Dissertations / Theses on the topic 'Community mental health services – Australia'

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1

Penrose-Wall, Jonine Public Health &amp Community Medicine Faculty of Medicine UNSW. "Evaluating five models of dissemination of NHMRC 'Guideline depression in young people for GP's' through divisions of general practice." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2003. http://handle.unsw.edu.au/1959.4/20445.

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Background: Dissemination of evidence-based mental health clinical practice guidelines had not been studied in Australia prior to the National General Practice Guideline Implementation Program. This naturalistic research reports ten national interventions designed to disseminate the NHMRC 1997 Clinical Practice Guideline Depression in Young People for GPs (GDIYP-GP) through 123 Divisions of General Practice. The guideline covered depression and suicide in young people aged 13 to 20 years. Aim: To evaluate a 'coordinated link agent' and 'enhanced packaged approach' for disseminating a national guideline by engaging 20 Divisions in using 5 dissemination models and to measure Divisions' capacities in performing unfunded local dissemination to GPs. Method: An Implementation Kit was the main national intervention, housing the guidelines and 5 models: Education by the Division; Education by an external provider; 3) Clinical Audit; 4) Segmented Formats and 5) Appraisal. Five studies are reported: 1) an organisational census on guideline-related practices in all topics; 2) a Case Study Database of 3 consecutive interviews of 51 participating Divisions; 3) a Guideline Appraisal study of 9 cohorts of doctors; 4) a Clinical Audit study of 54 doctors involving 1200 patients; and 5) a 'Segmented Formats' documentary analysis of Division communications on GDIYP-GP. Results: Prior dissemination by most Divisions was administrative mail outs rather than planned programs. In all, 70 instead of the pilot 20 organisations participated (57% of the sector) using 10,000 guidelines: 45 participated by 7 weeks and 71 by 35 weeks and the majority used multiple active strategies showing fidelity to the Kit. Education by the Division, Segmented Formats and Appraisal were the most adopted models. GDIYP-GP was acceptable and relevant to the majority of Divisions and to 9 samples of doctors. Conclusion: Divisions are one appropriate system through which evidence-based mental health guidelines can be disseminated to general practitioners. Uptake can be rapid using a flexible enhanced package approach with link-agent support. 3-6 months is needed for organisations to begin effective interventions. Divisions reorient their approach with guidance toward evidence-based dissemination but Division and practice barriers
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Beecham, Jennifer Kate. "Community mental health services : resources and costs." Thesis, University of Kent, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319222.

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Muga, Florence Adhiambo. "Community mental health in Kenya : an improbable dream?" Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263918.

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Simonson, Toni Lee. "The evaluation of comprehensive community services." Online version, 2000. http://www.uwstout.edu/lib/thesis/2000/2000simonsont.pdf.

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Senior, Jane. "The development of prison mental health services based on a community mental health model." Thesis, University of Manchester, 2005. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:85467.

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Goodwin, Simon Christopher. "Community care : the reform of the mental health services?" Thesis, University of Sheffield, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387717.

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Amador, Karina, and Natalie Salas. "MENTAL HEALTH SERVICES IN AN EXCLUSIVE LATINO COMMUNITY VERSUS A DIVERSE COMMUNITY." CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/878.

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This study examined whether Latino immigrants’ community environment influenced perceptions about the meaning of mental health and accessing mental health services. The two environments analyzed in were an exclusively Latino community (primarily Latino members) and a diverse community (composed of different ethnicities including Latinos). The research method used in this study was a qualitative survey design. A semi-structured interview guideline with questions on the meaning of mental health, mental health services access, and community norms on mental health was utilized with 24 respondents. Responses were then analyzed to find themes. Findings from this study found similarities as well as differences in the two groups in seeking mental health services. Differences were more commonly in the details of the responses rather than in the themes of the responses. The finding will help social workers, who provide a large percentage of mental health services, understand the individual, the barriers, and the importance of social environments in seeking mental health services.
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Kipping, Cheryl Joan. "Stress and coping in mental health nurses." Thesis, King's College London (University of London), 2000. https://kclpure.kcl.ac.uk/portal/en/theses/stress-and-coping-in-mental-health-nurses(233e7fff-f064-48c0-b626-4ff18eef9e40).html.

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9

Al-Issa, Birgitta. "User participation in English and Canadian community mental health services." Thesis, Lancaster University, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.282605.

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Foster, Juliet L. "The social representations of mental illness held by clients of the mental health services." Thesis, University of Cambridge, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270929.

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Prior, Pauline Mary. "Mental health policy in Northern Ireland 1921-1991." Thesis, University of York, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.306559.

