ABSTRACT
Ethnic differences in rehospitalization were examined in a program of intensive services for severely mentally ill hospital recidivists. The purpose was to determine whether ethnicity-related differences in psychiatric admissions observed in national data would appear among clients at great risk for hospitalization but enrolled in a program of case-managed care to promote community adjustment and tenure. After accounting for differences in prior emergency visits and hospitalizations as well as sociodemographic and clinical differences, blacks were found more likely than whites to visit the psychiatric emergency room and to be hospitalized. The marked needs of the severely mentally ill and the intention to address these needs with services did not obviate the continuing importance of racial differences in explaining reliance on inpatient sources of care.
Subject(s)
Bipolar Disorder/ethnology , Cross-Cultural Comparison , Emergency Services, Psychiatric/statistics & numerical data , Patient Readmission/statistics & numerical data , Psychotic Disorders/ethnology , Schizophrenia/ethnology , Schizophrenic Psychology , Alcoholism/ethnology , Alcoholism/psychology , Alcoholism/rehabilitation , Bipolar Disorder/psychology , Bipolar Disorder/rehabilitation , California , Combined Modality Therapy , Female , Humans , Male , Managed Care Programs/statistics & numerical data , Psychotic Disorders/psychology , Psychotic Disorders/rehabilitation , Public Assistance/statistics & numerical data , Public Housing , Retrospective Studies , Schizophrenia/rehabilitation , Social EnvironmentABSTRACT
Two hundred and thirty-four members of a 1973 sample of sheltered care residents, three-fourths of whom had schizophrenic disorders, were followed up between 1983 and 1985 to examine the role of supportive and of transitional, high-expectation sheltered care environments in the development of residents' social networks. The influences of revolving-door treatment experiences, psychopathology, and institutionalization were taken into account. The results showed that supportive rather than transitional, high-expectation environments contributed to the development of emotionally and instrumentally supportive social networks. Higher levels of psychopathology and a history of institutionalization resulted in the absence of certain support relationships. Surprisingly, revolving-door treatment experiences were related to positive support and social network outcomes.
Subject(s)
Halfway Houses/standards , Outcome Assessment, Health Care/statistics & numerical data , Schizophrenia/rehabilitation , Social Support , Adult , California , Female , Follow-Up Studies , Humans , Least-Squares Analysis , Male , Middle Aged , Psychiatric Status Rating Scales , Schizophrenia/diagnosis , Schizophrenic Psychology , Set, Psychology , Surveys and QuestionnairesABSTRACT
The social acceptance expressed by 234 former mental patients and by the general public toward persons with serious mental illness was compared. Factors that may affect social acceptance of such persons, including personal characteristics and experiences that promote identification with mentally ill persons and the subject's level of psychological distress, were examined. Former patients expressed attitudes that were much more accepting than those of the general public. As hypothesized, individual characteristics and experiences likely to increase former patients' identification with their peers (that is, visible deviant appearance, a high level of involvement within the sheltered care community, and the experience of negative community reactions to a resident's facility) were related to a higher score on a Guttman scale of social acceptance. An increased level of self-reported psychological distress tended to moderate such supportive attitudes.
