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Carolina Schiavo, Andrés Tate, Melina Penna, Luciana Stampella, Leandro N Grendas, Virginia Romarión-Benitez, Luciano Rose, Rodrigo Videtta, Josefina Arnaldo, Pablo Richly
INTRODUCTION: In Argentina, like in the rest of the world, deinstitutionalization policies have been implemented. In our country, the shortage of epidemiologic data regarding admissions in mental health is a limitation for the discussion about how this changes should be implemented and its effect. OBJECTIVES: Epidemiologic data of inpatients of the Mental Health Unit of the Teodoro Álvarez General Hospital between June 2012 and May 2013 has been analyzed in order to elaborate a comparative analysis with a previous study that took place in the same unit on the years 2004-2005...
May 2017: Vertex: Revista Argentina de Psiquiatriá
Jennifer Nazareno
The U.S. government has a long tradition of providing direct care services to many of its most vulnerable citizens through market-based solutions and subsidized private entities. The privatized welfare state has led to the continued displacement of some of our most disenfranchised groups in need of long-term care. Situated after the U.S. deinstitutionalization era, this is the first study to examine how immigrant Filipino women emerged as owners of de facto mental health care facilities that cater to the displaced, impoverished, severely mentally ill population...
January 1, 2018: International Journal of Health Services: Planning, Administration, Evaluation
John P Bartkowski, Janelle Kohler, Craig L Escude, Xiaohe Xu, Stephen Bartkowski
In recent years, people with intellectual and developmental disabilities (IDD) have moved from institutionalized settings to local community residences. While deinstitutionalization has yielded quality of life improvements for people with IDD, this transition presents significant health-related challenges. Community clinicians have typically not been trained to provide sound medical care to people with IDD, a subpopulation that exhibits unique medical needs and significant health disparities. This study reports the results of a comprehensive evaluation of an IDD-focused clinician improvement program implemented throughout Mississippi...
January 10, 2018: Healthcare (Basel, Switzerland)
Dinesh Bhugra, Soumitra Pathare, Rajlaxmi Joshi, Gurvinder Kalra, Julio Torales, Antonio Ventriglio
BACKGROUND: The burden of disease related to mental disorders across the world is substantial. However, there remains inequality between funding for clinical and research activities between physical illness and mental illness in almost all countries. AIMS: One way of reducing this inequality is to ensure that mental health policies reflect this. We were interested in looking at the policies of members of Commonwealth. METHOD: We decided to survey 52 member countries of the Commonwealth to explore whether mental health policies existed and whether there was equity between physical and mental health services funding...
February 2018: International Journal of Social Psychiatry
Aytakin Huseynli
Institutional care has proven to be detrimental for child development. This study examined the status of the State Program on Deinstitutionalization and Alternative Care (SPDAC), a public policy aimed at transforming 55 institutions covering 14,500 children during 2006-2016 in Azerbaijan. The success of this public policy was crucial for the country's entire child welfare system. The study used a crosssectional, descriptive, exploratory, and qualitative method. Data were collected through in-depth, semistructured interviews and archival resources...
November 3, 2017: Child Abuse & Neglect
Simon Malfait, Joeri Vandewalle, Kristof Eeckloo, Roos Colman, Ann Van Hecke
Patient participation is an important topic in mental health and receives increased attention along with deinstitutionalization. No tool exists to measure healthcare worker-related factors that influence patient participation. A three-staged study was conducted to develop and validate the 'Patient Participation Culture Tool for inpatient PSYchiatric wards' (PaCT-PSY), and to analyse its psychometric properties (n=603). The 60-items tool, comprising thirteen components, showed content validity, strong psychometric properties, and a high internal consistency...
