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Biomedical subjects

L R Faulkner

Publications and source records attributed to L R Faulkner.

At least 37 records · Page 2Linked to original sources
PubMed1993

Long-term follow-up of rural involuntary clients.

A cohort of 72 persons who had entered a rural Oregon county's involuntary treatment system in 1979 through 1982 was followed for six years. While schizophrenia was the most frequent diagnosis, several other conditions were represented including adjustment disorders, organic mental disorders, and substance abuse. The majority (55%) of persons with organic mental disorders died as did 12% of the individuals with schizophrenia. The overall mortality rate was three times the expected figure (p = .002). During the follow-up period, only 39% of the initial cohort received treatment from a community mental health program whereas 28% were newly admitted (involuntarily) to a state mental hospital. Hospital recividism was most likely among individuals who had had prior involuntary treatment. At least in rural areas, the civil commitment system seems to serve both "infrequent" and "persistent" users. Infrequent users mainly have diagnoses of adjustment disorders and/or substance abuse. Persistent users chiefly have diagnoses of organic mental disorders, mood disorders, or schizophrenia. Modifying the involuntary treatment system to take account of this heterogeneous population's diverse needs is discussed.

Adult↗
PubMed1993

The adaptation to prison by individuals with schizophrenia.

This report documents the adjustment to prison life by individuals with schizophrenia and compares their adaptation with a control group with no known mental illness matched for age, race, sex, most serious crime, and security level. On all outcome variables, number of infractions, number of "lock-ups", days in "lock-up," ability to obtain a job in prison, and ability to obtain release from prison, the group with schizophrenia was inferior to the control group. That inmates with schizophrenia may require special assistance in prison and the need for future investigation are discussed.

Adaptation, Psychological↗
PubMed1993

Indochinese patients in the civil commitment process.

This paper examines in detail the involvement of a group of Indochinese patients in the Oregon Civil Commitment process in the calendar years of 1985 and 1986. The authors found that there was no apparent difference in the rate of commitment as contrasted to the overall commitment rate of the general population. The results also indicated that there was heavy reliance on the Indochinese Psychiatric Program and staff to divert the involuntary Indochinese patients out of the commitment process. Furthermore, comparing the involuntary Indochinese patients to a randomly selected cohort of Indochinese patients hospitalized in the same period revealed no differences in demographic data, diagnosis, and treatment history except that the involuntary group was significantly younger and predominantly male. Finally, the follow-up study of the two cohorts showed high rates of hospitalization, noncompliance, and treatment drop-out.

Adult↗
PubMed1992

A quality improvement process for state mental health systems.

Continuous improvement of the quality of patient care is a major goal in state mental health systems, most of which operate several large hospitals and many community mental health centers geographically dispersed across the state. Although each facility may have an adequate quality assurance program, many opportunities for improvement are lost without integration of these efforts into a unified, statewide quality improvement system. The authors describe development of such a system in South Carolina and give examples of improvements in patient care that have taken place since the program was initiated in 1987. The activities of the central office of quality assurance include collecting and analyzing data about adverse incidents in state facilities, monitoring corrective actions, conducting annual surveys of operations at all state facilities, and investigating and coordinating resolution of complaints about patients' rights.

Community Mental Health Services↗
PubMed1991

Behavioral science in medical education: a 1987-1991 bibliography.

Holmes, et al. in 1988 compiled 61 studies in an updated bibliography of behavioral science in undergraduate and graduate medical education. Since then, 64 additional studies of behavioral science in medical education have been published and abstracted in Index Medicus and Psychological Abstracts, the sources for the bibliography.

Behavioral Sciences↗
PubMed1990

Family members' opinions about civil commitment.

As part of a survey of 260 Oregon family members with mentally ill relatives, respondents were asked about their experiences with civil commitment and their opinions about proposed modifications in the commitment statutes. Family members typically described their mentally ill relative as a schizophrenic man in his thirties who had had six psychiatric hospitalizations and was currently being treated with medications at a community mental health center. Three-fourths of the relatives had been committed. A majority (57 percent) of the respondents were in favor of mandatory outpatient treatment and medication after involuntary hospitalization but were not enthusiastic about outpatient commitment without hospitalization. Family members also wanted more education about mental illness, more information about the commitment process, and assignment of a professional to help in the commitment process.

Bipolar Disorder↗
PubMed1990

Threats and assaults against psychiatrists.

