Mental Illness (mental + illness)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Mental Illness

  • chronic mental illness
  • enduring mental illness
  • persistent mental illness
  • serious mental illness
  • severe mental illness

  • Terms modified by Mental Illness

  • mental illness diagnosis

  • Selected Abstracts


    M. Clare Taylor
    No abstract is available for this article. [source]

    Development and responsiveness of a scale to measure clinicians' attitudes to people with mental illness (medical student version)

    A. Kassam
    Kassam A, Glozier N, Leese M, Henderson C, Thornicroft G. Development and responsiveness of a scale to measure clinicians' attitudes to people with mental illness (medical student version). Objective:, We report the rationale, reliability, validity and responsiveness studies of the Mental Illness: Clinicians' Attitudes (MICA) Scale, a 16-item scale designed to measure attitudes of health care professionals towards people with mental illness. Method:, Items were generated through focus groups with service users, carers, medical students and trainee psychiatrists. Psychometric testing was completed in a number of student samples. The responsiveness of the scale was tested after a 1.5 h mental illness stigma related intervention with medical students. Results:, The MICA scale showed good internal consistency, , = 0.79. The test,retest reliability (concordance) was 0.80 (95% CI: 0.68,0.91). The standardised response mean for the scale was 0.4 (95% CI 0.02,0.8) after a mental illness related stigma intervention. Conclusion:, The MICA scale is a responsive, reliable and valid tool, which can be used in medical education and mental health promotion settings and studies. [source]

    Mental illness, nativity, gender and labor supply

    HEALTH ECONOMICS, Issue 4 2010
    Victoria D. Ojeda
    Abstract We analyzed the impacts of nativity and mental health (MH) on work by gender for non-elderly adults using the 2002 National Survey on Drug Use and Health. We employed two indicators of MH , the K6 scale of Mental Illness (MI) and an indicator for symptoms of Mania or Delusions (M/D). Instrumental variable (IV) models used measures of social support as instruments for MI. Unadjusted work rates were higher for immigrants (vs US-born adults). Regressions show that MI is associated with lower rates of work among US-born males but not immigrant males and females; M/D is associated lower rates of work among US-born males and females, and among immigrant males. Results did not change using IV models for MI. Most persons with MI work, yet symptom severity reduces labor supply among natives especially. Immigrants' labor supply is less affected by MI. Copyright 2009 John Wiley & Sons, Ltd. [source]

    Obstetric Complications in Women with Diagnosed Mental Illness: The Relative Success of California's County Mental Health System

    Dorothy Thornton
    Objective. To examine disparities in serious obstetric complications and quality of obstetric care during labor and delivery for women with and without mental illness. Data Source. Linked California hospital discharge (2000,2001), birth, fetal death, and county mental health system (CMHS) records. Study Design. This population-based, cross-sectional study of 915,568 deliveries in California, calculated adjusted odds ratios (AORs) for obstetric complication rates for women with a mental illness diagnosis (treated and not treated in the CMHS) compared with women with no mental illness diagnosis, controlling for sociodemographic, delivery hospital type, and clinical factors. Results. Compared with deliveries in the general non,mentally ill population, deliveries to women with mental illness stand a higher adjusted risk of obstetric complication: AOR=1.32 (95 percent confidence interval [CI]=1.25, 1.39) for women treated in the CMHS and AOR=1.72 (95 percent CI=1.66, 1.79) for women not treated in the CMHS. Mentally ill women treated in the CMHS are at lower risk than non-CMHS mentally ill women of experiencing conditions associated with suboptimal intrapartum care (postpartum hemorrhage, major puerperal infections) and inadequate prenatal care (acute pyelonephritis). Conclusion. Since mental disorders during pregnancy adversely affect mothers and their infants, care of the mentally ill pregnant woman by mental health and primary care providers warrants special attention. [source]

