PubMed Health⌕ Search

Biomedical subjects

L R Marcos

Publications and source records attributed to L R Marcos.

At least 19 recordsLinked to original sources
PubMed1991

Have general hospitals become chronic care institutions for the mentally ill?

OBJECTIVE: Dramatic increases in lengths of stay for general hospital psychiatric patients in New York City in recent years have raised speculation that general hospitals are assuming a large responsibility for care of the chronically mentally ill. This study examines changes in utilization patterns and patient characteristics to assess whether such a trend is occurring. METHOD: The authors obtained discharge abstract data for all New York City general hospital adult psychiatric patients in 1985 and 1988 as well as utilization data from the public general hospital system for 1977-1989. Three measures of chronicity were chosen: hospital stays longer than 60 days, discharges to long-term care, and three or more admissions per year. Data on psychiatric diagnoses and comorbid diagnoses for chronically ill patients were also reviewed. RESULTS: The mean length of stay of psychiatric patients in general hospitals has increased substantially in recent years and nearly tripled in the public hospitals during 1977-1989. Between 1985 and 1988, citywide increases were due largely to a growing proportion of patients with very long stays. Patients with stays longer than 60 days accounted for 35% of all inpatient days in 1988, compared with 27% in 1985. Patients with chronic illness accounted for half of all days in 1988, compared with 38% in 1985. CONCLUSIONS: Although many factors have contributed to these trends, the leading cause has been reimbursement policies favoring short-term inpatient care. Improving accountability for community treatment programs will be the key to redirecting funding priorities and creating more appropriate alternatives for the chronically mentally ill.

Chronic Disease↗
PubMed1990

Law, policy, and involuntary emergency room visits.

The authors present data showing that the number of mentally ill individuals brought by police officers to psychiatric emergency rooms in New York City increased by 69 percent from 1983 to 1989. They conclude that while the statutory criteria for the involuntary removal of mentally ill persons to hospitals have not changed, case law decisions and public policies that facilitate the involuntary treatment of patients who neglect their essential needs have contributed to this trend. The impact of these visits on hospital based psychiatric emergency room is discussed in terms of increased clinical and legal responsibility for the disposition of persons who are considered dangerous including those who are self-neglectful of their own essential needs.

Commitment of Persons with Psychiatric Disorders↗
PubMed1990

Psychiatry takes to the streets: the New York City initiative for the homeless mentally ill.

The authors describe New York City's program to remove seriously mentally ill homeless people from the streets to a public hospital. They report on the 298 patients hospitalized during the first year of this program. Most of the patients were male (66%), single (77%), and from outside of New York City (79%) and claimed a history of previous psychiatric hospitalization (92%) and that they had been homeless for more than 1 year (66%). Most of the patients suffered from schizophrenia (80%) and had additional medical diagnoses (73%). Follow-up contact with the patients 2 years after initiation of the program revealed that 55% of the patients either were living in a community setting or were under institutional care.

Adult↗
PubMed1990

Critical factors in the professional development of the psychiatrist-administrator.

A questionnaire was sent to 244 psychiatrist-administrators from the metropolitan New York City area to assess the actual and perceived effects of five factors--personality traits, clinical psychiatric training, formal training in administration, administrative experience, and a mentor relationship--on their professional development. The results, based on 200 completed questionnaires, revealed a discrepancy between the respondents' actual and ideal experiences in the areas of the mentor relationship and formal administrative training. The authors recommend structural changes in training programs to attract psychiatrists to administrative careers and to enhance their training and professional development.

Adult↗
PubMed1989

The role of stress on the language-independence and code-switching phenomena.

This investigation studies the extent to which stress affects the assumed functional separation of coordinate bilingual's linguistic organization. Spanish/English bilinguals were subjects in a GSR linguistic conditioning experiment using two intensities of buzzer sounds (stressful conditions) and two lists of words. One word for each list functioned as the conditioned stimulus. Generalization to semantically, phonemically, and unrelated words occurred in both languages and buzzer conditions. We found a differential impact of the buzzer on the functional separation of the languages, although not in the direction predicted. We concluded that stress produced code-switching, and hence, a primitivization of the subject's cognitive and linguistic functioning is assumed to have occurred. These findings are important in understanding the way stress affects the bilingual's languages at the linguistic and cognitive levels. They are also important in understanding the role of stress in language development and in the transfer of linguistic information.

Adolescent↗
PubMed1989

The making of the psychiatrist-executive.

The authors reviewed the literature on the factors influencing the development of psychiatrist-executives. The results indicate that personality traits, clinical psychiatry training, training in administration, mentors, and administrative experience have an impact on the making of the psychiatrist-executive. On the basis of these findings, the authors make recommendations for further research.

Career Choice↗
PubMed1989

Media power and public mental health policy.

The author describes the functions of the news media and their influence on public mental health policy making. News media functions are divided into the categories of selecting the news, reporting information, serving as a channel of communication, presenting views and opinions, and legitimizing the issues. These functions are illustrated by focusing on a highly publicized New York City policy to involuntarily hospitalize mentally ill homeless people living in the streets. Strategies are suggested to mental health professionals on how to effectively interact with the news media.

Administrative Personnel↗
PubMed1979

Nonverbal behavior and thought processing.

Generally, clinicians assessing mental status interpret patients' nonverbal behavior in terms of its discharge, expressive, interactional, or neurological properties. The present study addresses the conceptualization of hand movement behavior as related to central cognitive processes, and attempts to identify encoding-related motor behavior by comparing the hand movements of subordinate bilingual subjects in situations of dominant- and nondominant-language and low- and high-imagery verbalization. Compared to the parallel dominant-language situation, subjects verbalizing in their nondominant language produced more speech-primacy and groping hand movements. Also, in comparison with the verbalization about a high-imagery topic, when the subjects encoded a low-imagery topic they displayed more pointing movements. Unless they are aware of these movements, clinicians evaluating bilingual patients may interpret an increase in encoding-related motor activity as reflecting psychopathology. Apart from this psychodiagnostic significance, hypothetical implications of these findings for the study of aphasia and information processing mechanisms are discussed.

Adult↗
PubMed1979

Effects of interpreters on the evaluation of psychopathology in non-English-speaking patients.

Non-English-speaking patients in need of psychiatric services are usually evaluated with the help of an interpreter. Discussions with psychiatrists and lay hospital interpreters who had experience in these interviews and content analysis of eight audiotaped interpreter-mediated psychiatric interviews suggested that clinically relevant interpreter-related distortions could lead to misevaluation of the patient's mental status. The author notes that pre- and post-interview meetings of clinicians and interpreters have been found useful in minimizing these distortions.

Adjustment Disorders↗
PubMed1979

Dynamic psychotherapy with the bilingual patient.

Bilingualism is known to affect the communicative behavior of the individual. This paper describes the implications of the bilingual experience for the process of dynamic psychotherapy, and presents recommendations to psychotherapists treating the bilingual population.

Communication Barriers↗
PubMed1979

Hand movements and nondominant fluency in bilinguals.

16 subordinate bilingual subjects produced 5-min. monologues in their nondominant languages, i.e., English or Spanish. Hand-movement activity manifested during the videotape monologues was scored and related to measures of fluency in the nondominant language. The hand-movement behavior categorized as Groping Movement was significantly related to all of the nondominant-language fluency measures. These correlations support the assumption that Groping Movement may have a function in the process of verbal encoding. The results are discussed in terms of the possibility of monitoring central cognitive processes through the study of "visible" motor behavior.

Adult↗