College Men's Health in Practice: A Multidisciplinary Approach

Abstract

After a needs assessment indicated that male students underutilized campus health services, the San Francisco State University Student Health Service developed a coordinated complement of outpatient health services for men. The authors review their experience in developing, implementing, operating, and evaluating this ongoing clinical service. The needs assessment and subsequent program evaluation data suggest that male students on a large, culturally diverse, urban campus would respond favorably to targeted, multidisciplinary health initiatives that incorporate the principles of health promotion and disease prevention.     

Trauma Screening in Students Attending a Medical University

Abstract

Clinicians seldom assess trauma history in patients who seek treatment for psychological problems, yet trauma exposure is often related to psychological distress. Assessing trauma history can provide valuable information for treatment conceptualization and provision, although patients may not spontaneously share their histories because of embarrassment, avoidance, or other concerns. The authors compared 73 students at a southeastern US medical university who sought counseling and psychological services and completed intake paperwork without a trauma screen with 130 students whose intake procedures included trauma screening. They found that (a) patients who were specifically asked about trauma history were more likely to report such events, (b) previous physical assaults with a weapon were related to current psychological distress, and (c) physical assaults with or without a weapon were related to clinically significant psychological distress. These findings suggest that screening for lifetime trauma history should be a standard part of mental health screenings in similar medical university counseling centers.     

Cost of Including Males in a University Rubella Immunization Program: A Recommendation to Change a Discriminatory Policy

Abstract

Twenty-seven University of Rochester students developed clinical manifestations of rubella during 1976–77. Twenty-five were male and had not been immunized against this disease; 18 required infirmary care costing $4,876. On the basis of data for freshman males, a cost analysis demonstrates the feasibility of changing the university policy which encourages immunization only of females to encouragement of either selective or mass immunization of all males as well. Immunization during childhood with combined MMR vaccine is least expensive and should be encouraged. In certain circumstances, selective immunization of susceptible males may be less expensive than the present selective policy, which leaves males at risk.     

Kidney-transplanted children and their families: A social worker's experience

Abstract

This paper describes approaches to the problems of families with children who undergo kidney transplanation and the emotional stess experienced at different phases of assessment and treatment.

Thirty-seven families were studied. The author describes family-oriented interviews in preparation for transplantation, supportive conferences, counselling and other forms of socioeconomic support.

Previous literature shows that where the family has been given sufficient time for emotional preparation and adaptation mere are fewer problems. I have compiled information given by the patients after transplantation concerning social contact, isolation, school problems, dependency, emancipation, growth inhibition, and discrepancy between physical and psychological development. These problems seem to be most pronounced around secondary school-age/puberty.     

Alcohol-Related Problems Seen at the Student Health Services

Abstract

The number and types of alcohol-related problems seen by medical, nursing, and mental health professionals at the University of Massachusetts Health Services has been assessed since 1975 as part of a Demonstration Alcohol Education Project.

Medical outpatient clinic alcohol-related contacts using encounter forms completed on every outpatient visit during 1975 and 1976 revealed that 0.08% of approximately 92,500 visits annually were alcohol related, including 0.03% for chronic problems and 0.05% for acute problems (mainly contusions, lacerations, and fractures). Week-long contact surveys conducted in November 1976, and April 1977 recorded a much higher proportion of alcohol-related problems for over 60% of about 2,200 contacts each week. In November 1976, 1.4% of 1,346 reported visits were alcohol related, including 8.0% of contacts which occurred on weekends. In April 1977 2.7% of 1,582 reported visits were alcohol related, including 17.0% of weekend visits. No chronic alcohol problems were reported either week, and most of the acute problems involved traumatic injuries, such as contusions, lacerations, and sprains.

Mental health outpatient clinic alcohol-related contacts self-reported by students at the initial visit revealed that 5.8% of 1,179 initial visits between January 1976, and June 1977 were alcohol related, most involving their own alcohol use. Week-long contact surveys involving all 256 contacts during November 1976 and 192 contacts during April 1977 showed that 13.7% of contacts were for alcohol-related problems, over half due to alcohol abuse by someone else, such as a parent or boy/girlfriend.