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Enriquez, Josue D. "LATINO MENTAL HEALTH: EXPLORING BARRIERS TOWARDS MENTAL HEALTH SERVICES AMONG THE LATINO COMMUNITY WITHIN SAN BERNARDINO." CSUSB ScholarWorks, 2017. https://scholarworks.lib.csusb.edu/etd/536.

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The research presented on this paper examined the impact that the number of barriers have towards the delay in getting treatment among the Latino population. Participants (N=31) at Family Solution Collaborative, answered questions presented to them via a self-administered questionnaire that contained questions that examined types of barriers and how they impact mental health services. An independent sample t-test was conducted assessing generation status and the sum of perceived barriers. A Pearson correlation, design was used, for the purpose of searching for a relationship between the number of years in the U.S. and age with the sum of perceived barriers. Results for all test conducted showed no significance between all variables. In conclusion, although findings for this study did not support past research it is important to address the limitations to continue to develop culturally appropriate programs to help reduce the disparity of Latinos within mental health services.
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13

Duffy, Marina. "The impact of Ireland’s current Mental Health Policy on the profile of community mental Health Services." Master's thesis, Faculdade de Ciências Médicas, 2013. http://hdl.handle.net/10362/10861.

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RESUMO: Em 2006, foi aprovada uma nova política governamental para a saúde mental intitulada “Uma Visão para a Mudança”, a qual está neste momento no sétimo ano de implementação. A política descreve um enquadramento para o desenvolvimento e promoção da saúde mental positiva para toda a Comunidade e para a prestação de serviços acessíveis, baseados na comunidade, serviços especializados para pessoas com doença mental. A implementação da política e o tornar a “Vision for Change” uma realidade têm sido problemáticos, com críticas consideráveis por parte dos intervenientes, relativas à lenta e desconexa implementação. Este estudo fornece informação sobre as características dos serviços de três importantes tipos de instituições de saúde mental comunitária a nível nacional, nomeadamente Hospitais de Dia, Centros de Dia e residências comunitárias operantes 24 horas. A pesquisa analisa objetivos e funções, perfis dos pacientes, atividades terapêuticas, a eficácia das redes de comunicação e beneficia da perspectiva dos funcionários sobre o que mudou no terreno ao longo dos últimos sete anos. As questões identificadas a partir das características dos três serviços dizem respeito a todos. Os participantes indicaram que o ethos da recuperação parece ter alcançado um papel mais central no tratamento do paciente na comunidade mas reconheceram que o desafio de integrar os princípios de recuperação na prática clínica se mantém presente. Parece ser reconhecida a importância da planificação do cuidado individual nos serviços comunitários e os entrevistados indicaram que existe um empenho para garantir o envolvimento do usuário do serviço. Há diferenças entre os „pontos de vista do pessoal‟ e os „pontos de vista dos representantes‟ sobre uma série de aspetos da prestação de serviços. Este é o primeiro estudo irlandês deste género a examinar a prestação de serviços das três principais instituições comunitárias de saúde mental num só estudo. Estes serviços representam um enorme investimento em recursos, quer a nível monetário, quer humano. O estudo examinou os desafios e as questões fundamentais que lhe são aplicáveis e que têm impacto nestes três tipos de prestação de serviços. Também forneceu informações sobre os elementos de mudança positiva, os quais se começam a focar lentamente na prestação do serviço, assim como na importância da centralidade do utilizador do serviço e na promoção de um ethos da recuperação.----------ABSTRACT: In 2006, a new Government policy for mental health “A Vision for Change” was endorsed and is currently in the seventh year of implementation. The policy describes a comprehensive framework for building and fostering positive mental health across the entire community and for providing accessible, community based, specialist services for people with mental illness. The implementation of the policy and turning “Vision for Change” into reality has been problematic with considerable criticism from stakeholders concerning slow and disjointed implementation. This study provides information on three key community mental health service settings, namely Day Hospitals, Day Centres and 24 Hour Community Residences at a national level. The research looks at aims and functions, patient profiles, therapeutic activities, effectiveness of key communication networks and gains an insight from staff on what has changed on the ground over the past seven years. Issues identified from the three service settings pertain to all. Participants indicated that the recovery ethos appears to have moved to a more central role in patient care in the community but acknowledged that the challenge of integrating recovery principles in clinical practice remains present. The importance of individual care planning appears to be recognised in community services and respondents indicated that efforts are being made to ensure service user involvement. There were differences between „staff views‟ and „advocate views‟ on a number of aspects of service provision. This is the first Irish study of its kind to examine service provision across the three main community mental health settings in one study. These services represent a huge investment in resources both on a monetary and human level. This study has examined the challenges and key issues which are applicable and impacting on all three types of service provision. It has also provided information on the elements of positive change, which are slowly embedding themselves in service provision such as the importance of the centricity of the service user and the promotion of a recovery ethos.
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Birmingham, Luke Stephen. "The mental health of newly remanded prisoners, the prison reception health screen and the resulting management of mental disorder at Durham prison." Thesis, University of Newcastle Upon Tyne, 1998. http://hdl.handle.net/10443/600.

