Dissertations / Theses: 'Mental health system'

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NeeSmith, David Hagan. "Committed and voluntary psychiatric patients a longitudinal comparison of commitment patterns among first-time inpatients in the Oklahoma mental health system /." Access abstract and link to full text, 1993. http://0-wwwlib.umi.com.library.utulsa.edu/dissertations/fullcit/9403630.

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Knowles, Meredith L. "Policing Persons with Mental Illness in Georgia: Elucidating Perceptions of the Mental Health System." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/cj_theses/1.

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The criminal justice and mental health systems increasingly overlap as persons with mental illness (PMI) are disproportionately present throughout components of the criminal justice system, a concern to mental health and criminal justice professionals alike. In response, various initiatives (aimed across components of the criminal justice system) have been developed and implemented as a means of combating this overrepresentation. The following research will focus on one specialized police-based initiative, the Crisis Intervention Team (CIT), which aims to train police how to recognize mental illness, de-escalate persons in crisis, and to seek treatment-based alternatives to arrest, when appropriate (Schwarzfeld, Reuland, & Plotkin, 2008). Alternatives to arrest consist of various community-based mental health services such as public hospitals (some of which are designated as emergency receiving facilities, or ERFs) or private clinics. While the components of CIT training likely influence officers in unique ways, research has yet to empirically examine how CIT influences police perception, behavior or the incidence of referrals to mental health treatment. As an initial step, this research assessed the attitudes police have regarding the hospital and mental health system within their district. Specifically, this research provides a basic understanding of how police regard their local hospitals and mental health facilities that are posited as available alternatives to arrest, and help identify the role CIT plays in shaping these attitudes. This study found almost no significant difference in the attitudes CIT-trained officers had towards district ERF and the local mental health system as compared to non-CIT officers. Only in one of the six departments studied was there a significant difference between the attitudes of CIT-officers and non-CIT officers; with the non-CIT officers actually having more positive attitudes about their local mental health system than CIT-officers. The six departments studied had nearly similar attitudes of their mental health resources, which would barely be considered passing on a standard grading scale. While officers in this study do not have very positive attitudes towards the ERF they use to transport PMI or their districts’ mental health system, these attitudes may in fact be more positive than many police departments without any specialized approach or initiative. The significance and policy implications of these attitudes are discussed at length, as these findings speak to the need for increased attention by both the mental health and criminal justice systems. Recommendations for future research, including expanding this study to rural departments or agencies with no connection to CIT, are also outlined.

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Schell, Christopher Gregory. "Mental Health Issues and Recidivism among Male, System -Involved Youth." Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1498318986889895.

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Rodriguez, Adriana. "Stakeholder Views on Children’s Mental Health Services." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2891.

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Identification of evidence-based treatments (EBTs) has been an important development; however recently, some shortcomings of the approach have been highlighted. These complexities have led to a surge in transportability research in mental health services science with goals of identifying needed strategies to encourage the adoption of innovations. The mental health system ecological (MHSE) model is an approach necessary to assist with closing this gap effectively as it integrates mental health contexts: client-level, provider-level, intervention-specific, service delivery, organizational, and service system characteristics. The aim of this study is to use the MHSE model to examine perspectives of mental health stakeholders on their needs. Data consists of qualitative transcripts from parent, therapist, and administrator interviews/focus groups. Mixed methods were used to develop and analyze codes according to the MHSE model. Results suggested that stakeholder groups mentioned needs relevant to the group of interest and thus have implications for future dissemination efforts.

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Fiori, Laura. "Involvement of the polyamine system in suicide." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=95148.

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The polyamine system plays an essential role in a myriad of cellular functions, and dysregulated polyamine metabolism and functioning has been implicated in a number of pathological conditions, including neurological and psychiatric disorders. In recent years, gene expression and genetic association studies have provided strong evidence implicating the polyamine system in suicide, yet it was unclear how extensively polyamine metabolism is affected across the brains of suicide completers, if similar mechanisms are involved in other psychiatric conditions, nor the molecular events by which these alterations in gene expression arise. The studies comprising this thesis were thus designed to address these issues, as they represent essential considerations both for interpreting previous findings regarding the polyamine system, as well as for evaluating the potential for this system to be used as a therapeutic target for the treatment of suicidal behaviors. To address these issues, a combination of gene expression and genetic association studies were first performed in order to better characterize the extent by which polyamine metabolism is affected across the brains of suicide completers, to determine if similar mechanisms are implicated in other psychiatric conditions, and to assess how the altered expression of these genes is related to the local genetic environment. Following these studies, a series of experiments were performed to investigate the involvement of genetic and epigenetic mechanisms in determining the expression of polyamine genes in the brain, as well as to evaluate the association of these factors with suicide. Collectively, the studies contained herein have not only replicated previous findings implicating the polyamine system in suicide, but have also greatly expanded our knowledge regarding the extent by which this system is affected in suicide, and have extended these findings towards other psychiatric conditions. In addition, several genetic and
Le système des polyamines joue un rôle essentiel dans une myriade de fonctions cellulaires, et la dysrégulation du métabolisme et du fonctionnement des polyamines ont été impliqué dans quelques conditions pathologiques, incluant les troubles neurologiques et psychiatriques. Durant les dernières années, des études investiguant l'expression des gènes et les associations génétiques ont apporté des preuves convaincantes impliquant le système des polyamines dans le suicide. Ces études, par contre, n'indiquaient pas à quel point le métabolisme des polyamines est affecté dans les cerveaux de suicidés, ni si des mécanismes similaires sont impliqués dans d'autres conditions psychiatriques, et ne traitaient pas des événements moléculaires par lesquels ces altérations dans l'expression des gènes se présentent. Les études comprises dans cette thèse ont donc été conçus pour répondre à ces questions, car ils représentent les considérations essentielles pour interpréter les résultats antérieurs concernant le système des polyamines, ainsi que pour évaluer le potentiel de ce système à être utilisé comme cible thérapeutique pour le traitement des comportements suicidaires. Pour répondre à ces questions, une combinaison d'études examinant l'expression des gènes et d'études d'associations génétiques ont d'abord été réalisées afin de mieux caractériser dans quelle mesure le métabolisme des polyamines est affecté dans les cerveaux de suicidés. De plus, ces études ont permis de déterminer si des mécanismes similaires sont impliqués dans d'autres conditions psychiatriques et d'évaluer comment l'expression de ces gènes est liée à l'environnement local génétique. Suite à ces études, une série d'expériences ont été effectuées pour enquêter sur l'implication des mécanismes génétiques et épigénétiques dans la détermination de l'expression des gènes des polyamines dans le cerveau, ainsi que pour évaluer l

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Forouzan, Ameneh Setareh. "Assessing responsiveness in the mental health care system : the case of Tehran." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-109499.

