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Final Study Guide

Final Study Guide - Mental Health Systems and Policy...

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Mental Health Systems and Policy p.377-391 Focus on those with chronic, as opposed to acute, illnesses Inpatient vs. Outpatient Care In terms of inpatient care, majority of individuals get treatment from general hospitals that offer both general medical care and psychiatric care. Close to 20% of inpatient care is by private psychiatric hospitals 16.4% provided by public, state, and county mental hospitals Most clients now receive care on an outpatient basis Partial care (partial hospitalization) Four phases that reflect changing societal values Institutionalization o Late 1800’s to mid 1900’s o Mental hospital as the primary focus of care Deinstitutionalization o 1950’s to 1970’s o Mental hospitals de-emphasized in favor of community based care Consolidation of community-based care o 1980’s to early 1990’s o Emphasis placed upon coordinating and integrating community mental health services o Developing centralized authorities o Extending services to those most in need Managed care o Early 1990’s to present o Cost cutting and rationing of mental health services o Contracting out services to private providers (privatization) Institutionalization ***Total institution*** o Describes state mental hospitals o Same category as prisons o Designed to care for those who are felt to be incapable of looking after themselves and a threat to the community Reliance on state hospitals has declined since the 1960’s o These institutions continue to dominate mental health policy debates o Individuals with severe mental illness are still likely to spend time in a state mental hospital The average state spends 57% of its state mental health dollars on hospitals Deinstitutionalization Process of closing state hospitals and the transfer of inpatients to community based mental health services Began in the 1950’s o Hospitals were little more than ***warehouses*** Custodial care of poor and immigrant insane Inmates are rewarded for quiet and obedient behavior One Flew over the Cuckoo’s Nest
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Civil rights violations o 1960’s series of court cases o ***Least restrictive environment*** Use methods that curtail individual freedom to no greater extent than what is essential to secure valid community interests Allow patients to move from large custodial state institutions to facilities that are: Smaller, less structured, and integrated into the community Allow for independent living ***Parens Patriae*** o Serve best interests of individual o Must protect those with mental illness from potential harm o State can exercise power only when individuals are: Dangerous to themselves or others Psychiatric Drugs o Side effects (all major psychiatric drugs) Drowsiness, nausea, blurred vision, and sinus problems o Prolixin (common treatment for schizophrenia) and other drugs may cause: May affect motor movements Parkinson-like symptoms Akinesia (weakening and general muscular fatigue)
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Final Study Guide - Mental Health Systems and Policy...

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