The increased abscondment of Mental Health Care Users from institutions of care, treatment and rehabilitation has prompted the researcher to conduct the study because patients who are not visited do not stand a chance of getting a Leave Of Absence (LOA). Problem: The concern is the danger of assault, murder, rape and other high risk situations the mentally ill individuals and the community are exposed to, which is caused by frequent abscondment of mentally unstable individuals who roam around the community without proper treatment and care. This is caused by failure of the relatives in coming to request patients for leave of absence (LOA). Purpose: The study investigated the effects of mental illness on relationships amongst families with the mentally ill members. The number or frequency of visitations by relatives to the mental health institutions is used by the researcher, to measure the nature of relationships between families and the psychiatric patients related to them. Method: The population comprised families of the mentally ill persons admitted at Cecilia Makiwane mental health units. The sample was collected conveniently as relatives came to visit the mentally ill until the desired number was reached. The designed tool was a questionnaire which was self administered. Data were analysed manually. Tables and graphs are shown in the results. Conclusion and Recommendations: The study revealed that approximately 100% of respondents had a lack of knowledge about mental illness and the mentally ill, in terms of care, treatment and rehabilitation hence they all need assistance in dealing with the mentally ill in the community. Findings also revealed that mental illness causes breakdown in family relationships. Recommendations regarding the enhancement of relationships between families and their mentally ill members are formulated as coping skills in the dissertation. The burden of having to deal with mentally ill person whose illness is not understood can lead the family to a state of confusion and iv not knowing what to anticipate. Lack of resources compounds the problem as the family members are not able to visit the ill member due to lack of funds (Baumann, 2007:637). The families with a mentally ill member usually shoulder the greatest part of the burden of mental illness (Uys and Middleton, 2004:77); unfortunately, lack of resources pose a problem.

Adolescents who were admitted to the Adolescent Psychiatric Unit at Vancouver General Hospital for assessment between 1981 and 1983 who were queried to be in the process of developing a long term psychotic illness were followed retrospectively after five to seven years. At the time of assessment the subjects were between 13 and 16 years of age. The study was intended to act as a pilot project for a larger study. In tune with a biopsychosocial emphasis, outcome was defined as a multi-directional and multi-dimensional concept, involving both positive and negative outcomes in a variety of dimensions. Independent variables were drawn from a structured interview which pertained to the subjects' experience with family relationships, peer relationships, use of treatment resources, educational and employment achievement, drug and alcohol usage, legal difficulties, and quality of life issues since their hospitalization. Three structured outcome measures were used as dependent variables. These included scales which assessed current levels of family functioning, satisfaction and happiness, and community adjustment. Bivariate analysis was conducted using SPSSX:3. The resulting description of the population indicated a heterogeneous group with a variety of outcomes. Although some of the subjects fit the profile for chronic mental illness, diagnosis did not predict outcome. Positive outcome appeared to be associated with stability in overall family functioning, and in particular with the subjects' reports of a positive relationship with their fathers; with the ongoing use of treatment resources; with ease in establishing peer relationships; with self-motivatioin in the area of employment; and with the ability of subjects to move from alternate school settings back into the regular system. Subjects who described their families as having problems with control issues and with task accomplishment appeared to have had trouble in a number of areas during the intervening couse. Acceptance of the need for ongoing treatment was associated with the subjects' characterization of their families as being within norms for social values and norms at the time of outcome, suggesting the tendency of families and treatment personnel who have similar values to ally. Subjects who had had minimal or sporadic contact with treatment resources described their families as being weak in most areas of functioning, and in particular in the area of values and norms. The findings suggest several avenues for further exploration in a larger study. They also support a consideration by treatment resource personnel of the need to involve families as resources in the treatment process, and point to areas in which treatment interventions can be made. / Arts, Faculty of / Social Work, School of / Graduate

