Leona L. Bachrach

Leona L. Bachrach
AOL

Doctor of Philosophy

About

122
Publications
4,564
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3,132
Citations
Introduction
Leona L. Bachrach is currently retired. Leona has done research in Abnormal Psychology, Health Psychology and Clinical Psychology. Her most recent publication is 'Some Perspectives on Deinstitutionalization'.

Publications

Publications (122)
Article
Full-text available
The authors discuss what can be learned from our experience with deinstitutionalization. The deinstitutionalization of mentally ill persons has three components: the release of these individuals from hospitals into the community, their diversion from hospital admission, and the development of alternative community services. The greatest problems ha...
Article
To examine the relationship between psychosocial rehabilitation and psychiatry with particular emphasis upon treatment of people who suffer from schizophrenia. Current literature is examined in an effort to identify prevailing premises and myths held by each discipline as it relates to the other. A working definition of psychosocial rehabilitation...
Article
There is a core of services whose specific content varies from place to place that still appears to belong to the state mental hospital.
Article
This analytical review is intended to update the author's earlier writings on the position of the state mental hospital within the spectrum of services for long-term mental patients and to provide a perspective for the next generation of service planners. Findings and commentary are organized around four major questions. First, what is the prevaili...
Article
Full-text available
RÉSUMÉ Objectifs : Cette revue analytique a pour objectif de mettre à jour les écrits précédents de l'auteure sur la place des hôpitaux psychiatriques publics dans l'éventail des services pour personnes souffrant de troubles mentaux chroniques, et de fournir une perspective à la prochaine génération de planificateurs des services. Méthodes : les ré...
Article
This analytical review is intended to update the author's earlier writings on the position of the state mental hospital within the spectrum of services for long-term mental patients and to provide perspective for the next generation of service planners. Findings and commentary are organized around four major questions. First, what is the prevailing...
Article
1. To examine the conceptual underpinnings of psychosocial rehabilitation and underscore its essential relationship to the practice of psychiatry. 2. To explore and dispel some misunderstandings and myths that practitioners in each field sometimes carry about the other. Literature review and observation. Psychiatry and psychosocial rehabilitation's...
Article
Originally published in Contemporary Psychology: APA Review of Books , 1994, Vol 39(10), 967-968. Reviews the book, Surviving Mental Illness: Stress, Coping, and Adaptation by Agnes B. Hatfield and Harriet P. Lefley (see record 1993-98185-000 ). This small volume, containing fewer than 200 pages of text, is so densely packed with citations and quot...
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Full-text available
People with chronic mental illness present complex challenges for the design of health care financing reforms. In this position statement from the committee on psychiatry and community of the Group for the Advancement of Psychiatry, the authors describe chronic and severe mental illnesses as psychiatric illnesses that require acute and ongoing psyc...
Article
Consensus does not yet exist about the definition of case management as it is practiced in the care of long-term mentally ill patients. Case management interventions may be arrayed on a continuum, with brokering and clinical approaches at the poles. However, most actual case management programs fall along the continuum and not at the extreme poles....
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Full-text available
The relationship between psychosocial rehabilitation and psychiatry in the care of long-term mental patients is one that may often be characterized, at best, as an uneasy alliance. The author summarizes the basic concepts that define the discipline of psychosocial rehabilitation and discusses how those concepts have at times been distorted in actua...
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Although extensive research on the homeless mentally ill population has been conducted, existing studies have failed to answer three important questions: the prevalence of chronic mental illness among homeless persons, whether deinstitutionalization has precipitated increased homelessness in this population, and what kinds of services should be off...
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Recognizes that effective service planning for the mentally ill requires an additional principle to the existing 12 principles. The 12 principles acknowledge the need for targeting of chronic mentally ill individuals as primary service recipients, the importance of strong and viable interagency linkages, and the necessity for comprehensive services...
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This month's column is based on a discussion of six papers that were presented at an international conference, Changing Mental Health Care in the Cities of Europe. Sponsored by the World Health Organization in cooperation with the City of Amsterdam Municipal Health Service, the conference was held April 10-13, 1991, in the Netherlands. The presenta...
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Services for chronic mental patients in this era of deinstitutionalization present a major challenge to clinicians and planners alike. The complexity of these patients' clinical and other programmatic needs requires that an array of viable comprehensive services be made available to them. Following certain established principles of service planning...
