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The perceived social liberalisation of Irish culture over the past ten years has significantly impacted Irish writing, resulting in discussions of formerly tabooed topics like psychosis, menstruation, and infertility. This shift is particularly evident in the recent rise in public interest in creative non-fiction writing. This article examines the rise in popularity of illness narratives: tales of patients' and care-takers' embodied experiences of mental and physical ailments in light of Irish medical-historical developments. Focusing on chapters from recent Irish essay collections by Emilie Pine, Sinéad Gleeson, and Sophie White, this article considers how writing about the gendered experiences of women in Irish medical and mental institutions can shape political action and contribute to the formation of radical new cultures of care. [ABSTRACT FROM AUTHOR]

A significant number of patients with intellectual disability (ID) were admitted to forensic mental health asylums during the period 1915-1987. Many of these patients stayed for more than a decade, because of previous offending behaviour. We investigated the daily lives of 262 patients with an ID using casebooks. Two of the patients were studied more in detail. The available documents describe most of these patients as sociable, well-behaved and socially engaged although they missed having contacts outside the hospital. Long-stay patients were studied more in detail. [ABSTRACT FROM AUTHOR]

This article examines two institutions which were established in Scotland specifically for the accommodation of mentally-impaired children: Baldovan Asylum near Dundee and the ‘Scottish National Institution for the Education of Imbecile Children’ in Larbert, Stirlingshire. It surveys the aims and agendas of the institutions in the spheres of residential childcare, mental health, and education and training. It compares the admission regimes of these institutions and considers whether they complemented one another in serving an unsatisfied demand for places, or whether they were in competition for admissions, staff and charitable support. The survey covers the period from the opening of both institutions to the implementation of the Mental Deficiency Act of 1913 which required the (re)certification of all children. [ABSTRACT FROM PUBLISHER]

The shift of mental health service delivery from hospital to the community has proven to be, and continues to be, a complex matter. Huge gains have been achieved in a relatively short period of time. We now articulate the focus of mental health services as being to support people to live well in their communities; to promote relationships where people are active participants in their recovery, rather than passive recipients of treatment. Supporting people to overcome issues of disadvantage and social exclusion have become contemporary imperatives of community-based mental health services. Effective leadership is a key part of ensuring that this process continues.However, we need to consider such development and progress as 'a good start'. I get concerned when people speak of 'deinstitutionalisation' in the past tense - as if we've done that, so what next? The process of reform of mental health services is very much a work in progress. A fact I believe that we need to always be aware of that 'Change does not roll in on the wheels of inevitability' (Martin Luther King, 1963).I have used the story of the Emperor's New Clothes as a metaphor to illustrate what may now be lacking in mental health services. We can now speak quite articulately of recovery, of service user-led services, of community-based mental health services.. but scratch the surface and you can commonly find some quite vague and sometimes oppositional understandings of what these are about and what they look like. We risk being as the emperor; duped into believing that such finery truly exists, when in fact the substance of such finery may not be that tangible.What this paper will argue is that the evolution of post-institutional mental health services requires not just a change in policy or practice, but the development and propagation of a philosophy and range of values that will underpin such contemporary practices. This emerging framework raises an agenda that is potentially in conflict with biomedical psychiatry as the fundamental driver of mental health service provision and argues that leaders in the mental health sector are key to moving forward. A framework for putting such values in action is outlined. [ABSTRACT FROM AUTHOR]

SCL-90-R, a multidimensional assessment instrument for mental health status, is among the most widely used instruments for the evaluation of therapies and quality management in mental institutions. With 90 items it is rather long and has a high redundancy as can be seen in its highly correlated scales. Thus many short versions have been constructed, among them the SCL-27, which was devised as a screening tool. It has 27 items, retains six of the nine SCL-90 dimensions and has shown a good factor structure. So far it has only been validated in non-psychiatric samples. The aim of this study is to determine validity and other psychometric qualities of the SCL-27, compared to the SCL-90-R within a group of 449 psychiatric patients. The study found a large concordance between the symptom scales of the SCL-27 and the corresponding scales of the SCL-90-R. The SCL-27 further showed good reliability and a sensitivity to change comparable to that of the 90-item version. A confirmatory factor analysis yields an acceptable factor validity which is better than that of the long version. This study concludes that the SCL-27 is suitable as a short assessment instrument for psychological health in psychiatric patients. [ABSTRACT FROM AUTHOR]

