Spiritual issues in mental health care

Religious and spiritual issues in mental health are explored in the context of four conceptual models: the medical, the nursing, the humanistic, and the pastoral. This is done by looking at each model in terms of content, diagnostic focus, language and treatment goals, and primary qualities in the health provider.The models are illustrated by case studies gathered from a multidisciplinary setting. The discovery that each model can incorporate the religious and spiritual dimension in mental health care, but that each model does this in distinctive ways, is a key point.     

Values and religious issues in psychotherapy and mental health

A decade of work by Bergin and others is reviewed and synthesized concerning two broad issues: (a) the role of values in psychotherapy and (b) the relation of religion to mental health. Trends have changed and there is now more professional support for addressing values issues in treatment. There is also more openness to the healthy potentialities of religious involvement, and therapists themselves manifest a new level of personal interest in such matters. Cautions and guidelines for dealing with such issues are considered in both empirical and clinical terms. The multifactorial nature of religion is documented, and healthy and unhealthy ways of being religious are described. Suggestions are given for including education in values and religious issues in the training of clinicians so that the vast population of religious clientele may be better served.     

The French mental health law of 1938

Prehistory, attendant circumstances, and consequences are scrutinised on the occasion of the 150th anniversary of the first wide-ranging law on the treatment of the feeble-minded in France, forerunner of all subsequent laws on the matter.     

Religion,mental health,and clinical issues

This article reviews a number of studies investigating the relationship between religion and the variables of mental health and social behavior. Characteristics of religious health and pathology are examined, and a framework for clinical assessment and treatment of religious pathology is described. Tentative conclusions concerning the subject matter are drawn and limitations of the number and type of studies are outlined.     

Changing mental health law: Butting heads with a billygoat

This research examines the implementation of the Davis v. Hubbard (1980) decision which granted patients at Lima State Hospital in Ohio a qualified right to refuse psychotropic medication. The issues identified by the court are addressed including informed consent, emergency administration of medication, and due process procedures. The data include a content analysis of all due process hearing records during the first 24 months of the court order which include the patient objections, staff justifications for forcing medication, and the decisions. Also included are face-to-face interviews with 92 patients. It is concluded that most decisions do not meet the criteria set by the court for forced medications, and that the patients perceived the procedures to be unfair.     

Therapeutic jurisprudence and conflicts among values in mental health law

Therapeutic Jurisprudence provides a conceptual framework for a research agenda designed to promote development of legal rules, procedures, and roles in a manner consistent with the therapeutic mission of the mental health system. As such, it draws attention to the tension between the jurisprudential values of autonomy and well-being that permeates mental health law specifically and the law and ethics of health care generally. This article advances an analysis of these values in the context of the patient-centered approach to health care. The article endorses a priority for the deontic aspect of autonomy over well-being but allows balancing of the consequentialist component of autonomy against well-being. Finally, it applies this framework to several traditionally difficult types of cases.     

Clinical issues in mental health service delivery to refugees

Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.     

From status to contract: a future for mental health law

Given the many complex issues and interests involved it is hardly surprising that mental health is a controversial topic. The law has a critical role in protecting interests and balancing claims. But the law is a major part of the problem. Indeed analysis of its role in producing anti-therapeutic outcomes led to the development of therapeutic jurisprudence. And we keep changing the law; for example on 16 October, 1999 the British Government announced proposals for radical reform of the mental health laws of England and Wales which, in the current form, were heavily influenced by developments in the United States of America. A major problem, it is submitted, is that we do not have an agreed model of the law, upon which to develop an appropriate structure for the delivery of mental health services. Currently we emphasis 'status', which puts a premium upon drawing distinctions which it is difficult, if not unrealistic, to achieve in practice. Another approach would be to emphasize the centrality of the relationship between the patient, or client, and the inter-disciplinary team of people providing him or her with services. This approach, outlined and argued for in this article, would involve developing the law of contract.     

