Fountain House Research Articles

“No miracle cure” interface evaluation of a UK suicide prevention app in a Norwegian context

Background 600 Norwegians die by suicide annually. Self-help apps may potentially reach and support suicidal individuals, next of kin, bereaved and professionals with educational information, access to suicide emergency help, hotlines, and coping tools. Knowledge regarding feasible app interface for suicide prevention self-help apps in a Norwegian context is however lacking. Aim Evaluate user-friendliness and user interface of the Norwegian version of the British Stay Alive suicide prevention app and assess whether the app could be useful in suicide prevention. Materials and Methods Eight Norwegian Fountain house members and twelve university students evaluated the app interface, and their experiences were discussed through individual- or focus-group interviews. Results Participants perceived app tools as relevant and useful for suicide prevention, however they raised concerns on privacy, evidence base, interface complexity, unintended symbolic value of app colours and content, and suitability in suicidal states. Conclusion The current Norwegian Stay Alive version has the potential to be user friendly, however improvements of interface are suggested. Significance Stay Alive interface must be adjusted and subjected to reiterative evaluations and feasibility assessments in collaboration with additional stakeholder populations to remedy interface concerns, and identify optimal Norwegian interface design, prior to implementation.

Expanding community-based participatory action research practices to clubhouses through sustainable research activities.

There is growing utilization and acknowledgement of the benefits of community-based participatory action research (CBPAR) in advancing health practices and equity. However, the sustainability and full impact of CBPAR in health care settings faces many obstacles and limitations. The present article examines the synergies between CBPAR and Clubhouse programs, presents the demonstration and ongoing implementation of sustainable CBPAR practices at Fountain House in New York City, and offers lessons learned for other Clubhouses and similar programs seeking to integrate CBPAR. Alignment in practice and principles between CBPAR and Clubhouse programs are presented. The innovation and ongoing sustainable CBPAR practices in the Fountain House Clubhouse program are examined with a contribution of practice guidance for other Clubhouse and similar programs in further adopting and learning CBPAR into participatory health practices. Clubhouse psychosocial rehabilitation programs present structurally conducive settings for the success and sustainability of CBPAR activities and projects. The Fountain House examination and demonstration of integrating CBPAR sustainably into core Clubhouse programming presents opportunities for further integration, research, and practice guidance in uniquely leveraging features of the Clubhouse model to advance health equity and rehabilitative outcomes through CBPAR. The opportunity for incorporating structural CBPAR activities within Clubhouse programs can be informed by the experience, processes, and lessons applied in the Fountain House example. Further research into the rehabilitation, program, and equity benefits of Clubhouse and CBPAR integration could uniquely contribute to the advancement of sustainable participatory research practices across the mental health field generally. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Clubhouse virtual programming: A trend analysis of member engagement patterns before, during, and after pandemic lockdown.

The COVID-19 pandemic had a profound impact on the mental health of individuals with serious mental illness, with restricting social gatherings and limiting access to essential community and psychosocial support services. For programs like clubhouses, adapting typically in-person programming to online settings led to the creation of virtual clubhouse programming that persists at many sites even after reopening. Although it has been documented how clubhouses adapted their programming online, it has not been investigated at the individual level how those programs were utilized over time, by different member cohorts, and how they persist in comparison to one another. The present article presents descriptive and inferential statistics, analysis of variance, and secondary trend analysis of the Fountain House clubhouse in-person and virtual engagements of three member cohorts who enrolled in either three time periods before pandemic restrictions (the prior cohort), during pandemic restrictions (the pandemic cohort), and after lockdown restrictions (the reopening cohort). Initial findings show that the prior cohort sustained their overall rate of engagement across time periods. The pandemic cohort had a significantly higher rate of engagement than the prior cohort within the during period but demonstrated a significant decrease in engagement rate between the during and after period. Prior and pandemic cohorts had statistically similar virtual and in-person engagement ratios in the after period, but the reopen cohort differed significantly with a predominant ratio of in-person engagements. Member engagement trends within in-person and virtual offerings across the three different pandemic related time periods indicate important considerations for the sustainability and innovation of clubhouse virtual programming. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Усадьба Высокое графов Д. Н. и А. Г. Шереметевых. По документам Российского государственного исторического архива

