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.     

Responsive engagement in mental health services for foster youth transitioning to adulthood

ABSTRACT

As youth near the transition to adulthood and aging out of the foster care system, exposure to stress increases, especially for youth who have less-than-adequate support systems. Although mental health problems among foster youth often continue into adulthood, service use decreases dramatically within a year of turning age 18. Understanding how foster youth experience mental health services as they transition from care provides social workers and other mental health professionals important insight that can lead to specific, targetable strategies. This study sought to explore what situations were helpful in supporting mental health as foster youth transitioned to adulthood. Focus groups and interviews with former foster youth and professionals informed the development of a quantitative instrument, which was used to identify the most supportive and frequently encountered situations former foster youth experienced. Findings indicate the most helpful situations were those in which professionals and mentors were flexible and responsive to their individual needs and trusted their ability to make decisions. Supportive adults who honored their choices and collaborated in decision-making were also helpful. Engaging, empowering, and partnering with transition-age youth may increase the likelihood of positive mental health outcomes for this population, offering implications for family-centered, strengths-based practice.     

儿童游戏辅导与心理健康教育

儿童游戏辅导是处理青少年学生,尤其是小学生情绪困扰等心理问题的最适当的辅导和治疗模式.本文从儿童游戏、游戏辅导的概念入手,对如何利用游戏辅导对小学生进行心理健康教育进行了探讨.     

A Mexico City-based immersion education program: training mental health clinicians for practice with Latino communities

This article describes the philosophical foundations and educational methods of a Spanish language and cultural immersion program based in Mexico City, Mexico. The program is designed to assist U.S. graduate students in marriage and family therapy and clinical psychology programs to improve clinical service delivery with Latino clients. Utilizing critical pedagogy, the program works with future clinicians to develop multicultural and international competencies; acquire increased Spanish language skills; engage in self-of-the-therapist work; and expand their understanding of the historical and cultural influences shaping the mental healthcare needs of Latin American clients. A report of the themes from postimmersion surveys is provided and the implications for training are discussed.     

Interprofessional education for community mental health: Attitudes to community care and professional stereotypes

Social workers are considered key members of community mental health teams, yet difficulties in interprofessional collaboration between social workers and health care professionals, particularly psychiatrists and nurses, have been reported. This paper examines some sources of these difficulties in terms of perceived differences in models of mental illness, attitudes and values, including stereotyping, professional identification and role clarity. Interprofessional education (IPE) may diminish negative stereotypes and promote multidisciplinary teamwork. A theoretical framework is described and findings from the evaluation of a 1-year programme of interprofessional education for community mental health are presented. These findings suggest that attitudes and values concerning community care for people with mental health problems are largely shared by different professions, but they do confirm the existence of interprofessional stereotypes and of perceived status differences. In contrast to previous research, there was no evidence of changes in stereotypes. These findings are discussed in terms of the theoretical framework and the design of the programme.     

The impact of a health education intervention on health behaviors and mental health among Chinese college students

Abstract

Objective: This study aimed to assess the impact of a health education intervention on health behaviors, self-efficacy, and well-being among college students. Participants: Between March and October 2016, a total of 532 undergraduates participated. Methods: A theory-based intervention was conducted at Wuhan University, China. Participants were assigned to a control or intervention group (IG). The IG attended a 7-week health education class on knowledge, attitude, and practice of health behaviors. Results: Participants in the IG, compared with those in the control group (CG), reported significantly increased prevalence of high physical activity and regular breakfast, as well as lower screen time, sugar beverage intake, and Internet addiction tendency. Furthermore, intervention students improved in health behavior scores (p?=?0.040), compared with the CG, while the changes in subjective well-being and self-efficacy remained similar between the two groups. Conclusions: Health education may promote health behaviors among Chinese college students.     

Community mental health and mass media preventive education: the alternatives project.