Infants' meaning-making and the development of mental health problems

We argue that infant meaning-making processes are a central mechanism governing both typical and pathological outcomes. Infants, as open dynamic systems, must constantly garner information to increase their complexity and coherence. They fulfill this demand by making nonverbal "meaning"-affects, movements, representations-about themselves in relation to the world and themselves into a "biopsychosocial state of consciousness," which shapes their ongoing engagement with the world. We focus on the operation of the infant-adult communication system, a dyadic, mutually regulated system that scaffolds infants' engagement with the world of people, things, and themselves, and consequently their meaning-making. We argue that infant mental health problems emerge when the meanings infants make in the moment, which increase their complexity and coherence and may be adaptive in the short run, selectively limit their subsequent engagement with the world and, in turn, the growth of their state of consciousness in the long run. When chronic and iterative, these altered meanings can interfere with infants' successful development and heighten their vulnerability to pathological outcomes. Cultural variations in meaning-making and implications for clinical practice are discussed.     

A philosophical examination of coercion for mental health issues

This article considers two philosophical questions about coercion and mental disorders: (1) an analytical question, i.e., what is meant by the concept of coercion? (2) a normative question, i.e., what justifies the use of coercion? The article distinguishes between coercion from other forms of power such as inducement, persuasion, and authority. It then considers a range of arguments for the paternalistic use of coercion for the benefit of mentally disordered persons and the use of coercion to restrain mentally disordered dangerous persons. This article rests on the assumption that there is something to be said for an academic division of labour, that empirical research in mental health and the law can benefit from conceptual clarification and the analysis of normative arguments. In this article I distinguish between two importantly different sorts of questions that we can ask about coercion and then offer some answers to those questions in broad strokes.     

Student mental health. Part 2: the main study and reflection of significant issues

The difficulties faced by students and the contributory stressors include developmental issues. A number of factors appear to be the precipitators of stress but despite various suggestions from researchers in other countries there is little evidence in the UK of a comprehensive plan to ameliorate student mental health. It was the aim of this study to identify the factors perceived as stressors by students, find the extzent to which the stressors affect the students and identify a possible remedial strategy. The samples involved students from a wide variety of disciplines and included 40 students in a pilot study and a further 210 students in the main study. The pilot study led to a comprehensive list of potential stressors being drawn up for the main study. Most of these were assessed in a Problem Questionnaire, the General Health Questionnaire and the Glasgow Symptom Checklist. Emotional liability was significant and this was often accompanied by self-destructive thoughts. Student services appeared to be underused even when students felt suicidal. Students need more specialized and prolonged help both in the form of increased counselling facilities which include a Mental Health Service and also mentoring schemes.     

Some problems and issues in the implementation of mental health programs in the public schools

New roles are possible for school psychologists because of mental health needs engendered by today's problems in educational settings. There is a great urgency for school psychologists to seek larger scale kinds of solutions than have typified the more frequently practiced therapeutic efforts of school psychologists in the past. Mental health programs that are more suitably adapted to the life styles of low-income and minority groups is a high priority requisite for such work to be successful in today's schools.     

Bodies against the law: Abu Ghraib and the war on terror

In this essay, I argue that the contemporary notion of law has been reduced to regulations and disciplinary codes that do not and cannot give meaning to our emotional lives and moral sensibilities. As a result, we have increasing numbers of what I call “abysmal individuals” who suffer from a split between law—broadly conceived as that which gives form and structure to social life—and personal embodied sensations of pain and pleasure. My attempt to understand the place of Abu Ghraib within American culture leads to an analysis of our valorization of innocence and ignorance that not only becomes the grounds on which we morally (if not legally) excuse abusive behavior as “fun,” but also becomes part of the justification for condoning some forms of violence while condemning others. In addition, I argue that the distinction between legitimate and illegitimate violence trades on underlying assumptions about the relationship between culture and nature, technology and bodies, wherein bodies are imagined as natural and outside of the realm of law.