Clinically Significant Effects of Group Cognitive Behavioral Therapy on Spouse Caregivers' Mental Health and Cognitive Functioning: A Pilot Study

The objective of this pilot study was to investigate whether group cognitive behavioral therapy (CBT) resulted in clinically meaningful improvements in caregiver mood, burden, and cognition. We screened 97 caregivers in Toronto, Canada, of whom 25 with DSM-IV disorders began the 13-week CBT intervention, and 12 completed therapy and the 3-month follow-up. Each caregiver experienced clinically significant improvement on at least 2 of the following outcomes: diagnostic criteria, mood, attention, memory, and caregiver burden. Despite effectiveness, the challenges of recruiting distressed caregivers for therapy suggest that CBT might be most useful as part of a stepped care model of treatment.     

Assisted Living Facility Administrator and Direct Care Staff Views of Resident Mental Health Concerns and Staff Training Needs

This community needs assessment surveyed 21 administrators and 75 direct care staff at 9 larger and 12 smaller assisted living facilities (ALFs) regarding perceptions of resident mental health concerns, direct care staff capacity to work with residents with mental illness, and direct care staff training needs. Group differences in these perceptions were also examined. Both administrators and directcare staff indicated that direct care staff would benefit from mental health-related training, and direct care staff perceived themselves as being more comfortable working with residents with mental illness than administrators perceived them to be. Implications for gerontological social work are discussed.     

Schizophrenia: The Impact of Parental Illness on Children

This research sets out to discover what impact parental schizophreniamakes on a child’s life. It focuses on the daily lifeand experiences of children. Their health, education, familyand leisure activities are examined. Contact with helping agenciesand their unmet needs are investigated. The sample was drawnfrom the children of patients attending the mental health servicesin South West Dublin. They were matched with a control groupof children of well parents. The majority of children who haveone parent with schizophrenia had similar profiles to the childrenof well parents in the areas of physical health, positive familyfeelings, friendships, hobbies and household tasks. In a numberof other areas, however, differences were found. Sample childrenhad more psychiatric disturbance, more problems associated withschool, less contact with relatives and spent more time at home.The children had little access to services and were upset byhospital visiting. The need for an educational programme andsupport for these children was demonstrated. It is recommendedthat a more co-ordinated approach is required by both adultand child mental health services in order to meet their needs.     

Alcohol Misuse Among Older Adult Public Housing Residents

Low-income older adults living in public housing are at heightened risk for substance misuse. This study identified the prevalence of alcohol misuse among older public housing residents (n?=?187) and explored predictors of problem drinking. Including weekly drinking levels and binge drinking, 23% of the sample engaged in problem drinking behaviors. Logistic regression analysis revealed that race, gender, employment status, years smoking, and illegal drug use were significant predictors of problem drinking. No residents were receiving substance abuse treatment. As the number of older adults increase, training social workers to assess and treat alcohol misuse in older adults is critical.     

A preliminary review of the parenting assessment and skill development service: A 10-day residential service for families at risk of child maltreatment

Tweddle's Parenting Assessment and Skill Development Service (PASDS) is a 10-day residential programme for families at risk of child maltreatment. The service aims to conduct a comprehensive parenting capacity assessment to inform case management and improve parenting practices. The aims of the study were to (1) describe the psychosocial functioning of parents taking part in PASDS, (2) describe the key parenting assessment outcomes, and (3) explore parents' experiences of participation in PASDS including (a) perceived barriers and enablers of participation and (b) perceived outcomes for their family. Participants were 18 parents who participated in Tweddle's PASDS in Melbourne, Australia. A mixed methods study comprising a case file review and qualitative interviews was conducted. Parents accessing PASDS had experienced adverse childhood events, and many were experiencing mental health difficulties. Interviews with parents revealed perceived benefits of PASDS in improving parenting knowledge and skills, family relationships, and parenting confidence. At the time of discharge, 33% of families were assessed as unable to provide independent care for their child. The current findings have important implications for the further evaluation of evidenced-based services which can improve the accuracy of parenting capacity assessments, aiding in child protection decision-making related to child placement and safety.     

Alzheimer's in the Workplace: A Challenge for Social Work

It is estimated that 5.3 million Americans have Alzheimer's disease or a related disorder (ADRD) with approximately 500,000 of these persons younger than 65. Moreover, the number of people affected by the disease will increase 350% by the middle of this century. Although research exists on organizational policies with regard to caregivers, very little is known about how organizations deal with employees themselves who show symptoms of ADRD. This article reports on a pilot study of employers' responses to dementia as it impacts both caregiving employees and employees who themselves show signs of cognitive impairment.     

