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Pearson M, R Egglestone S, Winship G. The biological paradigm of psychosis in crisis: A Kuhnian analysis. Nurs Philos 2023; 24:e12418. [PMID: 36779230 DOI: 10.1111/nup.12418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 11/24/2022] [Accepted: 01/14/2023] [Indexed: 02/14/2023]
Abstract
The philosophy of Thomas Kuhn proposes that scientific progress involves periods of crisis and revolution in which previous paradigms are discarded and replaced. Revolutions in how mental health problems are conceptualised have had a substantial impact on the work of mental health nurses. However, despite numerous revolutions within the field of mental health, the biological paradigm has remained largely dominant within western healthcare, especially in orientating the understanding and treatment of psychosis. This paper utilises concepts drawn from the philosophy of Thomas Kuhn to explore the impact of what Kuhn terms 'anomalies' within the dominant biological paradigm: the anomaly of the meaningful utterance, the anomaly of complex aetiology and taxonomy and the anomaly of pharmacological inefficacy in recovery. The paper argues that the biological paradigm for understanding psychosis is in crisis and explores the implications for mental health nursing.
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Neill C, Read J. Adequacy of Inquiry About, Documentation of, and Treatment of Trauma and Adversities: A Study of Mental Health Professionals in England. Community Ment Health J 2022; 58:1076-1087. [PMID: 35094164 DOI: 10.1007/s10597-021-00916-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022]
Abstract
This study aimed to ascertain how often staff in community mental health services (CMHSs) in England ask about adverse experiences in childhood and adulthood, including abuse and neglect, how often those experiences are known about and documented by staff, and how staff respond when such experiences are known about and documented. The files of 400 people using four CMHSs in England were reviewed. Only 13% of clinical records contained documentation of any adverse experiences. One percent showed clear evidence that clients had been asked about adversities. People with psychosis diagnoses were less likely to have adverse experiences documented in their file. Rates of responses to adversities of which staff were aware were high, with 90% of records indicating some appropriate support following disclosure. Future research endeavours are recommended, including on reasons for not routinely asking and on type of training needed. Recommendations are made in relation to policy change, staff training and guidelines to improve routine enquiry about adversities. Ultimately, a move to 'trauma-informed' services, already underway in some areas, is required for all mental health services.
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Affiliation(s)
- Caitlin Neill
- School of Psychology, University of East London, Water Lane, London, E15 4LZ, UK
| | - John Read
- School of Psychology, University of East London, Water Lane, London, E15 4LZ, UK.
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Read J, Harper D, Tucker I, Kennedy A. Do adult mental health services identify child abuse and neglect? A systematic review. Int J Ment Health Nurs 2018; 27:7-19. [PMID: 28815844 DOI: 10.1111/inm.12369] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 11/26/2022]
Abstract
Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required.
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Affiliation(s)
- John Read
- School of Psychology, University of East London, London, UK
| | - David Harper
- School of Psychology, University of East London, London, UK
| | - Ian Tucker
- School of Psychology, University of East London, London, UK
| | - Angela Kennedy
- Tees, Esk and Wear Valleys National Health Service Foundation Trust, Darlington, UK
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Longden E. Listening to the Voices People Hear: Auditory Hallucinations Beyond a Diagnostic Framework. JOURNAL OF HUMANISTIC PSYCHOLOGY 2017. [DOI: 10.1177/0022167817696838] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While voice hearing (auditory verbal hallucinations) is closely allied with psychosis/schizophrenia, it is well-established that the experience is reported by individuals with nonpsychotic diagnoses, as well as those with no history of psychiatric contact. The phenomenological similarities in voice hearing within these different populations, as well as increased recognition of associations between adversity exposure and voice presence/content, have helped strengthened the contention that voice hearing may be more reliably associated with psychosocial variables per se rather than specific clinical diagnoses. Evidence is examined for understanding voice hearing as a psychological response to environmental stressors, and the implications of this for clinical practice. Consideration is also given to the impact of the International Hearing Voices Movement, an influential survivor-led initiative that promotes person-centered, nondiagnostic approaches to the voice-hearing experience.
