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Background: Cultural beliefs significantly shape societal attitudes toward mental illness, and these social attitudes profoundly impact help-seeking behaviors. Therefore, it is important to focus on understanding and addressing these social behaviors. Aim: This study aimed to evaluate the effect of chronic mental illness interpretations based on culture and religious beliefs on non-medical help-seeking behaviors among patients in Türkiye. Methods: The study was conducted from September to October 2023 using an inductive qualitative approach. In-depth face-to-face interviews were carried out with individuals diagnosed with chronic mental illness and their relatives, registered in a state-owned Community Mental Health Center (CMHC) in Türkiye. Using purposive sampling, 13 individuals who met the criteria were interviewed. Thematic analysis was used to identify themes. Results: Three main themes and eight sub-themes were identified, including the reasons for seeking non-medical help (psychological challenges, subjective norms, physical requirements), factors contributing to seeking non-medical help (predisposing factors, enabling factors, and myths), and reflections on the benefits of non-medical practices (perceived physical benefits, perceived psychological benefits). Conclusions: It was concluded that individuals with chronic mental illness and their relatives living in the Eastern Anatolia Region of Türkiye engaged in non-medical help-seeking behaviors and mostly turned to traditional religious practices. Culture and religious beliefs emerged as primary factors leading patients to seek non-medical treatment approaches. Consequently, there is a perceived need to explore non-medical alternative methods across various mental health settings and with diverse samples in future research endeavors. [ABSTRACT FROM AUTHOR]

Background: Cultural beliefs significantly shape societal attitudes toward mental illness, and these social attitudes profoundly impact help-seeking behaviors. Therefore, it is important to focus on understanding and addressing these social behaviors. Aim: This study aimed to evaluate the effect of chronic mental illness interpretations based on culture and religious beliefs on non-medical help-seeking behaviors among patients in Türkiye. Methods: The study was conducted from September to October 2023 using an inductive qualitative approach. In-depth face-to-face interviews were carried out with individuals diagnosed with chronic mental illness and their relatives, registered in a state-owned Community Mental Health Center (CMHC) in Türkiye. Using purposive sampling, 13 individuals who met the criteria were interviewed. Thematic analysis was used to identify themes. Results: Three main themes and eight sub-themes were identified, including the reasons for seeking non-medical help (psychological challenges, subjective norms, physical requirements), factors contributing to seeking non-medical help (predisposing factors, enabling factors, and myths), and reflections on the benefits of non-medical practices (perceived physical benefits, perceived psychological benefits). Conclusions: It was concluded that individuals with chronic mental illness and their relatives living in the Eastern Anatolia Region of Türkiye engaged in non-medical help-seeking behaviors and mostly turned to traditional religious practices. Culture and religious beliefs emerged as primary factors leading patients to seek non-medical treatment approaches. Consequently, there is a perceived need to explore non-medical alternative methods across various mental health settings and with diverse samples in future research endeavors.

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONChronic mental illness disrupts the ability to work, often resulting in the need for vocational rehabilitation in which occupational therapists play a role. Namibia does not have an occupational therapy vocational rehabilitation practice framework for service users with chronic mental illness. This study explored the contextual factors that should be considered for a vocational rehabilitation practice framework in Namibia.A qualitative collective case study design was utilized. In-depth interviews were conducted with nine mental health service providers that were purposively selected from two study sites. An inductive thematic analysis of data was done using ATLAS.ti.The need for collaborative advocacy for service users to raise awareness and engage stakeholders such as family members, employers and policy makers was highlighted. Vocational rehabilitation resources needed include sheltered workshops, financial resources and trained human resources. Recognition that vocational rehabilitation services are too limited to meet the needs of mental health service users. A vocational rehabilitation policy and strategy is required. Supported employment and self-employment are potential strategies that should be considered.Vocational rehabilitation for service users with chronic mental illness is limited in Namibia and there is a need to collaboratively improve the service.Occupational therapists should collaboratively advocate for vocational rehabilitation of mental health service users in low-income and middle-income countries such as NamibiaOccupational therapists should employ a human rights approach to vocational rehabilitation with emphasis on promotion of reasonable accommodation of service users in the workplace.Occupational therapists should collaboratively advocate for vocational rehabilitation of mental health service users in low-income and middle-income countries such as NamibiaOccupational therapists should employ a human rights approach to vocational rehabilitation with emphasis on promotion of reasonable accommodation of service users in the workplace. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine hope and psychological resilience in primary caregivers of patients with a chronic mental illness. The descriptive study was conducted on 297 caregivers in community mental health centers in Turkey. Data were collected using the Introductory Information Form, Dispositional Hope Scale and the Resilience Scale for Adults. Hope and psychological resilience of primary caregivers of patients with a chronic mental illness were moderate. To sociodemographic and caregiver characteristics; caregivers who are over 40 years old, lost his/her spouse, low education level, housewife or retired, unemployed, who evaluated their incomes low, mother, living in the same house with the patient, caring for ten years or more, caring for another patient and not getting help in care had lower hope and resilience levels. Compared to patients with a diagnosis of bipolar disorder, caregivers of patients with schizophrenia had lower hope and psychological resilience levels. Primary caregivers of patients with a chronic mental illness should be supported in terms of hope and psychological resilience. • Caregivers of patients with a chronic mental illness need support in terms of hope and psychological resilience. • Hope and psychological resilience levels of caregivers of patients with a chronic mental illness are affected by demographic, economic, accommodation, length of care and receiving support. • Compared to patients with a diagnosis of bipolar disorder, caregivers of patients with schizophrenia have higher hopelessness and lower psychological resilience. • Caregivers of patients with schizophrenia are more risky in terms of pathways thinking and planned future. [ABSTRACT FROM AUTHOR]

