Outcome evaluation: Deja vu all over again.

The current interest in and call for use of outcome evaluation data are not new in the mental health field. This paper identifies barriers that have served to temper the outcome evaluation movement in the past. Barriers identified and discussed include economic, technical, scientific, and organizational issues. For the consultant assisting mental health organizations establish outcome evaluation processes, several aspects to consider in developing a productive consulting relationship are offered. These include entry and movement in the mental health system; qualities of the mental health consultant most likely to be congruent with the values of mental health administrators; roles the consultant might play; and potential targets for the consultant's interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two little magic words.

Discusses the importance of perceived program need and agency and consultant contracts to the development of agency-based community mental health programs. For programs that depend significantly on the contributions of an outside consultant, 2 steps must be taken. First, the nature of the perceived program need and the relevance of the consultants' interests and skills to that need must be established. Second, contracts clarifying the agency's and the consultant's specific roles and responsibilities in the prospective program must be developed. Problems in need determination may involve misidentification of need or disagreement among agency staff about needs. A hypothetical program for training volunteers as companions of discharged mental patients is described to illustrate the steps taken in establishing contractual responsibilities. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accessibility and organizational power in the entry phase of mental health consultation.

Correlated indexes constructed to represent expert, legitimate, and reward power for each department of a college with the accessibility of each department to mental health consultants who began work with the college. Results support the hypothesis that accessibility to the consultant is inversely related to organizational power. Legitimate power appears to be the central factor in the data, although the power indexes were substantially correlated with each other and with accessibility. Results are interpreted in terms of power-dependency relationships within the organization. Implications for consulting are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Variables affecting group mental health consultation for teachers.

Examined the contribution of consultant style and group environment to consultee attitude toward the consultant and toward group mental health consultation. Ss were 150 student teachers who participated in 10-wk consultation groups. Consultees completed a consultant-style questionnaire, a 90-item group environment scale, and 2 semantic differentials. Data analysis indicated that identifiable process variables do contribute significantly to consultee attitude toward the consultant and toward group mental health consultation. Specifically, 94% of the variance in attitude toward consultation and 60% of the variance in attitude toward consultant are explained by clusters of items representing consultant style and by group environment subscales. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mary Starke Harper (1919-2006).

Presents an obituary for Mary Starke Harper, a leading authority on mental health care for minorities and the aged. Harper earned a bachelor's degree in education and a master's degree in nursing education with a psychiatric nursing clinical specialty. She moved unpretentiously among the politically influential, showing tireless drive and tenacity on behalf of her causes. She served as an advisor on mental health and aging for Presidents Carter, Reagan, G. H. W. Bush, and Clinton; directed the Office of Policy Development and Research for the 1981 White House Conference on Aging; served as a consultant for the 1995 White House Conference on Aging; and cochaired the Clinton administration's Mental Health/Public Sector Task Force for Healthcare Reform. After formal retirement in 1995, she remained an active, outspoken advocate for improved mental health care for minorities and the aged. She served as an expert adviser on women's health for the U.S. Department of Health and Human Services, a member of the National Institute of Aging's National Advisory Council, a state of Alabama trustee on mental health, and a consultant or member of the board of directors for a wide array of other organizations, foundations, and universities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consultation and training with school-based crisis teams.

Schools often bring outside mental health consultants to provide postcrisis counseling after a suicide or another tragedy. This article describes a different role for consultants who specialize in this type of work: training school personnel to provide this valuable service themselves. It is argued that training school-based personnel to provide postcrisis counseling results in greater value to a school system than does direct service provision by an outside consultant. The author's experience as mental health consultant to a large urban/suburban school district's crisis team is used to illustrate various training techniques that can be used and benefits that can be derived from this type of consultation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

File review consultation in the adjudication of mental health and chronic pain disability claims.

The role of the psychological file review consultant in assisting disability insurance carriers to adjudicate chronic pain and mental health claims is discussed. The authors advocate an empirical basis for the practice and outline the relevant professional issues and procedural steps to be taken in this consulting role. They examine the role of the consultant in evaluating the quality of assessment, whether empirically evaluated treatments have been applied, and what factors can be used in estimating return to work dates. Specific problems that a file review consultant might encounter and suggested solutions are described as are potential biases and ethical dilemmas that may occur when psychologists take on this emerging consulting role. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health consultation in the pediatric intensive care unit.

