Comprehensive Community Mental Health Program Research Articles

The Association Between Client Characteristics and Recovery in California’s Comprehensive Community Mental Health Programs

In November 2004, California voters passed the Mental Health Services Act, which allocated more than $3 billion for comprehensive community mental health programs. We examined whether these county-level programs, known as "full service partnerships," promoted independent living arrangements (i.e., recovery) among their clients. We used Markov chain models to identify probabilities of residential transitions among 8 living arrangements (n = 9208 adults followed up to 4 years). We modeled these transitions on the basis of patterns of program participation and clinical and sociodemographic characteristics. Interrupted program participation and substance abuse were significantly associated with a reduced likelihood of independent living and a greater probability of homelessness and incarceration. Persons with schizophrenia were the least likely to live independently, followed by persons with bipolar disorder. Compared with Whites, non-Whites were more frequently found to be homeless or in jail. Clients with sustained enrollment in California's comprehensive community mental health programs appear most likely to transition to independent living. The likelihood of this transition, however, shows a disparity in that ethnic minority clients appear least likely to transition to independent living.

Clinical care update schizophrenia and the life cycle

We reframe the longitudinal treatment of persons with schizophrenia from the perspective of phases in adult development. This approach articulates the need for different interventions of varying intensities over the person's lifetime. The paper discusses the implications of an adult developmental perspective in managing pharmacologic treatment and psychosocial interventions, and in reallocating financial resources for improved long-term outcomes. This perspective is especially useful in the context of a comprehensive community mental health program permitting access to a continuum of services throughout the lifecycle.

Is NIMH's dream coming true?

Do comprehensive community mental health services reduce admissions to state hospital? A recent Nader report says no. Surprisingly few studies have documented the success of comprehensive community mental health programs. Wyoming had four unique characteristics that aided in evaluating the impact of centers on hospital admissions. The results of this study indicated that community-based comprehensive mental health services do, in fact, reduce psychiatric hospitalization.

Symbiosis in planning and operation of a comprehensive health center and community mental health program in Philadelphia.

Symbiosis in planning and operation of a comprehensive health center and community mental health program in Philadelphia.

An experiential introduction to social systems

The concept of a social system, integrated with practice and related to a number of different social groupings, is an essential element in any pro gram of education for the "indigenous care-giving personnel"* avail able to a comprehensive community mental health program. This article reports on one of 28 four-hour sessions in the fifth an nual series of a continuing education program for clergymen held at the Menninger Foundation in co-operation with the local agency for com prehensive mental health services. Participants were local clergymen who had responded to a program announcement and had completed a written application form. Applicants were seen in individual interviews to per fect a "contract for learning"; they paid a tuition fee of $100 or re

Planning a community mental health program: a case history.

This paper describes in some detail the preparation of a plan for the development of one comprehensive community mental health program. The case history is ordered sequentially as follows: 1) Psychiatric hospital, the initial phase; 2) involvement of the other supporting institutions; 3) preparation for entry into the community; 4) entry into the community; 5) development of the Federal proposal. The process described illustrates a technique of planning borrowed from community organization theory and practice. Two specific approaches are identified: as method community organization practice encourages many people to participate in planning as the best way of achieving a particular goal; as process the technique encourages participation as an end in itself.

Goal attainment scaling: A general method for evaluating comprehensive community mental health programs

A mental health enterprise may be described by either (a) rather general philosophical total mental health goals, or (b) highly diverse and individualized patient-therapist goals. Goals a. have not provided a workable framework for program evaluation. This paper proposes that evaluation be done in the framework of goals b. by setting up, before treatment, a measurable scale for each patient-therapist goal, and specifying, for each patient, a transformation of his overall goal attainment into a standardized T-score. This method, together with random assignment of patients to treatment modes, was devised to permit comparison of treatment modes within a program, but it also provides a good basis for a judgmental evaluation of the total program.

From child guidance to community mental health: Problems in transition

Within the next five years, the South Shore Mental Health Center will operate a comprehensive community mental health program in a new $2 million building, now in the process of being designed. The Center will include inpatient beds for children and adults, extended outpatient services with children and adults, day-care programs for mentally retarded and emotionally disturbed children, and other comprehensive community mental health programs. These changes, no doubt, will bring with them additional administrative problems. They will include problems of integrating attendants, medical nurses, cooks, and maintenance personnel into the community mental health program, as well as such problems as keeping expanded aftercare services geographically distinct from the children's outpatient and inpatient programs. Having managed to confront and cope successfully with many problems in the past, we anticipate similar future successes as we approach our goal of an all-purpose, comprehensive community mental health center which will service the multiple mental health needs of the South Shore community.

The suicide prevention Center as a model for community mental health programs

A design is offered for the establishment of a community facility for suicide prevention. The operation of the Center is planned to embody all of the functions of comprehensive community mental health centers. It is suggested that a program for suicide prevention, which is a necessary part of every community health force, can demonstrate the principles of modern action for mental health, and thus initiate the development of a comprehensive community mental health program. The design emphasizes immediate answers to all “cries for help,” as well as a wide range of research activities. Comparisons are drawn between the proposed Center and other suicide prevention programs currently in existence.

BEHIND THE SCENES IN COMMUNITY MENTAL HEALTH

Comprehensive community mental health programs follow the pattern of public health philosophy which places the need for community service paramount to individual considerations. Public support and professional participation are seen as the cornerstones of such a program, but both the social and professional aspects are influenced by factors which we tend to overlook. In the community mental health field we have been all too prone to develop services without consideration to solving the vast community problems created by a wide range of disordered behavior. Proper integration and control of local services could have a preventive impact. This must become the ultimate goal, for without it, there is no solution.

MENTAL HEALTH AND SOCIAL WELFARE

MENTAL HEALTH AND SOCIAL WELFARE Affiliation Elizabeth P. Rice CopyRight https://doi.org/10.2105/AJPH.51.12.1927-a Published Online: August 29, 2011

The New York State Community Mental Health Services Act: its birth and early development.

We have described the origins, principles, and provisions of an attempt to establish a comprehensive community mental health program for an entire state. Widespread citizen readiness for coordinated and integrated planning of mental health services has been demonstrated, as has local and state government willingness to finance large-scale programs. This has focussed attention on the need for developing methods of evaluating the effectiveness of services and for more research especially into the causes of mental illness. The need for training of professional personnel is stressed; the demand greatly exceeds supply, and teaching centers give little training in community oriented psychiatry.