We argue that the notion of "mental institutions"-discussed in recent debates about extended cognition-can help better understand the origin and character of social impairments in autism, and also help illuminate the extent to which some mechanisms of autistic dysfunction extend across both internal and external factors (i.e., they do not just reside within an individual's head). After providing some conceptual background, we discuss the connection between mental institutions and embodied habits of mind. We then discuss the (...) significance of our view for understanding autistic habits of mind and consider why these embodied habits are sometimes a poor fit with neurotypical mental institutions. We conclude by considering how these insights highlight the two-way, extended nature of social impairments in autism, and how this extended picture might assist in constructing more inclusive mental institutions and intervention strategies. (shrink)

We propose to extend Clark and Chalmer’s concept of the extended mind to consider the possibility that social institutions (e.g., legal systems, museums) may operate in ways similar to the hand-held conveniences (notebooks, calculators) that are often used as examples of extended mind. The inspiration for this suggestion can be found in the writings of Hegel on “objective spirit” which involves the mind in a constant process of externalizing and internalizing. For Hegel, social institutions are pieces of the (...) mind, externalized in their specific time and place. These institutions are the products of shared mental processes. We then use these institutions instrumentally to do further cognitive work, for example, to solve problems or to control behavior. (shrink)

Work on situated cognition and affectivity holds that cognitive and affective processes always occur within, depend upon, and, perhaps, are even partially constituted by the surrounding social and environmental contexts. What some philosophers call a ‘mental institution’ consists of various tools and technologies that help people to solve a particular problem and scaffold their cognitive and affective processes in various ways. Examples include legal systems, scientific practice, and educational systems. I propose that insofar as it centers around technology and (...) involves a particular set of rules, practices, and shared expectations, the online learning environment can be understood as a mental institution. It shapes not only what and how students learn, but also how they understand the value and fundamental aims of learning. I argue that insofar as this mental institution both reflects and perpetuates neoliberal aims and values, it is in danger of limiting students’ communicative abilities and soliciting them to view higher education in distorted, limiting ways. (shrink)

One particularly influential strand of the contemporary philosophical literature on the metaphysics of social institutions has been the collective acceptance approach, most prominently advocated by John Searle and Raimo Tuomela. The continuing influence of the collective acceptance approach has resulted in alternative accounts that either preserve a role for collective acceptance, or replace it with some other kind of mental state. I argue that this emphasis on the mental in the metaphysics of social institutions is a (...) mistake. First, I raise problems for the collective acceptance approach itself, then for pluralist approaches that preserve a role for collective acceptance, and finally for approaches that replace collective acceptance with individual mental states such as beliefs and intentions. Lest my arguments undermining these approaches to the metaphysics of social institutions seem to also undermine our ability to give such a metaphysics at all, I end by sketching an alternative approach: focusing only on observable behavior, with no role for mental states. (shrink)

I argue in this essay that the phenomena we classify as "mental illness" result largely from the refusal of socially authorized "experts" to recognize - and thus to constitute - the Other as a subject. I suggest that Institutional Mental Health refuses to do this not merely because it seeks to aggrandize its own power but also because it fears to acknowledge that we are all participants in a process of historical development. It denies this because it is (...) historically conditioned by its own moment of origin in the project of the Enlightenment, It is conseqently wed to an ethos of rationalized order that does not accomodate, much less support, the unpredictable creative power of the Other and that sustains instead the project of mastery, of domination, of disovering eternal laws that will enable Reason to master history and to master the Other. For this reason Institutional Mental Health and its diverse ideologies, ranging from the pyschoanalytic to genetic defect models, constitute a major obstacle to the evolution of humanity. (shrink)

Joseph Agassi, together with Yehuda Fried, presented the paradoxes of paranoia and proposed to explain and solve them by introducing innovative diagnostic criteria for psychosis as reflecting a specific kind of rationality. Their ethical-clinical framework however, discouraged discussion of placing impositions on the mentally ill, even when in danger. According to these very criteria, Agassi’s institutional individualism framework renders paranoiacs defective in autonomy. Introducing the idea of degrees of autonomy as a guiding principle for research and practice will promote responsible (...) commitment to the mentally ill and to all other persons in society. (shrink)

