Acceptance of Online Health Services for Self-Help in the Context of Mental Health: Understanding Young Adults’ Experiences

ABSTRACT

This article explores the understanding of the acceptance of online health services from a self-help perspective in the context of mental health. By examining the experiences of young adults, this article develops a framework to leverage the current understanding of the factors that would support the acceptance and use of these types of services. To this end, a multidisciplinary perspective incorporating knowledge from the service marketing, health, and information systems literature is used. The results suggest that the production of online services that are meant for self-help purposes necessitates a focus on the acceptance of technology and, more importantly, instrumental value creation, as the purpose of using these types of services should be better understood and supported by technological solutions. This study also identifies several technological features supporting both the acceptance of technology and users’ ability to achieve well-being. Furthermore, when developing services for health self-help purposes, the issue of branding to increase acceptance should be assessed. From a user perspective, there appears to be a difference regarding whether the services are positioned as health services or as wellness services.     

Marketing Postsecondary Health Services

Abstract

This article reviews the major elements of marketing as applied to college and university health service programs. Changes in the health care industry, institutional debate about the advisability of institutionally based health centers, and the erroneous equation of promotion as marketing are reviewed. The necessity for research data to determine campus health program offerings is articulated as the most important aspect of successful marketing programs for health services. Types of segmentation for user groups are detailed, as well as the basic elements of an environmental analysis. The four fundamental aspects of health care marketing are discussed: the need to define the “core of service” for the health center; the issues associated with the access corridor to care; the task of refining communication channels; and the difficulty of measuring the effect of price on service usage rates. For marketing efforts to have a positive effect, colleges and universities must have an institutional commitment to health services. The article concludes by noting that marketing is a major management task.     

Relationship marketing and service quality.

The delivery of services in college health centers is improved through the use of relationship marketing and service quality advancement. Relationship marketing works to attract, maintain, and enhance customer or client relationships with the healthcare provider. The facets of relationship marketing are explored, with the greatest emphasis placed on internal marketing. Higher quality health services come from continuous improvement, a focus on process, and intensive staff development and participation, which build a service culture.     

A comprehensive health service evaluation and monitoring framework

ObjectiveTo develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services.MethodA targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders.ResultsThe framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable.ConclusionData collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle.     

The Importance of Hotel/Motel Products and Services as Perceived by Older Consumers

SUMMARY

Consumer satisfaction, an important concept in consumer behavior theory, is directly influenced by the availability of quality service which has become an increasingly important objective of hotel/motel managers. The purpose of this study was to investigate hotel/motel products and services valued most by older consumers-a substantial and growing market segment with special concerns. The sample for this study consisted of consumers age 55 and older in the state of Texas. Results indicate value and security were considered highly important, and suggest lodging operators should concentrate their efforts on providing and marketing value and security features in order to attract and satisfy older consumers.     

Peer Support Among Consumers of Professional Mental Health Services

ABSTRACT

Peer-support services have become increasingly prevalent in mental health; consumers now deliver many services once provided by professional mental health providers. Recognizing this key asset in mental health consumers' service environment is critical for social workers. This exploratory study examines differences among 311 consumers of professional mental health services, half of whom also used peer-support services. The two groups (peer support compared with non-peer-support) were compared on a number of dimensions related to their utilization of and satisfaction with professional mental health services. Users of peer-support services perceived greater availability of professional services and used more professional services, but found professional services to be less useful than those not participating in peer support. No differences between the two groups were found for overall satisfaction with professional services. Findings related to policy, practice, and research are discussed.     

Rural and Urban Differences Among Mental Health Consumers in One Midwestern State

Abstract

This study examines differences in rural and urban mental health service utilization and service satisfaction. A cross-sectional survey design was used to gather information from a sample of 311 mental health consumers regarding their use of services relative to accessibility, availability, affordability, and acceptability. Data were collected from respondents individually or in small groups in various locations in one Midwestern state. Study findings showed that rural consumers are aware of fewer services, use fewer services, and are less satisfied with services than are urban consumers. Implications for rural mental health policy, practice, and future research are discussed.     

Barriers to Utilization of Mental Health Services amongst Male Child Sexual Abuse Survivors: Service Providers’ Perspective

ABSTRACT

Most research on child sexual abuse has been on survivors to the exclusion of service providers. This paper focuses on one group of findings from a larger qualitative study. The aim of the paper is to identify existing services and highlight the gaps in the current programs available for male CSA survivors from the perspective of service providers. Semi-structured interviews were conducted with 11 mental health service providers, recruited from two Southern and Central Ontario cities. Findings presented here report service providers’ perspective of gaps in services for male CSA survivors. “Limited Male CSA Programs”, “Institutional Barriers”, “Attitudinal Barriers”, and “Systemic Gaps” emerged as four major themes from the data analysis. Findings demonstrate the need to re-evaluate currently available service and highlights gaps in mental health service available for male CSA survivors. Implications for policy, practice, and research are discussed.     

Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment

Objective: We modeled design factors influencing the intent to use a university mental health service. Participants: Between November 2012 and October 2014, 909 undergraduates participated. Method: Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Results: Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. Conclusions: E-Mental Health options could engage students who may not wait for standard services.     

Abortion: A Technique for Working through Grief

Abstract

The successful implementation by a large public university health service of a satellite clinic involves a number of processes and funding issues. The authors discuss the development of such a program at a small community college in Appalachia. The first 4 years' experience in operating the satellite clinic created a number of valuable management lessons that they believe could assist others with similar goals for extending their services.     

