Mental Illness Rehabilitation Research Articles

Design and Realization of a Comprehensive Management System for Severe Mental Disorders Based on FLUX Mode

The paper is to implement the management and treatment project of severe mental disorders, explore and update the work mode of prevention, treatment and rehabilitation of mental illness, thus establishing the information platform of "comprehensive management system of severe mental illness in Suzhou city." The operation of FLUX software architecture with users on the View are eventually mapped toon Action, which is passed to the Dispatcher, then performs the callback function registered on the specified Action. Finally, the operation of Store is completed. In case of the data in the Store being changed, the event of the data change would be triggered. Meanwhile the View monitors the events and responds to them. Software interface technology: communication with multiple systems and platforms is required. Therefore, this system adopts the independent server mode, which can be flexibly matched by views, intermediate tables, WebService and other methods to establish two working modes of "data timing synchronization" and "data real-time synchronization." Its main functions are: work overview, information registration, common queries, information query registration, statistical analysis, statistical analysis_quarterly work overview (hospital), report management, graphic analysis, basic maintenance, and organizational management of patients with severe mental illness. The implementation of the system is conducive to improve the overall work efficiency. The data mining and analysis of the comprehensive management system for mental disorders are to standardize the technical process, reduce the management cost, and provide the basis for improving the comprehensive management level of serious mental illness in Suzhou.

Social support system for family caregivers of schizophrenic patients in the communities of Beijing

Objective To develop the social support system for family caregivers of schizophrenic patients in community. Methods Based on the previous field investigation and the principle of comprehensiveness, feasibility, pertinence, suitability, generality and classification, the social support service item pool was established. Fifteen experts with intermediate or higher professional titles and working in the mental health fields were selected from government departments, specialized hospitals and community health service centers. The experts were consulted by Delphi and the results were analyzed. Results The average age of the consultation specialists was (40.7±8.0) years, and the duration of working in mental illness rehabilitation was (14.9±7.6) years. The positive coefficients of the two rounds of consultation were 100%, the authoritative coefficients of experts were 0.795, and the coordination coefficients of opinions were from 0.252 to 0.344, respectively. The 67 items of social support service for family caregivers of schizophrenic patients in Beijing were obtained after two rounds of expert consultation, but fewer of the services were for schizophrenic caregivers only. Conclusion The authority and society should take measures to establish a social support system for family caregivers of patients with schizophrenia, in order to reduce their family burden and improve the quality of rehabilitation for mental patients in the community. Key words: Delphi technique; Schizophrenia; Caregiver; Social support

Looking Beyond Distress: A Call for Spanning the Continuum of Mental Health Care.

BackgroundDespite mental health’s definition as a state of well-being, mental health research and practice has often narrowly focused on pathology and distress. The identification, treatment, and rehabilitation of mental illness are the primary activities pertaining to the role of mental health professionals, but only focusing on these primary activities carries the risk of neglecting other legitimate responsibilities related to prevention of illness and promotion of wellness. Therefore, it becomes important to highlight the potential utility of separately examining levels of distress, alongside levels of well-being in community samples. The goal of this study was to determine the extent to which low levels of distress or a lack of significant distress co-occurs with high levels of well-being in a sample of urban Indian adults.MethodsStandardized measures of psychological distress, along with measures of emotional, psychological, and social well-being, were used in a sample of 300 adults aged 20 to 60 years. The participation of community-dwelling adults who could respond to the questionnaires in English or Hindi (the most widely spoken and official language in India) was solicited through posting announcements on various platforms in a metropolitan city in Southern India. The participants had the option to respond to the questionnaires via a paper-pencil version or through an online Google survey. Psychological distress was assessed using the Kessler Psychological Distress scale (K-10) on which a score over 19 indicated significant distress. We used the 25th and 75th percentile points on the respective distributions of scores to determine high, low, and moderate ranges on the three measures of well-being.ResultsBoth men and women were well represented in the sample (47% and 53%, respectively). Approximately 41% were young adults, nearly 30% were in the 36 to 45-year age group, and 30% were in the 46 to 60-year age group. Approximately 48% of the overall sample (N = 143) exhibited an absence of significant distress. Patterns of well-being were examined in this group of low-distress participants. Only 13% of low-distress participants exhibited high emotional well-being (i.e., had a high positivity ratio) and high psychosocial functioning (i.e., had high psychological and social well-being). As many as 37.8% exhibited low well-being on at least one of the three measures of well-being, despite being low on distress. In other words, low well-being scores were fairly common in conjunction with non-significant levels of distress.ConclusionReliance on low distress for operationalization of mental health may mask lower levels of emotional well-being and psychosocial functioning in a given population. The findings underscore the need to span the entire continuum of mental health care by routinely including preventive and promotive aspects in research and practice.

