Psychiatric design : Using a salutogenic model for the development and management of mental health facilities

The prevailing model of psychiatric facility design does not fulfil its potential in supporting the healing process. A salutogenic approach can improve coherence and foster meaning, will actually improve mental health outcomes, not only manage patient behaviour.

NGOs, International Aid, and Mental Health in Cambodia

Thesis (Master's)--University of Washington, 2016-03

Quantum bioenergetics, mental boundaries and affective response : a randomized placebo-controlled pilot study

Previous research has demonstrated the effects of ostensible subtle energy on physical systems and subjective experience. However, one subtle energy technique that has been neglected by previous studies, despite anecdotal support for its efficacy, is Quantum BioEnergetics (QBE). Furthermore, personality traits that influence subtle energy effects remain unclear, and previous experimental studies have not investigated the constructs of Love and Joy, despite qualitative and anecdotal reports indicating that these variants of positive affect are essential elements of the subtle energy experience. The aim of the present study was to investigate experimentally the effects of QBE, and the personality trait Mental Boundaries, on positive and negative affect. Participants (N = 69) were administered the Boundary Questionnaire Short Form to quantify Boundaries, and then randomly assigned to one of three conditions: QBE, Placebo ("sham"), or Control. Affect was retrospectively assessed using the Positive and Negative Affect subdimensions of the Phenomenology of Consciousness Inventory (PCI). As predicted, a significant multivariate effect for condition was found with regards to the PCI subdimensions: Joy, Sexual Excitement, Love, Anger, Sadness, and Fear. In contrast to our expectations, a significant multivariate effect was not found for Boundaries with regards to the combined PCI-Affect variables. As hypothesized, significant interactions were found between condition and Boundaries with regards to Positive Affect, Love and Joy, with the QBE/Thin Boundaries factorial combination associated with the highest mean scores for these dependent variables. It will be prudent to ascertain whether these results are replicated in a larger sample and a placebo condition that improves on the standard randomized placebocontrolled protocols of previous subtle energy research.

Lay healing practices in the household

This thesis explores the power-knowledge relationship underlying lay healing practices in the household; a non-traditional area of study in public health. Lay knowledge continues to be discounted as illegitimate and !non-expert' by policymakers, health professionals and academics. Given the absence of theory on lay knowledge and decision-making, an eclectic theoretical approach was undertaken in this study. Theory is drawn from medical anthropology, sociology of the body, health economics, gender studies, social theory, psychology, nursing, ethics, philosophy and history of medicine in order to contribute to and advance debate. Operating within the genre of a 'multi-sited ethnography' (working across different sites), methods for data collection included 'anthropology at home' by undertaking fieldwork in Geelong, Victoria, Australia. I conducted interviews and focus group discussions with, and administered a questionnaire to, 98 participants who are parents of young children. They were recruited via primary schools and snowball sampling. The quantitative data presents a socio-demographic 'picture' of 78 women and 20 men (representing 98 households) from urban, rural and coastal areas of the region. The qualitative data contains case studies as well as narratives, analysed for their content and discourses. Additional methods included maintenance of a 'reflexive journal', inter-sectoral consultations and public health policy analysis. Research findings indicate laypeople's conceptualisations of the body, self, health and illness rest upon a notion of the embodied self and health that is physical, mental and spiritual. Lay people have a substantial knowledge base on health and ill-health that derives from many sources, is both generalised and specialised, and is set within the context of everyday life. Laypeople make diagnoses and treat illness and injury within the household. They also exercise substantial agency in determining their choice of healer(s) for therapeutic intervention and management of ill-health outside the household. This study has substantial implications for public health in terms of healers' clinical practices, research and policy.

