The diploma thesis deals with guardianship for people with mental illness. The tehoretical part is divided into six chapters, where the concept of mental disorder is defined within various documents. Furthermore the process of stigmatization, both from the family and the health care professionals, is also discussed here as self - esteem as a serious consequence of society's access to mental illness. The student also mentioned the process of providing psychiatric care, outlined the reform of psychatric care as a significant milestone in health care. A greta part of the theory consits od a complete description of a guardianship and self - administration. The last chapter focuses on social work with people with mental illnesss. The practical part aims to find out how the guardianship system for people with mental disorders works and how custodians loom at guardianship. The student used qualitative surveys ans semi - structured interviews. Using open encoding , several categories were identified and then responded to the main research question.

Contrary to the long-held assumptions, borderline personality disorder (BPD) is now considered a treatable disorder. Timely assessment has been recognised as one of the key treatment enablers and basic assessment standards have been stipulated by the UK’s National Institute for Health and Clinical Excellence (NICE). The current study was the first to have specifically investigated the quality of the diagnostic process in light of the government recommendations. Interpretative phenomenological analysis was used to analyse semi-structured interviews with eight adult female service users about their lived experiences with the original diagnostic disclosure of BPD. Five master themes and several subthemes featured in the majority of the participants’ experience: a) answer with a question mark; b) if only…; c) BPD like a star sign; d) star signs are not enough; it’s what happens afterwards!; e) being at the mercy of the system. Most participants’ experiences suggested that the original diagnostic process was largely negative and did not follow the national guidelines. Nevertheless, a minority of positive views also emerged. The findings are discussed with reference to the existing literature, whilst also detailing the study’s limitations, clinical and research implications.

This thesis deals with an issue of employment of people with mental disorders. The goal of thesis is to describe and to map mental disorders and to point out their maladaptive behaviors. Also to show possibilities of communication in working environment with people with mental disorders and to highlight opportunities of employment in the labor market. The issue is subsequently evaluated with use of questionnaire surveys and interviews with experts in the topic. The thesis is divided into two parts, in theoretical part are explained concepts related to mental illnesses and in practical part is described cooperation with organization Green Doors.

This dissertation deals with the constitutionality of the onus of proof in cases where mental illness is averred. Insanity refers to the legally defined state of mind and not to a specific psychological disorder. Mental illness is one of the factors recognised by South African law which negates criminal responsibility. The law recognises that persons suffering from insanity cannot be sanctioned in the same way as sane offenders. The law applicable in South Africa today with regards to the insanity defence is contained in the provisions of the Criminal Procedure Act 51 of 1977, which replaced the M’Naghten rules and irresistible impulse test that appeared in South African Law nearly a century before. Section 78(1) of the Criminal Procedure Act stipulates that in order to not be responsible for an alleged crime the accused must have committed an act which constitutes an offence and must at the time of said commission have suffered from a mental illness or mental defect which rendered him incapable of (a) appreciating the wrongfulness of his actions; or (b) acting in accordance with an appreciation of the wrongfulness of his actions. Due to legislative amendments any party who raises mental illness as a defence is supposed to prove on a balance of probabilities that the accused was mentally ill at the time of the commission of the offence. This constitutes a departure from the normal rules of evidence which requires the state to prove the accused’s guilt beyond a reasonable doubt. The test for insanity is therefore a mixed one in which expert testimony is vital. Psychologists as well as psychiatrists play an important role in assisting the court, by way of expert testimony, to determine the mental state of offenders. Lawyers and mental health professionals often don’t see eye to eye as a result of the differences in interpretation and application of mental illness in the respective professions. The various difficulties faced by the defence, as a dependant of the professions, is explored. A comparative study of the laws relating to the insanity defence in English Law and in the United States of America is conducted. These findings are contrasted to the current South African legal position. The selected jurisdictions share a common thread in that the insanity defence in these countries all originated from the M’Naghten rules and was subsequently modified by each. In the English law system, a general insanity defence is non-existent today. The strict M’Naghten rules are still applied as the test for insanity and seldom evoked by accused persons. In the United States of America the test for insanity differs from state to state but all have returned to the stricter English approach despite a number of different tests being developed and applied during the years since the defence’s existence. The presumption of innocence, which means that the burden of establishing the elements of criminal liability lies with the prosecution and is a fundamental aspect of the South African criminal justice system. In all three of the legal systems the burden of proof has always been placed on the defence to prove its case on a balance of probabilities. Following the legislative amendments in South African law, in section 78 (1) (A) and (B), this position has now changed to he who alleges must prove. Whether it constitutes unfair discrimination on the mentally ill accused to burden him with this higher onus than in normal defences, and whether it will survive constitutional scrutiny, concludes the study. Copyright / Dissertation (LLM)--University of Pretoria, 2012. / Public Law / unrestricted

