Identification of Children of Mentally Ill Patients and Provision of Support According to the Norwegian Health Legislation: A 11-Year Review

Background:According to amended legislation implemented in Norway in 2010, personnel in healthcare services for adults are obligated to identify patients' minor children and to assess the family situation. Health personnel is also obligated to contribute to adequate support to families affected by parental mental illness or substance use disorders. The intention behind the amendment was to support and protect children of mentally ill parents, as they are at risk of developing problems of their own. The aim of the present study was to evaluate health personnel's practice during the years 2010-2020, more specifically; (a) to what extent children of patients with mental illness and substance use disorders are registered in patient records, and (b) to what extent activities relating to the assessment and support of patients' minor children are documented in patient records.Method:The participants in the study are patients admitted to Division for Mental Health and Substance Use at the University Hospital of North Norway in the years 2010–2020. The data was drawn from patient records during October 2021.Results:The registration of patients' minor children is considerably strengthened since the introduction of the new Norwegian Health Personnel Act in 2010, and estimates show that 56% of patients' minor children are identified. However, only 31% of cases where patients have identified minor children this result in health personnel performing activities to support the children.Discussion:Based on the rising proportion of identified minor children throughout the 10-year period, it seems evident that the dissemination efforts have contributed to the development of some new skills among health personnel. However, compared with the national estimation that 35% of mentally ill and substance abusing patients have minor children, a large proportion of children remains unidentified. After identification, there seem to still be a long way to go before minor children are systematically offered support. Different solutions to strengthen the implementation of new skills in clinical practice, to ensure the identification of minor children and provision of necessary support for them is discussed.

The Construction of Self-Identity in the Chronically Mentally Ill: A Focus on Autobiographic Narratives of Mentally Ill Patients in South Korea

A systematic policy for treatment and management of chronic psychiatric patients in South Korea was begun with the passage of the Mental Health Act in 1995. The mentally ill patients who were previously separated from the society now have opportunities to live in local communities under medication with the help of rehabilitation facilities. This study aims to understand how mentally ill patients deal with their new medical environment. An autobiographic narrative analysis is methodically applied in order to link the social and the individual levels. Autobiographic narratives of illness show how the patient’s self-identity is formed and further developed according to the chronic conditions of his illness and the continual learning from experiences. In regard to the construction of selfidentity, two aspects should be taken into consideration: First, medication is absolutely necessary before patients can leave the hospital and participate in rehabilitation programs. Secondly, social integration is usually evaluated by the return of the patient into a normal biographical stage. It turns out that medication deprives the patients of control over their emotions, their bodies. Furthermore, their social environments – including family, friends and the labor market – work against them. Under these circumstances, mentally ill patients are liable to adhere to their own interpretation of mental illness, and what they experience is far different from the expectations of experts in the field. The new mental health environment also contributes to the formation of patient communities. As a result, chronic psychiatric patients are able to build their own subculture and to see themselves through their own eyes. Further studies are needed to explore whether and to what extent the ongoing improvement of social conditions for mentally ill patients has an impact on autobiographic narratives and self-identity construction.

Provincial treatment and care asylums for the mentally ill in East Prussia as forgotten cultural heritage: case study of the asylum in Allenberg (now Znamensk, Russian Federation)

The article focuses on issues demonstrating the role of architecture in the development of Prussian psychiatry in the nineteenth and the early twentieth century. The Provincial Treatment and Care Institution Allenberg (now Znamensk, Russian Federation) is used as a case study to demonstrate the perception of model solutions used in Prussian asylums located in distant provinces. The asylum discussed in this article met the contemporary requirements, proving that these models and newest trends reached East Prussia very quickly. The asylum complex in Allenberg was a testimony to the development of Prussian and European architectural thought in the service of medicine. Unfortunately, today the former asylum remains in a poor condition and is treated as unwanted legacy rather than a cultural monument.

Virtual Reality and Forensic Mental Health

This chapter provides an overview of virtual reality (VR) treatment and rehabilitation for mentally ill patients who have committed a crime or are at risk of relapse. The authors focus on the forensic mental health field since this area relates to any individual dealing with a psychiatric condition that is in trouble with the law, whether they be inpatient offenders, outpatient offenders, or inmates at a regular prison. Virtual reality (VR) and its current uses, as well as its benefits and barriers, are presented as a successful and individualized eHealth treatment. In addition, some examples of VR studies that were recently done with these individuals will be presented to show the results of their current approaches, demonstrate their limitations, and figure out possible ways of improvement.

Canadian Undergraduates’ Perspectives on Medical Assistance in Dying (MAiD): A Quantitative Study

Background and Objectives: In 2016, Medical Assistance in Dying (MAiD) became legal in Canada for those suffering a grievous and untreatable medical condition. Currently, it is not available to minors or to those with an untreatable mental illness, although it is likely the scope of MAiD will be widened to include persons with severe and untreatable mental illnesses. However, little is known about the factors predicting acceptance or rejection of MAiD for persons with either a grievous medical condition or an untreatable mental illness. Methods: A survey was administered to 438 undergraduate students to examine factors associated with their acceptance or rejection of MAiD. The survey included four different scenarios: a young or old person with an untreatable medical condition, and a young or old person with an untreatable mental illness. Demographic questions (age, sex, religion, etc), personality measures, and an attitude towards euthanasia scale were also administered, as well as questions assessing participants’ general understanding of MAiD and their life experiences with death and suicide. Results/Conclusion: Overall, most of the Canadian undergraduate participants accepted MAiD for both terminally ill and mentally ill patients; however, different variables, such as age, religion, and ethnicity, predicted the acceptance or rejection of MAiD for each scenario.