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Introduction: Understanding health service user perceptions of the quality of care is critical to developing measures to increase the utilisation of healthcare services. To relate patient experiences to a common set of standards, the World Health Organization (WHO) developed the concept of health system responsiveness. This measures what happens during user’s interactions with the system, using a common scale, and requires that the user has had a specified encounter, which they evaluate. The concept of responsiveness has only been used in a very few studies previously to evaluate healthcare sub-systems, such as mental healthcare. Since the concept of responsiveness had not been previously applied to a middle income country, such as Iran, there is a need to investigate its applicability and to develop a valid instrument for evaluating health system performance. The aim of this study is to assess the responsiveness of the mental healthcare system in Tehran, the capital of Iran, in accordance with the WHO responsiveness concept. Methods: This thesis is a health system research, based on qualitative and quantitative methods. During the qualitative phase of the study, six focus group discussions were carried out in Tehran, from June to August 2010. In total, 74 participants, comprising 21 health providers and 53 users of the mental healthcare system, were interviewed. Interviews were analysed through content analysis. The coding was synchronised between the researchers through two discussion sessions to ensure the credibility of the findings. The results were then discussed with two senior researchers to strengthen plausibility. Responses were examined in relation to the eight domains of the WHO’s responsiveness model. In accordance with the WHO health system responsiveness questionnaire and the findings of the qualitative studies, a Farsi version of the Mental Health System Responsiveness Questionnaire (MHSRQ) was tailored to suit the mental healthcare system in Iran. This version was tested in a cross-sectional study at nine public mental health clinics in Tehran. A sample of 500 mental health services patients was recruited and subsequently completed the questionnaire. The item missing rate was used to check the feasibility, while the reliability of the scale was determined by assessing the Cronbach’s alpha and item total correlations. The factor structure of the questionnaire was investigated by performing confirmatory factor analysis (CFA). To assess how the domains of responsiveness were performing in the mental healthcare system, I used the data collected during the second phase of the study. Utilising the same method used by the WHO for its responsiveness survey, we evaluated the responsiveness of outpatient mental healthcare, using a validated Farsi questionnaire. Results: There were many commonalities between the findings of my study and the eight domains of the WHO responsiveness model, although some variations were found. Effective care was a new domain generated from my findings. In addition, the domain of prompt attention was included in two newly labelled domains: attention and access to care. Participants could not differentiate autonomy from choice of healthcare provider, believing that free choice is part of autonomy. Therefore these domains were unified under the name of autonomy. The domains of quality of basic amenities, access to social support, dignity, and confidentiality were considered important for the responsiveness concept. Some differences regarding how these domains should be defined were observed, however. The results of the qualitative study were used to tailor a Farsi version of the MHSRQ. A satisfactory feasibility, as the item missing value was lower than 5.2%, was found. With the exception of the access domain, the reliability of the different domains in the questionnaire was within a desirable range. The factor loading showed an acceptable uni-dimensionality of the scale, despite the fact that the three items related to access did not perform well. The CFA also indicated good fit indices for the model (CFI = 0.99, GFI = 0.97, IFI = 0.99, AGFI = 0.97). The results of the mental healthcare system responsiveness survey showed that, on average, 47% of participants reported experiencing poor responsiveness. Among the responsiveness domains, confidentiality and dignity were the best performing factors, while autonomy, access to care and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Autonomy, quality of basic amenities and clear communication were dimensions that performed poorly but were considered to be highly important by the study participants. Conclusion and implications: This is the first time that mental healthcare system responsiveness has been measured in Iran. Our results showed that the concept of responsiveness developed by the WHO is applicable to mental health services in this country. Dignity and confidentiality were domains which performed well, while the domains of autonomy, quality of basic amenities and access performed poorly. Any improvement in these poorly performing domains is dependent on resources. In addition, attention and access to care, which were rated high in importance and poor in performance, should be priority areas for intervention and the reengineering of referral systems and admission processes. The role of subjective social status in responsiveness should be further studied. These findings might help policymakers to better understand what is required for the improvement of mental health services.

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Domenici, Donald Joseph. "Listening to the Voices of Consumers and Survivors: A Qualitative Study of Empowerment and the Mental Health System." Oxford, Ohio : Miami University, 2010. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1271114407.

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Daifotis, Katherine. "Mental Health in U.S. Prisons: How Our System Is Set Up For Failure." Scholarship @ Claremont, 2018. http://scholarship.claremont.edu/cmc_theses/1784.

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During the past 60 years, United States prisons have become one of the primary institutions caring for mentally ill individuals. Factors such as privatization of mental health care with a focus on profit-maximization, ineffective jail diversion programs, and unsuccessful mental health courts have contributed to prisons having an increased population of mentally ill inmates. In fact, about 20% of people who are currently incarcerated suffer from a major mental illness (Mason, 2007). Other elements outside of the justice system such as a lack of mental health awareness and a lack of resources have led to damaging interactions between the mentally ill and law enforcement and have added to this growing rate of mentally ill incarcerated. Given the harsh realities of prison, this overrepresentation of those suffering from mental illness is even more concerning and is worsened by aspects of prisons such as solitary confinement. This issue coupled with the lack of appropriate mental health care services being provided and the lack of support after release has led those suffering from mental illness to be potentially worse off than when they entered prison. This paper focuses on mental health care in prisons from admittance to post-release and provides evidence for the need to overhaul how those suffering from mental illness are treated. The responsibility of mental health care has been placed on prisons due to the escalation of inmates with mental illness, the failure of programs inside the justice system, and the lack of post-release follow-up. The physical setting, behavioral interactions, and personnel influences in prisons have led to worsening symptoms and have inhibited the ability to effectively treat these inmates. Given 95% of inmates will be released, these issues need to be addressed more comprehensively for the benefit of our society as a whole (Binswanger, Nowels, Corsi, Long, Booth, Jutner, & Steiner, 2011).

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Connell, Mong L. "A study of the cultural appropriateness of service delivery models in the Australian mental health system." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2002. https://ro.ecu.edu.au/theses/714.

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This study is an attempt to examine the cultural appropriateness of the mental health system in relation to the Vietnamese refugee community in Australia. Culture and mental health, as widely acknowledged in the field of transcultural psychiatry, are closely linked. No aspect of the diagnosis or treatment methods can be justified without reference to the cultural traditions of the mental health system and the client. In a country like Australia, where multiculturalism is a dominant feature of the society, the need is even greater in incorporating culture into every aspect of the mental health system, if it desires to provide a culturally appropriate service to all immigrant groups. Every immigrant group brings with them different cultural values and attitudes. Included in these are viewpoints about mental health/illness that can diverge distinctly from those belonging to the more prevalent Anglo-Saxon cultural norms. How the illness is perceived as to its cause, treatment to healing are different in most cultures. According to the Australian Bureau of Statistics (1996), Vietnamese immigrants form one of the largest displaced people ever to be accepted into Australia as refugees. Their history of escape from the communist regime in Vietnam have sparked worldwide concerns about the state of their mental health. Their journey of escape is not without torture and trauma. Once settled into a country like Australia, they face many settlement obstacles. The cultural and social adjustments that they have to undergo have made them one of the most vulnerable and disadvantaged immigrant groups in Australia. Faced with such a group that have a high predisposition to mental stress and anxiety, the question lies in whether the Australian mental health system is sufficiently informed and prepared to provide a service which has relevance and meaning to these people. I argue that the system has not adequately provided a service to such a purpose. Although much progress and research has been done, it still operates very much within a Western philosophy. Its traditions, values and attitudes reflect a worldview that make little cultural sense to these people. Its racist assumptions and attitudes which promote cultural superiority of the West has resulted in a system labelled as culturally inefficient. Racism has been socially constructed and entrenched within the system for many years and it's origins are lost in the history of Western culture. Its mental health system is essentially monocultural. Culturally inappropriate diagnostic and treatment programmes and a shortage of professionals with the necessary linguistic, cultural and clinical competencies are just some of the deficiencies that exist within the system. Many training programmes have failed to evoke practitioners into questioning the effectiveness and cultural appropriateness of these fundamental structures supporting existing models of service delivery. This study is done through a discussion of the history of racism, certain important concepts, for example, culture and mental health/illness and the social, historical and political experience of the Vietnamese. The rest of the research focuses on certain specific barriers of accessibility and concludes with how these barriers can be addressed. In doing so, it advocates for a totally non-racist approach from an international to a personal level of service. Only through this approach can the mental health system claim to provide a service that is culturally sensitive and meaningful.