This article explores the importance of assessing and improving the quality of life for individuals with chronic mental illness. It emphasizes the need for a person-centered approach and interdisciplinary collaboration in developing customized interventions. The article discusses various research studies on topics such as depression among science students during the Covid-19 pandemic, the impact of employment programs on the quality of life for people with psychiatric disorders, the relationship between creativity and mental illness, and the effectiveness of electro-acupuncture in treating post-stroke depression. It also discusses a systematic review and meta-analysis on Moyamoya disease and psychiatric manifestations, highlighting the most common symptoms and providing guidelines for treatment. The article concludes by emphasizing the importance of addressing factors often overlooked in the treatment of chronic mental illness, such as depression, physical health, lifestyle behaviors, and technology-aided interventions. [Extracted from the article]

Purpose: This study aims to examine the relationship between perceived social support, insight, and treatment adherence in patients with schizophrenia and bipolar disorder. Materials and Methods: This study was conducted with 110 individuals, including 55 bipolar and 55 schizophrenia patients, who had been hospitalized in our clinic in the last 1 year and were in remission. Participants were administered a sociodemographic and clinical data form, Young Mania Rating Scale (YMDÖ), Clinical Global Impression Scale (CGI), Three Components of Insight Rating Scale (IÜBDÖ), Morisky Treatment Compliance Scale (MTUÖ) and Multidimensional Perceived Social Support Scale (MSPSS). Results: The mean age was 40.47±12.96 for bipolar patients and 40.45±11.71 for schizophrenics. Perceived family, friend, significant others support, and total support was found to be higher (p=0.000, p=0.000, p=0.004, p=0.000, respectively) of bipolar patients, and the highest support was perceived from family, followed by friends and significant people. Although the groups did not differ in terms of treatment adherence (p=0.083), the insight score was significantly higher in bipolar patients (p=0.001). Groups were evaluated with hierarchical regression analysis in terms of factors affecting perceived social support. Gender, years of education, insight, and treatment adherence were found to be predictive of social support (p=0.04, p=0.01, p

This scoping review focuses on how the caregiving experience of unpaid carers of persons with schizophrenia (CPSs) is understood in the literature. One hundred and eighteen studies were included. Publications have steadily increased over the past two decades. Most studies were derived from India, the UK, and China and were quantitative research. Financial problems, disruption to social life, and family relationships were commonly evaluated to be objective burdens, while care recipients relapsing, CPSs suffering from violence from care recipients, and experiencing discrimination were identified as subjective burdens. The effectiveness of care services and the positive feelings and physical impacts of CPSs need to be further discussed. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Celal Bayar Üniversitesi Saglik Bilimleri Enstitüsü Dergisi is the property of Celal Bayar University Health Sciences Institute Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population. Aims: The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health and quality of life in accordance with best practice guidelines. Methods: Patients were invited to attend the clinic. The following areas were examined: personal and family history of cardiovascular disease, diet, exercise, and smoking. Mental state examination, waist circumference, BP, pulse, ECG and BMI. Laboratory tests including U + E, LFTs, HbA1c, Lipid profile and other tests as appropriate such as serum lithium. AIMS scale, HoNOS and WHOQOL-BREF scales as additional indicators of global health. Results: A total of 80 patients attended during 3.5 years of clinic. Mean age was 54.9 years (SD: 13.81) at first contact and 45% were females. Mean years in the service was 19.66 (SD: 11.54) and mean number of previous hospital admissions was 4.4 (SD: 5.63). Metabolic syndrome was present in 42% at first assessment. A statistically significant improvement was found for the psychological domain of the WHOQOL-BREF and the HoNOs, particularly at third assessment. (β = 4.64, Wald x2 = 7.38, df:1, p = 0.007, CI:1.3–8.1, β = −.889, Wald x2 = 4.08, df:1, p = 0.043, CI: − 1.752 to −.026) respectively. Conclusion: The results show a high prevalence of physical health conditions in this cohort, some of which represent a new diagnosis. This implicates better allocation of existing resources for screening and early detection, and potential to run joint clinics with primary care. [ABSTRACT FROM AUTHOR]

