A community mental health clinic's infant-toddler services

A community mental health clinic study of 20 infants for psychological risk status combined with a group of mother (200) and infant-toddler visits (450) over 1-year period is described as a program for providing services to the 0 to 3 age group. Recent studies in the development of human competence emphasize the importance of these years in obtaining various social and nonsocial abilities that are crucial to life and/or work satisfaction. The community mental health clinic has the knowledge, expertise, and mandate to provide services to this age group.     

Sexual assault history and use of health and mental health services

A history of sexual assault may be associated with increased current use of mental health and medical services because of the psychologically and physically disruptive consequences of assault. To test this hypothesis, we estimated rates of mental health and medical services use among 2560 randomly selected community residents, 343 of whom had been sexually assaulted. Sexual assault was associated with seeking both forms of care. Controls for demographic variables, psychiatric diagnosis, health status, and insurance suggested that assault increases use indirectly, through poor mental and physical health. Uninsured, assaulted respondents were especially likely to consult medical providers. Respondents assaulted during childhood were particularly likely to seek mental health care. Assault was more common among mental health service users than nonusers, and among women using medical services compared to female nonpatients. The high prevalence of assault among service users underscores the need for providers to recognize and treat sexual assault-related problems.     

Ethnic populations: Community mental health services ten years later

In a replication of a series of studies conducted by Sue and colleagues in the mid-1970s, demographic and service data were retrieved for the Seattle-King County area from the Washington Mental Health Information System. Caucasian clients were compared against Asian, black, Hispanic, and Native American client groups, and, where possible, against the findings reported earlier by Sue. These clients were compared in terms of basic demographic characteristics, characteristics of staff providing the services, dropout rates, and average number of services received. The most notable findings are (a) that failure-to-return rates are dramatically lower for the current sample than for Sue's and not greatly different for minorities than for Caucasians, (b) that variability in failure-to-return rates is most strongly related to level of functioning and not related to minority status, and (c) that although Asian Americans still average fewer services than Caucasians (other minorities do not differ significantly), the mean number of services had increased substantially for all groups but more for minorities than for Caucasians.     

The client as consumer and evaluator of community mental health services

Discussion of ethical issues which concern community psychologists and other mental health professionals has generated new emphasis on the psychiatric client as consumer. In light of the studies questioning the efficacy and ethics of various clinical procedures, it would seem that the client-consumer is being asked to accept treatment which is often less than desirable. In light of recent trends to safeguard the rights of the client-consumer, it is now appropriate to focus on the client as evaluator of services contracted. Having clients evaluate clinical services finds its logical fruition in the creation of client advisory boards. Avoiding many of the problems of citizen mental health advisory boards, client boards ensure continued and systematic client evaluation of community mental health services. The accomplishments of one client board are offered as evidence that there should be increased emphasis on the consumer as evaluator.     

Adolescent males' view on the use of mental health counseling services

This study investigated adolescent males' view on mental health counseling. Additionally, participants were asked if they had ever used mental health counseling services, if they expected to use such services in the future, and what types of services/activities would constitute a successful counseling experience. The participants' responses indicated that they associated mental health counseling with mental illness and pathology. Eighty-eight percent of the participants reported having never used mental health counseling services. Surprisingly, 69% reported a willingness to use mental health counseling services for life's concerns. Finally, the participants identified a preference for action-oriented counseling strategies. Implications for mental health counseling practice are discussed.     

The next wave of change for psychology and mental health services in the health care revolution

Recent national changes in the de facto system of health and mental health care are described. Although the percentage of people without health insurance (always or sometimes) has not decreased, the organization of insured care has changed dramatically. Of the insured population, 75% are under some form of managed care. For 88% of the managed care population, mental health care has not been integrated with health care: the so-called carve-out. The author argues that system integration (carve-ins), for a variety of reasons, will begin soon and will occur very rapidly. A tilt toward carve-ins will have substantial impact on psychologists' training, service delivery, and research.     

Barriers to use of mental health services by Japanese university students

The present cross-sectional study assessed the attitude of Japanese undergraduates towards mental health services and investigated whether mental distress is associated with reluctance to use, and a decreased perceived need for, mental health services. A convenience sample of 194 students (98 men and 96 women) completed the 28-item Japanese version of the General Health Questionnaire and questions regarding reluctance to use and perceived need for mental health services. Participants were in the second to fourth years of undergraduate work and their majors were psychology and technology. Analyses showed that approximately 70% of students were reluctant to use mental health services and this reluctance was less in the group scoring high on anxiety and insomnia than the group scoring lower. Also, perceived need for mental health services was higher for those scoring high on depression. There were some discrepancies in the results and previous studies. Implications of these findings for clinical and preventive practice and for direction for research are discussed.     

Sex, race/ethnicity, and romantic attractions: multiple minority status adolescents and mental health

This study examined the association between multiple minority statuses and reports of suicidal thoughts, depression, and self-esteem among adolescents. Data from the National Longitudinal Study of Adolescent Health were used to examine mental health outcomes across racial/ethnic groups for same-sex-attracted youths and female youths. Hispanic/Latino, African American, and White female adolescents reported more suicidal thoughts, higher depression, and lower self-esteem compared with male adolescents in their racial/ethnic group. Same-sex-attracted youths did not consistently demonstrate compromised mental health across racial/ethnic groups. Follow-up analyses show that White same-sex-attracted female adolescents reported the most compromised mental health compared with other White adolescents. However, similar trends were not found for racial/ethnic minority female youths with same-sex attractions.     

Use of mental health services among severely emotionally disturbed children and adolescents in San Francisco

This study examined the mental health services available to severely emotionally disturbed children and adolescents in San Francisco. Social, familial, developmental, and clinical data—as well as service use histories—on 192 youths were collected. Results indicated high levels of family dysfunction, physical and sexual abuse, and neglect in the total study population. The study also identified case history and demographic factors that were associated with repeated psychiatric inpatient hospitalizationand high annual rates of change in residential placement. These factors included being male, older, non-English-speaking, and having a history of physical and sexual abuse. The impact of the service system on the lives and course of illness of these youth is discussed and future directions for research are suggested.     

A method of evaluating the impact of services at a comprehensive community mental health center

American Journal of Community Psychology -     

State planning of mental health services

Planning is the vital process that links needs to solutions. The interorganizational field of human services constitutes a "turbulent environment," a condition of rapid change, and there needs to be greater receptivity toward comprehensive planning on the part of state departments of mental health. Increased overlap with various welfare and educational service, advances in scientific knowledge, and shifts in general attitudes and social philosophy lead to demands for new and different types of service and require changes in approach and method. Generalized findings of a study of 14 state departments of mental health are presented.