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)     

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)     

Review of Outcomes assessment in clinical practice.

Reviews the book, Outcomes assessment in clinical practice edited by Lloyd I. Sederer and Barbara Dickey. This book is a timely publication dealing with the urgent and imperative situation in health care delivery, especially in the area of mental health services. There are four Sections in the book. Section I is titled Integrating Outcomes Assessment into Clinical Practice. This section conveys in a rational and reasonable sequence the definition, impetus, history, scope, process, and current crisis-like status of mental health care, in terms of its financing, its validity, and its effectiveness. Section II is called Instruments of Outcomes Assessment and contains sixteen chapters, each describing a different instrument of assessment. Section III optimistically proclaimed a future improvement of health care delivery and access. These five chapters were exciting, but require a most open and direct acknowledgement of the need for protection of patients and therapists in this field. Complementing Section II is Section IV which contains the Appendices. According to the reviewer, this book has the potential to advance the practice of psychotherapy. But presenting it as a means to satisfy so many volatile and uncontrolled social, political, economic, and other forces can lead to its corruption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Editorial: What will the 21st century bring? An emphasis on quality care.

Day-to-day concerns frequently take precedence over abstract concepts for psychologists practicing in the United States. However, traditional mental health services are a subset of the more generic health care environment, and changes in this environment will eventually affect the daily practice of mental health practitioners. For a profession to continue to mature and thrive, leadership must be aware of and capitalize on relevant national and international changes. In the 21st century, advances in technology and communication will affect the quality of services and will likely result in increased stress for practitioners and patients. This article reviews developments within the American Psychological Association and explores both current and potential roles that will shape the future of professional mental health practice. (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 Madness and government: Who cares for the mentally ill?.

Reviews the book, Madness and government: Who cares for the mentally ill? by Emory A. Foley and Steven S. Sharfstein (1983). This book is a fascinating factual account of the struggle to develop community intervention alternatives to the 100-year domination of the state hospital system in the United States. It is the story of the efforts of "Washington's Noble Conspirators," who struggled for more than 20 years after World War II to expand the amount of federal support of medical research, to get federal money into the care of people with mental disorders, and to obtain federal support for the training of mental health personnel and research into the whole area of mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Clinical guidelines in cross-cultural mental health.

Reviews the book, Clinical guidelines in cross-cultural mental health edited by Lillian Comas-Diaz and Ezra E. H. Griffith (see record 1988-97772-000). This volume represents the latest work on psychotherapy with ethnic/racial minority populations, and was intended for mental health practitioners as well as academicians. The book is divided into three parts. The first section has six chapters addressing the role of "ethnosociocultural" factors such as ethnicity, family values, language, religion, politics, and race in the cross-cultural delivery of psychotherapeutic care. The second section focuses on clinical practice with specific ethnic/racial groups including Afro-Americans, Mexican-Americans, Puerto Ricans, Cubans, Southeast Asian refugees, and West Indians. A final section of one chapter by Comas-Diaz discusses the "state of the art" in cross-cultural mental health. Three factors set this book apart from previous ones on this topic: 1) devotion of an entire section to core ethnosociocultural factors; 2) use of case vignettes to illustrate important cross-cultural issues in mental health; and 3) provision of specific recommendations for the practitioner. Unfortunately, the effort falls short due to the strong academic approach to clinical issues evident throughout the book. Moreover, there was substantial variability in contributors' use of case material and provision of specific recommendations. This uneven coverage, one of the prime drawbacks of many edited volumes, may limit its appeal to practitioners. This book is an improvement over previous texts in this area, but it is by no means a clinician's guide to cross-cultural mental health because of the pervasive academic influence throughout. Consequently, there is an imbalance in favor of didactic over pragmatic approaches to cross-cultural mental health. Thus this book seems more suitable for clinicians in training than for clinicians in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

A Highlander Hookup Between Psychologists and Physicians.

Discusses the current author's work as a clinical psychologist at a community mental health center (CMHC) located in a village of 500 people in the mountains of western North Carolina. The public's perception, which is often loaded with fears and misinformation, of mental health services in small towns and rural settings is addressed. In the author's particular situation, mental health care is allowed only in a non-mental health setting. The role of the local hospital in the service delivery of the CMCH is considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Canadian mental health law and policy.

Reviews the book, Canadian Mental Health Law and Policy by John E. Gray, Margaret A. Shone, and Peter F. Liddle (2000). The authors of this book have produced a multidisciplinary text that succinctly summarizes the main points of Canadian mental health laws and the variability across provinces and territories in these laws and in their typical interpretation and application. This book offers a concise guide to the laws dealing with key issues such as involuntary hospital admission, authorization of psychiatric treatment, and treatment refusal. Although not always an easy read for those unfamiliar with legal terms and writing, the book is geared to a wide audience that includes legal and policy specialists, mental health professionals, and advocates for the mentally ill. These authors are to be congratulated for their efforts to disseminate and explain information on Canadian mental health law and to promote a more humane and scientifically grounded set of legal standards and interpretations that are pertinent to the disposition and treatment of Canadian citizens with severe mental disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Health Care, National Health Insurance, and Psychology.

