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Community Mental Health

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Community Mental Health I. What is mental illness? Criticisms of the Construct. Thomas Szasz (1961) Does mental illness exist or can these behaviors be better ... – PowerPoint PPT presentation

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Title: Community Mental Health


1
Community Mental Health
  • I.  What is mental illness?

2
Criticisms of the Construct.
  • Thomas Szasz (1961)
  • Does mental illness exist or can these behaviors
    be better conceptualized as problems in living? 
  • Rosenhan (1973)
  • Does mental illness largely reflect a set of
    expectancies derived from labeling?
  • Benefits of labeling.

3
Models of Mental Illness.
  • Deviation from the norm.
  • Degree of functionality.

4
Community Mental Health
  • II. What were the effects of the
    deinstitutionalization movement?

5
What caused this movement?
  • The wide-spread availability of psychiatric
    medications.
  • The philosophy of community psychiatry.
  •  
  • The general time period in which
    deinstutitionalization occurred.
  • Budget cuts?

6
What do critics believe was the negative fallout?
  • Lack of available housing.
  • Transinstutionalization of care.
  • Where do the largest portion of SMI live?
  • Alcohol and drug abuse.
  • Epidemiological research indicates that persons
    with mental illness are more likely than the
    general population to experience with drug and
    alcohol.
  • Sexual abuse.
  • Some research suggests that people with mental
    illness may be at more risk for sexual
    victimization (e.g., Mowbray et al., 1997).

7
Do environmental factors affect the success of
reintegration?
  • Community attitudes towards persons with mental
    illness.
  • Education is positively related to increased
    tolerance.
  • Size of the community also appears to be a
    factor.
  • Cities over 100,000 appear to be the least equip
    to provide services to the mentally ill.
  • Cities between 10 and 100K are the most.
  • Small towns falling somewhere in the middle.

8
Do environmental factors affect the success of
reintgration?
  • "Depersonalization of Care"
  • A fancy word for job burnout.
  • Causes of

9
Community Mental Health
  • III. Treatment options for CMI Populations

10
Intensive Case Mangement (ICM)
  • Typically, but not always, a social worker.
  • Links clients to needed services and gives
    instruction in basic living skills.
  • Has been found to reduce rates of hospitalization.

11
Assertive Community Treatment (ACT).
  • Mobile case management.
  • Developed by Stein and Test in 1985 in Madison,
    Wisconsin.
  • Other aspects of ACT is that takes a wholistic
    approach, attempts to capitalize on the clients
    strengths, and attempts to work within the
    ecology of the client.

12
Characteristics of ACT
  • Team Approach.
  • In vivo services
  • Small caseload and frequent contacts.
  • Fixed point of responsibility.
  • Flexible service delivery.
  • 24/7 Crisis Availability

13
Efficacy of ACT Programs
  • Bond et al. (1990) compared ACT to drop-in
    community centers.
  • Nelson et al. (2007) reviewed studies that
    compared ACT, ICM, or housing programs.

14
Staffing Pattern Per Team(ODMH Administrative
Rules for ACT Certification)
  • Team Leader
  • Psychiatrist
  • Nurse
  • Therapist
  • Community Support Specialist
  • Employment Specialist
  • Peer Specialist
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