Artifact in client satisfaction assessment: experience in community mental health settings

Artifact in client satisfaction assessment is discussed and the results of a study of three factors thought to mediate client satisfaction ratings; (a) general life satisfaction, (b) mode of administration, and (c) psychological symptomatology, are reported. A standard client satisfaction questionnaire (CSQ) was modified to yield parallel forms and was administered orally and in writing to 92 clients in two mental health day treatment programs. Satisfaction ratings obtained from these clients were quite similar to out-patient ratings obtained in previous studies conducted in this setting and using the same measures. Oral administration of the CSQ produced 10% higher satisfaction ratings than written administration (p less than .05) and less missing data (p less than .01). Satisfaction ratings were also obtained using a simple graphic instrument. Graphic ratings were comparable to CSQ ratings. Satisfaction with life in general and level of psychiatric symptoms together accounted for 25% of CSQ variance. The implication of these findings for future client satisfaction research is discussed.     

A gender-informed model to train community health workers in maternal mental health

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers.     

Psychodynamics and empowerment in community mental health

Abstract

This paper examines the relationship between empowerment philosophy and psychodynamic principles and practices, as it applies to community mental health work. It suggests that as empowerment philosophy is more a system of values than a model of mental health and illness, it cannot in itself act as a framework for understanding and working with disturbed people. I suggest ways of disentangling the often fraught relationship between the two frameworks by identifying the contribution I see each as able to make to the task of providing services which sustain people in the community, and attempt to articulate the elements of a practice model consistent with both sets of principles.     

The validity of assessing mental health needs with social indicators.

Selection of the appropriate number and types of social indicators for use in mental health planning has been a perennial problem. Social indicators have been associated with several concepts (quality of life, community disorganization, populations at risk) of varying relevance for planning mental health services, and abstracting social indicators from these conceptual domains poses a variety of validity issues. The issues are discussed, and the viability of social indicators in mental health planning is reexamined.     

HIV/AIDS among youth: A community needs assessment study

Adolescents remain at great risk for HIV transmission and contracting AIDS. Health education, preventive methods, and direct clinical intervention represent major strategies in combating this disease. In order to help increase the effectiveness of these activities, University faculty and a county health agency collaborated to conducted an extensive HIV/AIDS needs assessment of adolescents. The survey included high school, middle school, and community youth (N=1567). Results showed a relatively high level of knowledge about HIV/AIDS, yet participation in risk behavior which did not correlate with knowledge. Data suggested that parents and school were important sources of information about HIV/AIDS. Implications for social work practice and policy are discussed.The research was funded by the U.S. Conference of Mayors and done in collaboration with the Lucas County Health Department, Toledo, Ohio.     

Meeting the mental health needs of elderly clients

1. Older individuals in both community and institutional settings have traditionally underused mental health services. Providers of such care devote a minimum of their professional time to those over 65 years of age. 2. Ageism and difficulty with diagnosis are the most frequent explanations for inadequate mental health care to the elderly. This study found that lack of referrals and failure of the aged to seek services partially accounted for underuse. 3. Legislative changes mandating that aged persons be screened for and receive appropriate mental health services will increase the demand for qualified providers. 4. Nursing's approach to care of the older adult, which focuses on both physiological and psychological needs, can facilitate the delivery of comprehensive effective mental health interventions in and out of the institutional setting.     

A nurse's guide to mental health assessment reference sources

1. As the research base on psychological testing has proliferated across various disciplines, a comprehensive review of the testing literature is recommended. 2. In researching literature on psychological tests, nurses need to rely on traditional print as well as electronic databases and Internet sites. 3. In reviewing test items or in using a test, nurses need to be aware of test-user qualifications and publisher copyright restrictions.     

A principles-focused evaluation of community mental health short-term case management

Principles-focused evaluations allow evaluators to appraise each principle that guides an organization or program. This study completed a principles-focused evaluation of a new community mental health intervention called Short Term Case Management (STCM) in Toronto, Canada. STCM is a time limited intervention for clients to address unmet needs and personalized goals over 3 months. Findings showcase that a principles-focused evaluation, assessing whether program principles are guiding, useful, inspiring, developmental and/or evaluable (GUIDE), is a practical formative evaluation approach. Specifically, offering an understanding of a novel intervention, including its key components of assessment and planning, support plan implementation and evaluation and care transitions. Findings also highlight that STCM may work best for those clients ready to participate in achieving their own goals. Future research should explore how best to apply the GUIDE framework to complex interventions, including multiple principles, to increase evaluation feasibility and focus.     

Student mental health needs: survey results and implications for service.

