The primary purposes of the present study were (1) to see in which way, if any, the measured attitudes of psychiatric aides employed on geriatric wards differed from those of aides employed on non-geriatric wards at the same hospital; and (2) to explore the relationships between measured attitudes and other variables such as age, education, amount of experience as an aide, amount of experience on either geriatric or non-geriatric wards, and the number of patients per aide on each ward.

Summary Introduction: Lithuania, as well as other post-communist countries, has inherited the soviet system of mental health care, which was oriented towards long-term in-patient (residential) treatment, exclusion from public and negation of mental illnesses as a problem. Though Lithuania has made huge progress in humanisation and restructuring of mental health services - mainly thanks to mental health professionals employed in this area - there still is a mountain of soviet-inherited problems without settlement of which no further progress is possible. Without changing the image of mental health care institutions first, it is impossible to expect any changes in the public attitude, stigmatisation of patients and social exclusion, either. Objective of the work: To assess the structure of Lithuanian in-patient (residential) mental health care and trends of restructuring thereof. Tasks: 4.To analyse the existing arrangement, structure, scope of activities and related changes of Lithuanian in-patient (residential) mental health care institutions. 5.To assess the attitude of psychiatrists towards structural changes in in-patient (residential) mental health care. 6.To submit recommendations as to the restructuring of in-patient (residential) mental health care in Lithuania. Methodology: 3.Analysis of documentation, information publications and data of in-patient (residential) mental health care institutions. 4.Questionnaire interview of psychiatrists in outpatient and in-patient... [to full text]

At a time when the rest of Canada, and indeed much of the Western World, was looking for alternatives to large custodial mental hospitals, people in the Western Canadian province of Saskatchewan celebrated the opening of one of the country's largest asylums. The province remained committed to the institution throughout the interwar years, offering few alternatives for people deemed insane or mentally defective. People on the outside often saw the asylum as an economic boon, a marker of civilization, or as an institution that was crucial for protecting the health and safety of the public. Patients and their families, however, struggled against an institution where patients were subjected to a broad range of indignities. By carefully considering Saskatchewan's regional social and political culture, I examine the values that were projected onto the asylum by those on the outside and the boundaries that were established between the patients and the public that enabled the public to see the asylum as necessary despite widespread patient suffering. I argue that the public accepted the Weyburn Mental Hospital first as a monument worthy of celebration and then as a necessary, though perhaps regrettable, tool for segregation. The asylum in the interwar years is best understood as a political rather than a medical institution, where politicians and the asylum administration cultivated an image for the institution that conformed to regional values. The government and the media defined the patient experience for a curious public, portraying the institution and its patients in a way that not only legitimized the asylum but that also assigned it meaning far beyond its stated medical function. The values associated with the asylum changed over time, but were always guided by political concerns and were always facilitated by manipulating the relationship between the asylum, its patients, and the surrounding community.

During the first half of the 19th century institutions for the treatment of the insane were established throughout Europe and North America. These institutions were generally the result of government initiative and were founded on a belief that existed in the new psychiatric theories of treatment. Psychiatry was, at this time, an embryonic science, in which great conflict existed between different theoretical schools of thought, but in which a remarkable concensus existed regarding methods of treatment. Treatment was based on a view of the nature of man inspired by the philosophy of the Enlightenment, in which up-bringing was considered to be able to affect a person's entire character. In 1823, the Swedish Riksdag voted in favour of the etablishment of treatment hospitals. The background to this decision was the belief that it should be possible to diminish the costs of caring for the poor if mental illness could be treated. However, fears of a general increase in social unrest and philanthropic motives seem also to have been important factors. Sweden's first hospital for the treatment of the insane was established in Vadstena in 1826. Georg Engström (1 795-1 855) became the country's first full-time asylum doctor. Georg Engström was well-read in German, French and English psychiatric literature, but never himself formulated any psychiatric theory, neither did he write any articles of a principiai nature. His psychiatric activities may, however, be followed in his comprehensive medical journals and regular official reports. Engström saw the roots of mental illness in the existence of a surplus, a shortage, or an inbalance in the energy of the psyche. The cause of illness lay in the patients manner of living and, Engström stressed, in the importance of intense feelings and passions. The essence of treatment lay in the patient's being kept occupied and in his manner of living. Most of the recommendations for methods of treatment contained in the literature were tried out, a number of which — for example, being spun in a revolving chair — were quickly abandoned. The development of psychiatry and of the care and treatment of the mentally ill during the first half of the 19th century can be seen as a sign of the fact that science itself was developing and becoming paradigmatic. However, it is also possible the view developments from the perspective of the ideology of treatment and to focus on the way in which the philosophy of treatment and its concomitent optimism spread and reformed the old asylum system. Finally, it is also possible to observe developments from a pedagogical perspective, stressing the state's desire for control and order in a situation in which there were fears of an increasing social unrest. / <p>Behandlar huvudsakligen Georg Engström och förhållandena vid Vadstena hospital</p> / digitalisering@umu

