The dissertation discusses the provision of mental health care delivery by the Government of British Columbia, and the role and focus of Riverview Hospital in a changing organizational environment. The developing policy of regional and community service necessitates reorganization of the hospital's programs, in order to integrate and coordinate the components of the system. The question of the optimal organization for delivery of service in Riverview is examined through a discussion of the theoretical background for the provision of care to the mentally disordered, the development of mental health services in the province, and the alternatives and externalities which impinge on the provision and operation of the hospital's services. The intra-hospital planning, designed to effect an organizational response to environmental pressures, is outlined. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Magister Curationis - MCur / Aggressive and violent behaviour in inpatient mental health facilities is found worldwide and is a frequent and serious clinical and nursing care problem. Despite the importance of international research findings and recommendations, it appears that patients perceptions of the possible contributing factors toward aggressive and violent behaviour in mental health facilities is an area of enquiry that has not been widely explored in South Africa in general, or in the Western Cape, in particular. It is against this background that this study endeavoured to investigate the external and situational contributing to patients aggressive and violent behaviour in mental health facilities in Cape Town, as seen from patients perspectives. / South Africa

No description available.

The hypotheses investigated were (1) as measured by a test of impulse control, elopers are more impulsive than non-elopers, and (2) as measured by a test of impulse control, males are more impulsive than females. The Self-Report Test of Impulse Control (STIC) and the Barratt Impulsiveness Scale (BIS) were administered to 76 female and 40 male patients at the time of admission to an open psychiatric hospital. Of these, 20 females and 10 males eloped. The first hypothesis was only partially supported. The second hypothesis was not supported. The BIS was found to be a potential predictor of elopers. The data also suggested that males elope later than females.

A comparison of the voluntary and involuntary patients at Dammasch State Hospital, Wilsonville, Oregon. A representative sample of cases over time, were chosen for the year 1976, 72 voluntary and 72 involuntary patients. One-hundred and twelve variables were coded onto sheets for each patient. The variables concerned marital status, job history, history of violent acts, present living situations and relationships, as well as drug history and diagnosis and treatment in the hospital. The data were coded onto cards and a computer analysis was done using Factor and Discriminant Function Analysis. It was hypothesized the populations of persons voluntarily admitted and involuntarily committed would be different in several ways. (A) The population of involuntarily committed persons would have more anti-social aggression in their histories. This hypothesis was partially supported by the data. The involuntarily committed had a significantly higher incidence of being under a current legal charge at the time of commitment. There was no significant difference between the two populations in the number of previous incarcerations or on 'violence committed within the family'. (B) Persons involuntarily committed would have significantly fewer relationships with persons in the community and fewer ties to persons they support financially or emotionally or that support them emotionally or financially. This hypothesis was partly supported by the data. The two populations were approximately equal on all the variables of relationship and living conditions except 'lives with mate'; for this variable the voluntary patients had a higher score. (C) Involuntarily committed persons would have less successful job histories. None of the items of the job history were significantly different in the two populations. (D) The involuntary population was more likely to have alcoholism as a secondary diagnosis. The voluntary population was more likely to have alcoholism as a primary diagnosis. This hypothesis was not clearly supported by the data. It was found that the voluntary population was more likely to abuse alcohol and the involuntary population was more likely to use alcohol. (E) The involuntary population was more likely to have experienced violence in their homes, while children. There were insufficient data in the hospital records concerning childhood to test this hypothesis. In the factor which contained the variable 'commitment' there were no elements of a history of dangerousness. The only significant correlation with commitment was 'prescription of phenothiazines in the hospital'; this result may point to the use of drugs as 'chemical restraints'. No other variable which indicated relationships, job history, social status, or dangerousness correlated significantly with commitment. These were the most important findings in the study.

Indiana University-Purdue University Indianapolis (IUPUI) / “Gendered and Racialized Experiences at Central State Hospital, Indianapolis, 1877 – 1910” analyzes the treatment of African American patients at the now-defunct Central State Hospital in Indianapolis, Indiana, throughout the Gilded Age and Progressive Era, from the late 1870s through the 1900s. This thesis examines the impact of scientific racism and institutionalized sexism on female African American patients’ diagnoses, medical treatment, and the outcome of institutionalization through a close reading of hospital publications and a series of statistical studies of patient data. This thesis also analyzes the intersection of race and gender through the case study of one African American woman, Elizabeth Williams Furniss, who was institutionalized during the 1890s until her death in 1909. I argue that scientific racism and a deeply entrenched sexism significantly shaped the treatment of African American patients and women of all races throughout the Gilded Age and Progressive Era. Preconceived notions of race, gender, and class determined diagnoses, treatments, and treatments outcomes, without regard to individual patients’ needs. I also suggest ways for historians to identify and measure the impact of scientific racism and institutionalized sexism on African American patients in northern psychiatric institutions through statistical studies of patient data.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

