Rozprawy doktorskie na temat „Deinstitutionalisation”
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1
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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Browning, Mary. "Social relationships, compatibility and resettlement planning for hospital residents with a severe learning disability". Thesis, Bangor University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.296319.
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Parr, H. "'Sane' and 'insane' spaces : new geographies of deinstitutionalisation". Thesis, University of Wales Trinity Saint David, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.541449.
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4
Chou, Shihning. "Deinstitutionalisation, international adoption and the effects on the child". Thesis, University of Liverpool, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.539582.
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The primary question of this PhD study is the role of international adoption in deinstitutionalising young children (under 5). From an attachment theory and the child rights perspective, this PhD study first explored the potential problems with the current practices in international adoption by comparing the conduct of international adoption agencies operating on the internet. It found that at least 38% of the agency websites examined were in breach of the UNCRC and the Hague Convention. It then explored the relationship between international adoption and institutional care and how international adoption may impact on the progress in the deinstitutionalisation of children. Contrary to popular belief, the research found that international adoption is associated with the increase or maintenance of institutional care. The study went on to examine the current practices in the deinstitutionalisation of children in Europe, comparing them to a 10 Step good practice model for transforming children's services. The results tentatively suggest that countries with better community support services were more likely to meet the standards set out in the model. As child abandonment has been identified as one of the main reasons for the high numbers of children in institutional care or placed for international adoptions in the first place, a case study of Romania and a narrative literature review were carried out to explore the extent of the problem and the preventive strategies. In Romania, the main causes of child abandonment by the family were identified as; very serious economical problems, mothers' lack of formal education, lack of specialised services at the level of local communities, poor sexual education, homelessness and teenage parenting. The rate of child abandonment in maternities was calculated to be 1.8% of live births. A pilot study in three maternity units found that the two that introduced social workers saw marked reduction in the number of abandoned children whereas the number in the one without a social worker remained the same.The literature review found that there has been a lack of clear definitions on this social issue and a lack of unified recording system for abandoned children. Therefore, it is difficult to estimate the true extent of the problem. Reasons often observed for abandonment were poverty, young or single parenthood and the lack of welfare and services for parents in serious financial difficulties or found it hard to cope with the demands of the child(ren). To explore possible effects community services have on deinstitutionalised children, a follow up study of the children deinstitutionalised back into family based care, the integral part of community services, were carried out in Romania. Significant differences were found in all aspects of physical and psychology care and carer sensitivity received by the children between children who grew up in their own families, those who were deinstitutionalised into a foster or adoptive family and those who were returned to their biological families. The results showed that the quality of care received by fostered/adopted children was rated the highest on all items. This tentatively suggests that children who were de institutionalised and placed in foster and adoptive families are likely to receive better quality of parenting and have a better chance of rehabilitation and catch up with their peers. It may indicate that the selection process of surrogate families has been relatively successful. Finally, a systematic review comparing the psychosocial outcomes of internationally adopted children to adopted or non-adopted children within the host countries were carried out to shed light on the effects of international adoption on children. The results indicate that internationally adopted children who were not exposed to institutional care on a long term basis can recover well from their early adverse experience and catch up with same age children in the host countries in terms of development and cognitive functioning. However, information on international adoptees prior experience was poorly reported and difficult to verify. No study reported the assessment results that led to the decision on international adoption. Thus, it is not possible to determine whether international adoption was the most appropriate placement for those children.
5
Levien, Janett. "The transformation of Mangere Hospital: A case study in deinstitutionalisation". Thesis, University of Auckland, 1998. http://wwwlib.umi.com/dissertations/fullcit/9820238.
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This thesis is an analysis and evaluation of a case study in deinstitutionalisation of people with intellectual disabilities. The process has been viewed as an example of organisational change and the focus is on the relationship between formal and informal caregivers and the notion of care. Three key groups were included in the study, families of residents, the residents and staff. A qualitative approach was taken. The theoretical perspective that was developed attempted to account for links between social movements, organisations and individual experience in the arena of intellectual disability. This was based on the approach of New Institutionalism in organisational theory. The focus was primarily on the process--of change, and in caregiving. Three models of intellectual disability, which have informed policy and the recent changes to a preference for community care, have been identified and the links between these and the elements of organisations developed for providing care explored. The experience of families and residents within the hospital setting and then the community care setting has been examined in relation to the nature of the organisation. Outcomes for the three groups have been examined in terms of their needs and the extent to which these needs were met by the arrangements over a given time. It is concluded that community care has the potential to better meet the needs of those involved, than has hospital based care. A number of factors in the process of change and in the delivery of care have been identified as impacting on outcomes for those involved. Consideration is given to the practical implications of these findings.Subscription resource available via Digital Dissertations only.
6
Lemon, David John. "The Closure of the Templeton Centre". Thesis, University of Canterbury. Sociology, 2001. http://hdl.handle.net/10092/920.
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This M.A. thesis argues that the closure of the Templeton Centre was caused by the convergence of political, social and economic trends in psychopaedic care, occurring in other Western countries. The research paper commences with an historical exploration of the emergence of state institutions. It continues with an investigation of the role scandals played in creating the demand for the closure of psychopaedic institutions. The disability rights movements' discourse of 'normalisation', is shown as the social ideological force in the closure of state institutions, while neo-liberal ideology is seen to exploit deinstitutionalisation for economic gains. The research concludes with an assessment of parental and public reactions to the community placement of people with intellectual disabilities and an analysis of the positive outcomes and negative consequences of deinstitutionalisation. While current research on the closure of the Templeton Centre has explored the effect of deinstitutionalisation on the intellectually disabled and their respective families, the contribution of this research to the subject is its exploration of the sociological causes and effects of the deinstitutionalisation of the Templeton Centre The research methodology involved the collection, collation and interpretation of primary and secondary documents to construct a sociological account of the deinstitutionalistion of the Templeton Centre. The primary sources include health and social welfare documents, newsletters and letters and the secondary sources comprises books, journals and newspaper articles. The principal argument is that the Western political, social and economic ideologies which converged at differing times to create, shape and eventually close psychopaedic institutions, also affected the Templeton Centre (1929 to 1999) in New Zealand. The research paper's conclusion is that Western political, social and economic trends will continue to shape New Zealand Governments' policies on people with intellectual disabilities. Therefore, disability research specialists must continue to study changes on the international stage, to enable them to predict the probable discourses, issues and events which will inevitably occur in New Zealand.
7
Hennessy, Rachel A. "Deinstitutionalisation of the welfare state: the case of mental health care". Thesis, Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/94465.
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Grant, John Robert. "Deinstitutionalisation : community living and quality of life for ex-Templeton Centre residents". Thesis, University of Canterbury. Sociology and Anthropology, 2002. http://hdl.handle.net/10092/1969.
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This thesis examines the lives of ten former Templeton Centre residents subsequent to
deinstitutionalisation, through the eyes of their mothers. The central theme is concerned with how deinstitutionalisation has effected their quality of life. The aim is to provide a 'snap shot' of life in the community for persons with intellectual disabilities. In doing so, it will be argued that people with intellectual disabilities are a heterogeneous group, and thus have a variety of needs, wants and desires. A major factor in this regard is the type and/or level of disability. Consequently, the experiences of life in the community will be largely unique to the individual. Furthermore, due to this heterogeneity, the needs, wants and desires of persons with intellectual disabilities can not, in some circumstances, be adequately met through care in the community.
9
Moon, Je Yun. "Choreo-graphy : the deinstitutionalisation of the body and the event of writing". Thesis, Goldsmiths College (University of London), 2017. http://research.gold.ac.uk/20123/.
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Choreography is commonly understood as a technical term that describes what the choreographer does in a literal sense: writing the dancing bodies according to a master’s set narrative. However, recent events in contemporary choreography suggest a different possibility of articulating choreography as a technique of offering rather than a technique of domination over other bodies. Through an analysis of some groundbreaking choreographic experiments by Xavier Le Roy, Jérôme Bel, Boris Charmatz, Eszter Salamon, Christine De Smedt, Jan Ritsema, and Anne Teresa De Keersmaeker, which have gained visibility since the late 1990s in the global art scene beyond the Western institution of dance, this thesis aims to theorise this shift in what choreography is and can be. In an attempt to theorise choreography as a technique of offering, this thesis illuminates the relationship between some of the tactical operations in contemporary choreographic experiments and the post-structuralist rethinking of power, institution, the body, subjectivity and knowledge production. Turning to Michel Foucault’s rethinking of power and Jacques Rancière’s challenge of the position of mastery, it aims to articulate the tactical deconstructions of the choreographer-master in contemporary choreographic experiments. Borrowing Hannah Arendt’s notion of a ‘space of appearance’ and Jean-Luc Nancy’s rethinking of body, it attempts to articulate how choreography as a spatiotemporal technique offers spaces of appearances for other bodies. This thesis also highlights a different possibility of articulating choreography by positioning it in the critical field called the ‘curatorial’. Reflecting the contemporary disciplinary crisis in art, where the given methodologies and tools no longer do the job that they used to do, there are increasing demands from cultural producers for different modes of operations in order to open up new critical possibilities of interdisciplinary research. In thinking through Le Roy and De Keersmaeker’s ‘choreographed’ exhibitions, this thesis aims to rethink choreography in terms of the curatorial. This also means to rethink the curatorial in terms of choreography, where both theatre-making and exhibition-making can be rearticulated as a matter of body in relation to other bodies.
