Dissertations / Theses: '200409 Mental health'

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Reis, Leonardo Naves dos. "Perfil epidemiológico de um serviço ambulatorial de saúde mental - uma análise descritiva e analítica." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-05112012-200043/.

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Trata-se de um estudo quantitativo descritivo e exploratório, de natureza epidemiológica, de prevalência e correlacional realizado em um serviço ambulatorial de saúde mental (Núcleo de Saúde Mental), localizado no interior paulista. O trabalho teve dois objetivos, sendo o primeiro, descrever o perfil dos usuários atendidos no referido ambulatório com base no diagnóstico, informações sobre internação psiquiátrica e dados sociodemográficos; e o segundo, testar a associação entre a necessidade de internação psiquiátrica apresentada pelos usuários e seus diagnósticos, sexo e idade e com base nesta associação, determinar a probabilidade de necessidade de internação de novos usuários ingressantes no serviço de saúde, com base nas variáveis associadas. Os dados foram extraídos dos prontuários de todos os pacientes que atualmente realizam tratamento no Núcleo de Saúde Mental (NSM), totalizando 1281 prontuários. Os dados foram compilados diretamente em planilha elaborado no Microsoft Excel 2010 para posterior análise no software estatístico Stata 11. As variáveis utilizadas foram idade, sexo, escolaridade, diagnóstico e internação (se o paciente já foi submetido à internação psiquiátrica ao menos uma vez ao longo da vida). Na primeira etapa da análise de dados realizou- se a estatística descritiva exibindo o perfil geral do NSM e em seguida comparando- o com o perfil específico dos pacientes acometidos por cada um transtornos que apresentaram significância estatística (p<0,05) no modelo de regressão logística empregado. Na segunda etapa da análise de dados foi testada a associação entre a necessidade de internação psiquiátrica e as variáveis sexo, idade e cada um dos grupos diagnósticos; para tanto se utilizou a regressão logística com múltiplas variáveis. Ainda na segunda etapa, após a análise de regressão, com base nos coeficientes extraídos desta e referente a cada uma das variáveis que se adequaram ao modelo de regressão (p<0,005), elaborou-se a equação da população do NSM, a qual apresenta como variável resposta a probabilidade de um paciente do NSM necessitar de internação psiquiátrica ao menos uma vez ao longo da vida. Os resultados apontaram que a maior parte dos pacientes em tratamento no NSM são do sexo feminino (cerca de 69%); possuem baixo nível de escolaridade (quase 67% possuem no máximo o ensino fundamental completo); possuem idade entre 40 e 59 anos (pouco mais de 50%). Os transtornos mais prevalentes foram depressão, esquizofrenia, e distúrbios ansiosos. Aqueles que apresentaram maior probabilidade de internação psiquiátrica foram o transtorno esquizoafetivo, TAB e esquizofrenia. Espera-se que os resultados aqui demonstrados sirvam para demonstrar a importância do conhecimento epidemiológico como ferramenta de gestão, neste caso em especial para os serviços de saúde mental, norteando o direcionamento dos diversos tipos de recursos e possibilitando o atendimento integral e equânime aos usuários, pautado nos princípios do SUS e nos ideais de reabilitação psicossocial.
This is a quantitative, descriptive and exploratory study. It was epidemiological type of study of prevalence and correlation performed on an outpatient mental health service (Mental Health Center), located within the state of São Paulo. The study had two objectives: first, to describe the profile of users treated in the Mental Health Center based on the diagnosis, information about psychiatric hospitalization and sociodemographic data; and the second, test the association between the need for psychiatric hospitalization presented by users and their diagnoses, sex and age; based on this association, determine the probability of need for hospitalization of new users entering the health service, based on the associated variables. Data were abstracted from medical records of all patients currently being treated at the Mental Health Center, totaling 1281 files. The data were compiled by Microsoft Excel 2010 for further analysis in Stata 11. The variables used were age, gender, education, diagnosis and hospitalization (if the patient has been subjected to psychiatric hospitalization at least once throughout their lives). In the first stage of data analysis was performed descriptive statistics showing the overall profile of the Mental Health Center and then comparing it with the specific profile of patients affected by each disorder that showed statistical significance (p<0,05) in model employed logistic regression. In the second stage of data analysis tested the association between the need for psychiatric hospitalization and gender, age and each of the diagnostic groups, for so we used logistic regression with multiple variables. Also in the second stage, after regression analysis, based on coefficients extracted from this and referring to each of the variables that are suited to the regression model (p <0.005), developed the equation of the population of Mental Health Center, which presents response variable as the probability of a patient needs psychiatric hospitalization at least once throughout life. The results showed that most patients at the Mental Health Center are female (69%), have a low educational level (almost 67% have at most completed primary education), are 40 to 59 years (more than 50%). The most prevalent disorders were depression, schizophrenia, and anxiety disorders. Those who had a higher probability of psychiatric hospitalization were schizoaffective disorder, bipolar disorder and schizophrenia. It is hoped that the results serve to demonstrate the importance of epidemiological knowledge as a management tool, in this case for mental health services in particular, guiding the direction of the various types of resources and enabling the full and equal service to users, guided by the principles of the health care system and the ideals of psychosocial rehabilitation.

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Vaz, Valdeci Degiampietro. "O perfil dos pacientes atendidos nos Centros de Atenção Psicossocial em Porto Alegre, Rio Grande do Sul estudo de tendências de atendimentos de 2004 a 2009." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/66682.

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Objetivo: Este trabalho tem os seguintes objetivos: (a) analisar a mudança do atendimento nos Centros de Atenção Psicossocial (CAPS) entre 2004 a 2009 em Porto Alegre, Rio Grande do Sul, (b) descrever o perfil dos pacientes atendidos nos CAPS do Rio Grande do Sul no mesmo período e (c) descrever, com base populacional, o alcance dos CAPS. Método: Foi realizado um estudo transversal com base em dados públicos do Sistema de Informações Ambulatoriais (SIA-SUS) e Cadastro Nacional de Estabelecimentos de Saúde (CNES), disponíveis no site do Departamento de Informática do SUS (Sistema Único de Saúde)- DATASUS–, www.datasus.gov.br, no período de 2004 a 2009. Foram analisadas as frequências da produção ambulatorial dos serviços CAPS, em Porto Alegre e no Rio Grande do Sul, no período de 2004 a 2009, e calculado o Índice de Cobertura – IC de CAPS / 100.000 habitantes. Resultados: O estudo evidenciou que de 2004 a 2009 houve: (a) expansão em 142,5% dos CAPS no Brasil (de 605 para 1.467 unidades), 100% no Rio Grande do Sul (de 70 para 144 CAPS); (b) evolução oposta da produção ambulatorial entre o estado do Rio Grande do Sul e a capital do estado, com duplicação de procedimentos de cuidado intensivo no Estado (de 209.923 para 424.500), e redução de quase 50% dos mesmos na Capital (de 10.487 para 5.577); (c) aumento de 76% na cobertura do CAPS medida através do Índice de Cobertura no Estado (de 0,52 para 0,91), (d) redução de desigualdades regionais (em 2009, 37% das 19 regiões apresentavam Índice de Cobertura abaixo de 0,90, enquanto em 2010 passou para 10%) e (e) persistência do déficit global (49,04% da população do estado ainda residindo em municípios com cobertura Insuficiente, ou seja com IC abaixo de 0,90). Conclusão: Constatou-se a persistência de cobertura Insuficiente de CAPS para 49,04% da população do estado (IC abaixo de 0,9). Dez anos depois da implementação da Portaria nº 336/2002, que definiu os 3 modelos de serviços dos CAPS (I, II, III) e a sua finalidade (atendimento de transtornos mentais graves e persistentes), ainda encontramos no estado regiões de saúde com Índice de Cobertura Insuficiente, e principalmente, quase a metade da população vivendo em municípios com cobertura Insuficiente. Adicionalmente, em Porto Alegre, constatou-se uma redução no atendimento de pacientes nos centros de atenção psicossocial, o que mostra que a população-alvo dos CAPS está utilizando outros serviços que não o CAPS, ou não está utilizando os serviços montados para ela, por diferentes motivos (filtros, barreiras de acesso, opção por outros tipos de pagamento ou convênios). O estudo mostra necessidade de investigações adicionais para responder as questões levantadas, sobre o caminho que os pacientes tomaram, se estão em tratamento em outros locais não diretamente financiados por SUS (convênios, planos de saúde, sociedades beneficentes) ou se estão ficando fora dos serviços de saúde, confinados à cuidado na família e comunidade, somente utilizando o SUS na reativação da doença, emergências ou serviços gerais de saúde.
Objective: This paper aims: (a) to analyze the change in service at Psychosocial Care Centers (CAPS) in Porto Alegre, Rio Grande do Sul, from 2004 to 2009; (b) to describe the profile of patients at the CAPS in Rio Grande do Sul in the same period; and (c) to describe the scope of the CAPS on a population basis. Methods: We conducted a cross-sectional study based on public data from the Outpatient Information System (SIA-SUS) and the National Register of Health Establishments (CNES), available at the Department of the SUS (Unified Health System) - DATASUS-, www.datasus.gov.br from 2004 to 2009. We analyzed the frequencies of production generated from CAPS services by SIA in Porto Alegre and in Rio Grande do Sul from 2004 to 2009, and calculated the Coverage Ratio - CI CAPS / 100,000 inhabitants. Results: it was observed that from 2004 to 2009: (A) there was an increase of 142,5% in the number of CAPS in Brazil (from 605 to 1,467) and in Rio Grande do Sul they also increased from 70 to 144 (more than 100%); (B) there was a reduction of outpatient intensive care services in the capital city, Porto Alegre, in the period (from 10,487 to 5,577) while in the state of Rio Grande do Sul such services doubled (from 209,923 to 424,500) in the same period; C) there was an increase of 76% (0.52 to 0.91 CAPS/100.000 inhabitants) in the Coverage Ratio of Rio Grande do Sul, (d) there was an inequality reduction in health regions in 2009 (37% CI of 19 regions with below 0.90 in 2009 to 10% in 2010). (e) there was a persistent overall deficit (49,04% of the state population still lived in cities with inadequate coverage, with CI below 0.90 CAPS/100.000 inhabitants). Conclusion: Persistent Insufficient coverage (CI below 0,9) was found in 49.04% of the state population in 2009. Ten years after the implementation of Ordinance No. 336/2002, which defined the three service models of CAPS (I, II, III) and their purpose to care for severe mental disorders, we still find health regions with Low Index Coverage in the state and almost half the population living in cities with Insufficient Coverage. Furthermore, we also observed that there was a reduction in service in CAPS in Porto Alegre, showing that the target population is either resorting to other services rather than CAPS or not enjoying the benefits of available services for various reasons. This study shows the need of further investigation to answer some remaining questions about what directions patients have taken, if they are being treated somewhere else in private hospitals or by private medical plans, not funded by the SUS, if they are not being treated at all, or perhaps if they are being cared by their families or communities and only use health services provided by the SUS when the disease strikes back or in health emergencies.

