Suchergebnisse

In many African countries, mental health issues, including the burden of serious mental illness and trauma, have not been adequately addressed. These essays shed light on the treatment of common and chronic mental disorders, including mental illness and treatment in the current climate of economic and political instability, access to health care, access to medicines, and the impact of HIV-AIDS and other chronic illness on mental health. While problems are rampant and carry real and devastating consequences, this volume promotes an understanding of the African mental health landscape in service

Este artículo aborda la mirada cinematográfica sobre las instituciones psiquiátricas y la concepción de la enfermedad mental del franquismo desde la óptica antagónica que comenzó a promoverse desde distintos ámbitos sociales, políticos y culturales durante la transición española. Partiendo de una aproximación histórica cuyo objetivo es contextualizar la concepción de la psiquiatría franquista se procede a continuación al análisis formal y temático de cuatro documentales clave de la transición española: El desencanto (J. Chávarri, 1976), El asesino de Pedralbes (G. Herralde, 1978) Animación en la sala de espera (C. Rodríguez Sanz y M. Coronado, 1978-81) y Cada ver es. (A. García del Val, 1981). Dicho análisis pone de manifiesto el modo en que el cine documental contribuyó a articular una nueva mirada sobre la enfermedad mental que se hacía eco del debate social y lo promovía, cuestionando el orden moral, científico y jurídico a partir del cual se sentaron las bases de la exclusión social durante el régimen. ; This paper focuses on the cinematic gaze over the psychiatric institutions and the consideration of mental illness during Francoism, as well as on the antagonistic position fostered during the Spanish Transition on a variety of social, political, and cultural milieus. After establishing a historical frame with the aim of contextualising the conception of Psychiatry during Francoism, the author proceeds to a formal and thematic analyse of four key documentaries from the Spanish Transition period.

This paper describes the history and current provision of mental healthcare in the Czech Republic. After the political changes in 1989, there was an expansion of out-patient care and several non-governmental organisations began to provide social rehabilitation services, but the main focus of care still rested on mental hospitals. In recent years, mental health reform has been in progress, which has involved expanding community-based services and psychiatric wards of general hospitals, simultaneously with educational and destigmatisation programmes.

This paper discuss biolegitimacy as an instrument and device for the production of rights, recognition and access to services and care from the state, as a means to demand and conquer rights and as an expression of a new biopolitical regime. Biolegitimacy is articulated with a broader context of political shift, with an emphasis on the processes of pathologization, medicalization or biologization of social experiences, particularly concerning the production of public policies and actions of the state in the field of rights and citizenship. Despite the breadth of the issues that can be addressed through this concept in its formulation by Didier Fassin, the focus of this article is mental health policies in Brazil in the context of Brazil's Psychiatric Reform program, particularly those policies aimed at women. If on one hand the Psychiatric Reform is based on the principles of the human rights of the ill and of psychiatric patients, and on the democratization and universalization of access to healthcare, on the other hand, in various aspects these same policies reproduce the device of biolegitimacy. The focus is the notion of the "life-cycle" of women, a principle widely used in the documents and guidelines mainly in those specifically aimed at women's health.

This paper analyzes the impact of the hegemonic paradigm of global mental health (GMH) on Portugal. We specifically argue that GMH in Portugal has effected a change of priorities in health policies, favoring the prevention and treatment of common mental disorders to the detriment of the deinstitutionalizing process. Diffused through the media, this model has negative effects, such as the medicalization of social suffering, the reorganization of mental health policy areas according to utilitarian criteria, and the risk of greater invisibility of users with serious psychiatric diagnoses. However, the GMH approach, bringing to the frontline the impact of all social policies on mental health, represents a new opportunity to politically address social suffering. Characterized as a semi-peripheral country, Portugal may be representative of observable trends in similar countries. ; Este artigo analisa o impacto do paradigma hegemônico da saúde mental global (SMG) em Portugal. Argumenta-se que a SMG em Portugal promoveu uma mudança de prioridades nas políticas de saúde, favorecendo a prevenção e o tratamento das desordens mentais comuns em detrimento do processo de desinstitucionalização. Difundindo-se nos media, este modelo tem efeitos negativos, ao contribuir para a medicalização do sofrimento social, o escalonamento de áreas de intervenção de acordo com critérios utilitaristas e o risco de uma maior invisibilidade dos usuários com diagnósticos psiquiátricos graves. Contudo, o enfoque da SMG no impacto do conjunto das políticas sociais sobre a saúde mental representa uma nova oportunidade para encarar politicamente o sofrimento social. Caracterizado como país semiperiférico, Portugal pode ser representativo de tendências observáveis em países similares. ; Este artículo analiza el impacto del paradigma hegemónico de la salud mental (SMG) en Portugal. Se argumenta que la SMG en Portugal promovió un cambio de prioridades en las políticas de salud, favoreciendo la prevención y el tratamiento de los desórdenes mentales comunes en perjuicio del proceso de desinstitucionalización. Al difundirse en los medios, este modelo tiene efectos negativos, puesto que contribuye para la medicalización del sufrimiento social, el escalonamiento de áreas de intervención de acuerdo con criterios utilitaristas y el riesgo de una mayor invisibilidad de los usuarios con diagnósticos psiquiátricos graves. Sin embargo, el enfoque de la SMG en el impacto de las políticas sociales sobre la salud mental representa una nueva oportunidad para enfrentar políticamente el sufrimiento social. Caracterizado como país semi-periférico, Portugal puede ser representativo de tendencias observables en países similares.

