Persons With Mental Illness Research Articles

Religious Beliefs About Mental Illness Influence Social Support Preferences

Research demonstrates that social support facilitates recovery from a mental illness. Stigma negatively impacts the social support available to persons with mental illness (PWMIs). We investigated how religious beliefs about mental illness influenced the types of social support individuals would be willing to give PWMIs. Christian participants indicated their denominational affiliation and their religious beliefs about mental illness. We then asked participants to imagine a situation in which their friend had depression. Participants indicated their willingness to give secular and spiritual social support (e.g., secular: recommending medication; spiritual: recommending prayer). Christians’ beliefs that mental illness results from immorality/sinfulness and that mental illnesses have spiritual causes/treatments both predicted preference for giving spiritual social support. Evangelical Christians endorsed more beliefs that mental illnesses have spiritual causes/treatments than Mainline Protestant and Roman Catholic Christians, and they endorsed more preference for giving spiritual social support than Roman Catholic Christians.

The Mental Health Care Bill 2013: A step leading to exclusion of psychiatry from the mainstream medicine?

Byline: Choudhary. Narayan, Deep. Shikha, Mridula. Narayan After India signed and ratified the United Nations' Convention on Rights of Persons with Disability, 2006 (UNCRPD), Ministry of Health and Family Welfare (MOHFW) initiated the exercise of revising the Mental Health Act - 1987 (MHA-1987) to bring it in harmony with the UNCRPD in 2010. After about 31/2 years long drafting and consultation process, the proposed legislation named Mental Health Care Bill, 2013 (MHCB) was introduced in the Rajya Sabha in August 2013. The Parliamentary Standing Committee on Health Related Matters submitted its report with suggestions of some minor changes in November 2013. [sup][1] Though invited to the consultation process at different stages, Indian Psychiatry Society (IPS) was not assigned any role in drafting of the current Bill. IPS and other professional bodies of psychiatrists have expressed apprehensions about a number of provisions in the Bill, which are not considered to be in the interest of persons with mental illness (PMI). IPS has submitted its representations at various stages expressing these concerns. Antony (2014) said that the Bill has an over-inclusive definition for mental illness, which will hurt a huge number of victims of even minor mental illnesses and their families, because of the wide prevalence of stigma. [sup][2] Though there are provisions of emergency admission on any bed anywhere in the country for a maximum period of 72 h (96 h in NE states), all the hospitals or nursing homes who admit PMI have been brought under the purview of the Bill and are required to be registered as mental health establishments (MHEs). All involuntary admissions in MHE even for a day may be subject to review by Mental Health Review Board to be established throughout the country by the Mental Health Review Commission. Kala (2013) said that the provision is undoubtedly progressive, but expressed his doubt that whether we as a society, are ready for this large scale countrywide post-admission review in almost all cases of involuntary admissions. [sup][3] Unmodified electroconvulsive therapy (ECT) has been totally banned, and ECT to minors can be given only after approval from the board. Many other provisions like those of nominated representative, advance directive etc., are supposed to create an obstacle in the treatment of PMI. The Bill has many positive features as well which, if properly and genuinely implemented, are set to revolutionize mental health care services in our country. The Bill ensures the right of every person to access affordable and good quality mental health services funded by the government. All PMI have the right to equality of treatment, protection from inhuman and degrading treatment, free legal services, right to access their medical records, and right to complain regarding deficiencies in provisions of mental health care. [sup][4] Special emphasis has been given to human rights of PMI, and there is a separate chapter in the Bill for this purpose. The government is mandated to establish good quality mental health services at all levels so as to ensure everyone to have access to mental health care services. Decriminalizing suicide is another welcome feature of the Bill. The single provision, which is supposed to inflict greatest damage to the system of mental health care delivery, is that of bringing all the general hospital psychiatry unit (GHPU) within the ambit of definition of MHE. It will result in moving the clock backwards, so far as the development of psychiatry and mental health care in our country is concerned. In Indian Lunacy Act, 1912, there was no mention of the GHPU. In MHA-1987, "any general hospital or general nursing home established or maintained by the government and which provides also for psychiatric services" were excluded from the ambit of definition "psychiatric hospital/ psychiatric nursing home". Thus, the GHPU established or maintained by the government were exempted from obtaining a "license" for running psychiatric inpatient services. …

Treating Justice Involved Persons with Mental Illness

In this article, we present the results of a preliminary evaluation of a comprehensive treatment program specifically designed to treat co-occurring issues of mental illness and criminal risk in persons with mental illness (PMI) that are criminal justice involved. Participants include 47 incarcerated male PMI in a secure psychiatric prison or a residential treatment facility. Of the 47 participants, 31 (66%) completed the program, attended 94% of all sessions, completed 83% of assigned homework, and actively participated in treatment sessions as evidenced by participation ratings. Change was examined using a four-tiered assessment strategy, including pre–post significance testing, magnitude of effect sizes, clinical cutoffs, and reliable change indices. Results showed evidence of strong therapeutic alliance and treatment program satisfaction, as well as symptom reduction and some evidence for reduced criminal thinking. Program modifications and implications for enhancing service delivery to justice involved PMI are discussed.

