Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1997. / Source: Masters Abstracts International, Volume: 45-06, page: 2943. Abstract precedes thesis as 1 preliminary leaf. Typescript. Includes bibliographical references (leaves 66-67).

De-institutionalisation of mental health in Australia led to increased community management of mental illness. A breakdown in community care or change in illness manifestation may warrant acute mental health assessment. Increasingly, this occurs in the Emergency Department (ED). Patients with mental illness presenting to the ED represent a broad clinical spectrum. (For complete abstract open document)

This dissertation reviews the ways in which psychotherapists working in relatively long-term 'transformational' therapies construct the outcome goals of their interventions. It is generally accepted that a therapist's beliefs about what constitutes mental health will influence the client, and will therefore facilitate a certain outcome accordingly. A problem in a long-term, 'non-directive' therapy is that the eventual outcome is not always visible in the interim development of the client or in the business of individual sessions. Without a clearly defined 'plan' or 'goal' there is a real danger of the intervention having opposite results to what would have been desirable, or no noticeably beneficial results, both of which can be an abuse of the client's investment and trust in the process. The absence of clearly constructed goals makes it difficult to assess efficacy of a therapeutic method used to attain an improved state of mental health that will be lasting, i.e. a positive 'transformation'; it also problematises comparisons across orientations. The identification of explicit goals is of special importance in a developing 'third-world' community like South Africa, where western ('European') concepts of mental health are being offered as an alternative to so-called 'indigenous healing' and where different cultural communities may have different expectations, needs or demands of their members 'in health'. Individual-based therapeutic orientations included in the research were psychoanalysis and psychoanalytic therapies, including object-relational therapies with various emphases and self psychology, as well as transformative types of hypnosis, Gestalt therapy, client-centred therapy and transactional analysis. Twenty of the semi-structured interviews with 52 therapists working in one or more of these areas were selected for construct analysis. Through analysis of the constructs of mental health as aspirational goal that emerged in therapists' talking about their experience of the process and the consequences of therapy observed in their patients, it appeared that there are generalisable constructs across various orientations in the transformative therapies. It is hoped that these constructs may serve as a foundation for further research in the problem areas indicated, but also that therapists working in the field may use this research not only as a basis for self-evaluation, but for adding to the constructs from their own experience, to the further enrichment of the whole field of work.

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<p> The purpose of this research paper is to examine the effects of neighbourhood factors on attitudes towards Mental health facilities. The research hypothesis is that personal attitudes towards mental health are a major determinant of reactions to community mental health facilities. The study conducted by the Canadian Training Institute (CTI) in 1983 provides relevant data on attitudes toward mental health group homes. Attitudes towards mental health group homes were studied using measures of desirability and perceived neighbourhood impacts. In order to test the hypothesis, two sets of relationships were examined; the relationship between facility impact and neighbourhoods;and the relationship between facility desirability and neighbourhoods. The results provide support for the results obtained by Trute and Segal in Canada and Linsky in the United States. The results showed similar socio-demographic profiles and attitudes of potential accepting and rejecting neighbourhoods. Therefore, the conclusions are that attitudes towards mental health group homes vary spatially between different types of neighbourhoods. The results have practical reference because they can help planners locate mental health facilities in locations where public opposition and patient dissatisfactionare minimized. </p> / Thesis / Bachelor of Arts (BA)

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Childhood abuse and neglect, as suffered by in-patients of medium secure psychiatric hospitals, is an under-researched clinical variable within the literature. Associated study and work in this area is considered to be a core skill of the forensic mental health nurse (FMHN), as well as of other clinicians working in such hospitals. The study undertook an examination of childhood abuse and neglect in three medium secure units (n= 117), finding that 41% of the sample suffered abuse/neglect in childhood/adolescence. An examination of a wide range of patient characteristics in the units was also conducted, findings included observations of 94% of patients having committed a violent index offence, and 81.2% of patients being diagnosed with schizophrenia. A hypothesis test conducted on this data revealed a significant relationship between the gender of patients and abuse/neglect suffered in childhood. A further analysis of inter-rater reliability was undertaken, of FMHN's and Nurse Consultants against a Benchmark nurse, in rating the severity of abuse suffered by inpatients. This revealed findings of both fair to moderate, and poor agreement, between the nurses, Nurse Consultants and Benchmark nurse. Allied study of a range of clinicians knowledge and opinions concerning agreement or disagreement with statements related to concepts of abuse, mental disorder and violence revealed mixed results, dependent upon either a quantitative analysis indicating no variation amongst the clinician's, or qualitative analysis identifying some specific differences. The study overall has concluded that the use of a mixed methodology is beneficial to examining consistency of agreement, and knowledge and opinions, regarding clinical phenomena amongst clinicians. The study makes recommendations in terms of adjustments to forensic educational curricula and clinical practice, regarding inclusion of more, and improved, information concerning childhood abuse and neglect.