Deinstitutionalization Of Care Research Articles

Pedagogical Resocialization of Children and Youth with Behavioral Problems

Deinstitutionalization of care and transformation of homes represent changes and improvement in the Croatian social welfare system’s work with children and young people. In the context of the deinstitutionalization processes in this article, we consider the resocialization process of children and youth with behavioral problems, and we are focused on pedagogical resocialization as one of the main prerequisites for its successful operationalization. Therefore, this research subject is considered from the point of view of an interdisciplinary approach. The aim of the qualitative research is to analyze opinions and experiences of educational specialists and educators of the Community-based Service Center in Zadar, by conducting semi-structural interviews about the implementation of the pedagogical resocialization of children and youth with behavioral problems in the above-mentioned institution. According to the obtained results, it is possible to recognize their affirmative attitude towards resocialization processes within the framework of deinstitutionalization, whose implementation they consider as a successful simulation of family life. They also mention some shortcomings within the social welfare system; but, at the same time, the results imply that deinstitutionalization, as a kind of progress within the social welfare system, can also represent an incentive for the progress of all other factors and systems cooperating in this matter, such as the educational system.

Family repercussion of the deinstitutionalization of the ent with mental disorder

The deinstitutionalization of care for individuals with mental illness is one of the fundamental purposes of Psychiatric Reform in Brazil. Therefore, there is as a central phase, the resizing of the asylum with the argument of the gradual extinction of this circumstance, through the reduction of the number of beds and exchange for therapeutic services that are made available to the community. To identify the repercussions of the deinstitutionalization process for the family member of patients with mental disorders. Scientific articles were searched in the SCIELO, LILACS, BVS-BIREME databases, referring to the theme, with no distinct period. The inclusion criteria for the selection of the sample were: articles published in Portuguese, English, Spanish and European Portuguese that portrayed the theme under study, published and indexed in the referred databases. It can be seen that the greater predominance was given to the qualitative study with 12 articles (80%) due to being researches that mostly interpret qualitative data. It is understood, therefore, that living with the chronic condition becomes, in addition to the difficulties for the family member, a condition that alters the process of being healthy for individuals and groups.

Therapeutic institutions of violence: conceptualising the biographical narratives of mental health service users/survivors accessing long term “treatment” in England

Purpose This paper aims to conceptualise the residential and psychiatric hospital as a space where criminality and social harms can emerge. Because of recent media scandals over the past 10 years concerning privately-owned hospitals, this study examines the lived experiences of service users/survivors, family members and practitioners to examine historic and contemporary encounters of distress and violence in hospital settings. Design/methodology/approach The study consists of 16 biographical accounts exploring issues of dehumanising and harmful practices, such as practices of restraint and rituals of coercive violence. A biographical methodology has been used to analyse the life stories of service users/survivors (n = 9), family members (n = 3) and professional health-care employees (n = 4). Service users/survivors in this study have experienced over 40 years of short-term and long-term periods of hospitalisation. Findings The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. Practitioners recalled comprehensive experiences of violence within historic mental hospitals, although violence that may be considered criminal appeared to disappear from hospitals after the Mental Health Act (1983). These reports of criminal violence and coercive abuse appeared to be replaced with dehumanising and harmful procedures, such as practices of restraint. Originality/value The data findings offer a unique interpretation, both historical and contemporary, of dehumanising psychiatric rituals experienced by service users/survivors, which are relevant to criminology and MAD studies. The study concludes by challenging oppressive psychiatric “harms” to promote social justice for service users/survivors currently being “treated” within the contemporary psychiatric system. The study intends to conceptualise residential and psychiatric hospitals as a space where criminality and social harms can emerge. The three aims of the study examined risk factors concerning criminality and social harms, oppressive and harmful practices within hospitals and evidence that violence occurs within these institutionalised settings. The study discovered that institutional forms of violence had changed after the deinstitutionalisation of care. These reports of violence include dehumanising attitudes, practices of restraint and coercive abuse.

