Involving former patients,relatives, and community mental health professionals in the administration of a state hospital

This article describes the Western State Hospital Community Interface Panel, an administrative advisory pannel composed of former patients, relatives of patients, and community mental health professionals. The purposes served by this panel are to increase administrative lines of communication with those persons who are most capable of providing appropriate feedback on inpatient programs, share viewpoints on legislative and state policy issue, and work toward enhancing the general community hospital collaboration characterized as a “single system of care.” DAVID J. RISSMEYER, A.C.S.W., is the social work director at Western State Hospital, Staunton, Virginia. He also serves as the president of the Virginia chapter of the International Association of Psychosocial Rehabillitation Services.     

Follow-up group for schizophrenic patients using Clozapine and their relatives: the participants' perception

This study described the views of Schizophrenic patients as well as those of their relatives concerning the group follow-up. The population consisted of 11 patients participating in the group and of 11 relatives who most often accompanied them to group meetings. Interviews, which were tape-recorded and fully transcribed, were used for data collection. The obtained results showed that the group consisted in a favorable space for talking and listening about the disease as well as to exchange experiences as it provided more security and self-esteem to the participants. In addition to improving the patients' relationships and providing therapeutic help to their relatives. Such results showed the need for a new way to view mentally ill patients in order to search for more adequate therapeutic attitudes which can act on life production.     

A focus group investigation into young children's understanding of mental health and their views on appropriate services for their age group

BACKGROUND: Children's views about mental health and concurrent service provision are under researched areas. Yet there is concern regarding appropriate service development to meet the increasing mental health needs of children and young people. Recent government policy underlines the need for collaborative work with consumers in service development. METHOD: This was a qualitative study designed to explore 10- and 11-year-old children's understanding of the concept of mental health and their opinions regarding an appropriate service for their age group. Two focus groups were conducted with 10- and 11-year-old children and the data was analysed using Interpretative Phenomenological Analysis. RESULTS: The participants showed a sophisticated understanding of mental health. The participants thought that school-based services would not be appropriate for their age group. CONCLUSION: The participants demonstrated that their level of understanding and interest qualifies them for a place in discussions about services for their age group. Collaborative work with children and young people in line with government policy in this area is necessary for appropriate service development.     

Concepts of mental health and care according to mentally-ill patients and their relatives

This study aimed at 1) identifying social, demographic and clinical characteristics of mentally-ill patients and their relatives and 2) analyzing their conceptions concerning mental illness and psychiatric care. The Attitude Measurement Scale (AMS) was used. Quantitative and qualitative analyses of the data were carried out. The 104 study subjects comprised 35 patients and 69 relatives (n=104). The Mann-Whitney Test was used for comparing the opinions of patients X relatives and the Wilcoxon Test for comparing Concept and Care. There was homogeneity in the distribution of the subjects' scores for both Concept and Care. No questions stood out or were concentrated in either group. The subjects' profile shows the transition from asylum care to innovative experiences, although there is still a concentration of drug treatments and dependence on the psychiatric institution.     

A focus group study of rural health clinic performance

Rural health clinics (RHCs) provide primary health care services to the medically underserved in US rural areas. Although they face unique operational challenges, little research has been conducted to identify factors that contribute to RHC performance (efficiency and effectiveness). To identify such factors as viewed from a management perspective, focus groups were conducted of a national random sample of RHC administrators and managers. Factors identified as contributing to RHC efficiency were (1) sufficient and competent staff and (2) technology, particularly electronic medical record systems. Those contributing to RHC effectiveness were (1) ongoing communication with the community and (2) cooperative and/or satisfied staff.     

Meta-analysis of stigma and mental health

Recent research has emphasized the adverse effects of stigma on minority groups' mental health. Governments and service agencies have put much effort into combating stigma against a variety of conditions. Nevertheless, previous empirical research on the stigma-mental health relationship has yielded inconclusive findings, varying from strong negative to zero correlations. Thus, whether stigma is related significantly to mental health is yet to be confirmed. Using meta-analysis, the associations between stigma and mental health from 49 empirical studies were examined across various stigmatized conditions and mental health indices. Possible moderators were also explored. The mean correlation between stigma and average mental health scores corrected for sampling error, unreliability, and other artifacts was -.28 (N=10,567, k=52). No strong moderators were found, yet meaningful patterns were observed. Implications of the results are discussed.     

