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Journal article

Hypothesis testing in patients with persecutory delusions: comparisons with depressed and normal subjects

Authors:
YOUNG Heather Frances, BENTALL Richard Pendril
Journal article citation:
British Journal of Clinical Psychology, 34(3), September 1995, pp.353-369.
Publisher:
Wiley-Blackwell

The hypothesis-testing skills of patients with persecutory delusions were studied, and compared with those of matched depressed and normal control groups. The groups did not differ in the range of total number of hypotheses generated. The deluded subjects were less inclined than the controls to stick to their hypotheses when given positive feedback and were inclined to stick to their hypotheses following negative feedback. They also showed less evidence of 'focusing' down their hypothesis to an overall correct solution, in response to successive feedback.

Journal article

Uproar over missing links

Author:
SHEPARD Stuart
Journal article citation:
Health Service Journal, 28.08.08, 2008, pp.24-25.
Publisher:
Emap Healthcare

Most changes brought in under the Mental Health Act 2007 start taking affect in November. However the section ensuring the rights of detained patients to independent mental health advocacy services will not be introduced until April 2009.  The author reports on campaigners frustration by the delay.

Journal article

Stigma and coercion in the context of outpatient treatment for people with mental illnesses

Authors:
LINK Bruce, CASTILLE Dorothy M., STUBER Jennifer
Journal article citation:
Social Science and Medicine, 67(3), August 2008, pp.409-419.
Publisher:
Elsevier

The policies and institutional practices developed to care for people with mental illnesses have critical relevance to the production of stigma as they can induce, minimise or even block it. This article addresses two prominent and competing perspectives on the consequences for stigma of using coercion to insure compliance with outpatient mental health services. The Coercion to Beneficial Treatment perspective holds that the judicious use of coercion facilitates treatment engagement, aids in symptom reduction and, in the long run, reduces stigma. The Coercion to Detrimental Stigma perspective claims that coercion increases stigmatisation resulting in low self-esteem, a compromised quality of life and increased symptoms. The authors examine these differing perspectives in a longitudinal study of 184 people with serious mental illness, 76 of whom were court ordered to outpatient treatment and 108 who were not. They were recruited from treatment facilities in the New York boroughs of the Bronx and Queens. They measure coercion in two ways: by assignment to mandated outpatient treatment and with a measure of self-reported coercion. The longitudinal analysis allows stringent tests of predictions derived from each perspective and finds evidence to support certain aspects of each. Consistent with the Coercion to Beneficial Treatment perspective, they found that improvements in symptoms lead to improvements in social functioning. Also consistent with this perspective, assignment to mandated outpatient treatment is associated with better functioning and, at a trend level, to improvements in quality of life. At the same time the Coercion to Detrimental Stigma perspective is supported by findings showing that self-reported coercion increases felt stigma (perceived devaluation–discrimination), erodes quality of life and through stigma leads to lower self-esteem. Future policy needs not only to find ways to insure that people who need treatment receive it, but to achieve such an outcome in a manner that minimises circumstances that induce perceptions of coercion.

Book Full text available online for free

Regional reviews of tier 4 child and adolescent mental health services: summary and comment

Author:
KURTZ Zarrina
Publisher:
Care Services Improvement Partnership. Children, Young People and Families Programme
Publication year:
2007
Pagination:
93p.
Place of publication:
London

In-patient care, provided at Tier 4 level, is a specialised field aimed at provision of high-quality care for young people with serious mental health problems. This report summarises analyses and comments upon the findings from Reviews of Tier 4 Child and Adolescent Mental Health Services (CAMHS),undertaken during the past year or two, in the nine regions of England.

Book Full text available online for free

Attitudes to mental illness 2007

Author:
CARE SERVICES IMPROVEMENT PARTNERSHIP. Shift
Publisher:
Great Britain. National Statistics
Publication year:
2007
Pagination:
46p., tables
Place of publication:
London

Since March 1993, the Department of Health has placed a set of questions on TNS’ Face-to-Face Consumer Omnibus. From 1993 to 1997 the questions were asked on an annual basis, thereafter they have been asked every third year up until 2003. The current 2007 survey follows four years after the previous survey. These surveys serve as a tracking mechanism, and in this report, the most recent results are compared with those from previous years.  The respondents in the surveys were presented with a number of statements about mental illness. They covered a wide range of issues from attitudes towards, and perceptions of people with mental illness, to opinions on services provided for people with mental health problems.

