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Wetzel, Christine. "Avaliação de serviço em saúde mental: a construção de um processo participativo." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-16052007-150813/.
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Este estudo trata da avaliação de um Centro de Atenção Psicossocial (CAPS), um serviço supostamente funcionando nos moldes apregoados pela Reforma Psiquiátrica Brasileira, a qual, atualmente, na sua vertente assistencial, é marcada pela implantação de serviços substitutivos ao hospital psiquiátrico. A proposta da avaliação centra-se no microespaço e no cotidiano do serviço e ocorre mediante a participação da equipe, usuários e familiares. Trata-se de uma avaliação qualitativa, mediante a qual se busca apreender a dinâmica do serviço, a forma como os atores interagem e os sentidos que constroem em relação à própria prática; uma avaliação que também possa ser dispositivo, permitindo, mediante um processo participativo, que grupos de interesse ampliem a possibilidade de intervir na realidade do serviço, e que possam ser sujeitos, uma vez que em metodologias tradicionais estão excluídos. A Avaliação de Quarta Geração, desenvolvida por Egon G. Guba e Yvona S Lincoln juntamente com o Método Paidéia, desenvolvido por Gastão Wagner de Sousa Campos, foram norteadores do processo teórico-metodológico da pesquisa. Os instrumentos de coleta de dados foram entrevistas com equipe, usuários e familiares e observação. As questões que emergiram no processo avaliativo foram agrupadas em três núcleos temáticos: dimensões do objeto de trabalho, equipe, práticas e os meios de trabalho. Foi constatado que, mesmo que o serviço pareça ser um substitutivo para o atendimento no hospital psiquiátrico, tanto fatores externos, relacionados às políticas locais de saúde mental, quanto fatores internos, relacionados ao cotidiano do serviço, impedem que isso se efetive.This study is about the evaluation of a Center of Psychosocial Care (CAPS), a service supposed to work according to the patterns divulged by the Brazilian Psychiatric Reform which, currently, in its assistance trend, is marked by the implantation of services intended to replace the psychiatric hospital. The evaluation proposal is centered in the micro space and in the day-to-day of the service and is performed by means of the participation of the team, the users and family members. It is about a qualitative evaluation, by means of which one searches to grasp the dynamics of the service, the way how the actors interact and the directions that they construct in relation to the practice itself; an evaluation that can also device, allowing, by means of a participation process, that interest groups broaden the possibility of intervening in the reality of the service and that they may become subjects, considering that in traditional methodologies, they are excluded. The Evaluation of Fourth Generation, developed by Egon G. Guba and Yvona S. Lincoln, together with the Paidéia Method, developed by Gastão Wagner de Sousa Campos, guided the theoretical-methodological process of the research. The instruments for the collection of data were interviews with the team, users and family members as well as observation. The issues that emerged over the evaluation process were grouped in three central themes: dimensions of the work object, the team, practices and the working means. It has been noticed that, even though the service seems to be a replacement for the attendance in the psychiatric hospital, both external factors, related to the local policies of mental health, and internal factors, related to the day-to-day of the service, prevents it from becoming effective.
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Barajas, Brenda, and Iris Monzerrat Espinoza. "SOCIAL WORKERS' PERCEPTIONS ON FACTORS INFLUENCING THE UNDERUTILIZATION OF MENTAL HEALTH SERVICES AMONG LATINO MEN." CSUSB ScholarWorks, 2017. https://scholarworks.lib.csusb.edu/etd/530.
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The purpose of this study is to identify social workers’ perspectives on the barriers and motivating factors impacting Latino men in seeking mental health services, and to seek ways to overcome the barriers. Research has established that Latino men suffer from mental health problems at a similar rate compared to other populations, yet they underutilize mental health services. Given the rapid growth of the Latino population that continues to need mental health services, the findings of this study may influence the social work field to develop programs and interventions that are geared towards encouraging Latino men to seek services. They may also assist in preparing clinicians entering the field. This qualitative study used individual interviews as a tool to find themes from social workers’ point of views on the subject. The results from interviews were transcribed to written document. Major themes identified include barriers, motivating factors, and recommendations for change.
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Baker, Stephanie. "Staff and service user experiences of forensic mental health services." Thesis, University of Warwick, 2017. http://wrap.warwick.ac.uk/90135/.
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This thesis consists of three chapters. Chapter one is a systematic review of the qualitative literature examining the experiences of clinicians working in mental health services with forensic service users (FSU). Following systematic searches and a process of quality assessment, a total of 14 articles were included and their findings were systematically compared. Staff members experienced both positive and negative emotional responses to their work, there are conflicting aspects to their role and additional challenges within the organisational context. Implications for clinical practice and further research are discussed. Chapter two uses Interpretative Phenomenological Analysis (IPA) to consider the experiences of FSUs diagnosed with Personality Disorder (PD) in Forensic Services and the meaning given to recovery within their accounts. The findings discuss the disempowered position of FSU participants and suggest that feeling safe within relationships in their environment is important for those with this diagnosis. There was evidence in their accounts of attempts to establish new identities but there also appeared to be multiple barriers to this. Chapter three offers a reflective account of the researcher’s experience of carrying out this study. It demonstrates the reflexive strategies used that allowed the competing subjective roles alongside that of ‘researcher’, to be examined and their influence on the research process explored.
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Mitchell, Penelope Fay. "Mental health care roles and capacities of non-medical primary health and social care services : an organisational systems analysis /." Connect to thesis, 2007. http://eprints.unimelb.edu.au/archive/00003854.
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Goldberg, Looney Lisa. "Military Service Members’ and Veterans’ Preferred Approach to Mental Health Services." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3608.
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Mental health services are greatly underutilized by military service members and veterans. Among the reasons for this underutilization is that the services offered may not be a good fit for the specific problems facing service members/veterans and/or their families. The current study presented service members with descriptions of several approaches to treatment and asked them to indicate the likelihood of using each. Service members indicated the highest likelihood for using self-directed services, followed by individual treatment with a professional. They reported being least likely to use group approaches. These results may inform decisions about the implementation and dissemination of information about existing and new services.
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Crepaz-Keay, David. "Effective mental health service user involvement : establishing a consensus on indicators of effective involvement in mental health services." Thesis, Middlesex University, 2014. http://eprints.mdx.ac.uk/13932/.
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Mental health service user involvement had been UK government policy since the early 1990s. This dissertation explored the current state of policy and practice in mental health service user involvement by reviewing peer reviewed literature. A number of potential indicators of effective involvement were drawn from the literature. A discrepancy was found between policy and practice and the concept of indicators of effective involvement was proposed to support the process of enabling practice to develop to match policy expectations. A number of approaches to developing indicators were explored, with the explicit aim of introducing greater mental health service user ownership of the concept of effective involvement. In order to ensure both broad engagement and a degree of consensus, the Delphi process was chosen. An expert panel of mental health service users from England was recruited against a person specification co-developed with the National Survivor User Network (NSUN, an England wide, national network led by and for mental health service users). The 38 panel members represented a spread of ages and came from every region of the country. They have experience of and expertise in involvement at a strategic, operational and individual level. The panel completed two rounds of a Delphi process using an online tool. The panel reached consensus on 21 indicators of effective mental health service user involvement. There was a clear preference for collaborative involvement where service users and professionals worked together in a partnership that was as equal as possible. The chosen indicators have already influenced a number of international, national and local initiatives and have been used to support the development national standards for service user involvement in England.
