When I'm gone: mourning the dearly departed ... slightly before departure.

We are all going to die one day. There are some practical steps we can take now to increase the likelihood that our loved ones with SMI will have food, shelter, clothing, and hopefully some form of emotional care after we are gone. We can also work on accepting the legitimacy of this task for ourselves, other relatives, professionals, and our child with SMI. Sprinkled with a dollop of mercy, we can muddle through.

They tried reality therapy, but he froze in a cave: curriculum deficits.

Social workers increasingly are called on to work with mentally ill people, but in most cases they are not trained to do so. There is a significant lag between what researchers have found, particularly in the biological fields, and what educators teach in social work schools. This article describes curriculum deficits in teaching about mental illness and the devastating consequences of those deficits. It then outlines a suggested curriculum and appropriate teaching methods. Social workers are called to take the lead in curriculum reform; when they do, students will follow.

Support groups for family caregivers of patients with Alzheimer's disease.

The author discusses some assumptions, dilemmas, and questions that have come out of her experience in facilitating support groups for caregivers whose relatives have Alzheimer's disease, talking with other such facilitators around the country, reviewing the literature, and talking with group members themselves. Suggestions are made for a wider variety of support-group models, in recognition that caregivers have different needs.

The need for asylum for the chronically mentally ill.

Our society highly values autonomy, independence, and freedom. In our model programs for the chronically mentally ill (CMI), we aim for these values and, in the process, may be doing a disservice to those people who cannot attain them. This article proposes that even the best in community care is not enough protection for many CMI. We need to do a better job of discriminating between who can and who cannot benefit from model community programs. We also need to develop a whole continuum of care that accepts the dependency of CMI people, and their various levels of functioning, as well as the progress, deterioration, and inevitable fluctuations that occur. Emphasis is placed on the need for sanctuary and asylum for many that only permanent housing of some kind can provide.

Get out of my potato patch: a biased view of death and dying.

The acceptance of death has become a subject of note in both the professional and mass-market literature. In these personal reflections, the author argues that popularized views of dying have little to do with reality and ultimately add to the pressures facing those who must contend with the prospect of death.

Parental perspectives on chronic schizophrenia.

Parents of chronic schizophrenics are an understudied population. Few researchers have asked them about their wants, needs, and difficulties. The little work that has been done indicates that their suffering is great, their coping skills better than had been previously assumed, and the stresses they are experiencing almost unendurable. This paper looks at what parents are coping with: a child with a terribly debilitating disease about which little is known, a culture which heaps stigma and shame upon them, very difficult and often unworkable mental health and legal systems, and to top it all off, a large number of clinical (non-researchers) professionals who are ignorant about schizophrenia and often unsympathetic towards the parents. This paper then looks at what little data we have from parents about their needs, and offers suggestions about how parents and professionals might best work together, towards the benefit of all concerned.

Sexuality in nursing homes.

Since so little has been written on the subject of sexuality among the elderly in nursing homes, a study was conducted in some nursing home populations in Wisconsin. Resistance was encountered in certain areas but finally 63 residents (27 men and 36 women) agreed to be interviewed. A recently designed questionnaire was used, followed by a relaxed conversational period. Our findings indicate that the aged interviewees believed that sexual activity was appropriate for other elderly people in the homes; they personally were not involved, chiefly because of lack of opportunity. Most of them admitted having sexual thoughts and feelings. Medical and behavioral personnel showed great reluctance to discuss the subject. It would seem that, if the quality of life in old age is to be improved, there should be some provision in nursing homes for those who desire appropriate sexual activity.

Vicious circles in civil commitment.

Mental health legislation recently enacted in various states has improved on older laws by recognizing new procedural rights for patients. In many instances, however, it has also prevented treatment for patients who are severely ill. The authors discuss the new laws and the way they have effected the cooperative efforts of social workers, lawyers, and psychiatrists, the three groups involved in civil commitment.