Mental Health Care (mental + health_care)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Mental Health Care

  • acute mental health care


  • Selected Abstracts


    Mental health care reform in Sweden, 1995

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
    C.-G. Stefansson
    Objective:,To describe the content of the Community Mental Health Care reform in Sweden, in effect from 1995 and directed to severely mentally ill people (SMI). Method:,Evaluating changes, at local and national level, in living conditions among SMI and resources of services directed to them, by using registers, questionnaires, interviews and case studies. Results:,A survey, covering 93% of the population, identified 43 000 SMI (prevalence of 0.63%); 4000 long-stay patients and 400 rehabilitation programmes were transferred from psychiatric services to social services (15% of the budget of psychiatric services). Employment and rehabilitation projects, family support and user programmes and educational projects for social services staff, were launched (funded by state subsidies). Conclusion:,SMI still have difficulties in obtaining adequate support on the basis of disability laws and there continue to be barriers between social services and psychiatric services. [source]


    Development of the International Classification of Mental Health Care (ICMHC)

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2000
    A. De Jong
    Objective: Evaluations of the process of providing mental health care have been hampered because a tool to systematically describe the interventions actually provided by the services was lacking. In this paper the development of such a tool (the International Classification of Mental Health Care; ICMHC) is described. Method: Subsequent versions of the ICMHC were developed, using comments from experts in 24 WHO field centres and results from a number of field trials. In the final version 10 Modalities of Care can be used to describe Modules of Care, using the Level of Specialization scale. The inter-rater reliability of this version was evaluated by the Italian research team, using data from 43 services. Results: Reliability ranged from excellent for nine modalities to reasonably good for the remaining modality. Conclusion: In the context of evaluation studies, the ICMHC can be used to describe systematically mental health care interventions. [source]


    The Effects of Health Sector Market Factors and Vulnerable Group Membership on Access to Alcohol, Drug, and Mental Health Care

    HEALTH SERVICES RESEARCH, Issue 3p1 2007
    Susan E. Stockdale
    Objective. This study adapts Andersen's Behavioral Model to determine if health sector market conditions affect vulnerable subgroups' use of alcohol, drug, and mental health services (ADM) differently than the general population, focusing specifically on community-level predisposing and enabling characteristics. Data Sources. Wave 2 data (2000,2001) from the Health Care for Communities study, supplemented with cases from wave 1 (1997,1998), were merged with area characteristics taken from Census, Area Resource File (ARF), and other data sources. Study Design. The study used four-level hierarchical logistic regression to examine access to ADM care from any provider and specialty ADM access. Interactions between community-level predisposing and enabling vulnerability characteristics with individual race/ethnicity, age, income category, and insurance type were explored. Principal Findings. Nonwhites, the poor, uninsured, and elderly had lower likelihoods of service use, but interactions between race/ethnicity, income, age and insurance status with community-level vulnerability factors were not statistically significant for any service use. For ADM specialty care, those with Medicare, Medicaid, private fully managed, and private partially managed insurance, the likelihood of utilization was higher in areas with higher HMO penetration. However, for those with other insurance or no insurance plan, the likelihood of utilization was lower in areas with higher HMO penetration. Conclusions. Community-level enabling factors explain part of the effect of disadvantaged status but, with the exception of the effect of HMO penetration on the relationship between insurance and specialty care use, do not modify any of the residual individual-level effects of disadvantage. Interventions targeting both structural and individual levels may be necessary to address the problem of health disparities. More research with longitudinal data is necessary to sort out the causal direction of social context and ADM access outcomes, and whether policy interventions to change health sector market conditions can shift ADM treatment utilization. [source]