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Pusateri, Cassandra G. "Mental Health Services in Appalachia." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/3160.
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Palmer-Erbs, Jung Victoria Katherine. "Interactive competence and mental health service utilization among the severely mentally ill." Thesis, Boston University, 1992. https://hdl.handle.net/2144/34649.
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Thesis (Ph.D.)--Boston UniversityPLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
The American Psychiatric Association criteria for differential psychiatric diagnoses (DSM III-R) do not exhaust the list of socially problematic behaviors displayed by the mentally ill. The extent to which such behaviors influence a person's "career" as a deinstitutionalized patient is the major topic of this study. Fiscal crises and changing public commitments have reduced support to those with severe mental illness who are deinstitutionalized, increasing the importance of understanding how degrees of competence at activities of daily living and the extent of socially problematic behaviors affect their participation in the community. The concept Interactive Competence was developed on the basis of the writer's clinical experience and a review of the literature on community adjustment of persons with severe mental illness. The concept characterizes the social functioning of persons diagnosed as mentally ill, and includes demonstration of self-care (ADL) skills and self-management skills (trouble in relationships). Secondary analysis was performed on data from a 1984 probability sample of clients in Community Support Programs for seriously mentally ill adults. Factor analysis reduced items in the original instrument, The Uniform Client Data Instrument, to scales measuring Interactive Competence. Only persons with the diagnosis of Schizophrenia or Affective Disorders were studied (n=824 of 1053), excluding diagnoses which were diverse in nature and infrequent in occurrence. Bivariate correlation and regression techniques were used to test the major hypotheses: 1) Schizophrenics demonstrate less Interactive Competence than those with the diagnosis of Affective Disorder; 2) the greater the chronicity (length of time in the social role as a patient from point of first diagnosis) the less Interactive Competence; 3) lower level of Interactive Competence is associated with a lower level of mental health service utilization. Monitoring Interactive Competence self-care (ADL) skills and selfmanagement skills (trouble in relationships) provides new insights about the service utilization of the severely mentally ill and their families. Schizophrenics had less the Interactive Competence than those with Affective Disorders; those with lower scores on Interactive Competence used more services; family involvement influenced clients' use of crisis assistance services and urgent care services.
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Pang, Pui-yan Helen. "An exploratory study of mental health services in Guangzhou /." [Hong Kong : University of Hong Kong], 1991. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13117105.
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Jefferies, Natalie. "Young people moving on from child and adolescent mental health services to adult mental health services." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3715/.
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There is a sound evidence base on the effects of the therapeutic alliance on outcome in psychotherapy for adults. In comparison, there is a smaller amount of literature on the effects of the therapeutic alliance on outcomes for adolescents. Adolescents rarely are seen individually for therapy and instead are often seen by family therapists as part of a system with other members of the family. At present, it is uncertain what the effects of the therapeutic alliance on outcome for adolescents in family therapy are. This paper presents a systematic review that aims to investigate the effects of the therapeutic alliance on outcome in adolescents in family therapy and what factors influence the therapeutic alliance with adolescents in family therapy. A systematic review of electronic databases was carried out using a quality assurance checklist adapted from the American Academy of Neurology Clinical Practice Guidelines (2004). This checklist was used as it assessed aspects of the studies’ theoretical basis, design, measures, analysis and results. Eleven studies met the inclusion criteria and were reviewed. The findings of this review suggest that the therapeutic alliance affects outcome for adolescents in family therapy. The presence of identifiable features of the therapeutic alliance, such as task, goal and bond can strengthen the therapeutic alliance with adolescents. Research into this area is still in its preliminary stages. However, important factors have been identified that affect outcome. Further research is necessary before more substantial claims of the therapeutic alliance on outcome can be made. The limitations of this review are presented, followed by clinical, training and supervision implications and suggestions for future research.
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Harley, Judith Ann. "Mental Health Consumers' Perspectives on Traditional Mental Health Services Versus Peer-Run Services: A Qualitative Study." Ashland University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ashland1352125523.
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Riddington, Megan. "Rethinking rehabilitation : the lived-experience of service users in mental health rehabilitation services." Thesis, University of East London, 2009. http://roar.uel.ac.uk/3736/.
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Introduction: Community-based mental health rehabilitation is increasingly viewed as occupying a central position within the spectrum of care available to people with 'severe mental illness' (DH, 1999, pp.5). The definitions of rehabilitation informing this care primarily originate from service providers; service user understandings and experiences of rehabilitation have been inadequately explored, and the relationship between it and the potentially related concept of 'recovery' has not been examined. This study begins to address these issues by exploring the lived-experience in mental heath rehabilitation services, with specific attention to understandings and experience of rehabilitation. In doing so, it seeks to promote a fuller understanding of rehabilitation, benefiting the development and delivery of services, whilst providing a foundation from which the desirability of a unified definition of rehabilitation can be considered. Method: Semi-structured, audio-recorded interviews were undertaken with eight participants (seven men and one woman) recruited from 24-hour nurse-supported community mental health rehabilitation provisions. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (Smith & Osborn, 2003). Results: Analysis yielded the three master themes of (i) 'Positioning of Power'; (ii) 'Moving Forward' and (iii) 'A Conducive Setting'. Within these themes respectively, the six subordinate themes of (i) 'Control' and 'Meeting Standards', (ii) 'Being Involved in a Process' and 'Independence through Skills' and (iii) 'Relationships, Re-engagement and Togetherness' and 'Nurturing Environment' were identified. Discussion: The analysis is discussed in relation to the extant literature base, with particular focus on relationships, power, independence, and moving on through services. Implications are identified and recommendations for clinical practice and research are considered. Critical review: The study is reviewed with specific attention to its limitations, quality and control, and the impact of researcher factors on the research process.
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Ford, Tasmin Jane. "Services for children with mental health disorders : rates and predictors of service use." Thesis, King's College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.412482.
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Cook, Jacqueline S. "With good intentions: Appalachian service providers in human services and community mental health." Diss., Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/76485.
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This study is a self-assessment of a small group of Appalachian face-to-face service providers in human services and community mental health. It has evolved from their daily experiences. The purpose of the study has been to reflect back to these providers information about themselves. That reflection has been given in the form of an Adlerian life style analysis, a psychological assessment for individuals modified as assessment of a group.
The reflected impression provided its own image for change and an opportunity for the participants to assess what impact, if any, their jobs might be having on other aspects of their lives. In the process of informing the participants about themselves, there has been the intent to give that same information to the people who come for services, supervisors, administrators, policy makers, and ultimately the community of academics and scholars.