Introduction: This study analyzes the effect of telemedicine use on healthcare utilization and medical spending for patients with chronic mental illness. Methods: Using the IBM MarketScan Research database from 2009 to 2018, this study examined the timing of users’ first telemedicine use and identified similar periods for non-users by using random forest and random forest proximity matching. A difference-in-differences approach, which tests whether there are differences in the study outcomes before and after the actual/predicted first use among the treated group (users) compared with the control group (non-users), was then used to assess the impact of telemedicine. Analyses were done in 2021. Results: Comparing users with non-users after matching suggested that telemedicine use both increases the number of overall outpatient visits (0.461; 95% CI=0.280, 0.642; p

Objective. In this study, the physical activity levels of individuals with chronic mental illness will be determined, and the effect of physical activity levels on their methods to coping with stress will be examined. Methods. This study was planned as a descriptive relational study. The study was conducted with 94 psychiatric patients who applied to the psychiatry outpatient clinic of a University hospital in the Selçuklu district of Konya. In the collection of data; Personal information form prepared by the researchers, questioning socio-demographic characteristics, International Physical Activity Questionnaire and the Scale of Coping with Stress was used. To evaluate the relationship between sociodemographic characteristics and physical activity, t-test and one-way anaova tests were used with independent groups. Pearson correlation analysis was used to evaluate the relationship between the coping styles scale and physical activity. Results. The mean age of the participants was 33.54±12.02, 58.1% were female, 41.9% were male, 36.2% were university graduates, 61% were single, 73.3% were It was determined that 40 of them did not work in any job, 40% of them had an income of less than 1000 TL, 45.7% of them had the disease for less than 5 years, 39% of them had bipolar diagnosis and 53.3% of them perceived their health as moderate. The distribution of the physical activity levels of the participants and their stress coping styles scale mean score are presented in Table 1. It was determined that 81.6% of the participants were in the physically inactive (inactive) group, while 18.1% were in the group with low physical activity levels. The mean physical activity score of the participants was found to be 483.35±111.05. Stress coping styles scale Self-Confident Approach sub-dimension mean score 18.83±4.67, Helpless Approach sub-dimension mean 19.74±4.67, submissive approach mean score 12.53±3.45, optimistic approach score mean score of 12.68±3.32 and Seeking Social Support sub-dimension was found to be 9.14±2.88. Conclusions. According to the results of the study, women, married people, employees, those with chronic mental illness for 10 years or more, and those with a personality disorder diagnosis were included in the risk group in terms of physical activity. It was also observed that there is a relationship between physical activity and self-confident approach to coping with stress, submissive approach and seeking social support. [ABSTRACT FROM AUTHOR]

This study was aimed at investigating the effects of family support and psychoeducation program based on Calgary Family Intervention Model on coping, psychological distress and psychological resilience levels of families of chronic psychiatric patients. The sample of this quasi-experimental study consisted of the caregivers of chronic psychiatric patients who were admitted to the adult psychiatry inpatient and outpatient unit of a university hospital and the caregivers of chronic psychiatric patients registered with the Schizophrenia Solidarity Association. Nonparametric analysis was used in the analysis of the data. It was found that there was a significant decrease between the mean distress scores the caregivers participating in the Calgary Family Intervention-Based Family Support and Psychoeducation Program obtained from the measurements before, right after, and 3 and 6 months after the intervention (p < 0.05). There was no statistically significant difference between the coping scores and psychological resilience scores the caregivers obtained from the measurements before, right after, and 3 and 6 months after the intervention (p > 0.05). It was concluded that the family support and psychoeducation program based on the Calgary Family Intervention Model applied to family members giving care to individuals with chronic mental illnesses had positive effects on the general health status of the caregivers. • It is important to apply model-based interventions in empowering families. • Family-based interventions are very important in reducing the burden of chronic mental illnesses on the family. • CFIM is an important model in improving family functionality and providing changes in psychiatric nursing practices. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of selected sports games in leisure time on mindfulness skills, anxiety and depression of chronic mental patients. This is a quasi-experimental study and its participants consisted of women with chronic mental illness aged 20-30 years hospitalized in Atef Rehabilitation Centre of Mashhad in 2022. The statistical sample was selected as a total of 46 people, i.e., the entire statistical population. The samples were randomly divided into control and experimental groups. Data collection tools included the Kentucky Mindfulness Skills Questionnaire (2004), the Beck Depression Inventory (1961), and the Zung Anxiety Inventory (1971). In the pre-test, both groups filled out the questionnaires. The subjects of the experimental group played selected sports games for eight weeks, three days a week and every day for 60 minutes, and the control group continued their daily activities. Then, the two experimental and control groups participated in the post-test and filled out the questionnaires again. SPSS software version 24 was used for data analysis. Findings indicate that the mean of depression and anxiety decreased after the post-test, but the mean increased for mindfulness. Although there was a significant difference between the control and experimental groups in the variables of mindfulness, depression, and anxiety after selected sports games, the components of describing mindfulness and physical symptoms of anxiety were not significant. The results showed that considering that playing sports games in the leisure time of chronic mentally ill people improves their level of mental health, it is recommended that selected sports games be included in the leisure program of these patients; Therefore, spending sports leisure time while creating positive effects on the physical and mental dimensions of patients can be a good alternative to the same and inflexible daily programs of this group of society. [ABSTRACT FROM AUTHOR]

