Thesis--Columbia University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 163-165).

Thesis (M.S.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains v, 40 p. Includes abstract. Includes bibliographical references (p. 38-40).

Policy initiatives are calling for mental health services to change their ways of working to prioritising the promotion of service users’ personal recovery. This requires a major re-negotiation of working practices and the relationship between service users and staff/services and their respective social positions. Preliminary research has shown that change has been problematic. The present study aimed to explore the construction of recovery and the positioning of service users and staff during the adoption of recovery-oriented practices in a community support and recovery team. Transcripts of two rounds of focus groups with service users (n=9) and staff (n=5) held six months apart, service user care plans and Recovery Star notes were analysed using a Foucauldian Discourse Analysis. The study found that recovery was constructed as clinical/medical and personal recovery, at different times and in tension with each other. These constructions positioned service users as dependent, passive and hopeless or empowered and hopeful, and staff as helpless or facilitative. It was also apparent that a discourse of personal recovery was not available to service users. Staff oscillated between the constructions of recovery as medical and personal resulting in different subject positions and opportunities for action. The study concluded that adopting a recovery-orientation in services should lead to service users being positioned as more influential in decisions about their treatment and modes of support from the service, and services less likely to dictate their treatment. However, this can only happen if the recovery-orientation constitutes a widely shared discourse with all its assumptions and associated practices. The problematic aspects of the medical discourse and how it can position people socially and how those positions impact on the potential for personal recovery needs to be highlighted.

This work considers the nature of therapeutic relationships between nursing staff and patients on acute mental health inpatient wards. Section A is a literature review, exploring the psychological theories behind the care delivered by nurses through the medium of therapeutic relationships in inpatient settings and providing a meta-synthesis of studies investigating the nature of therapeutic relationships between nursing staff and patients from the perspectives of nurses. Section B presents a phenomenological study in which nursing staff completed in-depth interviews providing descriptions of their therapeutic relationships with patients. The results suggest a great variance in the nursing staff ability to get to know and understand patients and their needs from a psychological perspective. The knowledge gained about patients through the medium of relationships did not seem to be shared by the staff team and did not seem to be integrated into a coherent treatment plan.

The Ethnic Mental Illness (EMI) Scale, a questionnaire to discriminate European and Hispanic attitudes toward mental illness, was developed. Fifty-one college students of Hispanic ethnicity and 194 college students of European ethnicity completed a 150 item questionnaire measuring attitudes toward mental illness. A cross-validation sample of 50 Hispanic students and 194 European students ethnicity yielded 15 items that reliably differentiated the two groups. Based upon content, the 15 items were grouped into six categories: hopefulness, trust, biological aspects of mental illness, childhood origins, finances, and sex differences. Items which did not discriminate Hispanics and Europeans are described, as these items are possible indicators of common attitudes toward mental illness. A group of 66 Asian students also participated in the study. The items which differentiate Asians from Hispanics and Europeans are described. These items were not cross-validated.

No description available.

Self-harm is a behaviour constructed as ostracised and abhorrent in most social discourses. While there is an abundance of available research about self-harm, a distinctive gap in the literature concerns how an individual begins to self-harm. Research has indicated that having a friend or family member who self-harms is the strongest predictor of future self-harm, yet no published studies have sought to explain this in detail. This thesis explored how self-harming participants construct their first self-harming experience – a behaviour which appears prima facie to be outside of socially accepted conventions, and suggests that this behaviour may become normalised through knowing other self-harmers. It was found that both participants had a self-harming friend prior to the onset of their self-harming behaviour, and that both participants confided in someone who subsequently began to self-harm. Participants positioned these two categories of individuals in different ways. Participants relied on a ‘victim’ discourse to establish their self-harm as meaningful in a way which limited any blame or stigma attributable to them, but which subsequently limited their agency in their narratives. The discourse of attention-seeking heavily influenced participants’ narratives, and was acknowledged as the dominant discourse self-harmers must contend with in presenting their behaviour as meaningful and rational. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

