Suchergebnisse

While epidemiological research has offered much valuable information about substance use among homeless persons in general and homeless mentally ill persons in particular it has lacked information about the context in which substance use occurs, patterns of use, how use influences subsistence adaptation, and factors that mediate its effects. The Adaptation of the Homeless Mentally Ill (AHMI) research was able to address these gaps in our knowledge through long-term ethnographic field work with 50 homeless mentally ill individuals in the Skid Row area of Los Angeles. Most importantly, we found variation in the extent to which alcohol and drug use dominated the lives of sample members. Where some individuals organized their lives completely around the pursuit and use of drugs and alcohol, others were able to precariously balance their substance use with the tasks of meeting their basic needs. We then examine several of the possible factors that shape the relationship between substance use and subsistence adaptation, looking specifically at: (1) Skid Row; (2) psychopathology; (3) institutional affiliations; (4) values and beliefs, and; (5) the role of eventfulness. We conclude by summarizing our findings and their implications for social policy.

This article describes obstacles to the rational use of psychiatric drugs in a 1000-bed institution for people with intellectual disability employing the WHO framework for rationality. Quantitative data were collected from 98 charts and qualitative data from 14 individuals in this case study. Eight-three percent of patients were taking psychiatric medications, even though 67% of these had no psychiatric diagnosis. Antipsychotics were the first-order treatment; antidepressants were rarely prescribed. These prescribing patterns are influenced by institutional culture, including an emic construct of retardation as a form of psychosis. Low staff-to-patient ratios, a lack of non-medical treatments, and the hospitalization of patients for social reasons also contribute to medication misuse.

Background: Attempted suicide, a deliberate self-directed behavior situated within the unique social world of an individual, is a major risk factor for suicide. Efforts aimed at addressing female suicide must be based on understanding their perceived causes and the meaning of this behavior. Aims: This study describes the perceived causes of suicidal behaviors to determine preventive measures of female suicide in China. Methods: An in-depth interview about the process and causes of suicidal behavior as well as a detailed structured and a standardized diagnostic interview were administered to 244 female attempters treated at general hospitals and, separately, to their relatives. Results: The perceived three most frequent causes of the attempts were interpersonal conflict (87%), psychological problems (33%), and conflict between others that affected the subject (27%). On average 2.2 causes were identified for each case. The identification in the in-depth interviews of psychological problems as a cause of the attempt was concordant with the results of the independent psychiatric exam identifying a current DSM-IV mental disorder in 38% of cases (Kappa = 0.64). Conclusions: Preventive measures of improving interpersonal and problem-solving skills should be developed and assessed for addressing female suicide in China besides expansion of psychiatric services.

Global health is an area for study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide. Global mental health is the application of these principles to the domain of mental ill-health. The most striking inequity is that concerning the disparities in provision of care and respect for human rights of people living with mental health problems (MHP) between rich and poor countries

AbstractActively open‐minded thinking (AOT) is a thinking style in which people engaged in judgment and decision‐making actively seek out and then evaluate information in a manner that is intentionally disconnected from their prior beliefs and motivations and in line with self‐perceptions of autonomy. Actively open‐minded thinkers have been observed to make both more accurate judgments about the magnitude of risks and more evidence‐based decisions under uncertainty in a wide range of situations such as climate change and politics. In addition, actively open‐minded thinkers functioning in domains where they lack a desired level of knowledge are open to "outsourcing" the job of critical reasoning thinking to credible experts; in other words, they are better able to gauge who is trustworthy and then rely on the insights of these trustworthy others to help them reach a conclusion. We report results from a follow‐up to research previously published in Risk Analysis that confirms these tenets in the context of COVID‐19. We then extend these results to offer a series of recommendations for strengthening the process and outcomes of risk analysis: leveraging the latent norm of autonomy and personal agency that underpins AOT, activating or engaging with approaches to reasoning—such as decision structuring—that are in line with AOT, and working upstream and downstream of risk analysis to establish AOT as a norm of its own.

AbstractActively open‐minded thinking (AOT) operates in three dimensions: it serves as a norm accounting for how one should search for and use information in judgment and decision making; it is a thinking style that one may adopt in accordance with the norm; and it sets standards for evaluating the thinking of others, particularly the trustworthiness of sources that claim authority. With the first and third dimensions in mind, we explore how AOT influences trust in public health experts, risk perceptions, and compliance with recommended behaviors aimed at slowing the spread and severity of the COVID‐19 pandemic. Using survey data from a nationally representative sample of Americans (N = 857), we tested whether AOT will lead people to place greater trust public health experts (H1). Because these experts have been consistently messaging that COVID‐19 is a real and serious threat to public health, we also hypothesized that trust in experts would be positively associated with high perceived risk (H2), which should have a positive influence on (self‐reported) compliance with CDC recommendations (H3). And because AOT is a self‐directed thinking style, we also expected it to directly influence risk perceptions and, by extension, compliance (H4). Our results support all four hypotheses. We discuss the implications of these results for how risk communication and risk management efforts are designed and practiced.