Suchergebnisse

There have been numerous books published relating to minority mental health. Most of these have approached the topic from either of two perspectives. They may focus on specific minority populations and within each such section, discuss the mental illnesses affecting that population and the risk factors for mental illness. Alternatively, books have been organized around specific mental illness diagnoses and within each such discussion, have addressed the specific illness with reference to minority populations. This proposed text utilizes a completely different approach. First, we focus on minority mental health and wellness and, as such, addresses not only recognized risk factors for mental illness within specific minority populations, but also the protective factors and strategies to prevent mental illness. Second, the book will be organized around the determinants of mental health and wellness, using as a foundation Bronfenbrenner's model that considers determinants of health at the macrosocial, exosystemic, microsystemic (e.g., family) and ontogenic (individual) levels.

Background: Self-management of bipolar disorder (BD) is challenging for many individuals. Material: Interviews were used to assess perceived barriers to disease self-management among 21 high-risk patients with BD. Content analysis, with an emphasis on dominant themes, was used to analyze the data. Results: Three major domains of barriers emerged: individual barriers (psychological, knowledge, behavioral and physical health); family/community-level barriers (lack of support and resources); and provider/healthcare system (inadequate communication and access to care). Conclusion: Care approaches providing social and peer support, optimizing communication with providers and integrating medical and psychiatric care may improve self-management of BD in this vulnerable population.

Aims: This article investigates the subjective experience of the process of improvement and recovery from the point of view of persons diagnosed (according to research diagnostic criteria) with schizophrenia and schizo-affective disorders.Methods: A community study of persons using psychiatric services was conducted for a sample of ninety subjects taking atypical antipsychotic medications. Sociodemographic data and clinical ratings were collected to complement the qualitatively developed Subjective Experience of Medication Interview (SEMI), which elicits narrative data on everyday activities, medication and treatment, management of symptoms, expectations concerning recovery, stigma, and quality of life.Results: Recovery was observed through: (1) relatively low ratings of psychiatrically observed symptomatology through BPRS scores; (2) the subjective sense among the majority (77.4%) of participants that taking medication plays a critical role in managing symptoms and avoiding hospitalization; and (3) the subjective sense articulated by the vast majority (80%) that they would recover from their illness and that the quality of their lives would improve (70.6%).Conclusion: The overall quality of improvement and recovery is best characterized as an incremental, yet definitively discernable, subjective process.

Purpose:This study compared a novel self-management (TargetEd MAnageMent Intervention [TEAM]) versus treatment as usual (TAU) to reduce stroke risk in African American (AA) men.Design:Six-month prospective randomized controlled trial with outcomes evaluated at baseline, 3 months, and 6 months.Setting:Academic health center.Participants:Thirty-eight (age < 65) AA men who had a stroke or transient ischemic attack and a Barthel index score of >60 were randomly assigned to TEAM (n = 19) or TAU (n = 19).Intervention:Self-management training, delivered in 1 individual and 4 group sessions (over 3 months).Measures:Blood pressure, glycosylated hemoglobin (HbA1c), lipids, medication adherence, weight, and standardized measures of health behaviors (diet, exercise, smoking, substances), depression, and quality of life. Qualitative assessments evaluated the perspectives of TEAM participants.Analysis:T tests for paired differences and nonparametric tests. Thematic content qualitative analysis.Results:Mean age was 52.1 (standard deviation [SD] = 7.4) and mean body mass index was 31.4 (SD = 7.4). Compared to TAU, TEAM participants had significantly lower mean systolic blood pressure by 24 weeks, and there was also improvement in HbA1cand high-density lipoprotein cholesterol ( P = .03). Other biomarker and health behaviors were similar between groups. Qualitative results suggested improved awareness of risk factors as well as positive effects of group support.