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The legend and lessons of Geel, Belgium: a1500-year-old legend, a 21st-Century model
- Authors:
- GOLDSTEIN Jackie L., GODEMONT Marc M. L.
- Journal article citation:
- Community Mental Health Journal, 39(5), October 2003, pp.441-458.
- Publisher:
- Springer
Geel, Belgium, is the home of a legendary system of foster family care for people with mental illness. The current status of Geel's modern system of integrated community care and the 700-year history of this system (including the 10-year-long, international, multi-disciplinary Geel Research Project) are described. As a case study, Geel offers a microcosmic encapsulation of major issues related to mental illness. Though these issues have been dealt with across time and in all places, here they are contained in a single community. This is a case study can help other communities to identify significant factors that contribute to successful community mental health programmes.
Assessing clinically significant religious impairment in clients: applications from measures in the psychology of religion and spirituality
- Authors:
- HILL Peter C., KILIAN Macus K.
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.149-160.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reviews measures in the psychological study of religion and spirituality (RS) in terms of Hathaway’s conceptualisation of clinically significant religious impairment (CSRI). It is maintained that RS can be regarded as an endogenous variable impaired by psychopathology. Specific RS measures are discussed in terms of how they may be used to assess RS impairment in clients in terms of performing RS activities, achieving RS goals, and experiencing desired RS states.
Religious issues in diagnosis: the V-Code and beyond
- Authors:
- SCOTT Stacey, et al
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.161-173.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper addresses the issues around considering clients’ religious and spiritual functioning as a matter of client diversity. Such issues may be under appreciated by many clinicians. The introduction of a religious and spiritual problem V-Code (V62.89) into the DSM-IV provided a significant accommodation of client religious and spiritual functioning in contemporary psychodiagnostics. The V-Code allows for explicit identification of a nonpathological religious or spiritual focus in treatment. The nature of and history of the V-Code’s inclusion in DSM-IV is briefly reviewed. The strengths and limitations of the V-Code for raising clinician awareness of the religious and spiritual domain of client functioning is discussed and illustrated by a number of case examples. The V-Code approach is contrasted with Hathaway’s clinically significant religious impairment concept. Both are viewed as making complementary contributions to a religiously and spiritually sensitive clinical practice.
An audit of interventions for dual diagnosis in a psychiatric unit
- Author:
- SAUNDER Lorna
- Journal article citation:
- Nursing Times, 8.7.03, 2003, pp.34-36.
- Publisher:
- Nursing Times
Reports on a dual diagnosis training programme for mental health nurses working in an acute psychiatric unit, based on the recommendations in the Dual Diagnosis Good Practice Guide from the Department of Health. An audit of key standards were carried out to examine the interventions offered to patients with a dual diagnosis. An audit was repeated on month later. Concludes that although an improvement was observed in the standard of care, the sample size was small and without further statistical anlaysis it would be difficult to determine whether the improvement was statistically significant.
A three-factor analytic model of the MADRS in geriatric depression
- Authors:
- PARKER R. D., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(1), January 2003, pp.73-77.
- Publisher:
- Wiley
Major depression is a heterogeneous disorder, perhaps comprising several clinical subtypes or subgroups of symptoms. This study examined whether items on the Montgomery-Åsberg Depression Rating Scale (MADRS) form distinct symptom subgroups among geriatric depressive patients that might form the basis of new outcome measures for tracking treatment effects. The study examined a sample of 225 adults age 59 and older diagnosed with major depression. Three distinct interpretable factors were obtained. The first factor, dysphoric apathy/retardation, comprised five items: apparent sadness, reported sadness, lassitude, reduced concentration, and inability to feel. Psychic anxiety, the second factor, included three items: inner tension, pessimistic thoughts, and suicidal thoughts. The third factor, vegetative symptoms, resulted from items involving sleep and appetite.
The evolution of systems of care for children's mental health: forty years of community child and adolescent psychiatry
- Authors:
- PUMAARIEGA Andres J., WINTERS Nancy C., HUFFINE Charles
- Journal article citation:
- Community Mental Health Journal, 39(5), October 2003, pp.399-425.
