Economic conditions and mental hospitalization for functional psychosis

Economic downturns and population mental health: research findings, gaps, challenges and priorities

Prior research suggests that the current global economic crisis may be negatively affecting population mental health. In that context, this paper has several goals: (1) to discuss theoretical and conceptual explanations for how and why economic downturns might negatively affect population mental health; (2) present an overview of the literature on the relationship between economic recessions and population mental health; (3) discuss the limitations of existing empirical work; and (4) highlight opportunities for improvements in both research and practice designed to mitigate any negative impact of economic declines on the mental health of populations. Research has consistently demonstrated that economic crises are negatively associated with population mental health. How economic downturns influence mental health should be considered in policies such as social protection programs that aim to promote recovery.

Short-term economic change and the utilization of mental health facilities in a metropolitan area

The relationship between economic change and mental disorder has been examined by several investigators over the past century. The purpose of this paper is to explore this basic relationship and determine its direction in a large Metropolitan area. A time series analysis was undertaken to investigate whether or not unemployment and indicators of mental health are related over time. Trends in the following four indicators of mental health were examined: 1. Number of admissions to all psychiatric facilities serving Metropolitan Toronto. 2. Number of admissions to one provincial psychiatric hospital (Queen Street Mental Health Centre) in Toronto, which serves a chronic population. 3. Number of discharges from Queen Street Mental Health Centre. 4. Number of admissions plus those assessed and not admitted to Queen Street Mental Health Centre. In order to assess the possible delayed effects of unemployment, correlation analyses were computed for several lag times. "Lag time" is defined here as the time delay between unemployment and its potential effects on mental health indicators. Lag times used were zero, three, six and twelve months. The best equation found was for a six month lag, indicating an inverse relationship; as unemployment increases, admissions and discharges decrease. Results suggest that there are no simple relationships between the dependent and independent variables. Observed trends may be due to much wider exogenous factors such as hospital capacity and changing admission criteria.

Psychosocial outcome in schizophrenia and psychotherapeutic orientation

The purpose was to compare the psychosocial outcome in two groups of schizophrenic patients who were treated by different methods but were in other respects unselected, and to consider factors predictive of the outcome. The first sample, consisting of a total of 100 patients, had received hospital and outpatient care, here called traditional; only 12 of them had received sustained psychotherapy. Of the second sample, comprising 75 patients, 66 were treated in a psychotherapeutic community and 25 also received sustained psychotherapy. All patients were interviewed by the author on an average of 8 years after the first hospitalization. The patients treated in the psychotherapeutic community had remained longer under hospital care, particularly at first, and at the end of follow-up their functional capacity was lower, but they were more satisfied with the treatment received compared with the patients treated traditionally. The samples did not differ in terms of clinical status. The severity of the schizophrenic disorder, including diagnostic category, and a tendency toward grandiose thinking emerged as the most important factors predictive of psychosocial outcome. Premorbid psychosocial development and social support were also relevant to the outcome. After taking the predictor variables into account, extensive hospital care was still associated with a poor outcome. This may in part explain why, despite the greater amount of psychotherapy provided, the functional capacity of the patients who received psychotherapeutic community treatment had poorer outcome than those treated traditionally.