Migrant mental health: A model for indicators of mental health and health care consumption.

Objective: This study explores the relationship between mental health and health care consumption among migrants in the Netherlands. Design: Samples of the Turkish (n = 648), Moroccan (n = 102), and Surinamese (n = 311) populations in Amsterdam were examined. The study tested a hypothesized model of risk factors for psychiatric morbidity, indicators of well-being, and indicators of health care consumption. The model was specified on the basis of information from earlier research on the sample and literature on the topic. The model was tested and refined using structural equation modeling. Main outcome measures: Psychiatric morbidity and well-being measures were assessed with the CIDI 1.1 and MOS-sf-36 subscales, respectively. Health care consumption was assessed by the question "Have you ever consulted one or more of these professionals or health care facilities with respect to mental health problems or problems related to alcohol or drugs usage?" Results: The primary result of this study was the confirmation that health care consumption among migrants is predicted by need and predisposition factors, such as health condition and sociodemographic characteristics. In addition, mental health care consumption of migrants is predicted by acculturation characteristics. This result suggests an effect of cultural and migrant-specific factors in help-seeking behavior and barriers to mental health care facilities. Conclusions: Findings confirm the existence of migrant-specific mechanisms in health care consumption. Mental health care professionals should be aware of these. However, ignoring common ground for interventions unnecessarily creates distance between migrant groups and between migrant and indigenous Dutch groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues in mental health services for children and adolescents

Existing system of psychiatric care for children and adolescents is in need of basic reorganization. The authors propose: 1) reestablishment of the speciality of children's and adolescent psychiatrist, a specialist in children's and adolescent narcology, a psychiatrist of early child's age and a pediatric medical psychologist; 2) carrying out the reform of child mental care equal in rights with general psychiatry; 3) preservation and widening of both specialized inpatient and outpatient clinics in general system of child's mental care; 4) legislative and public rehabilitation of children's psychiatry, which suffered considerably from antipsychiatric campaign; 5) professionally organized systematic elevation of psychohygienic, psychiatric and psychotherapeutic knowledges of allied medical and other specialists as well as of parents and of all population too; 6) integration and interaction of govermental services concerning mental health of children and adolescent; 7) organization of regional psychoprophylaxic interdisciplinary centers for children and adolescent.     

Analysis of opinions regarding mental health benefits in comprehensive health care.

To assess the range of opinions regarding integration of mental health benefits and psychologists into the nation's health care system, a 116-item questionnaire was sent to a sample of the American Psychological Association's membership. The 624 respondents strongly endorsed coverage for traditionally defined (e.g., neuroses, psychoses) disorders treated by orthodox means (e.g., psychotherapy, medication). Ss tended to favor the federal government as a major source of funding for a national health care program, yet they preferred professional control of fee setting and quality assurance. A 2?×?2 MANOVA (Professional Identification?×?Degree) yielded some significant differences between groups with respect to these issues. However, the overall results are more noteworthy for the levels of agreement between groups. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Geography and mental health: a review

In our current health care context, characterized by fiscal restraint and decentralization of accountability for health to regional authorities, geographic inequities in need, access to care, utilization, and health outcomes will come under increasing scrutiny. Knowledge gained from ecological studies about geographic disparities in mental health are likely to have important implications for policy, program planning, and resource allocations. In light of the growing relevance of the geography of mental health, this paper will review (1) selected contributions of geographic studies to the field of mental health, (2) common ecologic study approaches used in most geographic studies, (3) key conceptual and methodological challenges related to the application and interpretation of ecologic models in mental health, and (4) the wider potential of this technique for resource equity. Given the importance of geography for needs assessment and service planning, it is surprising that geographic study designs, which use ecological data, have not received greater attention as an important and viable method of assessing population mental health.     

Understanding the mental health needs of children and adolescents in residential treatment.

With the penetration of managed care approaches in child welfare, residential treatment services have come under increased scrutiny. In these circumstances it is critical to understand the clinically indicated use of these expensive interventions. As part of a community-reinvestment strategy of reform within a state child welfare agency, a needs-based assessment of children and adolescents was undertaken. A review of cases revealed that although the level of mental health need for many was significant, a substantial proportion of children in residential placement were not at high levels of risk. On the basis of these data, a process of placement review was designed and implemented for more effective use of residential treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promoting adolescent mental health in primary care: a review of the literature

High levels of psychological disturbance amongst adolescents have been linked to behaviours which can damage physical health, and with mental health problems in adulthood. The aim of this review was to see if published literature supports the hypothesis that primary care is a suitable setting in which mental health problems in adolescents can be prevented by early detection and treatment. Medline, BIDS, SIGLE and Psychlit databases (January 1990-February 1997) were systematically searched for English language studies on adolescent health promotion and mental health in primary care; reference sections were checked for earlier work. When offered, adolescent health checks and clinics have been well received with attendance rates of 73% and 83% reported, respectively. Primary care offers a setting for the prevention and detection of mental health problems in adolescents. Further research is needed to determine cost effective ways of using these opportunities.     

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)     

The Fort Bragg continuum of care for children and adolescents: Mental health outcomes over 5 years.

Controversial early results of the Fort Bragg mental-health-effectiveness study indicated that the continuum of care did not produce better outcomes (i.e., children's rate of improvement was the same in both the demonstration and comparison sites). The present study considered outcomes at 5-year follow-up to examine long-term effects from the continuum of care. A random regression longitudinal model analyzed 10 key outcome variables measured 7 times. Long-term outcomes in continuum-treated children were no better than those of comparison children; results are consistent with those of earlier studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Delivering health and mental health care services to children in family foster care after welfare and health care reform

As the 20th century draws to a close, fundamental changes in the organization, financing, and delivery of health care and welfare services, principally directed at poor families, are likely to result in an increased number of children entering out-of-home care. These children typically have significant physical, mental health, and developmental problems. Whether the quality of health care services they receive will improve as a result of health care reform efforts and new approaches to service delivery remains to be seen. This article addresses some of the major changes wrought by welfare and health care reform and describes the essential features of a health care system that can meet the special needs of children in care.     

