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In Chapter 6, I argue that the terms ‘mental health’ and ‘mental illness’ have been used interchangeably in the previous literature on the representation of mental illness in the press. Specifically, I argue that using these two terms interchangeably (especially during data collection) may result in incomparable datasets. Through linguistic analysis, I show that the terms ‘mental illness’ and ‘mental health’ are distinct terms, and that the meaning of the two terms has shifted over the time period covered by the MI 1984–2014 Corpus. I argue that the lexical change I observed is consistent with pragmatic accounts of language change in which the language development is in part a result of euphemism (e.g. Traugott & Dasher, 2002).
This chapter provides a discussion of the reported findings. The research questions are revisited and caveats to the research are discussed. I provide suggestions for how research into the language of mental illness may be developed in future studies. I also discuss the practical implications of the research reported in the book.
Chapter 9 investigates if and how the symptoms of mental illness are present in the MI 1984–2014 Corpus by exploring the symptoms of each disorder type covered by the corpus. Specifically, using keyword and key semantic domain analysis, I explore whether the symptoms of mental illnesses are accurately represented in news articles on mental illness. In addition to corpus tools, I also qualitatively analyse the most prototypical text for each illness subcorpus (i.e. the text that contains the most frequent features of the illness subcorpus overall) to explore whether the keyness findings are also a feature of whole texts.
In this chapter, I show that mental health and illness is an increasingly important topic in UK society, both in terms of the number of newspaper articles covering mental illness-related issues and the increased prevalence of mental illness generally. I also show how the public are increasingly aware of the language used to discuss mental illness in the press. Moreover, I explain how the language used to discuss mental illness is being increasingly prescribed by anti-stigma initiatives. Despite anti-stigma activities and initiatives, very little research exists that explores the language used to discuss mental illness in the press using a purely linguistic approach. For this reason, I set out the research gap in the existing literature that this book goes some way to addressing. I also introduced the MI 1984–2014 Corpus and provide an outline for the rest of this book.
The very idea of mental illness is contested. Given its differences from physical illnesses, is it right to count it, and particular mental illnesses, as genuinely medical as opposed to moral matters? One debate concerns its value-ladenness, which has been used by anti-psychiatrists to argue that it does not exist. Recent attempts to define mental illness divide both on the presence of values and on their consequences. Philosophers and psychiatrists have explored the nature of the general kinds that mental illnesses might comprise, influenced by psychiatric taxonomies such as the Diagnostic and Statistical Manual and the International Classification of Diseases, and the rise of a rival biological 'meta-taxonomy': the Research Domain Criteria (RDoC). The assumption that the concept of mental illness has a culturally invariant core has also been questioned. This Element serves as a guide to these contested debates.
Mental Health: A Person-centred Approach equips students with the tools they need to provide exceptional person-focused care when supporting improved mental health of diverse communities.The third edition has been updated and restructured to provide a more logical and comprehensive guide to mental health practice. It includes new chapters on trauma-informed care, different mental health conditions and diagnoses, suicide and self-harm and the mental health of people with intellectual or developmental disabilities. Significant updates have been made to the chapters on the social and emotional well-being of First Nations Australians and mental health assessment. Taking a narrative approach, the text interweaves personal stories from consumers, carers and workers with lived experience. Each chapter contains 'Translation to Practice' and 'Interprofessional Perspective' boxes, reflection questions and end-of-chapter questions and activities to test students' understanding of key theories. Written by experts in the field, Mental Health remains an essential, person-centred resource for mental health students.
This chapter reflects a coming together of key issues and themes embedded in everyday work with consumers and carers. In recent times, the definition of a carer has expanded to include immediate family and friends, and may also include extended family members such as grandparents and cousins. In transcultural and other contexts, it is important to use humanistic language in line with a recovery approach; for example, the terms ‘support person/people’ and ‘support networks’ may be preferable to the term ‘carer’ in mental health practice and mental health nursing. This approach provides a foundation for human connectedness, and sets the consumer narrative as central to mental health practice and mental health nursing, specifically.The chapter introduces students to a narrative-based understanding of mental health and trauma-informed mental health care, as well as key concepts in mental health and mental illness. It discusses mental health nursing as a collaborative, specialised field of nursing.
This chapter introduces the concept of mental illness, how it is diagnosed, and the main diagnostic classification systems used in health practice. The experiences and symptoms of people living with mental illness – according to criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 – are reviewed. It is emphasised that diagnostic criteria can be considered within an overall framework for conversation and engagement between practitioners, consumers, and carers, with the overarching aim of exploring and understanding the best response to distress and treatment approach to promote recovery processes. Criticisms towards diagnostic classification systems are also summarised. Finally, potential effects of the COVID-19 pandemic and its implication for people’s mental health are presented.
The UK is currently considering making assisted dying available to patients who are terminally ill. We discuss ethical and practical aspects of this complex issue and outline the potential role of psychiatry. We set out the challenges of implementation of legislation, and potential unintended consequences including the impact on health inequalities.
