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Children placed in out-of-home care as midlife adults: are they still disadvantaged or have they caught up with their peers?
- Authors:
- BRANNSTROM Lars, et al
- Journal article citation:
- Child Maltreatment, 22(3), 2017, pp.205-214.
- Publisher:
- Sage
International research has consistently reported that children placed in out-of-home care (OHC) have poor outcomes in young adulthood. Yet, little is known about their outcomes in midlife. Using prospective data from a cohort of more than 14,000 Swedes born in 1953, of which nearly 9% have been placed in OHC, this study examines whether there is developmental continuity or discontinuity of disadvantage reaching into middle age in OHC children, compared to same-aged peers. Outcome profiles, here conceptualized as combinations of adverse outcomes related to education, economic hardship, unemployment, and mental health problems, were assessed in 1992–2008 (ages 39–55). Results indicate that having had experience of OHC was associated with 2-fold elevated odds of ending up in the most disadvantaged outcome profile, controlling for observed confounding factors. These findings suggest that experience of OHC is a strong marker for disadvantaged outcomes also in midlife. (Publisher abstract)
Effectiveness of a supportive housing program for homeless adults with mental illness and substance use: a two-group controlled trial
- Authors:
- GUTMAN Sharon A., RAPHAEL-GREENFIELD Emily I.
- Journal article citation:
- British Journal of Occupational Therapy, 80(5), 2017, p.286–293.
- Publisher:
- Sage
Introduction: The purpose of this study was to assess the effectiveness of a housing transition programme for homeless shelter residents with chronic mental illness and substance use. Method: A two-group controlled study design was used to assess the programme, with 10 participants in an intervention group and 10 in a control group. Goal attainment scaling and quality of life ratings were used pre- and post-intervention to determine if a statistically significant difference existed between groups at post-intervention. Results: A statistically significant difference existed between intervention and control group goal attainment scaling scores (U = 9.50, p < .03, d = 1.34), and on quality of life scores (U = 10.50, p < .04, d = 1.30) at post-intervention. At a 6-month follow-up, 57.14% of intervention group participants had transitioned into supportive housing, while only 25% of control group participants had transitioned. Conclusion: Findings suggest that intervention participants made greater progress toward desired housing goals and reported higher quality of life ratings than controls at post-intervention. This study provides support for the effectiveness of a housing programme for homeless adults with chronic mental illness and substance use histories to achieve housing goals and higher quality of life ratings. (Edited publisher abstract)
Forms and meanings of respect: aging mothers and adult daughters with mental illness
- Authors:
- CHADIHA Letha A., et al
- Journal article citation:
- Families in Society, 98(4), 2017, pp.3-19-328.
- Publisher:
- The Alliance for Children and Families
This qualitative study explores the perspectives of ageing mothers to understand the ways in which respect is experienced in relationships involving ageing mothers and adult daughters with mental illness. Data came from audiotaped personal interviews with a purposive sample of 21 mothers (ages 52–90) of adult daughters with a serious mental illness. An interpretative phenomenological approach was used to analyse transcripts and identify the forms of respect described by ageing mothers. Ageing mothers and their daughters with mental illness experience multiple forms of respect; however, the meanings of respect vary by generation. These findings have practice, educational, and research implications for social workers serving ageing families dealing with mental illness (Edited publisher abstract)
Associations between behaviours that challenge in adults with intellectual disability, parental perceptions and parental mental health
- Authors:
- WAITE Jane, et al
- Journal article citation:
- British Journal of Clinical Psychology, 56(4), 2017, pp.408-430.
