Exploring the Current Usage and Preferences for Everyday Technology among People with Serious Mental Illnesses

While literature reports people with serious mental illnesses can benefit from everyday technology, evidence supporting whether or not they are using it in their daily lives is limited. This study investigated what people with serious mental illness are using technology for, what they would like to use it for, and why they are currently not using particular features. Results indicated 97.1% of participants own or use a wireless device, 82.4% use text messaging, 64.7% use email, and 70.6% use voicemail. Implications for further research as well as implications for therapeutic interventions using technology are discussed.     

Waking Rip van Winkle: why developments in the last 20 years should teach the mental health system not to use housing as a tool of coercion

Many housing programs for people with mental illnesses rely on models that require the person to adhere to treatment as a condition of continuing access to housing. These models that 'bundle' housing and treatment are relics of a past in which persons with mental illnesses were afforded little real choice in treatment, housing and other social supports. Conditioning access to housing in this manner is coercive and at odds with current thinking regarding treatment, as well as legal principles that shape the environment in which treatment is provided. This article summarizes the reasons why housing for people with mental illnesses should be provided free of the use of coercion.     

Capacity to consent to research in schizophrenia: the expanding evidence base

Capacity to consent to research, fundamental to informed consent and thus vital to the ethical conduct of research, may be impaired among a variety of research populations. Until recently, relatively little empirical evidence has been available to inform discussion and policy-making regarding whose capacity should be assessed, what should be measured, and how it should be measured. Capacity to consent to research has emerged as a central topic in the field of "empirical ethics," an important area of biomedical research devoted to bringing evidence-based methods to the study of ethically salient issues in biomedical and biopsychosocial research. In this paper, empirical studies of capacity to consent to research are reviewed, with a particular focus on studies involving people with schizophrenia. These studies provide intriguing data regarding the nature, correlates, and modifiability of decisional abilities among potentially vulnerable research populations, including individuals with serious neuropsychiatric illnesses. Areas in need of further empirical ethics research are highlighted.     

Socially Valued Roles,Self‐Determination,and Community Participation among Individuals Living with Serious Mental Illnesses

Decades after deinstitutionalization, individuals living with serious mental illnesses remain isolated, socially disengaged, and devalued members of communities. Burgeoning research and services need conceptual clarity to improve such social conditions. This qualitative inquiry used grounded theory and participatory approaches to conduct an in‐depth exploration of community participation for individuals living with serious mental illnesses based on key stakeholder perspectives (n = 45). Results revealed that community participation is a multifaceted construct with layers of meaning for individuals living with serious mental illnesses. Overarching themes are contextualized in Self‐Determination Theory and presented with deidentified illustrations. Implications for services, research, and policy are discussed.     

Conflict of interest issues in informed consent for research on human subjects: a South Asian perspective

Health research for progress in the control and conquest of disease afflicting man is unquestionable. Concerns arise when motives other than the advancement of scientific knowledge and benefit for individuals and society are the driving force behind clinical trials. These conflicts of interests become even more pronounced when dealing with populations rendered vulnerable by virtue of poverty and ignorance. South Asia with its teeming millions represents one such region. This essay examines the reasons that make this population vulnerable to exploitation. Informed consent in the process of research is an area where such conflicts are prone to arise. In order to ensure that conflicting interests of researchers and funding agencies are kept in check, the processes of informed consent and ethical review of research need to be strengthened. Suggestions are put forward to modify the consent process to match the needs of South Asia and to strengthen the ethical review process for safeguarding the rights of the study subjects. But perhaps the most important safeguard against exploitation is the virtuous researcher himself with noble intentions. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Ignorance of hedonic adaptation to hemodialysis: a study using ecological momentary assessment

Healthy people generally underestimate the self-reported well-being of people with disabilities and serious illnesses. The cause of this discrepancy is in dispute, and the present study provides evidence for 2 causes. First, healthy people fail to anticipate hedonic adaptation to poor health. Using an ecological momentary assessment measure of mood, the authors failed to find evidence that hemodialysis patients are less happy than healthy nonpatients are, suggesting that they have largely, if not completely, adapted to their condition. In a forecasting task, healthy people failed to anticipate this adaptation. Second, although controls understated their own mood in both an estimation task and a recall task, patients were quite accurate in both tasks. This relative negativity in controls' estimates of their own moods could also contribute to their underestimation of the moods and overall well-being of patients.     

