Mental Health Section Research Articles

Development of a Mental Health Policy and System in Tanzania: An Integrated Approach to Achieve Equity

Development of a Mental Health Policy and System in Tanzania: An Integrated Approach to Achieve Equity

Tsan Ting and his practice on psychoanalysis

Tsan Ting entered the Department of Psychology of Nanjing Central University in 1931 and graduated in 1935, then went to the private Peking Union Medical College for graduate studies, where he received specialized training in psychoanalysis. Later Tsan Ting stayed in the neurology and public health department and worked in the mental health outpatients in Peiping Established First Health Offices, private Beijing Yuying Secondary School, the Peking Renli Carpet Factory there he applied psychoanalysis to cure patients. In 1940, Tsan Ting left Peiping and went to Chongqing, where he became the head of Mental Health Section of the Central Health Academy. During this period, Tsan Ting applied psychoanalysis to case investigation and child behavior guidance. He not only applied psychoanalysis in practice, but also studied psychoanalysis with an objective, complex-evidenced and critical attitude and was a proponent for psychoanalysis in a scientific and popular form. He introduced psychiatry and psychosomaticism associated with psychoanalysis and pushed forward the establishment of medical psychology in our country. Tsan Ting is the practitioner, researcher and proponent of psychoanalysis as well as the promoter of psychology.

Self-Report of Depressive Symptoms in African American and White Women in Primary Care

Depressive symptoms are frequently seen among female patients in primary care. The majority of screening instruments are cumbersome for a busy clinic. The effectiveness of a 2-item depression screening questionnaire was compared to the mental health section of the 36-Item Short Form Health Survey (SF-36). A total of 127 consecutive patients who presented for primary care service agreed to participate and completed the questionnaire. Of the final sample, 65.4% were African American and 44.9% of all women reported having depressive symptoms, with no significant difference in the prevalence of reported depressive symptoms between African American and white women (chi2 = 1.97, p = .16). The women reporting depressive symptoms were more likely to be in the lower-income group (chi2 = 9.02, p = .01); however, in stratified analysis this was only significant for the African American women (chi2 = 8.69, p = .01). Analysis of variance demonstrated that the women with depressive symptoms were more likely to score low on the mental health subscales of the SF-36 when adjusted for income (F = 58.32, P < .0001). Within race groups, the mean Mental Health Index scores were higher among African American women (t = -6.45, P <.0001) and White women (t = -3.59, P = .002) who reported depressive symptoms than among those who did not report depressive symptoms. The sensitivity and specificity of the 2-item depression symptom questions compared to the overall SF-36 mental health score were 70% and 77%, respectively. A simple 2-item questionnaire can be used to identify depressive symptoms in white and African American women in a primary care clinic.

Mens Sana: The Growth of Mental Health in the American College Health Association

In 1910, the first college mental health service sought to help college students with personality development and building a healthy mind. In 1920, the meeting that founded the American College Health Association (ACHA) identified “mental hygiene” as important, although a separate Mental Health Section was not established in ACHA until 1957. Between 1920 and 1960, a series of national meetings helped define the role and functioning of college mental health and counseling services. Most colleges employed a multidisciplinary staff of psychologists, psychiatric social workers, and psychiatrists to provide clinical services for students and consultation and education for faculty and staff. Mental health services on college campuses grew rapidly in the 1960s and 1970s, leading to discussions in the late 20th century of the use of brief psychotherapies, prevention and treatment of drug and alcohol abuse, prevention of suicide and homicide, the use of psychotropic medications, and effective campus interventions.

Predictors, Criteria, and Treatment Response

Article AbstractThis month's Focus on Childhood and Adolescent Mental Health section provides clinically useful information about predictors of bipolar disorder and suicidality, revised criteria for posttraumatic stress disorder (PTSD), and treatment response in youth with comorbid bipolar disorder and attention-deficit/hyperactivity disorder (ADHD).There is substantial comorbidity between bipolar disorder and ADHD in youth. Identification of those children with ADHD who are at risk for development of bipolar disorder is an issue of concern for clinicians and parents. Biederman and colleagues evaluated the predictive utility of the Child Behavior Checklist-Pediatric Bipolar Disorder (CBCL-PBD) profile to identify those children at risk for bipolar disorder. The CBCL-PBD was administered to 204 children, aged 6 to 18 years old, at baseline. The children were divided into groups based on their CBCL-PBD score, positive if the sum of the CBCL-PBD subscales attention problems, aggressive behavior, and anxiousdepressed was ≥ 210 or negative if below this cutoff.