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Recent cross-sectional studies have confirmed that the prevalence of mental disorder in English prisons is high but they provide little insight into the fate of the mentally disordered in prison. This thesis concentrates on a longitudinal study of mental disorder in 569 unconvicted adult male remand prisoners received into Durham prison between 1 October 1995 and 30 April 1996. Subjects were interviewed at reception by psychiatric researchers and monitored throughout the remand period. The data collected was used to establish the prevalence of mental disorder and substance misuse at reception into prison, effectiveness of prison reception screening, number of mentally disordered subjects identified and referred for psychiatric assessmentn, ature of psychiatric interventions, and final disposal of all subjects. Additional research was undertaken at Durham to evaluate health care provision at this prison, and, in order to comment on the generalisability of the findings, health care facilities at other prisons in England and Wales were investigated. More than a quarter of subjects at Durham prison were suffering from mental disorder. Serious disorders were especially prevalent and one in twenty remands was acutely psychotic. Drug and alcohol misuse was the norm. More than half of our subjects received current substance abuse or dependence diagnoses. Prison reception screening failed to identify nearly 80% of subjects with mental disorder, including 75% of those with acute psychosis. The treatment needs of the majority of mentally disordered subjects were overlooked in prison. Just over one quarter of mentally disordered subjects were referred for a psychiatric assessment. Contact with psychiatric services was frequently hampered by the prison regime and the actions of the courts. This resulted in acutely psychotic prisoners being released without adequate treatment or follow-up. Help for prisoners with drug and alcohol related problems was minimal. Detoxification regimes were insufficiently prescribed leaving the majority of subjects addicted to opiates, benzodiazepines and alcohol at risk of serious withdrawal. Inadequate resources, a lack of suitably trained health care staff, low morale and staff sickness hampered the delivery of effective health care at Durham prison. However, staff attitudes, institutionalised practices and negative responses from prisoners also made a significant contribution. Further inquiry indicates that Durham. prison is not unique in these respects. Problems of a similar nature are endemic in the Prison Health Service. Indeed, when the history of this organisation is traced it is apparent that such difficulties have plagued it throughout its existence.
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Hemingway, C. A. "The regulation of women detained under mental health legislation." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264817.

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16

Sears, Alan Carleton University Dissertation Anthropology. "Mental health, the state and labour-power; deinstitutionalization in Ontario 1959-1965." Ottawa, 1985.

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17

Brimblecombe, Neil. "An acute community mental health service : assessments, descriptions, predictions and implications." Thesis, Brunel University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.250209.

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Harvey, S. A. "Community mental health services : An analysis of theoretical, spatial and practical issues." Thesis, University of Leeds, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.375353.

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Gill, John. "Transparency of purpose and methods in a grass-roots agency a program evaluation of the Unitas Therapeutic Community Inc. : a project based upon an independent investigation /." Click here for text online. Smith College School for Social Work website, 2007. http://hdl.handle.net/10090/1040.

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Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2007
Typescript. Thesis submitted in partial fulfillment for the degree of Master of Social Work. Includes bibliographical references (leaf 58).
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20

Ferguson, Iain. "The potential and limits of mental health service user involvement." Thesis, University of Glasgow, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298905.

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Alexander, Kathy. "Promoting health at the local level : a management and planning model for primary health care services /." Title page, contents and introduction only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09pha376.pdf.

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Kaemmerer-Ruetten, Ursula. "Outcomes in the community care community mental health care quality of life and the perspective of service users a comparative study in Scotland and Germany." Thesis, University of Stirling, 2002. http://hdl.handle.net/1893/1509.