    Religious Involvement and the Use of Mental Health Care

    HEALTH SERVICES RESEARCH, Issue 2 2006
    Katherine M. Harris
    Objectives. To examine the association between religious involvement and mental health care use by adults age 18 or older with mental health problems. Methods. We used data from the 2001,2003 National Surveys on Drug Use and Health. We defined two subgroups with moderate (n=49,902) and serious mental or emotional distress (n=14,548). For each subgroup, we estimated a series of bivariate probit models of past year use of outpatient care and prescription medications using indicators of the frequency of religious service attendance and two measures of the strength and influence of religious beliefs as independent variables. Covariates included common Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, disorders symptoms, substance use and related disorders, self-rated health status, and sociodemographic characteristics. Results. Among those with moderate distress, we found some evidence of a positive relationship between religious service attendance and outpatient mental health care use and of a negative relationship between the importance of religious beliefs and outpatient use. Among those with serious distress, use of outpatient care and medication was more strongly associated with service attendance and with the importance of religious beliefs. By contrast, we found a negative association between outpatient use and the influence of religious beliefs on decisions. Conclusion. The positive relationship between religious service participation and service use for those with serious distress suggests that policy initiatives aimed at increasing the timely and appropriate use of mental health care may be able to build upon structures and referral processes that currently exist in many religious organizations. [source]


    Does Satisfaction Reflect the Technical Quality of Mental Health Care?

    HEALTH SERVICES RESEARCH, Issue 2 2003
    Mark J. Edlund
    Objective. To analyze the relationship between satisfaction and technical quality of care for common mental disorders. Data Source. A nationally representative telephone survey of 9,585 individuals conducted in 1997,1998. Study Design. Using multinomial logistic regression techniques we investigated the association between a five-level measure of satisfaction with the mental health care available for personal or emotional problems and two quality indicators. The first measure, appropriate technical quality, was defined as use of either appropriate counseling or psychotropic medications during the prior year for a probable depressive or anxiety disorder. The second, active treatment, indicated whether the respondent had received treatment for a psychiatric disorder in the past year. Covariates included measures of physical and mental health and sociodemographic indicators. Principal Findings. Appropriate technical quality of care was significantly associated with higher levels of satisfaction. The strength of the association was moderate. Conclusions. Satisfaction is associated with technical quality of care. However, profiling quality of care with satisfaction will likely require large samples and case-mix adjustment, which may be more difficult for plans or provider groups to implement than measuring technical indicators. More importantly, satisfaction is not the same as technical quality, and our results suggest that at this time they cannot be made to approach each other closely enough to eliminate either. [source]


    Two-Minute Mental Health Care for Elderly Patients: Inside Primary Care Visits

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2007
    (See editorial comments by Drs. Charles Reynolds, Bruce L. Rollman), Carrie Farmer Teh, Mario Cruz
    OBJECTIVES: To assess how care is delivered for mental disorders using videotapes of office visits involving elderly patients. DESIGN: Mixed-method observational analysis of the nature of the topics discussed, content of discussion, and the time spent on mental health. SETTINGS: Three types of settings: an academic medical center, a managed care group, and fee-for-service solo practitioners. PARTICIPANTS: Thirty-five primary care physicians and 366 of their elderly patients. MEASUREMENTS: Videotapes of 385 visits covering 2,472 diverse topics were analyzed. Coding of the videotapes identified topics, determined talk time, and coded the dynamics of talk. RESULTS: Mental health topics occurred in 22% of visits, although patient survey indicated that 50% of the patients were depressed. A typical mental health discussion lasted approximately 2 minutes. Qualitative analysis suggested wide variations in physician effort in providing mental health care. Referrals to mental health specialists were rare even for severely depressed and suicidal patients. CONCLUSION: Little time is spent on mental health care for elderly patients despite heavy disease burdens. Standards of care based on a count of visits "during which a mental health problem is discussed" may need to be supplemented with guidelines about what should happen during the visit. System-level interventions are needed. [source]


    Consensus Statement on Improving the Quality of Mental Health Care in U.S. Nursing Homes: Management of Depression and Behavioral Symptoms Associated with Dementia

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2003
    American Association for Geriatric Psychiatry, American Geriatrics Society
    The American Geriatrics Society and American Association for Geriatric Psychiatry Expert Panel on Quality Mental Health Care in Nursing Homes developed this consensus statement. The following organizations were represented on the expert panel and have reviewed and endorsed, the consensus statement: Alzheimer's Association, American Association for Geriatric Psychiatry, American Association of Homes and Services for the Aging, American College of Health Care Administrators, American Geriatrics Society, American Health Care Association, American Medical Directors Association, American Society on Aging, American Society of Consultant Pharmacists, Gerontological Society of America, National Association of Directors of Nursing Administration in Long-Term Care, National Citizen's Coalition for Nursing Home Reform, National Conference of Gerontological Nurse Practitioners. The following organizations were also represented on the expert panel and reviewed and commented on the consensus statement: American Psychiatric Association: Council on Aging, American Psychological Association. [source]


