Search results for ‘Subject term:"mental health problems"’ Sort:
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Factors associated with experienced discrimination among people using mental health services in England
- Authors:
- HAMILTON S., et al
- Journal article citation:
- Journal of Mental Health, 25(4), 2016, pp.350-358.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Research has found considerable variation in how far individuals with a diagnosis of mental illness experience discrimination. Aims: This study tested four hypotheses: (i) a diagnosis of schizophrenia will be associated with more discrimination than depression, anxiety or bipolar disorder; (ii) people with a history of involuntary treatment will report more discrimination than people without; (iii) higher levels of avoidance behaviour due to anticipated discrimination will be associated with higher levels of discrimination and (iv) longer time in contact with services will be associated with higher levels of discrimination. Method: Three thousand five hundred and seventy-nine people using mental health services in England took part in structured telephone interviews about discrimination experiences. Results: A multiple regression model found that study year, age, employment status, length of time in mental health services, disagreeing with the diagnosis, anticipating discrimination in personal relationships and feeling the need to conceal a diagnosis from others were significantly associated with higher levels of experienced discrimination. Conclusion: Findings suggest that discrimination is not related to specific diagnoses but rather is associated with mental health problems generally. An association between unemployment and discrimination may indicate that employment protects against experiences of discrimination, supporting efforts to improve access to employment among people with a diagnosis of mental illness. (Publisher abstract)
Improving psychiatric diagnosis in multidisciplinary child and adolescent mental health services
- Authors:
- MICHELSON Daniel, et al
- Journal article citation:
- Psychiatrist (The), 35(12), December 2011, pp.454-459.
- Publisher:
- Royal College of Psychiatrists
Obtaining an accurate clinic diagnosis is a critical process in mental healthcare pathways. This study was designed to develop and test a new one-day diagnostic training intervention for multidisciplinary practitioners (n=63) in out-patient child and adolescent mental health services. The authors examined learning outcomes, practice impacts and the implementation processes. The work was conducted in an inner London area where previous audits had revealed large inconsistencies in rates of recorded diagnoses. Training was viewed positively by most participants and was associated with significant increases in practitioner self-efficacy; this effect was sustained at 8-month follow-up. A comparative audit before and after training indicated that clinicians were significantly more likely to assign an Axis I diagnosis following the training intervention. However, absolute rates of Axis I classification remained relatively low (less than 40%) both before and after training. Practitioners were moderately successful at following through on personal plans for implementing new learning. Support for implementation within teams was inconsistent. The authors conclude that a brief training workshop may have some impact on practitioners’ behaviour so that diagnoses are made more promptly and appropriately recorded. However, they suggest that future workforce development initiatives should consider more comprehensive and diversified strategies, including targeted post-training support, if increased self-efficacy following training is to be translated into sustained changes in diagnostic practice.
Do perceptions of dysfunction and normality mediate clinicians' judgements of adolescent antisocial behavior?
- Authors:
- KIRK Stuart A., HSIEH Derek H.
- Journal article citation:
- Social Service Review, 83(2), June 2009, pp.245-266.
- Publisher:
- University of Chicago Press
The Diagnostic and Statistical Manual of Mental Disorders (DSM) requires clinicians making a judgment of mental disorder to first make complex mediating inferences about internal dysfunction and rule out the possibility that behaviours are normal reactions to a problematic environment. Responding to a case vignette in which the social context of antisocial behaviour was systematically varied, a sample of 1,500 social workers, psychologists, and psychiatrists made judgments about the presence of mental disorder, internal dysfunction, and normality in the antisocial behaviour of a youth. Perceptions about the presence of internal dysfunction and normality are found to be related to judgments of mental disorder, but they do not fully mediate the relationship between the influence of social context and judgments of mental disorder.
Revisiting the structure of mental disorders: borderline personality disorder and the internalizing/externalizing spectra
- Authors:
- JAMES Lisa M., TAYLOR Jeanette
- Journal article citation:
- British Journal of Clinical Psychology, 47(4), November 2008, pp.361-380.
- Publisher:
- Wiley
Researchers have turned to dimensional models of psychopathology as a means of explaining robust patterns of comorbidity. A hierarchical model consisting of internalizing and externalizing dimensions has been a useful approach to understanding comorbidity among some mental disorders, although a limited number of disorders have been examined within this framework. The objective of the present study is to determine how borderline personality disorder fits into this framework. The dimensional measures of nine psychiatric disorders were used in a confirmatory factors analysis to compare five models of comorbidity in 1,197 members (N=541 women) of a population-based sample. Symptom composites were derived from the Michigan Composite International Diagnostic Interview and the International Personality Disorders Examination Questionnaire. Five models were fit to dimensional indicators of nine disorders. A model in which borderline personality disorder served as a multidimensional indicator of the externalizing factor and the anxious-misery subfactor of internalizing disorders provided the best fit to the data in the whole sample and in men. For women, this model also fit well but an alternative model in which borderline personality disorder served only as an indicator of the anxious-misery subfactor of internalizing disorders fit equally well.
The prevalence, incidence, and factors predictive of mental ill-health in adults with profound intellectual disabilities
- Authors:
- COOPER Sally-Ann, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(6), November 2007, pp.493-501.