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Barnes, Maureen Therese. "Mad or bad? : Entry to the mental health system, from the courts." Thesis, University of Canterbury. Psychology, 1997. http://hdl.handle.net/10092/6769.

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This thesis is concerned with criminal defendants who become psychiatrically hospitalised as the outcome of their court proceedings. There are four routes whereby criminal defendants can become hospitalised in New Zealand. These are to be found not guilty by reason of insanity, to found to be under disability, to be found guilty and mentally disordered and for charges to be dropped and proceedings initiated under the Mental Health (Compulsory Assessment and Treatment) Act, 1992. The background to each of these options is explored, with an emphasis on the insanity defence, and the empirical literature reviewed. There are some theoretical contradictions in whether these legal provisions are therapeutic or punitive. The aim of the current study was to describe criminal defendants who enter the mental health system and become psychiatrically hospitalised via the Court Liaison Service. The Court Liaison Service is a part of the Regional Forensic Psychiatric Service. As part of this service, a nurse screens criminal defendants at court for indications that mental health intervention may be warranted. A sample of defendants, who were seen by the Court Liaison Service at Christchurch, is described. Of these defendants some receive a full psychiatric evaluation and a report is prepared for the courts. The characteristics of those who receive a report are compared with those who do not receive a report. Defendants, who are hospitalised as an outcome of their court proceedings, are compared with those who are not. The findings are consistent with international research, in that most defendants were male, and socially disadvantaged in a number of ways. The mental status screening assessment was a useful discriminator between those who received a report and those who did not, and between defendants who were hospitalised and those that were not. Most defendants who were hospitalised showed clear signs of psychotic processes. Defendants who received a report but who were not hospitalised are particularly vulnerable in terms of their mental health needs. This group showed more evidence of depression, and was rated to be of higher suicide risk. They tended to have psychopathic traits, and were more frequently referred because of concerns about dangerousness. A considerable proportion of all defendants have difficulties with substance abuse. Report and hospitalisation status could be effectively predicted, using information collected at the time of the Court Liaison screening. For example, using diagnosis and mental status data as predictor variables, there was 86% correct classification of cases as hospitalised or not. In conclusion, it is argued that the insanity defence serves little current pragmatic use. Revision is recommended in the current admission criteria to psychiatric hospitals for criminal defendants, with an emphasis on effective treatment programmes. The victim's perspective is not frequently considered in deliberations about mentally disordered offenders, and this is seen as important. Finally, the Court Liaison Service serves an extremely valuable function at the interface between the criminal justice and mental health systems in New Zealand.

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Worrall, Adrian. "Clinical governance in mental health services : a study of a quality system." Thesis, University of East London, 2009. http://roar.uel.ac.uk/3746/.

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Clinical governance is the most ambitious quality initiative in the history of the National Health Service. It is a comprehensive system of steps and procedures to ensure patients receive high quality care and, like most quality systems, it attempts to do this by influencing the behaviour of staff members. This study evaluates the implementation of clinical governance in 30 mental health trusts in England and Wales. It is set broadly within the action research paradigm and uses a participative research method to engage staff and help them learn from each other. Trusts were evaluated against a set of standards and using open questions in two annual cycles of self- and external peer-review. The first cycle focused on clinical governance structures and strategy; the second focused on how managers enabled front-line staff - a topic chosen in response to the findings of the first cycle. By the beginning of 2002, 5 years after clinical governance was introduced and when clinical governance was probably at its peak, this study found that only half the key strategies and structures were in place. Most managers view clinical governance as useful, but struggle to implement it under pressure from the government and without sufficient resources. It is of great concern that their clinical governance work is disconnected from the work of front-line staff and hence probably has little impact on patient outcomes. There are 3 main themes from both cycles: there is a hierarchical rather than enabling management style; there are poor resources, e.g. not enough skilled staff; and there are problems with support for front-line staff, e.g. risk management training needs to be provided to more staff. There was no statistically significant association between trust performance in both cycles and whether there had been a recent merger. Organisational theory was found weak and a tentative developmental model is offered. Clinical governance standards may have declined since the study was conducted because it is no longer the focus of statutory regulator's programme of reviews and because there are new policy priorities. Services need slow reforms with a staged pace and need enabling rather than hierarchical management styles. They also need better resources and to develop beyond a basic survival level to one where they are able to focus on growth and investment before embarking on ambitious policy initiatives.

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Villa, Juan. "Multicultural Training for Mental Health Professionals Working in the Juvenile Justice System." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10265291.

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The juvenile justice system provides a multicultural arena for mental health professionals who are interested in working in forensic social work. This curriculum aims to demystify cultural competence and highlights the importance of adapting multicultural perspectives and theoretical approaches to increase knowledge, awareness, empathy and respect for the diverse cultures of juvenile offenders. This curriculum is intended to train professionals on how to facilitate cross-cultural communication within the juvenile justice system, and establish a multicultural environment in the workplace. Most importantly, it will explore the nature of the juvenile justice system, analyze cultural competence models and integrate both domains to enhance the assessment and treatment of young offenders.

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Cox, Julia R. "Training Future Mental Health Professionals in an Evidence-Informed System of Care." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5964.

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High quality mental health services do not reach the youth who need them, leading to efforts to implement effective treatments more broadly. One focus of these efforts concerns training the mental health workforce, of which master’s-level social workers represent a large proportion. However, the curricula of master’s in social work (MSW) programs do not often emphasize evidence-based approaches. One possible solution is Managing and Adapting Practice (MAP; PracticeWise, LLC), a system that allows clinicians to (1) identify clinically indicated evidence-based programs by searching a growing evidence-base of randomized controlled trials (RCTs) and (2) build individualized evidence-informed treatment plans by focusing on common practice elements. MAP may also address the concerns about manual-based programs (e.g., inflexibility). Although some MSW programs have integrated MAP, the benefits of MAP training within MSW education have not yet been evaluated. This project evaluated multiple mechanisms of training in a semester-long MSW-focused MAP course relative to curriculum-as-usual control at a large public university. Participants were advanced MSW students (mean age = 27, SD = 5.8; 92.3% women; 59% white) either enrolled in the MAP course (n = 17) or enrolled in curriculum-as-usual (n = 22). The MAP course was co-taught by an expert MAP trainer and a MAP-trained social worker. Pre- and post-semester, participants completed a battery that included: (1) role-plays with standardized patients that were videotaped and coded using the Therapy Observational Coding System of Child Psychotherapy – Revised Strategies scale; (2) a written task that was subsequently coded to assess participants’ clinical decision-making skills during different phases of a standardized case; and (3) attitudinal factors that may be predictive of future MAP usage, such as attitudes toward evidence-based practice and the acceptability and feasibility of MAP. Results indicate significant uptake of cognitive and behavioral therapeutic strategies in the MAP condition. Overall, participants endorsed positive attitudes toward evidence-based practice broadly and MAP specifically. Findings may be used to inform the development of more effective evidence-informed curriculum for master’s-level clinical programs and future workforce training initiatives. Methodological considerations may inform advances in instrumentation to measure multidimensional training outcomes

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Serafini, Alexandra Rose. "CORRECTIONAL OFFICERS’ PERCEPTIONS AND ATTITUDES TOWARD MENTAL HEALTH WITHIN THE PRISON SYSTEM." CSUSB ScholarWorks, 2018. https://scholarworks.lib.csusb.edu/etd/735.

