Family Intervention and Services for Persons with Mental Illness in the People's Republic of China

ABSTRACT

Family services and intervention for persons with mental illness is crucial in mental health services. In this paper, the writer attempts to describe family intervention and services for persons with mental illness in the People's Republic of China. Family intervention and services like home-based care, guardianship network, family counseling, and psychoeducational programs are only preliminarily developed. Their effectiveness and challenges in future development are discussed.     

Homelessness Among Older Adults with Severe Mental Illness

ABSTRACT

This article tackles a problem that is often overlooked in the literature-the plight of homeless elders with severe mental disabilities. Drawing on his personal experience working with sheltered homeless persons who were mentally ill, the author argues for a focus not on self-sufficiency but on closely supervised care for this vulnerable population.     

Identified Problems and Service Utilization Patterns Among Kinship Families Accessing Mental Health Services

Abstract

This study examined the mental health problems and service utilization patterns of kinship families who accessed services in an urban outpatient child psychiatry clinic. A random sample of children who completed the intake process during a calendar year yielded 47 children, or 19% of the sample, whose primary caregiver was a relative, other than a biological parent; approximately half of those families were involved with the child welfare system. Data from an administrative database and from medical records describe the diagnoses, identified problems, and services used by the kinship families. Academic or school-related problems emerged as an identified problem in approximately half of the kinship cases, but school intervention was not a primary target for clinicians. The kinship sample was also compared with a random stratified sample of children who were living with primary caregivers other than kin. Kinship families were more likely to be African-American, but few differences were found between kin and non-kin cases on diagnoses and frequency, duration, or type of services received. The findings suggest that collaboration with schools might increase the engagement and retention of kinship families in mental health services.     

Disability Identity Formation and Affirmation: The Experiences of Persons with Severe Mental Illness

This article examines the pervasive nature and extent of the debilitating sense of shame associated with disability. It then explores the emergence of disability identity, pride, and culture to challenge such shame—illustrated in personal narrative accounts of the individual and collective journeys of people coping with severe mental illness.     

Business Incubation for People with Severe Mental Illness Histories: The Experience of One Model

ABSTRACT

The Enterprise People was a business incubator for people with serious mental health conditions that operated in Madison, Wisconsin, from 1998–2005. It supported entrepreneurs with learning basic business skills, start-up processes and expenses, back office supports, ongoing problem solving, and for some, with space to conduct their businesses. The original impetus was to discover whether people with SMI histories could successfully start and operate small businesses. Although this was confirmed, the experience also uncovered factors that will allow other projects of this sort to succeed, and some core infrastructural supports that need to be created. The experience demonstrates that self-employment supported by formal business incubation is a viable option in the range of mental health vocational rehabilitation models.     

Kinship Care for Children of a Parent With a Mental Illness

Little is known about “hidden” kinship caregivers of children of a parent with a mental illness (COPMI). An exploratory study surveyed 56 COPMI caregiver members of a kinship center administered by a school of social work in a large public university. The COPMI sample was a subset of a larger kinship caregiver study. Nearly one in four caregivers was providing COPMI kinship care. The COPMI caregivers reported numerous child behavioral crises and decreased caregiver physical and emotional health since they began providing care. Practice, policy, and research require development to increase support for COPMI caregivers and their families.     

Family Social Networks and Recovery From Severe Mental Illness of Clubhouse Members

This study examined the contribution of family social network variables to recovery among Clubhouse members. A random sample of 118 members from one Clubhouse was recruited for this cross-sectional study. Among all respondents, greater overall family support and better relationship quality with the most supportive network member were correlated with greater levels of recovery. Clubhouse members perceived higher quantity and quality of support and more criticalness from their most supportive network members, principally family members, compared to the rest of their family members. Longitudinal studies are needed to further investigate the relationship between family support and recovery.     

Youth with Serious Mental Health Disorders: Wraparound as a Promising Intervention in New Zealand

Youth with serious mental health disorders present with a complexity of challenges for the mental health system, schools, youth justice, care and protection, and their communities. Research shows their needs are best achieved by providing coordinated intensive, multidisciplinary, and individualised services. This article outlines the prevalence and characteristics of youth with serious mental health disorders. It also discusses community‐based interventions used in New Zealand and their limitations. It introduces Wraparound, an intensive individualised coordination and care planning process as a promising practice for youth with serious mental health disorders and their families. Key principles and phases underpinning the Wraparound process are presented along with a case vignette to exemplify the process. Its theory of change, the challenges experienced in practice, and a brief overview of the evidence‐base are also discussed.     

A Two-Level Community Intervention Model for Homeless Mothers with Mental Health or Substance Abuse Disorders

ABSTRACT

This paper describes a two-tiered community intervention model in response to a call from the Center for Mental Health Services for the development of best-practice strategies for homeless mothers with mental health and/or substance use disorders and their children. This model incorporates best practice principles gained from previous research projects pitched at the system and client levels. The model has been conceptualized, presented, and funded by CMHS and is currently being implemented in a local community. This model is unique in that it develops an intervention that addresses both levels of service delivery (i.e., system and client) in a single project. Blending systems integration/wraparound service philosophy and consumer-driven/strength-based development approaches provides a model that encompasses interventions at the individual client level via supported case management, and improved coordination and collaboration at the service system level. While this model was developed for a specific community population, the approach is general inits applicability to other areas of practice.     

