Complexity of process and role in the evaluation of an interdisciplinary mental health education program: The deacon's masterpiece

Research and literature on program evaluation must attend to problems of application, which can have major effect on the outcome. Increasing numbers of innovative, multifaceted programs operating in complex settings are presenting for evaluation. Evaluation process must become flexible, creative, and multifaceted in order to produce valid and comprehensive results, and to meet the needs of this field. Evaluators and evaluation, the evaluated program, and the environment become a mutually interacting system in the process of evaluation. Evaluation goals and roles must be conceptualized, agreed upon, sanctioned, and appropriately implemented or conflict and ineffectiveness will result. Three models of evaluation emerge: objective and independent, objective but serving one interest, and pseudo-scientific public relations. Evaluation of an interdisciplinary mental health education program illustrates these issues. Evaluation technology, process, and roles must all be attended to or the weak link undermines the rest.     

Alcohol abuse on a college campus: A needs assessment

This paper reports the results of a needs assessment study conducted by a university-based alcohol abuse prevention project. Data are presented on the drinking patterns and drinking problems of a random sample of 462 students. Results suggest that students are experiencing numerous difficulties in the physical, educational, legal and psychosocial areas due to their use of alcoholic beverages. Implications for prevention and intervention programming are discussed and the need for planning programs from a data-based perspective rather than a rational and intuitive approach is stressed.     

Enhancing program review for evaluation and management

Program review has not received the attention it warrants as a program evaluation tool despite its wide use for evaluation and management purposes. The use of the program review will probably endure on the strength of its face validity and irrespective of other developments in the field of program evaluation. Evaluators should realize this and, accordingly, attempt to improve its effectiveness. This paper presents one organization's approach to achieving this objective through the explication of development principles, implementation guidelines and review items. This paper also discusses benefits that can be expected from a systematic development of this tool and presents various research directions and potentials in this area.     

Behavioral epidemiology and social area analysis: The study of blackout looting

This article describes the use of social area analytic techniques in the study of the looting which occurred during the Con Edison power failure of July 13 and 14, 1977. Detailed procedures are outlined of the systematic collection and analysis of data which were developed from available data. Analyses contrasting competing explanatory theoretical models for blackout looting are presented. The central dependent variable is ratio of looted to retail stores. Both the numerator and denominator are aggregated to the census tract level.     

Accountability revisited: the arrival of client outcome evaluation

In the past few years, "accountability" for public mental health programs has become differentiated in the minds of not only program evaluators, but also program managers and funders, including state and local-level legislators. Increasingly, these officials are becoming concerned with more than just the numbers and targets of services delivered, and the cost involved, and are looking for evidence of positive outcome or impact on clients to justify program implementation and maintenance. This represents a significant move beyond the two accountability models that most recently seemed to be the focus of most formal accountability efforts--performance measurement and quality assurance. Pressures for implementing these two alternatives seem to have been reduced somewhat by the new federal Administration, but even prior to its advent there had been a rapid escalation in awareness of and concern for client outcome measurement among important audiences, including state and local mental health policy-makers and the U.S. Congress. This presents a major new opportunity and challenge for program evaluators at this new accountability focus continues to gather momentum.     

The application of PERT in evaluation of human service programs

In this study a strategy well known to industry. Project Evaluation and Review Technique (PERT), was used to evaluate the community placement procedures in one institution for retarded. Case file review of two samples of residents was used to develop PERT networks showing movements between various living and vocational training settings. Analysis of these networks provided data and pinpointed needed procedural changes to meet the placement objective. The large number of recommendations derived from PERT and supplemental data provided evidence that PERT can be a valuable evaluation package component in institutions for the retarded. Evaluation applications in other human service systems were suggested.     

