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Results for “Deinstitutionalization”

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PubMed2000

Italy's mad law.

Explore the source record for details and available documents.

Commitment of Persons with Psychiatric Disorders↗
PubMed1990

Major mental illness, housing, and supports. The promise of community integration.

Providing housing and supports for people with psychiatric disabilities, particularly those who are homeless, is a major public policy challenge. This article summarizes the ways in which the concept of these needs is rapidly shifting in the mental health field. The article is based on research on the effectiveness of non-facility-based community support and rehabilitation approaches, the findings of other disability fields, and the emergence of mental health consumers' own preferences for expanded choices, normal housing, and more responsive services, including consumer-operated services. These new sources of knowledge are facilitating a paradigm shift in which people with psychiatric disabilities are no longer seen as hopeless, or merely as service recipients, but rather as citizens with a capacity for full community participation and integration.

Community Mental Health Services↗
PubMed1991

Homelessness and public policy priorities.

Public policy issues related to homelessness and their priorities are reviewed. It is argued that the three most important policy issues are housing, income, and health. Cutting across these priority areas are the special problems of homeless children and youth, both in families and alone. Alcohol, drug abuse, and mental health services, although needed and effective, will neither stop nor slow the rate of increase in homelessness experienced in recent years. Psychologists, in emphasizing aspects of homelessness that they are expert in, are deflected from variables determining the prevalence and incidence of homelessness. The latter variables must be regarded as the priority policy issues in homelessness.

Adolescent↗
PubMed1992

The mental health system and older adults in the 1990s.

Trends in mental health services for older adults during the past decade were used to predict salient issues for the current decade. These include overreliance on inpatient treatment, increased use of general hospitals as treatment sites, inadequate integration with the nursing-home industry, and insufficient mental health referrals from general medical providers. In the decade ahead, the mental health needs of older adults are unlikely to be an identified focus; rather the issues will overlap with other priorities (e.g., biomedical research on brain functioning, alternative treatment programs for the chronically mentally ill, and containing health care costs). Advocates for the elderly will be successful to the extent that they cast aging services within the context of these other concerns.

Aged↗
PubMed1992

U.S. mental health policy. Doomed to fail.

Changes in the de facto system of mental health care in the last decade reflect organizational and entrepreneurial responsiveness to changes in health policy, not mental health policy. Various other actions described here reduced statutory or institutional leadership roles in mental health and increased the pace at which mental health policy was becoming dependent on health policy. In turn, U.S. health policy in the 20th century has been inherently flawed. The short-term general hospital--the "doctors' workshop"--emphasizing acute care and surgery, has been the cornerstone of U.S. health policy throughout the 20th century. The mimicry of health services by mental health leads to demonstrably more expensive and less effective mental health care and dooms mental health policy to failure.

Community Mental Health Centers↗
PubMed2001

A job and a home: social networks and the integration of the mentally disabled in the community.

Formerly hospitalized psychiatric patients participated in a program including skills in apartment living and employment. Contrasted to a comparison group, program graduates showed more multifunctional and more reciprocal relationships with other people. Results highlight the importance of work, housing, and the utilization of community services, and suggest the quality of supportive interpersonal relations as a criterion of program success.

Activities of Daily Living↗
PubMed2003

The social grid of community medication management.

Practitioners involved in case management at a community mental health center organized 5 elements of a psychotropic medication experience. Using case records, interview, and observational data, the authors examined an underresearched and especially problematic area of the management process: the interpretation of a medication's effect. They describe the divisions of labor, a grid of social relations, and spaces related to management, and they describe how the limits and potential of medications are realized in the intensity of monitoring and the knowledge produced in the day-to-day practices among all participants.

Adult↗
PubMed2006

Residential treatment of children and adolescents: past, present, and future.

This paper reviews the history of residential treatment, examines the central concepts that define the therapeutic modality, and shows how those concepts provide means of addressing criticisms that have been raised about it in the past and adapting residential programs to meet challenges facing them in the future.

Adolescent↗
PubMedDate not supplied

Outpatient commitment: a therapeutic jurisprudence analysis.

This article analyzes the legal and therapeutic jurisprudence considerations raised by outpatient commitment. Although older forms of outpatient commitment have both legal and therapeutic advantages, preventive outpatient commitment raises serious legal problems and potential antitherapeutic consequences that may outweigh its claimed therapeutic value. As a result, alternatives are proposed, including wider availability of community treatment and outreach and case management services, assertive community treatment, police and mental health court diversion programs, and creative uses of advanced directive instruments and behavioral contracting. Proposals also are made for how preventive outpatient commitment can be applied more therapeutically, including hearings that accord patients a sense of procedural justice and techniques designed to motivate individuals facing such hearings to agree to accept treatment voluntarily.

Advance Directives↗
PubMed1992

Serious mental illness and disability in the adult household population: United States, 1989.

The major significance of the current report is that it provides estimates and characteristics for that portion of the civilian SMI population living in households. Survey results show that approximately 3.3 million adult Americans have mental disorders that seriously interfere with one or more aspects of daily life and that about 2.6 million of these persons are currently limited in one or more functional areas. These results suggest that the household component of the SMI population is comprised of between 2.6 and 3.3 million adults, depending upon the criteria employed for inclusion. Undoubtedly, both of these numbers are conservative because of the likelihood of underreporting in the survey. Placed in the context of the entire adult population, these findings suggest that the SMI population can be conservatively estimated to include 4 to 5 million adult Americans, or 2.1 to 2.6 øpercent of the adult population. In addition to the household population, it is estimated that 200,000 SMI persons are homeless on any given day (13). An additional 1 million to 1.1 million are residents of nursing homes (14), approximately 50,000 to 60,000 are patients of mental hospitals, and approximately 50,000 are inmates of State prisons (15). A major remaining need is to collect similar data on all SMI persons, whether their residence is a household, an institutional or noninstitutional group quarter, or some other setting, including streets and shelters. In order to formulate more effective national policy to address the needs of these disabled Americans, a need exists to examine the longitudinal relationship between course of disorder and functioning as they relate to service and program participation.

Adult↗
PubMed1991

Evaluation of a comprehensive program for youth with severe emotional disorders: an analysis of family experiences and satisfaction.

An innovative pilot program of comprehensive services to youth with severe emotional disorders was evaluated by means of a self-administered questionnaire survey of family members. Results indicate that the program increased use of noninstitutional outpatient services, improved access to services, and enhanced family satisfaction and involvement with treatment planning and implementation.

Adolescent↗