The pattern of frequent discharges and readmissions which characterizes most psychiatric hospitalization in this country today was described, and it was argued that the costs of this “revolving door” outweigh such benefits as might be derived from it. An alternative stepwise progression model of aftercare was proposed. This model identified community tenure as the most appropriate goal for initial aftercare efforts. Attempts to identify correlates of the establishment of community tenure by mental hospital releasees were reviewed. It was found that the ex-patient's ability to remain in the community is not highly correlated with the extent to which he manifests deviant behavior. This finding was interpreted as an indication that environmental factors may play significant part in ex-patients’ avoidance of rehospitalization. Data were presented which indicated that a clear majority of mental hospital releasees take up residency immediately with family members. It was hypothesized, then, that measurable family variables are correlated with the ability of the ex-patient to achieve community tenure. An attempt was made to examine this hypothesis in the light of relevant research. Studies of the issue which contained substantive empirical support were categorized into four topic areas: family tolerance of the ex-patient's symptomatic behavior, kin role which the family affords to the ex-patient, familial expectations of the ex-patient's performance, and family attitudes and personality characteristics. After reviewing the studies of authors who attempted to assess the degree of correlation between the capacity of the ex-patient’s family to tolerate symptomatic behavior on the part of the ex-patient and the ex-patient’s ability to avoid rehospitalization, it was concluded that the linear correlation between the two variables which would be predicted logically may not exist. A review of studies of the relationship between the kin role which the ex-patient's family affords to him and the ex-patient's ability to achieve community tenure yielded a tentative conclusion that returning to the social biological role of “child” (son or daughter) as opposed to the kin role of spouse was positively correlated with remaining in the community. After examining studies which attempted to explore the relationship between familial expectations of instrumental performance on the part of the ex-patient and the ability of the ex-patient to avoid rehospitalization, it was concluded that little support was provided for the hypothesis that the two variables are related. A survey of attempts to identify family attitude and personality characteristic correlates of ex-patient achievement of community tenure resulted in arrival at the conclusion that such efforts, as a whole, have met with little success, although significant correlations between two general family attitudes toward mental illness and ex-patient avoidance of rehospitalization were found. Considering the findings which were reviewed as a whole, it was concluded that little support was provided for the hypothesis that measurable family variables are correlated with the ability of the ex-patient to achieve community tenure. The rather limited aftercare practice applications which could be drawn from the few correlations that have been discovered were described, and implications of the over-all finding for future research were discussed.

This study seeks to explore the challenges and difficulties faced by children raised by a parent with bipolar disorder, with a specific focus on the experiences and memories of daughters of these individuals. Bipolar disorder, previously known as manic-depressive illness, is characteristically referred to as an episodic, yet lifelong and clinically severe affective (mood) disorder. Bipolar disorder is a severe mental illness, which is stressful not only for patients, but also for family members. Very little work has been done to define more precisely the family burden associated with the illness. Studies that do focus on the impact of bipolar disorder on caregivers or families of the patient have looked at the family as a whole. There seems to be a scarcity of research looking at the experiences of children of parents with bipolar disorder. The children of individuals with bipolar disorder are at high risk for developing a range of mental disorders. Overall, parents with bipolar disorder tend to create a familial environment that is unstable and lacking in structure. Therefore in addition to being at genetic risk for the development of mental disorders, are exposed to a stressful familial environment that increases the risk of psychopathology and difficulties. Despite the importance of assessing the impact parental bipolar disorder can have on children, there is a lack of relevant literature. A non-probability sample of eight female individuals raised by a parent with bipolar disorder was selected from the student population at Wits University. Semi-structured face-to-face interviews were used to gain in depth information regarding the memories and experiences of these individuals. One interview was conducted per participant. Once the data was collected, thematic content analysis was used in order to analyse and draw conclusions from the data. From this method of analysis ten main themes were found, as well as six sub themes. The findings of this study suggest that bipolar disorder has a profound effect, not only on the individual suffering from the illness, but on their children as well. Manic episodes appear to be a particularly stressful time, featuring with great prominence in the memories of respondents. Participants felt strongly that their family environment was affected by their parent’s illness. In general it seemed as if participants with ill mothers described a far more chaotic family environment as compared to those participants with ill fathers. This study also found that knowledge and understanding help these individuals make sense of their parent’s illness, seemingly providing a sense of power and control. A number of participants mentioned the negative effects that stigma associated with mental illness has on the families concerned, often leading to adverse outcomes. In contrast to this, support and understanding by both healthcare professionals as well as the broader community is considered indispensable. The children of patients with bipolar disorder, in addition to being at genetic risk for the development of mental disorders, are exposed to a stressful environment that increases the risk of psychopathology and other difficulties. It is therefore imperative that further research be conducted in this area, as relatively little is known about the long term effects of the parent’s illness on their child.