Background: Psychiatric disorders are a type of illness in which people suffer from emotional problems that affect all aspects of a person's life. Numerous studies have examined the effectiveness of third-generation cognitive and behavioral therapies on improving the performance of the mentally ill. Nevertheless, the main question is whether the new therapies, including positive psychology- based skills, affect the self-efficacy and awareness of these patients? Aims: This study aimed to investigate the effectiveness of positive psychology skills on self-efficacy, problem solving, and mindfulness in chronically mentally ill patients. Methods: This was a quasi-experimental study with a pretest-posttest design with a control group The statistical population consisted of all chronic male mental patients attending the center overnight in Roozbeh mental patients in Zahedan in 1399Thirty patients were selected by convenience sampling method and randomly assigned to experimental (n=15) and control (n=15) Experimental group (positive psychology Quailiam,2003) received eight 90-minute sessions (biweekly). The control group received no intervention. The measurement instruments used in the study were the Self-Efficacy Questionnaire for Coping with Chesney Problems (2003) and the Mindfulness in Sports Questionnaire. The data obtained from the questionnaires were analyzed in two sections descriptively and inferentially using tests (multivariate and univariate covariance). Results: The results of the analysis of covariance showed that the skills training based on Positive Psychology is effective on "self-efficacy in coping with problems" and "mindfulness in exercise" of chronically mentally ill people (p

Abstract Background The psychosocial rehabilitation of an individual with mental illness is an evidence-based approach to reducing the burden of the illness and the associated stigma globally. Specifically, in Africa, it has promising scope for African life and the African economy. Psychosocial rehabilitation is described as a set of approaches that aim to assist an individual in achieving restoration from a state of dependency caused by schizophrenia to a state of being an independent decision-maker. However, there seems to be a dearth of literature and implementation of psychosocial rehabilitation in Africa. Therefore, it is necessary to map studies on how psychosocial rehabilitation is conducted for people living in Africa with the most chronic form of mental illness, schizophrenia. Methods This study will adopt the Arksey and O’Malley scoping review framework to search and compile relevant studies. This process will involve three steps: title screening, to be performed solely by the principal investigator, followed by abstract and full-text screening, to be performed independently by two reviewers (the principal investigator and co-investigator). Rayyan QCRI, a systematic reviews web app, will be used for tracking the screening records, and data charting form will be used to extract basic data of included studies. The risk of bias in the articles identified for screening will be assessed by the Mixed Method Appraisal Tool (MMAT). Finally, the content analysis of the screened studies will be performed with NVivo. Expected outcome This study has the likelihood of revealing a research gap in psychosocial rehabilitation approaches and methods. The review results will constitute part of the available evidence that the researchers aim to adopt in the broader part of the project, which aims to develop implementation strategies for the psychosocial rehabilitation of chronic mental illnesses, specifically schizophrenia, in Sub-Sahara Africa. The implementation process also encompasses disseminating the findings of this review to stakeholders, which will enhance their knowledge of the current state of Sub-Saharan Africa and may stimulate support for the implementation of rehabilitation strategies.

Background: Adult children of chronically mentally ill parents are prone to behavioural, emotional, and psychological problems compared to children and teenagers in the general community. Purpose: To gain an understanding of adult children’s experiences with a parent living with a chronic mental illness in Giyani, Limpopo Province, South Africa. Design and methods: A qualitative exploratory, descriptive research design was utilised. Ten purposefully sampled adult children with a parent living with a chronic mental illness participated in the study. Data were collected using in-depth phenomenological interviews. Data were analysed utilising Tesch’s open-coding method. Results: Adult children experienced having a parent living with a chronic mental illness as a difficult and painful journey filled with confusion. The support and lack of support they received from people around them. They ultimately accepted their situation based on the realisation their parent has a chronic mental illness. Conclusion: Based on the findings, it is recommended that healthcare professionals should promote individuals’ mental health and well-being through the provision of mental health education, facilitation of a reduction in mental health stigma in communities, and fostering resilience among adult children with a parent living with a chronic mental illness. The facilitation of support and acceptance of their parent’s mental status is also vital for these individuals. Collaboration between families with parental mental illness, the community, social services, mental health services and other relevant organisations and stakeholders were highlighted in supporting these families to achieve better outcomes.

