Field Of Community Mental Health Research Articles

Types of Mental Health Consultation

Mental health consultation is defined and differentiated from other forms of professional activity in the community mental health field. The four main types of mental health consultation are discussed and one, 'consultee-centered case consultation' is described in some detail, to illustrate the basic principles of method and technique.

Moderate Drinking Among People With Severe Mental Illness

Along with the increased recognition obsubstance abuse in the community mental health field, a clinical controversy about the advisability of modcrate drinking for persons who have severe mental illnesses has developed. Many clinicians argue that mentally ill individuals should be able to drink moderately, as do the majority ofAmenicans (1). Other clinicians argue that severely mentally ill persons should be encouraged to pursue abstinence because they arc extremely sensitive to the negative effects ofalcohol and highly prone to develop an alcohol use disorder. The dearth of research data about the effects of moderate drinking for this population undoubtedly contributes to the controversy. Longitudinal data about the maintenance of moderate drinking would be particulanly helpful in psychoeducational work with clients and their families. Mentally ill clients have the same legal right to drink as other citizens, but they and their families deserve to have accurate information on the consequences of moderate drinking. The purpose of this report is to evaluate the long-term stability and consequences of moderate drinking among severely mentally ill persons

Rediscovering Welfare Concepts in Social Work Practice in Community Mental Health

The tension between concepts of welfare and treatment remains an important issue for social workers practising in the field of community mental health. A primary concern with treatment has resulted in a neglect of welfare issues. The social consequences of developments in community mental health, particularly the poverty and disadvantage accompanying the deinstitutionalisation movement, have resulted in an increased need for social workers to redirect energy towards meeting welfare needs, particularly income security and housing.

Necessidades psicossociais do menor de baixa renda, na faixa etária de 10 A 15 anos

Este estudo visou apreender a problemática psicossocial de menores de 10 a 15 anos, a fim de obter dados que ampliem a capacitação operacional na área de Enfermagem em Saúde Mental Comunitária junto à famílias de baixa renda. Pesquisa do tipo exploratório, utilizando-se o método etnográfico combinado com a entrevista. Os resultados evidenciam a precariedade das condições sócio-econômicas em que vivem, a carência de afeto e a violência física e moral com que são educados, etc... Suas doenças incidem nos males físicos, com pouca referência a problemas atingindo diretamente a saúde mental.

An evaluation of a communications training program within a self-help group for sexually abusive families

Remediating the dysfunctional communications patterns of sexually abusive families is an important step in treating them. No communications training program for such families has been evaluated, however. This paper describes an evaluation of a communications training program carried out within the context of a self-help group for sexually abusive families. Group members were randomly assigned to receive an eight-week communications training program or to continue participating at self-help meetings. No group differences were apparent on a preintervention communications questionnaire, but the posttraining scores of experimental subjects were higher than controls. Experimental subjects maintained these scores upon follow-up and the scores of controls increased when the program was administered to them by a student therapist. It is suggested that the procedures and findings of this study contribute to the community mental health field by a) underscoring communications concepts that are helpful to abusive families; b) modeling a novel design for evaluating interventions that includes self-help participation as a nonspecific treatment; and c) illustrating the value of collaborative efforts between self-help groups and human services providers when they serve their mutual interests.

Consultation and Education in Community Mental Health

Within the field of community mental health, the specialty of consultation and education offers anthropologists numerous job opportunities. During the last three years I have directed the Consultation and Education (C&E) Department at St. Mary's Community Mental Health Center in Hoboken, New Jersey. My anthropological training has been as asset in this job. Moreover, I have found this field to be professionally satisfying. In this article I would like to make other anthropologists aware of this career opportunity and show how many of the skills which anthropologists possess are readily transferable to this field.

Individual and group psychology ? Are they opposed?

It is regrettable that classical psychoanalysis has failed to pursue Freud's early interest in group psychology. In this paper, the inseparability of individual and group psychology are affirmed and the concept of identification is employed to illustrate this unity. In the absence of a satisfactory global theory of group psychology, we must rely on the contemporary knowledge of specific concepts and mini-models. The human need for finding self-esteem and coherence through group ties is increasingly recognized in the field of community mental health.