Factors influencing the rate of incidents in a United Kingdom high secure psychiatric hospital: Weekend, ward round and diagnostic effect?

IntroductionBroadmoor is a high secure psychiatric hospital divided into personality disorder (PD) and mental illness (MI) pathways. Whenever an incident occurs, it should be recorded. To better understand which factors influence the rate of incidents, such as diagnosis or intervention by medical and psychological staff, we examined the difference in the number of incidents recorded on weekdays versus weekends, ward round (WR) versus non-WR days and the PD versus MI pathways.MethodAll incidents recorded over a one-year period (3.11.2014–2.11.2015) were examined. Extraneous incidents were excluded, leaving subgroups of “aggressive” (physical and verbal) and “physical” (excluding verbal) incidents which were analysed. Data were adjusted for the difference in number of beds in each pathway.ResultsOf the 2369 incident reports included, more were recorded per day on weekdays than weekends, with little difference on WR versus non-WR days. The rates of both types of incidents were similar on both PD and MI admission wards, although the rate of “physical” incidents was 2.6 times higher and “aggressive” incidents 3.3 times higher in PD compared to MI rehabilitation wards.ConclusionThe findings suggest the presence of medical and psychological staff during the week, and possibly the requirements they place on patients, may increase the rate of incidents within the hospital. Despite comparable rates on admission, MI rehabilitation wards have far fewer incidents than PD rehab wards, which may reflect the more intractable nature of PD versus MI. More work is required to confirm these findings.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Risk Factors for Disability Pensioning Caused by Mental Disorders - A Systematic Review

Background: Meanwhile, mental disorders are the main reason for receiving a disability pension. The present study aimed at providing an overview of the German literature on characteristics and factors related to ERMD and pointing out the current state in this field of research. Revealing parameters that are accompanied by an ERMD is a precondition to prospectively prevent this trend. Methods: A systematic literature review was conducted from 2001 through to 2014. All results regarding German statutory pension insurants pensioned due to mental disorders after 2001 were included. Studies were considered if they reported 2 or more relevant results. Research design was not limited, except for excluding anonymous questionnaires. Results: 20 studies were found meeting eligibility criteria. All included studies were based on secondary analyses of data derived from the German statutory pension insurance. By means of gender-specific regression analyses the level of qualification and the geographical region were unveiled to be significant predictors of the ERMD. Basically, most reported results were descriptive or explorative. Besides various single results and evidence for interactions, frequently reported results are that: (i) female insurants get pensioned more frequently due to mental disorders than male insurants, (ii) affective disorders are the most frequent diagnoses, (iii) insurants with mental disorders are younger than insurants with somatic disorders when they get pensioned and (iv) insurants with schizophrenic disorders are younger than insurants with other mental disorders when they get pensioned. The utilisation of rehabilitative services before getting pensioned is limited at 50%. Conclusion: This work demonstrates a lack of empirical evidence of how (and what) disability risks are associated with ERMD in Germany. Furthermore, our results illustrate that a major part of the insurants do not attend rehabilitative services before their retirement, even though rehabilitation of mental illness is assumed to be effective. Future studies should hence focus on identifying disability related risk factors and barriers to using rehabilitative services in order to develop starting points for preventive and individual strategies.

