Integrating Behavioral Aspects into Community Preparedness and Response Systems

Summary

This article examines the role of psychosocial and behavioral dimensions of terrorism that influence community preparedness and homeland defense efforts. Public health interventions will fail if people do not follow the recommendations. A broader public health model is applied to help identify the interactions between risk and safety appraisals, social factors, and behavioral response to uncertain and stressful situations. Community preparedness would benefit by linking disparate programmatic and advocacy initiatives that already exist. It stands to reason that improving the cohesiveness of existing systems of social organization would strengthen community resilience and serve as effective countermeasures for terrorism.     

Youth Exposure to Community Violence: Association with Aggression,Victimization, and Risk Behaviors

The purpose of this study was to examine the association between exposure to community violence and aggression, victimization, and risk-taking behaviors among young adolescents. Secondary analysis was conducted on data from a cross-sectional survey of 8,259 sixth, seventh, and eighth grade students from eight urban schools in Texas. Results indicated that students exposed to a high level of community violence were 7.7 times more likely to carry a handgun, 5.2 times more likely to be involved in a gang were 6.4 times more likely to use marijuana, 5.3 times more likely to binge drink, and 2.8 times more likely to be injured as a result of fighting. This suggests the need for an interdisciplinary approach to violence prevention that targets all the environments of youth, including schools, homes, neighborhoods, and other community units.     

Parent-School and Community Partnerships in Children's Mental Health: Networking Challenges, Dilemmas, and Solutions

Inter-agency collaboration, service coordination, and the creation of successful partnerships among parents, teachers, and human services professionals continues to be a challenge for the development of responsive community-based systems of care for at-risk youth and their families. We explore how one inner-city neighborhood struggles to create successful community partnerships through traditional networking strategies. Our findings identify networking strategies that appear to work and those that do not. Recommendations for improving communication are provided.     

Clergy Response to Domestic Violence: A Preliminary Survey of Clergy Members,Victims, and Batterers

Although the presence of both religious organizations and violence in American communities is pervasive, scant attention has focused on how to best enroll clergy and religiously oriented resources in the battle against family violence. Given that it is not uncommon for women or couples to seek counseling or advice from clergy before accessing community-based resources, the frequency, nature, and utility of these contacts were assessed in this exploratory study from the perspectives of 47 female victims and 70 male perpetrators of domestic violence. Forty-one clergy members from various denominations were also surveyed about their contacts with those seeking help for domestic violence. Results indicated that 43% of the victims and 20% of the perpetrators did seek help from clergy. Almost all of the victims who contacted clergy reported satisfaction with the counsel they received. All clergy respondents reported counseling people who had experienced domestic violence during their career, and 80% had violence-related contacts in the past year. The service-related implications of these clergy contacts from victim, perpetrator, and clergy perspectives are discussed.     

抑郁症的流行病学研究与预防——读《中国人群死亡及其危险因素流行水平、趋势和分布》有感

根据《中国人群死亡及其危险因素流行水平、趋势和发布》的报告和相关研究表明,全世界约有1亿人患有抑郁症,且数量有增无减,抑郁症将成为本世纪一种相当流行的病症.由于抑郁症是一种患病率高,严重危害人类身心健康,具有高自杀风险的精神疾病,更需要我们采取措施积极预防.目前采用的主要预防方法有:积极的心理健康教育、处理好家庭与社会的关系、社会支持、心理调适和体育锻炼等.     

Rethinking a Familiar Model: Psychotherapy and the Mental Health of Refugees

This paper examines with a somewhat critical eye the primary role that psychotherapy and other clinic-based services currently play in addressing the mental health needs of political refugees in the industrialized countries. Two factors are considered which suggest that refugee mental health needs might be better served by complementing clinic-based treatments with a variety of community-based interventions. The first factor concerns the pervasiveness of psychological distress within refugee communities, coupled with the reluctance of many refugees to utilize formal psychological and psychiatric services. This calls into question both the adequacy and appropriateness of clinical-based services as cornerstones of our response to the mental health needs of refugees. More precisely, it suggests the need to complement such services with a variety of culturally grounded, community-based strategies that do not require attendance in formal mental health settings. Second, recent findings have shown consistently that a considerable amount of the distress reported by refugees is related not to prior exposure to violent events, but to a constellation of exile-related stressors such as the loss of one's community and social network, the loss of important life projects, changes in socioeconomic status and related concerns about economic survival, the loss of meaningful structure and activity in daily life, and the loss of meaningful social roles. It is suggested that while psychotherapy can play an important adjunctive role in helping people confront these exile-related stressors, they may most effectively be addressed through targeted community-based interventions. Examples of such community-based approaches are briefly described, and suggestions are offered for community-level strategies that might be explored. The paper concludes by emphasizing the complementary nature of clinical and community-based programs, and by suggesting that psychotherapy might best be conceptualized as one component of a more comprehensive approach to addressing the mental health needs of refugee communities.     

Initial response to rape: The impact of factors within the rape situation

The relationship between specific aspects of the rape situation and immediate post-rape measures of depression, fear, anxiety, and social and interpersonal functioning in 50 recent victims of sexual assault was examined. The data failed to reveal any significant relationships between rape situation variables (e.g., stranger vs. known assailant, weapon vs. no weapon) and the nature or severity of the victims' psychological response. It is emphasized that this negative finding contradicts previous and current clinical lore, and has a number of implications for the assessment and treatment of rape victims.This research was supported by a grant from the National Institute of Mental Health (MH#29692) to the first two authors.     

