Madness and Literature

2022 ◽  

Mental illness has been a favourite topic for authors throughout the history of literature, and, conversely, psychologists and psychiatrists like Sigmund Freud and Karl Jaspers have been interested in and influenced by literature. Pioneers within philosophy, psychiatry and literature share the endeavour to explore and explain the human mind and behaviour, including what a society deems as being outside perceived normality. This volume engages with literature’s multifarious ways of probing minds and bodies in a state of ill mental health. To encompass this diversity, the theoretical approach is eclectic and transdisciplinary. The cases and the theory are in dialogue with a clinical approach, addressing issues and diagnoses such as trauma, psychosis, bipolar disorder, eating disorders, self-harm, hoarding disorder, PTSD and Digital Sexual Assault. The volume has three parts. Chapters in Part I address literary representations of madness with a historical awareness, outlining the socio-political potentials of madness literature. Part II investigates how representations of mental illness can provide a different way of understanding what it is like to experience alternative states of mind, as well as how theoretical concepts from studies in literature can supplement the language of psychopathology. The chapters in Part III explore ways to apply literary cases in clinical practice. Throughout the book, the contributors explore and explain how the language and discourses of literature (stylistically and theoretically) can teach us something new about what it means to be in ill mental health.

2021 ◽  
Author(s):  
Salima Farooq ◽  
Yasmin Parpio ◽  
Saadia Sattar ◽  
Zahra Ali ◽  
Shirin Rahim ◽  
...  

Abstract Background Globally, the prevalence of mental illness amongst university students is a major concern; same is the case with nursing students. Unaddressed mental illness stigma contributes towards hiding of symptoms hampers timely identification of the disease, and leads to reluctance in attitude towards seeking help. This study determined personal and perceived depression stigma and attitude towards help-seeking behaviors and its associated factors, among undergraduate nursing students at a private nursing institution in Karachi, Pakistan. Methods We conducted a cross-sectional study by recruiting 246 first and second-Year undergraduate nursing students using consecutive sampling. Data were collected using the Depression Stigma Scale (DSS) and the Attitude toward Seeking Professional Psychological Help Scale (ATSPPHS), along with a demographic questionnaire. Chi-square test, Fischer’s exact test and student T test were used to determine significance of difference of each response between first and second year students. Multiple linear regression was employed to determine predictors of DSS and ATSPPHS. Approval was obtained from the university’s Ethics Review Committee. Results The study findings revealed that the mean scores of the personal and perceived stigma scales were 29.7 ± 4.9 and 24.3 ± 6.1, respectively. The mean score of ATSPPHS was 16.5 ± 3.8. The participants reported a mean openness score of7.8 ± 2.6 and a value scale score of 8.7 ± 3.0. A history of psychiatric illness, current living arrangements, and personal depression stigma were found to be significant predictors of ATSPHHS. The year of study was a significant predictor of personal depression stigma whereas both years of study and the current living arrangements were significantly associated with perceived depression stigma. Conclusion Attitude towards seeking help for mental illness was significantly influenced by personal and perceived stigma. Moreover, previous history of psychiatric illness and living arrangements also predicted attitudes towards seeking help. In order to encourage positive attitudes towards seeking help for students’ well-being, it is essential to destigmatize mental health issues by adapting context-based, individualized, and group mental health interventions.


2021 ◽  
pp. 002580242110454
Author(s):  
Laureen Adewusi ◽  
Isabel Mark ◽  
Paige Wells ◽  
Aileen O’Brien

Individuals repeatedly detained under Section 136 (S136) of the Mental Health Act account for a significant proportion of all detentions. This study provides a detailed analysis of those repeatedly detained (‘repeat attenders’) to a London Mental Health Trust, identifying key demographic profiles when compared to non-repeat attenders, describing core clinical characteristics and determining to what degree a past history of abuse might be associated with these. All detentions to the S136 suite at South West London and St George's Mental Health NHS Trust over a 5-year period (2015–2020) were examined. Data were collected retrospectively from electronic records. A total of 1767 patients had been detained, with 81 patients identified as being a ‘repeat attenders’ (having had > = 3 detentions to the S136 suite during the study period). Repeat attenders accounted for 400 detentions, 17.7% of all detentions. Repeat attenders included a higher proportion of females (49.4%, p = 0.0001), compared to non-repeat attenders, and a higher proportion of them were of white ethnicity (85.2%, p = 0.001). 52 (64%) patients reported being a victim of past abuse or trauma. Of repeat attenders who reported past abuse or trauma, a high proportion had diagnoses of personality disorders, with deliberate self-harm as the most common reason for detention. They were more commonly discharged home with community support, rather than considered for hospital admission. In light of these findings, this paper discusses support potential strategies for those most vulnerable to repeated S136 detention, thereby minimising the ever-growing number of S136 detentions in the UK.


Author(s):  
Samuel Teague ◽  
Peter Robinson

This chapter reflects on the importance of the historical narrative of mental illness, arguing that Western countries have sought new ways to confine the mentally ill in the post-asylum era, namely through the effects of stigma and medicalization. The walls are invisible, when once they were physical. The chapter outlines how health and illness can be understood as socially constructed illustrating how mental health has been constructed uniquely across cultures and over time. To understand this process more fully, it is necessary to consider the history of madness, a story of numerous social flashpoints. The trajectories of two primary mental health narratives are charted in this chapter. The authors argue that these narratives have played, and continue to play, an important role in the social construction of mental illness. These narratives are “confinement” and “individual responsibility.” Drawing on the work of Michel Foucault and Roy Porter, the authors describe how Western culture has come to consider the mentally ill as a distinct, abnormal other.


