An African American Male Perspective on Medication, Schizophrenia, and Crime

Mental health disparities in African American males contribute disproportionate rates of incarceration treatment access. There is a significant need to revise current mental health practices to address treatment barriers. The purpose of this study was to understand whether medication management could reduce criminality in violent African American males diagnosed with schizophrenia. A phenomenological examination of psychiatric perceptions and psychological treatment coupled with race was performed, utilizing the critical race and rational choice theory. Two research questions were developed to understand effective medication management and what barriers are present that cause noncompliance resulting in criminal activity. A hermeneutic phenomenological approach was used examining 8-10 mental health and criminal justice professionals\u27 perceptions of medication and its effects on violent schizophrenic African American males. Anonymous questionnaires with pre-addressed stamped envelopes was sent to a national counseling center and a law enforcement agency. Data were analyzed through the application of qualitative research data, coding, and development of themes. Fifty questionnaires were mailed out, and 11 responses were returned. Three themes of medication management, medication knowledge, and managing care were explored. Data analysis and results coincided with previous research. Positive social change will be affected through professionals enforcing early intervention and education of the effectiveness of medication and how it can reduce incarceration

Attitudes toward Medication and Reasons for Non-Compliance in Patients with Schizophrenia: A Cross Sectional study

BACKGROUND: Non-compliance for the medication is an important area of concern in schizophrenia as it contributes to relapse and re-hospitalization of the patients. One of the ways to improve the drug compliance is to know crucial factors responsible for poor drug compliance and hence that proper strategies may be planned to improve patient’s drug compliance. AIM OF THE STUDY: The aim of the following study is to find out the attitudes of patients toward medication and reasons for drug non-compliance in schizophrenia and its association with clinical and socio-demographic variables. MATERIALS AND METHODS: Cross sectional descriptive study was conducted at institute of mental health kilpauk Chennai. Their socio-demographic details were noted and illness related variables were evaluated using Positive and Negative Syndrome scale (PANSS). Patient’s attitudes toward medication and the reasons for treatment non-compliance were assessed using the standardized tools, which consist of Drug Attitude Inventory-10 scale (DAI) and Rating of Medication Influences scale(ROMI) respectively. DATA ANALYSIS: Using SPSS software version 20.0 RESULTS: Nearly 38.7% of our study sample were non-compliant to medication. There is no significant association has been found between non-compliance and age group, sex, unemployment, Educational status, occupation, age of onset. There is significant association found between non compliance with severity of illness, negative symptoms and poorer insight into the illness. On comparing with patients attitude towards medication with drug compliances there is significant association has been found drug non compliance with negative attitude towards medication. The significant reasons for non-compliance in our study were Denial of illness, financial burden, less access to treatment facilities, Side-effects of the medication, Feeling that the medication was unnecessary and Substance abuse. CONCLUSION: Study findings suggest that there is a need for identification and reduction of factors responsible for noncompliance in schizophrenic patients. There is also a need to provide adequate information about mental illness and medications prescribed, to enhance medication compliance and to develop community mental health care facilities for the awareness regarding the illness. Non compliance is complex behavior issues and therefore it is necessary to measure non compliance from many angles and it needed multifaceted approach with patients and healthcare providers

Schizophrenia – time to commit to policy change

Schizophrenia is recognised as one of the most complex and profound mental health conditions, steeped in both myth and reality. Efforts needs to be multifaceted, including policy development, treatment guidance and scientific innovation, with all stakeholders working together to ensure meaningful progress. This report delves into the unique needs of people with schizophrenia, exploring supportive measures for their well-being, practical and attainable recommendations for change. The message to all nations, policy makers, payers and healthcare professionals is clear: strive for excellence, but most importantly – start somewhere

The experiences of caregivers of mental health care users with schizophrenia in Upington, Northern Cape

