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To walk on eggshells is to care for a mental illness
- Author:
- JOHNSTON Jean
- Publisher:
- The Cairn
- Publication year:
- 2005
- Pagination:
- 75p.
- Place of publication:
- Helensburgh
The book is an account of the agony, shock, love and stamina of a mother facing her child's mental illness. With clarity and humour she chronicles her daughter's childhood, teenage years and the eventual descent into severe mental distress. She offers her thoughts, advice and practical suggestions on self-management and recovery from the perspective of the carer. The author says: "As a former carer I know we were very fortunate in our experiences of mental health services. Anecdotal evidence would indicate that others are not so lucky. Unless appropriate recognition and support is given by professionals to this overlooked role, we are not only in danger of exacerbating patients' symptoms but also endangering the mental health and well-being of the carers themselves".
Scoping studies: towards a methodological framework
- Authors:
- ARKSEY Hilary, O'MALLEY Lisa
- Journal article citation:
- International Journal of Social Research Methodology, 8(1), February 2005, pp.19-32.
- Publisher:
- Taylor and Francis
This paper focuses on scoping studies, an approach to reviewing the literature which to date has received little attention in the research methods literature. We distinguish between different types of scoping studies and indicate where these stand in relation to full systematic reviews. We outline a framework for conducting a scoping study based on our recent experiences of reviewing the literature on services for carers for people with mental health problems. Where appropriate, our approach to scoping the field is contrasted with the procedures followed in systematic reviews. We emphasize how including a consultation exercise in this sort of study may enhance the results, making them more useful to policy makers, practitioners and service users. Finally, the authors consider the advantages and limitations of the approach and suggest that a wider debate is called for about the role of the scoping study in relation to other types of literature reviews.
Making a real difference
- Author:
- NEWBIGGING Karen
- Journal article citation:
- Mental Health Today, September 2005, pp.27-30.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The National Institute for Mental Health England (NIMHE) was established in 2002, and from the beginning had a commitment to put people who use services at the centre of their work, and involve service users and carers in the planning and delivery of work. In 2004 the NIMHE executive team conduced a review of service users and carer involvement at all levels within NIMHE, with the aim of identifying what action was needed to develop a more co-ordinated and strategic approach. This article provides a brief overview of the review, its key findings and recommendations.
Elder disability as an explanation for racial differences in informal home care
- Authors:
- LI Lydia W., FRIES Brant E.
- Journal article citation:
- Gerontologist, 45(2), April 2005, pp.2-6-215.
- Publisher:
- Oxford University Press
Adjusting for sociodemographic characteristics and disability levels, this study examines whether differences exist in the structure and function of community-dwelling Black and White frail elders' informal care networks. Data from in-person assessments of Michigan's Home and Community-Based Medicaid Waiver applicants were analyzed. The sample consisted of 936 Black and 3,182 White frail elderly persons. When sociodemographic characteristics were controlled for, racial differences were found in all informal care components except out-of-home chores. Differences in functional components (amount of care, scope of assistance, and personal care) were largely accounted for by disability, whereas racial differences in the structural components (source of care, living arrangement, and sole caregiver) and in-home chores were not. Findings suggest that Black elders are not better off than White elders in the receipt of informal care. Although Black elders receive more informal help, this difference is primarily because of level of disability. This study calls for heightened awareness of disability among low-income Black elders and the potential burden experienced by their caregivers
Health-related quality of life and attitudes to long-term care among carers of older people using social services
- Author:
- ILIFFE Steve
- Journal article citation:
- Research Policy and Planning, 23(3), 2005, pp.165-173.
- Publisher:
- Social Services Research Group
Using three standardised measures to screen for activity limitation (ADLs), depression (GHQ-28) and health related quality of life (HRQoL) (SF36), a study of carers and people aged 75 and over referred consecutively to social services departments in adjacent inner city areas showed a high prevalence of limitations in activities of daily living (ADLs), that a substantial proportion (42 per cent) had GHQ-28 scores high enough to suggest depression and their scores on the SF-36 showed that many carers were low in vitality and tired. Co-resident carers had poorer psychological health and more difficulties with social functioning than non-resident carers, and were older, but were not significantly different in self-reported physical health. Whether carers wanted the cared-for person to remain at home for as long as possible depended on their relationship (spouse or not) and whether the older person was depressed. The carers' own psychological health was not related to their attitude to institutional care. The study suggests that targeting social care resources on carers showing psychological distress may not reduce downstream expenditure on long-term care.
Family intervention and services for persons with mental illness in the People's Republic of China
- Author:
- YIP Kam-Shing
- Journal article citation:
- Journal of Family Social Work, 9(1), 2005, pp.59-76.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Family services and intervention for people with mental illness is crucial in mental health services. Here, the author attempts to describe family intervention and services for persons with mental illness in the People's Republic of China. Family intervention and services like home-based care, guardianship network, family counselling, and psychoeducational programs are only preliminarily developed. Their effectiveness and challenges in future development are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Child and adolescent mental health services: strategy, planning, delivery, and evaluation
- Editors:
- WILLIAMS Richard, KERFOOT Michael, (eds.)
