The incidence of smoking among mentally ill people is very high. Smokers have a 50%, rate of mental illness diagnosis compared with 23% rate for general population. To address this problem, the purpose of this project was to plan a smoking cessation program for patients in a mental health facility. The theoretical foundation for this project was based on the theory of planned behavior, which identifies the predictive nature of smoking and the benefits that can be derived from implementing a systematic approach for change. The project question examined the effectiveness of smoking cessation program using educational support, pharmacological strategies, and bi-weekly meetings to help patients in a mental health hospital to decrease smoking behavior. The project design was based on use of smoking questionnaires, the Hooked on Nicotine Checklist (HONC), effective pharmacological strategies, educational support, and counseling treatments to evaluate symptoms of dependency. The key results of this project included the creation of a plan that could foster reduction in illness, improved quality of life, and reduced costs related to the onset of major illness in this vulnerable population. This data collection process focused on a qualitative design in which selected professionals were asked to review the materials and answer questions. This project could increase awareness of the issue of smoking; in addition, this project could equip nurses with the tools to deliver evidence based interventions for tobacco dependence that may significantly reduce tobacco use. This project has the implications for positive social change through its potential to improve the health of people with mental illnesses. It also creates a safe and healthy environment in mental health facilities for patients who do not smoke.

Trauma due to sexual assault becomes a life changing event during a child's critical developmental years. Bronfenbrenner's ecological systems theory outlines the process of understanding an individual's environment and how disruptions in one level may affect other levels. This study determined if gender and ethnicity among sexually traumatized children diagnosed with post-traumatic stress disorder (PTSD) predict symptom severity as measured by the Trauma Symptom Checklist for Children (TSCC) after controlling for the socioeconomic level and home environment. The population consisted of 126 children aged 8 through 16 with at least a second-grade reading level. Multiple regression examined whether male and female children were significantly different concerning the magnitude of PTSD symptom presentation. Multiple regression was also used to test whether gender and ethnicity played a significant role in predicting specific symptoms. Female gender had statistically significant predictive power concerning anger and sexual concern. Age at intake was associated with significantly higher scores for anxiety, anger, and dissociation. Home environment was a statistically significant predictor for anxiety, depression, PTSD, and sexual concern with children living in a foster home having significantly higher symptom severity in these domains. Socioeconomic status was the strongest predictor variable. The addition of sexual assault in the diagnostic criteria for the diagnosis of PTSD with the adoption of DSM-5 indicate a justification for further research. Increased awareness of inefficiencies in identification of symptoms and inadequacies in training trauma providers are indicative of social change. Further knowledge of PTSD symptom expression propagates a new protocol when treating traumatized children.

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical lens through which this study was conducted. It was hypothesized that there is an association between veterans’ involvement in the wellness component of a program and their perceived QOL. The program is a specialty VA service known as Mental Health Intensive Case Management (MHICM). A total of 112 veterans served by a single MHICM program in the U.S. Southeast completed a validated VA survey that measures health related QOL. A chart audit was conducted to gather information such as years served by the program and type of wellness services received. Regression modeling was used to assess the relationship between a veteran’s involvement in the wellness interventions and his or her perceived QOL. The study results showed that the interventions were not significant predictors of veterans QOL. Two covariates, age and gender, were found to be significant predictors, but each accounted for less than 7% of the variance. The study findings show the need for further research to explore the role of wellness interventions in a veteran’s recovery. Social change may result from encouraging veterans with SMIs to participate in self-rated QOL measures.

Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high risk areas of inpatient psychiatry and emergency departments provided detailed descriptions about the phenomena. Data management was an inductive, iterative analysis completed and facilitated by the use of NVivo 10 software program. The study found that participants had a brief emotional response post assault mitigated by the community of nursing personal from their immediate surroundings and that assault is "part of the job." Providing a true culture of safety would include enhancements to the internal community of bedside nursing practice. In addition, research is needed on interventions that can effectively enhance the internal community after assault by patients. This study contributes to positive social change by providing registered nurses, an oppressed group, and a "voice" to mitigate negative consequences associated with assault in the hospital setting.

