Mental Health Services for Native Americans in the 21st Century United States.

As the population of American Indians and Alaska Natives continues to expand in the 21st century United States, an increasing number of professional psychologists will be called upon to provide culturally appropriate mental health services for Native American people and their communities. This article provides a general overview of contemporary tribal America before describing the legal, political, and institutional contexts for mental health service delivery administered through the federally sponsored Indian Health Service. Recommendations for mental health professionals who desire to avoid a subtle but profound Western cultural proselytization in their therapeutic service to Native clients and their communities are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building a world-class mental health care system for America.

This article examines our current mental health care system, and what can be done to expand this current system. It focuses on the mental health needs of our children, and makes some suggestions to improve their care. Some things discussed are putting more mental health professionals in schools, affordable and convenient treatment options for parents, and flexible treatment arrangements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic illness, pain and health behaviors of community behavioral health clients.

Persons with comorbid medical disorders, along with substance use disorders and mental illness, present complex treatment needs that are seldom addressed. Chronic physical illness negatively affects treatment participation and retention, decreasing effectiveness. Studies documenting higher medical morbidity and mortality in such persons have long been available. Less is known about their health behaviors. Respondents (n = 418) at a community behavioral health center were surveyed for prevalence of illness, pain, health behaviors, and interest in lifestyle change. A total of 73% reported at least one chronic health problem, and nearly half rated their health between fair and very poor. Most reported at least one negative health indicator or behavior (e.g., smoking). Encouragingly, nearly 50% desired lifestyle changes including smoking cessation, exercise, and stress management. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changing concepts in the training of therapists.

Many professionals in the mental health field recognize the ability of nontraditional workers with relatively little training to produce good therapeutic results. The question is raised and discussed as to why the guardians of our present system are slow to use fully new resources, the effectiveness of which has been demonstrated. The suggestion is made that professionals with long traditional training should identify themselves with the advancement of knowledge and leave more of the practice of crafts to new categories of workers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consultation to Help Individuals Cope With Lifestyle Modification.

The escalating prevalence of chronic health problems related to lifestyle is extremely costly to organizations. It is likely that organizational consultants will have increasing opportunities to plan and implement interventions at the individual level for health behavior change. This article describes the importance of such consultation, emphasizing the role of coping in the behavior change process. In addition to identifying relevant research and theoretical literature, specific recommendations for how to conduct lifestyle change consultation are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ecological constraints on mental health services.

Proposes 4 principles for community mental health programing that are consistent with an ecological thesis: (1) Assessment methods are focused on the total population rather than on those persons who presently receive a mental health service. (2) Mental health services are designed to reduce a high risk for community service. (3) Professional and research services are created as local community resources. "By initiating the informal coordination of current services, the community mental health program helps to create specific new community services as needed." (4) The program plans for change; this involves mobilizing anticipatory problem-solving resources not only for clients but for professionals as well. A "conception of community mental health work based upon the ecological thesis that adaptive programs change" is presented. (39 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Behavioral Medicine: Changing Health Lifestyles.

Reviews the book, Behavioral Medicine: Changing Health Lifestyles by Park O. Davidson and Sheena M. Davidson (1980). Since 1969, the Banff International Conferences have served as a "window" on the future applications of behaviour modification principles and techniques. Behavioral Medicine: Changing Health Lifestyles is the "report" of that conference. (the reviewer hastens to point out, however, that the Banff Conference reports are much more than a collection of papers presented at the conference itself. They are chapters written specially for publication.) For a number of years there has been an increasing awareness of and concern with the fact that "lifestyle" plays an important role in health and ill health alike. Faulty habits and behaviours such as smoking, alcohol consumption, overeating, lack of exercise, overwork, etc., may play a critical causal role in the development of physical disorders. At the same time, however, changing these behaviours, and maintaining the changes, has quite often proven to be beyond the skills of even the most talented clinician. The present volume addresses this challenge: the application of behavioural principles to the problems of physical health and illness. The chapters are well written and the usual vagaries of an edited book (such as stylistic differences between authors) have been minimized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk management with the suicidal patient: Lessons from case law.

Suicide continues to account for a comparatively large proportion of all lawsuits filed against mental health professionals. However, despite the prominence of suicide in mental health malpractice litigation, clinicians must resist resorting to defensive clinical practices in an attempt to shield themselves from potential lawsuits. By using accepted tenets of suicide management as a starting point, the author aims in this article to inform and educate practitioners about clinical malpractice from a legal, as well as a clinical, point of view. Hence, this article aims to demystify relevant case law for practitioners by offering informative, real life examples of how therapeutic practice is interpreted in the courtroom, as well as examples of how juries and judges typically view the treatment decisions clinicians routinely make regarding their suicidal patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lessons from Katrina: Disaster mental health service in the Gulf Coast region.

