Search results for ‘Subject term:"mental health problems"’ Sort:
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Assessing and treating sexual offenders with mental disorders
- Authors:
- LORD Alex, PERKINS Derek
- Journal article citation:
- Journal of Forensic Practice, 16(2), 2014, pp.94-109.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to increase our understanding of the role of mental disorder in sexual offending as well as identifying innovations in assessment and treatment with offenders who present with these typically complex risks and needs. Design/methodology/approach: The converging literatures on “good lives” and other developments in sexual offender treatment are compared with recovery from mental disorder and what is known about the particular needs and characteristics of sexual offenders with mental illness and severe personality disorder (PD). Findings: A key outcome of this review is that many mentally disordered sexual offenders have similar needs to those in prison and the community but there are particular challenges posed by severe PD, paraphilias and the relatively rare individuals whose offending is functionally linked to psychotic symptoms. Practical implications: Practical implications include the need for case formulation of complex needs related to mental disorder using direct and indirect measures of attitudes and interests. Treatment needs to be responsive to very different personality and mental health presentations as well as problems with offending and cognitive schemas. Direct functional links between mental health symptoms such as delusions and hallucinations are very rare in practice and are usually secondary to PD and sexual offending issues. In practice, treatment promoting recovery from mental disorder is highly compatible with the “good lives” approach to sexual offender treatment. Staff development, supervision and support are particularly important for staff treating mentally disordered sexual offenders. Originality/value: It is argued that mentally disordered sexual offenders are an under-researched sub-group within the wider sexual offender population. This paper brings together the relatively limited literature on treatment with examples of recent treatment innovations, multi-modal assessment approaches and reviews of research on the needs of this relatively uncommon but highly risky group. (Publisher abstract)
Mental health treatment in juvenile justice secure care facilities: practice and policy recommendations
- Authors:
- UNDERWOOD PsyD, Lee A., et al
- Journal article citation:
- Journal of Forensic Psychology Practice, 14(1), 2014, pp.55-85.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Responding to the needs of juvenile offenders with serious mental illness is a serious concern for correctional administrators and mental health providers. The recommendations for mental health treatment provide guidelines about how to address the needs of incarcerated youth. A national group of expert researchers and practitioners convened for a conference to recommend practice guidelines. Five overarching recommendations and practice guidelines for mental health treatment in juvenile justice secure care facilities emerged. Conference recommendations, practice and policy guidelines regarding characteristics of youth, screening and assessment, intervention and case management services, community transition, and residential safety are presented. Recommendations for future direction are provided. (Publisher abstract)
Anxiety disorders: QS53
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2014
- Place of publication:
- Manchester
This quality standard covers the identification and management of anxiety disorders in primary, secondary and community care for children, young people and adults. These include generalised anxiety disorder, social anxiety disorder, post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder and body dysmorphic disorder. The standard sets out the following four quality statements: people with a suspected anxiety disorder receive an assessment that identifies whether they have a specific anxiety disorder, the severity of symptoms and associated functional impairment; people with an anxiety disorder are offered evidence-based psychological interventions; they are not prescribed benzodiazepines or antipsychotics unless specifically indicated; and people receiving treatment for an anxiety disorder have their response to treatment recorded at each treatment session. (Edited publisher abstract)
“Is there a getting better from this, or not?” examining the meaning and possibility of recovery from mental disorder
- Journal article citation:
- Child and Youth Services, 35(2), 2014, pp.116-136.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The concept of “recovery” from mental disorder is widely used in the national conversation about youth and adult mental health treatment as if everyone is on the same page about what it means. Fundamental disagreements among researchers and practitioners exist, however, on a variety of issues related to the precise nature and meaning of recovery from mental, emotional, and behavioural disorder generally. Among these issues are: (a) The meaning of recovery; (b) The possibility of full recovery; and (c) Effective support for recovery. After reviewing diverging responses for each of these three issues, the authors then trace practical implications of competing interpretations for treatment and recovery itself. As demonstrated throughout, the stance taken on these questions can have profound and lifelong consequences for youth and children in treatment. (Edited publisher abstract)
Vascular depression: overrepresented among African Americans?
- Authors:
- REINLIEB Michelle E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(5), 2014, pp.470-477.
