Showing papers on "Mental health published in 1979"

Americans View Their Mental Health

Abstract: BOOK REVIEWS Americans View Their Mental Health. By Gerald Gurin, Joseph Veroff, and Sheila Feld. Price, $7.50. Pp. 444. Basic Books, Inc., 59 Fourth Ave., New York 3, 1960. This is the fourth in the series of ten monographs sponsored by the Joint Commission on Mental Illness and Health and designed to assess the nation's mental health resources and needs from a variety of perspectives. Its focus is the subjective dimension of mental health. Although not all of the monographs have been published so far, the findings and the recommendations of each have been already summed up and interpreted in the Commission's final report which, because of the publicity it has received, may be familiar to many readers. The present volume is based on an interview survey conducted in 1957 with nearly twenty-five hundred individuals selected to provide a probability sample of the country's adult population. It is a product of three social psychologists, all of whom are on the staff of the Survey Research Center at the University of Michigan, one of the few widely recognized and influential organizations of its kind in social sciences. Besides being impressive for sheer magnitude and the consistent clarity in the presentation and evaluation of the data, the study gives further testimony of the methodological sophistication and the technical know-how typical of the work produced by the Center. Without committing themselves to a definition of mental health, the investigators explore it through a number of measures of adjustment. The measures, however, all derive from the self-appraised, experiential realm of the respondent. In the area of general life adjustment, such measures are obtained from the information about the extent of worrying, evaluation of personal happiness, whether the respondent ever felt close to a nervous breakdown, and if he ever experienced a problem relevant for professional help. In the more specific areas of functioning, namely, marriage, parenthood, and work, adjustment is studied via consideration of such variables as satisfaction with the particular role, feelings of adequacy in performing it, degree of involvement, expectations about future, and the type of problems and their prevalence encountered in each role. It is worth pointing out that in taking a multiple-criterion approach to mental health, the investigators are implicitly in agreement with the current view (e.g., Jahoda, 1958; Smith, 1961) that the search for a conceptual formulation of mental health which could meet with a general consensus is futile because of the unavoidable valuative assumptions in all such formulations. The organization of the book is as follows : The first part deals mainly with the distribution and the interrelations of the indices of adjustment in different demographic groups, most often specified in terms of such variables as sex, education, and age. (Religion, in-

Impact of alcohol, drug abuse and mental health treatment on medical care utilization. A review of the research literature.

Abstract: This monograph reviews and assesses twenty-five studies that examined the question of whether treatment for mental illness, alcohol abuse or drug abuse reduces subsequent medical care utilization. In general, the studies found that such a reduction did take place. Twelve of thirteen studies found reductions of 5 to 85 per cent in medical care utilization subsequent to a mental health intervention. The median reduction was 20 per cent. The thirteenth study found that mental health services provided in a new neighborhood health center in a medically underserved neighborhood were followed by a 72 per cent increase in medical care encounters. The remaining twelve studies found reductions of 26 to 69 per cent in either medical care utilization or surrogate measures of such utilization subsequent to treatment for alcohol abuse. The median reduction was 40 per cent. The drug abuse literature in this area is sparse and primarily indirect. Although many of the studies suggested that alcohol, drug abuse or mental health (ADM) treatment was a cause of the subsequent reduction in medical care utilization, such causality was not definitively established, due to frequent methodological limitations, such as inadequate comparison groups, short time spans, small samples and lack of trend analysis. In addition, the studies focused primarily on outpatient psychotherapy in organized health care settings, particularly health maintenance organizations (HMOs), and on alcoholism treatment provided through employee-based programs and HMOs. Only very limited policy implications on such topics as health insurance and the linkage of health and ADM services can be drawn from the current body of literature. There is a need for additional research that is broader and more rigorous. To encourage such research, methodological recommendations for future studies are presented.

Possible causes of the apparent sex differences in physical health: an empirical investigation.

Abstract: For the past fifty years it has been consistently reported that men have higher rates of mortality, while women have higher rates of morbidity. The higher rates of mortality for males can be largely explained by the fact that they have higher rates for the chronic diseases which are the leading causes of death. The explanation of why women have higher rates of morbidity, however, remains unanswered. Recent literature suggests three possible explanations: (1) a greater willingness among women as compared with men to report they are ill and/or to react overtly to an illness, (2) the greater ability of women to adopt the sick role due to their lack of obligations, and (3) the possibility that the reported differences reflect real sex differences in illness. This paper evaluates these explanations and provides support for the view that the sex differences in morbidity are real. The data analyzed show that when one controls for marital status, living arrangements, psychiatric symptoms, and nurturant role obligations, the health differences between men and women disappear.

Measuring Components of Children's Health Status.

Abstract: Measures of physical, mental and social components of health status and general health ratings were studied for children ages 0-4 (N = 679) and 5-13 (N = 1473). Questionnaires were completed by adult proxies (usually mothers) in three generally healthy populations. Hypothesized multi-item scales were tested; reliability was estimated and preliminary attempts at validation were undertaken. Items in ten scales pertaining to mental health (Anxiety, Depression, Positive Well-Being, Mental Health Index), social health (Social Relations), general health ratings (Current Health, Prior Health, Resistance/Susceptibility to Illness, General Health Rating Index), as well as parental satisfaction with child development satisfied Likert-type and discriminant validity criteria. Because functional limitation items were endorsed for very few children, scales to measure physical health could not be tested. Almost all scales were sufficiently reliable for group comparisons; reliability coefficients were lower in the most disadvantaged population. Interrelationships among scales and validity variables generally supported their construct validity and supported a multi-component model of children's health status.