Deinstitutionalizing the Occupational Therapist

This paper will discuss the problems behind the lack of occupational therapists working in the community. The paper will also describe a strategy used by a professional group in Portland, Oregon to increase the employment of occupational therapists in the community mental health field. This is not a research report but a description of a problem and of one way it was approached and solved. While this paper is concerned primarily with service delivery in the mental health arena, it is felt that the problems presented and the strategy for their resolution apply equally to other areas of practice in occupational therapy. It is the author's contention that with changing health care patterns occupational therapists in all areas of practice need to focus job search efforts more in community settings rather than in the traditional occupational therapy 'clinic' within hospitals and other residential institutions.

Deinstitutionalizing the Occupational Therapist

This paper will discuss the problems behind the lack of occupational therapists working in the community. The paper will also describe a strategy used by a professional group in Portland, Oregon to increase the employment of occupational therapists in the community mental health field. This is not a research report but a description of a problem and of one way it was approached and solved. While this paper is concerned primarily with service delivery in the mental health arena, it is felt that the problems presented and the strategy for their resolution apply equally to other areas of practice in occupational therapy. It is the author's contention that with changing health care patterns occupational therapists in all areas of practice need to focus job search efforts more in community settings rather than in the traditional occupational therapy 'clinic' within hospitals and other residential institutions.

Characteristics of community psychologists in 1974 and 1978

DePaul University The present study describes characteristics of community psychologists in two comprehensive surveys conducted in 1974 and 1978 by the American Psychological Association. Data gathered on psychologists classified as community psychologists includes information on demographic character- istics, employment settings, and specialty areas, in addition, for the 1978 sample, comparisons were made between the types of community-oriented services provided by community psychologists and human service professionals d.e., clinical, social, school, and counseling psychologists). Implications of the documented changes among community psychologists over a 4-year period as well as differences in the roles of community versus human service professionals are discussed. Over the past two decades, the field of community mental health, community psychology (CMH/CP) has experienced considerable growth. This is evident by the emergence of a new division (27) in the American Psychological Association, as well as a precipitous rise in the number of universities which offer programs with curricula or majors in CMH/CP. (In 1962 there was 1 program, today there are over 62; Meyer & Gerrard, 1977.) Another sign of the evolving maturity of this field has been the recent creation of a Council of Community Psychology Program Directors. Given the exponential expansion of this emerging new discipline, there is a need to periodically document community-oriented curricula and training op- portunities in university and internship settings, and characteristics and specialty areas of practicing community psychologists.