10
Baker, Peter A. "Deinstitutionalisation of people with a learning disability : use of community and leisure facilities". Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/24831.
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Various measures of community and leisure use have been reported. However a range of problems exist with these that may compromise the reliability and validity of the data generated. In addition, rarely has normative data been produced that would enable comparison of individuals and groups of people with disabilities with non-disabled people. The thesis describes the development of the Guernsey Community Participation and Leisure Assessment (GCPLA). This is a comprehensive assessment of community participation and the use of leisure, which produces both quantitative and qualitative data. Data are presented that suggest that the instrument is potentially both valid and reliable. A study comparing community and leisure use of service users and a staff control group showed that service users had a smaller range of activities, were less busy(had fewer frequent activities), and were more likely to access their communities in the presence of staff or carers, rather than alone or with friends. Suggestions for the use of the GCPLA are discussed including individual planning, service evaluation and training. The impact of resettlement for the residents of a small learning disability hospital on their use of their communities and leisure was investigated using a mixed design in which changes in the dependent variable (GCPLA scores) were measured within-subjects (before and after leaving hospital) and between-subjects (using a comparison group of people who lived in the community throughout the study). This revealed that resettlement from hospital corresponded with significant increase in the range and frequency of leisure and community contacts. In addition, a standard multiple regression design was employed in order to explore the relative contribution of client and service variables to GCPLA scores. Community and leisure use was found to be related to place of residence, adaptive behaviour and the robustness of community goals within the service users individual plan.
11
Mirfin-Veitch, Brigit, i n/a. "Dislocation: deinstitutionalisation in the lives of families of people with an intellectual disability". University of Otago. Faculty of Education, 2005. http://adt.otago.ac.nz./public/adt-NZDU20061024.151035.
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This thesis is based on a research project that explored the deinstitutionalisation and eventual closure of a large residential facility for people with an intellectual disability. The thesis is focused on family experiences of deinstitutionalisation in order to understand how families interacted with this major process of social change, and pays specific attention to the role of adult siblings within this context.
Unstructured interviews were held with thirty-five families who had family members with an intellectual disability who were being resettled from an institution to alternative disability support services. Families were interviewed at three specific phases during the deinstitutionalisation process: prior to the resettlement of their family member; 1-3 months following resettlement; and one year after resettlement. In keeping with the constructivist paradigm that underpinned this qualitative study, repeated contact with families enabled me to develop some insights into how families made decisions relevant to their family members� transitions from the institutional environment.
The study findings highlight the complexity and heterogeneity of families. While families who participated in this study were found to have shared a similar journey toward institutionalisation, their responses and reactions to deinstitutionalisation and the decision-making associated with such a process were more diverse. My analysis presents the notion that taking a constructivist approach to theorising can facilitate an understanding of how families are influenced in their decision-making with regards to the resettlement of a family member with an intellectual disability. That is, we may be able to gain greater understanding of families� perceptions of their family members who have an intellectual disability and, subsequently, the decisions that families make regarding the care of that person by exploring the meanings they assign to their world. Ascertaining how families come to construct their understandings of disability is, in my view, critical to responding appropriately to families� needs within the context of disability support and service provision.
12
Young, Janet Louise. "Deinstitutionalisation and changes in life circumstances of adults with intellectual disability in Queensland /". [St. Lucia, Qld.], 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16161.pdf.
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Chenoweth, Lesley Irene. "Disability, deinstitutionalisation and discourse : an analysis of institutional reform policies in Queensland, 1994-1996". Thesis, Queensland University of Technology, 1998. https://eprints.qut.edu.au/36551/7/Digitised%20Thesis.pdf.
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The closure of large institutions for people with intellectual disability and the subsequent shift to community living has been a feature of social policies in most western democracies for more than two decades. While the move from congregated settings to homes in the community has been heralded as a positive and desirable strategy, deinstitutionalisation has continued to be a controversial policy and practice. This research critically
analyses the implementation of a deinstitutionalisation policy called Institutional Reform in the state of Queensland from May 1994 until it was dismantled under a new government in the middle of 1996. A trajectory study of the policy from early conceptualisation through its
development, implementation and final extinction was undertaken. Several methods were utilised in the research including the textual analyis of policy documents, discussion papers and newspaper articles, interviews with
stakeholders and participant observation. The research draws on theories of discourse and focuses on how discourses
of disability shape policy and practice. The thesis outlines a number of implications for policy implementation more generally as well as for disability services. In particular, the theoretical framework builds on
Fulcher's (1989) disabling discourses - medical, charity, lay and rights - and identifies two additional discourses of economics and inclusion. The thesis argues that competing disability discourses operated in powerful
ways to shape the implementation of the policy and illustrates how older discourses based on fear and prejudice were promoted to positions of dominance and power.
14
Tham, Huyen Anh. "Deinstitutionalisation from the perspective of sensemaking : an empirical investigation of the Electricity of Vietnam Corporation". Thesis, University of Nottingham, 2012. http://eprints.nottingham.ac.uk/28387/.
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This thesis is a study of deinstitutionalisation seeking to understand the evolvement of deinstitutionalisation process via the lens of sensemaking. It does so by conducting an in-depth qualitative, case study-based empirical study of the processual nature of deinstitutionalisation and the significance of organisational sensemaking during the deinstitutionalisation process. An interdisciplinary approach is adopted drawing insights from various literatures including institutional theory, sensemaking and social psychology. The need for greater understanding of the deinstitutionalisation phenomenon, especially its process is acknowledged after relevant literatures are reviewed. The potential of using microanalysis in examining the deinstitutionalisation process is demonstrated. The sensemaking perspective is thus used to facilitate this processual research. The findings emerged from this thesis have important implications for the theoretical development of institutional changes, sensemaking and especially deinstitutionalisation. First of all, the model and evidence sheds some light on the nature and development of the deinstitutionalisation process. Secondly, the analytic capacity of the institutional theory especially its descriptive and predictive contents are tested in the context of evolving institutions. The relative strengths of regulative, cognitive and normative influences in non-conventional cultural and institutional contexts extend our knowledge of institutional change and effects. Using sensemaking perspective, the findings also demonstrate the role and power of resistance during institutional processes and explain the possibility of multiple paces and outcomes within a single deinstitutionalisation process. As for sensemaking, crisis sensemaking will be examined in a new context: disaster-struck but not life threatening. In practical terms, this study is carried out in an organisational context therefore it has relevant managerial implications. Knowledge gathered here should offer useful insights for businesses, especially managers.
15
Hardman, Lisa, i 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.
16
Turnpenny, Agnes. "Deinstitutionalisation and community-based care for adults with intellectual disabilities in Hungary : policy change, challenges and outcomes". Thesis, University of Kent, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.590063.
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This thesis explores the processes of policy change and outcomes of deinstitutionalisation and community living for adults with intellectual disabilities in the context of a post-communist country, Hungary. The dissertation begins by presenting the international perspective. Using multiple theoretical perspectives it investigates how policies changed and what forces drove the process of deinstitutionalisation in different countries. Some common themes and experiences such as scandals, ideologies, policy learning, and the influence of advocacy coalitions are identified. This is followed by a review of the evaluation literature on the individual outcomes of different residential arrangements for people with intellectual disabilities. The second part of the dissertation presents the policy and practice in residential care in Hungary. Various interpretations of recent policy developments are put forward based on theoretical models of policy change, and the critical analysis of a broad range of policies suggests that residential care policies are resistant to change because institutions are a functional part of the policy system. The third part of the thesis describes the results of a field study looking at the quality of different residential arrangements in Hungary for people with intellectual disability. The thesis concludes with the discussion of the findings and the consideration of implications for national and international policies.
17
Bayanzadeh, Seyed Akbar. "Psychiatric rehabilitation : a study of a deinstitutionalisation program for patients with long-term disabilities in a psychiatric hospital". Thesis, Keele University, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.304535.
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Schweizer, Richard. "Schizophrenia and the Self: Rebuilding and Maintaining Identity After a Diagnosis of Schizophrenia". Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15515.
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Schizophrenia is a debilitating mental illness that strikes approximately 1 in 100 people in the population during their lifetimes. It is an illness that can have a severe impact on the sense of self of people affected. It is the purpose of this thesis to examine the processes by which such a sense of self is disrupted, rebuilt and maintained in people diagnosed with schizophrenia. Twelve people diagnosed with schizophrenia were interviewed with regards to the ongoing impact of their illness. In particular, interviews focused on processes relevant to their sense of identity before, during and after the diagnosis of schizophrenia. The thesis also thematises issues of power and social structure surrounding the person diagnosed with schizophrenia. It was found that, after medication, a number of social processes were important to rebuilding a sense of identity. These included the development of illness narratives, interaction with family and friends, illness management, life management, the setting of life goals and, in some cases, participation in organised religion. Identity was typically maintained through processes of stigma concealment and passing. The influence of psychiatrists, psychopharmaceutical companies and a deinstitutionalised environment in which severe mental illness is treated all emerged as significant factors in the process of rebuilding a sense of identity. The thesis seeks to make contributions to the sociology of schizophrenia and severe mental health concerns more widely. In particular, it deploys concepts of biographical crisis to make sense of the intensity of identity disruption people diagnosed with schizophrenia may experience. It also seeks to revise the perspectives of symbolic interactionism and phenomenology to better understand the emotive and embodied nature of identity processes in schizophrenia. Beyond this, the thesis explores the relationship between language, power and agency and its significance in shaping the experience of the patient diagnosed with schizophrenia. The concept of negotiated power networks is put forward to help make sense of these power relationships in a deinstitutionalised environment. Finally, the thesis proposes the concept of identity work as a way of understanding the operations of agency and relevant processes affecting identity.