- Publisher:
- Wiley
Objectives: This study examined parental perceptions of behaviours that challenge (CB) in their adult children with intellectual disability (ID), and explored whether perceptions mediated associations between CB and parental psychological distress. Design: A within-group correlational design was employed. Methods: Sixty-five parents reported on individuals with genetic syndromes and ID who had chronic CB. Parents completed the Illness Perception Questionnaire-Revised (IPQ-R) adapted to measure perceptions of self-injury, aggression or property destruction, alongside assessments of parental locus of control, attributions about behaviour, parental psychological distress, and CB. Results: A high proportion of parents evidenced anxiety and depression at clinically significant levels (56.9% and 30.8%, respectively). Contrary to predictions, psychological distress was not significantly associated with CB. The perception that the adult with ID exerted control over the parent's life mediated the association between CB and parental psychological distress. Few parents endorsed operant reinforcement as a cause of CB (< 10%). Conclusions: The high levels of psychological distress in parents is notable and of concern. Further research should consider the reasons why parents have causal attributions that might be inconsistent with contemporary interventions. Practitioner points: 1) Parents experience high levels of psychological distress while supporting adults with ID who engage in chronic behaviours that challenge; 2) A stronger belief that the adult with ID exerts control over the parent's life may mediate an association between CB exhibited by the individual with ID and parental psychological distress; 3) Few parents endorsed operant reinforcement as a cause of behaviours that challenge. (Publisher abstract)
Choir singing and creative writing enhance emotion regulation in adults with chronic mental health conditions
- Authors:
- DINGLE Genevieve A., et al
- Journal article citation:
- British Journal of Clinical Psychology, 56(4), 2017, pp.443-457.
- Publisher:
- Wiley
Objectives: Adults with mental health conditions commonly experience difficulties with emotion regulation which affect their social functioning. Arts-based groups provide opportunities for shared emotional experiences and emotion regulation. This study explores emotion regulation strategies and the emotional effects of arts-based group participation in adults with mental health problems and in controls. Design and method: The 62 participants included 39 adults with chronic mental health problems who were members of arts-based groups (ABG) and 23 comparison choir (CC) members who were not specifically experiencing mental health problems. The repeated measures design included self-reports of emotion upon waking (T1), the hour before group (T2), end of the group (T3), and evening (T4), as well as participant notes to explain their emotion ratings at each time. They also completed measures of individual and interpersonal emotion regulation. Results: The ABG participants engaged marginally more in affect worsening strategies than CC (p = .057 and .08), but there were no other group differences. All participants reported a significant increase in positive emotions and a decrease in negative emotions during the arts-based activity. The influence on positive emotions was short-lived, while the effect on negative emotions lasted until evening. Conclusion: Findings show that participation in arts-based groups benefits the emotions of both healthy adults and those experiencing mental health conditions through individual and interpersonal processes. Practitioner points: 1) Individuals with chronic mental health conditions often experience difficulties in emotion processing; 2) Participation in arts-based groups was associated with significant increases in positive emotions although these were short-lived; 3) Negative emotion was significantly decreased during arts-based group activities, and sustained to the evening assessment; 4) Adults with chronic mental health conditions were equally able to derive emotional benefits as healthy adults (Edited publisher abstract)
Football teams for people with intellectual disabilities living in the community: “it helps your self-esteem and that, don’t it?”
- Author:
- WHITE Rose
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 8(4), 2017, pp.201-211.
- Publisher:
- Emerald
Purpose: People with intellectual disabilities (ID) can be vulnerable to developing mental health problems. It has been found that participating in regular exercise can help to improve emotional well-being, both in typically developing people and those with ID. The purpose of this paper is to investigate the experiences of community clients with ID who have engaged in a football training programme, and the perceived impacts on attitudes, mood and behaviour. Design/methodology/approach: Interviews with seven patients from generic or forensic community ID services were conducted. The transcripts were analysed using interpretative phenomenological analysis. Findings: Two master themes were identified from the interviews, “Striving” and “Togetherness”. Originality/value: The most important factors related to taking part in the football programme were the social, emotional and personal growth associated with being part of a team and general enjoyment of being part of something. Although aspects of football knowledge and physical fitness were still evident, their impact seemed to be less significant. The experience of football was overwhelmingly positive. (Publisher abstract)
People with intellectual disabilities accessing mainstream mental health services: some facts, features and professional considerations
- Authors:
- STANDEN Penelope Jane, CLIFFORD Adam, JEENKERI Kiran
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 12(4), 2017, pp.215-223.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to provide information for non-specialists on identifying the characteristics, assessment and support needs of people with intellectual disabilities (ID) accessing mainstream services. Design/methodology/approach: A review of relevant policy and research literature is supplemented with observations from the authors’ own experience of working in mental health services for people with ID. Findings: With change in provision of services the likelihood of mainstream staff encountering someone with ID will increase. However, information on whether a person has ID or their level of ID is not always available to professionals in acute mental health services meeting an individual for the first time. Reliance on observational and interview-based assessments can leave people with ID vulnerable to a range of over- and under-diagnosis issues. This is as a result of difficulties with communication and emotional introspection, psychosocial masking, suggestibility, confabulation and acquiescence. For people with poor communication, carers will be the primary source of information and their contribution has to be taken into account. Practical implications: Knowing or suspecting an individual has ID allows staff to take into account the various assessment, diagnosis and formulation issues that complicate a valid and reliable understanding of their mental health needs. Awareness about an individual’s ID also allows professionals to be vigilant to their own biases, where issues of diagnostic overshadowing or cognitive disintegration may be important considerations. However, understanding some of the practical and conceptual issues should ensure a cautious and critical approach to diagnosing, formulating and addressing this population’s mental health needs. Originality/value: This synthesis of a review of the literature and observations from the authors’ experience of working in mental health services for people with ID provides an informed and practical briefing for those encountering people with ID accessing mainstream services. (Publisher abstract)
Psychiatry and intellectual disabilities: navigating complexity and context
- Authors:
- JONES Jo, JEENKERI Kiran, CUTAJAR Peter
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 12(4), 2017, pp.224-236.
