Does the length of institutionalization matter? Longitudinal follow-up of persons with severe mental illness 65 years and older: shorter-stay versus longer-stay.

OBJECTIVES: As part of the process of de-institutionalization in the Swedish mental healthcare system, a reform was implemented in 1995, moving the responsibility for services and social support for people with severe mental illness (SMI) from the regional level to the municipalities. In many ways, older people with SMI were neglected in this changing landscape of psychiatric care. The aim of this study is to investigate functional levels, living conditions, need of support in daily life, and how these aspects changed over time for older people with SMI. METHODS: In this study we used data from surveys collected in 1996, 2001, 2006, and 2011 and data from national registers. A group of older adults with severe persistent mental illness (SMI-O:P) was identified and divided into those who experienced shorter stays (less than 3 years) in a mental hospital (N = 118) and longer stays (N = 117). RESULTS: After correcting for longitudinal changes with age, the longer-stay group was more likely than the shorter-stay group to experience functional difficulties and as a result, were more likely to have experienced 're-institutionalization' to another care setting, as opposed to living independently. CONCLUSIONS: The length of mental illness hospitalization has significant effects on the living conditions of older people with SMI and their ability to participate in social life.

A reinstitucionalização de crianças e adolescentes na região oeste de Natal/RN / The reinstitutionalization of children and adolescents in the west of Natal-RN / La reinstitucionalización de niños y adolescentes en la región oeste de Natal/RN

O objetivo do presente artigo é analisar a incidência de casos de reinstitucionalização de crianças e adolescentes e discutir como a política de atendimento a essa população está organizada para fortalecer a função protetiva da família. Para tanto, foi realizada pesquisa documental em bancos de dados oficiais. Estes dados foram posteriormente categorizados e analisados à luz dos princípios da Doutrina da Proteção Integral. Nas análises documentais foram encontradas 81 Guias de Acolhimento que apontavam a reinstitucionalização. Destas, 34,6% referiam-se a acolhidos cujas famílias eram oriundas da Região Administrativa Oeste. Os dados apontam que a reinstitucionalização das crianças e adolescentes pode possuir forte relação com a situação de pobreza e ausência do Estado na proposição de políticas públicas efetivas.

The purpose of this article is to analyze the incidence of cases of new institutionalization of children and adolescents and to discuss how the policy of attending to this population is organized to strengthen the family's protective function. For this, a documentary research was carried out in official databases. These data were later categorized and analyzed. In the documentary analyzes were found 81 Guidance Reception that pointed to the new institutionalization. Of these, 34.6% referred to foster families whose families came from the Western Administrative Region. The data indicate that the new institutionalization of children and adolescents may have a strong relationship with the situation of poverty and absence of the State in proposing effective public policies.

El objetivo del artículo es analizar la incidencia de casos de reinstitucionalización de niños y adolescentes y discutir cómo la política de atención a esa población está organizada para fortalecer la función protectora de la familia. Para eso, se realizó una investigación documental en bases de datos oficiales. En los análisis documentales se encontraron 81 Guías de Acogimiento que apuntaban a la reinstitucionalización. De estas, el 34,6% se refería a acogidos cuyas familias provenían de la Región Administrativa Oeste. Los datos apuntan que la reinstitucionalización de los niños y adolescentes puede tener una fuerte relación con la situación de pobreza y ausencia del Estado en la propuesta de políticas públicas efectivas.

Origin, consolidation, and perspectives of Work and Organizational Psychology / Origem, consolidação e perspectivas da Psicologia das Organizações e do Trabalho / Origen, consolidación y perspectivas de la Psicología de las Organizaciones y del Trabajo

This essay is a reflection on the trajectory of Work and Organizational Psychology (WOP). The content analyzes its growth and introduction into society. Along this path, WOP took on the phenomena and problems of the relationships between individual, work, and society. Today, WOP presents a set of scientific, technical, and cultural productions integrating the conceptual and instrumental patrimony of society. WOP has enriched the understanding of performance at work by applying the concepts of Psychology to explain the relation between behavior and subjectivity. Facing the re-institutionalization of work from a form of employment to one of precarious autonomous work, WOP will be challenged to understand new phenomena that will arise within its territory. Its solid experience and firmness in the search for efficacy and for existential conditions sustains the assurance with which it faces the evolution of economic production. WOP has become a specialization capable of responding to the re-institutionalization of work now in progress in society.

