Mental Illness

Over the last decade state prisons have experienced unprecedented growth and many demographic changes. At the same time, courts are requiring states to provide mental health screening and treatment to prisoners. Findings from recent studies indicate that the prevalence of mental illness is higher in prisons than in the community, and comorbidity is common. Our ability to generalize from these studies is limited, however, because of major shifts in the demographic mix in prisons during the past decade. New studies on the prevalence of mental illness in prisons, which consider these recent changes would help planners allocate funds and staff to more effectively meet the needs of these individuals.

With 34 years of lived experience, I present a middle path bridging psychology and psychiatry, based on research and discoveries in developmental science. An experiential understanding of psychosis, as a thermodynamic, psychosomatic process. Enabled by developing an embodied awareness of the “affect” driven nature of nervous system activity and the “role of visceral state and visceral afferent feedback on the global functioning of the brain,” (Porges, 2011) during episodes of affective psychosis. Since 2007, my normal and abnormal states of mind have been explored with an improving sense of the “bidirectional influences between peripheral physiological state and the brain circuits related to affective processes.” (Porges, 2009) A model of experience based on: The Polyvagal Theory (Porges, 2011) and the discovery of “an integrated social engagement system,” (Porges 2001) vulnerable to “affect dysregulation.” (Schore, 2003) A phylogenetic perspective on “A
Traumagenic Neurodevelopmental Model,” (Read et al, 2001) with an understanding of traumatic experience and “the mis-attuning social environment that triggers an intense arousal dysregulation.” (Schore, 2003) With 7 years of experiential research focusing on “the primacy of affect” (McGilchrist, 2010) and the “primary process emotional/affective states,” (Panksepp, 2004) of my “innate affect” (Tomkins, 1995) driven imagery of consciousness, during episodes of “affective psychosis.” (McGorry et al, 2012)

This milestone text provides a comprehensive and state-of-the art overview of perfectionism theory, research, and treatment from the past 25 years, with contributions from the leading researchers in the field. The book examines new theories and perspectives including the social disconnection model of perfectionism and the 2 × 2 model of perfectionism. It also reviews empirical findings, with a special focus on stress, vulnerability, and resilience, and examines perfectionism in specific populations. Finally, it considers how perfectionism relates to physical health and psychophysiological processes and introduces new approaches to effective prevention and treatment. By increasing our understanding of perfectionism as a complex personality disposition and providing a framework for future explorations, this landmark publication aims to promote further research in this field. It will be invaluable reading for academics, students, and professionals in personality psychology, clinical and counselling psychology, applied psychology and related disciplines.

Introduction: Although recent advances in psychiatry have increased our understanding of psychiatric disorders, many people may be unaware about mental illness and its treatment. The negative attitude is known hindrance to providing quality service to mental ill people. The aim of this study is to assess the knowledge and attitude about mental illness among nursing students. Method: The study was carried out in mental hospital, Lagankhel, Nepal. All one hundred eight nursing students posted for psychiatric posting for two weeks formed the study population. A structured standard questionnaire was supplied to the students at the first day of posting for their responses. Results: It was a purposive, descriptive study with 108 respondents of age group 15-20 (85.1%). The study revealed that 97.2% of the respondents thought that all mentally ill patients are not mad. The majority had showed their knowledge about cause of mental illness as genetic (78.6%) and biochemical disturbances (97.2...

The analysis of mental disorders necessarily requires careful and multilayered reflection. Psychiatry is indeed focused on complex phenomena and symptoms that can be only partly traced back to merely quantitative objectifiable data. This is the reason why we witness a growing methodological and conceptual “mutual enlightenment” between philosophy and psychiatry. Whereas philosophy offers notions that can help to take into account also the qualitative aspects and the lived experiences of pathologies, clinical psychiatry seems to represent one of the most relevant practical fields for philosophy to test its explanatory capacity in relation to its many important issues. The history of phenomenological psychopathology, in particular, shows that philosophers have demonstrated a keen interest in the practical consequences of these issues in the field of clinical psychopathology.

