An objective rating form to evaluate grant proposals to the Hogg Foundation for Mental Health: a pilot study of implementation

The lack of support for mental health-related projects by private philanthropy, even among those that express an interest in mental health, is due in large part to the subjectivity of the grant review process. To address this problem, Whaley, Rodriguez, and Alexander developed the Grant Proposal Rating Form (GPRF) to make the grant review process more objective at the Hogg Foundation for Mental Health. The purpose of the current study is to establish the ecological validity of the GPRF by a pilot study of its implementation in the actual grant review process of the foundation. The overall results of this pilot study did not yield consistently favorable psychometric outcomes as the original study by Whaley et al. The implications of these results are discussed.     

Names in the News

Introducing Lisa K. Bernhardt , who now heads her LKB Strategies, which lobbies for public health organizations. For many, she needs no introduction: She has a long history on Capitol Hill and in the Department of Health and Human Services (HHS). Nobody on the Hill knows more about the Substance Abuse Prevention and Treatment block grant (SAPT BG). From 2010 until last fall, she was the top staffer at the Senate Appropriations Committee, Subcommittee on Labor, HHS, Education & Related Agencies. Prior to that, she was a budget analyst at HHS for eight years and interned there for two years previously. She knows how things work. When she left Capitol Hill last October, she did so because she felt she could do more good as an advocate helping public health navigate the appropriations process. We have known her for years as a source. Now she is out there helping people work through the systems she knows inside and out. When she worked for the great Sen. Tom Harkin (D‐Iowa), with whom she was in lockstep on policy, legislative language was clear and to the point. The Substance Abuse and Mental Health Services Administration, which had been hankering to get SAPT BG money into mental health, was put in its place more than once. There was no tinkering with the law. Thank you for your years of service, Lisa, and welcome to the exciting world of the private sector. To reach her, email Lisa.Bernhardt@LKBStrategies.com .     

Availability of treatment to youth offenders: Comparison of public versus private programs from a national census

Across the United States, the availability of mental health, substance abuse, and recidivism reduction programs in the juvenile justice system (JJS) varies from none or few to a rich variety of programs. Within the last decade, prison privatization in the adult correctional system has influenced the onset of privatization in the JJS. The differences between public and private sectors in their availability of mental health services and treatment programs to juvenile offenders are understudied. In this article, a secondary analysis of a national census of 3163 juvenile facilities was conducted to determine differences in treatment availability as well as the impact of treatment accessibility on the event of a suicide. Results indicate private facilities more likely to offer treatment services and schedule mental health personnel more frequently. Those facilities reporting family counseling treatment programs were less likely to have reported a suicide event. Policy implications and a review of progress towards improvement in the JJS are presented.     

Nursing in tele-mental health

This article discusses a cooperative project involving an academic health sciences center, a state university, a women's shelter, and a community mental health center in East Texas, a medically underserved, rural region of Texas. The U.S. Department of Commerce provided grant funding to develop a telehealth network to provide an evaluation, referral, and treatment program for victims of domestic violence. Nurses were involved in all phases of the project, from initial conception through development, implementation, and evaluation. The authors concluded that all of the women involved in the study had significant mental health issues and other health concerns that were not being addressed by the existing health care delivery system. Without the use of telehealth, these women would have had limited access to primary health care and virtually no access to mental health services. The East Texas Tele-Mental Health Network demonstrates the value of the clinical and organizational skills that nurses bring to innovative models of mental health service delivery.     

Assessment of the complex effects of trauma across child serving settings: Measurement properties of the CANS-Trauma Comprehensive