Background: One of the most important aspects of receiving medical care is access to that care. For people with mental illness who have greater healthcare needs and are at risk for poor health outcomes, reduced access to care constitutes a crisis. While the COVID-19 (coronavirus disease 2019) pandemic continues to affect the United States, specifying what it means to have access to mental healthcare is more critical than ever. Aims: The aims of this concept analysis are to review definitions and descriptions of access to mental healthcare in the literature and to synthesize the relevance of these findings to inform future research, theory development, policy, and practice. Methods: The concept of access to mental healthcare was analyzed using Rodgers's evolutionary concept analysis method. CINAHL, PsycINFO, and MEDLINE were queried for peer-reviewed articles about access to mental healthcare published from January 2010 to April 2020 (n = 72). Data were reviewed for concept antecedents, attributes, consequences, surrogate, and related terms. Results: Five models of access to mental healthcare were identified, with several antecedents and consequences: utilization, economic loss/gain, incarceration, and patient/provider satisfaction. Cross-sectional and predictive studies highlighted three interrelated attributes: clinical management, healthcare delivery, and connectedness. Conclusions: The concept of access to mental healthcare is often used stagnantly across disciplines to create health policies, yet the concept is transformative. Future research requires up-to-date operational definitions of access to mental healthcare to target interdisciplinary approaches. [ABSTRACT FROM AUTHOR]

Introduction People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population. Objectives The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health in accordance with best practice guidelines. Methods Patients were invited to attend the metabolic clinic. The following areas were examined: Personal and family history of cardiovascular disease, diet, exercise, smoking. Mental state examination, waist circumference, BP, pulse, ECG and BMI. Laboratory tests including U+E, LFTs, HbA1c, Lipid profile and other tests as appropriate such as serum lithium. AIMS scale, HoNOS and WHOQOL-BREF scales as additional indicators of global health. Results A total of 80 patients attended during 3.5 years of clinic. Mean age was 54.9 years (SD:13.81) at first contact and 45% were females. Mean years in the service was 19.66 (SD:11.54) and mean number of previous hospital admissions was 4.4 (SD:5.63). Metabolic syndrome was present in 42% at first assessment and 20% had at least one new physical abnormality identified during the clinic. A statistically significant difference was found for the psychological domain of the WHOQOL-BREF and the HoNOs particularly at third assessment. (β=4.64, Wald x2=7.38, df:1, p=0.007, CI:1.3-8.1, β =-.889, Wald x2=4.08, df:1, p=0.043, CI: -1.752 to-.026) respectively. Conclusions The results show a high prevalence of physical health conditions in this cohort, some of which represent a new diagnosis. This implicates better allocation of existing resources for screening and early detection, and potential to run joint clinics with primary care. Disclosure No significant relationships.

Background: The psychosocial rehabilitation of an individual with mental illness is an evidence-based approach to reducing the burden of the illness and the associated stigma globally. Specifically, in Africa, it has promising scope for African life and the African economy. Psychosocial rehabilitation is described as a set of approaches that aim to assist an individual in achieving restoration from a state of dependency caused by schizophrenia to a state of being an independent decision-maker. However, there seems to be a dearth of literature and implementation of psychosocial rehabilitation in Africa. Therefore, it is necessary to map studies on how psychosocial rehabilitation is conducted for people living in Africa with the most chronic form of mental illness, schizophrenia. Methods: This study will adopt the Arksey and O'Malley scoping review framework to search and compile relevant studies. This process will involve three steps: title screening, to be performed solely by the principal investigator, followed by abstract and full-text screening, to be performed independently by two reviewers (the principal investigator and co-investigator). Rayyan QCRI, a systematic reviews web app, will be used for tracking the screening records, and data charting form will be used to extract basic data of included studies. The risk of bias in the articles identified for screening will be assessed by the Mixed Method Appraisal Tool (MMAT). Finally, the content analysis of the screened studies will be performed with NVivo. Expected outcome: This study has the likelihood of revealing a research gap in psychosocial rehabilitation approaches and methods. The review results will constitute part of the available evidence that the researchers aim to adopt in the broader part of the project, which aims to develop implementation strategies for the psychosocial rehabilitation of chronic mental illnesses, specifically schizophrenia, in Sub-Sahara Africa. The implementation process also encompasses disseminating the findings of this review to stakeholders, which will enhance their knowledge of the current state of Sub-Saharan Africa and may stimulate support for the implementation of rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to adapt the stigma subdimension of the Family Interview Schedule (FIS) developed for a World Health Organization study for use with a Turkish population and to conduct a validity and reliability assessment of the instrument. Methods: The study sample consisted of 141 family members who presented at the Adult Psychiatry Inpatient and Outpatient Unit of a university hospital and the Izmir Schizophrenia Solidarity Association between May 2019 and November 2020 who met the sampling criteria. The inclusion criteria were age >18 years, literacy, family member of a patient with a diagnosis of schizophrenia, schizoaffective disorder, or a mood disorder. Internal consistency analysis and test-retest analysis were performed to assess reliability, and validity was evaluated using language validity analysis, content validity analysis, and exploratory factor analysis. Results: The content validity index of the stigma section of the FIS was 0.96, and a Cronbach alpha level of 0.81 was determined. The Spearman correlation coefficient of test-retest reliability between 2 measurements was 0.86. Conclusion: The results of the present study demonstrated that the Turkish version of the stigma section of the FIS created is a valid and reliable instrument that can be used to assess the stigma experiences of family members of people with chronic mental illness in Turkey. [ABSTRACT FROM AUTHOR]