Joseph Agassi, together with Yehuda Fried, presented the paradoxes of paranoia and proposed to explain and solve them by introducing innovative diagnostic criteria for psychosis as reflecting a specific kind of rationality. Their ethical-clinical framework however, discouraged discussion of placing impositions on the mentally ill, even when in danger. According to these very criteria, Agassi’s institutional individualism framework renders paranoiacs defective in autonomy. Introducing the idea of degrees of autonomy as a guiding principle for research and practice will promote responsible (...) commitment to the mentally ill and to all other persons in society. (shrink)

Natural disasters, technological disasters, and terrorist attacks have an extensive aftermath, often involving society’s institutions such as the legal system and the police. Victims’ perceptions of institutional trustworthiness may impact their potential for healing. This cross-sectional study investigates institutional trust, health, and social support in victims of a disaster that occurred in 1990. We conducted face-to-face interviews with 184 survivors and bereaved, with a 60% response rate 26 years after the disaster. Levels of trust in the police and in (...) the justice system were compared with general population data. We assessed the relationships between institutional trust and current psychological distress, social support, and quality of life. The levels of trust in the police and in the justice system were notably lower in survivors and bereaved than in the general population. Among the victims, low institutional trust was associated with more mental health problems, poorer social support, more barriers to seeking social support, and a lower quality of life. Lost trust in the aftermath of a disaster may perhaps never be restored and the lack of trust may act to strengthen or maintain health problems. An exclusively individualistic approach to trauma and disaster may miss out on the opportunities for promoting health and wellbeing that lies within the larger societal structures. Decision-makers should take this information into account, and acknowledge the potential long-term consequences of institutional performance in the aftermath of a disaster. (shrink)

Holism maintains that a phenomenon is more than the sum of its parts. Yet analysis--a mental process crucial to comprehension--involves dismantling the whole to grasp it piecemeal and relationally. Wading through such quandaries, Vincent Descombes guides readers to a deepened appreciation of the entity that enables understanding: the human mind.

This article reviews the development of a feminist analysis of female and male psychology from 1970 to 1990; the acceptance, rejection or indifference to feminist theory and practice by women in general and by female patients and mental health practitioners in specific. The article describes what feminist therapy ideally is and discusses the need for a Feminist Institute of Mental Health.

BackgroundTo prevent sexual boundary violations (SBV) in mental health care institutions overall governments require these institutions to report SBV incidents to a central registry and to develop institutional guidelines how to react. In Europe SBV policies are only recently developed or implemented, as is also the case in Flanders (Belgium). The implementation of a new institutional policy is always a challenge and can encounter resistance, especially when it concerns SBV, because they remain delicate and complex.MethodThis study evaluated (...) the extent to which mandatory policies on SBV have been implemented in mental health care institutions in Flanders, and possible factors for (non-)implementation of these policies. An online survey was sent to the executives of all mental health care institutions in Flanders (N = 162).ResultsIn total 56 executives of mental health care institutions filled out the survey (response rate 35%). Results showed that the implementation of an SBV policy in mental health care institutions is unfortunately inadequate and not all SBV incidents were reported to the central registry. Type of institution and opinions on the SBV policy were related to the (non-)implementation of the requirements.ConclusionsIt is recommended that governments regularly communicate with mental health care institutions to better understand the concerns and difficulties concerning implementation of the required SBV policy and to support/stimulate an organisational culture of more openness and safety on this topic. (shrink)

In the United States, the National Institute of Mental Health is seeking to encourage researchers to move away from diagnostic tools like the Diagnostic and Statistical Manual of Mental Disorders. A key mechanism for this is the “Research Domain Criteria” initiative, closely associated with former NIMH Director Thomas Insel. This article examines how key figures in US psychiatry construct the purpose, nature, and implications of the ambiguous RDoC project; that is, how its novelty is constituted through discourse. In (...) this paper, I explore and analyze these actors’ accounts of what is new, important, or desirable about RDoC, demonstrating how they are constituted through institutional context and personal affects. In my interviews with mental health opinion leaders, RDoC is presented as overly reliant on neurobiological epistemologies, distant from clinical imaginaries and imperatives, and introduced in a top-down manner inconsistent with the professional norms of scientific research. Ultimately, the article aims to add empirical depth to current understandings about the epistemological and ontological politics of contemporary psychiatry and to contribute to science and technology studies debates about “the new” in technoscience. Accordingly, I use discussions about RDoC as a case study in the sociology of novelty. (shrink)

