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PubMed2000

Visualism in community nursing: implications for telephone work with service users.

This article explores the potential effects of visualism (a prejudice in favor of the seen) on the perceived legitimacy of telephone work in community nursing. It discusses data from an exploratory study on telephone work, which used guided interviews with a purposive sample of 14 community nurses. Interviewees expressed both positive and negative ideas about telephone work and had particular concerns about the assessment of people, context, problems, and comprehension by telephone. These issues are discussed with reference to publications on visualism, metaphor, communication, and nursing work. The authors conclude that an awareness of the possible effects of visualism on ideas and practice could lead to improvements in both communication and assessment, whether carried out by telephone or face to face.

Attitude of Health Personnel↗
PubMedDate not supplied

Service users' views of psychiatric nurses.

With the shifting emphasis in the NHS towards quality assurance and consumerism, user satisfaction has become an important issue for mental health nurses to consider. This article provides some data from a survey of 516 psychiatric patients conducted by the authors on behalf of national MIND in 1990.

Attitude to Health↗
PubMed2004

Mental health, social inclusion and the green agenda: an evaluation of a land based rehabilitation project designed to promote occupational access and inclusion of service users in North Somerset, UK.

The current debate about social inclusion in the field of mental health reveals a tension between the political and economic objectives of social policy. The former utilises the language of citizen empowerment and rights, whilst the latter is concerned with reducing welfare dependency through labour market activation. A central question here is whether a suitable programme of therapeutic work, training and support will produce better outcomes than those predicted by either a clinical diagnostic assessment or indeed open employment in the labour market. This article evaluates a research project with mental health users designed to develop pathways towards inclusion. The principal means for achieving this was a programme of 'green' land-based activities, training and social support. The researchers employed a mixed method approach, utilising a quasi-experimental design with a hypothetical control and standardised testing. This was followed by interviews with users, staff and focus group discussion. The evaluation produced some unexpected findings; for example, it was found that no strong correlation existed between diagnosis and performance. Many users performed better than had been predicted by their diagnostic assessment. However, the reasons for this remained unclear until the qualitative interviews enabled users to give accounts of the problems they faced, explain what inclusion meant for them, and outline how the project had brought gains in confidence, motivation and self belief. The data gathered during the research derived from different epistemological positions. This can be seen as representing two ways of 'slicing the reality cake' rather than producing one complete view of mental health users reality. One construction related to how 'the system' diagnosed, processed, and 'objectively' managed them. The other was about how users' responded to their situation, utilised the opportunities available, and made 'subjective' sense of their experience.

Agriculture↗
PubMed1994

[The power of professionals in rehabilitation: the example of service users' group in social care].

Increasingly the purposes and focus of mental health rehabilitation has turned away from a concern to maximise the functioning of individuals towards an interest in helping people with mental needs to interact sufficiently well with their environment so as to gain independence in everyday life (Wing, 1980). Rehabilitation is to be seen, therefore, as a process rather than an event (Sheppard, 1984). In other words, rehabilitation not simply a single treatment (or fixed series of treatment) but often will be a longer term intervention to maintain social functioning and support adaptation. A failure to understand this distinction or to translate it into guiding principle which informs all aspects of professional practice in psychiatric rehabilitation results in misdirected effort (or, worse, in a series of empty rituals which reinforce dependence) (Watts and Bennett, 1993; Brandon, 1991). A central question for all the caring professions engaged in psychiatric rehabilitation, therefore, is how to utilize their skills to enable and support this process.

Activities of Daily Living↗
PubMed1993

A comparison of MEDLINE CD-ROM and librarian-mediated search service users.

Respondents performed searches primarily for themselves and for academic research. Overall, they preferred librarian-mediated searching to CD-ROM searching. Respondents who preferred the former did so because librarians are more familiar with MeSH headings and search strategies and because of time constraints. Respondents who preferred CD-ROM liked doing their own searches and the fact that there is no cost involved. While respondents preferred librarian-mediated searching over CD-ROM searching, overall they used CD-ROM more often, presumably because of other factors, such as time constraints and cost. This dichotomy could have significant implications for a library. Should the library strive to make mediated searches more attractive by providing immediate and cost-free results? Or, because CD-ROM is used more, should the library continue to purchase in this area and possibly reduce support for librarian-mediated overhead (e.g., training, search tools, etc.)? And do librarians have a responsibility to encourage patrons to use the tool that offers the higher quality of retrieval?

CD-ROM↗
PubMed2005

Mental illness and principal physical diagnoses among Asian American and Pacific Islander users of emergency services.

The stigma of mental illness is one of the factors that prevents Asian Americans/Pacific Islanders (APIs) from seeking formal mental health services. A somatic complaint is more acceptable in expressing psychiatric/emotional distress. Admission diagnoses in API emergency service users with secondary psychiatric diagnoses were identified from the 2001 National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). The sample consisted of 10,623 adult APIs. The study examined the differences in the six leading principal physical admission diagnoses between API emergency service users with psychiatric diagnoses and those without psychiatric diagnoses. Several of the study findings create concern (e.g., the higher percentage of APIs with psychiatric diagnosis who were discharged against medical advice, the high percentage admitted with medication intoxication). Further study is needed to provide guidance for clinical practice.