The author of this study functioned as a co-worker with the other participants, becoming a part of that system which she was observing. The job gave wide access for observation and work with the participants in a variety of settings. The primary interactions took place in the homes of families referred for alleged child abuse and neglect, to include sexual abuse.
The methodology allowed the research effort to be one of exploration and evolution. Based on the notion expressed by Carol Ehrlich that people can do research for and about themselves rather than having others do it for them, it drew from several theorists, described in order of their use in the study: H.T.Wilson, Brian Fay, Alfred Adler, Stephen Fawcett, and George Gazda.
Presenting one subjective view of reality, conclusions of the study pointed to unconscious guilt on the part of participants with respect to system inadequacies, marked by a desire to feel superior in the helping relationship or in the relationship with those perceived to have authority over them. Unaware of these feelings, and in the simple performance of their jobs, the participants help to perpetuate the systems in which they work and often purport to deplore.Ph. D.
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Woodbridge-Dodd, Kim. "A discursive study of how mental health social workers constructed their professional selves within the context of National Health Service mental health services." Thesis, University of Northampton, 2017. http://nectar.northampton.ac.uk/9721/.
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Since the 1990s there have been continued drives in England to integrate National Health Services and Local Authorities’ social care within a single mental health service, with the aim of bringing about improvements in health and social care (Local Government Association et al., 2016). This is underpinned by the belief that through bringing the different professional health (such as psychiatrists and mental health nurses) and social care disciplines together, people in need will have a single point of access to a range of skills and knowledge, that no one system could deliver alone (Cooper, 2017). However, the very unique professional approaches that have been stated as the reason to place social workers in NHS Mental Health Services have been the ones that mental health social workers have struggled to hold onto in this setting (Allen et al., 2016). This is a thesis of how mental health social workers constructed a professional self within the context of the NHS mental health services. I used a Foucauldian approach and the notion that professional identity is a socially constructed sense of self, produced from discourses, subject positions and a process of subjectification. Twelve social workers were interviewed; seven mental health social workers and five social workers who held positions as managers or educationalists. I asked social workers questions about their professional identity, their answers provided a rich source of ‘talk’ that I could analyse using Parker’s steps to discourse analysis. The findings discuss the nature of social work as a profession, generic and specialist social work, and suggests a typology of subject positions drawn from the mental health social workers’ discourses. These findings provide a useful resource to support critical social work practice, both as an example of how Foucauldian theory and concepts can be a rich toolbox for understanding practice in complex settings, and through the use of the typology of subject positions as a source to prompt self-reflection for mental health social workers’ practice.
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Curtis, Kathryn. "Mental health services and American expatriates." Manhattan, Kan. : Kansas State University, 2008. http://hdl.handle.net/2097/670.
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Murphy, K. "Recovery-orientation in mental health services." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11184/.
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Policy initiatives are calling for mental health services to change their ways of working to prioritising the promotion of service users’ personal recovery. This requires a major re-negotiation of working practices and the relationship between service users and staff/services and their respective social positions. Preliminary research has shown that change has been problematic. The present study aimed to explore the construction of recovery and the positioning of service users and staff during the adoption of recovery-oriented practices in a community support and recovery team. Transcripts of two rounds of focus groups with service users (n=9) and staff (n=5) held six months apart, service user care plans and Recovery Star notes were analysed using a Foucauldian Discourse Analysis. The study found that recovery was constructed as clinical/medical and personal recovery, at different times and in tension with each other. These constructions positioned service users as dependent, passive and hopeless or empowered and hopeful, and staff as helpless or facilitative. It was also apparent that a discourse of personal recovery was not available to service users. Staff oscillated between the constructions of recovery as medical and personal resulting in different subject positions and opportunities for action. The study concluded that adopting a recovery-orientation in services should lead to service users being positioned as more influential in decisions about their treatment and modes of support from the service, and services less likely to dictate their treatment. However, this can only happen if the recovery-orientation constitutes a widely shared discourse with all its assumptions and associated practices. The problematic aspects of the medical discourse and how it can position people socially and how those positions impact on the potential for personal recovery needs to be highlighted.
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Lovell, Jonathan. "Self-disclosure in mental health services." Thesis, University of York, 2017. http://etheses.whiterose.ac.uk/19278/.
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Sharing lived experience of mental health experiences by mental health practitioners is a topic of increasing relevance in statutory UK mental health settings, in part because of the rise in recent years of the employment of peer workers who share their lived experience by default. Literature to date has suggested that self-disclosure can have a range of benefits and risks, but existing studies have tended to focus on general rather than mental health disclosure, have not taken place in statutory settings, have studied a narrow section of the workforce, or have used analogue methodology. The current study used quantitative and qualitative methods through surveys and focus groups to explore statutory UK mental health practitioners’ and service-users’ views about the helpfulness of sharing personal mental health lived experience versus other types of lived experience. Service-users indicated that personal mental health lived experience was the most helpful disclosure topic, was valued when disclosed by all types of qualified practitioner, but it was shared least often. Practitioners who rate disclosure as helpful may be more reflective than practitioners who rate disclosure as unhelpful. Practitioners may be deterred from disclosing by a range of pressures, including risk of negative disclosure effects; adherence to therapeutic models; negative judgements from colleagues; pre-qualifying training; and perceived direction from professional codes of conduct and ethics. Despite perceived risks associated with hypothetical disclosure, most practitioners disclosed to some extent. Respondents gave almost 500 examples of real life disclosures which were almost exclusively helpful. It is recommended that practitioners are afforded greater autonomy, respect and permission to make decisions about disclosure without fear of judgment about professionalism. Training and guidance may be beneficial to help practitioners make best use of disclosures in statutory mental health service delivery.
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Jones, Siobhan. "Adolescent engagement in mental health services." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14807/.
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Despite older adolescence being a risk period for the development of mental health concerns, mental health service engagement is low amongst 16-18 year olds. As therapeutic attendance is linked to clinical outcome, it is important to understand engagement in this population. There is a paucity of research looking specifically at the older adolescent engagement phenomenon. Previous qualitative research into adolescent experiences has provided rich and detailed results. Ten 16-18 years olds, engaged in Child and Adolescent Mental Health Services, were recruited from two London-based services. Each young person was interviewed in order to understand their personal experience of engaging in mental health services. Interviews were transcribed and underwent Interpretative Phenomenological Analysis. Analysis produced twelve subthemes subsumed within five superordinate themes: engagement begins at help seeking, strength of inner resolve, evolution of the self, in the clinic room, and, existing within service walls: physical and policy-based boundaries. Themes are discussed in detail. Conclusions are drawn in relation to previous theory and research. When considering 16-18 year understandings of the engagement phenomena, key elements include: clinician and service developmental appropriateness, negotiation of developmental tasks in relation to engagement, experience of the physical building environment, and awareness of service policy limitations. Suggestions for clinical practice in relation to engagement facilitators and threat are made, and recommendations for future research proposed.