Protection and Advocacy for Individuals with Mental Illness Act

Abstract

This study explored the perceptions of one state's policy stakeholders toward the implementation of the Protection and Advocacy for Individuals with Mental Illness Act (PAIMI Act). This congressional act established state programs authorized to investigate abuse, neglect, and civil rights violations against individuals with mental illness in residential facilities. A qualitative case study approach was selected to study the perceptions of the impact of this law. Participants were chosen using a maximum variation sampling of four diverse stakeholder groups. In-depth interview responses were developed into a series of proposed assertions regarding the impact of the PAIMI Act.     

Mental Illness in Assisted Living: Challenges for Quality of Life and Care

ABSTRACT

An unknown number of mentally ill elders in the United States receive care in assisted living, along with persons facing physical or cognitive challenges. While dementia is familiar in assisted living, our data indicate that neither staff nor residents are prepared to work or live with the mentally ill. Challenges are created for professionals, since these residents bring diverse needs. Daily interresident interactions are also disrupted or stressful. Qualitative data describe the impacts on quality of resident life as well as care and management dilemmas identified within five assisted-living settings having varying presence of mental illness among residents.     

Elders with Serious Mental Illness: Lost Opportunities and New Policy Options

This article reviews key federal Medicaid policies affecting older adults with serious, long-term mental illness: (a) the Medicaid exclusion of coverage for Institutions for Mental Diseases, (b) the Preadmission Screening and Resident Review Process, and (c) the Medicaid Home and Community Based Services waiver policy. Documenting the incentives and restrictions in these policies provides an historical context for understanding the current gaps in treatment for elders with mental illness. New federal options under the Deficit Reduction Act may provide opportunities for reducing the institutional bias for older adults with mental illness and for improving mental health services for elders under Medicaid.     

Obtaining Informed Consent When a Profession Labels Itself as Providing Treatment for Mental Illness

Abstract

This paper examines when informed consent laws mandating explanation of the risks and benefits for proposed treatments (some talk intervention) and alternative to the proposed treatments (e.g., medications) apply to the social work profession. The reasons why an explanation of alternative treatments, including explaining medications, might be part of securing informed consent are proffered. Following this, consideration of how the task of explaining alternatives might be addressed is examined. The particular example of antidepressant medications provides a context for considering how to discuss medications as a treatment alternative. The kind of information a social worker might be obligated to possess and then impart to the client in fulfilling the task of obtaining informed consent is considered.     

Understanding Parental Grief as a Response to Mental Illness: Implications for Practice

ABSTRACT

Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969 Kubler-Ross , E. ( 1969 ). On death and dying . New York : Scribner . [Google Scholar]) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and their parents are discussed. Acknowledging and understanding parental grief, while providing emotional support, leads to a more effective working partnership. This collaboration of parents and social worker can result in more effective treatment for the child with mental illness. Examples from one of the co-author's personal experiences are included.     

Creative Solutions and Development for Social Workers Treating People with Serious Mental Illness - Contributions from Supervision

Social workers who are engaged in a therapeutic work with clients who have serious mental illness often face specific challenges and find themselves in crisis states in therapy, which stem from the return of the clients’ symptoms and their cognitive impairments as well as social stigma. These crisis states cause dramatic changes in the way social workers mentalize their clients and they are propelled to draw from covert, unformulated, and dissociated knowledge that they have about the client’s experience, which contributes to achieving new, surprising, and creative ways to mentalize the client. Such crisis resolutions enhance therapists’ personal and professional development and serve as an identification model for their clients.     

Telling and Re‐telling Stories: The Use of Narrative and Drawing in a Group Intervention with Parents and Children in a Remote Aboriginal Community

The Let's Start Parent‐Child Program is a manualised parent‐child program which aims to improve educational, social and emotional outcomes for Aboriginal parents and their four‐ to seven‐year‐old children. It has been implemented in the Northern Territory, Australia on the Tiwi Islands and in Darwin since 2005. This paper outlines the adaptation of the program to include narrative approaches, the sharing of stories and the use of expressive arts as a way to build understanding between program leaders and participating families. An example from a recent program is used to illustrate how the sharing of stories and expressive use of art engages and binds group participants together. It supports parents to tell their own stories, to speak about their lived experience, to reconsider aspects of their own and their children's experiences and to achieve an increased awareness of their personal resources and a sense of self‐empowerment. The program is designed and delivered with sensitivity to individual parents, children and families, where cultural and interpersonal differences and different developmental and family situations can be taken into account.     

The Emergence and Attributes of Second-Generation Community Support Systems for Persons with Serious Mental Illness

Abstract

This paper examines the original model of community support for people coping with psychiatric disabilities and illuminates four emergent factors that are bringing about what the author identifies as second-generation community support systems. The author discusses the important role of recovery in refraining the purpose and aims of second-generation community support systems and draws implications for how case management can function within these systems to make them more responsive to recipients.