A política de saúde mental preconiza a diminuição da oferta de leitos psiquiátricos e a criação de serviços na comunidade deslocando a responsabilidade pelo seguimento do tratamento da doença mental das equipes hospitalares para as equipes comunitárias, o doente mental e seus familiares. Pacientes com transtornos mentais e seus familiares vivenciam momentos cíclicos de controle e diminuição sobre situações problema, as quais podem ou não resultar em internação psiquiátrica. A família passa a ser a principal provedora de cuidados e apoio aos pacientes psiquiátricos, no meio extra-hospitalar, fator este que pode gerar sobrecarga na família.A sobrecarga familiar é definida como \"um estado psicológico que advém da combinação de trabalho físico, emocional e pressão social\". O período pós a alta hospitalar pode gerar a família grande impacto que ao longo do tempo se modifica. O presente estudo tem como objetivo descrever e comparar a sobrecarga objetiva e subjetiva do familiar cuidador de pacientes no primeiro mês de alta hospitalar e após três meses deste período. Método - Foi aplicada a escala FBIS-BR nos neste primeiros mês e após três meses deste período. Foram entrevistados 26 familiares de pacientes que realizavam seguimento em um serviço de saúde mental ambulatorial na cidade de Ribeirão Preto. Os dados foram analisados através de freqüência e porcentagem e o teste não paramétrico de Wilcoxon-teste t- foi aplicado para identificar os itens da FIBS-BR que se destacaram na sobrecarga familiar. Resultados e discussão:.Os familiares dos 63 pacientes que compareceram as consultas foram convidados a participar do estudos e destes somente 26 aceitaram participar .Os pacientes desta amostra são em sua maioria homens, casados e completaram o ensino fundamental .Com relação aos cuidadores a maioria eram mulheres e mães com média de idade de 51 anos .Os participantes deste estudo são pertencentes a classe social mais baixa. Os diagnósticos mais prevalentes no estudo foram dos seguintes agrupamentos: \"Esquizofrenia, transtornos esquizotípicos,Transtornos delirantes e Transtornos de Humor\" .Os resultados demonstraram que a sobrecarga objetiva destaca-se da subjetiva nos dois momentos analisados. Indicando que os familiares são sobrecarregados com atividades de cuidado do doente, porém não se sentem prejudicados por isso. Possivelmente este resultado indica que os familiares preferem responder que não se incomodam porque entendem que é sua obrigação cuidar do familiar.A sobrecarga do cuidado objetiva e subjetiva diminuiu do primeiro para o terceiro mês e três aspectos podem explicar este resultado : 1- Paciente ainda com sintomas da doença no primeiro mês após a alta hospitalar 2- Readaptação da família após três meses de alta hospitalar; 3- Estratégia de visitas domiciliares pela equipe de saúde. Considerações Finais: Este estudo aponta para a importância e necessidade de acompanhamento dos pacientes egressos e seus familiares. A visita domiciliar é uma estratégia importante pois consegue manter um vinculo mais estreito entre o doentes, sua família e o serviços de saúde mental. A visita domiciliar é parte das atividades do enfermeiro sendo portanto, um dos profissionais da equipe que pode contribuir muito para melhorar as condições de doentes e famílias. / The mental health policy calls for the reduced supply of psychiatric beds and the creation of services in the community by shifting responsibility for monitoring the treatment of mental illness of hospital staff to community teams, the mentally ill and their families. Patients with mental disorders and their families experience moments cyclic control and reduction of problem situations, which may or may not result in psychiatric hospitalization. The family becomes the primary provider of care and support to psychiatric patients in the middle-ofhospital, a factor that can lead to overload in the family. The family burden is defined as \"a psychological state that arises from the combination of physical work, emotional and social pressure\". The post hospital discharge to the family can generate great impact over time changes. The present study aims to describe and compare the objective and subjective burden of family caregivers of patients in the first month of hospital discharge and after three months of this period. Method - was applied FBIS-BR scale in this first month and after three months of this period. Were interviewed 26 relatives of patients who were performing a follow-up outpatient mental health services in Ribeirão Preto. Data were analyzed using frequency and percentage and the nonparametric Wilcoxon t-test was used to identify items of FIBS-BR that stood out in the family burden. Results and discussion: The relatives of 63 patients who attended the consultations were invited to participate in these studies and only 26 agreed to participate. The patients in this sample are mostly male, married and completed their primary education. With respect to most caregivers were women and mothers with an average age of 51 years. The participants in this study are belonging to lower social class. The most prevalent diagnosis in the study were the following groupings: \"Schizophrenia, schizotypal disorder, delusional disorders and mood disorders\". The results showed that the overhead lens stands out in two moments of subjective analysis. Indicating that family members are overwhelmed with patient care activities, but do not feel harmed by it. Possibly this result indicates that family members prefer to answer that do not bother because they understand that it is his duty to take care of the family. The burden of care objectively and subjectively decreased from first to third month and three aspects may explain this result: 1 - The patient has symptoms of the disease in the first month after hospital discharge; 2 Hospital - Rehabilitation of the family after three months of hospital discharge; 3 - Strategy of home visits by health teams. Final Thoughts: This study highlights the importance and necessity of patient follow up graduates and their families. The home visit is an important strategy because it can maintain a closer link between the patient, his family and mental health services. The home visit is part of the activities of nurses and therefore, a team of professionals that can do much to improve conditions for patients and families.

