Types Of Mental Health Services Research Articles

Examining Relationships Between Receiving Mental Health Services in the Pennsylvania Prison System and Time Served

This study examined a cohort of 7,046 men who were released from the Pennsylvania State prison system between 1999 and 2002 to Philadelphia County to assess the relationships between receipt of mental health services in prison and prison exit. Administrative data on prison stays for 7,046 men released from Pennsylvania prisons to Philadelphia locations were analyzed. Of the 7,046 men, 8.7% received ongoing or intensive mental health services and 25.9% received mental health services while incarcerated. Multivariate analyses indicate that use of mental health services was positively associated with increased odds of serving the full prison sentence (as opposed to receiving parole), although the relationship between mental health services received and length of prison episode was inconclusive. Dynamics related to prison release warrant further attention in efforts to reduce the prevalence of mental illness in prisons and to facilitate community reentry for persons so diagnosed.

Meso-level Comparison of Mental Health Service Availability and Use in Chile and Spain

Meso-level Comparison of Mental Health Service Availability and Use in Chile and Spain

Comparison of Users and Non-Users of Mental Health Services Among Depressed Women: A National Study

ABSTRACT Risk factors for major depressive episodes (MDE), determinants of not seeking treatment for it and types of health care service accessed by women who received treatment for MDE were examined using data collected in the Health and Mental Health cycle of the Canadian Community Health Survey, 2002. Of the 1,186 women with MDE, 45% did not receive treatment for it. The highest rates of MDE were found among women under 30 years of age, single mothers with young children, low income women, those with chronic health conditions, high levels of daily stress and low levels of social support. The odds of not seeking treatment for MDE were highest for single mothers with adult children, women with low social support and those with little formal education. The type of mental health services accessed by women with MDE was strongly associated with their age, education, length of time in Canada, language skills, income adequacy, physical health, stress level and chronic health conditions. Our findings signify a need for screening women at high risk of depression, especially those identified as more likely not to seek treatment.

Does the use of telemental health alter the treatment experience? Inmates' perceptions of telemental health versus face-to-face treatment modalities.

In corrections, where staffing limitations tax an overburdened mental health system, telemental health is an increasingly common mode of mental health service delivery. Although telemental health presents an efficient treatment modality for a spectrum of mental health services, it is imperative to study how this modality influences key elements of the treatment experience. In this study, the authors compared inmates' perceptions of the working alliance, postsession mood, and satisfaction with psychiatric and psychological mental health services delivered through 2 different modalities: telemental health and face-to-face. Participants consisted of 186 inmates who received mental health services (36 via telepsychology, 50 via face-to-face psychology, 50 via telepsychiatry, and 50 via face-to-face psychiatry). Results indicate no significant differences in inmates' perceptions of the work alliance with the mental health professional, postsession mood, or overall satisfaction with services when telemental health and face-to-face modalities were compared within each type of mental health service. Implications of these findings are presented.

Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency

Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency

A Longitudinal Study of the Use of Mental Health Services by Persons With Serious Mental Illness: Do Spanish-Speaking Latinos Differ From English-Speaking Latinos and Caucasians?

Reports of mental health care use by Latinos compared to Caucasians have been mixed. To the authors' knowledge, no large-scale studies have examined the effects of language on mental health service use for Latinos who prefer Spanish compared to Latinos who prefer English and to Caucasians. Language is the most frequently used proxy measure of acculturation. The authors used the administrative database of a mental health system to conduct a longitudinal examination of mental health service use among Spanish-speaking versus English-speaking Latinos and Caucasians with serious mental illness. There were 539 Spanish-speaking Latinos, 1,144 English-speaking Latinos, and 4,638 Caucasians initiating treatment for schizophrenia, bipolar disorder, or major depression during 2001-2004. Using multivariate regressions, the authors examined the differences among the groups in the type of service first used. The authors also examined the probability of use of each of four types of mental health services and the intensity of outpatient treatment. Spanish-speaking Latinos differed from both English-speaking Latinos and Caucasians on most measures. Compared to patients in the other groups, the Spanish-speaking Latinos were less likely to enter care through emergency or jail services and more likely to enter care through outpatient services. There were no group differences in the proportion that stayed in treatment or used inpatient hospitalization. This study suggests that for Latinos, preferred language may be more important than ethnicity in mental health service use. Future studies comparing mental health use may need to differentiate between Spanish- and English-speaking Latinos.