This study examined the measurement properties of the Child and Adolescent Needs and Strengths-Trauma Comprehensive Version (CANS-Trauma). This comprehensive, trauma-focused, and strengths-based assessment strategy is designed to assess the complex needs of traumatized children and adolescents across child-serving settings and support the treatment/service delivery process. The current study assessed 257 children and adolescents from three mental health agencies across the country that were partners in the National Child Traumatic Stress Network (NCTSN). Internal consistency and inter-rater reliability, convergent and discriminant validity, and scale properties of the CANS-Trauma were examined. Overall, measurement properties of the CANS-Trauma showed promising results. Internal consistency varied from marginally acceptable to excellent across most domain scores (α = 0.62–0.90); the traumatic stress symptoms domain demonstrated very good internal consistency (α = 0.82). Inter-rater reliability for the CANS-Trauma was good overall, while the traumatic stress symptoms domain had marginally acceptable reliability. There was evidence for convergent validity with more limited evidence for discriminant validity, based on the association between domains on the CANS-Trauma and subscales of the Trauma Symptom Checklist for Children-Alternate (TSCC-A) and the Child Behavioral Checklist for Children (CBCL). Rasch modeling analyses indicated that the CANS-Trauma had good scale properties overall, including item fit within each of the domains. These preliminary results also suggested that the various mental health and trauma symptom domains on the CANS-Trauma were more sensitive to populations with significant trauma symptoms and mental health difficulties compared to populations with lower to moderate difficulties in these areas. Implications of these findings are discussed in terms of the utility of a comprehensive, trauma-informed assessment strategy in practice settings.     

HMOs and the Future of Student Mental Health Services

Abstract

The health maintenance organization (HMO) is likely to have a prominent position under national health insurance, which will have a strong systematizing effect on the nation's health services. Over the past two years the University of Massachusetts mental health services have provided benefits at both the university and a private medical group practice. Experience has shown that a university which already provides broad services to a large student population can extend itself to the university community including its faculty and staff. Several advantages of this development, as well as some significant problems, are discussed. As the HMO grew and quality services were established, it became feasible for the private medical group to develop its own mental health component. Based on this and other experiences in mental health delivery systems, certain conclusions are drawn about the ways universities can develop HMOs and some recommendations are made for national mental health planning.     

Development of the Mental Illness and Disorder Understanding Scale

Abstract: Although administrative bodies such as community health centers have implemented various awareness campaigns to promote community understanding of mental health and to reduce the stigma associated with mental illness and disorder, there have been few reports that have quantitatively analyzed the effects of these campaigns in Japan. Therefore, this study was conducted for the purpose of developing the evaluative “Mental Illness and Disorder Understanding Scale (MIDUS)” for awareness campaigns and assessing its reliability and validity. A survey was conducted on 1 004 community residents using a self‐administered questionnaire. An assessment of the reliability and validity of the scale was then conducted. The Cronbach a coefficient of the MIDUS was 0.78, thus indicating adequate reliability. Factor analysis of the MIDUS revealed three factors: “Treatability of illness”, “Efficacy of medication” and “Social recognition of illness”. In addition, a significant correlation was observed between the MIDUS and existing scales, and fixed criterion‐based validity was demonstrated. The MIDUS utilizes items worded in the form of affirmative expressions so as to avoid promoting new bias. It was confirmed to be both reliable and valid, thereby suggesting its usefulness as an evaluative scale of awareness campaigns.     

Managed Mental Health Care for Employees:

Managed mental health care has become an increasingly significant influence in the timely, appropriate and cost-conscious delivery of mental health and substance abuse services. Social workers are being presented with new career paths in the private sector as EAP programs and managed health care corporations Look to them to provide the case review, supervision, provider selection, and the quality assurance functions of a well integrated managed health care system.     

Assessing the Effect of an Electronic Decision Support System on Children's Mental Health Service Outcomes

This study examined the effect of clinician adoption on an agency built Electronic Discussion Support System on the reduction of youth risk factors. This exploratory study is the first of its kind to assess an agency-built Electronic Decision Support Systems (EDSS) within a children's mental health program to see how it is utilized in a treatment as usual climate. The results showed a significant difference between the reduction-in-risk rating for two of the domains of the North Carolina Family Assessment Scale (Parental Capability and Environment). Yet findings showed that only a few staff utilized the EDSS regularly. Based on the findings, it appears there was a break down in the implementation process. Although the agency had the best of intentions by building the Dashboard, without proper emphasis on implementation their goal was never fully actualized.     