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Previous inattention to the specific circumstances of homeless mentally ill individuals in general hospital settings is discussed. Homeless mentally ill individuals who presented for emergency psychiatric care in a public general hospital setting exhibited distinctive patterns of service utilization and showed evidence of being a uniquely disabled,...
Chapter
Homeless mentally ill women clearly constitute what the President’s Commission on Mental Health (1978) in the Carter years termed a “special population”—a subpopulation of American citizens who experience extraordinary and often unremitting barriers to care. Indeed, several areas of “specialness” converge to affect the access of homeless mentally i...
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creative and innovative programs that may well be the envy of those who seek new and liberating solutions to the care of the chronic mentally ill. At the same time we have some systems of care whose gates are so rigidly kept that the most severely mentally ill individuals receive no services whatever. Many of them are homeless persons who seem unab...
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Services offered to chronic mental patients in state mental hospitals of the future are likely to be determined by a variety of forces external to the hospitals themselves.
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Public psychiatry strategies must take their direction both from past experience and from newly designed research efforts.
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The authors, reflecting on their combined experience of many years, comment on the status and direction of public psychiatry in an era of deinstitutionalization.
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Full-text available
Discusses problems associated with deinstitutionalization that have affected the course of psychiatric service delivery and comments on implications for future delivery of psychiatric services. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Recently at a social gathering I was introduced to someone who identified herself as the executive director of a community mental health center. Our conversation was but a few minutes old before she assured me that hers is the “new kind” of community mental health center: it has no medical staff or affiliation and makes no use of medical personnel....
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Three criteria--diagnosis, duration, and disability--are gaining currency in efforts throughout the United States to define the concept of chronic mental illness in a precise manner. However, there is presently no consensus on the specific character or relative importance of these criteria. Nor is there consensus on the nature of the interrelations...
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Homeless persons who received emergency psychiatric screening in a public general hospital exhibited patterns of gross geographic mobility. They did not uniformly avail themselves of community services, such as soup kitchens, and there were marked sex differences within the sample.
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Two variables are crucial to the development of treatment plans for chronic mental patients. Acceptance of the patient role and ability to form a therapeutic working alliance shape the clinical context within which treatment planning occurs.
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Although the growth and spread of homelessness in America is beginning to receive sustained public attention, few professional contributions acknowledge--much less deal with--gender differences. This analysis of an array of current literature explores dimensions of homelessness among women as an exceedingly complex sociological phenomenon with deva...
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In frankly focusing on the difficult patient qua patient, this chapter examines sociological and clinical correlates of a psychiatric treatment paradox: that the psychiatric service system often inappropriately serves or even fails to reach these patients who are typically desperately in need of care.
Article
Before I even begin my discussion of these thought-provoking papers, I want to issue-and then underscore-an important disclaimer. The remarks that I'm about to make are general kinds of comments on CMHCso We all know individual agencies that don't fit the general picture I'm going to be painting. I don't know of any way to get around this problem:...
Article
The evolution of general hospital psychiatry and the growth of the homeless mentally ill population in the United States have coincided temporally. Although the two have many points of confluence, their interaction has largely been of a last-resort variety, sometimes occurring by default and rarely adequately planned. The general hospital psychiatr...
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Discusses the concept that providers and systems of health care, rather than the patients, may be partially responsible for noncompliance. It is recommended that a true system of care and aftercare be developed with an adequate range and number of services and settings. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
of services for the chronic mentally ill who live in Juneau. First, there are the widely recognized problems that seem to plague service delivery throughout the United States. Juneau provides no exception to such issues as the absence of a consistent and predictable policy concerning entitlements for chronic patients. Along with other communities t...
Article
The author reviews the status of the state mental hospital and the chronic mental patient within the psychiatric service system and then examines the hospital's evolution from a systems perspective. She predicts that the state mental hospital will survive as an integral part of the service system, that it will be one of several loci of care for the...
