Showing papers on "Mental health published in 1975"

The sickness impact profile. Development of an outcome measure of health care.

Abstract: Dr. Betty Gilson is Associate Professor and Associate Dean, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington 98195. Dr. John Gilson is Director of Medical Education, Group Health Cooperative of Puget Sound, Seattle, Washington. Dr. Bergner is Assistant Professor, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington. Dr. Bobbitt is Research Professor, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington. Ms. Kressel is Senior Administrative Analyst, Health Policy Program, San Francisco, California. Dr. Pollard is a postdoctoral fellow, Department of Psychology, Northwestern University, Evanston, Illinois. Dr. Vesselago's address is: 2012 Tenth Avenue East, Seattle, Washington. This investigation was supported by the HMO Service of the Health Services and Mental Health Administration, Contract HSM 110-72-420. This paper was presented, in abbreviated form, at the American Public Health Association Annual Meeting, San Francisco, 1974. It was accepted for publication July 21, 1975. costly services. The proliferation of innovative organizational patterns for providing health services makes it necessary to obtain data demonstrating the relative benefits of available alternatives. Evaluators use three types of measures to assess health care services: measures of structure, measures of process, and measures of outcome. 1 2 Measures of structure or process assess factors that are presumably directly related to outcome. Measures of outcome are designed to assess the effects of the health care services on the population served. Often, structure or process measures are used because no adequate or efficient measure of outcome is available. While it has been assumed that these three types of evaluation measures are highly related and that structure and process measures can serve as proxies for outcome measures, the substitution will be legitimate only when the relationship between structure or process and outcome has been established. For example, one can assess the outcome of a program such as polio immunization by examining the number of immunizations administered (a process measure), since it has been demonstrated that such immunization leads to less polio (an outcome measure). On the other hand, since it is not known whether the number of clinician visits decreases illness, measuring numbers of visits does not provide knowledge of outcome.

Stimulating responses to mailed questionnaires: a review

Abstract: This study collates findings from the available research literature of sociology, psychology, business, and education on techniques to increase responses to mailed questionnaires. Among the techniques reviewed here are those that employ mechanical or perceptual means to facilitate responses, those that use broad motivational factors to build on social and personal values of the respondent, and those that offer direct rewards for return of questionnaires. It is concluded that a change in over-all research strategy may be necessary to increase our ability to ensure high mail-questionnaire returns. The author is Associate Professor in the Department of Sociology and Anthropology and Research Director for the National Institute of Mental Health Training Project, "Family, Community Agencies, and Behavior Problems," University of New Hampshire.

Mental health and going to school : the Woodlawn program of assessment, early intervention, and evaluation

Abstract: Mental Health and Going to School describes a longitudinal, community-based mental health program of research and service for young children in Woodlawn, a black urban neighborhood on the south side of Chicago. Sheppard G. Kellam and his associates from the Woodlawn Mental Health Center and the University of Chicago carried out a unique study of the mental health of all Woodlawn children as they entered the first grade and progressed through their early school years. 1974 Cloth $11.00

Asian americans in the community mental health care system

Abstract: A study of Asian American patients receiving care in community mental health facilities suggests that rates of psychopathology among Asain Americans have been underestimated and that treatment facilities are not responding to the needs of this group.

Toward a Redefinition of Density

Abstract: The concept of densitv is of central importance in olannina. urban design and architecture. There is an extensive literature on it and much discussion of the merits or demerits of specific densities and comparisons of them. It is my suggestion that at the moment density is not a very useful concept in human terms because it is seen largely as a matter of number of people per unit area and this is not a very useful approach. It seems necessary to develop some new conceptual approaches to the problem which would enable a redefinition of the term and hence would increase its usefulness. In this essay I will reexamine the concept of density and suggest some possible guidelines for a redefinition.

Incidence of depression in early adolescence: A preliminary study.

