A Interconsulta Psiquiátrica é considerada uma área da Psiquiatria, que trabalha no Hospital Geral compondo uma equipe (Psiquiatria de Ligação) ou prestando seus serviços a uma equipe solicitante (Consultoria Psiquiátrica). O Serviço de Interconsulta em Psiquiatria (SIP) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP) teve início em março de 1978 e a Terapia Ocupacional passou a integrar esta equipe em 1999. O cotidiano hospitalar tem uma marca própria com obrigações como usar vestimentas, ter horários previamente estabelecidos para se alimentar, para cuidar de sua higiene e para receber visitas, inclusive dos familiares. Os terapeutas ocupacionais, como profissionais que lidam com o cotidiano do indivíduo, têm sido inseridos nas equipes multiprofissionais do Hospital Geral, contribuindo com seus conhecimentos teóricos e técnicos específicos para cuidar de pessoas hospitalizadas. Apesar das várias funções que a Terapia Ocupacional (TO) pode exercer no Serviço de Interconsulta, existe escassez de estudos publicados sobre o perfil sócio-demográfico dos pacientes atendidos, o que prejudica o planejamento de ações e o levantamento da necessidade de recursos humanos para aquele Serviço. O objetivo deste trabalho foi realizar um estudo retrospectivo dos Pedidos de Interconsulta (PIs) para a TO do Serviço de Interconsulta em Saúde Mental (SISMen) do HCFMRP - USP no período de janeiro de 2000 a dezembro de 2005. Os sujeitos foram os indivíduos que estiveram internados nas enfermarias do campus do hospital universitário e para quem foi solicitada a assistência do Serviço de TO naquele período, perfazendo um total de 633 pacientes e 709 PIs. Os dados foram coletados mediante consulta dos PIs e dos prontuários dos pacientes. A maioria dos sujeitos consultados foi do sexo feminino, com ensino fundamental incompleto e houve distribuição equilibrada entre os solteiros e casados. Quanto à idade e à situação laboral, a média de idade dos pacientes foi de 39,2 anos e a maioria deles era autônoma ou aposentada, seguida de dona de casa. Verificou-se que a Clínica Médica foi a responsável por mais do que um terço dos Pedidos de Interconsulta feitos para o Serviço de TO, seguida das clínicas Unidade Metabólica e Psiquiatria respectivamente; o tempo médio de internação dos pacientes encaminhados para esse Serviço foi de 51 dias, sendo que a média de internação no HCFMRP-USP foi de 6,4 dias. Consequentemente, o gasto desses pacientes variou entre uma e 2,4 vezes mais do que os pacientes internados nesta instituição. A taxa média de encaminhamento para a TO do SISMen foi de 0,5%, sendo que o motivo de solicitação mais freqüente esteve relacionado aos aspectos emocionais do indivíduo, seguido por fatores referentes à hospitalização. Estes dados, de modo geral, estão de acordo com a literatura nacional e internacional dos SIPs. Concluiu-se que há necessidade de um instrumento padronizado para avaliar a população atendida pelo Serviço de Interconsulta de TO e que alguns pontos merecem estudos mais detalhados como a possibilidade de existência de associações entre dados sócio-demográficos e clínicos e o encaminhamento dos pacientes para esse Serviço. / Consultation Liaison Psychiatric is considered to be an area of Psychiatry which is part of a General Hospital, involving a team (Liaison Psychiatry) or providing services to a team that requests them (Psychiatric Consultation). The Consultation Liaison Psychiatric Service (CLPS) of the University Hospital, Faculty of Medicine of Ribeirão Preto (HCFMRPUSP) was started in March 1978 and Occupational Therapy became part of this team in 1999. The daily hospital routine has specific rules such as wearing specific clothing and taking meals, caring for ones hygiene and receiving visits, including those of relatives, at pre-established times. Occupational therapists, as professionals who deal with the daily routine of an individual, have been inserted into the multiprofessional teams of the General Hospital, contributing their specific theoretical and technical knowledge to the care of hospitalized persons. Despite the various functions Occupational Therapy (OT) can perform in the CLPS, there is a scarcity of published studies on the sociodemographic profile of attended patients, impairing the planning of actions and the determination of the human resources needed for that Service. The objective of the present investigation was to conduct a retrospective study of the Requests of Consultation Liaison (RCLs) sent to the OT of the Service of The Consultation Liaison in Mental Health (SCLMH) of HCFMRP-USP during the period from January 2000 to December 2005. The subjects involved were the individuals who had been admitted to the wards of the University Hospital and for whom the assistance of the OT Service had been requested during that period, for a total of 633 patients and 709 RCLs. The data were collected from the RCLs and the medical records of the patients. Most of the subjects involved were women with incomplete elementary schooling, with a balanced distribution of single and married subjects. Mean patient age was 39.2 years and most patients were self-employed or retired, followed by the housewife category. Internal Medicine was responsible for more than one third of the RCLs sent to the OT Service, followed by the Metabolic Unit and Psychiatric clinics. The mean time of hospitalization of the patients referred to this Service was 51 days, with the mean duration of hospitalization at HCFMRPUSP being 6.4 days. Consequently, the expenses with these patients ranged from one to 2.4 times more than those for the patients hospitalized in this institution. The mean rate of referral to the OT of the SCLMH was 0.5%, with the most frequent reason for the request being related to the emotional aspects of the individual, followed by factors related to hospitalization. These data, in general, agree with the Brazilian and international literature about the CLPS. We conclude that there is the need for a standardized instrument for the evaluation of the population attended at the Consultation Liaison Service of OT and that some points need more detailed studies regarding the possibility of the existence of an association between sociodemographic and clinical data and the referral of these patients to the OT Service.

