Acceptance Of Mental Illness Research Articles

Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis

Patient therapeutic adherence lies at the core of mental health care. Health Care professionals and organizations play a major role in promoting adherence among people with mental disorders. However, defining therapeutic adherence remains complex. We used Rodgers' evolutionary concept analysis to explore the concept of therapeutic adherence in the context of mental health. We conducted a systematic literature search on Medline/PubMed and CINAHL for works published between January 2012 and December 2022. The concept analysis showed that major attributes of therapeutic adherence include patient, microsystem and meso/exosystem-level factors. Antecedents are those related to patients, such as their background, beliefs and attitudes, and acceptance of mental illness-and those related to patient-HCP therapeutic engagement. Lastly, three different consequences of the concept emerged: an improvement in clinical and social outcomes, commitment to treatment, and the quality of healthcare delivery. We discuss an operational definition that emerged from the concept analysis approach. However, considering the concept has undergone evolutionary changes, further research related to patient adherence experiences in an ecological stance is needed.

Assessmentof Adult Attitude towards Mental Illness among Attendees of Family Medicine Outpatient Clinic at Suez Canal University Hospital, Ismailia Governorate

Background: Despite the improvement in healthcare services provided for mentally-ill individuals, yet they often choose not to seek such care or stop taking their medicines due to the surrounding stigma. Many tools in the last years have been developed to assess stigmatizing attitudes towards people with mental illness. Objectives: To assess public attitude towards mental disorders in Egypt and its association with their sociodemographic characteristics. Subjects and Methods: This is a cross-sectional study conducted at the Family Medicine outpatient clinic of Suez Canal University Hospital, Ismailia, Egypt. Two hundred and fifteen participants were interviewed and requested to fill in three questionnaires; demographic questionnaire, socioeconomic status questionnaire, and Attitude to Mental Illness questionnaire. Results: Participants had negative attitudes concerning the fear and exclusion of people with mental illness (19.03 ± 3.86 points). However, they had more positive attitude towards causes of mental illness and the need for special services (11.14 ± 2.02 points), integrating people with mental illness into the community (25.02 ± 4.09 points), understanding and tolerance of mental illness (27.38 ± 3.41 points). Conclusion: Public attitude towards mental illness can be variable. Although the attitudes regarding their fear and exclusion of patients with mental illness were negative; however, we found a huge understanding and tolerance towards mental illness and supported integrating patients with mental illness into the community. Recommendation: Anti-stigma programs are needed to boost people's acceptance of mental illness and strategies to increase social contact of the public with mentally-ill should be considered.

A Correlational Study of the Recovery Process in Patients With Mental Illness

The ideology of recovery addresses the autonomy of patients with mental illness and their ability to reconstruct a normal life. Empirical knowledge of this process of recovery and related factors remains unclear. To assess the process of recovery and related factors in patients with mental illness. This cross-sectional, correlational study was conducted on a convenience sample in a psychiatric hospital. Two-hundred and fifty patients with mental illness were recruited and were assessed using 3 instruments: Questionnaire about the Process of Recovery (QPR), Perceived Psychiatric Stigma Scale (PPSS), and Personal and Social Performance Scale (PSP). Data were analyzed using descriptive statistics, χ2, analysis of variance, and multiple linear regression analysis. Most of the participants were male, middle-aged, unmarried, educated to the senior high school level, employed, receiving home-care treatment, and diagnosed with schizophrenia. Those who were unemployed, living in a community rehabilitative house, and living in the community, respectively, earned relatively higher recovery scores (p < .05). The total scores of QPR and the 3 subscales were negatively correlated with PPSS (p < .01) and positively correlated with PSPS (p < .01; p < .05). Multiple regression analysis indicated that the factors of education, employment, having received community rehabilitative models, and stigma, respectively, significantly explained the recovery capacity of patients with mental illness. Community psychiatric nurses should provide care to help employed patients adapt to stresses in the workplace, strengthen their stigma-coping strategies, and promote public awareness of mental health issues by increasing public knowledge and acceptance of mental illness in order to minimize patient-perceived stigma and facilitate their recovery.

