Mental health in schools: expanded opportunities for school nurses

Emerging trends are reshaping the work of school nurses and other school service personnel. With respect to direct service and consultation, school nurses increasingly are called upon to deal with psychosocial and mental health problems. Beyond that, school nurses must continue to actuate their roles as advocates, catalysts, brokers, and facilitators of the type of reforms that can effectively address barriers to student learning and promote healthy development. Continuing education is seen as key to enabling school nurses to build capacity for such roles and functions. The newly formed Center for Mental Health in Schools at the University of California, Los Angeles (UCLA) hopes to be of assistance in this respect. This presentation highlights the Center's orientation to mental health in schools and offers a draft outline for related continuing education.     

Exercise, health, and aging: a need for more information. 1983

Vigorous exercise is currently being encouraged for health maintenance. There is much evidence that a moderate amount of exercise is needed for the maintenance of functional integrity of the cardiovascular system, muscles, bones, and ligaments. There is also fragmentary evidence of a preliminary nature suggesting that regularly performed exercise may protect against and have beneficial effects on coronary artery disease, diabetes, and hypertension. However, the scientific evidence that strenuous exercise has long-term health benefits or slows aging is meager and unconvincing. Even in the case of coronary artery disease, diabetes, and hypertension, the majority of studies have provided either negative or inconclusive results or have resulted in only minor improvements. Taken together, available evidence is inadequate to serve as a basis for recommending regular participation in strenuous exercise for middle-aged and older individuals. This is particularly true because the theories that exercise may accelerate the aging process as a result of increases in metabolic rate and stress hormone production have never been disproved. Therefore, because of the major public health implications of exercise, large-scale, well-controlled studies of the effects of exercise on coronary artery disease, adult onset diabetes, hypertension, and various aspects of the aging process are urgently needed. Important barriers to progress in this area are the current dearth of exercise physiologists interested in research on health maintenance and well trained in human exercise physiology and the lack of an appropriate research funding mechanism for large-scale, interdisciplinary studies of the effects of exercise on chronic disease processes and aging.     

The federal health scientist-administrator: An opportunity for role integration.

The federal health scientist-administrator is centrally involved in the national health program and serves in the interface between science and public policy. In this middleman role there is a role conflict which derives from the dichotomy between his values as a scientist and as an administrator. He is viewed as an expert in the process of federal grantsmanship as well as in the research area for which he has responsibility. It is suggested that he must be willing to accept this role conflict as an attribute of science administration today and work toward a process of integrating the 2 roles. Psychologists and other behavioral scientists should participate in such an effort at integration. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental aging and organicity in an alcoholic population.

Investigated whether changes in mental abilities associated with alcohol abuse are in the direction of mental aging or in the direction of organic brain syndrome. 158 25-64 yr old alcoholic inpatients were divided into 4 CA groups corresponding to WAIS age norms, and WAIS score profiles were computed for each group. Results indicate that Ss differed significantly from normative values derived from the WAIS manual both in accelerated mental aging and in evidence of organicity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental imagery and aging.

Young adult (aged 18–23 yrs) and elderly (aged 55–71 yrs) Ss performed 4 visual mental imagery tasks, each of which tapped different processes. The elderly had relatively impaired image rotation and image activation (the process of accessing and activating stored visual memories), and there was a hint that aging may impair the ability to maintain images. In contrast, the elderly were able to compose (the process of generating the segments of the shape, one by one) and scan visual mental images as well as young adults. However, when the authors correlated the mean performance of each age group across all the tasks, they found that the reaction times (RTs) of the elderly were almost perfectly predicted by the performance of the young Ss but that the error rates were not correlated. These findings suggest that although there is slowing with age, individual imagery processes are affected selectively by aging. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The federal response to child abuse and neglect.