19
Parker, Lukas Jay, i lukasparker@gmail com. "Trust and the Australian retail banking industry : the impact of deinstitutionalisation of Australian retail banking services on consumer trust". Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20051117.105403.
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Consumer trust research has principally developed from established psychological-based research. This conception of consumer trust largely draws from research pertaining to interpersonal trust. This study combined existing
theories from both sociological and psychological research in developing a consumer trust model specifically for banks.
Partly because of their historical position in society and also because of their
government-protected position, banks, bank branches and bank managers have traditionally held a respected, and trusted position in Australian communities. Because of this reputation and position in communities, banks were seen to display institutional attributes. These attributes were defined in this study as local community focus, local availability and visibility, relationship power symmetry and social obligation fulfilment.
This study explored the notion of institution-based trust in an Australian retail banking context. Institution-based trust was a measure of the levels of consumer trust in various defined institutional attributes. It was contended that through the diminishment and divestment of its institutional attributes banks were impairing their institutional cachet. The process was termed 'deinstitutionalisation' and was postulated to have a negative impact on consumer trust.
The hypothetico-deductive methodological framework was employed throughout the study, with a mail-based consumer survey used as the main means of primary data collection. 468 useable questionnaires from adult bank customers were yielded and the data analysed. These data were analysed and used to test twenty-three
research hypotheses of which nineteen were supported.
From the results, it was concluded that perceived local community focus, perceived social obligation fulfilment and perceived relationship power symmetry were antecedents to consumer trust in banks. Also, reasonable availability of conventional bank branch services was found to be an important component of perceived community focus of their banks, thus having an indirect relationship to
institution-based consumer trust in banks. Community Banks were found to be exhibiting and promoting many of these institutional attributes.
Consumers were found to be less likely to need bank branches for transactional or functional purposes, but branches were seen to be symbolically important. Also, consumers were found to be more likely to identify with intangible elements of their bank, principally bank brand, than with tangible attributes such as the bank branch. Importantly, consumers were found to be trusting of their banks, however
they were more likely to believe that banks were less trustworthy now than they were in the past.
20
Dixon, Roselyn May, University of Western Sydney i of Arts Education and Social Sciences College. "Moving out : the impact of deinstitutionalisation on salient affective variables, social competence and social skills of people with mild intellectual disabilities". THESIS_CAESS_XXX_Dixon_R.xml, 2004. http://handle.uws.edu.au:8081/1959.7/550.
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This thesis examined the social competency and affective functioning of people with mild intellectual disabilities through salient variables that impact on people with disabilities who have been deinstitutionalised. Its primary purpose was to extend the previous research on the impact of deinstitutionalisation by incorporating multi-dimensional self-concept, adaptive behaviour and quality of life, in combination with self esteem and locus of control, in longitudinal/comparison design. It is also aimed to examine the development of identity, self-esteem and social competencies from a qualitative perspective. Finally it assessed the efficacy of an interpersonal cognitive problem-solving intervention which incorporated techniques for the development of maintenance and generalisation and determined the impact of this intervention on real-life social behaviours. The findings have important implications for current theory of the self-concept for people with intellectual disabilities, the provision of programs and techniques to improve self-concept, and also for the provision of social skills programs to enhance the social competencies and the social integration for people who have been deinstitutionalised.Doctor of Philosophy (PhD)
21
Dixon, Roselyn. "Moving out the impact of deinstitutionalisation on salient affective variables, social competence and social skills of people with mild intellectual disabilities /". View thesis, 2004. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20050811.152254/index.html.
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Thesis (Ph.D.) -- University of Western Sydney, 2004.Thesis submitted to the University of Western Sydney in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliography.
22
Gallagher, Mark. "From mental patient to service user : deinstitutionalisation and the emergence of the Mental Health Service User Movement in Scotland, 1971-2006". Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8078/.
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Until recently research on the history of psychiatry was largely focused on the institutions where this controversial branch of medicine emerged, on its practitioners, treatments, theories and clinical practices, and the shifting social, institutional and legal contexts in which it has developed. Two pioneering figures in the histories of psychiatry and medicine, Michel Foucault and Roy Porter, opened the historiographical field up to much broader perspectives, expanding the range of sources and interpretations to encompass a wide-lens focus on matters such as the relationships between histories of madness and rationality, ‘the patient’s view’ and ‘anti-authority struggles’ by psychiatric patients. The study undertaken here seeks to develop aspects of the historiographical approaches advanced by Foucault and Porter by investigating how psychiatric patients engaged in collective action and campaigned for reform to mental health services in late twentieth-century Scotland. Through an excavation, description and analysis of untapped archival and oral history sources, I chart the spaces of emergence and trace the intersecting lines of descent of the ‘Scottish user movement’ in the era of deinstitutionalisation. By examining the records of patient groups and oral history interviews with activists, I reveal how this small but significant social movement was formed through the interplay between top-down social and governmental practices and bottom-up resistance and action by patients. The study makes visible the characters, voices, settings, events and actions, which made up the changing discursive and social practices of patients groups in Scotland over the last half-century.
23
Jones, Rob. "The impacts of deinstitutionalisation on the quality of life of a cohort of individuals with intellectual disabilities : a longitudinal mixed methods study". Thesis, University of Leicester, 2018. http://hdl.handle.net/2381/43016.
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Literature review: The systematic review aimed to examine the impact that deinstitutionalisation had on the community integration of service users with intellectual disabilities. Six electronic databases (PsychINFO, Medline, Scopus, Web of Science, CINAHL, and ASSIA) were searched and 12 studies met the inclusion criteria. Findings indicated that access to community facilities increased but integration did not. Frequency and quality of social relationships with staff, family, and peers was generally high post move but relationships with individuals unrelated to services remained infrequent. It is concluded that the focus of policy should move towards developing close personal relationships rather than community integration. Research report: The empirical research project aimed to examine how deinstitutionalisation had impacted the quality of life of a cohort of 14 service users. The study formed the second half of a quantitative longitudinal study spanning eight years. A mixed methods approach was used. Eleven staff members who knew service users well completed outcome measures. Transcriptions of discussions alongside this were analysed using template analysis. Interviews were held with social workers who knew the remaining three. Six themes were created: Social relationships; community use; choice; emotional wellbeing; challenging behaviour; and adaptive behaviour. The move to the community was experienced very differently by each service user. While it appeared that a number of gains were made for some service users, others experienced poor quality care and received few benefits. Relationships with staff appeared to be very important for some service users and these relationships appeared to impact all areas of quality of life. It is concluded that for the move to the community to be successful, staff must be sensitive to the changing needs of service users throughout their lives. Critical appraisal: The research process is critically appraised and reflected upon. Key decisional points are considered, and extended theory is discussed.
24
Whoriskey, Margaret. "Quality of life and deinstitutionalisation : an examination of the effects of relocating people with learning disabilities from hospital to life in the community". Thesis, University of St Andrews, 1999. http://hdl.handle.net/10023/13513.
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The quality of life for people with learning disabilities was examined for 50 people leaving hospital to live in a range of community residences and for 50 people remaining in hospital. Individuals were followed up for up to 30 months at six monthly intervals. The social validity of quality of life assessment was examined by comparing the importance of a number of service objectives to people with and without learning disabilities. This then informed the development of two measures used to assess aspects of quality of life. A range of measures were employed to address both objective and subjective dimensions of quality of life. Five main areas were identified and examined in two studies - competence and personal growth; health and well-being; quality of care; engagement in activity and staff resident interactions. The issues reflecting some of the difficulties in assessing subjective states of people with learning disabilities are discussed. Overall there was some relatively small changes in the areas of competence and personal growth, quality of care and staff interactions for people moving from hospital to live in the community. The changes tended to occur within six months of moving with little improvement thereafter. In general, there was no change for the people remaining in hospital. Implications for the detailed examination of the effects of deinstitutionalisation are discussed.
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Paula, Graziela Lonardoni de. "Cotidiano dos familiares de portadores de transtornos mentais desinstitucionalizados". Universidade Federal de Juiz de Fora (UFJF), 2016. https://repositorio.ufjf.br/jspui/handle/ufjf/3182.
