Psychiatric Agencies Research Articles

Reported prevalence of alcohol dependence in South-Verona: A case register study

In this study all patients who received from 1979 to 1982 the diagnosis of “alcohol dependence” have been selected from the South-Verona Psychiatric Case Register. The register area coincides with the health care area of a well-integrated community psychiatric Service, set up in 1978 under the new Italian Mental Health Act. The reported prevalence rates of alcoholic patients decreased in this 4-year period, this decrease being due mainly to the diminuition of male patients contacting a psychiatric agency. Age- and sex-specific prevalence rates are reported, as are patterns of inpatient and out-patient care and 1-year inception rates. Within the overall reported prevalence the ratio between patients who received community care only and those who had also or only inpatient care shows that about half of alcoholic patients contacting a psychiatric agency receive out-patient care only.

Psychiatric symptom patterns of chronic epileptics attending a neurological clinic: a controlled investigation.

The psychiatric morbidity of chronic epileptic out-patients unknown to psychiatric agencies was assessed using two questionnaire measures of psychopathology (GHQ and CCEI). Nearly half of the epileptics were classified as probable psychiatric cases. Psychiatric morbidity was both more prevalent and more severe in this group than in a comparison group of chronic neurological out-patients. Depression, anxiety and hysterical symptomatology were the commonest characteristics of psychiatrically impaired epileptics. The type and severity of epilepsy were found to influence both the degree and pattern of psychiatric morbidity. Contrary to previous findings, age of onset had no relation to psychopathology.

Prevalence of known and hidden alcoholism in the revisited lundby population

Using the new data from a second followup of the Lundby 1947 cohort, the aim of the present paper has been to analyze some relationships between “known” and “hidden” alcoholism in a Swedish general population sample. Information was collected by psychiatrists trough free, exploratory field interviews checked against documentary records. Alcoholism was medically defined for present purposes. Information was obtained for 98% of the 952 men surviving the cross-section date July 1, 1972. The distribution of alcoholism and other psychiatric disorders in the total population and in age subgroups was analyzed epidemiologically. The “true” prevalence of alcoholism in the adult men was 9.5%, comprising 7.2% “known” and 2.3% “hidden”. The proportion of hidden to known cases was 0.30∶1 (Temperance Boards 0.87∶1, Psychiatric Agencies 0.96∶1, Drinking and driving offences 4.3∶1). The main finding that about 70% of male alcoholics in Lundby appears to be known to the agencies is at variance with current views that there is an iceberg under the tip, though consistent with Rubington's suggestion that so-called hidden alcoholism is not totally but partially invisible in “welfare” societies.

An analysis of telephone referrals of a mental health association chapter

A total of approx 4700 recorded telephone calls were made during 1972, 1973, ten months of 1974 and the first six months in 1975 to the Queens County Mental Health Society in Queens. New York. These were analysed with respect to the sex and age of the client, the referral problem, the type of service requested by the caller and the geographical distribution in Queens County of the calls. The last item was also analyzed with respect to the number of calls per thousand of the residential population. These data show that most calls are made in the spring months, the average age of the client is approx 26 years. Males and females are evenly distributed. The calls per thousand of the local community population are not necessarily higher from the more disadvantaged areas of the County. Overwhelmingly, the range of problems presented required referral to psychiatric agencies.

An analysis of telephone referrals of a mental health association chapter

Abstract A total of approx 4700 recorded telephone calls were made during 1972, 1973, ten months of 1974 and the first six months in 1975 to the Queens County Mental Health Society in Queens. New York. These were analysed with respect to the sex and age of the client, the referral problem, the type of service requested by the caller and the geographical distribution in Queens County of the calls. The last item was also analyzed with respect to the number of calls per thousand of the residential population. These data show that most calls are made in the spring months, the average age of the client is approx 26 years. Males and females are evenly distributed. The calls per thousand of the local community population are not necessarily higher from the more disadvantaged areas of the County. Overwhelmingly, the range of problems presented required referral to psychiatric agencies.