Opened in February 1923 to raise the status of academic psychiatry in the UK, the Maudsley Hospital struggled to secure grant income. Without a track record of published research and lacking internationally recognized clinicians, it failed to impress the British Medical Research Council. To challenge leading U.S. and German departments of neuropsychiatry Edward Mapother, the medical superintendent, looked overseas for investment in an "institute of psychiatry." Intense lobbying and a modified strategy for research and training designed to meet the Rockefeller Foundation's prioritization of psychiatry and medical specialization ultimately led to a significant endowment. Alan Gregg and Daniel O'Brien at the Foundation played a pivotal role in re-defining the Maudsley's programs of research and teaching. Pressure on Mapother to attract funding was matched by that on administrators required to show that their philanthropy had yielded tangible gains in public health. While wealthy charities, like the Rockefeller, often had a vision of the direction that they wished to pull medical science, and they provided much needed income, the impact of their policy agenda was not without drawbacks. Institutions unwilling to embrace a charity's philosophy were unlikely to secure grants, while those that did might find themselves drawn into less optimal areas. [ABSTRACT FROM AUTHOR]

In 1939, Lionel Penrose published a cross-sectional study from 18 European countries, including the Nordic, in which he demonstrated an inverse relationship between the number of mental hospital beds and the number of prisoners. He also found strong negative correlations between the number of mental hospital beds and the number of deaths attributed to murder. He argued that by increasing the number of mental institution beds, a society could reduce serious crimes and imprisonment rates. The aim of the study was to test Penrose's theories longitudinally by monitoring the capacity of all psychiatric institutions and prisons in a society over time. From official statistics, we collected and systematized all relevant information regarding the number of mental institution beds and prisoners in Norway during the years 1930-2004, along with major crime statistics for the same period. During the years 1930-59, there was a 2% population-adjusted increase in mental institution beds and a 30% decrease in the prison population. During 1960-2004, there was a 74% population-adjusted decrease in mental institution beds and a 52% increase in the prison population. The same period saw a 500% increase in overall crime and a 900% increase in violent crimes, with a concurrent 94% increase in the size of the country's police force. Penrose's law proved remarkably robust in the longitudinal perspective. As opposed to Penrose, however, we argue that the rise in crime rates only to a very limited extent can be attributed to mental health de-institutionalization. [ABSTRACT FROM AUTHOR]

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Several hospitals, countries and cultures claim the privilege of being the first to have provided care to people suffering mental illnesses. Among them, the «Hospital de los Inocentes» (Hospital of the Innocents) founded in Valencia in 1410 stands out due to its originality and there are historic and cultural reasons to recognize its primacy. Furthermore, the organization and functioning of this institution and the model, spread like wildfire through the entire Iberian Peninsula during the 15th Century and shortly after through American Spanish speaking countries. For centuries, these establishments were considered exemplary and were copied in other European Countries. At the beginning of the 19th Century in Spain a forced sale of the Catholic Church properties or their "desamortización" among other a large number of hospitals establishments took place. This lead to a terrible collapse of health care for the mentally. From then on it took more than one century to recover a decent standard. The vicissitudes of the creation and progress of the hospital of Valencia and others which followed the example that allows to affirm that it was really the first psychiatric hospital in the World are analyzed in this present work. [ABSTRACT FROM AUTHOR]

This article traces the evolution of Central State Hospital and its role in providing care for people with serious mental illness in the state of Georgia. Founded in 1846 as the Lunatic Asylum of the State of Georgia, the institution rose to become the world's largest mental institution, at one time housing almost 13,000 patients. While more than 44,000 were committed to the institution over the span of 120 years, more than 30,000 individuals were buried at various sites on the hospital's grounds. Archived state documents, media accounts, and the like were used to explore the growth of this institution, its approaches to treating those with mental illness, its quality of care, and its role in providing for Georgia's neediest citizens. [ABSTRACT FROM AUTHOR]

This article describes a psychoanalytical experience that took place in an institution for mental health, located in Rio de Janeiro, Brazil. There, an art workshop was created in an attempt to welcome and shelter psychotic patients. This work space later proportioned a ''setting'' for the practice of psychoanalysis with psychotic patients. In the clinical case, herein examined, the author dedicates special attention to the relation that exists between certain psychotic aspects and the process described by Jacques Lacan as: the ''foreclosure of the name of the father''. [ABSTRACT FROM AUTHOR]