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A Reforma Psiquiátrica, no Brasil, efetivou-se com o objetivo de substituir o modelo hospitalocêntrico por sistemas extra-hospitalares e viabilizou-se com a criação do número adequado de aparatos e serviços substitutivos de assistência aos portadores de transtornos mentais. O processo de desinstitucionalização dos portadores de transtornos mentais asilados é uma realidade brasileira e um evento histórico a ser tratado com distinção. Neste sentido, é válido que se pense sobre o desdobramento e a efetivação deste processo, já que a maioria da sociedade não está apta e preparada para aceitar o convívio com o “diferente”, com o portador de transtorno mental, descaracterizado pelo modelo manicomial que se apoderou de sua autonomia, quesito imprescindível para atos da vida em sociedade. A inserção social se constitui em um caminho a ser perseguido a partir do movimento da Reforma Psiquiátrica e, em consonância a isto, considera-se relevante a percepção da família acerca desse processo, em especial, quando coabita com o portador de transtorno mental. Nessa pesquisa objetivo é compreender como os familiares de portadores de transtornos mentais percebem a inserção social destes a partir do processo de desinstitucionalização, é indispensável considerar e discorrer acerca de determinados elementos que precederam tal processo e foram responsáveis pelo afastamento do ‘louco’ do convívio social. Para contemplar o objetivo proposto e seus desdobramentos, propõe-se a abordagem qualitativa com o intento de aproximar-se, ao máximo, do objeto pesquisado. A coleta de dados foi realizada nos meses de janeiro e fevereiro do corrente ano, por meio de entrevistas individuais semiestruturadas. O encerramento da coleta de depoimentos ocorreu no momento em que houve a saturação dos dados necessários para a pesquisa. O critério de saturação foi determinado a partir dos significados similares expressos nos depoimentos, o que determinou a interrupção da coleta dos mesmos e o início do processo analítico que gerou três unidades de significados, a saber, O dia-a-dia em 11 cena: o ente portador de transtorno mental; O dia-a-dia em cena: o tratamento; O dia-a-dia em cena: motivações para o cuidado familiar. A análise do significado da percepção dos familiares dos portadores de transtornos mentais, acerca da relação cotidiana com os mesmos, foi intermediada pela Sociologia Compreensiva do Cotidiano de Michel Maffesoli. Esta pesquisa vem ao encontro da necessidade de buscar evidências que melhor elucidem a percepção das famílias de portadores de transtornos mentais acerca da inserção social deste a partir da ‘com-partilha’ de experiências da vida cotidiana. Esta compreensão contribui para revelar potencialidades de reinserção social, mediadas pela lógica do cuidado integral, que necessitam ser consideradas pelo enfermeiro, demais profissionais de saúde e gestores ao demandar assistência à saúde não apenas aos portadores de transtornos mentais, mas também a seus familiares.
The psychiatric reform, in Brazil, was accomplished with the purpose of replacing the hospitalocêntrico model for out-patient treatment systems and assisted with the creation of the appropriate number of devices and services supplying temporary replacements of assistance to people with mental disorders. The process of deinstitutionalization of people with mental disorders asylum seekers is a brazilian reality and a historic event being treated with distinction. In this sense, is valid if you think about the deployment and the effectiveness of this process, since the majority of society is not qualified and prepared to accept living with the "different", with the carrier of mental disorder, mischaracterized by the asylum model who took their autonomy, essential item for acts of life in society. Social inclusion is a path to be pursued from the psychiatric reform movement and, in accordance to this, it is considered relevant to perception of the family about this process, in particular when it with the carrier of mental disorder. On the exposed, this research aims to understand how the families of people with mental disorders understand the social inclusion of these from the de-institutionalisation process, it is essential to consider and discuss about certain elements that preceded this process and were responsible for the removal of the ' crazy ' of social conviviality. This research is part of the research line "Theoretical, political and cultural Foundations of health and Nursing Care" program of post-graduation stricto sensu of the Nursing School at the Federal University of Juiz de Fora, a master's degree in nursing. To contemplate the purpose proposed and their offshoots, the qualitative approach with the intention of approaching the most, of the object searched. The data were collected in January and February of this year, individual semi-structured interviews. The closure of the statements collection occurred at a time when there was a saturation of data needed for the research. The saturation was determined from similar meanings expressed in the statements, which determined the interruption of the collection of the same and the beginning of the analytical process that generated four cores of signification, 13 namely, the day-by-day on the scene: the bearer of mental disorder; The day-by-day: treatment; The day-by-day on the scene: motivations for family care. The analysis of the meaning of perception of the relatives of people with mental disorders, about the daily relationship with them, was represented by the Comprehensive Sociology of everyday life of Michel Maffesoli. This research comes to meet the need to seek evidence to better elucidate the perception of families of people with mental disorders on the social integration of this from the with-share ' experiences of everyday life. This understanding helps to reveal the potential of social reintegration, mediated by the logic of full care, that need to be considered by the nurse, other health professionals and managers to demand health care not only to people with mental disorders, but also to their families.
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Mamabolo, Lydia Mamakhoa. "Exploring community-based interventions for mentally ill patients to improve quality of care / L.M. Mamabolo". Thesis, North-West University, 2013. http://hdl.handle.net/10394/9674.
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Mentally ill patients need to be treated with dignity and their basic human rights must be respected. Community-based interventions are commonly used in many areas after deinstitutionalisation of mentally ill patients. However, it is unfortunate that mental health and mental disorders are neglected in many areas with no proper or standardized services in the community for treatment and support. As a result, most of the mentally ill patients roam in the streets in the rural communities. Exploring community-based interventions in rural areas could assist to improve the quality care of the mentally ill patients. The communities need to be aware of the interventions available to support the mentally ill patients and their family members so that community members who give care to mentally ill patients can be able to identify, implement, monitor and sustain effective interventions to meet the needs of the mentally ill patients in rural areas. Suggestions could also be made to the Department of Health with regard to the community-based interventions in order to improve quality of patient care.
The aim of this research was to explore and describe the current community-based interventions for the mentally ill patients as well as explore recommendations by the professional nurses and community caregivers about the utilization of community-based interventions to support mentally ill patients in a rural community.
In order to obtain rich in-depth data, a qualitative research approach was followed. A case study design was used to complement the holistic in-depth investigation. Purposive sampling was used to identify professional nurses as participants in the community and snow-ball sampling was used to identify further community caregivers who meet the inclusion criteria. Ethics was considered during the identification and selection of participants. Triangulation of data collection method was undertaken where structured interviews, field notes and documents were used as methods of data collection. A semi-structured interview schedule was formulated which was evaluated by experts in qualitative research. A trial run interview was conducted prior to data collection. Voice recorders were used for the purpose of audio taping the interviews, thereafter the interviews were transcribed and prepared for data analysis. The researcher ensured that field notes were taken immediately after each interview. Data was collected until saturation was reached after ten interviews and analysis of six documents.
Data was analysed by means of a written record or transcripts as suggested by Neuwenhuis (2011:89). A specialist qualitative researcher was appointed as a co-coder to analyse the data. The interpretative pattern of data analysis for qualitative data analysis was followed and the guidelines prescribed by Terre Blanche, Durrheim and Kelly (2011:321) were adopted. The identified themes were current interventions and utilizing current suggested interventions. Thus conclusions were drawn in relation to identified themes that with current interventions there are different categories of caregivers that are involved in the care of mentally ill patients in rural communities. Included are the health caregivers, non-governmental organisations, police officers, faith/spiritual healers, traditional healers, families and community members. However challenges were still identified for an example defaulting of treatment, relapse and readmissions of mentally ill patients. With regard to utilizing suggested interventions, participants emphasised more on the need to develop structures in order to support the mentally ill patients in their rural communities and continued community education mental illness and mental health. The recommendations were made to nursing practice, nursing research and nursing education.Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.
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Gale, Christine. "Deinstitutionalisation for children in the region of Central and Eastern Europe and Commonwealth of Independent States (CEE/CIS) : a comparative case study of Bulgaria and Ukraine". Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.690890.
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Millions of children around the world are living in large residential institutions where they lack individual care and a suitable environment in which to thrive. Increased awareness of the considerable risks these children face in terms of negative social, cognitive and physical development prompted international debate regarding deinstitutionalisation and development of policy and practice that eliminate the use of such establishments. Following the demise of the Soviet Union, world attention was alerted to the situation of thousands of children living in large residential institutions across countries of the Central and Eastern Europe and Commonwealth of Independent States (CEE/CIS) region. Since this time, governments in the region have been striving to effect political and social welfare reform, including development of deinstitutionalisation policies. Analysis of regional statistics revealed a variance in deinstitutionalisation results across the region, with a noticeable difference in accomplishments of two countries in particular, Bulgaria and Ukraine. This divergence has remained largely unexplained. This study applied a comparative case study approach in order to seek an explanation of this phenomenon. A literature review allowed for an exploration of the concept of deinstitutionalisation and contextual background of post-communist countries. Fieldwork involving semi-structured interviews with child care professionals provided information on the deinstitutionalisation process in Bulgaria and Ukraine with analysis allowing for comparison of factors contributing to differences and similarities in achievements. A main conclusion of this study is that the extent and continuity of political commitment are critical to development and implementation of a country's deinstitutionalisation policy and practice. Inclusion of this factor should form an integral component of a theoretical framework for deinstitutionalisation. Findings of this study will contribute to the understanding of deinstitutionalisation policy frameworks and programming, especially in the context of the CEE/CIS region.
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Drake, Gabrielle M. "The privatisation of the back wards: the accommodation of people with intellectual disability and people with mental illness in licensed boarding houses in Sydney". Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/1087.
