The psychologist as front-line mental health consultant in a general hospital.

Describes the experiences and diverse functions of a psychologist who acts as an independent mental health consultant in a general hospital. Particular attention is paid to problems that arise when psyche and soma interface, because these problems require knowledge of biology as well as of psychology. The appropriateness of this role for the psychologist and its acceptability to referring physicians are examined. The particular strengths of the psychologist as a behavioral scientist and the need for continuing education in differential diagnosis when psychological and physiological factors interact are also explored. Professional boundaries and role relations between psychology and related professions are reviewed. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Career counseling as a mental health intervention.

Discusses career counseling aimed at work adjustment or job change as a potential intervention for many individuals suffering from job stress and argues that, in certain instances, career counseling should be used instead of traditional psychotherapy and/or as an alternative to stress management. Assessment strategies for determining the appropriate intervention for individuals suffering from job stress are generated from work adjustment theory. The implications of utilizing career counseling as a mental health intervention are also presented. (34 ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Training in crisis intervention for students in the mental health professions.

An interdisciplinary training program in crisis therapy is described in terms of its teaching model, its structure, and its implications for facilitating professional growth. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hero/heroine modeling for Puerto Rican adolescents: A preventive mental health intervention.

Culturally sensitive treatments of the special mental health needs of high-risk Puerto Rican adolescents are lacking. The hero/heroine intervention was based on adult Puerto Rican role models to foster ethnic identity, self-concept, and adaptive coping behavior. 90 nonclinical Puerto Rican 8th and 9th graders were screened for presenting behavior problems in school and randomly assigned to an intervention and a control group. After 19 sessions, the intervention significantly increased adolescents' ethnic identity and self-concept and reduced anxiety. Treatment outcomes varied as a function of grade level, sex, and household composition. Self-concept was negatively affected among girls from intact families. The study supports the effectiveness of the culturally sensitive modality as a preventive mental health intervention for high-risk Puerto Rican adolescents, especially from single-parent families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comment: ''devining'' the role of the consultant psychiatrist in a public mental health service

Radiographically occult bronchogenic squamous cell carcinomas are early lung cancers that localize mainly in the bronchial wall, and are thought to be a good model for investigating genetic alterations through lung cancer progression. In order to elucidate sequential genetic changes in lung cancers, we analysed the incidence of allelic losses on chromosome regions 2q33, 3p21, 5q21, 7q31, 9p21 and 17p13 for 40 cases of radiographically occult bronchogenic squamous-cell carcinomas and 40 cases of advanced lung cancers microdissected. In this study we used eight microsatellite dinucleotide polymorphic markers. Frequent loss of heterozygosity (LOH) was observed on 3p21 (53%), 5q21 (44%) and 17p13 (61%) in roentgenographically occult bronchogenic squamous cell carcinomas. 2q, 7q and 9p were lost less frequently in both roentgenographically occult bronchogenic squamous cell carcinomas and advanced lung cancers. These results suggest that several tumour-suppressor genes are associated with lung cancer progression and that genetic changes on 3p21, 5q21 and 17p13 are early events.     

The development of a community child and family mental health service

The Community Child and Family Service is a primary care and community-based child mental health service working in a socio-economically disadvantaged area of inner London. This paper outlines the strategic framework and value base from which the service has developed. The clinical projects set up by the service in general practice, community and education settings are described, as are the training and supervision programmes that have been undertaken. The framework for evaluating the clinical and economic outcomes of the projects is outlined. There has been a positive response from purchasers, providers and clients to the introduction of this Service. The relationship between community- and hospital-based child mental health services is discussed, as is the future direction of the Service.     

