Showing papers on "Mental health published in 1978"

The de facto US mental health services system: a public health perspective.

Abstract: • The President's Commission on Mental Health has highlighted a heretofore unmet need for the linkage of data on the prevalence of mental disorder with national data on the use of mental health services. This study analyzes available epidemiological data and recent mental health services research findings to estimate the percent of the population with a mental disorder and the proportion utilizing various types of specialty mental health and general medical treatment settings. Provisional estimates indicate that at least 15% of the US population is affected by mental disorders in one year. In 1975, only one fifth of these were served in the specialty mental health sector, with about three fifths identified in the general medical (primary care) sector.

The effect of social support in moderating the health consequences of unemployment.

Abstract: In the context of a longitudinal investigation of the physical and mental health consequences of involuntary job loss, it is hypothesized that social supports modify the relationship between unemployment stress and health responses. As a result of two plant shutdowns, 100 stably employed, married men were interviewed at five stages over a two-year period. Social support was measured by a 13-item index covering the extent of supportive and affiliative relations with wife, friends and relatives. The rural unemployed evidenced a significantly higher level of social support than did the urban unemployed, a difference probably due to the strength of ethnic ties in the small community and a more concerned social milieu. No differences between the supported and unsupported were found with respect to weeks unemployed or to actual economic deprivation. However, while unemployed, the unsupported evidenced significantly higher elevations and more changes in measures of cholesterol, illness symptoms and affective response than did the supported. While health differences between supported and unsupported populations under stress are commonly interpreted as evidence that support buffers the effects of life stress, it is argued that these and other study findings demonstrate the exacerbation of life stress by a low sense of social support.

Characteristics of staff burnout in mental health settings.

Abstract: To determine the characteristics of staff burnout and ways of coping with it, the authors gathered data on institution-related and personal variables for 76 staff members in various mental health facilities in the San Francisco area. A correlational analysis revealed a large number of statistically significant findings. For instance, the longer staff had worked in the mental health field, the less they liked working with patients, the less successful they felt with them, and the less humanistic were their attitudes toward mental illness. The authors present recommendations for reducing staff stress and subsequent burnout, including allowing more chances for temporary withdrawal from direct patient care and changing the function of staff meetings.

Social Skills and Mental Health

Abstract: Part One 1 The Social Skills Training Approach 2 The Analysis of Social Behaviour 3 Development and Deficiency in Social Skills: A Review of the Evidence 4 Changing Social Behaviour 5 Outcome Studies of Skills Training: A Review by John Marzillier Part Two 6 Assessment 7 Training. Author Index. Subject Index.

the nimh community support program: pilot approach to a needed social reform*

Abstract: This year, the National Institute of Mental Health (NIMH) launched a modest but potentially significant pilot program titled the Community Support Program (CSP). CSP is designed to improve services for one particularly vulnerable population—adult psychiatric patients whose disabilities are severe and persistent but for whom long-term skilled or semiskilled nursing care is inappropriate. Specifically, CSP involves contracts (not grants) between NIMH and State mental health agencies, many of whom will subcontract with local agencies for demonstration projects. To date, 19 States have been awarded CSP contracts amounting to a total of approximately $3.5 million for the first year's activities. Although the program is so new that little has been published about it, interpretations are beginning to appear in the press and the professional literature. The New York Times (February 7, 1978), for example, while emphasizing the need for Federal leadership to improve services to chronic patients, referred to the CSP initiative in an editorial as "belatedly pulled together" and "meager." Professional literature has viewed it more positively. A recent article in the Scientific American (Bassuk and Gerson 1978, p. 53), for example, highlighted the importance of the program in "the acknowledgment of the specific needs of the chronic severely disabled person," and "the willingness of the Federal government to accept more responsibility for the mentally ill." The APA Monitor (Herbert 1977, p. 4)

Life change and illness studies: past history and future directions.