    Mental Illness and Length of Inpatient Stay for Medicaid Recipients with AIDS

    Donald R. Hoover
    Objective. To examine the associations between comorbid mental illness and length of hospital stays (LOS) among Medicaid beneficiaries with AIDS. Data Source and Collection/Study Setting. Merged 1992,1998 Medicaid claims and AIDS surveillance data obtained from the State of New Jersey for adults with ,1 inpatient stay after an AIDS diagnosis from 1992 to 1996. Study Design. Observational study of 6,247 AIDS patients with 24,975 inpatient visits. Severe mental illness (SMI) and other less severe mental illness (OMI) diagnoses at visits were ascertained from ICD,9 Codes. About 4 percent of visits had an SMI diagnosis; 5 percent had an OMI diagnosis; 43 percent did not have a mental illness diagnosis, but were patients who had been identified as having an SMI or OMI history; and 48 percent were from patients with no identified history of mental illness. Principal Findings. The overall mean hospital LOS was 12.7 days. After adjusting for measures of HIV disease severity and health care access in multivariate models, patients presenting with primary and secondary severe mental illness (SMI) diagnoses had ,32 percent and ,11 percent longer LOS, respectively, than did similar patients without a mental illness history (p<0.001 for each). But in these adjusted models of length of stay: (1) diagnosis of OMI was not related to LOS, and (2) in the absence of a mental illness diagnosed at the visit, an identified history of either SMI or OMI was also not related to LOS. In adjusted models of time to readmission for a new visit, current diagnosis of SMI or OMI and in the absences of a current diagnosis, history of SMI or OMI all tended to be associated with quicker readmission. Conclusions. This study finds greater (adjusted) LOS for AIDS patients diagnosed with severe mental illness (but not for those diagnosed with less severe mental comorbidity) at a visit. The effect of acute severe mental illness on hospitalization time may be comparable to that of an acute AIDS opportunistic illness. While previous research raises concerns that mental illness increases LOS by interfering with treatment of HIV conditions, the associations here may simply indicate that extra time is needed to treat severe mental illnesses or arrange for discharge of afflicted patients. [source]

    The Cost-Effectiveness of Independent Housing for the Chronically Mentally Ill: Do Housing and Neighborhood Features Matter?

    Joseph Harkness
    Objective. To determine the effects of housing and neighborhood features on residential instability and the costs of mental health services for individuals with chronic mental illness (CMI). Data Sources. Medicaid and service provider data on the mental health service utilization of 670 individuals with CMI between 1988 and 1993 were combined with primary data on housing attributes and costs, as well as census data on neighborhood characteristics. Study participants were living in independent housing units developed under the Robert Wood Johnson Foundation Program on Chronic Mental Illness in four of nine demonstration cities between 1988 and 1993. Study Design. Participants were assigned on a first-come, first-served basis to housing units as they became available for occupancy after renovation by the housing providers. Multivariate statistical models are used to examine the relationship between features of the residential environment and three outcomes that were measured during the participant's occupancy in a study property: residential instability, community-based service costs, and hospital-based service costs. To assess cost-effectiveness, the mental health care cost savings associated with some residential features are compared with the cost of providing housing with these features. Data Collection/Extraction Methods. Health service utilization data were obtained from Medicaid and from state and local departments of mental health. Non-mental-health services, substance abuse services, and pharmaceuticals were screened out. Principal Findings. Study participants living in newer and properly maintained buildings had lower mental health care costs and residential instability. Buildings with a richer set of amenity features, neighborhoods with no outward signs of physical deterioration, and neighborhoods with newer housing stock were also associated with reduced mental health care costs. Study participants were more residentially stable in buildings with fewer units and where a greater proportion of tenants were other individuals with CMI. Mental health care costs and residential instability tend to be reduced in neighborhoods with many nonresidential land uses and a higher proportion of renters. Mixed-race neighborhoods are associated with reduced probability of mental health hospitalization, but they also are associated with much higher hospitalization costs if hospitalized. The degree of income mixing in the neighborhood has no effect. Conclusions. Several of the key findings are consistent with theoretical expectations that higher-quality housing and neighborhoods lead to better mental health outcomes among individuals with CMI. The mental health care cost savings associated with these favorable features far outweigh the costs of developing and operating properties with them. Support for the hypothesis that "diverse-disorganized" neighborhoods are more accepting of individuals with CMI and, hence, associated with better mental health outcomes, is mixed. [source]