Mental Health Services in New Nepal – Observations, Objections and Outlooks for the Future

It has been over a decade since the government of Nepal adopted the National Mental Health Policy (NMHP) in 1997. This article analyses the current provision of fragmented mental health services in Nepal through case scenarios from Jumla in northwest and Janakpur in southeast Nepal, criticises the proposed mental health Act, discusses the reasons why the NMHP has not been implemented and suggests future models of delivering mental health services in the wider community. Absence of a mental health section within the department of health, insufficient budget, chronic shortage of trained manpower, and unplanned growth of private medical institutions appear to be the issues deserving urgent attention. Setting up specialist psychiatric facilities in all developmental regions or future states, developing community mental health programmes and integration of mental health into general health care are the ways forward to meet the needs and expectations of the new federal Nepal.

Report of the Indo-US health care summit 2009 - Mental health section

The 2nd Indo-US Health Care Summit held in January 2009 was a forum to discuss collaboration between physicians in the US and India on medical education, health care services and research. Six specialties were represented including Mental Health (MH). Using Depression as the paradigmatic disorder, the following objectives were developed.Objective I – Leadership and Public Education:Linkage with like-minded agencies and organizations. The core message should be simple. Major Depression is a brain disorder. Depression is treatable. Timely treatment prevents disability and suicide.Objective II – Medical Education:To improve psychiatric education, it was proposed that (1) relations between US/UK and Indian mid-level institutions be established, (2) teaching methods such as tele-psychiatry and online courses be pursued, (3) use models of teaching excellence to arouse student interest, and (4) develop core curricula for other branches of medicine, and CME.Objective III - Reduce Complications of Depression (Suicide, Alcoholism):Goals include (1) decriminalizing attempted suicide, (2) improving reporting systems, and including depression, psychosis, alcoholism, and suicide in the national registry, (3) pilot studies in vulnerable groups on risk and interventions, and (4) education of colleagues on alcoholism as a link between psychiatric and medical disorders.Objective IV - Integrating MH Treatment & Primary Health Care:The focus should be on training of general practitioners in psychiatry. Available training modules including long distance learning modules to be suitably modified for India.Collaborations and specific project designs are to be developed, implemented and monitored by each specialty group and reviewed in future summits.

Guest commentary

Introduction to mental health and well-being section.

Quality of life for adolescents with idiopathic scoliosis in relation to the duration of application of the modified Boston brace

Every child completed a detailed questionnaire (SRS-22) concerning the evaluation of function, pain, self image, mental health and satisfaction with management. Both groups were comparable according to age and degrees of scoliotic curve. Results There was no statistical significant difference between both groups in terms of the questionnaire. However, the mental health section results demonstrated a difference, with a favorable tendency for the second group.

Drug Prevention Needs to Be Extended to Baby Boomers

Drug Prevention Needs to Be Extended to Baby Boomers

Reproductive Neuroscience

Article AbstractTwo of the articles in this issue's Focus on Women's Mental Health section provide data on phenomenology and risk of psychiatric disorders in women, while 2 articles report findings from treatment trial results.The perimenopause has been identified as a high-risk time for major depressive disorder in women, as reviewed by Steinberg et al. in the introduction section of their article. The authors generously provide an accompanying editorial following this introduction, in which they put their results into a historical and clinical context.

Overview of the Mental Health Section

Overview of the Mental Health Section

L’enquête Santé Québec et la santé mentale des québécois : cadre conceptuel et méthodologie

The Santé Québec study is the most important inquiry into health yet undertaken in Quebec on life habits and the physical and psychological state of health of almost 20,000 persons aged 15 years and over living in private homes. The mental-health section of the study is situated within the tradition of socio-epidemiological inquiries. The article describes the reasoning behind the choice of mental-health indicators (psychological well-being, psychological distress, suicide thoughts and attempts, several severe psychological problems) and the measuring instruments. The study's usefulness and limits are discussed.