O Juqueri, oficialmente denominado Departamento Psiquiátrico II, conjunto pertencente à Secretaria de Estado da SaÚde, foi inaugurado em 1898 e situa-se nos municípios de Franco da Rocha e Caieiras, no Estado de São Paulo, dentro da área metropolitana da Grande São Paulo. O Juqueri tem uma area de 2.983,425 ha, área construída de 11.288,62m e possuía, em outubro de 1981, populção de cerca de 4.200 internos e 3.400 servidores. Os pacientes estavam localizados em 3 tipos de estabelecimentos: 21,8 por cento no Hospital Central, destinado a agudos; 62,8 por cento nas Colônias de Reabilitação, destinadas aos crônicos ou sem possibilidades de retorno social e 15,4 por cento no Manicômio Judiciário, destinado aos alienados criminosos ou em observação à disposição da Justiça. Uma série de serviços de infraestrutura necessários às duas populações, além das funções clássicas de hospital psiquiátrico, faz com que o conjunto tenha características de cidade com área rural contígua. O trabalho tem sua finalidade e metodologia descritas nos capÍtulos I e II, aborda a evolução histórica da instituição, sua organização atual e a inclusão na paisagem metropolitana (Capítulo III), estuda a população de internados (CapÍtulo IV) e a população de servidores (CapÍtulo V) e faz considerações finais (Capítulo VI). As conclusões, no CapÍtulo VII, baseadas nas análises e pesquisas realizadas são: (a) o Juqueri tem estado ausente da reformulação das polÍticas públicas de saÚde mental, de planejamento de saúde e de planejamento geral da área metropolitana; (b) a instituição tem grande pobreza organizacional e de recursos humanos quando comparada com outras similares; (c) suas características de cidade demandam modelos e condições excepcionais dentro da Administração Pública; (d) a instituição tem estado permanentemente sob crítica em dois campos em crise: o encarceramento e a hospitalização psiquiátrica, sem que lhe sejam dadas condiçÕes para um melhor desempenho. / The \"Juqueri\", officially called Psychiatric Department II, a complex belonging to the Health State Department, was installed in 1898. It is located in the Franco da Rocha and Caieiras municipalities, in the state of são Paulo, within the Metropolitan area of the Great São Paulo. The \"Juqueri\" covers an area of 2,983.425 ha, having 118,288.62m of constructed area and, in October 1981, it held populations of about 4200 inpatients and 3400 workers. The patients were assigned to three kinds of settlements: 21.8 per cent in the Central Hospital, addressed to acute cases; 62.8 per cent in Rehabilitation Colonies, addressed to chronic patients or those with no possibility of a social regress, and 15.4 per cent in the Judicial Lunatic Asylum addressed to the alienated criminals or those under observation on the hands of Law. A number of infrastructure services, needed by both populations, beside the traditional functions of a psychiatric hospital, gives the complex characteristics of a city with its rural area next. The paper has its goal and methodology described on Chapters I and II; broaches the institution historical evolution, its current organization and inclusion within the metropolitan picture (Chapter III); studies the inpatient population (Chapter IV) and the workers population (Chapter V) and makes final recommendations on Chapter VI. The conclusions, based on the analysis and researches worked out, are presented on Chapter VII; they are as follows: (a) the \"Juqueri\" has been absent from the public policy re-orientation of mental health, health planning and general planning regarding the Metropolitan Area; (b) the institution, when compared with similar ones, presents a great poorness concerning its organizational and human resources; (c) its city-like characteristics demand models of outstanding conditions within the Public Administration; (d) the institution has been constantly under the criticism of two fields in crisis - the psychiatric confinement and hospitalization - without being provided of any conditions to achieve a better performance.