    I'm not Alone: A Teen's Guide to Living with a Parent Who Has a Mental Illness

    Article first published online: 28 FEB 200
    No abstract is available for this article. [source]

    Caring for the Whole Person: Integrated Health Care for Older Adults with Severe Mental Illness and Medical Comorbidity

    Stephen J. Bartels MD
    First page of article [source]

    Behavioral treatment of substance abuse in schizophrenia

    Wendy N. Tenhula
    Abstract Co-occurring substance use disorders are highly prevalent among individuals with schizophrenia and other serious and persistent mental illnesses (SPMI) and are associated with clinically significant consequences. A multifaceted behavioral treatment called Behavioral Treatment for Substance Abuse in Serious and Persistent Mental Illness (BTSAS) can reduce substance abuse in persons with SPMI. The key treatment strategies in BTSAS include a urinalysis contingency, short-term goal setting, training in drug refusal skills, psychoeducation about the impact of drug use, and relapse prevention training. A case example illustrating the application of BTSAS is presented and relevant clinical issues are discussed. 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,11, 2009. [source]

    Vietnamese Americans' attitudes toward seeking mental health services: Relation to cultural variables

    Quang Charles X. Nguyen
    This study examined the relation between culturally based variables and attitudes toward seeking mental health services among a community sample of Vietnamese Americans ( N = 148) with at least 8 years' residence in the United States (U.S.). Variables included Stigma, Traditional Beliefs about Mental Illness, Help-Seeking Preferences, Problem Prioritizing, and Disclosure. The results indicated that Disclosure, Help-Seeking Preferences, and Problem Prioritizing were significant predictors of attitudes. Greater willingness to disclose, greater preference for professional resources over family/community resources, and higher priority placed on mental/emotional health concerns over other concerns were each associated with more favorable attitudes toward seeking mental health services. Stigma and Traditional Beliefs about Mental Illness did not appear to be significant predictors. Implications of the findings are discussed. 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 213,231, 2005. [source]

    Treating Mental Illness and Behavior Disorders in Children and Adults with Mental Retardation

    Edited by Anton Dosen & Kenneth Day American Psychiatric Press Inc., Washington

    Personal Recovery and Mental Illness: A Guide for Mental Health Professionals

    MICHAEL COFFEY phd rmn
    No abstract is available for this article. [source]

    Maybe He's Depressed: Mental Illness as a Mitigating Factor for Drug Offender Accountability

    LAW & SOCIAL INQUIRY, Issue 3 2009
    Leslie Paik
    Given the often perplexing relationship between mental illness and substance abuse among offenders, this article looks at how a juvenile drug court staff's presumptions of a youth's mental illness affect its decision-making process. Based on thirteen months of ethnographic fieldwork at a Southern California juvenile drug court, this article uses Manzo and Travers's "law in action" approach to analyze how the staff readjusts its application of normal remedies (a concept developed by Robert Emerson) designed to respond to a youth's noncompliance when it suspects mental illness may be influencing the youth's actions. In doing so, it highlights how court staff's considerations of youth mental disorders arise out of its everyday work practices. Furthermore, the article discusses how staff negotiations around a youth's mental illness create tensions for the juvenile drug court's accountability-based model of therapeutic jurisprudence, because assessments of mental illness tend to mitigate responsibility for a youth's behavior. [source]

    Another Way: Enclave Communities for People With Mental Illness

    James M. Mandiberg
    First page of article [source]

