Comprehensive Mental Health Program Research Articles

School-based mental health services: The Baltimore models

Through a variety of state and local funding and administrative arrangements, expanded school mental health (ESMH) programs have been developed in nearly half of the 176 Baltimore City schools over the past decade. These programs augment existing services provided by the school and help to ensure that a comprehensive range of services (assessment, prevention, case management, treatment) are available to youth in special and regular education. Baltimore's leadership in the emerging ESMH field led to the development of the Center for School Mental Health Assistance (CSMHA), one of two national centers that provide support and technical assistance to promote comprehensive mental health programs for youth in schools. This paper shares experiences associated with the growth of ESMH programs in Baltimore and activities and initiatives of the CSMHA. © 1999 John Wiley & Sons, Inc.

Gender-Appropriate Mental Health Services for Incarcerated Women: Issues and Challenges

The rapid increase in the number of incarcerated women, the growing recognition of the limitations of male-oriented prison services in the rehabilitation of women, and the associated demands for reform that address the multiple issues of parity for women in prisons have led to an increase in the types of programming and services offered within women's prisons. These complexities are explored through an historic view, current research, contemporary models of female psychological development, and a discussion of the development of a gender-specific, comprehensive mental health program in a 600-bed state prison for women. In so doing, the authors raise questions about how to plan gender-specific mental health programming for incarcerated women that addresses women's needs without reifying gender stereotypes.

Prepaid Comprehensive Mental Health Services for Children

A comprehensive mental health program for children in a Health Maintenance Organization setting is described, focusing on the synergistic relationship between a consultative (indirect service) role and specialized (direct service) treatment programs. About half the patients diagnosed by pediatricians as having a psychosocial problem are referred to mental health, over 97% of thsoe referred are seen 10 sessions or fewer, and under 2% require continuous (long-term) psychotherapy when a full range of alternatives exists. Cost and utilization data are presented, and case examples demonstrate the adaptation of traditional techniques to the setting. Such adaptation, and careful treatment planning, underlie cost containment.

Music Therapy in a Community Mental Health Program

This paper describes the evolution of the role of the music therapist in a community mental health program at the Milwaukee County Mental Health Center. Community mental health programming called upon the music therapist to expand his services to include servicing patients on all levels of the continuum of care, both within the hospital and in the community. Music therapy practice and techniques were influenced by the concepts of short-term hospitalization and alter and precare services. Professional responsibilities increased as the scope of the program expanded to include functioning as a primary therapist and group psychotherapist These duties were delegated by the psychiatrist who directed inservice training and supervision of those mental health professionals selected to function in those roles historically in the realm of other mental health professionals. The distinguishing element of a comprehensive mental health program is consultation and educational service to established community agencies and related professional personnel. Music therapy services in these areas, as in other mental health services, remain undefined and experimental due to lack of funds and staff. Limited experiences and speculation indicate both traditional and innovative practices of music therapy can contribute to this essential element of the community mental health program.

Combining the psychiatric resources of neighboring general hospitals.

Pending the development of comprehensive mental health programs at neighboring hospitals, a custodial-type inpatient unit for private patients in one of the institutions was developed into an intensive treatment service to admit indigent patients as well. The program was combined with that of an outpatient clinic in another hospital.

Anatomy of a local mental health program: a case history.

The evolution of a local mental health program, of which the author was director from inception in 1963 until 1967, is described. Issues and approaches explored in the effort to develop a sound conceptual and practical basis on which to institute the first component of a comprehensive mental health program are outlined.

Comprehensive Mental Health: The Challenge of Evaluation.

This volume is reported to be the proceedings of a 1966 symposium on the problems of evaluation in comprehensive mental health programs, 250 of which had by that time been established under Public Law 88164. The conference was sponsored by the University of Wisconsin, Department of Psychiatry, the Wisconsin Psychiatric Institute, and the Wisconsin State Department of Public Welfare, Division of Mental Hygiene. The editors represent these sponsoring agencies. A distinguished interdisciplinary group of mental health professionals was brought together from varied settings across the United States, and each is represented by a chapter. The papers as presented vary greatly in quantity and quality, ranging from Dr. Marc Fried's "Evaluation and the Relativity of Reality," which was detailed and helpful in its emphasis on the effect of contexts on behavior, and the need to consider transitory validation in developing evaluation procedures; to that of Dr. Werner Mendel's "On the