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.     

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。     

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。     

死亡赔偿制度的嬗变及反思——以死亡赔偿金及精神抚慰金为视角

死亡赔偿制度是侵权法的重要制度,如何处理好死亡赔偿金和精神抚慰金的赔偿问题也一直是人们争论不休的论题。犯罪行为致人死亡,是否应予赔偿以及如何赔偿是一个兼具理论和现实意义的问题。现行立法和司法将其区别于一般侵权赔偿。死亡赔偿金和精神抚慰金被排斥在死亡赔偿范围之外是基于“立法无明文规定、刑事责任可以替代民事责任、死亡赔偿“执行难”等理由。我们应当通过民事诉讼支持精神抚慰金,以此弥补刑事诉讼中的非刑罚处理方法和附带民事诉讼物质损失赔偿对被害人权利救济的不足;同时,立法上将精神损害赔偿引入附带民事诉讼,方能消弭相关法律冲突。死亡赔偿“执行难”实质是一个在司法环节暴露出来的社会问题,彻底解决这一问题有待于国家救助制度的最终建立。     

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.     

Social Networks and Social Control of Probationers with Co-Occurring Mental and Substance Abuse Problems

Probationers with co-occurring mental and substance abuse problems (PCPs) are both subject to considerable social control, and at high risk of probation failure. In this study, we screened 601 probationers for symptoms, interviewed 82 identified PCPs about their relationships, and then followed these PCPs for eight months to record treatment nonadherence and other probation violations. First, PCPs’ social networks were small, heavily comprised of professionals and opposing forces who engaged in risky behavior, and saturated with pressure to adhere to treatment. Second, the size and composition of PCPs’ social networks were more relevant to rule compliance than social support and undermining. Third, the quality of PCPs’ relationships was key: satisfying relationships with clinicians and, to a lesser extent, officers and the core network related to low perceived coercion, high treatment adherence, and low risk of future violations. In particular, having a likable clinician who engaged in participatory decision-making reduced the risk of violations. Implications for contextually sensitive risk reduction efforts are discussed.     

Intergenerational Transmission of Violence: the Influence of Self-Appraisals,Mental Disorders and Substance Abuse

Although research has demonstrated connections between experiencing abuse as a child and being in a violent relationship as an adult, the specific mechanisms through which this transmission occurs are unclear. The purpose of this study was to identify the relationship between certain personal factors (self-appraisals and mental/substance use disorders) and experiencing violence as an adult. Data from the National Comorbidity Survey (NCS) 1990–1992 were utilized. Respondents who reported experiencing childhood abuse or victimization and were in a current intimate partnership (N = 590) were selected for analysis. Multivariate logistic regression indicated that low self-esteem, past year PTSD, and past year alcohol dependence were significantly associated with intimate partner violence after controlling for other self-appraisals and mental disorders.     

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。