discuss the effects of substance abuse . How can substance abuse be prevented?
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Answer:
V iolence committed by individuals with severe mental illness living in the community has become an
increasing focus of concern among clinicians, policy
makers, and the general public—often as the result of
tragic, albeit uncommon events (1–3). In the current era
of cost containment, in which the use of hospitalization
is increasingly limited, there is a renewed priority on
developing strategies for managing violence risk in the
community. Such strategies may include formalized risk
assessment procedures (4), closer monitoring of outpatient treatment, greater attention to substance abuse comorbidity, and efforts to improve treatment retention
and compliance through intensive case management
(5). Legal interventions such as court-mandated, community-based treatment or involuntary outpatient commitment are also being cited as promising methods of
improving treatment adherence (6–9) and thereby reducing violence (1, 10).
As risk management strategies per se, a number of
these approaches are being advocated on the strength
of general clinical assumptions about what may cause
mentally ill individuals to commit violent acts, but they
lack the benefit of a solid research base that demonstrates the specific and interacting effects of major risk
factors for violent behavior as they actually operate in
the severely mentally ill population. Such effects are
shaped not only by the features of major psychiatric
disorder but by the social environments in which people
with severe mental illness often live. The present article
takes a step toward providing a better empirical understanding of violent behavior in individuals with severe
mental illness by specifying the magnitude of violence
risk represented by two key problems—substance abuse
and medication noncompliance—and showing how these
risk factors operate together in a group of 331 recently
hospitalized severely mentally ill individuals.
A number of studies have linked medication noncompliance to decompensation and hospital readmission.
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Answer: development of policies or enforcement of regulations, mass media efforts, and community-wide awareness programs. Increasing health education in the community
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