Background: Patriarchy exposes women to various forms of discrimination and oppression. Women are more often blamed for mental illness, which can result in social isolation and stigma. Method: Case Study. Results: Psycho-social intervention aided in empowering women by giving them voices to speak as well as by utilizing their strengths and available community resources to develop a sense of self-efficacy, coping strategies, and support system. Conclusion: Women with chronic mental illness have unique needs and challenges. Mentally ill women face sexual coercion in childhood or adulthood. The factors related to help-seeking in the context of abuse were family reactions, social support, and stigma. Our findings highlight the need to conduct risk assessments and provide community-based and coordinated services during follow-up visits.

Introduction: Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life. However, such psychosocial rehabilitation centers are limited in India. Aims: The present study assesses psychosocial rehabilitation centers (of urban day-care and rural residential rehabilitation center) operated by Ashadeep Charitable Foundation, a civil service organization and its effect on health outcomes of patients living with chronic mental illness. Materials and Methods: Records of 170 cases were retrieved for secondary analysis of demographic information, diagnosis, duration of stay, and health outcomes. Results: Rehabilitation activities included yoga, light physical exercises, group discussion, training for daily living skills, social skills, life skills, vocational training, individual, and family counseling. In addition, extensive outreach activities, mental health camps were also integral part of the rehabilitation activities. Patients who have accessed rehabilitation services were diagnosed with schizophrenia, psychosis, bipolar disorder, depression, and intellectual disability. The average duration of rehabilitation of patients (other than persons with intellectual disability) was ranged from three to four months. Out of those rehabilitated, 69% of them were successfully re-integrated with the family. Conclusion: Combination of pharmacological and psychosocial interventions are effective for re-integrate patients with mental illness to the family. This model of community-based rehabilitation has potential for scale-up.

Background: Individuals with mental illness, as they are stigmatized by society, are also stigmatized themselves, and this process is internalized. This may adversely affect the recovery process. Aims: This study was conducted to investigate the relationship between internalized stigmatization and subjective recovery in patients with schizophrenic. Method: This research was performed for patients with schizophrenia at rehabilitation centers registered with the community mental health center. The survey was performed out with 94 patients in the recovery phase who met the inclusion criteria and who going to the center. Sociodemographic information form, internalized stigmatization scale and subjective recovery assessment scale were used in the collection of data. Results: In the study it was found that there is a relationship between internalized stigmatization and subjective recovery. Increased levels of internalized stigma patient outcome would decrease the level of recovery. Conclusion: It is recommended that nurses perform intervention programs to reduce internalized stigmatization in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

David W Morris,1 Subroto Ghose,1,2 Ella Williams,1,2 Kevin Brown,1,2 Fuad Khan1,2 1Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA; 2Department of Psychiatry, Parkland Memorial Hospital, Dallas, TX, USA Introduction: Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED. Methods: Data from ED visits of patients who were admitted to the Parkland Memorial Hospital ED (the community hospital for Dallas County, TX, USA) with a psychiatric complaint more than once within a 30-day period were evaluated (n=202). A 50-item readmission survey was used to collect information on demographic and clinical factors associated with 30-day readmission, as well as to identify quality improvement opportunities by assessing related moderating factors. An analysis of acute readmission visits (occurring within 3 days of previous discharge) was also performed. Results: Patients readmitted to the ED commonly present with a combination of acute psychiatric symptoms, substance use (especially in the case of acute readmission), and violent or suicidal behavior. The vast majority of cases reviewed found that readmitted patients had difficulties coordinating care outside the ED. A number of moderating factors were identified and targeted for quality improvement including additional support for filling prescriptions, transportation, communication with family and outside providers, drug and alcohol treatment, intensive case management, and housing. Conclusion: Many of the resources necessary to reduce psychiatric patient visits to hospital EDs are available within the community. There is no formal method of integrating and insuring the continuity of community services that may reduce the demand for psychiatric and related services in the ED. While agreements between community service providers may be challenging and require considerable vigilance to maintain equitable agreements between parties, this route of improving efficiency may be the only available method, given the current and projected patient care needs. Keywords: chronic mental illness, psychiatric readmission, emergency psychiatry, public mental health

The spiral phenomenon of homelessness and mental ill-health are major growing epidemic in both developed and developing countries. Viewing from a socio-economic-political dimension, homelessness and mental ill-health cause detrimental effects on the individuals' lives as well as the nation-building process. The condition of women seems to be complex, as the gender perspectives are often described in terms of patriarchy and powerlessness. The bi-directionality of mental illness and homelessness creates a vicious cycle, and many women seem to end up in shelter care homes. The scenario of homeless women with chronic mental illness reflects the lack of community-based rehabilitation efforts and gender-sensitive policy level initiatives.

