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COMMUNITY TREATMENT

This comprehensive overview explores the evolution of community mental health treatment, emphasizing the decline of traditional mental hospitals and the rise of innovative outpatient models like PACT (Program of Assertive Community Treatment). It discusses the importance of coordinating services such as housing, therapy, and medical care within the community to improve the quality of life for individuals with severe mental illness (SMI). The historical context, key challenges, and effective models are examined, promoting empowerment rather than mere symptom management.

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COMMUNITY TREATMENT

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  1. COMMUNITY TREATMENT

  2. EVALUATIONS • 01:920:307:02 • HORWITZ, SOC. OF MENTAL ILLNESS • GOOD = RIGHT; BAD = LEFT • ON BACK - MOVIE SUGGESTIONS AND ANYTHING ELSE

  3. COMM. TREATMENT CONTEXT • DECLINE OF MENTAL HOSPITALS - NO NEED FOR HOUSING, INCOME, JOBS, BENEFITS • ALL SERVICES IN ONE PLACE - HOUSING, MEALS, THERAPY, MEDICAL CARE, SOCIAL CONTROL, SOCIAL INTERACTION • CREATE HOSPITAL IN COMMUNITY

  4. OUTPATIENT THERAPY • WAS ONLY ALTERNATIVE MODEL • ONLY THERAPY - NO OTHER SERVICES • LIMITED SOCIAL CONTROL • INADEQUATE FOR SERIOUSLY MENTALLY ILL • NEED FOR NEW KIND OF PROFESSIONAL FOR S.M.I.

  5. NEW PROGRAMS FOR SMI • EFFECTIVE MODELS ARE AVAILABLE • GOAL TO IMPROVE QUALITY OF LIFE AND EMPOWERMENT NOT JUST MANAGE SYMPTOMS • COORDINATE SERVICES • PACT

  6. PACT • TEAM CONCEPT • GO OUT INTO THE COMMUNITY • 24/7 AVAILABILITY • PROVIDE SERVICES AND MEDICATION

  7. BENEFITS OF PACT • KEEPS PEOPLE OUT OF HOSPITAL • COORDINATES SERVICES • RAISES QUALITY OF LIFE

  8. PROBLEMS W/PACT • PATERNALISM? • ATTITUDE TOWARD MEDICATION? • WHAT DO ALL DAY? • FEW PROGRAMS, E.G. JOB TRAINING

  9. FAMILIES • MORAL RESPONSIBILITY FOR ADULT SMI CHILDREN • FRUMKINS? • OFTEN BLAMED FOR ILLNESS OR FOR RELAPSES • BEARERS OF BURDEN

  10. CONSUMER MOVEMENT • AROSE IN 1970’S - “ANTI-PSYCHIATRY” (KAUFMANN) • COMBAT STIGMA • ALL SERVICES VOLUNTARY • CONSUMER RUN SERVICES

  11. REVIEW

  12. REVIEW • 60% MULTIPLE CHOICE • 40% TWO GENERAL ESSAYS FROM THREE CHOICES • ESSAY QUESTIONS BROAD - ANSWERS PARTICULAR • 1/3 OF GRADE BUT ALSO TREND • NOT CUMULATIVE

  13. CUCKOO’S NEST • HOW ILLUSTRATES MENTAL HOSPITALS BEFORE DI • SOCIAL CONTROL • MEDICAL MODEL • TYPES OF PATIENTS

  14. IS THERE NO PLACE ON EARTH FOR ME? • HOW ILLUSTRATES DI - SINCE 1970’S • PROBLEMS OF DI SYSTEM • LACK OF COORDINATION • HOW EXERT SOCIAL CONTROL? • SITUATION OF FAMILIES • WHAT WOULD BE EFFECTIVE WITH SOMEONE W/SYLVIA’S PROBLEMS?

  15. MENTAL HOSPITALS • HISTORY OF MENTAL HOSPITALS • WHEN AROSE • TYPE OF TREATMENT • TYPES OF PATIENTS • CHARACTERISTICS OF INSTITUTIONS • CHANGES OVER TIME - 1800-1955

  16. DEINSTITUTIONALIZATION • CHANGES IN RESIDENTS AND ADMISSIONS - 1950’S - 2000 • CHANGES IN TYPES OF PATIENTS • CHANGES IN COMMITMENT • MEDICAL AND LEGAL MODELS • CHANGES IN HOSPITALS

  17. REASONS FOR DI • DRUGS • PHILOSOPHY – CMHC, PRO-FEDERAL, ANTI-STATE • LEGAL - COMMITMENT, IN HOSPITAL, RELEASE • ECONOMIC

  18. ECONOMIC • FROM STATE TO FEDERAL FUNDING • MEDICAID, MEDICARE • SSI

  19. COMMUNITY TREATMENT • MAJOR ASPECTS OF PACT AND COMMUNITY TREATMENT • HOW DIFFERENT FROM TRADITIONAL INPATIENT AND OUTPATIENT • STRONG AND WEAK ASPECTS

  20. KAUFMANN • MENTAL HEALTH CONSUMER MOVEMENT • WHEN AROSE • MAJOR IDEOLOGY • ATTITUDES TOWARD M.H. PROFS.

  21. PICKETT, COOK • PSYCHIATRIC REHABILITATION • WHAT ARE IMPORTANT OUTCOMES?

  22. HIDAY • RATES OF M.I. IN PRISONERS AND GENERAL POPULATION • VIOLENCE AND MENTALLY ILL • USE OF INSANITY DEFENSE

  23. GUEST SPEAKER • HOW POLICE SHOULD HANDLE MENTALLY ILL

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