Showing papers on "Mental health published in 1969"

The structure of psychological well-being

Abstract: Preface Sir Isaiah Berlin has observed that there are deep differences in the ways in which people approach life, and that it may be useful to think of these ways as falling into two large groups-the way of the hedgehog and the way of the fox. Hedgehogs approach problems in an integrative manner, trying to bring everything into a single, universal, organizing principle that gives unity to the manifest diversities of life. Foxes, on the other hand, approach problems in a differentiating manner and pursue many disparate problems with little concern for haw they fit together or might fit into a larger integrated whole. Hedgehogs look for the unity in diversity; foxes look for the diversity that underlies the unity. In the field of mental health, the split between hedgehogs and foxes roughly parallels that between theorists and empiricists. The grand theorists such as Freud and Jung were militant hedgehogs. However, a review of the empirical literature in mental health, such as that by Jahoda (1958), shows the field to be dominated by foxes. This unfortunate split between hedgehog-theorists and fox-empiricists has resulted in unifying theories that dangerously approach explaining everything, and thus explaining nothing, or in disparate empirical findings that do not add up to anything. Too often theories are divorced from data, and data are collected with little regard for their theoretical import. This book is a hedgehog's attempt to bridge that gap and pursue systematic data collection within the framework of a single unifying concept. This concept-psychological well-being, or happiness has been of great concern to men since recorded history began and has been the object of vast amounts of thought and research for centuries. It is a logical concept to employ in the study of phenomena related to current concerns with mental health and mental illness, and one that is very congenial to the hedgehog mind. The particular conception of psychological well-being that is elaborated in this monograph emerges from a pilot study conducted by NORC (Bradburn and Caplovitz. 1965), which vi Preface attempted to develop instruments for measuring mental health in the population. Analysis of the data from that study led to a conceptualization of psychological well-being as a resultant of two almost completely unrelated dimensions of affect, which we called positive and negative feelings. The results of that study were sufficiently encouraging to suggest that further research along these lines would be productive. At …

Sexual status and psychiatric symptoms.

Abstract: This paper is concerned with testing the hypothesis that women will report more psychiatric symptoms than will men with an equal number of physical illnesses. Our hypothesis arises from an assessment of the societal definitions of what is "appropriate" or "inappropriate" behavior for someone occupying the status of male or female. In our view, men are expected to be less expressive than women in their emotional behavior. Analysis of data collected from a sample of 278 adults in 1965 and 1966 provides strong support for the hypothesis. On two indices consisting of what are judged to be psychological and psychophysiological symptoms, a greater percentage of women than men have "high" scores. Two other indices, containing physiological and ambiguous items, show a tendency for men to have slightly higher scores. Since the first two indices contain 15 items and the other two only 7, not unexpectedly women are higher than men on the over-all mental health inventory. This pattern is revealed in the analysis of data for both 1965 and 1966, and is also shown in analysis of "turnover" during the one-year period. A further finding is that women are more likely to seek medical care than are men with the same number of physical illnesses and similar psychiatric symptoms.

Why People Go to Psychiatrists

Abstract: This is the first examination in depth of the reasons and ways that people seek psychiatric help. Viewing contemporary metropolitan life from the standpoint of an experienced social analyst, Charles Kadushin deals with such issues as, why people believe they have emotional problems, what types of problems send them to psychiatrists, how, why, and by whom potential patients are told they are disturbed, why people choose psychiatry over other healing methods, and why many people do not receive treatment from the sources to which they apply.The author develops a new theory of social circles, describing how people move in a network of friends and acquaintances with varying degrees of knowledge of and interest in psychiatry. This factor affects decisions to obtain professional help and also has bearing on the types of problems presented. The study encompasses a wide variety of persons in a complex community environment--New York City, the psychotherapy capital of the world. The basic data were obtained from 1,500 patients in ten psychiatric clinics in three major treatment areas medical, analytic, and religio-psychiatric.The book provides new insights into the motivations of the patients as well as information about their social setting. It is an informative and engrossing work for students and scholars; for sociologists in the areas of medicine and mental health; for psychiatrists, clinical psychologists, and social workers actively engaged in treatment and casework; and for all professionals in the community health field.

Abnormal Sex Chromosomes and Mental Disorder

Abstract: The basis of this article was the Mental Health Research Fund lecture given on February 19 this year.

Religion, Mental Health, and Personality: A Review of Empirical Studies

Abstract: Reviewing a number of recent studies pertinent to the common belief that religion is a basis of sound mental health, general well-being, and humanitarianism, this author finds no empirical support for the theory He concludes that contemporary religious education does not seem to ensure healthier attitudes and discusses the possibilities for remedying this failure

A Controlled Evaluation of Day Hospital Effectiveness

Abstract: THE CONCEPT of sociopsychiatric treatment, the development of effective chemotherapy, and enormous public investment in community mental health facilities have radically affected the structure of psychiatric treatment within the United States. Mental health facilities geared to handle the diversity of patients for whom the traditional and often isolated mental hospital was once the only treatment resource have been and are being constructed. The comprehensive community mental health center, as outlined by the National Institute of Mental Health, 1 consists of five essential and interrelated services: inpatient, outpatient, partial hospitalization, emergency, and consultation-education. The specificity of these services, however, has not been clearly delineated. 2 For whom is partial hospitalization appropriate? Upon what basis should treatment assignments to the outpatient service be made? The present study is an attempt to compare two community based services and to determine whether each is capable

An open-systems approach to the study of mental hospitals in transition.

Abstract: In evaluating the functioning of a state mental hospital going through the transition of becoming a community mental health center, it is important to focus not only on the intraorganizational processes of the changing hospital but also on the exchanges and transactions between the hospital and the environment and the processes and structures through which parts of the environment are related to one another. This paper presents a framework for the study of the changing hospital organizational system and its relations to the community, based on the concepts of opensystems theory.

