Determinants of Mental Health Consultations Among Recent Chinese Immigrants in British Columbia, Canada: Implications for Mental Health Risk and Access to Services

Linked immigration and health administrative databases were analyzed to study the factors associated with the rate of mental health consultations with physicians in 1992–2001 of over 150,000 Chinese immigrants in British Columbia, Canada. Results showed that number of years since landing and rate of non-mental health visits to general practitioners were the most consistent variables associated with mental health consultations to general practitioners and psychiatrists in all sex and age groups. Other variables associated with the rate of consultations were age, place of origin, educational level, marital status and English skill. Supply of physicians was not observed to be associated with mental health consultations. The findings are consistent with Andersen’s behavioral model of health care utilization and introduce components specially pertinent to immigrants and mental health service utilization. They also highlight sub-populations among immigrants who may be at risk of experiencing mental health problems or encountering barriers to care.     

Transforming the Mental Health Field: The Early History of the National Association for Mental Health

The paper begins by noting the absence of any sustained analysis of post-war mental health pressure groups and movements. This is deemed problematic because such movements and groups have had a strong presence during this period and because movements, as such, are afforded a central role in much contemporary sociology on account of their role in the process of social change. Next the paper considers how such analysis should be conducted, and suggests a three-phase model for periodising the activity of the groups and movements of the post-war era. The largest part of the paper is then devoted to an examination of one particular aspect of the first phase: the birth of the National Association For Mental Health and their activities in their first ten years of life. Much can be learned from the study of this group.     

Market Planning for Mental Health:

No abstract available for this article.     

Investigating Service Users' and Carers' Views of Child and Adolescent Mental Health Services in Northern Ireland

The Review of Mental Health and Learning Disability, Northern Ireland commissioned the present consultation to support the work of its Child and Adolescent Mental Health (CAMH) subgroup. The investigation employed a two-stage qualitative approach to explore views and opinions held by users and carers about CAMH services. Nineteen services distributed questionnaires on a single day between 13 and 15 October, 2004 in order to provide a “snap-shot” of service user's views. Four focus groups, two consisting of parents/carers and two consisting of young people, were conducted. Responses from both stages were content analysed and key themes were drawn out. The content analysis of responses from the questionnaire study showed that 40% (six) of the derived categories described negative experiences of CAMH services, with 60% (nine) of the categories expressing positive views. Analysis of focus group data produced a total of 14 categories (88%) indicating dissatisfaction with CAMH services and two categories (12%) expressing generally positive views. These findings suggest that while users and carers valued CAMH services, they felt more could be done to help their children and wider families. Major areas for development highlighted include increasing capacity at all tiers of service, developing collaborative models of practice, developing public knowledge about child and adolescent mental health, and establishing meaningful structures for increased user participation in the planning and monitoring of CAMH services.     

Peer Reviewed: Public Health Surveillance for Mental Health

Public health systems have relied on public health surveillance to plan health programs, and extensive surveillance systems exist for health behaviors and chronic disease. Mental health has used a separate data collection system that emphasizes measurement of disease prevalence and health care use. In recent years, efforts to integrate these systems have included adding chronic disease measures to the Collaborative Psychiatric Epidemiology Surveys and depression measures to the Behavioral Risk Factor Surveillance System; other data collection systems have been similarly enhanced. Ongoing challenges to integration include variations in interview protocols, use of different measures of behavior and disease, different interval reference periods, inclusion of substance abuse disorders, dichotomous vs continuous variables, and approaches to data collection. Future directions can address linking surveillance efforts more closely to the needs of state programs, increasing child health measurements in surveys, and improving knowledge dissemination from survey analyses.     

Supply Dynamics of the Mental Health Workforce: Implications for Health Policy

The U.S. mental health workforce is varied and flexible. The strong growth in supply of nonphysician mental health professionals, ranging from psychologists to "midlevel" professionals like social workers and nurse specialists, helps to offset the dwindling numbers of medical graduates entering the field of psychiatry. Primary care physicians often see patients who have some form of mental illness, which they are not always trained to recognize and treat. The data on the supply of several specialists—psychiatrists, clinical psychologists, and clinical social workers—indicate that the distribution of mental health professionals varies widely by state. The composition, supply, and distribution of workers in this field also affect the care of vulnerable populations. Broader policy questions, including the lack of parity between mental and physical health insurance coverage and barriers to entry by nonphysician professions, may limit the cost-effective expansion of this diverse and dynamic workforce.     

Maternal Mental Health: Pathways of Care for Women Experiencing Mental Health Issues During Pregnancy

Perinatal mental health has become the focus for policymakers, government, research, the acute health sector, and health practitioners. The aim of this clinical data-mining study (Epstein, 2010 Epstein, I. 2010. Clinical Data-Mining: Integrating Practice and Research, New York, NY: Oxford University Press.  [Google Scholar]) was to undertake a retrospective exploration into the primary mental health and psychosocial issues experienced by women who were pregnant and accessing obstetric care at one of the largest maternity hospitals in Australia. The study also investigated service pathways and gaps. Aboriginal women were overrepresented, demonstrating their ongoing disadvantage, whereas other linguistically and culturally diverse women were underrepresented, suggesting the existence of barriers to service. Although psychosocial factors tend to be underreported (Buist et al., 2002 Buist, A.E., Barnett, B.E., Milgrom, J., Pope, S., Condon, J.T., Ellwood, D. and Hayes, B.A. 2002. To screen or not to screen – That is the question in perinatal depression. Medical Journal of Australia, 177(Suppl S): 101–105.  [Google Scholar]), the findings highlighted the integral rather than peripheral nature of these factors during pregnancy (Vilder, 2006 Vilder, C.H. 2006. Improving treatment outcomes for depressed women: Use of self help inventory in counselling settings. Psychotherapy Australia, 12(2): 74–81.  [Google Scholar]) and suggest the need for change to systems that work to support women's perinatal mental health.     

肥胖儿童心理状况及健康干预研究

目的了解肥胖对儿童心理健康的危害，为建立有效的健康教育及健康促进模式提供科学依据。方法随机抽取贵阳市3所（好、中、差各1所）学校肥胖儿童106名与相应对照组儿童进行心理指标检测，并对肥胖儿童进行为期1a的健康干预，干预措施包括饮食结构调整、生活方式改善、体能训练指导、及时心理指导等。结果重度肥胖女孩智力水平低于对照组。人格测定肥胖儿童P分高于对照组，E分低于对照组。行为问题测定女生肥胖组总分高于对照组；男生以多动、攻击性因子得分高于对照组；女生违纪因子分低于对照组，分裂样，强迫性因子高于对照组：干预前后除人格测定E分提高外，其余变化不明显。结论单纯性肥胖症导致儿童少年的行为、人格改变，形成了内向、多疑、易激惹、攻击性强等特征，重度肥胖儿童更为明显。干预前后各项心理指标改善不明显。