    A Qualitative Investigation of Individual and Contextual Factors Associated With Vocational Recovery Among People With Serious Mental Illness

    Erin C. Dunn
    Most people with serious mental illness (SMI) experience difficulty in fulfilling a vocational role, with many being unemployed or underemployed. Given the profound social and economic costs of this level of work impairment, researchers have investigated ways to enhance "vocational recovery," or the processes through which people with SMI regain their role as workers and reintegrate into the workforce. Using data collected from a larger qualitative study of 23 individuals who had progressed to an advanced stage of recovery from SMI, this study explored respondents' perspectives on employment and its relationship to their vocational recovery. Text passages describing employment were analyzed inductively by a diverse team of researchers. Seven themes were identified as being important in helping participants return to work or remain employed following the onset of a serious psychiatric disability: having the confidence to work, having the motivation to work, possessing work-related skills, assessing person,job fit, creating work opportunities, receiving social support, and having access to consumer-oriented programs and services. Implications of these findings on the development of interventions and policies to improve the vocational outcomes of people with SMI are discussed. [source]

    Another Breed of "Service" Animals: STARS Study Findings About Pet Ownership and Recovery From Serious Mental Illness

    Jennifer P. Wisdom PhD
    This study elucidates the role of pets in recovery processes among adults with serious mental illness. Data derive from interviews with 177 HMO members with serious mental illness (52.2% women, average age 48.8 years) in the Study of Transitions and Recovery Strategies (STARS). Interviews and questionnaires addressed factors affecting recovery processes and included questions about pet ownership. Data were analyzed using a modified grounded theory method to identify the roles pets play in the recovery process. Primary themes indicate pets assist individuals in recovery from serious mental illness by (a) providing empathy and "therapy"; (b) providing connections that can assist in redeveloping social avenues; (c) serving as "family" in the absence of or in addition to human family members; and (d) supporting self-efficacy and strengthening a sense of empowerment. Pets appear to provide more benefits than merely companionship. Participants' reports of pet-related contributions to their well-being provide impetus to conduct more formal research on the mechanisms by which pets contribute to recovery and to develop pet-based interventions. [source]

    Relationship of Stigma to HIV Risk Among Women with Mental Illness

    Pamela Y. Collins MD
    Urban women with severe mental illness (SMI) are vulnerable to stigma and discrimination related to mental illness and other stigmatized labels. Stigma experiences may increase their risk for negative health outcomes, such as HIV infection. This study tests the relationship between perceived stigma and HIV risk behaviors among women with SMI. The authors interviewed 92 women attending community mental health programs using the Stigma of Psychiatric Illness and Sexuality Among Women Questionnaire. There were significant relationships between personal experiences of mental illness and substance use accompanying sexual intercourse; perceived ethnic stigma and having a riskier partner type; and experiences of discrimination and having a casual or sex-exchange partner. Higher scores on relationship stigma were associated with a greater number of sexual risk behaviors. The findings underscore the importance of exploring how stigma attached to mental illness intersects with other stigmatized labels to produce unique configurations of HIV risk. HIV risk reduction interventions and prevention research should integrate attention to stigmatized identities in the lives of women with SMI. [source]

    Changes in Caregiving Satisfaction and Information Needs Among Relatives of Adults With Mental Illness: Results of a Randomized Evaluation of a Family-Led Education Intervention

    Susan A. Pickett-Schenk PhD
    The authors examined changes in caregiving satisfaction and information needs among 462 relatives of individuals with mental illness who participated in a study of a family-led education course, the Journey of Hope (JOH). Participants were randomly assigned to receive JOH or to a control group waiting list and followed for 9 months. General linear model repeated measures analysis of variance found that, compared with the control group, the intervention group showed significant improvement in caregiving satisfaction and information needs following course completion and maintained these gains for another 6 months. Education and support from other family members in the form of a structured course is effective in meeting the caregiving needs of relatives of persons with mental illness. [source]