In the light of the government's decision to delay the implementation of its Community Care' programme the author argeous for the de-institutional isation of psychiatric hospitals before psychiatric patients are discharged into hostile communities and before those communities thernselves become hospitals. Drawing on his experience and study in holy the author reviews the legislative, historical and theoretical aspects of the Italian exper ience of psychiatric reform and suggests that by having to take on e forced step back in the implementation of policy we can take two steps forward in the right direction for the development of a genuinely community-based mental health policy.

Federal, state, and local governments have criminalized mental illness by failing to fund necessary community-based mental health services while incarcerating people for behaviors arising from unmet mental health needs. This Article aims to provide a practical blueprint for a litigation-based decriminalization strategy that can be used by both impact litigation lawyers working towards systemic reform and by public defenders and others challenging arrests, convictions, and incarceration of individual clients. The legal theory draws on existing but largely overlooked U.S. Supreme Court precedent supporting the proposition that criminalizing persons with mental illness contravenes the fundamental values of our criminal justice system. Incorporating this legal theory into both individual criminal defense work and impact litigation has the potential to stem the tide of criminalization of mental illness and catalyze policy change on behalf of one of the most vulnerable populations in our country. If successful, this litigation would dismantle the practice of using jails and prisons as proxy mental health care providers, and drive the creation of community-based services.

Scottish mental health legislation includes a unique criterion for the use of compulsion in the delivery of mental health care and treatment. Under the Mental Health (Care and Treatment) (Scotland) Act, 2003, patients must exhibit 'significantly impaired decision-making ability' (SIDMA) in order to be eligible for psychiatric detention or involuntary psychiatric treatment outside the forensic context. The SIDMA requirement represents a distinctive strategy in ongoing international efforts to rethink the conditions under which psychiatric compulsion is permissible. We reconstruct the history of the Scottish SIDMA requirement, analyse its differences from so-called 'fusion law,' and then examine how the SIDMA standard actually functions in practice. We analyse 100 reports that accompany applications for Compulsory Treatment Orders (CTOs). Based on this analysis, we provide a profile of the patient population that is found to exhibit SIDMA, identify the grounds upon which SIDMA is attributed to individual patients, and offer an assessment of the quality of the documentation of SIDMA. We demonstrate that there are systemic areas of poor practice in the reporting of SIDMA, with only 12% of CTOs satisfying the minimum standard of formal completeness endorsed by the Mental Welfare Commission. We consider what lessons might be drawn both for the ongoing review of mental health legislation in Scotland, and for law reform initiatives in other jurisdictions.

Scottish mental health legislation includes a unique criterion for the use of compulsion in the delivery of mental health care and treatment. Under the Mental Health (Care and Treatment Act) (Scotland) Act 2003, patients must exhibit 'significantly impaired decision-making ability' (SIDMA) in order to be eligible for psychiatric detention or involuntary psychiatric treatment outside the forensic context. The SIDMA requirement represents a distinctive strategy in ongoing international efforts to rethink the conditions under which psychiatric compulsion is permissible. We reconstruct the history of the Scottish SIDMA requirement, analyse its differences from so-called 'fusion law,' and then examine how the SIDMA standard actually functions in practice. We analyse 100 reports that accompany applications for Compulsory Treatment Orders (CTOs). Based on this analysis, we provide a profile of the patient population that is found to exhibit SIDMA, identify the grounds upon which SIDMA is attributed to individual patients, and offer an assessment of the quality of the documentation of SIDMA. We demonstrate that there are systemic areas of poor practice in the reporting of SIDMA, with only 12% of CTOs satisfying the minimum standard of formal completeness endorsed by the Mental Welfare Commission. We consider what lessons might be drawn both for the ongoing review of mental health legislation in Scotland, and for law reform initiatives in other jurisdictions.

