The case of Terry Jenkins, a 15-year-old boy, who was found to have a sarcoma of bone, was discussed on television under the title of 'Inside Medicine'. The discussion revolved, not so much on the clinical details of the case or even of cancer of bone in a young person, as on the emotional disturbance that followed when the boy's mother refused to allow her son to be told about the nature of his illness or the proposed treatment. With hindsight, as is made clear in the discussion, the case should have been handled quite differently, with the general practitioner acting as the lynch pin and a psychiatrist and a social worker being brought into the emotional 'treatment' of the boy and his mother. As it was the boy was so disturbed about what he had guessed about his condition that he attempted suicide: fortunately he was rescued in time, and Terry is now stable, working, and mobile on his artificial leg. (+info)
An intervention for parents with AIDS and their adolescent children.
OBJECTIVES: This study evaluated an intervention designed to improve behavioral and mental health outcomes among adolescents and their parents with AIDS. METHODS: Parents with AIDS (n = 307) and their adolescent children (n = 412) were randomly assigned to an intensive intervention or a standard care control condition. Ninety-five percent of subjects were reassessed at least once annually over 2 years. RESULTS: Adolescents in the intensive intervention condition reported significantly lower levels of emotional distress, of multiple problem behaviors, of conduct problems, and of family-related stressors and higher levels of self-esteem than adolescents in the standard care condition. Parents with AIDS in the intervention condition also reported significantly lower levels of emotional distress and multiple problem behaviors. Coping style, levels of disclosure regarding serostatus, and formation of legal custody plans were similar across intervention conditions. CONCLUSIONS: Interventions can reduce the long-term impact of parents' HIV status on themselves and their children. (+info)
Social work and general practice. A report of a three-year attachment.
Much has been written about social worker/general-practitioner collaboration, particularly about conflict of roles, differing functions, avenues of accountability, and problems of distributing scarce resources.We suggest that if the two professions are to work more comfortably together, then it is imperative that both also share the despair, hopelessness, anxiety, and anger that are the occupational hazards of each. We suggest ways in which doctors and social workers can look at the pain their patients are suffering to the benefit of the patient and their own working relationship. (+info)
Papers and originals.
Six cases of persistent non-accidental poisoning of children by their parents are reported. Certain features may draw attention to the diagnosis, particularly bizarre symptoms and signs with no apparent pathological explanation, and toxicological analysis should be carried out to obtain rapid confirmation of the diagnosis. The underlying disorder may include marital conflict, overinvolvement between parent and child, or drug abuse in the parents. A suggested plan of action for managing this problem is outlined. (+info)
Suicides by mentally ill people.
In 1992, following consultations with the Royal College of Psychiatrists, the confidential inquiry into homicides and suicides by mentally ill people was set up by the United Kingdom Department of Health. The inquiry collects detailed information on contact with secondary mental health services by means of a questionnaire from clinical audit or information departments from these organisations. In Leeds, however, a wider range of available records including Coroner Reports, police, social, educational, and all health records were consulted. This resulted in a series of health/life event histories of suicide cases that had been in contact with psychiatric services. This paper presents an exploratory analysis of these data. The Leeds suicide cases formed less than one-third of all suicide cases in Leeds; the remainder had not come into contact with psychiatric services. This proportion is consistent with the U.K. national figures. Records show that 46% of the sample"s first contact with the psychiatric services was through a first failed attempted suicide. Other results include the role of prescribed drugs in repeat suicide attempts, education levels, and employment stability. It is concluded that the link between mental illness and suicide is questionable. Life event history type data on all suicide cases is desperately required to study suicide as a social process. (+info)
THE FUNCTIONING OF A PRIVATE PSYCHIATRIC CLINIC.
SOME OF THE CLINICAL ADVANTAGES OF A PRIVATE PSYCHIATRIC CLINIC ORGANIZED FOR GROUP PRACTICE ARE: Readily available consultations with colleagues; cross-referral with better communication; more evenly filled hours; larger pools of patients for establishing and maintaining group therapy; better off-duty coverage; ready availability of the three disciplines, psychiatry, psychology and social work; satisfaction to the private psychiatrist of being able to arrange competent and prompt treatment for patients unable to meet usual fees; and cooperative research.Financial advantages include economies of time and money, a profit sharing plan, and availability of group life insurance, health benefits and social security. (+info)
The occupational transformation of the mental health system.
The mental health workforce has changed dramatically since the mid-1970s. Nonphysician providers, particularly psychologists and clinical social workers, have become a much larger share of the workforce. While the supply of psychiatrists has been relatively stable, there has been a dramatic increase in the supply of psychologists and social workers. Changes in clinical practice, combined with the continued expansion of managed care into mental health, will largely determine the future composition and supply of the mental health workforce. (+info)
Mental and social health during and after acute emergencies: emerging consensus?
Mental health care programmes during and after acute emergencies in resource-poor countries have been considered controversial. There is no agreement on the public health value of the post-traumatic stress disorder concept and no agreement on the appropriateness of vertical (separate) trauma-focused services. A range of social and mental health intervention strategies and principles seem, however, to have the broad support of expert opinion. Despite continuing debate, there is emerging agreement on what entails good public health practice in respect of mental health. In terms of early interventions, this agreement is exemplified by the recent inclusion of a "mental and social aspects of health" standard in the Sphere handbook's revision on minimal standards in disaster response. This affirmation of emerging agreement is important and should give clear messages to health planners. (+info)