Abstract: The authors wished to determine whether depression was present in an early adolescent nonpatient identified school population. Questionnaires were administered to seventh and eighth grade students in a parochial extended elementary school. The findings indicated that 33.3% of this school population were experiencing moderate to severe depression and 35% of the sample acknowledged current suicidal ideation. A comparison of mean scores showed a trend toward more depressive symptomatology in the eighth grade, possibly indicating a developmental critical period. A correlation of individual scores and teacher ratings suggests that teacher evaluation may have some direct effect on the student's emotional health. The authors make specific suggestions for promoting improved mental health in a school setting.

Community mental health myths and the fate of former hospitalized patients.

Abstract: This paper addresses one of these important emerging problems--the fate of former hospitalized patients--and the policy issues that the problem raises. The discussion is derived from observations of the experience of the mental health system in the State of Hawaii, but the issues raised are of relevance to other states as well.

Support Systems and Community Mental Health

Abstract: (1975). Support Systems and Community Mental Health. International Journal of Group Psychotherapy: Vol. 25, No. 3, pp. 361-362.

A Prediction of Delayed Stress Response Syndromes in Vietnam Veterans

Abstract: It is posited that over the next years civilian mental health professionals will encounter stress response syndromes in Vietnam veterans, will misread etiological factors, and will be unable to treat such persons effectively. This paper attempts to describe the types of problems which may be expected and suggests special approaches which will be required and may assist the treatment process.

Race and mental illness: an epidemiologic update.

Abstract: This paper presentsf/inidings otn the relatiotns/ip between race aid metntal health extracted from aI m(jor fize year epidemiologic study conducted in the southeastern United States. Mental health scores on five separate psychiltric scales are compared for blacks antd whites. These comparisons are made inl two Ways. First, .imple correlabtins ulsig T tests atid atnalysts of'variantce are computed; theni the variable race is itncluded with age, sex and socioecotnomic statlLt ini a stepwise multiple regressiotn equationl. The results show, that blacks had higher meani scores thant whites otn all the scales: the difference. (ire

Sociocultural and social-psychological factors affecting personal responses to psychological disorder.

Abstract: SOCIOLOGISTS and social psychologists have given considerable attention in recent decades to the processes leading to the identification of mental disorders in the community and to factors affecting help-seeking. Such work was given impetus almost twenty years ago with the publication of Social Class and Mental Illness (Hollingshead and Redlich, 1958) and its analysis of social class differences in thresholds for identifying mental disorder and pathways into care. At approximately the same time Clausen and Yarrow (1955), then at the National Institute of Mental Health, in a study of the

Psychiatry and the elderly: an overview.

Abstract: The author notes that the elderly in our society have not been provided with treatment, research, and services commensurate with their needs. These needs are reflected in the increasing incidence of psychopathology, suicide, and poverty with increasing age. The psychiatric profession's therapeutic nihilism toward the elderly may reflect unresolved countertransference issues that result in a form of prejudice called "ageism." Many of the conditions labeled "senility" are actually manifestations of socioeconomic or medical problems that could be resolved with prompt, appropriate treatment. The author makes several recommendations--the creation of a multidisciplinary nongovernmental commission on mental health and illness of the elderly, reexamination by psychiatrists of their attitudes toward the elderly, and proportionate representation of older individuals in psychiatric services, training, and research.

Deprivation in the childhood of depressed women.

Abstract: With recent developments in community psychiatric services, concern with prevention has become an urgent social, as well as medical challenge. Comprehensive investigation into causation must therefore be given systematic emphasis. This paper is an effort toward clarification of etiology, specifically of the depressive disorder, in terms of early childhood experiences. The work is based on social and psychiatric history data collected by experienced psychiatric social workers on two groups of subjects from the National Institute of Mental Health (NIMH) Collaborative Depression Studies under the direction of Allen Raskin, Ph.D, of the NIMH Psychology Research Branch, and a third group of subjects from Boston State Hospital. The hypothesis that childhood deprivation, defined as "the lack, loss or absence of an emotionally sustaining relationship prior to adolescence", has a meaningful association with the occurrence of adult depression was tested in a sample of 347 depressed inpatient women and 114 outpatient women in comparison to 198 normal women used as a control or reference population. The subjects were all Caucasian. Events occurring during childhood that could be considered within the definition of deprivation were documented. Further, subjects were assessed as to depriving childrearing experiences. The findings revealed no association of adult depression with overt childhood loss events, but did provide evidence to support an association of depriving childrearing processes with adult depression. The findings also revealed evidence of a relationship between the degree of the depriving childrearing experience with the severity of the adult illness as measured by hospital status. The results are discussed in relation to findings from other studies of childhood deprivation and psychiatric disorder.