Author(s):  
Debra Kram-Fernandez

This chapter is concerned with the impact of practitioner biases on the experience of a meaningful life for individuals who live with serious mental illness (SMI). Professional biases, systemic biases that originate in societal fear and lack of knowledge, and internalized stigma taken on by the consumer affect life decisions. Following a history of treatment initiatives experienced by consumers as abusive, it is important to understand how a system envisioned to protect and treat was often experienced as harmful. In the 1980s a movement emerged to transform the nature of mental health treatment to a client-centered, recovery-oriented model. In 1999, the Surgeon General proclaimed that all agencies serving this population should be recovery oriented. Yet, the shift to this approach to understanding people with SMI has not been complete. While there are many explanations why practitioners may not fully embrace this perspective, this chapter introduces the concept of “schemas” from cognitive behavioral theory as a way of examining professional biases in the field of SMI.


2021 ◽  
pp. 389-410
Author(s):  
Anjali Albuquerque ◽  
Neha P Chaudhary ◽  
Gowri G Aragam ◽  
Nina Vasan

Stanford Brainstorm, the world’s first lab for mental health innovation, taps into the combined potential of academia and industry—bridging medicine, technology, and entrepreneurship—to redesign the way the world views, diagnoses, and treats mental illness. Convergence science has facilitated Brainstorm’s emergence as a pivotal protagonist in the history of the mental health innovation field. In turn, Brainstorm has catalyzed innovation within mental health by applying convergent approaches to tackle the scope, immediacy, and impact of mental illness. Stanford Brainstorm’s thinking about mental health represents a shift in the discipline of psychiatry from a focus on one-to-one delivery to collaborative and sustainable solutions for millions.


2017 ◽  
Vol 41 (3) ◽  
pp. 156-159 ◽  
Author(s):  
Nuwan Galappathie ◽  
Sobia Tamim Khan ◽  
Amina Hussain

Aims and methodTo evaluate differences between male patients in secure psychiatric settings in the UK based on whether they are detained under civil or forensic sections of the Mental Health Act 1983. A cohort of patients discharged from a secure psychiatric hospital were evaluated for length of stay and frequency of risk-related incidents.ResultsOverall, 84 patients were included in the study: 52 in the forensic group and 32 in the civil group. Civil patients had more frequent incidents of aggression, sex offending, fire-setting and vulnerability, whereas forensic patients had more frequent episodes of self-harm.Clinical implicationsSecure hospitals should ensure treatment programmes are tailored to each patient's needs. Civil patients require greater emphasis on treatment of their mental illness, whereas forensic patients have additional offence-related treatment needs. Regular liaison between forensic and general adult services is essential to help ensure patients can return to appropriate settings at the earliest opportunity in their recovery.


2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Mitchell ◽  
Cornelius Ani ◽  
James Irvine ◽  
Claude Cyr ◽  
Ari Joffe ◽  
...  

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.


CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 638-650 ◽  
Author(s):  
Joel A. Dvoskin ◽  
James L. Knoll ◽  
Mollie Silva

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.


2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0023
Author(s):  
Richard Cameron Allred ◽  
Sara Stremlau ◽  
Richard Gerkin ◽  
Steven Erickson ◽  
Jamie Pardini

Background: The Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire (PHQ-9) are mental health screening instruments that assess symptoms of depression and anxiety. Studies of patients with concussion suggest that history of mental illness is associated with prolonged recovery; however, little research has examined the value of these tools in a concussed pediatric population (Iverson et al., 2017). Hypothesis/Purpose: The purpose of this study was to explore the relation between anxiety and depression symptoms, mental illness history, sex, and time to recover in a concussed pediatric population. We hypothesized that mental health symptoms and history, and female sex would predict longer recoveries in the pediatric population. Methods: IRB-approved retrospective chart review was used for data collection. Demographics, self-reported mental health history, GAD-7, and PHQ-9 scores were acquired for 250 adolescents ages 12-18 (45.2% female) who presented to an outpatient concussion clinic for their initial visit. Days to recover was imputed for all patients who had been discharged by clinic physicians based on international return to play standards. Results: Mann-Whitney U tests were used for analysis of this nonnormally distributed data. Males were found to recover more quickly than females (female median = 15 days, IQR 7-27; male median = 12 days, IQR 6-23; p=.013). No significant differences were observed in days to clearance based on reported history of mental health disorder (p=.066). Individuals who scored above cutoff (see Kroenke et al., 2001; Spitzer et al., 2006) on the GAD-7 (below cutoff median = 12.00 days; above cutoff median = 21.00 days) and PHQ-9 (below cutoff median = 23.5 days; above cutoff median = 57.00 days) required longer recovery times (p <.001). Conclusion: We found longer recovery times in females versus males, and in those whose scores fell above cutoff for the PHQ-9 and GAD-7 at their initial clinic visit. Although a trend existed, there were no significant differences in recovery time for those who reported a mental health history compared to those who did not. Results suggest that the GAD-7 and PHQ-9 may be useful screening measures in a concussion clinic and may provide additional insight into potential recovery times for pediatric patients.


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