Abstract Using three different schizophrenic populations from Northern Finland, gender differences in some sociodemographic variables, age at onset, incidence, treatment, outcome and deinstitutionalization of schizophrenia were examined. The first study population comprises the Northern Finland 1966 Birth Cohort, which is an unselected, general population birth cohort. We followed prospectively 11017 subjects from 16 to 28 years of age by means of the Finnish Hospital Discharge Register. From this study population gender differences at the age of onset and incidence of schizophrenia were calculated. The second study population was formed of 1525 patients who had their first treatment episodes at the closed therapeutic community ward situated at the Department of Psychiatry, University of Oulu during 1977 - 1993. Gender differences were assessed in relation to age at first admission, some sociodemographic variables, degree of active participation of the patients in individual, group, and milieu therapy and institutional outcome of the patients with schizophrenia. The third study population consisted of all the 253 long-stay psychiatric inpatients treated for at least six months without a break during 1992 in the Department of Psychiatry, Oulu University Hospital. From this study population gender differences at the age of onset and in relation to some sociodemographic and clinical variables were studied. The placements after the last discharge and at the end of the follow-up and factors predicting hospitalization after the follow-up were also monitored. There were no statistically significant gender differences regarding age at onset in any of these three different study populations. The time lag between the first psychotic symptoms and the first psychiatric hospitalization was minimal. In the Northern Finland 1966 Birth Cohort study the annual incidence rate of DSM-III-R schizophrenia was relatively high, 7.9 per 10 000 in men and 4.4 in women by the age of 28. In men it was highest in the age group of the 20-24 year-olds while in women the peak occurred earlier in the age group of the 16-19 year-olds. In the Therapeutic community study there were no statistically significant gender differences in the sociodemographic variables, in the length of stay and in the number of treatment episodes in this ward in any of the diagnostic groups. Differences with regard to male and female participation in individual, group and milieu therapy and the institutional outcome were minimal, some trends, however, favoring females. In the long-stay patients study almost two-thirds of these patients were men. Very few gender differences were found in relation to sociodemographic and clinical characteristics or regarding the utilization of psychiatric hospital care. About 70% of the long-stay patients were discharged during the four year follow-up period and only 15% were able to live without continuous support. Marital status (being not married), dwelling place (living in city), absence of negative symptoms and severity of the illness were associated with hospitalization at the end of the follow-up. Gender did not predict hospitalization at the end of the follow-up period. The results of this study indicate that there are probably different subgroups of schizophrenia in which there are no gender differences regarding age at onset and in the clinical picture of the disturbance or there are regional differences in the manifestation of the illness. In Finland patients are hospitalized earlier after the onset of the first psychotic symptoms than in many other countries. According to the Northern Finland 1966 Birth Cohort study the incidence of schizophrenia is higher among young men than women and the total life-time incidence of schizophrenia may be smaller in women. The results from the Therapeutic community study suggest that therapeutic community treatment may level out the gender differences in the treatment process and outcome. The long-stay patient study showed that long-term patients are dependent on considerable support and that the most seriously ill patients are in fact in hospital. Alternative residential facilities have been a presupposition to the deinstitutionalization of the long-stay patients.