Chronic behavioral health conditions, such as psychiatric and substance use disorders, affect at least half of all arrestees, with two-thirds suffering from at least one chronic medical disorder. These conditions contribute to their criminal behaviors and propensities to recycle through the criminal justice system (Binswanger et al. Journal of Urban Health 89:183-190, 2012). Despite their limited resources, jails have nonetheless become de facto settings for the delivery of healthcare services. With the passage of the Affordable Care Act (ACA) of 2010, jail releasees will become eligible for government-subsidized healthcare coverage in 2014. The widespread availability of integrated healthcare services for the released jail population is likely to reduce criminal behavior, which is often associated with psychiatric and substance use disorders and their co-occurrence. This article provides an overview of behavioral healthcare services available to jail releasees. We discuss the evolving landscape of substance use and mental health interventions under healthcare reform, including anticipated changes in funding infrastructures and streams for treatment services. We examine the financial and practical implications of these changes for the criminal justice system, particularly for the nation's jails.

This commentary highlights the poor availability of essential psychiatric medicines at public sector facilities in India and illustrates why even a flourishing generics industry does not assure access to affordable psychiatric medicines for most Indian patients. The paper outlines the Indian government's pricing regulations and then enumerates recommendations for reform.

Four classes of specialty hospitals (children's, psychiatric, rehabilitation, and long-term) and two types of distinct-part units in general hospitals (psychiatric and rehabilitation) have been excluded from the Medicare hospital prospective payment system since it was enacted by Congress in 1983. The number of these facilities and the Medicare dollars expended have more than doubled in less than 5 years, prompting renewed policy interest in developing payment reform. In this context, the substantial research and policy development efforts to refine case-mix classification and payment policies for these facilities are reviewed and examined. Findings are discussed relative to possible legislative and regulatory directions.

The legal regime of the psychiatric care without consent, and the relevant legal provisions that surround it, are the direct consequence of the long-term development of the society in managing the mentally disabled people. This process of maturing, which reflects the delicate balance between the respect for fundamental freedoms and the imperatives of public order, mainly explains the rather belated recognition of these vulnerable patients as real subjects of rights. Through the law n°2011-803 of 5 July 2011 and the law n°2013-869 of 27 September 2013, the legislator maintained the model of care and medical administrative system without consent, dating from the nineteenth century. Nevertheless, through these last two reforms, the system has been attenuated by the introduction of a mandatory control of the liberty and custody judge and expanded these medical cares at the ambulatory. This system is characterised by its own duality in terms of admission rules: the request for care on demand of the representative of State (S.D.R.E.) on the one hand, and of a third party (S.D.T.) on the other hand. These two sets of procedures themselves are subdivided in a plurality of actions, each one justified on various purposes: urgency, absence of a third party, factual circumstances, existence of a serious public disorder or threat to the safety of individuals… Even if the legal regime for the medical care without consent is supposed to provide an appropriate care for each and every specific situations, often these policies are actually set for opportunistic reasons and do not always match reality. The disputes resulting from this exception legal regime demonstrate the many human rights violations suffered by the concerned patients. For these reasons, some tidying up can be envisaged. The latter would involve the merging of the two sets of procedures, the issuance of measures by the judge himself and a strengthening of the protection of civil rights and freedoms, provisions which will have to be surrounded by more effective ...

In 1964, the Italian poet Alda Merini was hospitalized in a mental hospital in Milan as the result of a violent fight with her husband. Merini would spend ten years in and out of hospital, while her relationship with her family and with the literary circles in which she moved deteriorated. Merini's experience in the asylum is narrated in her memoir L'altra verità. Diario di una diversa (1986). Through an analysis of some crucial passages in the memoir, this article seeks to demonstrate that Diario is a work charged with both literary and historical value that deserves more scholarly attention. Merini's memories shed new light on the situation of psychiatric patients, and especially of women, in Italy before and after Basaglia's reforms on mental institutions. Demonstrating how the abuse that she suffered in the hospital reflects society's attitudes toward mental illness, disability, and women, Merini shows that the type of trauma narrative that is produced under institutions of coercive control – such as the mental asylum – will often be one of resistance to oppression.

Cover; Half Title; Series Page; Title Page; Copyright Page; Table of Contents; Acknowledgments; Foreword; 1. Introduction; 2. Deinstitutionalization and mental health; Psychiatry, mental illness, and social exclusion; Psychiatric reform movements and the Brazilian context; New institutionalization within community mental health centres in Brazil; Beyond the fragmentation of the human: delineating the object of study; 3. Subjectivity as a transverse concept; Theory, epistemology and methodology within the study of subjectivity