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This research explored correction officers’ perceptions and attitudes in relation to inmates with mental health issues. In a qualitative fashion, semi-structured interviews were conducted with five correction officers in Southern California (N = 5) during the Winter 2018 Quarter. Using thematic analysis, this study identified six major themes from the interview data: mental health has remained a prominent issue within the prison population; correction officers were fairly knowledgeable about mental health; correction officers perceived themselves as having to play a limited role in the rehabilitation of inmates with mental health problems; constant prompts in daily activities and medication management were two challenges encountered by correction officers in their interaction with inmates; correction officers’ progressive preparedness to serve mentally challenged inmates; and correction officers reported a need for more support and higher level of care within the prison system. Implications for the criminal justice system were discussed. Keywords: mental health, correction officers, inmates, preparedness, lack of support

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Kim, Wonhee. "Association of Youth Mental Health Status with Caregiver Strain: The Moderating Role of Youth Mental Health Service Use in System of Care Research." Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1606841849946494.

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Hardman, Lisa, and mikewood@deakin edu au. "How deinstitutionalisation and the current public mental health system affects individuals with schizophrenia: Four case reports." Deakin University. School of Psychology, 2000. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20051202.085410.

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The professional component of this thesis focuses on how deinstitutionalisation and the current public mental health system have affected individuals with schizophrenia. Chapter one discusses the process of deinstitutionalisation and the research that has examined the impact of this initiative. Chapter two concentrates on schizophrenia, specifically the symptoms, course, etiological theories and treatments of this illness. Four case studies are then provided in order to explore how deinstitutionalisation and the current mental health system have affected individuals with schizophrenia. The names and identifying characteristics of these clients and their families have been modified to ensure anonymity. Chapter three describes a 47 year old woman, AA, who was referred for a neuro-psychological assessment. Chapter four outlines the second case study, a 23 year old male, BB, who was referred for a psychological assessment regarding diagnosis and treatment recommendations. Chapter five describes the third case study, a 54 year old woman, CC, who was referred for therapy and consultation regarding future treatment recommendations. Chapter six discusses the fourth case study, a 21 year old male, DD, who was seen for crisis intervention and treated in the community. Each of these case studies outlines the background history, formulation and treatment approaches. These case reports are used to illustrate how deinstitutionalisation and the present public mental health system affect individuals with schizophrenia. Chapter seven provides an overall discussion and conclusion to these case studies.

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Miller, Raselle. "An exploration of mental health triage and support in the criminal justice system : attitudes and experiences of professionals supporting people with mental health needs." Thesis, University of East London, 2016. http://roar.uel.ac.uk/5406/.

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A review of existing literature shows that there is a lack of research regarding appropriate adult schemes for vulnerable adults in England and Wales. Little is known about how appropriate adults construct and understand their role. Given this, the present study aimed to explore ‘professional’ appropriate adults’ accounts of working to support adults with mental health needs during their time in police custody. Semi-structured interviews were conducted with nine ‘professional’ appropriate adults attending police custody settings to support adults identified as mentally vulnerable according to the Police and Criminal Evidence Act (1984). A grounded theory method was used to collect and analyse the data. The core concept generated in the analysis was that appropriate adults ‘construct and manage multiple identities’ when working in their role. There were four categories identified as being part of this process: ‘what is PACE?’; ‘in negotiation with the police’; ‘in negotiation with the clients’ and ‘my appropriate adult scheme’. A complex negotiation and dynamic understanding of each category influenced participants’ construction of their identities as an appropriate adult, and how they went about carrying out their work. The findings are discussed, and recommendations for training, policy review and further research are outlined.

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McCubbin, Michael. "The political economy of mental health, power and interests within a complex system." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0023/NQ33057.pdf.

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Cumley, Samantha Renee. "Drug use, mental health and encounters with the legal system in Missoula County." CONNECT TO THIS TITLE ONLINE, 2007. http://etd.lib.umt.edu/theses/available/etd-05112007-130625/.

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Thomas, Zoe. "Women and the mental health system : the social impact of the biological model." Thesis, Open University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.340722.

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Wishnick, Hillary M. "DEMOGRAPHIC AND PSYCHOSOCIAL CORRELATES OF ENTRY INTO THE PUBLIC SECTOR MENTAL HEALTH SYSTEM." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin990545283.

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Trapé, Thiago Lavras 1982. "Rede de atenção à saúde mental : Estudo comparado Brasil - Catalunha." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313041.

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Orientador: Rosana Teresa Onocko Campos
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O desenvolvimento das políticas de saúde mental em países com sistemas nacionais de saúde se constituíram a partir de princípios relativos aos seus diferentes processos históricos , mas com diversos pontos de aproximação que são hoje consensos: ampliação das práticas comunitárias, fechamento progressivos dos hospitais psiquiátricos, diversificação de pontos de atenção, aumento do orçamento próprio, trabalho em rede, etc... Os estudos comparados nos permitem analisar realidades em paralelo para evidenciar aspectos convergentes e divergentes diante de organizações distintas, mas com objetivos comuns, possibilitando organizar matrizes que analise os avanços e desafios da rede de atenção à saúde mental. Este estudo pretende analisar e comparar as redes de atenção à saúde mental do Brasil e da Catalunha através dos componentes macro estruturais da política de cada território. Trata-se de uma tese apresentada em modelo alternativo, com 3 artigos com metodologia e resultados, próprios ancorados em revisão narrativa, análise documental e análise de indicadores de saúde. Ambos territórios possuem Leis que sustentam o modelo de saúde mental de base comunitária, Na Catalunha a política é construída de modo mais técnico e verticalizado, influenciado pelas OMS, enquanto no Brasil a construção é ascendente com ampla participação social na definição das ações. O financiamento na Catalunha é maior tanto na saúde global quanto especifico da saúde mental, no SUS a saúde mental é área subfinanciada dentro de um sistema subfinanciado. Em ambas o foco do financiamento vem se alterando, com maior investimento em serviços comunitários, mas a Catalunha ainda despende maior parte do financiamento para os hospitais. O modelo de gestão dos serviços é distinto, no Brasil ainda é fundamentalmente de gestão direta e na Catalunha indireto. O modelo de Governança regional da Catalunha é mais adequada que o municipalismo brasileiro, pois reduz a fragmentação sistêmica e possibilita organização em redes mais integradas. Ambos possuem uma rede ampla e diversificada de serviços, mas com necessidade em lidar com o contingente amplo de moradores de Hospitais Psiquiátricos e avançar em mecanismos avaliativos que respondam a complexidade da política
Abstract: The development of mental health policies in countries with national health systems constituted from principles concerning their different historical processes, but with different points that are now consensus: expansion of community practices, progressive closure of psychiatric hospitals, diversification points of attention, increase the budget itself, networking, etc ... The comparative studies allows us to analyze realities in parallel to highlight convergent and divergent aspects in different organizations, but with common goals, which allows us to organize arrays to analyze progress and challenges of mental health care network. This study aims to analyze and compare the care networks to mental health in Brazil and Catalonia through macro structural components of the policy of each territory. This is a thesis presented in alternative model, with 3 items with methodology and results, themselves anchored in narrative review, document analysis and analysis of health indicators. Both territories have laws that support the mental health community-based model, in Catalonia politics are built of more technical and vertical mode, influenced by WHO, while in Brazil the construction is up with broad social participation in the definition of actions. Funding in Catalonia is greater both in global and specific health mental health, the SUS mental health is underfunded area within a system underfunded. In both cases the focus of the funding is changing, with greater investment in community services, but Catalonia still spends most of the funding in hospitals. The management model of services is different in each country, in Brazil is still fundamentally direct management and in Catalonia, is indirect. The regional governance model of Catalonia is more appropriate than the Brazilian municipal model because it reduces systemic fragmentation and enables the organizations in more integrated networks. Both have a wide and diverse network services, but need to deal with the large number of residents of psychiatric hospitals and advance evaluation mechanisms that respond to the complexity of the policy
Doutorado
Política, Planejamento e Gestão em Saúde
Doutor em Saude Coletiva

