Modelo de intervención y retos en el acogimiento familiar: la experiencia de la Fundación Márgenes y Vínculos / No disponible

En este trabajo se realiza una aproximación a la intervención profesional en acogimiento familiar en Andalucía, exponiendo información relevante acerca de las Instituciones Colaboradoras de Integración Familiar (ICIF) habilitadas en nuestra comunidad autónoma y deteniéndonos particularmente en la práctica profesional de la Fundación Márgenes y Vínculos de Sevilla. Dicha práctica profesional está regulada en un marco jurídico al cual se hace referencia. Se define la diversa tipología del recurso de acogimiento familiar y se lleva a cabo un acercamiento a la población con quienes se desarrolla el quehacer profesional en el día a día. En el presente artículo también se presenta un recorrido a través de las diferentes fases del trabajo profesional en acogimiento familiar y las funciones que desempeña el equipo multidisciplinar. Finalmente, se recogen los retos actuales en el acogimiento familiar, tratando mirar hacia el futuro en una medida que cada vez adquiere una mayor relevancia en el sistema de protección de menores

In this paper, we provide insight into professional intervention in foster care in Andalusia. We expose further information about the Family Integration Collaborating Institutions (ICIF in Spanish) enabled in Andalucía and we particularly focus on the professional practice of Fundación Márgenes y Vínculos in Seville. This professional practice is regulated by a legal framework which we also reference in the paper. At the same time, we define the typology of fostering and we approach the foster population on which our daily professional practice is based. In the paper, we present several phases of professional work in foster care and tasks relevant to multidisciplinary team. Finally, the current challenges of fostering are explained in order to look to the future of foster care, a measure that is becoming increasingly relevant in child protection system

La investigación en acogimiento familiar: de la descripción a los procesos de adaptación y desarrollo / No disponible

Este artículo presenta una revisión de algunas líneas de investigación centradas en el acogimiento familiar sobre las que sería conveniente ampliar nuestro conocimiento, particularmente en España. Para que la medida de acogimiento familiar se ajuste mejor a las necesidades de los menores es fundamental dar el salto de los estudios descriptivos al análisis de los procesos relacionados con una mejor adaptación. Con motivo de una investigación actualmente en marcha por los autores, en este artículo se repasan algunas de las áreas más relevantes para el desarrollo de los menores en acogimiento familiar que aún están escasamente estudiadas. Concretamente, las áreas revisadas son la auto-regulación, las representaciones mentales de apego, la salud mental y la familia acogedora como contexto de recuperación. En cada una de ellas se subraya su importancia en el acogimiento familiar y se repasan los estudios más relevantes. El artículo finaliza con algunas conclusiones derivadas de la revisión

The current paper is a review of some research lines on foster care in which we need a greater knowledge, particularly in Spain. If we want foster care to be better adjusted to children needs, it is essential to move beyond descriptive studies to tackle processes and mechanisms that lead to a better adjustment. This article reviews some of these relevant areas for children development that are still scarcely studied in foster care, in line with a current research project by the authors. The areas reviewed are self-regulation, mental representations of attachment, mental health and the foster family as a context for recovery. In each area, it’s emphasized its relevance for foster care, and the major studies are reviewed. The article ends with some conclusions derived from the literature review

Custodian for elderly with memory impairment in Sweden - a study of 260 physicians' statements to the court.

BACKGROUND: In the modern world with new family structures, international migration and increased life expectancy, there is a growing need for legal ways of assisting elderly with impaired mental capacity to decide about their life and assets. There are few studies about the physician's role when a court appoints proxies for vulnerable elderly. Many doctors do not know how to assess mental capacity, and most lawyers and judges know little about medicine. METHODS: Applications for a custodian sent to the Stockholm Chief Guardian' Office in Sweden were used. Physician's statements to the court for elderly with memory impairment were selected and 260 statements were scrutinized with regard to formal quality, the narrative content and the physician who wrote it. RESULTS: The quality of the statements varied from one sentence to excellent. Most statements were written by senior family practitioners or geriatricians. Seventeen % of the statements were handwritten and had more formal shortcomings than machine/computer written statements.The majority of patients needed massive help with daily life and economy. Median age was 84 years of age. MMSE score was given in 20% of the cases and varied from 6-27.A diagnosis of dementia was established in 57%. At the time of application, at least 48% were in a hospital or nursing home and at least 27% were in their private home. Only 5% were living with a spouse or a child. In 53% of the cases, the doctor knew the patient, but in 40% of the cases, the identity of the patient was not confirmed. The physician found that 54% were unable to understand the idea of getting a custodian, but out of those very vulnerable elderly, 20% had signed consent and 57% were considered able to be heard in court. CONCLUSIONS: There is a large variation in the quality of physicians' statements to the court concerning the mental capacity of elderly patients with cognitive impairment. Many statements have serious short-comings, and the system is not safe. There is a strong need for guide-lines, and additional training for all professionals involved.

