The Infirmary as a Short-Term Psychiatric Facility

Abstract

The purpose of this study was to describe the role of the Oregon State University Infirmary (inpatient unit) in the provision of crisis intervention services for students with emotional problems. The focus was on the working assumptions of the infirmary program, the patient population which utilized the infirmary, the dimensions of treatment, and treatment outcomes.

Data were collected for a three year span on all patients who had contact with the infirmary for problems of an emotional nature. Records were reviewed for demographic variables, presenting symptomatology, diagnosis, treatment, disposition, and outcomes. Comparisons were made between these patients and those who received outpatient services through the Oregon State University Mental Health Clinic.

Demographic data indicated that patients who were treated in the infirmary differed only slightly from either the general student population of the university or from students receiving outpatient services. Presenting symptoms reflected a wide range of emotional problems. The severity of psychopathology was demonstrated by the finding that one-quarter of the patients manifested symptoms of acute psychosis, suicidal preoccupation, acute drug reaction, or toxic alcohol reaction. Consistent with the working assumptions of the program, the focus of treatment was short-term, intensive, and symptom directed. Treatment outcomes as determined by followup data were generally positive.

It was concluded that the infirmary provided an important treatment option which extended rather than duplicated outpatient services. The need for such an option was clearly demonstrated. The study was supportive of the concept that a university infirmary has the potential for utilization as a multipurpose facility.     

Current and Prior Mental Health Treatment of Jail Inmates: The Use of the Jail as an Alternative Shelter1 2

Changing policies in mental health and welfare are altering the character of urban jail populations. Iiomeless people, many of them ex-mental-hospital patients, occupy jail space in increasing numbers. They almost never commit violent crimes and seldom commit any real crime. They are given a charge and put in jail as a way to take them off the streets. The way in which official statistics are created and kept makes it difficult to demonstrate the nature and extent of this problem. This paper reports on one way this can be done.     

Perceptions of Cousin Marriage Among Young Bedouin Adults in Israel

Abstract

Attitudes of young Bedouin adults (26 men and 23 women) in Israel towards cousin marriage, a traditional marriage pattern in the Bedouin society, were investigated. A Bedouin clan (population 3,400) with a high rate of cousin marriage and consanguinity was targeted for this study. Thirty-seven percent of the respondents expressed unconditional positive attitudes towards cousin marriage, while 22% said that this form of mate selection is inevitable because of the parents. These views represented the persistence of this tradition in Bedouin culture. However, there was also support for change and modernization, reflected in a negative view of parental intervention (8%, all men) as well as in a new predilection for romantic love (22%). A majority (65%) of the respondents held the view that cousin marriage is associated with genetic diseases. However, the biomedical discourse of genetic risk did not change the traditional Bedouin method of mate selection and was rather incorporated into the traditional discourse through a system referred to as “healthy consanguinity” (namely the option of premarital carrier matching). The paper concludes by considering the persistence of consanguinity from educational, political and cultural perspectives.     

Localising Social Work: Lessons Learnt from a Community Based Intervention amongst the Bedouin in Jordan

This paper presents an example of local social work practice in Jordan in the health field. It draws on a research study on Bedouin health in the North Eastern Badia. The project developed, implemented and evaluated a training intervention developed in partnership with a range of providers for improving local social work practice. Evaluation methods used included a pre and post test, focus group discussions and students' field notes. Findings revealed the significance of promoting culturally competent practice to respond to local health and social needs. Students and practice assessors agreed that the training interventions were an effective way to implement theory into local practice in relation to Bedouin society. This training intervention is an example of developing local social work practice as a way of responding critically to social inequalities.     

Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

Abstract

Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between January and April 2006. Methods: A standardized 2-tiered screening approach for an inception cohort of students utilizing primary services. Primary care providers were trained to triage students with depressive symptoms. Results: Six percent of participants had clinically significant depressive symptoms (CSD). Severe depressive symptoms were found in less than 1.0% of participants. Male rates of severe depressive symptoms were more than double that of females. Only 35.7% of untreated depressed participants started treatment within 30 days following identification. Conclusions: Systematic primary care depression screening in a college health center is a promising approach to identify untreated students with depression. More study is needed to improve rates of treatment engagement.     

The Engaged Academic: Academic Intellectuals and the Psychiatric Survivor Movement

This paper considers some political and ethical issues associated with the ‘academic intellectual’ who researches social movements. It identifies some of the ‘lived contradictions’ such a role encounters and analyses some approaches to addressing these contradictions. In general, it concerns the ‘politico-ethical stance’ of the academic intellectual in relation to social movements and, as such, references the ‘theory of the intellectual’ associated with the work of Antonio Gramsci. More specifically, it considers that role in relation to one political ‘field’ and one type of movement: a field which we refer to, following the work of Peter Sedgwick, as ‘psychopolitics’, and a movement which, since the mid- to late-1980s, has been known as the ‘psychiatric survivor’ movement—psychiatric patients and their allies who campaign for the democratisation of the mental health system. In particular, through a comparison of two texts, Nick Crossley's Contesting Psychiatry and Kathryn Church's Forbidden Narratives, the paper contrasts different depths of engagement between academic intellectuals and the social movements which they research.     

