Psychological impairment under the Americans with Disabilities Act: Legal guidelines.

This article introduces mental health care providers to changes in the law defining a disability within the meaning of the Americans With Disabilities Act. The impact of these changes, based on recent U.S. Supreme Court cases, is reviewed in terms of how they affect psychologically disabled persons who allege employment discrimination on the basis of their impairment. Common pitfalls are identified for practitioners to avoid when consulting about psychologically impaired employees. Critical threshold questions are outlined, and 5 types of discrimination claims involving mentally impaired individuals are illustrated. The potential contribution of psychologists in disability cases is examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Saleem A. Shah (1931–1992): Obituary.

Memorializes S. A. Shah, whose contributions to the field of law and mental health included his commitment to the goal of achieving fair and equitable treatment for mentally disordered offenders and other persons whose mental status was at issue before the law. He also established law and mental health studies as a formal program priority at the National Institute of Mental Health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic jurisprudence and the civil rights of institutionalized mentally disabled persons: Hopeless oxymoron or path to redemption?

Examines, from a therapeutic jurisprudence (TJ) perspective, the rights of institutionalized mentally disabled persons to determine whether TJ is compatible with positions advancing civil rights and liberties, and whether lawyers for such individuals should look more closely to TJ as a source of rights. It concludes (1) that despite harsh criticisms of mental disability law reform, most of the important decisions in the areas of involuntary civil commitment, right to treatment, and right to refuse treatment law have a strong TJ component and (2) that TJ analyses may be the appropriate tool to reinvigorate this area of mental disability law. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability, discrimination & the Americans with Disabilities Act.

Discusses the prevalence of physical and mental disabilities in the US and the extent of the discrimination encountered by the disabled. The purpose and major provisions of the Americans with Disabilities Act are reviewed. Ambiguous areas in the new law that are of concern to psychologists are considered, specifically the disabled status of persons with chemical dependencies and psychological testing in employment settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Federal response to institutional abuse and neglect: The Protection and Advocacy for Mentally Ill Individuals Act.

Suggests that state institutions for mentally disabled people are often set in tranquil, rural surroundings that mask interiors filled with abuse, neglect, and tragedy. Factors are discussed that thwart efforts aimed at providing quality mental health services to individuals in need. In response to these conditions, the US Senate Subcommittee on the Handicapped developed the Protection and Advocacy for Mentally Ill Individuals Act, which became Public Law 99-319. This legislation established a nationwide system of protection and advocacy for mentally ill individuals in residential facilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability determination for the mentally impaired: Conflicts and changes.

Reports that the Social Security Administration (SSA) has been criticized for its handling of mentally impaired disability claimants. Requirements by the SSA for objective evidence of disability and the presumption that mentally impaired individuals are capable of unskilled work have been deemed prejudicial by those critical of the SSA. The 5-step process employed in determining whether disability benefits will be granted is outlined. Since reviews of existing disability cases began in 1981, a disproportionate number of mentally disabled beneficiaries have been selected for review and subsequent termination of benefits. Consequently, the disability programs of the SSA, particularly as they apply to mentally impaired claimants, have been challenged in federal courts and have been the subject of congressional scrutiny. Partly as a result, the SSA has suspended the review of disability cases and is in the process of modifying the determination and review process for disability claims involving mental disorders. Legislation pending in Congress indicates that sections of the Social Security Act pertaining to mental disorder are to be revised, and there will be increasing emphasis on determining the vocational impact of mental disorders. (69 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Criminalizing mental disorder: The comparative arrest rate of the mentally ill.

Notes that there has been a great deal of speculation that mentally ill persons are being processed through the criminal justice system rather than the mental health system. To date, this thesis has been based more on intuition than on empirical research. Data from a study of 1,382 police–citizen encounters are presented that suggest that the mentally ill are indeed being criminalized. Specifically, it was found that, for similar offenses, mentally disordered citizens had a significantly greater chance of being arrested than non-mentally-disordered persons. This finding has public policy implications for the basic tenets of the community mental health movement, as well as for optimal functioning of the criminal justice system. Several public policy modifications are suggested. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability and the law: Attitudes of police, lawyers, and mental health professionals.

