Occupational Choices for People with Psychiatric Disabilities: Comparing Attendees and Non-Attendees at Community-Based Day Centers

Research has shown that people with psychiatric disabilities who attend a day center rate their satisfaction with daily occupations equally in comparison with non-attendees. The current study investigates which occupations the target group performs and also differences in occupational choices between attendees and non-attendees. Reported occupations were analyzed with content analysis. Day center attendees reported more productive occupations, while non-attendees reported more recreational occupations and a greater breadth of occupations. This implies that non-attendees might compensate a lack of work-like occupations at a day center with satisfying recreational occupations. The results can guide development of psychiatric occupational-based rehabilitation.     

Making Mother-Blaming Visible:

No abstract available for this article.     

Integrating systems of care in california for youth with severe emotional disturbance II: Initial group home expenditure and utilization findings from the California AB377 Evaluation Project

The California AB377 Evaluation Project was established to study the replication of an innovative system of care in three California counties for youth suffering from severe emotional disturbance. Development of the innovative system of care was pioneered in Ventura County, California, and the replications were legislatively enabled through Assembly Bill 377 (AB377). This paper reports evaluative findings about a central goal of the innovative care system: the reduction of use of highly restrictive out-of-home placements though creation and maintenance of coordinated and effective community-based services. Group home facilities are the focus of the evaluation work because these facilities consume the largest proportion of all public expenditures for youth in residential placements in California. More than 10 years of aggregate county and state level monthly expenditure and utilization data are presented. The results indicate that the demonstration counties have generated lower per capita inflation adjusted rates of expenditures and per capita group home placements than California as a whole. The evaluation results provide evidence that an integrated system of care can reduce group home placements. However, the nature, quality and effectiveness of any and/or all alternative services provided remains a topic for further investigation.     

Bows and ribbons,tape and twine: Wrapping the wraparound process for children with multi-system needs

The wraparound process for children with multi-system needs is one of the most innovative and popular reform efforts in children's services. Nonetheless, the articles in this special issue are indicative of a service reform process that is still maturing and evolving. In this commentary, three key questions regarding the wraparound process are posed: (a) What is wraparound? (b) What is the current state of research regarding wraparound services? and (c) What are the implications for the future? It is argued that the future of wraparound depends at least in part on: (a) carefully defining the wraparound process, including how to best integrate the process with reforms based on the principles of a comprehensive system of care; and (b) making a strong commitment at all levels to the process of cumulative knowledge, of building and creating innovative research and program efforts over time, one upon the other. It is concluded that a failure to invest in careful definition, refinement, implementation, and research on the wraparound process consitutes a failure to invest in children and families with multi-system needs.     

Expanding Mental Health Services to Older High-Utilizing HMO Patients: A Pilot Study

Background: Expanded mental health benefits were offered to older HMO patients who were high medical utilizers. Outcomes of interest were use of services, subjective well-being, and psychopathology. Methods: Sixty-nine (25 male, 44 female) patients age 55 or above seeking frequent outpatient medical care completed the SF-36 health survey and the revised Symptom Check List (SCL-90-R). Patients were assigned to usual care, health education, or expanded mental health benefit conditions. Results: Patients showed high initial levels of psychopathology and distress. Over the 6 months of the study, patients in the expanded benefits group made a mean of 11.5 visits to mental health professionals versus a mean of 3.4 visits by usual care patients. Patients in the expanded benefits group showed significant improvement in SF-36 General Health and Mental Health well-being scores. Patients in the health education group showed no improvement. Patients in the usual care group showed improvements in Vitality scores. Psychopathology summary scores showed improvement for both usual care and enhanced benefit groups. Conclusions: Mental health treatment may improve well-being and reduce psychopathology in older high-utilizing patients. Creativity will be needed in expanding access to mental health services for this population.     

国外心理健康服务及其启示

在回顾了美国、瑞典等国家心理健康服务概况的基础上提出了以下启示：1．中国心理健康服务体系应以构建和谐社会理论为基础;2．在心理服务的教育与培训中,应当尽量兼顾普及知识与提高专业化水平两个目标;3．政府应当大力支持社区心理健康服务以及包含各种社区可用资源的综合性社区服务;4．中国心理健康服务必须从本国文化与国情出发,因此还需要更多这方面的文献总结与实际诃查工作;5．心理健康服务应当全面而有区别地实施予心理健康水平不同的人群。     

青少年心理健康与心理素质培养的整合研究

青少年心理健康与心理素质培养的整合研究是重庆市人文社会科学重点研究基地西南大学心理健康教育研究中心十多年来确立的研究主题。围绕该主题我们不仅从理论到实证进行了较为系统的探讨,取得了一批有本土特色的研究成果,受到国内外学术界关注,而且重视把研究成果及时转化运用于教育实践,开发了系统测量工具,编写了系列教材,开展了青少年心理素质教育的实验探索,推动了学校心理健康教育积极有效的开展。文章主要从青少年心理健康与心理素质培养整合研究的理论依据、方法论思考、研究主题等方面,概括总结心理健康与心理素质培养整合研究的概况,以期进一步促进该领域的深化研究。     

Health and Social Service Needs of Transgender People in Chicago

SUMMARY

A needs assessment of transgender people was conducted in Chicago in 2001 to assess their HIV risks, health and social service needs, and barriers to care. One hundred and eleven transgender individuals, 78 male-to-females (MTFs) and 33 female-to-males (FTMs), participated in the study. Fourteen percent of respondents reported being HIV-positive; they were all male-to-female and the majority was of color. Risk factors for HIV included unprotected sex and willingness to have high-risk sex in the future. Respondents experienced high levels of violence. Two-thirds of respondents had thought of attempting suicide. Respondents reported a high need for health and social services, particularly MTFs and people of color.     

Mapping Men's Mental Health

The central theme of this paper is that men are at one and the same time both damaged and damage-doing. The process of being damaged through the agency of masculinity predisposes men to exploit, dominate and abuse—not only as boys, as partners and fathers, but as priests, teachers, therapists, lawyers, nurses, psychologists and psychiatrists. Mental health services need to see both aspects of this male equation: a focus on male abuse alone leads to punishment, containment and, very likely, the continuation of abuse; a focus on male damagedness alone preserves the ideology of male unaccountability. However, evidence reviewed here suggests that most traditional psychiatric services fail to acknowledge the impact of inequalities on men's mental health as comprehensively as they fail to acknowledge the impact of these inequalities on the mental health of women. This is a significant problem, and we suggest ways that a gendered analysis of masculinity can be used to help address this deficit. This analysis is used to develop a map of men's mental health that not only accommodates traditional categories of mental health difficulty, but other important consequences of the close association between masculinity and sexuality inequality, especially the use of violence and the capacity to do harm. This analytical framework also invites consideration of the invisibility of male distress, the disallowing and desensitizing of ‘vulnerability, and their submersion in a kind of psychology of entitlement. Finally, we consider the implications of this mapping exercise for mental health services and for working with men.