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Affirm Recovery
Published in Sandra Rasmussen, Developing Competencies for Recovery, 2023
Deinstitutionalization from mental hospitals, a national movement beginning in the mid-1960s, resulted in more individuals living in the community. Simultaneously, a recovery approach gained impetus as a social movement due in large part to a perceived failure of traditional mental health/addiction services. Moreover, the realization that people recover surfaced. Influenced in part by the philosophy of Alcoholics Anonymous and social movements of the 60s and 70s, the New Freedom Commission on Mental Health established by President George W. Bush proposed a shift from the traditional medical psychiatric model of care toward the concept of recovery. The report, Achieving the Promise: Transforming Mental Health Care in America, boldly recommended recovery from mental illness as the expected goal of this transformed system of care.
Clozapine and Treatment-Refractory Illness
Published in Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman, Understanding and Caring for People with Schizophrenia, 2020
Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman
It may well be that no field is more in need of miracles and cures than psychiatry. Before the period of deinstitutionalization from the 1960s through the 1980s, up to half a million people with severe mental illness were living in state psychiatric hospitals (3). Many had treatment-refractory psychotic illness, especially schizophrenia. For a number of reasons, including the advent of antipsychotic medications, many of these patients were discharged into the community with the idea that they would receive treatment at community mental health centers. Unfortunately, the latter were often underfunded. Moreover, such individuals were often too ill for general community life – and the legal system made it extremely difficult to involuntarily commit individuals with severe psychotic illness to psychiatric hospitals when their conditions intensified. The result of deinstitutionalization was that many of these people who previously required chronic hospitalization became homeless or wound up incarcerated. If ever a miracle or cure were needed, it would be for severe mental illnesses such as schizophrenia.
“Listening to the Music of the Mind”
Published in Meidan Turel, Michael Siglag, Alexander Grinshpoon, Clinical Psychology in the Mental Health Inpatient Setting, 2019
The nature and missions of state facilities have changed rather dramatically during the past 20 years (Webster & Harmon, 2006). The process of deinstitutionalization that dominated inpatient mental health care since the advent of anti-psychotic medication over half a century ago is currently referred to by names such as “community focused care.” The process has heralded a dramatic downsizing both in the number of beds available and in the average length of stay of those who are admitted to such facilities (Torrey et al., n.d.). A premium is placed upon the rapid assessment, stabilization, and discharge of patients, with many resources being dedicated to the creation of realistic community based after-care services (Fisher, Geller, & Pandiani, 2009). Patients who require longer-term treatment are usually those who present with complicated profiles, symptoms that do not respond to a multiplicity of standard treatments, co-morbid disorders, criminal or forensic histories, and patterns of failed attempts to live in the communities (Fisher, Geller, & Pandiani, 2009).
Three-dimensional virtual reality: Applications to the 12 grand challenges of social work
Published in Journal of Technology in Human Services, 2019
Mark H. Trahan, Kenneth Scott Smith, Amy C. Traylor, Micki Washburn, Nicole Moore, Alberto Mancillas
The primary goals of the challenges, Reduce Extreme Economic Equality (Elliott et al., 2016) and Build Financial Capability for All (Huang et al., 2016) are to increase the income of the poor, build income and wealth stability, and ensure all people are financially capable. Homelessness, including housing instability, is one of the most important issues facing the United States today, particularly considering stagnating wages, decreased availability of full-time employment for those with limited education, and increased housing costs (U. S. Department of Housing and Urban Development Office of Community Planning and Development (HUD), 2017). Deinstitutionalization of those with chronic mental health conditions, accompanied by reductions in community-based substance abuse and mental health care also have contributed to the rising number of those experiencing homelessness (Schutt & Goldfinger, 2011). Holistic intervention approaches must be employed to ensure evidence-based psychosocial interventions always accompany housing assistance for those at risk of experiencing homelessness.
Assisted living for mentally ill—a systematic literature review and its recommendations
Published in Nordic Journal of Psychiatry, 2022
Joel Ketola, Erfan Jahangiri, Helinä Hakko, Pirkko Riipinen, Sami Räsänen
For decades there has been a global shift from psychiatric inpatient treatment to outpatient care and active rehabilitation, including housing services. This has been a trend in Nordic countries, as well [5,6]. The main goal of deinstitutionalization has been to participate people with mental disorders in society and therewith improve human rights and quality of life (QoL). Knapp et al. has stated that deinstitutionalization has not generated cost savings but it has been cost-effective when compared to hospital treatment [7]. Globally, the reduction of hospital beds has had a major effect on people suffering from psychotic disorders since individuals have moved from asylums to society [8,9].
Social care for older people – a blind spot in the Norwegian care system
Published in Social Work in Health Care, 2020
Walter Schönfelder, Helga Eggebø, Mai Camilla Munkejord
The process of deinstitutionalization is intertwined with two other processes, both with significant consequences for the provision of care. First, the distinction between health and social care has increasingly become unclear, with nursing staff focusing mainly on health-related issues and home helpers performing practical, household tasks (Vabø, 2009). Furthermore, there has been a tendency to deliver increasingly more healthcare services and less practical assistance (Mørk et al., 2016, p. 4). As a result, social care is addressed only implicitly in this distribution of care work, without being safeguarded by specific minimum or quality standards. Second, since the 1990s, public service delivery in Norway has increasingly been organized according to the principles of new public management (NPM). Regarding the particular adoption of these principles within health and social care delivery and their consequences, Vabø claimed that before the advent of NPM, “home care staff, including skilled nurses, were typical social professionals” (2012: 286). The extent to which nursing staff actually lived up to this claim before the introduction of NPM is debatable, as the need for more person-centered, holistic and flexible care service performance has been repeatedly emphasized in government white papers over the course of several decades (Helse- og omsorgsdepartementet, 2014; Sosial- og helsedepartementet, 1994, 1997, 2000). Despite various reforms, the professional basis for the provision of care services as well as the main challenges for providing high quality and person-centered care services remained unchanged. Therefore, our interest in this article is to investigate how social care appears in accounts given by professional caregivers.