Defining the role of the consultant psychiatrist in a public mental health service

OBJECTIVE: The aim of this paper is to clarify elements of the role of a psychiatrist working in the public sector. METHOD: The relevant literature was examined to help clarify some of the reasons psychiatrists have been leaving the public sector and to help define the key roles of a psychiatrist working in the public sector. RESULTS: Two principal roles for the consultant psychiatrist in the public sector are identified: the psychiatrist as a clinician and the psychiatrist as a manager. The management role is contrasted with the role as an administrator and important differences between these roles are identified. The management role includes planning, advocacy and managing human resources. The importance of professional development in the career path for the newly qualified psychiatrist is discussed. CONCLUSIONS: The role of the psychiatrist in public sector psychiatry is a challenging and exciting one. Psychiatrists will start to return to the public sector when they recognise this new role for the consultant psychiatrist. This will be to the advantage of public sector psychiatry in general and to the job satisfaction of psychiatrists. The key features of the clinical role are the demonstration of sophisticated clinical skills, providing clinical leadership via supervision, being accountable for patient care and providing consultant opinion on complex clinical problems.     

The family experience of mental illness: Implications for intervention.

This article discusses the family experience of serious mental illness, including subjective and objective burden, potential for family resilience, family roles, and personal and family variables that can mediate the impact of the illness. Following a specification of essential family needs, a number of effective family interventions are presented, including family support and advocacy groups, family consultation, family education, family psychoeducation, and psychotherapy. Finally, the authors examine ways of resolving potential conflicts related to confidentiality and offer suggestions that can enhance the effectiveness of psychologists who work with these families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new service ideology: The third mental health revolution.

Contends that the new service ideology stimulates development of an image of consumers capable of being the primary directors of their own growth and development. A new image of the professional is also emerging. He or she is now a valued member in a community of common concern but no longer dominates the helping process by virtue of special expertise. Examples of the new service ideology from community mental health, the mental hospital, and the new group-therapy movements are provided. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women''s liberation groups as a primary preventive mental health strategy

The purpose of this study was a critical evaluation of pedometer and actometer for estimating daily physical activity. Both instruments were tested for reliability on a carriage with movements in different directions. To obtain comparable data of different pedometers it was necessary to adjust the spring tension very carefully. The reliability of the individual actometer was satisfactory, but there are large differences between the watches. Therefore, a correction factor (C.F.) was introduced. Some experiments were carried out on a treadmill. 9 Children (aged 5-6 years) and 6 young adult males (aged 21-31 years) walked and ran at different speeds. The energy expenditure was calculated from formulas. The pedometer overestimates the actual step rate with 0.1-0.3 counts per step during fast walking (6-9 km-h-1) and fast running (15 km-h-1). It underestimates the actual step rate with 0.2-0.7 counts per step, while walking slowly. It was shown that the pedometer does not reflect the differences in energy expenditure levels at different speed very well. The actometer units per step increases more or less proportional to the speed of walking and running. In contrast to the pedometer results the actometer results are more related to the energy expediture levels at different speed. The results of this study suggest that the actometer might be a valid indicator of the daily physical activity in terms of energy expenditure.     

Culturally adapted mental health intervention: A meta-analytic review.

There is a pressing need to enhance the availability and quality of mental health services provided to persons from historically disadvantaged racial and ethnic groups. Many previous authors have advocated that traditional mental health treatments be modified to better match clients' cultural contexts. Numerous studies evaluating culturally adapted interventions have appeared, and the present study used meta-analytic methodology to summarize these data. Across 76 studies the resulting random effects weighted average effect size was d = .45, indicating a moderately strong benefit of culturally adapted interventions. Interventions targeted to a specific cultural group were four times more effective than interventions provided to groups consisting of clients from a variety of cultural backgrounds. Interventions conducted in clients' native language (if other than English) were twice as effective as interventions conducted in English. Recommendations are provided for improving the study of outcomes associated with mental health interventions adapted to the cultural context of the client. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical crisis counseling in a health maintenance organization: Preventive intervention.