Against all odds: Revitalization of local self-help alternatives by longterm mental health consumers

The article presents a grounded theory case study of a consumer-run alternative services organization, operated by and for people labeled chronically mentally ill in Michigan. We analyze the organization's emergence and development as a process of revitalization through which participants mobilized to transform their private and public identities. Innovations, including self-disclosure rituals and advocacy strategies, were developed by the group's founder during a period of social dislocation following deinstitutionalization. Subsequently, through their advocacy efforts for and with other consumers, group members laid the foundation for a unique form of locally-based political activism, blending innovative self-advocacy strategies with a critique of conventional mental health care. Active participants' efforts have created a mental health consumer organization that members perceive as an empowering and sometimes rehabilitative alternative within Michigan's public mental health care system.     

Comparison of basic data for the National Survey of Residential Group Care Facilities: 1966-1982

Major findings from this analysis of the data gathered in preparation for the 1966 and 1981 surveys of children's residential group care facilities are as follows below. In the field of residential care of pregnant adolescents, it appears that, despite an increase in the number of births to adolescent mothers since 1966, the preferred mode of serving this population is no longer residential group care. While there has been a small increase (6 facilities) in the number of residential facilities for pregnant adolescents that operate under public auspices, the 49% decrease in facilities under private auspices is the real indicator of the direction of residential services to pregnant adolescents since 1965. In the Child Welfare Stream, the most notable change between 1965 and 1981 was the decrease in the relative proportion of residential group care facilities for dependent, neglected, or abused children and youth. Overall, child welfare facilities accounted for 55% of all residential facilities listed for survey in 1965; in 1981 this percentage had fallen to 37%. As in 1965 the Child Welfare Stream was dominated by the private sector in 1981, with 83% of all child welfare facilities operating under private auspices. This pattern was found for most of the 50 individual states as well. In the Juvenile Justice Stream, the overall increase of 154% in the number of residential facilities since the 1965 listing is due in part to a notable increase in the number of private facilities in this stream of care. Although the majority of juvenile justice facilities are still public, there has been an increase of 17% since 1965 in the proportion of facilities under private auspices. An even greater increase in total number of facilities than was seen in the Juvenile Justice Stream is seen in the mental health field between 1965 and 1981. There were almost four times as many residential mental health facilities listed for survey in 1981 as in 1965. From representing about one-eighth of the total number of all residential group care facilities for children and youth with special problems or needs, the Mental Health Stream increased to a quarter of all such facilities by 1981. As in the earlier study, the Mental Health Stream was dominated by the private sector in 1981. The proportion of mental health facilities under private auspices had increased by 16% since 1965, indicating an even greater involvement of the private sector in the delivery of residential mental health services to children and youth.(ABSTRACT TRUNCATED AT 400 WORDS)     

Finding Your Niche: Identity and Emotional Support in Emerging Adults' Adjustment to the Transition to College

This mixed‐method longitudinal study investigated the role of identity synthesis and emotional support from family, friends, and professors in emerging adults' mental health during the transition to college. A total of 167 ethnically and socioeconomically diverse emerging adults were surveyed and interviewed during the fall and the spring quarters of their first year in college. Cluster analysis revealed four mental health clusters: greatly improving mental health; maintaining positive mental health; poor mental health declining; and good mental health declining. Clusters that maintained or improved mental health over the first year of college had higher identity synthesis and emotional support from friends and family than clusters where mental health declined. Emotional support from friends was especially important for adjustment.     

Mental health service utilization in children adopted from US foster care,US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

Aims

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization.

Data

As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17 years old (N = 1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse).

Results

For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services.     

Striving to help college students with mental health issues

Mental health problems in the college population appear to be increasing in number and severity. University counseling services are limited in the number of counselors they can hire to meet the increasing demands. In addition, it is believed that many students do not actually seek much-needed counseling services due to lack of knowledge about mental health problems or services, stigma, or denial of the severity of the problem. Left unrecognized and untreated, mental health problems may lead to students dropping out or failing out of college, attempting or committing suicide, or engaging in other risky, dangerous behaviors that may result in serious injury, disability, or death. Mental health nursing faculty can help address this problem on college campuses by offering courses on mental health issues and skills, becoming involved with NAMI-on-Campus groups, and seeking grant opportunities that can be used to help develop and enhance services for the college community. Information about how to establish a NAMI-on-Campus group can be obtained by accessing http://www.namioncampus.org or http://www.nami.org.     

