This thesis has examined community attitudes toward mental health in Delaware County. The paper also focused upon the community's awareness of, and attitudes toward the Delaware County Child Guidance Clinic. The method employed in this study was survey research.The findings suggested that the attitudes of the sample population concerning the area of mental health were positive. The findings also indicated that generally the respondents were reluctant to suggest professional assistance for problems of mental or emotional health. While the majority of respondents were aware that the Child Guidance Clinic existed, most of the sample were unfamiliar, with specific services which the facility provides. Further, the findings indicated that the individual's level of education was significantly related to that individual's general attitude toward mental health and his awareness of the Child Guidance Clinic.In summary, the results of this study indicated a public whose attitude was positive concerning the area of mental health but who is uninformed about the local facilities provided for the treatment of such disorders. Programs designed to provide public education in this area would be of great assistance.

Abstract Keywords: Lay counsellors, training and evaluation. The training of lay counselling is of great significance to the field of Counselling Psychology. Therefore,the Health Professions Council of South Africa (HPCSA) decided to allow for the registration of lay counsellor training courses. However, the criteria for registration need to be formulated. This study evaluated the Wits Crisis course for volunteer counsellors, via illumination of the perceptions of the trainees and a measurement of their self-efficacy and personal relations before and after the training. The study included qualitative and quantitative methodology. Past trained counsellors and trainees were interviewed and then assessed on Self-Efficacy and Personal Relations before and after training. A Wilcoxon Matched-Pairs Signed-Rank significance in self-efficacy or personal relations scores after training. However, the interviews of the participants' perceptions of the course and its impact on them supported the hypotheses. Overall, perceptions were positive. Negative perceptions were highlighted, as this information could add to the knowledge base of the program. / GR 2016