It is important to note that, in diagnosing and analyzing some disorders as well as in providing therapeutic instructions, psychiatry turns to concepts that have a pronounced philosophical relevance. Human being, person, self, intersubjectivity, common sense, lived body (Leib) and inanimate body (Körper) are but some of the concepts employed to comprehend several psychopathologies – for instance, those entailing profound emotional and intersubjective disabilities such as schizophrenia, autism spectrum disorder and depression. These notions have been the object of lively philosophical discussions. It is therefore quite difficult to imagine, for example, that the connections between time, body and otherness which emerge in certain psychopathologies could be analyzed in complete detachment from the philosophical debate over these issues or without asking whether there is any relationship between mental disorders and the peculiarity of human existence.

Considering these convergences, this special issue offers to its readers a series of contributions that investigate the possible relationships between specific psychopathological symptoms and some crucial philosophical issues from various viewpoints. Joel Krueger and Michelle Maiese argue that the notion of “mental institutions” – discussed in recent debates about extended cognition – can help better understand the origin and character of social impairments in autism, and also help illuminate the extent to which some mechanisms of autistic dysfunction extend across both internal and external factors (i.e., they do not just reside within an individual’s head). In his two papers, John Cutting explores the modus vivendi of schizophrenia and that of depression in relation to Max Scheler's phenomenology. Guido Cusinato develops a critical reflection on Cutting’s proposal, highlighting the intersubjective and enactive dimension of valueception impairments. Underlying  this discussion between Cutting and Cusinato there is a different way of interpreting the relationship between the modus vivendi of schizophrenia and Scheler’s phenomenological reduction. The next issue of the journal will include Cutting’s response to Cusinato’s observations. Guilherme Messas and Melissa Tamelini analyze two concepts of a philosophical origin – that of dialectics and that of essence – which, in their strict application to psychopathology, could be of considerable value for diagnostic purposes and for the introduction and follow-up of therapeutic strategies. Lucas Bloc and Virginia Moirera propose an outline of clinical phenomenology for eating disorders inspired by Merleau-Ponty’s philosophical phenomenology. Francesca Brencio explores the “pathic” dimension of existence, which is the capacity of both being affected and being situated within moods and atmospheres. The broader purpose of her paper is to show how the “pathic” dimension of existence is related to psychopathology and clinical practice, for example in affective disorders and schizophrenia. Valeria Bizzari draws attention to the interaffective and intersubjective dimensions of Asperger’s subjects. Finally, Gilberto di Petta and Mario Rossi Monti highlight the importance of the debate on these issues that took place in Italy, retracing the history of the Italian Society for Phenomenological Psychopathology and the School of Phenomenological-Dynamic Psychotherapy.

There will be a further issue of the journal on this topic. All together, these papers aim to promote a closer comparison and collaboration between psychiatry and philosophy, going beyond a reductive and merely symptomatological conception of mental illness and widening the horizon so as to research areas that so far have remained on the margins of phenomenological psychopathology, such as the dimensions concerning value and affectivity.


John Cutting and Guido Cusinato

Mental disorders affect a great number of people worldwide. Four out of the 10 leading causes of disability in the world are mental disorders. Because of the scarcity of specialists around the world and especially in developing countries, it is important for primary care physicians to provide services to patients with mental disorders. The most widely researched and used psychological approach in primary care is cognitive behavioral therapy. Due to its brief nature and the practical skills it teaches, it is convenient for use in primary care settings. The following paper reviews the literature on psychotherapy in primary care and provides some practical tips for primary care physicians to use when they are faced with patients having mental disorders.

RESUMEN.Reflexionamos sobre el debate que existe en la comunidad científica sobre los artículos de opinión que plantean valorar el posible uso terapéutico que puede tener el consumo regulado del Cannabis y por otra parte los estudios que muestran la relación entre el consumo de esta sustancia y el riesgo de enfermedad mental. Se diferencia entre "riesgo de enfermedad" y causalidad y se explica el concepto de estocasticidad en psiquiatría Debemos valorar así mismo "el coste de oportunidad que está suponiendo que el debate sobre el cannabis se siga planteando como un conflicto bélico entre partidarios y detractores del uso de esta sustancia milenaria y compleja".
Palabras clave: Cannabis, artículo de opinión, causalidad, riesgo de enfermedad, psicosis, enfermedad mental, consumo.
SUMMARY.We reflect on the debate that exists in the scientific community about the opinion articles that propose assessing the possible therapeutic use that the regulated cannabis consumption can have and on the other hand the studies that show the relationship between the consumption of this substance and the risk of mental illness. Differs between "risk of disease" and causality, and explain the concept of stochasticity in psychiatry. We must value "the loss of opportunity that is assuming that the debate on cannabis continues to arise as a war conflict between supporters and detractors of the uso of this ancient and complex substance. En las ciencias de la salud las cosas casi nunca son blancas o negras y la estructura empírica, el momento histórico, nos hace valorar debidamente

