Perceived stigma and community integration among clients of assertive community treatment.

Facilitating the integration of persons with psychiatric disabilities is an important goal of community programs. In addition to limitations such as inadequate housing, poverty, and unemployment, a common barrier to community adjustment identified by people with psychiatric disabilities is their perception of being stigmatized. This study examined the relationships between perceived stigma and community integration in 95 clients of assertive community treatment (ACT) teams, using sequential multiple regression procedures.

Subjective quality of life in the evaluation of programs for people with serious and persistent mental illness.

Despite the widespread application of the concept of quality of life in mental health evaluation, it has been observed that subjective quality of life measures do not reliably capture changes expected to result from intervention efforts. Moreover, because the domains selected to assess subjective life quality are typically generated by investigators or health professionals, the validity of subjective quality of life measures has also been questioned. Although it represents a conceptual shift from investigator-generated domains to client-elicited domains, it is suggested that a client-elicited approach to measuring subjective quality of life may provide fruitful avenues for resolving some of the conceptual and practical issues associated with understanding and measuring the impact of community-based programs on clients with serious mental illness.

Measuring client satisfaction with assertive community treatment.

Objective: A mailed survey was used to measure satisfaction of seriously mentally ill clients with services provided by an assertive community treatment team.

Methods: A detailed 35-item questionnaire was mailed in 1995 to all 174 clients of the Brockville (Ontario) Psychiatric Hospital's assertive community rehabilitation program.

Results: The rate of return was 51 percent.

Assertive community treatment of severe mental illness: a Canadian experience.

The study assessed one-year outcomes for 110 clients with serious mental illness who were randomly assigned to an assertive community rehabilitation program that provides psychiatric rehabilitation services in community settings or to hospital-based rehabilitation programs. Key elements of the community program include a multidisciplinary team on call 24 hours a day, in vivo treatment, and instruction and assistance in basic living skills. Data from client interviews after one year of service were used to assess clients' quality of life, satisfaction with services, and psychopathology.

Partnerships for people with serious mental illness who live below the poverty line.

Fifty-four persons with serious mental illness who were living below the poverty line were randomly divided into two groups. Members of one group received allowances and forgivable loans to raise them above the poverty line for one year. The others received some funds, but not enough to raise them above the poverty line.

Quality of life of people with psychiatric disabilities 1 and 3 years after discharge from hospital.

We interviewed 43 clients 1 and 3 years following discharge from a psychiatric rehabilitation programme. The Clients' Quality of Life Interview and Uniform Client Data Instrument examined several domains of clients' life situations. Quality of life measures of living situation, social and community living skills, and recreation improved from 1988 to 1990, and other measures were stable.

Dimensions of perfectionism, daily stress, and depression: a test of the specific vulnerability hypothesis.

We tested whether perfectionism dimensions interact with specific stressors to predict depression. A depressed patient sample (N = 51) and a general psychiatric sample (N = 94) completed measures of perfectionism, hassles, and depression. Subjects in Sample 2 also completed other personality measures to assess the amount of unique variance in depression.

Program outcome and QA: a new approach to evaluation.

Health care providers and managers are familiar with the limitations of current quality assurance (QA) practices, which do little to indicate the overall effectiveness of health care programs. This article discusses a comprehensive method of evaluating program effectiveness, efficiency, cost, client satisfaction, and adherence to standards. The authors present the Brockville Psychiatric Hospital's experience in evaluating a new program with data collected from a multi-faceted QA perspective, and suggest that combining program evaluation with QA could become the standard for future program assessments.

Transition from the hospital to the community: small group program.

1. Clients in a psychiatric hospital often experience loss of control over their lives and dissatisfaction with their quality of living. A small group rehabilitation program can counteract the effects of institutionalization and restore a sense of mastery to chronic psychiatric clients.

Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology.

This article attempted to demonstrate that the perfectionism construct is multidimensional, comprising both personal and social components, and that these components contribute to severe levels of psychopathology. We describe three dimensions of perfectionism: self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism. Four studies confirm the multidimensionality of the construct and show that these dimensions can be assessed in a reliable and valid manner.

Quality of life after psychiatric rehabilitation: the clients' perspective.

Fifty-five people discharged from inpatient psychiatric rehabilitation programs were interviewed 1 year after leaving hospital using the Client's Quality of Life Instrument. Following long periods of psychiatric hospitalization, these former patients had adapted to living in the larger community with considerable success. Ninety-six percent felt that their quality of life had improved as a consequence of leaving hospital.

Dimensions of perfectionism in unipolar depression.

We tested the hypothesis that self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism are related differentially to unipolar depression. The Multidimensional Perfectionism Scale was administered along with measures of depression and anxiety to 22 depressed patients, 22 matched normal control subjects, and 13 anxiety patients. It was found that the depressed patients had higher levels of self-oriented perfectionism than did either the psychiatric or normal control subjects.

Program evaluation as a measure of the quality of a new approach to community psychiatric care.

The effectiveness of a new approach to providing psychiatric rehabilitation services in community settings will be assessed using a combination of quality assurance principles and program evaluation techniques. A new Assertive Community Rehabilitation Program (ACRP) is evaluated and compared with existing hospital rehabilitation programs. Measures of service efficiency, admission, discharge and readmission rates, and service costs are made for 100 new referrals, 99 inpatients and 117 outpatients.

The ideal self: schematic processing of perfectionistic content in dysphoric university students.

This study assessed ideal-self-schematic processing, recall of perfectionistic content rated as not descriptive of the actual self or ideal self, and content-specific processing as a function of dysphoria. College students (n = 219) made structural (ST), ideal-self (IS), and actual-self (AS) ratings on perfectionistic, negative, and neutral words, and completed an incidental recall task. Words rated with the IS task were recalled better tha words rated with the ST task, but recall did not differ between the IS and AS tasks.

Competence to consent to treatment: a guide for the psychiatrist.

During the last decade there has been increasing pressure to legislate legal rights for psychiatric patients especially in relation to consent to treatment. The attempt to subject the irrationality of psychotic illness to the due process of rational laws has caused problems. Revision of the Ontario Mental Health Act (MHA) has already led to situations in which patients are being incarcerated without treatment because of review board decisions regarding dangerousness and competence.

Physician recruitment in Ontario Provincial Psychiatric Hospitals.

Recruitment of Physicians/Psychiatrists to staff the Ontario Provincial Psychiatric Hospitals remains an ongoing problem despite the introduction of measures such as University Affiliation and Incentive Grants. Historically there has been heavy reliance upon Foreign Medical Graduates (GOFM's) who have been denied the possibility of professional mobility and advancement because of restrictive licences. Recent changes in regulations have severely restricted the recruitment of GOFM's.