This chapter introduces the theme of mental illness in prison, situating it in the broader historiography of crime and punishment and the history of psychiatric care and institutional provision. It explains how our book redresses the neglect of prisons as a locus for the management of mental disorder, a major oversight given the number of mentally ill people confined in them during the nineteenth century. The introduction elucidates our particular methodology, with its emphasis on individual prison archives that provide a rich counter-balance to the sifted and mediated accounts of official inquiries and published annual reports. It outlines the potential of drawing on examples from England and Ireland, which, while sharing ideologies and with similar systems of prison administration, varied in interpretation and implementation. We summarise the expansion and remit of prisons in the nineteenth century, including the importance of the prison cell as a carefully curated space for reform and rehabilitation.
Chapter 6 outlines the growing momentum of prison reform, enacted by a broad range of prison reformers and within the prison administration itself, towards producing reforms of punitive penal regimes, including separate confinement. Critiques of late nineteenth-century prison regimes noted the continuing high incidence of mental breakdown in prisons and the detrimental effect of severe prison regimes. The chapter highlights how individual campaigners and campaign groups lobbied for the end of the separate system and for rehabilitative penal policies. However, while the Gladstone Committee inquiry of 1895 was hailed as a turning point, and the severity of prison discipline was eased earlier in Irish prisons, in practice change was ‘glacial’. The residue of the nineteenth-century prison system arguably remains with us today, in the physical structures of prison estates, in prison disciplines that still emphasise order and uniformity, in the retention of large numbers of mentally ill people and the imposition of solitary confinement, no longer a philosophy and method of reform, but a means of dealing with disruptive behaviour among prisoners and shortages of prison staff and resources.
Disorder Contained is the first historical account of the complex relationship between prison discipline and mental breakdown in England and Ireland. Between 1840 and 1900 the expansion of the modern prison system coincided with increased rates of mental disorder among prisoners, exacerbated by the introduction of regimes of isolation, deprivation and hard labour. Drawing on a range of archival and printed sources, the authors explore the links between different prison regimes and mental distress, examining the challenges faced by prison medical officers dealing with mental disorder within a system that stressed discipline and punishment and prisoners' own experiences of mental illness. The book investigates medical officers' approaches to the identification, definition, management and categorisation of mental disorder in prisons, and varied, often gendered, responses to mental breakdown among inmates. The authors also reflect on the persistence of systems of punishment that often aggravate rather than alleviate mental illness in the criminal justice system up to the current day. This title is also available as Open Access.
A growing body of research implicates inflammation as a potential pathway in the aetiology and pathophysiology of some mental illnesses. A systematic review was conducted to determine the association between parasitic infection and mental illnesses in humans in Africa and reviewed the state of the evidence available. The search focused on publications from Africa documenting the relationship between parasites from two parasite groups, helminths and protozoans, and four classifications of mental illness: mood affective disorders, neurotic and stress-related disorders, schizotypal disorders and unspecified mental illnesses. In the 26 reviewed papers, the prevalence of mental illness was significantly higher in people with parasitic infection compared to those without infection, i.e., 58.2% vs 41.8% (P < 0.001). An overall odds ratio found that the association of having a mental illness when testing positive for a parasitic infection was four times that of people without infection. Whilst the study showed significant associations between parasite infection and mental illness, it also highlights gaps in the present literature on the pathophysiology of mental illness in people exposed to parasite infection. This study highlighted the importance of an integrated intervention for parasitic infection and mental illness.
Raúl’s decline and disappearance constitute the sadistic climax of the posthumous stories. Storytellers linger with relish over their accounts of his descent, after 1930, into poverty, illness, homelessness, alcoholism, police detention, and finally madness, institutionalization, and death. So enthusiastic are they about ushering Raúl to his end that they begin to declare him dying or dead decades before his actual demise in 1955. His death was permanently useful to tell and retell as part of a tragicomedy about the foolishness of persisting in being a Black person in a country that had outgrown them (or, in its great wisdom, had arranged never to have any). In this sense, storytellers merely conscripted Raúl into the broader narratives of always-impending (but never quite complete) Black disappearance that had circulated since his grandparents’ day. “Deaths” shows how the defamatory stories about Raúl’s decline and death, circulating since the 1930s in the press and popular culture, sped him to the sad ends storytellers envisioned for him. Between 1930 and 1955, Raúl’s trajectory as revealed by the archival record converges, in many important details, with the denigrating tales that took shape around him. But this chapter tells that story very differently. In part, Raúl’s difficulties in these years had to do with extensive transformations in Argentine society – economic depression, a military coup, intensified police repression, and the renewed vigor of eugenics and scientific racism. In part, too, his struggles reflected the fact that the journalists, photographers, police officers, physicians and psychologists who encountered Raúl during the last decades of his life were themselves informed by preexisting narratives about class, citizenship, and Blackness in Argentina. Using press coverage of Raúl, photographs, his police record, and his medical records from a hospital and two psychiatric institutions, I reconstruct these last decades of his life and demonstrate how they were deformed at every turn by narratives of Afro-Argentine death that were only strengthened, in storytellers’ eyes, by what they saw as Raúl’s sorry state. Finally, building on highly suggestive clues in his psychiatric file, the chapter closes with an alternative, or rather intersecting, re-reading of his life through the lens of queerness and same-sex sexuality.