Treatment of the Stress Casualty during Operation Iraqi Freedom One

Service members with mental health issues during Operation Iraqi Freedom receive evaluation and treatment at different echelons of care. Mental health teams consist of professionals and paraprofessionals assigned to Combat Stress Control units, Division Mental Health Sections, and Combat Support Hospitals. Army doctrine for mental health care is delineated and examples describing how mental health personnel must be flexible in this challenging environment and are useful mental health tools for commanders in the operational environment are presented. Specific treatment issues related to the combat environment during Operation Iraqi Freedom are discussed in relation to each team and in light of doctrine.

Research to inform mental health practice: Social work's contributions

Although recovery from mental illness is now a real possibility, many Americans suffer its associated disabilities because of a fragmented, disconnected, and often-inadequate system of mental health care (President's New Freedom Commission on Mental Health, 2003). In fact, most people needing them do not have access to specialty mental health services. Older adults, children and adolsecents, individuals from ethnic minority groups, and low-income clients in public sectors are particularly plagued by difficulty in gaining access to quality care for mental disorders. Although these groups often do not reach specialty mental health care and many lack regular contact with a primary medical care provider, they are heavy consumers of social work services. As a way to help ensure access and earlier treatment to people with undetected mental disorder, the President's New Freedom Commission Report on Mental Health has targeted improving mental health care in readily accessible and low-stigma settings where a high level of risk for mental health problems exists, especially all federally funded adult and child health and human services (President's New Freedom Commission on Mental Health). Social work has a key role to play in improving the accessibility and quality of mental health care. Social work was designated as one of the four core mental health professions in the federal legislation establishing the National Institute for Mental Health (NIMH), and social workers are the largest group of mental health providers in the United States (SAMHSA, 1998). Social workers make up about 60% to 70% of the mental health work force and provide more mental health services in the community than any other profession (Ginsberg, 1995; Ivey Scheffler, & Zazzali, 1998; Lin, 1995; Redick, Witkin, Atay & Manderscheid, 1992). Mental health is the largest field of practice (Gibelman & Schervish, 1995) and the largest concentration for study among MSW students (Lennon, 1993). Howard and colleagues (1996) estimated that social workers spend more than half of their professional efforts providing mental health services. Mental health is a growth area in social work: NASW recently established a mental health section for members, and social work has more candidates in training than any other mental health profession (O'Neill, 2002; SAMHSA, 1998). Articles in this issue reflect social work's historic concern with people suffering from severe and persistent mental illness. Although the cost of mental illness is often quantified in terms of dollars spent on treatment or earnings lost because of illness, Hollingsworth highlights another important aspect of the high cost of mental disorder: the burden to family care across generations. She used quantitative data from an NIMH-funded longitudinal study of 322 women with persistent severe mental illness and qualitative data from semistructured interviews with 82 of the women to examine the contribution of mental illness to child custody loss. Her findings reveal that child custody loss is among the consequences of psychiatric hospitalizations. Findings also highlight economic, parenting, and social support correlates of custody loss, and underscore the importance of providing adequate support and resources for mothers suffering from mental illness. The generational impact of mental disorder was also the focus of study by Sales, Greeno, Shear, and Anderson, who examined whether maternal caregiving strain mediates between child and mother mental health problems. Their findings suggest that caregiving strain may be a pathway between a child's emotional problems and those of the mother and that a mother may have better mental health if she experiences less caregiving strain. These findings suggest the importance--for both the mother's and child's sake--of interventions to address caregiving strain in families of children with a mental disorder. Helping people with serious mental illness achieve their maximum functional capacity has long been a focus of social work practice. …