Addressing the problem of child maltreatment is a high priority for the Clinton administration. Guided by the principles of safety, permanency, and the child's well-being, the Administration on Children and Families (ACF) has made great strides in improving the lives of maltreated children. Critical programs administered by ACF include the Adoption and Safe Families Act, Community-Based Family Resource and Support Program grants, Children's Justice Act programs, and Child Abuse Prevention and Treatment Act research and demonstration projects. Projects serve both to expand existing programs and to develop innovative approaches. ACF has also sponsored several multidisciplinary national conferences designed to generate a sense of shared responsibility and a renewed commitment to solving problems of child abuse and neglect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health differences among retirees and workers: Findings from the normative aging study.

Researchers during the past decade have found little effect of retirement on physical health. However, retirement entails a number of losses, and its effect on mental health, as measured by the prevalence of psychological symptoms, is unclear. We examined psychological symptoms in a sample of 1,513 older men, participants in the Normative Aging Study, using the SCL-90-R (Derogatis, 1983). Analyses of variance indicated that retirees reported more psychological symptoms than did workers, even after controlling for physical health status. Exploratory analyses examining the circumstances of retirement found no effects for length of retirement or part-time employment, but did find effects for the timing of retirement. Both early and late retirees reported more psychological symptoms. Late workers (aged 66 and older) reported the fewest symptoms. Reasons for these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nursing and health care for an aging society: the case of The Netherlands

1. Demographic developments in European and western countries are not unique. Nurses should embrace the opportunity to learn from each others' care and research initiatives for the elderly population. 2. Current transitions in health care systems should be seized as an opportunity to further establish and develop the nursing profession, for example, through joining and initiating multidisciplinary initiatives. 3. The aging population is the fastest growing population in a number of countries. The training, recruitment, and retainment of nursing staff are key to continuously provide high quality care for the elderly.     

The federal role in disease prevention and health promotion.

Comments on articles by J. A. Heffernan and G. W. Albee, J. M. McGinnis, W. S. Cohen, and C. Lenfant and M. Schweizer (see PA, Vol 73:1705, 2593 and 1698, respectively) that summarize representative federal efforts to stimulate academia, the private sector, and the community to become more responsive to problems and opportunities in disease prevention and health promotion. The critical elements are in place for a concerted effort to develop and implement disease prevention/health promotion efforts on a nationwide basis, and the implications of successful outcomes of such activities suggests as ever-increasing demand for health behavior scientists and clinicians. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The federal budget and the New Federalism: Trends affecting mental health.

Outlines the Congressional budget process and its effects in 1981 on health and mental health issues, using federal aid to community health centers as a case illustration. The anticipated impact of the Reagan "New Federalism" proposal is assessed, and alternatives to block grants are mentioned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and psychic structure: an empirical study

Psychodynamic clinicians cite psychic structure and structural changes observed in treatment as sources of important information about unconscious psychological processes and configurations. Empirical studies have had difficulty demonstrating that psychic structure measures something different from psychiatric symptoms and everyday functioning. This study examined the relationship between psychic structure and mental health using the Health-Sickness Rating Scale (HSRS) to measure mental health and two different measures to assess psychic structure: Kernberg's personality organization (PO) and Wallerstein's Scales of Psychological Capacities (PSYCAP). Bivariate correlations and multiple regression analyses were computed based on ratings for 124 psychiatric inpatients and psychotherapy clients. Correlations showed that mental health and psychic structure are substantially interrelated, and multiple regression analyses indicated that 44% of the variance of HSRS is explained by psychic structure measured with the two methods taken together. The findings provide some support for a general factor of mental health and psychic structure and a "pure" component of psychic structure that is independent from mental health. Different factor-analytic models for understanding the relationship between mental health and psychic structure are discussed.     

Mental health outcome assessment: The new agenda.