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This thesis explores the use of licensed boarding houses in Inner Sydney as an accommodation option for people with intellectual disability and people with mental illness. Deinstitutionalisation, a significant social policy of the last century was introduced into Australia in the 1960’s and 1970’s, and involved the closure of large institutions and the integration of former residents into the community. One of the community-based accommodation options used for people leaving institutions was boarding houses. This research explores the extent to which boarding houses enact the human rights principles of deinstitutionalisation and contribute to the quality of life of residents with intellectual disability and residents with mental illness.The research draws on an extensive literature review and policy and legislative analysis. Denzin’s interpretive interactionism was used as the overarching methodological framework of the study. Informing the research are forty interviews with a range of participants including current and former licensed boarding house residents, proprietors, and staff of community organisations and government agencies.The results of this research provide evidence that licensed boarding houses are a form of transinstitutionalisation and do not serve to enact the human rights principles articulated in current policy and legislation. This thesis argues for the staged deinstitutionalisation of licensed boarding houses in New South Wales.
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Borges, Karenn Cynthia Santos e. Silva. "O cuidado em saúde mental na perspectiva dos profissionais dos Centros de Atenção Psicossocial". Universidade Federal do Maranhão, 2016. http://tedebc.ufma.br:8080/jspui/handle/tede/1729.
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Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (FAPEMA)
In the field of mental health care has been reoriented towards the hospital - centred model to the extra-hospital care model from the Psychiatric Reform, Psychosocial Rehabilitation Movement and the deinstitutionalization of the mentally ill. In this context, the CAPS assumed the role of service substitutive Authorising care network in mental health. However, in many of these units, this role has not yet been incorporated. Faced with the need to better understand the dynamics of work that leads to mental health care, originated this research. The objectives of this study were to understand the dynamics of mental health care; understand the links with the network of attention to the construction of mental health care and meet the design of care in mental health professionals interviewed. The methodological approach was descriptive and analytical qualitative research conducted with professionals working in mental health in three CAPS-I and a CAPS-II Health Region Pedreiras - MA. Data collection involved semi - structured interviews and focus groups. There was lack of resources, inadequate professional assistance associated with the work process fragmentation and not joint Network and difficult access to services. Conclusion: There was an outpatient, fragmented care emphasis, formed by multidisciplinary teams with little multidisciplinary, and a service that does not articulate the Care Network Health There is great personal investment of most professionals, however, little understanding of the purpose CAPS and how this fits into the network.
No campo da saúde mental, o cuidado tem sido reorientado no sentido do modelo hospitalocêntrico ao modelo de atenção extra-hospitalar a partir da Reforma Psiquiátrica, Movimento de Reabilitação Psicossocial e a desinstitucionalização do doente mental. Nesse contexto, os CAPS assumiram o papel de serviço substitutivo ordenadores da rede de cuidado em saúde mental. Os objetivos desta pesquisa foram compreender a dinâmica do cuidado em saúde mental; compreender as articulações com a rede de atenção para a construção do cuidado em saúde mental e conhecer a concepção do cuidado em saúde mental dos profissionais entrevistados. O recurso metodológico foi a pesquisa descritiva e analítica com abordagem qualitativa realizada com profissionais trabalhadores em saúde mental em três CAPS-I e um CAPS-II da Região de Saúde Pedreiras/MA. A coleta de dados foi por meio de questionário estruturado e grupo focal. Foi realizada Análise de Conteúdo na modalidade Análise Temática. Resultados: observou-se escassez de recursos, inadequação da assistência profissional, associada à fragmentação do processo de trabalho, a não articulação em Rede e dificuldade de acesso aos serviços. Conclusão: Observou-se uma ênfase assistencial ambulatorial, fragmentada, formada por equipes multiprofissionais com pouca multidisciplinaridade, e um serviço que não se articula à Rede de Atenção à Saúde. Há grande investimento pessoal da maioria dos profissionais, entretanto, pouca compreensão sobre a finalidade do CAPS e como este se insere na Rede. Sugerimos reorganização do processo de trabalho e mais inclusão do usuário em todo o processo.
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Battams, Samantha Jane, i sam battams@flinders edu au. "Housing for people with a psychiatric disability; community empowerment, partnerships and politics". Flinders University. Public Health, 2008. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20080926.215213.
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This research examined intersectoral relationships and community participation in policy processes across the mental health and housing sectors. The focus was on the development of suitable housing options for people with a psychiatric disability. The study period covered five years of mental health system reform in South Australia (2000-2005). The research found a shortage of housing and support options for people with psychiatric disability and lack of significant strategic policy coordination or ongoing cross-sectoral programmes. The problems faced by people in gaining access to housing and disability support services and the ways in which families provide housing or support in the absence of public services are documented.
This case study used qualitative research methods which were triangulated across four stages: 1) a thematic analysis of national and state policies in the health, housing and disability sectors; 2) participant observation of NGO activity, a thematic analysis of NGO documents, and interviews and focus groups with NGOs; 3) interviews and focus groups with consumer and carer representatives and a thematic analysis of the minutes from state-level groups; 4) interviews with professionals from the health, housing and disability sectors
The housing situation for people with psychiatric disability was explained in terms of a number of key issues in the policy environment;
X The overarching neo-liberal policy context synonymous with a decline in public housing resources and increasing tension between NGOs service provider and advocacy roles.
X The political nature of the local mental health policy context and lack of political commitment to ongoing resources. Broad community stigma reflected in the media and government, affecting ongoing political commitment to mental health and housing and the introduction and progress of housing ¡¥projects¡¦.
X The slow development of peak NGO and consumer organisations and alliances in South Australia which affected access to policy networks and contributed to the dominance of professional interests within policy processes.
X The separation of health, housing and disability policy and networks within and across levels of government. This was associated with bilateral agreements (between Australian and state governments) tied to resources within departments, the programme objectives and the goals of bureaucrats.
X The separation of policy networks by sector was also connected to the dominance of bio-medical discourses and interventions and associated professional interests in the health policy sector. Medical discourses on health and disability and ¡¥consumerist¡¦ discourses on participation also led to social determinants of health such as housing being overlooked within policy processes.
X Governance reform at a state level contributed to organisational instability within departments, causing some problems for cross-sectoral initiatives and protocols.
Kingdon¡¦s (2003) multiple streams analysis of policy helped to explain what missed or reached political agendas within each policy sector of the case study. Kingdon predicts that the unity of policy networks is important for the realization of policy solutions, and the lack of unity in policy sectors was an obstacle to policy agendas on housing for people with a psychiatric disability. However, the way in which problems were being represented (Bacchi 1999) was also important to understanding this policy environment. For example, a medical discourse on disability (Fulcher 1989) tied to the health sector led to a narrow focus on clinical mental health services. Similarly, neo-liberal discourse (Dean 1999) supported private housing solutions and resources or NGOs advocating ¡¥within sectors¡¦ for the types of services they already provided or wished to provide.
The case study suggested strategies for ¡¥policy change¡¦ need to address a number of factors across service delivery, policy and political realms. Firstly, better recognition is warranted of the difficulty experienced by many people with psychiatric disability in achieving stable housing, and the need for indicators on housing access and stability for this group. Secondly, processes to address stigma (particularly that perpetuated in the media) will be instrumental for policy change and political commitment. Thirdly, ongoing cross sectoral advocacy and alliances require development at both a national and state level and support by a political culture which encourages advocacy. Developing processes for working across sectors such as policy learning forums involving both experts and community groups could counter problems arising from professional culture and territories that were documented in this study. Finally, the cross-sectoral development of policy, programmes and accountability mechanisms and the stability of policy networks will be important to ensuring stable housing for people with psychiatric disability.
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Williams, Belinda Raylene. "May you never feel the same about mental illness again -- : community theatre's contribution towards deinstitutionalising and destigmatising people with mental health problems : a case study: Lillian". Thesis, Queensland University of Technology, 2001.
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This thesis investigates the field of arts-in-health in Australia by using Lillian 2000 as its primary case study. 'Arts-in-health' is a term coined by Sally Clifford in her Masters thesis (1997, p.3) to define participation-based community arts projects in healthcare settings. This research seeks to develop Clifford's work by analysing an arts-in-health project's impact on the community and its participants. Lillian is a rock musical written by Michael Bishop in collaboration with mental health patients at the Launceston Hospital in Tasmania in 1989. Over the past eleven years Lillian has been performed several times by a variety of people ranging from mental health workers and patients/clients, to community theatre groups and high school students. As a community theatre project, the musical aims to overcome public fears and destigmatise mental illness by raising community awareness and understanding about mental health issues. Issues addressed in this research include: the benefits of arts-in-health projects in healthcare settings; the need to combat negative stereotypes of mentally ill people proliferated by the media; a community theatre project's capacity to effect social change; and the discursive and ideological developments within mental healthcare - moving away from therapy to health promotion.
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Högström, Ebba. "Kalejdoskopiska rum : Diskurs, materialitet och praktik i den decentraliserade psykiatriska vården". Doctoral thesis, KTH, Urbana och regionala studier, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-90968.