    The American Geriatrics Society and American Association for Geriatric Psychiatry Recommendations for Policies in Support of Quality Mental Health Care in U.S. Nursing Homes

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2003
    American Geriatrics Society
    First page of article [source]


    Response to Donna Lenhoff's Letter on Mental Health Care in Nursing Homes, Nurse Staffing Studies

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2003
    Article first published online: 15 AUG 200
    No abstract is available for this article. [source]


    Mainstream In-Patient Mental Health Care for People with Intellectual Disabilities: Service User, Carer and Provider Experiences

    JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2010
    Ben Donner
    Background, Government guidelines promote the use of mainstream mental health services for people with intellectual disabilities whenever possible. However, little is known about the experiences of people with intellectual disabilities who use such services. Materials and Methods, Face-to-face interviews with service users, carers and community nurses were completed and analysed on a case by case basis using interpretative phenomenological analysis. The results were followed up in focus groups with service providers. Results, Positive aspects included the provision of respite, particularly for carers, and good basic care. These were outweighed by a perception of the admission as disempowering and lacking in flexible treatment provision. Accessing help emerged as a major problem, as well as the prospect of staff neglecting the specific needs of people with intellectual disabilities. Conclusions, While there were some indications of improvements in line with recent policies and guidance, mainstream services seem a long way off realizing aims of easy accessibility, person-centred practices and active partnership with intellectual disability services. [source]


    Mental Health Care for People of Diverse Backgrounds

    JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2008
    EIMEAR MUIR-COCHRANE
    [source]


    Humanizing Psychiatry and Mental Health Care: The Challenge of the Person-centred Approach

    JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2007
    RICHARD LAKEMAN dipnsg bn ba hons(nursing) pg dip(psychotherapy) Mr
    [source]


    Integrating Tobacco Cessation Treatment into Mental Health Care for Patients with Posttraumatic Stress Disorder

    THE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2006
    Miles McFall PhD
    The integration of tobacco cessation treatment into mental health care for posttraumatic stress disorder (PTSD), known as Integrated Care (IC), was evaluated in an uncontrolled feasibility and effectiveness study. Veterans (N = 107) in PTSD treatment at two outpatient clinics received IC delivered by mental health practitioners. Outcomes were seven-day point prevalence abstinence measured at two, four, six, and nine months post-enrollment and repeated seven-day point prevalence abstinence (RPPA) obtained across three consecutive assessment intervals (four, six, and nine months). Abstinence rates at the four assessment intervals were 28%, 23%, 25%, and 18%, respectively, and RPPA was 15%. The number of IC sessions and a previous quit history greater than six months predicted RPPA. Stopping smoking was not associated with worsening PTSD or depression. [source]


    A Reason for Optimism in Rural Mental Health Care: Emerging Solutions and Models of Service Delivery

    CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 3 2007
    Myra Elder Psychology Service
    This invited commentary responds to Jameson and Blank's literature review (2007) and utilizes different source materials, such as personal communications among clinicians and policymakers, Internet-based information, and direct professional experience. An update is provided regarding new graduate programs training clinicians for rural service. In addition, perceived barriers to treatment are challenged, because they are drawn from research results that could be interpreted in different ways, given the cultural heritage of southern and central Appalachian people. Lastly, the efforts of the Veterans Affairs Health Care System to reach rural citizens for mental health treatment are summarized. Some of these federal processes could be replicated at the state level, if sociopolitical and economic factors were more directly addressed. The commentary concludes, from the perspective of a professional providing clinical services in a rural setting, that a more optimistic outlook on the state of rural mental health care may be warranted. [source]