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Affiliation(s)
- Eleanor Longden
- Greater Manchester West Mental Health NHS Foundation Trust, Prestwich, Manchester, UK
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Girard V, Tinland A, Bonin JP, Olive F, Poule J, Lancon C, Apostolidis T, Rowe M, Greacen T, Simeoni MC. Relevance of a subjective quality of life questionnaire for long-term homeless persons with schizophrenia. BMC Psychiatry 2017; 17:72. [PMID: 28212630 PMCID: PMC5314634 DOI: 10.1186/s12888-017-1227-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/01/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Increasing numbers of programs are addressing the specific needs of homeless people with schizophrenia in terms of access to housing, healthcare, basic human rights and other domains. Although quality of life scales are being used to evaluate such programs, few instruments have been validated for people with schizophrenia and none for people with schizophrenia who experience major social problems such as homelessness. The aim of the present study was to validate the French version of the S-QoL a self-administered, subjective quality of life questionnaire specific to schizophrenia for people with schizophrenia who are homeless. METHODS In a two-step process, the S-QoL was first administered to two independent convenience samples of long-term homeless people with schizophrenia in Marseille, France. The objective of the first step was to analyse the psychometric properties of the S-QoL. The objective of the second step was to examine, through qualitative interviews with members of the population in question, the relevance and acceptability of the principle quality of life indicators used in the S-QoL instrument. RESULTS Although the psychometric characteristics of the S-QoL were found to be globally satisfactory, from the point of view of the people being interviewed, acceptability was poor. Respondents frequently interrupted participation complaining that questionnaire items did not take into account the specific context of life on the streets. CONCLUSIONS Less intrusive questions, more readily understandable vocabulary and greater relevance to subjects' living conditions are needed to improve the S-QoL questionnaire for this population. A modular questionnaire with context specific sections or specific quality of life instruments for socially excluded populations may well be the way forward.
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Affiliation(s)
- V. Girard
- 0000 0001 2176 4817grid.5399.6Public Health Research Unit EA 3279, Aix-Marseille University, Marseille, France ,0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - A. Tinland
- 0000 0001 2176 4817grid.5399.6Public Health Research Unit EA 3279, Aix-Marseille University, Marseille, France ,0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - J. P. Bonin
- School of Nursing, University of Montreal and Fernand-Seguin Research Centre, Québec, Canada
| | - F. Olive
- 0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - J. Poule
- 0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - C. Lancon
- 0000 0001 2176 4817grid.5399.6Public Health Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | - T. Apostolidis
- 0000 0001 2176 4817grid.5399.6Social Psychology Unit EA849, Aix-Marseille University, 13621 Aix-en-Provence, France
| | - M. Rowe
- 0000000419368710grid.47100.32Yale Program for Recovery and Community Health, Yale University, New Haven, USA
| | - T. Greacen
- Maison Blanche Hospital Research Laboratory, Paris, France
| | - M. C. Simeoni
- 0000 0001 2176 4817grid.5399.6Aix Marseille Université, LPS EA 849, 13621 Aix en Provence, France ,0000 0001 0407 1584grid.414336.7Service d’évaluation médicale, AP-HM, Conception, 13005 Marseille, France
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Read J, Sampson M, Critchley C. Are mental health services getting better at responding to abuse, assault and neglect? Acta Psychiatr Scand 2016; 134:287-94. [PMID: 26852371 DOI: 10.1111/acps.12552] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine whether staff responses to abuse disclosures had improved since the introduction of a trauma policy and training programme. METHOD The files of 250 clients attending four New Zealand mental health centres were audited. RESULTS There was a significant improvement, compared to an audit prior to the introduction of the policy and training, in the proportion of abuse cases included in formulations, and, to a lesser extent, in treatment plans. There was no significant improvement in the proportion referred for relevant treatment, which remained at less than 25% across abuse categories. The proportion of neglect disclosures responded to was significantly lower than for abuse cases. Fifty percent of the files in which abuse/neglect was recorded noted whether the client had been asked about previous disclosure, and 22% noted whether the client thought there was any connection between the abuse/neglect and their current problems. Less than 1% of cases were reported to legal authorities. People diagnosed with a psychotic disorder were significantly less likely to be responded to appropriately. CONCLUSION Future training may need to focus on responding well to neglect and people diagnosed with psychosis, on making treatment referrals, and on initiating discussions about reporting to authorities.
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Affiliation(s)
- J Read
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Vic., Australia.
| | - M Sampson
- Clinical Psychologist, Taylor Centre, Auckland District Health Board, Auckland, New Zealand
| | - C Critchley
- Department of Statistics, Data Sciences and Epidemiology, Swinburne University of Technology, Melbourne, Vic, Australia
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Lang FU, Becker T. Trauma and mental health sequels require attention and integration in practical care. Acta Psychiatr Scand 2014; 129:480-1. [PMID: 24313928 DOI: 10.1111/acps.12240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- F U Lang
- Department of Psychiatry II, Ulm University, Ulm, Germany
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