The problem of placing patients in the homes of paid caretakers is multifarious and complex. Among the most basic of the questions facing the agency planning to place patients is: what kind of patient to place in what kind of a home? When stated criteria are lacking for the selection of patients for both types of settings from the same hospital, the social worker's judgments become the gauge by which selection is made. This situation prevails at the Veterans Administration Hospital at Gulfport, Mississippi. Delineation of the factors contributing to successful placement would be useful in the selection and preparation of patients for community placement. The data of this study are primarily related to the successful community placement made by sixty white male veterans. Answers were sought to the following questions by an analysis of the data collected on 34 descriptive items. (1) How does the literature present and describe halfway house and foster home care as a form of community placement for male veteran patients? (2) Do the 30 veteran patients who have made a successful adjustment in the foster home care differ significantly from the 30 veteran patients who have made a successful adjustment to halfway house care when distributed on 10 selected social or baseline characteristics? (3) Do any of the 9 hospital and 8 military items significantly differentiate the patients in foster home care from the patients in halfway house care? (4) How do the 7 community placement adjustment items differentiate the two sub-samples? / Typescript. / "June, 1961." / "Submitted to the Graduate School of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Dorothy D. Hayes, Professor Directing Study. / Includes bibliographical references (leaves 65-66).

This is an exploratory follow-up study of the clientele of the Psychiatric Crisis Unit, a short-term, crisis-oriented inpatient psychiatric ward. The main objective of the research was to test the following null hypothesis: there are no significant differences between those individuals who attempt to gain aftercare treatment as opposed to those individuals who do not following discharge from the Crisis Unit. A sample of fifty-one voluntary patients who consented to participate in the study was used in testing this hypothesis. Each subject completed the Minnesota Multiphasic Personality Inventory (M.M.P.I.) and a sociological questionnaire while in the Crisis Unit, and a follow-up questionnaire was administered via telephone or personal contact approximately one month after discharge. The follow-up information was used to determine whether the subject fell into the "aftercare” or “no-aftercare” group. Data collection lasted from July 1, 1970 to December 15, 1970. The data revealed that there were significant differences between the groups and, thus, the null hypothesis was rejected. The ten M.M.P.I. scales revealed no significant differences between the groups on the individual scales. However, when examined collectively, the aftercare group scored higher than the no-aftercare group on all scales except Self-Sufficiency (which is scored in the opposite direction, corroborating the tendency in the other scales). A discriminant function correctly classified seventy-three percent of the subjects. These results indicate that the aftercare subjects probably viewed themselves as “needing” more help. The significant predictor variables found included prior familial and personal experiences similar to those bringing the subject to the Unit, employment status, age, diagnostic designation, length of hospitalization, referral planning, and self-ratings on a mood scale which was administered upon discharge from the Crisis Unit. These variables were obtained with less effort than the psychological test data. It was found that the aftercare group (compared to the other group) was younger, had a higher rate of unemployment, and had a higher rate of familial and prior personal experiences. They were also diagnosed more frequently as psychotic, with depression ranking second, and rated themselves lower on the mood scale scores. However, the difference between the before and after mood scale scores revealed that these subjects felt they had “gained” more than the no-aftercare subjects. The no-aftercare group was diagnosed more frequently as depressed, with behavior/character disorders ranking second. They tended to rate themselves higher on the mood scale scores. However, the differences between the before and after mood scale scores revealed that they had not “progressed” as much as the aftercare subjects. Although not statistically significant, it was found that the aftercare subjects were hospitalized two days longer than the subjects of the no-aftercare group. More significant is the fact that the aftercare group had a higher rate of rehospitalization than the no-aftercare group. Data collected concerning the referral process revealed that aftercare subjects were more frequently referred for treatment than were subjects of the no-aftercare group. It was speculated that those subjects who perceived themselves and/or were perceived as being "sicker" would seek further help after discharge from the Crisis Unit. The findings also suggested that not all patients need or perceived themselves as needing further help.

No description available.

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

Not available / text

published_or_final_version / Medicine / Master / Doctor of Medicine

No description available.