Consciousness,Trauma, and Health: A Cognitive Systems Response to Payne,Walsh, and Oman

Religion and cognitive science contribute complementary understandings of the human person, and an integrated perspective can bridge clinical, spiritual, and philosophical resources to facilitate healing and growth. Drawing upon cognitive science and systems theory, I respond to Richard Payne, Mary Walsh, and Doug Oman’s comments on my Mind, Brain, and the Elusive Soul (Graves 2008; Oman 2011; Payne 2011; Walsh 2011).     

Book Review: Managing Mental Health in the Community: Chaos and Containment

Abstract

The British Association of Counselling first introduced a Code of Ethics and Practice for Counsellors in 1984. It has subse-quendy been revised three times. The codes have to be sufficiently broad to be accepted by the membership of BAC, who come from a wide range of theoretical backgrounds. Inevitably this means that the codes do not satisfy everyone nor do they resolve all ethical dilemmas. This paper focuses on sections of the codes which are unsatisfactory, or inadequate for psychodynamic counsellors. It also looks at the influence of psychodynamic counsellors in changes to the clauses on sexual exploitation. Finally the absence of any mention of dual and multiple relationships is discussed.     

Ukuphepha: A Multi-level Community Engagement Model for the Promotion of Safety,Peace and Health

This article aims to describe a theoretically-informed community engagement model which delivers a suite of child safety, peace and health interventions.We provide an overview of critical concepts that inform the community engagement approach that underpins the implementation of the Ukuphepha Child Safety, Peace and Health Programme (UCSPHP), in low-income neighbourhoods just outside Johannesburg, and on the periphery of Cape Town, South Africa. Our analysis is framed within a participatory approach and suggests the importance of six interconnected community engagement pathways: relationship-building; community-centred learning; social justice and contextual congruence; the facilitation of democratic traditions; strengthening the case for community services; and the affirmation of local social economies.     

The Relationship Between Caregiver Capacity and Intensive Community Treatment for Children with a Mental Health Crisis

We studied 9,220 children referred to a comprehensive mental health crisis stabilization program to examine the impact of caregiver capacity on crisis worker decisions to refer children for intensive community-based treatment as opposed to inpatient psychiatric hospitalization. Due to the different role of caregivers in the child welfare system, analyses were stratified by state custody status. Among both groups, there was a significant inverse association between child mental health need and referral to intensive community-based treatment. For children not in state custody with low mental health need, there was no difference in the likelihood of referral to intensive community-based treatment across levels of caregiver capacity. However, for children not in state custody with medium and high mental health needs, those whose caregivers were deficient or severely deficient were significantly more likely to be referred for intensive community-based treatment than were those who had capable caregivers. Multivariate analyses demonstrated similar results after controlling for potential confounding variables and confirmed that caregiver capacity contributes significantly to the logistic model’s classification accuracy. Results suggest further investigation of the impact of caregiver capacity on mental health crisis worker referral decisions is needed.     

The Third Rail of Family Systems: Sibling Relationships, Mental and Behavioral Health, and Preventive Intervention in Childhood and Adolescence

Sibling relationships are an important context for development, but are often ignored in research and preventive interventions with youth and families. In childhood and adolescence, siblings spend considerable time together, and siblings’ characteristics and sibling dynamics substantially influence developmental trajectories and outcomes. This paper reviews research on sibling relationships in childhood and adolescence, focusing on sibling dynamics as part of the family system and sibling influences on adjustment problems, including internalizing and externalizing behaviors and substance use. We present a theoretical model that describes three key pathways of sibling influence: one that extends through siblings’ experiences with peers and school, and two that operate largely through family relationships. We then describe the few existing preventive interventions that target sibling relationships and discuss the potential utility of integrating siblings into child and family programs.     

综合性大医院与社区卫生服务中心合作切入点的分析

通过时沈阳市沈河区9个社区卫生服务中心进行调查和相关资料分析,探讨大型综合性院与社区卫生服务中心合作的可行性,如人员培训和技术支持,临床检查结果互认,实行“双向转诊”等,为建立新型城市医疗卫生服务体系参考依据。     

Lessons Learned from the Intensive Mental Health Program: A School-based,Community Oriented Program for Children with Serious Emotional Disturbances

The Intensive Mental Health Program meets the needs for services in school systems for children with serious emotional disturbances and for training graduate students in clinical applications with a difficult-to-serve population. We address the range of challenges and rewards experienced in the development of the comprehensive intervention program, the continued maintenance of program elements, and the program evaluation.     

Personality Dysfunction and the Management of Chronic Medical Illness: A Community Health Sample

The purpose of this study was to determine the influence of personality disorders on perceived health status, self-efficacy for management of the chronic illness, and physician perception of patient health. A total of 607 patients with self-identified chronicillness(es) volunteered to participate in the study. Out of this sample, 147 had collaborative physician data indicating a chronic illness. The final sample was 143 due to incomplete data. Results suggested that maladaptive personality characteristics, as measured by the Short-Form of the Coolidge Axis II Inventory (SCATI), were related to a number of important factors that influence self-management of chronic illnesses. When the personality constellations were broken into 3 groups (normal, subclinical, and clinical) significant differences were found on the 3 groups of dependent variables (Subjective Health, Self-Efficacy, Physician Appraisal) for the different personality disorders. These data provide useful information on several factors that influence effective disease management. Clinical implications and directions for future research are provided.