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Equity and social justice issues for residents and staff of supported residential facilities
- Authors:
- KRALIK Debbie, KOCH Tina, ASHTON Maxie
- Journal article citation:
- Research Policy and Planning, 22(3), 2004, pp.15-24.
- Publisher:
- Social Services Research Group
This paper discusses issues that arose during a recently completed community based project that aimed to develop continence promotion strategies for people who have mental illness. The authors researched with people who had mental health issues residing in Supported Residential Facilities (SRF) and the managers of those facilities. The policy of de-institutionalisation for people with mental illness has assumed that people will have somewhere suitable to live in the community with an appropriate level of support. These assumptions have resulted in people with mental illness relying on low cost accommodation in SRFs or hostel type accommodation. The article highlights the social paradox that SRFs operate in because of their exclusion from major government funding programs and the expectation that, as private enterprises, they will operate for profit. At the same time, SRFs provide housing for some of our community's most vulnerable, disenfranchised and impoverished groups of people.
Developmental Behaviour Checklist (DBC) in the assessment of psychopathology in Finnish children with intellectual disability
- Authors:
- KOSKENTAUSTA Terhi, ALMQVIST Fredrik
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 29(1), March 2004, pp.27-39.
- Publisher:
- Taylor and Francis
This study evaluates the Developmental Behaviour Checklist (DBC) in the assessment of psychopathology in a Finnish population of children with intellectual disability. Disruptive behaviour was more common in children with mild intellectual disability, and problems with social interaction and communication in those with moderate, severe or profound intellectual disability. The frequency of psychiatric disturbances was approximately 34 percent, with the highest rate occurring in children with moderate intellectual disability. Compared with the original standardisation data published by Einfeld and Tonge (1994), the mean Total Behaviour Problem Score (TBPS) and frequency of psychiatric disturbance were lower. This study suggests that the DBC is a good instrument for discriminating between children with intellectual disability with and without emotional or psychiatric disturbance.
The persistence of neuropsychiatric symptoms in dementia: the Cache County Study
- Authors:
- STEINBERG Martin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(1), January 2004, pp.19-26.
- Publisher:
- Wiley
The aim was to estimate the 18-month persistence of neuropsychiatric symptoms in dementia in a population-based sample, and to compare the severity of neuropsychiatric symptoms at baseline to the severity at 18-month follow-up. A population-based sample of 329 residents of Cache County, Utah, diagnosed with dementia was rated on the Neuropsychiatric Inventory (NPI). Of the 204 participants with neuropsychiatric symptoms at baseline (defined as total NPI score >0), NPI data were obtained approximately 18 months later on 117 who were alive and available for follow-up. Eighty-one percent of those with neuropsychiatric symptoms at baseline (defined as total NPI score>0) continued to have at least one symptom at follow-up. Sixty-seven percent of participants with a clinically significant total NPI score (defined as ;4) at baseline continued to have a clinically significant total NPI score at follow-up. Among the ten neuropsychiatric domains assessed at baseline, delusions persisted in 65.5% of individuals, followed by depression (58.3%), and aberrant motor behavior (55.6%), while hallucinations and disinhibition persisted in only 25.0% and 11.1% respectively. In participants who were symptomatic at both baseline and follow-up, the mean severity scores at the two observation points were comparable in all ten neuropsychiatric domains. Neuropsychiatric symptoms in dementia overall were highly persistent. Among those in whom symptoms did persist, symptom severity a year and a half later appeared to be comparable.
The mental health of young people looked after by local authorities in Wales: the report of a survey in 2002/2003 by the Office for National Statistics on behalf of the Welsh Assemby Government
- Authors:
- MELTZER Howard, et al
- Publisher:
- Office for National Statistics,|Stationery Office
- Publication year:
- 2004
- Pagination:
- 164p.
- Place of publication:
- London
This report presents the findings of a survey of the mental health of young people, aged 5-17, looked after by local authorities in Wales. The first part of the report focuses on the prevalence rates of mental disorders among young people looked after by local authorities. The second part shows a range of information including their background, personal and familial characteristics, physical health, use of services and social functioning.
Affective disorders in older inpatients
- Authors:
- WETTERLING Tilman, JUNGHANNS Klaus
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(5), May 2004, pp.487-492.
- Publisher:
- Wiley
After dementia the group of depressive disorders is considered to be the second most common psychiatric disorder in the elderly. There is dispute regarding whether depression in the elderly differs from depression in the younger age groups by a longer duration of inpatient treatment, a more frequent occurrence of delusions, more cognitive impairment or by a more frequent co-occurrence of physical disease. This study aimed to compare younger with older inpatients with respect to these aspects. Retrospective chart review of all admissions to the psychiatric department of a General University Hospital (n=9400) and review of the documentation of 15 348 psychiatric consultations in the years 1990-1998. The clinical diagnoses were made according to the ICD-10 criteria. 15.5% of the psychiatric inpatients in this period suffered from depressive episodes (ICD-10 F31.3-31.5,32,33). The proportion of depressive episodes increased with age, making up 5.4% in the age group below 30 years and 37.4% in the age group of 70-79 years. On the basis of the ICD-10 criteria for the severity of depressive episodes no significant differences could be demonstrated between the younger (< 65 years) and the older inpatients ( 65 years). In particular, no higher frequency of psychotic symptoms with increasing age could be found. The length of inpatient treatment did not significantly differ between both age groups. The elder patients showed less suicidal attempts prior to admission and less psychiatric comorbidity, but a significantly higher rate of concurrent physical illness. In 923 inpatients a psychiatrist was consulted by the other medical departments because of a co-occurrence of physical with affective disorders, making up 8.6% of the total seen by the psychiatric consultation service. Here again, the proportion of depressive episodes increased with age. The pattern of the depressive episodes in these patients did not differ from that seen in the psychiatric inpatients. Only clinical diagnoses made by experienced psychiatrists were evaluated. According to these results older depressive inpatients differ from younger ones only with regard to concurrent comorbidity but not with respect to the duration of inpatient treatment or the pattern or severity of depressive symptoms. They more frequently suffered from physical illness but less often showed concurrent psychiatric comorbidity.