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Valdez, Karla. "Taking a closer look at the mental health services act of 2004| A policy analysis." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1590186.

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The purpose of this policy analysis was to analyze the Mental Health Services Act (MHSA) of 2004 using research articles and state and governmental documents. The analysis explored the expansion of mental health services and the challenges of implementation. The programs that were developed to meet the specific needs of the MHSA included early intervention, prevention, curriculum development, education, training, and community services. A thorough examination of the act provided an understanding of how the funds are distributed and how the MHSA will continue to support specialized mental health program services. The information presented in this policy analysis focused on children and youth and in detailing the services they received through the MHSA.

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De, Sordi Georgia Soares. "Agentes decisores e a formulação da política de saúde mental do município de Campinas = 2001-2004." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313810.

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Orientador: Ana Maria Canesqui
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O município de Campinas possui uma rede assistencial densa e complexa na área de saúde mental, fruto de investimentos técnico-assistenciais e políticos, ancorados nas reformas psiquiátrica e sanitária. Desde a década de 1990, o município realiza um movimento de desospitalização e desinstitucionalização, visando a criação de uma rede assistencial articulada aos princípios do SUS e substitutiva ao manicômio. Dentro de um panorama histórico ampliado, no período de 2001 a 2004, foram formuladas novas políticas de saúde mental, havendo um incremento considerável na oferta da rede de cuidado. O objetivo desta pesquisa é analisar a formulação da política de saúde mental no período acima citado, enfocando os principais agentes formuladores, assim como reconstruir o contexto das políticas nacionais de saúde mental como substrato à compreensão da política local. A formulação é uma etapa da política e os agentes, gestores da política local, peças fundamentais, na medida em que decidem qual é o modelo político/assistencial a ser implementado no município. Nesta pesquisa, de cunho qualitativo, os dados foram coletados através de entrevistas semi-estruturadas com os agentes decisores da formulação da política, tendo como fonte secundária documentos arquivados no Cedoc - Centro de Documentação, e alguns documentos cedidos pelos agentes decisores. A análise de formulação contribuirá para a compreensão do modelo técnico-assistencial proposto pelos gestores, reconstruindo aspectos históricos inerentes ao processo de formulação/implementação das políticas e sua importância frente aos resultados alcançados pelo modelo assistencial empregado
Abstract: The city of Campinas has a dense and complex public mental health care network as a result of technical-assistance and political investments, anchored in the psychiatric and sanitary reform. Since the decade of 1990 the city has started a movement for the attention of patients outside hospitals and institutions, aiming to create an assistance network articulated to the principles of SUS and replacing the mental hospitals. In a panoramic history context, in the period from 2001 to 2004, new policies for mental health assistance have been formulated, with a considerable increase in the mental health care network. The scope of this research is to analyze the public mental health care policy formulation during this period, focusing on the main actors, as well as to reconstruct the context of national public mental health care policies as a substrate for the comprehension of local policies. Formulation is one of the phases of policy implementation and the actors and administrators of local policies are fundamental parts of this process, since they are the ones who decide which choice of political/assistance model would be implemented in the city. In this research, with a qualitative scope, data was collected through semi-structured interviews with the deciding agents of policies formulation, having as secondary source the documents from City Health Secretary (Secretaria Municipal de Saúde) archives of CEDOC (Center for Documentation of City Health Secretary), as well as some documents provided by the deciding agents. The analysis of the policy formulation may help the comprehension of the mental health care model proposed by the administrators, reviewing historical aspects inherent to the process of formulation/implementation of policies and their importance to the results attained by the implemented assistance model
Mestrado
Saude Coletiva
Mestre em Saude Coletiva

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Groenow, Chanique C. "A Change Is Going to Come| A Policy Analysis of the Mental Health Services Act of 2004." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10785630.

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The purpose of this study was to analyze Proposition 63, which later became the Mental Health Serviced Act (MHSA) of 2004. This legislation imposed a 1% increase in taxes for California residents with adjusted gross annual income over $1 million. MHSA provided funding to expand the mental health programs and services including prevention, early intervention, education and training programs. The analysis intended to explore the benefits and consequences of the tax increase, and how mental health services were impacted under MHSA. This study scrutinized a historical review of mental health services in the United States, in the first years of the 20th Century, Deinstitutionalization, and enactment of policies related to mental health. Using David Gil's 1992 modified policy analysis framework, the analysis concluded that the MHSA legislation has potentially increased mental health services for individuals with mental illness and their families. However, this study also found that the lawmakers failed to provide proper guidance for effective program evaluation.

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Ely, Michael. "Deinstitutionalizing difference| Asylums for the severely or profoundly mentally retarded between 1960 - 2000." Thesis, The University of Texas at San Antonio, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1588311.

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This is a history between 1960 and 2000 of asylums operated in the United States for children labeled as “severely or profoundly mentally retarded,” and “emotionally and behaviorally disturbed.” I use one primary case study of the Willowbrook State School in Staten Island, New York. Willowbrook has already received some focus in the works of David and Shelia Rothman as well as Drs. David Goode, Darryl Hill, and William Bronston, and Geraldo Rivera’s newscast in 1972. Primary focus has been given to it because it is both unique and indicative of asylums across the U.S. during the mid 20th Century. It was unique in some of the severity of treatment, which its residents experienced, but overall mirrors national trends in brutal and neglectful living conditions. It also signals larger national trends in the mid to late 70s, which carry over into the 80s and early 90s as part of the deinstitutionalization movement. I find that this movement was largely a response to the conditions for which Willowbrook became a national symbol. Furthermore, even in the wake of the deinstitutionalization movement, there are many problems with federal and state policy that disproportionately disaffect people of color as well as poor people. Finally, I argue that the historical canon must expand somewhat to take into account Deleuze and Guattari’s ideas about Societies of Control. Many scholars, such as the Rothman, Tonya Titchkosky, Kim E. Nielsen, and others base their work on the Foucault’s notion of a ‘disciplinary’ society. But Deleuze (sometimes with Guattari) offers a sympathetic critique of Foucault’s understanding of discipline that adds a great deal of depth to the study of asylums and deinstitutionalization in the mid to late 20th Century.

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Newlove-Delgado, Tamsin Victoria. "Service use and unmet mental health need in children and young adults : analysis of three years of follow up from the 2004 British Child and Adolescent Mental Health Survey & description of primary care psychotropic prescribing & transition in young adults with Attention Deficit Hyperactivity Disorder." Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/21211.

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This thesis aimed to examine service contact among children and young people with mental health problems, and has three complementary parts. The first is a secondary analysis of data from the British Child and Adolescent Mental Health Survey (BCAMHS) 2004, which explored mental health related service contact in relation to psychopathology over three years. The second and third parts focussed on young people with ADHD in transition from child services, which is a particularly challenging time. This involved a qualitative interview study of young peoples’ experiences, and an analysis of primary care prescribing of ADHD medication over the transition period using a cohort from the Clinical Practice Research Datalink from 2005-2013. Less than a third of children with a psychiatric disorder in BCAMHS reported contact with child mental health services. Instead, teachers were the most frequently used service, with two-thirds reporting mental health related contact. Interviews with young people with ADHD highlighted themes including concerns around medication management post transition and need for information. The prescribing analysis found that the majority of adolescents on ADHD medication at age 16 stopped during the transition period. This continuing disparity between estimates of symptom persistence and medication persistence suggests that many may be stopping medication from which they could still benefit; as various barriers have been identified to ongoing prescribing. In summary, the findings of these three linked studies suggest common themes in terms of unmet needs and gaps between policy and practice in mental health services for children and young people. One of the chief implications is the need for oversight and policy levers to ensure the implementation of best practice, accompanied by complementary efforts to better understand and overcome other barriers to providing optimal care, including research into knowledge and attitudes of different groups and the provision of targeted training.

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Herrrera, Elmer Ivan. "The Mental Health Services Act of 2004 and its impact on transitional age youth served in Los Angeles County| A policy analysis." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10046246.

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The Mental Health Services Act (MHSA) of 2004 was analysed using David Gil’s (1992) analytic framework. The strengths and weaknesses of the Act were assessed and special attention was placed on transitional age youth (TAY) who are consumers of Full Service Parternship (FSP) services in Los Angeles County. This analysis found that there have been some improvements in the provision of services to TAY as a result of the MHSA (2004). However, TAY continue to be a group that remains underserved despite the availability of MHSA (2004) funds. The lack of infrastructure of Department of Mental Health to oversee MHSA (2004) funded projects is likely one of the main reasons why new programs for TAY have not been developed. This analysis did find that TAY, who have been served under MHSA (2004) funded programs, have lower rates of incarceration and hospitalization. The recommendations for social work practice, policy and research are discussed.

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Oliveira, Maria Lilian Coelho de. "Caracterização socio-demografica, academica e clinica dos estudantes atendidos no serviço de assistência psicologica e psiquiatrica ao estudante (SAPPE) de 1987 a 2004." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308732.