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D'Antonio, Pamela L. "Deinstitutionalization and its implications on mental health emergency services in Berks County." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1993. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1993.Source: Masters Abstracts International, Volume: 45-06, page: 2937. Abstract precedes thesis title page as [2] preliminary leaves. Typescript. Includes bibliographical references (leaves 59-61).
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Sandbulte, Natalie J. "Rural communities and mental health care." Theological Research Exchange Network (TREN), 2007. http://www.tren.com/search.cfm?p088-0180.
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Aristidou, Angela. "Theorizing service user transitions through a relational practice perspective : insights from a study in the context of mental health services." Thesis, University of Cambridge, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708965.
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Aschan, Lisa. "Health inequalities and mental health service use in mental-physical comorbidity." Thesis, King's College London (University of London), 2015. https://kclpure.kcl.ac.uk/portal/en/theses/health-inequalities-and-mental-health-service-use-in-mentalphysical-comorbidity(6f2c678e-1d94-40c0-9622-333539e46c4b).html.
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Although mental and physical health are likely to share common social causes, most mental-physical comorbidity research has focused on immediate mechanisms between mental and physical illness. This thesis takes a social epidemiological approach to mental-physical comorbidity, where social disadvantage and the disproportionate availability of resources are central. The amplified burden of comorbidity in terms of poor health and functioning may have implications for the relationship between comorbidity and mental health service use (MHSU). Whilst much research examines the impact of comorbidity on physical health services, MHSU is under-researched. Furthermore, comorbidity inequalities may be perpetuated through processes of cumulative disadvantage. For example, barriers to social participation may deplete resources over time, thus leading to worse health outcomes and more adverse social circumstances. This project therefore aims to: 1. Estimate the prevalence of comorbidity, and describe inequalities in mental-physical comorbidity by key socio-demographic and socioeconomic factors 2. Describe and explain the association between comorbidity and mental health service utilisation and quality 3. Describe the trajectories of social functioning by comorbidity Analyses make use of survey data from the South East London Community Health Survey (SELCoH) phases 1 (N=1698) and 2 (N=1052) (73% response among those approached at follow-up). Statistical methods used include weighted cross-sectional and longitudinal regression analyses. The results indicate that comorbidity is associated with distinct socio-economic inequalities (most consistently by household income), increased MHSU over time, and persistent social exclusion. This suggests that comorbidity reflects a process of cumulative disadvantage, which has important implications for comorbidity and health inequality research, and local services and policy makers. Altering the downward spiralling trajectories of health and social disadvantage among those with mental-physical comorbidity may be addressed through integrated care models, while interventions aimed at reducing social inequalities may effectively 3 prevent comorbidity and interrupt its downward spiralling course of disadvantage.
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Kipping, Cheryl Joan. "Stress and coping in mental health nurses." Thesis, King's College London (University of London), 2000. https://kclpure.kcl.ac.uk/portal/en/theses/stress-and-coping-in-mental-health-nurses(233e7fff-f064-48c0-b626-4ff18eef9e40).html.
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Ohaeri, Frances Ahunna. "Parental satisfaction with child mental health services." CSUSB ScholarWorks, 2008. https://scholarworks.lib.csusb.edu/etd-project/3343.
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The purpose of this study was to identify to what degree specific factors influence the level of satisfaction experienced by foster parents whose foster children are recieving mental health services from agencies that they have been referred to by a Coming of Age Foster Family Agency.
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White, Bradley Patrick. "Mental Health and Mental Health Treatment Experiences of Transgender and Gender Diverse Persons:." Thesis, Boston College, 2021. http://hdl.handle.net/2345/bc-ir:109141.
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Thesis advisor: Susan Kelly-WeederBackground: Stigma, discrimination, and victimization are common occurrences in the lives of TGGD persons (e.g. non-binary, genderqueer, agender, and other non-cisgender identities) in the U.S., including occurrences in healthcare settings. Additionally, TGGD people in the U.S. experience numerous disparities related to physical health, mental health, substance use, and health risk behaviors. Suicide prevalence data provide the strongest and most urgent indication that healthcare organizations, and mental health providers specifically, are not optimally meeting the needs of this marginalized, at-risk population. TGGD persons have experiences of stigma and discrimination in healthcare settings, and these experiences are directly associated with provider behaviors, staff cultural competence, and institutional policies/practices. Minority Stress Theory suggests that experiences of stigma are directly linked to health outcomes and health disparities. It also suggests disparities may be mitigated by one’s internal coping skills and by level of support available from affirming others. Purpose: This dissertation’s research sought to better understand the relationship between stigma/discrimination and sexual/gender minority (SGM) population health and to better understand the experiences of TGGD persons who receive mental health services in the United States. Therefore, this dissertation begins to address this critical need and fill the gap in science. Three discrete manuscripts are proposed to fully explicate three concepts: 1) How state-level policies may affect SGM mental health (a secondary data analysis); 2) A comprehensive understanding of TGGD persons’ mental healthcare experiences (an integrative review); and 3) TGGD persons’ inpatient mental healthcare experiences (a qualitative study). Methods: First, we conducted a secondary data analysis examining state-level inclusivity for SGM populations, and relationships with indicators of mental health and health risk behaviors in those states; we sought to determine whether and to what extent there is a relationship between states’ SGM policies and practices, and the mental health and health risk behaviors of those states’ SGM residents. Second, we conducted an integrative review examining the mental health treatment experiences of TGGD adults; we sought to synthesize and characterize the existing health literature regarding the mental health experiences of TGGD adults. Third, we conducted a qualitative descriptive study examining the inpatient mental health and substance disorder treatment experiences of TGGD adults; we sought to better understand the inpatient mental health and/or substance treatment experiences of TGGD persons and to identify and characterize facilitators of/barriers to gender-affirming care in inpatient mental health and/or substance treatment settings. Results: In Chapter Two of this dissertation, an ecological secondary analysis of the BRFSS data set showed statistically significant relationships between LGBTQ persons’ state of residence and self-reported mental health symptoms and risk behaviors of the LGBTQ persons who live there. Restrictive state policy environments were shown to function as a distal stress factor and inclusive state policy environments were shown to function as a resilience factor. In Chapter Three of this dissertation, integrative review results suggest that TGGD persons experience incidents of stigma and discrimination in mental health treatment settings. In Chapter Four of this dissertation, participants reported both stigmatizing aspects and welcoming/affirming aspects of inpatient mental health/substance treatment experiences. Conclusions: This dissertation explored the mental health of TGGD persons through a Minority Stress Theory conceptual framework, including potential distal stress factors, proximal stress factors, and resiliency factors. This program of research has made substantial and meaningful contributions towards an enhanced understanding of TGGD mental health experiences, sources of TGGD stigma, and sources of coping/resiliency. In each chapter, findings suggested the presence of MST concepts of distal stress factors, proximal stress factors, and resiliency factors. Nursing remains underrepresented in health literature, and dissertation results highlight ample opportunities to advance TGGD population health through nursing practice, nursing education, nursing scholarship, and nursing policy
Thesis (PhD) — Boston College, 2021
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Jormfeldt, Henrika. "Dimensions of Health among Patients in Mental Health Services." Doctoral thesis, Lund University, Sweden, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-16873.