Introdução: Com o processo de desinstitucionalização psiquiátrica e a consequente reestruturação dos serviços de assistência em saúde mental, tem sido cada vez mais enfatizada a necessidade de avaliação dos equipamentos que compõem a Rede de Atenção Psicossocial. Diante da complexidade que envolve os sistemas de saúde e saúde mental, a avaliação é considerada como essencial para a garantia de qualidade dos serviços. A Organização Mundial de Saúde (OMS) destaca a necessidade de incorporar a avaliação dos resultados do tratamento como prática contínua e permanente, utilizando os dados da avaliação para melhorar a qualidade da assistência prestada. Objetivo: Este estudo tem por objetivo avaliar quantitativamente a estrutura, o processo de trabalho, a organização da atenção em saúde mental e o resultado da atenção em saúde mental oferecida pelo Centro de Atenção Psicossocial II em álcool e outras drogas (CAPSad) do município de Botucatu. Método: O estudo foi realizado em um CAPSad do município de Botucatu. Para a coleta dos dados utilizou-se de quatro instrumentos (coordenador, trabalhador, usuário e familiar) compostos pela Escala de Satisfação SATIS-Br, Escala de Mudança Percebida (EMP) e Escala de Atitudes Frente ao Álcool, Alcoolismo e Alcoolista (EAFAAA) e questões sobre os dados sociodemográficos, estrutura do serviço, recursos humanos e materiais e uso de álcool e outras drogas. Os dados foram processados de forma descritiva pelo Programa Statistical Package for Social Sciences (SPSS), versão 20,0 para Windows®. Resultados: A amostra foi de 01 coordenador, 19 trabalhadores, 25 usuários e 15 familiares. Foram obtidos níveis elevados de satisfação para usuário e familiares, e níveis intermediários de satisfação para trabalhadores com relação aos aspectos avaliados no serviço. Em relação à percepção de mudança teve-se percentuais elevados tanto para usuários quanto para familiares. Na questão de melhora global, 100% dos familiares perceberam a melhora em geral na vida de seu familiar, desde o início do tratamento, sendo que para os usuários 88% perceberam a ocorrência de melhora em seu tratamento. Evidenciou-se atitudes negativas desses trabalhadores frente ao alcoolismo, ao alcoolista e à bebida alcoólica, pois a maioria das médias dos fatores permaneceu na zona intermediária. Os resultados apontam a necessidade de investimentos em capacitações e cursos de atualização para os profissionais e melhora de pontos específicos em relação a infraestrutura do serviço. Como este estudo foi realizado em um único serviço de saúde mental, não pode ser generalizado para outros serviços. / Introduction: With the psychiatric deinstitutionalization and consequent restructuring of the mental health services, it is increasingly emphasized the need for evaluating services from the Network for Psychosocial Care. Given the complexity involved in health systems and mental health, evaluation is considered essential for quality assurance of the services. The World Health Organization (WHO ) emphasizes the need to incorporate the assessment of treatment outcomes as a continuous and ongoing practice, using assessment data to improve quality of care. Objective: This study aims to evaluate quantitatively the structure, work process, the organization of mental health care and outcomes of mental health care provided by the Psychosocial Care Center II for alcohol and other drugs (CAPSad) from the city of Botucatu . Method: The study was conducted in a CAPSad in Botucatu . To collect the data four instruments (coordinator , worker, family and user) were administered to the participants. Those instruments were composed by \" Satisfaction Scale - SATIS - BR \" Perceived Change Scale (EMP) and the Scale of Attitudes Towards Alcohol , Alcoholism and alcoholic (EAFAAA). The instruments were also composed by sociodemographic data, service structure, human and material resources and the use of alcohol and other drugs. Descriptive analysis of the data was performed using the software Statistical Package for Social Sciences (SPSS) version 20.0 for Windows® . Results: The sample consisted of 01 coordinator, 19 workers, 25 users and 15 relatives. We obtained high levels of users and family satisfaction, and intermediate levels of satisfaction for employees with respect to the evaluated service. Regarding the perceived change, the data showed high percentages of change for both users and for family. On a global question about improvements, 100% of the families noticed an improvement in the overall life of their relatives, when comparing to the beginning of treatment, and 88% of the users noticed the occurrence of improvement in their treatment. The data showed a tendency toward negative attitudes of these workers towards alcohol, alcoholism and alcoholics because for most means of factors remained in the intermediate zone. The results highlight the need for investment in training and extension courses for professionals and the need to improve specific points regarding the service infrastructure. As this study was conducted in a single mental health service, this results cannot be generalized to other services.

Este estudo trata da avaliação de um Centro de Atenção Psicossocial (CAPS), um serviço supostamente funcionando nos moldes apregoados pela Reforma Psiquiátrica Brasileira, a qual, atualmente, na sua vertente assistencial, é marcada pela implantação de serviços substitutivos ao hospital psiquiátrico. A proposta da avaliação centra-se no microespaço e no cotidiano do serviço e ocorre mediante a participação da equipe, usuários e familiares. Trata-se de uma avaliação qualitativa, mediante a qual se busca apreender a dinâmica do serviço, a forma como os atores interagem e os sentidos que constroem em relação à própria prática; uma avaliação que também possa ser dispositivo, permitindo, mediante um processo participativo, que grupos de interesse ampliem a possibilidade de intervir na realidade do serviço, e que possam ser sujeitos, uma vez que em metodologias tradicionais estão excluídos. A Avaliação de Quarta Geração, desenvolvida por Egon G. Guba e Yvona S Lincoln juntamente com o Método Paidéia, desenvolvido por Gastão Wagner de Sousa Campos, foram norteadores do processo teórico-metodológico da pesquisa. Os instrumentos de coleta de dados foram entrevistas com equipe, usuários e familiares e observação. As questões que emergiram no processo avaliativo foram agrupadas em três núcleos temáticos: dimensões do objeto de trabalho, equipe, práticas e os meios de trabalho. Foi constatado que, mesmo que o serviço pareça ser um substitutivo para o atendimento no hospital psiquiátrico, tanto fatores externos, relacionados às políticas locais de saúde mental, quanto fatores internos, relacionados ao cotidiano do serviço, impedem que isso se efetive. / This study is about the evaluation of a Center of Psychosocial Care (CAPS), a service supposed to work according to the patterns divulged by the Brazilian Psychiatric Reform which, currently, in its assistance trend, is marked by the implantation of services intended to replace the psychiatric hospital. The evaluation proposal is centered in the micro space and in the day-to-day of the service and is performed by means of the participation of the team, the users and family members. It is about a qualitative evaluation, by means of which one searches to grasp the dynamics of the service, the way how the actors interact and the directions that they construct in relation to the practice itself; an evaluation that can also device, allowing, by means of a participation process, that interest groups broaden the possibility of intervening in the reality of the service and that they may become subjects, considering that in traditional methodologies, they are excluded. The Evaluation of Fourth Generation, developed by Egon G. Guba and Yvona S. Lincoln, together with the Paidéia Method, developed by Gastão Wagner de Sousa Campos, guided the theoretical-methodological process of the research. The instruments for the collection of data were interviews with the team, users and family members as well as observation. The issues that emerged over the evaluation process were grouped in three central themes: dimensions of the work object, the team, practices and the working means. It has been noticed that, even though the service seems to be a replacement for the attendance in the psychiatric hospital, both external factors, related to the local policies of mental health, and internal factors, related to the day-to-day of the service, prevents it from becoming effective.