Master of Public Health - MPH / This thesis aimed to explore systematic health service problems that are related to frequent readmission of persons suffering from severe mental illnesses to Valkenberg Hospital. Reduction of acute and chronic beds in the Associated Psychiatric Hospitals, Western Cape over the past decade has led to increasing pressure for beds and rapid inpatient turnover, many of these inpatients being "revolving door" patients. Integration of mental health service into general health services, an intrinsic part of the comprehensive primary health care approach in South Africa, is supposed to make mental health care more accessible the public, therefore research into why patients are being frequently readmitted at secondary specialist level is indicated. / South Africa

The consequences and aftermaths of the 2008 Great Recession have played an important role in stirring people fear and agony to 'some' other people. The phenomenon is defined as the root of affective polarization. Research has claimed that affective polarization derives from partisan identity and the theory of social identity, and those affects are developed and reached beyond the classic concept of ideological polarization. During the post-economic crisis, a number of successful new radical right parties has surged across the continent. In addition, Western European politics has severely been polarized and increasingly characterized by growing hostility and incivility across partisan lines. Simultaneously, the trend of deinstitutionalization of party system goes upward across Europe. This article seeks to investigate a puzzle of whether and how increasing levels of party system deinstitutionalization are associated with increasing polarization. Assessing the association between party system deinstitutionalization and the two dimensions of polarization between 1997 and 2017 (82 elections in 15 countries), the empirical result shows such an unexpected result and strongly implies the underestimated effects of political structures on party system deinstitutionalization and polarization while...

Magister Artium (Social Work) - MA(SW) / Mental illness has been identified as one of the major contributors to the global burden of disease in the world. The four leading causes of mental health disorders are depression, alcohol abuse, schizophrenia, and bipolar disorder. Recent studies indicate that schizophrenia is among the major mental disorders affecting more than 21 to 29 million people in the world. Family members living and caring for a relative diagnosed with schizophrenia may experience burdensome challenges in such a way that can easily generate secondary stress in various life domains such as work and family relationships, loss of quality of life as well as high social and economic costs.

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Chan Wai-Lin. / "June 2003." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (p. 199-209). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

This study examined the process of gender policy reform. It sought to explain how and when gender policy reform has taken place in Venezuela across time. The study entailed observations of gender policy reform during specific periods of Punto Fijo democracy (1958-1998) characterized by democratic consolidation and deconsolidation, and during the transition towards a new type of hybrid democracy, the Chávez era (1999-2007). The policies considered were the ones addressing women’s equality at home and at work, reproductive rights, women’s economic rights, and political participation. The analysis showed that the likelihood of gender policy reform depends on the combination of certain institutional configurations that provide women access to the decision-making process of the state, but most importantly to women’s groups’ capacity to organize a broad coalition of women from civil society and from within the state apparatus behind to push for a reform by using frames based on international agreed norms that legitimized their struggle. In addition, the analysis reveals the negative influence of religious groups with decision-making power on the process of gender policy reform.

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published_or_final_version / Mental Health / Master / Master of Social Sciences