In this article, the authors review the literature on surveys pertaining to threats and assaults on psychiatrists and report the results of a questionnaire sent to Oregon psychiatrists. Although the responding psychiatrists were experienced clinicians, they appear to have had relatively little life experience with aggression. Assaults and threats were frequent in their careers, occurred across a variety of clinical settings, and involved a wide range of patients. The authors discuss specific strategies for psychiatrists to minimize the effects of patient threats and assaults and suggest ways in which organized psychiatry can help with the danger and sequelae of patient violence.

Adult↗
PubMed1989

Oregon's state-university collaboration in a national context.

Oregon's state-university collaboration incorporates the key principles of successful relationships: effective leadership, specific goals and objectives, trust, careful administration, and bilateral involvement and influence.

Community Mental Health Services↗
PubMed1989

A basic residency curriculum concerning the chronically mentally ill.

In this paper a group of knowledgeable individuals with expertise in psychiatric education present their recommendations for a basic psychiatric residency curriculum concerning the chronically mentally ill. The proposed curriculum consists of knowledge, skill, and attitude educational objectives, as well as clinical experiences, faculty supervision, didactics and seminars, and evaluation mechanisms. Recommendations are also made concerning changes in the Accreditation Council for Graduate Medical Education's Special Requirements for Residency Training in Psychiatry, which would require residency programs to place more emphasis on training to meet the needs of the chronically mentally ill. Obstacles to the implementation of the proposed recommendations are presented and possible solutions are discussed.

Accreditation↗
PubMed1989

An empirical study of emergency commitment.

The authors examine the emergency commitment process in one Oregon county and present data that document the impact of a local detention facility. The study reconfirms the dependence of commitment processes on the mental health system in which they occur, illustrates the relative inability of specific laws to determine the actual nature of commitment processes, provides support for the concept of community care for the people involved, and points to the need for additional research to clarify the effects of commitment procedures.

Commitment of Persons with Psychiatric Disorders↗
PubMed1989

Chronic mental illness and the criminal justice system.

A total of 260 family members responded to a survey seeking information about their mentally ill relatives' contacts with the criminal justice system. Reports by family members indicated that the mentally ill relatives were mainly men in their early thirties with a diagnosis of schizophrenia or bipolar disorder; they had had an average of four admissions to a state mental hospital. The majority had been arrested, but only a fifth had been convicted of a crime. Substance abuse and noncompliance with psychiatric medications were significant predictors of arrest. Family members overwhelmingly attributed the arrests to psychiatric crises, and in about half the cases a failed attempt at commitment had preceded the arrest. However, only a minority of the mentally ill relatives were taken to a hospital at the time of the arrest. The findings highlight the need for closer collaboration between mental health specialists and law enforcement personnel.

Adolescent↗
PubMed1989

Investigators' and judges' opinions about civil commitment.

As part of our work with the Oregon Task Force on Civil Commitment, we surveyed the judges and commitment investigators involved in the state's involuntary treatment program. In Oregon the investigators recommend whether or not a commitment hearing should be held. These mental health professionals indicated that current confidentiality laws restrict their access to important information. The investigators also expressed concern about the lack of resources with which to divert clients out of the commitment system. Judges too felt that relaxing the rules of evidence would improve the quality of commitment hearings. Regarding changes in the system, investigators and judges indicated that outpatient treatment (including compliance with medications) should be required of committed patients. These professionals noted that involuntary outpatient treatment could only be enforced if the system included a mechanism for hospitalizing patients who were noncompliant. Although the investigators believed commitment criteria should be broadened so that their clients could receive treatment before becoming dangerous, judges did not generally endorse this view. We discuss the implications of these findings for new civil commitment legislation.

Adult↗
PubMed1988

Drug treatment refusal and length of hospitalization of insanity acquittees.

Thirty-three insanity acquittees who had refused drug treatment were matched to a sample of nonrefusing hospitalized insanity acquittees in an attempt to measure the effect of treatment refusal on length of hospital stay. No measurable effects on the length of hospitalization were found. However, upon comparing the amount of time under court jurisdiction spent in the hospital and on conditional release in the community, it becomes evident that refusers spent significantly greater proportions of time hospitalized than the average hospitalized insanity acquittee, who had less hospitalization and spent more time on conditional release. These differences do not seem to be related to the issue of treatment refusal.

Adult↗