The arts and mental wellbeing : opportunities and challenges

Strategies to combat the many effects of mental illness on individuals and families need to go beyond psychopharmacology and institutional care. Evidence has been mounting for the healing and treatment role of art in clinical and health care settings. Art, in its many forms, has also been suggested as one valuable tool in addressing social exclusion in people with many forms of disability including mental illness.
This paper draws on Masters Research findings to present a discussion of the historical and the current landscape of Art for Health Programs with special emphasis on art programs targeting people with chronic mental illness. Recent studies in the UK and Scotland indicate that participation in the arts can enhance recovery, social connectedness and cultural inclusivity.

Effect of nutritional supplements on wound healing in home-nursed elderly: a randomized trial

 Objective: The objective was to determine whether provision of oral nutritional supplements, delivered by community nurses, could improve nutritional status and wound healing in home-nursed elderly. Methods: This was a double-blind, randomized trial in 50 elderly patients referred for wound management. Patients received 237 mL/d of 4 or 8 kJ/mL of an oral nutritional supplement for 4 wk. Nutritional status was measured with the Subjective Global Assessment and the Mini-Mental State Examination questionnaire to determine cognitive function and wound characteristics to assess healing. Differences between variables were examined with the Mann-Whitney or Student's t test for comparing two groups, one-way analysis of variance when there was more than two groups, and chi-square analysis for comparing two categorical variables. Associations between variables were examined with Pearson's correlation and regression analysis. Results: At baseline, 34% subjects were moderately malnourished and 8% were severely malnourished. In both groups, there was significantly greater improvement in Mini-Mental State Examination scores at week 4 (95% confidence interval -2.0 to -0.001, P = 0.04) and a greater decrease in the wound effusion score (95% confidence interval -2.0 to 0.0, P = 0.045). Median length of stay did not differ between groups (P > 0.05). Conclusions: Malnutrition is common in elderly patients who are nursed at home for wound management. Provision of energy- and protein-dense oral supplements by community nurses is effective in improving some indices of wound healing and cognitive function in this group. Although further study is needed to determine the effect on length of stay, the nutritional needs of this vulnerable group should not be overlooked. © 2005 Elsevier Inc. All rights reserved.

Mapeamento da demanda de saúde mental infantil em um município de pequeno porte

Pós-graduação em Psicologia - FCLAS

O trabalho como dispositivo de atenção em saúde mental: trajetória histórica e reflexões sobre sua atual utilização

The partnership between Mental Health (MH) and work is present throughout the history of psychiatry. Capitalist society has used and uses the fitness or unfitness for work not only as one of the elements to the definition of "normality", but also as a treatment strategy. In this perspective, one can find a position healing and, more recently, a different proposal put forward by the psychiatric reform that considers also make / produce, the construction of meaning in the work as crucial for subjectivity. This sense is present in therapeutic workshops that seek to value the uniqueness, not to override the differences. The objective of this paper is to reflect on the relationship between Attention in SM / Work. Initially presents three theses, from which this relationship is built historically: 1 - Work as a means of avoiding idleness returning productively to society; 2 - Work as a healing practice, from the prescription, and 3 - Work as a strategy for care and social inclusion. Below, we discuss some questions about therapeutic workshops and income generation in the mental health care as a device for attention and social inclusion.

Cultural models of healing and health: An ethnography of professional nurses and healers

Cultural models of the domains healing and health are important in how people understand health and their behavior regarding it. The biomedicine model has been predominant in Western society. Recent popularity of holistic health and alternative healing modalities contrasts with the biomedical model and the assumptions upon which that model has been practiced. The holistic health movement characterizes an effort by health care providers and others such as nurses to expand the biomedical model and has often incorporated alternative modalities. This research described and compared the cultural models of healing of professional nurses and alternative healers. A group of nursing faculty who promote a holistic model were compared to a group of healers using healing touch. Ethnographic methods of participant observation, free listing and pile sort were used. Theoretical sampling in the free listings reached saturation at 18 in the group of nurses and 21 in the group of healers. Categories consistent for both groups emerged from the data. These were: physical, mental, attitude, relationships, spiritual, self management, and health seeking including biomedical and alternative resources. The healers had little differentiation between the concepts health and healing. The nurses, however, had more elements in self management for health and in health seeking for healing. This reflects the nurse's role in facilitating the shift in locus of responsibility between health and healing. The healers provided more specific information regarding alternative resources. The healer's conceptualization of health was embedded in a spiritual belief system and contrasted dramatically with that of biomedicine. The healer's models also contrasted with holistic health in the areas of holism, locus of responsibility, and dealing with uncertainty. The similarity between the groups and their dissimilarity to biomedicine suggest a larger cultural shift in beliefs regarding health care. ^