From a psychological perspective there seems to be scant knowledge regarding the perceptions and beliefs of black traditional healers in South Africa about mental wellness and, consequently, also about mental illness. The aim of this qualitative study is to encapsulate the beliefs of black traditional healers in terms of four major areas, namely, definitions of mental wellness, definitions of mental illness, causes of mental illness, and approaches to promoting mental wellness. A convenience sample of black traditional healers was selected to participate in this study. Most of the participants practice in the greater Gauteng region and hold a monthly gathering in the Hammanskraal area where most of the research was conducted. There were no specific requirements in terms of age, gender, or field of specialisation. A total of 37 black traditional healers participated. A questionnaire was used to gather information on the beliefs and perceptions of the participants about mental wellness. The participants completed the questionnaires, after which the data was collected, and then analysed by means of thematic analysis. After the data had been analysed and transcribed it was returned to the participants for them to ascertain whether the interpretations were correct. The data that was interpreted showed that the black traditional healers participating in this study have very poorly developed definitions of mental wellness, as well as inadequate knowledge about Western mental health workers. The unique definition of mental illness as perceived by black traditional healers gave rise to new insights. During the research it emerged that there was a pressing need for proper training for black traditional healers in terms of what mental wellness actually is, and the functions of Western mental health workers. Also to the flipside it provides very important insights as to how mental wellness, mental illness and the management or promotion of these are perceived and approached by the black traditional healers participating in this study. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2008. / Psychology / unrestricted

Abstract The mental illness has increased sharply in the recent years and the focus on the psychosocial work environment has become more and more important. Today, the physical working environment is not the only thing that matters, the psychosocial work environment has taken more space and become a part of the labor environment law. The purpose of this work is to see how the concept of psychosocial environment law and mental health is regulated and worked with in the municipality of Jönköping, to gain a better understanding of how legal texts and rules apply in working life. Since the work is based on the regulations of Arbetsmiljöverket, the legal methodology is used to the greatest extent. The method is very similar to the traditional legal dogmatic method but provides little room for analysis. However, the legal sociological method will also be used to investigate what psychosocial work environment impact the employees. Psychosocial labour environment is very important for workers not to suffer from ill health. Various factors enter the psychosocial work environment that can contribute to psychological ill health. Stress, demands and uncomfortable working hours are just a few. The concept of psychosocial work environment is now included in the labour environment law and its regulations. There is, however, no indicative case law in this area. More research and more knowledge in the psychosocial labour environment is required for mental health to stop increase. Unfortunately, it is difficult to make the law more general, since each case in mental health is unique.

The increased abscondment of Mental Health Care Users from institutions of care, treatment and rehabilitation has prompted the researcher to conduct the study because patients who are not visited do not stand a chance of getting a Leave Of Absence (LOA). Problem: The concern is the danger of assault, murder, rape and other high risk situations the mentally ill individuals and the community are exposed to, which is caused by frequent abscondment of mentally unstable individuals who roam around the community without proper treatment and care. This is caused by failure of the relatives in coming to request patients for leave of absence (LOA). Purpose: The study investigated the effects of mental illness on relationships amongst families with the mentally ill members. The number or frequency of visitations by relatives to the mental health institutions is used by the researcher, to measure the nature of relationships between families and the psychiatric patients related to them. Method: The population comprised families of the mentally ill persons admitted at Cecilia Makiwane mental health units. The sample was collected conveniently as relatives came to visit the mentally ill until the desired number was reached. The designed tool was a questionnaire which was self administered. Data were analysed manually. Tables and graphs are shown in the results. Conclusion and Recommendations: The study revealed that approximately 100% of respondents had a lack of knowledge about mental illness and the mentally ill, in terms of care, treatment and rehabilitation hence they all need assistance in dealing with the mentally ill in the community. Findings also revealed that mental illness causes breakdown in family relationships. Recommendations regarding the enhancement of relationships between families and their mentally ill members are formulated as coping skills in the dissertation. The burden of having to deal with mentally ill person whose illness is not understood can lead the family to a state of confusion and iv not knowing what to anticipate. Lack of resources compounds the problem as the family members are not able to visit the ill member due to lack of funds (Baumann, 2007:637). The families with a mentally ill member usually shoulder the greatest part of the burden of mental illness (Uys and Middleton, 2004:77); unfortunately, lack of resources pose a problem.