In preparation for planning counseling and mental health services at Columbia University, the authors conducted a mental health needs assessment survey that sampled representative numbers of students. Respondents were most concerned about academic and school-related issues, followed by concerns in the area of love relationships. Multiple regression analysis revealed certain subgroups that were more likely to have these concerns and certain health and mental health problems that were significantly associated with these concerns. The study identified serious psychological problems, including suicidal/homicidal thoughts and sexual abuse, and surveyed respondents' treatment preferences. Finally, the authors discuss how the study findings contributed to sharpening and expanding focus on different aspects of program development in the collaboration between mental health and health education.     

Risk and new exclusions in community mental health practice

Abstract

Over the past two decades, mental health practice has become increasingly focused on assessing and managing the risks posed by service users. British researchers have made significant advances in studying the consequences of risk management for community-based health and welfare services, but in Australia this field remains largely undeveloped. Drawing on my experiences as a social worker in a Melbourne-based Crisis Assessment and Treatment Team from 1991 to 2008, the present paper offers a reflective analysis of the shift in practice orientation that has emerged through the growing prominence of risk as a foundation for intervention. Specifically, I argue that this shift has led to a narrowing of service provision and that “low-risk” clients are newly disadvantaged, often excluded from service.     

Child therapy outcome in a community mental health center

Studies by the Davis Child Therapy Effectiveness Project reveal that brief therapy is the norm. A retrospective outcome study in one mental health center shows a large proportion of adjustment reactions. Outcome ratings from therapists, parents and patients show fairly high levels of outcome and significant improvement in rated impairment. The children who were more impaired at intake were found to have the most visits and numbers of visits were unrelated to success in treatment. Examples are provided illustrating the use of parent responses to modify center practices.     

UPSTREAM! Together evaluation results from community efforts to prevent mental,emotional, and behavioral health problems

Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.     

Mental health needs assessment of children and adolescents

Needs assessment is essential input for program planning. Little data are, however, available about the various approaches and whether strategies for needs assessment are viable. It was found by an inexpensive methodology that opinions about the importance of various services, opinions about the potential acceptance of services, services provided, and the total need for services are interrelated. A hybrid approach that utilized data from teachers and the people that provide mental health services was also a practical means to obtain information about the unmet needs of children and adolescents in the country. Data supported the value of this technique for the assessment of the unmet needs of children and adolescents. Thus, an inexpensive methodology can provide useful information from multiple perspectives.     

The health needs of elders within an intentional community

A small-scale survey was carried out on the health needs of those members of the Findhorn Bay Community, in northeast Scotland, who were over the age of 60. The survey asked questions about their health, quality of life, support received and perceived needs in these areas. The responses of the elders are summarised and discussed. Most of the elders had health conditions which affected their quality of life, yet almost all were satisfied with the support they received and over half with their quality of life. Implications for the links between community, family, work and perceived health were identified. Une recherche a ete faite sur les besoins en sante des personnes ages de plus de 60 ans qui vivent dans la communaute de Findhorn Bay dans le nord est d'Ecosse. Il y avait un questionnaire qui leur demandait des informations sur leur sante, et qualite de vie; il leur etait aussi demande si ils se sentaient suffisamment soutenus et comment ils percevaient les differents besoins de leur vie. Les responses de les personnes sont brievement evoquees et discutees. Les implications concernant les rapports entre communaute, famille, travail et sante furent identifiees. La plupart d'entre eux avait des problemes de sante qui affectaient leur qualite de vie, cependant la majorite etait satisfaite du soutien recu, et plus de la moitie avec leur qualite de vie.     

Community-based behavioral health interventions: Developing strong community partnerships

The popularity of community-based interventions has experienced a revival over the last two decades. The general theme behind this trend is that greater community involvement provides researchers and practitioners with culturally relevant information to make interventions successful. This involvement is usually solicited through the formation of community coalitions and advisory boards. Although the positive influence of community partnerships is well established, strategies for successfully developing and sustaining these partnerships are less clear. To address this gap, this paper presents evaluation findings from The Making Connections Initiative, a national effort emphasizing community-level prevention strategies for improving the mental health of men/boys. Sixteen grantees were tasked with developing a coalition of community organizations to provide input into the development and implementation of a local prevention initiative. An evaluation of the 16 grantees’ planning activities identified four themes related to developing and sustaining successful community partnerships. This article reports on the strategies that were found most successful across grantees. With the increasing popularity of community-based programs, strategies for successfully partnering with local organizations are particularly important. This study adds to the limited research on best practices for forming community partnerships and should serve as a guide for community-based evaluators and program planners.