International review of psychiatry
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Review
Rehabilitation: new term for or further development of social psychiatry? A Dutch perspective.
Social psychiatry as an academic discipline and field of clinical practice seems to have lost its prominence and is being incorporated in regular clinical services of mental healthcare and also in various branches of social, genetic, psychiatric or clinical epidemiology. However, the central debate in social psychiatry from its very beginning on how to care best for patients with severe mental illness (SMI) in the community, what to do with mental hospitals as potentially harmful pernicious institutions or with the hospitalization process, has never lost its momentum even in scientific meetings today. ⋯ Rehabilitation as an ideological and somewhat revolutionary movement of users and professionals in wanting to produce a fundamental change of mental healthcare (e.g. no compulsory treatment) and of society (e.g. elimination of stigma) developed its methods away from medicine and psychiatry and also away from testing these methods. Nowadays we observe growing scientific evidence for various psychosocial rehabilitative interventions which could substantiate the original mission of social psychiatry.
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Although Parkinson's disease (PD) has been considered to primarily affect motor abilities, increasing emphasis is being placed on cognitive and behavioural impairment in this disorder. Depression, dementia, psychosis and impulse control disorders have a major impact on quality of life for both patients and families. This article reviews cognitive and behavioural disturbances in PD and their relation to affective and motor symptoms, treatment of dementia associated with PD, and treatment approaches to psychosis in PD. We also discuss similarities between the dementia of PD and dementia with Lewy bodies.
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Mental health policy enables the translation of the knowledge base of 'how' to help children and families into the actual 'provision' of help. Amid competing pressures to leave the allocation of services to the market, policy is required to define needs, select priorities, match resources with need, and to measure what has been accomplished. Crafting policy requires balancing contrasting goals and approaches, here spelled out. Public mental health policy can be compared to other forms of continuous quality improvement (CQI).
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To improve mental health care in Nepal, a National Mental Health Policy, Strategy and Plan of Action was approved by the Government in 1997. Nepal has high vulnerability to natural disasters compounded by a prolonged violent civil conflict affecting almost all districts of the country. Floods, landslides and earthquakes are the most regularly occurring disasters in Nepal. ⋯ In 2003 guidelines on best public health practices in emergencies for district health workers was developed in which the minimum standard and indicators include aspects of mental and social aspects of health. The experience of the complex emergency in April 2005 showed that in general the emergency preparedness plan has not been prepared well enough, but on the other hand the health system was able to cope quite well because of past training. Further strengthening of the mental health and psychosocial aspects of disaster preparedness is strongly recommended.