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Empirical studies focusing on the subjective experience of health among patients in contact with the mental health services are rare and most questionnaires are based on a medical model that emphasizes objectively observed disease-oriented health indicators. In studies I and II perceptions of the concept of health among patients and nurses in mental health services were explored and described using a phenomenographic approach. The perceptions and description categories that emerged from these studies were transformed into a number of items forming a questionnaire intended to measure subjectively experienced health among patients in mental health services. In study III, a randomly selected sample was used to test the psychometric properties of the new Health Questionnaire. A factor analysis revealed three factors labelled Autonomy, Social Involvement and Comprehensibility. The purpose of study IV was to examine the construct validity of the Health Questionnaire. The hypothesis was that subjectively experienced health would be positively associated to self-esteem, empowerment and quality of life, and negatively associated to psychiatric symptoms, perceived stigmatization experiences and perceived attitudes of devaluation and discrimination. This hypothesis was mainly confirmed insofar that overall health was positively correlated to self-esteem, empowerment and quality of life and negatively correlated to symptoms, attitudes of devaluation and discrimination and rejection experiences. The results of this thesis show that health is more than just an absence of disease and support a focus on health promotion interventions in mental health care.Medicine doktorsexamen
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Foster, Juliet L. "The social representations of mental illness held by clients of the mental health services." Thesis, University of Cambridge, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270929.
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Iveson, Claire. "From primary care to mental health services:." Thesis, University of Liverpool, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490634.
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Beecham, Jennifer Kate. "Community mental health services : resources and costs." Thesis, University of Kent, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319222.
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McGill, Fox Eileen. "Mental health services and late-onset depression." Manhattan, Kan. : Kansas State University, 2009. http://hdl.handle.net/2097/2361.
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Belt, Leslie Marie, and Leslie Paul Schellbach. "Perceptions of mental health services among marines." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3141.
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Soto, Sally Alejandra. "Utilization of Mental Health Services Among Hispanics." CSUSB ScholarWorks, 2016. https://scholarworks.lib.csusb.edu/etd/359.
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ABSTRACT
In the United States, Hispanics have the same prevalence of mental illness as any other group however researchers have found that they are less likely to seek mental health services. This population’s lack of mental health utilization is due to various barriers hindering the population’s need for help, a substantial for social work practitioners. To better understand the factors that lead up to that, the current study explored and identified perceptions toward seeking and receiving mental health services among Hispanic members. Using a qualitative data collection, ten participants were interviewed to elicit their perceptions about mental health services ranging from what they believed addressed their lack of seeking services and what they thought about services. Data analysis revealed five core themes among the participants’ responses: Closeness to Family as a reason for people not seeking professional help. Another theme found was environment as a reason for Mental Illness making them feel that there is no need to seek services since they can simply remove the environmental stressor and the illness will seize to exist. Existing support systems were found such as involvement in church as a form of therapy, they talked about their faith providing them a form of support for stressors. Shared culture was a theme that was found to be a necessity for therapy, they felt they did not seek services because they felt mental health practitioners would not validate their culture. The final theme was access and that theme encompassed : not knowing mental health services existed in their community, to lack of Spanish speaking clinicians. The recognition of these themes could potentially guide social work practitioners’ when they are trying to engage the Hispanic community to receive mental health services. Social workers can be aware of the obstacles toward engaging this population into professional therapy, by having an understanding of what they believe about therapy and helping to alleviate or use some of those perceptions as a form of engagement and validating existing strengths that the population has causing them to feel professional services are not needed.
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Rodriguez, Adriana. "Stakeholder Views on Children’s Mental Health Services." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2891.
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Identification of evidence-based treatments (EBTs) has been an important development; however recently, some shortcomings of the approach have been highlighted. These complexities have led to a surge in transportability research in mental health services science with goals of identifying needed strategies to encourage the adoption of innovations. The mental health system ecological (MHSE) model is an approach necessary to assist with closing this gap effectively as it integrates mental health contexts: client-level, provider-level, intervention-specific, service delivery, organizational, and service system characteristics. The aim of this study is to use the MHSE model to examine perspectives of mental health stakeholders on their needs. Data consists of qualitative transcripts from parent, therapist, and administrator interviews/focus groups. Mixed methods were used to develop and analyze codes according to the MHSE model. Results suggested that stakeholder groups mentioned needs relevant to the group of interest and thus have implications for future dissemination efforts.
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Dixon, Decia Nicole. "Mental health service delivery systems and perceived qualifications of mental health service providers in school settings." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0002991.
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Prior, Pauline Mary. "Mental health policy in Northern Ireland 1921-1991." Thesis, University of York, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.306559.
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Muga, Florence Adhiambo. "Community mental health in Kenya : an improbable dream?" Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263918.
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Roberts, Nicola. "Using attachment theory within mental health community services to improve patient outcomes and reduce service utilisation costs." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/using-attachment-theory-within-mental-health-community-services-to-improve-patient-outcomes-and-reduce-service-utilisation-costs(78a9832e-0e8f-4d2b-a6a4-8d7ffdf5aa6d).html.
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This thesis follows the paper-based format and papers one and two have been prepared for submission to Attachment and Human Development and the British Journal of Clinical Psychology, respectively. The relevant submission guidelines are included in the appendices (Appendix A and B).Attachment theory (Bowlby, 1977a) has prompted a wealth of empirical research in its contribution to adult attachment patterns and subsequent psychopathology in mental health (Holmes, 2001; Wallin, 2007). More recently, attachment theory has been proposed as a suitable framework by which to inform the organisation, design and delivery of mental health services (Goodwin, 2003; Seager et al., 2007) but it is unclear what this would look like in practice. Adopting an attachment-informed service model has key implications for individual and service outcomes and the two papers presented in this thesis aim to contribute to research in this area, followed by a critical review of the research, its relevance and future implications. Paper one is a narrative overview of the literature discussing the practice implications of services adopting an attachment-informed framework, and describes how this might be conceptualised in front-line service delivery. Articles reviewed described the influence of attachment theory in predominantly inpatient, secure forensic and/or psychiatric rehabilitation services, and its application within more generic community mental health services was explored. Paper two aimed to investigate the importance of individual attachment and service attachment to client psychopathology, quality of life, service utilisation and service costs in community-based mental health services. The final section, the Critical Review, critiqued the literature review and aimed to place the research within a wider context. This section considers the findings from the research and the limitations of the study, while also highlighting important issues for services, with implications for clinical practice and future research.
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Senior, Jane. "The development of prison mental health services based on a community mental health model." Thesis, University of Manchester, 2005. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:85467.
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NeeSmith, David Hagan. "Committed and voluntary psychiatric patients a longitudinal comparison of commitment patterns among first-time inpatients in the Oklahoma mental health system /." Access abstract and link to full text, 1993. http://0-wwwlib.umi.com.library.utulsa.edu/dissertations/fullcit/9403630.