There is growing evidence of the important role that family members play in the support and recovery of individuals diagnosed with a serious mental illness. The National Alliance for the Mentally Ill (NAMI) Provider Education Program (PEP) trains providers of mental health services to work collaboratively with families in the treatment of individuals with a mental illness. This study examines the effect of the NAMI-PEP on Assertive Community Treatment (ACT) provider representations of and services provided to families at Frontenac Community Mental Health Services. Qualitative and quantitative methods of research are combined to explore ACT provider beliefs about, feelings toward and services provided to families before and after participating the NAMI-PEP. Findings suggest that the NAMI-PEP is effective in initiating changes in provider representations of family at a cognitive level. Changes in provider views are detected indicating movement toward a strengths-based orientation and an improved understanding of the components of collaborative practice with families. Analysis of changes to ACT practice patterns illuminates the challenges of implementing cultural change at an organizational level and identifies a fertile area for further research.

Since the deinstitutionalisation of chronic mentally ill patients, there has been an increase in the number of relapsed chronic mentally ill patients who become acutely mentally ill and need to be re-admitted for acute care in psychiatric institutions. Professional nurses working at rural primary healthcare clinics find it difficult to care for these individuals because they lack the necessary knowledge and skills. Chronic mentally ill patients who have been admitted to acute care facilities are stabilised by rendering care, treatment and rehabilitation and then released into the care of the professional nurses working at rural primary healthcare clinics. These patients live in the community and have to make use of the primary healthcare clinics nearest to their homes to provide them with their prescribed medication and care. Furthermore the patients’ mental conditions do not always remain stable, possibly because of a knowledge deficit, at times about their mental status. Patients may become non-compliant, resulting in the recurrence of symptoms, and thus need to be re-admitted to the acute care facility. However, the problem leading to re-admission is not clear for all admissions. It may be that patients do not make use of the primary healthcare clinics. It also seems that the professional nurses in the primary healthcare clinics are unfamiliar in dealing with chronic mentally ill patients living in rural communities. The aim of this study was therefore, to explore and describe the experiences of these professional nurses in caring for chronic mentally ill patients living in a rural community. The researcher used qualitative, explorative, descriptive, and contextual research design. The research population consisted of professional nurses working at primary healthcare clinics. Non-probability purposive sampling was used to identify participants for inclusion in the study. Data collection was conducted using one-on-one, semi structured interviews, observations and field notes and interviews were tape-recorded and transcribed. Data analysis was conducted using Tesh’s method of content analysis to identify themes and sub-themes. A literature control was done to compare the findings to the current published research. Trustworthiness was ensured by using Gubas’s model (1985) of trustworthiness. A pilot study, conducted by interviewing a small sample prior to the start of the main study, determined whether the sampling and interviewing techniques of the researcher as well as the research questions were adequate for data collection. The researcher ensured that the study was of a high ethical standard by taking into consideration values that guide the principles of autonomy, beneficence, non-maleficence and justice. The findings of the study was categorised into three main themes and 13 sub-themes. The main themes were as follow: Professional nurses experience problems when they have to take care of psychiatric patients attending rural primary healthcare clinics. This theme had six sub-themes which were discussed in details in chapter three. The second theme was that professional nurses experience that psychiatric patients in rural communities experience problems which affected their well-being. This second theme has got five sub-themes which were discussed further in chapter three. The last theme was that professional nurses have positive experiences when caring for psychiatric patients in rural communities. This theme has got two sub-themes as well discussed further in chapter three.

Of the several techniques reported for the treatment of self-injurious behavior, response-contingent aversive stimu-lation and overcorrection seem to be the most successful. However, many procedures are precluded from use by legal or other restrictions. Thus, many procedures that are both ethnically and aesthetically tolerable to practitioners and the public must be developed. Facial screening (Lutkzer & Spencer, Note 1; Zegiob, Becker & Bristow, Note 2; Lutzker, Note 3), applying a terrycloth bib to cover the face contingent upon self-injurious behavior, has been shown to be effective. The purpose of this study was to investigate the parameters of facial screening with two subjects. Specifically investigated were: a) the role of non-contingent v~. contingent facial screening in therapy and extra-therapy setting; and b) the role of opaque vs. translucent bibs. In the first study, using a multiple baseline design, it was found that non-contingent facial screening was effective only after a history of pairing with contingent facial screening. While non-contingent facial screening reduced self-injurious behavior in two settings, it did not eliminate self-injurious behavior in all three settings in which it was observed. In the second study a reversal design-component analysis was used to compare a translucent to an opaque bib. The translucent bib was ineffective in reducing the self-injurious behavior while the opaque bib eliminated self-injurious behavior as long as facial screening was applied consistently.