The extent,nature, and utility of evaluating consumer satisfaction in community mental health centers

Evaluating consumer perceptions is a recent development in community mental health. The authors surveyed the 504 federally funded community mental health centers to discover the extent to which they assessed consumer satisfaction, the methods used to collect data, and the utility of the results. Of the 366 centers that responded, 48% had gathered consumer feedback in the previous 18 months, and most others planned to initiate such evaluations within a year. Methods of conducting the studies were extremely diverse. Respondents felt the results were useful and shared them primarily with agency personnel, rather than with outside funders, fellow agencies, or clients. The authors conclude that community mental health centers are evaluating consumer satisfaction more frequently than in the recent past, but this movement has not yet developed clear, standardized methods. Until evaluators consolidate their efforts this evaluation strategy will continue to have limited utility.     

Organization development: A new modality for community mental health

Organization development (OD) is discussed as being a valid tool for advancing mental health and for promoting the present goals of community mental health centers, as well as for accomplishing organization development's traditional objectives of increasing organizational effectiveness in business, industry, and government agencies. A comparison is made between the main objectives of the community mental health movement in the United States and the major thrusts of current OD practice, showing how the foci of the two fields are essentially similar. The psychological aspects of OD are presented in their relation to mental health. Organization development is demonstrated to be both a legitimate and an effective modality for the community mental health practitioner to use in reaching large numbers of people in promoting positive mental health, primary prevention, improved interpersonal relations, and personal growth activities in the community.     

Community-Based Interventions: A Return to Community Mental Health Centers' Origins

Consultation services offered by community mental health centers (CMHC) have gone through several significant changes since the signing of the Community Mental Health Center Act of 1963 (The President's Commission on Mental Health, 1978). Initially, consultation and education services were an integral part of the CMHC mission. With the passage of additional legislation that promoted a shift in focus, consultation services declined. By 1981, with the passage of the Omnibus Budget Reconciliation Act (Cutler, 1992) national mental health policy was adrift. Consultation and education were no longer seen as central components of mental health services, which increasingly were tied to acute care hospitalization. With a renewed focus on consultation and education, a coherent mental health policy can be reintroduced at the community level.     

Pastoral consultation through a community Mental Health Center

Conclusion Pastoral consultation through a mental health center in Kansas has been a beneficial experience for participating clergymen and the mental health center staff. This consultation has provided interested clergymen an opportunity to learn effective ways of serving parishioners through the church. The clergymen and mental health center staff have also begun to realize the mental health implications of religious resources, as well as ways in which ministers and the mental health center staff can effectively work together in serving troubled individuals within the local community. Pastoral consultation may become a means through which other community mental health centers and local clergymen can form meaningful professional relationships. The continuance of a pastoral consultation program over a longer period of time is needed to determine its possibilities and liabilities for assistingA report of one aspect of a special study project on Community Clergy and Mental Health, made possible by a grant from W. Clement Stone to the Menninger Foundation.     

A report on The National Council of Community Mental Health Centers

The National Council of Community Health Centers represents a professional development of great interest to clergy. Because mental health centers collaborate with community agencies and systems, their interventions on behalf of community mental health provide an occasion to work toward common goals. Their policy of shared responsibility with community leaders and consumers provides a unique opportunity for a practical integration of religious systems and the public arena. A number of pastors and mental health trained clergy are actively participating in this common effort on behalf of the nation's mental health.He has served five years as a member of the Council on Prevention of the National Council of Community Mental Health Centers.     

Attitudes toward human service organizations: perspectives from an urban black community.