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Eldridge, Sarah Marie. "The Barriers To Mental Health Services: How Facility Factors Impact Perceived Barriers To Mental Health Services In Nursing Facilities." Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1409246124.
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Fernandes, Juliana Cristina. "A prática social na saúde mental." Pontifícia Universidade Católica de São Paulo, 2017. https://tede2.pucsp.br/handle/handle/20630.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
The Psychiatric Reform, instituted as national policy in 2001, restructured mental health care in the country under the legal, political, social and care aspects. The reform brought the establishment of a network of assistance replacing the asylum system, with emphasis on the creation of Psychosocial Care Centers (PSCC). Guided by the community logic of social inclusion of people with mental disorders, PSCC should prioritize citizenship, access to rights and social participation of its users. However, due to the past of the treatment of mental health in the country, the stigma that falls on the population with mental disorders and in function of the political, social and economic context of the population that uses mental health services, the consolidation of the psychiatric reform and the accomplishment of appropriate social practices within the health services still face great difficulties. At that, the objective of this research was to study and analyze the social practices of the PSCC teams in relation to the social demands of users of these services, in a municipality of the state of São Paulo. This qualitative research considered the multidimensionality of the object of study, focusing in the 'making’ of the multi-professional teams, on the variety of social situations presented to them routinely. During the research, in-depth interviews were conducted with professionals from different training areas, as well as a discussion group and cursive observations of the work processes of the referred teams. We tried to examine the meanings attributed to the social; the social practices effectively implemented and its elaboration/execution dynamics. The conclusion was that the tutelary and “assistencialism” or “social handout” dimensions still appear in the social practices of the services addressed, although they appeared in a diluted and re-signified way by the professionals. The advancement of practices aimed at citizenship and the access to social rights of service users remain a major challenge in terms for the insertion of madness in contemporary society
A Reforma Psiquiátrica, instituída como política nacional em 2001, reestruturou a assistência em saúde mental no país sob os aspectos jurídicos, políticos, sociais e assistenciais. A reforma trouxe o estabelecimento de uma rede de assistência substitutiva ao aparato manicomial, com destaque para a criação dos Centros de Atenção Psicossocial (CAPS). Orientados pela lógica comunitária de inserção social das pessoas com transtorno mental, os CAPS devem priorizar a cidadania, o acesso aos direitos e participação social de seus usuários. No entanto, em função do histórico do tratamento da saúde mental no país, do estigma que recai sobre a população com transtornos mentais e em função do próprio contexto político, social e econômico da população usuária dos serviços de saúde mental, ainda são grandes as dificuldades para a consolidação da reforma psiquiátrica e para concretização de práticas sociais condizentes no interior dos serviços de saúde. Diante disso, esta pesquisa teve como objetivo estudar e analisar as práticas sociais das equipes dos CAPS em relação às demandas sociais dos usuários em um município do estado de São Paulo. De natureza qualitativa, a investigação considerou a multidimensionalidade do objeto de estudo, focando ‘o fazer das equipes multiprofissionais’ na variedade de situações sociais que lhes são apresentadas cotidianamente. Foram realizadas entrevistas aprofundadas com os profissionais de distintas áreas de formação; grupo de discussão e a observação cursiva dos processos de trabalho das referidas equipes. Procuramos examinar os significados atribuídos ao social; as práticas sociais realizadas efetivamente; assim como suas dinâmicas de elaboração/execução. Concluímos que as dimensões tutelares e assistencialistas ainda aparecem nas práticas sociais dos serviços abordados, ainda que maneira diluída e ressignificada pelos profissionais. O avanço das práticas voltadas para a cidadania e acesso aos direitos sociais dos usuários dos serviços permanecem sendo um grande desafio para a inserção da loucura na sociedade contemporânea
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Gault, Iris Isobel. "Service user and carer perspectives on medication compliance in mental health services: a qualitative study." Thesis, St George's, University of London, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.589951.
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This qualitative study analyses mental health service-user and carer perspectives on medication compliance and experience of compulsory treatment. Data were generated from interviews and focus groups with twenty four mental health service users/carers with a history of repeated admission under the Mental Health Act (1983) due to medication non- compliance. The research is set against the background of changes to mental health legislation in England, including Supervised Community Treatment. It makes use of the data generation and analytical techniques of grounded theory. Analysis of data indicated considerable confusion and paradox in the policy and practice context of contemporary mental health care. Eight initial categories emerged from qualitative interview and focus group data. These were the experience of desperation meeting with what is perceived as professional indifference; loss of a credible identity; playing the game; medicalisation of experience; meeting therapeutic competence; enabling collaboration; or alternatively, meeting therapeutic incompetence; disabling collaboration. Findings suggest that service users are initially reluctant to comply with mental health medication, but eventually accept the need for treatment. They actively seek out services providing acceptable care but avoid those offering unacceptable care. Categories were subsumed into a core category of Negotiating the Janus Face of Mental Health Care to develop substantive grounded theory. This explains how mental health service users who have had compulsory treatment manage their experiences of positive or negative care. It stresses the significance of mutually respectful relationships with professionals and the importance of communicative competence. Macro and micro elements of these findings were further analyzed within the Habermasian framework; the Theory of Communicative Action, evolving into Negotiating the Janus Face of Mental Health Care to Locate Communicative Action. This explains how service users seek professionals working in communicative and collaborative mode. The thesis concludes by addressing implications and recommendations for policy, practice, education and research. Keywords: compulsory medication, coercion, medication, compliance, concordance, supervised community treatment and grounded theory.
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Zendron, Patricia Fernanda Dimas. "Satisfação de familiares cuidadores de pacientes portadores de transtornos mentais com um serviço de saúde mental de um município do interior paulista." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-14012014-145607/.