Mentoring and Monitoring: The Use of Unit Watch in the 4th Infantry Division

A unit watch is an intervention used by Army mental health care clinicians to assist soldiers in regaining mastery over impulsive or dangerous behaviors. Although widely used, it is controversial because of concerns for soldiers' safety and lack of formal study into its efficacy as a treatment option. A retrospective chart review conducted at the 4th Infantry Division Mental Health Section gathered demographic and diagnostic information on soldiers placed on unit watch during the year 2000. The results showed the intervention to be used most commonly with young, junior-grade enlisted soldiers without serious psychiatric diagnoses. Its effectiveness appeared to arise from increased social support during times of stress (mentoring) as well as close observation of the soldier by unit members to discourage impulsive or dangerous behavior and ensure immediate assistance if necessary (monitoring). This article will discuss these benefits as well as highlight potential problems and suggest areas for further study.

The Gulf War and Mental Health: A Comprehensive Guide

This interesting book closely examines mental health services in the Persian Gulf War. Many of the chapter authors and editors were active participants and, as a result, give a knowledgeable, graphic, and comprehensive operational account. The book has three sections. The first, which details problems encountered in the process of organizing, preparing, deploying, and operating a credible mental health system during the Gulf War, takes up approximately 60% of the text. For the reader who is involved in the administration or organization of health services, particularly emergency response services, this book should have particular interest. The emphasis is on identifying and coping with organizational deficiencies. Those responsible for coordinating the Gulf War mental health system were presented with problems all too familiar. One author states that most division mental health sections arrived in Saudi Arabia deficient in experienced personnel, appropriate training, supplies, and equipment. Several authors mention the serendipity of

The Home Office Mental Health Unit

On 1 April the mental health section of the Home Office's C3 Division was renamed “Mental Health Unit”, as part of a wider initiative to streamline the Department and give more meaningful titles to the various different areas of work. The responsibilities of our Unit remain the same, however. First, we deal with the cases of restricted patients under mental health legislation. As well as advising Ministers or taking decisions on their behalf about leave, transfers and discharge, the Unit also authorises the transfer of mentally disordered prisoners to hospital. This prison transfer work is focused in a separate section of the Unit which is able to provide a very rapid response to urgent requests for transfer warrants. The number of transfers has gone up from 337 in 1990 to over 700 in each of the last three years.

A casemix for mental health services: the development of the mental health and substance abuse components of the Australian national diagnosis-related groups.

To describe the development of the mental health and substance abuse sections of the version of the Australian casemix system, Australian national diagnosis-related groups 3 (AN-DRG 3), released in July 1995. The guiding principles and data sources used to construct the mental health and substance abuse components of AN-DRG 3 are described by the group who undertook that task. The group used data sets of patients separating from hospitals throughout Australia, and from hospitals in South Australia, to examine the capacity of existing and revised diagnosis-related groups (DRGs) to predict patients' lengths of hospital stay. They also reviewed the lists of conditions allowed as complicating and comorbid conditions within the AN-DRG system. A variety of recommendations were made including: moving organic mental disorder DRGs to a neuroscience area of the AN-DRG; completely reorganising the mental health section of the casemix; creating a number of narrowly defined DRGs covering areas such as schizophrenia, major affective disorders, anxiety disorders and eating disorders, while allowing for a limited number of more heterogenous DRGs and simplifying substance abuse DRGs into groups covering alcohol and other substances, and differentiating intoxication and withdrawal from abuse and dependency. A casemix dialect based on clinical diagnosis, which describes mental health and substance abuse problems in terms which should be familiar to clinicians, has been developed. Its applications and limitations are briefly discussed.

Revitalizing Division Mental Health in Garrison: A Post-Desert Storm Perspective

The Division Mental Health Section (DMHS) has long been an essential component of the combat mental health mission. Relatively little attention has focused on its important functions in garrison. The authors, both veterans of Operation Desert Storm, review the DMHS mission in garrison and highlight forces currently jeopardizing the success of that mission. They describe Persian Gulf lessons with important implications for garrison mental health care and then discuss possible solutions to the varied problems facing DMHSs. They conclude, most importantly, that an effective DMHS must identify with the division, sharpen soldier and officer skills, respect organizational boundaries, and continuously prepare for combat.