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Orientador: Claudio Eduardo Muller Banzato
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A caracterização dos clientes é um passo importante na avaliação dos serviços oferecidos pelos centros de saúde mental de um campus universitário em seu planejamento e desenvolvimento futuros. Os objetivos do presente estudo foram descrever as características sócio-demográficas, acadêmicas e clínicas dos estudantes graduação e pós-graduação, que influenciam a procura por um serviço de saúde mental (Serviço de Assistência Psicológica e Psiquiátrica ao Estudante - Sappe) de um campus do Brasil (Unicamp) no período de 17 anos (Março/1987 - Março de 2004). Tais características foram também comparadas com as dos estudantes de toda a universidade. Método: Foram utilizadas as informações dos 2.496 prontuários dos estudantes que procuraram o Serviço. As informações foram sócio-demográficas, acadêmicas e clínicas do cliente e, foi estruturado um banco de dados. A base de dados da Unicamp foi consultada para obter informações sobre o corpo discente da universidade como um todo. Resultados: Os dados indicaram um sobre-representação entre os estudantes de graduação, sexo feminino, oriundos de outros estados brasileiros além de São Paulo. Os estudantes vivem na moradia estudantil do campus e possuem como principal fonte de rendimentos bolsas de estudo. Encontramos também um sobre-representação de estudantes de Ciências Humanas e Artes. Os motivos manifestos mais freqüentemente relatados foram: dificuldades em relações interpessoais, conflitos familiares e mau desempenho acadêmico. Conclusão: O nível do curso (graduação ou pós-graduação), área do conhecimento, residir na moradia estudantil da universidade e a dependência da concessão de bolsas de estudo influenciam o padrão de motivos manifestos para a procura pelo Sappe.
Abstract: The characterization of clients is an important step in the evaluation of services offered by campus counseling and mental health centers and in their further planning and development. The objectives of the present study were to describe reported demographics, academic and complaint of students (undergraduate and graduate) who sought counseling/mental health care at a Brazilian campus (Unicamp) mental health service (Serviço de Asssistência Psicológica e Psiquiátrica ao Estudante - Sappe) over 17 years (march/1987 - march/2004). Compare such characteristics to those of the overall university student body. Methods: Participants were all 2.496 students who sought counseling/mental health care at SAPPE. Information was obtained from client's clinical chart. Unicamp's data base was consulted for information about overall university students. Results: Findings indicated an overrepresentation, among clients, of undergraduates, female students, students from Brazilian states other than Sao Paulo, students living in the campus residence hall and those whose main source of income was a scholarship grant. We also found an overrepresentation of Humanities and Arts student-clients. The most frequently reported complaints were: difficulties in interpersonal relationships, family conflicts and poor academic performance. Conclusion: Course level (undergraduate or graduate), study field, living in a university residential facility and reliance on a scholarship grant were found to influence the mental health seeking behavior of Brazilian university students in this study. Course level was found to influence the pattern of complaints reported at first contact with the mental health service.
Mestrado
Saude Mental
Mestre em Ciências Médicas

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Quadros, Rodrigo Barbosa da Silva. "Contribuições da psicanálise à clínica em saúde mental no contexto da reforma psiquiátrica brasileira: análise sistemática das produções acadêmicas entre 2000 e 2014." reponame:Repositório Institucional da UFC, 2017. http://www.repositorio.ufc.br/handle/riufc/24668.

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QUADROS, Rodrigo Barbosa da Silva. Contribuições da psicanálise à clínica em saúde mental no contexto da reforma psiquiátrica brasileira: análise sistemática das produções acadêmicas entre 2000 e 2014. 2017. 147f. – Dissertação (Mestrado) – Universidade Federal do Ceará, Programa de Pós-graduação em Psicologia, Fortaleza (CE), 2017.
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The present study aims to present and discuss the contributions of psychoanalytic theory to national scientific production in the field of mental health, in particular to the clinical practices carried out in the CAPS between the years 2000-2014. The methodology used was the systematic analysis, which allows stipulating the panorama of the subject studied, pointing out issues/ problems that could result in the development of new researches. We used the Iramuteq software to analyze the data. From its main analysis, Descendant Hierarchical Classification, five classes, so called: new assistance model, the madness in question, psychoanalysis in the CAPS - construction of the clinical case, psychoanalytic theory and the place of the subject in the clinic. The results indicated by the software and the complete reading of all articles, dissertations and theses guided the organization and developed this dissertation. In their results, the methodology of the construction of the clinical case is pointed as the central point of the contribution of psychoanalysis to the field of clinical practices developed in the CAPS. This methodology is still considered by the researchers of wide scope in allowing the transmission of psychoanalytic ethics and the institution of new policies and new arrangements of power, especially by their collective practice.
O presente estudo tem por objetivo apresentar e discutir as contribuições da teoria psicanalítica à produção científica nacional no âmbito da saúde mental, em particular às práticas clínicas realizada nos CAPS, entre os anos de 2000-2014. A metodologia utilizada foi a análise sistemática, que permite estipular o panorama da temática estudada, apontando questões/problemas que poderão resultar no desenvolvimento de novas pesquisas. Tivemos como auxílio para análise dos dados o software Iramuteq. De sua principal análise, Classificação Hierárquica Descendente, surgiram cinco classes, assim denominadas: novo modelo de assistência, a loucura em questão, psicanálise no CAPS- construção do caso clínico, teoria psicanalítica e o lugar do sujeito na clínica. Os resultados apontados pelo software e a leitura na íntegra de todos os artigos, dissertações e teses nortearam a organização e desenvolvido desta dissertação. Em seus resultados, a metodologia da construção do caso clínico é apontada como ponto central da contribuição da psicanálise ao campo das práticas clínicas desenvolvidas nos CAPS. Essa metodologia é considerada ainda pelos pesquisadores de grande alcance ao permitir a transmissão da ética psicanalítica e a instituição de novas políticas e novos arranjos de poder, em especial por sua prática coletiva.

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11

Paterson, Brodie. "Events and social policy : an exploration of the influence of two homicides on developments in mental illness social policy in England 1985-2000." Thesis, University of Stirling, 2006. http://hdl.handle.net/1893/248.

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Background. A number of commentators (Holloway 1996 Muijen 1996a; 1996b) have suggested that two events in the form of homicides carried out by mental health service users came to exert a disproportionate influence on English mental health policy over the period 1985-2000. In particular it has been suggested that the events formed the focus for a ‘moral panic’ caused by ‘irresponsible’ and ‘sensationalist’ reporting in UK newspapers (Neal 1998; Prins and Swan 1998). Aims. In the light of such claims this study critically explores the role played by the deaths of Jonathan Zito and Isabel Schwarz play in establishing violent assaults perpetrated by people experiencing mental illness as a ‘social problem’. It examines whether a shift in the discourse on mental illness took place in UK newspapers and explores how the deaths of Isabel Schwarz were and Jonathan Zito were framed in terms of causal responsibility. Finally it evaluates what influence, if any, the deaths in question had on the social policy agenda. Design. Case study / mixed design integrating quantitative and qualitative methods. Method. Content analysis consisting of a longitudinal analysis of the nature of the representation of mental illness changed over the period in two UK newspaper. Framing a sub-type of discourse analysis examined changes in the discourse of mental illness and the effects of the emergence of the community care tragedy as a ‘new’ narrative. It was also used to examine the potential influence on social policy on mental illness of changes in societal level frames particularly the emergence of the risk society. Results. The content analysis found that mental illness appeared increasingly in the context of a threat to public safety in newspapers over the period but that the overall representation was more balanced. The framing analysis identified and evidenced a competitive process in framing the issue of homicides committed by service users with mental health problems and demonstrated the potential influence of macro level social frames on the policy making proces

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12

Orner, Phyllis. "Gender-aware policy and planning: a feminist analysis of aspects of the Mental Health Care Bill, 2000 and the Skills Development Act, 1998." Thesis, University of the Western Cape, 2000. http://etd.uwc.ac.za/index.php?module=etd&amp.

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13

Belmonte, Pilar. "História da homossexualidade: ciência e contra-ciência no Rio de Janeiro (1970-2000)." reponame:Repositório Institucional da FIOCRUZ, 2009. https://www.arca.fiocruz.br/handle/icict/6145.

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Esta tese analisa as representações em torno da homossexualidade presentes no discurso científico e contra-científico entre os anos de 1970 a 2000, no Rio de Janeiro, em torno das áreas da psiquiatria e da psicologia. As fontes primárias científicas referem-se às teses e dissertações produzidas na Universidade Federal do Rio de Janeiro e na Pontifícia Universidade Católica, bem como artigos do Jornal Brasileiro de Psiquiatria. A produção contra-científica refere-se a textos publicados nas revistas Rádice, Luta & Prazer e Orgón. Para esta análise apresenta-se tanto a discussão científica internacional e nacional sobre a homossexualidade elaborada, principalmente, em fins do século XIX e ao longo do século XX, quanto a influência da contracultura e dos movimentos sociais em nosso país, no período dos anos de 1960 a 1980. O que se pode observar é que a homossexualidade foi representada de forma ambígua tanto na produção científica quanto na produção contra científica, ora associando, ora desvinculado, a homossexualidade à ideia de patologia. Além disso, há uma maior ênfase em explicações psicológicas, calcadas na teoria psicanalítica, em detrimento de justificativas biológicas. Na produção contra-científica foi predominante o discurso em torno do livre arbítrio quanto à opção sexual .

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14

Campos, Cecília Godoi. "Perfil epidemiológico das internações psiquiátricas por álcool e outras drogas em um munícipio da região centro-oeste de Minas Gerais no período de 1998 a 2009." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-18072011-104703/.

