Erika Dyck
For many of us academics, doing community-engaged research means coming to terms with the significant gaps in experience, privilege, and power, and overall access to knowledge. We are trained to learn through texts, not through direct experience. In some ways, we are even conditioned to tune out experience, or anecdote, to dilute personal subjectivities in favor of a critical analysis informed by a combination of methods and sources, and a reliance on text-based forms of evidence. Whereas for most community members, evidence is experiential...
November 17, 2020: Journal of the History of the Behavioral Sciences
Christophe Clesse, S Salime, I Dumand, S Barbier Concetta-Ciciarelli, S Lavenir, K Kacemi, P Heckel-Chalet, Frank Sissung, Aurore Poinsignon, Anthony Simon, M Decker, M Batt
For the past forty years, the generalization of community-based approaches has prompted psychiatry into promoting a deinstitutionalization movement and a psychosocial rehabilitation approach (PSR) for individuals with schizophrenia and related difficulties. Unfortunately, this approach generally does not involve the most severe cognitive and psycho-affective clinical situations among this population despite an increasing number of publications advocating that all individuals should be included in PSR and deinstitutionalization programs...
2020: Frontiers in Psychiatry
Tatsushi Okayama, Kentaro Usuda, Emi Okazaki, Yoshio Yamanouchi
BACKGROUND: The number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge...
November 3, 2020: BMC Psychiatry
Briony Marie DuBose, Eileen K Fry-Bowers
Approximately 3.4% of Americans have a mental health condition and suicide is the 10th leading cause of death. While the rate of mental health conditions has slightly increased for adult populations, America's youth has experienced a significant rise in depression. From 2008 to 2017, occurrence of depression in the adolescent population increased from 8.3% to 13.3%. As adolescents mature into adults; it is likely the rate of mental health conditions for the adult population will rise as well as it is the common thread that binds the diseases of despair : drug abuse, alcoholism, and suicide...
November 1, 2020: Policy, Politics & Nursing Practice
Merve Kardelen Bilir, Fatih Artvinli
This article offers a brief history and the evolution of mental health policy in Turkey. It aims to analyse how mental health policies were transformed and why certain policies were introduced at specific times. The modern history of mental health policy is divided into three periods: the institutionalization of psychiatry and hospital-based mental health services; the introduction of community-based mental healthcare services; and lastly, the policy of deinstitutionalization after the 1980s. These periods have been categorized in a way that basically coincides with Turkey's modern political history...
October 30, 2020: History of Psychiatry
Pierre Lequin, Philippe Golay, Fabrice Herrera, Marie-Anne Brisard, Philippe Conus
Deinstitutionalization in psychiatry led to a decrease in hospital beds, short hospital admissions focussed on symptoms reduction, and the development of ambulatory care. However, the needs of patients who despite symptoms reduction do not display the minimal competencies to live alone or in a sheltered accommodation, are not met in such a context. They usually go through long admissions and fail to improve. In 2016, we implemented a new inpatient program focused on fostering the development of the competencies needed to adapt to living outside the hospital; the aim of this study was to evaluate if it lead to the resolution of these situations or in contrary if it turned into a long stay unit...
September 25, 2020: Psychiatric Quarterly
Ish P Bhalla, Elina A Stefanovics, Robert A Rosenheck
BACKGROUND: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems...
August 28, 2020: BMC Public Health
Phyllis Solomon, Ryan Petros
Two diametrically opposed positions predominate discourse for the care and treatment of persons with severe mental illness: anti-deinstitutionalization and anti-institutionalization. Both share the same goal of ensuring best quality of life for those with severe psychiatric disorders, but pathways to achieving this goal are very different and have resulted in much contention. Supporters of each position espouse a different belief system regarding people with psychiatric disorders and their presumed capabilities, placing varying emphasis on maximizing protection of the community versus protection of individual rights, and result in contrasting mental health policies and practice orientations...
August 28, 2020: Psychiatric Quarterly
Bhumika Shah, Luba Leontieva, James L Megna
Introduction Deinstitutionalization has led to various changes in the utilization of healthcare services. The increased focus on treating patients within the community has led to variations in the utilization patterns of inpatient units. Shifts in demographic variables and disease-related, system-based, and economic factors have been observed. Due to the paucity of recent literature, this study was planned to assess the characteristics and treatment patterns in an acute inpatient psychiatric unit of a university hospital...
July 19, 2020: Curēus
Kyle Sue, Nicole Mar
Background: Intellectual and Developmental Disabilities (IDD) are defined as physical/mental impairments before age 18. Not only are many IDD patients living into adulthood, but deinstitutionalization has also led to most living in community settings. Little is known about end-of-life needs in these adults, and existing literature does not examine attitudes of Canadian providers. Objective: Thematic and content analysis examined attitudes of Canadian Pediatric Palliative Care (PPC) practitioners on caring for adults with IDD to identify components of care, which could be improved...
July 28, 2020: Journal of Palliative Medicine
Alice Medeiros Lima, Ândrea Cardoso de Souza, Ana Lúcia Abrahão da Silva
OBJECTIVE: to analyze the process of deinstitutionalization resulting from a psychiatric hospital shut down, and know the fate of users after dehospitalization. METHOD: a descriptive, qualitative study based on the critical-analytical perspective, which had as its setting the Hospital Colônia de Rio Bonito. Institutional documents and narratives of five managers who participated in the deinstitutionalization process were analyzed. RESULTS: Hospital Colônia deinstitutionalization lasted longer than expected...