A task shifting mental health program for an impoverished rural Indian community.

Psychiatric disorders constitute a major source of disability across the globe. In India, individuals with mental disorders are diagnosed and treated inadequately, particularly in under-served rural areas. We implemented and evaluated a psychiatric 'task shifting' program for a rural, marginalized, impoverished South Indian tribal community. The program was added to a pre-existing medical program and utilized community workers to improve health care delivery. Following community wide discussions, health workers were trained to provide community education and to identify and refer individuals with psychiatric problems to a community hospital. Subsequently, they also followed up the psychiatric patients to improve treatment adherence. The program was evaluated through medical records and community surveys. Treated patients experienced significant improvement in daily function (p=0.01). Mean treatment adherence scores remained stable at the beginning and end of treatment, overall. The proportion of self-referrals increased from 27% to 57% over three years. Surveys conducted before and after program initiation also suggested improved knowledge, attitudes and acceptance of mental illness by the community. The annual per capita cost of the program was 122.53 Indian Rupees per person per annum (USD 1.61). In conclusion, the community-driven psychiatric task shifting program was implemented successfully. It was accompanied by positive changes in knowledge, attitudes and practice. Initial community consultations and integration with a pre-existing medical program increased acceptance by the community and reduced costs. We recommend a similar model with integrated medical and psychiatric health care in other resource-deficient communities.

Intersectional Stigma and the Acceptance Process of Women with Mental Illness

Acceptance of mental illness is facilitated by the presence of various resources that are needed to deal with associated stigma, prejudice, and discrimination. However, women with mental illness experience added levels of stigma and intersectional oppression that affect the acceptance process, including higher rates of victimization, unemployment, poverty, homelessness, and clinical disparities. Practitioners and researchers can benefit from sensitivity to intersectional stigma, or overlapping, multiple levels of stigma and discrimination, faced by women with mental illness. Participant case narratives from a qualitative study will be presented in order to demonstrate the impact of intersectional stigma on the process of acceptance for women with mental illness.

Acceptance of mental illness: Core components of a multifaceted construct.

The recovery movement has identified acceptance of mental illness as critical to quality of life and illness management. However, there is a general lack of research on the acceptance of mental illness. The present qualitative study was conducted with 30 participants with mental illness to clarify the construct of acceptance. Grounded theory methodology is utilized to analyze the 30 semistructured interviews. Results in the present study reveal acceptance to be a multifaceted construct composed of several core characteristics, including the: (1) identity component, (2) cognitive component, (3) emotional component, (4) behavioral component, and (5) relational component. In addition, when asked to define acceptance of mental illness, some participants noted negative connotations to acceptance. Implications for psychological services and future research will be discussed to guide additional study and practice in this area.

Mental Illness, Law, and a Public Health Law Research Agenda

Mental illness is a significant global public health issue. Disorders such as schizophrenia, bipolar disorder, and major depression put an enormous strain on afflicted individuals, their caregivers and communities. Yet, in some respects, acceptance of mental illness as a key part of the broader field of public health has developed only recently. Legal and policy responses to mental illness have shifted gradually over the last half century, away from the axis of involuntary institutional care and protection of individual rights, and towards an emphasis on ensuring access to community-based treatment and services – promoting autonomy and social inclusion within an ethos of recovery. A confluence of forces – deinstitutionalization, changing constitutional norms, advances in pharmacotherapies and community-based psychosocial treatments, and reform in the organization and financing of mental health services – has dramatically altered the landscape in which individuals today experience serious mental disorders and seek to recover from them. At the same time, public misperceptions, negative attitudes, and discriminatory behavior toward people with mental illness largely remain. And in fact, people with serious mental illnesses often do not receive the treatment they need and many become involved with the criminal justice system. What is the emerging role of law and policy in addressing the complex problems around mental illness from a public health perspective, and what is the agenda for research to inform those efforts? As part of a series of Theory, Practice and Evidence papers commissioned by the National Program Office for Public Health Law Research, this paper reviews the current evidence base on the relationship between law and mental health and offers a research agenda that situates mental health within an explicit public health framework. The paper begins by placing mental health law in its historical context, discussing the events and assumptions that in some measure continue to shape public policy and law. The review is organized according to a typology of public health law which encompasses the use of law in deliberate interventions designed to reduce mental illness and its associated harms as well as the incidental and infrastructural effects of law on mental health. The proposed research agenda identifies gaps in the evidence bases across the three types of public health law and suggests potential research designs which have the potential to illuminate them. In a time when our understanding of the burden of mental illness on population health is growing and continued economic pressures threaten individual and community resources for adequate treatment, this timely paper aims to catalyze new lines of research essential to determining how law and legal reform can best respond to mental illness as a public health problem of the highest order.