A finalidade da pesquisa foi produzir uma versão confiável do instrumento Quality in Psychiatric Care Outpatientes (QPC-OP) na língua portuguesa, adaptada para o contexto brasileiro, e contribuir com a política de saúde mental identificando a qualidade da assistência a partir da perspectiva de usuários de Centros de Atenção Psicossocial (CAPS) da cidade de São Paulo. O QPC-OP é um instrumento composto por oito dimensões da qualidade, desenvolvido na Suécia, que se propõe a mensurar a percepção do usuário sobre a qualidade da assistência em serviços extra-hospitalares de saúde mental. Esta investigação pressupõe que o QPC-OP é um instrumento válido para compor uma avaliação para a gestão no contexto brasileiro e que a qualidade da assistência em saúde mental percebida por usuários de CAPS da cidade de São Paulo seria boa, mas com aspectos a ser melhorados. Trata-se de um estudo metodológico de abordagem mista, desenvolvido em três etapas: a primeira foi o processo de adaptação do QPC-OP, que envolveu a tradução e retrotradução por profissionais da área independentes, a avaliação da primeira versão do QPC-OP por um comitê de sete especialistas e um pré-teste com 31 usuários de CAPS; a segunda foi a avaliação das propriedades psicométricas do QPC-OP, que testou a confiabilidade e validade do instrumento em uma amostra de 253 usuários. Para testar a confiabilidade da escala, foi avaliada a consistência interna do instrumento; para a validade, foi utilizada a Análise Fatorial Confirmatória (CFA). Já na terceira etapa, foram realizadas análises descritivas dos dados obtidos pela aplicação do QPC-OP e testes de associação dos dados produzidos pelo QPC-OP com informações sociodemográficas e de atendimento, utilizando-se os coeficientes de correlação de Pearson, de Kendall e o de Bisserial, com intervalo de confiança de 95%. As análises foram realizadas utilizando o Software R. Sobre o processo de adaptação transcultural, a equivalência conceitual do QPC-OP foi comprovada com a revisão narrativa da literatura, a avaliação do comitê de especialistas e a avaliação de usuários de CAPS. A equivalência semântica dos itens foi mantida, mas alguns sofreram modificações na versão brasileira em relação à extensão das questões e ao tempo verbal, de modo a apresentar linguagem mais coloquial. Três novos itens específicos do contexto brasileiro foram acrescidos na dimensão Direitos dos usuários, o que limitou a equivalência técnica, mas aumentou a significância prática. A CFA revelou que a versão brasileira do QPC-OP foi aceita com base nos resultados dos testes de adequação e possui estrutura de fatores correspondente à versão original, com exceção do fator alta. A consistência interna da escala completa foi avaliada como boa, porém a consistência interna de alguns fatores foi baixa, provavelmente devido ao número reduzido de itens por fator. Avançamos ao apresentar um instrumento validado, útil para monitoramento, avaliação e potencial qualificação dos CAPS na perspectiva do usuário, de atenção psicossocial, o que não existia até o momento. / The purpose of the research was to produce a reliable version of the instrument Quality in Psychiatric Care - Outpatients (QPC-OP) in the Portuguese language, adapted to the Brazilian context, and to contribute to the mental health policy by identifying the quality of care from the perspective of users of Psychosocial Care Centers (CAPS) in the city of São Paulo. The QPC-OP is an eight-dimensional quality instrument, developed in Sweden, which aims to measure the quality of care in outpatient mental health services from user\'s perspective. The assumption of the research is that the QPC-OP is a valid instrument to compose an evaluation for the management in the Brazilian context and that the quality of the mental health care perceived by users of CAPS of the city of São Paulo would be good, but with aspects that need to be improved. It is a methodological study, with mixed approach, developed in three stages: the first was the cross-cultural adaptation of the QPC-OP, which involved translation and back-translation by independent professionals, the evaluation of the first version of QPC-OP by A committee of seven experts and a pre-test with 31 CAPSs users; The second was the evaluation of the psychometric properties of QPC-OP, which tested the reliability and validity of the instrument in a sample of 253 users. To test the reliability of the scale, the internal consistency of the instrument was evaluated; For validity, the Factorial Confirmatory Analysis (CFA) was used. In the third stage, descriptive analyzes of the data obtained by the application of QPC-OP and tests of association of the data produced by QPC-OP with sociodemographic and care information were carried out, the Pearson correlation coefficients of Kendall and the Of Bisserial were used, with a 95% confidence interval. The analyzes were carried out using Software R. On the cross-cultural adaptation process, the conceptual equivalence of the QPC-OP was verified with the literature review, the evaluation of the expert committee and the evaluation of CAPSs users. The semantic equivalence of the items was maintained, but some items were modified in the Brazilian version in relation to the extension of the questions and the verbal time, in order to present more colloquial language. Three new items specific to the Brazilian context were added in the \"Users Rights\" dimension, which limited the technical equivalence, but increased the practical significance. The CFA revealed that the Brazilian version of the QPC-OP was accepted based on the results of the adequacy tests and has a factor structure corresponding to the original version, with the exception of factor Discharge. The internal consistency of the full scale was evaluated as good, but the internal consistency of some factors was low, probably due to the reduced number of items per factor. We proceeded by presenting a validated tool, useful for monitoring, evaluation and potential qualification of the CAPS from the perspective of the user, of psychosocial attention, which did not exist until the moment.