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Diante das profundas mudanças na assistência em saúde mental é de suma importância que a família seja inserida no processo terapêutico. Desta maneira urge a necessidade de se verificar quais são suas necessidades e avaliar sua satisfação em relação ao atendimento dispensado pelo serviço de saúde mental a seu familiar doente. Objetivo: verificar a satisfação de familiares cuidadores de pacientes portadores de transtornos mentais com um serviço de saúde mental e seus fatores associados. Método: Trata-se de um estudo transversal, exploratório descritivo realizado junto a 36 familiares cuidadores de portadores de transtornos mentais em um município do interior paulista. Foi aplicado um questionário sociodemográfico e clínico elaborado pela pesquisadora e em seguida, a Escala de Avaliação da Satisfação dos Familiares com os serviços de saúde mental (SATIS-BR- Forma abreviada). Todas as questões éticas foram respeitadas. Os dados foram analisados por meio de estatística descritiva com a utilização de frequência, porcentagem e desvio padrão e a correlação entre as variáveis foi verificada por meio de testes não paramétricos. Foi considerado o nível de significância alfa = 0,05. Foi utilizado o programa SPSS versão 19.0. Resultados: A maioria dos familiares cuidadores é do sexo feminino; de religião católica; não trabalham; escolaridade de primeiro grau incompleto; casados; com idade média de 45,58 anos e somente 22,22% referiram receber algum tipo de atendimento do serviço de saúde mental. Com relação aos dados clínicos dos pacientes: tempo médio de doença de 13,11 anos; tempo de tratamento de 6,15 anos; a maioria referiu que seu familiar recebe três tipos de atendimento no serviço e os diagnósticos referidos com maior frequência foram Esquizofrenia e Depressão. A maioria dos familiares estava satisfeita ou muito satisfeita em relação ao serviço de saúde mental. Foi verificada correlação significativa e positiva entre o conhecimento dos familiares cuidadores a respeito do tratamento de seu familiar e a satisfação. Considerações Finais: Ressalta-se a necessidade de serem realizados estudos sequencias e contínuos nos serviços para que haja constante reavaliação, aprimoramento e qualificação da assistência em saúde mental. O presente estudo retrata um único serviço, de modo que dada as particularidades colabora para o conjunto, mas seus resultados não podem ser usados para tecer generalizações. Este estudo cumpriu seu objetivo de avaliar a satisfação de familiares cuidadores de portadores de transtornos mentais com relação a um serviço de saúde mental, por meio da aplicação da escala SATIS-BR. Percebe-se que o nível de satisfação atingiu níveis altos, entre satisfeito e muito satisfeito, o que demonstra que o serviço de saúde mental avaliado segue os preceitos da RAPS e da PNSMGiven the profound changes in mental health care is extremely important that the family be entered into the therapeutic process. Thus there is an urgent need to check what your needs are and evaluate their satisfaction with the care provided by mental health service to your family sick. Objective: To verify the satisfaction of family caregivers of patients with mental disorders with a mental health service and its associated factors. Method: This was a cross- sectional, descriptive exploratory conducted with 36 family caregivers of people with mental disorders in an interior city. We administered a sociodemographic and clinical questionnaire prepared by the researcher and then was applied to Rating Scale Family satisfaction with mental health services (SATIS-BR-short form). All ethical issues were observed. Data were analyzed using descriptive statistics using frequency, percentage and standard deviation, and correlation between variables was verified by nonparametric tests. It was considered the significance level alpha = 0.05. We used SPSS version 19.0. Results: The majority of family caregivers are women, Roman Catholics, do not work; incomplete elementary schooling, married, with an average age of 45.58 years and only 22.22% reported receiving some type of care service mental health. Concerning to the clinical data of patients: mean disease duration of 13.11 years; treatment time of 6.15 years, the majority reported that their family receives three types of calls in service and the most commonly reported diagnoses were schizophrenia and depression. Most families were satisfied or very satisfied compared to the mental health service. It was observed a significant positive correlation between the knowledge of family caregivers regarding the treatment of his family and satisfaction. Final Thoughts: We emphasize the need for studies in continuous threads and services so there is constant re- evaluation and qualification improvement of mental health care. This study portrays a unique service so that given the particular contributes to the whole, but their results cannot be used to weave generalizations. This study accomplished his goal of evaluating the satisfaction of family caregivers of people with mental disorders in relation to a mental health service, through the application of the scale SATIS-BR. It is noticed that the level of satisfaction reached high levels, between satisfied and very satisfied, which demonstrates that the mental health service rated the precepts of RAPS and PNSM
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Graeff-Martins, Ana Soledade [UNIFESP]. "Serviços de saúde mental para crianças e adolescentes: recomendações para o planejamento de políticas públicas de saúde mental." Universidade Federal de São Paulo (UNIFESP), 2010. http://repositorio.unifesp.br/handle/11600/10077.
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Previous issue date: 2010-04-28BV UNIFESP: Teses e dissertações
Introdução Existem claras evidências do impacto social e econômico dos transtornos de saúde mental iniciados na infância e na adolescência e da ineficácia dos sistemas de saúde para lidarem com o problema até o momento, na maioria dos países. É urgente o estabelecimento de políticas públicas embasadas por dados epidemiológicos que promovam maior acesso a serviços de qualidade, coordenação entre os diversos setores que recebem crianças e adolescentes com problemas de saúde mental e financiamento regular para o funcionamento do sistema. Uma das questões fundamentais a ser aprofundada para o planejamento de políticas na área de saúde mental de crianças e adolescentes é o acesso a serviços e os fatores relacionados. Objetivos Revisar os achados de pesquisas acerca da prevalência de uso de serviços de saúde mental por crianças e adolescentes, e os fatores associados ao uso. Descrever os problemas metodológicos dos estudos e propor um modelo conceitual para ser utilizado em pesquisas futuras. Estimar a prevalência de uso de serviços de saúde mental e os fatores associados em uma amostra comunitária de estudantes. Identificar os fatores associados com a presença de componentes de saúde mental e o padrão de encaminhamento de alunos com problemas em instituições de ensino de quatro localidades de um estado da região sudeste do Brasil. A partir dos resultados, fazer recomendações para o planejamento de políticas públicas de saúde mental para crianças e adolescentes. Métodos 1) Busca sistemática de artigos na literatura que relatassem prevalência de uso de serviços de saúde mental em amostras não-referidas de sujeitos até 18 anos. 2) Uma amostra estratificada e aleatória de 6986 alunos foi avaliada quanto ao uso de serviços de saúde mental na escola e fora da escola, fatores sócio-demográficos, níveis de exposição ao atentado ao World Trade Center, provável diagnóstico psiquiátrico e ter falado com pais, professores e líderes religiosos sobre o ataque. 3) Foram entrevistados os responsáveis por todas as escolas especiais e por uma amostra aleatória das escolas regulares de quatro localidades do Rio de Janeiro. Por meio de uma entrevista estruturada, foi constada a presença de profissionais ou ações de saúde mental nas instituições e possíveis fatores associados. Resultados 1) Foram examinados 174 artigos na íntegra e 56 foram incluídos na revisão. Foi observada grande variabilidade nas taxas de prevalência de uso de serviços de saúde mental. Os fatores relacionados ao uso de serviços foram listados. 2) 17.1% dos alunos fizeram uso de serviços de saúde mental, mais na escola do que fora. Uso de serviços de saúde mental na escola está associado a ter falado com o professor sobre o atentado. Uso de serviços de saúde mental fora da escola está associado à exposição direta ao atentado, exposição prévia a eventos traumaticos, provável diagnóstico de depressão maior ou transtorno de estress póstraumático e a ter falado com o professor e com líder religioso sobre o atentado. 3) Componentes de saúde mental em escolas parecem estar relacionados à localidade em que a instituição está situada, serem mais frequentemente encontrados em creches e pré-escolas e em instituições que possuem componentes de outros setores de cuidado (saúde geral, justiça e assistência social). Os encaminhamentos dos alunos com problemas de saúde mental ocorrem mais nas escolas com componentes de saúde mental, para recursos da própria instituição. Conclusões É possível estabelecer um modelo conceitual para a pesquisa de uso de serviços de saúde mental por crianças e adolescentes, e algumas orientações são sugeridas quanto aos métodos. Políticas públicas na área de saúde mental de crianças e adolescentes devem incluir medidas que promovam o treinamento de profissionais que têm contato frequente com crianças e adolescentes, como professores, pediatras, médicos de família, enfermeiras, etc.; e campanhas de conscientização do público sobre os problemas de saúde mental de crianças e adolescentes. A provisão de serviços de saúde mental no ambiente escolar também deve ser considerada.