In this article, 4 mental health professionals provide firsthand accounts of experiences as volunteers in the Gulf Coast region following Hurricanes Katrina and Rita in the fall of 2006. These accounts are provided with the goal of informing psychologists and other mental health providers about the role of volunteers from a frontline perspective. The authors offer these observations as a compliment to formal training in disaster preparedness that psychologists might receive for volunteer service in the wake of a devastating disaster. Specifically, the authors discuss the training they received, the settings in which they worked, and the client needs and mental health skills they used to meet those needs. Last, the lessons the authors learned about providing disaster mental health services are discussed. It is hoped that these observations might inspire others to lend their expertise and compassion in response to future catastrophic events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Mental health law in Canada.

Reviews the book, Mental health law in Canada by Harvey Savage and Carla McKague (1987). Mental health professionals who come into contact with the law in the course of their work generally have an interest in the well-being of the client. However, they often feel dismayed and confused because of their lack of understanding of mental law and the legal system in general. Until recently, mental health professionals in Canada could not turn to a single volume which would help explain mental health law, including their clients' rights. However, Harvey Savage and Carla McKague's book, Mental health law in Canada, will help alleviate some of the concern and confusion Canadian mental health professionals have come to know. Although some authors have written about Canadian mental health law in specific contexts (e.g., criminal responsibility or fitness to stand trial), Savage and McKague's contribution is the only available comprehensive source directed to the law affecting psychiatric patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A practical approach to implementing theraplay for children with autism spectrum disorder.

Theraplay is a counseling approach that uses elements of play therapy to help children build better attachment relationships with others through attachment-based play. This article describes a practical approach for implementing Group Theraplay with children with Autism Spectrum Disorder (ASD), particularly those that are mainstreamed in a kindergarten classroom setting. The approach uses resources that are already in place in schools today, such as mental health professionals (e.g., school counselor, social worker, etc.) and teachers. Foundational Theraplay assumptions, therapeutic goals, empirical support, and implementation guidelines are provided. Comparative effectiveness research examining the use of Group Theraplay with this population in this setting versus the use of alternative therapeutic approaches is needed. To help guide future research in this needed area of outcomes investigation, several assessment instruments appropriate for clinical research use with this population are suggested. Ethical and cultural implications pertinent to the application of Group Theraplay for children with ASD also are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Review of The mental health of Asian Americans.

Reviews the book, The mental health of Asian Americans by Stanley Sue and James K. Morishima (1982). In The Mental Health of Asian Americans, Sue and Morishima assess the current status of theory and research strategies in this field and initiate dialogue regarding future directions for our investigative energies and service delivery efforts. They are largely successful at this ambitious mission. Their work represents one of the best and most comprehensive texts on the special issues related to Asian-American mental health. Although this book was published in 1982, the theories presented and issues discussed remain extremely pertinent to the problems encountered today in providing services to this population. The authors' major intent is not to demonstrate how to deal with cross-cultural issues in treating Asian-American clients, although therapeutic techniques with a particular client may be extrapolated from their discussion and numerous case examples. Instead, the authors focus on strategies for improving research and delivery of mental health services, and attaining a theoretical understanding of treatment issues within the cultural context. The content is aimed at those who are in training or currently participating in mental health research and service delivery to persons of Asian descent. Yet, this book is of interest to all professionals who are seeking a well-researched text which is grounded in theory and describes the importance of cultural factors in developing mental health services to an ethnic minority population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working as a psychologist in the Medical Reserve Corps: Providing emergency mental health relief services in Hurricanes Katrina and Rita.

This article details before, during, and after "snapshots" of what it is like to go into a disaster to provide emergency mental health as part of the nation's emerging Medical Reserve Corps. It is a first-time responder's personal account of "lessons learned" and "priorities" for psychologists in similar situations. Twelve recommendations for improving psychologists' effectiveness in addressing widespread mental health disasters are identified. These include (a) team deployment and mission, (b) anticipation of frustrations, (c) prioritization in a disaster, (d) ethical dilemmas, (e) recognition of the benefits, (f) development of rapid screening tools to identify those in greatest need of mental health intervention, (g) training allied health professionals in mental health response, (h) mental health interventions specific to Katrina, (i) the importance of supporting caregivers and systems, (j) identifying and activating one's own support system, (k) slowing down interventions, and (l) training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Future of Mental Health.

Examines the two sets of criteria that generally categorize mental health: those that emphasize internal events and those that deal with external events. The author discusses the future of mental health in light of many of its current trends, including greater acceptance of diversity, and he discusses the potential future role of the mental health professional. The author notes that greater numbers of mental health professionals have gotten involved with different populations, and suggests that the majority of mental health professionals will probably be experts in handling small units of behavior or experience for a limited time. The very process of making predictions changes the future course of events. Let us hope that this intricate process will result in greater satisfaction for greater numbers of people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Assessing and managing violence risk in juveniles.