Social work practice in community mental health

Reprinted from SOCIAL WORK, Vol. 26, No. 1, January 1981 ocial work practice in community mental health Steven P. Segal and Jim Baumohl The authors analyze social work's role in community mental health and describe practice models that enable practitioners to contribute to the improvement of an individ- ual’s mental status while main- taining a view of the person in the environment and a commitment to the improvement of social life. Steven P. Sega], Ph.D., is Associate Professor and Director, and Jim Baumohl, MSW, is Field Research Specialist, Mental Health and Social ' Welfare Research Group, School of Social Welfare, University of Califor- nia, Berkeley. DURING the past twenty years, the mental health field has become in- creasingly cognizant of the interaction between social life and mental status —a relationship that is the basis of traditional social work practice. So- cial work is committed to improving the interaction among individuals, among institutions, and between people and institutions to enhance the general quality of life. However, in mental health, the major concern (the “depen- dent variable” in research jargon) is mental status. This article is concerned with social work’s role in community A mental health: the activities that enable the social worker to contribute to the improvement of an individual’s mental status while maintaining a commitment to viewing the person in the environ- ment and to improving the overall quality of social life. ‘ BOUNDARIES As a profession, social work is con- cerned with all spheres of interaction between people and their envi- ronments. Social workers practice in the realm of formal organizations of care and control; are concerned with the social, psychological, and jural di- mensions of the family; and have be- come increasingly interested in the everyday support systems that function among friends and acquaintances. All these concerns have been identified, in one way or another, with the treatment of mental disorders or the promotion of mental health. To the consternation of many traditional mental health professionals, the field of community mental health has become so elastic that it now in- cludes almost all kinds of ameliorative activity. This expanded purview de- rives from the association of a myriad of social factors with the development of mental disorders and from the con- comitant tendency to equate social well-being with mental well-being. For instance, the relationship between so- cial class and mental illness and the relationship between social stress and mental illness clearly indicate that poor people are at the greatest risk of devel- oping mental disorders. Because of these relationships, it is tempting to conclude that full employ- ment, better housing for the poor, na- tional health insurance, and an array of poverty programs might be the best means to reduce mental disorders in a society. Unfortunately, there is little evidence to support this conclusion. Such policies and programs are laud- able in their own right, but their impact on the mental status of the individual is subject to question.‘ The equation of social well-being and mental well-being is like the Calvinist equation of wealth . with salvation: both are nice, but not necessarily related. I What does it mean, then, to “con- tribute to the improvement of individ- ual mental status” while “maintaining a commitment to improving the overall quality of social lifeq? The answer de- pends largely on how a mental health “problem” and a mental health “ser- vice” are construed. INAPPROPRIATE LABELS As one moves farther from the traditional concerns of mental health (with psychoses, for example), the re- liability of the assessment of mental status becomes poorer and the risk of ' inappropriately labeling “problems of livingq as “mental disordersq becomes greater. Similarly, when one ap- proaches human problems whose re- lationship to discernible mental dis- orders is ambiguous or distant, the definition of a “mental health service” becomes problematic. Current empirical understanding does not permit a more elegant solution in either case. Mental disorders are variously defined and diagnosed either in narrow or broad terms. And a mental health service is often what Congress, ' the National Institute of Mental Health, state legislatures, or local citizens’ ad- visory boards are willing to pay for. The clinical risks associated with in- appropriate labels make it incumbent on mental health practitioners to be specific and judicious in the use of labels. Further, the treatment of indi- viduals in mental health settings, as op- posed to social service or “genen'cq settings, may discourage potential clients who “know” that only “crazy peopleq (or members of any devalued 16 0037-8046/81/2601/0016 $0.50 © I981, National Association of Social Workers, Inc.

An analysis of topic areas and topic trends in theCommunity Mental Health Journal from 1965 through 1977

A content analysis of all (N = 604) published articles in the Community Mental Health Journal from 1965 through 1977 was performed (a) to provide a cross-sectional view of the community mental health field, and (b) to identify topic trends over time. Sixty-one content categories were used to classify topic areas. Results revealed major and growing emphases on organizing for the delivery and measuring of the effects of mental health service systems. Topics found to be increasing in relative frequency over time included training, measurement and research methodology, and intervention; those decreasing included planning and needs assessment, therapy, and suicide. Topic areas were compared with key characteristics of the field. Topic trends were interpreted in terms of open systems theory.

Social support and social adjustment: implications for mental health professionals.

The general importance of an individual's support network has been recognized in the field of community mental health; yet a more detailed understanding of how a client's available social ties may contribute to his or her adjustment is presently lacking. This study used network analysis to examine differences in the social networks of mental health clients to identify factors associated with positive social adjustment. Subjects were selected from three different types of mental health programs as well as from the general population of Marion County, Oregon. Results generally revealed that subjects from the community sample more often would look to immediate family members for support. Better functioning chronic clients emphasized professional contacts, whereas more poorly adjusted chronic clients would look to friends for support. The results have implications both for understanding the nature of the support available to a client and mobilizing the support resources of the existing network of relationships to aid adjustment to community living.

