"The purpose of this study was to collect and compile data for prognostic purposes in determining which clients probably will not continue in treatment until--in the opinion of the agency--'services are completed.' It was hoped that this guide would be helpful in selecting those clients to whom to offer further service. Also, it might be useful in modifying agency policies and procedures to better meet the needs of those people who cannot use the services as presently offered"--Introduction. / Typescript. / "May, 1958." / "Submitted to the Graduate Council of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: David L. Levine, Professor Directing Study. / Includes bibliographical references.

This study was intended to determine the architectural characteristics of a built environment that makes a positive contribution to the effective treatment of addictions and associated mental illnesses. Buildings affect people both physically and psychologically: Architects and interior designers create retail spaces that increase sales, restaurants that stimulate appetite and offices that maximise productivity. But do they design mental health-care facilities that improve treatment and recovery? Surely, given the nature of its function, this building typology is the most deserving of attention with regard to the subject of ‘environmental psychology’. On the contrary however, mental health-care has a history of inadequacy when it comes to the buildings that have been constructed to facilitate it: During the middle of the twentieth century – particularly in Great Britain and the United States of America – state ‘mental asylums’ housed hundreds of people in oppressive, inhumane buildings, remote from their communities. Derelict asylums bear testimony to the ‘de-institutionalism’ movement that followed, favouring out-patient care in the community context. On the other hand however, homeless, destitute addicts and mentally ill individuals tell of the shortcomings of community-based care. Current medical insights have now led to a new concept of ‘balanced-care’, which calls for the integration of in-patient and out-patient treatment. This new approach provides an opportunity for architects to re-define the mental healthcare facility – to humanise the institution and create treatment environments that contribute positively to recovery. The purpose of this study was therefore to establish a sound understanding of the unique needs of this particular user group, to interpret the implications of these needs with regard to the design of the treatment environment, and to assess the appropriateness of existing facilities in terms of these findings. The research was carried out by way of consultation with local mental health-care professionals, a review of existing literature on the subject, and relevant precedent and case studies. The outcome was a set of principles and criteria to inform the design of a new addiction and mental health clinic in Durban. / Thesis (M.Arch.)-University of KwaZulu-Natal, Durban, 2011.

M.Cur. / Violence stalks the streets of our erstwhile civilised cities and towns, and has also involved too many homes, transforming them from places of protection into pits of powerlessness and victimization. No immunization to this epidemic is afforded by culture, social class, economic states, education or ever religious affiliation. It is time to lift the shroud of silence and to shine the spotlight of truth on this social dilemma (Couden, 1999: 5). This research begins with the journey of awareness, which is intended to lead to healing, mental health and wholeness for the victimised women. It is intended to give victimised women a voice, since they are the experts of their own lives. Through sharing of their experiences, it is hoped that such awareness will positively impact our families, communities, churches and the wider society. The objectives of this research are to: • Explore and describe the experiences of victimised women of group interventions in a psychiatric clinic. • Formulate guidelines for the promotion of mental health of victimised women of group interventions. • In phase one of the research, the researcher made conclusions that the group interventions had an effect on victimised women. Group interventions enabled these women to understand that they can do something about being victimised. The main themes that came out were ventilating of emotions, support for each other in the group interventions, a sense of being empowered and a sense of forgiveness towards their perpetrators. In phase two guidelines were described for the advanced psychiatric nursespecialist to facilitate and promote the mental health of victimised women. An empowerment programme based on the suggestions given by Goodman and Fallon (113) described on the survey list by Dickoff et al (1968: 423). Conclusions, limitations and recommendations for the nursing practice, nursing education and research in nursing have been made.

The ability to monitor client change in psychotherapy over time is vital to quality assurance in service delivery as well as the continuing improvement of psychotherapy research. Unfortunately, there is not currently a comprehensive, affordable, and easily utilized outcome measure for psychotherapy specifically normed and standardized for use in psychology training clinics. The current study took the first steps in creating such an outcome measure. Following development of an item bank, factor analysis and item-response theory analyses were applied to data gathered from a stratified sample of university (n = 101) and community (n = 261) participants. The factor structure did not support a phase model conceptualization, but did reveal a structure consistent with the theoretical framework of the research domain criteria (RDoC). Suggestions for next steps in the measure development process are provided and implications discussed.