Factors Associated With Stigma Among Caregivers of Patients With Bipolar Disorder in the STEP-BD Study

Factors Associated With Stigma Among Caregivers of Patients With Bipolar Disorder in the STEP-BD Study

Factors Associated With Stigma Among Caregivers of Patients With Bipolar Disorder in the STEP-BD Study

Little is known about the factors contributing to mental illness stigma among caregivers of people with bipolar disorder. A total of 500 caregivers of patients participating in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study were interviewed in a cross-sectional design on measures of stigma, mood, burden, and coping. Relatives and friends with bipolar disorder were assessed on measures of diagnosis and clinical status, determined by a days-well measure derived from psychiatrist ratings of DSM-IV episode status. Because patients' clinical status varied widely, separate models were run for patients who were euthymic for at least three-fourths of the past year (well group) and for those who met criteria for an affective episode for at least one-fourth of the previous year (unwell group). Stepwise multiple regression was used to identify patient, illness, and caregiver characteristics associated with caregiver stigma. In the unwell group, greater mental illness stigma was associated with bipolar I (versus II) disorder, less social support for the caregiver, fewer caregiver social interactions, and being a caregiver of Hispanic descent. In the well group, greater stigma was associated with being a caregiver who is the adult child of a parent with bipolar disorder, who has a college education, who has fewer social interactions, and who cares for a female bipolar patient. Mental illness stigma was found to be prevalent among caregivers of persons with bipolar disorder who have active symptoms as well as for caregivers of those who have remitted symptoms. Stigma is typically associated with factors identifying patients as "different" during symptomatic periods. Research is needed to understand how the stigma experienced by caregivers during stable phases of illness differs from the stigma experienced during patients' illness states.

Campus Group Opens Minds About Mental Illness

Back to table of contents Previous article Next article Association NewsFull AccessCampus Group Opens Minds About Mental IllnessMark MoranMark MoranSearch for more papers by this authorPublished Online:4 Nov 2005https://doi.org/10.1176/pn.40.21.0005Brian Malmon committed suicide in March 2000 after graduating from Columbia University. His death prompted his sister, Alison, a freshman at the University of Pennsylvania at the time of her brother's death, to found Open Minds, a student-run organization dedicated to raising campus awareness of mental health and mental illness (Psychiatric News, September 19, 2003).Today the organization, now known as Active Minds, has chapters on 24 college campuses around the country. APA's Task Force on College Mental Health sent member psychiatrist Richard Kadison, M.D., to speak at Active Minds' Third Annual Mental Health on Campus Conference, which was held last month at Duke University in Durham, N.C.Kadison, who is the author of College of the Overwhelmed (Jossey Bass-Wiley, 2004), told Psychiatric News that mental illness problems on college campuses are growing—in part because many more students are taking medication for mental illness—and that there is a dearth of psychiatric input at colleges around the country.“Student groups can play a key role in reducing stigma on campus, and Active Minds is one of the more visible ones,” Kadison said.“ There is a lot of groups forming on different campuses and we really want to support students being able to advocate for their own health needs. I believe that student involvement and engagement in the process of reducing stigma is essential.”Brian Malmon and his sister, Alison, pose for a photo in 1998. Brian committed suicide two years later, soon after he graduated from Columbia University.Courtesy of Alison MalmonKadison is chief of mental health services at Harvard University Health Service.Task force chair David Fassler, M.D., called Active Minds an innovative grassroots organization and said APA was looking forward to productive collaboration with the group.“With established chapters on 24 college campuses, they are providing information and support for thousands of students,” Fassler said.“ They are having a significant impact on the recognition, understanding, and acceptance of mental illness in these settings. They are also advocating for improved access to psychiatric services for college students.”Fassler said support of Active Minds is just one of a number of activities being undertaken by the Task Force on College Mental Health, formed last year by then- APA President Michelle Riba, M.D. Fassler told Psychiatric News that the task force is producing a fact sheet for distribution to students and colleges about the immediate and longer-term emotional consequences of hurricanes Katrina and Rita.Information on college mental health is posted on APA's“ Healthy Minds, Healthy Lives” Web site at<www.healthyminds.org/collegementalhealth.cfm>.▪ ISSUES NewArchived