The article presents the results of the research on the history of the Vysokoe Estate in the Smolensk province (currently located in the village of Vysokoe in the Novodugino district of the Smolensk region) based on documents from the Russian State Historical Archive, which houses the personal archive of Count Alexander Dmitrievich Sheremet’ev (1859–1931). In comparison to the well-studied Kuskovo and Ostankino estates near Moscow, as well as the famous Fountain House in St. Petersburg, the Vysokoe Estate remains a relatively understudied property of the Sheremet’evs. Thanks to archival documents it became possible to reconstruct the history of the acquisition of this Estate by the representatives of the renowned Sheremet’ev family and the creation of a unique architectural complex in Vysokoe. The majority of archival documents are introduced into scholarly circulation for the first time. From the materials of Count A. D. Sheremet’ev's archive (Russian State Historical Archive, fond 1118), who inherited Vysokoe after his mother's death and continued to develop the Estate, it is known that the property of the Sheremet’ev Counts became theirs in 1857 after the marriage of Count Dmitry Nikolaevich Sheremet’ev (1803–1871) to the Smolensk noblewoman Alexandra Grigorievna Mel’nikova (1825–1874). The latter inherited only a part of the Estate and fully bought it from her mother and sisters after the wedding. At the behest of Countess A. G. Sheremet’eva, architect N. L. Benois designed about 20 stone buildings, including the main estate house ("Palace"), the Church of the Tikhvin Mother of God, and various service buildings. The execution of the work in Vysokoe was supervised by his assistant R. K. Mueller, who later became the architect of the Countess's wooden house. The archive contains the designs of many buildings, correspondence between N. L. Benois and R. K. Mueller with the Main Office of the Sheremet’ev Counts in St. Petersburg, texts of contracts between N. L. Benois and foreign and domestic craftsmen involved in the finishing, and suppliers of interior items. The documents provide valuable information about the client's involvement in the details of the work, allowing us to assess various stages of project implementation, and indicating the Countess's special attention to the arrangement and decoration of the main estate house and the church. For example, marble slabs for the Palace" terrace were ordered from Italian sculptor A. Triscorni, and icons for the church were commissioned from the academician of painting A. G. Goravskii. A significant part of the planned work was carried out in the early 1870s, and after the death of Countess A. G. Sheremet’eva in 1874, Vysokoe was inherited by her only son, A. D. Sheremet’ev. The surviving building designs, supplemented by various administrative documents, currently represent not only scholarly but also practical interest, associated with the commencement of work on the restoration of the remarkable architectural complex of the former Sheremet’ev Estate.

New Greek inscriptions from Akmoneia and its territory

This paper publishes nine new inscriptions copied during the archaeo­logical surveys conducted in the Phrygian city of Akmoneia and in its territory between 2014 and 2017. Even though there have been no systematic excavations to date, the city is remarkable due to its rich epigraphic documentation. The new finds make a notable contribution to this. Of the nine inscriptions published here, one (No. 1) concerns the erection of the statues of Koros, the goddesses, as well as of the sacred council, by a certain Hierokles, the priest and the agonothete of the Great Asklepieia. In another inscription (No. 2), a woman called Flavia Hedeia, the daughter of Flavius Montanus of consular rank and the wife of Sallius Aristainetos of consular rank, is honoured by her foster-parents. We attempt to identify Flavius Montanus through some related inscriptions already published from the city and thereby propose a dating in the mid-3rd century AD. Nos. 3–6 are grave inscriptions and they all date from the Roman Imperial period except for No. 6. Even though the remaining inscriptions (Nos. 7–9) consist of fragmentary texts carved on architrave blocks, they still provide valuable information, such as proving the existence of a gymnasium, as well as a fountain house in Akmoneia.