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Esta pesquisa trata-se de um estudo epidemiológico de série histórica, de caráter ecológico do tipo descritivo, temporal e exploratório sobre o perfil epidemiológico das internações psiquiátricas por álcool e outras drogas da população do município de Divinópolis, Minas Gerais, Brasil no período de 1998 a 2009. O objetivo do estudo foi descrever a evolução das internações psiquiátricas por álcool e outras drogas, por meio dos dados fornecidos pelo sistema de informática do Sistema Único de Saúde - DATASUS. Foram analisados o número de internações, tempo de permanência hospitalar e taxa de mortalidade, quanto ao mês, ano, sexo e faixa etária. As informações obtidas foram inseridas no software Microsoft Excel (versão 2003) para tratamento dos dados e apresentação dos resultados. Os resultados deste estudo possibilitaram mostrar a situação das internações por uso e abuso de álcool e outras drogas no município. As internações por uso e abuso de álcool e outras drogas corresponderam a 22,3% (751) das internações psiquiátricas totais na popupalção de Divinópolis, sendo 48% (363) por álcool e 52% (388) por outras drogas. Os meses de maior número de internações foram janeiro, abril e maio o que coincide com as festas do município; entre os anos de 2004 a 2007 ocorreram os maiores índices de internação; quanto ao sexo foram 76,4% (574) do sexo masculino e 23,6% (177) do feminino. Observou-se aumento significativo a partir de 2002 no número de internações do sexo feminino. Ao analisar o tempo de permanência nestes 12 anos, nota-se a média de 27,4 dias de internação, tendo o sexo feminino maior permanência, 30,1 dias; as faixas etárias de 15 a 19 anos, de 40 a 49 anos e de 50 a 59 anos apresentaram maior tempo de internação, 28 dias. No período de 1998 a 2009 não houve nenhum óbito nas internações psiquiátricas devido ao uso e abuso de álcool e outras drogas. Conclui-se com este trabalho que a problemática álcool e outras drogas tem se tornado cada vez mais incidente na população, em especial no sexo feminino, adolescentes e adultos-jovens, sendo aconselhável maiores estudos para conhecimento do perfil dos usuários e drogas de consumo para desenvolvimento de políticas específicas, organização de serviços, formação e capacitação de profissionais especializados.
This paper is about an epidemiologic study based on historical data which has an ecologic feature which is related to hospitalization description, time and exploratory over the epidemiologic feature of psychiatric hospitalization due to alcohol and other drugs abuse by the population from Divinópolis city, state of Minas Gerais, Brazil from 1998 to 2009. The aim of this study was to describe the evolution of psychiatric hospitalization due to alcohol and other drugs abuse according to means provided by Informatics Single System of Public Healthcare - DATASUS. It was analyzed the number of hospitalization, hospitalization period and death rate, related to month, year, gender and age. The information collected was inserted into Microsoft Excel software (2003 version) to data treatment and outcome presentations. This study outcomes made possible to show the situation of hospitalization by use and drug abuse were 22,3% (751) from total amount of psychiatric hospitalization from Divinópolis inhabitants, 48% (363) by alcohol abuse and 52% (388) by other drug abuse. The months which demonstrated a higher number of hospitalization were January, April and May, which propably is related exactly with the local parties that occurs during these months; from 2004 to 2007 the were higher rates of hospitalization related to gender were 76,4% (574) male and 23,6%(177) female. It was observed a significant increasing from 2002 in the number of female\'s hospitalization. By analyzing the period of hospitalization during 12 years, it is observed the average of 27,4 days of hospitalization in which female the period in hospital was higher, 30,1 days, ages raging from 15 to 19 years old, from 40 to 49 years old and 50 o 59 years old present higher period of hospitalization, 28 days. From 1998 to 2009 there was not any death due psychiatric hospitalization to alcohol and drug use or abuse. It was concluded in this paper that the alcohol and other drugs abuse matter and has become over and over recurrent in local inhabitants particularly female, teenagers and young adults being advisable further studies in or order to recognize the drug addicted features and kind of drug consumed to help the specific politics, services organization, training and specialized professional enabling.

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15

Ibell, Bernadette Mary. "An analysis of mental health care in Australia from a social justice and human rights perspective, with special reference to the influences of England and the United States of America, 1800-2004." Phd thesis, Australian Catholic University, 2004. https://acuresearchbank.acu.edu.au/download/08cd80266073cee2195a33e254f4a9298144ba8d6f3a2eece63325aee6b2021c/3481468/64925_downloaded_stream_150.pdf.

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The aim of this thesis is to analyze mental health care in Australia from a social justice and human rights perspective, in order to demonstrate that social justice as a philosophical manifestation of justice and fairness, is an essential ingredient in the theory and practice of mental health care. It is contended that the needs of the mentally ill would be most appropriately answered by the utilization of a Natural Law model, based on Finnis's Natural Law theory. The Scope of the Thesis.The needs and care of the mentally ill are discussed, together with the treatment meted out to these vulnerable members of society since, approximately, the year 1800. Neither the criminally insane, nor the intellectually disabled are included in this discourse. Each group of people merits a thesis on its own: criminal insanity requires a debate to include the history, psychiatric and legal approaches to the subject, and current management of the insane. The intellectually disabled are not mentally ill; their ability to function as all round, naturally competent individuals is diminished by an inadequacy and/or impairment of their intellectual capacities. The needs of these two groups are far too broad and demanding to be included within the current thesis. Rationale for the Timeframe The timeframe, 1800 until 2004, has been established because it approximates to the transition from the end of the Classical through the Modern Age to the Post Modern Age, together with the predominance of Enlightenment philosophical theories, and the development of a scientific approach to medicine. Further, many politico-economic and social changes were taking place, associated with the Industrial Revolution. All are shown to have affected the introduction of asylumdom, and the institutionalization of those unable to participate actively in the industrial workforce.;Of significant importance to the development of institutionalization for such marginal groups is the philosophy of Jeremy Bentham. Bentham espoused Classical Utilitarianism which will be shown to believe that the ultimate standard of utility is not the individual's happiness but the greatest amount of happiness altogether. The thesis will demonstrate that this philosophical view prevailed from the beginning of the Industrial Revolution, with Benthamism influencing the sequestration of the unemployable into institutional life. Development of the Thesis.The thesis is developed against a background of prevailing philosophical, and other changes as stated above, including the medicalization of mental illness and the development of psychiatry as a branch of medicine. There is manifestation of many social injustices to those incarcerated in the asylum in all three countries under consideration: England, USA, and Australia. It is demonstrated that social justice and human rights of their work forces were disregarded by many employers at the time of the Industrial Revolution. Such values were, therefore, unlikely to prevail with regard to the mentally ill. Asylumdom continued with few changes in its practices until after World War II. It is shown that the predominance of post Enlightenment theories, together with further politico-economic, social and pharmaceutical revolutionary change followed the Second World War. Encouraged also by the founding of the United Nations and World Health Organizations as well as provision of the Declaration of Human Rights, circumstances led to the process of de-institutionalization of the mentally ill. The latter were decanted with apparently unseemly haste into a community ill prepared for such a change, and with little evidence of infra- structure to support the move. Need to conduct a National Inquiry. There was, then, a need to investigate what was now an overt issue of mental health care.;The two subsequent inquiries by the Australian Health Ministers Advisory Council, (AHMAC) and the Burdekin Report, both focused on social justice issues, and addressed epidemiological, economic, sociological and justice considerations. Within the thesis, both investigations are critiqued against a Natural Law model, using Finnis's Natural Law theory. It is demonstrated that contrary to Enlightenment principles of social justice as described by Miller, such a theory is eminently practical, and answers the needs of all members of the community, providing not merely 'the greatest happiness for the greatest number' but the common good of all Conclusion. Evidence shows that such a Natural Law theory is required to give a firm foundation to the needs of the mentally ill, especially at a time when relativism, economic rationalism and negative aspects of globalization prevail. Without such a basis the mentally ill are left insecure, uncertain and adrift in a world uncaring of their plight, while all the earnest exhortations espoused by Reports remain platitudes, subject to the whims of whatever government is in power. Our responsibilities to all our fellow human beings demand better from us than this.

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16

Ibell, Bernadette Mary, and res cand@acu edu au. "An Analysis of Mental Health Care in Australia From a Social Justice and Human Rights Perspective, With Special Reference to the Influences of England and the United States of America: 1800-2004." Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp113.25102006.