- Publisher:
- Wiley
In this population-based prospective cohort study, adults with profound intellectual disabilities underwent psychiatric assessment (n = 184), with further assessment after 2 years (n = 131). Point prevalence of mental ill-health was 52.2% by clinical, 45.1% by Diagnostic Criteria for Psychiatric Disorders for use with Adults with Learning Disabilities (DC-LD), 10.9% by the ICD-10 Classification of Mental and Behavioural Disorders Diagnostic Criteria for Research (1993) (DCR-ICD-10) and 11.4% by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (2004) (DSM-IV-TR) criteria. The highest 2-year incidence rates were for affective disorders (6.1%) and problem behaviours (6.1%). Type of accommodation/support, and the number of preceding life events were predictive of incidents of mental ill-health, but age, gender, living in areas of greatest deprivation, and having special communication needs were not. It is concluded that mental ill-health is more commonly experienced by adults with profound intellectual disabilities than the general population, or other adults with intellectual disabilities, warranting proactive supports/interventions. Predictive factors differ, compared with the general population.
Going mad?: understanding mental illness
- Authors:
- CORRY Michael, TUBRIDY Aine
- Publisher:
- Newleaf
- Publication year:
- 2001
- Pagination:
- 163p.
- Place of publication:
- Dublin
One of the most alarming experiences has to be losing control over one's thoughts, feelings and behaviour. Everyone knows that if they lose control over the simple things, they are no longer running their lives. The fear of mental illness is not exclusive to high levels of anxiety and panic, although it is the commonest source. There are many symptoms that terrify people simply because they can't be explained - flashbacks to traumatic incidents, panic attacks, inability to concentrate or sleep. Psychological distress has a stigma that physical disease doesn't share. Well meaning suggestions are laced with judgement. Those who can't pull themselves together are thought spineless, lazy or weak. In this climate of achievement, success and money, who wants to employ someone who has had a 'nervous breakdown'? In this book, the authors chart the course of psychological distress from the minor to the major, clearly documenting what happens and what doesn't. They aim to make mental illness understandable and inseparable from the experience of being human. And the question the attitude and behaviour of the medical profession towards it.
Psychiatric diagnoses in a sample of HIV-infected people of color in methadone treatment
- Authors:
- WINIARSKI Mark G., et al
- Journal article citation:
- Community Mental Health Journal, 41(4), August 2005, pp.379-391.
- Publisher:
- Springer
This article describes the rates of psychiatric diagnoses in a convenience sample of HIV-positive, African American and Hispanic clients in methadone treatment in the Bronx, New York. Out of 139 HIV-positive volunteers, 99 subjects had diagnoses in addition to opioid dependence on agonist therapy. These findings confirm the need to target mental health as part of the national response to the HIV/AIDS epidemic in inner cities.
Siblings of people diagnosed with a mental disorder and posttraumatic growth
- Authors:
- SANDERS Avihay, SZYMANSKI Kate
- Journal article citation:
- Community Mental Health Journal, 49(5), 2013, pp.554-559.
- Publisher:
- Springer
This study examines the potential for posttraumatic growth (PTG) for siblings of persons diagnosed with a mental disorder. Using the posttraumatic growth Inventory the authors compared siblings (N = 33) with a comparison group of participants who did not experience trauma (N = 30). The group of participants who had a sibling diagnosed with a mental disorder by a mental health professional (N = 33) reported higher PTG scores with mostly large effect sizes on most of the inventory subscales. Participants who took an active role in care giving experienced less PTG than participants who did not. Having a sibling diagnosed with a mental disorder presents an opportunity to experience PTG. Implications for the therapeutic milieus are discussed. (Publisher abstract)
A prospective study of PTSD following recovery from first-episode psychosis: the threat from persecutors, voices, and patienthood
- Authors:
- BRUNET Kat, et al
- Journal article citation:
- British Journal of Clinical Psychology, 51(4), November 2012, pp.418-433.
- Publisher:
- Wiley
Focusing on post-traumatic symptoms and people with psychosis, this prospective study tested hypotheses based on retrospective findings that threat appraisals of voices, persecutors, or the new label of 'mental health patient' predict symptoms of post-traumatic stress disorder (PTSD). Fifty patients in Birmingham in the acute phase of a first psychotic episode were assessed for appraisals of threat from voices, other persecutors, and the diagnosis. 39 patients completed the follow-up stage 18 months later, which was designed to establish PTSD symptom levels and diagnosis. The article describes the study methodology, analysis, and results. It reports that 31% of participants who completed the follow up phase met criteria for PTSD diagnosis, and 49% were still distressed by memories of their psychosis or the associated treatment. Appraisals of threat from voices and persecutors during the acute phase of psychosis were generally not predictive of subsequent post-traumatic stress. The authors discuss the findings and suggest that further research is required to assess the true impact of psychosis on PTSD.
UK extended Medical Assessment Programme for ex-service personnel: the first 150 individuals seen
- Author:
- PALMER Ian P.
- Journal article citation:
- Psychiatrist (The), 36(7), July 2012, pp.263-270.
- Publisher:
- Royal College of Psychiatrists
This study describes an interim service set up to examine the breadth of UK ex-service personnel’s concerns in relation to their mental health and military service and provides a record of the first 150 individuals assessed following conformation of military service and examination of all available military and civilian medical records. The majority of attendees were White male ex-soldiers. Average age, service and time to assessment were 44.5, 15.8 and 11.7 years respectively. Two-thirds were receiving help from the National Health Service and ex-service non-governmental organisations. Rates of post-traumatic stress disorder were similar to previous UK studies. Obsessional symptoms were of relevance to the clinical presentation in a third. Fabrication and/or exaggeration occurred in about 10%. The authors note that the spread of diagnoses and delay in help-seeking are similar to civilians. They believe that the link between mental disorders and military service is seldom straightforward and fabrication or exaggeration is difficult for civilians to recognise. Verification and contextualisation of service using contemporaneous service medical records is of value given the possible occupational origin of mental health conditions.