A literature review on the attitudes of police officers, lawyers, and mental health professionals toward the disabled indicates that police officers' attitudes are related to the extent of their formal education and the amount of information they have about relating to persons with various types of disabilities. Lawyers who have disabled clients tend to be more knowledgeable and to have more positive attitudes than lawyers without such clients, but it is not easy to turn lawyers into advocates for disabled clients. Mental health professionals, who may be called on to provide advice to police officers or lawyers or to testify in court cases, have some negative aspects that may impair their helpfulness, but their attitudes are more positive than those of less educated persons. Data also indicate that the attitudes of psychologists are less negative than those of psychiatrists. It is concluded that rehabilitation psychologists need to undertake studies of the attitudes of these groups and to set up programs designed to change the attitudes of members of these professions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Failure of a moral enterprise: Attitude of the public toward mental illness.

Presents a critical analysis of published reports on the public's attitudes toward mental illness and toward deviant conduct. The mental health movement fits the defining criteria for a moral crusade, motivated and supported by moral entrepreneurs. The reported data indicate that the mental illness paradigm, as a formula for understanding and controlling deviant conduct, has not been widely accepted by the public. The central objective of the mental health movement has been to influence the general public to regard mental illness with the same nonrejecting valuations as somatic illness. Social survey reports and other data point to the conclusion that the public tends to declare negative (rejecting) valuations on persons diagnosed as mentally ill. However, the public tends to be more tolerant of deviant conduct when it is not described with mental illness labels. (37 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The criminalization of the mentally ill: Speculation in search of data.

Examines the evidence for the speculation that mentally ill persons who would previously have been treated within mental hospitals are now processed through the criminal justice system and constitute an ever-increasing proportion of the jail population. Three factors underlie this speculation: the increase in mentally ill persons residing in the community, police handling of the mentally ill, and evidence that persons thought to be dangerous are among the most unwanted clients of mental health agencies. Three types of research are explored: archival studies, investigations of police decision making, and studies of the prevalence of mental disorder among jail detainees. It is concluded that the research literature, albeit methodologically flawed, offers at least modest support for the contention that the mentally ill are being processed through the criminal justice system. (81 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association for the Advancement of Psychology: 1983.

This article describes the public policy activities in Congress of the Association for the Advancement of Psychology (AAP), which is the recognized independent national advocacy arm of American psychology, representing the interests of psychology in the public policy arena. AAP's public policy activities in Congress continued to focus on the elimination of discrimination with regard to the treatment of mental illness and mental health professionals, increased federal funding of behavioral and social science research and research training, and the protection of constitutional rights without exception. AAP activities included working with other mental health advocacy groups to urge Congress to enact fiscal 1984 appropriations measures favorable to psychology, lobbying for various child-related federal programs in 1983, and legislation drafted by the AAP to eliminate current discrimination between physical and mental health benefits for the 10 million federal employees, annuitants, and families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Service use and mental impairment among the elderly: Arguments for consultation and education.

Compared the service use patterns of older adults with varying levels of mental impairment, and assessed the effects of services received on their mental health status over a 1-yr period. Data were obtained from a US General Accounting Office (1977, 1979) study of 531 elderly persons (mean age 76.1 yrs), which included administration of a modified version of the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Ss were interviewed twice, 1 yr apart. 174 Ss were classified as having a mild psychiatric impairment, and 118 Ss had a severe psychiatric impairment. The existence of mental impairment was related to marital status, race, and level of education. Usage of mental health services was low, although mentally impaired Ss were more likely than unimpaired Ss to use social and medical services. Results also suggest that such services can have an important effect on the mental health of older persons. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists and civil commitment: Review of state statutes.

