Operationalizing the International Classification of Functioning, Disability and Health in Clinical Settings.

Functional status may be a better indicator of health care needs and outcomes than diagnosis. Appropriate use of the International Classification of Functioning, Disability and Health (ICF) in health service settings can provide a standardized way for clinicians to communicate complex clinical assessments to other professionals, administrators, and payers. The American Psychological Association is working with the World Health Organization to develop a Procedural Manual and Guide for a Standardized Application of the ICF for use by multidisciplinary health professionals. The Procedural Manual includes operational definitions of concepts, examples of each code, and assessment information relevant to each qualifier. The purpose of the Procedural Manual is to provide health professionals with the guidance necessary for reliable, valid, and clinically useful classification. This article discusses a range of issues and problems in the application of individual ICF codes in the context of health care and offers some potential solutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic testing and psychology: New roles, new responsibilities.

Advances in genetics and genetic testing promise to catalyze a fundamental change in the practice of medicine. Psychologists have much to offer as psychotherapists, researchers, educators, and policymakers to a society heavily influenced by the genetic revolution. To make the most of new opportunities available to mental health professionals in genetics, psychologists must know basic genetic principles and learn what is new about 21st-century genetics. The core competencies for all health professionals developed by the National Coalition for Health Professional Education in Genetics are related in this article to the significant roles psychologists can play in helping individuals with genetic concerns to cope with vulnerability, optimize family interaction, and improve health behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Origins of health locus of control beliefs.

Explored the origins of health locus of control (HLC) beliefs using a multidimensional HLC battery that was administered to 270 undergraduates. A structural equations analysis showed that beliefs in Self-Control Over Health were positively related to early health habits involving self-care and medical professionals and negatively related to prior family experiences with sickness. Beliefs in Provider Control Over Health were positively related to early health habits involving medical professionals and negatively related to prior sickness experiences in one's family. Beliefs in Chance Health Outcomes were positively related to prior sickness experiences. None of these dimensions of HLC were affected by recent sickness experiences, supporting a view of HLC beliefs as fairly stable individual-difference measures developed relatively early in life. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychodynamic research perspectices on development, psychopathology, and treatment in later life.

Reports on a meeting held at the National Institute of Mental Health (NIMH). At this meeting, over 700 psychoanalysts and other mental health professionals and investigators gathered to consider research on the interplay of personality, biology, and society in shaping adaptation to aging. The convening of this meeting, co-sponsored by the Center for Studies of the Mental Health of the Aging and the Psychosocial Treatments Research Branch, marked the first time that NIMH had sponsored a conference in which the clinical and theoretical contributions of psychoanalysis to the study of normal and pathological development had been so explicitly recognized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward professional counseling among Asian-American college students: Acculturation, conceptions of mental illness, and loss of face.

The present study attempted to examine the influence of culture-bound barriers such as acculturation status, loss of face, and conception of mental health on the attitudes of Asian American college students (n = 134) toward seeking professional psychological help. An adapted Acculturation Attitude Scale (AAS; U. Kim, 1988), Zane's (1991) Loss of Face Scale (LOFS), a 10-factor Conception of Mental Health Scale (CMHS; Nunnally, 1961), and a modified version of the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS) with four subscales (Fischer & Turner, 1970) were used in this study. Results support the hypothesis that acculturation and conceptions of mental health were significantly correlated with attitudes toward mental health services. Loss of face was also significantly correlated with attitudes of being open to professional counseling. Implications for mental health professionals working with Asian Americans are highlighted. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Trauma, change, and psychological health in the 21st century.

The impact of stressful life events on health has been the object of inquiry for decades. Health care professionals have studied how stressful life events may precipitate or contribute to the onset of illness. Traumatic events and experiences can profoundly affect physical and psychological well-being, which in turn may predispose an individual to greater resilience or greater vulnerability to life stresses. Examined herein is the relationship between life stresses--including social stressors, political stressors, and environmental stressors--and the critical health related issues that psychologists need to prepare for in both the science and the practice of psychology over the next decade and during the 21st century. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV-AIDS Patients' Evaluation of Health Information on the Internet: The Digital Divide and Vulnerability to Fraudulent Claims.

Access to health information on the Internet has revolutionized how medical patients learn about their illnesses. Valuable information can be found online; however, many health Web sites contain inaccurate or misleading information. The authors surveyed 324 adults with HIV concerning their Internet use for obtaining health information. Health information found online was then rated for quality by participants and by medical professionals. Participants were less critical of health information found online than medical professionals and made smaller distinctions between high-quality and low-quality information. Assigning credibility to low-quality information was predicted by lower incomes and educational attainment, poorer reading comprehension, lower literacy levels, and irrational health beliefs. Results suggest that patients do not always evaluate online information critically and may be vulnerable to misinformation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serving the underserved: Our societal responsibility.

