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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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PubMed1983

The well-being of chronic mental patients.

The concept, "quality of life" (QOL), offers a broad perspective for assessing the needs and outcomes of chronic mental patients. In this survey of Los Angeles board-and-care homes, 278 randomly selected, mentally disabled residents evaluated their QOL in structured interviews based on a general QOL model. Life areas studied included living situation, family, social relations, leisure, work, safety, finances, and health. The model performed as well among these residents as among the general population, explaining 48% to 58% of the variance in global well-being. Adding patients' subjective QOL evaluations doubled the explanatory power of a model based only on personal characteristics and objective life conditions. Global well-being was most consistently associated with personal safety, social relations, finances, leisure, and health care variables. The study identifies methodological and service issues in need of further examination.

Activities of Daily Living↗
PubMed1996

Community psychiatric care: from libertarianism to coercion. Moral panic and mental health policy in Britain.

This article discusses recent developments in mental health policy in Britain, focusing on the move towards compulsory supervision of mentally ill people in the community. It is argued that the desire for compulsion reflects moral panic rather than rational appraisal of the undoubted problems with community mental health care. Alternative strategies involving education of the patient and cares, the deployment of psychological treatments of psychosis and an emphasis on the negotiation of treatment plans, are advocated.

Coercion↗
PubMed1989

Evaluation of a community treatment program for young adult schizophrenics.

To evaluate a program of intensive case management for young adult chronic schizophrenics released from a large urban state mental health facility, several interrupted time series analyses were conducted over an 18-month period on 64 patients. Findings indicate that the intensive, active, and reactive role of case managers contributes significantly to the effectiveness of an aftercare, community-based treatment program.

Adult↗
PubMed1989

The development of factor-based level of functioning scales from a level of care instrument.

A factor analysis of data from 1,295 administrations of a level of care instrument produced a seven-factor solution. The scales developed from these factors through a simple unit weighting procedure were internally reliable and replicable on an additional sample of clients. The seven factors are discussed in terms of level of functioning measures. Results suggest that community living skills and self-care skills are two among several robust dimensions of level of functioning in psychiatric clients. Implications are discussed.

Activities of Daily Living↗
PubMed1993

Effects of positive and negative reinforcement on daily living skills in chronic psychiatric patients in community residences.

The effects of contingent positive and negative reinforcement on adaptive behavior and mood were examined in a sample of 36 chronic, psychiatric outpatients. Group 1 received contingent positive token reinforcement to improve daily living skills, group 2 received a negative reinforcement procedure based on removal of free-tokens, and group 3 was a no-treatment control. Subjects were assessed via a weekly daily living checklist and were pre- and posttested on the Profile of Mood States (POMS). Significant differences were found between the control and treatment groups on both total activities of daily living and among five individual targeted behaviors. Mood states did not differ among the groups, which indicates benign effects of negative reinforcement. The findings of this study are relevant to the treatment of the serious and persistently mentally ill.

Activities of Daily Living↗
PubMed2000

Maximizing therapeutic effects in treating sexual offenders in an Australian correctional system.

In Australia, the community response to sexual offenders is marked by uncertainty as to whether offenders should be incarcerated as punishment or provided treatment in order to reduce the likelihood of re-offense. The incarceration of sexual offenders results in particular management, ethical, and political issues. Nevertheless incarceration can provide leverage to encourage the offender to participate in treatment while delivering punishment for wrongdoing and acting to protect the community. In the state of Victoria the CORE Sex Offender Programs have developed a statewide strategy in the public correctional system in order to assess, manage, and treat male sexual offenders. However, such offenders are notoriously reluctant to engage in treatment to address offending behaviors. A critical element of the strategy has been the Victorian Adult Parole Board, an entity that can determine that an offender needs to engage in treatment before he is considered for parole. Using the therapeutic jurisprudence framework as outlined by Wexler (1990), strategies to minimize the anti-therapeutic effects of the Victorian Adult Parole Board and maximize the therapeutic effects of the CORE Sex Offender Programs are highlighted.

Adult↗
PubMed1984

Personal support systems of former mental patients residing in board-and-care facilities.

This is a study of the personal support networks of a selected group of formerly hospitalized psychiatric patients now residing in board-and-care facilities in Galt, California. Its purpose was to assess the particular forms of support available to such persons and to suggest ways in which short-comings in needed supportive interaction might be remedied. The article first reviews the circumstances of board-and-care placement. It then examines the concept of support systems and their relevance to the health and well-being of individuals. Following this, the findings of a study of 39 psychiatrically disabled persons residing in board-and-care homes in one rural California community are reported. Several recommendations are offered which illustrate two ways in which agency and community services might affect the support available to board-and-care residents.

