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University Micrxsilms International 300 N INFORMATION TO USERS This reproduction was made from a copy of a document sent to us for microfilming. While the most advanced technology has been used to photograph and reproduce this document, the quality of the reproduction is heavily dependent upon the quality of the material submitted. The following explanation of techniques is provided to help clarify markings or notations which may appear on this reproduction. 1.The sign or “target” for pages apparently lacking from the document photographed is “Missing Page(s)” . If it was possible to obtain the missing page(s) or section, they are spliced into the film along with adjacent pages. This may have necessitated cutting through an image and duplicating adjacent pages to assure complete continuity. 2. 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These prints are available upon request from the Dissertations Customer Services Department. 5. Some pages in any document may have indistinct print. In all cases the best available copy has been filmed. University MicrxSilms International 300 N. Zeeb Road Ann Arbor, Ml 48106 8504044 Lecklitner, Gregory Lee PROTECTING THE RIGHTS OF MENTAL PATIENTS: A VIEW OF THE FUTURE The Ohio State University Ph.D. 1984. University Microfilms International 300 N. Zeeb Road, Ann Arbor, Ml 48106 PLEASE NOTE: In all cases this material has been filmed in the best possible way from the available copy. Problems encountered with this document have been identified here with a check mark V . 1. Glossy photographs or pages______ 2. Colored illustrations, paper or print______ 3. Photographs with dark background______ 4. Illustrations are poor copy______ 5. Pages with black marks, not original copy______ 6. Print shows through as there is text on both sides of_____ page 7. 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O ther__________________________________________________________________________ __ University Microfilms International PROTECTING THE RIGHTS OF MENTAL PATIENTS: A VIEW OF THE FUTURE DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree doctor of Philosophy in the Graduate School of The Ohio State University By Gregory Lee Lecklitner, B.A., M.S. ***** The Ohio State University 1984 Reading Committee: Approved By Andrew Schwebel, Ph.D. Thomas Milburn, Ph.D. Adviser Bruce Walsh, Ph.D. Department of Psychology ACKNOWLEDGMENTS This project required the cooperation of literally hundreds of people. Thanks must first be extended to the 345 study panelists who participated in the study. Without the con­ tribution of their knowledge and experience, this study could not have been done. Dr. Andrew Schwebel served as my advisor on this study and graciously gave of his time and guidance. The final draft of this document reflects his careful review and criticism. Dr. Thomas Milburn and Dr. Bruce Walsh also served on the reading committee and gently asked the right questions. This study also benefitted greatly from the direction of Dr. Paul Greenberg of the Human Interaction Research Insti­ tute in Los Angeles. His concerns for detail and complete­ ness contributed in a substantial way to the quality of this work. Dr. Tom Wickens and Dr. Marty Gahart, both of UCLA, were consulted on the statistical treatments used in this study. Their unique expertise made it possible to convert massive amounts of unstructured data into coher­ ent statements of results. Finally, I must express my heartfelt appreciation to my wife, Meg Grant. She patiently gave of her nights and weekends, converting my scribbling into neatly typed pages. More than this, however, she provided the well-placed kick in the pants and the well-timed hug to keep me going. ii VITA April 29, 1951............ Born - Lafayette, Indiana 1973........................ B.A. , Indiana University, Bloomington, Indiana 1977........................ M.S., San Diego State University, San Diego, California 1977-197 8 .................. Graduate Fellow, Ohio State University, Columbus, Ohio 1978-197 9 .................. Psychology Intern, San Fernando Valley CMHC, Van Nuys, California 1979-198 3 .................. Senior Research Associate, Human Interaction Research Institute, Los Angeles, California PUBLICATIONS Litrownik, A.J., Cleary, C.J., Lecklitner, G.L., & Franzini, L. Self-regulation in mentally retarded persons: Acquisi­ tion of standards for performance. American Journal of Mental Deficiency, 1978, 83, 86-89. Roth, D . , Lecklitner, G., & Landsberg, G. Patterns of use. In Landsberg, G., Neigher, W.D., Hammer, R.J., Windle, C . , & Woy, J.R. (Eds.), Evaluation in practice: A sourcebook of progx'am evaluation studies from mental health care systems in the United States. (DHEW Publication No. (ADM) 78-763). Washington, D.C.: National Institute of Mental Health. Greenberg, P.D., Freddolino, P.P., & Lecklitner, G.L. National directory of mental health advocacy programs. Los Angeles: Human Interaction Research Institute, 1982. FIELDS OF STUDY Major Field: Clinical/Community Psychology Studies in Behavior Therapy. Professor Alan Litrownik Studies in Community Systems, Professor Andrew Schwebel iii TABLE OF CONTENTS ACKNOWLEDGMENTS................................................. i i VITA............................................................. iii LIST OF TABLES................................................... V CHAPTER 1. INTRODUCTION............................................1 Historical and Conceptual Issues.............4 Defining the Rights of Mental Patients.... 13 Conflict and Controversy..................... 20 Patient Rights in the Community.............29 2. MAJOR STUDY OBJECTIVES.............................. 43 Study Rationale................................ 43 Study Objectives...............................46 3. STUDY METHODOLOGY.................................... 49 Overview of Study Design..................... 49 Futures Methodology........................... 51 The Study Panel................................ 53 Phase One Method...............................55 Phase Two Method...............................58 4. STUDY RESULTS......................................... 62 Phase One Results............................. 62 Phase Two Results............................. 78 5. DISCUSSION............................................127 Review of Major Study Findings.............127 Summarizing the Stakeholder Group Perspectives.........................136 Conclusions and Implications............... 140 REFERENCES...................................................... 153 APPENDICES......................................................169 iv LIST OF TABLES Table Page 1 Study Design.................................................. 50 2 Phase One Study Panelists.................................. 57 3 Phase Two Study Panelists.................................. 61 4 Number of Secondary Group Affiliations by Primary Stakeholder Groups.............................. 81 5 Secondary Group Affiliations by Primary Stakeholder Groups.................................. 83 6 Cluster Confirmation Statistics for Equity Cluster........................................... 85 7 Cluster Confirmation Statistics for Autonomy Cluster......................................... 86 8 Cluster Confirmation Statistics for Services Cluster......................................... 86 9 The Rights Issue Clusters.................................. 87 10 Rights Tissue Cluster Scores by Primary Stakeholder Groups.............................. 89 11 Rights Issue Item Scores by Issue Clusters and Primary Stakeholder Groups.................. 92 12 Items Included in the Optimism/Pessimism Cluster.................................. 95 13 Optimism/Pessimism Cluster Scores by Primary Stakeholder Groups.................................. 96 14 The Five Most Positive Forecasts and the Five Most Negative Forecasts as Rated by the Entire Panel............................... 98 v LIST OF TABLES (continued) 15 Cluster Confirmation Statistics for Public Understanding and Support Cluster............... 99 16 Cluster Confirmation Statistics for Political Activism Cluster.................................. 100 17 Cluster Confirmation Statistics for Confrontation
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