The findings suggest that a significant proportion of students seen by student health services have acute rather than chronic alcohol-related problems, especially acute traumatic injuries and relationship problems.     

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.     

Understanding engagement in the Program of Assertive Community Treatment (PACT) from the perspectives of individuals receiving treatment

ABSTRACT

Engagement of individuals with serious mental illnesses in community mental health services is a significant challenge. The Program of Assertive Community Treatment (PACT) is an individual-centered and self-contained mental health program that provides psychiatric treatment, rehabilitation, and support services to persons with serious mental illness who have a history of or likelihood of disengagement with services. Understanding what helps and hinders consumers’ involvement in PACT services may provide information on how to tailor engagement strategies to individuals based on their treatment needs and preferences. The current study builds on existing studies by exploring factors that help and hinder engagement in PACT services from the perspectives of individuals receiving treatment. We conducted open-ended, semi-structured interviews with 17 individuals receiving PACT services. Nine themes were identified through thematic analysis: Desirable qualities of PACT, Focusing on positive outcomes, PACT as a safety net, Recovery orientation, Practical barriers, Conflictual relationships, and Medication side-effects. We conclude that the development of a trusting, therapeutic relationship that is collaborative and person-centered and that is facilitated by both practical and emotional support is critical to engaging individuals in treatment and maximizing positive outcomes.     

Identified Problems and Service Utilization Patterns Among Kinship Families Accessing Mental Health Services

Abstract

This study examined the mental health problems and service utilization patterns of kinship families who accessed services in an urban outpatient child psychiatry clinic. A random sample of children who completed the intake process during a calendar year yielded 47 children, or 19% of the sample, whose primary caregiver was a relative, other than a biological parent; approximately half of those families were involved with the child welfare system. Data from an administrative database and from medical records describe the diagnoses, identified problems, and services used by the kinship families. Academic or school-related problems emerged as an identified problem in approximately half of the kinship cases, but school intervention was not a primary target for clinicians. The kinship sample was also compared with a random stratified sample of children who were living with primary caregivers other than kin. Kinship families were more likely to be African-American, but few differences were found between kin and non-kin cases on diagnoses and frequency, duration, or type of services received. The findings suggest that collaboration with schools might increase the engagement and retention of kinship families in mental health services.     

Evaluating a Health Risk Reduction Program

Abstract

Within the context of movement toward a preventive health model, Bowling Green State University has implemented a health risk reduction program. This is comprised of three components: 1) Database Acquisition For Student Health (DASH), 2) peer health education, and 3) intervention programs in weight control, exercise, and smoking cessation. In the present study, freshmen who had completed a DASH health questionnaire prior to entering the university, were assigned to one of three treatment groups: 1) DASH information was discussed with a peer health educator and then distributed to the student; 2) DASH results were sent through the mail; 3) DASH results were temporarily withheld (no-feedback control group). It was hypothesized that the most effective means of feedback would be by the peer health education program. Pre-post change in students' health attitudes, health locus of control expectancies, and perceived value of health was not systematically related to the different methods of feedback. Based on these results and low enrollment in the three intervention programs, the original hypothesis was not supported. Results were interpreted in the context of possible program failure and in terms of low reliability of the measures utilized, ceiling effects, and sample characteristics. Recommendations for the future delivery of services for the health risk reduction program were proposed.     

Quality Assessment Study of Brief Psychotherapy at a University HMO Setting

Abstract

This paper describes the results of a short-term psychotherapy (four to fifteen sessions) quality assessment study conducted at the University of Massachusetts Mental Health Service. The outcome measures devised and the process of their administration are described. The positive outcome results of this study are encouraging and supportive of the impression that high quality brief psychotherapy can be provided at university counseling services. Student and health maintenance organization (HMO) member consumer evaluation opinions were positive and their utilization of services was found to be psychologically sophisticated and appropriate. A frequency table lists the most common presenting problems of this population. Practical modifications are suggested for future quality assessment research of brief psychotherapy.     