The Influence of Language Form and Conventional Wording on Judgments of Illness

Prior research indicates that category labels influence category judgments, but little is known regarding the effects for familiar categories with significant social consequences. The present studies address this issue by examining the effect of linguistic form on judgments of illnesses. Both mental and physical illnesses were presented in each of three linguistic forms: noun, adjective, and possessive phrase. In Study 1, participants were asked to judge the permanence of a set of novel illnesses that differed in wording (e.g., “He is a baxtermic”; “He is baxtermic”; “He has baxtermia”). In Studies 2 and 3, participants were asked to judge which forms of wording were most familiar for actual mental illnesses (e.g., schizophrenia) and physical illnesses (e.g., diabetes). In Study 4, participants were asked to judge the permanence of a set of familiar illnesses that differed in wording. The results indicated that for novel illnesses, nouns (“is a”) imply greatest permanence and possessive nouns (“has”) imply least permanence. However, for familiar illnesses, permanence judgments are also influenced by how frequently each form appears in ordinary language use. Mental illnesses are more often expressed with relatively permanent forms (“is” and “is a”) , whereas physical illnesses are more often expressed with relatively transient forms (“has”). The results demonstrate the importance of both linguistic form and conventional wording patterns on how categories are interpreted.     

'You can spend your life dying or you can spend your life living': identity transition in people who are HIV-positive

This article examines, through the lenses of HIV-positive people, the unique phenomenon of identity transition. This research proposes that life-changing illnesses, such as HIV, are an undesired 'possession' that people accept to varying degrees, which we refer to as 'ownership'. While illnesses, such as HIV compel individuals to undergo a transformation process that usually begins with a deep feeling of detachment, and then proceeds to acceptance of their illness, and to feeling empowered and in control of their HIV status and lives, this process is very complex and non-linear as it involves many iterative progressions in identity transition. These transitions are highly individualistic; however, the underlying theme is that the more positive trajectories were those of people who focus on their new lives, living with HIV (i.e. taking ownership of their illness), rather than focusing on what they have lost when they became HIV-positive. The findings demonstrate that identity transition is a result of the ways that individuals rework, negotiate and transform their roles, actions and behaviours through their active engagement with support mechanisms. This study suggests that it is vital to promote positive interactions with support mechanisms to ensure that those with HIV view themselves positively.     

Issues Involving Informed Consent for Research Participants with Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia which is estimated to impact 350,000 people over 65 years of age in Canada. The lack of effective treatment and the growing number of people who are expected to be diagnosed with Alzheimer’s disease in the near future are compelling reasons why continued research is in this area is necessary. With additional research, there needs to be greater recognition of the complexity of seeking ongoing informed consent from those with Alzheimer’s disease. This complexity is because the impairment of memory and cognitive ability does not diminish in a linear manner, but rather fluctuates between periods of impairment and relatively normal cognitive lucidness. There is limited discussion in the guidelines of those progressing from early stages of Alzheimer’s disease who have intermittent cognitive function. Guidelines to research and Research Ethics Boards require further development to facilitate researcher including those with Alzheimer’s disease while protecting this growing pool of potential participants.     