October 2017: Archives of Psychiatric Nursing
John Owuor, Fiona Larkan
People with intellectual disability (ID), are some of the most stigmatized and marginalized social groups. Ongoing global initiatives such as the United Nations Convention on the Rights of Persons with Disabilities (UNCPD) and Strategic Development Goals (SDGs) aim to accelerate their inclusion into the society. In many high-income countries, deinstitutionalization of care for people with ID forms part of the broader social inclusion agenda for people with ID into the society. Access to appropriate assistive technology (AT) can mediate the ongoing normalization/inclusion efforts for people with ID...
2017: Studies in Health Technology and Informatics
Lars Henrik Myklebust, Knut Sørgaard, Rolf Wynn
OBJECTIVES: Studies on the dynamics between service organization and acute admissions to psychiatric specialized care have given ambiguous results. We studied the effect of several variables, including service organization, coercion, and patient characteristics on the rate of acute admissions to psychiatric specialist services. In a natural experiment-like study in Norway, we compared a "deinstitutionalized" and a "locally institutionalized" model of mental health services. One had only community outpatient care and used beds at a large Central Mental Hospital; the other also had small bed-units at the local District Psychiatric Centre...
2017: SAGE Open Medicine
Laura N Medford-Davis, Rakel C Beall
Deinstitutionalization has left an inadequate supply of inpatient psychiatric beds. Simultaneous cuts to public funding and insurance coverage for outpatient mental health treatment have increased the frequency of acute psychiatric crises. The resulting lack of available options has shifted the burden of treatment to emergency departments and the criminal justice system. Recent legislation has improved insurance access, but rules are not always enforced and there are still few options for care. Discussion of mental health care delivery must acknowledge that many emergent behavioral health crises arise in the context of acute substance intoxication, withdrawal, or dependence...
September 2017: Psychiatric Clinics of North America
Alo Jüriloo, Lauri Pesonen, Hannu Lauerma
BACKGROUND: As in many European countries, Finnish psychiatric services experienced a rapid process of deinstitutionalization in the 1990s. In recent decades, the decrease in numbers of psychiatric hospital beds has in several countries been found to be linked with increasing criminality among severely mentally ill individuals. It has been concluded that deinstitutionalization could be the main reason for this development. AIM: To investigate whether the prevalence of severely mentally ill persons to prison is a growing trend also in Finland...
July 24, 2017: Nordic Journal of Psychiatry
Paulo Roberto Fagundes da Silva, Maria Cecília de Araújo Carvalho, Maria Tavares Cavalcanti, Rodrigo Cunha Echebarrena, Adriana Santos de Mello, Catarina Magalhães Dahl, Débora Bastos de Lima, Flávia Mitkiewicz de Souza
Critical Time Intervention (CTI) is a time-limited mental health intervention offered to people with mental disorders during critical/transition periods. This study assesses the impact of CTI-BR on social performance and quality of life within a population in the process of deinstitutionalization, after long-term hospitalization in a psychiatric institution. The study population was split into two groups, one of which received CTI plus the regular care. Results showed no advantage of the intervention compared to the regular programs provided by the institution...
July 2017: Ciência & Saúde Coletiva
Damien Brennan, Rebecca Murphy, Philip McCallion, Mary McCarron
BACKGROUND: Changing family sociodemographic factors, increased life expectancy for people with an intellectual disability, deinstitutionalization and policy prioritization of the family as the principal care provider, presents new challenges to care sustainability. METHOD: A qualitative study design was employed, entailing focus groups and semistructured interviews, with purposive sampling via the parent study population of the Intellectual Disability Supplement to The Irish Longitudinal Database on Ageing...
June 30, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
Nina Petersen Reed, Staffan Josephsson, Sissel Alsaker
Mental health services have changed over the past decades through an increased emphasis on deinstitutionalization and normalization, and with recovery processes situated in everyday life as a new locus of support. These changes have led to a need for new knowledge and methods concerning the provision of community mental health services. The aim of the present study was to explore how community mental health workers provide support to users, by investigating professionals' own narratives of how they work. Seven community mental health workers participated in narrative interviews, which were subject to a qualitative, interpretive analysis...