This is a qualitative research centred on factors related to depressing and mental health among elderly Chinese immigrant women living in Ontario, Canada. The purpose of this qualitative research study was to examine those social factors that affect or contribute to depression or other forms of mental illness among elderly Chinese immigrant women. Qualitative content analysis was used. Reports of organisations concerned with elderly Chinese immigrants, qualitative research articles on elderly Chinese immigrant women, and government reports and publications were analysed based on their content. From the data, three main categories were developed. These are pre-migration, settlement experiences and health promotion. Some of the themes or sub –categories under these three main categories include the following: separation, isolation and loneliness, family and economic dependence, communication barriers, physical and psychological illness, transportation and food challenges, and empowerment. These themes or sub-categories were presented alongside the general conditions affecting elderly immigrant women as reported by other literature. From these findings several recommendations with regards to feminist health promotion were discussed. These include empowerment, making health social support accessible, family connectedness and others.

In the past two years, six National Football League players have died by suicide. Investigations into most of the deaths revealed that the players suffered from brain damage likely caused by repeated concussions. As is the case with many health issues, tragedy often precedes action; the suicides of these high profile football stars have catalyzed action on concussion policy and practice, as well as opened up the conversation about the overall mental health of athletes. This thesis joins the conversation around mental health and athletes, specifically Canadian varsity football players. Mental health problems and illnesses are presented as especially common, affecting about 1 in 5 Canadians. That is not to underestimate the severity of mental illnesses, which can deteriorate an individual’s quality of life, significantly impact friends and family and, in the most severe cases, also lead to death by suicide. That said, this thesis adopts a theoretical perspective that focuses on the promotion and protection of good mental health. This thesis is primarily concerned with investigating the social, political, and external factors that negatively impact how football players conceptualize mental health and mental illness, and also the recommended behaviour to seek professional help if needed. The growing body of research concerning the negative impact of mental illness stigma is compelling and leaves no doubt that stigma is a significant barrier to recovery. This thesis explores the stigma process as well as its social function in groups. Next, it investigates how the already powerful stigma around mental illness is further exacerbated by gender and more specifically, how traditional masculine ideology (i.e. men should be strong and powerful) conflicts with stereotypical beliefs about mentally ill people (i.e. weak and/or incompetent). Gender and health are further linked in terms of behaviour. In other words, rejecting health behaviours becomes a strategy some men utilize to project their masculinity, paradoxically contributing to the creation or worsening of many health problems. A health behaviour that is explored in detail is psychological help-seeking, and the psychosocial processes of help-seeking, which are also mainly regulated by masculinity. An overview of the most common mental health problems and illnesses found in male varsity athletes is provided. All of the above components are then applied to the unique context of varsity football players. The thesis draws on the literature as well as qualitative interview data that explores the experiences of 8 varsity football players at the University of Ottawa. Regarding mental health promotion, the findings show that football players may require adapted communication approaches. To that end, the thesis transitions into an early-stage health communication plan supported by the literature and the primary data. The plan proposes overall outcomes, short term/intermediate objectives, a communication strategy, and a tactical approach. Next, a web-based health resource is suggested as a primary communication vehicle and is outlined in detail. The plan then suggests potential partnerships for extending the strategic communication plan’s reach and credibility. This is followed by suggestions for evaluating both the short term/intermediate objectives as well as the strategic communication plan’s overall impact. This thesis concludes with a chapter exploring the contributions lifted from the eight qualitative interviews, as well as suggested directions for research, policy and practice.

