Engagement in community service among college students: is it affected by significant attachment relationships?

This study served as an exploratory analysis of how engagement in community service activities among college students is affected by significant attachment relationships. More specifically, this study investigated the difference between community service and non-service students in terms of their motivation to engage in community service activities as a function of the quality of their attachment to parents and close personal friends. A quantitative approach was used to analyse these issues. The findings revealed that students who had some community service experience evidenced more secure attachments to close personal friends while their attachments to parents were varied. Closer examination of the attachment data revealed that the community service students were more likely to have either very high or very low attachment relationships with their parents. These findings suggest that when incorporating service-learning into the college curriculum, one should examine the influence of other important contexts, (i.e. parents and peers) on community service outcomes.     

Family perspective on community treatment orders: a New Zealand study

BACKGROUND: People with serious mental disorders typically live with family members. Despite increasing interest in compulsory community treatment for such patients, the experience and views of their family members have been little studied. MATERIAL: Qualitative interviews with 27 family members, whose relatives have been subject to compulsory community treatment. DISCUSSION AND CONCLUSIONS: Family members are generally in favour of the use of compulsory community treatment orders. They perceive a positive influence on their relative, on themselves, on family relationships, and on relations with the clinical team. Family members are aware of the ethical and other dilemmas that attend the use of compulsory community care.     

Followup of psychotic outpatients: dimensions of delusions and work functioning in schizophrenia

We studied three characteristics or dimensions of delusions in schizophrenia patients living in the community, including their influence on work and community functioning. The 149-patient sample included 57 delusional schizophrenia and nonschizophrenia outpatients, 50 nondelusional outpatient controls, and 42 delusional inpatient controls. The data indicated the strength and prominence of acute-phase psychopathology on characteristics of delusions, with large significant differences in intensity of delusions between the acute inpatient phase and the postacute inpatient and outpatient phases. Contrary to some views, the data indicate that the overall presence of any delusions in general, and the various dimensions of delusions, both influence work performance and community functioning, with the greater part of the variance due to the presence of delusions in general. Despite their outpatient status, delusional outpatients showed surprisingly poor self-monitoring about whether others would regard their delusional ideation as unrealistic. Schizophrenia and affectively disordered patients with high emotional commitment to their delusions showed significantly poorer work functioning and were significantly more likely to be rehospitalized (p < 0.05), indicating the important impact on functioning of patients' feelings of immediacy and urgency about their unrealistic beliefs.     

The role of residential homelikeness in promoting community participation by adults with mental retardation

We tested the influence of (1) the homelike appearance of residences, (2) residential staff-members' attitudes about people with mental retardation and (3) Client IQ on the number of activities adults clients with mental retardation conducted in their community. We tested the hypothesis these three variables exerted their influence by promoting positive staff-member interactions with clients. This was assessed by measuring the duration of Staff-initiated Social Interactions with residential clients. In our initial path model, Residential Homelikeness, Positive Staff Attitudes and Client IQ had no significant direct effect on Community Activities. In the final model, however, Residential Homelikeness and Positive Staff Attitudes exerted a statistically significant influence on Staff-initiated Social Interactions with clients, which in turn, exerted a statistically significant influence on Community Activities. This model illustrated: (1) the nearly equal influence of Staff Attitudes and architectural characteristics on Staff-initiated Interactions; and (2) the role of Staff-initiated Interactions in mediating the influence of Residential Homelikeness on community participation by adults with developmental disabilities.     

Community attitudes toward mental illness: the influence of contact and demographic variables

Residents of three large rural cities were surveyed to investigate the influence of 'psychiatric exposure' and demographic variables on community attitudes toward mental illness. Samples drawn from the three communities, which differed according to the availability of mental health services, were administered the Opinions About Mental Illness Scale, with questionnaire items that elicited measures of the amount of contact with mental illness and standard demographic data. Multiple regression analyses showed that demographic but not 'exposure' variables had a significant influence on community attitudes. Contrary to previous findings, the older, less-educated members of the public were more positive in their opinions on mental health issues. Other variables to have an influence on attitudes were ethnic origin and occupational status.     