The aim of this study was to assess the attitudes of community psychiatric nurses, mental health professionals and primary health care nurses towards mental illness, mentally ill people and deinstitutionalisation. The sample of this study comprised 38 community psychiatric nurses, 20 mental health professionals and 55 primary health care nurses, all of whom were from Durban, Pietermaritzburg and their surrounding areas. Each participant completed a biographical questionnaire, the Opinions of Mental Illness scale (1962) and the Community Mental Health Ideology scale (1967). Four focus groups on attitudes towards deinstitutionalisation, comprising 25 participants in total, were also conducted. Statistical analyses were computed using the Statistical Programme for Social Scientists. Krueger's (1984) methodology was employed to analyse the focus groups results. The quantitative results revealed that community psychiatric nurses, mental health professionals and primary health care nurses generally tended to express neutral attitudes towards mental illness, mentally ill people and deinstitutionalisation. Significant differences in attitudes towards mental illness and mentally ill people were found amongst respondents in different categories of race, educational levels and treatment of a friend for a mental illness. The focus groups results revealed that while the community psychiatric nurses and mental health professionals were positive about the concept of deinstitutionalisation, they did not favour it's implementation within the current South African economic and social contexts. Based on their fear of mentally ill patients, the primary health care nurses displayed negative attitudes towards the concept of deinstitutionalisation and were also cautious about it's implementation within the current South African context. Implications and recommendations arising from this study are discussed. / Thesis (M.A.)-University of Durban-Westville, 1998.

Children of parents with mental illness (COPMI) are often referred to in the literature as invisible given the lack of services dedicated to this large population at increased risk for a multitude of psychosocial difficulties. Of the services available, few have been empirically validated. This study undertook a qualitative evaluation of Kids in Control, a psycho-education and support program intended to enhance the resilience of children of mentally ill parents. The goals of this study were to: determine whether the program was beneficial to the participants, identify the critical program elements deemed helpful/unhelpful by the participants, determine whether program objectives were being met, and to provide insight on how to improve the program to better meet the needs of this population. It is ultimately hoped that this research will give children of parents with mental illness a voice, thereby boosting their visibility and contributing to their psychosocial well being. Flanagan’s (1954) critical incident technique (CIT) was employed to determine the participants’ perceptions of helpful and unhelpful aspects of the program. Twelve participants (10 boys, 2 girls) ranging in age from 8-12 were recruited from 4 groups held in the Lower Mainland of British Columbia. Semi-structured interviews were conducted, followed by telephone interviews to discuss and verify the information shared. Participants reported a total of 121 critical incidents, which were classified into 8 helpful categories (105 incidents) and 2 unhelpful categories (16 incidents). The eight helpful categories were: identifying, communicating and managing feelings; learning about mental illness; helpful messages about responsibility, control, and empowerment; effective facilitator group management skills; having fun; connecting with other children experiencing parental mental illness; learning about stigma; and identifying supports. The unhelpful categories were: ineffective facilitation skills, and disruptive behaviour exhibited by other group members. Participants recommended improvements related to the areas of group instruction, time management, and group management. In addition, a 10-point rating scale was administered to determine the participants’ overall perception of program helpfulness. A mean rating of 7.63 was obtained which corresponds to very helpful on the scale. A comparison of incident categories with program objectives indicated a high degree of consistency, with a few exceptions. Implications for program improvements, wider program dissemination, and counselling practice are discussed. In addition, methodological issues related to using the critical incident technique with children are outlined.

Rationale: Consumers of the mental health system with serious mental illness have been deprived of meaningful occupations since de-institutionalization began in the late 20th century.Community mental health policy has failed to focus on the meaningful occupational lives of this group of service users. Given the disparity in activity and meaningful time use for people with serious mental illness when compared to the general population, it is clear that a treatment that draws attention to occupational balance and engagement is needed. As balanced time use has been shown to increase community adjustment and life satisfaction, it is an important area of focus. Objectives: The purpose of this study was to pilot test the efficacy of a new occupational time use intervention, provisionally titled “Action over Inertia,” designed to increase occupational balance and engagement in the lives of people with serious mental illness living in the community. Methods: A prospective, multi-centre randomized controlled trial of the intervention, involving 5 Assertive Community Treatment (ACT) teams in southeastern Ontario,ran in Fall 2007/Winter 2008. 18 ACT clients took part in the 12 week intervention, which was delivered by the ACT team occupational therapists. Results: Time use, used as a measure of occupational balance, shifted away from sleep to increased general activity in the treatment group(p=0.05). Treatment and control groups did not differ on occupational engagement measures after the completion of the trial. Feedback on the clinical utility of the intervention was very positive from both therapists and treatment participants. Conclusions: This pilot test revealed initially positive data on the efficacy and clinical utility of the intervention.Further study of the “Action over Inertia” intervention is needed on a larger scale, potentially with a longer treatment timeline to further investigate its usefulness. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2008-09-22 14:36:47.279