This study investigates the impacts of an intensive care coordination intervention for adults with severe mental illness who have guardians. Program impacts on medical and legal outcomes were assessed using interrupted time series analysis. Program participation was associated with statistically significant reductions in the level and trend of psychiatric hospitalizations, number of days in psychiatric hospitals, emergency room visits, and arrests. Days incarcerated did not change significantly. The decrease in medical and legal outcomes may be associated with decreased spending on these services. The program and other intensive care coordination interventions for this population warrant further replication and research. [ABSTRACT FROM AUTHOR]

Background: Patriarchy exposes women to various forms of discrimination and oppression. Women are more often blamed for mental illness, which can result in social isolation and stigma. Method: Case Study. Results: Psycho-social intervention aided in empowering women by giving them voices to speak as well as by utilizing their strengths and available community resources to develop a sense of self-efficacy, coping strategies, and support system. Conclusion: Women with chronic mental illness have unique needs and challenges. Mentally ill women face sexual coercion in childhood or adulthood. The factors related to help-seeking in the context of abuse were family reactions, social support, and stigma. Our findings highlight the need to conduct risk assessments and provide community-based and coordinated services during follow-up visits. [ABSTRACT FROM AUTHOR]

Introduction: Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life. However, such psychosocial rehabilitation centers are limited in India. Aims: The present study assesses psychosocial rehabilitation centers (of urban day-care and rural residential rehabilitation center) operated by Ashadeep Charitable Foundation, a civil service organization and its effect on health outcomes of patients living with chronic mental illness. Materials and Methods: Records of 170 cases were retrieved for secondary analysis of demographic information, diagnosis, duration of stay, and health outcomes. Results: Rehabilitation activities included yoga, light physical exercises, group discussion, training for daily living skills, social skills, life skills, vocational training, individual, and family counseling. In addition, extensive outreach activities, mental health camps were also integral part of the rehabilitation activities. Patients who have accessed rehabilitation services were diagnosed with schizophrenia, psychosis, bipolar disorder, depression, and intellectual disability. The average duration of rehabilitation of patients (other than persons with intellectual disability) was ranged from three to four months. Out of those rehabilitated, 69% of them were successfully re-integrated with the family. Conclusion: Combination of pharmacological and psychosocial interventions are effective for re-integrate patients with mental illness to the family. This model of community-based rehabilitation has potential for scale-up. [ABSTRACT FROM AUTHOR]

Severe mental illness (SMI) is associated with a reduced life expectancy of up to 20 years. One possible contributor to this fact is dysregulation of the hypothalamus-pituitary-adrenal (HPA)-axis. Looking at the morphology of effector organs, such as the adrenal glands themselves, could reveal insights into organ function and response to possible HPA-dysregulation. This forensic autopsy-based study investigated if there were any morphological changes in adrenal glands between decedents who had previously been submitted to a psychiatric hospital with a diagnosis of schizophrenia (n = 34), bipolar (n = 5), or depressive disorder (n = 20), any other psychiatric diagnosis (n = 36) compared with decedents who had no previous psychiatric admission (n = 40). Length of admissions to psychiatric wards and admission in the 180 days preceding death was included in regression as proxy variables for severity of illness. On the macroscopic level, we found no difference in gland weight or volume. On the microscopic level, we found a 25% increase in cross-sectional area of the zona fasciculata (ZF) in decedents who had a diagnosis of schizophrenia compared with controls (p = 0.033). Other diagnosis groups did not differ from controls. Total admission length was positively correlated with area of the ZF. Lay Summary People with a severe mental disorder may be in a constant state of increased stress, which is harmful. This study looked at the adrenal gland, which produces stress hormones, to see if they were different in deceased persons who had suffered from a severe mental illness. We found that the part of the adrenal gland that produces stress hormones is larger in deceased patients who suffered from schizophrenia, but not other types of psychiatric illnesses, compared to deceased persons with no history of psychiatric illness. [ABSTRACT FROM AUTHOR]

Background: Chronic mental illnesses like Schizophrenia, Bipolar Affective Disorder, Depression, Alcoholism have a negative impact on the quality of life and affect the reasons for living in such patients. This study was done to find out how the quality of life affects the reasons for living in such chronic patients. Aim: To study the Quality of life and Reasons for living in patients suffering from chronic mental illness. Materials and methods: 60 patients suffering from chronic mental illness were selected as subjects. WHO Quality of Life - BREF scale and Reasons for Living inventory are used in this study. SPSS software was used for statistical analysis. Results: Mean RFL score for Males was 151.52. Mean RFL score for females was 133.28. Strong Positive Co-relation was seen between RFL and Quality of life Domains with significant p-values (<0.05). Conclusion: Females have more Fear of Suicide and Psychological domain in quality of life whereas, Males have more Reasons for Living, Survival and Coping Beliefs, Responsibility to Family, Child Related Concerns, Fear of Social Disapproval, Moral Objections, Physical health, Social relationships and environmental domains. [ABSTRACT FROM AUTHOR]