Lam, Yin Hung. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (p. 89-97). / Abstracts in English and Chinese. / ABSTRACT --- p.iii / 摘要(ABSTRACT IN CHINESE) --- p.iv / ACKNOWLEDGEMENTS --- p.v / TABLE OF CONTENTS --- p.vi / TlST OF TABLES --- p.viii / LIST OF FIGURES --- p.ix / LIST OF APPENDIX --- p.x / Chapter CHAPTER I: --- INTRODUCTION --- p.1 / PSYCHOTIC DISORDERS --- p.1 / EXPRESSED EMOTION & RELAPSE OF PSYCHOTIC DISORDERS --- p.2 / POSITIVE EXPRESSED EMOTION COMPONENTS --- p.3 / ASSESSMENT TOOLS OF EXPRESSED EMOTION --- p.5 / CULTURAL CONSIDERATIONS OF EXPRESSED EMOTION --- p.7 / PSYCHOSOCIAL WELL-BEING OF PPD --- p.10 / RECOVERY: EMPOWERMENT & LIFE SATISFACTION --- p.11 / EMPOWERMENT --- p.13 / LIFE SATISFACTION --- p.14 / PSYCHOSOCIAL WELL-BEING OF RELATIVES --- p.14 / AIMS OF STUDY --- p.15 / HYPOTHESES OF STUDY --- p.16 / Chapter CHAPTER II: --- METHOD --- p.17 / PARTICIPANTS --- p.17 / MEASURES --- p.21 / PROCEDURE --- p.33 / Chapter CHAPTER III: --- RESULTS --- p.33 / INTER-RATER RELIABILITY OF FMSS CATEGORIZATIONS --- p.33 / NEGATIVE AND POSITIVE EE SCORES --- p.34 / RELATIONSHIP BETWEEN OVERALL EE AND SUB-EE --- p.36 / RELATIONSHIP BETWEEN FMSS AND SELF-REPORT MEASURES --- p.38 / "RELATIONSHIP BEWTEEN DEMOGRAPHIC CHARACTERISTICS, SELF-REPORT EE AND OUTCOME VARIABLES" --- p.39 / RELATIVES' EE: BREAKDOWN BY DEMOGRAPHIC CHARACTERISTICS --- p.43 / COVARIATES RELATED TO PPD´بS LIFE SATISFACTION CONTROLLED FOR --- p.47 / RELATIONSHIP BETWEEN RELATIVES´ة EXPRESSED EMOTION AND PSYCHOSOCIAL WELL-BEING OF RELATIVES AND PPD --- p.49 / PROPOSED MODEL (MODEL 1): SELF-REPORT AND FMSS --- p.49 / REFINED MODEL (MODEL 2): SELF-REPORT AND FMSS --- p.52 / FINAL MODEL (MODEL 3 A): SELF-REPORT AND FMSS --- p.56 / ALTERNATIVE MODEL (MODEL 3B): SELF-REPORT AND FMSS --- p.61 / Chapter CHAPTER IV: --- DISCUSSION --- p.67 / EXPRESSED EMOTION --- p.68 / SCORING SCHEME FOR EE --- p.68 / FMSS EE CATEGORIZATION --- p.68 / FMSS & SELF-REPORT OVERALL & SUB-EE --- p.69 / RELATIONSHIP BETWEEN FMSS & SELF-REPORT EE --- p.71 / "RELATIONSHIP BETWEEN DEMOGRAPHICS, SELF-REPORT EE & OUTCOME VARIABLES" --- p.71 / COVARIATES RELATED TO PPD，S LIFE SATISFACTION --- p.73 / "RELATIONSHIP BETWEEN RELATIVES, EE AND PSYCHOSOCIAL WELL-BEING OF RELATIVES & PPD" --- p.74 / OVERALL COMPARISON BETWEEN FMSS & SELF-REPORT MODELS --- p.78 / IMPLICATIONS --- p.79 / LIMITATIONS OF THE STUDY AND FUTURE DIRECTION --- p.82 / REFERENCES --- p.89