Risk,Recovery and Capacity: Competing or Complementary Approaches to Mental Health Social Work

Mental health social workers have a central role in providing support to people with mental health problems and in the use of coercion aimed at dealing with risk. Mental health services have traditionally focused on monitoring symptoms and ascertaining the risks people may present to themselves or others. This well-intentioned but negative focus on deficits has contributed to stigma, discrimination, and exclusion experienced by service users. Emerging understandings of risk also suggest that our inability to accurately predict the future makes risk a problematic foundation for compulsory intervention. Therefore it is argued that alternative approaches are needed to make issues of power and inequality transparent. This article focuses on two areas of practice: the use of recovery-based approaches, which promote supported decision-making and inclusion; and the assessment of a person's ability to make decisions, their mental capacity, as a less discriminatory gateway criterion than risk for compulsory intervention.     

Mental health program evaluation: Where you start?

Seduced by the elegance, sophistication and jargon characteristic of new developments in applied research, practicing evaluators are in danger of becoming distracted from achievement of their evaluative goal: that of providing timely, reliable and useful data to program management to facilitate rational data-based decision-making. To avoid such seduction, the author advocates adaptation of simple, inexpensive and efficient evaluative methods tailored to organizational needs and presentation of findings in language readily understood by constituent groups. Likewise, insistance by evaluators upon maintenance of a strict role boundary — that is, limiting role functioning exclusively to those tasks considered evaluation — may be dysfunctional. Rather than detract from accomplishment of his goals, the author maintains that such participation allows development of skills, insights and staff relationships which enhance the evaluator's effective functioning within the organizational context and contribute to organizational acceptance and use of his evaluative results.     

Quality of life assessment and drug abuse treatment program evaluation

Quality of life assessment is used as an outcome measure technique to evaluate a central medical intake (CMI) unit for drug treatment programs. While significant improvements across time are evident in both perceived well-being and in the standard federal funding criteria, no differences are observed between those referred into treatment by the CMI and those entering directly. Moreover, the improvements observed are the same regardless of whether the patient stayed in treatment or not.     

A case study in defining developmental costs for quality assurance in mental health center programs

Issues related to the state-of-the-art of ambulatory mental health care review as well as to the resources necessary for planning and operating a quality assurance program may be hampering development of such programs in community mental health centers nationwide. Faced with the problem of responsible and prudent program management, it has become increasingly difficult for CMHC directors to implement innovative, but unproven, and often unpriced programs which have the potential to draw scarce professional resources away from direct service delivery. Pressure to implement CMHC program requirements that are not ordinarily considered revenue-producing in nature, for example, consultation and education services and quality assurance activities, may further create anxiety for mental health program directors, especially during periods when they are ostensibly confronted with the need to maximize CMHC revenues. Before mental health professionals and administrators of mental health programs can be expected to introduce quality assurance programs, they need to have some idea how much the system costs. The figures reported from three North Carolina mental health centers may offer some indication of what other mental health centers might expect to spend in developing a quality assurance program. Salary expenses for multidisciplinary staff participation in quality assurance activities are presented.     

The impact of citizen evaluation review on community mental health center programs

A field study of techniques for involving local citizens in the evaluation of Community Mental Health Center (CMHC) services shows that lay citizens can make recommendations that service agencies will use to improve services. Seventeen citizen groups received evaluation information from participating CMHCs and developed 310 recommendations. Seventy-one percent of these suggestions were used by the CMHCs. Staff and governing board attitudes, fiscal pressures, and other organizational characteristics affected the success of the citizen groups.     

Employee counseling services evaluation system: design, issues and conclusions

Employee Counseling Services (ECS) programs have emerged as an effective method for dealing with employees whose job performance has deteriorated due to personal problems such as alcoholism or drug abuse. It is estimated that 18% of any work force is effected by such problems at any given time and that these employees cost industry billions of dollars annually in lost productivity, abuse of sick leave, etc. One of the critical concerns of this emerging field is the need for comprehensive evaluation that can demonstrate the cost-effectiveness and cost-benefits of ECS programs. This paper will describe the model Federal ECS developed at the U.S. Department of Health and Human Services as well as the components of the evaluation system designed to determine its effectiveness. The system is the first of its kind and will be a valuable contribution to the field. The paper then raises issues and develops conclusions about designing such an evaluation within the context of a large bureaucracy.     