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While most individuals naturally develop networks in the course of social and vocational activities, chronic mental patients may require the assistance of a mental health professional to develop viable networks. Such assistance, which is most needed at the time of placement out of the hospital and into the community, may range from facilitating or...
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The articles included in this special issue of the Community Mental Healthdournal adopt a variety of approaches to service planning for chronically mentally ill individuals. They treat this general topic from both research and theoretical perspectives, and they deal with a wide array of issues, such as state mental health system interventions, home...
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Of growing concern to service providers in this era of deinstitutionalization is an apparent increase in the population of chronic mental patients who experience problems in the area of substance abuse. While it is acknowledged that these individuals generally require special kinds of clinical interventions ~'2 relatively little attention has been...
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Emergency psychiatric services in the general hospital setting play an increasingly critical role in the nation's psychiatric service systems. It is essential that general hospital emergency psychiatric services develop a spirit of accommodation to and common enterprise with other psychiatric service delivery facilities.
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The theoretical basis of an integrated service approach to the care of chronic mental patients is discussed. An experiment testing the Treatment Network Team (TNT) program, based on that approach, is described and results are reported. Although TNT and control patients exhibited minimal differences in symptomatology and psychopathology, those in th...
Article
Program development for chronic mentally ill women is emerging in a climate where more general concerns relating to women's health and mental health are increasingly being examined. Although in the past the special needs of chronic mentally ill women have received scant attention in the professional literature, there is evidence today of a growing...
Article
The shift in responsibility for the care of chronic mental patients has generated a variety of problems for general hospital psychiatry. In response to these new demands, general hospital psychiatry has evolved a variety of effective strategies. Nevertheless, widespread concern over the appropriateness of serving chronic patients in an acute care s...
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A survey of male and female psychiatric administrators revealed that men often fail to realize that women are disadvantaged by such things as lack of mentors, sexism, and inflexible laws. The authors suggest several approaches to investigate the number of qualified women in administration and call for additional research to better understand such c...
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Full-text available
The paper examines the way in which semantics relates to policies of deinstitutionalization of persons with mental illness and mental retardation. Different understandings of common terms in the field are illustrated and it is suggested that the government plays many games, both number games and word games, in dealing with homeless people, migrant...
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Reviews and analyzes the literature concerning deinstitutionalization and women and highlights specific ways in which a major public policy initiative has affected the lives of both chronically mentally ill women and women who have been charged with the responsibility of caring for the chronically mentally ill. Special effects of deinstitutionaliza...
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Applied research that is conducted in an atmosphere of urgency carries an implied risk. In the near future, findings from a number of studies of the service needs of the homeless mentally ill will become available to planners and service providers. Users of data from these studies are cautioned to view the results with care. Specifically, they shou...
Article
The decision to change the primary locus of care for chronically ill psychiatric patients from the state mental hospital to the community has often set off a chain reaction of consequences. Notably, reducing the role of institutions has frequently resulted in destroying needed sanctuary for some patients. The author discusses the relationship betwe...
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A recently labeled psychiatric service entity, young adult chronic patients ( YACPs ), is gaining widespread recognition in the professional and popular literature. This analytical overview of the literature demonstrates that the YACP concept has been useful as an ideal construct by which current deficits in the psychiatric service system may be as...
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Assessments of the consequences of deinstitutionalization tend to focus primarily on observable changes in psychiatric services. Equally critical, and less often noted, are changes in the target population of deinstitutionalization that have accrued as the result of new service initiatives and changing loci of care. Young adult chronic psychiatric...
Article
This sociological review of the literature analyzes the delivery of psychiatric services in rural America. Nonsocial, demographic, socioeconomic, interpersonal, and ideological influences are considered. Factors encouraging change in the psychiatric service system (for example, shifting demographic realities, new environmental stimuli, and progress...
Article
The need for systems-oriented planning strategies is being increasingly recognized and a sophisticated body of literature on the essentials of comprehensive deinstitutionalization planning is beginning to emerge.

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