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This thesis examines the effects of community mental health care on the quality of life of mental health service users in Britain - especially Scotland - and Germany. The analysis is based on current developments in community care policy and practice in the countries of comparison and the perspective of mental health service users in relation to this. The research strategies adopted include qualitative and quantitative methods, in particular a questionnaire survey among mental health service users in Scotland and in Germany. The examination of outcomes in community care with a specific focus on the concept 'quality of life' shows that quality of life is useful as an outcome measure for the comparative evaluation of community care from a user perspective. The study develops a model of quality of life which highlights significant components of community care identified as health, housing, employment, finances, support and social contacts. The examination of some of the foundations of health care and social care in Britain and in Germany, and the comparison of specific mental health care policies and legislation emphasise distinct national characteristics and fundamental differences concerning themes and issues in mental health care. Most significantly, the analysis shows a different national emphasis on major policy objectives and concepts such as quality of life or on the role of the service user. Furthermore, the examination of significant components of community care shows how different national policies can affect support options and general availability in community mental health care. The analysis of the views of mental health service users indicates that their quality of life is directly affected by specific national developments and different national approaches in mental health care. This concerns the availability (or absence) of different support options, but also the role of service users as participants in service provision (Scotland) or rather as recipients of service provision (Germany). The comparison of different national support options and the analysis of user views in relation to this highlights specifically positive and negative effects on the quality of life of mental health service users. Most appreciated by service users are support options that provide opportunity for choice, independence, personal autonomy and fulfilment. The study shows that community based service provision and especially professional support is extremely important to mental health service users and has a direct and vital impact on their quality of life.
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Génier, Tanya Sylvie. "Experiences of Adolescents Receiving Mental Health Services: A Study of the Benefits, Limitations and Recommendations." Thesis, Laurentian University of Sudbury, 2013. https://zone.biblio.laurentian.ca/dspace/handle/10219/2062.

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This study focused on youths’ experience of receiving school-based mental health services and community-based mental health services. This qualitative study utilized a sample of eight girls and boys, ages 15-17 years old, who attended school within the district of Timmins. Data was collected using individual interviews and analyzed using thematic analysis. Results of the study revealed benefits to services, limitations to services, and some recommendations for changes to services. This research helped to explain what the participants, who have had experiences with mental health services, thought about the services they have had; it also provided some recommendations the participants made for changes to the mental health services based on their experiences. The conclusion of this study involved a connection between this study and social work practice, and offered suggestions for future research in the field of children’s mental health services.
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Tsang, Sai-ling. "Community readjustment of discharged stroke patients : an exploratory study /." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12322490.

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Duncan-Grant, Alec. "Clinical supervision activity among mental health nurses : a critical organizational ethnography." Thesis, University of Brighton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299192.

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This qualitative study IS underpinned by interpretive-constructionist methodological governing principles, and took shape around a developing research focus and aim rather than in relation to pre-existing research questions. The focus of the research is on clinical supervision activity. This refers to formal and informal research encounters with participants and significant others in the organization in which the study was carried out, about: the experience of the practice of clinical supervision; attempts to translate textual prescription and description of clinical supervision into organizational reality; finally, the meaning endowment placed on both of the above by myself, my participants, and significant others associated with my research. In order to address an important gap in the literature, the aim of the research developed as the need to unpack and clarify the meaning, and the affective and organizational theoretical implications of clinical supervision activity. Part one of the ethnographic report is constructed around three overlapping categories: owning, resisting and feeling. These categories are developed around the proposition that the bureaucratic rationality inscribed within both the literature on clinical supervision, and in organizational attempts to implement it, fails to take account of both the emotional underlife of the organization and otherorganizational factors. Specifically, I argue that clinical supervision activity, and my inscription within it as 'insider' researcher', was influenced, shaped and constrained by the pre-existing interpersonal rules and norms of the organization in which my research was conducted. Those governed what could and could not be done or said in or about clinical supervision activity, arguably undermining organizational goals to implement it. Part two of the ethnography explores the maIn theoretical and conceptual implications an sIng from the preceding ethnographic construction, around structural organizational power and politics. This addresses a significant gap in the contemporary literature in clinical supervision in nursing and mental health nursing. I conclude with a critical auto-critique of the study itself, around a discussion of its strengths and limitations and possible future research directions
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McConnell, Pamela M. C. "Mental health and needs for care in the district of Derby." Thesis, Queen's University Belfast, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287210.

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Single, Helen M. "Factors influencing women with mental health problems' attendance at work projects." Thesis, University of Sheffield, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274945.

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Bellman, Natalie K. "Latino clients' perspectives on mental health services provided at a local community health center /." View online ; access limited to URI, 2007. http://0-digitalcommons.uri.edu.helin.uri.edu/dissertations/AAI3280551.

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Winters, Krysta. "A voice in the wilderness a needs assessment of a developing rural community /." Online full text .pdf document, available to Fuller patrons only, 2002. http://www.tren.com.

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Davies, J. Bryn. "The experience of Community Programme, unemployment and employment : mental health and individual differences." Thesis, University of Sheffield, 1992. http://etheses.whiterose.ac.uk/3471/.