Being a service user and a social work academic: balancing expert identities

Abstract

I am a service user and academic working in a university social work department. My hybrid identity allows me to draw on different types of knowledge in all aspects of my work, including: academic, practice and experiential wisdom. Service user involvement is mandated across social work education but the scope and breadth of different kinds of participation is developed in diverse ways across university contexts. This article affirms the value of service user involvement in health and social care education, exploring its positive impact on students. When lecturers share personal experience of using services alongside practice and academic wisdom in the course of teaching, sometimes the value of experiential knowledge is doubted and its influence dismissed. I examine the importance of experiential wisdom in social work education, specifically when it is embedded in an academic role in a university social work department, and consider how it can be respected and valued. The parallel experiences of involving peer support workers in mental health services, who use their knowledge of recovery to mentor other service users, are then briefly examined, together with reflection of the concerns across mental health with professionals sharing their experiential wisdom with the people that they support.     

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.     

Community Based Rural Health Care in India

SUMMARY

India is a large country, geographically as well as popula-tionwise. The majority of its population lives in rural areas, i.e., villages. Again, most of the villages are in remote areas. The State has been making sincere efforts to make the basic social services accessible to all in the rural area. Health being one of the vital services, it has been a challenging task before the State to extend it to the remote rural areas, many of which are not yet connected by motorable roads. As a result of various experiments carried out over the last five decades, the State has developed a fairly well-designed primary health care service, and it is in operation in rural areas. However, there appears to be a striking gap between the delivery of health services in rural areas and utilization of the services by the people. Attempts have been made in this article to apprise the readers of the health service system in India, and it discusses the issue of health service delivery at the village level. The discussion is based on a small study carried out in a rural area in the State of West Bengal (India) where students of social work of the University to which the author belongs are placed for field work. Following the inputs received through supervision of the students' work, the study was initiated and conducted.

This article based on the study seeks to focus on peoples' perception of the health services as provided by the State in rural areas, which in turn gets reflected in the extent to which they utilize the services. Social workers being an integral part of the health set up, their role bears special significance. Discussion, therefore, centres on scope for social work intervention at the community level as well as in institutional level of the health service delivery system to make the services meaningful and effective in rural areas. In fact, it has to take the leadership role in reforming the service delivery system when required.     

Ethnicity and Health Service Use in a Women's Prison

ABSTRACT

This paper highlights the findings in relation to health need, ethnicity, and health service use among a sample of women in prison. Medical records review for 129 women and interviews with 15 women were conducted to determine factors associated with differential service use. Statistical analyses reveal that ethnicity and an interaction between ethnicity and whether one is on medication at prison admission (a health need variable) significantly predict extent of service use. Women of color use fewer services overall, with the exception of those on medication. Qualitative analyses reveal that women of color view the quality of medical care and the ways they are treated less positively than White women. Implications for equitable service provision are explored.     

Deficits in young men's knowledge about accessing sexual and reproductive health services

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.     

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.     

Civic engagement among student veterans

Abstract

Objective: The purpose of this study was to assess participation rates in civic volunteering among service member and veteran students. Participants: Data for the present cross-sectional study were obtained from the American College Health Association’s (ACHA) 2011–2014 National College Health Assessment II (NCHA). Methods: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with either Fisher’s exact test or maximum likelihood multiple logistic regression. Results: Service member and veteran students were more likely to engage in volunteerism than their non-veteran counterparts. Additionally, student veterans and non-veteran students reported that engagement in volunteer efforts both reduces their feelings of depression and increases their use of mental health services. Conclusion: The findings of this research suggest that the promotion of civic engagement and participation in volunteerism for service member and veteran students on college campuses might contribute to successful reintegration outcomes.     

Do student service members/veterans experience worse mental health stigma than their peers? A comparative study in a national sample

ABSTRACT

Objectives: Examine differences in mental health treatment-related stigma in student service members and veterans (SSM/Vs) and peers from 57 post-secondary institutions across the United States. Methods: In total, 909 SSM/Vs and 1818 demographically- and institutionally-matched non-SSM/Vs completed assessments of stigma-related barriers to mental health service utilization as part of the Healthy Minds Study between 2011 and 2015. Results: When compared to non-SSM/V peers, SSM/Vs reported more mental health treatment-related stigma toward help-seekers and less confidence in the helpfulness of therapy/counseling and psychotropic medications. However, effect sizes were small in magnitude (ds = .10 to .16), and depressed students in both groups reported greater stigma. Conclusions: SSM/Vs experience greater treatment-related stigma than non-SSM/V peers, which may deter service use in many cases. However, differences in stigma were small and other under-studied barriers to help-seeking may apply to the substantive subset of SSM/Vs and non-SSM/Vs who may benefit from utilizing available services.     

A Consumer Cooperative Association Specializing in Services for the Elderly

Summary

Over the past 10 years, a Japanese cooperative association named Fukushi Club Seikyo (FCS) has developed a unique, non-profit business specializing in services for the elderly. It aims to promote a reciprocal support system among neighborhood community members. FCS has successively organized its active members, mainly homemakers, into workers' collectives and successfully provided various life support services at a very small charge. Their human-touch service appears in sharp contrast to bureaucratic public services and profit-making private services. The civil initiative presented by FCS suggests a potential for a community-based social service system that may guarantee quality services without raising taxes and premiums for social insurance.