    The European perspective of psychiatric reform

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
    T. Becker
    Objective:,To provide a framework of mental health care reform across Europe. Method:,On the basis of summary quantitative indices and expert ratings of broad aspects of mental health care structure, the process and outcome of psychiatric reform common trends and differences are outlined. Results:,There has been a broad trend away from an institutional model of care with the mental hospital as the dominant institution, and community- and general hospital-based mental health services of varying comprehensiveness are in place in most countries. The social and broad community aspects of psychiatric reform have generally been somewhat less successful than changes in service set-up. Assessment of reform outcomes proves particularly difficult. Conclusion:,Psychiatric reform processes have achieved some of their aims, and there are broadly similar trends. Regional variation is substantial and may be as important as cross-national differences. Mental health care reform is ongoing across the European region. [source]


    Mental health care reform in Sweden, 1995

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
    C.-G. Stefansson
    Objective:,To describe the content of the Community Mental Health Care reform in Sweden, in effect from 1995 and directed to severely mentally ill people (SMI). Method:,Evaluating changes, at local and national level, in living conditions among SMI and resources of services directed to them, by using registers, questionnaires, interviews and case studies. Results:,A survey, covering 93% of the population, identified 43 000 SMI (prevalence of 0.63%); 4000 long-stay patients and 400 rehabilitation programmes were transferred from psychiatric services to social services (15% of the budget of psychiatric services). Employment and rehabilitation projects, family support and user programmes and educational projects for social services staff, were launched (funded by state subsidies). Conclusion:,SMI still have difficulties in obtaining adequate support on the basis of disability laws and there continue to be barriers between social services and psychiatric services. [source]


    Mental health care for the elderly: The end of the line?

    INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 6 2007
    Leonie Clancy
    No abstract is available for this article. [source]


    The ISTSS/Rand Guidelines on Mental Health Training of Primary Healthcare Providers for Trauma-Exposed Populations in Conflict-Affected Countries,,

    JOURNAL OF TRAUMATIC STRESS, Issue 1 2006
    David Eisenman
    Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations. [source]


    Barriers to care in severe mental illness: accounts from perpetrators of intra-familial homicide

    CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2005
    FRANZCP Consultant Psychiatrist, Josephine Stanton MA, MBChB
    Objective To review perceptions of barriers to receiving effective mental health care described by patients who had committed intra-familial homicide in the context of untreated severe mental illness. Method Semi-structured interviews addressed issues such as support, help-seeking, experience of illness, and what participants felt might have helped prevent the death(s). Transcripts were analysed for themes related to barriers to help-seeking. Results Themes identified included: hiding or minimizing difficulties, lack of knowledge or understanding of mental illness, loss of control in the context of illness, seduction by the illness, reality-distorting effects of the illness, distortion of interpersonal relationships, diminished ability to trust and difficulty acknowledging need for medication. Conclusions Barriers to care exist at individual, interpersonal and wider societal levels and need to be addressed at all of them. Copyright © 2005 John Wiley & Sons, Ltd. Copyright © 2005 John Wiley & Sons, Ltd. [source]


    Influence of psychotherapist density and antidepressant sales on suicide rates

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009
    N. D. Kapusta
    Objective:, Antidepressant sales and suicide rates have been shown to be correlated in industrialized countries. The aim was to study the possible effects of psychotherapy utilization on suicide rates. Method:, We assessed the impact of antidepressant sales and psychotherapist density on suicide rates between 1991 and 2005. To adjust for serial correlation in time series, three first-order autoregressive models adjusted for per capita alcohol consumption and unemployment rates were employed. Results:, Antidepressant sales and the density of psychotherapists in the population were negatively associated with suicide rates. Conclusion:, This study provides evidence that decreasing suicide rates were associated with both increasing antidepressant sales and an increasing density of psychotherapists. The decrease of suicide rates could reflect a general improvement in mental health care rather than being caused by antidepressant sales or psychotherapist density alone. [source]


    The therapeutic relationship in secondary mental health care: a conceptual review of measures