    Integrative Model of Caregiving: How Macro and Micro Factors Affect Caregivers of Adults With Severe and Persistent Mental Illness

    Winnie W. S. Mak PhD
    The study tested an integrative model of caregiving by examining the effects of sociocultural characteristics, interpersonal relations, mental health service structure, consumers' symptoms, objective burden, and evaluation of service systems on the subjective experiences of caregivers. The sample consisted of 428 caregivers of adults with severe and persistent mental illness. Results from multiple regression analyses indicated that ethnicity was the most significant sociocultural factor on caregivers' worry, personal growth, and benefits. Caregivers enrolled in managed care plans worried more about their consumers' welfare and felt less gratified by their experiences than their counterparts from fee-for-service plans. Implications to and partnerships among caregivers and mental health service systems were discussed. [source]

    Burden and coping strategies in mothers of patients with schizophrenia in Japan

    Setsuko Hanzawa phd
    Aim:, The present study was conducted to identify factors contributing to burden of care in 57 mothers caring for patients with schizophrenia. Methods:, Members of the Federation of Families of People with Mental Illness in Nagasaki Prefecture were evaluated using well-validated scales to evaluate burden of care (eight-item short version of the Japanese version of the Zarit Caregiver Burden Interview), general health status (General Health Questionnaire 12-item version), difficulty in life, coping strategies, emotional support, and understanding of mental illness and disorders. Results:, Burden of care was significantly associated with general health status and difficulty in life. Conclusion:, On multiple regression it was found that ,social interests' and ,resignation', both of which are the subscales of coping strategies, exerted significant and independent effects with respect to burden of care. [source]

    Marie Nathusius' Elisabeth and Fontane's Effi Briest: Mental Illness and Marital Discord in the "Century of Nerves"

    THE GERMAN QUARTERLY, Issue 1 2010
    Nicole Thesz
    This comparative analysis of Marie Nathusius' Elisabeth (1856/57) and Theodor Fontane's Effi Briest (1895) reveals striking similarities. Both novels depict child brides whose disappointment in marriage leads to nervous ailments. The Kur that both heroines undergo represents one of several contrasts between domesticity and the outside world. Illness, in Nathusius's portrayal, is an opportunity to negotiate difficulties in marital relationships. While Elisabeth upholds traditional models of femininity, it also shows the husband's nervous reactions to discord. Like Effi Briest, there are implications of social pressures, but ultimately healing Elisabeth involves her free will to choose religious faith, and thus health or "das Heil". Fontane, in contrast, places the etiology of illness firmly within the vicissitudes of patriarchal society, which crushes the individual beneath its hypocritical norms. The Kur thus offers Effi no respite, and instead transports her toward isolation and untimely death. [source]

    Journeys in Complex Genetics: Music and Mental Illness

    ANNALS OF NEUROLOGY, Issue 1 2009
    Stephen L. Hauser MD Editor
    No abstract is available for this article. [source]

    Are perceptions of parenting and interpersonal functioning related in those with personality disorder?

    Evidence from patients detained in a high secure setting
    We explored the widely-held assumption that dysfunctional interpersonal behaviour, a key characteristic of personality disorder, is associated with adverse experiences in childhood in a sample of patients detained in high secure care. We obtained Parental Bonding Inventory (PBI) and Chart of Interpersonal Relations in Closed Living Environment (CIRCLE) data from 79 patients detained at a high secure hospital. This comprised 48 with the legal classification (1983 Mental Health Act) of Psychopathic Disorder (PD) and 31 with the legal classification of Mental Illness (MI). On the PBI, the PD group had significantly lower care scores and increased protection scores compared with the MI group; the latter reported care and protection scores similar to those from published norms. The CIRCLE scores also demonstrated significantly different interpersonal functioning between the PD and MI groups, with each group typically plotted in opposing halves of the interpersonal circle (IPC). Although the PDs showed abnormalities in both the PBI and CIRCLE in the expected direction, there were no clear associations between aspects of abnormal parenting and adult dysfunctional interpersonal behaviour within this group. This finding did not confirm our hypothesis and we discuss possible explanations. Copyright 2001 John Wiley & Sons, Ltd. [source]