Self-Objectification, Internalized Transphobia and Psychological Distress in Male-to-Female Transgenders

The present study was conducted to investigate the relationship between self-objectification, internalized transphobia, and psychological distress in male-to-female (MtF) transgenders. It was hypothesized that: 1) there would be a positive relationship between self-objectification, internalized transphobia, and psychological distress in male-to-female (MtF) transgenders; and 2) Self-objectification and internalized transphobia would predict the psychological distress in MtF transgenders. A correlational research design was used. A sample comprising of 136 MtF transgenders with an age range of 19-55 years (M = 34.46, SD = 9.09) were approached by employing purposive sampling technique. Data were collected from Fountain House and the Khawaja Sira Society of Lahore. A self-constructed demographic information sheet, Urdu versions of Self-objectification Questionnaire, Transgender Identity Scale, and the Depression Anxiety Stress Scale-21 (DASS-21) were used for assessment. The results exhibited a positive relationship between self-objectification, internalized transphobia, and psychological distress in MtF transgenders. Furthermore, the results also displayed that self-objectification and pride and shame related internalized transphobia positively predicted the psychological distress in MtF transgenders. This study will contribute towards the development of program that will ensure lesser distress and improved quality life for the transgender communities.

JOURNEY OF ORGANIZING WPA THEMATIC CONGRESS

How the Journey Started? "Hey, Majid, why are you not taking any dessert?" asked Prof. Afzal Javed,1 the President of World Psychiatric Association. "No. Thank you, Sir. I want to maintain my weight," I answered. "You know there is another good strategy to control your weight. Why don't you organise a WPA Thematic Congress in Karachi!" intervened Prof. Nasar Sayeed Khan, a former President of Pakistan Pakistan Psychiatric Society.2 This was almost two years ago in Lahore, while I was enjoying dinner in the company of these esteemed colleagues. The next evening at the Fountain House Lahore3 dinner, the three of us had the same idea. This is how the seed for organising a WPA Thematic Congress in Karachi was planted. The following day, we conducted an unofficial meeting to plan the first-ever WPA Thematic Congress in Karachi. To think it all began there…!

A return to lived experiencers themselves: Participatory action research of and by psychosocial clubhouse members.

Within the history of psychology and phenomenology, people with lived experience of mental illness have often served as participants in research, but far less as co-researchers themselves. There is now a growing movement focused on "participatory" research, where people with lived experience directly contribute to various stages of the research process. This article presents such a qualitative, participatory research study, led by members of a large psychosocial rehabilitation clubhouse-Fountain House in New York City-and informed by phenomenological research principles. The study focused on collaboratively assessing and improving the clubhouse program for its members. A key feature of the project was the extent of lived experiencer involvement, for instance, in designing and conducting the study, and co-writing this research report. Members of Fountain House were trained in phenomenologically-informed research methods and developed a research study that focused on the quality improvement of their clubhouse program. Member researchers conducted a series of focus groups with fellow clubhouse members, generating qualitative data that were analyzed and written up by member researchers in collaboration with staff and university partners. Overall, study findings place emphasis on the theme of action in members' experiences-both with respect to how action, agency, and valued activity were key drivers of meaning and recovery for people facing severe mental illness, and with respect to the key component of the research process itself [i.e., participatory action research (PAR)]. Four major subthemes emerged from the study. First, findings revealed how members with mental illness experienced the clubhouse as a "new hope" and "the place for me," to counteract their experience of inactivity, stigma, depression, and hopelessness prior to that point. Second, findings showed how, as members' life goals changed, so did the precise meaning and role of Fountain House in their lives. Third, findings portrayed members' need for, and pursuit of, transformation within the clubhouse space itself to provide more opportunities for meaningful work rather than what they viewed as merely busy-work. Finally, member researchers viewed their direct participation in this project as an opportunity to actively combat stigma, to be a driver of research, and to engage in what they viewed as a generative activity. These action-oriented themes serve as a counter to the historical view of people with mental illness as merely passive experiencers of symptoms and passive recipients of mental health care. We discuss how the process and content of participatory research can help enhance the relevance of research for stakeholders' lives and contexts.