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During the period 1967-1995, Swedish mental healthcare underwent a complete re-organisation, starting with county councils taking over responsibility for mental healthcare from the state. Asylums were then phased out and mental health care moved closer to patients. The Mental Health Reform of 1995 completed this decentralisation and put the emphasis on an independent and integrated life as a citizen in society and the idea of a dwelling of one’s own. This thesis describes and analyses spatial aspects of decentralised mental healthcare in Sweden, focusing on the decentralisation discourse regarding organisation, localisation, patient care and working methods behind decentralisation and its spatial performance. A case study of decentralised mental healthcare in Nacka, a Stockholm suburb, between 1958-1999 examines in particular the emerging decentralisation discourse 1958-1973, The Nacka Project 1974-1980 (one of the first examples of community care in Sweden), psychiatry in Nacka 1980-1994 and the official report Welfare and Freedom of Choice from 1995. The methods used include studies of documents, interviews, visual and architectural drawing analysis. The theoretical point of departure for the analysis is a post-structural heterogeneous concept of space where spatial materiality and discursiveness are looked upon as intertwined. The result shows that the re-organisation of mental healthcare brought about a substantial spatial transformation. Normalisation of patients’ lives involved integration into society and support for independent living. The local environment was the main trope for the early stage of decentralised mental healthcare, but the notion of a dwelling of one’s own became the important trajectory to an independent life after 1995. The idea of the patient is challenged by the independence discourse, which could be said to contain an idea of the ‘non-patient’. Overall, it can be concluded that spatial organisations of the built environment are never value-free or neutral. They reflect, enable and constrain power relations in a society and material space can contribute to the power of one group at the expense of another. Furthermore, the results of the spatialities, or the meanings, cannot be predicted. It is therefore crucial to distinguish power in all its configurations and scales and to keep negotiations alive, especially within the field of mental healthcare, but also in the care sector as a whole and in other societal institutions where policies buildings and built environment interact with user practices. This kaleidoscopic perspective can be used for examining complexities in the past and present and for encouraging future potentialities in the process of making/enacting spatial relations.QC 20120306
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Basheer, Farheen. "Attitudes towards mental illness, mentally ill people and deinstitutionalisation". Thesis, 1998. http://hdl.handle.net/10413/3651.
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The aim of this study was to assess the attitudes of community psychiatric nurses, mental health professionals and primary health care nurses towards mental illness, mentally ill people and deinstitutionalisation. The sample of this study comprised 38 community psychiatric nurses, 20 mental health professionals and 55 primary health care nurses, all of whom were from Durban, Pietermaritzburg and their surrounding areas. Each participant completed a biographical questionnaire, the Opinions of Mental Illness scale (1962) and the Community Mental Health Ideology scale (1967). Four focus groups on attitudes towards deinstitutionalisation, comprising 25 participants in total, were also conducted. Statistical analyses were computed using the Statistical Programme for Social Scientists. Krueger's (1984) methodology was employed to analyse the focus groups results. The quantitative results revealed that community psychiatric nurses, mental health professionals and primary health care nurses generally tended to express neutral attitudes towards mental illness, mentally ill people and deinstitutionalisation. Significant differences in attitudes towards mental illness and mentally ill people were found amongst respondents in different categories of race, educational levels and treatment of a friend for a mental illness. The focus groups results revealed that while the community psychiatric nurses and mental health professionals were positive about the concept of deinstitutionalisation, they did not favour it's implementation within the current South African economic and social contexts. Based on their fear of mentally ill patients, the primary health care nurses displayed negative attitudes towards the concept of deinstitutionalisation and were also cautious about it's implementation within the current South African context. Implications and recommendations arising from this study are discussed.Thesis (M.A.)-University of Durban-Westville, 1998.
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Dartnall, Elizabeth. "Is deinstitutionalisation appropriate? Discharge potential and service needs of psychiatric inpatients in KwaZulu Natal and the Eastern Cape, South Africa". Thesis, 2014.
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Deinstitutionalisation - the movement of psychiatric inpatients out of hospitai - has been promoted internationaily on the precept that care in the community leads to better treatment outcomes and a better quality of life for people with mental illness. It currently forms a key element of proposals to transform the provision of mental health care in South Africa.
Experiences with deinstitutionalisation in other countries have, however, been mixed and while some efforts have demonstrated positive results, others have resulted in a worse state of affairs for patients and their families. In too hasty deinstitutionalisation processes, hospitals have been closed and people moved into the community in an ad hoc and random manner. With scarce or inadequate community services, many patients have been left to wander the streets, joining the ranks of the homeless (Krupinski 1995) and are often abused by unprepared and prejudiced communities. Further, the assumption that all patients with mental illness respond favourably to deinstitutionalised care may not be justified, with some patients achieving better outcomes within institutional settings (Lawrence et al 1990). Moreover, cost savings, a major motivation for deinstitutionalised care for the mentally ill, have not materialised. There is a clear understanding that community services need to be developed either ahead of or in conjunction with patient
discharge, necessitating additional resources.
These are the challenges facing mental health services in South Africa, which are currently highly institutionalised and based on an outdated, custodial model of care. It is made more complex by a context of limited community mental health care resources, restricted health budgets and competing community development needs.
A comparison between the existing levels of p r o v in r i-j! psychiatric services against recommended national norms for psychiatric care (Flisher et al 1965) suggests that there is no over provision of psychiatric beds or staff, but rather a need io transfei :ong term bed resources to acute and residential beds, over time. The implication is that ad^l.cno! resources will have to be found if community services for people with a mental illness are to be developed.
In a review of existing non-governmental services conducted in KwaZulu-Natal, McClaren and Philpott (1998) found that community based services were poorly developed and where they existed, were threatened by the lack of emphasis given to mental health in the overall health agenda, inadequate financial assistance and limited communication between government and non-government sectors. The absence of a guiding framework for mental health services in these provinces served to further perpetuate the apparent ad hoc and fragmented nature of the development of these services.
In light of these findings, it seems that a decrease in bed numbers - a traditional focus of a
deinstitutionalisation thrust - would serve to further deplete an already under resourced service.Using deinstitutionaiisation as a vehicle for transformation of the mental health services in these provinces may put the services at risk of losing what little resources they do possess.
A more considered approach to a discharge oriented policy is needed. To better guide mental health sector transformation, a study of psychiatric institutions in the Eastern Cape and KwaZulu Natal Provinces was conducted in order to answer the following questions: Who is actually being cared for in these institutions, what is their discharge potential and what services might they need in the community if they were to be discharged?
The study was funded through a research grant from the Health Systems Trust.
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Kosprtová, Dita. "Aktuální problémy v zařízeních sociálních služeb pečujících o dospělé osoby a seniory s mentálním a kombinovaným postižením". Master's thesis, 2020. http://www.nusl.cz/ntk/nusl-436420.
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This thesis deals with issues concerning adults and seniors with mental disability living in institutions providing social services. Special care is dedicated to those who relocated into the institutions in their adult life, often after their parents' death. Qualitative research was chosen to provide the obtained information with proper depth. The results of this research come from the analysis of interviews provided by users of social services and professionals working with people with mental disability. The aim of this thesis is to describe behavioural problems associated with users who came into the institutions later in their life, and offer them specific recommendations that would make their transition easier. Key words Mental disability, ageing, social services, deinstitutionalisation
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Dixon, Roselyn M., University of Western Sydney i of Arts Education and Social Sciences College. "Moving out : the impact of deinstitutionalisation on salient affective variables, social competence and social skills of people with mild intellectual disabilities". 2004. http://handle.uws.edu.au:8081/1959.7/17713.
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This thesis examined the social competency and affective functioning of people with mild intellectual disabilities through salient variables that impact on people with disabilities who have been deinstitutionalised. Its primary purpose was to extend the previous research on the impact of deinstitutionalisation by incorporating multi-dimensional self-concept, adaptive behaviour and quality of life, in combination with self esteem and locus of control, in longitudinal/comparison design. It is also aimed to examine the development of identity, self-esteem and social competencies from a qualitative perspective. Finally it assessed the efficacy of an interpersonal cognitive problem-solving intervention which incorporated techniques for the development of maintenance and generalisation and determined the impact of this intervention on real-life social behaviours. The findings have important implications for current theory of the self-concept for people with intellectual disabilities, the provision of programs and techniques to improve self-concept, and also for the provision of social skills programs to enhance the social competencies and the social integration for people who have been deinstitutionalised.Doctor of Philosophy (PhD)
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Dixon, Roselyn M. "Moving out : the impact of deinstitutionalisation on salient affective variables, social competence and social skills of people with mild intellectual disabilities". Thesis, 2004. http://handle.uws.edu.au:8081/1959.7/17713.
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This thesis examined the social competency and affective functioning of people with mild intellectual disabilities through salient variables that impact on people with disabilities who have been deinstitutionalised. Its primary purpose was to extend the previous research on the impact of deinstitutionalisation by incorporating multi-dimensional self-concept, adaptive behaviour and quality of life, in combination with self esteem and locus of control, in longitudinal/comparison design. It is also aimed to examine the development of identity, self-esteem and social competencies from a qualitative perspective. Finally it assessed the efficacy of an interpersonal cognitive problem-solving intervention which incorporated techniques for the development of maintenance and generalisation and determined the impact of this intervention on real-life social behaviours. The findings have important implications for current theory of the self-concept for people with intellectual disabilities, the provision of programs and techniques to improve self-concept, and also for the provision of social skills programs to enhance the social competencies and the social integration for people who have been deinstitutionalised.
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Babington, Brian Keith. "For the benefit of children alone? A discourse analysis of policymaking relating to children's institutions in Indonesia, 1999-2009". Phd thesis, 2015. http://hdl.handle.net/1885/104490.