The role of psychologists as health care providers and the parameters of reimbursement for health care services are timely and controversial issues. A landmark decision was reached in this controversy in the 1980 appeal of a Virginia suit by clinical psychologists in which the court ruled that Blue Shield's refusal to directly reimburse psychologists was a violation of antitrust law. Thus, the requirement that psychologists bill through physicians was not upheld. In recent years a specific aspect of this controversy involved psychologists' roles in potential national health insurance programs. A limited study (appearing in the "National Register of Health Services Providers in Psychology" 1976-1978) of clinical psychologists' attitudes toward national health insurance suggests that Congress and psychologists may have disparate views. In addition to favoring national health insurance, over 85% of psychologists surveyed responded that consumers would benefit from such a program with mental health coverage. Only 16% agreed that such a program would constitute a subsidy of the rich by the poor (Albee, 1977). Several areas of conflicting or confusing responses in this study may reflect legitimate reasons for concern by Congress regarding institution of national health insurance. Belief that providers would benefit from mental health coverage in a national health insurance program was shared by 80% of respondents. Ninety-five percent of respondents identified the inclusion or exclusion of clinical psychologists in such a national health insurance as affecting the future of the profession. Curiously, over 50% of respondents agreed that primary care physicians should be reimbursed for mental health services, although such physicians have received no formal training in psychological services. (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)     

The Evolution of Behavioral Primary Care.

The financing, organization, and delivery of behavioral health care services has undergone dramatic change in the past 25 to 30 years. The authors trace the evolution of behavioral health care delivery in the United States over the past several decades and find (a) that the value of mental health "carve-outs" has diminished greatly and that they are being replaced by "carve-ins," (b) that primary care physicians (PCPs) are becoming a primary source of mental health care secondary to the introduction of new medications, and (c) that PCP treatment of mental health disorders is suboptimal. The authors conclude that the behavioral health care system is entering an era of flux as it experiments with ways of integrating behavioral and primary care. Opportunities for psychologists are explored. (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)     

Beliefs about mental illness as a functon of psychiatric status and psychiatric hospitalization.

Beliefs about mental illness were assessed among psychiatric inpatients at a VA hospital, the mental health staff responsible for their treatment, and a group of medical and surgical (control) patients. Results indicated that: (a) Psychiatric and nonpsychiatric patients generally hold similar opinions regarding mental illness. Severely disturbed psychiatric patients, however, view mental illness in more moralistic terms than do "normals." (b) Psychiatric hospitalization is generally accompanied by a change in the patient's beliefs concerning mental illness, toward those held by the staff. (c) Psychiatric patients whose beliefs about mental illness are most strikingly influenced by the staff tend to respond most favorably to treatment, as measured by length of hospital stay and gains in self-esteem during the 1st month of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reply to Silverman.

Responds to commentary by I. Silverman (see record 2007-08963-001) entitled "Review of Pure types are rare": Comment on book review. I do not think that either one of us will change his position, and therefore it is up to the interested (yet disinterested) reader to adjudicate our dispute by checking Professor Silverman's book and his references. In the process, the reader will be forced to consider the thought-provoking implications for our mental health system of some of the incidents which the author describes so vividly, and that will not be a bad thing. There is one point, however, which is worth pursuing further here, for Professor Silverman persists in an elementary statistical fallacy. Let us take the situation which he cites, where the base rate for diagnosing schizophrenia is 50%. Suppose with the same base rate the degree of agreement is in fact 53%; this is far above chance level. It must be emphasized, however, that the 53% agreement under discussion came not from a study where the base rate for diagnosing schizophrenia was 50%, but from one where the conditions were far more stringent since the base rate for diagnosing schizophrenia was around 20%. (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)     

Practice, policy and parity: The politics of persistence.

The road to comprehensive mental health parity legislation at the state level often reaches a dead end when mental health advocates are forced to compromise by accepting partial parity for "severe mental illness" (SMI) only. In 1999 Connecticut became the first state to modify a biologically based or SMI mental health parity law into comprehensive mental health and substance abuse parity legislation. In this article we chronicle the fight for mental health parity in Connecticut and discuss subtleties of legislative advocacy. This information should prove useful to psychologists who are pursuing parity in other states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Women's Mental Health: A Comprehensive Textbook.

Reviews the book, Women's Mental Health: A Comprehensive Textbook edited by Susan G. Kornstein and Anita H. Clayton (2004). The reviewer notes that this book was so helpful that I could not put it down to write a review. In my opinion, many readers, including clinicians in psychology and psychiatry, researchers, graduate students, and sophisticated undergraduates would all benefit from perusing this text and examining chapters related to specific disorders and aspects of the reproductive stages of women's lives. This book is definitely a gold mine for busy academics preparing comprehensive lectures on women's mental health issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)