Supported Decision-Making for Persons with Mental Illness: A Review

Persons with mental illness (PWMI) are often not afforded the same opportunity to make decisions on a par with others in society. Article 12 of the International Convention on the Rights of Persons with Disabilities (CRPD) states that persons with disabilities should have equal recognition before the law and the right to exercise their legal capacity. Exercising legal capacity can mean making decisions about employment, medical or psychosocial treatment, property, finances, family, and participation in community activities. The aim of this paper is to comprehensively review the evidence on supported decision making for PWMI, both in legislation and research globally, with a focus on low- and middle-income countries (LMICs). Results reveal only a few countries have provisions for supported decision-making for PWMI, with a particular shortage of such provisions in legislation in LMICs There is also a general paucity of research evidence for supported decision-making, with the majority of research focusing on shared decision-making for treatment decisions. This review highlights the need for additional research in this area to better guide models, which can be utilised in domestic legislation, particularly in LMICs, to better implement the ideals of Article 12 of the CRPD.

Dangerous People or Dangerous Weapons

said President BarackObama while trying to console the nation in the wake ofthe January 2011 attempted assassination of Rep GabrielleGiffords in Tucson, Arizona. The shooting at a civic gath-ering left 6 bystanders dead, renewing the politically divi-sivedebateabouttheappropriateresponsetoviolence:bandangerousweaponsorprohibitdangerousindividualsfrompossessing firearms?The public overwhelmingly supports limiting access tofirearms for children, violent criminals, and persons withmental illness, which is consistent with the National RifleAssociation’sinsistencethat“gunsdon’tkillpeople,peoplekillpeople.”Childrenlackthecompetencyandmaturitytouse firearms wisely, whereas most convicted felons have ahistory of violence. Singling out persons with mental ill-ness,however,isfarmorecomplexbecausetheyrepresentabroadspectrumofindividuals,someofwhomalreadyhavebeensubjectedtosocialostracism,butthemajorityofwhomare not violent.TheUSSupremeCourt’srecentdecisionthattheSecondAmendmentconfersanindividual’srighttobeararmsren-dersitincreasinglydifficulttoenactgenerallyapplicablelawsregardingfirearms,butthecourtexplicitlysupports“long-standing prohibitions” on possession of firearms by indi-vidualswithmentalillness.

Effectiveness of an Education Program to Reduce Negative Attitudes Toward Persons With Mental Illness Using Online Media

The purpose of this study was to develop an educational program to reduce negative attitudes toward persons with mental illness (PMIs) using online media and to test its effectiveness. A nonequivalent control group with a pre-posttest was employed in this study. A total of 143 lay people were enrolled. The study variables were knowledge and attitudes about mental illness, and social distance. The four domains of attitudes were authoritarianism, benevolence, social restrictiveness and community mental health ideology. Phase 1: In an attempt to develop an educational program, the researcher conducted interviews with lay people and families of PMIs, and reviewed the pertinent literature. Three mental health professionals were consulted after developing the program. The program consisted of eight sessions. Phase 2: Community mental health ideology differed significantly between groups after the experiment. Knowledge tended to increase in the experimental group, while social restrictiveness showed a tendency to decrease. However, the changes were not significant in either case. Authoritarianism, benevolence, and social distance were not significantly different between groups. There was a significant difference in the pattern of change over time for both groups regarding authoritarianism, benevolence, and social restrictiveness. The program developed here was partially effective at changing negative attitudes. The online video program can be used by community mental health nurses to enhance general knowledge and help reduce stigma.