This study evaluated the use of a tok en, operant conditioning technique as a treatment procedure in a group setting with chronic, hospitalized, psychiatric patients. Fifteen patients were randomly assigned to two experimental groups and to one control group; each group included five patients. The two experimental groups received tokens during phases of contingent reinforcement for "Therapeutic Responses" and under a yoked-control phase of non-contingent token reinforcement; the sequence of these phases was the major difference between the two experimental groups. The control group met under conditions of no tokens, and the frequency of "Therapeutic Responses" was recorded on those subjects. "Therapeutic Responses" were characterized as open, confrontive, and problem-solving oriented interaction among group members as defined by Quadrant IV of the Hill Interaction Matrix (HIM). Results clearly supported the hypotheses that therapeutic responses did occur significantly more frequently and for longer durations in both the experimental groups in the following predicted directions: (1) under conditions of contingent token reinforcement as compared to conditions of non-contingent token reinforcement and to baseline and extinction phases; (2) in both of the experimental groups as compared to the control group. Reversal procedures demonstrated the expected extinction effects. Also, all three groups were compared on follow-up outcome data which included: (1) pre- and post-test ratings by hospital attendants of the group member's behavior changes on the ward as measured by The Behavioral Adjustment Scale; (2) pre- and post-test scores on the HIM-B (an unpublished instrument based on the HIM measuring attitudes toward group interaction). There were no differential effects among the three groups' MACC Behavioral Adjustment Scale and HIM-B posttest scores. These results were discussed in respect to the implications of applied research in the area of verbal conditioning, and implications for the treatment of chronic psychiatric patients. Recommendations for future research to examine possible generalization effects were offered.

The intent and direction of this thesis is to recognize personal and social concerns that influence soldiers’ reintegration process. The missing element in current literature is capturing the soldiers’ lived experiences, ideas, perspective and knowledge of what it truly means to be a soldier and having to reintegrate back into the civilian life after being submerged the military culture for an extended period of time. One of the vital concerns to the soldiers is how civilians, specifically the community, politicians, scholars and mental health providers, are not necessary fully aware nor do they recognize the influential impacts of the experiences and environment the military culture has over the soldiers. Soldiers may suffer from depression, anxiety, isolation, alienation, lack of belonging and perceived burdensomeness upon returning home. Previous research often from the civilian point of view expects soldiers to face personal and social concerns, but this research does not allow soldiers to speak for themselves – from their military perspective and lived-experiences. The mission of this thesis, with the support of members of the US Army, is to help bridge the disconnect in communication and the lack of understanding between the two cultures, military and civilian, in order to work together to find a more improved solution on helping soldiers reintegrate processes. The main objective of the mission is to increase our awareness and understanding on who a soldier is, who they develop into and who they become throughout their military career, and how this influences their reintegration journey.

No description available.

During the earliest days of the penal colony in New South Wales in 1788, the plight of the mentally ill was given little consideration by the governing authorities, particularly the convict insane, who lived (and died) by their wits and suffered cruel punishment if their behaviour was seen as recalcitrant. This thesis traces a history of mental health carers (nursing) from the foundation of the penal colony until the Federation of the Australian colonies to form a nation in 1901. The research makes a contribution to the profession of mental health nursing by providing an understanding of the origins and development of that profession in New South Wales. The thesis also examines ways in which the historic development of mental health nursing has influenced the work of mental health nurses and nursing in the present, and exposes recurrent dominant issues of the past which will, if they remain unaddressed, continue to influence that profession in the future. / Doctor of Philosophy (PhD)

This research project began from an interest in 'what happened' at a residential psychiatric disability support service (therapeutic community) where I had previously worked as a social worker, or, as it was termed in the program, support worker. Residents used the program in various ways, to get back on track with their lives, and workers aimed to support them in that process. My approach to data collection was, as for many social work researchers, qualitative. As my work on the project developed over time, I was consistently informed and re-informed not only by ideas arising from my engagement with participants and relevant literature, but also by new concepts and areas of interest that opened up as a result of my teaching in a progressive Bachelor of Social Work course. Gradually, as my understanding of critical and reflective postmodern social work theory evolved, new interpretations crept into my writing. Some of the tensions that arose as a result of th is overlaying of new conceptual frameworks are evident in the thesis. While I have tried to create internal cohesion, the layers of different approaches that informed me are sometimes evident, like the sides of a canyon that display evidence of its historical and ongoing formation. This may not be dissimilar to social work itself in the new millennium, as new ideas variously challenge, consolidate, destabilise and/or reshape theory and practice. While this thesis began as an exploration of the experiences of individuals in a therapeutic community and the role of support workers in that process, it became, additionally, an exploration of ways in which the role and practice of social work is constructed. However, the stories of participants remain a central feature. Chapters include: the professional gaze and the construction of subjects; problematising worker power and professionalism; boundaries, vulnerability and authority; therapeutic community; sensemaking, meaning ascription and the creation of cul ture; change and turning points; and problematising and exploring outcomes in mental health.

Thesis (M.S.W.)--University of Hong Kong, 1976. / Includes bibliographical references (leaves 56-59) Also available in print.