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2007
    J. Catty
    Objective: The study aimed to determine the conceptual basis of measures of the patient,professional relationship used in routine mental health services research by reviewing their face, content and construct validity. Method: A comprehensive literature search identified measures of the relationship used in mental health services research. The conceptual basis of each identified measure was identified by a review of measures' authors assessments of face, content and construct validity plus item analysis of the measures themselves. Results: The search identified 15 measures. The seven developed in psychotherapy were likely to be better validated conceptually; most were based on therapeutic alliance models. Measures developed specifically for mental health services were based on a wider range of models including global assessments of the relationship. Conclusion: Most of the better validated measures originate in psychotherapy, but there is limited evidence for their validity in general mental health services. Four measures are recommended. [source]


    A framework for evidence-based mental health care and policy

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2006
    L. Salvador-Carulla
    Objective:, Care planning integrates a growing number of disciplines, research fields and analysis techniques. A framework of the main areas of interest with regard to evidence-based health care in mental health is provided here. Method:, The framework is based on the experience of working with data analysts and health and social decision makers at the PSICOST/RIRAG network, a Spanish research association which includes psychiatrists, health economists and health policy experts, as well as on a review of the literature. Results:, Three main areas have been identified and described here: outcomes management, knowledge discovery from data, and decision support systems. Their use in mental health care is reviewed. Conclusion:, It is important to promote bridging strategies among these new fields in order to enhance communication and information transfer between the different parts involved in mental health decision making: i) clinicians and epidemiologists, ii) data analysts, iii) care policy makers and other end-users. [source]


    Psychiatric services for people with severe mental illness across western Europe: what can be generalized from current knowledge about differences in provision, costs and outcomes of mental health care?

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2006
    T. Becker
    Objective:, To report recent findings regarding differences in the provision, cost and outcomes of mental health care in Europe, and to examine to what extent these studies can provide a basis for improvement of mental health services and use of findings across countries. Method:, Findings from a number of studies describing mental health care in different European countries and comparing provision of care across countries are reported. Results:, The development of systems of mental health care in western Europe is characterized by a common trend towards deinstitutionalization, less in-patient treatment and improvement of community services. Variability between national mental healthcare systems is still substantial. At the individual patient level the variability of psychiatric service systems results in different patterns of service use and service costs. However, these differences are not reflected in outcome differences in a coherent way. Conclusion:, It is conceivable that the principal targets of mental healthcare reform can be achieved along several pathways taking into account economic, political and sociocultural variation between countries. Differences between mental healthcare systems appear to affect service provision and costs. However, the impact of such differences on patient outcomes may be less marked. The empirical evidence is limited and further studies are required. [source]


    Community forensic psychiatry: restoring some sanity to forensic psychiatric rehabilitation

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2002
    J. Skipworth
    Objective:, To review clinical and legal paradigms of community forensic mental health care, with specific focus on New Zealand, and to develop a clinically based set of guiding principles for service development in this area. Method:, The general principles of rehabilitating mentally disordered offenders, and assertive community care programmes were reviewed and applied to the law and policy in a New Zealand forensic mental health setting. Results: There is a need to develop comprehensive community treatment programmes for mentally disordered offenders. The limited available research supports assertive community treatment models, with specialist forensic input. Ten clinically based principles of care provision important to forensic mental health assertive community treatment were developed. Conclusion:, Deinstitutionalization in forensic psychiatry lags behind the rest of psychiatry, but can only occur with well-supported systems in place to assess and manage risk in the community setting. The development of community-based forensic rehabilitation services in conjunction with general mental health is indicated. [source]


    Schizophrenia in homeless persons: a systematic review of the literature

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2002
    D. Folsom
    Objective:,This article systematically reviews studies of prevalence of schizophrenia in homeless persons. Method:,Medline and PsychInfo were searched using the key words: homeless person, mental illness, psychosis, and schizophrenia. The bibliographies of identified articles were also reviewed. Results:,Study designs varied considerably. The rate of schizophrenia in homeless persons reported in the 33 published reports, representing eight different countries, ranged from 2 to 45%. In the 10 methodologically superior studies, the prevalence range was 4,16% and the weighted average prevalence was 11%. In addition, rates were higher in younger persons, women and the chronically homeless. Slightly less than half of the homeless persons with schizophrenia were not currently receiving treatment. Conclusion:,Schizophrenia is much more prevalent among homeless persons than in the population at large. Future research should focus on better ways of meeting the mental health care needs of homeless people with schizophrenia. [source]