Abstract: A selected review of life changes and illness studies is presented, which illustrates both the diversity of samples that have been tested in these studies and the generally positive results that have been obtained. Although early (retrospective) work in this field led to simplistic explanations, later (prospective) studies have begun to document the several intervening variables that occur between subjects recent life change experiences and their subsequent symptomatology and disease. A life change and illness model is presented to illustrate key intervening variables. The authors believe that future research in the field of life change and illness should concentrate on further delineations of these intervening variables — an effort necessitating active collaboration between social and medical scientists.

The development and application of a classification scheme of informal helping behaviours.

Abstract: A classification scheme is presented composed of 26 helping behaviours which were empirically generated and reliably coded by a team of three judges, based on a content analysis of interview protocols. The protocols describe the types of informal social support provided to a sample of single mothers. The categories are organized into four main classes of influence and each category has been defined and illustrated with an example taken from the protocols. In order to illustrate one application of the scheme, data are presented contrasting the helping behaviours extended to the women in response to three problem areas. Methods of further validating the scheme and evaluating the efficacy of informal social support are discussed. One of the hallmarks of the community mental health ideology is that coping resources should be available to people experiencing stress at an early time and in their natural environment. Translated into practice, this ideology has taken the form of mental health consultation with a variety of "community caregivers" such as teachers, clergymen, and family physicians who have broad contact with the public and who have been trained to engage in basic diagnostic, counselling, and behaviour change activities with the "clients" they normally serve. Recently, however, this approach to the secondary prevention of mental disorder has been criticized both on the basis of insufficient empirical evidence of preventive outcomes (Mannino & Shore, 1975) and on grounds of professional colonialism towards the caregiver-consultees (Gottlieb, 1974). The latter criticism - that training in the professional mould may supplant or weaken the natural helping skills of caregivers - has been strengthened with the appearance of a literature documenting the existence of numerous natural forms of service delivery which operate largely outside the professional sphere of influence, but which involve a great many people (Collins & Pancoast, 1976; Gottlieb, 1976). These natural support systems range from the more organized self-help group to the spontaneous helping transactions extended within personal networks. A number of these natural human services are currently being subjected to evaluative research; however, the more general claim This research was supported by Grant No. S74-0726 from the Canada Council. Thanks are expressed to John Hughes, Barbara Piggins, Bill Psihogios, and Michael Wuitchik for their patience and attention to the minutiae associated with the development of the classification scheme. Requests for reprints should be addressed to Benjamin H. Gottlieb, Department of Psychology, University ofGuelph, Guelph, Ontario, NIG 2W1.

A study of psychological well-being.

Abstract: The concept of psychological well-being is introduced, and scales to measure three of its different facets are described and applied to 1655 British respondents. Results from measures of positive and negative affect are compared with North American findings, and hypotheses are broadly confirmed. Two clusters of specific anxiety items are identified, to do with financial and family anxiety and with health anxiety. The third measure (ratings of present life in general) yields a major cluster of happiness items, but suggests additional dimensions for more detailed investigation. Interrelationships between the several measures and with employment position, motivation to work, job characteristics and age are examined. The study of everyday life as 'normal psychology' is advocated.

The Child Behavior Profile: An Empirically Based System for Assessing Children’s Behavioral Problems and Competencies

Abstract: (1978). The Child Behavior Profile: An Empirically Based System for Assessing Children’s Behavioral Problems and Competencies. International Journal of Mental Health: Vol. 7, The Epidemiology of Children’s Behavior Disorders: Implications for Planning, pp. 24-42.

Risk Factors in the Continuation of Childhood Antisocial Behavior into Adulthood

Abstract: (1978). Risk Factors in the Continuation of Childhood Antisocial Behavior into Adulthood. International Journal of Mental Health: Vol. 7, The Epidemiology of Children’s Behavior Disorders: Implications for Planning, pp. 96-116.

Informed consent: consequences for response rate and response quality in social surveys.