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The aim of this thesis is to analyze mental health care in Australia from a social justice and human rights perspective, in order to demonstrate that social justice as a philosophical manifestation of justice and fairness, is an essential ingredient in the theory and practice of mental health care. It is contended that the needs of the mentally ill would be most appropriately answered by the utilization of a Natural Law model, based on Finnis’s Natural Law theory. The Scope of the Thesis.The needs and care of the mentally ill are discussed, together with the treatment meted out to these vulnerable members of society since, approximately, the year 1800. Neither the criminally insane, nor the intellectually disabled are included in this discourse. Each group of people merits a thesis on its own: criminal insanity requires a debate to include the history, psychiatric and legal approaches to the subject, and current management of the insane. The intellectually disabled are not mentally ill; their ability to function as all round, naturally competent individuals is diminished by an inadequacy and/or impairment of their intellectual capacities. The needs of these two groups are far too broad and demanding to be included within the current thesis. Rationale for the Timeframe The timeframe, 1800 until 2004, has been established because it approximates to the transition from the end of the Classical through the Modern Age to the Post Modern Age, together with the predominance of Enlightenment philosophical theories, and the development of a scientific approach to medicine. Further, many politico-economic and social changes were taking place, associated with the Industrial Revolution. All are shown to have affected the introduction of asylumdom, and the institutionalization of those unable to participate actively in the industrial workforce. Of significant importance to the development of institutionalization for such marginal groups is the philosophy of Jeremy Bentham. Bentham espoused Classical Utilitarianism which will be shown to believe that the ultimate standard of utility is not the individual’s happiness but the greatest amount of happiness altogether. The thesis will demonstrate that this philosophical view prevailed from the beginning of the Industrial Revolution, with Benthamism influencing the sequestration of the unemployable into institutional life. Development of the Thesis.The thesis is developed against a background of prevailing philosophical, and other changes as stated above, including the medicalization of mental illness and the development of psychiatry as a branch of medicine. There is manifestation of many social injustices to those incarcerated in the asylum in all three countries under consideration: England, USA, and Australia. It is demonstrated that social justice and human rights of their work forces were disregarded by many employers at the time of the Industrial Revolution. Such values were, therefore, unlikely to prevail with regard to the mentally ill. Asylumdom continued with few changes in its practices until after World War II. It is shown that the predominance of post Enlightenment theories, together with further politico-economic, social and pharmaceutical revolutionary change followed the Second World War. Encouraged also by the founding of the United Nations and World Health Organizations as well as provision of the Declaration of Human Rights, circumstances led to the process of de-institutionalization of the mentally ill. The latter were decanted with apparently unseemly haste into a community ill prepared for such a change, and with little evidence of infra- structure to support the move. Need to conduct a National Inquiry. There was, then, a need to investigate what was now an overt issue of mental health care. The two subsequent inquiries by the Australian Health Ministers Advisory Council, (AHMAC) and the Burdekin Report, both focused on social justice issues, and addressed epidemiological, economic, sociological and justice considerations. Within the thesis, both investigations are critiqued against a Natural Law model, using Finnis’s Natural Law theory. It is demonstrated that contrary to Enlightenment principles of social justice as described by Miller, such a theory is eminently practical, and answers the needs of all members of the community, providing not merely ‘the greatest happiness for the greatest number’ but the common good of all Conclusion. Evidence shows that such a Natural Law theory is required to give a firm foundation to the needs of the mentally ill, especially at a time when relativism, economic rationalism and negative aspects of globalization prevail. Without such a basis the mentally ill are left insecure, uncertain and adrift in a world uncaring of their plight, while all the earnest exhortations espoused by Reports remain platitudes, subject to the whims of whatever government is in power. Our responsibilities to all our fellow human beings demand better from us than this.

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17

Eyjolfsdottir, Harpa Sif. "Social capital, self-rated health and the importance of sleep : The case of Iceland in 2007 and 2009." Thesis, Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS), 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-77285.

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The frequently studied concept of social capital has often been related to health, but theconceptualisationand measurement of the conceptisanon-goingdebate. The main aim of this thesis is to study the relationship of four different indicators of social capital; informal social capital, formal social capital, trust towards institutions and trust towards others, with self-rated physical health and self-rated mental health in Iceland in 2009, shortly after a harsh economic crash. Insomnia symptoms will be studied as a possible mediator or moderator in the relationship. Furthermore, longitudinal data on informal social capital will be used to see the causal effect of social capital on health and to see if informal social capital decreased after the economic collapse. Population-based panel data from Iceland in 2007 and 2009 will be used to perform both cross-sectional analysis (n = 3,243) and longitudinal analysis (n = 3,131). The main results are that the four indicators of social capital all relate differently to physical and mental self-rated health, and insomnia symptoms seem to mediate the relationship between social capital and health, especially physical health. Surprisingly, informal social capital did increase during the economic collapse. The panel analysis further suggests that having poor informal social capital has causal effects on poor self-rated mental health when adjusted for symptoms of insomnia, age, gender, family status, education and smoking.

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18

Barros, Regis Eric Maia. "Caracterização clínica-demográfica das internações psiquiátricas na região de Ribeirão Preto - SP entre 1998 e 2004." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/17/17148/tde-07102008-173614/.

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No início de 1990, as internações psiquiátricas no Brasil constituíam-se a segunda fonte de despesas com internações hospitalares. A partir de 1992, com as diretrizes do Ministério da Saúde, houve mudanças na caracterização das internações. Os hospitais psiquiátricos, progressivamente, deixaram de constituir a base do sistema assistencial, com o aumento da rede de serviços extra-hospitalares. A XIII Diretoria Regional de Saúde (DRS XIII), com sede em Ribeirão Preto, foi submetida a estas diretrizes, levando à reorganização do atendimento de saúde mental. De modo que, no início da década de 1990, a DRS XIII dispunha de 685 leitos psiquiátricos para internações agudas. As taxas de ocupação chegavam a 96% e o tempo de permanência era elevado com grande número de re-internações. Com as diretrizes, houve redução para 114 leitos para internações agudas e, concomitantemente, houve uma ampliação dos serviços extra-hospitalares de saúde mental. Essas medidas levaram a uma diminuição do número de internações e na taxa de ocupação para 60 a 70%. No entanto, a partir de 2003, passaram a ocorrer dificuldades para internação integral devido à falta de vagas. Esta pesquisa objetiva avaliar essas mudanças caracterizando as internações. Foi criado um banco de dados único utilizando dados armazenados nos banco de dados de cada hospital envolvido no estudo. Todas as internações entre os anos de 1998 a 2004 foram contabilizadas. Foram analisadas as seguintes variáveis: faixa etária, sexo, estado civil, ocupação, diagnósticos, procedência, distrito sanitário para pacientes que residiam em Ribeirão Preto, tempo de permanência, re-internações, giro leito e taxa de ocupação. Foram internados 5362 pacientes correspondendo a 11.208 internações com as seguintes proporções de distribuição: Hospital Psiquiátrico (47,8%), Hospital Geral (14,1%) e Emergência Psiquiátrica (38,1%). As taxas de ocupação nos serviços de internação integral tiveram aumento nos últimos anos da pesquisa apesar do giro leito permanecer relativamente elevado. Não existiram marcantes diferenças entre os serviços em relação às características demográficas das internações, mantendo-se um padrão de predominância de pacientes do sexo masculino, adultos jovens, sem vínculos conjugais estáveis, inativos profissionalmente e provenientes da própria região de Ribeirão Preto. As internações mais curtas predominaram nos serviços, havendo maior proporção de internações prolongadas no Hospital Geral, provavelmente pela gravidade dos casos. A maior proporção das internações é proveniente de Ribeirão Preto, com predomínio daquelas oriundas do distrito atendido pelo Núcleo de Saúde Mental do Centro de Saúde Escola. Os diagnósticos mais encontrados em todos os serviços foram os transtornos relacionados ao uso de substâncias psicoativas, transtornos do humor, transtornos psicóticos e transtornos de personalidades, havendo algumas diferenças nas proporções entre os serviços. O número de re-internações aproxima-se de um quarto (1/4) das internações em cada ano. O aumento das internações pode está relacionado as limitações da rede de serviços extra-hospitalares. A emergência psiquiátrica foi responsável por cerca de 40% das internações no período do trabalho. Novos serviços extra-hospitalares podem determinar melhorias na rede de atendimento.
At the beginning of the 1990s, psychiatric hospitalization costs were the second-largest source of all hospitalization costs in Brazil. Since 1992, as a result of the Ministry of Heath guidelines, there have been changes in the characteristics of these hospitalizations. Psychiatric hospitals have progressively ceased to be a part of the core health care system, and there has been an increase in the outpatient service network. The 13th Regional Health Authority (DRS XIII), headquartered in Ribeirão Preto, followed these guidelines, which led it to reorganize its mental health care. At the beginning of the 1990s, DRS XIII had 685 beds for the treatment of acute psychiatric patients: their occupancy rate was as high as 96%, the length of stay was high and there was a high number of readmissions. The guidelines, however, resulted in a reduction in the number of beds for acute patients to 114, whilst there was a simultaneous expansion in the mental health care outpatient services. These measures led to a drop in the number of hospital admissions, and the occupancy rate fell to 60 - 70%. Nevertheless, since 2003, it has been more difficult to provide full-time hospitalization due to lack of beds. The aim of this project is to evaluate these changes in the hospitalization policy. A central database was created using the data stored in the databases of each of the hospitals involved in the study. All hospitalizations between 1998 and 2004 were taken into account. The following variables were analyzed: age, gender, marital status, occupation, diagnosis, origin, health district (for patients that live in Ribeirão Preto), length of stay, readmissions, bed turnover rate and occupancy rate. 5,362 patients were hospitalized a total of 11,208 times according to the following breakdown: Psychiatric Hospital (47.8%), General Hospital (14.1%) and Emergency Psychiatric Unit (38.1%). The occupancy rate for full-time hospitalization services has increased over the last few years in spite of the bed turnover rate remaining relatively high. There are no significant differences between services as far as the demographic characteristics of the hospitalized patients are concerned: patients are still predominantly young unemployed males, who are not in stable partnerships, and come from the Ribeirão Preto region. Short-stay hospitalizations are predominant, with a higher proportion of longer hospitalizations in the General Hospital, which was probably due to the serious nature of these cases. The largest proportion of hospitalizations comes from Ribeirão Preto, especially from the district served by the Núcleo de Saúde Mental do Centro de Saúde Escola (Mental Health Unit of the Learning Health Center). The most common diagnoses were disorders brought on by psychoactive substance abuse, mood disorders, psychotic disorders and personality disorders, with there being some differences in the proportions from one service to another. Around 1/4 of the hospitalizations each year are readmissions. The psychiatric hospitalization increasing may be dual to the outpatient service network deficient. The emergency psychiatry unit was answerable for 40% of psychiatric hospitalization reported in this study. The outpatient service development may be improve the health care system.

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Quadros, Rodrigo Barbosa da Silva. "ContribuiÃÃes da PsicanÃlise Ã ClÃnica em SaÃde Mental no contexto da Reforma PsiquiÃtrica Brasileira: anÃlise sistemÃtica das produÃÃes acadÃmicas entre 2000 e 2014." Universidade Federal do CearÃ, 2017. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=19774.