Former research showed that up to 20–25 % of those who leave schools of type VIII are referred to nursery homes for chronic mental patients not due to medical problems but because of social ones. According to the authors’ opinion, such social practice has more positive than negative aspects. However, this issue requires extensive discussions. Organizing special post-diploma training courses of 16–24 hours on ethical-psychological aspects of referral various categories of patients to nursery homes for chronic mental patients (...) also seems to be reasonable. (shrink)

Child and adolescent researchers must balance increasingly complex sets of ethical, legal, and scientific standards when investigating child and adolescent mental disorders. Few guidelines are available. One mechanism that provides the investigator immunity from legally compelled disclosure of research records is described. However, discretion must be exercised in its use, especially with regard to abuse reporting, voluntary disclosure of abuse, and protection of research data. Examples of discretionary issues in the use of the certificate of confidentiality are provided.

The effects of mental disorder are apparent and pervasive, in suffering, loss of freedom and life opportunities, negative impacts on education, work satisfaction and productivity, complications in law, institutions of healthcare, and more. With a new edition of the 'bible' of psychiatric diagnosis - the DSM - under developmental, it is timely to take a step back and re-evalutate exactly how we diagnose and define mental disorder. This new book by Derek Bolton tackles the problems involved in (...) the definition and boundaries of mental disorder. It addresses two main questions regarding mental illness. Firstly, what is the basis of the standards or norms by which we judge that a person has a mental disorder - that the person's mind is not working as it should, that their mental functioning is abnormal? Controversies about these questions have been dominated by the contrast between norms that are medical, scientific or natural, on the one hand, and social norms on the other. The norms that define mental disorder seem to belong to psychiatry, to be medical and scientific, but are they really social norms, hijacked and disguised by the medical profession? Secondly, what is the validity of the distinction between mental disorder and order, between abnormal and normal mental functioning? To what extent, notwithstanding appearances, does mental disorder involve meaningful reactions and problem-solving? These responses may be to normal problems of living, or to not so normal problems - to severe psycho-social challenges. Is there after all order in mental disorder? With the closing of asylums and the appearance of care in the community, mental disorder is now in our midst. While attempts have been made to define clearly a concept of mental disorder that is truly medical as opposed to social, there is increasing evidence that such a distinction is unviable - there is no clear line between what is normal in the population and what is abnormal. 'What is Mental Disorder?' reviews these various crucial developments and their profound impact for the concept and its boundaries in a provocative and timely book. (shrink)

During the three decades since Albania overthrew the communist dictatorial system and began its democratic changes, the existence of a line of thought in Albanian society has been noted, which tends to explain the behaviour of Albanian politicians during the transition period based on the assumption of a “communist mentality” carried by them. This line of thought has often been dominant and has been reflected in the Albanian media and public space as a form of “main” explanation to show many (...) of the failures that Albanian democracy has faced during these 30 years, the authoritarian behaviour of political elites, the “state capture” by political parties, the crisis of state institutions, etc. Applying the concept of “communist mentality” in the Albanian media and public space and explaining through it (almost) any kind of negative phenomenon, problem, or behaviour that contradicts the idea of democracy or prevents it from developing, is very problematic, therefore it has served as an impetus in undertaking this study. In this paper, a critical approach will be offered to this discourse that has often dominated the Albanian media and public space, questioning whether is this “communist mentality” the determining factor for the behaviour of Albanian politicians and the failures of Albanian democracy or there are other factors that may explain these phenomena. (shrink)