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Dlatu, Ntandazo. "The integration of mental health care services into primary health care system at King Sabata Dalindyebo Municipality Clinics." Thesis, Walter Sisulu University, 2012. http://hdl.handle.net/11260/d1008290.

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Introduction: Primary Health care refers to care which is based on the needs of population. Mental health care provided within general primary care services is the first level of care within the formal health system. There is no research in King Sabata Dalindyebo, carried out on issues around integration of mental health with primary health care. The present study is initiated to overcome this gap. Aim of the study: The aim of the study was to investigate the level of knowledge, implementation and barriers of integrating mental health care services into primary health care system at King Sabata Dalindyebo clinics, in Mthatha region. Methods: This descriptive cross-sectional study was conducted at King Sabata Dalindyebo Clinics, between January 2010 and December 2011. A 10% random sample of all health professionals from King Sabata Dalindyebo was interviewed concerning their demographic characteristics, education/ qualifications, general and further training in psychiatry, awareness about Mental Health Care Act 17 of 2002 and mental health care services characteristic related to the integration of mental health care services into primary health care system. For data analysis, the means of continuous variables across 2 groups were compared using Student-t test. The proportions (%) of the categorical variable across 2 groups were compared using Chi-square test. Results: A total of 52 health professionals (40.4% males, 59.6 females, 59.6 married, 3 doctors, 49 nurses, mean age 36.9± 8 years range 23 years-52 years), were surveyed. The participants were characterized by low level of qualification in specialization, further training in psychiatry, and by very low awareness about Mental Health Care Act 17 of 2002. Furthermore, there was no implication of expects (Regional psychiatrist, psychologist, social worker) and co-ordination of mental health care services. Working in remote and disadvantaged area, health workers with lower education qualification, absence of a coordinator for mental health care services and absence of workshop on Mental Health Care Act 17 of 2002 were determinants of lower awareness about Mental Health Care Act 17 of 2002. However, there was a good to excellent framework for potential implementation of mental health care services into primary health care system. The government support in infrastructures, drugs availability, transport and equipment was evident. Patients were helped within abroad based ethical, human rights and psycho-social framework. Conclusion: There is a lack of improving human capacity for mental health in terms of continuous training in mental health issues, policies, organisation and development. Globally, the integration of mental health care service in King Sabata Dalindyebo is non-optimal.

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Czaika, Gabrielle. "The social construction of female criminality : women, mental health, and the criminal justice system." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ64030.pdf.

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Merrill, Brett M. "Youth Motivation as a Predictor of Treatment Outcomes in a Community Mental Health System." BYU ScholarsArchive, 2014. https://scholarsarchive.byu.edu/etd/4187.

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The role of motivation in relation to youth symptoms and psychotherapy outcomes is not well understood. Some cross-sectional research suggests that motivation predicts youth treatment outcome in low-motivation populations. The purpose of this study was to examine patterns of change in youth motivation over the course of treatment and to elucidate the relation between motivation, youth symptoms, and psychotherapy outcomes in a routine community mental health setting. Participants and their caregivers were from three community mental health outpatient clinics and completed youth or parent forms of the Youth Outcome Questionnaire (Y-OQ) and Treatment Support Measure (TSM) at frequent intervals throughout treatment. Data were collected over a period of about 2 years. On average, youth motivation significantly increased over the course of therapy according to self- (p < .001) and parent-report (p < .001). This change followed a square root function better than linear and quadratic models. Initial motivation was not predictive of overall change in symptoms or rate of change at the p <.05 level after accounting for initial levels of youth symptoms. Individual rates of change for youth motivation varied significantly over the course of treatment (p < .001), which might suggest unique trajectories of motivation for different subsets of youth based on presenting concerns or other variables.

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Richter, Sundberg Linda. "Mind the Gap : exploring evidence-based policymaking for improved preventive and mental health services in the Swedish health system." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-118179.