- Publisher:
- Springer
Over the past 20 years, child and adolescent community mental health has evolved conceptually, clinically, and scientifically towards the community-based systems of care model. This model asserts important values and principles, including the centrality of the child and family in the care process, the integration of the efforts of disparate agencies and interveners into a contextual approach, and the importance of serving children with serious disturbances in their homes and communities. The article reviews the evolution of the community-based systems of care model, its evidence-base, its application in practice, and the challenges it faces in today's human services environment
Baseline experience with Modified Mini Mental State Exam: The Women's Health Initiative Memory Study (WHIMS)
- Authors:
- RAPP S. R., et al
- Journal article citation:
- Aging and Mental Health, 7(3), May 2003, pp.217-223.
- Publisher:
- Taylor and Francis
The Modified Mini Mental State Exam (3MS) is widely used for screening global cognitive functioning, however little is known about its performance in clinical trials. The authors report the distribution of 3MS scores among women enrolled in the Women's Health Initiative Memory Study (WHIMS) and describe differences in these scores associated with age, education, and ethnicity. The 3MS exams were administered to 7,480 women aged 65-80 who had volunteered for and were eligible for a clinical trial on postmenopausal hormone therapy. General linear models were used to describe demographic differences among scores. Factor analysis was used to characterize the correlational structure of exam subscales. The distribution of 3MS scores at baseline was compressed in WHIMS compared to population-based data. Mean 3MS scores (overall 95.1) tended to decrease with age and increase with education, however these associations varied among ethnic groups ( p < 0.0001) even after adjustment for health, physical disability and occupation attainment. Four factors accounted for 37% of the total variance. Each varied with education and ethnicity; the two most prominent factors also varied with age. Despite relatively narrow distributions in WHIMS, baseline 3MS scores retained associations with age and education. These associations varied among ethnic groups, so that care must be taken in comparing data across populations.
Where next?: new directions in in-patient mental health services for young people; report 1 different models of provision for young people; facts and figures
- Authors:
- STREET Cathy, SVANBERG Jenny
- Publisher:
- YoungMinds
- Publication year:
- 2003
- Pagination:
- 51p.,bibliog.
- Place of publication:
- London
Looks at issues emerging, and views from young people, parents and staff. Different Models of provision for young people: facts and figures, the background context to the study is set out, along with the study design and methodology and the conclusions and recommendations arising from the research. One chapter describes the sample in-patient units, including for each the challenges they identified in providing services and their plans for the future. Another presents a range of different models for providing support to young people with mental health difficulties on a residential basis. These include a service designed to fill the gap between adolescent and adult psychiatry and one set up for young people with early onset psychosis. The report also discusses the learning from the study on how to consult with young people about mental health services and includes an appendix summarising useful literature on this issue.
Early intervention in psychosis: a pilot study of methods to help existing staff adapt
- Authors:
- PAXTON Roger, et al
- Journal article citation:
- Journal of Mental Health, 12(6), December 2003, pp.627-636.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Improved detection and clear referral systems are prerequisites for effective early intervention. Although specialist early intervention services are being introduced in Britain, changes are still required in the practice of existing primary and secondary care staff. This paper describes an exploratory evaluation of a partnership approach to help existing staff adapt their practice to support early intervention. Policies and procedures of the service described were compared systematically with national policy guidance. Structured interviews with 53 primary care and mental health staff were used to explore changes in their knowledge, attitudes and professional practice. The service model complied with most UK national policy requirements for early intervention. There was increased awareness and knowledge of early psychosis and improved detection, assessment and intervention practice on the part of primary and secondary care staff. It appears possible to influence the practice of existing staff to deliver early intervention using an economical service model.
The development of potential models of advance directives in mental health care
- Authors:
- ATKINSON Jacqueline M, et al
- Journal article citation:
- Journal of Mental Health, 12(6), December 2003, pp.575-584.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The review of mental health law in the UK has involved consideration of mechanisms for advance directives in mental health care. The aim was to develop potential models of advance directives based on the views of stakeholders in mental health services in Scotland. Focus groups and individual interviews were conducted with service users, professionals and carers who had an interest in advance directives. Leaflets and policy documents from campaign groups and voluntary organisations were collected and along with data generated in interview and group discussion were analysed for themes. Six potential models were developed that highlighted the overarching themes of co-operation versus autonomy and the legal status of any directive. There is a wide variety of opinion about what advance directives could or should bring to mental health care, they are not all achievable through the use of any one model.