扩展中国社会学新境界

费孝通晚年多次倡导,中国社会学要突破实证社会学的单纯科学主义视野,应当科学精神和人文精神并举,在对社会生活开展客观性研究的同时伸张人文关怀。根据这个原则,费孝通主张社会学应当注重对精神世界开展研究,重视文化传统、意会沟通和内在自我等方面在社会生活中的深层作用,要在各民族的古代文明中发现具有不同特点的思维方式和对社会生活的研究方式。费孝通的这些主张具有十分重要的学术价值,为中国社会学开拓新视野、展开新境界指明了前进的方向。     

Depression in Older Adults: A Meta-Synthesis

Depression in older adults is often overlooked and dismissed as a part of aging. A body of knowledge—both quantitative and qualitative—has developed on the topic of depression in older adults. Meta-analyses and systematic reviews have been used to synthesize the quantitative findings of studies, and our research seeks to synthesize the qualitative studies that have been conducted on elders' experience with depression. Thirteen studies met inclusion criteria, and 4 major themes were extracted: experiences, causes, recovery, and barriers to treatment. These themes are detailed and their implications for practice are explored.     

Enriching our understanding of vulnerability through the experiences and perspectives of individuals living with mental illness

ABSTRACT

Vulnerability is a central concept in research ethics and typically serves to identify individuals or groups whose participation in research prompts specific concerns or warrants special consideration. While theoretical discussions on vulnerability have contributed valuable insights to discussions of mental health research and care, they have not been enriched thus far by stakeholder perspectives. This oversight has important consequences for the ways in which we frame vulnerability. It misses the far-reaching insights and experiential knowledge of mental health research participants whose experiences this ethics concept ultimately seeks to capture. In view of this gap, our study combines a pragmatist ethics framework and interpretive phenomenological analysis of qualitative interviews to explore user perspectives on the notion of vulnerability through the lived experiences of mental health research participants and patient-advocates. Importantly, these perspectives offer essential clues to address the difficulties of operationalizing concerns for vulnerability in concrete and practical ways. They help refine our understanding of this key ethics concept.     

Mental Health Service Utilization Among Frail,Low-Income Elders

Abstract

This study was conducted to determine the extent to which service providers in a community-based care program accurately identified and referred elders with symptoms of depression. Interviews were conducted with 79 frail, low-income elders, with the CES-D used to gauge depressive symptomatology. Reviews of their case files were then conducted to determine first, the extent to which case managers recognized depressive symptoms and second, the extent to which respondents who screened with significant symptoms were referred for mental health services. Results suggest an imperfect association between CES-D scores and case managers' perceptions and referrals. Less than 1/3 (31%) of those who screened for depression received counseling.     

Community care for adults with severe mental disorders in rural China: A case study

In China, family care is the dominant form of care for people with mental disorders. Since 2004, the government has been developing a community‐care model that places more responsibility on community organisations and the local governments at the provincial, municipal and county levels for the provision of formal care. As a large number of people with severe mental disorders live in rural China, this case study was conducted in a rural county in order to examine the development of community care. It was found that, although family care remains dominant, families’ need for formal care is increasing. Community services have improved, but their development is constrained by several contextual and micro factors. In this study, it is argued that the community‐care model introduces a process of reconfiguration of the relative responsibility for care among the family, social organisations and the government, but progress depends on further administrative and fiscal reforms.     

An Exploration of Mental Health Literacy Among African American Clergy

ABSTRACT

The purpose of this qualitative study was to explore African American clergy's mental health literacy with older congregants 60 years of age and older. Using a grounded theory approach, we recruited a purposive sample of 9 African American clergy representing diverse ages, denominations, locales, and educational levels. Data was coded and classified according to Kevin's (1976) Kevin, R. C. 1976. Factors influencing the judgment and referral of mental health presenting problems by clergymen and psychologists, Unpublished doctoral dissertation: University of Texas, Austin.  [Google Scholar] typology of pastoral counseling and Jorm et al.'s (1997) Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B. and Pollitt, P. 1997. “Mental health literacy”: A survey of the public's ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166: 182–186. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] conceptual model of mental health literacy. Findings from data analysis revealed study respondents were adherents of Kevin's Religious–Community (R–C) model. Additionally, the following themes emerged: loss of cognitive functioning, psychosocial stressors, religiosity, and appreciation for professional assistance, cultural barriers, and key informants/familiarity with formal mental health providers which partially maps onto Jorm et al.'s conceptual model of mental health literacy.     