Background: Self-compassion which may be shaped by early attachment experiences involves being kind to oneself at times of difficulty and is consistently linked to psychological well-being. Self-compassion may be particularly useful in adolescence during which, difficulties associated with physiological and psychosocial transitions can lead to psychological distress. Aims: The aims of this thesis were twofold. First: to review the literature exploring the relationship between self-compassion and psychological distress in adolescents. Second: a research study to investigate the emerging theory that self-compassion may offer a healthier self-relating construct than self-esteem. The study examined whether self-compassion or self-esteem mediated the relationship between attachment and depression and anxiety in adolescents attending child and adolescent mental health services (CAMHS). Method: A systematic search of articles related to the relationship between self-compassion and psychological distress in adolescents was conducted. The quality of included papers was assessed. In the research study, 53 adolescents (mean age 15.52 years; 75% female) attending CAMHS presenting with symptoms of anxiety and/or depression were asked to complete five self-report questionnaires measuring: self-compassion, self-esteem, quality of life, satisfaction with attachment relationship and current symptoms of depression and anxiety. Results: The systematic review revealed 25 studies for inclusion. Studies reported an inverse relationship between self-compassion and psychological distress in adolescents. Quality ratings illustrated variation in methodological quality of included studies. In the research study self-compassion and self-esteem were both negatively correlated with depression and anxiety. The mediating impact of self-compassion was only apparent in the relationship between attachment availability and depression, but not anxiety. Contrary to the hypothesis, self-esteem mediated the relationship between attachment security and depression and anxiety to a greater extent than self-compassion. Conclusions: Self-compassion may have clinical implications in improving psychological well-being among adolescents. Future studies with different measures of self-compassion; varying study designs and consideration of contextual factors would increase understanding of the relationship between self-compassion and psychological distress in adolescents.

Transitioning into adulthood is an exciting and challenging time for emerging adults, and is even more difficult for young adults with emotional and behavioral difficulties (EBD). Even though the number of transition-aged individuals with EBD is significant, few studies have explored the experiences of this population engaged in educational activities, and there is limited information regarding the personal experiences of emerging adults with EBD. The purpose of the study is to acquire a better understanding of the experiences of young adults diagnosed with an EBD who are working toward their academic goals. Further, this study may give voice to individuals who have not had the opportunity to share their experiences and beliefs. The researcher employed phenomenological research methods for this study. The purpose of phenomenology is to describe, rather than explain phenomena (Ehrich, 2003). Five participants, aged 18 to 25, and diagnosed with an Axis I disorder in the DSM-IV-TR, were selected using purposeful sampling. The researcher conducted one in-depth interview with the participants, and a brief follow up interview. Data were analyzed using the following seven steps: preliminary grouping, reduction and elimination, clustering the invariant constituents, identification and validation of the invariant constituents and themes by application, construction of an analysis and development of impressions of each participant, and construction of a composite description of the meanings and essences of the experience, representing the group as a whole. Although living with an EBD is a "continuous struggle," it also provides opportunities for feelings of success and empowerment. Salient aspects of living with an EBD include its effect on the self, impact on relationships, and managing treatment, such as medication and therapy. Participants also discussed how EBD impacts their transition experiences and their ability to achieve their goals; relevant themes included academic challenges, issues regarding seeking assistance, and their selection of career choices. The participants are able to manage these challenges because of the supports they have received and coping strategies they have developed. Furthermore, their own personality traits, such as determination, belief in themselves, and goal orientation have been integral in their journey towards achieving their academic and career goals.