Impact of personality on termination of short-term group psychotherapy in depressed elderly outpatients

OBJECTIVE: Termination in group psychotherapy is an essential phase of the psychotherapeutic process, yet its clinical determinants remain largely unknown, especially in elderly patients. The aim of this study was to assess how patients' personality traits influence their way of leaving a short-term psychotherapy group as well as a larger therapeutic community program. METHOD: Personality traits were assessed with the NEO Five-Factor Inventory in 24 elderly depressed outpatients. Patients' terminations from the group as well as from the community were ranked into four classes according to their appropriateness (completeness of experience and ability to deal with feelings of separation). RESULTS: Neuroticism was not related to the quality of termination. In contrast, agreeableness and openness to experience were strongly associated with successful termination. Conscientiousness and extraversion may have a differential impact depending on the type of group (group psychotherapy versus therapeutic community). CONCLUSION: Personality traits may be important clinical determinants of the quality of termination process in both group psychotherapy and therapeutic community settings for elderly depressed patients.     

Community psychiatry: results of a public opinion survey

BACKGROUND: Mental health authorities must know the public's attitude to community psychiatry when planning community mental health services. However, previous studies have only investigated the impact of demographic variables on the attitude to community psychiatry. AIM: To assess the influence of psychological and sociological parameters on the public opinion of community psychiatry in Switzerland. METHOD: Linear regression analyses of the results of a public opinion survey on a representative population sample in Switzerland (n = 1737). RESULTS: Most respondents have positive attitudes to community psychiatry. In the regression analysis (R2 adjusted = 21.2%), negative emotions towards mentally ill people as depicted in the vignette, great social distance, a positive attitude to restrictions, negative stereotypes, high rigidity and no participation in community activities significantly influenced negative attitudes to community psychiatry. Additionally, other parameters, e.g. contact with mentally ill people and the nationality of the interviewee, have a significant influence. CONCLUSIONS: In planning psychiatric community services, general individual traits and emotive issues should be considered because they influence the response towards community psychiatry facilities in the host community.     

Perceived stigmatization of mentally ill people and its consequences for the quality of life in a Swiss population

The awareness of social conceptions of mental illness is essential in understanding the social realities of people with mental illness. Labeling due to psychiatric hospitalization can have a powerful influence on people's life chances. Little is known about subjective perceptions of stigmatization and discrimination and the influence of these beliefs on the quality of life of mentally ill people. We used a psychiatric inpatient sample and a community sample to analyze and compare perception of stigmatization and discrimination. Both patients and community members believed that most people rejected former mental patients. Thus, attitudes toward mental illness have their source in the socialization of the individual and his or her cultural context rather than in the currently pathological state of those affected. In a multiple regression analysis, we showed that even if controlled for demographic and clinical factors, perceived devaluation and discrimination had a significant negative effect on the quality of life of the mentally ill people. For planning and implementing psychiatric treatment programs, it is important to be aware of social conceptions of mental disorder.     

Working in the public and private domains: staff management of community activities for and the identities of people with intellectual disability

In addition to describing how the concept of stigma continues to be a pervasive influence in encounters between people with intellectual disability and others, the present study suggests that the management of this situation has passed into the control of care staff. An ethnographic study of young adults and community relationships suggests that the activities of staff are crucial in shaping the social profile of people with intellectual disability. The views of care staff about the taken‐for‐granted rights which characterize presence and participation in the community domain encourage them to adopt a semi‐insulation approach to their work. Staff extend this approach by adopting information control strategies to conceal important information from students. The present author argues that there is a need for on‐going research into staff activity in the community domain.     

Implementing an Evidence-Based Parenting Program in Community Agencies: What Helps and What Gets in the Way?

Adoption of evidence-based programs for families by community agencies requires an understanding of variables that influence implementation. Managers and service providers from 64 community agencies reported on variables that affected the implementation of Triple P, an evidence-based parenting program. Both types of stakeholders reported adequate office resources; over half the managers and over two-thirds of service providers reported adequate training. Adequate office resources and positive agency characteristics, including organizational climate, were associated with higher program usage. Service providers' reports of the variables impacted their individual adherence rates; managers had broader perspectives of the quality of implementation in their organizations.     