Empowerment movements and mental health: Locus of control and commitment to the united farm workers

Psychologists in the community mental health field have contended that enhancement of psychological well-being is a likely benefit for individual participants in selfhelp, social-change-oriented organizations. This investigation sought to provide an empirical test of that proposition. A cross-section of 102 Mexican-American male seasonal farm workers who were differentially related to the United Farm Workers (Cesar Chavez, Director) were found to differ significantly on the I-E locus of control variable. It was possible to demonstrate a positive relationship for the participants between commitment (involvement) to the U. F. W. and an internal locus of control orientation (low perceived powerlessness).

The use of the telephone hotline in crisis intervention: a review.

This article is an investigation of a new and relatively controversial development in the field of community mental health, the telephone hotline. It examines the rationale for crisis intervention, the theoretical basis, and historical development of the hotline. The telephone adds a unique dimension which makes it therapeutically useful for many people who would not ordinarily avail themselves of helping services. Those factors which contribute to the utility of the hotlines are examined, with an emphasis on the role of the nonprofessional telephone worker. Finally, the empirical literature evaluating the effectiveness of the hotlines is reviewed. While the evaluative studies performed to date are inadequate and outcome studies have not been attempted, the use of the telephone hotline can be defended theoretically and practically. The hotlines fill a gap left by conventional helping services and serve an ever-increasing clientele, which emphasizes the need for the services hotlines provide.

Behavior therapy techniques as a fulfillment of community mental health ideology.

Due to value orientations, lack of knowledge, or exposure, the behavioral approach has been avoided by many professionals in the community mental health field. This is unfortunate, because many concepts of behavior analysis are identical to some of the guiding principles of the community mental health movement. Furthermore, the methods derived from a behavioral framework can help implement the community mental health idiology. This paper identifies possible linkages in the areas of treatment, client population, and evaluation.

The emerging role of sociological consultation in the field of community mental health

One of the most innovative features of the community mental health movement is its expansion to include other than the traditional mental health personnel. It seems most appropriate now that the sociologist be among the new manpower resources put to use by the various agencies concerned with the community mental health movement. In this regard, it is necessary that both professionals and lay people working in mental health be made aware of what the sociologist can contribute to the mental health movement. Sociological services relative to the comprehensive community mental health centers, to other mental health agencies, and to lay and professional persons concerned with mental health are described. The emergence of this role will not be without problems, several of which are described here.

Orientation to community mental health for clinicians in training.

Many of the principles and practices of community mental health are compatible with valid clinical training and offer perspectives and context within which training can flourish. This article addresses some of these considerations and outlines some of the training opportunities that focus on the substantial common ground between the two fields. Some of the reluctance of clinical training institutions to develop training in community mental health can be understood as stemming from an awareness of the complexities of training required to develop a community mental health specialist. If the focus is on a basic orientation to the field of community mental health for the clinician, rather than specialty training, the total program can be enriched, rather than diminished, and the commonalities between the fields expanded.

The Paraprofessional and Family Therapy

The new career movement in the community mental health field will increasingly demand that training programs provide the paraprofessional with a clinical role that avoids the temporary and mostly erroneous advantages of being an “indigenous” worker. Clinical functions taught in training need to be related to the problems of the urban poor; it is this group that needs a concept of service that can combine management of reality with beneficial restructuring of psychological systems. The resulting role is that of the paraprofessional family therapist — a new career that offers service to the troubled family unit of the urban poor and vocational definition to the person who is so trained.

Communty mental health--an underview.

This paper has attempted a panoramic view of an immensely complex aspect of psychiatry, an aspect so tumultuous as to over-flow the bounds of psychiatry as a specialty of medicine. The panorama is described as an “underview” because it is not seen from without and above, but aspectually, by a participant, and from within. In spite of the inescapable restrictions of the author's perspective, he has tried to maintain as much objectivity as possible and to make the biases explicit where they could not be avoided. No attempt is made to predict where the emergent thrust of historical movement will carry the field of community mental health. No attempt is made to espouse any particular direction of future growth. It has seemed enough of a task to attempt to say where we are and whence we came to this place. The future comes in its own time.