Emotionally triggered involuntary violent behaviour not attributed to a mental disorder: conceptual criteria and their reliability. This study conceptualised emotionally triggered involuntary violent behaviour (ETIVB), developed criteria for the identification of ETIVB, and examined their validity and reliability. South Africa criminal courts allow for a defence called “non-pathological criminal incapacity”. It refers inter alia to extreme emotional arousal triggering involuntary violent behaviour. This is usually called an “emotional storm” or a so-called “psychological blow automatism”. Psychiatrists are often called to give expert testimony in this regard, but there is no conceptual clarity or criteria upon which to base it. This difficulty is compounded by the requirement set by the criminal courts that the behaviour may not be attributed to a mental disorder (in this thesis the terms mental disorder and mental illness are used interchangeably). The first advance in obtaining clarity was afforded by focusing on the behaviour as distinct from 1) legal and jurisprudential considerations as well as 2) whether the behaviour is (not) attributed to mental disorder. The subsequent research questions driving the study were, “what counts as ETIVB?” In particular, what counts respectively as „emotional triggered‟, „involuntary‟, „violent‟, and „behaviour‟. Through conceptual methods suggested in the work of J.L. Austin, draft ETIVB-criteria were developed and then repetitively applied to a set of 28 cases. Twenty seven of these cases involved a charge of murder. The other one had behaved violently, but was not charged. The criteria were refined and their content validity derived by a repetitive to-and-fro process between comparative exploration of the concepts and their empirical application to the set of cases. The criteria were formulated into an instrument by which a psychiatrist can identify ETIVB. In addition provision was made to record whether ETIVB is, or is not, attributed to specific causes including mental disorder, but only as an attribution that follows after ETIVB has been identified. The ETIVB-instrument was subjected to reliability testing among 14 psychiatrists and 10 psychiatrists in training. They applied the ETIVB-criteria to a set of 5 externally validated case summaries. The participants had first been trained in the use of the instrument by considering other example cases. Statistical analyses of inter-rater reliability were performed. The modified kappa agreement ranged from 0.388 (fair) to 0.636 (substantial) across study cases for all criteria A.1 – H.1. The criteria for violence had exceptionally high inter-rater agreement, all being 0.947 and higher. The complexity of the ETIVB-construct transpired when inter-rater reliability analyses were compared between cases in that different cases posed different challenges for inter-rater agreement. The reliability testing across cases however, showed which less agreed-upon items would benefit from refinement. / Thesis (PhD)--University of Pretoria, 2015. / gm2015 / Psychiatry / PhD / Unrestricted

Bakgrund: Psykisk ohälsa ökar i befolkningen och 17 procent har utvecklat någon form av psykisk ohälsa. I Sverige är det fler kvinnor än män som lider av psykisk ohälsa. Patienter med psykisk ohälsa är en av de mest sårbara patientgrupper som besöker akutmottagningar och besöket kan få negativa följder och kan resultera i ett vårdlidande. I mötet med patienter med psykisk ohälsa ska sjuksköterskor främja patienters hälsoprocess och ha deras livsvärld i åtanke. Det finns en stigmatisering hos sjuksköterskor till psykisk ohälsa. Sjuksköterskors roll är att lindra lidande och främja välbefinnande hos patienter.  Syfte: Att belysa sjuksköterskors erfarenheter av att möta patienter med psykisk ohälsa på allmänna akutmottagningar. Metod: En litteraturstudie som sammanställts till ett resultat av åtta vetenskapliga artiklar som sökts fram i databaserna Cinahl och Psycinfo. De vetenskapliga artiklarna kvalitetsgranskades med hjälp av en granskningsmall och analyserades genom en integrerad innehållsanalys Resultat: Resultatet redovisas med utgångspunkt från fyra kategorier; Erfarenheter av kompetens, Sjuksköterskors attityder till och fördomar mot psykisk ohälsa, Utmanande att möta psykisk ohälsa och Vårdmiljöns påverkan. Det finns flera aspekter som har betydelser i mötet med psykisk ohälsa på allmänna akutmottagningar Slutsatser: Det flera aspekter i mötet med patienter med psykisk ohälsa på en akutmottagning som gör att mötet anses utmanande och kan medföra lidande både för patienter och sjuksköterskor. Enligt sjuksköterskor kan mer kunskap kring psykisk ohälsa medföra en trygghet i mötet med patienter med psykisk ohälsa / Background: Mental illness is increasing in the population and 17 percent have developed some form of mental illness. In Sweden, there are more women than men who suffer from mental illness. Patients with mental illness are one of the most vulnerable patient groups who visit emergency rooms and the visit can have negative consequences and can result in a patient suffering. In the meeting with patients with mental illness, nurses must promote patients' health process and keep their world of life in mind. There is a stigma attached to nurses to mental illness. The role of nurses is to alleviate suffering and promote the well-being of patients. Aim: Nurses' experiences of meeting patients with mental illness in general emergency rooms. Method: A literature study compiled as a result of eight scientific articles searched in the databases Cinahl and Psycinfo. The scientific articles were quality reviewed using a review template and analyzed through an integrated content analysis Results: The results are reported on the basis of four categories; Experiences of competence, Nurses' attitudes to and prejudices against mental illness, Challenging to face mental illness and the impact of the care environment. There are several aspects that have significance in the encounter with mental illness in general emergency departments Conclusions: The several aspects of the meeting with patients with mental illness in an emergency room that make the meeting considered challenging and can lead to suffering for both patients and nurses. According to nurses, more knowledge about mental illness can lead to security in the meeting with patients with mental illness