Mental health and psychiatric care in Bolivia: what do we know?

BackgroundRecently Bolivia has implemented a universal health system, but their mental health policy is still emerging.ObjectivesTo investigate the current state of the mental health care system in Bolivia and discuss challenges for structuring a coordinated network of services that can effectively meet the needs of the Bolivian population.MethodsThis review was conducted by searching for scholarly articles through the databases Lilacs, Medline OPS, HISA and IBECS REPIDISCA via the search portal in the Virtual Health Library - NLM (http://www.bireme.br).ResultsBolivia has a National Mental Health Plan that is intended to guide mental health promotion, prevention, treatment and rehabilitation of mental illness, but the resources for this area of health are limited. There are 1.06 psychiatrists and 0.46 psychologists per 100, 000 inhabitants. Information on psychiatric morbidity in Bolivia and the impact of mental disorders on the global burden of disease is scarce. Admission statistics reported by psychiatric hospitals in the country show that the main cause of hospitalization is substance abuse (30%). Alcohol consumption is responsible for 90% of these admissions, in addition to being a major cause of deaths in traffic and one of the main risk factors for domestic violence. Almost one in two women in Bolivia (47%) experienced some form of violence from their partner in the last year. Nineteen percent of women living with a partner reported being physically abused, while 7% were sexually abused by their partners. Isolated studies report that suicide rates are disproportionately high in Bolivia.ConclusionsAlthough there is a shortage of epidemiological data in Bolivia, it is clear the impact of alcohol addiction in psychiatric admissions, domestic violence and traffic accidents. Violence against women and suicides are important issues to be tackled. Among the proposed strategies to afford human resources for mental health in Bolivia, “task shifting”, the delegation of tasks to non-specialists should be extensively adopted in the country to improve mental health care.

Mental Illness Self-stigma: A Risk Factor of Mental Rehabilitation

Mental illness self-stigma is the phenomenon in which patients with mental illnesses internalize the stereotypes,prejudice and discrimination by the public and formulate prejudice and discrimination against themselves. Mental illness self-stigma has a series of negative effects on patients and is a high risk factor for mental rehabilitation. Self-stigma is likely to compromise mental rehabilitation through patients' negative perception,negative emotion and self-discrimination it induces. Intervention of self-stigma should be implemented on patients and the general public respectively. The localization of research on self-stigma in the context of the Chinese culture should be focused on the establishment of relevant theories,the improvement of measurement tools and intervention strategies,and the integration of anti-stigma intervention and mental illness rehabilitation.

The aftermath: aspects of recovery described by perpetrators of maternal filicide committed in the context of severe mental illness

Mentally abnormal maternal filicide is a rare and horrifying event. Clinicians are unlikely to develop broad experience with this and there is little information available about recovery. This paper presents a range of descriptions of recovery experiences derived from a qualitative study of mentally abnormal maternal filicide perpetrators. Transcripts from a qualitative, semi-structured interview study of six women who committed filicide in the context of major mental illness were reviewed. Descriptions related to rehabilitation issues were grouped and themes extracted. The women described patchy but horrific memories they avoided thinking and talking about. They described intense self-judgement and self-hate. They valued ongoing relationships with surviving children and were distressed by perceptions that they might be a danger to other children. Managing illness was not described as a major challenge. Acknowledgement of illness was described as important in coming to terms with what they had done. Surviving children and relationships with family and other support networks were described as important in their rehabilitation. We conclude that optimizing treatment and rehabilitation for mental illness, supporting the woman to acknowledge the role of illness in the offence, maximizing support from personal networks, and enabling her to regain some aspect of the mother role may be more efficacious than debriefing with respect to the offence.