Deinstitutionalization of large institutions for individuals with mental retardation has been an ongoing process for almost 20 years. Because the process continues and because there are still many concerns about deinstitutionalization, especially for populations with more challenging behaviors, the question of relative costs of institutional service and community services is raised periodically by legislators, bureaucrats, and advocates. This study compares the costs within one institution, Fairview, in Oregon, with the costs of providing community-based services in five small group homes and an apartment complex serving populations with more challenging behaviors. In general, institutional costs are slightly higher than the community-based programs. However, after equalizing salary rates between the two environments, community-based residences that serve individuals with challenging behaviors are more expensive than the institution. [ABSTRACT FROM AUTHOR]

The right to refuse treatment seems well established for psychiatric patients. Individual states, however, have very different procedures for managing this right and for overriding the refusal. Oregon’s administrative procedure for override depends on an evaluation by an independent examining psychiatrist. This article empirically examines the 432 refusals leading to override requests in three Oregon psychiatric institutions in 1983 and 1984. Treatment refusal was found to be a common occurrence in all age groups. Those who refused treatment were seriously ill, unemployed, singled individuals with previous psychiatric hospitalizations. Most refused treatment because of denial of their illness or delusional thinking about medication. Most refusals were overridden following the independent psychiatrist’ examination. Because of the significant cost of the override procedure to the patient and the mental health system, the authors propose a new procedure which combines parts of the current procedures with a requirement that, at the time of the civil commitment hearing. [ABSTRACT FROM AUTHOR]

The article assesses the quality of life of mentally retarded adults in large institutions and after transfer to new small units. The study showed significant improvement after transfer on environmental changes in management practices and staff-resident interaction for both types of living units. Furthermore, the total adaptive behavior of transferred residents increased in the new small units. The study also showed an initial increase in the total maladaptive behavior and antipsychotic drug prescription.

A policy evaluation of Community Support Services, an assistance group created by the Minnesota Department of Human Services to prevent admission of individuals with developmental disabilities to large state facilities, was presented. The model of these out-reach services was described. Program evaluation data were presented. The possible effect of Community Support Services on admissions to large state facilities, characteristics of individuals served compared to those waiting for these services, cost-benefit issues of operating Community Support Services, and community service providers' satisfaction with these services were discussed. Issues related to the establishment and operation of Community Support Services were also presented. [ABSTRACT FROM AUTHOR]

The article discusses the advantages and disadvantages of the concept of placing mentally deficient persons in groups. The authors point out that while there are advantages in placing several patients on the same job, the same room, or in the same community, there are also certain disadvantages in such a procedure which should be considered.

The article reports on the standards for private institutions, schools, homes and like specialized facilities for the care and training of the mentally deficient as adopted by the council of the American Association on Mental Deficiency on May 1952. Standards in the philosophy of operation include the need for evidence that the institution, school, home or like specialized facility is a home for those entrusted to its care.

This article presents a reprint from the article "A vocational study of a group of institutionalized persons," by Margaret O'Brien, which appeared in the 1946 Summaries of Doctoral Dissertations, volume 14. The article discusses the results of a vocational study of a group of persons released from Illinois state hospitals for mental defectives under the family-care program supervised by the Department of Public Welfare. The study aims to determine the factors concerning the vocational adjustment of post-institutionalized mental defectives. The author concludes that the need for helping the slow-learning child learn how to make adequate use of his leisure time is an important implication of the study.

The article discusses the role of society towards the development of people suffering from mental disabilities in the U.S. The author identifies several classification of mental illnesses and provides tips on how they must be cared. According to the author, there are cases that require the public's protection against mentally ill persons and there are also those that need humane custodial care in institutions and in the community.

The article presents a speech by Helen Morgan, chief of the Examination Division of State of Bureau of Personnel in Madison, Wisconsin. She discusses the history of the Bureau's recruitment procedure of psychiatric aids for people with mental disabilities. According to her, the period of wars changed the course of the recruitment procedure.

The article discusses the mental deficiency care in Denmark. Denmark has a established a legal foundation in the Act of Provision for Mentally Defectives that took effect on May 16, 1934. Mental deficiency care, under the Ministry of Labor and Social Affairs, is administered by the Director of Social Special-Care. According to the author, Danish mental institutions are self-supporting institutions.

The article discusses the development of a plan for training mental defectives at the Ontario Hospital School in Orillia. An overview of the history and philosophical development of mental institutions in Ontario is provided. The institution became an integral part of the system of mental institutions in Ontario. In conclusion, the author points out that adequate professional training, good personal orientation and appreciation of the problems of the mentally deficient are necessary in institutional officers and employees.