Reviews the book, Assessing and managing violence risk in juveniles by Randy Borum and David Verhaagen (see record 2006-12484-000). This book is a compilation of research findings designed to accomplish the goal of equipping the reader to "conduct risk assessments that are thorough, fair, helpful, and developmentally and empirically sound." New school psychologists will find an excellent framework for learning how to approach the daunting task of assessing risk of violence in children and adolescents. Experienced practitioners will find new research results integrated throughout the book to improve the precision of their risk assessments as well. This book is written for mental health professionals in schools, therapy settings, and juvenile justice systems. Although these three contexts are presented as very different from each other (differences in treatment plans are noted), the basic principles of assessment are applicable to all. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Continuing education in cultural competence for community mental health practitioners.

Continuing education in cultural competence is a key strategy for enhancing provider effectiveness in working with culturally diverse clients. In the mental health field, a majority of published works address training issues related to students in graduate programs. Few articles, however, discuss specific models or methods of continuing education for practitioners working in community-based settings. The authors present a case example of an interactive workshop in cultural competence for community mental health practitioners. They discuss key modules of this workshop, including (a) cultural competence and outreach principles, (b) cultural identity and worldview, (c) stereotyping and automatic thinking, (d) dynamics of difference, and (e) application exercises. Recommendations are offered for administrators, direct care staff, trainers, and researchers who may be interested in undertaking or participating in cultural competence continuing education efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient-centered culturally sensitive health care: Model testing and refinement.

Objectives: This article presents the results of an empirical test of a literature-based Patient-Centered Culturally Sensitive Health Care Model. The model was developed to explain and improve health care for ethnically diverse patients seen in community-based primary care clinics. Design: Samples of predominantly low-income African American (n = 110) and non-Hispanic White American (n = 119) patients were recruited to complete questionnaires about their perceived health care provider cultural sensitivity and adherence to their provider's treatment regimen recommendations. Main Outcome Measures: Patients completed written measures of their perceived provider cultural sensitivity, trust in provider, interpersonal control, satisfaction with their health care provider, physical stress, and adherence to provider-recommended treatment regimen variables (i.e., engagement in a health promoting lifestyle, and dietary and medication adherence). Results: Two-group path analyses revealed significant links between patient-perceived provider cultural sensitivity and adherence to provider treatment regimen recommendations, with some differences in associations emerging by race/ethnicity. Conclusion: The findings provide empirical support for the potential usefulness of the Patient-Centered Culturally Sensitive Health Care Model for explaining the linkage between the provision of patient-centered, culturally sensitive health care, and the health behaviors and outcomes of patients who experience such care. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Practice makes perfect and other myths about mental health services.

Expenditures for mental health services, as a proportion of health care expenditures, have plummeted in the past decade. Concurrently psychologists have been unable to muster scientific evidence for the effectiveness of typical services. The clinical world failed to collect such evidence while the academic world focused on laboratory studies. Beliefs in the mechanisms thought to assure the quality and effectiveness of typical services may have created complacency. Psychologists seem confident that effective services are assured by (a) more experienced clinicians, (b) degree programs, (c) continuing education, (d) licensing, (e) accreditation, and (f) clinical supervision. After reviewing relevant scientific literature, the author concludes that these are myths with little or no evidence to support them. The author suggests 4 ways to improve the quality and effectiveness of services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Engaging Latinos through the integration of cultural values and motivational interviewing principles.

A rapidly growing Latino population challenges the U.S. mental health system. Despite a high service need, significant disparities in access to care have resulted in patterns of low utilization and frequent dropout. Furthermore, natural ambivalence as individuals access a traditionally underutilized source of support may further compromise the effective therapeutic engagement of Latinos. Thus, practitioners and researchers seek to identify means by which to enhance service delivery for this historically underserved population. Following the demonstrated efficacy of motivational interviewing with highly ambivalent client populations and drawing on the authors' clinical experiences with monolingual Spanish-speaking Latinos in a community mental health setting, this article describes the application of motivational interviewing principles to 3 Latino cultural values and offers clinical practice recommendations to help create a client-centered and culturally congruent therapeutic milieu. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction: Methodological issues in school-based mental health services research.

New research directions on the effectiveness of mental health services for children and adolescents offer the opportunity for school psychology to apply its knowledge base to the systemic juncture between mental health and school systems. Models of service delivery to children, adolescents, and their families that integrate school, mental health, and other service sectors are being actively studied to answer questions about the outcomes of these services for children with mental health problems. The papers in this journal were first presented at the 6th Annual Research Conference of the Florida Mental Health Institute on "A System of Care for Children's Mental Health: Expanding the Research Base." The papers describe state-of-the art studies of school-based mental health interventions for children, adolescents, and their families. In each of the papers, particular attention is paid to the salient methodological issues researchers face in conducting these studies within school settings. It is hoped that these articles will foreground the healthy and creative tensions that exist between different research paradigms and multiple service communities, especially mental health and school systems, by encouraging new research on important and as yet unanswered questions about the effectiveness of school-based service delivery to children and adolescents with mental health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)