This dissertation demonstrates how patients' mental illness treatment careers depend on the change and/or stability among differing levels of social structure. Theorists of the mental illness career tend to ignore the role that higher levels of social structural change have on individuals' mental illness career. Researchers using an organizational perspective tend to focus on the organizational environment but ignore the treatment process from the individual's point of view. Both perspectives neglect what the nation-state's broader socio-political and economic circumstances could imply for people seeking treatment for mental disorders. Organizational theory and theories of the mental illness career are independent theoretical streams that remain separate. This dissertation connects these independent theoretical streams by developing a unifying theoretical framework based on historical analysis. This historical analysis covers three phases of treatment beginning at the end of World War II to the present. This framework identifies mechanisms through which changes in larger levels of social structure can change the experience and career of mental patients. This new perspective challenges current conceptions of the mental illness career as static by accounting for the various levels of social structure that play a part in the mental illness treatment career. Taken together, the inclusion of differing levels of social structure and the subsequent reciprocal relationship between these levels of analysis produce a narrative that explains why and how stability and change within the mental health sector shape the mental illness treatment career. / Ph. D.

Indiana University-Purdue University Indianapolis (IUPUI) / Research suggests that misperceptions about the mentally ill and about their ability to recover and live productive lives are still commonly held by the public. Psychoeducation programs and direct contact can help both correct misperceptions and offer encouraging messages about recovery in those with and without mental illness. Consumer presentation programs, such as NAMI’s In Our Own Voice (IOOV), were designed in part for these purposes. This study examined archival IOOV audience evaluations (n = 599) from 2009 to better understand how audiences respond to IOOV in natural settings. Qualitative and quantitative analyses were conducted to examine: 1) viewers’ responses to the program, 2) differences between consumer and nonconsumer responses, and 3) whether the program satisfies program goals for audience members. Results indicate that the majority of viewers respond positively, in a variety of ways and to a variety of program elements not previously identified. Additionally, the program’s effects appear to generalize across consumers and nonconsumers equally well, with the exception that nonconsumers more frequently reported finding the program educational and consumers more frequently reported personally relating to presenters. Finally, results suggest that IOOV is indeed meeting its two stated program goals for audience members: educating the public and offering a hope-inspiring message of recovery. In conclusion, IOOV, as it is performed in the field, appears to be a valuable addition to educational and inspiring recovery-oriented programming available to the public.

Thesis (M.A. (Clinical Psychology)) --Univesity of Limpopo, 2013 / South Africa has a growing rate of mental health care users. Because of the lack of health resources and personal beliefs many of these mental health care users consult with their church leaders. The treatment of mental illness by clergy in South Africa is largely undocumented. The aim of the study was to explore and describe the treatment of mental illness by Afrikaans speaking church leaders in Polokwane, Limpopo Province. To gain a deeper understanding of the views held by the Afrikaans-speaking church leaders, a qualitative approach was utilized. Ten participants agreed to participate in the study. The results tend to suggest that most of the respondents use a combination of supportive therapy and teachings from scripture to treat some mental illnesses, and that they feel positive towards collaboration with other mental health care professionals. Lastly the results indicated that most respondents emphasized the importance of homophily in referral criteria. Key Concepts Mental illness; Christian church; Afrikaans speaking; church leader; treatment

The primary objective of this research was to explore the impact of possible social factors on non-institutionalized adults 18 years of age or older residing in the United States who exhibited severe mental illness (SMI). A holistic sociological model was developed to explain SMI by incorporating elements of social learning theory, social disorganization theory, and gender socialization theory with social demographic factors. Based on the holistic sociological model, the following factors were investigated: demographic aspects of age, education, income and gender; gender socialization; influence of neighborhood area; social network influence based on communication and interaction among peers and family members; and socially deviant behaviors such as frequently smoking cigarettes, drinking alcohol and using drugs specifically marijuana. The impact of these factors on SMI was examined. A sample of 206 respondents drawn from National Survey on Drug Use and Health, 2003 was assessed. These respondents had answered all the questions related to SMI; social deviant behaviors; neighborhood environment; and communications among peers, family members and friends; and the other studied factors. Ordinary linear regression with interaction terms was employed as a statistical tool to assess the impact of social determinants on SMI. Being female, living a disorganized neighborhood, and frequent and high levels of smoking cigarettes and drinking alcohol had a significant influence on SMI. This reevaluation and reexamination of the role of gender socialization path, socially deviant behaviors like smoking and drinking, and community construction on SMI provided additional insights. This research is one of the first to develop a more holistic sociological model on SMI and explored the previously untested interactive relationships. The limitations of this study suggest the need to test a potential recursive research model and explore additional bi-directional associations.

