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Journal article

The role of work in psychiatric rehabilitation: a review of the literature

Author:
VOSTANIS Panos
Journal article citation:
British Journal of Occupational Therapy, 53(1), 1990, pp.24-28.
Publisher:
College of Occupational Therapists

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Journal article Full text available online for free

Trauma exposure in pre-school children in a war zone

Authors:
THABET Abel Aziz Mousa, KARIM Khalid, VOSTANIS Panos
Journal article citation:
British Journal of Psychiatry, 188(2), February 2006, pp.154-158.
Publisher:
Royal College of Psychiatrists

This study investigates the relationship between exposure to war trauma and behavioural and emotional problems among pre-school children. A total of 309 children aged 3–6 years were selected from kindergartens in the Gaza Strip, and were assessed by parental reports in regard to their exposure to war trauma, using the Gaza Traumatic Checklist, and their behavioural and emotional problems, using the Behaviour Checklist (BCL) and the Strengths and Difficulties Questionnaire (SDQ). The results found that pre-school children were exposed to a wide range of traumatic events. The total number of traumatic events independently predicted total BCL and SDQ scores. Exposure to day raids and shelling of the children’s houses by tanks were significantly associated with total behavioural and emotional problems scores. The authors conclude that direct and non-direct exposure to war trauma increases the risk of behavioural and emotional problems among pre-school children, which may present as non-specific psychopathology.

Journal article

When are attachment difficulties an indication for specialist mental health input?

Authors:
RATNAYAKE Adheesha, BOWLAY-WILLIAMS Jeanette, VOSTANIS Panos
Journal article citation:
Adoption and Fostering, 38(2), 2014, pp.159-170.
Publisher:
British Association for Adoption and Fostering

This article presents the characteristics of 83 looked after and 67 adopted children at the time of their first assessment by a designated mental health team in the context of potential appropriateness of this service. Attachment and mental health problems were significantly associated across most subscales of the Relationships Problems (RPQ) and the Strengths and Difficulties Questionnaires (SDQ). Adopted children were younger and were rated higher on both measures. One-third of the children were rated below the clinical cut-off SDQ score. The service appeared to adopt broad referral criteria to include attachment difficulties rather than just mental health disorders. The findings are discussed in relation to the varied interpretation of the constructs of attachment difficulties and disorders, and the future development of care pathways for looked after and adopted children. (Publisher abstract)

Journal article

“Nuts, schiz, psycho”: an exploration of young homeless people's perceptions and dilemmas of defining mental health

Authors:
O'REILLY Michelle, TAYLOR Helen C., VOSTANIS Panos
Journal article citation:
Social Science and Medicine, 68(9), May 2009, pp.1737-1744.
Publisher:
Elsevier

This research explores the term ‘mental health’ as articulated by a group of young people living in homeless shelters utilising staff in a mental health service. This mental health service was offered in 5 large geographical areas (urban, semi-urban and rural) in England to 18 homeless shelters and we interviewed 25 homeless young people, 5 Mental Health Coordinators and 12 homeless shelter staff. Using discourse analysis of semi-structured interviews, the ideological dilemmas presented by the young people were investigated. They report negative and stigmatising descriptions of mental health despite their involvement with a mental health service. Four key interpretative repertoires are identified; denial of problems, mental health as negative, the need to talk, and challenging prejudice. It is concluded that the term ‘mental health’, which appears in the title of the service (of which they are clients), presents barriers for usage but works to challenge prejudice and educate young people. Discussion of the implications of naming services and the importance of shared meanings are considered.

Journal article

Interprofessional perspectives on transitional mental health services for young people aged 16-19 years

Authors:
RICHARDS Maxine, VOSTANIS Panos
Journal article citation:
Journal of Interprofessional Care, 18(2), May 2004, pp.115-128.
Publisher:
Informa Healthcare

This qualitative study investigated the need for transitional mental health services for young people aged 16 - 19 years in a health district, as perceived by professionals from mental health, social, education and non-statutory services. Semi-structured interviews with 39 managers and practitioners who planned or provided services for this age range, from a wide range of agencies, explored issues related to older adolescents' needs, service communication, transfer arrangements, current gaps, and recommendations. Interviews were transcribed verbatim and themes emerged according to grounded theory. The four identified themes, with 21 categories, were: older adolescents have multi-faceted needs; statutory mental health services are not geared towards this age group; communication between services is variable; and there are no formal transfer arrangements from child to adult services. The findings support the need for specialist transitional services, and the adoption of an interprofessional service model incorporating education, social services and non-statutory agencies.