Adult↗
PubMedDate not supplied

[Awareness of the Info-Sante CLSC telephone service by users of urgent care services].

BACKGROUND: The CLSC's Info-Santé telephone service is one of the Quebec health network's reorganization measures aimed at decreasing the number of visits to hospital emergency rooms for non-urgent health problems. This study analyzes the awareness of this service among users of hospital emergency services and walk-in medical clinics. METHODS: In all, 850 patients were interviewed. Logistic regressions were performed. RESULTS: The results revealed that 75.5% (CI .95 = 0.73-0.78) of the participants were indeed aware of the CLSC's Info-Santé telephone service. Awareness was found to be dependent on age, sex, income, the use of walk-in CLSC medical services, the availability of a regular source of health care and the perception of one's health status. INTERPRETATION: Further strategies should be developed in order to increase the use of this service, thus helping to guide patients to more appropriate sources of health care.

Adult↗
PubMed2001

Prevalence of mental illness in homeless men in Munich, Germany: results from a representative sample.

OBJECTIVE: The aim of the study was a reliable assessment of the prevalence of DSM-IV mental disorders in a representative sample of homeless men in the city of Munich. METHOD: A preliminary survey yielded an estimate of 1,022 single homeless men in Munich divided among three sectors (shelter users, service users and street dwellers). A random sample of 265 single homeless men was surveyed from these three sectors. An age-matched comparison group of 178 men was selected randomly from a community register. The Structured Clinical Interview for DSM-IV (SCID-IV) was used for diagnostic classification. RESULTS: The lifetime prevalence rates of mental disorders were as follows: 72.7% vs. 15.2% for alcohol dependence, 32.8% vs. 7.3% for mood disorders, 15.9% vs. 6.2% for anxiety disorders and 9.8% vs. 0.6% for psychotic disorders. Of the homeless males in Munich, 93.2% had at least one lifetime DSM-IV axis I diagnosis, while this was the case for only 38.2% of the community controls. One-month prevalence for all SCID DSM-IV axis I disorders in homeless males was 73.4%. CONCLUSION: Lifetime DSM-IV axis I mental disorders were 2.4 times more frequent among homeless individuals compared to community control. Implications for health care planning are discussed.

Adolescent↗
PubMed1997

User participation in service planning. A qualitative approach to gauging the impact of managerial attitudes.

It is often suggested that professional and managerial attitudes significantly delimit the impact of new structures for enhancing the role and influence of service users in health and social care planning. Considers the existence and clarity of such managerial attitudes in the context of one attempt to involve users in mental health care planning. The existence of latent and explicit managerial parameters to the role played by users in the planning of services was confirmed by the research at a very general level. Perhaps inevitably though, even in relation to a very specific user participation project, these parameters became less uniform as more detailed issues were considered. This suggests that an investigative focus on the "process" oriented attitudes and assumptions of managers and professionals, although important, should not be allowed to detract from a concern with gauging the demonstrable outcomes of user participation.

Administrative Personnel↗
PubMedDate not supplied

User/consumer involvement in mental health service delivery.

The involvement of mental health service users in service delivery is a new and growing phenomenon. Such involvement is complex, given the history of paternalism in the mental health system, the power differential between service providers and service users, and the very differing views each group holds on multiple issues. Unless such differences are addressed, there can be no meaningful involvement. Service user involvement needs to apply to all aspects of the service delivery system, including professional training, service design, delivery, evaluation, and research. User/survivors, and their organizations, have developed a body of experience and knowledge that needs to be recognized and respected. Unless there are multiple opportunities for ongoing and open dialogue on these many difficult issues, real user involvement will not occur.

Community Participation↗
PubMed1996

Legislating for user involvement in the United Kingdom: mental health services and the NHS and Community Care Act 1990.

Recent legislation in the U.K., particularly the NHS and Community Care Act 1990, has encouraged the direct participation of service users in the planning and management of care services. This paper explores evidence of how the interests of service users experiencing mental distress are represented within community care services in the U.K. and the extent to which this leads to a devolution of power to those service users. The evidence is drawn from a survey of principal officers in social services departments responsible for mental health services and interviews with 135 service users. This reveals considerable confusion about the meaning and purpose of user involvement and about how service users can best be represented; little evidence, despite users' interest in it, of power-sharing; and limited commitment of resources to make further participation possible. The conclusion considers how, in the light of this evidence, Central and Local Government might further develop user involvement.

Attitude of Health Personnel↗
PubMed2005

Zero tolerance of violence by users of mental health services: the need for an ethical framework.

Concerns about violent conduct of service users towards healthcare staff have prompted a ;zero tolerance' policy within the National Health Service. This policy specifically excludes users of mental health services. We attempt to challenge artificial distinctions between users of mental health and other services, and propose an ethical underpinning to the implementation of this policy.

Ethics, Clinical↗