- Publisher:
- Emerald
Purpose: The paper is a review, for the general adult mental health practitioner, of the issues to consider when managing a mental health presentation of a person with intellectual disability (PWID). The paper aims to discuss these issues. Design/methodology/approach: A neurodevelopmental model is outlined to assist practitioners in unravelling the wide range of potential factors relevant to intellectual disabilities (IDs). This includes an emphasis on complexity and interdisciplinary formulation within an individual’s context, and implications of the current policy changes. Findings: In practice, managing the mental health of PWID can be challenging within usual mainstream services; there is more to consider than is usual for the general population. Originality/value: The paper provides general mental health practitioners with a framework for a greater depth of understanding of the issues involved in the management of people with intellectual disability (ID). This includes discussion of the current policy context in ID, and some of its limitations. (Publisher abstract)
The effect of midlife risk factors on dementia in older age
- Author:
- PERSONAL SOCIAL SERVICES RESEARCH UNIT
- Publisher:
- Public Health England
- Publication year:
- 2017
- Pagination:
- 45
- Place of publication:
- London
This evidence review examines the association between different midlife (ages 40 to 64) risk factors and onset of dementia later in life. The review covers all types of dementia and in all age groups. The review is part of a wider study to help commissioners to make decisions about the prioritisation of primary prevention measures for dementia. The risk factors considered comprise: smoking, excessive drinking, high blood pressure, lack of physical activity and obesity, diabetes, depression and other common mental health conditions, social isolation and loneliness, and lifelong learning and cognitive stimulation. The review shows that there is evidence that the risk of dementia is increased by: physical inactivity, current smoking, diabetes, hypertension in mid-life, and obesity in mid-life and depression. It also shows that mental activity can reduce the risk of dementia. The review identifies areas for future research. (Edited publisher abstract)
The journey from first inspection to quality standards (1857-2016): are we there yet?
- Author:
- CAMPBELL Martin
- Journal article citation:
- Journal of Adult Protection, 19(3), 2017, pp.117-129.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to qualitatively analyse the inspection and regulation of care for people with learning disabilities and mental health problems in Scotland, in two time periods. Design/methodology/approach: The paper uses comparative historical research drawing on primary sources from 1857 to 1862 in the form of Annual Reports of the General Board of Commissioners in Lunacy for Scotland and associated papers, to compare inspection methods, quality standards and to identify persistent challenges to effective inspection. Findings: Political, clinical and public awareness led initially to criticisms of existing care and eventually to the development of the “The Lunacy Act” of 1857. This Act resulted in the first attempts to set minimum standards of care for individuals at risk, with enforceable regulation. Some factors recur as challenges to effective practice in the inspection and regulation of care today. Practical implications: There are problems of definition, reliable monitoring of quality standards and adequate, independent inspection of services that respond to unacceptable standards of care. There is a growing evidence base about best methods of inspection of services for people in care who are most at risk. These methods attempt to strike a balance between evidence- and value-based judgments. Perspectives from history may help focus resources. Originality/value: This paper compares common and common challenges in two time periods to investigate what can be learned about the development of policy and practice in inspection and regulation of care. (Publisher abstract)