The Shift of Employee Welfare

ABSTRACT

Arizona State University has accepted a preventive framework for its multi-purpose Employee Assistance Program, and is partnering with local service providers to ensure that these services are relevant and of high quality.     

Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting

Abstract

Patient satisfaction with health care services is an important factor in health care delivery. It will significantly influence whether or not a patient seeks medical care, complies with prescribed treatment, and/or maintains a continuing relationship with a medical practitioner.

A survey questionnaire, relating patient satisfaction with a number of variables identified through a literature review, was mailed to a random sample of 500 students utilizing Student Health Service (SHS) at Kent State University (KSU) during the five week study period. The data obtained would be utilized to help with planning future health care services and staff inservice education programs.

The findings of this survey indicate that patient satisfaction has a statistically significant correlation with perceived technical competence of the practitioner and perceived adequacy of the interpersonal aspects of the practitioner-patient relationship. A significant relationship did not exist between satisfaction and expectations the patient holds of the practitioner's role performance. A statistically significant relationship was found to exist between receiving health information/education related to diagnosis, prognosis, and treatment plan and satisfaction with health care services. This relationship did not hold for health information/education related to activity restrictions or preventive measures. The study also revealed that time waited during the medical care encounter was inversely related to satisfaction. Last, stepwise regression found that perceived technical competence of the practitioner was the most important variable influencing patient satisfaction with health care services.

This study provides data about factors important to personal satisfaction with health care services for a selected group of college students.     

Children of Substance Abusing Women on Federal Welfare

SUMMARY

The present study sought to characterize well-being indicators for a sample of children of substance dependent TANF women. Participants were 372 mothers meeting DSM-IV criteria for substance dependence and 156 non-substance abusing women from two urban counties in New Jersey. Children of substance dependent TANF mothers experienced significant vulnerabilities, as demonstrated by higher levels of contextual risk factors and negative behavioral and emotional and school outcomes. Overall, these rates were about double those found in children of non-substance abusing mothers. Results highlight the need for multi-systemic services to address the problems experienced by substance abusing TANF women and their children.     

Family use of community services in economically stressed rural counties

This study focuses on stresses, coping strategies, and satisfactions of respondents in eight economically distressed rural counties in the state of Washington. An adult sample is divided into two groups: those who indicate specific economic problems and/or are unemployed (n=236) and those who are still employed and do not report specific economic stresses (n=190). Although those with specific economic problems show higher levels of perceived stress and financial dissatisfaction, there are no differences reported in over-all family satisfaction. Results point to the importance of providing specific employment-related community services to family members in these types of communities.Dorothy Z. Price, Ph.D. is a Professor in the Department of Child and Family Studies, Washington State University, Pullman WA 99164-2010. Her research interests include decision making and consumer behavior. She received her Ph.D. from Michigan State University.Lonnie J. Dunlap, M.A., is a Graduate Research Assistant in the Interdisciplinary Ph.D. Program, Washington State University, Pullman, WA 99164-2010. Her research interests include work and family interactions and career development.     

Depressed College Students and Tricyclic Antldepressant Therapy

Abstract

Charts of all outpatients (n = 267) seen during three consecutive months of 1977 by a university student mental health clinic were retrospectively reviewed for reports of depression. Over one-fourth of university students (n = 76) seen during this period were noted to present with significant symptoms and signs of depression. Charts of depressed patients were further analyzed for distribution by final diagnostic category, demographic data, and treatment outcome results. The majority of depressed patients were diagnosed as depressive neurosis while the second most common diagnosis was adjustment reaction. A significant proportion of patients with a final diagnosis of depressive neurosis had initially been diagnosed as adjustment reaction. Vegetative signs of depression were Infrequently noted In patients with adjustment reaction. These patients were usually treated with psychotherapy alone and showed symptomatic Improvement in one-half of cases. Vegetative signs, especially sleep disturbance, were noted in one-half of patients with depressive neurosis. These patients were often treated with tricyclic antidepressants plus psychotherapy, which resulted in significantly greater Improvement in both dysphoria and vegetative signs than treatment with psychotherapy only. Treatment outcomes for depressed patients thought to have concomitant character disorders were uniformly poor.

