The Mentally III in the Criminal Justice System in Western Australia: Definition and Disposition

The definition and disposition of mentally ill persons involved in the criminal justice system has been a long standing problem in most western cultures. Most allied debates, however, have been theoretical and philosophical rather than pragmatic. The following paper examines data from the Western Australian courts, prison and mental health systems to determine the nature and extent of the problem, together with the current dispositions of mentally ill offenders. In so doing, fundamental problems in the system are highlighted and possible alternatives suggested.     

Changes in the group defined as severely mentally ill: five years after the mental health-care reform in Sweden

A mental health-care reform was implemented in Sweden in 1995. The objective of this study has been to investigate whether, five years after the reform, there were any changes in the group of persons considered to be severely mentally ill. To estimate the number and needs of severely mentally ill persons, a survey was made in 1995/96 and again in 2000/2001, using the same definition of 'severely mentally ill', and the same interview form used on both occasions. Needs were assessed using the Camberwell Assessment of Need. In the 1995/96 survey, 602 individuals were identified as severely mentally ill. In 2000/2001, the number was 828. Those surveyed in 2000/2001 had, on average, fewer unmet needs. The results indicate that one reason for the difference in the size of the groups was that the way the concept of severely mentally ill was interpreted had changed.     

Seeing the Insane in Textbooks of Abnormal Psychology: The Uses of Art in Histories of Mental Illness

Pictures in historical chapters of textbooks convey information about the values and assumptions of the authors'professions and the larger culture. We scrutinized 15 recent abnormal psychology textbooks for reproductions of art created before 1900. Thirteen works appeared in three (20%) or more textbooks. Overall, these pictures support a "Whiggish" account of history that celebrates the present and gives a distorted, incomplete rendering of the past. The 13 pictures tended to depict the mentally ill as an underclass who are released from their literal and metaphorical shackles by men who are "ahead of their time" in their struggles against prevailing ignorance. The pictures also emphasized the difference of the mentally ill by presenting a catalogue of stereotypic visual elements attributed to insanity throughout Western history. We argue for the inclusion in textbooks of "history for the sake of the past" as a way of genuinely engaging different ideologies and thereby stimulating interest in our own implicit values and biases.     

Discharge procedures for mentally ill people: The prespective of former psychiatric patients on their professional social network

The analysis of the perspective of mentally ill people on their social network is not complete if the professional arena is left out. This article draws on literature about social network and other forms of human interaction to support the social network concept and an idea about how the professional arena has developed and become a vital part of the network. Fifty-three former patients were interviewed to get their perspective on the professional network. Intimate relations with family and friends seemed to be a model even for contacts with professionals. A social psychological analysis of the satisfaction of the long-term mentally ill respondents with relations to home care workers and their dissatisfaction with psychiatric professionals seemed to be connected to the professionals' ability to undertake a caring relationship.     

"We mentally ill smoke a lot": identity, smoking, and mental illness in America

Most of the history of the tobacco industry over the last few decades has focused on the conflicts between tobacco industry leaders who promoted smoking and tobacco control advocates who warned of the health consequences. Yet a view of this conflict from the perspective of smokers who are also mentally ill raises questions about how to frame public health policy for these individuals. Mentally ill consumers wrote to the tobacco industry between the 1970s and 1990s and expressed their commitment to smoking and to cigarette companies, despite their awareness of the health risks. This paper explores the relationship between mentally ill consumers, the tobacco industry, and public health in the United States through letters written by mentally ill smokers.     

Part III: A student learns casework

Abstract

When homeless and severely mentally ill individuals leave housing programs designed to help them achieve stability, their very lives become at risk. Despite the prevalence of this problem and its potentially life-threatening consequences, there is a complete dearth of case studies examining why clients in programs for the homeless and mentally ill suddenly depart from those programs, and how paranoid and other seemingly unreachable clients can significantly improve the quality of their lives. This single case study, utilizing a naturalistic methodology, provides a before and after picture of a client who precipitously left a housing program, then returned two years later in a state of severe physical and mental decompensation. The study focuses on understanding why the client left the program the first time and what could be done to prevent another premature discharge. The findings point to a lack of coordination of care and problems with stable human interaction on the part of those caring for Charles, and are critical to understanding how to engage successfully with homeless and severely mentally ill clients.     

Support for and From Aging Mothers Whose Adult Daughters are Seriously Mentally Ill

This article discusses, from the grandmother’s perspective, the ways in which support is exchanged in families coping with serious mental illness. A strengths perspective was utilized to identify ways in which family members help each other. Employing a qualitative approach, this study focuses on interviews obtained from a sample of 22 aging mothers, aged 52–90, who are in contact with their daughters who have a mental illness. Grandmothers provided several kinds of support to their mentally ill adult daughters and to their grandchildren, who also supported the aging mother in numerous ways. As social workers seek to assist individuals with mental illness, it is important to assess the existing strengths of their intergenerational family context.     

An interdisciplinary look at the deinstitutionalization of the mentally ill

Deinstitutionalization of the mentally ill has had an enormous impact on the mentally ill, the community, family members and taxpayers. This paper assesses the impact of deinstitutionalization on each of these groups. The approach is interdisciplinary in nature, using schools of thought found in the fields of political and economic thought in analyzing the effect of deinstitutionalization on each stakeholder group. Although assessments vary by stakeholder group, some overall observations can be made. Ironically, both libertarian and utilitarian arguments favor deinstitutionalization, although for different reasons. A deontological view, however, finds deinstitutionalization lacking.     