    Overcoming Barriers to Increase the Contribution of Clinical Psychologists to Work With Persons With Severe Mental Illness

    David Roe
    Psychosocial treatments for persons with severe mental illness (SMI) have been developing rapidly over the past decade. Despite the fact that people with SMI are often in the greatest need of care, clinical psychologists are not currently playing a major role in their treatment and are underrepresented compared to other disciplines in this area such as nursing, social work, and psychiatry. In this article, we present possible reasons for clinical psychologists' underrepresentation and discuss motivators, potential opportunities, and ways for clinical psychologists to take a greater role in the provision of services for persons with SMI. Implications for the training of clinical psychologists are discussed. [source]

    Mental illness, nativity, gender and labor supply

    HEALTH ECONOMICS, Issue 4 2010
    Victoria D. Ojeda
    Abstract We analyzed the impacts of nativity and mental health (MH) on work by gender for non-elderly adults using the 2002 National Survey on Drug Use and Health. We employed two indicators of MH , the K6 scale of Mental Illness (MI) and an indicator for symptoms of Mania or Delusions (M/D). Instrumental variable (IV) models used measures of social support as instruments for MI. Unadjusted work rates were higher for immigrants (vs US-born adults). Regressions show that MI is associated with lower rates of work among US-born males but not immigrant males and females; M/D is associated lower rates of work among US-born males and females, and among immigrant males. Results did not change using IV models for MI. Most persons with MI work, yet symptom severity reduces labor supply among natives especially. Immigrants' labor supply is less affected by MI. Copyright 2009 John Wiley & Sons, Ltd. [source]

    Patients' experiences of psychosis in an inpatient setting

    The aim of this report was to describe patients' experiences of psychosis in an inpatient setting. Mental illness, as a result of psychosis, has traditionally been defined from the viewpoint of clinical experts. Psychiatric nursing, as an interactive human activity, is more concerned with the development of the person than with the origins or causes of their present distress. Therefore, psychiatric nursing is based on eliciting personal experiences and assisting the person to reclaim her/his inner wisdom and power. The design of the study, in the report discussed below, was phenomenological. In 1998, nine patients were interviewed regarding their experiences of psychosis in an acute inpatient setting. The verbatim transcripts were analysed using Giorgi's phenomenological method. The participants experienced psychosis as an uncontrollable sense of self, which included feelings of change and a loss of control over one's self with emotional distress and physical pain. The participants described the vulnerability they had felt whilst having difficult and strange psychological feelings. The informants experienced both themselves and others sensitively, considered their family and friends important and meaningful, and found it difficult to manage their daily lives. Furthermore, the informants experienced the onset of illness as situational, the progress of illness as holistic and exhaustive, and the admission into treatment as difficult, but inevitable. [source]

    Gender differences in jail inmates' symptoms of mental illness, treatment history and treatment seeking,

    Amy L. Drapalski
    Background,Rates of mental illness among prisoners are substantial, but little is known about the unique mental health needs of women in jail, those under pre-trial custodial remand or serving short sentences. Aims,To compare male and female jail inmates along a wide range of symptoms of mental illness using identical assessment methods, and to examine gender differences in treatment seeking before and during incarceration. Methods,Soon after incarceration in a county jail, 360 male and 154 female pre-trial and post-trial inmates completed the Personality Assessment Inventory, a wide-ranging measure of psychiatric symptoms. Treatment seeking information was taken from official jail records. Results,Women were more likely to report clinically significant symptoms of anxiety, borderline personality features, somatic concerns and trauma-related symptoms; however, trauma-related symptoms and borderline features were also common among male inmates. Although both men and women reported high rates of drug-related problems, alcohol-related problems were twice as prevalent among male inmates. Female inmates were more likely to seek and be enrolled in jail-based treatment; there were no differences in reported help seeking prior to incarceration. Conclusions,Female jail inmates are especially in need of mental health services. Effective interventions for post-traumatic stress disorder and borderline personality disorder are needed in jail settings for both male and female inmates during incarceration and upon release. Copyright 2009 John Wiley & Sons, Ltd. [source]

    An exploration of research into substance misuse and psychiatric disorder in the UK: what can we learn from history?