CLINICAL APPLICATION OF ICD-11 AND ITS UNDERSTANDING AMONG THE PSYCHIATRISTS AND POST GRADUATE PSYCHIATRIC RESIDENTS OF PAKISTAN

Objectives: To find out the problems associated with the clinical utilization of ICD-11 by the psychiatrists of Pakistan. To understand the basic description of its utilization in clinical practice. Study design: It is a cross-sectional descriptive study. Place and duration of study: The study was conducted through an online survey which was circulated to the psychiatrists across country. Subjects and methods: A sample size of 130 psychiatrists including the post graduate residents responded to the e-mail and WhatsApp messages. The survey was on Google Docs, and it was an online survey with responses of “yes, no and don't know”. The ethical approval for the survey was taken from Pakistan psychiatric research centre, fountain house Lahore, Pakistan. Results: Out of 130 psychiatrists, 65.4% were the residents who heard about ICD-11 mostly from academic activity conducted by the authors. 48.5% of psychiatrists believe that it is difficult to adjust with the new classification system. Conclusion: ICD-11 is a new classification system. It requires training from the seniors and workshops related to its utility through the online mortality and morbidity statistics by WHO across various countries.

A Health Equity-Oriented Research Agenda Requires Comprehensive Community Engagement.

Health policy and research communities have taken new approaches to addressing health equity, going beyond traditional methods that often excluded the contributions of health care consumers and persons with lived experience. This reevaluation has the potential to drive critical improvements in how we conduct research and innovate policy toward reducing health and health care disparities in the United States. Such considerations have led Fountain House, the founder of the Clubhouse model for peer-based psychosocial rehabilitation for persons with histories of serious mental illness, to incorporate community-based participatory action research (CBPAR) protocols within their research and service programs. The combination of CBPAR research methods within novel participatory care settings like Clubhouse programs presents unique and informative opportunities for the advancement of innovative health equity approaches to consumer empowerment in health care. In this piece, the authors (two staff researchers and one member researcher) propose how CBPAR research methods conducted in Clubhouses can uniquely advance equity-focused research methods, and how the benefit and enhancements from equity-focused research are continuously applied, practiced, and accountable to the communities within which the research is conducted. Embedding CBPAR practices within participatory care settings like Clubhouses, creates novel opportunities for research work to not only become more equitable but also become a part of the rehabilitative process, empowering the main beneficiaries of the research with the means to sustain and achieve further improvements for themselves. Such experiences are particularly important within rehabilitation settings, where there is a process of reclaiming empowerment and self-efficacy over a disability or illness and the social circumstances surrounding those conditions. Different stakeholders can all play important roles in advancing health equity–oriented research agendas by leveraging CBPAR principles. Academics and others in the research community can more comprehensively embed CBPAR methods into the design of their research studies. A critical link exists among how researchers conduct their studies, how providers organize care delivery and support, and how health plans pay for and evaluate care. CBPAR-generated research needs to fully engage clinical teams to ensure that ongoing community-involved care settings have direct applications to real-world care delivery. It is equally important that providers fully engage with their communities as they adjust their approaches to supporting the populations they serve.

Incidence of Psychiatric Disorders in Children affected with Intellectual Disability

Intellectual disability is caused by environmental influences, genetic disorders and infections including perinatal, postnatal and neonatal infections. Physical disabilities are also associated with intellectual disability (ID) children.Identification of ID patients occurred by test of intellectual disfunctioning. A cross sectional and analytical study was performed from September 2019 to March 2020on intellectually disabled children on the Pakistan Air Force (PAF) children school Lahore, Fountain house in Sargodha and Shadab institute of special education, Punjab, Pakistan. The level of intellectual disability was based on the intelligence quotient (IQ). In present study, out of 200 children, 80 children were suffered from this disease, 56 were males and 24 were females. Cases related to intellectual disability were identified with in different age groups such as age group 0-5 (N = 13), 6-10 (N = 27), 11-15 (N = 27), 16-20 (N = 10), 21-25 (N = 3) and 26-30 (N = 3). A total of 33.75% were belong to 6-10 years of age group. Out of 80 children 27.50% (N = 22) were affected due to malnutrition in pregnancy, 16.25% (N = 13) children had folic acid deficiency, 15% (N = 12) children were due to exposure to the chemicals or radiations in pregnancy, 21.25% (N = 17) children had hypothyroidism and 16% (N = 20) children had other gene disorder associated with intellectual disability. Proper recognition of disorder can play an important role in dealing with psychiatrists patients.