Day care and early childhood settings. Fostering mental health in young children

The authors, with research supporting the relationship between experience and the developing brain, envision a new and innovative model of child care in which principles of child development and mental health play an integral role. The School of the Twenty-first Century, although housed in existing school buildings, will be far more than a traditional 8:00 AM-to-3:00 PM educational facility. It will become a hub of child and family life in the community and provide institutional and outreach services for children from birth to 12 years of age. Active developmental and mental health programs that provide education for parents, primary caretakers, and other providers are central to the model. These programs will include preventive, evaluative, and treatment services for children. The child psychiatrist is viewed as an important member of the mental health team, who helps identify, assess, and treat children with developmental and psychiatric difficulties.     

A call for integrating a mental health perspective into systems of care for abused and neglected infants and young children.

A system of care for abused and neglected infants and young children should adopt a comprehensive perspective, with mental health considerations systematically incorporated into policies and decisions affecting children and their families. Children age birth to 5 years have disproportionately high rates of maltreatment, with long-term consequences for their mental and physical health. Research on normal development and developmental psychopathology has shown that early development unfolds in an ecology of transactional influences among biological, interpersonal, and environmental domains. Psychologists should collaborate with other early intervention disciplines to create systems of care based on an ecological–transactional model of development that includes early mental health principles in order to serve the needs of these young children. Didactic courses, practicums, and internships in infant and early childhood mental health should become integral components of undergraduate and graduate curricula in psychology in order to build capacity to achieve this goal. Recommendations are offered for systemic change by integrating infant and early childhood mental health principles into existing systems of care for young children and their families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefits of comprehensive health care for improving health outcomes in women.

The American Psychological Association Health Care for the Whole Person Task Force was formulated to provide a rationale for integrating behavioral health services in primary care. Collectively, the task force called for a transformation of the biomedical system into one based on the biopsychosocial model. This article is a summary of the Women's Health Committee position paper that reviewed contextual factors in women's health, provided recommendations for clinical service action, and recommended an integrated primary health care system to address women's health needs. This article provides a vision of integrated care and a practical guide for psychology practitioners as they collaborate with other health care providers and health policy groups to improve health outcomes for women over the life course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comprehensive program for mental health and behavioral medicine in a large children's hospital.

Primary health care services are differentiated from secondary or tertiary levels of care. Problems of illness-related psychopathology, sometimes called psychosomatic or behavioral medicine, are differentiated from traditional forms of emotional disturbances such as neurosis, psychosis, and personality disorders. It is shown how primary mental health care and behavioral medicine combine to form a special branch of child psychology known as pediatric, medical, or health care psychology. A program for work of this type in a large children's hospital is outlined. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National health insurance: Inclusion of mental health care and clinical psychology.

Mental health benefits can and should be included in any national health insurance (NHI) plan. The field of clinical psychology is also under pressure to demonstrate the necessity for inclusion in any NHI plan as an autonomous mental health service provider. Arguments from both sides of the issue, psychiatry and clinical psychology, are examined. Data lead to the conclusion that clinical psychology must be included, free from medical supervision and referral, in any NHI plan. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and primary health care for children.

There is an emerging consensus among those responsible for primary health care to children that such care should not only include medical concerns but also should assist parents with common problems of development and behavior. Psychologists are increasingly included among the personnel of medical groups that provide primary care to children. A model for this relatively new type of practice is described. Such pediatric primary-care settings also offer new research opportunities for psychologists. An important public policy issue concerns how comprehensive primary health care, including psychological services, can be made accessible to all children, and how research to evaluate such services and improve their efficacy can be encouraged. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Needed: Metaphors for the prevention model of mental health.

Comments on the article by J. D. Coie et al (see record 1994-09654-001) regarding prevention science. It is argued that the reason that prevention science has not taken its rightful place in national research programs is that metaphors from the medical model still pervade the prevention model of mental health. Metaphors from architecture may be more helpful in generating ideas within the prevention model, because they deal with planning, working with large populations, the interaction of people and the environment, and building healthy and aesthetic surroundings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A public mental health approach to the postdisaster treatment of children and adolescents

This article describes the implementation of mental health intervention programs for children, adolescents,and their families exposed to natural disaster and violence. Recommendations are made regarding needed levels of organization, methods of screening and triage, training and supervision of mental health staff, design and implementation of treatment approaches, and longitudinal monitoring of course of recovery and intervention outcome.     

The economics of mental health care.

Attempts to assist psychologists involved in policy discussions regarding the economics of mental health care by summarizing important sources of information on the characteristics and trends of psychological service providers and the cost of such services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed mental health care: The client's perspective.

Changes in psychotherapy services have been the focus of controversy between psychologists and the managed-care industry, yet too seldom have client preferences been directly heard in that debate. This study investigated consumer attitudes about the central elements of psychotherapy service delivery by 3 participant groups: self-pay clients, managed-care clients, and adults without therapy experience. Important differences of opinion were found among participant groups, yet results revealed that all 5 elements investigated were considered essential. Autonomy in treatment decision-making was ranked most important, followed by choice of therapist, copayment amount, limits to confidentiality, and ease of access to care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)