When do older adults seek primary care services for depression?
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Age Factors↗
Biomedical subjects
Patrick W Corrigan
Publications and source records attributed to Patrick W Corrigan.
Factors that explain how policy makers distribute resources to mental health services.
Advocates hope to influence the resource allocation decisions of legislators and other policy makers to capture more resources for mental health programs. Findings from social psychological research suggest factors that, if pursued, may improve advocacy efforts. In particular, allocation decisions are affected by policy makers' perceptions of the scarcity of resources, effectiveness of specific programs, needs of people who have problems that are served by these programs, and extent of personal responsibility for these problems. These perceptions are further influenced by political ideology. Conservatives are motivated by a tendency to punish persons who are perceived as having personal responsibility for their problems by withholding resources, whereas liberals are likely to avoid tough allocation decisions. Moreover, these perceptions are affected by political accountability, that is, whether politicians perceive that their constituents will closely monitor their decisions. Just as the quality of clinical interventions improves when informed by basic research on human behavior, the efforts of mental health advocates will be advanced when they understand the psychological forces that affect policy makers' decisions about resources.
Budgets↗
From whence comes mental illness stigma?
BACKGROUND: This paper seeks to answer two fundamental questions: What is the basis of the current form of mental illness stigma? and Why do western cultures stereotype people with mental illness as dangerous, incompetent and blameful, rather than something else? MATERIAL AND DISCUSSION: We argue that a motivational model called system-justification offers several benefits for answering these questions. System-justification portrays stigma as a way of making sense of economic and political differences between the majority and stigmatized subgroups. We contrast system-justification with two cognitive models of stigma that seem to have strong support from naive psychology: mental illness stigma results as the normal perception of a group of people who are dangerous and/or blameworthy and there is a kernel of truth to the stigmatizing attitudes about people with mental illness. Although research supporting the latter two models is mixed, there are significant limitations to the models, as well as concerns that normal perception and kernel of truth might actually promote stigma. CONCLUSIONS: As an alternative, system-justification combines three paradigms that suggest its worthiness for future research: 1) a review of historical and economic forces that influence social phenomena; 2) the need of humankind to understand these forces and organize them into a unitary framework; and 3) the cognitive mechanisms that are essential for this comprehension. Implications of this model for stigma change are discussed.
Attitude to Health↗
Towards an integrated, structural model of psychiatric rehabilitation.
In the past two decades, the number of principles and approaches that have been touted as psychiatric rehabilitation have overwhelmed the service provider. As a result, the field seems to be bombarded by contradictory ideas. In this paper, I seek to resolve this problem by providing an overview of psychiatric rehabilitation in terms of four key structures: goals (the reasons why people with psychiatric disabilities seek rehabilitation), strategies (the tools which service providers might use to help consumers reach their goals), settings (the places in which providers and consumers use these tools), and roles (the variety of professional and personal backgrounds which influence providers in carrying out their duties). In this paper, I review the research literature that has identified relevant examples of each of these structural dimensions. This description of psychiatric rehabilitation is based on a two-factor model of the life challenges that arise from mental illness: the disabilities produced by the disease and the loss of opportunity that result from stigma and discrimination. The paper also includes a brief discussion of the two-factor model.
Cognition Disorders↗
The effects of stereotype suppression on psychiatric stigma.
The effects of stereotype suppression on psychiatric stigma were investigated in two studies. In experiment 1, 52 participants were presented with a photograph of someone labeled with schizophrenia and instructed to write a passage describing a day in that person's life. Half of the participants were instructed to avoid using schizophrenia-related stereotypes in their passages (the stereotype suppression condition). Participants were then presented with a photograph of a different individual labeled with schizophrenia and asked to write another passage with stereotype suppression instructions omitted. The results showed that while stereotype suppression occurred for the first passage, the expected rebound effects were not observed in the second passage. Furthermore, the results were unchanged when participants' prior experience with persons with mental illness was considered. In a second study, the effects of stereotype suppression on behavior (i.e. seating distance from a person with schizophrenia) were examined in 58 participants. While the stereotype suppression instructions resulted in less stereotypical passages, replicating the results of study 1, no rebound effects on behavior were observed. A non-significant trend was observed whereby previous contact with persons with mental illness was associated with less social distance from someone with schizophrenia. Implications of the findings for reducing psychiatric stigma are discussed.