Um estudo comparativo de dois serviços de saúde mental: relações entre participação popular e representações sociais relacionadas ao direito à saúde

The present paper originated from a qualitative study that analyzed social representations related to the right to health, expressed by users of two types of mental health services, one with participation by users and families and the other without such participation. The aim was to analyze such representations not only in relation to the awareness of the right to health, but also concerning associated factors, such as: popular participation; illness; public health care; perception of social intervention capacity; and concepts concerning the state. Social representations of the right to health involve expectations that the health system and the state meet their roles of ensuring care and support. Users of the mental health service without user/family participation tended to be more resigned and pessimistic. The group with participation views the service it has built as having characteristics denied by the official system and view advocacy as a possible alternative focus for forming new social representations.

Is Telepsychiatry Equivalent to Face-to-Face Psychiatry? Results From a Randomized Controlled Equivalence Trial

The use of interactive videoconferencing to provide psychiatric services to geographically remote regions, often referred to as telepsychiatry, has gained wide acceptance. However, it is not known whether clinical outcomes of telepsychiatry are as good as those achieved through face-to-face contact. This study compared a variety of clinical outcomes after psychiatric consultation and, where needed, brief follow-up for outpatients referred to a psychiatric clinic in Canada who were randomly assigned to be examined face to face or by telepsychiatry. A total of 495 patients in Ontario, Canada, referred by their family physician for psychiatric consultation were randomly assigned to be examined face to face (N=254) or by telepsychiatry (N=241). The treating psychiatrists had the option of providing monthly follow-up appointments for up to four months. The study tested the equivalence of the two forms of service delivery on a variety of outcome measures. Psychiatric consultation and follow-up delivered by telepsychiatry produced clinical outcomes that were equivalent to those achieved when the service was provided face to face. Patients in the two groups expressed similar levels of satisfaction with service. An analysis limited to the cost of providing the clinical service indicated that telepsychiatry was at least 10% less expensive per patient than service provided face to face. Psychiatric consultation and short-term follow-up can be as effective when delivered by telepsychiatry as when provided face to face. These findings do not necessarily mean that other types of mental health services, for example, various types of psychotherapy, are as effective when provided by telepsychiatry.

Social Networks and Their Relationship to Mental Health Service Use and Expenditures Among Medicaid Beneficiaries

Social Networks and Their Relationship to Mental Health Service Use and Expenditures Among Medicaid Beneficiaries

Psychiatrists' Ascertained Treatment Needs for Mental Disorders in a Population-Based Sample

Population-based studies of prevalence have been used to approximate the amount of need for treatment of mental disorders. This study aimed to estimate need for treatment of alcohol dependence, major depression, panic disorder, agoraphobia, and social phobia. Psychiatrists used the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to assess individuals in a probability sample of the Baltimore Epidemiologic Catchment Area follow-up study for need for and use of mental health services. Population-based estimates were calculated with probability weights. The SCAN sample included 816 participants who were interviewed between 1993 and 1999. Prevalence of need for mental health services in the general population was 28.7%+/-2.7%. Among the disorders studied, the greatest need was for treatment of alcohol dependence; 90% of the SCAN sample who met criteria for this diagnosis, or 13.6%+/-1.9% of the population, needed treatment. In the general population, 10.5%+/-2.1% needed treatment for major depression; 5.2%+/-.9%, for social phobia; 5.2%+/-1.6%, for panic disorder; and 3.2%+/-.9%, for agoraphobia. The highest needs for specific treatment modalities were self-help groups for alcohol dependence, talk therapy for depression, behavior modification for social phobia and agoraphobia, and antidepressant medications for panic disorder. Overall, less than 33% of needs were met. Social phobia and alcohol dependence were the two disorders with the highest proportion of unmet need. Prevalence of mental disorders is only an approximation of the need for treatment. There is a substantial need for mental health services in the general population. Most individuals who would benefit from treatment are not receiving any type of mental health services.