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It is estimated that between two and eight million children live
in orphanages or other residential institutions in the developing
world (the Global South) and in the former Eastern Bloc. In
recent decades the UN and international non-government
organisations have called upon governments in these countries to
develop and implement policies to ‘deinstitutionalise’, or
reduce substantially the number of children who live in
institutions.
Despite this heightened interest, research into how and why
deinstitutionalisation policy change occurs remains in its
infancy, especially with regard to the Global South. Using a
discourse analysis methodology advanced by Hajer this
dissertation sheds light on deinstitutionalisation policymaking
in Indonesia. Specifically, it asks: What factors led Indonesia
to adopt a policy during the 2000s to reduce reliance on a type
of children’s institution known as panti asuhan?
The prevailing explanation for Indonesia’s policy change has
been that it decided in the mid-2000s to comply more fully with
the 1989 UN Convention on the Rights of the Child which opposes
the separation of children from their parents except in special
circumstances. Through field interviews and other analysis I
show, however, that political, economic, cultural, and religious
discourses—rather than concerns about children’s rights
only—predominated in shaping new policy.
I identify three phases in developing the new panti asuhan
policy. First, from the late 1990s, a pro-reform group (or
‘discourse-coalition’) began to agitate for policy change.
Second, in the mid-2000s, a ‘status quo’ discourse-coalition
which supported panti asuhan opposed prospective policy change.
Finally, the Indonesian Government’s wish to signal its
adherence to international children’s rights standards, align
policy with changed national economic, social and administrative
directions, and avoid conflict with pro-panti asuhan forces
generated the final policy outcome under which panti asuhan would
continue to play a central, if somewhat changed, role while
appearing to comply with Indonesia’s children’s rights
obligations. Rather than designed only to benefit children, final
policy thus attempted to appease both pro-reform and pro-panti
asuhan groups.
The study provides important messages for practice and research.
For policymakers and advocates, employing Hajer’s methodology
can improve understandings about factors that impede or advance
progress on deinstitutionalisation policymaking in other
countries of the Global South. The study also contributes new
understandings to literatures on deinstitutionalisation, public
policy, and on panti asuhan themselves. It extends research into
the deinstitutionalisation of children’s institutions by being
the first to apply Hajer’s methodology to understand how this
type of policymaking occurred in the Global South. As well as
shedding further light on Indonesian social policy in general, it
also provides new understandings about attitudes towards, and the
operations of, panti asuhan.
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Price-Humphrey, June Wenstene T. "Mental health institutionalisation in a small Caribbean country: patient factors contributing to long term hospitalisation". Master's thesis, 2018. http://hdl.handle.net/10362/42903.
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RESUMO: As instituições psiquiátricas evoluíram na sua forma de funcionar nos últimos 2000 anos. Os serviços modernos de saúde mental mudaram de um modelo institucional para modelos baseados na comunidade. Este estudo procurou avaliar os fatores relacionados com o paciente que podem contribuir para internamentos prolongados. Estas pessoas institucionalizadas diferem de algumas formas das pessoas com doença mental que não foram institucionalizadas e, portanto, é vital abordar estas preocupações no processo de alta. Estes fatores incluem a gravidade da doença, habilidades sociais e apoio, fatores relacionados com a doença, como a adesão ao tratamento e o “insight”, e o apoio fornecido pela instituição para facilitar a recuperação e a autossuficiência.
Os pacientes institucionalizados sofreram predominantemente de doenças psicóticas, foram internados involuntariamente na admissão inicial, apresentaram um funcionamento deficiente e tomaram vários medicamentos psicotrópicos. As avaliações da equipe mostraram preocupações em relação à adesão à medicação e aos sintomas residuais. Apesar de metade dos pacientes revelarem insatisfação com a enfermaria, surpreendentemente, em geral, não estavam insatisfeitos com os profissionais e os outros pacientes.. Comorbilidade com uma segunda doença mental ou doença médica foi observada na coorte examinada.
Em pacientes institucionalizados, o modelo de recuperação, visto como uma filosofia orientadora, pode aumentar a probabilidade de alta. Este modelo foca-se na esperança e na resiliência na presença de doenças em curso. Os programas de saúde mental nas instituições devem primeiro reorientar as atitudes da equipe para o empoderamento do paciente, fornecer recursos para a reabilitação e incentivar o envolvimento e a conexão da comunidade.ABSTRACT: Psychiatric institutions have evolved in function over the last 2000 years. Modern mental health services have moved away from institutional care to community-based models. This study sought to evaluate the patient related factors which may contribute to long-stay hospitalisation. These institutionalised persons differ in some ways from persons with mental illness who have not been institutionalised, and therefore it is vital to address these concerns in the discharge process. These factors include severity of illness, social skills and support, illness related factors such as compliance with treatment and insight, and the support provided by the institution to facilitate recovery and self-sufficiency. Institutionalised patients suffered predominantly from psychotic illnesses, were involuntarily detained in hospital at initial admission, showed moderate function on assessment, and were prescribed multiple psychotropic medications. Staff ratings reflected concerns regarding compliance with medication and residual symptoms. Although half of patients interviewed were dissatisfied with the ward, surprisingly patients were not generally dissatisfied with the staff or other patients. Comorbidity with a second mental illness or medical illness was noted in the cohort examined. In institutionalised patients the recovery model as a guiding philosophy may enhance the likelihood for discharge. This focusses on hope and resilience in the presence of ongoing illness. Mental health programs in institutions must first reorient attitudes of the staff towards patient empowerment, provide resources for rehabilitation and encourage community involvement and connectedness.
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Rughoonauth, Hemant. "A thematic analysis on perceptions of foster care through the lens of ethnic belongingness in multicultural Mauritius". Master's thesis, 2021. http://hdl.handle.net/10071/22995.
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The development of a comprehensive foster care system as an alternative to the institutionalisation of children in out-of-home care remains underdeveloped in Mauritius. With no prior studies on the perceptions of foster care in this multiethnic island state and the relatively low number of registered foster parents, this qualitative study sought to explore the perceptions of the Afro-Mauritians and Indo-Mauritius on the reality of foster care. Also, this study sought to identify factors perceived to prevent or encourage members of particular ethnic groups in fostering a child. Similarly, it aimed to understand demographic factors perceived as significant for effective foster care. Using semi-structured interviews alongside purposive sampling, 10 parents were interviewed from which 5 were of African descent and 5 of Indian descent. From the thematic analysis, national silence on foster care alongside the urgency to make foster care a working reality was advanced. Unconditional acceptance of the foster child and support to foster parents were also reported as vital. While more similarities between the two ethnic groups were uncovered, some unique reasons to start foster care and barriers to do so were also revealed by members of particular ethnic groups. Family structure, age, educational level and socioeconomic status were revealed as important demographic indicators for effective foster care. It was recommended for social workers and policy makers to fully commit towards implementing more family-oriented care provisions. Also significant is the relevance of considering ethnic belongingness as an important and equally relevant demographic marker in the multicultural Mauritian context.
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Marques, Ana Filipa Amaro Afonso. "Impactos e desafios da desinstitucionalização para as casas de acolhimento de grande dimensão : estudo de caso num Centro de Acolhimento Temporário para crianças dos 0 aos 6 anos". Master's thesis, 2021. http://hdl.handle.net/10400.14/36849.
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As orientações internacionais para a desinstitucionalização dos sistemas de proteção de crianças privadas de cuidados parentais recomendam que os cuidados alternativos sejam dados em ambiente familiar, apelando à eliminação de estruturas residenciais de grande dimensão pelo impacto negativo da institucionalização. Em Portugal, a revisão de 2015 à Lei de Proteção de Crianças e Jovens em Perigo incorpora essas recomendações ao definir a prevalência do Acolhimento Familiar (AF) sobre o Residencial (AR). Através de um Estudo de Caso a um Centro de Acolhimento Temporário (CAT) para 60 crianças até aos 6 anos, este trabalho estuda os impactos possivelmente atribuíveis à alteração legislativa, bem como a resposta do CAT em termos de funcionamento. É também descrita a atual discussão interna sobre o futuro da instituição, caracterizável em três caminhos de opção não exclusiva: Conservador (mantém a resposta de AR), Evolutivo (desenvolve resposta alternativa ligada à proteção da criança em perigo, como AF ou Centro de Apoio Familiar e Aconselhamento Parental) e Alterador (encerra o AR e abre uma resposta nova compatível com a sua estrutura de grande dimensão, como Creche). Conclui-se que há alterações importantes no movimento de crianças nos últimos 6 anos, nomeadamente a redução significativa da taxa de ocupação do CAT, e que têm sido implementadas alterações aos espaços e aos modos de funcionamento no sentido de aproximar as práticas do CAT aos princípios orientadores do novo paradigma. Relativamente ao futuro, constata-se uma preferência pelo caminho Conservador e uma grande resistência ao Alterador. Existe abertura à opção Evolutiva, ainda que com reservas sobre se o mesmo deve incluir o AF.The international guidelines on deinstitutionalisation for protection systems for children who are deprived of parental care recommend that the alternative care be provided in a family environment, thus requiring the elimination of largescale residential structures, given the negative impact of institutionalisation. In Portugal, the 2015 review of the Law for the Protection of At-Risk Children and Youths has incorporated said recommendations by defining a preference for Foster Care over Residential Home Care. Based on a Case Study on a Temporary Care Home for 60 children up to the age of six, this thesis studies the possible impacts of this change in the legislation, as well as the response of the Temporary Care Home in terms of its functioning. The current debate on the future of the institution is also described and characterised on the basis of non-exclusive options: Conservative (residential home care is maintained); Evolutive (an alternative response based on protection of the child at risk is developed, either in the form of Foster Care, a Family Support Centre or a Parental Counselling Centre); or Change-based (the home is closed and a new response that is in line with its large-scale structure, such as a crèche, is opened in its place). The data has shown conclusively that there were significant changes in the movement of children over the last six years, resulting namely in a significant reduction in the occupation rate of the Temporary Care Home, and that changes have been made to the spaces and to the modes of operations with a view to bringing the Temporary Care Home practices into line with the principles that guide the new paradigm. As far as the future is concerned, there is a noted preference for the Conservative option above, as well as major resistance to the Change-based one. There is a certain openness to the Evolutive option, albeit with reservations as to whether it should include Foster Care.