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Background: The challenges in the utilization of scientific findings in the fields of prevention and mental health are well documented. Scholars have found significant gaps between the knowledge available and the knowledge applied in healthcare. Studies have suggested that about half of the patients receive the recommended care for their medical condition. In order to address this gap, health systems at global, national, regional and local levels have made diverse efforts to facilitate the uptake of research for example through evidence-based health policy processes. In Sweden, government agencies and health policy actors such as the National Board of Health and Welfare support and control the health care system through evidence-based policies amongst other steering tools. The overall aim of this thesis is to explore evidence-based policy processes, and to further understand barriers to implementation of policies in the fields of preventive and mental health services. Methods: A multiple case study approach was used, and data were collected from several sources. Qualitative content analysis methodology was used. Case 1 comprises the development and early implementation of national guidelines for methods of preventing disease managed by the National Board of Health and Welfare during 2007–2014. Case 2 covers the effort to improve health care for the older population that was undertaken through an agreement between the Swedish government and the Swedish Association of Local Authorities and Regions during 2009–2014. Case 3 involves an effort to implement an adapted version of a systematic review from the Swedish agency for health technology assessment and assessment of social services on treatment of depression in primary health care. Data was collected between 2007 and 2010. In Paper 1, the policies from Case 1 and 2 were studied using a longitudinal, comparative case study approach. Data were collected through interviews, documents and observations. A conceptual model was developed based on prior frameworks. The model was used to organize and analyse the data. In Paper 2, the guideline development process (Case 1) was studied through interviews and the collection of documents. A prior framework on guideline quality was used in order to organize the data. Paper 3 investigated decision-making processes during guideline development using a longitudinal approach. Qualitative data were collected from questionnaires, documents and observations and analysed using conventional and summative content analysis. In Paper 4, the barriers to implementation were investigated through interviews and the collection of documents. Data were analysed using qualitative content analysis with a conceptual model to structure the analysis. Results: The sources and procedures for policy formulation differed in Case 1 and 2, as did the approaches to promote the implementation of the policies. The policy processes were cyclical, and phases overlapped to a large degree. The policy actors intended to promote implementation, both during and after the policy formulation process. The thesis shows variation in how the key policy actors defined and used research evidence in the policy processes. In addition, other types of knowledge (e.g. politics, context, experience) served as alternative or multiple sources to inform the health policies. The composition of sources that informed the policies changed over time in Cases 1 and B. During the policy formulation and implementation process, efforts to integrate research evidence with clinical experiences and values were associated with tension and recurrent dilemmas. On the local level (i.e. primary health care centres), barriers to implementation were found related to the innovation and among health professionals, patients, in social networks as well as in the organizational, economic and political contexts. Conclusion: The concept of evidence holds a key position in terms of goals and means for knowledge based policymaking in the Swedish health system. Broad definitions of evidence – including research and non-research evidence - were requested and to various extents utilized by the policy actors in the studied cases. An explicit terminology and systematic, transparent methodology to define, identify, and assess also non-research evidence in policy processes would potentially strengthen the clarity and validity of these processes and also enhance policy implementation. Particular determinants to implementation, such as the interventions characteristic, are to a considerable degree established early in the policy process, during agenda setting and policy formulation. This early phase offers unique opportunities to assess and build capacity, initiate and facilitate implementation. Early analysis and considerations of target populations and contexts and other implementation determinants related to the specific policy scope (e.g. disease preventive guidelines) could enhance the forth-coming implementation of the policy.

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Maxwell, Mark David. "God in the marital system| A theory of covenant attachment." Thesis, Alliant International University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3592826.

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Attachment theory has been applied in examining an individual's relationship with God through various research studies. Few research studies, however, have examined a romantic couples' relationship with God and each other as part of a family system. The purpose of this constructivist grounded theory study was to develop a deeper understanding of the relational system of married couples and God. I interviewed nine marital couples from multiple Christian denominations that reported having a strong relationship with each other and a strong relationship with God together. The interviews were transcribed and analyzed using constructivist grounded theory techniques presented by Charmaz (2006). I analyzed emergent categories of behaviors, emotions, and cognitions to construct a theory and model of marital couples and their shared relationship with God. I compared and contrasted the results and theory to existing literature on attachment theory as well as theology on kinship covenant to demonstrate a shared attachment to God that reflects a covenant attachment system. Finally, I discuss clinical, pastoral and future research implications.

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Swiatek, Scott A. "The Nepali Caste System and Culturally Competent Mental Health Treatment: Exploring Stratification, Stress, and Integration." University of Akron / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=akron1619654745373203.

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Everett, Barbara. "A fragile revolution, consumers and psychiatric survivors confront the power of the mental health system." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq22906.pdf.

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Scyner, L. A. "The development of mental health policy : A comparative study of a federalist and unitary system." Thesis, University of Bristol, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.379352.

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Montenegro, Cristian R. "Service-user organisations and the Chilean mental health system : tracing policy expectations and political contestations." Thesis, London School of Economics and Political Science (University of London), 2018. http://etheses.lse.ac.uk/3806/.

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Calls for the involvement of service users and their organisations in the design, provision and evaluation of services are prominent in contemporary mental health policy discourse. Models and examples have penetrated national agendas, shaping definitions and expectations about the role and potential contribution of users. The social sciences have addressed this process, especially in the English-speaking world where service-user activism has a long history and involvement practices are well established. Most of this literature assumes that between the goals of service user groups, family organisations and mental health authorities there is continuity. If friction arises, it is marginal in relation to a set of shared aspirations: More prevention, better services, safer treatments, etc. This approach, common in ‘Global Mental Health’ interventions and calls, frames participation and users’ involvement as a technical decision in the hands of mental health systems. On the other hand, a critical literature, particularly based on English-speaking countries, has denounced the futility and superficiality of participatory agendas and their ability to hijack the authentic voices of users on the ground. However, the sharp distinction between a technical and a critical approach does not provide a suitable framework for the identification, description and analysis of the processes by which participation becomes relevant for mental health systems and the emergent self-organisation and self-differentiation of user groups. Applying Niklas Luhmann’s version of social systems theory, and drawing on interviews and participant observation with users, professionals and policymakers, this project simultaneously explores the emergence of mental health service-user initiatives in Chile and the ways in which users’ participation is - and has been - approached and defined by professionals and mental health services. As an exercise of ‘second-order observation’, it takes a step back from the technical/critical distinction, asking how mental health systems observe the collective actions of users and how autonomous user groups organise and define themselves vis-à-vis the observation and expectations of mental health systems. Through four independent papers, this thesis demonstrates that the way in which the mental health system defines and approaches the actions of users is less a result of their organised actions than of the changing needs of mental health policy for ‘user representation’, both at a broader policy level (Paper 1) and at the level of local participatory initiatives (Paper 2). Autonomous user groups, on the other hand, engage in the creation of forms of reciprocity and meaningful action at the margins of the mental health system (Paper 3). They embrace a politics of disengagement and incommensurability that challenges the interests and problematises the situation of social researchers (Paper 4). By adopting a constructivist, historical and reflexive approach, this thesis: highlights the role of policy shifts in determining how participation comes to be valued or devalued; puts forward an alternative approach to the political nature of users’ collective actions, based on practices disengagement, rejection and incommensurability; reframes ethical and epistemological tensions between academic research and activism in the mental health field. Finally, it demonstrates that, regardless of global calls, practices of participation are shaped by local policy scenarios and trajectories. These findings challenge the technical implementability of participation: although involving policy decisions and designs, participation is not a decision. It responds to contingent scenarios, it is subjected to complex expectations and its definition is the subject of contention by autonomous user groups.

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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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Taylor, Guy O. "Perspectives of Sierra Leoneans Healthcare Workers' Mental Health During the Ebola Outbreak." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7086.

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The mental health of healthcare workers during the Ebola outbreak in West Africa was a serious concern for healthcare professionals and the mental health field. One area in West Africa where healthcare workers played a significant role during the Ebola outbreak of 2014 and 2015 was Sierra Leone. This qualitative research study was designed to explore the perceptions of Sierra Leoneans healthcare workers' mental health, how they coped, and treatment they received while providing care for Ebola virus patients. This study, with a phenomenological research approach, used purposeful sampling to recruit 10 healthcare workers to participate in semi structured, open-ended interviews. The stress theory model and a hermeneutic phenomenology conceptual framework were used as a lens of analysis to understand the views of healthcare workers who worked directly with Ebola virus patients in Freetown, Sierra Leone. The results of the analysis of the collected data produced 9 major themes. The major themes suggest that healthcare workers experienced mental health symptoms such as depression and anxiety, personal thoughts and feelings such as insomnia, and suicidal ideation. Strategies for coping included using the Bible; and the detrimental impact included facing discrimination after the Ebola outbreak. Most of the healthcare workers blame the government for not providing adequate coping resources, which led to the personal consequence of hopelessness. This study may benefit mental health professionals working in an epidemic. Additionally, this study may contribute to social change by providing a deeper understanding of the mental health system and healthcare workers in Freetown, Sierra Leone.