Discusses pending Congressional actions regarding a federal role in health care and the responsibility of mental health care professionals in shaping policy aimed at ensuring the maintenance of mental health care service provision. The challenge of the Substance Abuse and Mental Health Services Administration (SAMHSA) is to convince policymakers that existing and newly designed programs are meaningful and are accountable for significant results in terms of improved services, greater efficiency, and successful measurable outcomes. The programs of 3 SAMHSA centers, the Center for Mental Health Services, the Center for Substance Abuse Prevention, and the Center for Substance Abuse Treatment, focussing on these issues are delineated. Issues in the advancement of Telehealth-Telemedicine and mental health care components of treatment for the elderly in long-term care facilities are also described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem-based learning: application and possibilities in Brazil

The Ministry of Health launched the Family Health Program (FHP) with the aim of establishing comprehensive primary care for families and communities. The Public Health School of Ceará has been applying problem-based learning as the instructional method for the training of the family health teams. The importance of this method and the possibility of applying it in the implementation of a new and effective approach to the continuing education of Brazilian health professionals are emphasized.     

Achieving a Mental Health Bill of Rights.

The Mental Health Patient's Bill of Rights was the culmination of a meeting of the presidents of 9 national associations of mental health professionals to examine how to best educate the public, policy makers, and benefit managers about ensuring the availability of quality mental health and substance abuse treatments. The principles to which they unanimously agreed hold that mental health clients must have guaranteed confidentiality, a real role in determining their treatment, and a choice of provider. The clients have the right to full information about their coverage as well as parity of mental health and physical health coverage. The actual text of the Mental Health Patients' Bill of Rights is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Providing mental health care services to Americans.

Summarizes legislation introduced or cosponsored by the author, a US Senator from Minnesota, to respond to Americans' need for mental health services. This legislation included the Medicare Ambulatory Mental Health Services Access Amendments of 1987; S.123, a bill that would amend Part B of the Medicare program to recognize and reimburse psychologists as independent mental health providers; S.763, the Services for Homeless Mentally Ill Individuals Act of 1987; S.809, the Urgent Relief for the Homeless Act; and S.1663, the Child Abuse Prevention Act of 1987. The author encourages mental health professionals to promote public policies that expand Americans' access to public health services through research, effective communication of this research, and preventive mental health efforts (such as programs aimed at preventing teen suicide). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work Stress, Support, and Mental Health in Construction

Construction professionals are subjected to a plethora of occupational demands that can have a negative effect on their psychological wellbeing. Such demands can have an adverse influence on individual and organizational performance. To investigate the nature of self and social supports and mental health among construction professionals, an exploratory study was undertaken using the Stress and Mental Health Survey. The survey was distributed to construction professionals throughout Australia and 449 responses were received. Analysis revealed that those working for a contracting organization on-site reported higher levels of poor mental health and greater work stress than consultants. Those working on-site also experienced greater levels of self-stress, whereas consultants reported higher levels of self and work support. Work support was a significant predictor of poor mental health for consultants. Good health, however, was predicted by self, situational, and work support, whereas those working for a contractor only self-support predicated good mental health. It is concluded that while supports are essential in the fostering of good mental health, the absence of these supports can have a significant impact on poor mental health.     

Health promotion in the workplace: A prescription for good health.

Encourages health promotion in the workplace, asserting that the growing awareness of the effectiveness of preventive activities in reducing health care costs presents a challenge to psychologists and other mental health professionals because changes in attitudes and behaviors are at the core of preventive efforts. The present author describes his introduction in 1983 of the Preventive Health Care Incentive Act to provide a tax credit for employers who provide preventive health programs to their employees. Examples of health-promotion programs for the workplace are offered, and advantages of such programs are considered. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Primary Mental Health Project: Seven consecutive years of program outcome research.