The purpose of this secondary analysis of Malone's (1993) study was to identify formal and informal resources used by families with an adult son with chronic mental or physical illness. It also explored the identified perceptions of health care providers by the families in this study. This study was guided by the Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin & McCubbin, 1993).The sample population was patients who were receiving outpatient care from Valley Mental Health Center and University Hospital Neurology Clinic in Salt Lake City, Utah, and families which met certain criteria. The data of 42 respondents of the original 68 in Malone's (1993) study were perused for trends and themes about the use of formal and informal resources and perceptions of health care professionals using the process of secondary analysis.Findings revealed that the outpatients and families used six formal resources and seven informal resources. Family resources accounted for 44 percent of the total utilization of informal resources by the respondents. Hospital/clinics accounted for 24.3 percent of the total formal resources used by the respondents. Findings also revealed that perceptions of health care professionals by the respondents was negative.With the increase of chronic illnesses, the recommendations and implications for nursing identify that patient education in the future will undoubtedly be the most vital and crucial component to an individual's success/failure to adjust to the chronic illness. With the additional knowledge base, prevention of unnecessary anxiety related to the chronic illness would promote a more positive environment for the patient. In addition, both the patient and family could make that smooth transition into the adaptation phase and function effectively with the chronic mental or physical illness. / School of Nursing

Thesis (MA (Psychology))--University of Stellenbosch, 2006. / An immense burden is placed on families caring for a member with a mental disorder as a result of deinstitutionalisation in South Africa. The aim of present study was to identify resilience factors in families living with and caring for a member with a mental disorder. The focus was on families living in an underprivileged, semi-rural area; caring for a patient using the state-sponsored psychiatric services. Using a cross-sectional survey design, interviews were conducted with 34 family representatives. During these interviews, qualitative and quantitative data was gathered by means of a biographical questionnaire, an open-ended question and set of self-report questionnaires. The results yielded from the data analysis are in keeping with findings from international and South African family resilience studies. After content analysis of the qualitative data, three themes related to resilience factors emerged: internal factors within the home, external factors outside of the home and factors related to the member with a mental disorder. The most commonly mentioned resilience factors cited by the family representative were religion and spirituality, characteristics of individual family members (excluding the patient), family characteristics, and social support. Spearman’s correlations and best subsets multiple regression analysis were performed on the data to ascertain which factors are significantly correlated or associated with family adaptation. In both statistical analyses, communication styles of the family unit were the most important. Spearman’s correlations further revealed that in addition to family communication, the ability of the family to work together, and communication between the marital couple had the strongest correlation with adaptation. Passive acceptance of problematic issues in the family has a negative correlation with family adaptation. The two most significant predictor variables of family adaptation are the family’s style of family communication during crises and the family’s use of passive appraisal as a coping style.

published_or_final_version / Social Work / Master / Master of Social Work

Aim: The aim of this study was to explore the lived experiences of reintegration into the community of mental health care users in the Libode district. Methodology: A phenomenological approach was used in this study to explore the lived experiences of reintegration into the community of mental health care users. It describes the feelings experienced by mental health care users concerning their reintegration into the community, and explores barriers to their reintegration into the community. The study was conducted in the Libode mental health clinic in the Libode district. A total of six participants volunteered to participate in the study. The interviews were audio-taped then transcribed. The data were manually analysed using Tesch’s approach of phenomenological analysis. Findings: The results of the study revealed that the participants were not living independent lives following their discharge from the mental health institution. The evidence suggests that the environment is not conducive to meeting the needs of mental health care users. They lack support from families and communities which impacted on them negatively, contributing to the high relapse and readmission rate. This study explores the barriers to their reintegration into the community such as the following: poor medication compliance, lack of vocational skills, unemployment, substance abuse, stigma and discrimination which were the main barriers to their reintegration into the community. The study consequently makes recommendations for practice and policy which can contribute to an improved quality of service delivery. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2010.

The purpose of this study was to explore the role of family members in support of their relatives who are mentally ill and to develop guidelines for the support of mentally ill relatives by their families in a rural community. The research design was qualitative, explorative, descriptive and contextual. The research population consisted of families of mentally ill relatives collecting their monthly medications at the Jane Furse Gateway Clinic. Purposive sampling was used to draw the sample. Data was collected by individual in-depth semi-structured interviews that were tape-recorded. The study revealed that families provide physical, psychosocial, financial and developmental support to their relatives. Furthermore, families are faced with frustrations when providing support to their mentally ill relatives / Health Studies / M.A. (Health Studies)