Previous research has suggested that black Americans tend to view mental health services and community mental health centers more negatively than do white Americans. This article discusses a recent study that sought to determine whether black persons possess positive or negative attitudes, what factors influence attitude formation, and the implications of these findings. Based on a sample of black residents in a city in the Northeast, the study found that fewer than 20% of black persons possess negative attitudes toward community mental health centers, that 34% possess positive attitudes, that women and married persons tend to possess more positive attitudes than do men and unmarried persons, that those with high levels of racial consciousness tend to possess more positive attitudes than those who do not, and that those with a high tolerance of substance use tend to possess more negative attitudes than do less tolerant persons. The author suggests that human service agencies should educate social and health workers to become more aware of the cultural diversity and attitudes of the black community so that they may more effectively serve black clients.     

Mental health consultation to law enforcement: Secret Service development of a Mental Health Liaison Program

The Mental Health Liaison Program developed and used by the Secret Service is presented as a model for comprehensive, multidimensional interactions between law enforcement and mental health systems, with particular focus on assessing and preventing violent behavior. The structure of the program pairs consultants—psychologists and psychiatrists—with Secret Service field offices to provide (a) consultation regarding risk assessment and case management of individuals who threaten or display inappropriate interest in the President or other protectees; (b) training for agents on risk assessment, mental illness, and mental health care issues; and (c) liaison activities between the Secret Service and the mental health community. Practical benefits to the Secret Service are discussed to encourage more systematic use of broad based psychological and psychiatric consultation to law enforcement, with a goal of enhanced intersystem communication and collaboration. The need for program evaluation and outcome research is discussed in the context of applying the model to improve other mental health and law enforcement systems interactions. © 1998 John Wiley & Sons, Ltd.     

Knowledge assessment of mental health advisory boards

Informed citizen advisory boards are vital to the operation of community mental health programs. In order to provide relevant educational experiences, a continuing education program conducted a survey of the self-judged level of knowledge of a sample of board members in a large city. The sample consisted of 57 respondents representing 16 of 19 city mental health centers and the three federally funded community health centers located in the city. The results indicated areas of strength and weakness. Also, knowledge assessments differeed in relation to years of experience on advisory boards. Several suggestions are made about designing curricula for mental advisory boards.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

A qualitative evaluation of a mental health literacy intervention for parents delivered through community sport clubs

Intervention studies have rarely targeted parent mental health literacy despite its importance for adolescent mental health. This qualitative study evaluated the experiences of parents (n = 352) who participated in the Ahead of the Game mental health literacy workshop delivered through community sport clubs. Moreover, the study aimed to investigate the relevance, retention and use of intervention content by parents, assess the acceptability and feasibility of delivering mental health education through community sport clubs, and identify strategies for increased engagement. In total, 17 parents (13 mothers, four fathers) participated in semi-structured interviews up to one month after the workshop. Reflexive thematic analysis revealed that parents perceived mental health education as important and valuable, and believed the community sport club was an appropriate setting to discuss adolescent mental health. Parents reported increased awareness and knowledge of mental health disorders and help-seeking options, and increased confidence and preparedness to communicate and assist someone experiencing a mental health issue. The workshop stimulated conversation about mental health between parents and their children, and between parents within and outside the sport club community. Parents used information and resources provided in the workshop to help those in their networks and reflected back on the workshop when noticing changes in their adolescent’s behavior. Potential additions to the workshop (as suggested by parents) included increased discussion among parents as well as opportunities for further information sessions or tailored online material. Future research might look to engage more fathers, actively encourage parents to aid in the recruitment of others, and investigate long-term adolescent mental health outcomes.     

Community Psychology and Community Mental Health: A Call for Reengagement

Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well‐being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area. The issue includes 12 articles authored by diverse stakeholder groups. Following a review of the state of community mental health scholarship in the field's two primary journals since 1973, the remaining articles center on four thematic areas: (a) the community experience of individuals with serious mental illness; (b) the utility of a participatory and cross‐cultural lens in our engagement with community mental health; (c) Housing First implementation, evaluation, and dissemination; and (d) emerging or under‐examined topics. In reflection, we conclude with a series of challenges for community psychologists involved in future, transformative, movements in community mental health.     