Screening for complex healing processes and psychological intervention in injured individuals

Introduction Injured individuals face a high risk for the development of psychological symptoms such as depression or anxiety, which influences early return to work after an accident. So far, it is unclear to which extent early psychological interventions can improve the ability to return to work. Purpose of the study The aim of the study was to investigate whether an improvement of the treatment-triage (by the screening questionnaire work and health [FAB]) influences early return to work and well being in injured individuals. Methods The study sample consists of injured individuals with different mental health-related or work-related disabilities after an accident. Participants are included eight weeks after an accident. Participants are randomly assigned to the intervention or to the control group. The intervention is an individualized psychotherapy consisting of cognitive-behavioral therapy and work related topics in an individual setting. Well being and work related actors are assessed at baseline and after six months. Results The recruitment is still ongoing. The preliminary results of this randomized controlled study will be presented at the conference. Conclusion An individualized psychotherapy might have the potential to improve the rehabilitation process in injured individuals and improve the ability to return to work.

Psychiatrists' and Psychiatric APRNs' Views of the Adolescent Mental Health Nurse's Role In the Inpatient Setting

Current perceptions about nurses’ roles and responsibilities are examined in this study, specifically relating to adolescent inpatient MHNs. Psychiatrists and psychiatric advanced practice registered nurses (APRNs), who work with MHNs and have also published scholarly psychiatric articles, were contacted to request their participation in an anonymous survey hosted by SurveyMonkey.com. This research was conducted to examine the stereotypes that exist against nurses within the health care profession itself, as compared to the pre-existing stereotypes displayed by the media’s view of nurses. Due to investigator time constraints, only six subjects participated in the study. Analysis of survey responses revealed four overarching themes. First, MHNs are a critical component of the health care team, emerging as rigorous, independent leaders, although still classified as female and sociable. Second, MHNs complete a wide range of daily activities, many of which go unnoticed by observers, often resulting in mixed feelings regarding whether MHNs are given the respect and recognition deserved. Third, MHNs treat each patient as a person with unique thoughts, feelings, and physical make-up. Fourth, MHNs act as a coordinator of care between various health professionals to provide the patient with a holistic approach to healing.

AN ASSESSMENT OF THE CURRENT STATUS OF MENTAL ILLNESS IN BENDEL STATE OF NIGERIA: IMPLICATIONS FOR PUBLIC MENTAL HEALTH POLICY AND EDUCATION

This descriptive study assesses the current status of mental illness in Bendel State of Nigeria to determine its implications for mental health policy and education. It is a study of the demographic characteristics of psychiatric patients in the only two modern western psychiatric facilities in Bendel State, the various treatment modalities utilized for mental illness, and the people's choice of therapeutic measures for mental illness in Bendel State.^ This study investigated ten aspects of mental illness in Bendel State (1) An increase of the prevalence of mental illness (psychiatric disorder) in Bendel State. (2) Unaided, unguided, and uncared for mentally ill people roaming about Bendel State. (3) Pluralistic Treatment Modalities for mentally ill patients in Bendel State. (4) Traditional Healers treating more mentally ill patients than the modern western psychiatric hospitals. (5) Inadequate modern western psychiatric facilities in Bendel State. (6) Controversy between Traditional Health and modern western trained doctors over the issue of possible cooperation between traditional and modern western medicine. (7) Evidence of mental illness in all ethnic groups in Bendel State. (8) More scientifically based and better organized modern western psychiatric hospitals than the traditional healing centers. (9) Traditional healers' level of approach with patients, and accessibility to patients' families compared with the modern western trained doctors. (10) An urgent need for an official action to institute a comprehensive mental health policy that will provide an optimum care for the mentally ill in Bendel State, and in Nigeria in general.^ Of the eight popular treatment modalities generally used in Bendel State for mental illness, 54% of the non-patient population sampled preferred the use of traditional healing, 26.5% preferred the use of modern western treatment, and 19.5% preferred religious healers.^ The investigator concluded at this time not to recommend the integration of Traditional Healing and modern western medicine in Nigeria. Rather, improvement of the existing modern western psychiatric facilities and a proposal to establish facilities to enable traditional healing and modern western medicine to exist side by side were highly recommended. ^