Abstract: The study described in this paper was designed to measure the effects of variations in (1) the amount of information provided to respondents about the content of a survey ahead of time, (2) the assurance of confidentiality given to respondents, and (3) the request for and timing of a signature to document consent on three aspects of social surveys: (a) overall response rate, (b) response rates to individual questions, and (c) response quality. That is, the study was designed to measure the impact of informed consent procedures on response rates and response quality in social survey research. For this purpose, a fully crossed 2 x 3 x 3 factorial design was imposed on a national probability sample of 2,084 potential respondents. The questionnaire consisted of a large number of items in such presumably sensitive areas as drinking, marijuana use, sexual behavior, and mental health, in addition to more conventional questions about leisure activities. Majorfindings can be summarized as follows: 1. The overall response rate to the survey was 67%; of the three variables investigated, only the request for a signature had a significant effect on the probability of responding. Seventy-one percent of those not askedfor a signature were interviewed, compared with 64% and 65% of those asked to sign before and those asked to sign afterwards. 2. Only the assurance of confidentiality had a significant effect on item nonresponse. Despite the sensitive nature of the interview, nonresponse to individual questions was very low. On those questions to which the nonresponse rate totaled more than 3%-all of them questions about behavior rather than attitudes-respondents given an assurance of absolute confidentiality had a lower nonresponse rate than those in two other experimental groups, in some cases by a statistically significant margin. 3. None of the three independent variables had either consistent or large effects on the quality of response. However, there are suggestions in the data that asking for a signature before the interview has a sensitization effect, so that better data are obtained if the respondent is asked to sign a consent form afterwards.

Stress disorders among Vietnam veterans : theory, research, and treatment

Abstract: The United States military involvement in Viet Nam began in earnest during the bold and exuberant presidency of John Kennedy and ended with the disorderly evacuation of the American Embassy in Saigon in April 1975. The slide from the exhilaration of Camelot to the cynicism of Watergate was unexpected and unsettling. Even now it remains difficult to write with moderation about this epoch and its major casualties-the Viet Nam veterans. The editor introduces this book by setting out six goals: I) to define the construct of Viet Nam-related combat stress disorders, 2) to alert mental health professionals to the theoretical and clinical importance of these disorders, 3) to persuade the reader that the residue ofcombat stress transcends time and situation, 4) to remind the reader that little is known about long-term results of catastrophic combat experience, 5) to provide treatment guidelines, and 6) to expand the knowledge base of combat-related stress disorders. These are ambitious tasks to accomplish in one volume, they are made even more elusive by the editor’s attempt to be evenhanded. Twenty-four authors contribute to this book. The reader will recognize the names and views of well-known antiwar activists as well as those of some career military mental health professionals. Two representative points of view seem in conflict. The first hypothesis is that the military experience in Viet Nam was unique and traumatic because ofthe inherent nature and savagery of the conflict, the elusive character of the enemy, the impact of individually tailored one-year duty rotations, and the ambivalent homecoming accorded combatants. The prediction made in this view is that initial opinions about the successful adjustment of veterans will not stand the test of time and that many veterans will seek help months and years later for delayed catastrophic stress disorders (post-Viet Nam syndromes). The second hypothesis is that attempts to attribute the problems of veterans to their unique experience in Viet Nam does not withstand scrutiny and does not lead to unique symptomatology. It is suggested in this view that those who have had the most difficulty during military duty and as veterans are those who already had the greatest number and kinds of preexisting handicaps in personal skills. The text is divided into three major sections involving theoretical formulations, some representative research reports, and suggestions for treatment of this special veteran population. The first and third divisions include papers based on literature reviews and clinical experiences with an emphasis on psychosocial perspectives. The section on research reports presents the results of descriptive follow-up studies with appropriate statistical analyses. Sixty-one pages in this section are used to reproduce the various research instrument questionnaires; this will not likely prove useful to most readers. Sober reflection suggests that, for many, the war in Viet Nam is still not over and the need for mental health services targeted for Viet Nam veterans continues and may increase. This book provides a service to those who work with veterans by examining pertinent treatment issues and offering relevant suggestions for therapeutic interventions that may be useful in making the mental health professional better informed and more empathic.