Saúde mental, democracia e responsabilidade / Mental health, democracy and responsability

No presente artigo se abordam as relações entre saúde mental e as tarefas atuais da democracia no Brasil e, nesse contexto, os desafios que os Hospitais de Custódia e Tratamento Psiquiátrico representam para o campo da saúde mental. Considera-se que os Manicômios Judiciários, sua lógica, sua população constituem uma das últimas fronteiras relativamente resistentes ao avanço do movimento antimanicomial. Com sua especificidade e ambiguidade, entre o crime e a loucura, eles produzem e reproduzem de maneira prática o mito da periculosidade. Nesse contexto, o artigo examina, especificamente, a questão da responsabilidade do louco infrator

Saúde mental, democracia e responsabilidade / Mental health, democracy and responsability

No presente artigo se abordam as relações entre saúde mental e as tarefas atuais da democracia no Brasil e, nesse contexto, os desafios que os Hospitais de Custódia e Tratamento Psiquiátrico representam para o campo da saúde mental. Considera-se que os Manicômios Judiciários, sua lógica, sua população constituem uma das últimas fronteiras relativamente resistentes ao avanço do movimento antimanicomial. Com sua especificidade e ambiguidade, entre o crime e a loucura, eles produzem e reproduzem de maneira prática o mito da periculosidade. Nesse contexto, o artigo examina, especificamente, a questão da responsabilidade do louco infrator(AU)

The evolving role of the state hospital in the care and treatment of older adults: state trend, 1984 to 1993.

OBJECTIVE: To understand the current and potential role of state hospitals in serving geriatric patients, national trends in the use of state mental hospitals by adults age 65 and older were examined. METHODS: State hospital use by older adults in the 50 states and the District of Columbia was compared for the years 1984 and 1993 using published data from the Center for Mental Health Services. RESULTS: Nationally, the number of state hospital admissions and residents declined between 1984 and 1993, and the rate of decrease was greater for older adults than for younger adults. However, states varied considerably in the rate of decrease in the number of older adult state hospital residents and admissions and in the proportion of older adult patients diagnosed with an organic mental disorder. In ten states, the older-adult state hospital population increased. CONCLUSIONS: Although the national trend is toward a declining role for state hospitals in treatment and care of older adults, in several states the hospitals fill an important function in providing custodial care and acute care for this population.

Housing for people with mental illnesses: a comparison of models and an examination of the growth of alternative housing in Canada.

The decrease over the past three decades in institutional care for people with mental illness has not been matched by the adequate development of specialized housing in the community. Broadly speaking, two major models of housing have emerged in the past 30 years: custodial and alternative. Large custodial settings, including boarding houses, nursing homes and special care homes, are typically not associated with residents' satisfaction or a positive outcome. Alternative housing refers to a range of models, including halfway houses, group homes, co-ops and supported housing. It is associated with better residents' outcomes. This paper briefly compares the two models and examines key issues in alternative housing and its development in Canada.

From asylum to community. The threatened disintegration of public psychiatry.

Before 1950, publicly supported psychiatric services (i.e., those of so-called public psychiatry) were provided primarily at state hospitals. Over the past 30 years public psychiatry has shifted its emphasis away from long-term custodial care to outpatient and community-based services. Paradoxically, this broadening of focus has become associated with both an expanded use of psychiatric services and a threatened decline in clinical standards and treatment goals. Five areas of policy confusion and contradiction threaten the stability of public mental-health services: the shift in emphasis from public to private services, the issue of rehabilitation and reintegration into society versus custodial care, the differential treatment of the lower-class patient, the demedicalization of public services, and conflict between professionals and blurring of roles within the psychiatric profession. These problems reflect public psychiatry's overemphasis on social reform and political rather than clinical definitions of treatment, its lack of specific treatment and of defined treatment goals, and its inability to change psychiatry's (and society's) historical assignment of low status to the public patient.

Current trends of mental health care in Belgium.

Till 1970, most psychiatric patients were "treated" in legally closeed wards. The nursing and medical personnel were scarce. A fundamental change is now slowly taking place. From a legal point of view, many patients forcedly admitted are no longer under this legal status. From a hospital point of view, new standards have been enforced concerning medical and paramedical personnel, architecture and function. Another fact: in 1972 the closed psychiatric institutes were at last regarded as hospitals. Paralleling these changes, an effort is being made to create mental health services outside of the hospital. All of these modifications should allow the setting up of a curative and preventive psychiatry. The therapeutic function of the hospital should replace the residential function of the psychiatric hospitals.