Adolescents Seeking Mental Health Services

Summary

Inner-city adolescents receiving mental health services often get inadequate medical care. However, when those who seek counseling are asked about their health concerns, they say they want to discuss them with their therapists. Based on responses to a clinical self-assessment questionnaire (Adquest), adolescent mental health clients reported sleep difficulties, weight and eating concerns, and frequent headaches and stomachaches. Age and gender differences in patterns of vulnerability and willingness to talk were explored.     

Learning Disabilities Within Postsecondary Education

Abstract

Learning disabilities (LD) are a significant issue in the U.S. educational system and the fastest growing disability group in need of services at the postsecondary educational level. This growth has led to an increase in colleges and universities offering support services to the adult LD population. However, many students are still having difficulty remaining in college and completing degree programs. This difficulty may arise, in part, from confusion and misunderstanding among postsecondary professionals, including disability support coordinators and professors. The purpose of this article is to address some of the issues postsecondary educational staff and faculty members come across when dealing with the adult learning disabled population.     

Asian Americans and Mental Health Services

Abstract

Research in the 1970s and 1980s revealed that Asian Americans, compared with other ethnic groups, tended to under-utilize mental health services. This article is aimed at adding new information to the literature by examining data from the 1990s. The raw data comprised 97,212 total admissions representing 45,774 total individuals utilizing mental health services during a four-year period in San Diego County, California. By comparing our findings with previous research cases on utilization patterns of mental health services, new evidence is found about Asian Americans in terms of their (1) underrepresentation in mental health services, (2) presentation of more severe symptoms than those of other racial/ethnic groups when first seen at clinics, (3) lower dropout rates and higher average lengths of stay than other racial/ethnic groups, and (4) higher percentages of using day treatment and outpatient programs but lower percentage of using inpatient programs.     

Information Systems and Mental Health Services

Summary

This paper examines issues related to applying information technology in behalf of mental health service delivery systems. Each of these issues has an impact on how well information technology has been able to serve the mental health system. These are not primarily information technology issues. They are concerns that have to do with the structure of the mental health system; the way management might use an information system; and the role of money and power in the mental health system. How these issues are resolved will have a major impact on how well the promise inherent in information technology is realized in the coming decade.     

An Editorial Planning for Health Services

Abstract

The field of administration and management has undergone a steady evolution since its origin at the turn of the century. A perspective regarding that development is useful to the health service administrator. This paper examines and interprets selected writings in administration and management. The appropriateness of this open-communication model to medical settings is demonstrated and the application of this model to a specific student health service is described and discussed.     

Sexual Health Services for the Family

No abstract available for this article.     

A Report on Student Health Services

Abstract

Objective: Stress impacts college students, faculty, and staff alike. Although meditation has been found to decrease stress, it is an underutilized strategy. This study used the Reasoned Action Approach (RAA) to identify beliefs underlying university constituents’ decision to meditate. Participants: N = 96 students, faculty, and staff at a large midwestern university during spring 2012. Methods: A survey measured the RAA global constructs and elicited the beliefs underlying intention to meditate. Thematic and frequency analyses and multiple regression were performed. Results: Quantitative analyses showed that intention to meditate was significantly predicted (R² = .632) by attitude, perceived norm, and perceived behavioral control. Qualitative analyses revealed advantages (eg, reduced stress; feeling calmer), disadvantages (eg, takes time; will not work), and facilitating circumstances (eg, having more time; having quiet space) of meditating. Conclusions: Results of this theory-based research suggest how college health professionals can encourage meditation practice through individual, interpersonal, and environmental interventions.     

Maternal Health Care Services in the Himalayas

ABSTRACT

The state of health of the people in developing countries does not show a very good trend. They are faced with the double burden of communicable and noncommunicable diseases as well as other sociocultural factors that need to be addressed, especially in rural areas. The present study was conducted in a rural area with the dual purpose of training the undergraduate medical student in the field and exposing or sensitizing them toward the need of the rural masses and provision of services in the form of medical aid or health education and awareness. It was a camp-based approach where an intense phase was planned for a week and a follow-up phase every month. The present article is the result of the week-long intense phase. The intensive phase is basically the period when this camp was run for 7 days with the involvement of specialists from various departments providing their services. In the next phase there were follow-up activities and services that were provided once a month. The study generated an interest in the students, and they are very keen for the follow-up visits. Because the students were allotted families, the whole village was covered and health awareness was generated, which created demand. This demand was met given the number of patients attending the clinics, of which 57% were females. Furthermore, 77% of the patients reported that they were fully satisfied with the services being provided.     

Evidence-based Medicine and Child Mental Health Services

There is increased focus on using research evidence to guide clinical practice in the provision of child mental health services, to allocate resources and to make policy decisions. Emphasis has been placed on randomised controlled trials, which are clearly vital. However, given the complexity of children's lives and the multiple systems relevant to their care, it is important to consider alternative research designs and to think creatively about outcomes. In the context of difficulties with random allocation a number of quasi-experimental designs are described that may more closely reflect actual clinical work. In the context of ecological theory, the importance of taking a systems level approach to evaluation is highlighted, with examples from the US. Finally, the ways in which qualitative outcomes measures can be used to sensitively describe the effects of treatment are outlined, and their potential for giving voice to children and families as consumers of mental health services. These suggestions aim to lessen the tension between the requirements of the scientific investigations of treatment effectiveness and the realities of clinicians' daily experiences.     

