Indiana University-Purdue University Indianapolis (IUPUI) / Employment specialist competencies were examined as predictors of employment outcomes for consumers with severe mental illness participating in supported employment. Using a cross-sectional correlational design a variety of self-report and supervisor-rated performance measures were examined for their association with three consumer employment outcomes (e.g., the percentage of consumers on an employment specialist's caseload that were competitively employed, the percentage of consumers on an employment specialist's caseload that were employed 90 consecutive days, and the rate in which consumers dropped out of employment services). Six mental health agencies with a total of 57 employment specialists and 14 supervisors from across the nation participated in the study. Competitive employment rates ranged among employment specialists from 0% to 80%. Higher supervisor-rated job performance, supervisor-rated employment specialist efficacy, percentage of work time spent in the community during the past month, and number of contacts with consumers during the past month were related to improved consumer employment outcomes. However, employment specialist attitudes, knowledge of supported employment, conscientiousness, and self-efficacy were unrelated to employment outcomes. This study is one of the first of its kind to examine employment specialist competencies as they relate to supported employment for consumers with severe mental illness. While supported employment is a great improvement over traditional vocational programs, further examination of employment specialist competencies could hold the key to unlocking employment success for many more consumers.

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)

published_or_final_version / Social Work / Master / Master of Social Work

Individuals with a psychiatric disability have had the poorest vocational outcomes of all the disabled populations when comparing rehabilitation success rates. The purpose of this study was to explore the relationships between selected background, social, and service variables and vocational rehabilitation outcome in order to identify potential indicators of success or failure. Data was gathered from records in the Tucson, Arizona offices of the state-federal vocational rehabilitation program. The sample included 210 White and Hispanic subjects with a psychiatric disability. Their records had been closed in the years 1983 through 1987. The independent variables were the background variables of Age, Age of Onset, Ethnicity, and Educational Level, the social variables of Living Situation, Ability To Get Along With Others, and Employment History, and the service variables of Training and Support. The dependent variable was Employment Status as determined by the vocational rehabilitation program: Successful subjects, coded a Status 26, were closed having been employed at least 60 days; unsuccessful subjects, coded a Status 08, 28, or 30, left the program unemployed. The study followed a correlational design using a regression approach. Logistic Regression Analysis with forward selection was the strategy employed to identify the best predictive model. A chi-square test of independence was used to further study variables that showed some predictive potential. An effort was made to control for the presence of one or more additional disabilities. The results indicated that the variables most highly related to Employment Outcome, in the order of their importance, were Training, Employment History, and Ability To Get Along With Others. Ability To Get Along With Others disappeared as a key indicator when the sample was divided into single and multiple disability groups. However, the findings suggest that Ability To Get Along With Others and Support Services may contribute to the effect of the two more powerful variables. It is also cautiously suggested that Training that is job-related and skill-building in nature may be more useful than formal education for this population.

Research in community management of the severely mentally ill has been scarce. Two primary components of community care in particular need evaluation, residential arrangements and styles of "case management." The purpose of this study was to evaluate the interaction of two types of residential arrangements (single- and double-occupancy) and two types of case management ("assertive" and "limited") in a 2 X 2 design. Participants were individuals with a severe mental illness served by CMHS, Inc. Individuals were matched on DSM-III-R diagnoses and sex: 8 had roommates and received assertive case management, 5 had roommates and limited case management, 5 lived alone and received assertive case management, and 5 lived alone with limited case management. Data were obtained from three independent sources: (1) each client was interviewed using the Denver Community Mental Health Questionnaire (DCMHQ) and the Inventory of Socially Supportive Behaviors (ISSB) on four separate occasions over three consecutive months; (2) frequency of client contact with family members over the same time interval was tracked by case managers; and (3) concurrent attendance in day treatment sessions, diagnosis, number of previous hospitalizations, and approximate number of months of previous hospitalization were obtained from community mental health center records. DCMHQ scores for acute symptoms and interpersonal conflict were combined into an index called problems, while ISSB scores measured social support received. Monthly follow-ups for three consecutive months were used to obtain stable estimates of problems and support. Significant positive correlations were found between family involvement and problems, family involvement and residential arrangements, social support and problems, group attendance percentage and age, problems and social support, and a marginal relationship between residence and social support. Statistically significant negative correlations were found between case management and problems, social support and number of previous hospitalizations, group attendance percentage and problems, and residence and age. In multiple regression involving all predictors, the variables other than roommating and case management, (i.e., average family involvement, number of previous hospitalizations, program attendance, and age, considered together) predicted both problems reported and support received, while as second and third steps in the regression analysis case management and residence did not significantly predict problems or social support. In other words, once chronicity (i.e., number of previous hospitalizations), family contact, age, and group attendance were controlled, case management and residence both vanished as predictors. Future studies should consider these factors, and other aspects of the natural context, when evaluating community interventions for the mentally ill in a more controlled experimental design. With respect to developing new research for community adjustment, recommendations for more controlled studies were made and two new community intervention procedures were described. / Department of Psychological Science