June 23, 2017: International Journal of Mental Health Nursing
Maria Herczog
The reliable and disaggregated data on children deprived of family care, living in different forms of public care is essential information to implement the UN Guidelines on Alternative Care of Children and its principle on necessity and suitability. At the same time all needed information and data would also be needed on all forms of support, universal, targeted and specialized services provided or not provided to children and their families locally to prevent separation of children, on different forms of informal care...
June 2, 2017: Child Abuse & Neglect
Kathryn Law Hale
Drawing on clinical data from 15 months of on-site participant observation in the only public psychiatric hospital in the state of Puebla, Mexico, this article advances our understanding of globalization in relation to psychiatry. I challenge the construction of psychiatry as only treating the individual patient and provide grounded doctor-patient-family member interaction in a Mexican psychiatric clinic in order to review what happens when doctors cannot interact with patients as atomized individuals even though in theory they are trained to think of patients that way...
December 2017: Culture, Medicine and Psychiatry
Sami H Alzahrani, Ebtihaj O Fallata, Marwa A Alabdulwahab, Wesam A Alsafi, Jamil Bashawri
BACKGROUND: Mental disorders are considered important public health problems not only to people with mental illness but also their caregivers. As is the case in many countries, the deinstitutionalization of mental health services in Saudi Arabia, has meant that informal caregivers are shouldering responsibilities for which they are not usually prepared; therefore, the current study was aimed at assessment of the burden on caregivers of people with mental illness. METHODS: Through a cross-sectional design, a sample of the caregivers of people with mental illness (n = 377) was selected randomly from a psychiatric hospital in Jeddah...
May 30, 2017: BMC Psychiatry
D Corridore, F Guerra, C La Marra, D Di Thiene, L Ottolenghi
INTRODUCTION: The aim of this study is to investigate the oral health status and Oral Health-Related Quality of Life (OHRQoL, measured with OHIP- 14) in psychiatric patients assisted by the unique Italian mental health care system, in accordance to regulatory Law 180/78. MATERIALS AND METHODS: Demographic and medical variables were retrieved from institutional medical records. General health and oral health variables, oral health-related behavior and last dental contact were recorded...
March 2017: La Clinica Terapeutica
T Taylor Salisbury, H Killaspy, M King
BACKGROUND: The process of deinstitutionalization (community-based care) has been shown to be associated with better quality of life for those with longer-term mental health problems compared to long stay hospitals. This project aimed to investigate the relationship between national progress towards deinstitutionalization and (1) quality of longer-term mental health care (2) service users' ratings of that care in nine European countries. METHODS: Quality of care was assessed in 193 longer-term hospital- and community-based facilities in Bulgaria, Germany, Greece, Italy, the Netherlands, Poland, Portugal, Spain and the UK...
May 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
Solrun Brenk Rønning, Stål Bjørkly
One of the prioritizations in the World Health Organization's (WHO) Mental Health Action Plan 2013-2020 is the provision of community mental health and social care services, such as supported housing. The ongoing process of such deinstitutionalization has raised issues concerning the impact on users' quality of life. The purpose of this study was to explore how residents in supported housing experience receiving professional help and how they perceived their relationships with nurses. The second aim was to investigate the relevance of Giorgi's method of analysis and self psychology in analyzing these experiences...
2017: Journal of Multidisciplinary Healthcare
Marshall W Tyler, Josefa Zaldivar-Diez, Stephen J Haggarty
The discovery of haloperidol catalyzed a breakthrough in our understanding of the biochemical basis of schizophrenia, improved the treatment of psychosis, and facilitated deinstitutionalization. In doing so, it solidified the role for chemical neuroscience as a means to elucidate the molecular underpinnings of complex neuropsychiatric disorders. In this Review, we will cover aspects of haloperidol's synthesis, manufacturing, metabolism, pharmacology, approved and off-label indications, and adverse effects. We will also convey the fascinating history of this classic molecule and the influence that it has had on the evolution of neuropsychopharmacology and neuroscience...
March 15, 2017: ACS Chemical Neuroscience
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