The process of deinstitutionalization in South Africa after 1994 have resulted in mental health services being decentralized to community level in an effort to integrate psychiatric care into primary health care services at community level, thus moving away from institutionalised and pharmacological treatment alone, to include environmental resources such as community-based clinics and hospitals as care providers for mental illness such as schizophrenia, which is at the centre of this study. Primary health care services alone were not affected by this shift, but the families of psychiatric patients, as well as the families were required to assume responsibility of care for psychiatric patients. A major concern with regards to deinstitutionalisation was the preparedness of families to resume this responsibility of care. Public health care in South Africa is characterised by a great divide between public –and private health care services with the minority of the country being served by the majority of health care professionals employed in the private health care system, thus contributing to disparities in health care and contributing to a lack of specialised human resources in the public health care system. Challenges such as lack of public awareness on mental health; stigma against mental health care users and families, and inequity between the provinces in the country with regards to the distribution of resources and services amongst others, are external factors contributing to the functioning of the family system and the burden experienced by those caring for family members diagnosed with mental illness. In addition to these environmental factors, families are also affected by mental illness as they have to adapt, learn new skills and coping mechanisms to deal with schizophrenia and care for their family member. The aim of the study was to explore the experiences of the caregivers of mental health care users with schizophrenia in the town of Upington in the Northern Cape. Research was qualitative in nature with a sample of eight participants – all of whom were responsible for caring for family members diagnosed with schizophrenia – drawn from different primary health care clinics in Upington. The findings of the study indicate that caregivers are experiencing challenges mainly related to factors external to the family system. These challenges cannot be attributed to a single factor, but to different environmental factors related to treatment, availability of support services and lack of awareness amongst others. The experiences of the caregivers with regards to their role are influenced more by external factors as previously mentioned, than by the patients they care for and their behaviour. The study concludes that caregivers are influenced and affected by different systems within their environment in which they function. It is also concluded that there is a lack of basic support, education and training services aimed at creating awareness on schizophrenia and developing caregiver skills to cope with the role of caregiver. The recommendation is made that community-based mental health care services are implemented to provide support to families living with mental illness, that community awareness is raised on schizophrenia to enable caregivers to cope in a more effective manner, resulting in improvement of family functioning and reducing caregiver burden.Mini Dissertation (MSW (Healthcare)--University of Pretoria, 2019.Social Work and CriminologyMSW (Healthcare)Unrestricte

Content and Psychology

The theoretical underpinnings and practical worth of content-based, intentional, or "folk" psychology have been challenged by three distinct groups of philosophical critics in the past 15 years or so. The first group, comprised by Hilary Putnam, Tyler Burge, and other advocates of "wide" or "externalist" theories of meaning, claims that traditional psychologists have been mistaken in assuming that our beliefs, desires, and other content-laden states supervene on or inhere in our individual minds or brains. The other two groups are both "eliminative materialists," who charge that the intentional approach is inadequate and that it can or will be replaced by a completely non-interpretive discipline: either neuropsychology, in the view of Patricia and Paul Churchland, or a strictly syntactic computational psychology, according to Stephen Stich. ;This dissertation defends "notional world" or narrow intentional psychology against these charges, primarily on the strength of its practical merits, in contrast to the limitations and adverse effects of the proposed alternatives. Psychology is at least partly an applied science with a mandate to help understand and treat concrete psychological problems such as Post Traumatic Stress Disorder and depression, I argue, so any theorist who proposes to reconfigure or phase out existing approaches must be prepared to take over these duties with at least equal facility. However, whereas various "narrow" schools of psychotherapy such as Cognitive Therapy are fairly successful in this regard and show every indication of continuing to be needed for the foreseeable future, the Syntactic Theory seems to show very poor promise of being able to help relieve the distress of people with psychological disturbances, while a purely neurobiological approach is inappropriate in many cases, and tends to cause a variety of untoward and dangerous side-effects. As for the "wide" theorists with their emphasis upon the social and environmental contributions to meaning: they must acknowledge that a good deal of content is in the head; and, more importantly, by focusing on the role of the "experts" in a society's language-game, they miss the whole point of a psychological attribution, which is to understand an individual's reasons--however idiosyncratic--for acting as he or she does

