New institutionalization as a rebound phenomenon? The case of Israel.
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OBJECTIVE: To explore whether the history of significant deinstitutionalization in Western European countries since the 1950s, and in Israel more recently, may have led to the establishment of new alternative institutions as a "rebound" phenomenon. METHODS: Data on service provision in Israel are analyzed and compared with published data from Europe. We considered five commonly used indicators of mental health services to reflect trends in institutionalization in psychiatric hospitals, the forensic system and supported housing. RESULTS: In Israel, there has been a substantial increase in placement in supported housing (by 307%), psychiatric treatments in the prison population (by 61%), and a reduction of psychiatric hospital beds (by 42%) between 1991/2 and 2002/3. The changes are consistent with trends observed during the same decade in European countries with a different history of psychiatric institutionalization. However, increases in involuntary admissions in Israel, England, the Netherlands and Germany have not been shared by Spain, Italy and Sweden. CONCLUSION: The appearance of possible new forms of institutionalization also occurs in Israel and appears not to depend on a history of large asylums and deinstitutionalization since 1950s. Thus, it cannot be explained as a mere "rebound" phenomenon, and may be influenced by other societal factors that are shared by various European countries.. (+info)
Italian Law 180: the enduring principles it represents and the community of Arezzo.
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This work reconstructs the atmosphere that developed in the city of Arezzo with the approval and application of Italian Law 180. A detailed description of the events, which saw this mediumsized community involved in what was to become an example for mental health policy, helps to illustrate the values underlying Italian Law 180. This endeavour was at once a scientific, cultural and political project making Italian Law 180 an undeniable part of Italian national heritage. (+info)
The effects of crisis plans for patients with psychotic and bipolar disorders: a randomised controlled trial.
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Occurrence of comorbid substance use disorders among acute psychiatric inpatients at Stikland Hospital in the Western Cape, South Africa.
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OBJECTIVE: Little is known about the epidemiology of substance use disorders (SUD) among psychiatric inpatients in the Western Cape, South Africa. Therefore, this study was conducted to examine the prevalence of SUD among acute adult psychiatric inpatients at Stikland Hospital, one of three state acute psychiatric hospitals in the Western Cape. METHOD: A prospective descriptive prevalence survey was undertaken over a three-month period. During this period, data was collected on psychiatric patients (N=298) who were hospitalized in the acute psychiatric wards at Stikland. This included patient demography, psychiatric and substance use history. Urine was also collected and analyzed for substances commonly abused in the Western Cape. RESULTS: A co-morbid SUD (abuse or dependence) was diagnosed in 51% of patients. In addition, a diagnosis of a substance-induced psychiatric disorder was made in 8% of these patients, 1% of who was diagnosed with a substance-induced mood disorder, while 7% was diagnosed with a substance induced psychotic disorder. Patients diagnosed with a co-morbid SUD were younger than those without a SUD and more likely to have been involuntary admissions. These patients also displayed more violence prior to admission that contributed to their admission and were more likely to have used cannabis or methamphetamine as their preferred drug of abuse. Only a small group of patients had documented evidence of any prior interventions for their SUD. CONCLUSION: SUD are prevalent among psychiatric inpatients and contribute to their morbidity. This has implications for staff training and service development. (+info)
Current situation and future tasks for psychiatric services in Japanese prisons.
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I outline the current situation and future tasks for psychiatric services in Japanese prisons. I describe the provision of facilities specializing in psychiatric services, preparation of legal aspects related to involuntary treatment, provision of therapeutic educational programs regarding addictive crimes, and the measures required for continuation of treatment after release from prison. I also discuss how, in the current system, under the "Act on Mental Care and Treatment for Persons who have Caused Serious Cases under the Condition of Insanity," unfairness arises in the treatment of mentally disordered offenders, requiring a division between medical care and justice (correctional institutions). (+info)