Psychiatric Disorders and Treatment in Adoptees: A Meta-Analytic Comparison with Non-Adoptees

ABSTRACT

This meta-analysis integrates the results of 85 studies on psychiatric disorders and treatment in adoptees and non-adoptees. The risk of adoptees experiencing psychiatric disorders, contact with mental health services, or treatment in a psychiatric hospital was approximately twice as high as that of non-adoptees. Elevated risks were observed for attention-deficit/hyperactivity disorders, anxiety disorders, conduct disorders/oppositional defiant disorders, depression, substance use disorders, and psychoses. Larger effect sizes were, in part, found in clinical studies than in community-based studies, in studies with a higher percentage of individuals adopted after the age of three years and international adoptees, and in older studies.     

The Role of a Psychiatric Pharmacist in College Health

Abstract

Published evidence indicates there is a growing prevalence of psychiatric illnesses on college campuses, and that approximately one quarter of students may be taking psychotropic medications. But attracting and retaining experienced mental health care professionals to college health settings is a challenging task. The psychiatric pharmacist is one professional resource that can serve as both a clinical and educational consultant for college mental health services. A pilot psychiatric pharmacist service project is described.     

The dybbuk and the ikota: similarity and difference in Jewish and Slavic traditions about the possession of an evil spirit

Both the dybbuk and the ikota are mythological spirits which possess a person whom they force to speak in a voice that is not his or hers. They have common transitional, liminal features to a greater degree than many other mythological creatures in Jewish and Slavic traditions. A comparative typology of these Jewish and Slavic demonological creatures, describing them according to their main features and functions, reveals some remarkable parallels between them. The comparative categorization will facilitate the elucidation of the specific features of each of the creatures and universal features that characterize all demonological creatures with a similar characteristic.     

Childhood Sexual Abuse,Adult Psychiatric Morbidity,and Criminal Outcomes in Women Assessed by Medium Secure Forensic Service

There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non–childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of this group were victims of a subsequent sexual assault in adulthood. The perpetrators were all male. The majority of intrafamilial cases resulted in victims being raised in environments outside the family home. Childhood sexual abuse was associated with later relationship, educational, and occupational difficulties. Significant associations were also seen with personality disorder, self-harm, and substance misuse. Treating services need to recognize the potential importance of childhood sexual abuse in their models of care given the complexity of the association between childhood sexual abuse and psychosocial needs and its impact on successful rehabilitation.     

Variations in Student Mental Health and Treatment Utilization Across US Colleges and Universities

Abstract

Objective: On US college campuses, mental health problems are highly prevalent, appear to be increasing, and are often untreated. Concerns about student mental health are well documented, but little is known about potential variations across the diversity of institutions of higher education. Participants: Participants were 43,210 undergraduates at 72 campuses that participated in the Healthy Minds Study from 2007 to 2013. Methods: Multivariable logistic regressions focus on associations between institutional characteristics and student mental health and treatment utilization. Results: The following institutional characteristics are associated with worse mental health: doctoral-granting, public, large enrollment, nonresidential, less competitive, and lower graduation rates. Among students with apparent mental health problems, treatment utilization is higher at doctorate-granting institutions, baccalaureate colleges, institutions with small enrollments, and schools with strong residential systems. Conclusions: Although high rates of mental health problems and low treatment utilization are major concerns at all types of institutions of higher education, substantial variation occurs across campuses.     

Correlates of Sexual Abuse in a Sample of Adolescent Girls Admitted to Psychiatric Inpatient Care

We examined correlations of child sexual abuse among 300 adolescent girls in psychiatric inpatient treatment. Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children—Present and Lifetime and from data on family and behavioral characteristics from the European Addiction Severity Index (EuropASI). A total of 79 girls (26.3%) had experienced child sexual abuse during their lifetime. Child sexual abuse was associated with an adolescent’s home environment, sibling status, smoking, posttraumatic stress disorder diagnosis, self-mutilating behavior, and suicidal behavior. At least 62% of the perpetrators were acquaintances of the victims. Correlates of child sexual abuse can be used to identify child sexual abuse victims and persons at heightened risk for child sexual abuse.     

Predicting job satisfaction of mental health peer support workers (PSWs)

ABSTRACT

The Mental Health Recovery Model is an empowering service philosophy which has been transforming the field of mental health. An important service approach to actualizing this model is hiring peer support workers (PSWs) who are peers advanced in recovery and employed to assist other peers in their recovery process. This study reports on factors hypothesized to affect PSW job satisfaction. Using multiple regression analyses, organizational culture and relationship with peers predicted 29% of job satisfaction. Based on these findings, suggestions are offered to assist social work administrators in effectively integrating and supporting PSWs in the workplace.     