    Ilana B. Crome
    Background and aim,This review explores UK-based research developments in substance misuse and mental illness over the last 25 years. The main body of work comprises policy-orientated projects funded by the Department of Health from the late 1990s. Early research tended to focus on alcohol, especially alcoholic hallucinosis: the relationship of the latter with schizophrenia-like illness was examined, with the finding that very few cases did develop into schizophrenia. Method and implications,Parallels are drawn with the current debate around the link between cannabis and psychosis, urging caution in too rapid an assertion that cannabis is necessarily ,causal'. The clinical and policy implications of the misinterpretation of evidence are discussed. A proposal is put forward that the genesis of psychotic illness in alcohol misuse be revisited using more sophisticated research methodologies. Given the changing landscape of substance use in the UK, particularly the fashion of polysubstance use and the recognition that this is associated with psychotic illness, other drugs that are associated with psychotic illness should be similarly investigated to determine whether there is a common mechanism that might throw light on understanding the relationship between substance use and psychotic illness or schizophrenia. Copyright 2007 John Wiley & Sons, Ltd. [source]

    Pharmacological issues in the management of people with mental illness and problems with alcohol and illicit drug misuse

    Trudi Hilton
    Background,While there is plentiful information on the pharmacological management of detoxification from alcohol and on withdrawal from or maintenance of opiates for people with a principal problem of substance misuse or dependency, the pharmacological management of substance misusers presenting with a mental illness can be more complicated. Mental health and substance misuse services tend to be separate, but there is now a drive to increase effective overlap between them by equipping mental health clinicians with the skills and confidence to manage substance misuse disorders in conjunction with major mental illness. Aims,This paper aims to highlight, for a multi-professional readership, some of the prescribing options and precautions to consider when psychotropic medicines are prescribed for treatment of a mental illness in someone who may continue to use illicit substances or alcohol. It also considers interactions with the completely licit substances, nicotine and caffeine. With recent legislation prohibiting smoking in public places people are likely to reduce or stop smoking, which can have a substantial effect on the levels of medication in their blood. Copyright 2007 John Wiley & Sons, Ltd. [source]

    Impact of assertive community treatment and client characteristics on criminal justice outcomes in dual disorder homeless individuals

    Dr Robert J. Calsyn PhD
    Background People with severe mental illness and substance use disorders (dual disorder) often have considerable contact with the criminal justice system. Aims To test the effects of client characteristics on six criminal justice outcomes among homeless (at intake) people with mental illness and substance misuse disorders. Methods The sample was of participants in a randomized controlled trial comparing standard treatment, assertive community treatment (ACT) and integrated treatment (IT). Data were analysed using hierarchical logistic regression. Results Half the sample was arrested and a quarter incarcerated during the two-year follow-up period. The regression models explained between 22% and 35% of the variance of the following criminal justice measures: (1) major offences, (2) minor offences, (3) substance-use-related offences, (4) incarcerations, (5) arrests, and (6) summons. Prior criminal behaviour was the strongest predictor of all of the dependent variables; in general, demographic and diagnostic variables were not. Similarly, neither the type nor the amount of mental health treatment received predicted subsequent criminal behaviour. Conclusion Elsewhere the authors have shown that ACT and IT had advantages for health and stability of accommodation but these analyses suggest that more specialized interventions are needed to reduce criminal behaviour in dual disorder individuals. Copyright 2005 John Wiley & Sons, Ltd. [source]