An innovative mental health preventive education and public information program employing mass media was conducted in the Louisville, Kentucky, metropolitan area. Social work and mental health concepts of prevention were applied as a framework for developing project goals. Systematic evaluation, based on data from client-initiated telephone contacts and surveys of the community, demonstrated project success in increasing awareness and utilization of community mental health resources. The overall impact on assessment attitudes was positive; changes in resolution attitudes were not statistically significant. Implications for mass media utilization in mental health prevention are discussed.     

Examining the link between program implementation and behavior outcomes in the lifestyle education for activity program (LEAP)

Lifestyle Education for Activity Program (LEAP) was a comprehensive, school-based intervention designed to promote physical activity in high school girls. The intervention focused on changes in instructional practices and the school environment to affect personal, social, and environmental factors related to physical activity. Multiple process evaluation tools and an organizational assessment tool were developed to monitor program implementation from a framework called the LEAP essential elements, which characterized complete and acceptable intervention delivery; secular trends were also monitored. Using process data, LEAP intervention schools were categorized into low- and high-implementing groups and compared with control schools on nine essential elements assessed at the organizational level. The Wilcoxon scores test revealed that low- and high-implementing intervention, and control schools differed significantly on two of nine administrator-reported organizational-level components: having a physical activity team and having a faculty-staff health promotion program. A mixed-model analysis of covariance indicated that, compared to control schools, a greater percentage of girls in high-implementing schools reported engaging in vigorous physical activity. Process evaluation can be used to understand the relationship between level of implementation and successful program outcome.     

The mental health of young people aging out of care and entering adulthood: Exploring the evidence from England and France

This paper explores the research evidence from England and France on the mental health of young people aging out of care and into adulthood. It represents the first comparative review based on the evidence from these two countries. Set in the legal, policy and service framework for both countries, it reviews evidence on the mental health of young people in the general population, young people living in care, young people aging out of care, and young adults. It shows: the high levels of psychological adversity of young people entering care; the high rates of mental health problems of young people in care compared with the general population of young people; the increased risk of mental and physical problems at the time of aging out of care, and the general improvement in longer-term outcomes for young adults, although some continue to have serious mental health problems. In conclusion, it suggests that interventions across the life course of young people are needed.     

Perceived barriers to mental health treatment among men enrolled in a responsible fatherhood program

ABSTRACT

Low-income men may experience elevated risk for mental health concerns and be less likely to seek treatment; this may be due in part to perceived barriers to accessing and receiving treatment. Men who enrolled in a community based responsible fatherhood program self-identified their health and mental health conditions. Although participants reported serious health conditions at rates consistent with the general population, we found higher than expected rates of depression, anxiety, or other mental health conditions and explored perceived barriers to mental health treatment among this sample. Findings suggest that low income men face a variety of perceived psychosocial and structural barriers impacting access to and compliance with mental health treatment.     

Issues in mental health care benefits: the costs of mental health parity

This Issue Brief discusses issues in mental health care benefits. It describes the current state of employment-based mental health benefits and discusses studies and issues regarding full mental health parity. It also includes an analysis of the effect of full mental parity on the uninsured population and the effects of the limited mental health parity provision contained in the VA-HUD appropriations bill. The final section discusses the implications of mental health parity for health plans and health insurers. When employers began to provide health insurance benefits to their employees and their families, they extended coverage to include mental health benefits under the same terms as other health care services. Many employers continued to add mental health benefits through the 1970s and early 1980s until cost pressures required employers to re-examine all health care benefits that were offered. They quickly found that, while only a small proportion of the beneficiaries used mental health care services, the costs associated with this care were very high. As a result, employers placed limits on mental health benefits in an attempt to make the insurance risk more manageable. The general strategies employers have used to manage their health care costs are cost sharing, utilization review, managed care, and the packaging of provider services. Employers' cost management strategies may be restricted, however. Five states have mental health parity laws, but three of the states--Rhode Island, Maine, and New Hampshire--apply these laws only to the seriously mentally ill. In addition, 31 states mandate that mental health benefits be provided. However, state mandates apply only to insured plans, not to self-insured employer plans, which are exempt from state regulation of health plans under the Employee Retirement Income Security Act of 1974 (ERISA). A number of recent studies have examined the effect of mental health parity on health insurance premiums in a "typical" preferred provider organization and on the uninsured. In general, the studies concluded that mental health parity could increase health insurance premiums, decrease health insurance coverage for non-mental health related illnesses, and increase the number of uninsured individuals. All studies of mental health parity, and mandated benefits in general, assume that there is a strong likelihood that increased health benefit costs would be passed along to workers in the form of higher cost sharing for health insurance, lower wage growth, or lower growth in other employee benefits.     