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Szwed, Marcin. "Przymusowe umieszczenie w zakładzie psychiatrycznym w świetle współczesnych standardów ochrony praw człowieka". Doctoral thesis, 2018. https://depotuw.ceon.pl/handle/item/2907.
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Podstawowym celem dysertacji było ustalenie współczesnych konstytucyjnych i międzynarodowych standardów w zakresie przymusowego umieszczenia w zakładzie psychiatrycznym, rozumianego jako każda forma skierowania osoby z zaburzeniami psychicznymi do zakładu psychiatrycznego bez jej zgody. Analizowane standardy odnoszą się zarówno do materialnych przesłanek dopuszczalności detencji, jak i gwarancji proceduralnych oraz warunków pobytu w zakładzie. Rozważono w szczególności takie kwestie jak: czy i kiedy przymusowe umieszczenie w zakładzie psychiatrycznym jest w ogóle dopuszczalne? Jaki organ powinien podejmować decyzję o umieszczeniu w zakładzie? Jak powinna być skonstruowana procedura, aby spełniać wymóg rzetelności? Jakie warunki bytowe i terapeutyczne należy zapewnić pacjentom? Analizie zostały również poddane obowiązki państwa w zakresie zapewnienia osobom z zaburzeniami psychicznymi alternatywnych względem izolacji form leczenia i wsparcia.
Rozprawa składa się z sześciu rozdziałów. Pierwszy ma charakter wprowadzający i poświęcony jest przede wszystkim wyjaśnieniu medycznego i prawnego znaczenia pojęć „zaburzenia psychiczne” oraz „niepełnosprawność” oraz przedstawieniu analizowanej w pracy problematyki w ujęciu historycznym. W drugim przymusowe umieszczenie w zakładzie psychiatrycznym zostało poddane analizie jako forma pozbawienia wolności. Przedstawiono więc konstytucyjne i prawno-międzynarodowe definicje wolności osobistej oraz pozbawienia wolności. Rozdział trzeci koncentruje się na przedstawieniu materialnych przesłanek dopuszczalności przymusowego umieszczania osób w zakładach psychiatrycznych. W rozdziale czwartym zaprezentowano standardy proceduralne. Rozdział piąty dotyczy warunków przymusowego pobytu w zakładach psychiatrycznych. Ostatni rozdział poświęcony został obowiązkom państwa w zakresie zapewnienia osobom z zaburzeniami psychicznymi dostępu do nieizolacyjnych form wsparcia i opieki.
Przedstawione w pracy rozważania doprowadziły do konkluzji, że standardy prawne w zakresie przymusowego umieszczenia w zakładzie psychiatrycznym, w szczególności odniesieniu do jego dopuszczalności oraz ewentualnych materialnych podstaw, wciąż nie są jednolite. Wynika to przede wszystkim z odmiennych wizji statusu osób z zaburzeniami psychicznymi w Konwencji o prawach osób niepełnosprawnych z jednej strony oraz w orzecznictwie Europejskiego Trybunału Praw Człowieka i Trybunału Konstytucyjnego z drugiej. Ta pierwsza, zgodnie z tzw. społecznym modelem niepełnosprawności, kładzie nacisk na poszanowanie autonomii wszystkich osób z niepełnosprawnością, co znajduje swój wyraz w działalności Komitetu Praw Osób Niepełnosprawnych, który potępia wszelkie formy przymusowego leczenia psychiatrycznego. W świetle orzecznictwa EKPC i TK natomiast, choć przymusowe umieszczenie w zakładzie psychiatrycznym stanowi pozbawienie wolności i wymaga do uzasadnienia szczególnie ważkich argumentów, to jednak niekiedy jest ono dopuszczalne, a nawet konieczne dla realizacji przez państwo jego pozytywnych obowiązków w zakresie ochrony życia i zdrowia. Drugim wnioskiem sformułowanym w pracy jest to, że poszanowanie wolności osobistej osób z zaburzeniami psychicznymi wymaga nie tylko wprowadzenia odpowiednich gwarancji proceduralnych chroniących przed arbitralnym pozbawieniem wolności, ale i zapewnienia odpowiednich, nieizolacyjnych form wsparcia i opieki. Znajduje to swój wyraz przede wszystkim w wyrażonym w KPON „prawie do bycia włączonym w społeczeństwo” oraz, podkreślanej przez wiele organów międzynarodowych, konieczności przeprowadzenia procesu tzw. „deinstytucjonalizacji”.The primary object of the dissertation was to identify contemporary constitutional and international standards in the field of involuntary commitment in a psychiatric establishments, understood as any form of placement of a person with a mental disorder in a psychiatric institution without his/her consent. The analyzed standards refer to both the substantive criteria for legality of detention as well as procedural guarantees and conditions of stay in psychiatric establishment. In particular, the thesis attempts to answer questions such as: whether and under what conditions is involuntary placement in a psychiatric institution admissible? Which body should take decisions with regard to placement? How should the procedure be constructed to meet the requirement of fairness? What living and therapeutic conditions should be provided to patients compulsorily placed in psychiatric establishments? The dissertation analyzes also positive obligations of the state to provide people with mental disorders with alternative, non-isolative forms of treatment and support. The thesis consists of six chapters. The first one is of an introductory character and its primary goal was to explain the medical and legal meaning of the terms "mental disorders" and "disability" and to present the issues analyzed in the dissertation from a historical perspective. In the second chapter, compulsory placement in a psychiatric establishment was analyzed as a form of deprivation of liberty. Thus, constitutional and international definitions of personal liberty and deprivation of liberty were presented. The third chapter focuses on the presentation of substantive criteria for involuntary placement in psychiatric establishment. The fourth chapter presents procedural standards. The fifth chapter deals with the conditions of involuntary stay in psychiatric establishment. The last chapter focuses on the question of positive obligations of the state to provide persons with mental disorders with access to non-isolative forms of support and care. The analysis presented in the dissertation led to the conclusion that the legal standards regarding the compulsory placement in a psychiatric establishments, in particular regarding its admissibility and possible substantive grounds, are still not fully harmonized. This is caused mainly by the different visions of the status of people with mental disorders in the Convention on the Rights of Persons with Disabilities on the one hand and in the case law of the European Court of Human Rights and the Constitutional Tribunal on the other. The former, in accordance with the so-called “social model of disability”, concentrates on the respect for autonomy of all persons with disabilities, what is reflected in the activities of the Committee on the Rights of Persons with Disabilities, which condemns all forms of compulsory psychiatric treatment. However, in the light of the case law of the ECHR and the Constitutional Tribunal, while compulsory placement in a psychiatric institution constitutes deprivation of liberty and requires particularly important arguments for justification, it is sometimes admissible and even necessary for the state to fulfil its positive obligations in the area of protection of life and health. The second conclusion formulated in the dissertation is that respect for personal liberty of persons with mental disorders requires not only the introduction of appropriate procedural safeguards against arbitrary deprivation of liberty, but also provision of appropriate, non-isolative forms of support and care. This obligation is reflected primarily in “the right to be included in society” expressed in the CRPD, as well as the necessity to undertake so-called “deinstitutionalisation” process, underlined by many international bodies.
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KUPSOVÁ, Jitka. "Rizika a přínosy vyplývající ze vztahu sociálního pracovníka a klientů s mentálním postižením". Master's thesis, 2015. http://www.nusl.cz/ntk/nusl-200524.
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The work deals with the specifics of interactions between mentally disabled clients in the residential facilities providing institutional care, in particular with the relations between clients and social workers/carers. It analyses the role of interpersonal relations for individual´s inherent dignity, describes cultural and religious sources which recognise dignity of the mentally disabled in the contemporary society. It also strives to explain healthy ways of communication as an important and integral part of social interactions and how such methods can help to prevent conflicts in residential facilities. There is identification of risks of asymmetric relations between clients and carers due to the organisational hierarchy and the relevant changes brought about in the course of the deinstitutionalisation process. It provides various aspects of the relationship between employees and clients in traditional and alternative forms of residential facilities which in this particular case are represented by the Arch and Camphill communities. The Conclusions provide a summary of risks and benefits resulting from friendly attitude to mentally disabled clients and risks posed by the unequal and unnatural relations in residential facilities.