The need for psychosocial intervention to be integrated with medical care on intensive care units is high, but too often mental health professionals are ill-equipped by traditional training programs for such work. Medical crisis counseling provides a conceptual framework useful in developing the skills needed to effectively intervene in such settings. The pediatric intensive care unit ( PICU ) is arguably one of the most emotionally demanding and high-stress areas where mental health clinicians may be asked to consult. This article describes medical crisis consultation in the PICU setting, suggests survival strategies for the mental health consultant to the PICU, and provides illustrative case examples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caplanian mental health consultaiton: Historical background and current status.

Traces the historical roots of Caplanian mental health consultation and lists 9 aspects of the model that have proven valuable over time. A relatively new development, mental health collaboration, is discussed with reference to the internal consultant. The role of mental health consultation in primary prevention is briefly reviewed, and it is argued that consulting psychologists who conduct organization development would do well to consider explicitly the preventive aspects of their work. The paper concludes with some thoughts regarding potential problems of working through intermediary caregivers to achieve the goals of primary prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic Effects on Women's Positive Mental Health: Do Marital Relationships and Social Support Matter?

Interpersonal relationships are important factors in mental health. A genetically sensitive design was used to examine associations among marital quality, adequacy of social support, and 2 aspects of positive mental health in a sample of 652 Swedish twin women and their families. There were 3 main findings. First, the covariance between relationships and positive mental health was partially accounted for by common genetic variance. Second, nonshared environmental influences played a substantial role in the covariance among the 3 constructs, with evidence for husbands being a source of this influence. Finally, different patterns of associations were found between relationships and 2 aspects of mental health, well-being and global self-worth, which shows how seemingly similar constructs can be differentially associated with relationships. Together, these findings emphasize the importance of genetically informed studies in family research and the role of the environment and interpersonal relationships in promoting and improving mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of race and consultant verbal behavior on perceptions of consultant competence and multicultural sensitivity.

Sought to determine the influence of race and consultant verbal behavior on perceptions of consultants' competence and multicultural sensitivity. In this analog study, 154 female preservice teachers viewed a videotape of a problem definition interview in which the race of the consultee (African American or Caucasian), race of the consultant (African American or Caucasian), and verbal behavior of the consultant (race-sensitive or race-blind) were completely crossed. The participating preservice teachers (African American and Caucasian) rated the consultants on measures of competence and multicultural sensitivity. A 2?×?2?×?2?×?2 multivariate analysis of variance (MANOVA) and subsequent univariate follow-up tests revealed a main effect for consultant behavior, favoring race-sensitive vs race-blind verbalizations for both dependent variables. Significant interactions were also found for each dependent variable for participant race?×?consultant behavior and consultant race?×?consultant behavior. Possible explanations for these findings are discussed, and implications for practice and future research directions are identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The consultant as expert witness in school and workplace cases—Part 2.

This article provides a review of both Part 1 and Part 2 of a series of the Consulting Psychology Journal on the consultant as an expert witness in school and workplace cases. Part 1 covered topics such as professional consultants as expert witnesses from a legal perspective, sexual harassment and retaliation cases in the workplace, and special education consultants in due process hearings. In part 2, three articles focus on violence in the workplace and two articles alert the consulting psychologist to the issues related to malingering by clients and how to detect it. These articles are meant to provide a sampling of contemporary issues for which the mental health consultant may provide expert testimony in litigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Goal definition by staff consensus: A contribution to the planning, delivery, and evaluation of mental health services.

To provide a basis for the evaluation of VA mental health services, a survey was conducted of staff opinion regarding the importance of several specific goals for these services. Nine goals were formulated and submitted to 6,435 central office and field facility staff to obtain their ratings of each goal's importance, with an "of no importance" rating being possible. The goals dealing with (a) the development of patient skills necessary for being self-supporting, (b) the elimination of psychological disorders, and (c) the protection of patients and others from violence received the highest average ratings. The remaining goals were considered as having some importance although there were substantial differences among the sample about the degree. Interoccupational group differences in importance ratings were statistically significant but small. Although the goals formulated and ratified by staff were general, they were more specific than previous goal statements. It is suggested that because of this relative specificity, they provide useful guidance for planning, managing, delivering, and evaluating mental health services. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Performance Evaluation for Cost Estimators by Reliability Interval Method

Most consultant selection models stress the importance of past performance. However, there are so far very few studies on evaluating consultant’s performance. It hampers the whole process of the selection model. This paper tries to establish a systematic approach in developing a consultant’s performance evaluation model for the evaluation of the performance of cost estimators in the construction industry of Hong Kong. Nominal group technique is adopted in identifying the decision criteria for the evaluation, and a reliability interval method (RIM) is developed to assess the importance weighting of each criterion. The RIM allows statistical analysis and fuzzy assessment of the weight. The results report the weights of each decision criterion and its subcriterion in evaluating cost estimator’s performance. Interestingly, the results show that traditional functions of cost estimator are the least treasured from the clients. Proactive and professional advice is considered to be much more important. The study is highly relevant to industry practitioners in assessing performance of costs estimators, as well as to researchers in further developing the consultant selection model.     