Mental health courts – a human rights perspective

This presentation analyzes specialised mental health courts (MHCs), as one solution to the long-standing, growing challenge of dealing fairly and justly with persons with mental illness (PMIs) coming before the criminal justice system, from a human rights (HR) perspective. MHCs have garnered professional and political support in North America. Redefining their primary purpose from the determination of fault and the imposition of punishment to the provision of treatment and the enhancement of well-being, to date little consideration has been given to whether the costs of MHCs in terms of de-individualised justice are worth their benefits. As Harris points out, 'sometimes wise policies and practices can have unintended side effects'. And as Thomas Jefferson reminds us, 'the price of liberty is eternal vigilance'. Thus, addressing the HR implications of MHCs should rank highly on its advocates' agendas. Potential HR concerns, arising from MHCs and relating to PMIs essential dignity rights as well as their rights to non-degrading treatment, autonomy, privacy, due process and non-discrimination, will be assessed. Like other writers, the presenter urges that only through respecting PMIs' rights to services and fulfilling society's duty to provide same, and not through MHCs, will PMIs be afforded the full rights that democratic states ought to provide their citizens. The manner in which MDOs are managed (or not) by the multiple services and systems they typically encounter creates a broad measure of dissatisfaction that goes beyond any single jurisdiction or country. Moreover, the sufficient issue overlaps and fundamental commonalities in approaches to the problems faced by MDOs provide a general societal and judicial context for an analysis of MHCs and a related HR discussion, notwithstanding the presenter references the provisions of the European Convention on Human Rights (ECHR) (1950) for her HR analysis.

Mental health triage in the ER: a qualitative study

The London Health Sciences Centre found that its emergency room (ER) mental health services were affected by people presenting with problems that did not require psychiatric intervention. Consequently, a second triage using a crisis worker (CW) was introduced in the ER to identify those persons with mental illness (PMI) who presented for social stressors related to housing, finances and legal issues. A qualitative, process evaluation study was conducted to capture experiences and perceptions of the new triage and CW. Qualitative input was obtained from a broad range of stakeholders in three waves of data-gathering over a 25-month period. This method allowed corroboration of findings from informants with varying interests and backgrounds. The data were collected through interviews, focus groups and surveys. The NUD-ist Qualitative Data Analysis Software Program was used to conduct content analyses. Many PMI seeking ER mental health services are presenting with problems related to social stressors and being referred by the second triage to the CW. The introduction of the second triage CW has had a positive effect on ER functioning, the workload of ER staff and the experience of persons presenting at ER. A defined triage process coupled with the use of psychiatric nursing staff may be applicable to ERs within general hospital settings to improve ER functioning, focus support for PMI and further integrate ERs within the community mental health model.

Pretrial Court Diversion of People with Mental Illness

Court diversion is a method of administering justice compassionately for persons with mental illness (PMI). Evidence-based practices of this intervention were identified by reviewing the existing literature. Findings suggest that: (a) formal case finding procedures are important for the early identification of mentally ill offenders in need of services, (b) stable housing enhances the possibility that the divertee will remain in regular contact with her or his treatment provider, and (c) active case management improves compliance and reduces the likelihood of recidivism. In summary, research has not yet yielded generalizable knowledge about diversion and thus, it is suggested that evaluations should involve well-defined indicators, benchmarks, and outcomes.

Pre‐arrest diversion of people with mental illness: literature review and international survey

Mental health diversion is a process where alternatives to criminal sanctions are made available to persons with mental illness (PMI) who have come into contact with the law. One form of mental health diversion is pre-arrest, in which the police use their discretion in laying charges. Concomitant with the growth of pre-arrest diversion programs is a growing body of research devoted to the phenomenon. The purpose of this paper is to review the existing literature of pre-arrest diversion, and to report the results of an international survey of pre-arrest diversion programs we conducted to identify evidence-based practices. On the basis of our review and survey, we note that successful pre-trial programs appear to integrate relevant mental health, substance abuse and criminal justice agencies by having regular meetings between key personnel from the various agencies. Often, a liaison person with a mandate to effect strong leadership plays a key role in the coordination of various agencies. Streamlining services through the creation of an emergency drop-off center with a no-refusal policy for police cases is seen as crucial. While there is some indication that mentally ill offenders benefit from their participation in this form of diversion, the evaluative literature has not yet achieved the "critical mass" necessary to create generalizable, evidence-based knowledge. The absence of generally agreed-upon outcomes could lead to the inequitable application of basic principles of diversion. We suggest that indicators, benchmarks, and outcomes must be agreed upon if a comprehensive understanding of pre-arrest programs is to emerge.

Design of an algorithm to identify persons with mental illness in a police administrative database

North American police maintain a database to track events and information related to their involvement with the public that contain a series of electronic caution/dependency flags attached to an individual's name for internal communication. To identify persons with mental illness in a police administrative database, an algorithm was developed that was composed of (a) caution/dependency flags, (b) addresses, and (c) key search words indicative of mental illness. Based on the level of confidence of the algorithm, persons with mental illness (PMI) were then assigned to one of three categories: Definite, Probable and Possible PMI. Results for 2000 include the sociodemographic characteristics of PMI and non-PMI in the database. The mean number of contacts, types of interactions, re-involvement with a year, charges and dispositions are described. The algorithm provides a cheap, quick method to identify PMI for North American police. It enables police to monitor the effectiveness of pre-arrest diversion programs and allows researchers to analyze questions of criminalization and mental illness.