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

A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements of the PhD degree. Johannesburg 2014 / The current study investigates the relationship between stressful life events, personality profile, dissociative experiences, attachment styles and the types of crimes committed among 100 mentally ill offenders and 100 criminal offenders in the South African context. It is motivated by the fact that there are no studies in South Africa comparing forensic patients and criminal offenders and the various factors that may lead to criminal behaviour, and how these may present in terms of the type and/or nature of offences committed. Instead, there is a growing emphasis on observation of patients and assessments for fitness and competence to stand trial with very little focus on understanding the mentally ill offenders and criminal offenders. This study aims to improve the understanding and knowledge with regards to the presentation of each of these groups under study and also to investigate possible differences in the types of crimes committed. It aims to assess possible correlations between the variables of the study (stressful life events, personality profiles, dissociative experiences, attachment styles and the types of crimes). It further aims to inform future treatment interventions in the forensic setting and to offer possible prevention models for the community setting. The study hypothesises that there are no differences between the mentally ill offenders and criminal offenders with regards to stressful life events, personality profile, dissociative experiences, attachment styles and the types of crimes committed. Ethical clearance was obtained from the Committee for Research on Human Subjects of the University of Witwatersrand‟s medical school. The sample size of this study consists of 200 participants (156 males and 54 females). Convenience sampling was used, where 100 mentally ill offenders admitted at the Sterkfontein Psychiatric Hospital and 100 criminal offenders, incarcerated at the Johannesburg Correctional Services in the Johannesburg area at the time of data collection, were involved in the study. The mentally ill offenders from Sterkfontein Psychiatric Hospital were interviewed at the hospital and the criminal offenders from Correctional Services were interviewed in their respective prisons without the presence of a prison guard. Participants‟ ages ranged from 18 years to 60 years. Those people who were not willing to participate were not included in the study. The Biographical details questionnaire, Social Readjustment Rating Scale (SRRS), Stressful Life Events Screening Questionnaire (SLESQ), Multiphasic Minnesota Personality Inventory – II (MMPI-II), Dissociative Experience Scale (DES) and Attachment Styles Questionnaire (ASQ) were administered to the participants of the study as a means of gathering information regarding the variables under study. The types of crimes and diagnoses were obtained from the records. The study attempted to ascertain whether there were any associations, and whether predictions could be made for possible future assessments and treatment strategies. It is a quasi-experimental design with “diagnosis” as the between-participants factor. Independent variables of the study were the type of offender, i.e. mentally ill/clinical/forensic patient offender and criminal offenders, as well as the types of crimes, i.e. violent or non-violent crime. The dependent variables were stressful life events. These variables were measured in terms of low risk to illness, moderate risk and high risk to illness; personality profile; dissociative experiences, measured as either low levels or high levels of dissociation and attachment styles (secure, fearful avoidant, ambivalent and preoccupied attachment styles). The confounding variables were substance abuse, medication and comorbid diagnoses. Descriptive statistics and the discriminant function analysis were performed. Box M was also performed to test the null hypothesis that the covariance matrices did not differ between groups formed by the dependent variables. The Chi Square test for independence was also used to determine whether associations existed between two nominally categorical variables. The results of the study indicated that there were only four female participants in the clinical offender group. A high number of research participants were single in both the criminal (72%) and clinical (80%) offender groups. Furthermore, the majority of the participants in the study were Black, where 93% in the criminal offender group and 75% in the clinical offender group. 65% of the participants in the criminal offender group and 85% in the clinical offender group had no tertiary education. There was evidence that clinical offenders tended to commit more violent crimes (83%), while criminal offenders committed more non-violent (61%) and “other” crimes (21%). 91% of criminal offenders reported homelessness compared to clinical offenders (22%). The Dissociative Experience Scale was statistically significant, suggesting that dissociative experiences were a strong determinant of whether one is deemed a criminal or clinical offender. High levels of stress were correlated with higher incidents of criminal behaviour. In contrast to the literature review, past childhood trauma was not statistically significant in the current study. Clinical offenders reported more psychological problems. When ANOVA‟s were performed, psychological difficulties such as depression, anger, antisocial practices, low self-esteem, psychasthenia and family problems were statistically significant, suggesting that these variables were strong determinants for the likelihood of criminal offending. Dismissive and Fearful attachment styles were statistically significant. In conclusion, dissociative experiences, social re-adjustment, psychological pathology and both dismissive and fearful attachment styles were strong determinants of offending behaviour.

No description available.

Engaging with marginalized communities to address issues of importance to their emotional well-being is central to counseling psychology’s core missions in social justice advocacy. Among those who have been historically viewed as deficient and marginalized are people who have been diagnosed with a serious mental illness (Schneider, 2012). Community-based psychosocial interventions have been identified as an effective form of treatment, particularly when they emphasize collaboration with community members, the empowerment of people with serious mental illnesses, the ability of such individuals to take action on behalf of themselves and others, and ownership of findings and knowledge by all partners (Corrigan & Garman, 1997; Davidson et al., 1999; Salzer, 2002). This dissertation study represents an attempt to position participatory action research (PAR) as such an intervention in the context of two marginalized identities—ethnic Chinese minority identity and the bearing of a serious mental illness diagnosis. The launching, design, and analysis of the PAR process with this population was tracked to examine the potential strengths and challenges of its utility in relation to Chinese survivors of serious mental illness. Through collaboration and dialogue, the project identified and addressed topics that the PAR co-researchers (the Chinese community members diagnosed with a serious mental illness) experienced as significant problems in their specific settings and took actions that resolved those problems, thus bridging theory and discussion topics with real-world situations, issues, and experiences, and leaving the community co-researchers and their respective agency better prepared to create such action in the future.

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.