Reviews the new market-driven demands for mental health outcomes research, summarizes issues pertaining to choice of outcome measures, describes the implementation of an outcome assessment system in a clinical environment, and suggests directions for the future. Rising health care costs and resulting reimbursement limitations imposed by 3rd-party payers have led to increased demands to justify mental health services. Profiling, report cards, instrument panels, and benchmarking have emerged as methods for understanding, documenting, and reporting quality and outcomes of treatment. Several national efforts are underway to achieve consensus on a core battery of measures to serve as a standard for a national mental health "report card." An example of an outcome assessment system within a clinical setting is presented along with outcome profiles for age, gender, and diagnostic subgroups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health services for children: The state of the art.

Throughout this century, people in the United States have been concerned about the serious deficiencies in the mental health care of our children. Despite eloquent needs assessment and recommendations for remediation, most of the unserved needs and deficiencies of our mental-health-care-delivery system remain the same. This article reviews the current status of mental health services to children, youth, and families to highlight the necessity of an integrated system of mental health care. The development of a continuum of care that is coordinated across the mental health and non-mental-health systems that naturally occur in all children's lives has the potential to vastly improve mental health services to children, youth, and families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The aging woman: Developmental issues and mental health needs.

Reviews findings that support the conclusion that adult women across all age categories are more distressed than their male counterparts although the source of this distress may differ for middle-aged and older women cohorts. Underlying the disturbance for the middle-aged woman are role loss, lack of marketable skills, and general inability to "break into" the larger social arena. For elderly women, the key issue underlying mood and behavioral dysfunction is identified as social isolation. Literature on widowhood and retirement is briefly examined, a short review of the relevant psychotherapy literature is undertaken, and forms of support for middle-aged and elderly women in the community are presented. The possibility of linking women in both age categories into community networks and the development of adult counseling centers are discussed. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health services in health maintenance organizations: Implications for psychology.

Contends that roles for psychologists in health maintenance organizations (HMOs) are affected by the nature of HMOs, economic considerations, standards set by federal legislation, claims for the cost-effectiveness of mental health services, and the federal administration's goal of removing mental health services from those required in law. Legislation is not precise concerning the nature or extent of mandated mental health services, and administrative interpretation of this legislation encourages considerable latitude in services provided. Studies do not support arguments for mental health services on the basis of their claimed cost-offset effects as strongly as one might wish. It is concluded that if psychologists are to establish areas of unique worth to HMOs, they may have to do so by adding contributions other than traditional clinical services to meet the need structure of HMOs. Possible ways of doing this are discussed, drawing on contributions that are developing in the field of behavioral health and relating these contributions to the prime purposes of HMOs. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protecting confidentiality rights: The need for an ethical practice model.

All psychologists must uphold the same ethical standards about confidentiality even though each state imposes different legal limits on their ability to protect clients' confidences. The resulting ethical-legal confusion is exacerbated by legally based confidentiality training that treats legal exceptions as if they were the rule and fosters the impression that attorneys are now the only real experts about this aspect of practice. This article provides an ethics-based confidentiality practice model that clarifies the ethical rule and puts its legal exceptions into ethical perspective. Like the Confidentiality section of the American Psychological Association's (2002) Ethical Principles of Psychologists and Code of Conduct, this outline would apply to all psychologists regardless of state laws, but the details of its implementation would vary according to role and setting. It can be used as a universal training outline, a consultation and supervision tool, a guide to professional practice, and a basis for clearer ongoing conversation about the ethics of "conditional confidentiality." Psychologists can use this practice model to regain their status as experts about the confidentiality ethics of their own profession. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Scholarship in psychology: The advantages of an expanded vision.

The authors comment positively on "Scholarship in Psychology: A Paradigm for the Twenty-First Century" (D. F. Halpern et al., 1998) and further expand that vision of scholarship. Giving high priority to social responsibility, they criticize overly narrow scholarship, including its effects on the discipline, and examine the economics of scholarship and the criteria for evaluation. Emphasis on applied research and the integration of knowledge is encouraged, along with the application of psychology and the scholarship of pedagogy and teaching. A broader, flexible, more grounded vision of scholarship and a modification of the culture of academic psychology is required. (PsycINFO Database Record (c) 2010 APA, all rights reserved)