Does family intervention for adolescent substance use impact parental mental health? A systematic review

Adolescent substance abuse is a prevalent problem and both individual and group family interventions are increasingly being used to assist families to cope. A literature review was conducted to identify whether individual and group family interventions for adolescent substance abuse enhance the mental health of parents and other family members. The review also sought to identify direct and indirect effects of family intervention processes on depressive symptoms and general distress. Based on quality criteria a total of nine studies were included. Of these, six quantitatively examined family intervention outcomes on family member mental health, with all six reporting positive effects. Four of the nine studies measured levels of depressive symptoms and three of these four studies reported significant direct effects of family intervention on parental depression. The positive effects were also found in the three qualitative studies included in the review. Indirect therapeutic mechanisms that contributed to mental health improvements included: reduction of stress symptoms, improved coping, improved family functioning, more effective parenting behaviours, attitude changes, perceived changes in relative’s substance use, and improved social support. The available literature suggests that a number of determinants of family mental health may potentially be impacted through family intervention for adolescent substance abuse. However, definitive conclusions cannot be made at this point as the literature is mostly descriptive and there have been few longitudinal studies or randomised controlled trials.

An examination of adolescents' help seeking processes

This thesis examined factors that predict adolescents' professional help seeking when experiencing mental health problems over six months. Factors that strongly predicted help seeking included adolescents' ability to recognise that they were experiencing a problem; the type and severity of the problem experienced; and the preceived support from their family. The portfolio examined the potential benefits of using manualised CBT programs in a more flexible and individualised manner when treating children and adolescents.

Mindfulness in forensic mental health : does it have a role?

Treatment and rehabilitation in forensic settings have been largely based on cognitive behavioural models and therapies. In the past decade, “third wave” approaches have developed in cognitive behavioural therapy, strongly influenced by spiritual and contemplative traditions such as Buddhism. Mindfulness is the most analysed and researched of such approaches. In this paper, we ask whether mindfulness is relevant to therapeutic work with offenders in forensic mental health and criminal justice services. We review the known criminogenic and other needs of offender groups and discuss whether the psychological processes affected by mindfulness are relevant to reducing risk, alleviating distress and facilitating coping. We conclude that they are. Finally, we address some of the problems that may arise in implementing mindfulness interventions in forensic settings.

It's not that bad : the views of consumers and carers about routine outcome measurement in mental health

The mandatory use of routine outcome measurement (ROM) has been introduced into all public sector mental health services in Australia over the past 6 years. Qualitative processes were used to engage consumers and carers in suggesting how the measures can be used in clinical practice. The project involved an audit by survey, followed by a range of interactive workshops designed to elicit the views of consumers, carers and clinicians, as well as to involve all parties in dialogue about ROM. In addition, there was engagement of consumers and carers in the training of clinicians in the clinical use of ROM, and in the production of promotional materials aimed at informing consumers and carers about ROM. When consumers and carers have had an opportunity to be involved in ROM they have found it a useful experience, and those who had not been involved can see the potential. Consumers and carers indicated that they believe the greatest opportunity arising from the suite of measures is the use of the consumer self-assessment measure the Behaviour and Symptom Identification Scale (BASIS-32).

Stigma toward mental illness : a cross-cultural comparison of Taiwanese, Chinese immigrants to Australia and Anglo-Australians

This study investigated the relationship between culture and attitudes toward mental illness. In total, 196 men and 347 women were recruited from Australia and Taiwan. All participants completed a questionnaire assessing their attitudes toward mental illness. Australian-born Chinese and Chinese immigrants to Australia also completed a questionnaire assessing cultural values. Chinese immigrants to Australia and Taiwanese held more stigmatizing attitudes than Australian-born Chinese and Anglo-Australians. Australian-born Chinese adopted Australian cultural practices more than Chinese immigrants, but these groups did not differ in terms of adherence to Chinese cultural practices. The adoption of Australian cultural practices was significantly associated with lower stigmatizing attitudes. These findings reveal the influence of culture and acculturation processes on stigmatizing attitudes toward the mentally ill.

Mental health diversion courts: a two year recidivism study of a South Australian mental health court program.

The need to develop specialized judicial processes to deal with offenders with mental illnesses is now widely recognized and has led to the introduction of mental health court diversion programs around the world. At present, however, there is only limited evidence from which to assess the impact of these initiatives. This paper describes the South Australian model of diversion, with specific reference to the relationship between identified participant characteristics, program compliance rates, and re-offending outcomes. The results of a two-year recidivism study suggest that involvement with the program has a positive impact on recidivism, but that this is independent from the individual's level of success in the program. Lower risk offenders were more likely to achieve successful outcomes than those in the higher risk categories. The implications of these results, as well the factors that might inform the ongoing development of mental health court programs, are discussed.