Adults with serious and persistent mental illnesses, such as schizophrenia, schizoaffective disorder, and bipolar disorder, who are under guardianship/conservatorship, may experience health care, social, financial, and housing concerns, which can be addressed by care coordination programs. In such programs, providers assist with communication across service sectors, assistance with monitoring of psychiatric care, and support with practical needs. Such programs are understudied in the context of guardianship/conservatorship. Through a review of electronic records for 217 consumers who were enrolled in a model program continuously for 3 years or more, we examined trends before and after enrollment in a model care coordination program for adults with serious and persistent mental illnesses under guardianship/conservatorship. We sought to describe the number of days and rates of hospitalization, emergency room visits, and arrests before and after receiving program services. Comparing utilization among consumers three years pre- to three years post-enrollment, we identified statistically significant reductions in hospitalizations and imprisonment, but no change in state hospitalizations. We also saw some (non-significant) reduction in emergency room visits. Findings provide preliminary evidence of effectiveness of the model program; future efforts could expand its reach to more adults with serious and persistent mental illnesses. [ABSTRACT FROM AUTHOR]

Background: Intrapersonal, interpersonal, social and economic factors associated with chronic mental illness influence mothers' parenting abilities which in turn influence childhood mental health. Aim: The aim of the study was to explore and describe the parenting experiences of mothers with a chronic mental illness. Methods: An explorative, descriptive and qualitative research design was used. Ten participants were purposively sampled until saturation occurred. Data was collected using in-depth individual interviews and a content analysis was carried out. Results: Mothers with a chronic mental illness experienced various challenges and expressed their family support needs. Conclusion: A family-centred approach to mental healthcare, treatment and rehabilitation is proposed.

A case report is employed that illustrates the need for residential mental health treatment (RT) and the need for continuation of support post RT. Children and youth with moderate-to-severe mental health needs that require intensive treatment in a safe setting for a duration of several months might access RT. RT is sometimes the treatment of choice, and, in fact, is the best treatment option for some youth regardless of whether the youth is in the care of the family or child welfare authorities. However, mental health needs do not stop after discharge from RT. A continuation of supports and continuation of contact with a mental health professional may provide stability that can foster the youths’ progress in education and interpersonal relationships that are significantly affected by the mental health disorders but are simultaneously essential for transitioning to adulthood. [ABSTRACT FROM AUTHOR]

The spiral phenomenon of homelessness and mental ill-health are major growing epidemic in both developed and developing countries. Viewing from a socio-economic-political dimension, homelessness and mental ill-health cause detrimental effects on the individuals' lives as well as the nation-building process. The condition of women seems to be complex, as the gender perspectives are often described in terms of patriarchy and powerlessness. The bi-directionality of mental illness and homelessness creates a vicious cycle, and many women seem to end up in shelter care homes. The scenario of homeless women with chronic mental illness reflects the lack of community-based rehabilitation efforts and gender-sensitive policy level initiatives. [ABSTRACT FROM AUTHOR]

Background: The chronic mental illnesses constitute substantial difficulties to person affected and the family. The difficulties could arouse due to the symptoms, functional disability, and stigma attached with the mental illness. Method: Using a single case method, we qualitatively evaluated the effectiveness of psychiatric social work interventions in a case of person with chronic schizophrenia. The interventions were psychoeducation, social skill training, activity scheduling, supportive work and family interventions. Result and Conclusion: In the qualitative assessment, we have found that these interventions were helpful in improving functional status and family environment [ABSTRACT FROM AUTHOR]

Objectives Adults with mental health conditions commonly experience difficulties with emotion regulation which affect their social functioning. Arts-based groups provide opportunities for shared emotional experiences and emotion regulation. This study explores emotion regulation strategies and the emotional effects of arts-based group participation in adults with mental health problems and in controls. Design and method The 62 participants included 39 adults with chronic mental health problems who were members of arts-based groups ( ABG) and 23 comparison choir ( CC) members who were not specifically experiencing mental health problems. The repeated measures design included self-reports of emotion upon waking (T1), the hour before group (T2), end of the group (T3), and evening (T4), as well as participant notes to explain their emotion ratings at each time. They also completed measures of individual and interpersonal emotion regulation. Results The ABG participants engaged marginally more in affect worsening strategies than CC ( p = .057 and .08), but there were no other group differences. All participants reported a significant increase in positive emotions, F (3, 180) = 28.044, p < .001 [ABSTRACT FROM AUTHOR]