Adult↗
PubMed2006

A comparison of offenders with intellectual disability across three levels of security.

BACKGROUND: A number of authors have described, with disparate results, the prevalence of people with intellectual disability and their characteristics, in a range of offender cohorts defined by service use. These have included high security, a range of criminal justice services and community services. There is a need for research comparing cohorts of offenders with intellectual disabilities across different settings. AIM AND HYPOTHESIS: To conduct such a comparison and test the hypothesis that severity of characteristics measured will be highest in highest levels of residential security. METHOD: A clinical-record-based comparison a offenders with intellectual disability in high security (n = 73), medium/low security (n = 70), and a community service (n = 69). RESULTS: Groups were similar in age and tested IQ levels. Early psychiatric service contact had been more likely in the lower security groups. In line with the hypothesis, more complex presentations, in particular comorbid personality disorder, was more likely in the highest security group. Both fatal and non-fatal interpersonal violence convictions were significantly related to group, with more in the high security group sustaining a conviction both at the index offence and prior to that. Over 50% of all groups had at least one conviction for a sexual offence. A regression model accounting for 78% of the variance was made up largely of disposal variables (Mental Health Act status and probation) and indications of antisocial traits (criminal damage, lifetime conviction for murder and ICD-10 personality disorder classification). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The authors show that context of sampling affects most relationships between intellectual disability (ID) and offending when the methods for measuring ID are held constant. The results also present several questions on the relationship between risk, services available in an area and referral to higher security.

Adult↗
PubMed2004

Prison psychiatry.

Explore the source record for details and available documents.

Commitment of Persons with Psychiatric Disorders↗
PubMed1993

Reduced list costings: examination of an informed short cut in mental health research.

The demands for cost information in health services are many and various but the supply of such information is less than might be expected and is compounded by the expense of undertaking costs research. This paper examines a short cut to mental health research which, if certain rules and conventions are obeyed, can still produce valid costs data. By distilling evidence from previous research a reduced list of services is identified which accounts for the greater part of the total costs of care packages. By concentrating on these key services, 94 per cent of the total costs of care were predicted for discharged long-stay patients and no less than 91 per cent for people supported by community psychiatric nurses. The results suggest that this reduced list method can work well where the aim is to obtain broad orders of magnitude for the costs of care. By reducing the resources required for research, the approach could expand the current costs information base and move towards meeting the pressing practice demands for costs data.

Combined Modality Therapy↗
PubMedDate not supplied

A critical analysis of recent Canadian health policy: models for community-based services.

As part of the thrust by Health and Welfare, Canada, to strengthen community health services, the National Health Research and Development Program commissioned a series of literature reviews. I undertook to review organizational models for community-based services, but said that this would be done in the context of the developing organization of the national health insurance program. With the help of colleagues I examined the literature from a number of different viewpoints. This article will present our findings on the development of policy and will trace the difficulties in making a shift towards providing more care in the community. We found that organization theories were helpful for explaining developments in the health service as a whole and the place of community-based services within it. We were able to use these theories to analyse efforts at restructuring. They provide explanations for the concurrent existence of policies of rationalization and cutbacks with policies of expansion in the area of health promotion.

Aged↗
PubMed2001

Living with support in a home in the community: predictors of behavioral development and household and community activity.

The purpose of this article was to review studies of behavioral development and household and community activity among adults with mental retardation living in community residential services and to distill knowledge about the factors that influence outcome. Research points to behavioral development occurring across the full spectrum of disability but influenced by mental retardation syndrome and the acquisition of pivotal skills. However, engagement in household and community activities has been found to be strongly related to individual adaptive behavior. People with more severe mental retardation are vulnerable to leading lives characterized by underoccupation and lack of community involvement. Moving from institutional to community-based residential services may be accompanied by significant increases in adaptive behavior, but a plateau effect on subsequent development has also been reported. There is substantial evidence to suggest that key aspects of effective teaching technology may be absent in community-based residential environments. Community settings support greater engagement in household and community activities than institutions. Ordinary housing stock and normative architecture and standards of material enrichment are to be preferred. The use of normative housing constrains group living to relatively small scale, but there is little evidence that smaller size within this range is to be preferred to larger size. There is little evidence to suggest that higher staff-to-resident ratios lead to uniformly better outcomes, but staff orientation, working methods, and performance are important influences. Little is known about what precise characteristics of community location give rise to greater community integration. MRDD Research Reviews 7:75-83, 2001.

Adaptation, Psychological↗