The community and the community mental health center.

The community has responsibility "for the quality and adequacy of the mental health services that it gets. The opportunities are now open for communities to employ the mechanism of the comprehensive mental health center to take major strides toward more intelligent, humane, and effective provision for their people. If communities rise to this opportunity, the implications for the national problem of mental health and for the quality of American life are immense." Guidelines are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Psychologist in community mental health.

It is "our belief that the field of community mental health is a challenging and stimulating field for research oriented psychologists. We feel strongly that the identity of the psychologist may be best maintained through a scientist-professional model." Recommendations are made for the future training of psychologists in this field. The individual psychologist "must be assisted by adequate post-doctoral interdisciplinary training in a university setting." Major sections are: Maintenance of an Identity, Scientist and Professional, and Training the Scientist-Professional. (PsycINFO Database Record (c) 2010 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)     

Review of The mental hospital in the 21st century.

Reviews the book, The mental hospital in the 21st century by Emmanuel Persad, Shane S. Kazarian, and Llewellyn W. Joseph (1992). The authors not only review past endeavors in the delivery of mental health services but speculate as to the role the mental hospital may take in the years to come. The starting point for this book is a conference entitled "The Role of the Mental Hospital in the 21st Century" sponsored by the London Psychiatric Hospital in October 1990. The book features 20 brief chapters regrouped in three sections. In all, 29 contributors mainly from Canada, bring forth varying perspectives on the role of the mental hospital. The real contribution of this book is that it puts into perspective the magnitude of the challenge that confronts the major stakeholders in developing a comprehensive and balanced system of mental health services. The present book could serve as a starting point for some serious debate among the stakeholders about the way the mentally ill are treated and to determine how the role of the mental hospital should change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Shifting the paradigm in community mental health: Towards empowerment and community.

Reviews the book, Shifting the paradigm in community mental health: Towards empowerment and community by Geoffrey Nelson, John Lord, and Joanna Ochocka (2001). This book, as it combines theory, practice, and research (a case study) about the processes of empowerment and integration of consumers of mental health care in a Canadian setting, delineates strategies and approaches that can be factors in fulfilling this important aim. Shifting the Paradigm in Community Mental Health is a welcome contribution to the literature on the implementation of consumer empowerment and involvement in mental health treatment and care. The authors offer an approach enabling the reader to see the dimensions for empowerment and community integration termed the empowerment-community integration paradigm. The book will be useful for a wide audience, including consumers, professionals, stakeholders, researchers, and policy makers, and should be in the libraries of all institutions, formal and informal, that deliver mental health care. The overall clarity of the writing and all the approaches will be very much appreciated by all those who work or receive services in mental health. (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)     

Advancing mental health in political places.

The author describes his career as a psychologist serving in elected office. He found that by his attending to individual concerns, supporting community consensus on key issues, playing the outsider role, leading an issue individually, and calling media attention to a problem, city hall could be moved to action. In the state legislature, the author serves in the minority but has made an impact by amending legislation, sponsoring less controversial bills, or generating enough public support for a bill that the majority advances its own similar bill. He identified the following mental health needs in Ohio: better understanding by legislators of the nature and impact of mental illness, adequate funding, mental health parity legislation, and more effective advocacy. (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)     

Predictors of outpatient mental health service use by American youth.

Among American children and adolescents aged 1 to 17 years, the 12- to 17-year-olds represent the largest users of outpatient mental health services. This study utilizes a nationally representative sample of this age group from the 2005 National Survey on Drug Use and Health to illuminate predictors of services use from three treatment settings: day treatment programs, mental health clinics/centers, and private/in-home settings. Univariate analyses were used to calculate the percentages of the study sample that used mental health services in these settings. In bivariate analyses, the authors estimated the strength of the associations between available predisposing, need, and enabling factors and the outcomes. Multiple logistic regressions estimated the independent effects of each covariate on the outcomes. Lifetime depression, lifetime general anxiety, delinquent behaviors, drug dependence, and Medicaid were consistent predictors of services use in the three treatment settings. Several other factors were associated with services use in bivariate analyses but lost most of their statistical significance when the authors adjusted for other confounders. Interpreted in light of its potential limitations, this study has important research and policy significance. (PsycINFO Database Record (c) 2010 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)     

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)     

Challenges of providing mental health services in Spanish.

The disparity in mental health services to Spanish-speaking clients is well documented. This study examines the service delivery experiences of Spanish-speaking mental health providers by exploring their perceptions and concerns regarding their competence and training to provide services in Spanish. It also identifies practitioner priorities for improving training experiences specific to bilingual mental health service delivery. Implications for graduate psychology programs are discussed in an effort to promote and enhance necessary competencies regarding bilingual training endeavors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and the mental health movement.