Adaptational Problems of Vietnamese Refugees: I. Health and Mental Health Status

Abstract: • The forced migratory influx of Vietnamese to the United States has raised questions regarding the resettlement process, the effect of culture shock, the refugees' coping behavior and adaptabilities, and their health and mental health status. We report the two-year results of ongoing research on the Vietnamese refugees based on the use of the Cornell Medical Index (CMI). The responses on the CMI on the first (1975) and second (1976) administrations indicate a high and continuing level of physical and mental dysfunction. The second administration also revealed significant shifts in dysfunctions as well as exposing factors that related to these dysfunctions, ie, age/sex interactions, marital status, family groupings, and public assistance. The follow-up CMI also showed an increase in anger and hostility with concomitant reductions in feelings of inadequacy.

Natural history of male psychologic health: effects of mental health on physical health.

Abstract: Four decades ago 204 men were selected as adolescents for an interdisciplinary study of health; since then they have been followed biennially. Of the 185 men who remained in the study and in good health until 1964 (age, 42 +/- 1 years), 100 men remained in excellent physical health over the next 11 years, 54 acquired minor problems, and 31 acquired serious chronic illness or died. Of 59 men with the best mental health, assessed from the age of 21 to 46 years, only two became chronically ill or died by the age of 53. Of the 48 men with the worst mental health from the age of 21 to 46, 18 became chronically ill or died. The relation between previous mental health and subsequent physical health remained statistically significant when the effects on health of alcohol, tobacco use, obesity, and longevity of ancestors were excluded by multiple regression analysis. The data suggest that good mental health retards midlife deterioration in physical health.

Endorphins in mental health research

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Offspring of patients with affective disorders.

Abstract: All the children (ages 5-15) of 14 consecutive patients admitted to hospital at the National Institute of Mental Health with a diagnosis of bipolar or unipolar affective disorder were studied. The children were seen twice, four months apart, and assessed by an interview and rating scales. The parents were also assessed. Of 14 boys, five were depressed on both interviews and three were depressed on one interview. Four of the 16 girls were depressed on both interviews and 11 were depressed on one interview. The clinical picture and the ratings showed the boys, but not the girls, to have a significant correlation for depression on both interviews. The children diagnosed as suffering from depression showed the symptoms of a primary unipolar affective disorder without other significant pathology.

Perception of poor health in the healthy older adult.

Abstract: A survey of 977 community subjects aged 65 or older identified 719 of them as not impaired in physical health. Of these, 104 (14 percent) perceived their physical status to be poor, whereas 615 (86 percent) accurately perceived it to be unimpaired. There were no significant differences between the two groups with regard to age, sex, race, social class, living arrangements and number of drugs used. The physically healthy elderly who perceived their physical status to be poor were more depressed, more hypochondriacal, and more dissatisfied with life. They tended to complain of multiple symptoms; activities of daily living were decreased, and they were more likely to visit their doctor frequently during the year (analysis controlled for physical health in each case). Mental health was slightly but significantly more impaired in these subjects; nevertheless, they were more likely to seek the help of a trained counselor. The findings suggest that a self-perception of poor health among the physically healthy elderly may represent a generalized request for attention from trained personnel in the social environment.

Mortality in Middle-Aged Smokers and Nonsmokers

Abstract: We assessed the relation of cigarette smoking to mortality in an 11-year follow-up study of 4004 men and women, 35 to 54 years of age, who responded to urging to have multiphasic health checkups. Accounting for 48 other characteristics, both individually and in combination, failed to eliminate the association of smoking with mortality from all causes or with mortality from coronary heart disease. The smoker-to-nonsmoker mortality ratios, crude and adjusted respectively, were 2.6 and 2.1 for all causes and 4.7 and 3.6 for coronary heart disease. This analysis did not support the counterhypothesis that the association of cigarette smoking with mortality is secondary to some underlying characteristic.

Social support and social adjustment: implications for mental health professionals.

Abstract: The general importance of an individual's support network has been recognized in the field of community mental health; yet a more detailed understanding of how a client's available social ties may contribute to his or her adjustment is presently lacking. This study used network analysis to examine differences in the social networks of mental health clients to identify factors associated with positive social adjustment. Subjects were selected from three different types of mental health programs as well as from the general population of Marion County, Oregon. Results generally revealed that subjects from the community sample more often would look to immediate family members for support. Better functioning chronic clients emphasized professional contacts, whereas more poorly adjusted chronic clients would look to friends for support. The results have implications both for understanding the nature of the support available to a client and mobilizing the support resources of the existing network of relationships to aid adjustment to community living.

Social class and the use of professional help for personal problems: 1957 and 1976.