The Primary Mental Health Project (PMHP) is a school-based mental health program for the early detection and prevention of school-adjustment problems. This study assessed the PMHP's effectiveness by evaluating 7 consecutive annual cohorts of children (N?=?2,310; 75% were primary graders) seen through the program from 1974 through 1981. Pre- and postprogram evaluations were based on teacher ratings on the Classroom Adjustment Rating Scale and the Health Resources Inventory and child-aide ratings of problem behaviors. At postevaluation, school mental health professionals rated educational and behavioral changes of PMHP Ss during the year. Results, from all 3 perspectives, strongly and consistently showed that Ss were judged to have improved in adjustment, thus supporting the conclusion that the model is effective and socially useful. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dr. B. C. Dasgupta Memorial Oration. Priorities, issues, inter-state variations and challenges

India spends only 1.5% of GDP on health as against the recommended 5% by W.H.O. for equity and universal coverage. States have a high share (89%) of funding their health care activities as against 9% by centre and 2.8% by U. T.'s. Increasing proportion of health expenditure on salaries (60-90%) and a markedly reduced (29%-5%) proportion on non-salary components is reflected in low-level of utilization of health services. Committed involvement by others in selected crucial areas is lacking. Health financing seems to be directed towards the urban sector with maximum outlays to curative care. There are high inter-state variations in health expenditure and health status. Higher share of SDF on public health does not guarantee a better health status. Health services sector urgently & legitimately needs additional resources. There is need to set up technical committee and research cells to sensitise policy makers, academicians and others and to steer and guide research. Health Financing and Management must be considered together to address issues of equity, efficiency and effectiveness in health care services.     

Involuntary medication, trial competence, and clinical dilemmas: Implications of Sell v. United States for psychological practice.

The recent U.S. Supreme Court decision in Sell v. United States (2003) raises a number of challenging issues for mental health professionals regarding the involuntary medication of individuals who are incompetent to stand trial. The authors examine the Sell decision, other relevant legal decisions, and research findings on coercion and procedural justice, and discuss the implications for mental health professionals involved in the treatment and assessment (both clinical and forensic) of defendants who may be affected by Sell. The authors conclude by proposing recommendations for mental health professionals working with defendants in Sell contexts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A health care system of one.

Health care has been, and to large measure remains, an enormous collection of considerably independent professionals, freestanding institutions, highly individualized consumer demands, and laws that vary considerably state by state. To a great extent, health services in the US have been organized and offered as an exchange between individuals, and American practitioners and patients have valued this independence. Over the past decade and a half, however, we have begun to recognize that provision of health care on an individuated basis comes at an enormous cost. Beyond simply the economic cost, there is the growing realization that the "independent" nature of the actions taken by the individuated sectors of our health system can often be characterized as idiosyncratic, unmanaged, uncoordinated, and irrational. One small but critical step toward improving the fractious nature of our health system is to advance the cause of states recognizing the professional licensure of health professionals by other states. Such mutual recognition, long overdue, promises real benefits for patients and, in the long run, for professionals as well. Professional bodies both private and public should focus on patients and their needs when considering any regulatory changes to be made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Domestic violence: legal, practice, and educational issues

Domestic violence is a recognized and growing public health concern in the United States. Health care professionals have a duty to improve the identification of victims of domestic violence, intervene effectively, and advocate for better education to break the cycle of abuse.     

CMA-sponsored Task Force on the Allocation of Health Care Resources.

Hurray for the Canadian Medical Association! They have just released Health: A Need for Redirection, the report of a Task Force on the Allocation of Health Care Resources. The task force, headed by Joan Watson, the former hostess of CBC's "Marketplace," included the Honourable Pauline McGibbon, former lieutenant-governor of Ontario, Roy Romanow, former NDP attorney general of Saskatchewan, and two physicians, John O'Brien-Bell and Leon Richard. The purpose of the task force was to examine the allocation of health care resources in the face of an increasing elderly population and the explosion of new technology. The report could help shape the future of the health care system. The report makes it clear that the health system is in crisis and the reform of the health system needs us all, as both active professionals and critical consumers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging, mental health, and demographic change: Challenges for psychotherapists.

People are living longer, and in better health, than in any prior point in history, with far-reaching but as yet underrecognized implications for mental health professionals. This phenomenon affects both the developed and the developing world. With greater numbers of older people, mental health professionals will need to develop greater awareness, understanding, and appreciation of gerontology to deliver optimally effective psychotherapy with this population. The nature of psychological issues encountered in clinical practice will also change—for example, intergenerational issues among blended families, increased retirement and leisure time, and expectations of greater health and productivity in later life from baby boomer cohorts. These issues are important for mental health professionals to recognize, as the increased sophistication of the baby boomer generation in terms of health care will lead to higher expectations of mental health care. The authors have chosen to discuss the implications of an ageing population with reference to a cognitive–behavioral perspective, but the issues raised here and practical suggestions contained within this article are not restricted to practitioners of Cognitive–Behavior Therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)