Housing First and Photovoice: Transforming Lives,Communities, and Systems

This article presents findings from a community‐based participatory evaluation of a Housing First program on the Island of O'ahu. In this study, clients in a Housing First program used Photovoice to evaluate the program and to advocate for progressive housing policies. Written together by members of the Housing First Photovoice group, this collaborative article describes the outcomes from both the Housing First program and the Photovoice project and demonstrates the ways in which participatory program evaluations can interact with client‐driven programs like Housing First to produce a cumulative, transformative impact. Findings suggest that community psychologists hoping to re‐engage with community mental health systems through enacting transformative change should consider taking a community‐based participatory approach to program evaluation because increased client voice in community mental health programs and their evaluations can have far‐reaching, transformative impacts for research, practice, and policy.     

人工智能辅助下的心理健康新型测评

近年来,人工智能技术的飞速发展及应用催生了"智能化心理健康测评"这一领域。智能化心理健康测评能够弥补传统方法的不足,降低漏诊率并提高诊断效率,这对于心理健康问题的普查及预警具有重大意义。目前,智能化心理健康测评处于初步发展阶段,研究者基于在线行为数据、便携式设备数据等开展主要以数据驱动为导向的探索研究,旨在实现更高的预测准确率,但是测评结果的可解释性等指标尚不够理想。未来的智能化心理健康测评需要强调心理学领域知识和经验的深度介入,提高测评的针对性和精细化程度,加强信效度检验,这对于智能化心理健康测评工具的进一步发展和应用至关重要。     

Multiple outcome measures and mixed methods for evaluating the effectiveness of theory-based behaviour-change interventions: a case study targeting health professionals' adoption of a national suicide prevention guideline

Interest in behaviour-change interventions targeting health professionals' adoption of clinical guidelines is growing. Recommendations have been made for interventions to have a theoretical base, explore the local context and to use mixed and multiple methods of evaluation to establish intervention effectiveness. This article presents a case study of a behaviour-change intervention delivered to community mental health professionals in one Primary Care Trust, aimed at raising adherence to a national suicide prevention guideline. A discussion of how the theory-base was selected, the local context explored, and how the intervention was developed and delivered is provided. Time series analysis, mediational analysis and qualitative process evaluation were used to evaluate and explore intervention effectiveness. The time series analysis revealed that the intervention was not effective at increasing adherence to the guideline. The mediational analysis indicates that the intervention failed to successfully target the key barrier to adoption of the guidance, and the qualitative process evaluation identified certain intervention components that were well received by the health professionals, and also identified weaknesses in the delivery of the intervention. It is recommended that future research should seek to further develop the evidence-base for linking specific intervention strategies to specific behavioural barriers, explore the potential of theories that take into account broader social and organisational factors that influence health professionals' practice and focus on the process of data synthesis for identifying key factors to target with tailored interventions. Multiple and mixed evaluation techniques are recommended not only to explore whether an intervention is effective or not but also why it is effective or not.     

Identification Reduces Stigma of Mental Ill‐Health: A Community‐Based Study

The stigma surrounding mental ill‐health is an important issue that affects likelihood of diagnosis and uptake of services, as those affected may work to avoid exposure, judgment, or any perceived loss in status associated with their mental ill‐health. In this study, we drew upon social identity theory to examine how social group membership might influence the stigma surrounding mental ill‐health. Participants from two urban centers in Ireland (N = 626) completed a survey measuring stigma of mental health, perceived social support as well as identification with two different social groups (community and religion). Mediation analysis showed that subjective identification with religious and community groups led to greater perceived social support and consequently lower perceived stigma of mental ill‐health. Furthermore, findings indicated that high identification with more than one social group can lead to enhanced social resources, and that identification with a religious group was associated with greater community identification. This study thus extends the evidence base of group identification by demonstrating its relationship with stigma of mental ill‐health, while also reinforcing how multiple identities can interact to enhance social resources crucial for well‐being.     

