Psychological service needs of older women.

Attention to the unique psychological needs of older women will become increasingly important as the "baby boomer" generation enters the retirement years. The present article aims to review some of the salient issues, diagnoses, and themes involved in providing psychological services to older women and to provide recommendations for enhancing their access to mental health care. Areas addressed include caregiving; grief, bereavement, and end-of-life care; psychiatric and cognitive disorders; culturally diverse groups, rural older women, and nursing home residents; barriers to psychological service utilization; and suggestions for improving access to care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public policy and the provision of psychological services to older adults.

Public policy shapes who delivers health care, how care is delivered, and how much providers are paid. The impact of public policy will become even more important to psychologists who serve older adults as 76 million members of the so called “baby boom” generation enter their later years. Armed with basic public policy facts, psychologists can better maneuver the systems created by public policy and even change policy. This article reviews how Medicare works since it is the primary payer of mental health services for older adults. The article then turns to the question of how many health care professionals (including psychologists) will be required to meet the needs of a rapidly growing older population and concurrent challenges of training and building that work force. Finally, different policy visions for a better mental health care system for older adults are summarized since they may be roadmaps to what the future of mental health care will look like. The article closes with practical recommendations on how psychologists can influence mental health and aging public policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Relationship adjustment, PTSD symptoms, and treatment utilization among coupled National Guard soldiers deployed to Iraq.

Although combat-related posttraumatic stress disorder (PTSD) is associated with considerable impairment in relationship adjustment, research has yet to investigate how PTSD symptoms and relationship distress uniquely and jointly predict utilization of a range of mental health services. The present study sought to examine these issues utilizing a longitudinal sample of National Guard soldiers surveyed 2–3 months following return from deployment to Iraq and again 12 months later (N = 223). Results indicated that PTSD symptom severity, but not relationship adjustment, uniquely predicted greater odds of utilizing individual-oriented mental health services. A significant interaction was found indicating associations between PTSD symptoms and the odds of using services were increased when soldiers reported greater relationship adjustment. For utilization of family-oriented care, greater relationship distress was significantly correlated with greater odds of using services, but associations with PTSD symptoms were nonsignificant. The association between relationship distress and utilization of family-oriented services did not vary significantly with severity of PTSD symptoms. Results suggest supportive intimate relationships facilitate mental health treatment utilization for soldiers with PTSD symptoms. (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)     

Attitudes to the use of dummies in New Zealand; a qualitative study

AIMS: To explore experiences with, and attitudes to, the use of dummies (pacifiers). METHODS: Seven focus group discussions were held with groups of mothers and of health professionals. RESULTS: Most mothers and health care workers had a generally negative view of dummy use. This related particularly to dislike of toddlers with them and practical issues such as getting lost or dirty. All would allow their use in a very unsettled baby. No mothers had personally experienced problems with breastfeeding due to the use of a dummy, but concern about this possibility was expressed by some health care workers. Recommendations varied about the length of time that dummies need to be avoided. CONCLUSIONS: Mothers in New Zealand use dummies selectively for their infants and were concerned with issues of weaning the baby from the dummy, keeping it clean and not losing it. In analysing the relationships between dummy use and breastfeeding it is important to take into consideration the context of dummy use.     

The rural mental health worker as public servant: Challenge or conflict of interest.

Discusses ethical dilemmas resulting from the conflicting expectations of professional standards and bureaucratic regulations in the delivery of rural mental health services. Three cases are presented to illustrate ethical issues and practical problems of rural mental health professionals. (French abstract) (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Laryngeal cancer: quality-of-life and cost-effectiveness

The purpose of this paper is to review the current literature in relation to mental illness and criminal behaviour. The material presented for discussion was selected from forensic and general psychiatric literature. However, a number of important publications, policy documents and independent reports were used to explore the debate surrounding this subject. Contemporary studies of prison populations in the UK and abroad illustrated the difficulty in relating mental illness to crime. Papers presenting research in the UK revealed important implications for mental health policy and the way in which the penal system deals with mentally disordered offenders. The literature reviewed provided arguments for and against an association between mental illness and criminal behaviour. Methodological problems associated with criminological and psychiatric research were addressed in relation to the exploration of whether people suffering from a mental illness are more dangerous or violent than other people. Research papers focusing on public reaction to mentally ill people living in the community provided important considerations when addressing mental illness and criminal behaviour in the context of care in the community policy. This paper will be of interest to a broad range of mental health professionals, particularly those working with individuals who have a history of mental illness and violent behaviour, or mental health professionals working with mentally disordered offenders.     

Where angels fear to tread: Issues in sampling, design, and implementation of school-based mental health services research.

Research on school-based mental health systems is an important but hazardous enterprise. Current trends suggest that child mental health professionals will increasingly focus on community service systems that are family-based and school-centered. Challenges to conducting research on effectiveness of such services include underidentification of children with emotional or behavioral disorders, lack of concordance between diagnostic criteria used in school vs mental health systems, problems of comorbidity, analysis of data from multiple informants, lack of interdisciplinary or interagency collaboration, community involvement, and a variety of other factors. These issues and suggestions for addressing them are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are the roles of the nurse specialist and the master of health services the same?