Thinking and Practice of Cultivating Humanistic Spirit in Universities

大学人文精神是大学文化的核心与灵魂,体现了大学对人的价值和生存意义的终极关怀。本文分析了我国大学人文精神培育的主要误区．探讨了大学生人文精神的养成对科技创新的重要意义,探索构建和培育大学生人文精神的基本思路与实践,提出了高校培育创新人才要进一步提升大学教育理念。拓展大学教育功能;优化课程资源配置,渗透人文精神培育过程;加强校园文化建设,营造人文精神培育环境;注重传统文化教育．进而培养大学生的人文精神。     

College Health as a Partner in the Care of Pediatric Cancer Survivors

Abstract

Objective: This study reviews an initiative to educate providers on pediatric cancer survivor care and to establish a cancer survivor registry in a college health center. Participants: Participants were University of Georgia (UGA) college health providers. Methods: Providers attended lectures on survivor care and were encouraged to register on Cancer SurvivorLink. Changes in provider familiarity and practice were measured using baseline and follow-up surveys. A survivor registry was created using health entrance forms and medical records abstraction. Results: Twenty-four providers registered on SurvivorLink, and 16 completed both surveys. Familiarity with survivor care (p = .003) and a survivor health care plan (p = .016) increased. Likelihood to deliver survivor care increased (p = .01). UGA follows 95 survivors; 71 diagnosed at < 21 years. Among survivors diagnosed at < 21 years, 91% reported their diagnosis on entrance forms. Conclusions: Through education and optimization of health informatics, college health centers can identify and provide survivor care to this medically vulnerable population.     

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.     

Aftermath of Tragic Events: The Development and Use of Community Support Meetings on a University Campus

Colleges and universities need to be prepared to address the psychological impact of tragedies on their campuses. In this article, the author describes the development and successful implementation of campus postvention services in the aftermath of college student deaths by suicide as well as by natural and accidental causes. The program has been well received and has gone a long way toward helping the campus community come together and heal after these types of tragedies. College officials adapted the program to address issues related to troubling national and international events as well local incidents, such as suicide attempts and students' loss of housing through fires. The author provides specific instructions so that readers can replicate the program on their own campuses, and additional materials are available upon request.     

Implementation of a Mental Health Task Force in a collegiate-based emergency medical services organization

Abstract

Objective: A Mental Health Task Force (MHTF) was implemented in 2016 by a collegiate-based emergency medical services (CBEMS) organization to (1) improve mental health emergency response and to (2) address concerns for the mental health of CBEMS providers. Participants: Skidmore College EMS is a Basic Life Support First Response service staffed by volunteer undergraduate students. Methods: In coordination with faculty and staff, students in the MHTF developed trainings, peer support structures, community events, policies, and informational resources. Results: Sixteen students joined the MHTF within 1 year. Over 35 Skidmore College EMS members received training on mental health emergency response, peer-support, and self-care. Debriefing programs, mindfulness-based events, shift-length limitations, and access to informational resources promoted the mental health of Skidmore College EMS members. Conclusions: Implementing an MHTF is an innovative, student-led approach to coupling education on emergency response with programming that supports the mental health of CBEMS providers.     

Evaluation of Lehman's Brief Quality of Life Interview in Assessing Outcome in Psychiatric Rehabilitation in People with Severe and Persistent Mental Disorder

Abstract

Lehman's Brief Quality of Life Interview (QOLI) was administered to psychiatric rehabilitation program clients 6 times at 6-month intervals. Participants were individuals with predominantly psychotic-type diagnoses. Results showed no change over time and few gender differences. No change over time indicates no improvement but also no deterioration in this chronic population. Correlations between test times indicated that the subjective scales were relatively stable in comparison to the objective scales. Results indicate that the QOLI has poor sensitivity, and therefore limited utility, for assessing change in psychiatric rehabilitation of individuals with severe and persistent mental disorders. However, the QOLI does have an important use: It provides a good indication of the clients' perspectives on the quality of their lives and services received.     

Treatment Choices in a Managed Care Environment: A Multi-Disciplinary Exploration

This article reports the results of an exploratory study to determine how managed care is influencing mental health practice from an inter-disciplinary perspective. Using two case vignettes, respondents were asked about how they would classify presenting problems and treatment strategies within the context of two scenarios: (1) managed care and its limitations, and (2) fee-for-service/private pay. Findings suggest that managed care has a significant influence on case assessment and treatment planning across the mental health disciplines. Although respondents did not favor adjusting treatment approaches to meet managed care expectations, they nevertheless did so. Findings also substantiate managed care's negative impact on earnings and job satisfaction. These preliminary results begin to address discipline-related cost effectiveness from the perspective of practitioner treatment choices and preferences and highlight the perceived incompatibility between preferred practice and the dictates of managed care.