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This thesis explores some theoretical, conceptual, empirical and methodological issues concerning psychological research into unemployment. A review of the literature revealed some important limitations in the approach which has hitherto been taken to examine this phenomenon. Specific weaknesses included an undervaluation of the role of theory, a dearth of empirical research on intervention programmes or other responses to unemployment, as well as oversimplification, overgeneralisation, imprecision and unfalsifiability in the theoretical contributions which have been offered. Moreover, it was noted that there had been a lack of attention to dispositional factors in empirical research or theory, and inadequate (particularly undifferentiated) conceptualisation and operationalisation of mental health variables. The empirical part of the study, therefore, was developed as an initial exploration of (a) Individual differences in the mental health of unemployed adults, and (b) the experience of participation on Community Programme (CP), a UK government intervention for long-term unemployed adults. A multi-method, multivariate design was used adopting a theoretically grounded, guiding conceptual framework. Qualitative in-depth interviews (N = 60) were conducted with CP participants from two CP managing agencies. In addition, a large scale cross-sectional quantitative survey (N=484) was undertaken incorporating individuals who were: (a) Participating on CP (b) Employed (c) Unemployed. The findings of the stud demonstrated a number of relationships between personal characteristics (i. e. demographic and personality related variables), intervening variables and dimensions of mental health. Some theoretical and empirical implications of these findings were discussed and directions for future empirical research and theoretical development were suggested. With respect to the experience of Community Programme, the findings suggested that within these two managing agencies, the content of the scheme (i. e. the nature of the work) was evaluated positively by the respondents, but that the context of the scheme and its temporary nature were perceived in a negative light. Some suggestions are made as to how these different aspects of the scheme impacted upon the mental health of the participants.
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Ford, Richard Norman Chubb. "Quality of life for people with severe mental illness : the impact of intensive care management and community mental health nursing." Thesis, King's College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300158.

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Ziguras, Stephen. "Evaluation of the bilingual case management program in community mental health services in Melbourne /." Connect to thesis, 2001. http://eprints.unimelb.edu.au/archive/00000678.

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Pierre, Samuel Augustus. "Psychiatry and citizenship : the Liverpool Black mental health service users' perspective." Thesis, Liverpool John Moores University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313133.

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Smark, Ciorstan. "Pound foolish accounting's role in deinstitutionalisation /." Access electronically, 2002. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060404.123052/index.html.

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Bird, Victoria Jane. "Supporting the recovery of black individuals who use community mental health services." Thesis, King's College London (University of London), 2015. http://kclpure.kcl.ac.uk/portal/en/theses/supporting-the-recovery-of-black-individuals-who-use-community-mental-health-services(bf52050a-9911-4a9e-8c53-ac22f5ebca4d).html.

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Despite a recovery orientation being mental health policy within England, the perceptions of recovery and the effectiveness of recovery-focused interventions for black individuals are under-researched. This thesis describes the development and evaluation of an intervention to support the recovery of black individuals who use community mental health services. The Medical Research Council (MRC) framework for designing and evaluating complex interventions was the guiding scientific framework, with an embedded experimental mixed method design adopted. A systematic review and narrative synthesis identified the evidence base regarding the meaning of recovery for mental health service users. The Conceptual Framework of Recovery was developed from the review. Only one study included in the review focused on the perceptions of recovery for black individuals. Four focus groups with 26 participants and 14 semi-structured interviews were conducted with service users who self-ascribed their ethnicity as black. The results were used to develop the Framework of Recovery Support, in which identity - (re)gaining a positive sense of self, was central to recovery. The Conceptual Framework of Recovery and Framework of Recovery Support were used to develop a component of the REFOCUS pro-recovery intervention called Working Practice 1: Understanding Values and Treatment Preferences. The effectiveness of the REFOCUS intervention for black individuals was assessed in a pre-planned subgroup analysis of a cluster randomised controlled trial (RCT). One hundred and ten service users participated in the RCT, with 81 (74%) followed up after 12 months. The two primary outcomes were personal recovery (Questionnaire about the Process of Recovery) and service satisfaction (Client-Satisfaction Questionnaire - 8 item version). Secondary outcomes included hope, empowerment, wellbeing, quality of life, symptom levels and clinical need. Multilevel mixed-effects regression modelling, which controlled for clustering at the team level, was conducted for the analysis of treatment effect. A process evaluation embedded within the trial included interviews with eight individuals who had received the intervention. Results indicated that the intervention had no effect on either recovery (p=0.693) or service satisfaction (p=0.77). However, the intervention significantly improved service user-rated level of met need. Overall the intervention was well-received and associated with positive experiences, however the process evaluation highlighted issues with routine implementation.
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van, Wormer Rupert Talmage. "Risk Factors for Homelessness Among Community Mental Health Patients with Severe Mental Illness." PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/653.

