Thesis (M.S.W.)--University of Hong Kong, 1976. / Typewritten.

published_or_final_version / Architecture / Master / Master of Architecture

Thesis (Ph .D.)--York University, 1998. / Typescript. Includes bibliographical references (leaves 376-384).

Thesis (M.S.)--University of Michigan, 1969.

Thesis (M.S.)--University of Michigan, 1969.

Professional literature in the past five years regarding the care and treatment of deinstitutionalized chronic mentally ill (CMI) persons has presented growing concerns that services for some CMI persons are inadequate or nonexistent. A number of previous authors have suggested that there may be a consistent, as opposed to a random, bias in the traditional mental health service delivery system whose services are contingent upon client characteristics that, in the very least, assume foresight, independence, initiative, and consistency. Lacking these qualities, clients may not seek services to which they are entitled or they may be frustrated in maintaining those services. This study provides a description of a CMI population (n = 142) that received outreach services from a small county psychiatric hospital. These clients were selected because they were evaluated as severely disturbed, potentially impulsive, and had a history of not following through with traditional mental health services, i.e., they did not make or keep prescribed appointments for therapy or education. This group served as a model against which to compare characteristics of the traditionally engaged clients. Previous authors as well as this study found that the dropout populations were younger, less compliant with prescribed anti-psychotic medication, engaged in more alcohol and drug use, were more likely to live independently and to be rehospitalized with greater frequency. Increased hospitalization also correlated with less functional independent living skills. In other reported research several variables were found to discriminate the younger CMI. This study could only confirm an increase in substance abuse although several confounding factors are discussed. Finally, the outreach program itself was examined, some services were quantified, and some were related to specific client characteristics. For instance, 40 percent of this CMI population was primarily reliant on their outreach worker for all transportation beyond walkable distances; and those clients receiving the most number of outpatient visits were those rated most rejecting of services and those with the poorest independent living skills. The treatment population was found to have reduced their total number of admissions and days hospitalized during the two-year period of investigation.

No description available.

This study was designed to investigate the possibility of relationships among sociometric status, prognosis, and selected personality variables of state hospital patients.

Two related program evaluations of the mental health system in Puerto Rico are conducted. Initially, research is carried out in two state psychiatric hospitals involving an organizational analysis of relevant systems variables as they impinge upon effective institutional functioning. In this scheme hospital effectiveness is predicted by success in achieving formally prescribed goals and in the adequacy of resource utilization. The basic assumption is that the psychiatric hospital reflects the patterning of reciprocal and interdependent behaviors of individuals which form a larger all-important pattern. The hospitals are studied by means of a questionnaire administered to staff to ascertain perceptions of the work environment, communication and coordination processes, overall hospital organization, and the treatment environment. The results of organizational functioning are presented in a profile analysis plotting institutional means over ten functional dimensions. Individual component variables are converted into standard scores and broken down by staff sub-groups. Each institution and staff sub-group differs uniquely across the dimensions. Overall the results point to excessive staff frustration and disillusionment with the organization's functions, and a treatment environment limited in patient autonomy, socio-emotional interaction, and therapeutic content. The complementary study of first releases from these hospitals examines background and performance characteristics of a sample of patients in an effort to distinguish those who complied with aftercare referrals from those who did not, and those who were readmitted from those still in the community one year after release. Bivariate analysis of the relationship between each of the two dependent variables and the several demographic and treatment variables at each hospital reveals that the strongest differentiation of compliers from non-compliers is having been active in pre-hospital outpatient care, while the extent of use of aftercare was the strongest predictor of remaining in the community. Implications for policy and for further research in mental health service delivery are discussed.

Between 1955 and 1985 the United States reduced the population confined in its public mental hospitals from around 600,000 to less than 110,000. This dissertation provides a novel analysis of the movement that advocated for psychiatric deinstitutionalization. To do so, it reconstructs the unfolding setting of the movement’s activity historically, at a number of levels: namely, (1) the growth of private markets in the care of mental illness and the role of federal welfare policy; (2) the contested role of states as actors in driving the process by which these developments effected changes in the mental health system; and (3) the context of relevant events visible to contemporaries. Methods of computational text analysis help to reconstruct this social context, and thus to identify the closure of key opportunities for movement action. In so doing, the dissertation introduces an original method for compiling textual corpora, based on a word-embedding model of ledes published by The New York Times from 1945 to the present. The approach enables researchers to achieve distinct, but equally consistent, actor-oriented descriptions of the social world spanning long periods of time, the forms of which are illustrated here. Substantively, I find that by the early 1970s, the mental health system had disappeared from public view as a part of the field of general medicine — and with it a target around which the existing movement on behalf of the mentally ill might have effectively reorganized itself. Drawing together the case and the method, conceptually, is the idea of a standpoint: a framework within which objects obtain significance.