Epidemiology of mental disorders: emerging trends in the United States.

Abstract: • Psychiatric epidemiology in the United States currently is being influenced by developments in genetics, psychopharmacology, neurobiology, and particularly psychopathology after the heavy influences of the social sciences during the post-World War II period. The integration of recent scientific developments in psychiatry, with the methodological precision that characterized the earlier studies of the 50s and 60s promises to provide new knowledge on the epidemiology of mental disorders in the community, which will have important implications both for professional practices in medicine and public health and for public policy in the planning of mental health services, training, and research.

Child Art Therapy

Abstract: Illustrations. DVD Contents. Acknowledgments. Preface: 25th Anniversary Edition. Background. Changes in Art Therapy and Mental Health. Changes in Organization and Content of the Book. PART I: The Context. 1. Roots: Personal and Professional. 2. A Framework for Freedom. 3. Understanding Development in Art. 4. A Picture of the Therapeutic Process. 5. Some Ways to Facilitate Expression. PART II: The Individual. 6. An Individual Art Evaluation. 7. Decoding Symbolic Messages. 8. Some Case Studies. 9. Case Illustration: Understanding and Helping. PART III: The Family and the Group. 10. A Family Art Evaluation. 11. Family Art Therapy. 12. Art Therapy with Parents. 13. Group Art Therapy. 14. Multimodality Group Therapy. PART IV: Art Therapy for Disabled Children. 15. Art as Therapy for Children with Disabilities. 16. Art Therapy with Disabled Children and Their Parents. PART V: Art as Therapy for Everyone. 17. Helping the Normal Child through Art. 18. Helping Parents through Art and Play. PART VI: General Issues. 19. What Child Art Therapy Is and Who Can Do It. 20. Why and How the Art Therapist Helps. 21. How the Art Therapist Learns through Research. A Cautionary Note. References. Index. About the DVD.

Ethnicity and patterns of help-seeking.

Abstract: This study reconstructs and analyzes pathways of help-seeking traveled by severely disabled mental patients in the community. Ethnicity is a prime factor in differentiating patterns of help-seeking in that Chinese patients are kept for prolonged periods of time within their families in the beginning of pathways, while Anglo-Saxons and Middle Europeans are referred by their families or themselves to multiple social and mental health agencies. Native Indians are referred by persons other than family members or themselves between social and legal agencies in the community. Eventually all of these pathways lead to psychiatric inpatient intervention. There are major impediments to treatment in these patterns, most notably isolation and deterioration of patients within confines of families or lack of coordination of agencies in the community. Recommendations aimed at the improvement of treatment in the community are presented in light of these findings.

Children's views of health: a developmental study.

Abstract: Two hundred and sixty-four first, fourth, and seventh grade children were asked to define health, state what it felt like to be healthy and not healthy, and to give criteria they would use to judge another person's health status. A chi square analysis was done to compare differences for age, sex, intelligence, and socioeconomic status. Results indicated that children saw health as a positive attribute which enabled them to participate in desired activities, that a person was healthy if he could do what he wanted to do, and that health and illness were two different cncepts rather than on a continuum as is often cited in the literature. Mental health was not considered as part of being healthy except by a few of the oldest children. There were both qualitative and quantitative changes with age which were consistent with theories of concept development. It is recommended that future studies be conducted with both adults and health workers. (There is some evidence that consumers and health professionals do not have the same ideas about health.)

Mental health and the environment.