This explorative study assesses perceptions of mental health and help-seeking behavior among adults in Vietnam. Methods included questionnaires (200) and focus group discussions (eight). Respondents were often unable to name specific mental illnesses. Frequently mentioned symptoms of mental illness were talking nonsense, talking/laughing alone and wandering. Pressure/stress and studying/thinking too much were often identified causes. Most respondents showed a preference for medical treatment options, often in combination with family care. The results show that perceptions of mental health and help-seeking behaviour are influenced by a lack of knowledge and a mix of traditional and modern views.

The literature on homeless adults with severe mental illness is generally silent on a critical issue surrounding service delivery—the contrast between housing first and treatment first program philosophies. This study draws on data from a longitudinal experiment contrasting a housing first program (which offers immediate permanent housing without requiring treatment compliance or abstinence) and treatment first (standard care) programs for 225 adults who were homeless with mental illness in New York City. After 48 months, results showed no significant group differences in alcohol and drug use. Treatment first participants were significantly more likely to use treatment services. These findings, in combination with previous reports of much higher rates of housing stability in the housing first group, show that “dual diagnosed” adults can remain stably housed without increasing their substance use. Thus, housing first programs favoring immediate housing and consumer choice deserve con...

When looking back on the spiritual experiences of women in the Middle Ages, often times we seek to understand the experiences through a pathological contextualization - ultimately assigning a diagnosis to explain their encounters. Women such as Joan of Arc and Hildegard of Bingen both experienced spiritual revelations where in which they appeared to have been communicating with a higher power through auditory, visual, and sensory incidences, which could easily be understood as hallucinations. However, while their experiences may fit into a diagnostic model and possibly the criteria for mental illness such as schizophrenia, it is important to understand and contextualize their experiences from a myriad of perspectives. Therefore, this paper examines the spiritual experiences of these women from psychological, spiritual, and cognitive directions, while exploring their unique and individual experiences. Additionally, their childhood experiences and idiosyncratic personal histories are explored as an illustrative framework for the way in which these women’s experiences occurred, emerged, and manifested.

Eight community mental health care centres (initiated by the South-Eastern Europe Stability Pact) in Albania, Bosnia-Herzegovina, Croatia, Macedonia, Moldova, Montenegro and Romania were evaluated. Characteristics of patients, patient reported outcomes and patient views of care were assessed in 305 psychiatric patients. Patient characteristics varied across centres, with most patients having long term psychotic disorders. Treatment satisfaction and therapeutic relationships were rated favourably. Subjective quality of life mean scores were rather low, with higher satisfaction with health and dissatisfaction with the financial and employment situation. Being unemployed was the only factor associated with poor quality of life and lower treatment satisfaction. Most developing centres target patients with persistent psychotic disorders. Care appears highly valued by the patients. The findings encourage establishing more centres in the region and call for employment schemes for people with mental illnesses.

Purpose: This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts. Materials and methods: During 1996–98, 563 suicide attempts were studied in a general hospital in Madrid (Spain). Medication overdose was used in 456 suicide attempts (81%). The ratio between dose taken and maximum prescription dose recommended was used to evaluate the medication toxicity.

As with ill health in general, the conventional wisdom is that mental illnesses are more prevalent in urban settings. This assumption has meant that there has been a paucity of literature documenting the mental health needs of rural and remote communities. For example, the present literature on psychiatric inpatient admissions in Ireland is essentially a descriptive overview of psychiatric services at both the national and county level–their activity; an outline of the current services or planned changes to the structure and ...

This article aims to explore the ways in which mental illness is used in contemporary cinema, highlighting the differences of representation of the mentally ill in accordance to genre. Furthermore, this article will examine not only the use of mentally ill characters, but also the narrative structure of films which include the mentally ill, and how the genre of such a film can dictate the resolution of the narrative. The genres studied include horror, comedy, drama, and children’s cinema, as well as sub-genres within these; an analysis of these genres will illuminate the ways in which modern cinema uses mental illness as a narrative drive, and how doing so has implications on the audiences that watch it.