Differences Between African American and White Research Volunteers in Their Attitudes,Beliefs and Knowledge Regarding Genetic Testing for Alzheimer’s Disease

Genetic susceptibility testing for common diseases is expanding, but little is known about race group differences in test perceptions. The purpose of this study was to examine differences between African Americans and Whites in knowledge, attitudes, and motivations regarding genetic susceptibility testing for Alzheimer’s disease (AD). Before enrolling in an AD genetic testing research trial, 313 first-degree relatives of AD patients (20% African American; 71% female; mean age = 58 years) were surveyed regarding: (1) knowledge about genetics and AD risk; (2) concerns about developing AD; and (3) reasons for seeking testing. In comparison to Whites, African Americans were less knowledgeable about genetics and AD risk (p < .01) and less concerned about developing AD (p < .05), with lower levels of perceived disease risk (p = .04). The results suggest that African Americans and Whites differ notably in their knowledge, beliefs, and attitudes regarding genetic testing for AD. Additional research with more representative samples is needed to better understand these differences.     

Delusional disorder and delusions: is there a risk of violence in social interactions about the core symptom?

Delusional disorders are rare, but psychoses with prominent and persistent delusions are less so. A small but significant association between psychosis and violence is often mediated by delusions in such illnesses. Traditionally, delusions have been viewed as “incorrigible”, but there is evidence that they change over time. During development of a scale for measuring delusions, it was found that people who acted violently on their “most important” delusion were more likely to have modified that belief after a mild form of challenge to it. When cognitive–behaviour therapy (CBT) is used for schizophrenia, attempts to modify psychotic symptoms are generally included. Could studies of CBT provide further information about possible risks of social interactions about delusions? In the UK, 2000 people with schizophrenia have been in randomized controlled trials of CBT with a goal of symptom modification. These studies were examined for evidence of violence during the treatment. There was none. Given the period prevalence of violence among people with psychosis, this is surprising. In these studies, however, both challenge to delusions and change in them was minimal and in the context of a safe clinical relationship. Challenge to delusions may, however, occur in a variety of social situations. There are no systematic data on lay challenge to them, but it seems likely that some in the sufferer's social circle will do so vigorously. Relatives, friends, and acquaintances are the people most vulnerable to the most serious violence by someone with psychosis. Study of how people interact in these circumstances and whether their interactions are relevant to modification of delusions would be worthwhile. Could those close to a sufferer learn skills for responding to such pathological beliefs that could be protective against violence, perhaps derived from the principles of CBT?. Copyright © 2006 John Wiley & Sons, Ltd.     

Some reflections on potential abuses of psychology’s knowledge and practices

This article identifies ten implicit and explicit assumptions of Western psychology that are rooted within its cultural history, traditions, and values. Unfortunately, these assumptions have informed and dominated the knowledge and practice of psychology across the world because of historic, cultural, political, and economic reasons. It is now clear, however, that the indiscriminate acceptance and application of Western psychological knowledge and practices constitutes a serious abuse for non-Western people and for ethnic/racial minorities in Western nations. This abuse is often transmitted and exacerbated via the training of international and ethnic minority students who learn to accept Western psychology as universal. In a global community in which all our lives have become interdependent, it is essential Western psychology be re-considered as a “cultural construction” with all the ethnocentric limitations this implies. As a counter, efforts must be made to acknowledge, develop, and transmit the diverse indigenous/national psychologies from across the world.     

Mental Illness: Fact or Myth? Revisiting the Debate Between Albert Ellis and Thomas Szasz

Although it is widely accepted that mental illnesses affect millions of people worldwide, there is still disagreement among scholars about the facts of mental illness. The orthodox position is that mental illness is a fact; critics argue that it is a myth. Thomas Szasz was perhaps the most influential critic of mental illness while Albert Ellis was one of the most influential psychotherapists of the twentieth century. Yet, they disagreed about the facts of mental illness. Ellis argued that mental illness is a fact; Szasz argued that mental illness is a metaphor that we have mistaken for a fact. Both men were practicing psychotherapists: Ellis developed Rational Emotive Behavior Therapy and treated mentally ill clients as irrational thinkers; Szasz developed Autonomous Psychotherapy and treated clients as existential game-players who choose, or have been coerced into, the role of sick patient. Szasz vehemently disagreed with Ellis’s view that some people with serious mental illnesses should be institutionalized and treated against their will. While Ellis argued that mental illness is a convenient label for people who are a danger to themselves and others, Szasz argued that mental illness is a metaphor for moral problems in living and involuntary institutionalization and treatment are crimes against humanity. This paper, then, revisits the debate between Ellis and Szasz on the vexed topic of mental illness.     