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CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior
O presente estudo tem por objetivo apresentar e discutir as contribuiÃÃes da teoria psicanalÃtica Ã produÃÃo cientÃfica nacional no Ãmbito da saÃde mental, em particular Ãs prÃticas clÃnicas realizada nos CAPS, entre os anos de 2000-2014. A metodologia utilizada foi a anÃlise sistemÃtica, que permite estipular o panorama da temÃtica estudada, apontando questÃes/problemas que poderÃo resultar no desenvolvimento de novas pesquisas. Tivemos como auxÃlio para anÃlise dos dados o software Iramuteq. De sua principal anÃlise, ClassificaÃÃo HierÃrquica Descendente, surgiram cinco classes, assim denominadas: novo modelo de assistÃncia, a loucura em questÃo, psicanÃlise no CAPS- construÃÃo do caso clÃnico, teoria psicanalÃtica e o lugar do sujeito na clÃnica. Os resultados apontados pelo software e a leitura na Ãntegra de todos os artigos, dissertaÃÃes e teses nortearam a organizaÃÃo e desenvolvido desta dissertaÃÃo. Em seus resultados, a metodologia da construÃÃo do caso clÃnico Ã apontada como ponto central da contribuiÃÃo da psicanÃlise ao campo das prÃticas clÃnicas desenvolvidas nos CAPS. Essa metodologia Ã considerada ainda pelos pesquisadores de grande alcance ao permitir a transmissÃo da Ãtica psicanalÃtica e a instituiÃÃo de novas polÃticas e novos arranjos de poder, em especial por sua prÃtica coletiva.
The present study aims to present and discuss the contributions of psychoanalytic theory to national scientific production in the field of mental health, in particular to the clinical practices carried out in the CAPS between the years 2000-2014. The methodology used was the systematic analysis, which allows stipulating the panorama of the subject studied, pointing out issues/ problems that could result in the development of new researches. We used the Iramuteq software to analyze the data. From its main analysis, Descendant Hierarchical Classification, five classes, so called: new assistance model, the madness in question, psychoanalysis in the CAPS - construction of the clinical case, psychoanalytic theory and the place of the subject in the clinic. The results indicated by the software and the complete reading of all articles, dissertations and theses guided the organization and developed this dissertation. In their results, the methodology of the construction of the clinical case is pointed as the central point of the contribution of psychoanalysis to the field of clinical practices developed in the CAPS. This methodology is still considered by the researchers of wide scope in allowing the transmission of psychoanalytic ethics and the institution of new policies and new arrangements of power, especially by their collective practice.

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Pintor, Nelma Alves Marques. "Uma análise do projeto espaço integrado de desenvolvimento e estimulação (EIDE) na rede municipal de ensino de Niterói/Rj período 2008-2009." Instituto Fernandes Figueira, 2011. https://www.arca.fiocruz.br/handle/icict/6449.

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Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil
Esta pesquisa se constituiu como a primeira experiência de avaliação oficial de um projeto de estimulação pedagógica, exploratório (EIDE – Espaço Integrado de Desenvolvimento e Estimulação), com o objetivo de estudar as condições e forma de educação e escolarização, em classes comuns das escolas municipais, para alunos que apresentam significativas defasagens em suas condições vitais, implicando, principalmente, em deficiência intelectual acentuada, desenvolvido concomitantemente por meio de ação intersetorial entre os profissionais da saúde e da educação. Para avaliar o desenvolvimento e aprendizado dos alunos, tomou como referência a teoria sóciohistórica, com base em quatro categorias estudadas por Vygotsky e seus colaboradores e para avaliar o projeto em sua dimensão social, utilizou a proposta do Manual de Avaliação de Projetos Sociais do Cepal (1997). De índole qualitativa, a pesquisa utilizou, em seu estudo etnográfico, entrevistas semiestruturadas, anamnese, documentos, relatórios de atividades e observação participante para colher informações com os sujeitos. Os resultados mostraram que a consciência social do direito à educação e a cultura por parte dos profissionais da educação e dos profissionais da saúde avançou, da mesma forma que a presença de uma cultura inclusiva em boa parte das escolas públicas da Rede Municipal de Ensino da cidade de Niterói. Em contraste, foi percebida a presença do preconceito e da crença na incapacidade de aprendizado dos alunos com deficiência intelectual e múltipla. Esta foi considerada a principal barreira para a promoção da inclusão escolar e educacional dos alunos severamente comprometidos na Rede Municipal de Ensino de Niterói/RJ. O modelo de escolarização nas escolas é incompatível com uma proposta educativa onde eles estão (ou deveriam estar) incluídos. Contudo, a conclusão principal desta pesquisa é de que esses alunos são capazes de aprender, se colocados em situações que estimulem a interação social, a linguagem, a imitação e o brincar. Em relação às ações de trabalho conjunto entre os profissionais da saúde e da educação foi comprovada a necessidade de fortalecimento da proposta de intersetorialidade entre estes setores, visando à promoção integral da saúde das pessoas com deficiência. Concluindo, a pesquisa mostrou que os resultados alcançados por meio do estudo etnográfico e da meta-avaliação do EIDE podem oferecer subsídios para avaliação de outros Programas e Projetos na área da educação, inclusive de outros sistemas de ensino no Brasil.
This research was developed as the first official evaluation experience of a pedagogical stimulation project, exploratory (EIDE-Espaço Integrado de Desenvolvimento e Estimulação) aiming studying the forms and conditions of education and schooling , in municipal school common classes, for students who have significant gaps in their vital conditions, implying, especially in severe intellectual disability, developed concurrently through intersectoral action between health and education professionals. To evaluate the student learning and development, its reference to socio-historical theory, based in the four categories studied by Vygotsky and his contributors and to evaluate the project’s social, utilized Cepal’s Social Projects Evaluation Handbook proposition (1997). From qualitative nature, the research used semi-structured interviews in its ethnographic study, anamnesis, documents, activities reports and participant observation to gather information with the subjects. The results showed that the social awareness by education and health professional to the right to education and culture has developed, the same way that the presence of an inclusive culture in most of schools in the municipal schools in the city of Niterói. In contrast, were noticed the presence of prejudice and belief in the learning disabilities of students with intellectual and multiple disabilities. This was considered the main barrier to promote of school and educational inclusion of the severely compromised students in the municipal school of Niterói/RJ. The educational model in schools is not compatible with an educational proposal where they are (or should be) included. However, the main conclusion of this research is that these students are able to learn, if placed in situations that encourage social interaction, language, imitation and play. In relation to the actions of joint work between health and education professionals has been proven the need to strengthen the proposed intersectoral between these sectors aimed at promoting integral health of persons with disabilities. In conclusion, this study shows that the results achieved through the ethnographic study and meta-evaluation EIDE may provide the basis for evaluation of other programs and projects in the area of inclusive education from other education systems in Brazil.

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Ure, Gale Barbara. "Mental health care in South Africa 1904 to 2004: legislation influencing ethical patient care." Thesis, 2009. http://hdl.handle.net/10539/7285.

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M.Sc.(Med.), Faculty of Health Sciences, University of the Witwatersrand, 2009
Mental health in South Africa has undergone many changes since the pioneering work of colonial doctors in the early 1900’s. With the advent of a human rights based constitution in the 1990’s, mental health was forced to review its methods of care and the political motivation behind many long-term hospitalisations. Because of these practices, government mental health structures maintain and fund institutions that warehouse a legacy of institutionalised and disenfranchised patients from the apartheid area. A number of these patients have been hospitalised for over forty years – some without an appropriate psychiatric diagnosis. Many of these patients cannot be discharged back into the community, as their families have been lost over time. Many patients are institutionalised to the extent that they are unable to manage even the most menial of personal tasks and thus cannot leave the safety of the centres in which they are housed. International developments in the field of Eugenics underpinned much of the sweeping social change that was embraced by Europe and the USA. Germany based many of its policies of eradication of the ‘unfit’ on eugenic principles that could comfortably accommodate the rejection of racial differences. The profound effect that eugenics exercised in the medical and social spheres internationally drove the development of many apartheid-based government policies in South Africa. These included reform in the areas of education, mental health, social development, group areas etc. This research report briefly explores some of the social, medical, political and legislative influences active in the field of mental health from 1904 to 2004.

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Hao, Yi-Ting, and 郝懿婷. "The Impact of Food Away From Home on Mental Health：Nutrition And Health Survey in Taiwan 2004–2008 ( NASIT 2004–2008 )." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/f5h7p2.

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碩士
國立臺灣大學
農業經濟學研究所
107
As the proportion of food-away-from-home (FAFH) has increased over years, it has become the main dietary style. According to the “Survey of Family Income and Expenditure”, Taiwan’s household food expenditure consumed in restaurants was up to 43.48% in 2017. Many countries concern the issues about the impact of FAFH on people''s health, and many studies point out that the food energy per unit in the restaurant is far greater than the intake of cooking at home, it will let us consume too much calories, sodium, less vitamin and other nutrients, and be easy to cause the burden on the body, such as obesity, chronic diseases and cardiovascular diseases. In the study of the relationship between food and mental health, mainly based on study of nutrients and emotions, previous studies have confirmed that proper intake of nutrients can improve depression and other emotional problems. Using data from the National Health and Nutrition Survey in 2004-2008 in Taiwan (NAHSIT), we used OLS and Probit model to discuss the effect of FAFH on mental health. We also use inverse probability weighting (IPW) to solve the endogeneity problem. The results show that there is a significant positive correlation between dinner and mental health, a significant increase in the total score of Brief Symptom Rating Scale (BSRS-5) and the probability of depression.

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Mitchell, Christina. "Exploration of changes in outpatient clinical presentation and diagnosis in children and adolescents at a South African community service and psychological training centre from 1987 to 2009." Thesis, 2012. http://hdl.handle.net/10413/9168.