ἄριστον μέν ὕδωρ: An Examination of the Public Waterworks in Athens in the Early 5thC BCE

This article examines the design and social impact of waterways in Athens in the early 5thC BCE. While the Athenian political landscape transitioned from a series of tyrannies to democracy at the end of the Archaic period (ca. 650-480 BCE), the archaeological record also shows widespread innovation in the development of public water systems, particularly in sanitation and water supply. A movement away from buildings constructed by the Athenian tyrants facilitated the development of the Classical Agora and the creation of new public-use spaces and structures, like the Southeast Fountain House and the Great Drain in the Agora. The fountain has long been identified with the famous Peisistratid Enneakrounos (“Nine Spouts”) fountain, but through investigation into the arguments of J.M. Camp and Jessica Paga, I propose that a later date ca. 500 BCE is more suitable for the historical and archaeological context of the fountain. 
 I investigate several Athenian waterworks built/maintained during the late Archaic period to the Classical period (~500-323 BCE): the Great Drain in the Agora, the Southeast Fountain House, the Klepsydra fountain, and the Asklepieion on the Akropolis. The works of Hippocrates, Thucydides, and—to a lesser extent—Pausanias, inform my examination of the implications of the construction of these waterworks and the development of democracy in the 5th century. These waterways show a dedicated shift from the private use of water and tyrannical building works, to a new, fully public and communal mode of engagement with the city and its resources.

304 - Mental healthcare services and advocacy for older people amidst the COVID crisis: Voices from South Asia

AbstractAsia has some of the fastest developing economies and largest conglomerations of populations in the world. One such geographically unique region is South Asia, which accounts for nearly 25% of the global population and one-fifth of the psychiatric morbidity worldwide. This region is also ageing rapidly compared to rest of the world due to modifications in healthcare facilities, hygiene, and lifestyle as well as improved sanitation and infection control. Besides, some of the South Asian countries have also been worst-hit by the COVID-19 pandemic which has led to an exaggerated psychosocial crisis among their older people. Many of these nations face issues with community psychiatric care, trained manpower, socio-economic resources, legislation catering to psychological care and health inequalities. However, recent years have also witnessed paradigm shift in mental health policies, infrastructure and technology among these nations. Climate changes, migration, displacement and ecological characteristics further make South Asia unique in mental health needs and challenges.With this background, leaders in the field of psychogeriatric care from some of the South Asian nations come together to discuss and highlight upcoming strategies for mental health advocacy and service delivery among older people in these regions. Mutual collaboration and cross-country research are globally called upon.Panelists:1. Dr. Gautam Saha (President, Indian Psychiatric Society) drgsaha@yahoo.co.in2. Dr. G.Prasad Rao (President, Indian Association of Geriatric Mental Health) prasad40@gmail.com3. Dr. Sudarshan Narsingh (President, Psychiatrists’ Association of Nepal & President, SAARC Psychiatric Federation) drsudar@yahoo.com4. Dr. Wazizul Alam Chowdhury (President, Bangladesh Associa tion of Psychiatrists) bap@agni.com5. Dr. Afzal Javed (President, World Psychiatric Association and Chairman, Pakistan Psychiatric Centre, Fountain House, Lahore) afzalj@gmail.comModerator:Dr. Debanjan Banerjee (Old Age Psychiatrist, NIMHANS, Bangalore; Member, IPA Public Awareness and Advocacy Committee) dr.Djan88@gmail.com