Abstract: By comparing national survey data collected in 1957 and 1976, this paper assesses the stability of relationships between social class and the use of professional help for personal problems, examining the influence of education and income on: (a) problem definition, (b) the decision to seek help, and (c) the choice of a particular help source. In spite of a general increase in "readiness for self-referral" from 1957 to 1976 for the population as a whole, social class differences in defining a problem as relevant for professional help and in adopting a self-help position with regard to potential problems (both reported in 1957) generally persist in 1976. Among those who have identified a personal problem as relevant for help, however, social class differences in the actual use of help, apparent in 1957, have largely disappeared. Despite a marked increase in the use of mental health professionals in all socioeconomic strata, education and income differences in the use of psychiatrists and psychologists found in 1957 also generally persist in 1976, although the gap between highand low-income groups appears to be narrowing. Although perceived psychological distress is found to play a major role in seeking help, differences in professional help-seeking by socioeconomic status are largely independent of reported symptom levels. These patterns of persistence and change are interpreted as reflecting differential changes in the influence of motivational versus facilitating factors, respectively.

The role of the pediatrician in the delivery of mental health services to children.

Abstract: Nine pediatricians reported on all patients seen during a four-week period in January and February 1976 in Monroe County, N.Y., to determine the prevalence and nature of mental health problems seen in their practices, the characteristics of the affected children, and the treatment provided to them. Of the 3,742 patients seen, 187, or 5.0%, were reported to have an emotional, behavioral, or school problem. The prevalence rate ranged from 1.4% to 7.8% by pediatrician, with five reporting rates within ± 1.2% of the mean. High rates were associated with children in the 7 to 14 year age group (9.9%), those on Medicaid (8.6%), those who were not living with a father (10.9%), those whose presenting complaint was a chronic physical condition (11.7%), and children with a disease of the digestive system (16.7%) or with "symptoms, signs and ill-defined conditions" (14.3%). Functional impairment was reported to be moderate or severe in 40% of the 187 children with mental health problems. The most frequently reported problems (primary or otherwise) were adaptation reaction (22.5%), specific learning disorder (19.3%), hyperkinetic disorder (19.3%), psychosomatic disorder (12.8%), and conduct disorder (12.8%). The most frequent form of treatment provided was supportive therapy or counseling (85.6%) and suggestions regarding environmental changes (43.3%). Drugs were prescribed for 16.0% of the affected children, with 6.4% receiving methylphenidate or amphephetamines. Referral for psychological care or consultation was made for 36.9%. The frequency of mental health problems observed by the pediatricians was about five times the annual rate of Monroe County children contacting a psychiatric inpatient or outpatient setting.

Conceptualization and Measurement of Health for Adults in the Health Insurance Study: Vol. III, Mental Health

Abstract: This report discusses the conceptualization and measurement of the mental health of individual members of general populations in developed countries.

Sociocultural stress and the american native in Alaska: An analysis of changing patterns of psychiatric illness and alcohol abuse among Alaska natives

Abstract: This paper presents selected morbidity and mortality statistics to outline developing trends and the current status of psychiatric illness and alcohol abuse among the Aleut, Athabascan, Yupik, Inupiat, Tlingit, Haida and Tsimpshian people of Alaska. Analysis of the records of the Indian Health Service, the Community Mental Health Centers and the Alaska Psychiatric Institute, the providers of care for Alaska Natives, shows that the number of individuals treated as inpatients and outpatients for psychiatric illness and alcohol abuse has been rising steadily. Accidental injury and suicidal behavior are common. The treated prevalence rates for these diagnoses exceed recorded rates for other American Native and non-Native groups. For each category of violent death, suicide, homicide, accidents and alcohol, rates for Alaska Natives are higher than rates for Alaska non-Natives, American Indians and the U.S. (all races) and are rising. The data suggest a public health problem in which the primary elements are behavioral disturbance and violent death.

Barriers between mental health services and Mexican Americans: An examination of a paradox

Abstract: The paradox of underutilization of mental health services by Mexican Americans is critically examined. It is argued that Mexican Americans live under high levels of psychological and environmental stress that would ordinarily lead to mental health problems and an increased utilization of mental health services. A number of barriers to the use of mental health services by Mexican Americans are examined. Included among these barriers are such factors as the relationship between social class and treatment offered, stereotypes concerning Mexican American folk psychiatry, limitations imposed by language differences, and the effects of stereotypes between Anglo Americans and Mexican Americans. Paradoxical findings in some studies which show a positive perception of mental health services by Mexican Americans are seen to further underscore the need for more research on the Mexican American's position. Stereotypes and generalizations about Spanish-speaking and bilingual Mexican American's approaches to psychotherapy are challenged in the light of recent empirical findings. Recommendations for future research directions and for improving the delivery of mental health services are presented.

Violence against women--the myth of masochism.

Abstract: Women have been victims of violence throughout history. Freud's theory of masochism stated that women enjoyed suffering, and until very recently the mental health profession went along with this universal human tendency to blame the victim. In this paper a new understanding of the dynamics of abused wives and violence-prone husbands is being presented indicating that the explanation lies in the new field of the study of psychological reactions of victims of violence and catastrophe.