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

This study compared the prevalence of depression and the determinants of mental health service use in Canada and the United States. The study used data from preliminary analyses of the 2003 Joint Canada/United States Survey of Health, which measured Canadian (N=3,505) and United States (N=5,183) resident ratings of health and health care services. Cross-national comparisons were made for the 12-month prevalence of DSM-IV major depression, 12-month service use for mental health reasons according to the type of professional seen, and determinants of service use. The rates of depression were similar in Canada (8.2%) and the United States (8.7%). However, U.S. respondents without medical insurance were twice as likely as Canadian respondents and U.S. respondents with medical insurance to meet the criteria for depression. Rates of mental health service use did not differ between Canada (10.1%) and the United States (10.6%). In the United States, medical insurance was not a determinant factor of service use. However, U.S. respondents with no medical insurance were more likely than the other two groups to report an unmet need. Also, among those with depression, U.S. respondents with no medical insurance were less likely to use any type of mental health service (36.5%) than U.S. respondents with medical insurance (55.7%) and Canadians (55.7%). Further, a positive correlation between a mental health need and service use was observed in Canada but not for those without medical insurance in the United States. There was no difference in the prevalence of depression and mental health service use between Canada and the United States. Among those with depression, however, disparities in treatment seeking were found to be associated with medical insurance in the United States. Both Canada and the United States need to improve access to health services for those with mental disorders, and special attention is needed for those without medical insurance in the United States.

Living with mental illness in Australia: Changes in policy and practice affecting mental health service consumers

The movement of large numbers of people from psychiatric hospitals in the 1960s changed the face of mental health services in Australia. This paper explores some of the issues facing people living with mental illness in the community today and the impact of social policy, legislative change and funding of services on their lives, with particular reference to New South Wales. The growth of support and advocacy groups in the 1970s and 1980s, and their role alongside psychologists and other health workers in bringing about change in the provision and type of mental health services, are examined. Opportunities for advocacy and real input into the quality of service provisions have increased, and many people living with disabilities are active in contributing to policy development and advocacy services. However, the level of funding of mental health services and the resources available to care for people living with mental illness in the community remain low and, in many cases, inadequate to provide proper quality care for people living with mental illness.

Characteristics of mental health services at 325 general hospitals in Beijing

Describe the mental health services provided at different types of general hospitals in Beijing. Distribute the "Hospital Mental Health Services Survey" to all 508 hospitals in the 18 Beijing districts; the survey covers information for 2001 on the type of mental health services provided, the characteristics of the service providers, the number and diagnoses of first-visit mental health patients, and the prescription of psychotropic medications. 73% (373/508) of the hospitals completed the survey, including 75% (325/436) of the general hospitals. Among the 325 general hospitals, 171 (53%) provided one or more types of mental health services; they had a total of 420 staff members who provide these services, but their educational level was relatively low and mental health training limited. 61 general hospitals had mental health outpatient departments that treated 50% (47,151/93,891) of all first-visit mental health patients seen in all hospitals (including psychiatric hospitals) in the municipality; 90% (42,578/47,151) of these first-visit patients in general hospitals were seen at 18 level-3 hospitals. Among the 44,441 first-visit patients for whom diagnostic information was available, the main diagnoses were neurosis (43%) and depression (30%). 103 of the participating general hospitals prescribed 73% of antidepressant medications prescribed at all hospitals in the municipality and 97% of all fluoxetine (Prozac and others). General hospitals-particularly level-1 and level-2 general hospitals-need to put more emphasis on mental health services, increase training of staff who provide the services and open relevant departments. Monitoring the development of mental health services in general hospitals and increasing the quality of their mental health services will require periodic assessment of the types and range of mental health services provided and of the diagnostic accuracy and treatment standards of the staff providing these services.

A multi-site study of medicaid-funded managed care versus fee-for-service plans' effects on mental health service utilization of children with severe emotional disturbance

Although Medicaid-funded managed care arrangements are commonly used in the delivery of mental health and substance abuse services to low-income children and youth, little is known about the effectiveness of such efforts. This article examines differences in mental health services utilization between children and youth with severe emotional disturbance covered by Medicaid-funded managed care behavioral health plans and those covered by fee-for-service plans. Data are from a federally funded multi-site study. In multivariate analyses controlling for child and caregiver demographic and clinical factors, enrollment in a managed care behavioral health plan was associated with lower inpatient/residential, psychiatric medication, and nontraditional services utilization. No difference was found in outpatient services utilization. Medicaid-funded managed care behavioral health plans appear to reduce use of some types of mental health services, but it is important to address the question of whether low-income children's enrollment in such programs deprives them of needed services.