Journal article

Barriers to mental healthcare for psychiatrists

Authors:
WHITE Alfred, et al
Journal article citation:
Psychiatric Bulletin, 30(10), October 2006, pp.382-384.
Publisher:
Royal College of Psychiatrists

The aim was to determine the opinions of psychiatrists on mental illness among themselves and their colleagues a postal survey was conducted across the West Midlands. Most psychiatrists (319/370, 86.2%) would be reluctant to disclose mental illness to colleagues or professional organisations (323/370, 87.3%). Their choices regarding disclosure and treatment would be influenced by issues of confidentiality (n=245, 66%), stigma (n=83, 22%) and career implications (n=128, 35%) rather than quality of care (n=60, 16%). The stigma associated with mental illness remains prevalent among the psychiatric profession and may prevent those affected from seeking adequate treatment and support. Appropriate, confidential specialist psychiatric services should be provided for this vulnerable group, and for doctors as a whole, to ensure that their needs, and by extension those of their patients, are met.

Journal article

Impact of functionalised community mental health teams on in-patient care

Authors:
COMMANDER Martin, DISANYAKE Lallana
Journal article citation:
Psychiatric Bulletin, 30(6), June 2006, pp.213-215.
Publisher:
Royal College of Psychiatrists

A before-and-after design was used to evaluate whether the routine implementation of functionalised community mental health teams (CMHTs) would reduce demand for in-patient care. Residents of west Birmingham, aged 16-64 years, who were in hospital between 23 March 1992 and 22 September 1992 were identified. The same period was studied in 2003 by which time the newly introduced teams were well established. The number of people in hospital fell by one-third between 1992 and 2003. There was no change in the number of admissions by each patient or the length of stay. The percentage identified as Black, single, living with other adults, resident in hostels and unemployed increased, as did the proportion with schizophrenia or manic depression and those detained compulsorily. Functionalised CMHTs can decrease the use of in-patient care in inner-city areas. They may also attenuate, but by no means halt, the rise in compulsory admissions seen across the UK in the past decade.

Journal article

Methods of observation in mental health inpatient units

Author:
PAGE Mathew J.
Journal article citation:
Nursing Times, 30.05.06, 2006, pp.34-35.
Publisher:
Nursing Times

Observation is a common procedures that is controversial as it may be experienced by patients as oppressive. This article discusses the nature of observation in mental health inpatient units, concluding that the practice is likely to continue as it provides a written record of what has occurred. However, the quality of the nursing intervention is more likely to have a significant impact on patients than is observation.

Journal article Full text available online for free

Patient-rated mental health needs and quality of life improvement

Authors:
SLADE Mike, et al
Journal article citation:
British Journal of Psychiatry, 187(3), September 2005, pp.256-261.
Publisher:
Royal College of Psychiatrists

Patient-rated unmet need is cross-sectionally associated with quality of life. This study aims to test the hypotheses that: (a) higher patient-rated unmet need is associated with lower individual quality of life assessments by a patient over time; and (b) reduction in patient-rated unmet need precedes improvement in quality of life. One hundred and one individuals using adult mental health services in Croydon, London were asked to complete 6-monthly questionnaires, comprising quality of life (Manchester Short Assessment of Quality of Life, MANSA) and unmet need (Camberwell Assessment of Need Short Appraisal Schedule, CANSAS) assessments. Seventy-three participants provided 240 separate pairs of consecutive assessments. Random effects regression models indicated an impact on current quality of life for both average level of unmet need and change in unmet need over the past month. The authors conclude that changes in patient-rated unmet needs may cause changes in quality of life.

Journal article

Why not?

Author:
JACKSON Catherine
Journal article citation:
Mental Health Today, 2004, pp.12-13.
Publisher:
Pavilion
Place of publication:
Hove

Assesses the new initiative 'Building on the best: choice and equity in the NHS' and how it relates to patient choice in mental health services.

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