A qualitative study of primary health care access, barriers and satisfaction among people with mental illness

Research has found that a substantial proportion of individuals with mental illness have high morbidity and mortality rates, and high under-diagnosis of major physical illnesses. Furthermore, people with a mental illness tend not to seek out or utilise health care services. The reasons for the negative attitudes and behaviour towards health care services among this population have not been investigated. This paper presents findings from a study that investigated the health care service needs of people with mental illness (n = 20), and views from health care providers (n = 16) regarding access to these services by people with a mental illness. Results indicated that psychiatric patients identified a range of barriers to their health care usage and low levels of health care satisfaction. These views were shared with health care professionals. Reasons for these findings and strategies to address these problems so that there is better access to health care services for people with mental illness are discussed.     

Clergy involvement in occupational safety and health

The toll exacted by occupational injuries and illnesses on employed people involves a degree of personal and family suffering of such magnitude that clergy can legitimately consider it a part of their pastoral responsibilities to address the problem. Several cogent reasons for clergy involvement in occupational safety and health are provided, along with approaches clergy can implement to help parishioners reduce their workplace risks. Resources for assistance in engaging in these activities are suggested.This article represents an expansion of a paper that appeared originally inCurrents in Theology and Mission, Fall 1979.     

The shield of pallas: The virtual contemplation of the human soul: The aesthetic of Fr. Arthur Little S.J. (1887–1949)

This paper explores the extreme but well-argued-for thesis that the indirect object of an aesthetic experience of serious art is the human soul of the person having the experience. The author of the thesis was Fr. Arthur Little S.J. a mid twentieth-century Irishman, professional philosopher and philosophical popularizer. The paper treats Little’s thesis seriously: comparisons are drawn with Kant, which may be of interest even to those hostile to Little’s central assertion. Little makes a brilliant analysis of a ‘free-beauty’, making the sharpest contrast between this and the most serious art, tragedy. Tragedy, Little holds Kant not able to cope with. One agrees. The people who cry before my pictures are having the same religious experience I had when I painted them. Mark Rothko This book is a development of a series of lectures given to the Study Club of the Central Catholic Library in Dublin. The view of art that it proposes is, for reasons explained in the book, more exactly called Aristotelean than Thomistic. But where it has been necessary to base conclusions in aesthetics on philosophical presuppositions outside of that science the philosophy presupposed will be Thomism. Even so, however, the Thomistic doctrine, that must be accepted by anyone who will assent to the book’s thesis, is consistent with most philosophical positions that are not openly or latently materialistic. Anyone who believein the spirituality of the soul can accept that thesis… Arthur Little S.J.     

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self‐report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non‐urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses.     

For Better and For Worse: Differential Susceptibility to Environmental Influences

ABSTRACT— Evidence that adverse rearing environments exert negative effects particularly on children presumed "vulnerable" for temperamental or genetic reasons may actually reflect something else: heightened susceptibility to the negative effects of risky environments and to the beneficial effects of supportive environments. Building on Belsky's (1997, 2005) evolutionary-inspired proposition that some children are more affected—both for better and for worse—by their rearing experiences than are others, we consider recent work on child vulnerability, including that involving measured genes, along with evidence showing that putatively vulnerable children are especially susceptible to both positive and negative rearing effects. We also consider methodological issues and unanswered questions in the differential-susceptibility equation.