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The purpose of this study was to identify risk factors associated with homelessness, assess the relationship between housing status and consumption of costly publicly funded resources, to identify characteristics associated with service retention, and to evaluate whether length of treatment is associated with better outcomes. The target population was homeless and formerly homeless adults with SMI enrolled in community mental health services at the Downtown Emergency Service Center SAGE mental health program located in Seattle. The sample consisted of 380 SAGE patients who had continuous enrollment in 2005. These patients formed the cohort for the study. Agency records for these patients were reviewed for a 3-year period (2005-2007). The study utilized a non-experimental retrospective cohort study design. Multiple logistic regression, hierarchical multiple regression, two-way repeated measures ANOVA, and Cochran's Q test were used to analyze the data. Homelessness was associated with African American race, substance use, lower income, and younger age. Patients who were homeless spent more time in jail and required more mental health staff time compared with patients with stable housing. Patients with schizophrenia were more likely to retain services and African American patients were less likely to retain services. Overall, patients who remained enrolled in services from Year 1 to Year 3 had improved housing stability, fewer days of incarceration, and required less staff support. The overrepresentation of African Americans among patients who experienced homelessness suggests that racism could be a factor contributing to homelessness for this racial group. Further research is needed to assess the relationship between race and homelessness.
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Quashie, Komlan Charles. "An analysis of the impact of public expectations on mental health care." Thesis, University of Huddersfield, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327182.

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Lee, John. "Purchasing, providing and participating in mental health services." Thesis, University of Bedfordshire, 1999. http://hdl.handle.net/10547/336986.

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This thesis examines the implications of the changes introduced by the NHS and Community Care Act 1990 for mental health services. It focuses on two main issues. Firstly, the impact on mental health services of the 'market' system of purchasers and providers introduced by the 1990 Act. Second.ly, the extent to which the 1990 changes had led to any increase in user participation and involvement in the planning and delivery of psychiatric services. Analysis of the existing theoretical literature found that there had been little research which focused on the specific implications of health care 'markets' for mental health services. In addition, much of the work on the development of psychiatry had not focused on the role of the local context in influencing the nature of mental health service provision. In this thesis these issues are explored through a case study of the mental health services of one English county. Semistructured, qualitative interviews were und.ertaken with managers, professionals and individuals in purchaser, provider and voluntary sector organisations. People using community mental health services in the county were also interviewed. This contrasts with many previous studies which have tended to concentrate exclusively on users of in-patient services. The study found that local circumstances played a significant role in the relationships between those purchasing, providing and participating in mental health services. The imminent closure of a large Victorian psychiatric hospital and the uncertainty about which services would replace it had been a source of tension between the newly formed purchaser and provider organisations in the county under study. The lack of any strong existing groups in the local area representing users of mental health services was also significant. It meant that increased user participation in the county after the 1990 Act was reliant on initiatives by managers and professionals rather than organised pressure from user groups and users themselves. The variety of different local mental health agencies purchasing and providing mental health services in the county called for a degree of cooperation between organisations which conflicted with the competition encouraged by the 'market' system introduced by the 1990 Act. The focus, first, on psychiatric services in the examination of 'markets' and, second, the importance of the local context in mental health service development provides the basis for the study's contribution to theoretical and policy debates both about the 1990 Act and psychiatric services in general.
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39

Wyder, Marianne, University of Western Sydney, College of Social and Health Sciences, and School of Applied Social and Human Sciences. "Understanding deliberate self harm : an enquiry into attempted suicide." THESIS_CSHS_ASH_Wyder_M.xml, 2004. http://handle.uws.edu.au:8081/1959.7/644.

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This study focused on the quantitative and qualitative aspects of suicidal behaviour of 90 people who had come to the attention of the Accident and Emergency Department of Westmead Hospital, Sydney, N.S.W., after an attempt to harm themselves. The risk factors identified in the study were combined with the circumstances and motive of attempt. Participants were regrouped according to whether the problems the respondent described were chronic (longstanding) or acute (pivotal). The participants were further classified according to the persistence of thoughts of self-harm ( impulsive or non-impulsive/deliberate) and the presence or absence of these feelings at the time of the interview (the resolution of the attempt) and the types of problems/situations and triggering events the person described as wanting to escape. By developing strategies and treatments for the problems as they were identified in this study and by raising the awareness that there is help available for these different issues, we may be able to reduce the pain which results in an attempt to self harm.
Doctor of Philosophy (PhD)
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40

Kendall, Marilyn. "Lost in space : service users' experience of mental illness." Thesis, Durham University, 2000. http://etheses.dur.ac.uk/1524/.