Keywords: Mental illness, narrative, genre, social implications

Purpose-The murders of Black people at the hands of police in 2020 have led to global protests that have called on public officials to defund or abolish the police. What has been drowned out in these conversations, however, is the traumatizing aftereffects of anti-Black police violence as a public health crisis. In this paper, I argue that the racial terrorism of anti-Black police violence is a deeply felt wound in Black communities that extends beyond the individuals who directly experience it and that this type of collective trauma must be understood as an urgent public health crisis. Design/methodology/approach-Using published studies and online commentaries on anti-Black police violence and its mental health impacts in Canada and the United States, this paper examines the mental health impacts of anti-Black police violence at both the individual and community levels. Findings-A public health response to the traumatizing aftereffects of anti-Black police violence and other forms of state violence must highlight important policy imperatives, such as policies of action focused on improving the public health system. It must also encompass a recognition that the public health crisis of anti-Black police violence is not solvable solely by public health agencies alone. Rather, strategic opportunities to address this crisis arise at every level of governmental interaction, including law enforcement, health care, employment, business, education and the media. Originality/value-While the impact of anti-Black police violence on the mental health of Black individuals has been emerging in the literature over the last several years, what has been less focused on and what I address in this paper is how the threat of that violence lingers in Black communities long after the protestors have packed up their megaphones, resulting in collective trauma in Black communities.

Higher income societies have moved from institutional to community-based care for people experiencing mental illness. However, stigma and discrimination persists and undermines help-seeking, recovery and life chances. Mental illness prevalence is higher amongst communities that face multiple prejudices and disadvantages within society, including black and minority ethnic communities who may experience migration trauma, racism, acculturation and adverse social circumstances. This study examines beliefs, stigma and the effectiveness of existing national mental health campaigns with Pakistani, Indian and Chinese heritage communities in Scotland, UK, using community based participatory research. Community organisers were trained and supported to co-facilitate focus groups with 87 people using a range of languages. Whilst diversity within and between communities was apparent, important trends emerged. People with mental illness experience high levels of stigma from communities. Families experience significant associated stigma. This shame combines with culturally inappropriate services to reduce help seeking from mental health services, friends and families. Existing anti-stigma campaigns have failed to reach or engage with communities due to a combination of practical issues such as the use of inappropriate language, imagery and media, but also due to assuming western medical concepts of illness. Participants suggested a new model for national campaigns placing greater emphasis upon community development, cultural events, positive contact and dialogue with families, faith leaders and youth groups. National anti-stigma programmes must develop more effective partnerships with communities or risk magnifying existing inequalities.Despite a range of national programmes to address stigma towards people with mental illness, it remains as the major barrier to social inclusion for people with mental illness living in communities. Stigma is particularly severe if people have a mental illness and are also economically disadvantaged or face multiple stigmas. By adopting Community Based Participatory Research (CBPR) approaches with three black and ethnic minority communi- ties in Scotland, this study makes the case that stigma can only be understood and effectively addressed with reference to its socio-cultural context.

The prevalence of psychiatric disorders among incarcerated juveniles in Mississippi was examined. A total of 482 adolescents completed a diagnostic questionnaire and a subset (N = 317) was assessed with face-to-face semi-structured interview. Most of the study participants met criteria for one mental disorder, 71–85% depending on assessment method, one-third have co-occurring mental health and substance abuse disorders. Gender and placement site differences in rates of some psychiatric disorders were also noted. Routine mental health screening should be performed on all juveniles placed in secure detention facilities to identify those who need treatment services.

New communication technologies offer novel possibilities for the prevention of mental illness, in which geographical and psychosocial distances often hamper help-seeking. This paper introduces ES[S]PRIT, an Internet-based eating disorders (ED) prevention programme for university students. The programme follows a stepped-care approach combining various support components of increasing intensity. These components comprise psychoeducation, symptom monitoring, supportive feedback, peer support, and professional online counselling. Participants who develop substantial ED symptoms during their participation are referred to the University Student Counselling Center. We outline the underlying concepts and various components of the programme and report first experiences with the approach in a sample of German college students. Finally, potentials of the approach are highlighted and the need for further research is stressed.