Journey From Recovery To Functional Recovery Through Physical Activity And Sports Participation: A Single Case Study Of Rehabilitated Patient With Schizophrenia

This qualitative study explored the positive effect of physical activity on the prognosis of chronic patient with schizophrenia. This single case study carried out on the patient with schizophrenia who was admitted at the age of 36 at Fountain House Lahore Pakistan. The member belonged to single parent and had the history of wandering behavior and ran out 4 times from house and lastly stayed around 8 months away from his home. After getting admitted at Fountain House member undergone drug therapy along with that he was involved in physical exercise, assembly and given sports responsibility by the sports therapist. After 6 months of continuous stay at Psycho social rehabilitation center and involved in the physical activities and conducting sports as assistant remarkable improvement was seen in the overall behavior of the member. The member discussed in semi structured interview that his life became disciplined, positively elevated his mood, provided him confidence and he does not feel like to be sedentary. The most encouraging remark he shared that he got more awareness about his symptoms of disease instead of reacting now he wanted to share any change in him with his father or the therapist.

Visual images of beauty of the word in the Persian poetry of XVI - the beginning of XVIII century: the Indian style and painting by word

The article is devoted to the problem of changing stylistic paradigm in the Persian poetry of XVI-XVII centuries and reflection of this process in self-consciousness of outstanding authors of the period. Parallel with preserving stable norms of traditional poetics literary practice demonstrates flexibility and forms new range of popular poetic strategies. New aesthetic criteria if ideal poetic language, expressed with epithet ‘colourful’ ( rangin ), appears alongside with criteria of previous period, expressed with epithet ‘sweet’ ( shirin ) and step by step gets leadership. Lyric poetry ( qhazal ) of three famous authors of the period of formation and golden age of Indian style served the object of analyses. The phenomena of visualization of imagery connected with perfect poetic language illustrated by examples of ‘Poet and Poetry’ motifs located in ‘frame text’ in end of the qhazal . These motifs serve one of the regular contexts of author’s name ( takhallus ) and show author’s attitude to his creation, including stylistic preferences. Refinement of poetic fantasy being declared basic condition of creating perfect poetry described visually as coiling lasso, poetry itself as flourishing garden, fountain or European house decorated with painting. Such characteristic of word creation has analogies in the works of Baroque style theorist Giambattista Marino (1569-1625).

Effect of revenge on sadism and schadenfreude in clinical and non clinical adults: moderating role of misanthropic beliefs.

To investigate the concept of moderating effect of misanthropic beliefs in the relationship involving revenge tendencies, sadism and schadenfreude among clinical and non-clinical adults. The cross-sectional study was conducted at the Department of Psychology, University of Sargodha, Punjab, Pakistan, over a period of one year from 2017 to 2018, and comprised adults aged 22-65 years in both clinical and no-clinical settings enrolled from the University of Sargodha, Punjab Institute of Mental Health and the Fountain House. Data was collected using Vengeance, Misanthropic, Short Sadistic Impulse and Perceived Schadenfreude scales. Data was analysed using SPSS 23. Of the 500 subjects, 250 (50%) each were in the clinical and non-clinical groups. Misanthropic beliefs were found to moderate the relationship involving revenge attitude, sadism and schadenfreude in both groups (p<0,05). Misanthropic beliefs moderated the relationship involving revenge attitude, schadenfreude and sadism.

Seven Poems

While poets can, one way or another, feel exiled in their own countries, the corollary may also be true: abroad, the paradoxes of leaving one’s homeland gnaw and chafe. Wang Jiaxin’s early sojourns outside China, especially in Europe and the United Kingdom, provided fruitful poetic material, again with the sting of separation. His subsequent travels to the United States, Germany, Scandinavia, and elsewhere were no less useful, tinged with an edged self-reflection that became one aspect of his art. For mainland poets of Wang’s generation, growing up during the Cultural Revolution, modern literature from western Europe, Britain, and the United States was almost unavailable. Hence, the work of Mandelstam, Pasternak, Akhmatova, and Tsvetaeva, along with Dante, the classical Greeks, and of course the Chinese classics, lie deep in his aesthetic marrow. Much of this was evident in Darkening Mirror, Wang’s first full-length volume in English, which Diana Shi and I had edited and translated. More recently, Wang visited St. Petersburg, where Akhmatova survived years of Stalinist terror in the “Fountain House,” now a museum. This issue’s suite of poems commemorates markers from the historical, personal, and literary past, in confluence with present realities, particularly when Wang sets his mature experience against a haunted landscape. As Akhmatova so memorably observed, the poet must not only imagine, but witness.

