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。     

Addressing the Mental Health Needs of the Rural Underserved: Findings from a Multiple Case Study of a Behavioral Telehealth Project

Behavioral telehealth is a reasonable solution to the accessibility to mental health care problem that exists in many rural communities. This paper reports the results of a multiple case study of a behavioral telehealth program administered through a marriage and family therapy training program. The results suggest that mental health services can be effectively delivered using existing distance education technology to underserved rural populations. Rural communities have unique barriers to accessing mental health care, some of which can be overcome through the distance delivery of services and some of which cannot. In order to effectively deliver treatment, accommodations to the technology must be made by both therapist and client.     

Television,madness and community care

This paper describes the forms and contents of television representations of mental illness in the UK in 1992. The theoretical framework is provided by Moscovici's theory of social representations and some modifications are proposed for the case of madness. Quantitative and qualitative methods are used in the empirical analyses. It is shown that madness has multiple meanings on television, while at the same time violence is commonly included. It is also suggested that a partial reconfiguration of the representational field has taken place in recent years. Media stories about the responsibility of the policy of community care for scandals and tragedies are now commonplace. © 1998 John Wiley & Sons, Ltd.     

Mental Health Literacy of Australian Rural Adolescents: An Analysis Using Vignettes and Short Films

The mental health literacy (MHL) of rural adolescents has rarely been investigated. This study examined the MHL of 122 rural‐based adolescents (49 males, 73 females) aged 12–18 years (M = 16, SD = 1) using written vignettes and short films to examine knowledge about depression. For the written vignettes, 68% of the rural adolescents were able to correctly identify someone with depression, which is similar to the findings for metropolitan adolescents; however, knowledge about recovery times and avenues of assistance were below that of their metropolitan peers. Participants were less likely to correctly diagnose depression when suicidal intent was not expressed and when the scenario was presented in the more naturalistic form of a film. This finding raises questions about the place of films and written vignettes in future MHL research.     

Participating in social enquiry and action

This paper describes the collaborative endeavours of residents and a wide range of professional workers in a particular area of Nottingham, with reference to a community psychology approach to addressing sources of psychological distress. The activities include a survey of people's views about living in the area and the factors they identify as affecting their health; and initiatives in community participation and action. One hundred and twenty three people were interviewed by members of the Sneinton and Bakersfield Community Forum. Harmful influences upon health and causes of stress were revealed as litter, dog dirt, air and traffic pollution, feeling unsafe to go out at night and lifestyle-related issues such as smoking and diet. Public meetings, the local press and short written reports were used to publicize these results and encourage further involvement. Many local residents and professionals are now active in a network of groups which address social and environmental concerns.     

Predicting Resource Utilization by Children with Serious Emotional Disturbance and Their Families

Our study represents a rural case management agency's use of its data to aid in its transition from being funded by federal grant funds to self-sustainment. We wanted to learn if some characteristics of those children served could predict the resources needed to serve them. We analyzed data on 90 children and adolescents living in a rural community. Using multiple regression analysis we found that CAFAS total and CBCL total problem scores predicted Medicaid reimbursements but not flexible funds spending or case management hours. History of psychiatric hospitalization, however, predicted flexible funds spending and case management hours. Using one-way ANOVA and post hoc analysis we found that the staff members' assessments of each child and family's level of service needs were reflected in differences in mean CAFAS total scores, Medicaid reimbursements and case management hours, but not CBCL total problem scores or flexible funds spending.     

Understanding public opinion relating to the establishment of community mental health facilities: implications of a discourse analytic approach

This paper demonstrates a novel approach to investigating the problem of public opposition to community mental health facilities. With the move towards community care, organizations setting up mental health facilities have encountered public opposition. It has been argued that this is due, in part, to the attitudes held by the public towards mentally ill people. A knowledge and understanding of attitudes towards this client group therefore has the potential to be of practical use to policy makers and practitioners who have a responsibility to consult on, and implement, community care for mentally ill people. The survey approaches and hypothetical situations used in previous British studies of community attitudes towards mentally ill people have, however, failed to take account of the rhetorical richness and complexity of the attitudes likely to be expressed in real‐life community care contexts. By contrast, the study reported in this paper used a discourse analytic approach to explore the views expressed about mentally ill people in a ‘hot situation’. Specifically, people's views were explored in the contexts of the arguments they used to challenge or advocate a supported accommodation project for mentally ill people in their community. This paper examines some of these arguments and discusses the theoretical implications for traditional approaches to attitude research. In conclusion, the potential practical utility of the findings is considered. Copyright © 1999 John Wiley & Sons, Ltd.     