published_or_final_version / Architecture / Master / Master of Architecture

M.Cur. / Violence and aggression in psychiatric hospitals are a worldwide known phenomenon. South Africa is no exception to the rule. Previous researches conducted in psychiatric institutions have mainly focused on the patients, leaving everyone to guess how this violence affects nurses who are in contact with the patients on a daily basis and who are key role-players in the care, treatment, and rehabilitation of the patients under their responsibility. The research aimed to explore and describe the lived experience of aggression and violence by the registered nurses in a Gauteng psychiatric institution, the essence of this violence, and how nurses cope with this violence, in order to formulate guidelines and recommendations that could assist them to manage violence. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews, and naïve sketches. Tesch’s method was used for data analysis, here and an independent coder was utilised. The uniqueness of this study was to bring to the surface the other side of violence as it is perceived and lived by the nurses. The findings show that the nurses face violence on a daily basis. Among the contributing factors there are: the type of patients admitted in the hospital; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation. The consequences of this violence to the nurses are emotional, psychological, and physical and take the form of: fear, anger, frustration, despair, hopelessness and helplessness, substance abuses, absenteeism, retaliation, a development of an “I don’t care attitude”, injuries, and damage to personal properties such as clothes, and spectacles.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-01-22T11:33:27Z No. of bitstreams: 1 Maria Clara Schnaidman Suarez.pdf: 2591900 bytes, checksum: 46e13730031259f4703c7a9a6eab2059 (MD5) / Made available in DSpace on 2018-01-22T11:33:27Z (GMT). No. of bitstreams: 1 Maria Clara Schnaidman Suarez.pdf: 2591900 bytes, checksum: 46e13730031259f4703c7a9a6eab2059 (MD5) Previous issue date: 2017-12-08 / The region of Sorocaba/SP concentrated between the 1960s and 2012, the largest number of psychiatric beds in the country, mainly occupied by long-term patients. Based on the precepts of the Brazilian Psychiatric Reform and motivated by denunciations of ill-treatment, in December 2012, the signing of a Conduct Adjustment Agreement determined the deinstitutionalization of all persons interned together with the restructuring of the Psychosocial Care Network. From the GM Ordinance 3088/2011, which included the Primary Care as one of the main points of the PCN, there have been several changes and adjustments necessary for the mental health care in these services would be possible and effective. The Matrix Support came as the main tool suggested by the Ministry of Health for this construction. This research aims to demonstrate the relationship between the matrix support in mental health in primary care and the improvement in solving cases, and know the opinion of the BHU teams after the matrix support in order to better understand the needs of users with mental suffering. This is an observational, cross-sectional and exploratory study with a quanti-qualitative approach. Information collection were obtained through a semi-structured questionnaire with open questions validated by an expert committee of 5 specialists and applied to 36 health professionals from four of the thirty-one BHU of Sorocaba/SP, after approval by The Ethics Committee of Faculdade de Ciências Médicas e da Saúde of PUC-SP. A Laurence Bardin content analysis method was used for open questions analysis. The research showed that the matrix support improves the resolution of the problems related to Mental Health in the BHU and in the opinion of the participants offers greater satisfaction to the team in this resolution, for a better understanding of the cases attended, and for the opportunity to discuss the cases with the matrix support teams, despite pointing obstacles to be overcome / A região de Sorocaba/SP concentrou entre a década de 60 e 2012, o maior número de leitos psiquiátricos do país, ocupados principalmente por pacientes de longa permanência. Embasado nos preceitos da Reforma Psiquiátrica Brasileira e motivado por denúncias de maus tratos, em dezembro de 2012 a assinatura de um Termo de Ajustamento de Conduta1 determinou a desinstitucionalização de todas as pessoas internadas juntamente com a reestruturação da Rede de Atenção Psicossocial. A partir da Portaria 3088/2011, que incluiu a Atenção Primária como um dos principais pontos da Rede, fizeram-se necessárias adequações para que o atendimento em saúde mental nestes serviços fosse possível e eficaz. O matriciamento veio como a principal ferramenta sugerida pelo Ministério da Saúde para esta construção. Esta pesquisa tem por objetivos demonstrar a relação entre o matriciamento em Saúde Mental na Atenção Primária e a melhora na resolutividade dos casos e conhecer a opinião das equipes das Unidades Básicas de Saúde (UBS) após o matriciamento, no sentido de compreender melhor as necessidades dos usuários com sofrimento mental. Trata-se de estudo observacional, transversal e exploratório, de abordagem quanti-qualitativa. As informações foram coletadas por meio de questionário semiestruturado de múltipla escolha, contendo também questões abertas, validado por um Comitê de cinco especialistas e aplicado a 36 profissionais de saúde de quatro das trinta e uma UBS de Sorocaba/SP, após aprovação do Comitê de Ética em Pesquisa da Faculdade de Ciências Médicas e da Saúde da PUC-SP. Foi utilizado o método de análise de conteúdo de Laurence Bardin para análise das respostas às perguntas abertas. A pesquisa mostrou que o apoio matricial melhora a resolutividade dos problemas relacionados à Saúde Mental nas UBS e, na opinião dos participantes, oferece maior satisfação nesta resolução, por melhor compreensão dos casos atendidos e pela oportunidade de discutir os casos com as equipes de matriciamento, apesar de apontar obstáculos a serem vencidos