Concern about mental health is on the increase in North America. Increased concern necessitated the provision of more treatment facilities for mental illness. For this reason, research is being conducted in the mental health field. This study is the first undertaken in Canada, in an attempt to investigate a possible relationship between social class and mental illness. The study focussed on social class and treatment in a mental health setting at the Mental Health Centre, Burnaby, and comparisons were made with studies done in the United States. Data were made available through the B. C. Department of Vital Statistics. These data were collected at the Mental Health Centre, Adult Clinic, Burnaby from April 1, 1959 to March 31, 1964. As the data were not collected by the researchers, there are limitations which are discussed in the study. Of the total number of persons seen at the Adult Clinic, 1231 were given treatment and terminated during this five year period. These were the subjects of this study. The findings reveal no significant relationship between social class and the kind of treatment, or, between social class and the length of treatment. However, the findings do indicate that diagnosis is related to both social class and assignment of a therapist. / Arts, Faculty of / Social Work, School of / Graduate

A dissertation submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for a Masters degree with the Faculty of Humanities (Health Communication and Music). Johannesburg, May 2017 / This dissertation synthesises the fields of narrative medicine and music composition to address the experience of delirium, and to learn whether music has a role to play in understanding and communicating its nature. My submission takes the form of a written dissertation accompanied by a new musical composition, Delirium Part II. Both written and composed texts are based on interviews and small discussion groups with people who have experienced delirium, their families, and healthcare professionals who are familiar with delirium in people under their care – as well as observation and recording from a hospital intensive care unit (ICU). The composition incorporates both interviews and ambient hospital sounds as audio components, and was performed first on 2 March 2017 at the Music Room, University Corner, University of the Witwatersrand. The study addresses significant gaps in our understanding of delirium, from its definition to the qualities of the experience for all those affected by it. Violence is shown to be inherent to the experience, driven by a cycle that imposes it by turns on HCPs and patients. Delirium is, moreover, characterised by losses of numerous kinds: orientation, dignity, control, and ultimately personhood. This study suggests, however, that it is within our grasp to limit significantly the impacts of these losses through re-evaluating our interactions with patients and families and challenging the dehumanising aspects of care. The music of Delirium Part II, moreover, is shown to have the capacity to contribute to this re-evaluation. There are clear indications here of the potential for music and the arts more broadly to convey complex health experiences, and to be of use in training and education. Music contributes centrally to the development of this research, as a tool both for data analysis and for provoking discussion of a complex, emotive topic. The possibilities for creative practice in narrative medicine are illuminated by this cross-disciplinary study, which demonstrates both that narrative-based musical composition can teach us much about delirium; and that delirium can teach us much about care. / MT2018

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.