The role of primary prevention in mental health services: A review and critique

Community psychology in the West has had a growing impact on mental health service provision. One facet of this development has been the advocacy of an increased focus on the primary prevention of mental illness. This paper reviews both theoretical and practical work in this area in order to assess the current role and relevance of primary preventive interventions. There is a discussion of primary prevention's historical and theoretical contexts, of its conceptualisations and definitions, of criticisms of its relevance and efficacy, and of examples of its practice. It is argued that primary prevention is inappropriately marginalised in current service provision and that there is a need to engage in the long-term planning and evaluation of primary preventive interventions in order to facilitate their fuller incorporation into national and local policies on mental health.     

中西方关于心理健康标准问题的探讨及对我们的启示

分析了国内外学者在制定心理健康标准时所作的探讨,提出了适应与发展应是心理健康考察的基本对象,对心理健康的评估应是对心理机能的评估,我国在制定心理健康标准时应借鉴西方的有关理论和经验。     

现代社会需要心理健康教育——评《现代心理健康教育》

随着社会的发展,人们越来越重视心理健康教育。《现代心理健康教育》一书集中反映了俞国良教授及其课题组多年扎根于心理健康教育领域的工作特色:研究对象广泛,研究成果有创新,学术研究与普及工作齐头并进。     

Exploring Counselor-Client Agreement on Clients’ Work Capacity in Established and Consultative Dyads

Counselor-client agreement on the work capacity of clients living with serious mental illnesses informs the counseling relationship and facilitates accurate assessments of client eligibility for public programs. In this exploratory mixed-methods study, we assessed counselor-client agreement on clients’ work capacity in 61 established therapeutic dyads and compared it with 30 dyads involved in an initial assessment session. Intraclass correlation coefficients and mountain plots were used to examine counselor-client agreement. Results revealed moderate counselor-client agreement of work capacity for both dyads. Counselor interviews illuminated sources of discordance. These results have practical implications for assessing the work capacity of clients.     

农村中学生心理健康状况的调查研究

本研究运用SCL-90量表对农村545名中学生进行了调查,结果发现:中学生存在一些轻微的心理健康问题,在年龄、性别方面也有一定的差异。并就存在的问题进行了全面分析,提出了促进中学生心理健康的几点应对措施。     

Supervision in Community Mental Health: Understanding Intensity of EBT Focus

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the supervisor level and implementation climate was the only significant factor associated with EBT supervision intensity. While individual clinician and supervisor factors may play a role in EBT coverage in supervision, our results suggest that an implementation climate that supports EBT may be the most critical factor for improving intensity of EBT coverage. Thus, implementation efforts that address the extent to which EBTs are expected, rewarded, and supported within an organization may be needed to support greater coverage of EBT during workplace-based supervision.     

The Effects of Capitation on Outpatient Mental Health Episodes of Children

We analyzed the effects of the Colorado Medicaid Capitation Program on the duration and services of over 21,000 outpatient mental health episodes for young children. The study spanned a three year period before and after capitation was implemented, and compared episodes of outpatient care for children from 14 capitated Community Mental Health Centers (CMHCs) with those from three CMHCs that remained fee-for-service. Proportional hazards regressions revealed that capitation resulted in an increase in outpatient episode duration, over and above similar effects for the comparison fee-for-service episodes. The hypothesis that there were longer capitated episodes for children who were hospitalized was not supported. Children with behavioral and anxiety disorders had longer capitated episodes. Service intensity decreased over time in the managed care sites. Changes in case mix may have had an impact on changes in episode duration and service intensity. That outpatient episode duration increased over time while costs were lowered in the capitated agencies indicates some effects of capitation in changing patterns of care.