Emotional and behavioural responses to music in people with dementia: an observational study
- Authors:
- SHERRATT, K., THORTON A., HATTON C.
- Journal article citation:
- Aging and Mental Health, 8(3), May 2004, pp.233-241.
- Publisher:
- Taylor and Francis
Using continuous time sampling and direct observation methodology, this study examined the impact of social interaction in music listening on behavioural responses of people with moderate-to-severe dementia (n = 24). Using Kitwood's theory of personhood as a framework, it was hypothesized that levels of well-being and engagement would be greatest during a live music condition compared with recorded and no music conditions and that levels of challenging behaviour would decrease most in the live music conditions compared with the other music conditions. The relationship between severity of cognitive impairment and well-being, engagement and challenging behaviours across conditions was also examined. The findings suggest that live music was significantly more effective in increasing levels of engagement and well-being regardless of level of cognitive impairment. No significant differences across conditions were found for challenging behaviours, but the correlation between these and cognitive impairment revealed mixed results. Clinical implications regarding the use of live music in dementia care settings are highlighted and recommendations for future research of interventions aimed at reducing challenging behaviours are discussed.
Validation of the Algase Wandering Scale (Version 2) in a cross cultural sample
- Authors:
- ALGASE D. L., et al
- Journal article citation:
- Aging and Mental Health, 8(2), March 2004, pp.133-142.
- Publisher:
- Taylor and Francis
This study examined the psychometric properties of an expanded version of the Algase Wandering Scale (Version 2) (AWS-V2) in a cross-cultural sample. A cross-sectional survey design was used. Study subjects were 172 English-speaking persons with dementia (PWD) from long-term care facilities in the USA, Canada, and Australia. Two or more facility staff rated each subject on the AWS-V2. Demographic and cognitive data (MMSE) were also obtained. Staff provided information on their own knowledge of the subject and of dementia. Separate factor analyses on data from two samples of raters each explained greater than 66% of the variance in AWS-V2 scores and validated four (persistent walking, navigational deficit, eloping behavior, and shadowing) of five factors in the original scale. Items added to create the AWS-V2 strengthened the shadowing subscale, failed to improve the routinized walking subscale, and added a factor, attention shifting as compared to the original AWS. Evidence for validity was found in significant correlations and ANOVAs between the AWS-V2 and most subscales with a single item indicator of wandering and with the MMSE. Evidence of reliability was shown by internal consistency of the AWS-V2 (0.87, 0.88) and its subscales (range 0.88 to 0.66), with Kappa for individual items (17 of 27 greater than 0.4), and ANOVAs comparing ratings across rater groups (nurses, nurse aids, and other staff). Analyses support validity and reliability of the AWS-V2 overall and for persistent walking, spatial disorientation, and eloping behavior subscales. The AWS-V2 and its subscales are an appropriate way to measure wandering as conceptualized within the Need-driven Dementia-compromised Behavior Model in studies of English-speaking subjects. Suggestions for further strengthening the scale and for extending its use to clinical applications are described.
Developing links between school nursing and CAMHS
- Authors:
- MITCHELL Gemma, BAPTISTE Lucretia, POTEL Debra
- Journal article citation:
- Nursing Times, 3.2.04, 2004, pp.36-39.
- Publisher:
- Nursing Times
Discusses the national changes taking place in school nursing and describes a consultation undertaken to clarify the training needs of school nurses in relation to child and adolescent mental health . The consultation interviewed 17 school nurses in Islington. Covers the types of problems encountered, levels of knowledge and confidence and training priorities.
The mental health of young people looked after by local authorities in Scotland: the report of a survey carried out in 2002/2003 by the Office for National Statistics on behalf of the Scottish Executive
- Authors:
- MELTZER Howard, et al
- Publisher:
- Office for National Statistics,|Stationery Office
- Publication year:
- 2004
- Pagination:
- 233p.
- Place of publication:
- London
This Summary Report provides up-to-date baseline information about the prevalence of mental disorders among 5-15 years olds in Scotland in order to inform policy decisions about the need for child and adolescent mental health services. The main purpose of the survey was to produce rates of three main categories of mental disorder: conduct disorder, hyperactivity and emotional disorders by the characteristics of the children and where they lived. The survey also looked at the impact and burden of children's mental health problems and at their use of health, social and educational services.
What works for troubled children?
- Authors:
- BUCHANAN Ann, RITCHIE Charlotte
- Publisher:
- Barnardo's
- Publication year:
- 2004
- Pagination:
- 182p.,bibliog.
- Place of publication:
- Ilford
- Edition:
- 2nd
Many children have emotional or behavioural problems at some stage and most recover with a little help from those around them. There is evidence however that the number of children with behaviour difficulties is rising and that the heaviest concentration is in inner urban areas where services are already stretched. Although more psychiatric and psychological services are required, most children with troubled behaviour need social and educational solutions rather than health interventions. The best people to help may be those who know the child best. The book looks at developments in assessment, prevention projects and behavioural/cognitive behavioural interventions The book is addressed to front-line workers, social workers, teachers, health visitors, as well as managers and policy makers and updates and revises the 1999 edition.