The role of neurocognition and social context in predicting community functioning among formerly homeless seriously mentally ill persons

OBJECTIVE: To test the influence of neurocognitive functioning on community functioning among formerly homeless persons with serious mental illness and to determine whether that influence varies with social context, independent of individual characteristics. METHODS: In metropolitan Boston, 112 persons in Department of Mental Health shelters were administered a neuropsychological test battery and other measures and then randomly assigned to empowerment-oriented group homes or independent apartments, as part of a longitudinal study of the effects of housing on multiple outcomes. Subjects' case managers completed Rosen's 5-dimensional Life Skills Inventory at 3, 6, 12, and 18 months and subjects reported on their social contacts at baseline, 6, 12, and 18 months. Subject characteristics are controlled in the analysis. RESULTS: Three dimensions of neurocognitive functioning--executive function, verbal declarative memory, and vigilance--each predicted community functioning. Better executive function predicted improved self-care and less turbulent behavior among persons living alone, better memory predicted more positive social contacts for those living in a group home, and higher levels of vigilance predicted improved communication in both housing types. CONCLUSION: Neurocognition predicts community functioning among homeless persons with severe mental illness, but in a way that varies with the social context in which community functioning occurs.     

Perceptions of exonerees in Australia

Identifying and preventing miscarriages of justice is paramount; however, it is also imperative to consider what happens to exonerees after they have been exonerated in order to better inform their integration back into the community. The present study examines the influence of the type of evidence used to exculpate the accused, and the length of time spent in prison, on public perceptions of exonerees in Australia. The findings reveal that innocent and exonerated individuals are perceived differently to guilty individuals in terms of desired closeness, and do not suggest that exonerees are stigmatised in the same way as guilty individuals may be. Media coverage of the incidence of wrongful conviction is increasing public awareness; however, targeted education regarding the causes and impact of wrongful conviction may assist exonerees’ acceptance once they are integrated back into the community.     

社区养老与家庭养老影响老年人生活质量的比较分析

目的 研究社区养老与家庭养老对老年人生活质量的影响。方法 抽取社区养老院或敬老院中70岁以上、自筹费用的老人220名(研究组)；再随机抽取70岁以上．不与子女居住的家庭养老的老人220名(对照组)。两组均采用《生活质量综合评定问卷》评价其生活质量。结果 在躯体功能方面两组相比无显著性差异．但研究组在心理功能、社会功能方面均显著优于对照组．物质生活条件则差于对照组。结论 从生活质量的总体看，研究组在心理功能、社会功能方面优于对照组。     

Principles of Community Psychiatry

Our primary goal in community psychiatry is to satisfy the service needs of a bounded population for whose mental health we have accepted responsibility and accountability. We base our programs on public health practice models: These direct us to focus on segments of our population which are currently exposed to harmful bio-psycho-social factors that increase their risk of becoming mentally ill. We focus on preventing psychosocial problems or their consequences by reducing their population rates: either the incidence of new cases (primary prevention), the prevalence of all existing cases (secondary prevention), and the rates of residual disability (tertiary prevention). We increase our efficiency and effectiveness by organizing our program on the basis of crisis theory which demands that we reach out to people in crisis and provide them with immediate guidance and help to master their current difficulties during the short period when they are open to influence and amenable to change in ways that have long term mental health consequences. We spread our own influence by organizing support groups and we multiply many-fold our impact on the huge problems involved in covering the needs of our population by recruiting the collaboration of other professional caregivers and non-professional helpers. We enhance the mental health component in the daily work of all caregiving agencies and institutions and individual professionals in the community through education and mental health consultation and collaboration. We also reach out to assist non-professional caregiving individuals and organizations, especially those who provide mutual help to fellow sufferers. In our latest work we are currently identifying harmful practices in our caregiving systems that actually harm those people whom we are trying to help. We are in the process of developing methods for reducing this system-generated damage.Study of Psychological Stress     

Participation of children with developmental coordination disorder

Children with developmental coordination disorder (DCD) participate less frequently and in less diverse activities compared to typically-developing children. Participation restrictions have been attributed to poor motor skills, but no studies have examined the influence of the environment on participation of children with DCD. This study examined participation in children with DCD at home, school and in the community, considering both personal and environmental factors.Eighty-one parents of 4- to 12-year-old children with DCD (M = 8.3, SD = 2.1) completed the Participation and Environment Measure-Child and Youth (PEM-CY). Our data were compared to previously published data on typically-developing children. Children with DCD participated less frequently than typically-developing children in school and community settings and had less overall environmental support in all three settings. Regarding improvement in participation, children with DCD would benefit from motor interventions that also focus on modification of the environment to support their participation in home, school, and community settings.     

