These limitations notwithstanding, the findings presented here may be useful Elsa Peretti Bean bracelet bringing home the message that risk of violence among persons with SMI is a significant problem that must be considered in a broad context, with a particular emphasis on social-environmental factors. Individuals with SMI who should raise the most concern are those with combined risk factors in several domains-past traumatic experiences, current clinical problems including substance abuse comorbidity, and continuing exposure to adverse social environments characterized by everyday violence.
Effective interventions to reduce risk of violence among persons with SMI must be Venetian Link bracelet yet specifically targeted-addressing underlying major psychiatric disorder but also addiction, trauma sequelae, domestic violence, and need for housing, income, and community support Our findings suggest that there may be several specific subgroups within the population of individuals with SMI who are at increased risk for violent behavior. For example, 1 subgroup may be suffering primarily from the long-term complications of violent victimization, which may have begun in early life and is recurrent in adulthood. Addressing violent behavior in this group may require a specific clinical focus on posttraumatic stress problems. Another subgroup may consist of Tiffany 1837 cuff in conflict-laden domestic relationships that may require relationship counseling, conflict resolution, anger management, or domestic violence interventions. A third subgroup may comprise of persons who are frequently homeless. Appropriate interventions in this group could focus on achieving stable housing in conjunction with delivery of mental health services.
Interventions may need to include treatment for alcohol addiction or substance abuse Tiffany 1837 bangle with appropriate medical management of a primarily psychiatric illness that addresses the additional complication that substance abuse often poses for treatment adherence. A legal approach such as assisted outpatient treatment (or involuntary outpatient commitment) may be warranted in addressing treatment nonadherence.31All of these approaches require significant resources, both in terms of identification and assessment of the problem and in terms of delivery of specific services. However, better-- focused and -targeted interventions that assess and anticipate risk of violence could reap very worthwhile benefits, given the dimensions and cost of the problem of community violence in persons with SMI and, perhaps more to the point, its tragic consequences in many lives and in society in general if not prevented.AcknowledgmentsThe Mental Health Matrix: A Manual to Improve Services, by Graham Thornicroft, Ph.D., M.R.C.Psych., and Michele Tansella, M.D. New York, Cambridge University Press, 1999,280 pp., $85.00.
Psychiatric care for more than 100 years has been more of a public responsibility than has Tiffany 1837 cuff in other areas of medicine. Mental illness, because of concerns about social control and economic dependency, continues to be a community responsibility at local, regional, and national levels. Direct treatment and related supportive services are paid for with tax dollars, and the political marketplace has been even more important than the economic marketplace in the opportunities available to individuals and families for care and support.
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