Vloet ◽

Marcel Romanos

Keyword(s):

Mental Disorders ◽

International Classification Of Diseases ◽

International Classification ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

Classification Of Diseases ◽

Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

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