While tobacco use remains a leading preventable risk factor for mortality and morbidity in Canada (Patra, Rehm, Baliunas & Popova, 2007), the overall smoking prevalence rate of Canadians has decreased substantially from close to 50% of the population in 1965 to 16.1% of the population in 2012 (Canadian Tobacco Use Monitoring Survey (CTUMS) 2012; Reid, Hammond, Rynard & Burkhalter, 2014). However, up to 85% of individuals with a mental illness continue to use tobacco products (Harris, Parle & Gagne, 2007), contributing to an inequitable distribution of negative health outcomes for this population. Individuals with severe mental illness die an estimated twenty-five years earlier than the general population, with sixty per cent of these deaths due to cardiovascular, pulmonary and infectious disease (Parks, Svendsen, Singer, & Foti, 2006). A recent study that examined specific tobacco-attributable deaths in these populations found that tobacco accounted for 53% of deaths in individuals with schizophrenia, 50% of all deaths for those diagnosed with a depressive disorder, and 48% of all deaths for those with a diagnosis of bipolar disorder (Callaghan et al., 2014). This research project is intended to increase our understanding of what constitutes an effective intervention for smoking cessation and smoking reduction in a population of individuals with severe mental illness who are homeless or vulnerably housed, living in a large urban setting. Two areas of inquiry were proposed. The first inquiry examined data collected as part of a needs assessment to determine the overall prevalence rate of smoking and related behaviours for a population of individuals with severe mental illness receiving services from a community mental health agency. We found that the tobacco use prevalence was 72%, and 62% of smokers had high or very high levels of nicotine dependence; however almost half of respondents (47%) were interested in quitting or reducing tobacco within the next 6 months. Smokers were found to be over 9 times more likely to have a co-occurring substance use disorder (OR=9.44, 95%CI[6.33,14.08]). The second inquiry was a pilot study conducting a randomized controlled trial design to evaluate smoking cessation and smoking reduction outcomes for two groups of individuals (n=61) with severe mental illness receiving different smoking cessation interventions. Clients randomly assigned to the routine Smoking Cessation group (SC-R) received up to 24 weeks of no-cost Nicotine Replacement Therapy (NRT) and clients assigned to the Smoking Cessation Plus group (SC+) received up to 24 weeks of no-cost Nicotine Replacement Therapy (NRT) plus two initial individual sessions of motivational interviewing followed by weekly psychosocial group interventions for up to 24 weeks. Primary outcomes were levels of tobacco use at the 3-month and 6-month follow-up. The 7-day point prevalence abstinence rate measured at 3 months was 21.9% (n=7) for the SC+ group and 13.8% (n=4) for the SC-R group (OR=1.75,95%CI[.46,6.74]). At 6 months, the 7-day point prevalence abstinence rate was 12.5% (n=4) for the SC+ group and 6.9% (n=2) for the SC-R group (OR=1.93, 95%CI[.33,11.41]). Secondary outcomes included change in reported quality of life, physical health and mental health status functioning over the course of the study. We found that there were no statistically significant differences in the smoking quit or smoking reduction rates between the two treatment groups. At the 3-month time point the overall quit rate for both groups combined was 18% (n=11) and at the 6-month time point the quit rate was 10% (n=6). Reduction in the number of daily cigarettes smoked was statistically significant over time (F [1.68, 98.90] = 55.13, p < .001, η p 2 = 0.48) for both groups, as was the overall reduction of the FTND score (F [2, 94] = 17.98, p < .001, η p 2 = 0.28). This research demonstrates that collecting vital tobacco prevalence and dependency information is a straightforward and important task for community mental health agencies. Individuals with mental illness have both the interest and ability to quit or reduce their use of tobacco. Practitioners need to be aware of alternative smoking practices that may contribute to understanding tobacco use patterns and dependence in this population. Other factors such as co-morbid substance use disorder and level of community functioning may influence smoking status and, consequently, how treatment is provided. The findings of the pilot trial demonstrate the feasibility of conducting smoking cessation research with the population. Findings also suggest that a larger definitive trial is warranted to examine the effectiveness of the SC+ intervention. This research adds to the limited but growing knowledge base of how to address tobacco use and provide treatment to this vulnerable group, and will contribute to advances in population health by informing effective interventions with the attendant implications for program and policy development.