To examine socioeconomic disparities in use of electroconvulsive therapy (ECT) among homeless or unstably housed (HUH) veterans with mental illness.
National data from medical records in years 2000 to 2019 on 4 to 6 million veterans with mental illness, including 140 000 to 370 000 homeless veterans served annually from the U.S. Department of Veterans Affairs (VA) healthcare system, were analyzed to examine ECT utilization and changes in utilization over time.
ECT utilization was higher among HUH veterans (58–104 per 1000) than domiciled veterans with mental illness (9–15 per 1000) across years with a trend toward increasing use of ECT use among HUH veterans over time. Among HUH and domiciled veterans who received ECT, veterans received an average of 5 to 9 sessions of ECT. There were great regional differences in rates of ECT utilization among HUH and domiciled veterans with the highest overall rates of ECT use at VA facilities in the Northeast and Northwest regions of the country.
ECT is commonly and safely used in HUH veterans in a comprehensive healthcare system, but geographic and local factors may impede access to ECT for veterans who may benefit from this treatment. Efforts should be made to reduce barriers to ECT in the HUH population.
Offending is highly gendered, with men/boys constituting most offenders whether measured by criminal legal system data (e.g., arrests and incarcerations) or self-report data. The number of incarcerated women has steadily risen for at least the past two decades in many countries across the world, and the scholarship and programming/treatment devoted to women/girl offenders has also been on the rise, particularly in the last few of decades. This chapter addresses the characteristics and needs of women offenders, particularly in terms of gender-based abuse and other trauma histories, mental health (e.g., mental illness and drug and alcohol addiction), and physical health (e.g., HIV/AIDS, traumatic-brain injuries, and reproductive health). An intersectional lens is used to describe how structural sexism, racism, and classism are key contributors to offending women’s experiences. The chapter concludes with best practices in treating women offenders (e.g., trauma-informed, community collaboration, and empowering services) and descriptions of some innovative programs.
Approaching 2 years into a global pandemic, it is timely to reflect on how COVID-19 has impacted the mental health of the global population. With research continuing apace, a clearer picture should crystallise in time. COVID-19 has undoubtedly had some impact on population mental health, although the severity and duration of this impact remain less clear. The exceptional period of COVID-19 has provided a unique prism through which we can observe and consider societal mental health. This is a momentous time to be involved in mental health research as we strive to understand the mental health needs of the population and advocate for adequate resourcing to deliver quality mental healthcare in the post-pandemic period.
In this chapter, working with scientific evidence, I build up a picture of the psychopathic personality which can be applied to my preferred account of moral responsibility. After sketching an introduction to the history of psychopathy as a clinical construct, I consider some disputes and controversies surrounding its diagnosis. I distinguish psychopathy from Antisocial Personality Disorder (APD), a rival construct commonly used in clinical settings. I also sketch the implications of evidence for a distinction between ‘successful’ and ‘unsuccessful’ psychopaths for the overall construct. I conclude that the Hare Psychopathy Checklist is the most robust measure available, a measure which describes psychopathy as a condition characterised primarily by emotional deficiencies. I then review neuroscientific evidence for structural and functional correlates and causes of psychopathy. I also review evidence for the treatability of the condition, concluding based on the current psychological and psychiatric evidence that psychopathy appears to be highly recalcitrant to the treatment methods that have been tried so far, and that some of these methods may even be counter-productive.
There is evidence of the effectiveness of multi-professional home treatment models with regards to improving mental health for elderly patients with mental illness. However, there is a lack of studies examining the efficacy with regard to physical health.
To explore the effectiveness of geropsychiatric home treatment for elderly patients with mental illness with regards to improving physical health by assessing the need of physical treatment.
A 1-year retrospective matched-pair cohort study was conducted in four regions of Austria. We compared 91 patients with a broad spectrum of mental disorders in geropsychiatric home treatment by 1:2 matching to 182 patients in treatment as usual regarding number of contacts with health services, prescriptions, hospital discharges and length of hospital stay.
Patients in geropsychiatric home treatment showed significantly lower numbers of consultations with general practitioners (P < 0.001) and specialists (internal medicine, P = 0.022; psychiatry, P < 0.001), and lower numbers of prescriptions (medical drugs except psychotropic drugs, P < 0.001; psychotropic drugs, P < 0.004) compared with patients in treatment as usual. However, there was no significant difference in the number of hospital discharges and length of hospital stays.
Geropsychiatric home treatment has a positive effect on mental and physical parameters, which is discussed in the context of stress reduction.
Are psychopaths morally responsible? Should we argue with them? Remonstrate with them, blame them, sometimes even praise them? Is it worth trying to change them, or should we just try to prevent them from causing harm? In this book, Jim Baxter aims to find serious answers to these deep philosophical questions, drawing on contemporary insights from psychiatry, psychology, neuroscience and law. Moral Responsibility and the Psychopath is the first sustained, book-length philosophical work on this important and fascinating topic, and will be of deep interest and importance to researchers in these fields – not to mention anyone who has had to interact with a psychopath in their everyday life.