Adult↗
Some recovery processes in mutual-help groups for persons with mental illness; I: qualitative analysis of program materials and testimonies.
Outcome research is beginning to suggest that mutual-help programs lead to significant improvements in the quality of life and related factors of members who have serious mental illness. This paper is the first in a series that examines recovery processes that may account for these positive outcomes. In Study 1, a content analysis was completed on one dimension of the written program for GROW, a mutual-help program with more than 40 years of experience. Thirteen reliable recovery processes emerged from this analysis; most prominent among these was to "be reasonable" and to "decentralize from self by participating in community." In Study 2, the recovery processes that emerged from this analysis of one aspect of GROW's written program were applied to 22 written testimonies made by Growers. Results of this analysis again showed being reasonable and decentralizing from self by participating in community were essential processes in this mutual-help program. Analysis of the personal testimonies also showed accepting one's personal value as an important element in the GROW program.
Community Mental Health Services↗
Empowerment and serious mental illness: treatment partnerships and community opportunities.
The health goals of persons with serious mental illness are greatly improved when their personal power is advanced. Two targets of empowerment are discussed in this paper: treatment partnerships and community opportunities. Strategies that enhance treatment partnerships include provider endorsement of recovery rather than promoting an approach that suggests poor prognoses, treatment plans that are collaborative rather than unilateral decision making that is perceived as coercive, and treatment services provided in the person's community rather than geographically or psychological distant institutions. Approaches that focus on the person and treatment relationship are not sufficient however. Stigma and discrimination are significant barriers to the kind of community opportunities that are necessary to help people attain life goals. Communities that substitute stigmatizing attitudes and discriminatory behaviors with realistic views of mental illness are more likely to provide the kind of reasonable accommodations that some people need for work and independent living opportunities.
Attitude of Health Personnel↗
Transformational leadership and the mental health team.
Bass's (1990) multifactor model contrasts transformational and transactional styles of leadership with an essentially ineffective style: laissez-faire leadership. This study examines the relationship between these leadership styles and measures of organizational culture and staff burnout in mental health services teams. There were 236 leaders and 620 subordinates from 54 mental health teams who provided their perceptions of leadership style, organizational culture, and burnout in their program. Results show transformational leadership to be positively associated with a cohesive organizational culture and negatively associated with burnout. Moreover, leaders and subordinates differ in their ratings of transformational leadership-leaders viewed themselves more positively. These findings are helpful for understanding the central role of leaders in the organizational structure of teams.
Burnout, Professional↗
Challenging two mental illness stigmas: personal responsibility and dangerousness.
Two stigmatizing attitudes related to dangerousness and personal responsibility may undermine the opportunities of persons with serious mental illness. This study set out to examine path models that explain how these attitudes lead to discriminatory behavior and to assess the impact of antistigma programs on components of personal responsibility and dangerousness models. Two hundred thirteen persons were randomly assigned to one of five antistigma conditions: education on personal responsibility, education on dangerousness, contact with a person with serious mental illness where personal responsibility is discussed, contact where dangerousness is discussed, or no change. Persons completed an attribution questionnaire (AQ) representing personal responsibility and dangerousness path models at pretest, posttest, and 1-week followup. They also completed tasks that represented helping behavior. Goodness of fit indexes from linear structural modeling were mixed for both models but suggested that fear of dangerousness was a key attitude leading to discriminatory behavior. Results also showed that subjects who had contact with persons with serious mental illness experienced greater changes than subjects in the education or control groups did on measures of attribution and helping behavior.
Adolescent↗
Illness management and recovery: a review of the research.
Illness management is a broad set of strategies designed to help individuals with serious mental illness collaborate with professionals, reduce their susceptibility to the illness, and cope effectively with their symptoms. Recovery occurs when people with mental illness discover, or rediscover, their strengths and abilities for pursuing personal goals and develop a sense of identity that allows them to grow beyond their mental illness. The authors discuss the concept of recovery from psychiatric disorders and then review research on professional-based programs for helping people manage their mental illness. Research on illness management for persons with severe mental illness, including 40 randomized controlled studies, indicates that psychoeducation improves people's knowledge of mental illness; that behavioral tailoring helps people take medication as prescribed; that relapse prevention programs reduce symptom relapses and rehospitalizations; and that coping skills training using cognitive-behavioral techniques reduces the severity and distress of persistent symptoms. The authors discuss the implementation and dissemination of illness management programs from the perspectives of mental health administrators, program directors, people with a psychiatric illness, and family members.