No description available.

Located squarely within the experiences of legal aid lawyers, with particular emphasis on the challenges they face in delivering effective representation, this dissertation, designed as an institutional ethnography, problematizes the provisions and practices related to involuntary admission in psychiatric facilities in Poland, as well as the organization of legal aid representation in involuntary admission cases. Through detailed accounts of paramedics, psychiatrists, judges, and legal aid lawyers’ work, connected and coordinated by legal and administrative texts, I demonstrate how the disjuncture between institutional regimes and lawyers’ experiences is institutionally produced by the set of legal, professional, financial, and social relations that organize both the involuntary admission procedure and the system of legal aid in Poland. While I start my exploration with legal aid lawyers’ embodied experiences of performing their work, accounting for how that work is organized and coordinated in local sites, this dissertation moves beyond a solo ethnographic description in seeking to discover relations, especially the social and legal relations mediated by the texts that govern these local experiences and practices. I trace the material and discursive practices that operate in key sites to organize the legal aid system, involuntary commitment procedures, and judicial decision-making. In Poland, the overwhelming majority of involuntary commitment cases are taken on by legal aid lawyers, whose work conduct is bound by both the law and a code of professional ethics. In this dissertation, I advance my thesis by closely reviewing the legal context of involuntary commitment; the material practices associated with legal aid lawyers, such as appointment, client access, and remuneration; the processes through which psychiatric documents are created and attached to admittees; and the role psychiatrist-generated texts play in court. I argue that within the context of involuntary admission, lawyering is organized in such a way that legal aid attorneys are unable to perform at their utmost, in a way that would most benefit their clients. Moreover, through my research I show that―despite perhaps their best intentions―legal aid lawyers not only actively participate in the practices that circumscribe the space for their legal advocacy for admittees, but also reproduce the very discourses and practices that objectify people during involuntary admission procedures to psychiatric facilities in Poland. / Graduate

