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  1. Mental Disorders among Homeless People in Western Countries
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Programs that provide long-term a year or longer stable housing for people with mental illnesses can help to improve mental health outcomes, including reducing the number of visits to inpatient psychiatric hospitals. A study concluded that services that deliver cognitive and social skill training, particularly in developing and maintaining relationships, would be useful in helping people with mental illnesses and homelessness regain housing. Advice for Parents of Children with Anxiety Disorders.

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Colvin Prize for Mood Disorders Research. The Pardes Humanitarian Prize. Productive Lives Awards. About Us. These were the initial efforts to reduce stigma toward deinstitutionalization and the development of a nationwide, community-based mental health program in Jamaica. It has been suggested 24 that some study participants, those 40 years of age or older, may have positive memories of the radio psychiatry and cultural therapy programs and other efforts made during that period more than 30 years ago.

That study concluded that, because the focus-group participants in this age group expressed empathy and positive attitudes toward individuals with mental illness, some earlier deinstitutionalization campaigns may have had a lasting, positive impact. The findings of this study concur with the quantitative findings of a previous study 25 in Jamaica that suggested that since the s, there has been a beneficial effect stigma toward mental illness produced by interaction between the general population and the mentally ill.

This finding is in marked contrast to the significant body of literature from Western nations 26 that suggests a strong stigma associated with mental illness that has been increasingly recognized as a barrier to effective care and mental-health related service utilization, and may substantially reduce the quality of life for individuals with mental illness and their families Most of the study participants were attempting to reconcile an often mythical belief that the mentally ill are violent with a conscious experience and the reality of present-day Jamaican community mental health public policy, which negates these strongly-held myths.

As a result, participants have restructured and resynthesized new models of care and kindness to deal with their men-tally ill relatives, friends, and community members. The authors of the present study suggest that these findings were forged in the crucible of the extensive changes to mental health public policy, grounded in the social re-engineering of Jamaica's society as it moved out of European colonialism into the post-colonial era. One of the profound consequences of the mental health public policy movement in Jamaica is that the acutely mentally ill are being treated in the open wards of general medical hospitals across the country In fact, since , patients with acute mental disorders have been treated in the open medical wards of general hospitals islandwide, with minimal negative sequelae, and with tremendous success, recovery, and follow up.

This approach seems to be unique to Jamaica. Meta-analyses in the Cochrane Library have failed to replicate this finding worldwide 29, This novel work on community mental health and deinstitutionalization and its association with the transformation of attitudes and stigma among the Jamaican people suggest that changes in mental health delivery have taken a leading role in shaping stigma toward mental illness in Jamaica. These findings are in marked contrast to findings from North America 31 and the United Kingdom Generally, these studies have reported an increase in negative stigma toward mental illness following deinstitutionalization, particularly an association between violence and mental disorders, such as schizophrenia, alcoholism, and drug dependence The present study suggests that in Jamaica, the custodial mental hospital represented a negative institutional construct that was the main source of the development of stigma toward mental illness, and this stigma was transferred to other hospital-based treatment facilities across the country.

However, deinstitutionalization and integration of community mental health care with primary health care services have played a non-stigmatizing role, particularly through increased public interaction with the mentally ill and by building public awareness of community mental health services and their effectiveness.

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Since this was a qualitative study that used focus-group discussions, a conclusive statement could not be made regarding an association between changes in public policy regarding mental health and the attitudes of the Jamaican population toward mental illness and its stigma. Several hypotheses about this relationship were formulated and could be used in future studies to design questionnaires that would quantitatively assess these suppositions.

The use of focus groups is commonly thought to limit the ability to generalize the study results to the larger population. However, the number of focus groups that were studied and the demographic breadth, across gender, age, socioeconomic status, and locations across the island, are thought to increase the researchers' ability to make hypotheses that are, for the most part, representative of the general public. Future research using quantitative measures within a population sample should explore the current study findings to clarify issues raised, including: knowledge about and attitudes toward the various mental health services institutions, hospitals, community mental health services ; knowledge about and attitudes toward mental illness; and the rights of the mentally ill.

Future research should also be geared toward identifying the gaps between public knowledge of mental illness and its treatment, and the public education programs that have been implemented in the past. It may also be important to identify the role that the news and entertainment media play in the development of current public opinion on mental illness, and to identify where these sources fall short. The ultimate goal of these research findings is to create and implement a health television and radio station in Jamaica that provides more effective public education.

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Based on these preliminary findings, a growing public acceptance of community mental health services is likely to necessitate a relative increase in services and facilities available to the general public. Services must be expanded to effectively manage the increasing number of cases of mentally ill persons requiring treatment-a situation that began with deinstitutionalization and is expected to grow-and to prevent anyone from falling through the cracks or becoming a "revolving door case" due to lack of follow-up and aftercare post-discharge. Hickling FW.

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