Adaptation, Psychological↗
Evidence-based practices need to beware of experts.
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Evidence-Based Medicine↗
Motivational interviewing to improve insight and treatment adherence in schizophrenia.
Poor insight and low treatment adherence are common features among persons with schizophrenia that are often related to poor outcome. While insight is a multidimensional phenomenon, common measures of insight have shortcomings and do not include all items relevant for insight and compliance. Different causes of poor insight and compliance such as neurocognitive deficits and psychological coping mechanisms are considered and also the role of awareness in the context of health behavior theory and the stages of change-model. Motivational Interviewing can, with specific modifications for persons with schizophrenia, successfully increase their insight and compliance, because it allows them to explore their own goals and to take a more active role in treatment.
Adaptation, Psychological↗
Validation of French- and English-Canadian versions of the Social Cue Recognition Test.
OBJECTIVE: Our primary objective was to create and validate the Social Cue Recognition Test-C (SCRT-C), a Canadian test comparable with the original SCRT. METHOD: We administered the SCRT-C and the original SCRT to 111 normal undergraduate students. RESULTS: In our sample, the reliability and validity of the SCRT-C were moderately high and similar to those found with Corrigan's SCRT. The results also suggest that the English and French versions of the Canadian SCRT are equivalent. CONCLUSIONS: The SCRT-C is an appropriate instrument for assessing social cue recognition in emotional contexts.
Adult↗
Staff burnout and patient satisfaction: evidence of relationships at the care unit level.
Research on burnout has thus far focused primarily on the individual; however, in work environments in which teamwork is emphasized, it seems plausible that a meaningful group-level burnout construct could emerge. This theory was tested by examining burnout in psychosocial rehabilitation teams and its effects on patient satisfaction. Three hundred thirty-three staff from 31 behavioral health teams completed the Maslach Burnout Inventory; 405 of the clients they served completed the Consumer Satisfaction Scale. Multilevel analyses (hierarchical linear modeling) confirmed the existence of a meaningful team-level burnout construct. Team-level analyses revealed significant relationships between team burnout and patient satisfaction.
Burnout, Professional↗
Understanding the impact of stigma on people with mental illness.
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Journal Article↗
Psychosocial treatment compliance scale for people with psychotic disorders.
OBJECTIVE: Psychosocial treatment compliance is essential for effective treatment outcomes. A psychometrically valid compliance scale is required for identifying possible obstacles causing treatment non-compliance and testing the effectiveness of compliance therapy. This study developed a scale to measure psychosocial treatment compliance of people with psychotic disorders and established its psychometric properties. METHOD: An initial item pool was generated by literature review and contacts with psychiatric professionals. The content validity and cultural relevancy of this scale were examined by experienced researchers, mental health professionals and mental health consumers which resulted in the 17-item Psychosocial Treatment Compliance Scale (PTCS). Some 108 adults with a DSM-IV diagnosis of psychosis verified by certified psychiatrists were recruited from mental hospitals and social service settings in Hong Kong. Self-stigma, self-esteem, self-efficacy, insight and attitudes to medication of the participants were measured by relevant assessment instruments through interviews. Case therapists then filled in the PTCS and recorded their demographic data. SPSS version 11.0 was used for data analysis. RESULTS: Exploratory factor analysis revealed a two-factor solution (participation and attendance) accounting for 70.74% of the variance. Test-retest reliability and internal consistency were 0.90 and 0.96, respectively, for 'participation'; and 0.86 and 0.87, respectively, for 'attendance'. Its convergent validity was supported by the correlational relationships with measures on self-stigma, self-esteem, self-efficacy, insight and attitudes to medication. CONCLUSION: PTCS is a reliable and valid scale which may be used to measure the compliance to psychosocial treatment of people with psychotic disorders.
Adult↗