Michigan Continues to Cut Public Psychiatry Beds

Michigan Continues to Cut Public Psychiatry Beds

Is there a role for compliance in the assessment of insight in chronic schizophrenia?

Current work on insight focuses on its assessment, a trend that is reflected in the inflation of newly-developed scales. Most scales assess compliance with treatment, recognition and acceptance of mental illness and relabeling of abnormal mental experience as pathological. A handful of studies indicate that compliance is weakly to moderately correlated with awareness of illness and relabelling of symptoms in acute samples. As the parameters of compliance differ between acute and chronic populations, this study investigated the relationship between the three components using the Schedule to Assess the Components of Insight in 78 outpatients with chronic schizophrenia. A weak positive correlation was found between acceptance of illness and relabelling. However, compliance was not reliably related to either the awareness or relabelling component. As the incidence of non-compliance in the present sample did not differ from comparable populations, it appears that non-compliance does not account for these findings. Non-compliance may be viewed as an evaluation of the costs and benefits of treatment on daily living rather than an insight deficit. The lack of a reliable relationship between compliance and insight suggests that the two phenomena should be viewed as distinct constructs and assessed separately in chronic schizophrenia.

A phenomenological study of families and psychoeducation support groups.

1. An essential characteristic for nurses is hope, which much be passed on to caregivers of people diagnosed with schizophrenia. 2. The sharing of experiences by families contributes to the development of a common human bond that facilitates understanding and acceptance of mental illness by significant others. 3. Empowerment of family caregivers increases their ability to deal with the illness and enhances the family's chance of living a normal life.

Role playing: a tool for the prevention and acceptance of mental illness.

A Tool for the Prevention and Acceptance of Mental Illness

Indian parents and their youth: some perceived and actual differences

The present study examined perceived and actual differences in the perception of mental illness, religiosity and westernization in a selected group of Indian adolescents and their mothers. The total sample comprising 80 male and 80 female adolescents and their mothers were tested on a specially constructed Eastern-Western Mental Illness Scale and a biographical questionnaire. Analyses of the data indicated that mothers have a greater acceptance of mental illness than the youth credit them with. Generally, the adolescents perceive themselves as less religious and more westernized than their parents. The implications of these generational and sex differences were discussed in terms of conflict and change in a transitional society.S. Afr. J. Sociol. 1984, 15(3): 124–128

The consequences of labeling a person as mentally ill

A random sample of 1,405 respondents were interviewed to determine their attitudes about mental illness and the extent of tolerance for the mentally ill in terms of their willingness to interact with ex-mental patients. The generally accepted proposition that rejection results when a person is labeled as mentally ill was tested. The data did not support or refute this proposition. They do indicate, however, that there is a trend toward greater acceptance of mental illness and the mentally ill by the public.