The following points are elaborated: "1. Among many other things, mental health is a vast social movement which, for better or for worse, will carry us all along with it. 2. Psychologists, for a number of reasons, have not been enthusiastic participators in this social movement. 3. Psychologists have a great deal to contribute to the mental health movement, and they can contribute mightily without loss of identity." Mental health as a social movement seems due to three factors: (a) The tendency to conceive human behavior in naturalistic terms. (b) The American belief in the almost infinite improvability of almost anything. (c) The rising level of aspiration for health and well-being. The scientific humility of the psychologist "can become maladaptive diffidence, and diffidence sometimes becomes irresponsibility." 6 suggestions for dealing with diffidence are indicated. The psychologists perceptions of mental health, the orientation of the movement toward the "pathological," and the focus on the clinical may have discouraged the interests of psychologists in mental health. The unique contribution of the psychologist to mental health is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Psychologist Connection: Service Linkage and Role Definition.

The mental health field is not always perceived in terms of benevolent experiences, and Gothic attitudes can still prevail. Although the stigma attached to mental illness has diminished, some lay and professional people, including physicians, still have difficulty recognizing mental health problems and/or if recognized, knowing where to refer patients for proper treatment. In addition, many people lack awareness of the range and role of mental health professionals who are available to deal with the complex issues of treatment and prevention surrounding mental illness. This commentary highlights some of the shortcomings that exist when professional roles are not clearly understood and how such a lack of understanding adds to the separation that already exists between professionals when attempting to provide appropriate service linkages. (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)     

The process of mental health consultation: A systematic look within the context of community psychology.

The process of mental health consultation has been generally defined in terms of the techniques which the psychologist uses, "the how" of the consultant's role. The content, "the what" of this process is now being considered. The issues raised are partly based on the analysis of all consultation - contacts (N-56) collected during the first nine operational months of a project serving a sample population previously not reached by traditional clinical settings. Specifically this paper discusses the way in which a record-keeping method, devised specifically to account for "what" happens during a consultation, yields findings clarifying, complementing and at times diverging from what has been impressionistically reported to be content of the consultation process: a focus on psychopathology and intrapsychic conflicts of the consultee's charges. This pilot project in its attempt to systematically record all consultant's activities, has methodological implications for valid functional definitions of the mental health consultant within the context of community psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community mental health service use by older adults with dementia.

We considered the role of community-based public mental health services in providing care to older persons with Alzheimer's disease and other forms of dementia, and examined service outcomes within California's county-based public mental health system over a 3-year period. Treated prevalence rates, repeat service use rates, and service mix patterns were regressed onto individual, market, and contextual variables across 25 counties over 12 observation periods. The number of older adults with dementia who used community mental health services increased slightly over the observation periods, and service use was associated with age and Medicaid status. Service outcomes also were affected by complementary mental health and aging service systems within each county, as well as the poverty rate and location of the county. Future research is needed to clarify how administrative policies and service management practices contribute to increasing community mental health service use by persons with dementia. In the meantime, these findings can help program administrators and service providers understand the role of community-based mental health services in providing care to persons with dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confrontations with aggression and mental health problems in police officers: The role of organizational stressors, life-events and previous mental health problems.

The extent to which the frequency of facing aggression incidents is associated with mental health problems among police officers when organizational stressors, life-events, and previous mental health problems are taken into account is unclear. To elucidate this data from a longitudinal study of police officers was analyzed (N = 473). Mental health problems (MHPs) are here defined as severe anxiety, depression, hostility, burnout symptoms, and/or sleeping problems according the SCL-90–R and MBI. All MHPs were assessed at baseline and 27 months later. Logistic regression showed that serious threat was statistically significant associated with MHPs at follow-up among officers without MHPs at baseline, but not among those with MHPs at baseline. However, stepwise logistic regression showed that serious threat and/or physical aggression were not independently associated with MHPs at follow-up. Organizational stressors, that is, problems with colleagues were independent predictors in all analyses. Among the total study sample, previous MHPs were the strongest independent predictors. These findings suggest superiors should attend to the mental health, organizational stressors and life-events of their officers regularly and not only following critical incidents at work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using community outreach to promote integrated health care: A pilot project.

Although research has demonstrated the efficacy of psychological services for ameliorating physical conditions, consumers are often uninformed of the advantages of integrated health care. To begin to address this knowledge gap, the authors developed, offered, and assessed a 2-hr community outreach program, which included lectures highlighting the benefits of providing psychological services within general health care, a demonstration of stress-reduction techniques, and first-person accounts of the benefits of psychological health care. The preliminary results of the evaluation were positive. It is recommended that similar programs be disseminated in diverse communities. Suggestions for planning and conducting these types of programs are offered. Furthermore, strategies for improving the goals and content of workshops are offered, with a focus on the distinction between promotion of attitudinal change versus practical activism. Finally, implications for community outreach that is intended to inform the public of the value of psychological health care services are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A proposal to unite two different worlds of children's mental health.

Responds to comments made by Holden and Blau (see record 2006-11202-017) on the current authors' original article (see record 2005-11115-005). The current authors suggest combining the complementary strengths of the community-based approaches identified by Holden and Blau (2006) and the evidence-based approaches discussed in their original article, rather than argue about the comparative limitations of each approach. Given that the contents of both systems of care and wraparound are free to vary with available services in the community, they suggest ensuring that those specific services are, in fact, interventions that have been tested and shown to work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)