Constructing an Indigenous Model of the Self to Address Cultural and Mental Health Issues in the Canadian Subarctic

Since the last decades, academic research has paid much attention to the phenomenon of revitalizing indigenous cultures and, more precisely, the use of traditional indigenous healing methods both to deal with individuals' mental health problems and with broader cultural issues. The re-evaluation of traditional indigenous healing practices as a mode of psychotherapeutic treatment has been perhaps one of the most interesting sociocultural processes in the postmodern era. In this regard, incorporating indigenous forms of healing in a contemporary framework of indigenous mental health treatment should be interpreted not simply as an alternative therapeutic response to the clinical context of Western psychiatry, but also constitutes a political response on the part of ethno-cultural groups that have been stereotyped as socially inferior and culturally backward. As a result, a postmodern form of "traditional healing" developed with various forms of knowledge, rites and the social uses of medicinal plants, has been set in motion on many Canadian indigenous reserves over the last two decades.

Racionalizando adicciones en una reserva indígena canadiense: la construcción narrativa del yo mediante discursos de salud mental y personalidad

Durante décadas sucesivas, la experiencia social y epidemiológica en las reservas indígenas canadienses, afrontando elevadas tasas de problemas psicosociales y de salud mental, ha generado un tipo de racionalización cultural elaborada dentro de un movimiento social de revitalización neo-animista o neo-tradicionalista denominado healing movement. Esta ponencia examina cómo discursos de salud mental, producidos dentro de este movimiento social de revitalización indígena a nivel local, proporcionan una racionalidad cultural para la construcción contemporánea de la identidad. El diseño de la investigación ha sido cualitativo, realizándose un estudio de caso etnográfico en una reserva indígena en el noreste de Ontario y utilizando un muestreo intencional. Para la recolección del material empírico se utilizaron técnicas basadas en la entrevista y observación participante. Estrategias de análisis del contenido y del discurso han coadyuvado en la obtención de unos resultados que revelan cómo la concepción de la salud mental en reservas indígenas ha llegado a ser un dominio simbólico para crear y recrear la noción del yo indígena y para afrontar su posición marginal en el contexto poscolonial y sociopolítico canadiense. Las conclusiones de este estudio señalan cómo los problemas psicosociales en el contexto de las reservas indígenas trascienden el fenómeno epidemiológico para convertirlo en un fenómeno político, reflexivo y moral.

The lived experience of healing touch with cancer patients

The recent use of complementary therapies by cancer patients has prompted the study of the use of Healing Touch, an energy based therapy, to learn the meaning of the experience. By using Ray's Caring Inquiry, a phenomenologic-hermeneutic process, the lived experience of receiving Healing Touch was elicited from three cancer patients. Through the interactions of the Healing Touch practitioners, the cancer patient participants, and the energy in and around them, specific themes were expressed: body-physical, emotion-feeling, mental-knowing, and spirit-essence. Further abstracting lead to the metathemes sensation and perception. Through a change in consciousness, a oneness/wholeness was experienced. The unity of meaning elicited was the Rhythm of Oneness Through Energy which is the connecting, opening, and cocreating through caring, the wholeness of each to become one through rhythms of energy. ^