Department of Advanced Nursing Science / MCur

Les antipsychotiques de seconde génération (ASG) peuvent induire des effets métaboliques tels qu’une prise de poids, des troubles cardio-métaboliques, des effets endocriniens et dans de très rares cas une mort soudaine d’origine cardiaque. Les effets indésirables métaboliques potentiels des ASG doivent être surveillés. L’Alliance canadienne pour la surveillance de l’efficacité et de l’innocuité des antipsychotiques (CAMESA) propose des lignes directrices à cet effet. Les objectifs de cette étude rétrospective sont d’évaluer, à long terme, les taux d’enfants et d’adolescents recevant pour la première fois un ASG bénéficiant d’un monitoring dans les cliniques de santé mentale et de documenter les facteurs qui peuvent les influencer. À cet effet, les dossiers médicaux de 180 enfants et adolescents (âge moyen 13,3 ± 3,1 ans, 54,4 % garçons), traités pour la première fois par ASG entre janvier 2016 et juin 2018, ont été examinés. Les périodes de monitoring ont été divisées en baseline, de 1 à 6 et de 9 à 24 mois. La population étudiée a été stratifiée en enfants (4- 12 ans) vs adolescents (13-18 ans). Les caractéristiques sociodémographiques, le diagnostic psychiatrique et les comorbidités, les types d’ASG et les comédications prescrites, les mesures anthropométriques (MA), la pression artérielle (PA), les bilans sanguins (BS), l’électrocardiogramme (ECG) et les années de pratique du psychiatre ont été collectés. Des tableaux croisés ont été utilisés pour présenter les taux de monitoring. Les catégories ont été comparées par analyse de co-variable. Les taux de patients monitorés ont été comparés à travers les catégories de monitoring, en ayant recours au test exact de Fisher. Nos résultats démontrent des taux de monitoring pour MA, BS et PA de : 55 %, 47,8 % et 46,7 % au baseline ; 50 %, 41,7 % et 45,2 % à 1-6 mois ; et 47,2 %, 41,5 % et 40,6 % à 9-24 mois, respectivement. Des taux de monitoring plus élevés étaient associés de manière significative au statut d’adolescent (MA, BS et PA au baseline ; MA et PA à 1-6 mois), à un diagnostic de trouble psychotique et / ou affectif (MA, BS et PA au baseline ; MA et PA à 1-6 mois; BS à 9-24 mois), avoir ≤ 1 comorbidités psychiatriques (BS à 1-6 mois), et à l’expérience du clinicien (BS et ECG à 1-6 mois). En conclusion, cinq ans après les recommandations de CAMESA, le monitoring métabolique est effectué chez moins de la moitié des patients et diminue tout au long de la durée du traitement. Dans notre échantillon, les catégories d’âge, de diagnostic, de comorbidités psychiatriques et d’expérience du clinicien ont influencé les taux de monitoring. Toutefois, des progrès importants doivent encore être réalisés pour parvenir à un taux de monitoring satisfaisant. / Second generation antipsychotics (SGA) can induce metabolic effects such as weight gain, cardiometabolic disorders, endocrine effects and in very rare cases sudden cardiac death. The potential metabolic side effects of second generation antipsychotics need to be monitored. The Canadian Alliance for Monitoring the Efficacy and Safety of Antipsychotics (CAMESA) offers guidelines for this purpose. The objectives of this retrospective study are to evaluate, the long-term rates of youths receiving monitoring in mental health clinics and document the factors that may influence them. To this end, the charts of 180 children and adolescents (average age 13.3 ± 3.1 years, 54.4 % males) receiving SGA treatment for the first time between January 2016 and June 2018 were reviewed. Monitoring was divided into baseline and 1 to 6 and 9 to 24-month periods. The population under study was stratified into children (4-12 years) vs adolescents (13-18 years). Sociodemographic characteristics, psychiatric diagnosis and comorbidities, prescribed SGAs and comedications, anthropometric measurements (AM), blood pressure (BP), blood tests (BT), electrocardiogram (ECG) and the psychiatrist’s years of practice were collected. Cross tables were used to present the monitoring rates. Categories were compared by covariate analysis. Rates of patients monitored across categories were compared using Fisher’s exact test. Our results show that monitoring rates for AM, BT, and BP were: 55 %, 47.8 %, and 46.7 % at baseline, 50 %, 41.7 %, and 45.2 % at 1 to 6 months, and 47.2 %, 41.5 %, and 40.6 % at 9 to 24 months, respectively. Higher monitoring rates were significantly associated with adolescent status vs child (baseline AM, BT, and BP; 1-6-month AM and BP), a diagnosis of psychotic and/or affective disorder (baseline AM, BT, and BP; 1-6-month AM and BP; 9-24-month BT), having ≤ 1 psychiatric comorbidities (1-6-month BT), and clinician’s experience (1-6-month BT and ECG). In conclusion, five years after publication of the CAMESA guidelines, metabolic monitoring is conducted for less than half of patients and decreases over time. In our sample, age, diagnostic category, psychiatric comorbidities, and clinician’s experience influenced the monitoring rates. Major progress still needs to be made before reaching a satisfactory level of monitoring.

