Facilitating Help Seeking Behavior and Referrals for Mental Health Difficulties in School Aged Boys and Girls: A School-Based Intervention

Although the need for early intervention for mental health difficulties is widely acknowledged, few studies have attempted to explicitly increase actual help seeking behavior for mental health difficulties. Students in intervention classrooms received two one-hour, in-class workshops on distress and help seeking and were compared to students in non-intervention classrooms in a 2-level hierarchical model. More frequent help seeking behavior and more mental health referrals were observed among students in the intervention group than among students in the comparison group. Effects were moderated by the level of distress experienced by students, but not by help seeking attitudes, and could not be accounted for by school staff referrals or website utilization. Results showed that help seeking behavior for mental health difficulties and mental health referrals can be increased with only a moderate investment in time, but that benefits of school-based intervention may be greatest among students with specific needs, such as high levels of distress.

Competence to Complete Psychiatric Advance Directives: Effects of Facilitated Decision Making

Psychiatric advance directives (PADs) statutes presume competence to complete these documents, but the range and dimensions of decisional competence among people who actually complete PADs is unknown. This study examines clinical and neuropsychological correlates of performance on a measure to assess competence to complete PADs and investigates the effects of a facilitated PAD intervention on decisional capacity. N=469 adults with psychotic disorders were interviewed at baseline and then randomly assigned to either a control group in which they received written materials about PADs or to an intervention group in which they were offered an opportunity to meet individually with a trained facilitator to create a PAD. At baseline, domains on the Decisional Competence Assessment Tool for PADs (DCAT-PAD) were most strongly associated with IQ, verbal memory, abstract thinking, and psychiatric symptoms. At one-month follow-up, participants in the intervention group showed more improvement on the DCAT-PAD than controls, particularly among participants with pre-morbid IQ estimates below the median of 100. The results suggest that PAD facilitation is an effective method to boost competence of cognitively-impaired clients to write PADs and make treatment decisions within PADs, thereby maximizing the chances their advance directives will be valid.     

Sudden and Unexpected Death in Three Cases of Ehlers‐Danlos Syndrome Type IV*

Abstract: Ehlers–Danlos syndrome (EDS) type IV is a connective tissue disorder characterized by the inability to produce sufficient amounts of collagen or a defect in the structure of collagen. The most serious complications include a rupture of a viscus or vascular rupture with or without mural dissection. Death may result from internal hemorrhage. This report describes three cases of sudden and unexpected death caused by EDS type IV. Two cases involved hemothorax as a result of dissection of the subclavian artery and aorta, respectively. The third case represented spontaneous pulmonary rupture and hemorrhage. A detailed family history should be sought, and additional specimens collected to confirm the diagnosis, including skin fibroblasts for collagen testing and blood for DNA testing. The forensic pathologist should consider the possibility of EDS type IV upon discovery of spontaneous visceral or arterial rupture and should alert the family members of this hereditary and potentially fatal condition.     

初探精神鉴定中人为性鉴定失误行为

目前,我国尚无统一的精神卫生法,关于鉴定人员在鉴定中的行为,缺少相应的法律规范。而由于各种原因所致,鉴定中时有“人为性鉴定失误”现象发生。致使精神正常人被错关入院的案例不断出现。文章对该现象出现的原因、该不当行为的违法性,进行具体分析。并提出关于消除该现象的个人观点。以期能对未来我国精神卫生法的制定有所启发。     

论大学生心理健康的社会支持系统及其构建

文章首先对社会支持的内涵进行了界定,并分析了三种作用模型中社会支持对大学生心理健康的影响机制。文章认为,来自学校的社会支持是大学生社会支持系统的主要构成要素,学校必须帮助大学生构建包括专业教师、管理人员、心理咨询员以及同伴这四类人员提供的社会支持系统。     

强制治疗精神疾病患者的程序法研究——基于国内六部地方性法规的实证分析

对精神疾病患者实施强制治疗程序包括强制送治程序和强制治疗程序,由于该程序涉及到对人身自由的限制,应该严格遵循法治行政的原则。不过,国内各地所制定的六部精神卫生条例,赋予该程序的法根据并不充足;同时,程序法上的规定也并非十分完善。因此,我国应该尽快制定《精神卫生法》,详细规定强制治疗的程序,为保障精神疾病患者的权益提供坚实的法律根据。     

人身损害赔偿中精神障碍者民事行为能力评定

目的寻求并确证人身损害赔偿中精神障碍者民事行为能力评定的考量指标。方法回顾性收集司法部司法鉴定科学技术研究所2003--2005年的关于人身损害赔偿中精神障碍者民事行为能力评定案例中被鉴定人的相关材料,提炼出6个考量指标：处境认识、争端理解、结果认识、信息利用、环境功能和决定交流进行评定,并用SPSS11．5软件进行统计分析。结果考量指标与专家鉴定结论间的相关系数在0．632～0．876,考量指标间的相关系数在0．575～0．911。结论提炼的6个考量指标在人身损害赔偿中精神障碍者民事行为能力评定具有代表性,可以此为基础深入开展民事行为能力标准化评定及量化研究。     

The nearest relative in the Mental Health Act 2007: still an illusionary and inconsistent safeguard?

Abstract

The role of nearest relative (NR) is intended as a safeguard in the Mental Health Act 1983 (as amended in 2007) to curb the excesses of professional discretion and protect patients from unwarranted compulsory hospitalisation. It is unique to the mental health compulsory detention process in England and Wales. There are, however, evident tensions in the role and a lack of clarity surrounding the precise functions of the NR. There is also some uncertainty and confusion among practitioners about the scope of the NR involvement, and government plans announced recently to review mental health legislation will include a focus on the role of family and carers in the care of detained patients. Despite long-standing concerns about the role, there is remarkably little published research available to date on its use and effectiveness, in so far as evaluating the extent to which it provides an adequate safeguard for patients, as intended by the legislation. This article will briefly explore the background to the role, highlight some of the difficulties and tensions within it and conclude with some observations about where further research and reform may be needed to provide greater protection and clarity for patients, relatives and health and social care practitioners.