The Approved Social Worker -- Reflections on Origins

Correspondence to Pauline M. Prior, Department of Social Policy and Social Work, University of York, Heslington, York YO1 5DD. Summary The aim of this paper is to examine the role of social workersunder current mental health law, in order to see if the adventof the Approved Social Worker (ASW) represents any more thanthe re-appearance of old concepts in a new guise. It is arguedthat it is impossible for the ASW to be anything more than anupdated version of the Relieving Officer of the last century,in view of the fact that the Mental Health Act 1983 does notprovide a clear mandate for an effective professional advocateon behalf of mentally ill people.     

Housing the Homeless Mentally Ill

This paper presents the housing outcomes from an assertive case management program for the homeless mentally ill. The program was evaluated using an experimental design. Qualifying clients in a state hospital were randomly assigned to the case management program or routine services. At six month follow-up, over twice as many experimental as control clients were housed. None of the experimental clients had returned to living on the streets or in shelters     

Parental Mental Illness,Family Living Arrangements,and Child Behavior

The association between family living arrangements and children's behavior problems is examined in 306 children with mentally ill parents. Children living with alternative families (with adoptive or foster parents or with other relatives) display fewer behavior problems than children living with two biological parents, a single biological parent, or a biological and a stepparent. The proportion of mentally ill family members and the degree of mother-child discord explain the vanations in children's behavior problems among the different living arrangements. Thus, in placement decisions, the prevailing legal principle of safeguarding the integrity of the child's biological family should be weighed against the mother-child relationship and the mental health of the family members.     

You Don't Always Have to Pick Up Your Mess Right Away: How Being Messy Can Be Really Neat!

SUMMARY

The purpose of this paper is to illustrate a first year student's field placement experience at a group home for mentally ill adolescent boys. Upon discovering she has to “un-learn” past “learned” group work skills, she eagerly anticipates future opportunities to utilize “re-learned” theory acquired from major method course readings and lectures. Once in the field, she confronts the difficulties that this presents. The following is an account of the fears and frustrations as well as the joys and rewards one student encountered while attempting to apply and practice group work methodology in the field.     

Group Development and Shared Decision Making Working with Homeless Mentally Ill Women

An on-site Community Support System (CSS) team in a single room occupancy (SRO) hotel worked with homeless mentally ill residents toward rehabilitation through empowerment. The issue of power in the group process over a five-year period of time is described and analyzed.     

SLOF: a behavioral rating scale for assessing the mentally ill

Rating scales for assessing the mentally ill usually focus on the role functioning of clients and their psychiatric symptomatology. This article introduces a rating scale to measure more directly observable behavioral functioning and daily living skills of clients in mental hospitals and in the community. Results are presented from a series of studies designed to test the instrument's psychometric properties.     

Moving into Homelessness After Psychiatric Hospitalization

A six-month follow-up study of 132 former patients of a state hospital examines those subjects who become homeless and compares them with those subjects who do not. A quantitative and qualitative approach is used to document the process of homelessness that occurs after psychiatric hospitalization. A set of policy options is resented that can respond to the special needs of homeless mentally ill persons.     

Discharge procedures for mentally ill people: The perspective of former psychiatric patients on their primary social network, quality of life and future life expectations

This article on literature about social networks and social support in order to integrate a number of key concepts and findings that must be considered in research about the social conditions of mentally ill people. Interviews with 53 former psychiatric patients were carried out to get their perspective on their social network, quality of life and future life expectations. The duration of and stigma attached to mental illness, being without work and gender seemed to have the most influence on the primary network. The same issues, except for gender, together with place of residence, financial difficulties and inability to exert influence over one's own situation influenced the respondents' quality of life and their expectations of the future. These findings are analysed and discussed from a social psychological perspective.     

A Client-Developed Functional Level Scale

In response to a mandate imposed by the County Community Mental Health Board, a psychosocial rehabilitation agency proposed that its consumer group would develop their own functional level scale to measure effectiveness of the services provided. The paper describes the development of the scale and the procedures used to examine its reliability and validity. The findings suggest that the Community Living Skills Scale developed by the Client Oriented Program Evaluation (COPE) group taps all relevant areas in regard to functional levels of the chronically mentally ill in the community and that its reliability is high.     

First initiatives for social integration of the mentally ill in one phase of pre-deinstitutionalization. The example of Saint-Jean-de-Dieu, 1910-1950

This article on the first initiatives of social integration of the mentally ill, using the example of the H?pital St-Jean-de-Dieu, explores the implementation of a period of deinstitutionalization in the early decades of the 20th century. Our study is situated in the recent historiography that offers a rereading of the period just prior to the Quiet Revolution in Quebec. We intend to contribute by demonstrating that the policies, strategies and practices of the Sisters of Providence and the psychiatrists of St-Jean-de-Dieu developed a system of deinstitutionalization that reintegrated patients into their family as early as the 1910s, half a century before the first wave of deinstitutionalization of the 1960s was orchestrated by the authors of the Bédard report.     

Support Groups for Mentally Ill People

This paper outlines demand levels for day care for the mentally ill and explores the contribution that support groups can make within the package of care. It outlines costings and results of one particular experimental low cost venture which involved public and voluntary sector cooperation.     

Are the Homeless Mentally Ill?

In Australia, it is widely believed that most homeless people have mental health issues and that mental illness is a primary cause of homelessness. This paper uses information from a study of 4,291 homeless people in Melbourne to investigate these propositions. The research found that 15 per cent of the homeless had mental health issues prior to becoming homeless. This challenges the community perception that mental illness is the primary cause of homelessness. The research also found that 16 per cent of the sample developed mental health issues after becoming homeless. Homelessness causes mental health issues for some people, particularly anxiety and depression. The claim that most homeless people are mentally ill sends the wrong message to policy makers about the services that are needed to assist homeless people.