On a souvent considéré qu'une philosophie de l'esprit devait choisir parmi les traits distinctifs du mental celui qu'elle retiendrait pour le mettre en relief. Il ne serait pas possible de faire place dans une même philosophie aux trois faits majeurs : l'intentionnalité du mental (on discerne les pensées de quelqu'un en disant à quoi il pense), le holisme du mental (impossible de concevoir un état d'esprit isolé du tout d'une vie mentale), la part impersonnelle du mental (...) (les acteurs ne manifestent pas seulement des capacités mentales attachées à leurs personnes respectives, mais aussi des manières de penser communes, des institutions de sens formant ce qu'on appelle un esprit objectif). Ainsi, les théories intentionalistes de l'esprit ont généralement exalté le sujet aux dépens des totalités symboliques, tandis que les théories des structures de l'esprit ont paru faire de l'acteur un simple figurant sur la scène du signifiant. De tels partis pris signalent l'échec de bien des philosophes à concevoir clairement les conditions d'une analyse holiste des phénomènes de l'esprit. Ce livre utilise les ressources analytiques de la logique des relations de C.S. Peirce pour développer une conception holiste de l'intentionnalité de l'esprit (tant subjectif qu'objectif). Ce faisant, il introduit, par l'analyse d'exemples plutôt que par un simple survol historique des doctrines, aux problèmes discutés dans les grandes philosophies de l'esprit de ce temps : phénoménologie, individualisme, structuralisme, pragmatisme. (shrink)

Cognitive neuroscientists frequently talk about the brain representing the world. Some philosophers claim that this is a confusion. This paper argues that there is no confusion, and outlines one thing that might mean, using the notion of a model derived from the philosophy of science. This description is then extended to make apply to propositional attitude attributions. A number of problems about propositional attitude attributions can be solved or dissolved by treating propositional attitudes as models.

1 This book is the product of a one-year project conducted by the Hastings Center, Institute of Society, Ethics and the Life Sciences, during 1976-1977. The Behavior Control Research Group-an ongoing, interdisciplinary working group com posed of philosophers, psychiatrists, psychologists, social sci entists, and lawyers-met four times over the course of the year with special consultants with expertise in the field of mental retardation. At those meetings, participants gave in formal presentations, which were followed by group discus sion. As (...) the project progressed, formal papers were delivered and subjected to further critical commentary. This volume, in two related parts, represents the deliberations of the group as a whole, and then offers individual papers prepared by some scholars in order to give a sense of the kind of specific arguments on which the general conclusions were based. We undertook the project to examine: (1) questions of competence and consent; and (2) the practical implications, lThe project, entitled "Ethical Issues in the Care and Treatment of the Mildly Mentally Retarded," was supported by the EVI5T program of the National Science Foundation under Grant No. 05576-14793. Any Opinions, findings, conclusions, or recommendations expressed herein are those of the authors and do not necessarily reflect the views of the National Science Foundation. ix x PREFACE in terms of care and treatment, that evolve from differing definitions and models applied to mental retardation. (shrink)

To the memory of Alan White The idea of mental representation occupies a rather prominent place in much contemporary discussion, both in philosophy and cognitive science, and not as a particularly controversial idea either. My reflections here, however, are intended to douse much of that discussion with some cold water. I should emphasize at the outset that I have no problems at all with the very idea of mental representation. What I find quite unsatisfactory is the philosophical or (...) doctrinal underpinning of much current theorising about it. Anyway, I shall suggest that talk of mental representation needs at least to be supplemented with, if not actually replaced by, a distinct notion of mental presentation , which cannot be reduced to it. But I start with the notion of an impression. (shrink)

Positive mental health involves not the absence of mental disorder but rather the presence of certain mental goods. Institutions, practitioners, and theorists often identify positive mental health with well‐being. There are strong reasons, however, to keep the concepts of well‐being and positive mental health separate. Someone with high positive mental health can have low well‐being, someone with high well‐being can have low positive mental health, and well‐being and positive mental health sometimes (...) conflict. But, while positive mental health and well‐being are not identical, there is an informative conceptual connection between them. Positive mental health usually contributes instrumentally to the living of a good human life, where a good human life includes (but is not limited to) well‐being. (shrink)