Bakgrund: Vid psykisk sjukdom spelar olika faktorer in och symtomen varierar beroende på diagnos. Patienter med psykisk sjukdom upplever osäkerhet vid kontakt med vården på grund av att stigmatisering är ett vanligt förekommande problem. Sjuksköterskor ska ge en god omvårdnad oberoende personliga värderingar och patientens sjukdom, etnicitet eller kultur.  Syfte: Syftet är att beskriva sjuksköterskors attityder om patienter med psykiska sjukdomar och upplevelsen av att vårda dessa patienter, utanför psykiatriska vårdenheter. Metod: Examensarbetet genomfördes som en litteraturöversikt där 18 vetenskapliga artiklar söktes fram utifrån syftet, analyserades och sammanställdes till resultatet. Artiklarna var av både kvalitativ, kvantitativ design samt en mixad metod. Databaserna Cinahl och PubMed användes som sökmotorer.  Resultat: Resultatet består av tre huvudkategorier. ”Sjuksköterskors upplevelse av vårdmötet” där både negativa och positiva upplevelser framkommer samt faktorer som påverkar upplevelsen av vårdmötet med patienten. ”Sjuksköterskors upplevelse av kompetens” där många studier visar att utbildning har en positiv inverkan på upplevelsen av vårdmötet samt att sjuksköterskorna vill ha utbildning för att känna sig trygga i omvårdnaden av patienter med psykisk sjukdom. ”Sjuksköterskors attityder” där stigmatisering mot patienten framkommer.  Slutsats: Sjuksköterskor är i behov av utbildning för att få en ökad kunskap om psykiska sjukdomar och att vårda patienter med psykiska sjukdomar. Kunskap kan minska stigmatisering av psykisk sjukdom och främja upplevelsen av vårdmötet genom att öka sjuksköterskans trygghet i att bemöta patienter med psykiska sjukdomar. / Background: In mental illness, different factors play a role and the symptoms vary depending on the diagnoses. Patients with mental illness experience insecurity when in contact with care since stigma is a common problem. Nurses must provide good care regardless of personal values and the patient's illness, ethnicity or culture.  Aim: The aim of the study was to describe nurses’ attitudes about patients with mental illness and the experience of nursing these patients, outside of psychiatric care units.  Method: The degree project was conducted out as a literature review where 18 scientific articles were searched for based on the purpose, analyzed and compiled for the results. The articles were of both qualitative, quantitative design and a mixed method. The Cinahl and PubMed databases were used as search engines. Result: The result consists of three main categories. "Nurses' experience of the care meeting" where both negative and positive experiences emerge as well as factors that affect the experience of the care meeting with the patient. "Nurses' experience of competence" where many studies show that education has a positive impact on the experience of the care meeting and that the nurses want education to feel safe in the care of patients with mental illness. "Nurses' attitudes" where stigma towards the patient emerges. Conclusion: Nurses need education to gain an increased knowledge of mental illness and to care for patients with mental illness. Knowledge can contribute to a more positive attitude and promote the experience of the care meeting by increasing the nurse's confidence in dealing with patients with mental illnesses. The nursing meeting is also negatively affected by a lack of time as the nurses feels that the patient is not receiving the necessary care.

This study illustrates the experiences and knowledge on mental illness within the police organization. The main queries are how the police education prepare the police for encounters with mentally ill individuals, what police officers experience and what is done within the department in relation to strengthen knowledge and competence on mental illness.Nine interviews were conducted with police students, police officers and a business developer and the findings are that the overall perception of the police programme is that it provides future police officers with a basic understanding about mental illness. However, experienced police officers feel that they need more knowledge about mental illness to feel more secure and comfortable in these meetings. Furthermore, the police department works with the governmental assignation by preparing study material for different groups to strengthen their knowledge and competence on mental illness. The aim is to provide the police with knowledge about legal frames, recognition of mental states/disorders, how to respond to mentally ill individuals and what agencies are available to assist in the community. The limitation of the study was the relatively small sample considering that data was collected from different parts of the organization. However, this study has demonstrated an overview of the whole organization and their work connected to mental illness. The conclusion of this study is that the police department in Sweden has realized the knowledge gap and developed an educational plan to resolve the missing puzzle pieces.

ABSTRAKTBakgrund Många individer som är i återhämtning från psykisk ohälsa har en anställning, men få studier fokuserar på hur individerna bibehåller sin anställning utan återfall i psykisk ohälsa.Syftet med studien är att undersöka hur individer i återhämtning från psykisk ohälsa hanterar en anställning. Metoden utgår från en kvalitativ metod i form av semistrukturerade intervjuer med fem informanter. Informanterna är mellan 20-60 år gamla och arbetar inom olika yrkesområden. Studien använder tematisk analysmetod.Resultatet tyder på att informanterna utvecklat flertalet strategier för att hantera upplevda svårigheter i arbetslivet så väl som privatlivet. Strategierna innefattar bland annat metoder för att hantera arbetsrelaterade- och sociala krav, samt psykosomatiska symtom. Trots presenterade strategier, framkom ett antal svårigheter med brist på effektiva strategier eller som kräver arbetsledningens stöd. Slutsats Studiens resultat kan öka kunskapen om individers egna strategier och förmågor, men även behov och förutsättningar. Denna kunskap kan användas för att anpassa arbetsplatsen i förebyggande syfte och minska risken för psykisk ohälsa i arbetslivet. / ABSTRACTBackground Many individuals in recovery from mental illness are employed, but few studies focuses on how these individuals manages to retain employment without relapse.The purpose of the study is to investigate how individuals recovering from mental illness manage employment.The method is based on a qualitative method in the form of semi-structured interviews with five informants. The informants are between 20-60 years old and work in different professional areas. The study uses a thematic analysis method.The results suggests that the informants developed several strategies for dealing with perceived difficulties in working life as well as in private life. The strategies includes methods for managing work-related-, and social requirements, as well as psychosomatic symptoms. Despite presented strategies, a number of difficulties emerged with a lack of effective strategies or which require support from the workplace management.Conclusion The study's results can increase knowledge about individuals' own strategies and abilities, but also needs and conditions. This knowledge can be used to adapt the workplace for preventative purposes and reduce the risk of mental illness in working life.

