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Biomedical subjects

M A Test

Publications and source records attributed to M A Test.

At least 19 recordsLinked to original sources
PubMed1992

A model for measuring the implementation of community support programs: results from three sites.

We present and test a model for measuring the implementation of Community Support Programs (CSPs) for persons with severe mental illnesses. The model is intended to facilitate the description and replication of these programs and the future study of their critical ingredients. The model defines important implementation variables in seven areas of program functioning; we then suggest instruments to measure each of these variables. Results of a study examining the application of the model and measures to three conceptually distinct CSPs illustrate the utility of the model and measures for implementation analysis of CSPs. Importantly, findings revealed that a priori hypotheses about how the programs were expected to differ on the implementation variables were largely supported.

Adolescent↗
PubMed1990

Gender differences of young adults with schizophrenic disorders in community care.

Gender differences were studied in the lives of 122 young adults (mean age = 23.11 years) with schizophrenia or schizophrenia-related disorders who are participants in a long-term study of progressive community care. Across the first 2 years, males who required hospitalization showed a trend toward greater recidivism and spent more time in institutions than women who required hospitalization. Women spent more time in inpatient medical settings for nonpsychiatric reasons. In community living domains, significant gender differences were found in parent roles, frequency of heterosexual relationships and behaviors, substance use, arrest rates, the number who spent time in jail, and residential settings. In the study to date, more males than females have committed suicide. We discuss specific ways in which treatment can be sensitive to these gender-relevant issues. We also note the need for future research on gender differences in schizophrenia to consider the very different community lives of men and women.

Adult↗
PubMed1990

Suicide and schizophrenia: data from a prospective community treatment study.

This article reports the analysis of prospectively gathered data on eight young adults who committed suicide during an ongoing longitudinal study of long-term treatment of schizophrenia in the community. Young adult men with an early onset of psychiatric illness were identified as a high-risk subgroup. At the time of admission to the study, the subjects who eventually committed suicide reported significantly more distress and tended to be less satisfied with their lives than the other subjects. Specifically, baseline measures of self-reported subjective distress were consistently predictive of later suicide, whereas interviewer-rated measures and postbaseline assessments were not.

Adolescent↗
PubMed1989

Substance use in young adults with schizophrenic disorders.

Use of nonprescribed mood altering substances is pervasive and problematic in young adults with serious mental illnesses in community care. Fifty-eight percent of young adult clients with clearly defined schizophrenia or schizophrenia-related disorders participating in a long-term community treatment study were rated by staff or themselves as using alcohol, cannabis, or other street drugs several times a week or more. We interviewed in depth a random sample of these "significant users" to obtain their perspective on their frequencies, patterns, histories, contributing factors to, and effects of substance use and their related treatment experiences. Results revealed these clients' substance use to be of long duration and deeply entrenched, with current use often involving multiple substances including both street drugs and substances of "everyday life" (e.g., caffeine, nicotine). Clients reported compelling reasons for use including anxiety reduction, relief of boredom, and a means for social contact. Staff and clients clearly view substance use quite differently, with the latter focusing at least as much on consequences of symptom relief as symptom exacerbation. Treatment implications are discussed.

Adolescent↗
PubMed1987

Health care practices and health status of the mentally ill in the community.

The chronically mentally ill generally need a variety of social supports to maintain themselves in the community. This study assessed the health care practices and health status of community-based respondents to determine if the health care needs of this chronic population were being met. Although positive results were found, service gaps deserving of attention were also revealed.

Adult↗
PubMed1985

Characteristics of young adults with schizophrenic disorders treated in the community.

The authors describe the characteristics of 100 young adults with schizophrenia or schizophrenia-related disorders who are being treated in the community, patients who are at high risk for serious, long-term impairment but have not necessarily developed such impairment yet. In contrast to subjects in some other studies of young adult chronic patients, the patients show great variability in previous levels of functioning, such as employment history, ability to live independently, and drug use. The authors hypothesize that highly individualized assessment and comprehensive treatment provided early in the course of illness can prevent or limit chronic functional disability for many patients; they provide recommendations for such treatment.

Adolescent↗
PubMed1980

Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation.

A conceptual model for the development of community-based treatment programs for the chronically disabled psychiatric patient was developed, and the results of a controlled study and follow-up are reported. A community-treatment program that was based on the conceptual model was compared with conventional treatment (ie, progressive short-term hospitalization plus aftercare). The results have shown that use of the community program for 14 months greatly reduced the need to hospitalize patients and enhanced the community tenure and adjustment of the experimental patients. When the special programming was discontinued, many of the gains that were attained deteriorated, and use of the hospital rose sharply. The results suggest that community programming should be comprehensive and ongoing.

Adult↗
PubMed1980

Alternative to mental hospital treatment. II. Economic benefit-cost analysis.

A cost-benefit analysis should be seen not as a mechanism for deciding mechanically on the allocation of funds and resources among programs but as a structure for weighing advantages and disadvantages (that is, for organizing knowledge). Considering all the forms of benefits and costs that we were able to derive in monetary terms, the experimental program provided both additional benefits and additional costs as compared with the conventional treatment. However, the added benefits, some +1,200 per patient per year, are nearly +400 more per patient per year than the added costs. A number of the forms of benefits and costs that we have measured in quantitative but nonmonetary terms show additional advantages of the community-based experimental program. The generalizability of a single experiment is limited, but the methodologies developed may be useful if their proper role is appreciated.

Adult↗
PubMed1980

Alternative to mental hospital treatment. III. Social cost.

Much concern has been expressed over the possible burden placed on family and community members by programs that emphasize community treatment of severely disturbed patients. In this study, the social costs of an experimental in-community program were compared with those of a traditional approach using short-term hospitalization plus aftercare. Six objective and one subjective measures of the burden placed on the family members of patients in both groups were obtained. Community burden was assessed through police records of frequency of patient arrests, number of suicidal gestures that required medical attention, and frequency of emergency room use. All measures showed that the total in-community program resulted in no more burden on the family or community than the traditional approach. The large amount of support provided to patients, families, and community members in the experimental approach is emphasized in explaining these results.

Adult↗
PubMed1977

Special living arrangements: a model for decision-making.

Many chronically disabled patients need special support systems to help them meet material needs, personal-care needs, and psychosocial needs. The authors propose two guidelines that must be considered simultaneously when deciding what special support system is most appropriate for a particular client. The first is that the system be adequate to meet the client's unmet needs, and the second is that the system not meet needs the client can meet hiself. The authors feel that one should look first to support systems other than special living arrangements, which can easily overprovide services to clients. If a special living arrangement is considered appropriate, the one selected should provide only for those needs the client cannot meet himself.

Community Mental Health Services↗
PubMed1976

Practical guidelines for the community treatment of markedly impaired patients.

A sound technology does not yet exist for successfully treating in the community those patients traditionally treated by public mental hospitals and aftercare programs. The current paper attempts to advance this technology by presenting practical guidelines based on the empirical work of the writers and others. Recommendations include a focus on the teaching of coping skills, an in vivo site of treatment, an assertive approach, and use of a variety of social learning techniques. Staffing and monetary needs for community treatment are also discussed.

Adaptation, Psychological↗