SUMMARY. Old age may involve a sense of loss which needs working through if psychological health is to be achieved. Rigid ideas about the capabilities of the elderly may lead to a failure to explore useful therapies. Expressive therapy in a group proved to be a fruitful way forward for elderly patients in a day hospital. Fifteen structured sessions were held, which involved role play, art and music. The therapists hoped the clients would gain some insight into their potential strengths and also an acceptance of their limitations.
The patients who appeared to benefit most from the clinic were suffering from schizophrenia. Their reattendance rate was significantly higher than nonschizophrenic patients. Out of 63 schizophrenic patients, 30 became long attenders compared to 65 out of 197 non-schizophrenic patients (X 2 =5, P < 0.025). It was felt that the open access policy was pivotal in this respect. The mental state of many of these patients was stabilised or improved. It is likely that some would have deteriorated rapidly without psychiatric care, eventually requiring hospital admission. Of the chronic schizophrenic patients, 37 (59%) had not been receiving psychiatric care for six months prior to their first consultation with us, suggesting that they had been lost to previous follow-up. Despite this about half became long attenders at our clinic.Sixty-two per cent were initially managed at the clinic; 80/0 were admitted voluntarily to hospital; 80/0 to a detoxification unit and 5% to our sick bay. Over half of patients attended only once. There are many factors underlying this. Our non-prescribing policy for opiates and reluctance to prescribe benzodiazipines except on a short-term basis was undoubtedly unattractive to some. Others had only self-limiting problems, in particular those with neurosis or personality disorder in crisis, and follow-up in such cases would not be expected. However, we were also aware that some mentally ill homeless did not reattend more out ofchoice than for obvious external reasons. It is also likely that despite the ease of access to our clinic some homeless would still not attend.It is not unique for psychiatrists to work in a general practice setting and this is usually found to be satisfactory. This system has many advantages in dealing with the single homeless. Referrals can be
Occupational therapy as a discipline (Finlay, 1988) has grown and matured with time. It has moved away from an ill-defined, imprecise and informal discipline to one which, while treating the patient as a whole being, nevertheless attempts to identify an individual's unique problems and treats them through purposeful activity. It strives to attain the qualities of a holistic, goal-orientated objective process.
The bulk of transcultural research has concentrated on particular themes, which include parasuicides among British Asian women, schizophrenia among Afro-Carribeans, and clinical presentation of somatisation in different races (Littlewood & Lipsedge, 1989). The focus has largely been on clinical patterns of illness and the social determinant of distress as experienced by ethnic minorities in the community remains largely neglected. An attempt has been made, after two years experience of working in a Birmingham city catchment area with an Asian Muslim community, to highlight day to day cultural issues which directly or indirectly contribute to psychiatric morbidity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.