The relationship between contact and attitudes: Reducing prejudice toward individuals with intellectual and developmental disabilities

Increases in intellectual and developmental disability (IDD) diagnoses coupled with higher rates of inclusion in school and community settings, has created more opportunities for exposure and integration between those with IDD and the mainstream population. Previous research has found that increased contact can lead to more positive attitudes toward those with IDD. The current study further investigated this impact of contact on attitudes by examining the influence of the quality and quantity of contact on both explicit and implicit levels of prejudice, while also considering potential mediation via intergroup anxiety and implicit attitudes. Based on past research and theory, we predicted that contact (especially quality contact) would have a strong relationship with explicit and implicit positive attitudes toward individuals with IDD. In the present study, 550 people completed a survey and short task that measured their level of contact with individuals with IDD across their lifetime, their current attitudes toward these individuals, and other constructs that are thought to influence this relationship. Multiple regression analyses suggested consistent links between higher quality of contact and lower levels of prejudice toward individuals with IDD at both the explicit and implicit levels. After controlling for quality of contact, higher quantity of contact was either not significantly associated with our measures of prejudice or was, importantly, associated with higher levels of prejudice. Additional analyses support intergroup anxiety and implicit positive attitudes as significant mediators in the associations between quality of contact and the various dimensions of explicit prejudice. Thus, it would seem that it is the quality of interpersonal interactions that is most strongly related to positive attitudes toward individuals with IDD, making it crucial to take care when developing inclusion opportunities in community settings.     

Community structural instability, anomie, imitation and adolescent suicidal behavior

The current study examines the contextual effects of community structural characteristics, as well as the mediating role of key social mechanisms, on youth suicidal behavior in Iceland. We argue that the contextual influence of community structural instability on youth suicidal behavior should be mediated by weak attachment to social norms and values (anomie), and contact with suicidal others (suggestion-imitation). The data comes from a national survey of 14-16 years old adolescents. Valid questionnaires were obtained from 7018 students (response rate about 87%). The findings show that the community level of residential mobility has a positive, contextual effect on adolescent suicidal behavior. The findings also indicate that the contextual effect of residential mobility is mediated by both anomie and suggestion-imitation. The findings offer the possibility to identify communities that carry a substantial risk for adolescent suicide as well as the mechanisms that mediate the influence of community structural characteristics on adolescent risk behavior.     

The shift of psychiatric inpatient care from hospitals to jails and prisons

Far-reaching structural changes have been made in the mental health system. Many severely mentally ill persons who come to the attention of law enforcement now receive their inpatient treatment in jails and prisons, at least in part, because of a dramatic reduction of psychiatric inpatient beds. While more high-quality community treatment, such as intensive case management and assertive community treatment, is needed, the authors believe that for many, 24-hour structured care is needed in the mental health system for various lengths of time to decrease criminalization. Another central theme of this article is that when a mentally ill individual is arrested, that person now has a computerized criminal record, which is easily accessed by the police and the courts in subsequent encounters. This may influence their decisions and reinforce the tendency to choose the criminal justice system over the mental health system.     

Differentiating psychiatric readmissions from nonreadmissions

This study tracked a cohort of 550 discharged state hospital patients through an entire publicly-funded mental health aftercare system. Data from hospital and community agency records indicate that neither social-demographic nor clinical characteristics successfully differentiated psychiatric readmissions from nonreadmissions. Use of aftercare services--in terms of the variety available and their relevance to discharged patients' assessed needs--had the greatest influence on predicting the likelihood of readmission.     

Enhancing Pathways Into Care (EPIC): Community development working with the Pakistani community to improve patient pathways within a crisis resolution and home treatment service

Black and Minority Ethnic (BME) communities receive different pathways into mental health care with BME service users often presenting in crisis. This is associated with both an over representation of such groups in psychiatric wards and people avoiding mainstream services altogether. The Sheffield Crisis Resolution Home Treatment (CRHT) created the Enhancing Pathways Into Care (EPIC) project, which initially focused on engagement with the Pakistani community (the largest BME group in Sheffield). The project aimed to empower the Pakistani community to seek mental health support earlier within their own community, build up trust in mainstream services and enhance the clinical pathways within services to provide more culturally appropriate care. CRHT joined with the local Pakistani Muslim Centre (PMC) to work in partnership. The PMC had existing links with the Pakistani community and provided a range of social, respite and occupational opportunities. The partnership created an innovative new role: the Pakistani link worker. The EPIC partnership strengthened the PMC's influence and raised awareness of mental health issues in the community. Through integration of the link worker within the everyday practice of clinicians, pathways of care showed evidence of positive change including more referrals to the PMC from psychiatric services. The EPIC project piloted a model of partnership working that is effective and transferable.