Cyber Counseling for Queer Clients and Clinicians

Abstract

As the Internet grows, so does its use by mental health professionals and by clients seeking mental health services. Drawing on his own experience as an example, the author describes how the Internet can enhance clinical practice. Social service professionals can utilize the Internet to provide a supportive forum for patients grappling with issues of self-identity; facilitate communication between therapist and client; provide community education about mental health issues; provide referrals to local social service professionals; market a private psychotherapy practice; and provide patient billing, scheduling, and record keeping.     

Mental Health Knowledge Gaps in the Child Protection Work with Parents: A Narrative Review of the Social Work Literature

This is a narrative review of the latest peer-reviewed social work literature on the child protection work with parents. Aiming to identify knowledge gaps, the study researches the mental health aspects of the implicit or explicit theoretical perspectives underpinning the assessment and intervention with parents. An electronic database search extracted 38 peer-reviewed journal articles. It was found that the theoretical perspectives the publications adopted were the managerial, the critical, the humanistic, the psychodynamic and the behavioural. The study identified mental health knowledge gaps in the assessment and intervention work with parents across all theoretical perspectives and stressed the need for process and effectiveness studies on the work with parents, under explicit theoretical perspectives. The study finally highlights the need for the social work profession to increase its mental health literacy through mental health education for students and practitioners alike.     

Psychiatric nursing for the 21st century. The PACED model.

Health care reform has had a profound effect on the way psychiatric treatment occurs in this country. Decreasing length of stay, increasing acuity, and reducing staff levels are making traditional approaches to mental health care infeasible. Resources already in place may still be focusing on long-term treatment issues and do not facilitate rapid stabilization and discharge planning that includes continued care within an integrated system. Research supports the feasibility of quality mental health care, which can be accomplished in shortened lengths of stay, as long as clinical managers plan inpatient programs focused on short-term goals followed by appropriate aftercare. In addition to recommendations for clinical managers, this article provides a proposal for executives redesigning a mental health care delivery system, which includes the goals of rapid assessment and stabilization, as well as discharge planning and appropriate follow up within an integrated system.     

From plan to action: Adapting evaluation to serve the developmental needs of a newly-funded multidisciplinary research center

The Southeastern Coastal Center for Agricultural Health and Safety (SCCAHS) is one of many newly-funded federal research centers, housing five multidisciplinary research projects and seven pilot projects, and serving a multi-state region. In the early stages of such a complex project, with multiple teams separated by geography and disciplines, the evaluation program has been integral in connecting internal and external stakeholders at the center and project levels. We used a developmental evaluation (DE) framework to respond to the complex political environment surrounding agricultural health and safety in the southeast; to engage external stakeholders in guiding the center’s research and outreach trajectories; to support center research teams in a co-creation process to develop logic models and tailored indicators; and to provide timely and feedback within the center to address communications gaps identified by the evaluation program. By using DE principles to shape monitoring and evaluation approaches, our evaluation program has adapted to the dynamic circumstances presented as our center’s progress has been translated from a plan in a grant proposal to implementation.     

The Role of Self-Conscious Emotions in the Sexual Health of Gay and Bisexual Men: Psychometric Properties and Theoretical Validation of the Sexual Shame and Pride Scale

Researchers have theorized about the role of sexual shame as a mechanism through which sexual minority stress manifests into mental health difficulties, such as sexual compulsivity for gay and bisexual men (GBM), and about the resilience-promoting effects of sexual pride. However, no validated measures to date have directly tapped into these constructs rather than using proxies for them, such as internalized homonegativity. We developed the Sexual Shame and Pride Scale (SSPS) and conducted a psychometric evaluation of it using a sample of 260 highly sexually active GBM. The scale had the expected structure in factor analysis and showed evidence of internal consistency and test–retest reliability. Correlational analyses demonstrated the convergent validity of sexual shame and sexual pride with relevant constructs. Regression analyses demonstrated the predictive validity of sexual shame in relation to sexual compulsivity, accounting for unique variability even after adjusting for previously demonstrated etiological factors, and the predictive validity of both shame and pride, which interacted to consistently predict four sexual behavior outcomes. Findings suggest the SSPS is a psychometrically valid and reliable measure that may be useful in future empirical work and highlight preliminary evidence for the role of these constructs in the sexual health of GBM.