The general aim of the present thesis is to investigate needs of support and service in clients with long-term mental disabilities living in the community. A further aim is to study changes in these client needs during a 3.5-year follow-up. A questionnaire, The Need of Support and Service Questionnaire (NSSQ), was developed to provide staffs in psychiatric care and social services with a brief instrument to assess how their clients live in the community and to identify their needs. The results are based on 1,759 clients. The prevalence of clients in urban and rural areas was 6.4/1,000 and 4.5/1,000 inhabitants, respectively. The clients living in the urban setting were more frequently male, older, with a diagnosis of schizophrenia and needed more support in activities of daily living than rural clients. Clients identified by staff in psychiatric care only were more often living with a partner, with children living at home and more often had a rehabilitation allowance than clients identified by social services staff. In clients assessed by both organizations similar needs at a group level were identified. However, agreements were lower at the individual level. Although clients reported fewer needs than staff in psychiatric care, the reported needs were in the same areas. A majority of the clients with unmet needs of service at baseline had their needs met at the 3.5-year follow-up. New unmet needs were also identified at the follow-up, however. The results demonstrate less improvement in clients with schizophrenia as compared with non-schizophrenic clients. In conclusion, needs of support and service present a dynamic process and both psychiatric care and social services should critically evaluate assessments of these needs.

The goal of this study was to examine the views and perspectives of Tamil mental health outpatients and mental health care workers on the impact social activities and social network has on mentally ill patients’ general and mental health. The study was conducted at an outpatient mental health program at a Canadian hospital, using the grounded theory approach. Data were collected through questionnaires, document review and semi-structured interviews. Results showed that the mental health program had a positive impact on the mental health outpatients’ quality of life, including improvement in mental health, physical health, social network and social skills. The importance of cultural integration in mental health programs was discussed. Furthermore, barriers in accessing and utilizing mental health resources were highlighted and recommendations for program development were provided. Mental health programs can be effective in helping to improve the quality of life for Tamil consumers of outpatient mental health services. / UOIT

Objective: This research explores the critical need for individualized care planning to ensure maximum cost savings by providing a balance between individuals’ care needs and care wishes. The primary objective of this research is to identify common goals of care (GoC) expressed by long-term care residents (using the interRAI LTCF) and clients receiving community supportive services (using the interRAI CHA) or community mental health services (using the interRAI CMH). Methods: Three interRAI datasets were used to perform data analyses. The responses to the open-ended GoC item were quantified and grouped into common goal categories, which were then examined against the interRAI outcome measures and Clinical Assessment Protocols (CAPs). Demographic and clinical characterisitics were compared across the sample populations using the chi-square test. Logistic regression models were created to reveal variables that are predictive of not having a GoC recorded within each care setting. Results: Twenty-five GoC categories were created. Although the GoC responses were very diverse, many persons had no goal recorded. Nearly 70% of long-term care (LTC) residents and community support service (CSS) clients were unable to state a GoC. Different populations in different service settings had distinct GoC but had some commonalities as well such as goals that focused on general physical or mental health issues. GoC varied with the CAPs- the triggering of a CAP did not necessarily mean a corresponding GoC was noted. Each care sector had different predictor variables that were strongly associated with not having a GoC. Conclusions: There is not a “one size fits all” solution to care planning. The same goals and outcome measures are not appropriate or realistic for all persons. It is critical to incorporate self-reported goals into the development of effective and individualized care plans to ultimately improve one’s quality of life, satisfaction with care, and success in achieving desired outcomes of care.

Thesis (Ph. D.)--University of Queensland, 2001. / Includes bibliographical references.

Thesis (Ph. D.)--UCLA, 2009. / Vita. Description based on print version record. Includes bibliographical references (leaves 145-167).

No description available.

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

The Austrian mental health care system has been characterized by reform initiatives since the 1970s. The reform strategies can be summarized under the term 'community mental health care'. The thesis focuses on an analysis of the reform (context) and the related challenges for mental health care financing with respect to its interdependencies with service provision in the process of change. In a qualitative research process, firstly, reform documents and transcripts of qualitative interviews have been analyzed via a discourse-analytical approach. Secondly, secondary data on mental health care financing in Austria and in western European countries have been collected. An analytical framework was, finally, applied to analyze the interrelations between mental health care financing and reform discourse with respect to its impact on the micro-level and on the macro-level of the mental health care system. The results show that the reform discourse reflects broader welfare state transformation processes. Yet, financing issues have hardly been addressed in reform discussions. Nevertheless, discursive elements are either explicitly or implicitly associated with financing issues or are even linked to specific financing models. A central impact from the restructuring processes on the micro-level is an increasing (financial) responsibility for people who are affected by a mental disorder and/or their relatives. On the macro-level, the processes of change are related to decreasing (financial) responsibility for the sector 'state' while responsibility for the sectors 'family' and 'voluntary/community' is rising. The international development shows similar characteristics. The thesis finishes with some recommendations for developing an alternative financing model and provides a guideline for a comprehensive discussion of alternative mental health care financing approaches. (author´s abstract)

No description available.

The thesis looks at developing a new model for a mental health support program which is integrated into a natural recreational environment. Its starting point is Beginning Again, a registered charity in Richmond Hill, Ontario, Canada, which provides a supportive workplace, called Treasures, to engage psychiatric patients in meaningful and productive work. The intent of the thesis is to develop an architecture that reflects the mission and objectives of the program in order to increase the opportunity for recovery and interaction with the local community. This is done by creating a more general prototype or “parent seed” which can be applicable to many locations and then testing the model by planting it in the Oak Ridges Corridor Park, located in the suburban community of Oak Ridges, Ontario. This thesis builds upon the long history of rehabilitative environments to create a community model of care that regards work as primarily a social and cultural activity.