A comparison of perception of ADHD among diagnosed children and their parents

Although research on youngsters’ and parents’ experience of ADHD has grown in recent years, little is known about their subjective perception of ADHD as a disorder. Previous studies on subjective perceptions of individuals with ADHD have examined only one or two facets of such perceptions simultaneously. However, theories of illness perception suggest that such perception consists of at least five constructs (see the Common-Sense Model of Illness Representations or CSM; Leventhal et al., 1997, 1984). The present thesis sought to address this research gap by applying CSM in the context of ADHD. The thesis aimed to 1)obtain a comprehensive understanding of perception of ADHD among diagnosed youngsters and their parents, 2)examine the predictive ability of the perceptions on their coping and emotional well-being, 3)compare parents- and offspring perceptions, and 4)examine the predictive ability of discrepant perception on their coping and emotional well-being. The systematic review of literature shows that disproportional research attention has been paid to the perceived effectiveness of treatment compared to other illness beliefs. The empirical study utilizing cross-sectional design included 61 dyads of adolescents with ADHD (10 to 18 years) and their parents, who were recruited from clinic, support groups and educational consultancy. Findings show that several illness beliefs (e.g., coherence, timeline), which have been under-researched, are predictors of adolescents’ coping. Adolescents see ADHD as less threatening and less biologically based than parents. Several discrepant illness beliefs (e.g., timeline, cause) seem to predict adolescents’ coping and quality of life. Different perceptions of impact were related to parents’ elevated stress. Overall, the present study provided initial evidence for the utility of CSM in youngsters of ADHD and their parents that may have significant implications for psycho-education, clinical practice and ongoing research

Service engagement and disengagement in first episode psychosis

Aims: The effectiveness of early intervention (EI) services for people with first episode psychosis is dependent on meaningful service engagement. Difficulties with engagement in EI services increases risk of drop out which has implications for poorer functioning and poorer clinical outcomes. The purpose of the current study was to explore associations between engagement, clinical, and relational variables, and to investigate factors that predict service engagement in an early intervention service for first episode psychosis. Methods: The study gathered prospective routine date from an early intervention service using a naturalistic cohort of 83 individuals with first episode psychosis in Scotland, UK. Cross sectional associations between engagement, attachment, and carer’s burden of care were explored. Sociodemographic, clinical and psychiatric predictors of engagement were examined using hierarchical and stepwise regression. Results: Poorer clinician engagement as measured by the service engagement scale (SES) was associated with greater positive symptoms and greater disorganisation, poorer insight, more effortful caregiving and higher number of adverse childhood experiences. In regression analysis, only lack of insight predicted engagement at 12-weeks. We found that engagement scores at 12-weeks predicted engagement at 26-weeks. Additionally, engagement scores at an earlier point of treatment were predictive of psychiatric recovery at 12-month follow-up. Conclusions: Our findings suggest that clinicians in early intervention services are well placed to identify those who are at risk of poorer engagement and subsequent poorer psychiatric outcomes which has implications for treatment planning. Additionally, people who lacked insight into their diagnosis of psychosis and need for treatment, as rated by clinicians, were rated with poorer levels of service engagement. This may reflect clinicians framework of psychosis and mental illness and might suggest the need for clinicians to work within the patients own beliefs of their experiences and framework of mental illness to help increase engagement

Mental Health Service Users\u27 Mobile Phone Contact Method: Preference and Medication Adherence

Research suggests that medication adherence among individuals with mental health problems is problematic. The issue of medication non-adherence among this population is consistent among the different mental health diagnoses. Numerous factors contribute to medication non-adherence: patient issues, service delivery issues, and issues related to the measurement of medication adherence, which lacks a gold standard. This dissertation is a compendium of three manuscripts that represent three distinct but related studies on medication adherence among individuals with mental health challenges. The first manuscript is an integrative review that seeks to assess the validity, reliability, and levels of evidence of existing instruments for measuring medication adherence in patients with schizophrenia. The second is another integrative review that examines literature in the past decade (2006-2016) on the use of mobile phone contacts (MPC) in individuals with severe mental illness to improve medication adherence after hospital discharge. The third, a descriptive correlational study, examines mental health services (MHS) users’ preferred MPC delivery method when receiving support to increase medication adherence after discharge. The findings from the first integrative review show the importance of validating medication adherence measures in this population. Findings from the second show the extent to which MPC support the increase of medication adherence in this population. Findings from the third show the importance of identifying patients’ preferences for an MPC method when providing support to increase medication adherence in this population. The findings of the two integrative reviews and the descriptive correlational study are integrated at the conclusion of the dissertation