Two Studies of Crowding in Urban Public Spaces.

Abstract: In the past few years, an increasing amount of research has been directed toward discovering the psychological effects of high density. Most people who have lived in cities and have used crowded facilities find high density situations at least somewhat annoying some of the time. The question remains whether the effects of high densities are more significant than the transient frustration of waiting in lines, standing on subways, or finding that the movie one wanted to attend is sold out. The urgency for evidence on density effects is increasing. With rising construction and land costs in urban centers, developers call for revisions in zoning regulations to permit the construction of

A comprehensive approach to psychiatric diagnosis.

Abstract: The author discusses problems of the typological diagnostic system currently used in psychiatry, which focuses primarily on symptoms in classifying psychiatric disorders. He describes a comprehensive diagnostic system that would involve routine evaluation of five patient characteristics: symptoms, circumstances associated with symptoms, previous duration and course of illness, quality of personal relationships, and level of work function. He suggests that such a multivariable approach to psychiatric diagnosis can provide valuable information about the patient to clinicians, researchers, and other mental health workers.

The Customer Approach to Patienthood

Abstract: Large psychiatric walk-in clinics and community mental health centers have been swamped with patients whose orientations are worlds apart from the professionals who serve them. It has been a challenge to conduct these operations for the benefit of the clientele, composed mainly of poor people, communication being what it is. When at the same time there is responsibility for good teaching, the difficulty is compounded. In the current issue of Archives of General Psychiatry 32:553-558, 1975), Lazare and co-workers have faced this challenge and report on the process of negotiation between clinician and patient in the initial psychiatric interview in a busy walk-in clinic. Dropout rates as high as 60% have been reported after the first interview in some of these clinics. The goal of these authors was to compensate for the social differential between patient and therapist, to render improved patient care, to improve staff morale, and to teach

Psychophysiological Responses to Crowding.

Abstract: Two theories dealing with the individual’s response to environmental variations are of great importance in their implication for population theory: those of Cannon (1915, 1929) and Selye (1946, 1956, 1963). Cannon placed emphasis on the secretions of the adrenal medulla, while Selye has mainly implicated the actions of the adrenal cortex. A number of mammalian investigations suggest that the adrenal medulla plays an important role in the adaptation of groups as well as individuals. Medullary hyperplasia and hypertrophy in mice have been shown to accompany crowding (Bullough, 1952), and medullary hypertrophy has been observed in a number of species of captive wild ungulates subjected to crowding (Christian, 1960). Moreover, elevated blood sugar levels noted in rats living under conditions of crowding (Ader et al., 1963; Barnett et al., 1960) can be interpreted as evidence for catecholamine stimulation of glycogen breakdown (Turner, 1961). A more common occurrence found in natural and confined populations which may implicate medullary secretion is a sudden increase in mortality. Crowding of animals is often followed by prostration, convulsions, and sudden death (Christian, 1960). The greater the number placed together, the greater

Women Athletes and Aspects of Psychological Well-Being and Body Image

Abstract: The dependent variables in the present study included measures of psychological well-being and body image. Analyses were made of (1) women athletes and nonathletes and, (2) women gymnasts and basketball players. The women athletes had higher scores than the nonathletes on both measures of psychological well-being and body image. The gymnasts had higher scores on the psychological well-being items than the basketball players but these findings were not statistically significant and the differences between the two sports on the measures of body image were inconclusive. The findings of this study raise questions about the negative stereotypes regarding women athletes. Some evidence also suggests that stereotyped differences between sports by women are breaking down.