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41

Williams, Robert D. "A study of the effect of an integrated continuum of Intensive Crisis Intervention Services (ICICIS), including Assertive Community Treatment (ACT), on civil commitments in north central West Virginia." Morgantown, W. Va. : [West Virginia University Libraries], 2005. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=3950.

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Thesis (Ph. D.)--West Virginia University, 2005.
Title from document title page. Document formatted into pages; contains v, 136 p. Includes abstract. Includes bibliographical references (p. 105-113).
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42

Lemmer, Bill. "An investigation of a constructivist approach to self-discovery in community mental health care." Thesis, University of Surrey, 1991. http://epubs.surrey.ac.uk/844185/.

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A constructivist approach is found by identifying its cross-disciplinary roots in prior research. The theoretical connections are an exposition of personal and moral issues in a science of human services. Self-discovery emerges as an alternative focus to institutionalised care for a first-year cohort in the planned closure of a psychiatric hospital. The development of three educational courses as the investigation progresses provide (i) an extract of the methodology, (ii) a demonstration of the heuristic nature of the research, and (iii) the utility of an industry and university collaboration in doctoral study. Because they are products of the research, the curricula provide no data as yet, but incorporate much of what was learnt during the course of the research. Three staff-supported residential settings provide the basis for an empirical study of a constructivist approach to self-discovery. The fieldwork is a video-taped record of triangulated data collection in the houses, the evidence for each of which is individually presented in narrative format. The data is a tapestry of multiple realities that decentres individual construing while demonstrating a will to know. The study provides guidelines (i) in the use of a constructivist approach to connect the centre with the periphery of a mental health service, (ii) for a unifying basis in multi-professional working, and (iii) for an empowering mechanism of personal support to replicate good practice in psychotherapeutic work.
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43

Haruna, Mohammed Awaisu. "Managing the treatment of mental illness in a Nigerian hospital." Thesis, Lancaster University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337582.

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44

Fentress, Shelley Greenwell. "A Needs Assessment of Communicare's Children Mental Health Services." TopSCHOLAR®, 2012. http://digitalcommons.wku.edu/theses/1207.

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This document is a review of literature on needs assessments and the benefits of conducting one. Communicare is a mental health agency that serves the Lincoln Trail Region. Currently, most of the revenue from their children programs comes from Medicaid, which is a fee-for-services payer source. The Kentucky Medicaid Program is in the process of contracting with managed care organizations to oversee services that have been paid directly from Kentucky Medicaid. With these changes, mental health organizations must identify specific community service needs as well as expanding revenue sources. Applying for grants is one way mental health agencies can expand revenue sources. Communicare has identified the KY SEED grant that focuses on prevention and providing services to early childhood programs as a potential funding source. A needs assessment was conducted to gather information on children services implemented by Communicare. It was conducted in order to assess current programs and seek out potential areas of future program growth. The needs assessment further sought to identify gaps in services for the early childhood programs and assist in the grant application process. A review of existing data on children’s services offered at Communicare, including a satisfaction survey and a System of Care Assessment Report, was conducted as part of the needs assessment. A Community Forum with community partners from the Lincoln Trail region was held to gather additional data for the needs assessment.
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45

De, Voe Jennifer. "New national approaches to community health : a comparative analysis of historical case studies from Australia and the United States." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367771.

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46

Mitchell, Penelope Fay. "Mental health care roles and capacities of non-medical primary health and social care services : an organisational systems analysis /." Connect to thesis, 2007. http://eprints.unimelb.edu.au/archive/00003854.

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47

Moodley, Bobby. "Toward a Program Evaluation of the Community Mental Health Center Selected Application of the Parsonian Model." Thesis, North Texas State University, 1986. https://digital.library.unt.edu/ark:/67531/metadc331912/.