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Andrews, Michael J. "Client empowerment in mentoring program for minority male youth in the child welfare system| A grant proposal." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10032300.

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The purpose of this project was to write a grant to develop a mentoring program for foster youth. The program will be designed for minority male youth, ages 12 to 18, and will espouse the Recovery Model. This model seeks to promote client empowerment by allowing the minority males to have a say in the selection of mentors. The client will have a large state in their treatment plan and other goals concerning permanency following departure from the out of home foster care environment.

A literature review was conducted in order to provide empirical evidence in support of a mentoring program. The mentoring program will be located in Ettie Lee Youth & Family Services, located in Los Angeles County. The actual submission or funding of this grant was not a requirement for the successful completion of the project.

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Wynaden, Dianne Gaye. "The primary carer's experience of caring for a person with a mental disorder in the Western Australian community: a grounded theory study." Thesis, Curtin University, 2002. http://hdl.handle.net/20.500.11937/883.

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One in five Australians has a mental disorder and it is estimated that one in four families have a member who has a mental disorder. Since the 1960s there has been an 80 percent decrease in Australian institution-based mental health care. The majority of people who have a mental disorder are now treated in their local community and many of them live with their families. The change in the delivery of mental health care has seen the family emerge as one of the most important supports to their ill family member. While the changes in the delivery of mental health care have been based on human rights concerns, changes in mental health legislature, and economic factors, the multi-dimensional experience of being a primary carer of a person with a mental disorder remains relatively unexplored. The need for empirical evidence on the primary carer's experience is noted in both the scientific literature and from carers themselves and the principal aim of conducting this research was to address the identified need. This qualitative study, using grounded theory methodology, presents the findings of interviews with 27 primary carers and memos documented throughout the study. In addition, existing literature of relevance to the findings of this study is presented. A substantive theory of seeking balance to overcome being consumed is presented in this thesis. Using the grounded theory method the constant comparative analysis of data revealed that the basic social psychological problem shared by all participants was the experience of "being consumed". The problem of being consumed consisted of two stages: "disruption of established lifestyle" and a "sustained threat to self-equilibrium". Six conditions were identified as influencing participants' experience of being consumed.In order to address the problem of being consumed, participants engaged in a basic social psychological process of "seeking balance". When participants were engaged in this process they moved from a state of being consumed to one whereby they established and consolidated a balanced life perspective that incorporated their caregiving role. The process of seeking balance consisted of three phases: "utilising personal strategies to reduce the problem of being consumed', "restoring self- identity", and "reaching out to make a difference". In addition, data analysis identified the presence of a three phase sub-process entitled "trying to make sense of what was happening". Phases one of the core and sub- processes occurred primarily in the period prior to the time when a psychiatric diagnosis was made on the affected family member. Participants became engaged in the remaining two phases of the core and sub-processes when they became aware that their affected family member had a mental disorder. At the time of being interviewed for this study some participants were not yet engaged in the final phase of the process of seeking balance. Participants' experience of seeking balance was not related to the length of their caregiving experience but rather to their experience of seeking balance and the conditions influencing that process. Four conditions were identified as influencing participants' experience of seeking balance.This thesis presents the substantive theory of seeking balance to overcome being consumed. While the findings support existing scientific literature, the substantive theory also presents a new insight on caring from the primary carer's perspective. In particular, the findings challenge health professionals to actively pursue strategies to reduce carers' experience of being consumed. The findings of this study have implications for service provision and clinical practice, policy and planning, research, education, the general population, mental health consumers, and carers.

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Miller, Nancy R. F. "Creating Opportunity after Crisis| Examining the Development of the Post-earthquake Haitian Mental Health Care System." Thesis, California Southern University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10281123.

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Scope of Study: The scope of this theoretical study is comprised of an extensive review and interpretation of published studies by governmental organizations such as the World Health Organization (WHO); non-governmental organizations (NGOs); and individuals detailing the theories, concepts, and relationships that exist regarding the social and economic effects of the global burden of mental health disorders and the substantial treatment gap of mental health conditions in low-resourced settings such as Haiti. Humanitarian emergencies are presented as opportunities to build better mental health systems in low-income countries (LICs). Exploring Haiti’s trauma signature (TSIG) identified risk factors for post-disaster mental health consequences to include posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) within the adult population. Three culturally relevant community-based mental health programs Soulaje Lespri Moun (SLM), Partners in Health/Zanmi Lasante (PIH/ZL), and Pwogwam Sante´ Mantal (PSM), and one hospital-centered program, Project Medishare Hospital, are highlighted to demonstrate the implementation of successful mental health care services in post-earthquake Haiti. This project is focused on confronting the barriers to mental health services in Haiti with the goal of developing a long-term sustainable mental health system.

Findings and Conclusions: This research project’s findings are congruent with previous research, which described coordinating with local leadership and integrating culturally relevant, community-focused, and evidence-based mental health care with existing health services. These elements are essential in the development of long-term sustainable services in LICs.

The final chapter is a presentation of recommendations for future areas of inquiry to contribute to greater understanding of global mental health needs, prevention, and delivery of services in LICs before and after complex humanitarian crises. Expanding sustainable mental health care for Haiti will reduce disability and suffering from mental illnesses and build a stronger and more resilient society.

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Tuntiya, Nana. "The Forgotten History: The Deinstitutionalization Movement in the Mental Health Care System in the United States." [Tampa, Fla. : s.n.], 2003. http://purl.fcla.edu/fcla/etd/SFE0000112.

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Shoesmith, Wendy Diana. "The Development and Testing of Consensus Recommendations for Collaborative Practice in the Malaysian Mental Health System." Thesis, Curtin University, 2021. http://hdl.handle.net/20.500.11937/88089.

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This project used participatory action research to develop and test a model of collaborative practice for the Malaysian mental health system. A hospital committee and a Delphi committee were formed to create a set of collaborative practice guidelines. Some of these recommendations were implemented in a psychiatric hospital, including staff training and systems changes. A realist evaluation, using both qualitative and quantitative methods, showed that some of these changes were effective in improving collaboration.

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Mahaffey, Barbara Ann. "Effect of Adding a Patient Computer-Mediated Symptom Tracking System to a Partial Hospitalization Treatment Program." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1243959319.

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Lalovic, Aleksandra. "Genetic studies of suicidal behaviour : investigation of genes involved in the serotonergic system and cholesterol metabolism." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=79022.

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Substantial evidence has accumulated indicating that a genetic predisposition underlies suicidal behaviour, and that the mediating mechanism may involve decreased serotonergic activity and/or low serum cholesterol level. Most association studies have focused on genes involved in the serotonergic tophan hydroxylase (TPH) gene has been extensively examined and conflicting findings have been reported. The meta-analysis presented here was conducted to clarify the role of the TPH gene in suicidal behaviour. No overall association between the TPH gene and suicidal behaviour was found. A shift in focus to genes related to regulation of cholesterol level may provide useful clues. Thus, five genes encoding proteins involved in cholesterol biosynthesis and metabolism were investigated for a role in suicidal behaviour. No association was detected between any of the genes examined and suicide, suggesting that none of the genes investigated plays a major role in the etiology of suicide. Further studies in a larger sample are necessary to exclude possible small genetic effects.