Children go to school for approximately 32 hours each week of an academic year. Many children who are in need of mental health treatment do not get the services they need because of barriers such as lack of access and stigma. Teachers are one of the primary sources of referrals for children's mental health services, and they often make referrals based on their perceptions of their students' mental health needs. Although teachers are typically the primary source of referrals for mental health services, they usually do not have any specialized mental health training. The purpose of this study was to gain insight into the perceived needs of teachers' in Title I schools on what is needed to help their students with emotional and behavioral problems. This research study was framed by Bronfenbrenner's bioecological model, which provides one framework for research and practice of school-based mental health. Bronfenbrenner's theory explains the impact of a child's interrelations with classmates, peers, parents, community, and society upon his or her development, particularly his or her mental health. Data was collected from audiotaped face-to-face interviews with 12 Title I elementary teachers. The interviews were then transcribed, coded, and several themes were identified. Relevant themes included the school's role in mental health, the school's current plan to help children, quality of mental health services, barriers to services, supports at school for mental health; reasons for referrals, administration training and classes on mental health, behavioral management systems, and changes to classrooms that will benefit children with mental health problems. Teachers are on frontlines everyday with students and should have all the training that's needed to help their students be successful.

The purpose of this study was to determine if there was a significant relationship between school-based mental health services and academic achievement. The study focused on (N=38) students in elementary and middle school, who participated in services from the 2012-2013 school year. The test scores before and after they received services were gathered from an existing database to determine how effective school-based mental health services were. The results indicated there was not a significant difference in measures of academic achievement before and after school-based mental health services. However, results demonstrated a positive relationship between test scores before and after school-based mental health services. Limitations to study, such as the sample size, are also discussed.

Latino children make up the largest ethnic group in the United States today. Latino children are also the ethnic group less likely to access and utilize mental health services. As a result, Latino children have higher rates of unmet mental health needs. There is limited research focusing on the mental health services needs of Latino children and lack of access and use of such services. This qualitative study explored barriers among Latino children in accessing and utilizing mental health services. This study conducted face-to-face and Skype interviews with eight mental health providers who work or have worked with Latino children with mental health needs. The eight interviews were transcribed and analyzed to identify common themes regarding barriers Latino children face in accessing and utilizing mental health services in participant responses. The major themes identified by this study included: cultural values, insurance, socioeconomic status, lack of bilingual providers, agency days and hours of operation, immigration status, and lack of awareness of mental health. Through identifying such barriers, this study may raise social worker awareness of barriers Latino children face and better equip social workers to plan and implement approaches to address identified barriers in efforts to increase Latino children’s access and use of mental health services to meet their mental health needs.

The purpose of this study ­is to identify social workers’ perspectives on the barriers and motivating factors impacting Latino men in seeking mental health services, and to seek ways to overcome the barriers. Research has established that Latino men suffer from mental health problems at a similar rate compared to other populations, yet they underutilize mental health services. Given the rapid growth of the Latino population that continues to need mental health services, the findings of this study may influence the social work field to develop programs and interventions that are geared towards encouraging Latino men to seek services. They may also assist in preparing clinicians entering the field. This qualitative study used individual interviews as a tool to find themes from social workers’ point of views on the subject. The results from interviews were transcribed to written document. Major themes identified include barriers, motivating factors, and recommendations for change.

Zion Lutheran Church in Portland has had contact with a number of neighborhood residents who have been released from mental institutions but who have had little community support. The Church has felt the need for some time to develop a residential program for former patients in the area they serve. The authors of this report agreed to conduct a needs assessment and to develop a program relative to the results of the assessment. A needs assessment identified the target population, attempted to determine what services they would use and how such services might best be delivered. The assessment was conducted in Northwest Portland because this is the general area which interests Zion Lutheran Church. It was designed to discern whether a residential program for released mental patients would be used in the area designated, and, if so, how such a program would best be formulated. However, it was also designed to allow respondents to express interest in other types of programs and services.

The theoretical underpinnings of Washington County Children's Services Division (CSD) Immediate Conflict-Resolution Family Treatment Program include the systems theory of family therapy with a focus on communication and roles. One of the many approaches to helping families in crisis, it incorporates theories regarding assessment of and intervention in families in crisis. Finally, while it draws upon several different approaches to family therapy, the Washington County program is most closely related to Multiple Impact Therapy (MIT). Thus, a review of relevant literature must address portions of the above enumerated theories that illuminate the thinking behind the Immediate Conflict- Resolution Family Treatment Program. While each of the four components of the literature review (systems theory, family crisis theory, assessment of families in crisis, and Multiple Impact Therapy) represents a topic area of breadth and complexity, the aspects of each topic area which seem most relevant to Washington County's MIT project have been reviewed.