- Publisher:
- Wiley
Objective: Our primary aim was to compare the rate of vascular depression among a clinical sample of African American and Caucasian depressed older adults. Secondary aims included characterizing the clinical and neuropsychological profile of vascular depression and comparing antidepressant response rates between patients with vascular and nonvascular depression. Methods: This was a two-site, multi-ethnic, open 8-week trial of antidepressant medication in older adults with depression. Men and women 50 years or older meeting DSM-IV criteria for nonpsychotic unipolar depression participated in this trial. Each participant underwent a comprehensive psychiatric and neuropsychological evaluation and a brain MRI, which were performed at baseline. Results: Forty-six patients met inclusion and exclusion criteria. Forty-two of those patients received an MRI at baseline. Sixteen patients met criteria for vascular depression. Patients with vascular depression were significantly more likely to be African American and have a higher likelihood of being female, a higher rate of hypertension and psychomotor retardation, a lower rate of family history of affective illness, and frontal systems dysfunction on neuropsychological testing. The difference in response rates between patients with vascular and nonvascular depression did not reach statistical significance. Conclusions: This is the first study to document high rates of vascular depression in a clinical sample of African Americans and Caucasians. Our findings suggest that vascular depression may be overrepresented among African Americans, which is consistent with the high rates of cardiovascular disease, hypertension, and stroke in this population. (Publisher abstract)
Self psychology and male child sexual abuse: healing relational betrayal
- Journal article citation:
- Clinical Social Work Journal, 42(1), 2014, pp.41-48.
- Publisher:
- Springer
- Place of publication:
- New York
The prevalence of male child sexual abuse (MCSA) is higher than initially thought with up to 26 % of men in community samples reporting sexual abuse in childhood, and up to 36 % of men in clinical samples reporting childhood sexual abuse. Disclosure of MCSA is complex because of men’s difficulties in viewing themselves as victims, especially of sexual violence. This difficulty is exacerbated by societal attitudes that sexual abuse rarely occurs with boys, and is further complicated with the taboo of victimisation by same sex perpetrators. Too often, the response to disclosure is disbelief and minimisation. For these reasons disclosure is often delayed or withheld thus prolonging the abuse. The negative effects of child sexual abuse are well documented and far reaching with depression, anxiety, post-traumatic stress disorder, addictions, sexual dysfunction and impaired interpersonal relations as common presenting issues in therapy. Treatment is indicated for significant numbers of male survivors. This paper identifies aspects of interpersonal relational difficulties commonly experienced by male sexual abuse survivors, and describes self psychology as guiding a clinical approach to address these interpersonal difficulties. The application of self psychology with male sexual abuse survivors is traced and discussed through the use of a clinical case study with Adam. (Edited publisher abstract)
Bipolar disorder: the assessment and management of bipolar disorder in adults, children and young people in primary and secondary care: CG185
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2014
- Place of publication:
- Manchester
This guideline covers the recognition, assessment and management of bipolar disorder in children, young people and adults. It includes specific recommendations for diagnosis in children and young people because presentation in these age groups can be complicated by other conditions such as ADHD. The recommendations apply to people with bipolar I, bipolar II, mixed affective and rapid cycling disorders. The guideline highlights the key priorities for implementation in relation to: care across all phases of bipolar disorder; recognising and managing bipolar disorder in adults in primary care; managing mania or hypomania in adults in secondary care; managing bipolar depression in adults in secondary care; managing bipolar disorder in adults in the longer term in secondary care; and recognising, diagnosing and managing bipolar disorder in children and young people. (Edited publisher abstract)
A systematic review of studies examining effectiveness of therapeutic communities
- Authors:
- MAGOR-BLATCH Lynne E., et al
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 35(4), 2014, pp.168-184.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment of substance-use disorders with reference to substance-use, crime, mental health and social engagement outcomes. Design/methodology/approach: A systematic search with broad inclusion criteria resulted in the review of 11 studies. The studies investigated community-based TCs, as well as TCs modified for prisoners, prisoners transitioning to community living and TCs for individuals with co-occurring substance-use and mental health issues. Findings: Results were analysed by comparing the findings of the studies under investigation, of which three studies investigated within-subjects outcomes, four compared TC treatment with a no-treatment control condition and four compared TC treatment with another treatment condition. Conclusion: consistent with previous systematic reviews of TCs, outcomes varied across studies but indicated TCs are generally effective as a treatment intervention, with reductions in substance-use and criminal activity, and increased improvement in mental health and social