This paper is interested in Swedish psychiatry during the period between 1930-1950,localized to Mariebergs hospital in Sweden. The purpose of this paper has been to testSjöstroms evidence of the pattern that he used to create three analytical concepts, roughlytranslated to; morally educative discipline-treatment, the production process and the idealinstitution citizen. Sjöström motivates that his concepts gives insight into one aspect of thepsychiatric expansion between 1860-1960 as well as creates an understanding of psychiatryas an institution. The source material for this paper has been patients' medical notes writtenby the chief physician of the institution. Via a method which mainly different from Sjöstromin its selection, categorization and more thorough presentation, this paper has seen the samepatterns which Sjöström has created his three concepts from. The ideal institution citizen,defined by its well behaved and calm behaviour emerges also in this papers quantitativecompilation of qualitative data as the clear majority. The morally educative disciplinetreatment,treatments and punishments that focuses on creating an acceptable behaviourrather than the treatment of insanity itself, can be seen in the adjective behaviouraldescriptions of the type well-behaved / badly-behaved which are dominant. The focus in thejournals is behaviour rather than mental decease symptoms such as hallucinations andtreatment is based on unaccepted behaviour rather than symptoms. Also, the sequential orderthat exists between badly-behaved behaviour and treatments, and well-behaved behaviourand rewards shows the focus on behaviour which the concept is based on. The previous tworesults together is the two parts of Sjöströms production process, that trough the morallyeducative discipline-treatment the institution creates an acceptable, quiet and well behavedideal institution citizen were the mental decease becomes secondary.

During the long 19th century and the great development of mental health care, several new hospitals were built, and new methods emerged. The society wanted healthy citizens who could work, to contribute to the economy and that made the mental hospitals very important during that time. The economic status of social classes was also reflected in the mental hospitals where patients were divided into different class units. In the first class, one could find patients with good economic backgrounds, meanwhile the poor patients were living in the crowded third class. This research follows the lives of five patients, three men and two women, who were diagnosed with melancholia during the early 20th century at Kristinehamn’s hospital. Letters, patient records, examinations etc. will be examined to get an insight into their lives, but also the doctors’ thoughts and methods. Their most common symptoms, how they were taken care of and how themselves experienced their illness will be discussed and analyzed in this paper.