Bakgrund: Depression är en av de vanligaste psykiska sjukdomarna idag och att det är i lika grad stigmatiserat. Stigma kan kopplas till okunnighet om psykisk ohälsa. Detta gör det nästintill omöjligt för individer som lider av psykisk ohälsa, såsom depression, att kunna vara en del av samhället och yttra sina känslor utan att motta negativitet relaterat till sin sjukdom. Som ett tillägg till detta är individerna i fråga oftast ensamma, dvs de föredrar isolering än sällskapet av de som stigmatiserar dem. Detta i sin tur ger upphov till känslor av oro och hopplöshet, hämmad återhämtning och även vägran att söka hjälp och behandling. Syfte: Syftet är att undersöka hur upplevelser av stigmatisering kommer till uttryck i blogginlägg bland unga vuxna med depression. Metod: En kvalitativ metod med hjälp av textanalys utfördes. Åtta blogginlägg sammanlagt användes för att komma fram till ett resultat. Blogginlägg granskades efter relevans av vårt syfte och studie. Resultat: Tre teman uppkom under studiens gång. Dessa är: ”Rädslan att prata om sin diagnos”, ”Depression är ett skämt” och ”Stigma från professionella”. Konklusion: Individer som upplever stigmatisering från samhället som en följd av sin psykiska sjukdom upplever ovilja till återhämtning, känslor av förtvivlan, värdelöshet och illamående som kan leda till isolering och minskade möjligheter i samhället. / Background: Depression is one of the most common mental illnesses today and it is equally stigmatized. Stigma can be linked to ignorance of mental illness. This makes it almost  impossible for individuals suffering from mental illness, such as depression, to be a part of society and express their feelings without receiving negativity related to their illness. In addition to this, the individuals in question are usually alone, i.e. they prefer isolation rather than the company of those who stigmatize them. This in turn gives rise to feelings of anxiety and hopelessness, inhibited recovery and even refusal to seek help and treatment. Purpose: The purpose of this study is to investigate how the experiences of stigmatization is expressed in blog posts among young adults with depression. Method: A qualitative study using text analysis was used. A total of eight blog posts were analysed to get the results. Blog posts were reviewed after the relevance for our purpose and study. Result: Three themes arose during the study. These are: "The fear of talking about their diagnosis", "Depression is a joke" and "Stigma from professionals". Conclusion: Individuals who experience stigmatization from society as a result of their mental illness experience reluctance to recovery, feelings of despair, worthlessness and malice that can lead to isolation and diminished opportunities in society.