Mental Health Services in Kentucky Nursing Homes: A Survey of Administrators

National surveys have shown that mental health problems are prevalent in long-term care and suggest that these settings are largely underserved by mental health services. Nursing home administrators are gatekeepers for mental health services in nursing homes. Administrators of Kentucky nursing homes were surveyed regarding their perceptions of mental health problems, current and future services use, satisfaction with services, and need for consultation. The response rate was 24%. Administrators appeared to underestimate mental health problems among residents. Most facilities were using at least one type of mental health service, but fewer residents received services than would be expected given the problem prevalence. Psychological services were underused, in spite of the fact that behavior management stood out as a major need. Psychiatry was more frequently used, but with less satisfaction. Results indicate significant financial and logistical barriers to mental health services. Future work is needed on developing, assessing, and disseminating models of effective service provision to long-term care.

Attitudes Towards Mental Illness and Knowledge of Mental Health Services Among the Australian and Chinese Community

The study aimed to examine the attitudes toward mental illness and knowledge of mental health services among Anglo-Australian and Chinese-Australian adults. Participants included 105 Anglo-Australians and 129 Chinese-Australians. Participants were requested to complete a questionnaire on attitudes toward mental illness and knowledge of mental health service available in the community. The results indicated that there was a significant ethnic difference in attitudes towards mental illness. Chinese-Australians endorsed authoritarian, restrictive attitudes towards people with mental illness and interpersonal etiology more than Anglo-Australians. There was also a significant difference in attitudes towards mental illness due to the amount of contact with people with mental illness. The more contact the participants had with people with mental illness, the less they endorsed authoritarian, and restrictive attitudes toward people with mental illness. Though there was a non-significant difference in knowledge of mental health services due to ethnic origin or amount of contact with people with mental illness, there were ethnic differences in the type of mental health services preferred. Among Chinese-Australians, age was positively related to knowledge of services for acute and chronic cases of mental illness. Implications for community mental health education programs are discussed.

HIV-infected prisoners: What mental health services are constitutionally mandated?

State and federal correctional facilities currently have approximately 23,000 inmates who are infected with human immunodeficiency virus (HIV). These inmates suffer from the same mental health disorders as uninfected inmates but are additionally subject to mental health problems uniquely related to their HIV infection. Many prison systems are struggling to provide minimal mental health care to uninfected inmates. How will prisons address the additional mental health needs of the staggering number of inmates being diagnosed with AIDS and HIV? This article describes the type of mental health services that are constitutionally mandated and discusses whether and how prisons will have to respond to the distinct mental health issues related to HIV infection.

Suicidal Ideation and Behaviours among University Students in Australia

The aim of the study was to investigate the prevalence and demographic correlates of suicidal ideation and behaviours among university students in Australia and the utilisation of mental health services by this population. Suicidal ideation and behaviours and demographic variables were assessed in a population of 1,678 undergraduate students by use of a modified Suicide Ideation Scale (SIS) and questionnaire. Sixty two percent of students surveyed showed some suicidal ideation and 6.6% reported one or more suicide attempts. Over half of the group who reported suicide attempts did not use any type of mental health services. Suicidal ideation was found to be highly correlated with previous use of mental health services. In examining the relationship between suicidal ideation (SI) and demographic variables, SI was not significantly different for gender or parental marital status but was related to living arrangements, racial groups, religious affiliation and father's education. The results suggest that a higher proportion of students reported suicidal ideation and behaviours than that documented in related studies undertaken in the USA. While these findings draw attention to a higher level of suicidal ideation in students who utilise mental health assistance, more than half of those who reported suicide attempts did not use any kind of mental health service. The study has particular implications for detecting and assisting young people with a high suicide risk within the university environment.

Mental Health Service Use by Adolescents in the 1970s and 1980s

Shifts in the use of mental health services by adolescents between 1975 and 1986 are examined by levels of care--outpatient, partial hospitalization, residential treatment center, and inpatient. Data from National Institute of Mental Health surveys of U.S. facilities include client characteristics (age, sex, race, diagnosis, clinical history) and treatment characteristics (referral source, type of intervention, length of stay). Major increases in mental health service use were observed for all levels of care during this period. Nonetheless, a relatively small percent (less than 2%) of adolescents in the U.S. received any type of mental health service in 1986. The clinical and treatment variables available were only moderately helpful in differentiating levels of care.