Integrated mental health: a creative model for community mental health in the 1980s.

Integrated Mental Health is a membership corporation designed as a non-profit management, funding, planning and evaluation vehicle for a two-county community mental health service system. It emphasizes incentives, coordination and research capability with special attention to the chronically mentally ill.     

Survival strategies for community mental health organizations: A conceptual framework

Changing conditions call for each Community Mental Health Center (CMHC) to develop a survival strategy based on its own standards and values. The strategy must contain political, funding, programmatic, structural and role change components. A CMHC must orchestrate its strategy as part of an overall survival plan, but may be constrained by the degree of control it has over programs and resources. Major types of risks associated with entrepreneurial (viz., high control over programs and resources) and restricted models (viz., low control over programs and resources) are reviewed.     

Survival strategies in community mental health: a study of management consensus

Human service agency and program managers were surveyed on survival strategies in the face of shrinking government funding. The two groups ranked strategies in order of importance and researchers compared results. There was strong general agreement between the two groups, suggesting that top and middle management are working ideologically and practically along the same lines.     

Community mental health services in the community jail

A frequently neglected group of community residents are those who find their way into jail. Jails tend to be the collecting point for many disturbed persons. This paper briefly describes the problems of the jail population and staff and suggests a policy of mental health intervention. To illustrate these points, the Mental Health Project in the Salt Lake County Jail is described as an example.     

Carers and community mental health services

Background There is a growing appreciation of the role and needs of carers for people with mental health problems. Carers are a diverse group, including partners, relatives and friends who are seen as such by service users. Methods Sixty-four carers of people with severe mental health problems served by four different mental health care providers were interviewed using the Experiences of Care-giving Inventory. The districts were selected to differentiate services that are targeted at more severely impaired users from those that include a wider spectrum, and to contrast services that have greater integration between health and social care providers with those whose health and social care agencies operate relatively discretely. Results In the two districts where service users had more severe mental health problems, carers worried more about negative symptoms and thought less about good aspects of the caring relationship. In the two districts where health and social services worked more closely together, carers worried significantly less about the need to back up services. Conclusions These findings suggest that service organisation can affect carers, in particular that integration between health and social care for people with mental health problems may benefit carers in ways that were hitherto unproven. They highlight the needs of carers for younger people. They show that the ECI is a useful instrument in measuring the impact of caring for people with severe mental health problems. Accepted: 19 September 2001     

Unit costs of community mental health services

The unit (hourly) costs of delivering services for six community mental health agencies in the greater Portland, Oregon area were computed. The calculations include an explicit methodology for allocating indirect costs associated with clinical services and with administrative overhead. Substantial variation among the six agencies in their unit costs was found and is explained by agency differences in: use of high cost (chiefly medical) personnel, the fraction of time staff spend in direct face-to-face client contact, and numbers of clients in treatment groups. The methodology as well as the results are increasingly important for community mental health programs in the era of managed mental health care.This study was partially supported by National Institute of Mental Health grant numbers P50 MH43458 and R01 MH45015.     

韩国社区精神卫生服务的印象

<正>自上世纪80年代起,随着韩国工业的迅猛发展,其精神卫生服务机构及住院病床数也迅速提升,到90年代中期韩国政府提出社区康复理念,并于首尔建立第一个社区精神卫生中心。随后,很多省市也建立起社区精神卫生机构。其社区服务理念注重"以病人为中心",对精神病患者"轻症状"、"重全人",并将这一理念深入到医疗康复服务的每一细节,对患者病情、身体状况、居住情况、经济能力、劳动能力、生活能力、人际关系等进行综合评估,再结     

社区心理卫生服务研究进展

目前生活节奏快,竞争压力日益增加,各种不良的心理应激因素也相应增加,越来越多地影响人们的生活质量和健康水平,人们也开始关注如何保持良好的心态,对心理健康服务的需求日益增大。现代社区心理卫生服务起源于20世纪五六十年代的西方发达国家,它是由临床心理学和社会心理学交叉而形成的一门较新的心理学科。现在,社区心理卫生服务已在全球发展并在发达地区渐趋完善,社区心理卫生服务机构已成为人们预防、治疗心理疾患的重要场所。     

Evaluating mental health services in a Greek community

This study aims to evaluate rendered mental health services for children and adolescents through the investigation of those factors which are related to non-compliance with therapy and which affect treatment outcome. Data were collected from the files of all new cases who applied to a Community Mental Health Centre in Athens during 2000–2002 (N = 363). For each case, the following factors were examined: age, sex, family situation, parents’ educational level, referral source, child’s psychiatric and psychosocial diagnoses, type of proposed therapy, phase at which termination of therapy occurred and outcome. Around 45.7% of the sample did not complete therapy. The probability of treatment compliance increased when the patient was male, with a diagnosis of a specific developmental disorder, treated in a well-structured therapy programme, was from a healthy family environment and his mother was better educated. On the contrary, an adverse family situation (one-parent family, inadequate parental supervision) and the female sex had a negative association with treatment compliance. Most of the cases discontinued their treatment upon completion of the diagnostic procedure. Referral source did not influence treatment compliance. Evaluation of our service has shown that more attention should be paid to less-educated families and those in adverse situations, particularly when the patient is female.