This study aimed at identifying the role of the nurse with a graduate degree at the service level based on nurses and service directors expectations in health care institutions. A total of 278 nurses and 25 service directors responded to a questionnaire and an instrument was designed to measure their expectations towards the nurse with a postgraduation degree. The results indicate that nurses and service directors hope nurses with a postgraduation degree to be highly qualified to provide care. While service directors express a slight difference in favor of both the master degree and the deep knowledge of the specialty, nurses expectations in relation to it, are a little greater in all aspects. Service directors priorize refresh courses for nurses while nurses priorize specialization courses. The study has implications for a deeper discussion of these professionals functions in service and for the objective of postgraduate education programs in the region.     

The Future of Mental Health.

Examines the two sets of criteria that generally categorize mental health: those that emphasize internal events and those that deal with external events. The author discusses the future of mental health in light of many of its current trends, including greater acceptance of diversity, and he discusses the potential future role of the mental health professional. The author notes that greater numbers of mental health professionals have gotten involved with different populations, and suggests that the majority of mental health professionals will probably be experts in handling small units of behavior or experience for a limited time. The very process of making predictions changes the future course of events. Let us hope that this intricate process will result in greater satisfaction for greater numbers of people. (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.     

Childbearing within the prison system

The immediate pre and postnatal periods are a time of high anxiety for most women, but for those living in prisons, the stressors can be multiplied. Deprived social backgrounds, inconsistent family contact, isolation, poor physical and mental health, and the probability that the baby will be put into care are some of the problems such women face. This article describes the provision of health care generally for women in prison, then examines the particular problems faced by those who are pregnant.     

Cultural barriers to health care reform

The rate of proliferation of health care reform proposals makes it impossible to consider them all adequately; whatever plan is finally legislated, there will be many who are not satisfied with it, and clamor for change is likely to be a prominent feature of health care politics for a long time. This article takes a brief look at the health care reform process in the United States, including some of the impediments to development of a plan that would address both contemporary and future issues. Some traditional ethical viewpoints and cultural values, having to do with concepts of justice, are seen as inimical to long-range program development. The need for alteration of traditional views is regarded as urgent, to facilitate cultural movement in directions that will not only permit development of workable health care programs, but will extend broadly to address other compelling societal issues. The impetus for advantageous cultural movement originates among perceptive individuals who are regarded by society as legitimately influential. Many physicians still are accorded this sort of recognition, and the considered input of medical professionals is essential.     

Serious mental health problems: policy changes

Recent developments in services and strategies for helping people with serious mental health problems represent a watershed in mental health provision. This has implications not only for specialist mental health nursing, but also-- as increasing numbers of people with serious mental health problems live in the community-- for nurses working in all areas of health care, who will have to play a role in meeting their needs. This article describes current developments in policy and practice, and seeks to explain the basic principles of working with people in this client group.     

The impact of deployment on U.S. military families.

Several recent articles have explored the effects of military deployment on U.S. service members' mental health outcomes. Although increased attention has also begun to focus on the effects of deployment on military families, providing a conceptualization for the mechanisms of this process can help organize existing information and inform future efforts. In this article we seek to draw greater attention to the effects of deployment on service members and to provide an overview of recent literature on the impact of deployment on service members and military families. A further goal is then to provide one conceptual perspective—a model of family stability—that may help inform our understanding of the impact of military deployment on families. Beyond informing research, the issues presented in this article have far-reaching consequences not only for American military families and their current mental health and primary care providers but also for practitioners in the broader mental health community who will be increasingly called upon to provide services to this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of psychologists' education, knowledge, and experience treating clients with HIV/AIDS.

Practicing psychologists are providing services to persons with HIV infection and those at-risk for AIDS. However, most practitioners have not received formal training about HIV/AIDS. In this study, the majority of psychologists surveyed had treated persons at-risk for the virus but had not received HIV/AIDS information in formal educational programs. Most respondents obtained knowledge through popular media. There is a growing body of specialized knowledge about HIV/AIDS for mental health professionals. In addition to better serving HIV-infected clients, psychologists with current multidisciplinary HIV/AIDS knowledge will be valuable members of health care teams. (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.     

A step in the right direction: A resource for collaboration on health-related issues.

Reviews the book, Health-related disorders in children and adolescents edited by L. Phelps (see record 1998-07780-000). This edited text provides an overview of 96 medical conditions that place children at risk of developing psychological or educational problems. The central feature of this book is that it is intended as a reference tool for professionals who collaborate with medical professionals. Increasingly, there have been many vehicles for school psychologists to collaborate with medical professionals, including comprehensive school health care programs and school-based health clinics, and community-based coordinated services that provide children and youth comprehensive care. In this regard, school psychologists are likely to encounter increasing numbers of children who experience health disorders, along with more traditional areas of practice including mental health and educational issues. Although not a purely medically oriented text, Phelps has taken a perspective that school psychologists work within the context of a multidisciplinary team of professionals who are likely to provide services for these children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparing psychologists for managed care settings: Enhancing internship training programs.

Do internship programs prepare new professionals for success in today's behavioral health care marketplace? Managed care has quickly affected internship training programs and has dramatically altered the delivery of mental health services. but training programs have been slow to adapt to these changes. For example, instruction in business concepts and training in clinical and professional issues unique to managed care are discernible deficiencies in contemporary internship training programs. This article presents strategies to remedy training deficits in order to produce psychologists who are capable of meeting current market demands. (PsycINFO Database Record (c) 2010 APA, all rights reserved)