The purpose of this research was to examine “who” was best served by a mental health court (MHC) by identifying the characteristics of participants that were predictive of six-month post opt-in program retention and non-recidivism. Participants were 148 available adults who had recently enrolled in 1 of 4 west coast MHCs, were diagnosed with an Axis I schizo-spectrum disorder, bipolar disorder, or major depression, were legally competent, and provided informed consent. This court-based exploratory study used structured in-person interviews to administer standardized measures to collect demographic, socioeconomic, criminal history, psychiatric, substance use/misuse, health, motivation to change, and therapeutic alliance characteristic data. Additional data were provided by the MHC study sites. Participants ranged in age from 18 to 64 (M = 36.56, SD = 11.81) and most had less than a high school education (M = 11.46, SD = 2.49). Participants were more typically male (61%), white (58%), unmarried (93%), unemployed (92%), had a prior felony (57%), and were diagnosed with schizophrenia (49%) and a comorbid substance use disorder (68%). At 6-month follow-up, 72% of the participants remained enrolled in MHC and 55% remained arrest-free. Results from chi-square and independent sample t-test analyses showed significant differences in the years of education, GAF scores, number of contacts with a mental health professional, and strength of therapeutic alliance with the MHC judge between retained and not retained participants. A significant logistic regression model identified that more years of education, a higher number of contacts with a mental health professional, and a stronger therapeutic alliance with the MHC judge were significant predictors of participants’ program retention. Additionally, significant differences were found between recidivating and non-recidivating participants’ age, ethnicity, education, income, housing, prior criminal history (e.g., prior charges, arrests, and jail days), GAF scores, BPRS scores, AUDIT scores, DAST scores, and comorbid substance use disorder. Another significant regression model identified being older, more educated, white, and having income other than SSI/SSDI were predictive of non-recidivism. MHC programs may use these findings to better assess potential participants, provide more targeted treatment and other related support services, and consider ways to strengthen their working alliance with participants. / text

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Public Administration / Master / Master of Public Administration

No description available.

The Ethnic Mental Illness (EMI) Scale, a questionnaire to discriminate European and Hispanic attitudes toward mental illness, was developed. Fifty-one college students of Hispanic ethnicity and 194 college students of European ethnicity completed a 150 item questionnaire measuring attitudes toward mental illness. A cross-validation sample of 50 Hispanic students and 194 European students ethnicity yielded 15 items that reliably differentiated the two groups. Based upon content, the 15 items were grouped into six categories: hopefulness, trust, biological aspects of mental illness, childhood origins, finances, and sex differences. Items which did not discriminate Hispanics and Europeans are described, as these items are possible indicators of common attitudes toward mental illness. A group of 66 Asian students also participated in the study. The items which differentiate Asians from Hispanics and Europeans are described. These items were not cross-validated.

No description available.

The purpose of this qualitative study was to explore and better understand the stigma experienced by a specific subgroup of the population experiencing mental illness---older adults. Using the framework of the Modified Labelling theory, the effect and significance of stigma on their self-image was investigated. Semi-structured interviews were conducted with ten seniors who participate in the Community Mental Health Program at the Cummings Jewish Centre for Seniors in Montreal, Quebec. Using a purposive sample, study participants were included according to: age (i.e., 50 plus), participation in a mental health program in a community center, and having a diagnosis of a mental illness. Interviews were analyzed according to individual coping strategies as well as thematic content across interviews. Study results enhance understandings of how older people resist dominant discourses of stigma attached to mental illness and how personal perceptions on mental illness, age and health influence self-image.

AIM The purpose of the research study was to explore and to describe stereotypes associated with serious mental illness and the effects of familiarity on the serious mental illness stigma process in potential employer informants in the greater Durban area, eThekwini district, KwaZulu-Natal. Methods A quantitative non-experimental cross sectional survey relational research design was used to describe firstly, the stereotyping and individual discriminatory behavior (desire for social distance) of potential employers to a person with a SMI, and secondly, the effect of familiarity and other person variables (culture, age and gender) on the stigma components of stereotyping, emotional reaction and individual discriminatory behavior (desire for social distance). The population included potential employers of the SMI person in the greater Durban area, eThekwini District, KwaZulu-Natal. The target population was all students enrolled for a part-time management course at two academic institutions in the Durban central area. Non-randomized, non-probability purposive sampling was used. Demographic data and four self report tools were compiled into one self report questionnaire to collect data. Results The sample was evenly distributed amongst male and female within the various age groups. All cultural groups were represented but this representation was not a perfect fit with national or provincial population statistics. Just less than half of the participants (48% n=55), both genders and across all cultural groups, had intimate and or personal contact with persons with a serious mental illness. Demographic associations suggest that male participants had greater perceptions of dangerousness, unpredictability and incompetence and a greater desire for social distance. The statistical results indicated limited correlations between emotional reactions and desire for social distance, stigmatizing attitudes and desire for social distance, and evidence of no significant relationship between familiarity and other components within the stigmatizing path. Fear was associated with a desire for social distance and with perceptions of limited potential for recovery. Stigmatizing attitudes were most negative towards persons who had a previous admission to a psychiatric hospital and the least negative towards 'bipolar mood disorder'. Stigmatising attitudes were recorded for all serious mental illness labels (including that of bipolar) with 75% of participants scoring closer to the negative polar adjective of stigmatizing attitude. Conclusion and Recommendations In conclusion, the supposed lack of desire for social distance, the dependent variable in this study, may reflect political policy and current ideology but the strength of the negative stereotypes suggests that changing policy is easier than changing attitudes. It is suggested that the stigmatizing stereotype of limited potential for recovery may have more salience in developing countries such as South African than the developed western world. Limited potential for recovery has financial and emotional implication within a developing country and to this extent, desire for social distance and fear are correlated to perceptions of limited potential for recovery. Recommendations include additional research include measures of social desirability bias to clarify the relationship between familiarity, emotional reaction and social distance. Secondly, intervention studies, specifically with potential employers, are required to obtain empirical data related to the combine effectiveness of disconfirming information and contact with people with a serious mental illness. Further, that health departments actively engage in evidence based anti-stigma initiatives. Lastly it is recommended nursing curricula recognise the importance of student psychiatric nurses developing a balanced view of mental health care users assigned the serious mental illness labels through a balanced clinical exposure to recovered, as well as acutely ill mental health care users. That the new undergraduate nursing degree curricula strengthen content related to recovery and psychosocial rehabilitation, specifically nursing interventions / strategies to facilitate rehabilitation in all the areas of study, socialization, community living, and specifically in the area of work. / Thesis (MN)-University of KwaZulu-Natal, Durban, 2010.