Mental health clinicians can play a cost-effective role in reducing distressing psychological symptoms accompanying diagnosis of chronic illness. Medical crisis counseling (MCC) is a focal short-term intervention directly addressing illness-related psychosocial problems. A randomized clinical trial tested the effectiveness of MCC. Counseling was offered to patients who had cancer that was newly diagnosed, 1st heart attacks, or adult-onset diabetes and was contrasted with a control group receiving an HMO's standard mental health care. Significant reductions in distress attributable to MCC were noted in some patient groups. No increases in overall medical costs and some decreased mental health utilization and costs were noted with MCC use. Practitioners can easily apply MCC to improving patients' quality of life and mental health, without adding to health care costs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of women working as child aides in a school-based preventive mental health program.

Investigated whether a group of 50 adult women hired to work as nonprofessional mental health workers (child aides) were higher than 40 demographically comparable controls on attributes which, on an a priori basis, could be expected to be related positively to effective functioning in their role. Ss were compared on the Personality Research Form, the SVIB, the Marlowe-Crowne Social Desirability scale, a semantic differential, the Situational Response Test, and R. Hogan's Empathy Scale. The groups were significantly differentiated from one another on a wide range of scales. The inference is drawn that the aide group possessed more desirable attributes than the control group for the role of nonprofessional mental health worker. (25 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity generalization of a school-based preventive mental health program.

Summarizes results of 6 independent evaluations of school district implementations of the Primary Mental Health Project (PMHP), a program for early detection and prevention of school adjustment problems. Data indicate that each district program was effective beyond chance expectation. The pooled change profile, based on 370 primary-grade children seen through the 6 district programs, was positive. Findings support the soundness and utility of PMHP's underlying program model and suggest that it can be implemented flexibly and effectively in a variety of settings. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The family, the courts, and mental health professionals.

Discusses the different facets of the role of mental health professionals (MHPs) in the legal system. The MHP's role in the family court is compared with that in the criminal court. In the family court, MHPs generally deal in crisis intervention, evaluation, and referral for treatment. Involuntary civil commitment and child abuse are also major issues. MHPs are called on to intervene in divorce and child custody proceedings. Some state legislatures have mandated the employment of MHPs in mental health clinics attached to the courts. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnic group perceptions of mental health service providers.

Assessed 121 male and 118 female Chicano, 124 male and 123 female Black, and 126 male and 125 female Anglo college students' perceptions of 100 characteristics of 6 service-provider groups and the likelihood that Ss would discuss 9 problem areas with professional groups. Analysis revealed main effects for race, sex, and provider groups; factor analysis of the 9 problem topics revealed personal-social and educational-vocational dimensions. Females were more likely than males to discuss both problem areas with provider groups. Blacks and Chicanos were more likely than Anglos to take personal problems to professionals. Ss preferred to consult psychiatrists and clinical psychologists for the same types of problems more than counseling psychologists, who in turn were preferred more than college counselors, high school counselors, and advisers. For educational-vocational concerns, Ss generally expressed a stronger probability of consulting providers other than psychiatrists and clinical psychologists. Methodological issues, previous findings, and implications for service providers are discussed. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of indicated preventive intervention (secondary prevention) mental health programs for children and adolescents

Evaluated the outcomes of 130 indicated preventive interventions (secondary prevention) mental health programs for children and adolescents that seek to identify early signs of maladjustment and to intervene before full-blown disorders develop. Results indicate such programs significantly reduce problems and significantly increase competencies. In particular, behavioral and cognitive-behavior programs for children with subclinical disorders (mean ESs in the 0.50s) appear as effective as psychotherapy for children with established problems and more effective than attempts to prevent adolescent smoking alcohol use, and delinquency. In practical terms, the average participant receiving behavioral or cognitive-behavior intervention surpasses the performance of approximately 70% of those in a control group. Of particular interest was the high mean effect (0.72) achieved by programs targeting incipient externalizing problems which are customarily the least amenable to change via traditional psychotherapeutic efforts when they reach clinical levels. Priorities for future research include greater specification of intervention procedures, assessment of treatment implementation, more follow-up studies, and identifying how different participants respond to early intervention.     

Marital distress and mental health care service utilization.

Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. Results: Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. Conclusion: The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)