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Sex Offenders with a Major Mental Illness (SOMMI) are doubly stigmatized, as these individuals are members of two highly marginalized social groups (Guidry and Saleh, 2004). Within each of these groups SOMMI only represent a small minority. For professionals seeking to base their practice in empirical research this has led to a significant problem since the literature related specifically to this group is both limited and hard to locate. Additionally, intensity of psychological risk factors varies as a function of psychiatric decompensation for some SOMMI making it hard to apply certain procedures that work with ordinary sexual offenders. The purpose of this paper is to provide a review of the relevant literature and recommendations for clinical practice that are responsive to the particular challenges posed by this unusual group of sexual offenders.

The current paper provides a review of literature on risk factors for sexual recidivism and validity of current risk tools as it pertains to SOMMI. Recommendations for risk assessment with SOMMI are provided.

The static actuarial tools appear to be useful with SOMMI. However, risk assessments measuring dynamic risk factors have poorer predictive validity. Additional factors that will need to be considered involve a possible higher recidivism rate for SOMMI and a variable relationship between major mental illness and sex offending with it sometimes predisposing, sometimes exacerbating existing risk factors, and sometimes mitigating risk.

There is a paucity of research and guidance in assessment and risk management of SOMMI. The current paper is the first to thoroughly explore the efficacy of current sex offender risk assessment tools with SOMMI and provide structured guidance for making decisions about risk and risk management needs for this challenging population.

This paper explores issues surrounding the under‐representation of people from the Gujarati community in mental health statistics and services in the UK and asks why people from the Gujarati communities are less likely to seek assistance for mental health problems. It is well known that members of the African‐Caribbean community are over‐represented in mental health statistics, and this is attributed to factors such as racial discrimination, social adversity and stress of migration. However, members of the Gujarati community have also been exposed to these hardships, but are not similarly represented in the mental health statistics. The paper explores a selection of the key literature. Two questions are considered: first, whether this group genuinely has very good mental health (and if so why); and second, whether there are any factors that hold members of this community back from seeking help.

The purpose of this chapter is to apply structural functional theory and the concept of “unbundling” to an analysis of the deinstitutionalization and community mental health efforts that have shaped the current mental health services environment.

We examine the original goals of the institutional movement, the arguments supporting it, and the functions of the institutions that were created. We then examine the criticisms of that approach and the success of the subsequent deinstitutionalization process, which attempted to undo this process by recreating the hospitals’ functions in community settings. Finally, we address the question of whether the critical functions of psychiatric institutions have indeed been adequately recreated.

Our overview of outcomes from this process suggests that the unbundling of state hospital functions did not yield an adequate system of care and support, and that the functions of state hospitals, including social control and incapacitation with respect to public displays of deviance were not sufficiently recreated in the community-based settings.

The arguments for the construction of state hospitals, the critiques of those settings, and the current criticism of efforts to replace their functions are eerily similar. Actors involved in the design of mental health services should take into account the functions of existing services and the gaps between them. Consideration of the history of efforts at functional change might also serve this process well.

The current paper seeks to outline the Crisis Intervention Team (CIT) and review extant research regarding its efficacy in reducing criminalization of people with mental illness, as well as improving interactions between this population and law enforcement officers.

The CIT model and theoretical underpinnings are discussed and an evaluative review of the current literature is presented.

Research on the CIT model has generally shown improved officer and community safety; better mental healthcare for those in need; and decreased criminalization of those with mental illness. Methodologies have included the use of records reviews and officer surveys, primarily.

Implications in the practice of law enforcement and psychology include decreasing criminalization of those with mental illness; reducing the frequency of police use of force; minimizing injury to consumers and law enforcement officers; and connecting people with mental illness to needed psychological/psychiatric resources.

Success of CIT has wider social implications, such as decreasing stigma regarding mental illness and fear of involving police in mental health related crises.

The authors provide a summary of the CIT model in the context of law enforcement's response to people with mental illness; highlight important research to date; discuss implications of the programme; and suggest directions for future research in the area of CIT.

Depressive disorder has been defined by increasingly specific neurophysiological mechanisms and features during the past two decades. At the same time, depression has grown into an epidemic proportion and become a major public health problem. Consequently, the scope of depressive experience and conduct has also widened and the meaning of depression has multiplied and become equivocal. This chapter analyses how this tension is handled in current Western mental health care. The focus of the study is the role of neuroscientific views in mental health reasoning and practice. The empirical case is the mental health discussion in Finland from the late 1980s to the present day. The analysis of the historical change in understandings of depression in Finnish psychiatry and mental health care provides a view of the relevance of neuroscientific models in defining depressive illness and outlining diagnostic and treatment practices. Moreover, the analysis brings forth the relationship of neuroscientific concepts to other ways of defining depression – epidemiology, diagnostic classification, psychodynamic and other psychological theories – within clinical reasoning. A conclusion to be drawn from the analysis of the Finnish case is that neurobiological concepts of depression have only limited influence on the ways in which the disorder is conceived within the practical context of mental health care. It seems that the idea of depression as a multi-factorial disorder remains a good enough conceptual framework for clinical practice. Even the influence of neurosciences on treatment is still somewhat marginal. Within current practices of depression management, it is not the brain that is treated but risks, symptoms, and persons.

