Suchergebnisse

This article discusses three cases of American Indian families who presented for therapy at an urban mental health center. The framework of adult attachment is used to understand the cross-generational continuity of mental health concerns in these families, and American Indian families more generally, who present with mental health problems. The demographics of American Indian family life are presented, along with a background review of the adult attachment literature.

The Diagnostic and Statistical Manual, Edition IV (DSM-IV) represents a significant advance over past editions in terms of attention to the role of culture in the assessment process. A major share of this accomplishment is due to the work of the National Institute of Mental Health Group on Culture and Diagnosis which orchestrated a large body of knowledge and diverse array of scientists to argue for a more culturally informed approach. This paper focuses on the nature and form of the debate as it unfolded with respect to the mood disorders. Specifically, it considers the Culture and Diagnosis Group's recommendations as to the cultural features of mood disorders to be included in DSM-IV, critically appraises the outcomes and suggests directions for future efforts along these lines.

Objective: To describe the types and extent of psychiatric disorders found in a group of recently-arrived Eastern Europeans being treated by native-speaking mental health providers. Patients: Forty seven Hungarians, Romanians, Czechoslovakians, Poles and Gypsies referred by voluntary or government agencies, other organizations or community members to a refugee counseling service in Seattle, Washington. Over 90% were refugees and 68% maintained this status at the intake evaluation. Method: Clinical, descriptive study of data collected retrospectively by chart review. Results: The majority of clients had poor or fair English skills and less than half were employed. Twelve (26%) had a prior mental health problem and five (11%) a psychiatric hospitalization. The most common diagnoses were adjustment reaction in 21 (45%), marital/family problems in five (11 %), and paranoid schizophrenia in five (11 %). Conclusions: Psychiatric disorders were frequent in this clinical population of Eastern Europeans presenting for outpatient mental health care and may be associated with previous mental health problems. Our findings emphasize the need for sensitivity to the special risks of emigration.

The insanity defense is a particularly controversial aspect of the interaction between law and mental health. During the past decade, many states have revised or abolished their insanity defenses. Oregon, however, chose in 1978 to retain its existing defense and create a new, unique system for the post-adjudication management of insanity acquittees. Oregon's legislature established the Psychiatric Security Review Board (PSRB), which is composed of five part-time members drawn from different disciplines, to conduct periodic hearings to determine the placement and supervision of defendants who successfully raise the insanity defense and remain mentally ill and dangerous. The PSRB has received national attention as a promising approach to managing mentally ill offenders. The authors first describe the structure and operation of the Oregon system. Then they summarize the empirical studies they have conducted of the PSRB in action.

The insanity defense is a particularly controversial aspect of the interaction between law & mental health. During the past decade, many states have revised or abolished their insanity defenses. Ore, however, chose in 1978 to retain its existing defense & create a new, unique system for the postadjudication management of insanity acquittees. Ore's legislature established the Psychiatric Security Review Board (PSRB), which is composed of five part-time members drawn from different disciplines, to conduct periodic hearings to determine the placement & supervision of defendants who successfully raise the insanity defense & remain mentally ill & dangerous. The PSRB has received national attention as a promising approach to managing mentally ill offenders. The structure & operation of the Ore system is described, & empirical studies conducted of the PSRB in action are summarized. HA

American Indians have endured numerous significant historical events, including epidemics, warfare, genocide, relocation, and for many, confinement to reservations. These events often are thought to be the root cause of contemporary physical and mental health problems within this population. Yet despite the presumed force of history in shaping their contemporary lives, there has been surprisingly little empirical examination of the extent to which Native people contemplate their history or understand it in relation to their present lives. This article explores attitudes toward and knowledge of significant historical events using a representative, community-based sample drawn from two tribes, one in the Northern Plains culture area and the other in the Southwest. Taken as a whole, findings suggest that the past continues to have meaning for contemporary American Indians and is related in important ways to identity and formal education.