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Child and adolescent mental health represents a key area of concern and public health relevance. Mental health disorders are one of the most prevalent illnesses affecting young people and contribute significantly to the global burden of disease. Childhood and adolescent mental health problems often persist into adulthood and as such frequently result in lifelong negative consequences. Yet despite the growing concern with regards to the mental health needs of children and adolescents, not much research, both internationally and particularly locally, has focused on the provision of mental health services to children and adolescents. Additionally, little has been published on the changes and trends in diagnostic rates and assessment procedures over time. Only a few international studies have investigated mental health trends in children and adolescents; hence, there is a crucial need for South African data to inform preventative and curative services for children in South Africa. This present study therefore investigated the trends and patterns relating to diagnostic rates and assessment practices in children and adolescents over time at a local South African psychological community service centre in Pietermaritzburg. The study was a retrospective chart review and the sample consisted of 679 case files from children and adolescents between 3-17 years of age, who had been seen at a local psychological service centre between 1987-1989, 1997-1999 and 2007-2009. The case files were systematically analysed with regards to diagnosis and assessment practices. It was hypothesised that the years of continuous social and political conflict in the Pietermaritzburg area, namely 1987-1989, had a direct impact on the psychological development and well-being of children and adolescents from this area, and that this would be reflected in the case files from the corresponding years. The research findings with regard to the assessment practices were comparable to the internationally observed trends relating to choice of tests and procedures. In addition, the findings of the current study also showed similar trends with regard to the increasing diagnostic rates for ADD/ADHD, Mood Disorder, and Autism Spectrum Disorders as were observed internationally. Additionally, the reported decreasing diagnostic rates for Mental Retardation and behaviour disorders were also found in this local study. However, the internationally observed increases in Anxiety Disorder diagnoses contrast with the findings of this study, where the results revealed that the rates for Anxiety Disorder and PTSD were considerably higher in the late 1980s and 1990s. This finding supports the initial hypothesis that the violence and social unrest had an effect on children’s psychological well-being.
Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

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Tsai, I.-Chun, and 蔡宜純. "An Exploration of Using Mental Health Escort Services for Medical Treatments from 2007 to 2009 in Kaohsiung County." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/84081707957840280162.

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碩士
輔英科技大學
護理系碩士班
99
For the purpose of protecting psychiatric patients'' health rights, Taiwan implemented the Mental Health Law since December 7, 1990, as the basis to send psychiatric patients for enforced treatment and compulsory evaluation in order to protect the public from possible harm.Providing the first line health care professionals and policy makers with evidence, and educating the public about the appropriateness of using these services are worthy for study.The purpose of this study was to investigate the uses of mental health escort services for medical treatments among Kaohsiung county townships and the influences of psychiatric patients'' demographic and disease characteristics, as well as community mental health care factors on using mental health medical escort. This study utilized a retrospective and descriptive research design by analyzing Suspected Psychiatric Patient Identification and Medical Treatment Database form 2007 to 2009 provided by Health Bureau of Kaohsiung County Government and Mental Care Information Management System. SPSS statistical software package version 17.0 was applied for descriptive and inferential statistical analysis. 1,386 subjects who had used mental health escort services from 2007 to 2009 were included in final data analysis. Among them, 65.9% were male with an average age of 40.7. Most of them lived in Fengshan City (15.1%), Okayama town (10.4%), Daliao Township (12.8%) and Linyuan Township (10.3%). The main reason of using the mental health escort services is suspition of mental disorders (51.8%). The public used these services mostly during office hours (55.9%). About 52.3 % of the people who were sent to the mental health escort were those who were not supervised by community health nurses and 54.6 % of the people who were not officially classified as mental illness. An average of 1.2 escort services was in this study. 15,644 psychiatric patients received supervision by community health nurses from 2007 to 2009. Among them, 53.2% were male with an average age of 45.5. About half of them lived in newly developed counties (45.7%), and were asymptomatic (50.9%) without functional impairments (51.7%) of community living. Half of them were with moderate mental impairment (50.1%) and received stage 4 (44%) supervision by community health nurses. Most of them were stable in terms of their mental health condition (53.6%) and took medication regularly (68.2%). The factors of influencing psychiatric patients to use mental medical escort services included: gender (OR: male 1.92), age (OR: 18-29 5.309, 30-44 5.608), education (OR: junior high school 2.481, college and above 3.334), symptom severity (OR: moderately severe 2.59, severe 2.473, slightly 2.353), level of community function (OR: moderately severe 4.488, severe 5.133), community health nursing care stage (OR: stage 1 5.782, stage 2 6.725, stage 31.634 , stage 51.764), visiting doctors (OR: irregularly visit doctors 4.579, no insight 5.951),and prescriptions (OR: irregularly take medication 8.154). The findings of this study showed certain new amendments to the Mental Health Law to protect the rights of mental patients , public health nurses should be given positive support and appreciation to the management of psychological care for theresults. People in the first line on duty would be beneficial from this study''s findings. The government could use these findings as references for making policy and to develop community mental health promotion-related public lectures, public education, community mental health escorts for medical treatment launched adequacy of communication with the right window, so that mental health resources to a more rational use.

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Tsai, Ya-Ping, and 蔡亞萍. "Trends in Outpatient Mental Health Care Provided By Psychiatrists and Non-Psychiatrists in Taiwan from 2000 to 2010." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/42689984017072829705.

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碩士
國立陽明大學
醫務管理研究所
104
ABSTRACT Objective: In recent years, there was changing of mental health care pattern from institutional inpatient care mode to community based ambulatory care services. Primary care physicians are believed to play an increasingly important role in the care of mentally ill individuals. It may be critical to understand the provision of mental care and assess potential differences in treatment patterns between psychiatrists and non-psychiatrists. In Taiwan, the prevalence of probable common mental disorders doubled from 11.5% in 1990 to 23.8% in 2010. Therefore, in order to understand changes in the provision of mental care, we aim to assess recent trends in outpatient mental health care provided by psychiatrists and non-psychiatrists, 2000-2010. Method: The data for this study were derived from the 2000, 2005 and 2010 cohort of National Health Insurance Research Database. We identified the outpatient visits with three mental health care indicators (including mental disorder diagnoses, psychotropic medications, and psychotherapy) in 2000, 2005, and 2010. We used repeated cross-sectional data to estimate the rates and percentages of outpatient visits with mental disorder diagnoses, psychotropic medications, and psychotherapy by dividing the sampling of one million. Logistic regression analysis and Cochran-Armitage trend test were used to assess time trends in mental health visits provided by psychiatrists and non-psychiatrists. We also stratified our analyses by youths (≤20 years) and adults (>20 years). Results: A significant increase occurred in the rate of per 100 population of psychiatrist visits with mental disorders (10.26 to 23.23) (OR = 1.24, 95%CI 1.22-1.25), psychotropic medications (9.11 to 21.94) (OR = 1.32, 95%CI 1.31-1.34), and psychotherapy (1.07 to 9.89) (OR=1.80, 95%CI 1.79-1.82) between 2000 and 2010. In the meantime, a significant increase occurred in non-psychiatrist visits with mental disorders (10.18 to 17.56) (OR=1.26, 95%CI 1.26-1.27), psychotropic medications (15.93 to 20.52) (OR = 1.09, 95%CI 1.09-1.10), and psychotherapy (0.69 to 2.55) (OR = 1.79, 95%CI 1.77-1.81). By contrast, the rate of per 100 youths of non-psychiatrist visits with mental disorders is higher than the rate of psychiatrist visits (3.16 to 12.87; 2.51 to 7.87). Additionally, non-psychiatrist visits with psychotherapy increased significantly faster than psychiatrist in youths (OR= 2.53 and 1.37, respectively). Conclusions: Overall, the mental health visits to either psychiatrists or non-psychiatrists had increased significantly from 2000 to 2010. Non-psychiatrists play an important role in mental health care provision, particularly among youths. The significant role and treatment patterns of non-psychiatrists in providing mental health services shall not be overlooked. However, the differences in treatment patterns between psychiatrists and non-psychiatrists may need further investigations and more attentions.

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Kordes, Doris. "The arts of care in an asylum and a community 1925-2004: Kenmore Hospital, New South Wales and Canberra, the Australian Capital Territory." Phd thesis, 2009. http://hdl.handle.net/1885/155196.

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This thesis examines the arts of care in an asylum in New South Wales (NSW) and a mental health community in the Australian Capital Territory in twentieth-century Australia, and describes and compares a range of governmental responses for responding to persons deemed to be in need of care. The thesis explores similarities between twentieth-century Australian care techniques and the key principles underpinning a ‘care system’ that was developed over 200 years ago. It proposes three twentieth-century care regimes, each one characteristic of a certain period: Herd Care, set in an asylum era that emphasised custodialism and confinement (1925-1958); Therapeutic Community, a period during which the asylum was reconfigured into a facilitative community (1959-1983); and Community Care, beginning around 1983, when NSW asylums were ‘rationalised’, their care techniques fragmented and outsourced in diverse settings generally referred to collectively as the mental health community. Some of the dynamics, continuities and ruptures in twentieth-century care regimes are analysed. Chapters describe the landscapes of care. They explore how environmental settings have been designed to reinforce the care regimes in which they are mobilised and how they ‘make up’ the possibilities for action of the subject of care. The dynamics of care between care providers and their recipients are examined. Some of the continuities and discontinuities of meanings associated with ‘family’ and ‘community’ in each of the care regimes are observed. Fieldwork findings are combined with the cultural narrative of psychiatric primitivism to consider why subjects have been deemed in need of care, at times in need of protection and training and at other times in need of discipline and restraint. The new possibilities for action that have emerged in Australian twentieth-century mental health governance are considered, when subjects of care have been encouraged to learn how to be free

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Feo, Paolo. "Policing and planning child and adolescent neuropsychiatry : the reform process in Bologna 2009-2014." Master's thesis, 2014. http://hdl.handle.net/10362/14248.

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Desde a aprovação do plano de saúde mental regional em Itália ... o Departamento Local de Saúde Mental e Perturbações aditivas em Bolonha, tem desenvolvido um projeto de reforma cujo objectivo é inovar o sistema de saúde mental local. ...ABSTRACT: Since the Regional mental health plan 2009-2011 was approved in Italy the Department of Mental Health and addictions of the Bologna local health trust developed as a laboratory aimed at innovating the mental health systen locally. ...

