Mental health. Commissioned for service

GPs often lack the data to make well-informed judgements about commissioning mental health services. A multi-agency group, including a multifund, health authority and social services, has developed service agreements which are proving useful to practices. The system provides primary care commissioners with clinical information linked to expenditure for all patients with a mental illness.     

Mental health service for medical students

Summary. The authors describe the problem of impairment of medical students from the point of view of mental health professionals who have directed a large and successful evaluation and referral service for students suffering from a wide array of stress-related and mental disorders. They outline the nature of the impairment problems, the history of the efforts at their medical school to address these problems, and their recent experience in providing mental health services to students who are referred for evaluation and treatment. Diagnostic data, referral and the implications of mental disorders for medical students are discussed. The authors offer some suggestions for the formation of student well-being committees prior to the implementation of student assistance programmes to address the problems of substance abuse.     

Mental health and work environment of a group of public health preventive service users

BACKGROUND: In a previous organizational study we proposed shared technical initiatives in public occupational health and mental health public services dedicated to mental health at work which is now completely neglected. OBJECTIVES: To study the occupational mental health demand in public health services users by improving shared tools among public health services. METHODS: Data collection on socio-demographic characteristics, relationship between mental health and working environment, organizational constraints in a group of mental, occupational and public health service users (no 90). RESULTS: A third of the users, mostly women, described the working environment as negative for mental health. The main reported organizational constraints were poor career possibilities, relationship with the public and workload. Inadequate workload is the leading cause for a negative evaluation of working conditions for mental health. CONCLUSIONS: This study confirms that mental health at work is a public health problem that has to be better investigated using tools shared between mental and occupational health services.     

380人次艾滋病咨询电话记录研究分析

2004年1月至2005年4月，山东省疾病预防控制中心健康教育所共接听艾滋病咨询电话380例，作对咨询和咨询情况进行了分析，结果如下。     

Mental health needs and service use in Ontario

This study uses data from the Resident Assessment Instrument Mental Health (RAI-MH) on everyone admitted to an Ontario inpatient psychiatric facility between October 2005 and June 2007 to describe patients characteristics and service utilization, and to determine whether these differ based on prioritization of mental health issues in the Integrated Health Service Plan (IHSP) put forth by the Local Health Integration Network (LHIN) providing service.     

精神疾病的社区优先干预类型

随着经济和社会的不断发展,生活节奏加快,竞争压力的日趋增加,我国居民精神疾病的发病率呈上升趋势。2004年9月,国务院办公厅发布了《关于进一步加强精神卫生工作的指导意见》（以下简称《意见》）,强调了社区精神卫生服务在精神疾病防治中的重要作用,     

Automatic message handling for a national counselling service

An automatic email handling system (AutoRouter) was introduced at a national counselling service in Australia. In 2003, counsellors responded to a total of 7421 email messages. Over nine days in early May 2004 the administrator responsible for the management of the manual email counselling service recorded the time spent on managing email messages. The AutoRouter was then introduced. Since the implementation of the AutoRouter the administrator's management role has become redundant; an average of 12 h 5 min per week of staff time has been saved. There have been further savings in supervisor time. Counsellors were taking an average of 6.2 days to respond to email messages (n = 4307), with an average delay of 1.2 days from the time counsellors wrote the email to when the email was sent. Thus the response was sent on average 7.4 days after receipt of the original client email message. A significant decrease in response time has been noted since implementation of the AutoRouter, with client responses now taking an average of 5.4 days, a decrease of 2.0 days. Automatic message handling appears to be a promising method of managing the administration of a steadily increasing email counselling service.     