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The purpose of this study is to test the utility of Talcott Parsons' AGIL Model, i.e., Adaptation, Goal Attainment, Integration, and Latency (Pattern Maintenance) in evaluating the program effectiveness of a community mental health center (CMHC). The model provided a conceptual framework for the selection of appropriate variables. The dependent variable in this study is the overall evaluation of the CMHC as measured through the perception of community leaders. Fourteen hypotheses were constructed to identify and test the relationship among the AGIL criteria and the use of a selected set of independent variables. Data for this study were collected from primary and secondary sources. Secondary data were obtained from the Texas Department of Mental Health and Mental Retardation in Austin and the CMHC center in Eton. Primary data were collected through personal interviews of general community leaders and influential persons in health-related activities in the community. The selected independent variables included the scope of leadership, the attitude towards this community, socio-economic status, knowledge of the CMHC, and the commitment and involvement in the CMHC. Data indicated that Parsons' criteria for evaluating the CMHC's program were comprehensive and related to each other both positively and negatively. Among the selected independent variables, the type of leader was found to be the best predictor of program evaluation of this CMHC. Overall, generalized community leaders were more defensive and favorable to the CMHC's program compared with the specialinterest leaders. The leaders also differed in their emphasis of the AGIL criteria. The generalized community leaders were conservative in emphasizeing the evaluative criteria of adaptation, integration, and pattern maintenance; the special-interest leaders gave more emphasis to the goal attainment function of CMHC. It was concluded that Parsons' AGIL model was useful for evaluating a CMHC. The variant direction of relationship among AGIL criteria indicated differences in the perception of community leaders in the evaluation of the CMHC.
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48

Mangan, Brian Gerard. "The implementation and evaluation of a quality assessment and quality improvement system in mental health services within a health board." Thesis, Queen's University Belfast, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301742.

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49

Cook, Jacqueline S. "With good intentions: Appalachian service providers in human services and community mental health." Diss., Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/76485.

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This study is a self-assessment of a small group of Appalachian face-to-face service providers in human services and community mental health. It has evolved from their daily experiences. The purpose of the study has been to reflect back to these providers information about themselves. That reflection has been given in the form of an Adlerian life style analysis, a psychological assessment for individuals modified as assessment of a group. The reflected impression provided its own image for change and an opportunity for the participants to assess what impact, if any, their jobs might be having on other aspects of their lives. In the process of informing the participants about themselves, there has been the intent to give that same information to the people who come for services, supervisors, administrators, policy makers, and ultimately the community of academics and scholars. The author of this study functioned as a co-worker with the other participants, becoming a part of that system which she was observing. The job gave wide access for observation and work with the participants in a variety of settings. The primary interactions took place in the homes of families referred for alleged child abuse and neglect, to include sexual abuse. The methodology allowed the research effort to be one of exploration and evolution. Based on the notion expressed by Carol Ehrlich that people can do research for and about themselves rather than having others do it for them, it drew from several theorists, described in order of their use in the study: H.T.Wilson, Brian Fay, Alfred Adler, Stephen Fawcett, and George Gazda. Presenting one subjective view of reality, conclusions of the study pointed to unconscious guilt on the part of participants with respect to system inadequacies, marked by a desire to feel superior in the helping relationship or in the relationship with those perceived to have authority over them. Unaware of these feelings, and in the simple performance of their jobs, the participants help to perpetuate the systems in which they work and often purport to deplore.
Ph. D.
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50

Pace, Carmel. "Remodelling services for new contexts : responding to community mental health need in Malta." Thesis, University of Leicester, 2002. http://hdl.handle.net/2381/31350.

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Active Remodelling for Congruence' (ARC) has been developed by this author as an approach to systematically adapt exogenous models and policies to the context of an adopting country. Models are not imported whole, but analysed into components. The separate adaptability of each component is examined with respect to characteristics of the receiving context. Simultaneously, a context-congruent service framework is derived and proposed for the delivery of community mental health services in Malta. ARC is used to adapt models from overseas, especially UK. ARC is thus tested out and refined. Congruence on the services level is sought with four other levels, each of which is therefore first appraised. The Maltese country context is portrayed through history, cultural expectations, comparative welfare and the progress of public policy and management. The user world is examined through questionnaire interviews designed by leading researchers into community mental health needs, met and unmet, family impact of illness and quality of life. Prevailing and desirable values are identified and applied. Recommendations for service are then made, congruent also with the organisation level, or local management capability. Rather than reactivity fitting with them, congruence creatively questions contexts too, appealing to values. Relatively weak Maltese resources and capability contrast with strong - though surprisingly undeveloped - potential in family and civil society. A flexible case management is recommended that can 'change gear' into less or more resource intensive alternative models. This prudently limits assumed responsibility and cost, sharing them with civil society, and invests in managerially supported targeting, streaming, prioritising, minimising bureaucracy and promoting independence. Relevant issues are thus identified, preparing ARC for use in other country contexts. Finally, bridges are suggested to contemporary readers between intellectual disciplines, cultures and 'epochs' (namely, post-modernity and pre-modernity) hoping that such research can be viewed with less fragmented and less unsure minds.
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