Medieval philosophy is often presented as the outcome of a large scale encounter between the Christian tradition and the Greek philosophical one. This picture, however, inappropriately tends to leave out the active role played by the medieval authors themselves and their institutional contexts. The theme of the mental language provides us with an interesting case study in such matters. The paper first introduces a few technical notions—'theme', 'tradition', 'textual chain' and 'textual borrowing'—, and then focuses on precise passages about (...) mental language from Anselm of Canterbury, Albert the Great and William of Ockham. All three authors in effect identify some relevant Augustinian idea (that of 'mental word', most saliently) with some traditional philosophical one (such as that of 'concept' or that of 'logos endiathetos'). But the gist of the operation widely varies along the line and the tradition encounter is staged in each case with specific goals and interests in view. The use of ancient authoritative texts with respect to mental language is thus shown to be radically transformed from the eleventh to the fourteenth century. (shrink)

This paper will be about the relationship between mental disorder and physical disorder. I shall also be concerned with the connection between these notions and the notion of ‘illness’.

This chapter presents the meeting points and conflicts between Arthur Danto’s philosophy of art and George Dickie’s avowedly succeeding theory. Its focus is on the internalist-externalist debate on the ontology of the artwork as created and perceived within the artworld. It shows that both Danto and Dickie developed anti-formalist theories, that contributed to the demise of aesthetic modernism. Inverting the formalist distinction between internal and external properties of the artwork, they classified the sensuous properties of the artwork as secondary in (...) its essence and identity. Accordingly, Danto and Dickie’s definitions of art emerged from the challenge “to be consistent with art appearing in every possible way.” Both negated the Neo-Wittgensteinians’s proposal to forgo the project of defining art and found the then-new pluralism to be revealing of the essence of art, directing philosophy to art’s nonexhibited infrastructure – beyond the reach of the eye. Across from this, the chapter presents their opposing ideas as revealed through different analyses of the concept of the “artworld”: as an intellectual sphere by Danto versus an institutional one by Dickie. Danto’s internalist/intentionalist ontology begins with the mental and stretches to its embodying material. Opposing it, Dickie’s externalist ontology points to social practices as constituting the artwork, which is attributed with the status of “arthood” by agents in its social sphere. Accordingly, I claim, Danto’s ontology is more versatile than Dickie’s. -/- . (shrink)

The knowledge and skills of employees could play a valuable role in organizational success. Organizations seek practices to create a knowledge-sharing culture to take full advantage of individual competencies. However, the knowledge-hiding behavior of individuals is a hurdle in the internal dissemination of knowledge and expertise. It becomes more critical in the case of teaching institutions, where the students are taught and trained. Scholars are now putting their efforts into seeking the antecedents and consequences of knowledge-hiding behavior. This study (...) also attempts to determine the role of interpersonal distrust as an antecedent of knowledge hiding behavior of music education students. Based on the social exchange theory, the present study attempts to check the association of interpersonal distrust with emotional exhaustion and knowledge hiding. For empirical investigation, this study assumes that interpersonal distrust positively enhances knowledge hiding and emotional exhaustion, respectively. Moreover, the present study also attempts to check the association of emotional exhaustion with knowledge hiding. This study also assessed the mediating role of emotional exhaustion in the relationship between interpersonal distrust and knowledge hiding. This current study also aims to check the moderating role of mental health self-efficacy in the relationship between emotional exhaustion and knowledge hiding. For empirical investigation, the present study collected the data from 310 music learning students of various Chinese universities through a structured questionnaire method using a convenient sampling technique. This study applied partial least square structural equation modeling for empirical analyses using Smart PLS software. The findings of this study revealed that interpersonal distrust does not directly influence knowledge hiding; however, interpersonal distrust has a positive association with emotional exhaustion. The findings also acknowledged that emotional exhaustion positively correlates with knowledge hiding. The results also confirmed that emotional exhaustion positively mediates the relationship between interpersonal distrust and knowledge hiding. Further, the outcomes depicted that mental health self-efficacy negatively moderates the relationship between emotional exhaustion and knowledge hiding. In addition, this study’s findings also serve the literature of knowledge hiding by providing important theoretical and practical implications. (shrink)