The Community Mental Health Act of 1963 launched the deinstitutionalization movement, whereby individuals with serious mental illnesses were released from psychiatric hospitals and began living and receiving mental health care in the community (Carling, 1995). However, these actions have not necessarily integrated those individuals into all aspects of community life (Dewees, Pulice, & McCormick, 1996). This is unfortunate because people with serious mental illnesses frequently report that community integration is not only important to them, but that it also aids in reducing symptoms and promoting recovery (Townley, 2015). Although past research suggests that receiving mental health care in the community has a positive impact on symptom management, the influence of other community factors (e.g., sense of community, community participation) has yet to be fully explored (Segal, Silverman, & Temkin, 2010). Furthermore, there is lack of understanding as to how these community factors influence other aspects of recovery, such as mental and physical health. As such, the goal of the current study is to better understand the association between community participation and recovery by investigating sense of community as a potential mediating factor between community participation, psychological distress, mental health, and physical health. Data were collected from 300 adults with serious mental illnesses utilizing community mental health services in the United States. Results indicated that sense of community partially mediated the association between community participation and mental health, as well as psychological distress, and fully mediated the association between community participation and physical health. Implications include contributing to the current knowledge base about the role of community factors in recovery and informing future interventions aimed at promoting community integration of adults with serious mental illnesses.

