RESUMEN
If help were provided early; if professionals were well trained, knowledgeable, and made the right referrals; if insurance paid for the help that is needed; if people with mental illness had a quiet, safe, gentle place to regroup when they were in crisis ... how different the outcomes of mental health services would be.
Asunto(s)
Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Utopias , Adolescente , Adulto , Niño , Costo de Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Rol del Enfermo , Ajuste SocialRESUMEN
Risk Reconsidered: Targets of violence in the Social Networks of People with Serious Mental illness. This exploratory analysis addresses the questions: 1) Who among the members of the social network of a person diagnosed with a major psychiatric disorder is likely to become a target of violence? 2) What kind of relationships do targets have with respondents in terms of the quality and quantity of interactions?, and 3) What are the risk factors that contribute to being a target of violence for people who are in the social networks of persons with serious mental disorders? The samples of 169 people with serious mental disorders were followed for 30 months. A logistic regression model of the risk for being a target of violence among the members of the cohort's social network reveals that both target and respondent characteristics are salient, and that mothers who live with adult children who have schizophrenia and co-occurring substance abuse bear a substantially elevated risk of becoming a target of violence, compared to other social network members. Other factors that elevate the risk for being a target of violence are being an immediate family members of the respondent, more time in residence with the respondent, and whether the respondent is financially dependent on the family. Respondents with the most mental health center visits had lower odds of committing an act or threat of violence against a social network member.
Asunto(s)
Cuidadores/estadística & datos numéricos , Trastornos Mentales/epidemiología , Apoyo Social , Violencia/estadística & datos numéricos , Adulto , Cuidadores/psicología , Costo de Enfermedad , Humanos , Masculino , Trastornos Mentales/psicología , Relaciones Madre-Hijo , Riesgo , Violencia/psicologíaAsunto(s)
Seguro por Discapacidad/estadística & datos numéricos , Trastornos Mentales/economía , Seguridad Social/estadística & datos numéricos , Adulto , Actitud Frente a la Salud , Femenino , Humanos , Renta , Masculino , Trastornos Mentales/psicología , North Carolina , Vigilancia de la Población , Apoyo Social , Bienestar Social/psicología , Estados UnidosRESUMEN
OBJECTIVE: The authors examined the relationship between violent acts and threats by persons with serious mental illness, the size and composition of their social networks, and characteristics of the social support they received. METHODS: A group of 169 respondents with serious mental illness and 59 of their significant others were interviewed using structured and semi-structured protocols to elicit data on demographic characteristics, clinical characteristics, characteristics of respondents' social networks and of the social support they received, and perceptions of threat within the social network. Data on acts and threats of violence by respondents over an 18-month period were collected from self-reports by respondents and significant others and from hospital and court records. RESULTS: Fifty-six respondents either threatened violence or committed a violent act during the study period. Respondents with a diagnosis of schizophrenia were more likely to commit violent acts but were not more likely to threaten violence than were respondents with other diagnoses. Respondents in larger networks, those with networks composed primarily of relatives, and those who lived with unrelated persons were more likely to threaten violence. Financial dependence on family was associated with more violent threats and acts. Respondents who perceived hostility from others were more likely to engage in violent threats and acts, and those with confused thinking were less likely to act or threaten violence. More than half of the targets of violence were respondents' relatives, particularly mothers living with a respondent. Respondents who were violent perceived their significant others as threatening but did not perceive themselves as being threatening in return. CONCLUSIONS: The interpersonal and social contexts of respondents and their perceptions of these contexts are important considerations in assessing risk for violence by persons with mental illness. Mothers who live with an adult offspring with schizophrenia may be at increased risk for being a target of violence. Violence by persons with psychiatric disorders may be linked to their perceptions and experience of being threatened by others.
Asunto(s)
Trastornos Mentales/psicología , Apoyo Social , Violencia/psicología , Adulto , Estudios de Cohortes , Demografía , Miedo , Femenino , Humanos , Relaciones Intergeneracionales , Entrevista Psicológica , Modelos Logísticos , Masculino , Factores de Riesgo , Ajuste Social , Violencia/estadística & datos numéricosRESUMEN
Schizophrenia is an I am illness--one that may overtake and redefine the identity of the person. This essay explores concepts of personhood and subjectivity from social science that are useful in understanding the experiencing subject in schizophrenia. Relationships between the self and sickness have not been investigated adequately with reference to their influence on prognosis. Chronicity is conceived of as a loss of self and of positive social roles and identity. Methods for the study of self and identity in relation to schizophrenia include analysis of illness-identity representations made by persons with schizophrenia.