The maternal deprivation hypothesis was arguably the most discussed debate in midcentury psychiatry. Combined with the gender ideology prevalent in America and Britain, it solidified the idea that the mother-child relationship had formative influence on personality development. This essay explores the formation of this hypothesis by situating its knowledge claims against an institutional innovation set to prevent juvenile delinquency and promote mental hygiene, the establishment of child guidance clinics on both sides of the Atlantic in the late 1920s. It (...) then tracks the development of investigative agendas by child guidance practitioners, examining the practices they adopted to construct psychological knowledge claims in conformity with preventive objectives and positivist standards. Shifting the historiographical focus toward the clinical scenes in which psychological assertions were made, the essay examines how investigators sought to determine the “pathogenic” influence of early parental environment by way of estimating its emotional qualities. It argues that it was this positivist-determinist effort to achieve preventive goals that foregrounded the role of the mother in the etiology of personality disturbance and marked the knowledge field that came to be called the maternal deprivation debate. (shrink)

Psychophysiological correlations form the basis for different medical and scientific disciplines, but the nature of this relation has not yet been fully understood. One conceptual option is to understand the mental as “emerging” from neural processes in the specific sense that psychology and physiology provide two different descriptions of the same system. Stating these descriptions in terms of coarser- and finer-grained system states macro- and microstates, the two descriptions may be equally adequate if the coarse-graining preserves the possibility to (...) obtain a dynamical rule for the system. To test the empirical viability of our approach, we describe an algorithm to obtain a specific form of such a coarse-graining from data, and illustrate its operation using a simulated dynamical system. We then apply the method to an electroencephalographic recording, where we are able to identify macrostates from the physiological data that correspond to mental states of the subject. © 2009 American Institute of Physics. DOI: 10.1063/1.3072788. (shrink)

To the memory of Alan WhiteThe idea of mental representation occupies a rather prominent place in much contemporary discussion, both in philosophy and cognitive science, and not as a particularly controversial idea either. My reflections here, however, are intended to douse much of that discussion with some cold water. I should emphasize at the outset that I have no problems at all with the very idea of mental representation. What I find quite unsatisfactory is the philosophical or doctrinal (...) underpinning of much current theorising about it. Anyway, I shall suggest that talk of mental representation needs at least to be supplemented with, if not actually replaced by, a distinct notion of mental presentation, which cannot be reduced to it. But I start with the notion of an impression. (shrink)

Philosophers of mind typically conduct their discussions in terms of mental events, mental processes, mental properties, mental states – but rarely in terms of minds themselves. Sometimes this neglect is explicitly acknowledged. Donald Davidson, for example, writes that ‘there are no such things as minds, but people have mental properties, which is to say that certain psychological predicates are true of them. These properties are constantly changing, and such changes are mental events’.2 Hilary Putnam (...) agrees, though for somewhat different reasons: The view I have long defended is that the mind is not a thing; talk of our minds is talk of world-involving capabilities that we have and activities that we engage in. As Dewey succinctly put it, “Mind is primarily a verb. It denotes all the ways in which we deal consciously and expressly with the situation in which we find ourselves. Unfortunately, an influential manner of thinking has changed modes of action into an underlying substance that performs the activities in question. It has treated mind as an independent entity which attends, purposes, cares and remembers”. But the traditional view, by treating mental states as states of the “underlying substance”, makes them properties of something “inside”, and, if one is a materialist philosopher, that means properties of our brains. So the next problem naturally seems to be: “Which neurological properties of our brains do these mental properties ‘reduce’ to?” For how could our brains have properties that aren’t neurological? And this is how materialist philosophers saw the problem until the advent of such new alternatives in the philosophy of mind and philosophy of language as Functionalism and Semantic Externalism. (shrink)

With more than half of individuals incarcerated having serious mental health concerns, correctional settings offer excellent opportunities for epidemiological, prevention, and intervention research. However, due to unique ethical and structural challenges, these settings create risks and vulnerabilities for participants not typically encountered in research populations. We surveyed 1,224 researchers, Institutional Review Board members, and IRB prisoner representatives to assess their perceptions of risks and vulnerabilities associated with mental health research conducted in correctional settings. Highest ranked risks were related (...) to privacy, stigma, and confidentiality; lowest ranked risks were related to prisoners’ loss of privileges or becoming targets of violence due to having participated in research. Cognitive impairment, mental illness, lack of autonomy, and limited access to services emerged as the greatest sources of vulnerability; being male, being female, being older than age 60, being a minority, and being pregnant were the lowest ranked sources of vulnerability. Researchers with corrections experience perceived lower risks and vulnerabilities than all other groups, raising the question whether these researchers accurately appraise risk and vulnerability based on experience, or if their lower risk and vulnerability perceptions reflect potential bias due to their vested interests. By identifying areas of particular risk and vulnerability, this study provides important information for researchers and research reviewers alike. (shrink)