The Case for the Indigenous Therapist

Abstract: THERE is strong evidence, both direct and indirect, upon which to build a case for the indigenous therapist. The evidence is strong enough to suggest a series of systematic innovations, carefully supervised and evaluated, to ascertain the place of indigenous therapists in formal psychiatric services. If and when the indigenous therapist is so utilized, he could be a useful adjunct to already existing services and a major part of the solution to the mental health manpower problem. The term "indigenous therapist" implies a person who is sanctioned by a particular culture or subculture to do "psychotherapy" even though he has not been so trained by acceptable Western professional standards. The term, therefore, includes a whole range of individuals from shamans, witch-doctors, and medicine men to college students working in mental hospitals, housewives working as psychotherapists, and neighborhood residents being used as "mental health assistants" in

Epidemiological studies of college mental health.

Abstract: SINCE the earliest reports of college mental health activities, there have been many attempts to describe the distribution in the college population of the phenomena observed. Some of these attempts have been more successful and have had wider generalizability than others. It is the purpose of this paper to review the history and current status of such epidemiological reports. First a historical review of the development of student health services is presented and then a review of literature dealing with estimates of incidence and prevalence of psychiatric illness among college students, discussing studies both of facility usage and those based upon population surveys. Some of the methodological considerations in comparing these results and using them as a basis for developing rational approaches for intervention are discussed. The Early Development of College Psychiatry Dr. Stuart Paton is generally given credit for formulating 1,2 and developing 3 the first formal mental health

Group dynamics training.

Abstract: Knowledge about groups and the behavior of individuals within them is of increasing importance in the training of psychiatric residents and other mental health professionals. The department of psychiatry at Yale University School of Medicine has established a group training program, described by the authors, which centers about a "study group" experience. This experiential group is followed by more formal seminars in which important group concepts—including authority relations, structure, boundaries, culture, tasks, and role relationships—are examined.

Attitudes and opinions of rural people about mental illness and program services.

Abstract: ENTAL health program personnel have for many years attempted to find solutions to the problem of delivery of mental health services to rural communities. Mobile clinic teams have been tried with relatively little lasting success and, indeed, have helped to prove that other than traditional clinic approaches are mandatory. Attempts have been made to utilize other professionals in rural communities to help with the mental health job. These have included public health nurses,1-3 local welfare workers, and, from time to time, members of the agricultural extension services. Single professionals have been deployed in given areas to provide consultation, referral, educational, and case services. Examples of this are the mental health worker program of Florida4 and the community consultant approach in New Mexico5 and Wisconsin.6 These workers also provide leadership for the development of indigenous mental health programs tailored to local needs, resources, and political processes. It seems obvious that some means must be found that will utilize the manpower from all the human services programs that exist in rural areas, as scarce as they are in comparison with their urban and better financed counterparts. It seems equally obvious that the need for mental health services in rural areas will be with us for some time to come. In spite of the rapid urbanization and coincident decline in rural population, it is still a fact that 30 per cent of our total population lives outside the boundaries of our urban places. In North Carolina alone, 34 of the 100 counties have no urban places (2,500 people or more) as defined in the 1960 census, which means these counties are 100 per cent rural. Eighty-nine of the 100 counties had more rural than urban population in 1960. In the face of this and similar circumstances in vast stretches ofthis country we in the Community Psychiatry Section of the Department of Psychiatry at the University of North Carolina have initiated a project designed to develop, evaluate, and assess the feasibility of a pattern of rural mental health services which might also have application in other rural areas in the country. Among the strategies employed to test

Police as a community mental health resource.

Abstract: In their pathways to the state mental hospital, almost 50% of mentally ill patients and their families from Baltimore utilize the police as a community resource. To better understand why so many people use the police for help with mental problems, a comparison was made between first admission patients who used the police (N=17) and those who used more conventional medical resources (N=35). The results indicate that families decide to call the police because other, more appropriate, resources are not as accessible and will not offer services to recalcitrant patients. Until community mental health facilities develop more active evaluation and treatment programs for reluctant patients, the police will continue to serve a needed role in the care of the mentally ill.

Evaluation of the Quality of Mental Health Services

Abstract: PROGRAM evaluation studies are notable for the large number of people in favor of doing them and the small number of people who actually try. This is very understandable considering both the importance of good information about the usefulness of various health programs and the extreme difficulty of obtaining this information. In the area of mental health programs, the call for studies is, if anything, louder, and the number of studies, fewer. In a time of expanding programs and rising costs, this is an unfortunate situation which demands a high priority of attention. It is our purpose here to examine one type of program evaluation—evaluation of the quality of mental health services—and to suggest in what ways immediate progress in the field may be possible. The stimulus of our consideration is a paper by Donabedian 1 in which he discusses quality evaluation of medical care. We will not repeat what

Resistance to change in mental health professionals.

Abstract: A rapidly changing society requires that we establish more responsive models of theory and practice. But mental health professionals often resist looking at totally new models. This paper analyzes the fears of reduced status, financial return, work satisfaction, and feeling of competency that seem to be the cause of such resistance.

Mental health roles of physicians in a Mexican-American community.

Abstract: Family physicians who practice in a primarily Mexican-American community in Los Angeles were interviewed and answered questionnaires concerning their attitudes, opinions, and experiences in regard to mental illness and psychiatry. The results indicate that the physicians have a varied hut often high regard for psychiatry, a very diverse degree of sensitivity to and recognition of emotional disorders in office practice, and a desire in the majority for additional psychiatric education, consultation, and resources. Family physicians appear to serve as by far the most active and available mental health sustaining service in this particular low-income, ethnic community with its poverty of formal psychiatric facilities.