This study looks at two community mental health facilities. The one setting is that of a state aided organisation, while the other is a non-government organisation (NGO). These two settings are contrasted in terms of how they conceptualise the concept 'community', their physical settings and facilities, and the activities and processes at each setting. The differences in the day-to-day operational processes, and activities according to their respective philosophies - psychiatric medical model and ecological model - are explored and captured from the participants through utilising qualitative data gathering methods such as interviews, observations and the personal experiences of the researcher. The information obtained from each participant in both settings reflect how they think, feel and behave towards their work. This information contributes to an understanding of how community mental health clinics operate. Finally the recommendations are of how work could be done differently, making them both more community orientated. / M. A.(Clinical Psychology)

This study looks at two community mental health facilities. The one setting is that of a state aided organisation, while the other is a non-government organisation (NGO). These two settings are contrasted in terms of how they conceptualise the concept 'community', their physical settings and facilities, and the activities and processes at each setting. The differences in the day-to-day operational processes, and activities according to their respective philosophies - psychiatric medical model and ecological model - are explored and captured from the participants through utilising qualitative data gathering methods such as interviews, observations and the personal experiences of the researcher. The information obtained from each participant in both settings reflect how they think, feel and behave towards their work. This information contributes to an understanding of how community mental health clinics operate. Finally the recommendations are of how work could be done differently, making them both more community orientated. / M. A.(Clinical Psychology)

MCur / Departrment of Advanced Nursing Science / In mental health, a Maximum-Security Ward is a special setting for care of patients who are unique and exceptional. People who have committed crimes due to their mental conditions are admitted for care, treatment and rehabilitation. Patients admitted in this ward are verbally and physically aggressive, violent, unpredictable, unmanageable and at times manipulative. Professional nurses working in the Maximum-Security Ward are at risk of suffering from occupational stress, burnout, lack motivation and are anxious. The aim of this study is to investigate the experiences of professional nurses working in the Maximum-Security Ward at Hayani hospital. A qualitative approach using a descriptive, exploratory and contextual design was used. A purposive, convenient sampling was used to sample professional nurses working in the Maximum-Security Ward of Hayani hospital. In-depth interviews were used to collect data. A voice recorder was utilised to record all data and the researcher being the main instrument for data collection. Dependability, confirmability and transferability were upheld to ensure trustworthiness of the findings. Data was analysed using Tech’s eight steps approach. Three themes with their categories and subcategories emerged after data analysis. The themes were as follows: the participants’ views on type of patients admitted in the ward, participants’ views on safety in the ward and participants’ views on staff interaction. The study recommended the following: Emotional counselling and debriefing sessions to be conducted at regular intervals or after a traumatic incident. Motivational and team building activities to be organised for professional nurses. Safety of professional nurses must be of significant value. More support is needed in times of emotional difficulties. Development of a model to support professional nurses. / NRF