Analysis of follow-up data on 123 adolescents treated over a four-year period indicates that intensive short-term residential treatment that includes emphasis on work with families, involvement in community activities, and discharge planning can be an effective means of helping youngsters with severe psychiatric disorders who have not responded to briefer or less intensive forms of psychiatric treatment.

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The results indicate masking can have an adverse impact on close relationships and psychological well-being. This study presents an initial basis for clinicians working with Parkinson's populations to recognize of the needs of people who experience masking and better support such individuals and their families to live satisfying social and emotional lives. Implications for Rehabilitation People who have Parkinson's and their families are often unaware facial masking is a symptom of Parkinson's disease. Masking may be confused with negative affect and become a barrier to satisfying close relationships. Masking related health resources and support are perceived to be of poor availability and quality. This qualitative study suggests masking be considered as an etiology of interpersonal and psychological difficulties in Parkinson's disease, and encourages better recognition of this unique population's health education needs.

The authors describe trends in inpatient psychiatric length of stay (LOS) and admissions for the population of children and adolescents (N = 784) at the Menninger Clinic from 1988 to 1994. During this period. median LOS declined dramatically from 7 months to 3 weeks, whereas admissions increased 4-fold. The diagnostic case mix changed substantially, with a crossover in modal principal diagnosis from personality disorder to affective disorder. Use of medications became almost universal. Diagnosis and medication use became less important determinants of LOS over time. The practical implications of these patterns include higher patient turnover, fewer inpatient clinical contact hours, and heightened importance of continuity with outpatient care. Research should center on the impact of declining LOS on clinical and functional outcomes for children and adolescents.

It is challenging, particularly in the unfamiliar and stressful environment of the antenatal unit, for midwives to assess emotional distress and needs for health information. Deliberate screening for antenatal distress might provide the opening for midwives to empower women to identify their options, strengths, and strategies for self-care and emotional resilience.

A CorrespondingObjective: To understand the experiences of twelve New Zealand women with medical complications in pregnancy.Method: Inductive, semantic, qualitative analysis was employed to obtain an in-depth insight into the experience of having a medical complication during pregnancy. Semi-structured interviews were conducted face-to-face with twelve women. Six had been hospitalised during their pregnancy, while a further six were recruited from outpatient settings.Findings: Five themes were identified: pregnancy distressing and overshadowed by complications; unpredictability and the need for control; importance of the relationship with midwives; disempowerment in hospital; and lessons learnt on the importance of support. Key conclusions:Medical complications during pregnancy can be extremely stressful and women feel particularly vulnerable during this time. Midwives play a key role in supporting women through the process of coping with a pregnancy marked by illness and uncertainty. Implications for practice: Midwives can play a unique role in translating medical jargon and providing emotional guidance and support. A midwife who is engaged and responsive to a woman's needs has the ability to lower distress at this critical juncture in the development of a woman and her family.

This study examined the mental health services available to severely emotionally disturbed children and adolescents in San Francisco. Social, familial, developmental, and clinical data---as

Clients who received crisis services at a homeless shelter for transition-aged youth were recruited for a study to describe the youth served, to track outcomes of care, and to examine factors associated with differing outcomes. Participants were 202 men and women who completed a battery of interviews and self-report measures at intake and at 3 follow-up points. Youth served had experienced high levels of adversity and trauma and typically had poor educational and vocational preparation. A multidisciplinary array of services was provided, and overall, participants showed significant improvement from intake to discharge and in the 6 months after discharge. Background, service, and psychological factors did not predict housing outcomes. Better vocational outcome was associated with more recent work experience. Results point to the need for providers of services to the homeless to be aware of the distinct needs and characteristics of transition-aged youth.