A force field evaluation tool for telephone service in ambulatory health care

The tool presented here is useful in analyzing the constraints and capabilities of a health care telephone service. It also provides a systematic method for assessing systems problems. As part of our analysis, we recommended that the manager implement the following steps. First, the manager determines whether the driving force on the unit is continuity of care by an individual provider or consistency of response. This focus directly affects how the unit's telephone service can be best organized (i.e., decentralized or centralized) and clarifies the factors most needed for success. For example, to function effectively and efficiently, a centralized phone service needs strong provider-endorsed protocols. Second, the manager should carefully examine neutral constraint factors to determine methods to transform these constraints into capabilities, such as planning for extra staff or office hours (or both) during influenza season. Planning for extra hours or staff depends largely on whether budget and resource planning is done in advance and whether value is placed on customer access and satisfaction during peak demand periods. The manager must next determine whether the service delivery format (centralized or decentralized) is consistent with the force field analysis findings. If the findings are not consistent, can the analysis present a compelling argument for using the opposite approach? Finally, the manager must create a plan of action for minimizing the constraints revealed and maximizing existing capabilities to achieve the overall goal of excellent phone service. The process of analysis and creating a plan of action is an excellent opportunity to involve staff, providers, and administrators in efforts to achieve better health care telephone service for all customers.     

Mental health policies and changes in emergency service demand

OBJECTIVE: To verify the modifications observed in a school hospital psychiatric emergency unit in Ribeir?o Preto - SP, Brazil (EP-RP), due to alterations in the mental health policies implemented in this region. METHODS: Data about attendances was collected from university hospital files of the EP-RP, from 1988 to 1997. The following variables were studied: sex, age, origin and main diagnosis. Data about changes in mental health policies of the region was obtained from documents of the city and state departments of health. RESULTS: The yearly increase in the number of attendances followed the progressive involvement of EP-RP with the mental health service network, as the number of patients who looked for the service in 1995 was 2.3 times greater than in 1988. During this period, attendance at the EP-RP gave support to the modifications in the mental health policies in this region, resulting in a reduction of 654 psychiatry beds. In 1996 and 1997, a reduction of about 20% was observed in the total of attendance, as compared to 1995, result from an increase in the attendance capacity and number of the extra-hospital services. Since 1990, the EP-RP started to attend a higher proportion of older, male patients, with drug dependency and psychotic disorders and a lower proportion of non-psychotic patients. CONCLUSIONS: The changes observed in the EP-RP are related to modifications in the Ribeir?o Preto region mental health policies, like the psychiatric beds control, installed in 1990, the reduction of psychiatric beds after 1993, and the creation and/or amplification of extra-hospital services, in 1995.     

Mental health service utilization among the Arabs in Israel

National hospitalization records (1995, 1986, N = 15,698) reveal that Arab women utilize psychiatric services less than Arab men. The exact reverse occurs among Jewish patients. Moreover, Arab patients significantly underutilize mental health services, compared to Jewish patients. Possible reasons for these utilization patterns include: Arab health care utilization patterns in general; the availability of mental health services in Arab communities; the influence of the "cultural" over the "professional" in Arab mental health utilization; the lack of Arab mental health practitioners; Arab attitudes towards mental health; and gendered role constructions within Arab society. Findings emphasize the need for a policy of developing infrastructure and trained personnel that can provide services adapted to the special cultural characteristics of the Arab population.     

Improving quality and amount of service for volunteers in a telephone counseling service

Conclusions This study suggests that the most valuable volunteers are women between the ages of 25 and 50 who have had some volunteer or workrelated counseling experience. Therefore, telephone counseling services might want to focus recruitment activities on groups such as teachers, nurses, and community service leagues. This study also indicates that allowing volunteers to participate in supervision, advanced training, and social activities increases length of stay and improves quality of work. While this study does not explore causative relationships, it suggests that offering such activities is worthwhile. This is supported by interviews and informal discussions with volunteers who indicate that one of the major satisfactions of volunteering is the inter-personal contact which such activities provide. Therefore, regardless of the social characteristics of available volunteers, crisis centers can increase volunteer quality and amount of service by providing in-service support activities. Due to a printer’s error, Dr. Stern’s name was omitted from this article when it was first published in the Spring 1985 issue of theJournal of Mental Health Administration.