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Jenkins, Juliette Swanston. "Community Health Worker's Perceptions of Integration into the Behavioral Health Care System." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6908.

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Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl's five stream confluence policy process theory and Lipsky's street level bureaucracy theory provided the foundation to explore the perceptions of the CHWs about their integration into the behavioral health care system; the problems, policies, processes, and programs that impacted their ability to be integrated into the behavioral health team; and their function as a street level bureaucrat to facilitate their integration. A deductive iterative coding approach was used, culminating in the identification of the following 6 themes: health system utilization of CHW behavioral health integration, official policy recognition of the CHW profession, accountability for CHW integration, CHW practice support, integrated health care team management of physical and mental health and behavior, and building the CHW profession. The social change implications of this study are that CHWs' integration into the broadly defined, integrated, physical and mental behavioral health team can support having a more cost-effective way toward having healthy people and communities because they link the community to health and social services and advocate for quality care.

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Moranelli, Ryan A. "An Investigation Into the Collaboration of Mental Health and Social Worker Services with the Criminal Justice System." Kent State University Honors College / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors162065733632442.

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Bittner, Olin J. "Designing a Data-Tracking System for a Private Therapeutic Day School." Antioch University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1448896028.

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Melissa, Cook. "Learn the language : understanding the needs of young people outside the school system with mental health issues /." St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17393.pdf.

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Roberts, Petra. "Structural family therapy with families from diverse backgrounds with an adolescent involved in the mental health system." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0010/MQ32236.pdf.

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Smedi, Keith John. "Self-disclosure utilized in a dyadic interview as an intervention in a military community mental health system." Virtual Press, 1988. http://liblink.bsu.edu/uhtbin/catkey/533876.

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In this study the position was taken that therapist self-disclosure could be utilized as an intake interview intervention. It was believed that initiating a working therapeutic relationship would appear to require the ability to collect pertinent and reliable information from the client. Mutual self-disclosure is an important vehicle for enchance the therapeutic relationship (Curtis, 1981; Jourard, 1971). Self-disclosure assists therapists in obtaining vital client information and in establishing a strong, trusting, clinical relationship (Curtis, 1981). The utilization of self-disclosure between client and therpaist serves (Jourard & Friedman, 1970) as encouragement for success and growth in therapy and thus "encourages the development of trust" (Curtis, 1981, p. 502). Moreover, the client is expected to disclose personal information often in a setting in which he/she knows little about the trustworthiness of his therapist that presumes immediacy and accuracy without trust.."the patient's own disclosures, with which the therapists can recognize, identify, and articulate counter-productive patterns, cannot be assured inasmuch as the patient might not be motivated to reveal such personal information without at least receiving the impression of the therapist's reciprocity" (Curtis, 1981, pp. 502, 503).
Department of Counseling Psychology and Guidance Services

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Wakeland, Elizabeth Sarah. "Professionals' experiences of deaf people : a grounded theory approach within the mental health and criminal justice system." Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7720/.

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The thesis consists of two volumes. Volume One: This volume consists of three chapters: the first, a literature review of the prevalence of abuse within the deaf and hard of hearing population; the second is a qualitative study using grounded theory exploring professionals’ experiences when working with deaf offenders with mental health difficulties; the third chapter comprises a public domain briefing document which briefly provides a plain language explanation of both the literature review and the empirical paper. Volume Two: The second volume contains five forensic clinical practice reports (FCPR). The first contains the case of a 16-year-old girl in a low secure adolescent unit presenting with self-injurious behaviours and aggression, formulated from both psychodynamic and behavioural perspectives. The second FCPR is an evaluation of the Structured Assessment for Violence in Youth (SAVRY) when used in a low secure adolescent service to predict future aggression. The third report is a single-case experimental design investigating the effectiveness of individual therapy using Cognitive Behavioural principles with a 17-year-old female presenting with low mood. The fourth FCPR presents a case study of a 53-year-old Deaf female with paranoid schizophrenia, formulated using narrative principles. The final report is an abstract of an oral presentation of a case study involving a 27 year old female within a prison based Offender Personality Disorder Pathway (OPDP) comprising a detailed assessment, formulated from a psychodynamic perspective, and recommendations for interventions.

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Bimerew, Million S. "Developing a framework for a district-based information management system for mental health care in the Western Cape." Thesis, University of Western Cape, 2013. http://hdl.handle.net/11394/3324.

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Philosophiae Doctor - PhD
A review of the literature has shown that there is a lack of mental health information on which to base planning of mental health services and decisions concerning programme development for mental health services. Several studies have indicated that the use of an evidence-based health information system (HIS) reduces inappropriate clinical practices and promotes the quality of health care services. This study was aimed at developing a framework for a district-based mental health information management system, utilising the experiences of health care providers and caregivers about a district mental health information system (DMHIS). Activity Theory was used as the philosophical foundation of the information system for the study. A qualitative approach was employed using semi-structured individual interviews, Focus Group Discussions (FGDs), systematic review and document analysis. The intervention research design and development model of Rothman and Thomas (1994) was used to guide the study, which was conducted in the Cape Town Metropole area of the Western Cape. A purposive, convenient sampling method was employed to select study participants. Ethical clearance for the study was obtained from the University of the Western Cape, and permission to use the health facilities from the Department of Health. The data collection process involved 62 individual interview participants, from mental health nurses to district health managers, health information clerks, and patient caregivers/families and persons with stable mental conditions. Thirteen caregivers took part in the FGDs. Document review was conducted at three community mental health centres. The data were analysed manually using content analysis. Core findings of the interviews were lack of standardized information collection tools and contents for mental health, information infrastructure, capacity building, and resources. Information processing in terms of collection, compiling, analysing, feedback, access and sharing information were the major problems. Results from document analysis identified inconsistencies and inaccuracies of information recording and processing, which in turn affected the quality of information for decision making. Results from the systematic review identified five functional elements: organizational structure; information infrastructure; capacity building; inputs, process, output and feedback; and community and stakeholders’ participation in the design and implementation of a mental health information system (MHIS). The study has contributed a framework for a DMHIS based on the findings of the empirical and systematic review. It is recommended that there is a need to establish a HIS committee at district health facility level for effective implementation of the framework and quality information processing. There is a need to ensure that staffs have adequate knowledge and skills required for effective implementation of an information system. It is recommended that higher education institutions include a course on HISs in their curriculum. It is suggested that the South African Mental Health Policy be reviewed to include an MHIS and ensure involvement of the community and stakeholders in this system as well as adequate budget allocation.

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Yates, Chad M. "The Use of Per Session Clinical Assessment With Clients In a Mental Health Delivery System: An Investigation Into How Clinical Mental Health Counseling Practicum Students and Practicum Instructors Use Routine Client Progress Feedback." Kent State University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=kent1331567104.

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50

Klahn, Erin J. "Debating identity urban Indians in the healthcare system /." CONNECT TO THIS TITLE ONLINE, 2008. http://etd.lib.umt.edu/theses/available/etd-05272008-202310/.

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Dissertations / Theses on the topic 'Mental health system'

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