Thus, depressed college students In the present study represented several distinct diagnostic groups, of which patients with depressive neurosis showed optimal treatment outcomes following tricyclic antidepressant therapy.     

The Role of Technology in Mediating Use of Outpatient Substance Abuse Treatment Services

ABSTRACT

This study examined the relationship between Connect, a telephone-based information and support system, and the use of outpatient substance abuse treatment services. Regression models were formulated to examine the relationship between use of substance abuse treatment services and Connect. The results indicate that Connect use was not significantly related to the likelihood of using treatment (N = 240). However, an inverse relationship was found between Connect and use of treatment services (n = 123). The findings raise the conceptual issue of whether one introduces technology as an “add-on” to or as a “substitute for” traditional substance abuse treatment services.     

What do urban college students really think about health insurance? A qualitative study

Abstract

Objective: To determine barriers and opportunities to health insurance enrollment among an undergraduate students at a large urban university. Participants: Participants were 31 college students enrolled in 4-year and community colleges in the City University of New York (CUNY), and six health services and insurance enrollment specialists who facilitate and assist in the health insurance enrollment process for CUNY students. Methods: Focus groups were conducted with students and in-depth interviews with key informants in May 2017. Results: The research revealed important insights into how students perceive and value insurance and yielded recommendations for the university to improve enrollment of its students. Conclusions: Many colleges can increase student enrollment in health insurance by informing and educating students about the process. Improving enrollment processes can increase insurance rates and improve student population health.     

Making activism a participatory,inclusive and developmental process: a research programme involving mental health service users

Abstract

Understanding real-world experiences and issues is a priority for research funders, yet there are challenges in directly engaging with people for evaluation and investigation of the professional services they receive. Much professional work takes place within institutional restrictions, arising from legislation, policy and local practices. Collaborative research is therefore complex but relevant for improving services. This research programme started in 2002 with focus group research, led by occupational therapists based in a local National Health Service trust and a university, followed by eight further projects including a Photovoice project. This programme and our perspectives from reflections suggest we do not always know who we are, what we want or who cares about research outcomes, but it is important to embrace the potential of activism, to energise and focus people for positive action, wherever they are based.     

The utilization of child care by households engaged in home-based employment

A logit procedure is used to examine the factors associated with the likelihood of using child care services among a sample of households with both a home-based worker and a child designated as needing care. Being a single-parent, having high family income, and the presence of a two-year old child are positively associated with the likelihood of using child care. Being an older worker, having a child who is one year or less or children who are 11 to 12 years, and having a less professional occupation decreases the likelihood of using child care. Self-employment decreases the likelihood of usage; owning a business that hires employees or services increases the likelihood of usage. The major conclusion is that home-based work may be a coping strategy for some child care needs, but home-based working households often need and use child care.This article reports results from the Cooperative Regional Research Project, NE-167, entitled, At-Home Income Generation: Impact on Management, Productivity and Stability in Rural/Urban Families, partially supported by the Cooperative States Research Service, U. S. Department of Agriculture and the Experiment Stations at the University of Hawaii, Iowa State University, Lincoln University (Missouri), Michigan State University, Cornell University (New York), The Ohio State University, The Pennsylvania State University, Utah State University, and the University of Vermont. Authors are listed in descending order of their contributions to this research paper. Appreciation is expressed to Frank Chiang for the computer assistance needed to complete these analyses. Patsy Sellen was instrumental in formatting and stylizing this article to required guidelines.Her current research interests include household asset and debt formation, working families and employers' benefits, and home-based employment. She received her Ph.D. from Purdue University in 1978.Nancy C. Saltford, has recently been a Visiting Scholar at the Employee Benefit Research Institute, a public policy research organization in Washington D.C. where she specialized in employer policies for working families. Her Ph.D. was received from Purdue University in 1971.Her research interests include the economics of divorce and at-home income generation. She received her Ph.D. from Oregon State University in 1986.Her primary areas of research are rural families, household production, family time use and its meaning, and the interactive aspects of managerial, productive and affective functions of families. She received her Ph.D. from the University of Missouri-Columbia in 1983.