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Biomedical subjects

U Aviram

Publications and source records attributed to U Aviram.

17 recordsLinked to original sources
PubMed1995

Discharge-ready patients who remain hospitalized: a re-emerging problem for mental health services.

There is evidence that mentally ill patients nationwide are retained in state hospitals in spite of the fact that they are discharge-ready. New Jersey provided a unique opportunity to study this phenomenon, since it has been using specific procedures to identify discharge-ready patients in state hospitals. An analysis of New Jersey state hospital data found that about 45% of the state hospital patients were designated by either the legal or the clinical system, or both, as discharge-ready. Although a substantial number of these patients were disabled, they were assessed as being able to manage in the community with appropriate support. Characteristics and service needs of these patients are described, and the differences between those designated as discharge-ready and those who were not are examined. Recommendations are made for future research addressing the legal, clinical and social processes that affect discharge readiness.

Adolescent↗
PubMed1990

Community care of the seriously mentally ill: continuing problems and current issues.

The crisis in community care for the seriously mentally ill (SMI) stems from organizational and financial difficulties as well as from deeply embedded structural factors. The analysis shows a preference for medicalizing and individualizing the problems of SMI rather than viewing them as structural social welfare issues. The author discusses problems of deinstitutionalization, homelessness, service provisions, financing, accounting and reporting, employment, bureaucratic skimming and burden to families and points out the ambivalent ideology and the inherent contradictions within the mental health service system. Finally, the centrality of social control and the maintenance of orderly social life in public policy and program development is illuminated.

Chronic Disease↗
PubMed1990

Community care of the severely mentally ill: is social control a "necessary evil" in policy-making considerations?

Analysis of the crisis in community care for the severely mentally ill (SMI) reveals that it stems not only from organizational and financial problems, but also from the social structure and ideological perspectives embedded in American society. The desire of society for social control and the maintenance of orderly social life is illuminated as a central factor in public policies regarding the SMI. Policy planning, aimed at improving services for the SMI, must take social structural consideration into account and accept the social control component, perhaps as a necessary evil, nevertheless a necessity, in policies regarding the severely mentally ill.

Community Mental Health Services↗
PubMed1989

Officers' attitudes toward combat stress reaction: responsibility, treatment, return to unit, and personal distance.

This study examines the attitudes of 176 Israel Defense Forces officers toward combat stress reaction (CSR) in four areas: (1) the degree of personal responsibility the officer accepts for the treatment of the CSR casualty; (2) the type of treatment the officer views as most effective for CSR; (3) the officer's willingness to accept the CSR casualty's return to the unit following treatment; and (4) the personal distance the officer experiences between himself and the phenomenon. The impact of the following variables on officers' attitudes was assessed: casualty's rank, casualty's level of combat skill, presence of an additional physical injury, type of symptomatology, and respondent's background variables. Each officer was presented with one of 24 vignettes describing a CSR incident and was requested to fill in an attitudes questionnaire. Findings revealed that officers were more severe and less tolerant in relation to the CSR casualty who was an officer than toward lower ranking casualties. Officers were expected to take more responsibility for their own recovery than simple soldiers, support of commanding officers was seen as less effective in their treatment, and respondents were less willing to accept them back into their units after treatment.

Attitude↗
PubMed1984

Overutilization of the general hospital emergency room for psychiatric referrals in an Israeli hospital.

Consecutive referrals numbering 177 to the psychiatrist in an Israeli general hospital emergency room (ER) over a two-month period were evaluated. Only one-third met our criteria of justifiability. When the general practitioner (GP) was the referral source, we considered only 29 per cent of cases justified as compared to 70 per cent of the self-referrals. A combination of poor understanding by the GP of when to refer urgently, efforts by the GP to bypass clinic waiting lists, and lack of alternative community facilities may have accounted for this finding.

Adolescent↗
PubMed1981

Facilitating deinstitutionalization: a comparative analysis.

The purpose of the paper is to highlight issues related to deinstitutionalization and community care of the mentally ill by using a comparative approach. Through a comparison of the trends in the U.S.A. and Israel, an attempt is made to account for factors which promoted deinstitutionalization. The paper focuses on specific policies and programs which were crucial in reducing the rate of resident population in mental institutions and facilitating the development of community care for the mentally ill in the U.S. It points out the environmental conditions, social, political, legal and organizational, which may be conducive to legislative and administrative actions in order to facilitate deinstitutionalization.

California↗
PubMed1979

Reintegrating the mentally ill in the community.

Substantial reductions in the in-patient census of state hospitals throughout the United States have led to the concentration of large numbers of formerly mentally ill individuals in sheltered living arrangements in local communities. These efforts represent a major change in providing care for the long-term chronic patient. How is the life of this individual affected by community placement? A survey was completed of 499 residents in 234 facilities representing all formerly hospitalized non-retarded mental patients between 18 and 65 years old in California's sheltered care facilities. Results indicate that the social functioning of individuals in the external community is enhanced primarily by the characteristics of the community in which they are placed. In contrast, the social functioning of individuals within the immediate environment of their sheltered living arrangements is most affected by the character of the placement itself. The particular characteristics of communities and facilities found to be most important in addition to the characteristics of the residents which impact on social integration are discussed in the study.

Adolescent↗
PubMed1977

From hospital to community care: the change in the mental health treatment system in California.

In 1968 California enacted a law transforming its state hospital centered mental health services to a single system of patient care based on local community responsibility. The 1968 law was not the cause of radical change in California, but rather the culmination of a process that began three decades earlier. The 1963 federal regulation enabling former mental patients to become eligible for categorical aid through public assistance programs and the development of psychoactive drugs were two necessary catalysts that provided the opportunity ot maintain many formerly hospitalized mental patients in the community and to avoid lengthy hospitalization of others.

California↗
PubMed1976

Policy decisions and the reduction of mental hospitalization of the aged.

Inappropriate hospitalization of elderly persons in mental institutions has been a cause for much concern. Reduction of this type of hospitalization has become an accepted national policy. The observed variations among the states in the rates and trends of hospitalization of aged patients may indicate that trends income states are more congruent with national policy than those in others. In an effort to account for the wide variation among the states, time trend analyses of rate changes of hospitalized aged were made for a sample of states. These reveal that there are relationships between impatient trends and specific policies and programs for the aged. The results provide insights into mental hospitalization of elderly persons, and indicate how the inappropriate mental hospitalization of the aged can be reduced.

Aged↗
PubMed1975

Psychiatric epidemiology in Israel: an analysis of community studies.

A review is presented of all psychiatric surveys conducted thus far in Israel. A brief description of these five epidemiological studies is followed by an analysis which focuses on the objectives of the studies, their respective methodology and data sources. The results obtained in these studies are discussed according to several parameters, i.e., the range of prevalence rates found, the differential distribution of rates among social groups and the relationship found between psychopathology and several variables such as age, country of origin, social class and area of residence. Suggestions for further epidemiological research are included.

Adult↗