Staff views on member participation in a mental health clubhouse.

The clubhouse model is a community psychiatric rehabilitation program aiming to provide a restorative environment for people with severe mental health problems. These clubhouses provide their members with opportunities for friendship, employment, and education, which help them on their paths towards mental health recovery. Towards that end, the model features clubhouse members and staff working side by side to execute clubhouse activities. That is, unlike most of the community mental health programs where staff provide services to their clients, clubhouse staff are required to partner with members in their work. The aim of this qualitative study was to understand how the clubhouse staff elicited member participation and facilitate recovery. The research was conducted between Year 2013 and Year 2014 at the world's first clubhouse: Fountain House in New York City. The first author conducted 262hr of active participant observation in 41 visits to Fountain House, and in-depth interviews with 38 staff members who had worked at Fountain House for at least 1month during the study period. The dimensional analysis procedure was used to analyse the observation notes and interview transcripts. Results showed that participation was a key to rebuilding members' self-confidence, which further encouraged members to seek more opportunities for self-enhancement and personal growth. Specific organisational policies, programming, practical considerations, and other strategies shaped a positive environment for members to exercise autonomy, experience self-efficacy, and model behaviours after others who have succeeded. Findings of this research support the egalitarian staff-member relationships and the maintenance of an open and transparent atmosphere of the clubhouse, as observational learning enables members to move forward with their journeys to recovery. Findings also may inform efforts to shift traditional psychiatric services towards recovery-oriented care.

A Distinctly Rhetorical Space;Eusynoptosand the Greek Council-House

A Distinctly Rhetorical Space;<i>Eusynoptos</i>and the Greek Council-House

Effects of internalized stigma on symptoms and quality of life in schizophrenic patients; mediated by dysfunctional attitude

The objective of this study was to determine the effects of internalized stigma on symptoms, quality of life of schizophrenic patients; mediated by dysfunctional attitude. A descriptive correlational research design was used to investigate the relationship between symptoms, quality of life and dysfunctional attitude in schizophrenic patients. Linear regression was used to investigate the mediational effects of dysfunctional attitude. Purposive sampling technique was used for the selection of the participants. The study was conducted on diagnosed schizophrenic patients from psychiatry ward of Nishtar Hospital Multan, Fountain House Rehabilitation Centre Lahore and Punjab Institute of Mental Health Rehabilitation Centre Lahore. The sample of the study was 50 registered patients of schizophrenia. Calculated sample size was 50 schizophrenic patients among them 34 were Males and 16 were Females. Internalized Stigma of Mental Illness Scale was used to see the effects of stigma on schizophrenic patients (ISMI, Ritsher, 2003), along with Positive and Negative Syndrome Scale was used to evaluate the positive and negative symptoms in schizophrenic patients (Kay, et al., 1987), World Health Organization Quality of life BREF Scale (WHOQOL-BREF, 2003) was used to assess the quality of life of schizophrenic patients, along with another scale of Dysfunctional Attitude Scale (DAS, Weissman, 1978) was also used to assess the cognitive functioning of the schizophrenic patients. Studies showed that internalized stigma had significant positive correlation with dysfunctional attitude and negative significant correlation with symptoms and quality of life of schizophrenic patients. Internalized stigma had strong significant effects on the symptoms, quality of life and dysfunctional attitude. Studies also showed that people with mental illness has to face negative stereotype, rejection and finally alienation from society because of stigma which is a big hurdle in their process of recovery and treatment.