The Multilevel Relationships of HIV‐Related Stigma to Child and Caregiver Mental Health among HIV‐Affected Households in South Africa

HIV/AIDS‐related (HAR) stigma is still a prevalent problem in Sub‐Saharan Africa, and has been found to be related to mental health of HIV‐positive individuals. However, no studies in the Sub‐Saharan African context have yet examined the relationship between HAR stigma and mental health among HIV‐negative, HIV‐affected adults and families; nor have any studies in this context yet examined stigma as an ecological construct predicting mental health outcomes through supra‐individual (setting level) and individual levels of influence. Multilevel modeling was used to examine multilevel, ecological relationships between HAR stigma and mental health among child and caregiver pairs from a systematic, community‐representative sample of 508 HIV‐affected households nested within 24 communities in KwaZulu‐Natal, South Africa. Two distinct dimensions of HAR stigma were measured: individual stigmatizing attitudes, and perceptions of community normative stigma. Findings suggest that individual‐level HAR stigma significantly predicts individual mental health (depression and anxiety) among HIV‐affected adults; and that community‐level HAR stigma significantly predicts both individual‐level mental health outcomes (anxiety) among HIV‐affected adults, and mental health outcomes (PTSD and externalizing behavior scores) among HIV‐affected children. Differentiated patterns of relationships were found using the two different stigma measures. These findings of unique relationships identified when utilizing two conceptually distinct stigma measures, at two levels of analysis (individual and community) suggest that HAR stigma in this context should be conceptualized as a multilevel, multidimensional construct. These findings have important implications both for mental health interventions and for interventions to reduce HAR stigma in this context.     

Community-Based Participatory Research for Improved Mental Health

Community-based participatory research (CBPR) focuses on specific community needs, and produces results that directly address those needs. Although conducting ethical CBPR is critical to its success, few academic programs include this training in their curricula. This article describes the development and evaluation of an online training course designed to increase the use of CBPR in mental health disciplines. Developed using a participatory approach involving a community of experts, this course challenges traditional research by introducing a collaborative process meant to encourage increased participation by special populations and narrow the parity gap in effective mental health treatment and services delivery.     

An assessment of a community's mental health needs

Summary This study tested the potential utility of social indicators and survey data in the prediction of community mental health sevice utilization and construction of a model of community need. The results showed that both kinds of data are strongly associated with rates of usage across census tracts within the community. The social indicator data appeared to describe the social forces acting with various segments of the community. The strength of these forces were unevenly distributed, and disadvantaged areas were most likely to have higher rates of mental health center utilization rates, although to a lesser extent than the social indicators. The two sets of data were highly convergent and both were seen as useful to planning of mental health sevices. The social indicators appeared to identify best where to look in the community for high-risk populations, while the survey data showed what to look for as mental health problems for the people of a given locale.The authors contributed equally to this research. They wish to acknowledge the assistance and encouragement of Dennis McSharry, Director of Research and Evaluation, Granite Community Mental Health Center.     

The Test–Retest Reliability and Predictive Validity of a Battery of Newly Developed Occupational Performance Assessments

The Canadian Occupational Performance Measure was used as a tool to compare goals for intervention identified by seven clients living in a long-term residential program and diagnosed with schizophrenia, with their goals as identified by the occupational therapist. In-depth interviews were conducted in conjunction with the use of the Canadian Occupational Performance Measure. Data analysis revealed an overarching theme that described the clients' concerns as, “I want to accomplish goals outside of the residence program.” During the analysis, however, the data revealed that the occupational therapist primarily focused her attention on goals to be achieved within the residence program, emphasizing programming and symptom management as each client's priorities for intervention, rather than community involvement. The findings reveal how data from the Canadian Occupational Performance Measure was used to reveal client/therapist disconnect in goal setting and the need to continue to examine client-centered practices in mental health settings.