Abstract: Introduction Like Moliere's Monsieur Jourdain, who discovered to his delight that what he had been speaking for so many years was actually prose, we have become aware fairly recently that our familiar surroundings are †̃¿ the environment'. This is not without significance; anthropology has shown that the attribution of a name can itself result in objective changes to real pheno.. mena. Attaching a label is thus the beginning of a process of identification and analysis, with a view to possible intervention. Such a process is most overdue in relation to the psychopatho logical effects of the environment on individuals, but the whole subject, which one might well regard as crucial to the sciences of the mind, has been so neglected that it lacks not only scientific data but even properly defined concepts. This is surprising, since European psychiatry at least acknowledges for most disorders a multifactorial origin which must surely include aspects of the environment; in the present state of knowledge, though, these aspects can be no more than roughly assessed. Correspondingly, few recom mendations with any true professional validity can yet be made by psychiatrists for environ mental action to promote mental health. The core of specific data is therefore small, but there is a vast borderland of information in related areas which needs examining before a psychiatry of the environment can properly begin. Little more can be done here than to sample the more important contributions; the present author has reviewed some aspects of the subject previously (Freeman, 1972, 1975), and there is an annotated bibliography by Esser and Deutsch (i@7@). Craik (ig73) states that the man-environment discipline has two con

Community residential treatment for schizophrenia: two-year follow-up.

Abstract: Two-year outcome data from a study comparing two kinds of treatment given similar groups of young, newly diagnosed, unmarried schizophrenic patients deemed in need of hospitalization are reported. The experimental program, Soteria, is a nonmedical, psychosocial program with minimal use of antipsychotic drugs; it is staffed by nonprofessionals and located in a home in the community. The control program is a short-stay, crisisoriented inpatient service in a community mental health center where neuroleptic drugs are the principal treatment. The experimental group had significantly longer initial stays, and only 8 per cent received neuroleptics during their initial admission. Over the two-year follow-up period, there were no significant differences between the groups in readmissions or levels of symptomatology. However, experimental subjects significantly less often received medications, used less outpatient care, showed significantly better occupational levels, and were more able to live independently.

Depression in old age.

Abstract: We are increasingly becoming a society of older people. The most prevalent emotional disturbance in this group is depression. Its management is an urgent concern to professionals in the mental health field. A review is presented of the clinical management of depression in old age in the special out-patient setting of an Affective Disorders Clinic. Sociologic, psychologic, and biologic factors as they affect the aging process are discussed in the frame of a developmental approach to aging. Illustrative clinical material shows the value of this approach in the assessment and management of depression in the aged.

The responsiveness and equality of mental health care to Chicanos and Native Americans.

Abstract: An examination was made of the services received by Chicano and Native American clients in 17 community mental health facilities. Although these minority clients differed from Anglos in demographic variables, there was no evidence that they were rendered inferior or discriminatory services. However, failure to return for therapy was much higher among minority clients. Possible reasons for this failure to return are discussed. It is suggested that for ethnic group clients, equality of services may not mean responsive services.

The military family syndrome.

Abstract: The author reviewed the case records of 792 children and adolescents seen in a military clinic over a two-year period. His data suggest that the incidence of behavioral disorders was higher in this clinic than in a civilian mental health center. Seven problem areas common to records in which a behavioral disorder was diagnosed were found. The author suggests that the behavioral problems of the group studied represent a process of acting out in the rigid, autocratic system of the military. He also suggests that an approach using systems theory and modified goals may be more helpful in dealing with problems of military families than the traditional individual approach.

The effect of aircraft noise on the mental health of a community sample: a pilot study.

Abstract: Results of the investigation of a sample of size N = 200, half of whom live in the vicinity of a main airport, are reported. Three health indicators were examined: (1) annoyance reactions measured with a scale which did not include symptoms; (2) a symptom score, obtained with a screening instrument which identifies possible psychiatric cases; and (3) confirmed psychiatric cases identified with a traditional diagnosis after an interview by a psychiatrist. Noise was undoubtedly associated with annoyance. An association between noise and psychiatric measures was only present in a subgroup of respondents of high education. There was a marked association between annoyance and psychiatric measures. An attempt was made to clarify the nature of this relationship. Hypersensitivity to noise was associated with a high frequency of psychiatric symptoms and should be considered among the high risk factors for psychiatric illness.