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Chang, Tsochen, and 張作貞. "Trend in mental health services utilization and treatment dropout predictors for patients with psychiatric disorder in Taiwan - from 1997 to 2004." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/12511804948713558946.

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博士
國立暨南國際大學
社會政策與社會工作學系
100
The study is a longitudinal examination of mental health services utilization and treatment dropout risk factors for patients with schizophrenia and manic-depression psychosis from 1997 to 2004. The claim data of this study comes from the LHID2000 of Bureau of National Health Insurance. Repeated recurrent event survival analyses were used to identify predictors of treatment dropout. Main findings of this study were as follows: (1).Number of patients with serious mental illness had an increased tendency that the average year-growth rate was 17% from 1997 to 2004. The proportion of using mental health services decreased from 96.7% in 1997 to 52.8% in 2004. However, unused proportion of mental illness persons was increased year by year. The newly cases of serious mental illness leaved off treatment in the following year ranged form 44.4% to 59.8%. (2).The average expenditure of mental health services and medicine rose year after year. Using community rehabilitation services was lower than using daycare wards of hospitals. (3).The average length of stay for acute care had a decreased direction from 41.8 days in 1997 to 28.2 days in 2004 in patients with Schizophrenia, and form 17.6 days to 16.1 days in those with manic-depression psychosis. (4).The average admission day of Schizophrenia had a drop course from 54.3 days in 1997 to 36.0 days in 2004 for acute treatment (<=180 days), and from 322.9 days to 314.5 days for non-acute treatment (>180 days). The average admission day of manic-depression psychosis was steadily kept on 26.1 days during 1997-2004 for acute treatment. Otherwise, non-acute treatment had a downside from 291.0 days in 1997 to 265.7 days in 2004. The risk factors of treatment dropout are: (1).the female sex, young age, underinsured status, and schizophrenia were associated with high dropout risk. (2).psychiatric comorbidity was related with a trend toward dropout. (3).patients who used daycare services and psychiatric community rehabilitation services had a higher dropout rate than who did not use these services. (4).patients who had catastrophic illness cards were at higher dropout risk than those without the cards. The results also support the planning process and improvement of mental treatment system.

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Ibell, Bernadette Mary. "An analysis of mental health care in Australia from a social justice and human rights perspective, with special reference to the influences of England and the United States of America: 1800-2004 /." 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp113.25102006/index.html.

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Thesis (Ph. D.)--Australian Catholic University, 2004.
Submitted in fulfillment of the requirements for the degree of Doctor of Philosophy. Includes bibliographical references (p. 345-375). Also available in an electronic format via the internet.

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"Trends in insurance coverage and out-of-pocket payments for mental health and substance abuse services: An examination of Medical Expenditure Panel Survey data, 1996--2004." THE UNIVERSITY OF TEXAS SCHOOL OF PUBLIC HEALTH, 2008. http://pqdtopen.proquest.com/#viewpdf?dispub=3304200.

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Daw, Christina Marie Nunez Roberts Robert E. Rosenau Pauline Vaillancourt. "Trends in insurance coverage and out-of-pocket payments for mental health and substance abuse services : an examination of Medical Expenditure Panel Survey data, 1996--2004 /." 2008. http://proquest.umi.com.www5.sph.uth.tmc.edu:2048/pqdweb?did=1503397361&sid=1&Fmt=2&clientId=92&RQT=309&VName=PQD.

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Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2008.
"May 2008." Source: Dissertation Abstracts International, Volume: 69-03, Section: B, page: 1561. Adviser: Luisa Franzini. Includes bibliographical references.

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Giuntoli, G., S. Hughes, Kate Karban, and J. South. "Towards a middle-range theory of mental health and well-being effects of employment transitions: Findings from a qualitative study on unemployment during the 2009-2010 economic recession." 2014. http://hdl.handle.net/10454/9084.

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This article builds upon previous theoretical work on job loss as a status passage to help explain how people's experiences of involuntary unemployment affected their mental well-being during the 2009-2010 economic recession. It proposes a middle-range theory that interprets employment transitions as status passages and suggests that their health and well-being effects depend on the personal and social meanings that people give to them, which are called properties of the transitions. The analyses, which used a thematic approach, are based on the findings of a qualitative study undertaken in Bradford (North England) consisting of 73 people interviewed in 16 focus groups. The study found that the participants experienced their job losses as divestment passages characterised by three main properties: experiences of reduced agency, disruption of role-based identities, for example, personal identity crises, and experiences of 'spoiled identities', for example, experiences of stigma. The proposed middle-range theory allows us to federate these findings together in a coherent framework which makes a contribution to illuminating not just the intra-personal consequences of unemployment, that is, its impact on subjective well-being and common mental health problems, but also its inter-personal consequences, that is, the hidden and often overlooked social processes that affect unemployed people's social well-being. This article discusses how the study findings and the proposed middle-range theory can help to address the theoretical weaknesses and often contradictory empirical findings from studies that use alternative frameworks, for example, deprivation models and 'incentive theory' of unemployment.

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Taylor, Joanna Jane. "Appeals against assisted and involuntary admission under the Mental Health Care Act no 17 of 2002 in region A, Gauteng Province, South Africa, between December 2004 and December 2011." Thesis, 2015. http://hdl.handle.net/10539/18471.

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Pinheiro, Vera. "Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis." Master's thesis, 2021. http://hdl.handle.net/10362/135190.

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ABSTRACT - Background: It is well established that the health of a population is highly influenced by its socioeconomic context, welfare systems, labour markets, public policies, and demographic characteristics. Thus, changes in these key determinants may be reflected in the mental health and wellbeing of a population, through risk factors such as unemployment, financial strain, debts and job-related issues, as people posed with these challenges are usually more susceptible to mental ill-health. Following the worldwide economic crisis of 2008, several studies have found contradicting results in regards to this association, with some showing an increased risk for self-harm and suicidal behaviour, be it in the form of suicides or suicide attempts (many requiring urgent hospitalization), worldwide and in Europe, and others finding the opposite association. There is no research in Portugal on the matter. Therefore, our goal was to estimate the impact of the Portuguese economic crisis of 2009-2014 on the deaths and hospitalization rates trends by suicide and self-inflicted injury in Portugal. Methods: A retrospective ecological study, with an interrupted time series analysis of hospitalizations and deaths by suicide and self-inflicted injury (data from the national Hospital Morbidity Database) in mainland Portugal, between 2003 and 2014, was performed. Resident population data aged 15 years old or older was retrieved from the National Statistics Institute. Binomial negative generalized linear models were used to compare rates and trends before (2003-2008) and during (2009-2014) the Portuguese economic crisis. Regression coefficients were calculated (p<0.05) along with 95% Confidence Intervals. All rates were stratified and adjusted for seasonality. Results: Globally, for the whole mainland population, the 2009-2014 economic crisis in Portugal was associated with an increase in the hospitalization and death rate trends due to suicide and self-inflicted injury, with unemployment playing a significant albeit mixed mediating role. However, in line with previous results in the literature, many differences exist in different subgroups, with males, working-age groups (25-44 and 45- 64) and the North and Centre regions being the most impacted, globally. Conclusions: Economic downturns pose considerable risks for suicidal behavior. This should be a priority area for urgent intervention, especially in the context of the COVID- 19 pandemic crisis and the economic crisis it provoked, with a potentially tremendous impact in mental health.
RESUMO - Introdução: Está bem estabelecido na literatura que a saúde das populações é altamente influenciada pelo seu contexto socioeconómico, segurança social, mercado de trabalho, políticas públicas e características demográficas. Como tal, alterações nestes determinantes podem refletir-se na saúde mental e no bem-estar de uma população, através de fatores de risco como desemprego, dificuldades financeiras, dívidas ou problemas laborais, sendo que os indivíduos a eles sujeitos estão geralmente mais suscetíveis para problemas de saúde mental. Após a crise financeira global de 2008, vários estudos encontraram resultados contraditórios no que toca a esta associação, com alguns a mostrar um risco aumentado de comportamento suicidário (suicídios e tentativas de suicídio, muitas das quais requerem hospitalização), no mundo e na Europa, enquanto outros encontraram a associação inversa. Tanto quanto foi possível averiguar, não existem estudos em Portugal sobre o assunto, neste período de tempo. Assim, o objetivo deste estudo foi estimar o impacto da crise económica de 2009- 2014 nas tendências de óbitos e hospitalizações por suicídio e lesões autoinfligidas em Portugal. Métodos: Foi realizado um estudo retrospetivo ecológico, com análise de séries temporais interrompidas de hospitalizações e óbitos por suicídio e lesões autoinfligidas (dados da Base de Dados de Morbilidade Hospitalar) em Portugal Continental, em 2003- 2014. Os dados relativos à população residente em Portugal com 15 anos de idade ou mais foram retirados da base de dados do Instituto Nacional de Estatística. Através de modelos binomiais negativos, foram comparadas as tendências das taxas de mortalidade e hospitalizações por suicídio no período da crise económica (2009-2014) em comparação com o período anterior (2003-2008), em Portugal Continental. Foram calculados os coeficientes da regressão (p < 0.05), bem como os Intervalos de Confiança a 95%. Toda a análise foi estratificada e ajustada para sazonalidade. Resultados: Globalmente, para o total da população, verificou-se uma associação positiva e estatisticamente significativa entre a crise económica de 2009-2014 e as tendências das taxas de mortalidade e de hospitalização por suicídio, com o desemprego a desempenhar um papel de mediador de efeito com resultados opostos. No entanto, e em linha com a literatura, existem grandes diferenças nos resultados da análise estratificada, com homens, indivíduos em idade ativa e residentes nas regiões do Norte e Centro a sofrer o maior impacto. Conclusões: As crises económicas constituem riscos significativos para comportamento suicidário, sendo esta uma área urgente para intervenção prioritária, especialmente no contexto do grande impacto económico da crise provocada pela pandemia de COVID-19, com enorme potencial impacto na saúde mental.

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Dissertations / Theses on the topic '200409 Mental health'

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