Anticipated tuberculosis stigma among health professionals and Haitian patients in South Florida

This paper compares tuberculosis-related stigma perceptions of health professionals with that of local patient populations, and examines these in relation to other measures of anticipated distress. Comparison groups were service providers and Haitian American patients diagnosed with latent TB (LTBI). Providers consistently rated LTBI higher on anticipated stigma than patients both overall and for internal perceptions and emotions, external perceptions and actions, and Haitian identity. Health professionals were almost five times more likely than patients to report the possibility of other types of psychosocial distress. The findings are consistent with previous studies reporting a higher degree of perceived stigma among unaffected populations compared with people diagnosed with a medical condition. Results suggest that providers may overestimate the likelihood that patients with a stigmatized condition will experience negative consequences. This may negatively affect adherence to TB testing guidelines because of confidentiality concerns. The implications for achieving national TB elimination goals are discussed.     

The health and wellbeing of mental health professionals

We examine dimensions of job satisfaction, occupational burnout and general health of a sample of 123 mental health care professionals (psychiatric nurses and nursing assistants, and smaller professional groups such as social workers, occupational and recreational therapists and psychologists) employed at a large Canadian psychiatric hospital. Psychiatric nursing assistants exhibit more of the consequences of job-related stress (less job satisfaction, greater occupational burnout, greater incidence of negative physical and psychological symptoms of stress) relative to the other professional groups in the sample. This may be linked with their position within the hospital organization (having less authority and professional autonomy relative to the other groups), affecting their ability to cope with job-related problems and stresses experienced by all direct care workers. We examine attitudes of mental health professionals towards organized support groups at the hospital, which could provide one forum for the open discussion (and potential resolution) of job-related stresses and problems experienced in hospital settings.     

The quality of life, mental health, and perceived stigma of leprosy patients in Bangladesh

The present study aims to determine the quality of life (QOL) and general mental health of leprosy patients compared with the general population, and evaluate contributing factors such as socio-economic characteristics and perceived stigma. A total of 189 patients (160 outpatients, 29 inpatients) and 200 controls without leprosy or other chronic diseases were selected from Dhaka district, Bangladesh, using stratified random sampling. A Bangladeshi version of a structured questionnaire including socio-demographic characteristics-the Bangla version of the World Health Organization Quality of Life Assessment BREF (WHOQOL-BREF)-was used to assess QOL; a Self-Reporting Questionnaire (SRQ) was used to evaluate general mental health; the Barthel Index to control activities of daily living (ADL); and the authors' Perceived Stigma Questionnaire was used to assess perceived stigma of patients with leprosy. Medical records were examined to evaluate disability grades and impairment. QOL and general mental health scores of leprosy patients were worse than those of the general population. Multiple regression analysis revealed that factors potentially contributing to the deteriorated QOL of leprosy patients were the presence of perceived stigma, fewer years of education, the presence of deformities, and a lower annual income. Perceived stigma showed the greatest association with adverse QOL. We conclude that there is an urgent need for interventions sensitive to the effects of perceived stigma, gender, and medical conditions to improve the QOL and mental health of Bangladeshi leprosy patients.     

Immigrant women’s perceptions and experiences of health care services: Insights from a focus group study

Aim  

This study aimed to describe perceptions and experiences related to access and utilization of health care services of African and Brazilian immigrant women in Portugal.     

精神分裂症患者和一级亲属全血23种微量元素含量的测定与分析

采用等离子体发光法测定６６例精神分裂症病人、２４例精神分裂症病人的健康一级亲属和５０例正常对照３组人群全血２３种微量元素含量。结果显示：精神分裂症病人铝（Ａｌ）、铜（Ｃｕ）、锌（Ｚｎ）、钡（Ｂａ）和铬（Ｃｒ）的含量显著低于对照组（Ｐ＜００５），铁（Ｆｅ）、镁（Ｍｇ）和硼（Ｂ）含量显著高于对照组（Ｐ＜００５），一级亲属铁（Ｆｅ）、镁（Ｍｇ）和硼（Ｂ）含量显著高于对照组（Ｐ＜００５）；同时铜（Ｃｕ）、钙（Ｃａ）和钡（Ｂａ）低于对照组（Ｐ＜００５）；精神分裂症病人与其一级亲属组相比无明显差异（Ｐ＞００５）。提示精神分裂症病人存在微量元素代谢异常，这种异常可能是精神分裂症病理过程的表现，同时遗传因素对精神分裂症的发生有一定作用。     