engagement evident in a number of studies reviewed. Research limitations/implications: Variability in outcomes suggests further TC research and research syntheses focusing on a second key research question in the evaluation of complex interventions – how the intervention works – could play an important role in understanding TC effectiveness, and for whom it is effective and in what contexts. Practical implications: Although there is some variability in treatment populations included in this review, evidence reported in other studies suggests individuals with severe substance-use disorders, mental health issues, forensic involvement and trauma histories, will benefit from TC treatment. This is supported by the literature which has found a general relationship between severity of substance use and treatment intensity (Darke et al., 2012; De Leon et al., 2008) with outcomes further enhanced by self-selection into treatment and appropriate client-treatment matching (see De Leon, 2010; De Leon et al., 2000, 2008). The weight of evidence gleaned from multiple sources of research, including randomised control trials and field outcome studies (De Leon, 2010) suggests TCs are an important and effective treatment for clients in improving at least some aspects of their quality of life, specifically mental health and social engagement, and in reducing harmful behaviours, including substance-use and crime. Variability in treatment setting and populations reflect the real-world setting in which TC treatment is delivered, providing a multifaceted treatment modality to a complex population in variable circumstances. Originality/value: The strength of the current study is that it provided a broad evaluation of TC effectiveness across a range of outcomes (substance-use, criminal activity, mental health and social engagement), and is therefore valuable in updating the current literature and providing context for future research in this area. It aimed to address a key question in evaluating complex interventions: whether they are effective as they are delivered. Findings suggest that TC treatment is generally effective for the populations of concern in reducing substance use and criminal activity and contributing to some improvement in mental health and social engagement outcomes. (Publisher abstract)
Assessment and treatment of physical health problems among people with schizophrenia: national cross-sectional study
- Journal article citation:
- British Journal of Psychiatry, 205(6), 2014, pp.473-477.
- Publisher:
- Cambridge University Press
Background: In the UK and other high-income countries, life expectancy in people with schizophrenia is 20% lower than in the general population. Aims: To examine the quality of assessment and treatment of physical health problems in people with schizophrenia. Method: Retrospective audit of records of people with schizophrenia or schizoaffective disorder aged ≥18. We collected data on nine key aspects of physical health for 5091 patients and combined these with a cross-sectional patient survey. Results: Body mass index was recorded in 2599 (51.1%) patients during the previous 12 months and 1102 (21.6%) had evidence of assessment of all nine key measures. Among those with high blood sugar, there was recorded evidence of 53.5% receiving an appropriate intervention. Among those with dyslipidaemia, this was 19.9%. Despite this, most patients reported that they were satisfied with the physical healthcare they received. Conclusions: Assessment and treatment of common physical health problems in people with schizophrenia falls well below acceptable standards. Cooperation and communication between primary and secondary care services needs to improve if premature mortality in this group is to be reduced. (Publisher abstract)
Beyond co-occurring disorders to behavioral health integration
- Authors:
- DAVIDSON Larry, et al
- Journal article citation:
- Advances in Dual Diagnosis, 7(4), 2014, pp.185-193.
- Publisher:
- Emerald
Purpose: Despite the high prevalence of co-occurring disorders and the need for systems of care to integrate mental health and addiction services, integration remains a challenge. The purpose of this paper is to address this challenge by focusing on shared processes of recovery. Design/methodology/approach: After reviewing commonalities between mental health and substance use recovery, integration of treatment with recovery supports under the rubric of a “recovery-oriented system of care” is described. Philadelphia's Department of Behavioral Health and Intellectual disAbility Services is then used as an example to illustrate strategies for achieving two forms of integration: mental health and addiction and treatment and recovery supports. Findings: Viewed through the lens of people with mental health and addiction challenges, the services and supports that promote recovery are very similar. One of the common themes that emerged was the need for these services to go beyond helping people manage their symptoms or achieve abstinence, to also helping them to rebuild their lives in their communities. In addition to co-location and increased collaboration, service providers must possess common values, a consistent approach, and a shared vision for the people they serve. Practical implications: Systems need to find innovative and effective ways to integrate recovery support services with treatment and other interventions, hopefully transforming existing services in the process. Originality/value: In the process of developing a truly integrated behavioral health system, a shared vision across all sectors of the system must shift away from the field's historical focus on illness and problems to a new focus on strengths and possibilities. (Publisher abstract)