Comprehensive Mental Health Center Research Articles

Implementing and maintaining school-based mental health services in a large, urban school district.

The Dallas (Texas) Public Schools established the first school-based health center in the United States in 1969. In 1993 a partnership between two school principals, a school mental health professional, and the medical director of the county mental health center was the impetus for the first comprehensive school-based mental health center in Texas. In 1995 the programs joined together as Youth and Family Centers (YFCs) to provide physical health, mental health, and other support services to students and their families. The 10 strategically located school-based centers are directed by licensed mental health professionals employed by the district who lead a multidisciplinary team of physical health and mental health providers. Students served by the YFCs have fewer discipline problems, course failures, and school absences.

The Quality Journey in a Comprehensive Mental Health Center: A Case Study

In early 1992 the chief executive officer (CEO) and consequently the senior leadership of Shawnee Hills, a mental health care organization comprising more than 65 facilities in West Virginia, decided to begin the journey toward total quality management (TQM). TQM provided guidance for establishing an infrastructure for planned organizational change and continuous improvement while maintaining the CEO's responsibility to set the vision and provide direction. TQM'S IMPACT: Absenteeism and turnover rates have decreased, which are felt to reflect increasingly high levels of staff satisfaction. The tripling of the operating budget from 1993 to 1995 is also considered a byproduct of TQM. TQM has increased the potential for this organization's success in the new health care environment by providing an infrastructure for "managing" managed care. Setting forth the vision, purpose, mission, and goals required a focus on customer satisfaction and the development of partnerships, empowerment, and teamwork. The leadership identified strategic indicators for critical success factors--customer satisfaction, positioning for future success, financial viability, and safe and professional environments--and teams were formed to address how improvements can be made. If a problem is minimal or average, processes are improved. If it is severe, reengineering is indicated. For example, each program at Shawnee Hills had its own intake procedure. To simplify access to service, it was determined that a single point of entry was needed, requiring a total redesign of current operations. Although not a panacea for all the problems an organization might be experiencing, TQM does provide guidance and direction to organizations in an ever-changing environment.

Application of total quality management to mental health: a benchmark case study.

The search for models or "benchmarks" that reflect the successful application of total quality management (TQM) to the mental health field is one that goes largely unrewarded. This article describes a case study of one comprehensive mental health center that has made a serious commitment to the philosophy and principles of TQM and that is reaping significant benefits from that effort.

Functional Adaptation to the Job Market: Incorporating Specialized Skills of Music Therapy in a Comprehensive Mental Health Center

Journal Article Functional Adaptation to the Job Market: Incorporating Specialized Skills of Music Therapy in a Comprehensive Mental Health Center Get access Jerrilyn S. Herd, RMT-BC Jerrilyn S. Herd, RMT-BC coordinator of a Community Support Program 2Four County Counseling Center, Logansport, Indiana Search for other works by this author on: Oxford Academic PubMed Google Scholar Music Therapy Perspectives, Volume 3, Issue 1, Spring 1986, Pages 50–52, https://doi.org/10.1093/mtp/3.1.50 Published: 01 March 1986

A unique approach to performance standards for clinicians in a CMHC.

Performance standards were developed for clinicians of a large comprehensive mental health center. Clinicians were required to provide a minimum average of 20 hours of face-to-face service per week. Credit values, ranging from .5 to 3.0, were assigned for each hour of service provided based on the difficulty of the service to deliver and the amount of paperwork required. Total credits were considered as an extra accomplishment and utilized as a criterion for determining merit increases. The results indicated an increase in the utilization of family and group therapy as well as a more equitable system for evaluating widely differing services.

Ensuring quality of care in a comprehensive mental health center.

A six-phase process is currently being utilized by a large comprehensive mental health center to ensure delivery of the highest quality of care to its patients. In the first phase, during the admission process, each patient's assets and liabilities are determined. The second phase involves a disposition team that reviews and assigns each case. The third phase involves both the clinician and patient in developing a treatment plan. The fourth phase is a periodic review of each patient's file by the clinician's supervisor. The fifth phase involves a peer review of randomly selected files. The final phase is a retrospective review of randomly selected patients who are no longer receiving services, comparing the current assets and liabilities with those on the initial assessment to determine if progress did occur and was sustained.

Ethnicity as a variable in the utilization and referral patterns of a comprehensive mental health center.

Ethnicity as a variable in the utilization and referral patterns of a comprehensive mental health center.

Concluding Perspectives: Promise and Practice

In this brief perspective I shall attempt an update of the state of application of the systems analysis orientation we offered a few short years ago, drawing on the work reported in this issue and on my own experience subsequent to the publication of our earlier article in order to evaluate where the mental health system is in relation to the components we felt to be critical at that time. As our prototype we used the private psychiatric hospital to illustrate an application of systems analysis concepts. Had our personal experiences been different, we could as easily have used the comprehensive mental health center or the state mental health system. Events have transpired in all of these areas in the past four years that have relevance to the systems analysis perspective. To recapitulate: we stated that the goal of systems analysis was to facilitate rational choice by looking at elements as subsystems of the whole and, through the development and use of a management information system (MIS), to provide feedback loops. These feedback loops enable the system to learn systematically from its experience, through the application of decision analysis to close the gap between goals and performance. In particular, we focused on a problem-oriented record-keeping system as the backbone of the MIS. We identified the utilization-review (U-R) function as one aspect of decision-making in which a successful feedback loop could be useful. Where are we now?