Criminalizing Homelessness: Circumstances Surrounding Criminal Trespassing and People Experiencing Homelessness

Criminal trespassing (CT) is an understudied misdemeanor offense often enforced to maintain control over contested spaces and, in practice, often disproportionately used against disenfranchised populations such as the homeless and mentally ill. This study uses the CT case files of a county criminal district attorney’s office to investigate how cases involving defendants experiencing homelessness are handled compared with other defendants. Results show that homeless defendants make up a substantial portion of all CT cases, are more likely to be repeat CT defendants, and account for most jail sentences. Whereas defendants with mental health issues were often deferred for services, this avenue was not similarly extended to homeless defendants. Qualitative analyses show varied circumstances related to CT arrest for homeless and non-homeless defendants. The findings suggest various policy implications to refocus police resources and promote interagency cooperation to address the underlying causes of CT involvement by people experiencing homelessness.

PSYCHIATRIC HOSPITALIZATIONS AND IMPLEMENTATION OF CAPS IN RIO GRANDE DO SUL

The CAPS was created with the objective of offering care that prioritizes the rehabilitation and psychosocial reintegration of the mentally ill individual. However, psychiatric hospitalization remains a widely used resource. This study aims to evaluate the rates of psychiatric hospitalizations and the implementation of CAPS in the state of Rio Grande do Sul, from 2008 to 2018. The study has an ecological time series design. As a result, we found a 42% increase in psychiatric hospitalizations. The CAPS coefficient was 0.64 in 2008 and increased to 0.85 (34% higher). The correlation between the CAPS coverage coefficient and the rate of psychiatric hospitalizations in RS exhibited a positive and statistically significant coefficient. These data diverge from what is found in the literature, which indicates a reduction in psychiatric hospitalizations in recent years. Thus, it is possible to conclude that there was an increase in hospitalizations and an increase in CAPS during the study period.

What About Us? Experiences of Relatives Regarding Physician-Assisted Death for Patients Suffering from Mental Illness: A Qualitative Study

Physician-assisted death (PAD) for patients suffering from mental illness is legally permitted in the Netherlands. Although patients’ relatives are not entrusted with a legal role, former research revealed that physicians take into account the patient’s social context and their well-being, in deciding whether or not to grant the request. However, these studies focussed on relatives’ experiences in the context of PAD concerning patients with somatic illness. To date, nothing is known on their experiences in the context of PAD concerning the mentally ill. We studied the experiences of relatives with regard to a PAD request by patients suffering from mental illness. The data for this study were collected through 12 interviews with relatives of patients who have or had a PAD request because of a mental illness. We show that relatives are ambivalent regarding the patient’s request for PAD and the following trajectory. Their ambivalence is characterised by their understanding of the wish to die and at the same time hoping that the patient would make another choice. Respondents’ experiences regarding the process of the PAD request varied, from positive (‘intimate’) to negative (‘extremely hard’). Some indicated that they wished to be more involved as they believe the road towards PAD should be a joint trajectory. To leave them out during such an important event is not only painful, but also harmful to the relative as it could potentially complicate their grieving process. Professional support during or after the PAD process was wanted by some, but not by all.

The Phenomenon of Cognitive Polyphasia in Social Representations on the Mentally

The present study is focused on the phenomenon of cognitive polyphasia in the context of representations of mentally ill people by different groups of society. The authors put at the forefront the problem of finding the conditions for the actualization of cognitive polyphasia. The study was aimed at identifying manifestations of cognitive polyphasia in the structure of social representations (SRs) of the mentally ill in the groups of Orthodox respondents and non-believers. The sample consisted of Orthodox Christians: N = 114 (49 males and 65 females) and non-believers: N = 113 (76 males and 37 females) in the age ranges 18-23, 40-45 and 60-65 years, permanently residing in Moscow. The survey of the respondents at the main stage of the research was carried out using: (1) the authors questionnaire developed on the basis of the results of the search stage and including 29 statements; (2) a scale of self-assessed degree of religiosity; (3) a modified D. Feldes Psychological Distance Scale; (4) a modified sentence completion method; (5) the Bubbles technique and (6) a question pool for obtaining socio-demographic information. The results showed that the emotional component of SRs of the mentally ill changed their modality depending on the survey methods used. When the respondents evaluated the statements of the questionnaire, the core of SRs in both groups contained elements that were extremely sympathetic towards the mentally ill, and the statements revealing negative emotions (the possibility of contracting a mental illness or the need to isolate these people from society) were on the periphery of their representations. At the same time, the data of the projective methods showed that the negative representation background (as compared to the positive one) in relation to mentally ill people significantly predominated among both believers and non-believers. The negative representation of the mentally ill is most pronounced in the group of non-believers and reaches the highest rates in the group of 60-65-year-old respondents. We regard such ambivalence as a manifestation of cognitive polyphasia and, in particular, its variety, i.e., selective prevalence.