It can be hard to see where money fits in the world. Money seems both real and imaginary, since it has obvious causal powers, but is also, just as obviously, something humans have just made up. Recent philosophical accounts of money have declared it to be real, but for very different reasons. John Searle and Francesco Guala disagree over whether money is just whatever acts like money, or just whatever people believe to be money. In developing their accounts of (...) class='Hi'>institutions as a part of social reality, each uses money as a paradigm institution, but they disagree on how institutions exist. Searle argues that the institution of money belongs to an ontological level separate from the physical world, held up by the collective intentions of a group, while Guala claims that money is a part of the ordinary physical world and is just whatever performs a “money-like function” in a group, regardless of what that group believes about it. Here, we argue that any purely functional account like Guala’s will be unable to capture the distinctive phenomenon of money, since monetary transactions are defined by the attitudes transactors hold toward them. Money will be obscured or misidentified if defined functionally. As we go on to show by examining recent work by Smit et al., belief in money does not require taking on all of Searle’s ontological commitments, but money and mental contents will stand or fall together. (shrink)

RESUMEN Introducción: Son escasos los servicios en salud mental dentro del contexto escolar que permitan una integración intersectorial para superar la brecha de falta de asistencia en salud mental en la población infanto - juvenil, aun cuando, es en la escuela donde se detectan mayoritariamente los problemas de salud mental. Objetivo: Comentar el uso de servicios de salud mental en el ambiente escolar en relación con los trastornos mentales y trastornos subumbrales. Método: El presente resultado se (...) obtiene a partir del “Estudio de Prevalencia Comunitaria de Trastornos Psiquiátricos y Utilización de Servicios de la Población Infanto-Juvenil Chilena”. La muestra estuvo representada por sujetos entre 4 y 18 años. La información sobre el uso de servicio de salud mental se recogió con una versión modificada de la Escala Service Assesment for Children and Adolescent. Se realizó un modelo de regresión logística para analizar cinco áreas del uso de servicios en el ambiente escolar, las cuales se correlacionaron con diagnósticos de trastorno mentales y trastorno subumbral de ansiedad, disruptivo y depresión en el último año. Resultados: Las escuelas se enfrentan a grandes desafíos sobre cómo proporcionar apoyo efectivo de salud mental para los estudiantes, que presentan algún tipo de trastorno mental o trastorno subumbral. Discussión: Las instituciones educativas requieren ser visualizadas como una entidad que podría satisfacer las necesidades que se advierten de manera urgente en atención, prevención y promoción de problemas mentales en la población infanto- juvenil, si se vinculan de forma más directa con los servicios de salud mental. ABSTRACT Introduction: Mental health services are scarce within the school context that allow intersectoral integration to overcome the gap in mental health care in the child and adolescent population, being the school where mental health problems are mostly detected. Objective: to know the use of mental health services in the school environment in relation to mental disorders and subthreshold disorders. Method: The present secondary study is carried out from the "Study of Community Prevalence of Psychiatric Disorders and Utilization of Services of the Chilean Child-Youth Population". The sample was represented by subjects between 4 and 18 years old. Information on the use of mental health service was collected with a modified version of the Service Assessment Scale for Children and Adolescents. A logistic regression model was performed to analyze five areas of the use of services in the school environment, which were correlated with diagnoses of mental disorders and subthreshold anxiety, disruptive and depression disorder in the last year. Results: Schools face great challenges on how to provide effective mental health support for students, who present some type of mental disorder or subthreshold disorder. Discusion: Educational institutions need to be visualized as an entity that could meet the needs that are urgently noticed in attention, prevention and promotion of mental problems in the child and adolescent population, if it is linked more directly with health services. (shrink)