Indiana University-Purdue University Indianapolis (IUPUI) / People with severe mental illness (SMI) often suffer from comorbid physical conditions that result in chronic morbidity and early mortality. Physical health decision-making is one area that has been largely unexplored with the SMI population. This study aimed to identify what factors contribute to the physical healthcare decision-making autonomy preferences of persons with SMI, and to identify the impact of these autonomy preferences on medication adherence. Ninety-five adults with SMI were recruited from an integrated care clinic located in a community mental health center. Fifty-six completed a three-month follow-up. Multiple linear regression for hypothesis 1 (n=95) and hierarchical regression for hypothesis 2 (n=56) were used to analyze data on personal characteristics, physical health decision-making autonomy preferences and medication adherence. For the open-ended questions, thematic analysis was used to uncover facilitators and barriers to medication adherence. With this sample, being male predicted greater desired autonomy, and having less social support predicted less desired autonomy. When background characteristics were held constant, autonomy preferences and perceived autonomy support from the physician only contributed an additional 1% of the variance in medication adherence. Lastly, participants reported behavioral factors and having family/personal support to take medications as facilitators to medication adherence for physical health care, while citing financial and other resource limitations as barriers.

The increase of mass shootings in the U.S. has amplified news reporting on mental illness as a possible factor in the shootings despite no evidence linking the two issues. Sources used to explain mental illness in stories that explore the motivations of mass shooters affect audience perception. Through a qualitative content analysis of local newspaper coverage of five U.S. mass shootings in 2015, journalists linked mental illness as a possible motive through sources who were not qualified to treat or diagnose mental illness. Journalists also ignored professional guidance from the Associated Press on mental illness reporting in the context of mass shootings. Additionally, journalists assumed the audience was knowledgeable of mental illness in general terms and specific diagnoses. These findings indicate coverage of mass shootings includes inaccurate information about shooters' motives, and it also continues to frame mental illness as dangerous.

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Thesis (MA (Psychology))--University of Stellenbosch, 2006. / Many researchers have argued that social factors such as poverty and urbanisation play a role in the experience of and may be risk factors for mental disorders. There is however a paucity of research examining this issue, particularly in developing countries, where the prevalence of mental disorders has been shown to be as high, if not higher than in developing countries. The present study aimed to begin to address this gap by collecting in depth exploratory data that could inform further study in the field. We conducted ten qualitative case studies consisting of semi structured interviews with family members of households caring for a member with a mental illness. The specific factors of interest were the role of structural factors, namely, municipal and health services in the experience of mental illness. Data were analysed thematically, using an adaptation of Yin’s (2003) approach. The findings indicate that factors associated with service delivery and cost recovery in poor urban contexts may increase stress and burden on households who are caring for a member with a mental illness. This has implications for the course and experience of mental illness and the primary environment in which care is received. These claims are tentative and further research is needed to substantiate them.

In light of the increasing number of mentally ill inmates in the criminal justice system, felony mental health courts aim to de-criminalize these individuals and link them to appropriate types of treatment within the community. Few studies have investigated the successful linkage of community-based treatment among felony mental health court participants. More specifically, there is an absence of research on the efficacy of pharmacotherapy on recidivism status among felony mental health court defendants. This retrospective study used archival data to determine if receiving pharmacotherapy will increase duration of time between arrests and keep felony mental health court participants out of the criminal justice system longer. The study also aimed to investigate if psychotropic medication use helped to reduce the risk of violent arrests among those participating in the felony mental health program. Lastly, it evaluated whether drugs from specific classes had more of an effect on recidivism status than others. Cox regression analyses, with propensity score adjustments, were used to determine if psychotropic medication keeps felony mental health court participants out of the criminal justice system longer. Cox regression analysis was also used to determine if specific drugs from different classes had more of an effect on time to re-arrest than others. Lastly, a binary logistic regression, with propensity score adjustments, was used to determine if psychotropic medication helped to reduce the risk of future violent offenses after entry into the FMHC program. All analyses included covariates to control for any potentially confounding factors to the outcome. The study yielded non-significant results when testing whether or not the use of psychotropic medication had an impact on the time to re-arrest, and on risks of future violent offenses.