Certain mentally ill patients who repetitively commit minor crimes as part of their lifestyle rather than because of psychotic thinking are best managed by a cooperative effort between the criminal justice and the mental health systems. This effort, which is based on the belief that such patients should be dealt with as any other responsible citizen who commits a crime, involves educating and supporting the patients, the patients' families, and criminal justice professionals throughout the entire judicial process. The involvement of the criminal justice system is not a substitute for treatment by the mental health system, nor should arrest or incarceration be used simply because mental health treatment is unavailable.

Chronic Disease↗

PubMed1984

Increasing medication compliance in young adult chronic psychiatric patients.

Explore the source record for details and available documents.

Adult↗

PubMed1984

Utilization of patient expertise in medication groups.

Medication groups can be an effective way for the psychiatrist to assess changing medication requirements, while also informing patients about the medications that they are taking. Groups can also facilitate patients' own sense of expertise by allowing them to teach each other and to share their own experience with medications. Two different groups are described that encourage chronically mentally ill patients to gain a sense of expertise about their medication. These groups increase patient involvement in their own medication and seem to increase medication compliance, while also decreasing the amount of physician time required to provide effective treatment.

Group Processes↗

PubMed1983

Suicide management skills and the medical student.

To determine the suicide management skills of medical students at different levels of training, 141 medical students were administered the Suicide Intervention Response Inventory (SIRI), a self-report instrument assessing skills in responding to the self-destructive patient. As predicted, third-year students having completed a course in medical interviewing scored higher on the SIRI than first-year students who had not. Additional improvement in suicide management skills was evidenced for third-year students who completed a six-week inpatient psychiatry rotation. Whether or not students believed that suicide was ethically acceptable in some circumstances had no impact on their ability to select an appropriate response to the self-destructive patient. Several additional findings are discussed, and the potential utility of the SIRI in evaluating medical student skills in this important area is highlighted.

Clinical Competence↗

PubMed1983

Enhancing medication use in schizophrenic patients.

Practical strategies for increasing schizophrenic outpatients' compliance with medication are outlined in detail. The strategies are based on the assumptions that (1) interventions which encourage patients to take control of their lives are good in both a moral and clinical sense, (2) schizophrenics, like all people, want to feel as good as possible, (3) fighting a losing battle with a patient regarding medication is counterproductive unless the fight makes some larger strategic sense. Specific approaches range from simply being sure to ask about compliance to involving the patient's family and extended support network in such efforts.

Antipsychotic Agents↗

PubMed1983

Outpatient use of a double-blind medication trial: a clinical example.

It is often difficult to determine whether a patient's improvement following a trial of a new medication is based on pharmacologic or nonspecific factors. A chronic schizophrenic patient initially had a dramatic improvement in his behavior during an open trial of phenytoin, but a double-blind trial demonstrated that this was not a pharmacologic response. Such double-blind controlled trials can easily be carried out in outpatient settings.

Adult↗

PubMed1981

The use of minor tranquilizers with jail inmates.

The decision of whether or not to prescribe minor tranquilizers becomes an apparent dilemma for mental health professionals working in jails. By dispensing anxiety-reducing drugs, they may help the inmate cope with existing hardship conditions, but they may also contribute to drug dependency. A survey of California county jail systems revealed a general distrust of minor tranquilizers as a therapeutic modality. The authors conducted a medication-linked group therapy program in one county jail to provide an alternative to the usual policies governing use of tranquilizers.

Anti-Anxiety Agents↗

PubMed1970

Osmotic properties of spheroplasts from Saccharomyces cerevisiae grown at different temperatures.

Spheroplasts were prepared from cells of Saccharomyces cerevisiae NCYC 366, grown at 30 or 15 C, by incubating cells with snail-gut juice after pretreatment with 2-mercaptoethanol. Walls of cells grown batchwise or in continuous culture at 15 C were more resistant to digestion with snail juice than walls on cells grown under the same conditions as 30 C. Spheroplasts lysed when suspended in hypotonic solutions of mannitol. The resistance of spheroplasts to osmotic lysis tended to increase when the test temperature was lowered below 30 C. The increased resistance was greater with spheroplasts from cells grown at 15 C. Cations, especially Ca(2+), protected spheroplasts against osmotic lysis. In general, the protective effects, measured at 30 C, were smaller with spheroplasts from cells grown at 15 C compared with 30 C. Citrate and ethylenediaminetetraacetate (EDTA) decreased the resistance of spheroplasts to osmotic lysis. On the whole, the decrease was greater with spheroplasts from cells grown at 30 C rather than 15 C. In the presence of EDTA, spheroplasts from cells grown at 30 C were less resistant to osmotic lysis at 5 C than at 30 C; when spheroplasts from cells grown at 15 C were similarly examined, they were more resistant to lysis at 5 C than at 30 C. Spheroplast membranes from cells grown at 15 C had slightly but significantly greater contents of Mg(2+), Ca(2+), K(+), and Na(+) compared with spheroplast membranes from cells grown at 15 C. Mg(2+) and Ca(2+) were more easily extracted with EDTA from membranes of 30 C-grown cells than from 15 C-grown cells.

Calcium↗

PubMedDate not supplied

A psychotherapeutic approach to task-oriented groups of severely ill patients.

This paper presents a conceptual approach for leading various types of groups of chronically mentally ill patients. Although these groups may have a concrete, task-oriented purpose, with skillful leadership they also function as psychotherapy groups. The developmental deficits in ego functions, object relations, and social skills that severely impair such groups can be compensated by non-interpretative actions of the therapists. The group leader must actively work to provide for the structure, stability, and safety of the group when group members are unable to provide these for themselves.

Adult↗