Spirituality and spiritual care have long been kept separate from patient care in mental health, primarily because it has been associated with psycho-pathology. Nursing has provided limited spiritual care competency training for staff in mental health due to fears that psychoses may be activated or exacerbated if religion and spirituality are addressed. However, spirituality is broader than simply religion, including more existential issues such as providing non-judgmental presence, attentive listening, respect, and kindness. Unfortunately, healthcare personnel working in (...) class='Hi'>mental health institutions are not well prepared to address spiritual concerns or resources of their patients. Therefore, a mixed-method pilot study was conducted using a self-assessment survey tool to examine spiritual care competencies of mental health staff in Norway and to understand the perspectives of mental health staff in the Scandinavian context. Five questions and comments related to survey items provided rich qualitative data. While only a small pilot with 24 participants, this study revealed a need for spiritual care educational materials targeted specifically for those who work in mental health, materials that address the approach of improving attitudes, enhancing skills, and increasing knowledge related to spirituality and spiritual care of patients. (shrink)

This article argues for the importance of studying life after mental illness. A significant proportion of people who experience mental illness recover, but the experience continues to affect their lives. Historical examination of the birth of mental after-care through the Mental After-Care Association (MACA) highlights the challenges faced by those who were discharged recovered from English and Welsh lunatic asylums between 1879 and 1928. This research demonstrates the relationship between ideas regarding psychiatric recovery and citizenship. Throughout (...) the period, certification of insanity for institutional treatment stripped patients of the status and rights of citizenship. Discharge on account of recovery restored a patient's legal access to citizenship, yet suspicions about their right and ability to particate in society lingered. The MACA designed after-care to facilitate restoration to full citizenship. The MACA was a product of the active citizenship movement, according to which, one's right to identify as a citizen depended on the performance of certain duties to the community. These duties varied according to socio-economic position and sex, meaning that each individual was prescribed a gendered personal citizenship role. MACA personnel saw their endeavours as part of their own citizenship roles, and designed their treatments accordingly. The MACA used a patient's assumption of a citizenship role to indicate recovery, and believed that supporting the performance of that role had mentally healing effects for patients who had been discharged recovered. MACA workers thus imbued the psychiatric innovation of after-care with the liberal political and social values of active citizenship. (shrink)

The publication of DSM-5 has been accompanied by a fair amount of controversy. Amongst DSM’s most vocal ‘insider’ critics has been Thomas Insel, Director of the US National Institute of Mental Health. Insel has publicly criticised DSM’s adherence to a symptom-based classification of mental disorder, and used the weight of the NIMH to back a rival research strategy aimed at a more biology-based diagnostic classification. This strategy is part of Insel’s vision of a future, more preventative psychiatry in (...) which mental disorders are not only understood as biological disorders of the brain, but also as neurodevelopmental disorders. This paper examines the interest and merit of Insel’s views of mental and neurodevelopmental disorder for the philosophy of psychopathology, with a special focus of his neurodevelopmental model of schizophrenia. Pitman’s ‘moderate materialism’ will be used both as a philosophical lens through which to examine Insel’s position, as well as an example of a philosophical framework that may require updating and revision in the light of moves towards a neurodevelopmental conception of mental disorder. (shrink)

Recovery is a model of care in (forensic) mental health settings across Western nations that aims to move past the paternalistic and punitive models of institutional care of the 20th century and toward more patient‐centered approaches. But as we argue in this paper, the recovery‐oriented services that evolved out of the early stages of this liberating movement signaled a shift in nursing practices that cannot be viewed only as improvements. In effect, as “recovery” nursing practices became more established, more (...) codified, and more institutional(ized), a stasis developed. Recovery had been reterritorialized. The purpose of this paper is to examine some of the threads of recovery, from its early days of antipsychiatry activism to its codification into mental health—including forensic mental health—institutions through the lens of poststructuralist philosophers Gilles Deleuze and Felix Guattari. We believe that Deleuze and Guattari's scholarship provides the necessary, albeit uncomfortable, framework for this critical examination. From a conceptualization of recovery as an assemblage, we critically examine how we can go about creating something new, caught in a tension between stasis and change. (shrink)