Building and Maintaining Clinical Programs

This paper describes the basic elements of practice development and management within the academic medical setting. These include assessment of the market environment, both in the community and within the medical setting, product development, marketing, budget basics, quality, managed care negotiations, and finding time to do research in a financially-driven health care system.     

Effects of Different Telephone Intervention Styles with Suicidal Callers at Two Suicide Prevention Centers: An Empirical Investigation

To determine the relative effectiveness of telephone intervention styles with suicidal callers, researchers listened unobtrusively to 617 calls by suicidal persons at two suicide prevention centers and categorized all 66,953 responses by the 110 volunteer helpers according to a reliable 20-category checklist. Outcome measures showed observer evaluations of decreased depressive mood from the beginning to the end in 14% of calls, decreased suicidal urgency ratings from the beginning to the end in 27% of calls, and reaching a contract in 68% of calls, of which 54% of contracts were upheld according to follow-up data. Within the context of relatively directive interventions, a greater proportion of Rogerian nondirective responses was related to significantly more decreases in depression. Reduction in urgency and reaching a contract were related to greater use of Rogerian response categories only with nonchronic callers.     

Mental health service utilization among Puerto Rican children ages 4 through 16

This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives.     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

主观声旁家族对汉语儿童汉字命名的影响

研究选取三年级、五年级和七年级学生,采用两个汉字命名实验,考察主观声旁家族对汉字命名的影响。实验一操纵主观声旁家族大小,发现三年级儿童没有表现出家族效应;五年级儿童表现出边缘显著的家族抑制效应,即对大家族的字命名更慢;七年级儿童表现出显著的家族抑制效应。实验二操纵了目标字是否有高频家族成员字（higher frequency neighbors,HFNs）这个变量,发现儿童普遍都表现出HFNs抑制效应,即对有高频家族成员字的目标字命名更慢。以上结果表明随着年级增长,主观声旁家族对儿童命名的影响逐渐增强,且高年级儿童已表现出家族抑制效应,这一表现与普遍出现的HFNs抑制效应有关。     

Citizen Advocacy Observed: Tool or Tokenism?

Citizen advocacy, where a volunteer works in partnership with a vulnerable person, compliments self- and legal advocacy. In the context of mental health services, citizen advocacy is a tool for enabling and empowering people who use these services, and is founded on the recognition that mental health service users are frequently socially oppressed and disadvantaged. This article describes the development of a Citizen Advocacy service for people with mental health difficulties, and also the problems they brought to this service. The problems encountered in sustaining the service are noted and lessons are drawn for the future.     

A focus group study on the potential of autonomous vehicles as a viable transportation option: Perspectives from people with disabilities and public transit agencies

Autonomous vehicle (AV) technology is becoming one of the most promising alternatives to improve mobility for people with disabilities. Nevertheless, how people with disabilities perceive AV as transportation services has not been explored. Also, limited information exists about how public transit agencies comprehend and perceive autonomous vehicle transportation (AVT) services. This study discusses mobility issues for people with disabilities and explores the potential of AVT to serve that population, particularly those with visual impairments or physical disabilities. Researchers conducted six focus groups comprising people with disabilities (N = 23) and public transit service experts (N = 10) in Austin, Texas and Houston, Texas. Each session was audio-recorded and analyzed using conventional content analysis. This study identified people with disabilities’ mobility issues related to: (1) current transit services (including fixed-route and paratransit services) and (2) the quality of neighborhood built environments. Both people with disabilities and transit experts expected that AVT could mitigate current mobility issues, especially in improved built environments. However, participants with disabilities also expressed concerns and anxieties regarding AVT. Transit experts agreed that more targeted strategies would be needed to overcome possible barriers to AVT for people with disabilities. This study provides insights on shaping AVT strategies and policies relevant to improving mobility for people with disabilities.