Encontros entre dança, subjetivação e saúde mental

Taking from starting point the contact with the experience of a dancing body language group at Centro de Atenção Psicossocial (CAPS) II in Fortaleza-CE, aiming to investigate the relationship between what we denominate dancing-dispositive and the process of de-institutionalization of insanity. Based in the philosophy of difference and in the cartographic perspective, we used the concept of dispositive in order to make visible the lines that compose it and the way they tangle in the production of different ways of subjectivation through another form of expression using the body. We followed two fortnight groups of body language recording the conversations that took place in the beginning and in the end of the activities. We also recorded our informal talks with the workshopper, with the psychiatrist responsible for the course of formation of artists of CAPS and the choreographer who was part of the artistic formation of the workshopper aiming to elucidate the body, dance and art conceptions which guided such work. Finally, we interviewed some technicians and we participated of a meeting of the team aiming to understand how that activity was perceived. We observed that the use of certain conception of dance in the field of mental health is in consonance with the the Phychiatric Reform, since it provides another way of dealing with the body, different from that produced by the contention and by the discipline. Nevertheless, we understood that there is a risk that, in some moments, the group being more a place of normalization than one of experimenting other ways of relating with yourself and with the others. We also noted that the dancing-dispositive appears as an important analyzer of the connections established at CAPS, indicating a need of the service to be more opened to the production of new care and harboring strategies, breaking the mental health facility logic of incarceration of life which still persists in the quotidian of that institution

Saúde mental na estratégia saúde da família: notas cartográficas sobre processos de trabalho em saúde

This study aims to map the working process in the health area starting from the meeting between the family and health teams and mental trouble carriers./MTC. The area of research was the Family Health Unit of Ozeas Sampaio, which is located in the county of Teresina-PI. As regard to the methodology procedure, we used a semi-structured interview timetable, aimed to detail the care practices, admittance and diagnostics that those teams realize with their users. Three teams of eleven workers each were interviewed. There was a doctor, a nurse and two health community agents in each team. The other tools we used were a camp logbook, in which we wrote down some informal dialogs, daily observations and feelings of the unit, and also the accompaniment of the staffs in house calls as well as the weekly meetings in the unit. Those meetings allowed us the construction of two analytic axes: 1) description of the establishment (Family Health Unit) of the organization, (municipal foundation of health and the service network), and the institutions and practice of health. 2) Analysis of the meetings between the worker and the user of Mental Trouble Carriers. In the first axis, we verified the repetition of the working logic focused on jobs in the hospital with the maintenance of the hierarchical relations between worker and the work processes which dissociate management and watchfulness in health care. We identified the lack of physical structure, the lack of self-confidence of the worker in the attention of the mental health care. At the second axis, we assess that the meetings, at the Family Health Unit (FHU) or at the dwelling of the users cause nuisance, discomfort and anxiety to the workers because they deal with issues that go beyond what is named as being the health order such as life stories, family conflicts, unemployment, hunger, sexual and psychological violence. As a matter of fact, they involve difficulties for having new relationships, reception and responsibility for this request

A CRONIFICAÇÃO NOS SERVIÇOS SUBSTITUTIVOS NA REDE DE SAÚDE MENTAL DE NATAL/RN

Brazilian Psychiatry Reform, through Psychosocial Care Strategy, has intended to build insane people care practices from community care services which contemplates the subjects complete lives. However, to change the traditional care ways demands the facing of a series of epistemological, political and cultural obstacles. One of the current challenges deals with patients aggravation processes, with management ways, with devices and with professionals, as well as with the assistance network. The purpose of this thesis was to investigate how these aggravation processes has been constituted in Natal mental healthcare network, understanding its effects in the work teams and patients. Theoretical and methodological perspective used was Institutional analysis was, subsidizing the usage of concept-tools as the implication analysis, selfmanagement and self-analysis, and restitution. The research was carried out at the Natal East Sanitary District Mental Healthcare Clinic, with the participation of technicians and patients. The research procedures were: literature and document research on the attendance and the analyzed theme; attendance registers analysis; participating observation of the institutional routine for three months and field log entries; talking groups, one with the team and one with the patients. Two main discussion points are shown: 1. The mental healthcare clinic organization logic and the intersector politics; 2. The work and management processes developed at the mental healthcare clinic. The analysis show diversity in the attended demands in the service, which has favored the patients aggravation, this device and the substitute network processes. The work processes are apart from the political sphere and from the managements processes. In this sense, we show the need to reevaluate the clinic device as well as the management models adopted in the Brazilian Psychiatry Reform context

Inferior alveolar nerve transposition with involvement of the mental foramen for implant placement