Journal article

Post traumatic stress disorder reactions in children of war: a longitudinal study

Authors:
THABET Abel Azia, VOSTANIS Panos
Journal article citation:
Child Abuse and Neglect, 24(2), February 2000, pp.291-298.
Publisher:
Elsevier

This article aims to establish rates of post-traumatic stress disorder (PTSD) reactions and general mental health problems in children who had experienced war trauma. Concludes the reactions tend to decrease in the absence of further stressors, although a substantial proportion of children still present with a range of emotional and behavioural problems. Cumulative previous experience of war trauma constitutes a risk factor for continuing PTSD symptoms.

Journal article Full text available online for free

Mental health problems of homeless children and families: longitudinal study

Authors:
VOSTANIS Panos, GRATTAN Eleanor, CUMELLA Stuart
Journal article citation:
British Medical Journal, 21.3.98, 1998, pp.899-902.
Publisher:
British Medical Association

Presents the results of research aiming to establish the mental health needs of homeless children and families before and after rehousing. The main outcome measures used were children's mental health problems and social support one year after rehousing. Concludes that homeless families have a high level of complex needs that cannot be met by conventional health services and arrangements. Highlights an need for local strategies for rapid rehousing into permanent accommodation, effective social support and health care for parents and children, and protection from violence and intimidation to be developed and implemented.

Journal article

Looked after and adopted children: how should specialist CAMHS be involved?

Authors:
RAO Pradeep, ALI Alvina, VOSTANIS Panos
Journal article citation:
Adoption and Fostering, 34(2), Summer 2010, pp.58-72.
Publisher:
British Association for Adoption and Fostering

Looked after children are at high risk of developing mental health problems and these are often complex and related to other needs and agency involvement. However, the distinction between mental health needs, problems and disorders is not clearly defined. Therefore, there is considerable service variation, lack of models and consensus on which children and young people would benefit from specialist child and adolescent mental health services (CAMHS) input. This article reports on a study that aimed to compare the characteristics of looked after and adopted children referred to a designated CAMHS team, and to identify whether these fell within the perceived remit of specialist CAMHS. The referrals, over one year, were rated by an independent researcher using a checklist that contained details of the referrer, the child’s placement and reason for referral, outcome, and reasons for decisions. The results showed that children with an indication of likely disorders were accepted, while there was less consistency on decisions relating to attachment and behavioural problems, and the role of different agencies. The article concludes that mental health and social care services for vulnerable children need jointly to develop clear care pathways, with definition of agency roles. The presence of behavioural and attachment problems should not justify referral to specialist CAMHS, which would depend on other concurrent mental health difficulties and risk factors involved.

Journal article

Organisational issues facing a voluntary sector mental health service for homeless young people

Authors:
TAYLOR Helen, STUTTAFORD Maria, VOSTANIS Panos
Journal article citation:
Journal of Integrated Care, 15(1), February 2007, pp.37-47.
Publisher:
Emerald

The voluntary sector has an important role to play in the provision of services for people with mental health needs of lessor severity, thus complementing statutory services, as suggested by recent national policy. This article describes such a service for young homeless people, and discusses the perceptions of key stakeholders of the benefits and challenges of such a service. The service largely met the mental health needs of young people who would not have easily accessed statutory mental health services, and who fulfilled the criteria (low/moderate need) of the service. Challenges for the future include the different organisational cultures, the professional isolation of the mental health practitioners and the lack of operational and commissioning links with statutory mental health services.

Journal article

A UK survey on how homeless shelters respond to the mental health needs of homeless young people

Authors:
TAYLOR Helen, STUTTAFORD Maria, VOSTANIS Panos
Journal article citation:
Housing Care and Support, 9(2), October 2006, pp.13-18.
Publisher:
Emerald

Research and national policies have highlighted that accommodation providers need to offer holistic interventions to encourage young homeless people with mental health needs to break the cycle of homelessness. In this study a postal questionnaire was sent to 132 managers of the Foyer Federations homeless shelters in the UK, achieving a response rate of 64.4%. Frequencies and descriptive statistics were calculated, and written data was analysed using content analysis. Mental health problems were prevalent, and homeless shelters responded in a variety of ways (use of GP services, internal services, referring to external services, in-house outreach services, no service provision, etc). Only 27% of managers of homeless shelters reported that their services were sufficient to meet their young people's needs. These findings reflect the need for inclusion of mental health in homeless shelters' strategic objectives, and development of commissioning of local partnerships with health agencies.

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