Este ensaio consiste numa reflexão sobre a origem e trajetória da Psicologia das Organizações e do Trabalho (POT). Seu conteúdo analisa sua construção e inserção na sociedade. Nessa trajetória, a POT assumiu os fenômenos e problemas das relações entre a pessoa, o trabalho e a sociedade e ganhou confiança dos gestores e da sociedade. Hoje, a POT apresenta produção científica, técnica e cultural no patrimônio conceitual e instrumental da sociedade. A POT enriqueceu a compreensão do desempenho no trabalho aplicando conceitos da Psicologia na interface comportamentos e subjetividade. Diante da institucionalização do trabalho da forma dos empregos para o trabalho autônomo precário, a POT será desafiada pela compreensão de novos fenômenos. A solidez de sua experiência e sua firmeza na busca da eficácia e das condições existenciais alimentam sua segurança frente à evolução da produção econômica. A POT tornou-se capacitada para enfrentar a atual reinstitucionalização do trabalho, na sociedade.

Este ensayo es un análisis de la trayectoria de la Psicología de las Organizaciones y del Trabajo (POT). Su contenido expone su origen e inserción en la sociedad asumiendo los fenómenos y problemas entre la persona, el trabajo y la sociedad. Hoy, la producción conceptual, técnica y cultural de la POT integra el patrimonio instrumental de la sociedad. La POT enriqueció la comprensión de la relación entre el desempeño y la subjetividad. Delante de la reinstitucionalización del trabajo como empleo para actividad autónoma precaria, nuevos fenómenos y problemas surgirán para los cuales la POT está capacitada y motivada. Su experiencia y firmeza en búsqueda de la efectividad del desempeño y de las condiciones de existencia la capacitan para enfrentar eses nuevos fenómenos y problemas en la evolución de la producción económica.

How has the extent of institutional mental healthcare changed in Western Europe? Analysis of data since 1990.

OBJECTIVES: It has been suggested that since 1990, de-institutionalisation of mental healthcare in Western Europe has been reversed into re-institutionalisation with more forensic beds, places in protected housing services and people with mental disorders in prisons. This study aimed to identify changes in the numbers of places in built institutions providing mental healthcare in Western Europe from 1990 to 2012, and to explore the association between changes in psychiatric bed numbers and changes in other institutions. SETTINGS AND DATA: Data were identified from 11 countries on psychiatric hospital beds, forensic beds, protected housing places and prison populations. Fixed effects regression models tested the associations between psychiatric hospital beds with other institutions. RESULTS: The number of psychiatric hospital beds decreased, while forensic beds, places in protected housing and prison populations increased. Overall, the number of reduced beds exceeded additional places in other institutions. There was no evidence for an association of changes in bed numbers with changes in forensic beds and protected housing places. Panel data regression analysis showed that changes in psychiatric bed numbers were negatively associated with rising prison populations, but the significant association disappeared once adjusted for gross domestic product as a potential covariate. CONCLUSIONS: Institutional mental healthcare has substantially changed across Western Europe since 1990. There are ongoing overall trends of a decrease in the number of psychiatric hospital beds and an increase in the number of places in other institutions, including prisons. The exact association between these trends and their drivers remains unclear. More reliable data, information on the characteristics of patients in different institutions, long-term pathway analyses and effectiveness studies are required to arrive at evidence-based policies for the provision of institutional mental healthcare.

The process and inspiration of deinstitutionalization of mental health institutions of USA and other countries / 中华医院管理杂志

During past 50 years,has achieved a great progress and derived some profound lessons worthy of learning and studying for our country.This article introduces the deinstitutionalization processes of mental health institutions,reinstitutionalization and the inspiration for Chinese mental health reform.Introduced the paper are the reform of deinstitutionalization of mental health institutions in USA and some other countries,and the concept of such a reform,pointing out inspirations of such a reform for mental health reform in China.