Psykisk ohälsa är ett stort och växande samhällsproblem som drabbar barn och unga i Sverige. Därtill leder psykisk ohälsa till stora, mångfacetterade och komplexa behov i samhället. För att motsvara de komplexa behoven och ge barn och unga det bästa stödet och samtidigt tillgodose deras behov förutsätts att skola och socialtjänst samverkar.Syftet med föreliggande studie har varit att undersöka hur samverkan mellan socialtjänst och skola rörande barn och unga med psykisk ohälsa ter sig i verkligheten, samt att få fram personalens erfarenheter och upplevelser av samverkan, avseende målgruppen, inom dessa två organisationer. Samverkan mellan socialtjänsten och skola är i fokus. Syftet är också att undersöka vad personalen ser som dels hämmande dels främjande vid samverkan och jämföra med tidigare forskning. Studien är kvalitativ och baseras på fyra semistrukturerade intervjuer med två socialsekreterare från socialtjänsten samt två lärare från skola. Jag har i studien undersökt vad respondenterna upplever som förutsättningar och svårigheter vid samverkan. I min analys av empirin har jag haft samverkansteoretiskt som utgångspunkt, där jag tagit stöd av Berth Danermarks och Axelsson och Bihari Axelssons studier om samverkan begreppet. I resultaten fastställs att det finns förutsättningar som kan möjliggöra och förhållande som kan försvåra vid samverkan mellan parterna. Resultatanalysen visar att förutsättningar för samverkan bygger på samsyn, likartad tolkning av gemensamma mål, helhetssyn, samt kommunikation. I resultaten framkom flera samverkansvårigheter som genomsyrar och de består av, regelverk brist på återkoppling, informationsbyte och kommunikation. Vidare visar resultaten att skilda kunskapstraditioner, oklarheter kring ansvarsområden och ansvarsfördelning skapar ofta svårigheter vid samverkan. / Psychological bad health is a vast and growing problem affecting children and young people in Sweden. In addition, this comes to substantial, versatile and complex demands on society. To meet these complex demands and in order to provide children and young people with the best support and, at the same time, satisfy their needs it is crucial that the school organization and the social services unit and cooperate.The purpose of this study to investigate how the real life collaboration between social services and schools regarding groups of children and young people appears and also to find out the experiences of such collaboration from people working within the social services area and the school area. Another purpose has been to investigate what social services and school professionals deem as on one hand obstructive and on the other hand as promotional as to collaboration and to compare their views with earlier scientific research. The study is qualitative and is based on four semi-structured interviews with two social workers from the social services and two teachers working in school. In my analysis of the interviews the outset has been collaboration theory. My result analysis demonstrates that factors enabling collaboration are based on consensus, similarities in interpreting the common goals, comprehensive views and communication. The analysis also shows that factors aggravating collaboration depends on different standards and rules, inadequate feed-back and exchange of information or lacking communication. Furthermore, my conclusion is that different knowledge platforms, ambiguity around responsibility areas and allocation of responsibility often create collaboration problems.

Bakgrund: De senaste decennierna har socialpolitiska beslut präglats av en viljeinriktning att individer med psykisk funktionsnedsättning ska leva i samhället med andra, i en gemenskap. Det visar sig dock att många står utanför samhällets gemenskap och saknar ofta sysselsättning. Att ha sysselsättning kan vara en avgörande faktor som inte bara möjliggör att isolering bryts men även att vägen mot återhämtning från psykisk ohälsa kan påbörjas. Att få vara en del av ett sammanhang visar sig ha positiva effekter för återhämtningsprocessen som bidrar till att personer med psykisk funktionsnedsättning kan leva ett tillfredsställande liv trots att hen aldrig blir helt symptomfri.Syfte: Syftet med denna studie har varit att undersöka fontänhusets betydelse för medlemmarnas återhämtningsprocess. Syftet har även varit att belysa om det finns erfarenheter av både främjande och hindrande faktorer på fontänhuset för medlemmarnas återhämtning. Metod: Fem semistrukturerade intervjuer med medlemmar på fontänhuset som har erfarenhet av personlig återhämtning har genomförts och analyserats tematiskt.Resultat: Studien visar att fontänhuset är av betydelse för medlemmarnas återhämtningsprocess. Fontänhuset upplevs av flera av deltagarna i studien som en bidragande faktor till deras återhämtning. Studien påvisar också att det kan finnas problematik på fontänhuset som påverkar de sociala relationerna mellan medlemmarna. Vidare lyfts att återhämtningsprocessen består av fram och tillbakagångar men att ha en plats dit man kan gå bidrar till fler framgångar än motgångar. / Background: In recent decades, social policy decisions have been characterized by a determination that people with mental disabilities should live in society with others, in a community. However, it turns out that many people are outside society's community and often lack employment. Having employment can be a crucial factor that not only enables isolation to be broken but also that the path to recovery from mental illness can begin. Being part of a context proves to have a positive effect on the recovery process that helps people with mental disabilities live a satisfying life despite never becoming completely free from symptom.Purpose: The purpose of this study has been to investigate the importance of the fountain house for the members' recovery process. The purpose has also been to highlight whether there are experiences of both promotion and preventive factors in the fountain house for members' recovery.Method: Five semi-structured interviews with members of the fountain house who have experience of personal recovery have been conducted and analyzed thematically.Result: The study shows that the fountain house is important for the members' recovery process. The fountain house is experienced by several of the participants in the study as a contributing factor to their recovery. The study also shows that there may be problems at the fountain house that affect the social relations between the members. Furthermore, it is emphasized that the recovery process consists of advances and reversals, but having a place you can go contributes to more successes than adversities.