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dc.contributor.authorPalmer-Erbs Jung, Victoria Katherineen_US
dc.date.accessioned2019-04-08T17:39:37Z
dc.date.issued1992
dc.date.submitted1992
dc.identifier.otherb19735078
dc.identifier.urihttps://hdl.handle.net/2144/34649
dc.descriptionThesis (Ph.D.)--Boston Universityen_US
dc.descriptionPLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.en_US
dc.description.abstractThe American Psychiatric Association criteria for differential psychiatric diagnoses (DSM III-R) do not exhaust the list of socially problematic behaviors displayed by the mentally ill. The extent to which such behaviors influence a person's "career" as a deinstitutionalized patient is the major topic of this study. Fiscal crises and changing public commitments have reduced support to those with severe mental illness who are deinstitutionalized, increasing the importance of understanding how degrees of competence at activities of daily living and the extent of socially problematic behaviors affect their participation in the community. The concept Interactive Competence was developed on the basis of the writer's clinical experience and a review of the literature on community adjustment of persons with severe mental illness. The concept characterizes the social functioning of persons diagnosed as mentally ill, and includes demonstration of self-care (ADL) skills and self-management skills (trouble in relationships). Secondary analysis was performed on data from a 1984 probability sample of clients in Community Support Programs for seriously mentally ill adults. Factor analysis reduced items in the original instrument, The Uniform Client Data Instrument, to scales measuring Interactive Competence. Only persons with the diagnosis of Schizophrenia or Affective Disorders were studied (n=824 of 1053), excluding diagnoses which were diverse in nature and infrequent in occurrence. Bivariate correlation and regression techniques were used to test the major hypotheses: 1) Schizophrenics demonstrate less Interactive Competence than those with the diagnosis of Affective Disorder; 2) the greater the chronicity (length of time in the social role as a patient from point of first diagnosis) the less Interactive Competence; 3) lower level of Interactive Competence is associated with a lower level of mental health service utilization. Monitoring Interactive Competence self-care (ADL) skills and selfmanagement skills (trouble in relationships) provides new insights about the service utilization of the severely mentally ill and their families. Schizophrenics had less the Interactive Competence than those with Affective Disorders; those with lower scores on Interactive Competence used more services; family involvement influenced clients' use of crisis assistance services and urgent care services.en_US
dc.language.isoen_US
dc.publisherBoston Universityen_US
dc.subjectMental healthen_US
dc.subjectMental health servicesen_US
dc.subjectPsychiatryen_US
dc.titleInteractive competence and mental health service utilization among the severely mentally illen_US
dc.typeThesis/Dissertationen_US
dc.description.embargo2031-01-01
etd.degree.nameDoctor of Philosophyen_US
etd.degree.leveldoctoralen_US
etd.degree.disciplineSociologyen_US
etd.degree.grantorBoston Universityen_US
dc.identifier.barcode11719017588890
dc.identifier.mmsid99186336920001161


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