2020: Revista Brasileira de Enfermagem
Marie-Claude Thifault, Laurie Kirouac
Introduction : This study examines the humanization movement at the Saint-Jean-de-Dieu psychiatric hospital between the 1960s and the 1990s.Context : Conducting a historiography of psychiatric deinstitutionalization in Quebec during the twentieth century shows that the institution was a place of social control and, above all else, a place where psychiatric patients were neglected and dehumanized.Objective : While the historiography since the 1960s has focused on a largely one-dimensional and critical reading of the way in which deinstitutionalization took place in Quebec, I have instead chosen to focus on the changes that took place within the Quebec hospital's walls...
December 2019: Recherche en Soins Infirmiers
Preethi Kesavan, Christopher J Dy
The medical device industry has long been subject to criticism for lack of price transparency and minimal regulations surrounding device approval, which have functioned as barriers to providing quality and cost-effective care. Recent health care reforms aimed at overcoming these barriers, including improving market approval regulations, increasing postmarket surveillance, and using comparative effectiveness research, have drastically changed industry practices. These reforms have also prompted increasingly cost-aware health care practices, which have encouraged new trends in medical device innovation such as frugal innovation and deinstitutionalization...
May 2020: Hand Clinics
Christien Muusse, Hans Kroon, Cornelis L Mulder, Jeannette Pols
Deinstitutionalization is often described as an organizational shift of moving care from the psychiatric hospital towards the community. This paper analyses deinstitutionalization as a daily care practice by adopting an empirical ethics approach instead. Deinstitutionalization of mental healthcare is seen as an important way of improving the quality of lives of people suffering from severe mental illness. But how is this done in practice and which different goods are strived for by those involved? We examine these questions by giving an ethnographic description of community mental health care in Trieste, a city that underwent a radical process of deinstitutionalization in the 1970s...
April 3, 2020: Culture, Medicine and Psychiatry
Antoine Couatarmanach, William Sherlaw, Pierre-Marie Prigent, Cyrille Harpet, Valérie Bertaud
OBJECTIVES: Psychiatric inpatients suffer from poorer oral health than the general population, and difficulties in accessing necessary dental treatment remain even when a dedicated dental service is available within the psychiatric hospital. The aim of this study was to identify barriers to access dental care from the point of view of dentists working within French psychiatric hospitals. METHODS: The relatively small number of dentists working in psychiatric hospitals necessitated a qualitative approach...
March 25, 2020: Community Dentistry and Oral Epidemiology
Joel A Dvoskin, James L Knoll, Mollie Silva
This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs...
March 20, 2020: CNS Spectrums
Zahra Tamizi, Masoud Fallahi-Khoshknab, Asghar Dalvandi, Farahnaz Mohammadi-Shahboulaghi, Eesa Mohammadi, Enayatollah Bakhshi
INTRODUCTION: After the psychiatric revolution and implementation of deinstitutionalization policies, caring for people with a mental health condition shifted from psychiatric hospitals to their families. In this way, family caregivers were forced to take full responsibility for taking care of the patients that lead to the occurrence of challenges for them. Only a few studies have investigated the caregiving challenges of family caregivers in patients with schizophrenia. AIM: This study aimed to gain a better understanding of caregiving burden in family caregivers of patients with schizophrenia and its related factors...
2020: Journal of Education and Health Promotion
Caterina Ronchetti, Veronica Toffolutti, Martin McKee, David Stuckler
BACKGROUND: The Italian 180/1978 reform abolishing asylums is one of the most contested mental health programs ever implemented. It aimed to shift care of mental illness into the community improving outcomes and reducing expenditure. It was a model for successive deinstitutionalization initiatives across Europe and North America. However, there were longstanding concerns that, without expansion of community care, it may have deprived patients with mental illness access to support, placing them at increased risk of suicide...
February 19, 2020: European Journal of Public Health
Joseph Adu, Abram Oudshoorn
Institutionalization of people living with mental illness has evolved over the years, especially in the 19th and early 20th century. This has created over crowdedness in various psychiatric institutions, specifically in low and-middle-income countries, including Ghana. The objective of this study is to use Bronfenbrenner's Social-Ecological Model (1979) to propose a process for deinstitutionalizing psychiatric services in Ghana while supporting a transition to community-based mental health care. Using the concept of Bronfenbrenner's Social-Ecological Model, this article explores some benefits and difficulties with the concept of deinstitutionalization with regards to mental health care services in Ghana...
January 30, 2020: Issues in Mental Health Nursing
Lok Yan Chu, Tin Wai Chang, Tsz Yuet Dai, Lok Hui, Hei Tung Ip, San Yuet Kwok, Kin Long Ying, Fung Man Chan, Daniel Bressington
INTRODUCTION: A non-uniform policy was recently adopted in selected Hong Kong rehabilitation wards to align with the philosophy of the Recovery Model. The change in policy is relatively novel in Asia, where no previous studies have reported how this may influence nursing care and service users' recovery. AIM: To explore Hong Kong mental health nurses' views about wearing non-uniform within an in-patient rehabilitation unit in regards to facilitating service users' recovery process...
January 20, 2020: Journal of Psychiatric and Mental Health Nursing
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