Evaluating sociodemographic data: implications for program planning and development

Sociodemographic data can have broad implications for program planning and development. Yet, such data are often obtained and analyzed in a non-rigorous methodological fashion. Four of these methodological issues are discussed in this paper. Their relevance for program planning and development are clarified, using examples from the utilization, needs assessment, illness behavior, and social functioning literature.     

Learning from Mental Health Lived Experience and the Influence on Students’ Practice

This study explored how learning from mental health lived experience influenced Australian social work students’ practice during their first fieldwork placement. Involvement of mental health consumers in social work education is gaining momentum, yet little is known about how this type of learning informs students’ practice. Ten social work students participated in semistructured interviews and one focus group. Findings suggest that learning from lived experience promoted social work practice that honoured the expertise of mental health consumers and privileged personal recovery. Factors such as organisational culture and supervisor attitudes were found to mediate the students’ attempts to privilege lived experience.     

高校困难群体心理状况调查

贫困生作为高校中普遍存在的一个群体,已经成为高校工作的一个重要方面。但实践中存在着片面地注重对贫困生的经济帮助,较少关注其真实的心理境况的问题。研究试图从心理学、社会学、教育学等多角度入手,分析研究高校贫困生的心理状况,从深层次上挖掘内因,比如,大学生群体中,男生和女生谁更在意经济状况？谁更敏感？遇到问题时谁更容易选择极端的方案？来自于城市、郊区和乡村这三类不同生源地的大学生存在哪些差异与特性？经济困难学生有哪些健康的特质或潜在的危机？目前的经济状况会不会影响大学生的人生选择？经济困难的学生愿意选择什么样的资助方式？以期通过将高校的帮困助学和人文关怀以及心理干预相结合的方式．有针对性地帮助他们,使贫困群体渡过经济和心理的多重难关,健康成长。     

Ethical problems in program evaluation: Advice for trapped evaluators

This paper argues that ethical problems in program evaluation are increased when conflicting or incompatible evaluation models are applied concurrently. Three models are illustrated: an Amelioration Model, generating better information for a program's own decision makers; an Accountability Model, focusing on public data disclosure and citizen participation in evaluation; and an Advocacy Model, in which the evaluation is designed to advance the program's interests in the competition for resources. Ethical problems inherent in each model, and arising from combining models are presented, along with case examples and discussion. The authors suggest several directions that program evaluators can consider to reduce their vulnerability to ethical problems.     

Attitudes of mental health professionals about changing ages of legal majority

Questionnaires were sent to mental health professionals surveying their attitudes toward legal age limits which govern the rights of the young to make decisions for themselves. Inquiries were also made about respondents' opinions of the impact that increasing those rights might have on their professional interactions with young people. Responses were received from 69 predominantly young professionals and reflected a fairly libertarian outlook toward the rights of minors. Discussion emphasized the value of consulting with mental health professionals who work with children when shaping and interpreting new standards of autonomous decision making.     

Staff burnout from a social perspective

Physical distress, emotional distress, and cognitive fatigue are common symptons of burnout. The consequences of burnout affect the effectiveness of the care giver, the client, and the agency employing the burned out worker. The authors emphasize the societal context in which we all work and the changes in this context that have led to changes in the attitudes, behaviors, and roles of care givers and recipients. The change of role perception and the role behavior has occurred in a wide variety of public agencies. The authors suggest establishing agency guidelines for personal and system limitations concerning assistance to clients. Care givers can also work on an individual basis with clients and outline limits of assistance. As more people seek assistance when resources are limited, the need to build realistic expectations for the care giver, client, and agencies increase.