Overview: Forging research priorities for women's mental health.

After a decade of reports underscoring the inadequacy of existing scientific knowledge for understanding gender differences in mental disorder and its treatment, the National Institute of Mental Health has developed a women's mental health research agenda with five priority areas for research: diagnosis and treatment of mental disorder, mental health issues for older women, violence against women, multiple roles, and poverty. This overview highlights some of the major findings in each of these five areas and introduces the more in-depth treatment given in this Psychology in the Public Forum section to the areas of violence, poverty, and multiple roles. It also underscores the importance of identifying sources of gender bias in all mental health research. Women's mental health issues have become officially recognized as part of the NIMH research agenda. Only time and continued monitoring will determine how these official policy priorities will become translated into actual funding and research initiatives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using the psychiatrist

The change in the practice of psychiatry has been sufficiently marked and sufficiently recent to generate uncertainty as to the psychiatrist's function, and particularly how he might best be used by other doctors. This article examines some issues relevant to the psychiatrist's function as a clinical consultant, as a contributor to preventive psychiatry, and as a mental health consultant in relationship to community medicine in general, and the family doctor in particular.     

Geriatric Mental Health Policy: Impact on Service Delivery and Directions for Effecting Change.

The treatment of mental health problems in older adults has advanced considerably over the past several decades. Nevertheless, the mental health needs of the nation's elderly population remain substantially unmet. This article identifies the significant but previously neglected role of regulatory policies and administrative practices in limiting the use and provision of geriatric mental health services. Such factors are the least recognized and understood by psychologists, although they are the very factors on which psychologists can have the most potential influence. This article subsequently identifies salient legislative proposals and regulatory developments, while addressing the importance of advocacy on agenda setting and policy change. The final section provides specific proposals and mechanisms at micro and macro levels for improving the geropsychology service system. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The critical importance of personal involvement.

Suggests that the deliberations surrounding Medicare may once again become the key to the enactment of national health care reform legislation and argues that if psychologists want to directly influence public policy, more of them must become personally involved in full-time advocacy and public policy work. Examples of federal policies that affect psychologists are discussed as well as the importance of joint psychology-law programs and the efforts of a psychologist and associate commissioner in Maine to shape a unified, outcome-driven mental health and mental retardation system. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A within-subject longitudinal study of the effects of positive job experiences and generalized workplace harassment on well-being.

Drawing on the mobilization-minimization hypothesis, this research examines the influence of positive job experiences and generalized workplace harassment (GWH) on employee job stress and well-being over time, postulating declines in the adverse influence of GWH between Time 1 and 2 and less pronounced declines in the influence of positive job experiences over this same timeframe of approximately one year. A national sample of 1,167 workers polled via telephone at two time periods illustrates that negative job experiences weigh more heavily on mental health than do positive job experiences in the short-term. In the long-term, GWH's association with mental health and job stress was diminished. But its effects on job stress, and mental health, and physical health persist over one year, and, in the case of long-term mental health, GWH overshadows the positive mental health effects of positive job experiences. The research also argues for a reconceptualization of GWH and positive job experiences as formative latent variables on theoretical grounds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On Mental Illness.

Two official position papers of our APA seem to contradict each other with respect to whether mental illness is a myth or not. The APA official position paper, "The Community and the Community Mental Health Center," questions the appropriateness of the term "illness." The APA official position paper, "The Psychologist and Voluntary Health Insurance." identifies psychology in some of its roles as a health profession. Is psychology in some of its roles supposed to be a health profession that regards illness as a myth in some of its other roles? The answer seems to be, "Yes." If psychologists would switch hats as they changed roles from clinician to social science consultant, the contradiction would be resolved easily. Instead, the contradiction is denied by one role player or the other. Somehow, the medical model is supposed to be absolutely evil and to stand in the way of social progress. At the same time, psychiatrists seem to expect to exercise leadership in matters of social science. I believe that mental illness exists. Psychiatrists have primary responsibility for its treatment, and there is a very large and honorable role for clinical psychologists in the struggle against mental illness. Social disorganization exists. I doubt very much that psychologists deserve primary responsibility for the amelioration of social disorganization, but psychologists can make important contributions. Let us not overdefend against the boundless ambitions of our medical colleagues as social science experts by denying the legitimacy of mental illness and of the medical model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)