Predicting resource utilization in a comprehensive center: An evaluation of three alternative methods

Three alternative methods for obtaining anticipated resource utilization information for comprehensive mental health centers are proposed. The methods differ on two dimensions, sample selection and statistical technique. Using an admission cohort rather than a discharge cohort and eliminating patients who terminated treatment against medical advice permitted a refined prediction. Although no significant differences were found between the chi-square and multiple-regression techniques, the latter resulted in a substantially greater degree of flexibility.

Locus of control and the voluntary control of heart rate.

Pennsylvania State University, University Park Pennsylvania 16802 and the Comprehensive Mental Health Center, Savannah, Georgia Address for reprint requests: Dr. W. J. Ray, Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania 16802 Received for publication September 10, 1973; revision received November 15, 1973. This research was performed in the psychological laboratory of Dr. Hans Strupp, Vanderbilt University, Nashville, Tennessee.

Patients, programs and results in a comprehensive mental health center.

Patients, programs and results in a comprehensive mental health center.

Mental health insurance: a comparison of a fee-for-service indemnity plan and a comprehensive mental health center.

Services and utilization rates of a comprehensive mental health center supported by a prepaid insurance plan are compared with those of a fee-for-service indemnity plan. Data accumulated over a period of seven years indicate that by the end of that period hospitalization rates among members of the center were lower than those for members of the indemnity plan, while the mental health center's utilization of services was higher.

The effects of consumer control on the delivery of services.

A confluence of historical, social and political forces has resulted in the emergence of increased pressure for community control over human resources, particularly in urban areas. This paper explores a comprehensive mental health center's shift from institutional to consumer regulation, and the impact of that transition upon the delivery of services.

Therapeutic abortion: the psychiatric nurse as therapist, liaison, and consultant.

It is noted that as abortion becomes an accepted medical practice, more nurses will be involved in the treatment and counseling of the therapeutic abortion patient. The authors, psychiatric nurses in a Colorado comprehensive urban mental health center, became involved in the treatment of the therapeutic abortion patient with the passing of the State's liberalized 1967 abortion law. As they became involved with all aspects of therapeutic abortion patients' care, they identified 3 specific roles for the psychiatric nurse: 1) providing direct They treatment, 2) providing liaison service and promoting continuity of care for the patient, and 3) providing consultation service to the staff involved with the patient. As the psychiatric nurses shared their own mixed feelings about abortion with the obstetrical staff, the staff began to feel less guilty and less alone with their feelings. The became more involved with the patients and benefited them more.

Readmissions to a community mental health center.

The readmission experience of a modern comprehensive mental health center was examined and was compared in several ways to the experience of a similar center. The evidence indicated that institutions should expect their own readmissions to constitute a substantial part of their patient load. A scheme for differentiating types of readmissions was examined. The subclasses which evolved slightly softened the impression that all readmissions are therapeutic failures. However, even with a relatively limited definition of failure, the majority of readmissions still fell into this class. Further refinements of the scheme for differentiating types of readmissions are suggested.

Expectations for the comprehensive mental health center: the community.

The process of developing community support for a comprehensive mental health center in a rural and an urban setting is described. The more limited the community in existing services, manpower and economic potential, the more radical the realignment of such resources must be before a center can emerge. In his efforts to obtain community commitment, the mental health professional must be aware that idiosyncratic expectancies of what the center will accomplish are held by the sponsoring agencies. Shaping such diverse aspirations into a realistic program of services is a hazard and a strength of the community mental health movement.

Letters to the editor: Comprehensive mental health center.

Letters to the editor: Comprehensive mental health center. S BlosteinCopyRight https://doi.org/10.2105/AJPH.59.9.1570 Published Online: August 29, 2011

How Caseworkers Decide: A Study of the Association of Selected Applicant Factors with Worker Decisions in Admission Services

This exploratory study examines one aspect of social work practice in the admission service of two comprehensive mental health centers, in terms of the effect of different items of information about applicants on the decision for further action. Tape recordings of 98 initial interviews by twelve intake workers were examined in terms of demographic charac- teristics, referral data, condition at start of interview, presenting problem, crisis situation, and diagnostic impression obtained. Decisions were grouped into six possible categories: to continue for further study, to refer to intake team, to refer to inpatient service, to refer to outpatient service, to refer elsewhere, or to defer action. Predictions of association based on case models were analyzed separately, and some patternings were ascertained.

The concept of mental illness: A new look at some old assumptions

It is suggested that new conceptual models are necessary to rehabilitate the poor risk patient. The institutional model of rehabilitating the psychiatric patient is not enough, but must be complemented by a comprehensive mental health center approach based in the community. The emergence of the comprehensive mental health center from the therapeutic community idea is intimated, but caution is offered against making the same mistakes often made by the therapeutic community approach. Minimal emphasis on rehabilitation in comprehensive mental health centers is pointed out as a weakness. The importance of vocational rehabilitation as a therapeutic agent in the community is stressed.

From state hospital to community psychiatry: Problems in two kinds of communities

A division of a decentralized state hospital has experienced a 75% drop in census since practicing community psychiatry. Soon, it is anticipated that two comprehensive mental health centers will develop in the area it serves and that the division will "go out of business." In working with the "natural community" and the "therapeutic community," recurrent problems have been noted. Examples are offered in the areas of communication, working toward a community mental health center, deciding who should come to the hospital, and in the particular problems of the therapeutic community, including the problems of change, hospital size, and training.