- Publisher:
- Oxford University Press
- Publication year:
- 2005
- Pagination:
- 556p.
- Place of publication:
- Oxford
The mental health problems of children and adolescents are a major concern and a challenge to policymakers, service designers, planners, commissioners, and providers of services within health and social care. However a considerable amount of evidence has accumulated in the last 50 years about effectiveness and the factors that affect how best to deliver services. This book brings together this evidence in the following areas: the background developments in policymaking, strategic thinking, and adult education that impact on the future roles of professionals, managers, and child and adolescent health services; how to identify problem populations and devise effective methods for obtaining reliable and valid measures of need that will enable service planning to take place, and which will then promote the development of commissioning strategies that make sense to practitioners; the evidence base for current interventions so that informed choices can be made, particularly in relation to expensive and residential provisions ; how to ensure that children and families are directed to services that are likely to have the optimal effect in relation to their identified needs; how services are currently being mapped and what recent experience tells us about the performance of state-funded services in the UK; what we know from international sources about how the impact of mental health problems on younger people translates into burden on parents, families, carers, and primary level staff; how their experiences relate to demand for and on specialist child and adolescent mental health services, and what the literature tells us about demand management; the developments that have occurred in services in the last 15 years and likely future directions.
Involving carers and service users in the training of psychiatrists
- Authors:
- FADDEN Grainne, SHOOTER Mike, HOLSGROVE Gareth
- Journal article citation:
- Psychiatric Bulletin, 29(7), July 2005, pp.270-274.
- Publisher:
- Royal College of Psychiatrists
In June 2005 it became mandatory for psychiatric trainees to receive training directly from people who experience mental health problems and their carers. This will be checked on approval visits to all training schemes, and accreditation may be withheld until this aspect of training is in place. For many of those who are responsible for training, this may be a new undertaking. The authors outline some of the issues that trainers need to consider when involving service users and carers in their training programmes, including background issues, how to prepare both those delivering and those receiving training, and logistical considerations. It is hoped that this paper will alert trainers to issues that need to be considered if such training is to be successful.
Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment
- Authors:
- GARAND Lina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(6), June 2005, pp.512-522.
- Publisher:
- Wiley
In this American study interview assessments were completed on a cohort of 27 spouses of persons with a recent diagnosis of mild cognitive impairment (MCI). Patient medical records were reviewed to collect information regarding the MCI patient's medical history. The results found respondents endorsed elevated levels of both task-related responsibilities and subjective caregiver burden. Depression and anxiety symptom levels also showed some elevations. Measures of caregiver burden were significantly associated with depression and anxiety levels. In particular, even after controlling for demographic risk factors for distress, nursing task burden was correlated with elevated depressive symptoms, and greater lifestyle constraints were correlated with higher anxiety levels. The findings suggest that MCI caregivers have already begun to experience distress in association with elevated caregiving burden. These individuals may be ideal targets for selective preventive interventions to maximize their psychological well-being as caregiving burdens related to their spouses' cognitive impairment increase.
The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial
- Authors:
- FINNEMA Evelyn, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(4), April 2005, pp.330-343.
- Publisher:
- Wiley
The aim was to examine the effect of integrated emotion-oriented care on nursing home residents with dementia and nursing assistants. A multi-site randomized clinical trial with matched groups was performed, and measurements taken at baseline and after seven months. Sixteen psychogeriatric wards in fourteen nursing homes in the Netherlands were examined. One hundred and forty-six elderly residents with the diagnosis dementia of the Alzheimer (DAT) type, mixed DAT and vascular dementia, and dementia syndrome (NAO) and 99 nursing assistants participated. The following measurements were used. Demented elderly: Behaviour and mood related to adaptation to the illness and the institutionalization. Nursing assistants: General health as measured by feelings of stress, stress reactions, feeling of competence and illness. Positive effects in favour of the integrated emotion-oriented care were found in mild to moderately demented residents on two adaptive tasks: maintaining an emotional balance (less anxiety) and preserving a positive self-image (less dissatisfaction). In the trained group of nursing assistants fewer stress reactions were found only in those who perceived improvement in their emotion-oriented care skills after training. Emotion-oriented care is more effective with regard to the emotional adaptation in nursing homes of persons with a mild to moderate dementia. For the severely demented elderly we did not find this surplus value. This outcome is of clinical importance for elderly persons with dementia who are cared for in nursing homes. With respect to the nursing assistants it is concluded that emotion-oriented care has a positive influence on stress reactions in some of them.