Positive Connections: a programme for children who have a parent with a mental illness

Mental health professionals working with parents who suffer from a mental illness often overlook the children within the family. Children whose parents are mentally ill face numerous obstacles to their own emotional development and these children are at higher risk for developing mental illnesses than other children. These risks can be decreased if protective or positive interventions are available for the children. This article will describe the development and implementation of Positive Connections, an effective intervention programme specifically designed for children whose parents have been diagnosed with a mental disorder. The effectiveness of this programme has been evaluated using both qualitative and quantitative research strategies, and the results are presented.     

Adult children of parents with mental illness: Family stigma and coping on sense of self

Family stigma is associated with persistent negative outcomes among adult children of parents with mental illness (ACOPMI). Loss of sense of self has been reported by ACOPMI; however, the role of family stigma on sense of self remains unclear. Additionally, research suggests coping behaviour (i.e. adaptive or maladaptive) influences the effect of stigmatization on sense of self. This study investigated the impact of family stigma and coping on sense of self among ACOPMI (N = 134, 63.4% female). As hypothesized, high family stigma was associated with weak sense of self (p < 0.001), and ACOPMI who endorsed adaptive coping demonstrated higher sense of self than those who coped maladaptively (p < 0.001). Further, coping moderated the relationship between family stigma and sense of self (p < 0.001). Unexpectedly, this relationship was only significant for ACOPMI with adaptive coping skills (p < 0.001). At higher levels of stigmatization, post hoc analysis revealed coping styles did not exert an influence on sense of self. Results suggest family stigma contributes to loss of sense of self among ACOPMI, with adaptive coping being protective only at lower levels of family stigma. Findings highlight the need for a systemic approach to eradicate family stigma.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

A critical review of mental health and mental health‐related policies in China: More actions required

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services. Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy‐related questions concerning the lack of community‐based psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.     

Collective citizenship: From citizenship and mental health to citizenship and solidarity

Although the concept of citizenship is a widely used theoretical framework within political philosophy, its use in the field of mental health remains underexplored. Within this context, citizenship emphasises the social inclusion and participation of people who are marginalized and offers a more social and relational view of services and support for people with mental health problems than has been common in mental health systems of care. At the same time, however, the citizenship approach has operated in the context of systems of care in the United States that favour highly individualized conceptions of, and approaches to, care, and these systems of care operate in the social and political context of highly individualized concepts of the citizen. In this article building on the work of other citizenship scholars, we argue that a collective form of citizenship, grounded in the 5Rs framework, holds the individual and collective in creative tension. Furthermore, the paper applies this model to the domain of mental health, where people are treated in individualistic ways and experience marginalisation, making the collective dimension imperative and promoting participation, empowerment and the contribution for social change to people with mental health problems. Our theoretical framework of collective citizenship, while geared toward the needs of persons with mental health problems, also contributes to recent citizenship theory on the inclusion of marginalized, stigmatised, and excluded groups. We illustrate the application of this approach through an ethnographic-participant observation case study of a collective citizenship group with which we are associated.     

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.     

Outcomes assessment: evaluation in routine practice

Evaluating the quality and effectiveness of human services, whether social services or medical services, is critically important for the providers, for the organization, and for the payers of those services. We propose that outcomes assessment, a continuous model of evaluation designed for routine services settings, can be considered for use in evaluating the effectiveness of human services on a routine basis. In medical care, outcomes assessment measures initial and subsequent disorder-specific and generic outcomes domains as well as prognostic or case-mix characteristics that can be used to adjust outcomes among groups. We describe a current implementation of outcomes assessment in a state mental health system in the US and make recommendations for the future of the field.     

Discharge procedures for mentally ill people The perspectives of professionals and former psychiatric patients on their quality of life

This article draws on literature about the quality of life and social relations to integrate a number of key concepts. Fifty-three former patients were interviewed to give their opinion on their quality of life. Almost as many professionals gave their opinion on the same issue. According to the former patients, the quality of life was influenced by duration of and stigma attached to mental illness, being without work, financial difficulties, inability to exert influence over their own situation and negative expectations of the future. Illness patterns seemed to be the all-pervading issue concerning the professionals' views on the former patients' quality of life. A social psychological analysis of these disparate views made it clear that they bring about contrasting claims; the professionals demanded continuation of a patient role whereas the former patients mostly wanted to find some means of embarking on ordinary useful lives.