Gender disparities in AMI management and outcomes among health professionals,their relatives,and non-health professionals in Taiwan from 1997 to 2007

Numerous reports of gender differences in the management and mortality of acute myocardial infarction (AMI) patients have raised concerns on gender inequity in cardiac care. However, no study has explored whether gender disparity exists among health professionals and their relatives. Therefore, this study assesses gender disparity in the management and mortality of AMI patients in Taiwan, and determines whether such disparity exists among health professionals and their relatives. National Health Insurance (NHI) files were used to obtain information on a cohort of 79,360 AMI patients aged 30–85 years in Taiwan from 1997 to 2007. The use of catheterization and revascularization (CATH/RAVS) and one-year mortality were compared between men and women in all adult patients, health professionals and their relatives, and non-health professional patients. Taiwanese women with AMI were significantly less likely than their male counterparts to receive CATH/RAVS, and showed greater one-year mortality. Similarly, women in the professional group were significantly less likely to receive CATH/RAVS. However, they did not have worse survival outcomes (hazard ratio: 1.01; 95% CI: 0.68–1.50) compared to men. Regarding mortality following CATH/RAVS, no gender disparities against women were observed in health professionals and their relatives, whereas significant gender disparities persisted in non-health professional patients. In conclusion, this study shows a substantial gender disparity against women in the management and one-year survival of AMI patients in Taiwan. This research extends earlier studies by showing similar gender gaps in treatment uses among health professionals and their relatives without strong evidence on gender disparities against women in survival.     

Psychometric study of dysthymic patients and their first-degree relatives

Psychometric evaluation of severity of depression and personality characteristics of 20 dysthymic patients (mean age 29.05+/-7.08 ys.) was carried out using Hamilton Depression Rating Scale (HDRS) and Eysenck Personality Questionnaire (EPQ) and was compared with that of 20 major depressive patients (mean age 33.60+/-7.7ys.) and 20 normal controls (mean age 32.85+/-6.17 ys.). Psychosocial stressors that might trigger depression were also looked for. All first-degree relatives (118 persons) were subjected to clinical interview for detection of dysthymia. EPQ was also applied to assess their personality characteristics. Depression among dysthymic patients was mainly of mild degree. Severe depression was found in about 55% of major depressive and none of dysthymic patients. Application of EPQ revealed high neuroticism among dysthymics and high psychoticism among major depressives. Lie scale was high for both groups. Psychosocial stressors were more reported by dysthymic patients; however they were of mild or moderate degrees. Stressors reported by major depressive patients were mainly acute and severe. Assessment of the first-degree relatives revealed that 66% of dysthymics' relatives had dysthymia or high EPQ scores compared to 36% of major depressives and 22% of normals.     

Auditory P300 studies in schizophrenic subjects and their first degree relatives.

Nineteen subjects with schizophrenia, 6 subjects with related disorders (schizophrenic spectrum disorders (S.S.D.)), and 20 unaffected first degree relatives from a sample of schizophrenic pedigrees, together with 35 normal control subjects, had auditory P300 evoked responses measured, using the "odd-ball" paradigm for stimulation. Bipolar recording on the midline (CZOZ) and two contralateral sites (CZ-mastoid) was carried out. It was found that approximately 40% of schizophrenics/S.S.D.'s had abnormal P300 responses. Abnormalities were seen in latency, RMS response voltage and in the left side response--right side response cross correlation coefficient. Schizophrenics/S.S.D.s showed responses which were topographically different than those of normal controls. Significant left-side/right-side response voltage asymmetry was not observed. In our study, only 10% of unaffected relatives of schizophrenics/S.S.D.'s showed abnormal P300 responses.     

A qualitative study of service user experiences of occupation in forensic mental health

Background/aim: This qualitative study explored occupational engagement of those detained in forensic units. Legal and institutional restrictions on occupation have implications for their health and wellbeing. Method: Twenty‐six current forensic mental health service users participated in five focus groups, which were audio‐recorded, transcribed verbatim and subjected to constant comparative analysis. Findings: The participants highlighted previous occupations, current occupations and hopes. Key aspects were control over decision‐making, motivation and support, generating suggestions alongside positive experiences of occupational therapy. Conclusions: Institutional barriers could be overcome with a dynamic balance between risk management and mental health promotion through occupation. This demands a sustained focus on occupation for everyone involved in providing care and treatment in these settings.