Educating the future mental health executive: a public health approach.

The mental health program we are developing at the Yale School of Public Health has as its basic element a broad introduction to the concepts and principles of public health and mental health administration and is rooted in conern for community well-being. It is our belief that this combination of public health - mental health training will produce administrators for mental health, psychiatric and human resource agencies who will be able to design, implement, manage, and evaluate programs that improve mental health and help communities evaluate and structure the human services they need.

Sex-role related countertransference in psychotherapy.

Data from one psychological and one psychiatric agency were collected to determine if psychotherapists' treatment decisions about opposite-sex persons might be influenced by sex-role prescriptions for dealing with sexual impulses. Accordingly, male therapists were hypothesized to prolong and female therapists to avoid treatment situations likely to arouse their sexual curiosities. The results at both facilities provide some support for these notions and, if generalizable, establish sex-role primed countertransference as a factor in patient selection and termination.

Psychiatric consultation with a police youth-aid unit.

Police officers in a special unit designed to aid troubled children and adolescents requested mental health consultation after a series of frustrations in their attempts to refer cases to psychiatric agencies. The officers initially sought guidelines to help them determine which clients needed further care and select appropriate agencies for referral. As the meetings progressed it became apparent that what they needed most was help with their interviewing techniques. The authors describe the consultation sessions, some of the cases dealt with, and the major areas on which consultation focused. They emphasize the importance of flexibility in the consultative process so the needs of consultees will not be overlooked.

Applications of Mental Health Statistics: Uses in Mental Health Programmes of Statistics Derived From Psychiatric Services and Selected Vital and Morbidity Records.

Dr. Kramer is chief of the Biometry Branch of the Office of Program Planning and Evaluation of the National Institute of Mental Health. His qualifications in the area of mental-health statistics are well-established and he speaks of the subject with authority. This short book, published by the World Health Organization, is aimed at administrators of mental-health programs. It attempts to survey the organization of mental-health statistics and methods for employing such statistics in different studies. Most particularly, it addresses itself to the problems of planning and evaluating mental-health programs through the analysis of various kinds of data accruing from routine collection of mental-hospital and other psychiatric facility data, population data (census), and health, social, educational, and other agency data. Brief discussions are included concerning the use of psychiatric case registries, morbidity surveys, and attempts at controlled evaluation studies. The limitations and dangers of misinterpretation of reported statistics are discussed

Decision-Making in a Psychiatric Screening Agency

The analysis of the decision-making of a systematic sample of 83 protocols of psychiatric commitment interviews indicates that these decisions are related not to reported characteristics of committable mental illness but rather to characteristics of the responses of others. These findings suggest that an understanding of deviance requires a consideration of the critical part played by the societal reaction in the creation of deviance.

Periodic surveys of community resources: A project to improve referrals for direct services

This report is based on a demonstration project in which outpatient psychiatric and counseling agencies available to residents of Prince George's County, Maryland, were surveyed by mail questionnaire every 3 months over a 15-month period. The purpose of the project was to review current services available in each agency. All agencies offering their services to county residents participated in the surveys. The results of each survey were fed back to the participating agencies as well as to other agencies who were known to refer to mental health resources. An evaluation of the project by the above agencies was conducted by mail questionnaire after the demonstration period. It revealed that this kind of service is of considerable value when interagency referrals are made.

Uses of data in planning community psychiatric services.

UNFORTUNATELY, in thinking about the subject of data for planning psychiatric services in the community, it is easy to drift into a polemical discussion about both planning and data. But, in the face of a complicated problem, it is not amusing to be confronted with assertions about the obvious shortcomings of the tools available for its solution. I shall, then, try to refrain from polemics. In general, it appears to me that we are far behind in using the potentials open to us for collecting and interpreting valid and reliable data for planning and evaluation purposes. We may be even further behind in making use of the data we have presently. Surely, in both instances, we lag in the face of important changes occurring constantly in the form of psychiatric services. Whatever the reasons for these shortcomings, we need data relevant to a set of goals common in their general form for all mental health or psychiatric agencies, and particularistic in certain specifiable ways for different forms of psychiatric service. I shall briefly outline the points I want to make, and then try to fill in that outline with something more specific in the way of explanation and proposal. We need data systems which will:

DEPRIVATION AND FOSTER CARE

Five years of experience as psychiatric consultant to the foster care division of an urban welfare department have led me to the disturbing conclusion that present programs of foster care are failing to meet the needs of many children who will have to remain in foster homes to the age of eighteen (Eisenberg, 1962b). The number of cases seen in the welfare department psychiatric clinic because they presented serious behavior disorders exceeded by tenfold the rate of service in community psychiatric agencies for the general child population. Although it is true that foster children are under somewhat more careful surveillance than youngsters in the general population and that social workers may be likely to seek psychiatric care sooner than many families would, it is also true that the foster care cases seen were a fraction of those referred since services were limited. Although it is not possible to determine the true prevalence of psychiatric disturbance simply from the frequency of services provided, the data nonetheless suggest a disproportionately high rate of psychiatric disability in the foster care population. In our study the disturbed foster children were contrasted on a number of salient social characteristics with the remaining children in the city and state foster care program. The disturbed children were much more likely to be illegitimate, to have come into care at a time when they were living with either a distant relative or a family friend

Person-matching by electronic methods

Record linkage in the updating of files is accomplished in many establishments through the use of a preassigned number, such as payroll number, customer number, or social security number. In vital and health records, however, a unique number is generally not preassigned to an individual for purposes of reporting services received to the health department. In order to determine whether different physician reports refer to the same individual, name and other identification must be compared. This is a laborious operation which is subject to various errors because of name misspellings, changes of name upon marriage, and other problems. We are interested in the maintenance of a psychiatric case register in Maryland, where many of the reports from over a hundred psychiatric agencies refer to the same patient. These records must be linked in order to provide unduplicated counts of individuals under care and longitudinal records of psychiatric history. An earlier paper [1] describes our general procedures for register maintenance by use of a digital computer (Honeywell 800). Here we present in more detail our initial procedures for the person-matching process in order to elicit comments and suggestions from persons who have had experience in matching.

Adult court psychiatric clinics.

In 1909 when William Healy began his work in the Cook County Juvenile Court he was not only inaugurating a new and vitally important approach to the study of delinquency and crime, but he was also introducing an entirely new element into the constitution of our courts-the court psychiatric clinic. It is not my purpose in this presentation to trace the development of the juvenile court clinics but to confine myself to an analysis of the development and functioning of the adult court psychiatric clinics. Despite the rapidly increasing acceptance of psychiatry by most disciplines-education, religion, the army, and even the law-the establishment of court psychiatric clinics has been amazingly and disappointingly slow. We must either conclude that these clinics, during the past quarter century, have proved ineffectual in improving the quality of the work of the criminal courts to which they are attached, or that their accomplishments have not been sufficiently publicized. I hold strongly to the latter view. Indeed, I believe that these court clinics are among the most important psychiatric agencies in our American society. In all there are 7 such clinics, Chicago having 2. The first adult psychiatric clinic was established in Chicago. Dr. Healy’s pioneer clinic in the Chicago Juvenile Court apparently so greatly impressed Chief Justice Olsen of the Municipal Court that a psychopathic laboratory was established in conjunction with that court in 1914, under the direction of Dr. William J. Hickson. Detroit and Baltimore both established adult psychiatric court clinics in 1921. Dr. John Rathbone Oliver was the first director of the Baltimore clinic. Dr. Oliver, long an active member of The American Psychiatric Association, was a colorful and unique figure. He was a psychiatrist, an ordained priest of the Anglican Church, an authority

A study of current trends in the use and coordination of professional services of psychiatrists, psychologists and social workers in mental hygiene clinics and other psychiatric agencies and institutions.

A study of current trends in the use and coordination of professional services of psychiatrists, psychologists and social workers in mental hygiene clinics and other psychiatric agencies and institutions.