Zkušenost, expertiza a participace uživatelů: případ české reformy psychiatrické péče

This paper focuses on users' involvement in the reform of mental-health care in the Czech Republic, which, like in other countries, is connected with the destigmatisation of mental illness and the deinstitutionalisation of care. As part of the reform process, users' and caregivers' representatives were invited by the key stakeholders to participate in working groups, expert committees, and government bodies that associate users' and representatives of parents. At the same time, users and caregivers mobilised from below and participated in a number of bottom-up initiatives. Against this backdrop, this study set out to identify the main positions of patients and caregivers in the Czech process of reforming mental-health care. Moreover, the role of the different forms of knowledge that inspire civic engagement are examined. The study is based on an analysis of semi-structured interviews, primary and secondary sources, and field observations. First, the following four positions taken by users as part of their involvement in the reform of mental-health care are identified: guardians, negotiators, awakeners, and fighters. Second, this study discusses the complexity of relations between users' participation and knowledge, showing that the key source of users' involvement is personal experience, which is difficult to separate from expert knowledge. The paper concludes with a discussion of the implications of the complexity of relations between expertise and experience for users' involvement.

Reforma Psiquiátrica no Rio de Janeiro: situação atual e perspectivas futuras

This article analyzes the mental health network in the city of Rio de Janeiro. It provides a report on the current status of the implementation of psychiatric reform and identifies progress, limitations and challenges in this area. Documentary research was carried out by examining official documents, ordinances, SUS databases, information that was available at the Superintendency of Mental Health of the city of Rio de Janeiro, and a literature review of Brazilian and international scientific articles. The results point to important advances in the de-institutionalization of care, with a substantial reduction in the numbers of psychiatric beds, and increased community facilities. However, the following significant challenges remain: the need for increased coverage by psychosocial care centers; the implementation of psychiatric beds in general hospitals; the integration of mental health with primary health care; the de-institutionalization of people who remain in hospitals for long periods; the expansion of the number of residential facilities; and an increase in the provision of specific services for people using alcohol and other drugs.

Children in Need in the South of Italy: Features and Distortions in the Deinstitutionalisation of Care

Despite the shift in emphasis from institutional to foster family care, in the south of Italy children in need are mainly looked after by residential services. These are required to provide family‐style care and to place children on a short‐term basis. Using data from research on a 100% sample of day units, residential services and children in care in the Calabria region, this article investigates the functioning of the system of care for vulnerable children at the sub‐national level, describes looked‐after children’s characteristics and life conditions and questions the extent to which a real deinstitutionalisation process has occurred in this area. Finally, some deinstitutionalisation recommendations are given.

“Time Enough! or Not Enough Time!” An Oral History Investigation of Some British and Australian Community Nurses’ Responses to Demands for “Efficiency” in Health Care, 1960–2000

Oral history methodology was used to investigate the perspectives of retired British district nurses and Australian domiciliary nurses who had practiced between 1960 and 2000. Interviews yielded insights into the dramatic changes in community nursing practice during the last four decades of the 20th century. Massive changes in health care and government-led drives for greater efficiency meant moving from practice governed by "experiential time" (in which perception of time depends on the quality of experience) to practice governed by "measured time" (in which experience itself is molded by the measurement of time). Nurses recognized that the quality of their working lives and their relationships with families had been altered by the social, cultural, and political changes, including the drive for professional recognition in nursing itself, soaring economic costs of health care and push for deinstitutionalization of care. Community nurses faced several dilemmas as they grappled with the demands for efficiency created by these changes.

Victimization of people with enduring mental illness in the community.

The deinstitutionalization of care for the mentally ill has been in vogue for about fifty years. Broadly speaking, this transition can be seen to exhibit the following main trends: a dramatic decline in the inpatient population of psychiatric hospitals, coupled with a corresponding increase in community facilities such as psychiatric units in general hospitals, day hospitals, and day centres. It has been claimed that deinstitutionalization ends previously enforced seclusion, enhances human dignity and allows individual privacy. The deinstitutionalization movement has inevitably led both to large numbers of former long-stay patients being cared for in the community and to significant numbers of individuals developing enduring mental illness in the community without ever having had a long inpatient tenure. The findings of recent studies (Gould 1992, Brockington et al. 1993) suggest that there is a positive public attitude towards the mentally ill. However, Kelly (1997), while carrying out Quality of Life research, found that over half of the community-based long-term mentally ill he surveyed reported that they had experienced harassment/victimization. This paper is not a report on the Quality of Life research but a discussion on the theme of victimization that has emerged from the study. The extent of the problem is discussed as are the implications for mental health professionals.