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PubMed2006

Release from jail: moment of crisis or window of opportunity for female detainees?

Despite extensive documentation of the reentry challenges facing female prisoners, few such studies have focused on women exiting jails. The Window Study investigated factors associated with the perceived availability of stable housing upon release from detention. Anonymous surveys were conducted with a random sample (n=148) of female detainees at the Baltimore City Detention Center from January 21 to March 17, 2005. Interviews focused on socio-demographic background, health status, recent drug use and sexual behavior history, and material and social resource availability upon release. The median age of female detainees was 37 (interquartile range [IQR]: 29, 41), 69% were African-American, and 33% identified as lesbian or bisexual. The median income in the 30 days prior to arrest was $145 (IQR: 0, 559), and the median number of prior arrests was 5 (IQR: 3, 11). In the presence of other variables familial support (Adjusted Odds Ratio [AOR] 2.57; 95% Confidence Interval [CI] 1.21, 5.47) and a monthly income of $400-799 (AOR 3.18; 95% CI 1.00, 10.07) were positively associated with perceived housing stability upon release; wanting a support group for having traded sex for money, drugs or a place to stay (AOR 0.25; 95% CI 0.10, 0.63) was significantly negatively associated with perceived housing stability upon release. This study suggests the importance of pre-release planning and continuity of care for female detainees. Interventions should emphasize access to housing, economic opportunity and family reunification. Special attention is warranted to those who have engaged in sex work, who may be marginalized from family and service-based support networks.

Adolescent↗
PubMed1995

The current status and future challenges of psychiatric/mental health nursing.

To obtain a global picture of the current status of nursing education and nursing practice in the mental health/psychiatric field, the International Council of Nurses (ICN) sent a questionnaire to 23 of its 101 member associations. The basis for the selection was to obtain information from a broad spectrum of different associations, e.g. state of development--economic and political, language, and geographical region. Of these, 16 (or 69%) returned completed questionnaires, often accompanied by extensive supporting documentation. In addition, four nurses' associations in Africa completed the questionnaire during staff field visits in that region. This paper makes reference to the responses received to the questionnaire and some verbatim quotes are included.

Deinstitutionalization↗
PubMed1982

Quality of life in the evaluation of community support systems.

As a result of the authors' experience in conducting an evaluation of the community support system (CSS) program in New York State, they have identified five reasons for focusing on quality of life (QOL) as a desired outcome for programs for the chronically ill. These reasons are presented and problems in QOL evaluative research are discussed. Psychological indicators are distinguished from social indicators of QOL, and two methods of operationalizing perceived QOL, the psychological well-being and life domains methods, are examined. A conceptual model is presented and the results of an exploratory study of the QOL of 118 chronic psychiatric patients receiving CSS services are presented.

Chronic Disease↗
PubMed1988

The evaluation of case management services with the chronically mentally ill.

This study reports the results of an experiment comparing a developmental-acquisition model of case management to usual case management services provided through a mental health center. This is the first study of case management with the chronically mentally ill to employ a true experimental design comparing two types of case management service. The statistically significant discriminant functions resulting from the analysis correctly classified 77% of the subjects based on the case manager's assessment of clients' socialization skills, assessment of community living skills by a significant other and the client, the client's tolerance of stress, use of leisure time, community behavior, and vocational training. Implications for research and service delivery are discussed.

Adult↗
PubMed1991

Japan's new Mental Health Law: more light shed on dark places?

The legislative response to the crisis in the Japanese mental health care system has, on the one hand, been prophylactic. The major thrust of legal reform has been to prevent the human rights abuses which occurred all too easily under the former structure of legal regulation. Thus, a new category of admission, voluntary admission, has been recognized and promoted as the preferred hospitalization procedure. Standards for the physical treatment of patients have been promulgated, and procedures instituted for review of periodic reports and requests for discharge or improved physical treatment, with notification given patients as to their rights under the law. The model chosen for this new system of safeguards is far from a thorough-going legalistic model. Patients have no right to a judicial hearing. Even the informal hearing provided may be limited, or eliminated in the PRB's discretion. Reliance is placed upon the PRB and the Designated Physicians to protect the patient's rights and to prevent improper admission and treatment. However, the PRB is not independent. It is appointed by the prefectural governor and its functional units, the review panels, are controlled by Designated Physicians judging, in most cases, decisions or actions taken by other Designated Physicians. The individual Designated Physicians to whom are entrusted many of the critical diagnostic, therapeutic and physical treatment decisions respecting an individual patient will in many cases be, moreover, an employee of the hospital concerned. Beyond this closed administrative process, there are, in legal terms, only the extraordinary powers of the governor or Minister of Health and Welfare to detect improper admissions or physical treatment and remedy them by order. There are no appeal procedures and no access to the courts specifically provided within the Law's system of safeguards. Certain areas of concern, such as the right to refuse certain types of medical treatment, are not addressed in the Law at all. The new system of legal safeguards reflects the continuation of a paternalistic, medical model in which abuses will be more difficult to hide from the light of the new, carefully channeled and limited administrative review process. Related to but even beyond the question of the prevention of human rights abuses, the new Law is also concerned with the affirmative realization of the most important right of the mental patient, the right to effective treatment and a return to a normal place in society.(ABSTRACT TRUNCATED AT 250 WORDS)

Commitment of Persons with Psychiatric Disorders↗