The article describes how the Top O' the Hill institution make use of free play and liberty of action in the care of physically and mentally handicapped children. The children are treated in every was as if they were normal. Within wide limits they are allowed the run of the houses and grounds. They are not excluded from the bedrooms after certain hours, nor from the kitchen and dining room at any hour. The staff eats with the wards and participates in their table talk. The method resulted in the decrease or elimination of the problems of character and personality that many of the children exhibited on admission.

The article focuses on the study concerning the need for security protection in correctional institutions as observed by the staff from the National Institute of Mental Health (NIMH) Hospital Improvement Program at the Dannemora State Hospital (DSH) in 1967-1972 in New York. According to the authors, the operation of DSH during this period as a correctional mental hospital receiving all patients from institutions under the New York Department of Correction was phased out. The study also cited that the patient rehabilitation projects were impeded by the operations of the DSH Security staff.

The article focuses on the study which compared diagnostic classification practices of the medical staff at the Dannemora State Hospital (DSH) conducted by a staff from the National Institute of Mental Health (NIMH) Hospital Improvement Program in 1967-1971 in New York. The mental health and penal codes of the state specify a standard procedure for commitment in correctional mental hospitals for prisoners who develop mental disorders. The study indicates that warden of any penal institution may initiate a commitment procedure in which two independent physicians examine the prisoner. The conditions of commitment and hospital diagnostic classifications of all patients at the state hospital are also explored.

The article focuses on the progress in mental health services during the time of Kathleen Jones, who pushed for the creation of asylums in the early 18th century to the 1990's. It explores the how counties compel to create asylums through the efforts of Jones, the former chair of the Association of Psychiatric Social Workers. It also cites the transformation of the asylums and the publication of the "Asylums and After" which defend mental hospitals and call for quality mental health services.

The article reports on the establishment of an out-patient department for mental disease under the direction of Dr. Chrochley Clapham in Sheffield, England. The establishment of the department has attracted a number of patients, whom he believes that the necessity of asylum treatment has been avoided. Clapman believes that the department he created has exemplified the greater readiness of patients to be associated in treatment with other diseases rather than to attend as out-patient to an asylum or lunatic hospital. With the department's positive result, it is expected that department of mental health will also be established in other large towns.

The article reports on the proposal of Rethink and Sainsbury Centre for Mental Health in Great Britain for the treatment of offenders with mental health problems in the community.

The article reports on the safe practices cited by Dr. Ben Thomas, a mental health personnel at the National Patient Safety Agency (NPSA), to avoid incidents of ligature among inpatient units in mental institutions. Thomas revealed that installation of collapsible rails in inpatient units had not been implemented in some mental institutions. He also suggests institution managers to ensure that staff has required resuscitation skills.

Reports on the state of mental health care in Eastern Europe as of August 17, 2002. State of medical, legal, and social-care practice in the region, which is considered neglected by national governments and the European Union; Idea that those with mental health problems are hidden in social care homes; Living conditions in the homes, which are frequently harsh.

Presents the reaction of Great Britain's Health Secretary regarding the failure of the health care system, especially that of mental health care, in the late 1990s. The need to regain the public's confidence in the health care system; Indications that the number of hospital beds for the mentally ill have diminished; Details of a proposed package to help the mentally ill.

The article discusses the progress of a study which will evaluate the mental health of parents who have placed their profoundly mentally retarded children in institutions in the U.S. A questionnaire is to be given to parents to assess the significance of the study. Currently, the preliminary draft of the questionnaire is finished. The preliminary results gathered will be printed in 1983. The assessment on full-scale will be released as soon as they are ready, but it is assumed to be on 1985 onwards.

The article discusses developments in the field of oral health care in mental institutions. The author informs that there had been advances in the area according to results of a study he conducted at the Michener Centre. The study indicates that the introduction of 1% chlorhexidine gluconate, 1.23% fluoride and 1% phosphate gel as the patient's only source of dentrifice contribute to a rapid reduction of caries and periodontal problems.

The article presents a report on of a research and demonstration project on secondary education in a state mental hospital. The project, supported by funds from the National Institute of Mental Health, was carried out at Vermont State Hospital, Waterbury, Vermont. Remedial instruction and vocational courses plus the usual high school subjects were provided to twenty students by one teacher.