    The European perspective of psychiatric reform

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
    T. Becker
    Objective:,To provide a framework of mental health care reform across Europe. Method:,On the basis of summary quantitative indices and expert ratings of broad aspects of mental health care structure, the process and outcome of psychiatric reform common trends and differences are outlined. Results:,There has been a broad trend away from an institutional model of care with the mental hospital as the dominant institution, and community- and general hospital-based mental health services of varying comprehensiveness are in place in most countries. The social and broad community aspects of psychiatric reform have generally been somewhat less successful than changes in service set-up. Assessment of reform outcomes proves particularly difficult. Conclusion:,Psychiatric reform processes have achieved some of their aims, and there are broadly similar trends. Regional variation is substantial and may be as important as cross-national differences. Mental health care reform is ongoing across the European region. [source]


    Mental health in Europe: problems, advances and challenges

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
    W. Rutz
    Objective:,To describe mental health care needs and challenges across the WHO European region of 51 nations. Method:,Based on morbidity and mortality data from HFA Statistical Database and Health21, the policy framework of WHO Europe, major trends in mental health care needs, psychiatric reform and mental health promotion are discussed. Results:,There is a mortality crisis related to mental ill health in Eastern European populations of transition. Destigmatization is required to improve early intervention and humanization of services, and national mental health audits are needed to create the basis for national mental health planning, implementation and monitoring. There are both problems and advances in service restructuring, and comprehensive mental health promotion programmes, preventive and monitoring strategies are required. Conclusion:,Partnerships between national and international organizations, especially WHO and the European Union, have to be strengthened to make progress on the way to integrated community mental health services. [source]


    Spanish psychiatric reform: what can be learned from two decades of experience?

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
    José Luis Vázquez-Barquero
    Objective:,The objective of the paper is to describe the impact of Spanish psychiatric reform on the organization and functioning of mental health services. Method:,This paper is based on official administrative reports and on relevant related publications. Results:,The most significant achievements of Spanish psychiatric reform have been: (i),the development of a new organization of mental health care, decentralized in character and territorially based; (ii),the integration of psychiatric patients in general health care; (iii),the creation of an extensive community network of health centres; and (iv),the development of more positive attitudes towards mental illness. However, our analysis also reveals the existence of significant deficiencies. Conclusion:,Analysis of the Spanish experience shows that the process of psychiatric reform depends basically on long-term commitments, which in a system such as Spain's must come from central administration and also from the autonomous communities. [source]


    European perspectives: a carer's view

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
    Ursula Brand
    Objective:,To present the work of the European Federation of Associations of Families of Mentally Ill People (EUFAMI) and discuss issues of concern to family carers. Method:,The problem areas identified and discussed by family carers are presented on the basis of questionnaire surveys organized by EUFAMI. Addresses of national organisations of family carers are included. Results:,A range of problem areas are identified; they include subsistence and welfare payments for the severely mentally ill, some shortage of general hospital units, problems of care co-ordination, issues of respect for family carers and family involvement. Conclusion:,The aim of best practice in mental health care throughout Europe has not yet been reached. Key activities of EUFAMI are aimed at empowerment of families and best practice in psychiatry in Europe. [source]


    Cognitive behaviour therapy with coping training for persistent auditory hallucinations in schizophrenia: a naturalistic follow-up study of the durability of effects

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2001
    D. Wiersma
    Objective: To investigate the durability of positive effects of cognitive behaviour therapy (CBT) with coping training on psychotic symptoms and social functioning. Method: Forty patients with schizophrenia or related psychotic disorders and refractory auditory hallucinations were given CBT and coping training in an integrated single family treatment programme. In a naturalistic study patients were followed after 2 and 4 years since the start of treatment. Results: The treatment improved overall burden of ,hearing voices', with a generalization into daily functioning. Improvement with regard to fear, loss of control, disturbance of thought and interference with thinking was sustained by 60% of the patients while one-third improved further. Complete disappearance of hallucinations occurred in 18% of the patients. Conclusion: CBT with coping training can improve both overall symptomatology and quality of life, even over longer periods of time, but a status of persistent disablement indicates a continuing need for mental health care. [source]