Process evaluation of an on-line computer-assisted unit for intake assessment of mental health patients

An emerging maxim accompanying the introduction of new methods and/or procedures in health care is that both process and outcome must be measured in order to adequately evaluate alternative programs. The intent of this paper is to present the results of a process evaluation of a prototype computer-assisted on-line Psychiatric Assessment Unit (PAU). The distinction between process and outcome measures is clarified by reference to appropriate target populations. The PAU assessment process is shown to be comparatively superior to the traditional psychiatric admitting process employing a psychiatric physician and ancillary support staff.     

Development of an on-line problem-oriented system for the evaluation of mental health treatment services

Current on-line assessment applications are limited to mimicking instruments designed for paper and pencil. The development of an instrument designed specifically for on-line technology is described. The instrument provides research data on treatment effectiveness, clinical information for treatment planning, and management information for resource allocation.     

Organizational preparedness for change: Staff acceptance of an on-line computer-assisted assessment system

An on-line assessment system is briefly described. Previous positive evaluation studies are summarized. Results of studies of staff acceptance and staff preparedness for change are reported. Findings are interpreted in terms of the need for planning for change. Implications related to the acceptance of other on-line computer systems in psychology are discussed.     

Development of an on-line management information system for community mental health centers

An on-line computerized management information system has been developed at the Salt Lake City VA Hospital and is currently being implemented at Salt Lake Community Mental Health Center. An introduction to this system, including systems design and procedures for development, are presented. The advantages of on-line technology as compared to batch processing technology are also discussed.     

New uses for the on-line computer medium in mental health care

A number of research projects related to new uses for computers in mental health service delivery are presented. These projects include work on software psychology, new computer applications in mental health care, and studies relating to the successful implementation of technology in mental health settings. Emphasis is placed on developing a better understanding of appropriate uses of technology rather than merely describing new applications.     

Relationship assessment in infant mental health

Infant-caregiver relationships are the crucial context for infant development and psychopathology. Considerable evidence suggests that infants may construct qualitatively different relationships with different caregivers. For these reasons, infant-caregiver relationships should be a centerpiece of assessment in infant mental health. We advocate assessing infant relationships with all important caregivers in both clinic based and naturalistic settings. In this article we describe our approach, which attends both to the external component of the relationship, behavioral interaction, as well as the internal component of the relationship, subjective experience. By integrating results from assessments of these two components, we determine both level of relationship adaptation and the specific domains of strengths and weaknesses. © 1997 Michigan Association for Infant Mental Health     

Principles of forensic mental health assessment: implications for neuropsychological assessment in forensic contexts

Forensic mental health assessment (FMHA) is a form of evaluation performed by a mental health professional to provide relevant clinical and scientific data to a legal decision maker or the litigants involved in civil or criminal proceedings. Such FMHA evaluations can be further specialized when the clinical and scientific data are primarily neuropsychological. This paper provides an adaptation of 29 recently derived principles of FMHA (Heilbrun, 2001) that have been described in two forms: general guidelines for application in FMHA, and guidelines for application to neuropsychological assessment in forensic contexts. Each principle is described, and the general guideline is compared with the highly specialized neuropsychological guideline. In this way, the applicability of such FMHA principles to forensic neuropsychological assessment is described.     

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.     

Design considerations for an on-line computer system for automated psychiatric assessment

The computer-assisted multidisciplinary Psychiatric Assessment Unit at the Salt Lake City VA Hospital required a unique computer system. Design considerations and procedures for development of a Psychiatric Real-Time Information System for Management (PRISM) are outlined. This design is presented as an example for others considering implementing on-line systems. Advantages of the approach are discussed.     

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.     

Culturally competent outcome evaluation in systems of care for children's mental health

Conclusions The area of culturally competent outcome evaluation and cross-cultural mental health research in general needs to be greatly developed given the culturally diverse nation we live in and the different needs of culturally diverse children and their families. Such evaluation is crucial in supporting the need for and effectiveness of culturally competent programs and special programs with a focus on particular cultural populations. The imperatives for cost effectiveness and clinical effectiveness which have been promoted by the transition to managed systems of care may actually promote the development of higher levels of cultural competence in community-based systems of care. Culturally competent care may well be the most cost-effective and clinically effective care.     

Psychological evaluation by means of an on-line computer

The use of an on-line microcomputer-based testing system in a private clinical psychology practice is described. Advantages and disadvantages are discussed. Information about procedures and fees are presented.     

Psychological assessment of children in a community mental health clinic

Collaborative and Therapeutic Assessment (TA) models (Finn & Tonsager, 1997; Fischer, 1985/1994) use psychological tests to answer client-constructed assessment questions in an understandable language, to be an intervention in and of themselves, and to initiate recommendations related to the referral. This article considers the application of Finn's TA model to an urban community psychology clinic in Oakland, California, where foster and kinship care, the child welfare system, trauma, neglect, and attachment disruptions are children's usual experience. These children hide their pain and complaints (Kelly, 1999), but show highly problematic behaviors to bewildered and frustrated caretakers, social workers, and school personnel. Their trauma, however, also often permeates the assessment data and shocks the assessor. A rationale is made for the necessity of a relational, culturally aware, systemic model in providing psychological assessment services to children and families in a community setting.     

The development and evaluation of an online computer-assisted Rorschach Inkblot Test

An interactive computer program was developed in the BASIC language to present the performance and inquiry phases of the Rorschach Inkblot Test. As the subjects handled the traditional cards they entered their perceptions into the computer database, guided by instructions presented on the computer display. No assumptions were made about the percepts, but the Klopfer scoring questions were asked directly by the computer during the inquiry. The program scored the test as the subject answered the scoring questions on the keyboard. Thirty subjects were assessed using a test-retest design. One subgroup was tested first by a psychologist, and the other was tested first by the computer. The determinants of the psychologist and computer testing situations were found to be correlated and overall not significantly different except in location and time scores where the media differed.