Conducted a national survey to examine to what extent psychologists have increasingly been recognized in new state statutes regarding civil commitment of the mentally ill. This survey reveals that although 24 out of 50 states include psychologists in their commitment statutes, inclusion is generally of an optional type, in which a psychologist can be substituted for 1 of 2 physicians. Most often psychologists are included in the judicial form of commitment and much less frequently in voluntary or emergency procedures. Even though psychologists have increasingly been included in state civil commitment procedures for the mentally ill since 1970, they remain in many ways unrecognized as qualified mental health professionals competent to judge the appropriateness of hospitalization of mentally ill persons. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Planning a community-based mental health system: Perspective of a family member.

The parent of a young adult son afflicted with schizophrenia describes the family's experience with schizophrenia and the mental health system. The process by which an integrated service system for the mentally ill in California was signed into law is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

DRGs are not enough.

Proposes that the federal government conduct research and demonstrations on community support maintenance organizations (CSMOs). Capitation would be given to CSMOs for providing a continuum of comprehensive, rehabilitatively oriented service packages that would reduce the use of inpatient and other costly and restrictive services by seriously or chronically mentally disabled persons. It is concluded that psychological theory, research, and practice can make a contribution to the development of prospective payment alternatives to DRG (diagnosis-related group) based systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Roles for mental health professionals in critical law enforcement incidents: An overview.

Law enforcement personnel routinely face various critical incidents in the course of their workday including confrontations with irate, violent, and/or mentally challenged individuals. While less frequent, law enforcement personnel also are called in response to hostage incidents, barricaded subject incidents, and attempted suicide/suicide by cop incidents. Over the past 30 years, response strategies utilized by law enforcement personnel have been evolving and have been influenced by mental health professionals. This article briefly reviews the histories of Critical Incident Teams (CITs) and Crisis Negotiation Teams (CNTs), discusses the roles of mental health professionals in the development and continuing evolution of CITs and CNTs, presents some of the obstacles to mental health involvement with law enforcement, and highlights areas in need of more empirical research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Selected characteristics of psychologists and psychological assessment in five settings: 1959–1982.

Surveyed 458 psychologists in psychiatric hospitals, community mental health centers and clinics, centers for the developmentally disabled and mentally retarded, counseling centers, and Veterans Administration medical centers to determine if the pattern of psychological service delivery has changed since B. Lubin and A. W. Lubin's (1972) national survey. Results reveal changes in areas such as the assessment function of psychologists, referral questions, and referral sources and support Lubin and Lubin's conclusion that surveys of psychological assessment should report individual rather than composite results for these 5 settings. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health promotion and the media: Community response to the Kansas City hotel disaster.

Describes how Kansas City mental health organizations responded to the community-wide mental health crisis that resulted from a hotel disaster in which 111 persons were killed and over 200 were injured. The mental health organizations provided mental-health-related education through the media, training for local psychologists and other caregivers, and support groups for those affected by the disaster. More than 500 persons contacted the community mental health centers for assistance. Outstanding aspects of the mental health organizations' response to the disaster were the rapidity and coordination of their efforts, and their success in obtaining cooperation from the media for the public education campaign. Information in that campaign was based on psychological research on the effects of disasters on mental health. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability and work: risk assessment

Recent parliamentary debate has brought the rights of disabled people back into the spotlight of media attention. In the workplace, the occupational health nurse (OHN) is uniquely placed to make a positive contribution to the achievement of equal opportunities for people with disabilities. The author describes a risk assessment approach to the occupational health and safety of disabled persons and their employers. Such approaches can help to ensure that the work skills of all employees are used to maximum potential.     

Interpersonal contact and acceptance of persons with psychiatric disorders: A research synthesis.

This meta-analytic review predicted and confirmed that interpersonal contact between mental health employees or students and persons diagnosed with psychiatric disorders is associated with improved attitudes toward the latter group. As also predicted, the amount of attitude change was found to be smaller, although still significant, when the evaluative measure described a group of the "mentally ill" rather than specific individuals, and when the respondents were mental health employees rather than students. Contrary to predictions, contact interventions of longer duration were not associated with greater attitude changes. It is concluded that contact interventions occurring in mental health settings are effective in promoting attitude change toward persons with psychiatric disorders, and methodological refinements that should strengthen the effectiveness of future contact interventions are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)