Inferior Alveolar Nerve (IAN) transposition is an option for prosthetic rehabilitation in cases of moderate or even severe bone reabsorption for patients that do not tolerate removable dentures. The aim of the present report is to describe an inferior alveolar nerve transposition with involvement of the mental foramen for implant placement. The surgical procedure was performed under local anesthesia, by the inferior alveolar, lingual and buccal nerve blocking technique. Centripetal osteotomy was performed, and bone tissue was removed, leaving the nerve tissue free in the foramen area. After that, transsection of the incisor nerve was performed, and lateral osteotomy was started from the buccal direction, toward the trajectory of the IAN. The procedure was concluded, by making use of a delicate resin spatula to manipulate the vascular-nervous bundle. The drilling sequence for placing the dental implants was performed, and autogenous bone was harvested using a bone collector attached to the surgical suction appliance. After the implants were placed, the bone tissue previously collected during the osteotomies and drilling processes was placed in order to protect the IAN from contact with the implants. The surgical protocol for inferior alveolar nerve transposition, followed by implant placement presented excellent results, with complete recovery of the sensitivity, seven months after the surgical procedure.

Conceptual spaces and consciousness: Integrating cognitive and affective processes

In the book Conceptual Spaces: the Geometry of Thought [2000] Peter Gärdenfors proposes a new framework for cognitive science. Complementary to symbolic and subsymbolic [connectionist] descriptions, conceptual spaces are semantic structures constructed from empirical data representing the universe of mental states. We argue that Gärdenfors' modeling can be used in consciousness research to describe the phenomenal conscious world, its elements and their intrinsic relations. The conceptual space approach affords the construction of a universal state space of human consciousness, where all possible kinds of human conscious states could be mapped. Starting from this approach, we discuss the inclusion of feelings and emotions in conceptual spaces, and their relation to perceptual and cognitive states. Current debate on integration of affect/emotion and perception/cognition allows three possible descriptive alternatives: emotion resulting from basic cognition; cognition resulting from basic emotion, and both as relatively independent functions integrated by brain mechanisms. Finding a solution for this issue is an important step in any attempt of successful modeling of natural or artificial consciousness. After making a brief review of proposals in this area, we summarize the essentials of a new model of consciousness based on neuro-astroglial interactions. © 2011 World Scientific Publishing Company.

Dissertação readymadenemtanto da aluna de poesia Rrosé Selavy Duchampignon (work in progress) -: ideograma mental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O espaço fórum como apoio na formação da rede intersetorial regional em saúde mental: desafios e potencialidades

Pós-graduação em Psicologia - FCLAS

Apontamentos genealógicos a respeito da noção de deficiência mental e de suas instituições de cuidado no Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Saúde mental: a roda viva da política pública do estado do Pará

Ao longo das últimas décadas diversos países, inclusive o Brasil têm implementado políticas de atenção em saúde mental, baseadas no elemento central comum de alteração do eixo da atenção do hospital para a comunidade, objetivando a continuidade do cuidado e a atenção integral, um processo de se costuma denominar de Reforma Psiquiátrica. Buscando compreender qual o modelo de assistência aplicado no Pará entre 2007 e 2010, o tradicional, manicomial ou o da reforma psiquiátrica e quais os resultados da política em termos de impacto?” esta pesquisa foi realizada, a partir de uma revisão bibliográfica sobre os processos de reforma psiquiátrica em vários países da Europa, da América Latina sem perder de vista as especificidades do Brasil e do Pará e uma análise sobre o papel do Estado, das políticas públicas sociais, dentre elas a política pública de Saúde e o Sistema Único de Saúde, além de análise de documentos e entrevistas com os executores das políticas. Como resultados foram observados avanços na política de saúde mental entre 2007 e 2010, tais como aumento (96%) no número de serviços, ainda que com a efetividade questionada tanto pela gestão quanto pelo movimento social, além de um estabelecimento de canal de diálogo entre gestão e movimento social através de conselhos gestores, ouvidorias internas e eventos de capacitação diversos. Por outro lado, os problemas estruturais persistem e de acordo com a análise efetuada têm relação com o contexto político-econômico vivenciado pelo Brasil de aprofundamento das desigualdades sociais e da negação dos direitos sociais, econômicos, culturais e ambientais instituídos na Constituição de 1988. Fica evidenciada, assim, a consolidação do processo de globalização neoliberal, com ações voltadas para a estabilidade econômica e focalização de políticas públicas sociais. Como alternativa a essa situação a autora apresenta o ponto de vista de que o SUS é um sistema em construção e que o desafio posto na atual conjuntura que tenha por objetivo superar as profundas desigualdades sociais através de um movimento de massas que retome as propostas de superação da crise e avance em propostas concretas.