Nineteenth-century state mental hospitals across New England and the United States are linked today with images of confinement, forced treatment, torture, abandonment, and family separation. This project does not directly challenge those associations. An ethnographic study in medical anthropology, this study is based on three years of fieldwork observations and qualitative interviews with neighbors, townspeople, former employees, and visitors to the open campus of a decommissioned state mental hospital in Massachusetts. Excavated from that hospital’s annual reports dating back to 1896 and gathered from local memories and storytelling, this projects considers the central place that work once held in the lives of psychiatric patients at Medfield State Hospital and the place that idleness holds for patients living within today’s institution of community care. Participants’ memories track the shifting perceptions and meanings of mental illness that resulted once “industrial therapy” programs were ended in state mental hospitals. This inquiry describes the ways that the loss of work changed psychiatric patients’ experiences of suffering, promoting the use of new chemical treatments, accelerating deinstitutionalization, and catalyzing new patterns nationally of service utilization and psychiatric disability. From participants’ memories and the author’s reflections on clinical practice as an independently licensed social worker (LICSW) in Massachusetts, this analysis uncovers the social functions of staying sick within contexts of unequal opportunity and joblessness. This study reveals the complicated and punishing work of surviving and helping people survive across de-industrialized landscapes as mental health practitioners assist the disenfranchised by recasting social suffering into psychiatric illness with treatment-induced embodiments that simultaneously help to manage poverty and perpetuate risk within disabilized citizens.

The purpose of this study was to explore alcohol use among psychiatric in-patients in a mental hospital in Ethiopia. A quantitative, descriptive, cross-sectional study design was used. Data were collected through face to face structured interviews and a document analysis checklist. A researcher-modified interview-version of the Alcohol Use Disorder Identification Test (AUDIT) questionnaire was used to measure alcohol use. The study population comprised of 70 psychiatric in-patients. Data analysis showed that being male, living in an urban area, being diagnosed with schizophrenia, and having parents who drink alcohol had a statistical significant association with the alcohol use of the respondents. Respondents reported that it was difficult to abstain or stop using alcohol. They also felt discriminated against when forbidden by relatives to drink. It was alarming to find that thioridazine, which has been discontinued in most countries for the treatment of psychosis, was still being prescribed in Ethiopia. The study highlighted the need for health education to strengthen patients’ perceptions about the negative consequences of alcohol use. Care should be taken when prescribing psychotropic drugs such as thioridazine to psychiatric in-patients because of possible cardiotoxic effects. / Health Studies / M.A. (Public Health)

The problem with which this study is concerned is that of ascertaining the effects of intensive Remotivation Techniques on institutionalized geriatric mental patients in terms of their ward behavior, self-concept, and visual-motor perceptions and to compare these with the effects of a similar group experience that does not emphasize patient-staff or patient-patient interactions, and a third group which acts a a control. The investigation is designed to answer or obtain information concerning the following questions: (1) Do institutionalized geriatric mental patients in a state mental hospital manifest measurable changes in terms of their (A) ward behavior as defined as raw scores on the Hospital tment Scale (including interpersonal communication and interpersonal relations; self care and social responsibility; level of participation in ward activities, recreation and work therapy; total score), (B) self-concept as defined as Goodenough raw scores on the Draw-a-Person Test, and (C) awareness of environment as defined as Pascal and Suttell raw scores on the Bender Visual-Motor Gestalt Test, as a result of experiencing the social and verbal interactions of intensive Remotivation Techniques? (2) Is the Remotivation Technique more effective in producing these changes than a similar group experience that does not emphasize social and verbal interactions?

The purpose of this study was to explore alcohol use among psychiatric in-patients in a mental hospital in Ethiopia. A quantitative, descriptive, cross-sectional study design was used. Data were collected through face to face structured interviews and a document analysis checklist. A researcher-modified interview-version of the Alcohol Use Disorder Identification Test (AUDIT) questionnaire was used to measure alcohol use. The study population comprised of 70 psychiatric in-patients. Data analysis showed that being male, living in an urban area, being diagnosed with schizophrenia, and having parents who drink alcohol had a statistical significant association with the alcohol use of the respondents. Respondents reported that it was difficult to abstain or stop using alcohol. They also felt discriminated against when forbidden by relatives to drink. It was alarming to find that thioridazine, which has been discontinued in most countries for the treatment of psychosis, was still being prescribed in Ethiopia. The study highlighted the need for health education to strengthen patients’ perceptions about the negative consequences of alcohol use. Care should be taken when prescribing psychotropic drugs such as thioridazine to psychiatric in-patients because of possible cardiotoxic effects. / Health Studies / M.A. (Public Health)