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Biomedical subjects

M F Shore

Publications and source records attributed to M F Shore.

At least 55 records · Page 3Linked to original sources
PubMed1981

Overview: deinstitutionalization of psychiatric patients, a critical review of outcome studies.

The authors performed a critical review of experimental studies on the outcomes for psychiatric patients of 1) alternatives to hospital admission, 2) modifications of conventional hospitalization, and 3) alternatives to continued long-term hospitalization. The internal validity of many of the studies was compromised by shortcomings in design and performance and generalizability limited by selection of patient populations. With these qualifications experimental alternatives to hospital care of patients have led to psychiatric outcomes not different from and occasionally superior to those of patients in control groups. This conclusion is best supported for alternatives to admission and for modifications of conventional hospitalization. The available studies do not permit firm conclusions regarding alternatives to continued long-term hospitalization of chronically ill patients or for a critical analysis of the optimal management of specific subpopulations of psychiatric patients. Satisfactory deinstitutionalization appears to depend on the availability of appropriate programs for care in the community.

Adult↗
PubMed1981

Alternatives to hospitalization developed by an urban mental health center: an overview.

For 150 years public institutions, caught between society's insistence that all needy persons receive some kind of services and taxpayers' reluctance to support such services, have been forced to take in all patients who have no place to go, without adequate resources for providing services to them. This long experiment on the effects of underfunding has led to the move to develop alternatives to large public institutions. Massachusetts Mental Health Center, which serves its urban catchment area without a backup hospital, has set up a comprehensive system of alternatives to hospital care; serving the chronic patient is a major concern. This paper and the following four papers describe certain aspects of the center's alternatives to hospitalization. They include a four-year follow-up of deinstitutionalized patients, a Quarterway House for patients with persistent severe disabilities, a network of residential placements, and a program for training psychiatric residents in the care of chronic patients.

Boston↗
PubMed1979

Public psychiatry: the public's view.

A 1977 survey of public attitudes toward psychiatry found that the quality of institutional psychiatry was one of several factors associated with negative attitudes toward the field. Noting the shortage of psychiatrists in public institutions, the author questions whether the public associates psychiatrists with conditions in the institutions despite their lack of involvement, or because of it. He believes that the inadequate care provided in many public facilities is a result of a tacit social contract between the public and private sectors that enables private institutions to maintain their fiscal integrity and their quality of care by moving undesirable patients to public institutions that provide inadequate care. Although the problems with the system extend beyond psychiatry and the mental health field, he suggests that psychiatrists could force some positive changes by refusing as a profession to practice in institutions that provide inadequate care, and by supporting the delivery of public services by nongovernmental bodies. The ultimate answer, he believes, lies in research into more effective treatment for mental illness that would make such institutions unnecessary.

Government↗
PubMed1979

The effect of deinstitutionalization on the state hospital.

Recalling the important statement about the bankruptcy of the state hospital system and the need for a multitude of treatment settings made by Harry Solomon, M.D., in 1958, the authors acknowledge that the changes he prophesized have largely come about. Using the Massachusetts Mental Health Center as the model, they describe how an inpatient unit operates as part of a deinstitutionalized network of services for seriously ill patients. They discuss the five general types of patients admitted and the problems of providing adequate care to such a diverse population. Finally, they make a strong plea for the establishment of regional facilities to care for patients with unusual, complicated problems.

Boston↗
PubMed1978

Halfway house and family involvement as related to community adjustment for ex-residents of a psychiatric halfway house.

What variables are highly correlated with successful community adjustment? A group of ex-patients who left a halfway house to return to the community were interviewed around their active involvement and perceived support from the staff members of the halfway house, while living on their own or with their families. There was a highly positive relationship between continuing contact with the halfway house and the level of adjustment in the community. The implications for understanding the nature, continuity, and purpose of social supports for this group are discussed.

Aftercare↗
PubMed1977

Cooperative apartments: new programs in community mental health.

The potential of cooperative apartments as an alternative in residential care for former mental patients is only beginning to be explored. Existing programs demonstrate the viability of these apartments as a last stepping-stone to be used by patients as they move toward a completely independent way of life. In contrast to other residential arrangements, such as foster home care or halfway houses, cooperative apartments seem on balance to be less likely to induce patient dependence or to have an aura reminiscent of the hospital to patients. Moreover, they are relatively inexpensive, can be established without attracting untoward attention in the community, and permit their occupants to live more like other people and with comparatively little stigma. As indicated by the variety of sponsoring agencies described in this article, the impetus to establish cooperative apartments can come from many sources. Such diversity is currently necessary. Only through the evaluation of different models and their effectiveness will criteria be established for a national policy regarding residential care.

Community Mental Health Services↗
PubMed1975

The effects of consultation. A review of empirical studies.

Although consultation, as an activity for intervention, has achieved considerable popularity among human service professionals and figures prominently in current federal mental health legislation, a basic question still unanswerable is, "Does it work?" This paper reviews 35 consultation outcome studies reported between 1958 and 1972 in an attempt to provide some answers to this question. Although their quality varies greatly, the evidence seems to lend some support to the effectiveness of consultation as a change method. In 69% of the studies reviewed, positive change was demonstrated on the consultee, client, or system level or at some combination of these. The review also suggests that, despite a need for studies which build cumulatively on earlier ones so as to provide comparable data instead of a conglomerate of isolated findings, progress has been made in the evaluation of consultation.

Achievement↗