Introduction There is clear evidence of social and economic impact of mental health disorders started in childhood and adolescence and of the inefficiency of health systems to deal with the problem in most countries. Public policies based on epidemiological data are urgently needed to promote greater access to services, coordination among the various sectors that receive children and adolescents with mental health problems and regular funding for systems. One of the key issues to be studied for planning policies in mental health of children and adolescents is access to mental health services and related factors. Objectives The aims of this study are: to review research findings on the prevalence of mental health services use by children and adolescents and factors associated; to describe the methodological problems of studies and propose a conceptual model to be used in future research; to estimate the prevalence of mental health services use and associated factors in a community sample of students; and to identify factors associated with the presence of components of mental health and the pattern of referral of students with problems in educational institutions from four localities in a state of southeastern Brazil. Recommendations for public policies on mental health for children and adolescents will be done. Methods 1) A systematic review of articles in the literature was performed, to identify studies that reported the prevalence of mental health services use in non-referred samples of subjects up to 18 years old. 2) A stratified random sample of 6986 students was assessed regarding mental health service use in school and out of school, sociodemographic factors, different levels of exposure to the attack, probable psychiatric diagnosis and having talked to parents, teachers and religious leaders about the attack. 3) Responsibles for all special schools and a random sample of regular schools in four areas of Rio de Janeiro State were interviewed about the presence of mental health professionals or procedures in the institutions and associated factors. Results 1) 174 full-text articles were examined, and 56 studies were included in this review. Great variability of mental health services use prevalence rates ! 5 was found. Factors related to services use were listed. 2) 17.1% of the sample had used mental health services, more in schools than out. Mental health service use in school was associated to having talked to teacher about the attack. Mental health service use out of school was associated to direct exposure to the attack, previous exposure to traumatic events, probable diagnosis of major depressive disorder and posttraumatic stress disorder and having talked to teacher and religious leader about the attack. 3) The presence of mental health professionals or procedures in schools seems to be associated to the area in which the institution is located, are more often found in nurseries and pre-schools and institutions that have professionals or procedures of other sectors of care (general health, justice and welfare). Referrals of students with mental health problems occur more frequently in schools with professionals or procedures of mental health, to the resources of the institution. Conclusions It is possible to establish a conceptual model for research on mental health services use by children and adolescents, and some methodological guidelines are suggested. Public policies on mental health of children and adolescents should include measures to promote training of professionals who are in frequent contact to children and adolescents, as teachers, pediatricians, family physicians, nurses, etc., and public awareness campaigns on children and adolescents mental health. The provision of mental health services in school environment should also be considered.
TEDE
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Birmingham, Luke Stephen. "The mental health of newly remanded prisoners, the prison reception health screen and the resulting management of mental disorder at Durham prison." Thesis, University of Newcastle Upon Tyne, 1998. http://hdl.handle.net/10443/600.
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Recent cross-sectional studies have confirmed that the prevalence of mental disorder in English prisons is high but they provide little insight into the fate of the mentally disordered in prison. This thesis concentrates on a longitudinal study of mental disorder in 569 unconvicted adult male remand prisoners received into Durham prison between 1 October 1995 and 30 April 1996. Subjects were interviewed at reception by psychiatric researchers and monitored throughout the remand period. The data collected was used to establish the prevalence of mental disorder and substance misuse at reception into prison, effectiveness of prison reception screening, number of mentally disordered subjects identified and referred for psychiatric assessmentn, ature of psychiatric interventions, and final disposal of all subjects. Additional research was undertaken at Durham to evaluate health care provision at this prison, and, in order to comment on the generalisability of the findings, health care facilities at other prisons in England and Wales were investigated. More than a quarter of subjects at Durham prison were suffering from mental disorder. Serious disorders were especially prevalent and one in twenty remands was acutely psychotic. Drug and alcohol misuse was the norm. More than half of our subjects received current substance abuse or dependence diagnoses. Prison reception screening failed to identify nearly 80% of subjects with mental disorder, including 75% of those with acute psychosis. The treatment needs of the majority of mentally disordered subjects were overlooked in prison. Just over one quarter of mentally disordered subjects were referred for a psychiatric assessment. Contact with psychiatric services was frequently hampered by the prison regime and the actions of the courts. This resulted in acutely psychotic prisoners being released without adequate treatment or follow-up. Help for prisoners with drug and alcohol related problems was minimal. Detoxification regimes were insufficiently prescribed leaving the majority of subjects addicted to opiates, benzodiazepines and alcohol at risk of serious withdrawal. Inadequate resources, a lack of suitably trained health care staff, low morale and staff sickness hampered the delivery of effective health care at Durham prison. However, staff attitudes, institutionalised practices and negative responses from prisoners also made a significant contribution. Further inquiry indicates that Durham. prison is not unique in these respects. Problems of a similar nature are endemic in the Prison Health Service. Indeed, when the history of this organisation is traced it is apparent that such difficulties have plagued it throughout its existence.
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Quinn, Fenella. "Primary school-based mental health services : head-teachers' perspectives." Thesis, Regent's University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.646044.
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It is generally reported that around one in 10 children in the UK today suffer from some kind of mental health problem. It is of course compulsory for all children between the ages of five and 16 to partake in a certain amount of education, which in the vast majority of cases means school. Head teachers are statutorily obliged to safeguard the children in their care, which also means addressing their physical and mental health. Therefore schools are growing in their importance as sites of mental health care interventions. There is little or no published research which explores the phenomenon of on site mental health provision from the perspective of the head teachers, in terms of how it impacts them. For this study, five head teachers of mixed sex primary schools were interviewed about the mental health service that they had commissioned for their school. All five participants employed the same service. Using the interpretive phenomenological approach to analyse these interviews, five major themes were discovered: ambivalence towards the mental health service; mixed feelings towards mental health issues; that the mental health service helped alleviate heads’ sense of anxiety; the paradoxical nature of head teachers’ intersubjective experience; and that while head teachers like to describe themselves as part of a collective identity, they locate themselves as individuals when they feel the need to assert power. It is hoped that these findings might aid providers of mental health services to schools and children by providing a more sophisticated understanding both of head teachers’, and therefore commissioners’, anxieties and positive feelings about such services.
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Smark, Ciorstan. "Pound foolish accounting's role in deinstitutionalisation /." Access electronically, 2002. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060404.123052/index.html.
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Hemingway, C. A. "The regulation of women detained under mental health legislation." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264817.
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Goodwin, Simon Christopher. "Community care : the reform of the mental health services?" Thesis, University of Sheffield, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387717.
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