Health Status and Health Care Services Among Older Persons in India

Summary

India is characterized by significant rural-based living, population heterogeneity, financial constraints, and reverse sex ratio. Traditions of joint families, life-long physical activity, vegetarianism, and social and spiritual enrichment, all known to promote healthy aging, are widely prevalent. With the increasing pace of population aging, the health of older persons in India has been the focus of recent attention. Existing data indicate a significant morbidity among the aged, much of which may remain subclinical. Considerable variations in morbidity exist with respect to gender, place of residence (rural vs. urban), and socioeconomic status. Rapid demographic transition without a concomitant epidemiological transition is responsible for the dual load of infections and degenerative diseases in older persons, these being common causes of death. Most age-related morbidity is preventable. Health promotion and cost-effective interventions based on the primary health care approach over a lifelong course, especially at the village level, will greatly help towards achieving the goal of healthy aging. The rapidly changing socioeconomic scenario in India also calls for appropriate policy actions to achieve this goal.     

Human Resource Issues in University Health Services

Abstract

To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.     

Webster v. Reproductive Health Services:

This article analyzes the constitutional significance of Webster v. Reproductive Health Services (1989). The decision of the U.S. Supreme Court has two prominent features. First, the Court upheld the restrictions on the right of women to abort by devaluing the provisions of the challenged Missouri law. It is suggested that these provisions are far more significant than the Court majority acknowledged, and that their significance became apparent soon after the Court's resolution of the case. Second, the Court's approach to resolving Webster suggests a reconceptualizing of fundamental rights questions wherein state action jurisprudence has been turned upside down and compelling state interest analysis has been eschewed. While Roe v. Wade (1973) was not overruled in Webster, it appears that the contemporary Court's approach to operationalizing the right of choice is unlikely to restrict the power of the states to regulate in this area.     

Preparing College Health Professionals to Deliver Gay-Affirmative Services

Abstract

On every campus, there may be many gay students, faculty, and staff who might benefit from medical and mental health services sensitively developed as an integral part of the range of health services provided to the total campus. It is crucial to develop a cadre of providers from different disciplines who have a knowledge of gay lifestyles, developmental issues, and societal pressures. Staff must develop or heighten sometimes painful self-awareness engendered by empathic identification with a stigmatized minority. They must also conceptualize homosexuality as a relationship preference or lifestyle choice and appreciate the importance of same-sex attachments in normal development.

This paper reviews common presenting themes of gay patients and clients who rarely come for help to change their preference. The effects of homophobia on staff practices and attitudes are reviewed in the context of learned negative stereotyping in the larger culture. Heterophobic expectations of potential gay consumers are explored, including those of being diagnosed as deviant, mentally ill, or arrested libidinally. Suggestions are offered for the design and marketing of collaborative gay-nongay services and for service to older hidden populations. Individuals are encouraged to examine their own relationships to homosexuality and to experience new learning through enriched encounters with gays.     

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.     

Data-Mining Client Concerns in Adolescent Mental Health Services

Summary

Via a practice-based research collaboration, clinicians, supervisors, and managers in an urban adolescent mental health program studied previously collected intake information concerning adolescent risk exposures, behaviors, worries, and self-assessed coping. In addition, desire to talk with a mental health counselor about specific risks and worries was systematically analyzed with the aim of generating practice insights into the clinical challenge of engaging urban adolescents in mental health services. Though provided with research consultation, practitioners were full participants in all aspects of the researchprocess. This organizational development process placed strains on the participants and organization, but many benefits were derived from it. One significant benefit was that mining the expressed concerns of clients gave participants a powerful vehicle for reshaping services. The organization came to see its clients as more than mere service recipients, resulting in a recommitment to Youth Development principles and a renewed effort to increase direct client participation in organizational life.     

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.     

The Health Status of Elderly People and the New Direction of Health Services

The projected increase of people in Japan aged 75 years and older in the years to come implies the increase of the disabled elderly. Thus, the core of societal preparation for the aging of the population is generally considered to be the expansion of services for the disabled elderly. However, gerontological studies on the health status of the elderly conducted in Japan show that the prevalence of disability is quite low and even decreasing. Relative to the services for the disabled elderly, preventive services for the healthy elderly have long been overlooked. In 1994, the Metropolitan Tokyo Government organized a task force to develop a new health education program as the preventive health service for the healthy urban elderly. A preliminary plan outlining the health education program consisting of propagation with a booklet, on-the-job training of practitioners, and development of new curricula and teaching materials was proposed by the authors for discussion within the task force. Although the inquiry has just begun and the plan is still nascent, it seems adequate to fit the needs for preventive health services in the near future.     

Older Lesbians and Gays Accessing Health and Aged-Care Services

Abstract

The present paper examines older lesbian and gay people's experiences of and expectations for the delivery of health and aged-care services. In-depth narrative interviews were conducted with older gays and lesbians in the Blue Mountains, west of Sydney (NSW, Australia). Data were analysed by identifying evaluative statements within specific narratives and grouping these statements into themes. Participants reflected on the meaning of their sexual identity and how they would like it to be acknowledged when in contact with health and aged-care service providers. In addition to direct discrimination, participants reported a more indirect form of discrimination in providers’ assumption of heterosexuality among clients and their failure to provide lesbian- or gay friendly services. The findings highlight the need for health and aged-care services to better understand and acknowledge older gay and lesbian people's sexual identities to enable improved access to services in the future.