HIV among people with mental illness: contributing factors, prevention needs, barriers, and strategies

1. Findings suggest that PWMI, including those with serious mental illness, are sexually active although some individuals, including mental health professionals, perceive them to be asexual or not sexually active. 2. PWMI may be particularly susceptible to HIV risk-related behaviors due to poor judgment, limited impulse control, deficits in problem-solving skills, and suicidal intent and self-destructive behavior. 3. Nurses, due to their close interaction with PWMI, are in key positions to document HIV risk-related behaviors and to advocate for integrating HIV risk reduction strategies into the therapeutic milieu.     

Dissemination and implementation science in program evaluation: A telemental health clinical consultation case example

Increased attention has been placed on evaluating the extent to which clinical programs that support the behavioral health needs of youth have effective processes and result in improved patient outcomes. Several theoretical frameworks from dissemination and implementation (D&I) science have been put forth to guide the evaluation of behavioral health program implemented in the context of real-world settings. Although a strong rationale for the integration of D&I science in program evaluation exists, few examples exist available to guide the evaluator in integrating D&I science in the planning and execution of evaluation activities.This paper seeks to inform program evaluation efforts by outlining two D&I frameworks and describing their integration in program evaluation design. Specifically, this paper seeks to support evaluation efforts by illustrating the use of these frameworks via a case example of a telemental health consultation program in pediatric primary care designed to improve access to behavioral health care for children and adolescents in rural settings. Lessons learned from this effort, as well as recommendations regarding the future evaluation of programs using D&I science to support behavioral health care in community-based settings are discussed.     

Expanding evaluator competency research: Exploring competencies for program evaluation using the context of non-formal education

The overlap of competencies between general program evaluation and specific contexts or content will always be reality because evaluators may need unique competencies to answer evaluation questions for particular contexts or content areas. Limited research exists that explores the essential competencies required by professionals who use evaluation as one part of their job portfolio, which leaves unanswered questions regarding the applicability of current evaluator competency models in such settings. We used a modified three-round Delphi technique to identify evaluator competencies for non-formal educators in Cooperative Extension (CE). Our panelists identified 36 competencies in the non-formal educational programming context for CE educators that they considered important to be included in evaluation capacity building efforts. We categorized our 36 identified competencies from the Delphi study into the five competency domains proposed by the American Evaluation Association. Our findings provide information to help guide professional development among non-formal educators related to program evaluation.     

The state and my happiness: Youth mental health,citizenship education and discursive contestations in contemporary Indonesia

Complementing studies on youth mental health that were mainly depoliticised, this article offers a discursive examination of youth mental health in an Indonesian educational context. We argue that subject positions enabled by the discourse of mental health were at odds with dominant constructions of an ideal Indonesian citizen. Drawing upon qualitative data from 22 teachers and 20 students in a junior high school in Indonesia and analyses of educational policies and textbooks, we identified three discourses underpinning the ideal(ised) constructions of young Indonesian citizen, namely, neoliberalism, (masculine) patriotism and (religious) moralism and discussed how these inhibited youth mental health.     

The mental health of the never-married

Although the interaction between mental health and marital status has been the object of much social scientific research, little is known about the mental health of never-married people. This article reviews research relevant to mental health and marital status as it pertains to never-marrieds. Methodological problems and current gaps in such research are pointed out. The mental health of never-marrieds is examined from three popular models of mental health—the social protection, social reaction, and social selection models. Each model offers competing explanations for differences in rates between married and unmarried people and between unmarried men and women. Suggestions are offered for improvement in researching the mental health of this neglected group.