This paper reports on research into adolescents' mental health literacy, focusing on their ability to recognise two diagnosable mental illnesses and three mental health problems associated with loss. A vignette‐based questionnaire was developed and completed by a school‐based sample of adolescents. Different levels of understanding were identified for each vignette. Participants responded well, demonstrating the different levels of understanding. Grading of the responses provided an opportunity to explore and discuss differences between professional and lay understanding of mental health and illness. It was also useful when considering implications for practice. These were considered in relation to mental health promotion for young people and training the workforce across the child and adolescent mental health services (CAMHS) tiers.

This paper, which builds on the findings of WHO's Report on Mental Health and Development, aims to highlight the health, social, economic, and human rights effects of unaddressed mental disorders in low and middle income countries (LMICs) and to propose effective strategies to address mental disorders and their impacts as part of an overall development strategy.

The paper first reviews the findings of relevant research on mental disorders and poverty and then proposes solutions that can be adopted by countries to promote development.

This evidence of strong links between poverty and mental disorder supports the argument that mental disorders should be an important concern for development strategies. Mental disorders have diverse and far‐reaching social impacts, including homelessness, higher rates of imprisonment, poor educational opportunities and outcomes, lack of employment and reduced income. Targeted poverty alleviation programmes are needed to break the cycle between mental illness and poverty. These must include measures specifically addressing the needs of people with mental health conditions, such as the provision of accessible and effective services and support, facilitation of education, employment opportunities and housing, and enforcement of human rights protection.

The paper highlights that four out of every five people suffering from mental disorders are living in LMICs. Many LMICs have identified mental health as an important issue, yet lack the finances and technical expertise to address the problem. Having mental health on the agenda of development organizations will be a critical step for overcoming the negative development consequences of mental disorders.

Lack of understanding around mental illness and stigma are an overwhelming barrier in help-seeking behaviour for mental health concerns. The purpose of this paper is to examine mental health literacy and social attitudes as instrumental factors in building capacity of the demand-side to support and access mental health care at the community level in India.

Knowledge, Attitude and Practice surveys were administered to 521 persons from the general population, distributed equally in the age range of 15-60 years. The study included 52 respondents per district from ten districts across five states in India, namely Andhra Pradesh, Assam, Delhi, Gujarat and Uttar Pradesh. The responses were collected and analysed thematically, keeping in mind the relevance of these findings as contributors to knowledge of mental health and to the construct of stigma.

Pervasive socio-cultural factors, especially stigma inhibit access to basic mental health information and care, despite knowledge that mental illness is treatable. Degrading treatment, loss of personal liberty and social exclusion, i.e. compromised human rights at the community level are widespread. Self-reported attitudes when encountering a person with mental illness show that respondents act out of fear and are guided by misinformation and myths. Extant knowledge on mental health is attributed predominantly to informal networks, as a potential resource to be strengthened.

Realising mental health care, including help-seeking behaviour calls for greater knowledge-sharing, sensitisation and community engagement.

This paper fulfils an identified need to study current levels of mental health literacy and underlying perceptions that contribute to the persistent treatment gap.

Despite a plethora of research on diversity and inclusion, workplace-related issues pertaining to individuals with schizophrenia (SCZ) remain grossly underexplored. This paper seeks to develop a relational, multilevel perspective of issues and challenges faced by individuals with SCZ in the work and career.

The research draws on the findings from in-depth, qualitative interviews with schizophrenic individuals, individuals’ family members, healthcare professionals and nongovernmental organization (NGO) representatives.

The findings highlight the interconnected nature of multilevel issues faced by schizophrenic individuals and indicate that at the societal level, social stigma, economic conditions and inadequate government policies are the key challenges faced by them. At the organizational level workplace support and job suitability and design affect individuals’ employment. At the individual level, self-stigma affects the employability in a negative way whereas personal motivation and resilience, family and social support and realization of illness are the facilitating factors.

The study adds to disability and diversity literature by developing a relational perspective that holistically captures the issues faced by schizophrenic individuals and suggests that the work and employment-related issues may be simultaneously addressed at multiple levels.

The purpose of this paper is to inform education of non-mental health professionals who provide care to people with severe mental illness; to describe dentistry students’ knowledge and views about mental illness, including willingness to engage in various social situations with a person hospitalised for mental illness; and to assess and understand the impact of a targeted lecture on views and attitudes.

The paper employed mixed methods to examine dental students’ knowledge and views about mental disorder before and after a seminar covering mental disorder, disadvantage and oral health. Findings from a bespoke questionnaire administered to third-year dental students were triangulated with qualitative data gathered in interviews with a subsample.

Students understood mental disorder broadly, employing diverse causal models. Although knowledge was typically grounded in media stereotypes, attitudes were benevolent and most students reported willingness to provide dental care to affected individuals. The seminar, especially the consumer delivered section, was valued and associated with increased appreciation of the impact of mental disorder on oral health and need for assertive action to promote access to care. However, students reported being reluctant to disclose their own mental health problems for fear of being considered a professional or personal failure. A minority knew how to seek support if a friend talked of suicide.

This study highlights the need for further investigation of the knowledge and attitudes of dentistry students pertinent to provision of care to people with mental illness and to examine the links between attitudes and practice. The paper also provides a useful foundation for development of brief educational interventions, particularly the value in integrating the service user perspective, and their evaluation. Research should also examine the impact of mental health education on practice.

A single inexpensive educational session, such as the one the paper developed may support reconsideration of often unconscious views of mental illness which might affect practice.

If people with mental illness are to receive equitable access to health care, non-mental health professionals should be supported to develop knowledge and attitudes which are conducive to inclusive treatment. An education session such as this could be helpful.

There is scant literature examining attitudes of dentistry students and no reports of mental health-specific education with this population.