The purpose of this study was to design and implement the two phases of a three-phased approach to the integration of the psychiatric component into the PHC system in the Eastern Cape. The study included an educational approach in which the PHC nurses were trained to diagnose, treat and rehabilitate psychiatric patients. Case studies and surveys were used to collect data. A sample of six clinics in which twenty registered nurses were trained was conveniently selected. Nurses had to volunteer so that 50% of the registered nurses would take part in the study. Each clinic was seen as a case in which a record review and questionnaires were used to collect data. The data revealed that, given the training in the diagnosis, treatment and rehabilitation, nurses could provide the first line of psychiatric care efficiently if there is a backup support from a team of consultants at the secondary health services and a support and supervision from an advanced psychiatric nurse. / Thesis (Ph.D.)-University of Natal, Durban, 1996.

Thesis (Ph.D.)--Flinders University, Faculty of Health Sciences, Dept. of Public Health. / Typescript bound. Includes bibliographical references: (leaves 406-434) Also available online.

No description available.

Este estudo trata da avaliação de um Centro de Atenção Psicossocial (CAPS), um serviço supostamente funcionando nos moldes apregoados pela Reforma Psiquiátrica Brasileira, a qual, atualmente, na sua vertente assistencial, é marcada pela implantação de serviços substitutivos ao hospital psiquiátrico. A proposta da avaliação centra-se no microespaço e no cotidiano do serviço e ocorre mediante a participação da equipe, usuários e familiares. Trata-se de uma avaliação qualitativa, mediante a qual se busca apreender a dinâmica do serviço, a forma como os atores interagem e os sentidos que constroem em relação à própria prática; uma avaliação que também possa ser dispositivo, permitindo, mediante um processo participativo, que grupos de interesse ampliem a possibilidade de intervir na realidade do serviço, e que possam ser sujeitos, uma vez que em metodologias tradicionais estão excluídos. A Avaliação de Quarta Geração, desenvolvida por Egon G. Guba e Yvona S Lincoln juntamente com o Método Paidéia, desenvolvido por Gastão Wagner de Sousa Campos, foram norteadores do processo teórico-metodológico da pesquisa. Os instrumentos de coleta de dados foram entrevistas com equipe, usuários e familiares e observação. As questões que emergiram no processo avaliativo foram agrupadas em três núcleos temáticos: dimensões do objeto de trabalho, equipe, práticas e os meios de trabalho. Foi constatado que, mesmo que o serviço pareça ser um substitutivo para o atendimento no hospital psiquiátrico, tanto fatores externos, relacionados às políticas locais de saúde mental, quanto fatores internos, relacionados ao cotidiano do serviço, impedem que isso se efetive. / This study is about the evaluation of a Center of Psychosocial Care (CAPS), a service supposed to work according to the patterns divulged by the Brazilian Psychiatric Reform which, currently, in its assistance trend, is marked by the implantation of services intended to replace the psychiatric hospital. The evaluation proposal is centered in the micro space and in the day-to-day of the service and is performed by means of the participation of the team, the users and family members. It is about a qualitative evaluation, by means of which one searches to grasp the dynamics of the service, the way how the actors interact and the directions that they construct in relation to the practice itself; an evaluation that can also device, allowing, by means of a participation process, that interest groups broaden the possibility of intervening in the reality of the service and that they may become subjects, considering that in traditional methodologies, they are excluded. The Evaluation of Fourth Generation, developed by Egon G. Guba and Yvona S. Lincoln, together with the Paidéia Method, developed by Gastão Wagner de Sousa Campos, guided the theoretical-methodological process of the research. The instruments for the collection of data were interviews with the team, users and family members as well as observation. The issues that emerged over the evaluation process were grouped in three central themes: dimensions of the work object, the team, practices and the working means. It has been noticed that, even though the service seems to be a replacement for the attendance in the psychiatric hospital, both external factors, related to the local policies of mental health, and internal factors, related to the day-to-day of the service, prevents it from becoming effective.