Evaluation approaches in mental health: Implications of the new federalism

Since the introduction of federal mental health legislation in 1963, there has been a changing emphasis on evaluation and accountability. With direct federal funding of community mental health services, accountability demands were met through expectations for local agency evaluation activities which were overseen by federal authorities. The advent of the New Federalism and the shift to block grant funding of mental health services to state mental health authorities have shifted responsibility for evaluation to the states and local programs. This paper reviews federal mental health statutes to trace the extent and locus of required evaluation activities and discusses two approaches to carrying out program evaluation: "top-down" where the evaluation topic, method, and data collection are mandated by an administering or funding body; and "bottom-up" approaches where the subject, method of study, and data to be collected are developed in response to a felt need at the local agency level. A case study of each approach as used at the state level in mental health is examined. Based on the literature and the case studies, conclusions are presented on the pro's and con's of each method in meeting accountability demands and the barriers which must be overcome for either method to be successful.     

Trends in Alcohol Consumption Among Undergraduate Students at a Northeastern Public University, 2002–2008

Abstract

Objective: This study examined alcohol consumption patterns and trends at a public university in the Northeast from 2002 to 2008. Participants: Stratified random sampling was used to select undergraduate students enrolled in courses during spring semesters in 2002, 2004, 2006, and 2008. Methods: Data were collected during regularly scheduled classes for 4 measures of alcohol consumption and 5 demographic categories using the Core Alcohol and Drug Survey. Results: Four groups showed significant increases in both frequency and volume of alcohol consumption—students who were female, over 21 years of age or over, living off-campus, or performing well academically. There were no decreasing trends for any demographic group. These results differ from national college health surveys, which have shown alcohol use remaining steady during this period. Conclusions: Campus-specific trend data can provide unique perspectives and guide programming efforts. These trends suggest a need for new intervention strategies on this campus.     

The carver in Africa: Individually acclaimed artist or anonymous Artisan?

This paper explores a number of issues raised by William Burton's annotated photographs of professional artists (or craft specialists) taken at his mission station in Katanga province in the 1930s. It focuses, in particular, on why Burton recorded the names of two carvers, one a chief, the other a court sculptor attached to the Nkulu chieftainship. The questions raised by this decision leads me to consider the relationship between indigenous consumer attitudes to African artists, and changing perceptions of the identity and status of these artists by foreign buyers and art historians since the early 20th century. In the course of this discussion I draw attention to the fact that it is only in context‐specific studies of patronage that meaningful attempts have been made to address the ways in which artists themselves have responded to the increasingly complex marketplace in which they now work.     

Corporate Citizenship Enacted as Operating Practice

This paper explores values that underpin corporate citizenship embedded in operating practices as they affect stakeholders. Fundamentally, the paper argues that corporate citizenship is embedded integrally in the day-to-day operating practices that companies develop to relate to their important stakeholders. This systems perspective incorporates not only the objective but also subjective and intersubjective aspects of human civilization and arguably provides a systems basis for thinking about the roles and responsibilities of the corporation in society. This revised version was published online in July 2006 with corrections to the Cover Date.     

Prioritizing Environmental Health Risks in the UAE

This article presents the results of a comparative environmental risk‐ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency‐Abu Dhabi (EAD). It represents the first national‐level application of a deliberative method for comparative risk ranking first published in this journal. The deliberative method involves a five‐stage process that includes quantitative risk assessment by experts and deliberations by groups of stakeholders. The project reported in this article considered 14 categories of environmental risks to health identified through discussions with EAD staff: ambient and indoor air pollution; drinking water contamination; coastal water pollution; soil and groundwater contamination; contamination of fruits, vegetables, and seafood; ambient noise; stratospheric ozone depletion; electromagnetic fields from power lines; health impacts from climate change; and exposure to hazardous substances in industrial, construction, and agricultural work environments. Results from workshops involving 73 stakeholders who met in five separate groups to rank these risks individually and collaboratively indicated strong consensus that outdoor and indoor air pollution are the highest priorities in the UAE. Each of the five groups rated these as being among the highest risks. All groups rated soil and groundwater contamination as being among the lowest risks. In surveys administered after the ranking exercises, participants indicated that the results of the process represented their concerns and approved of using the ranking results to inform policy decisions. The results ultimately shaped a strategic plan that is now being implemented.     

AIDS: An Unconventional Perspective

Amidst the destruction of AIDS, a glimmer of hope, not necessarily for a cure but for psychological well-being, exists among many persons afflicted with the virus. A large number of HIV-infected individuals have sought and attained emotional well-being despite carrying the virus and its associated stigmas. In fact, emotional growth may not necessarily be hindered, but rather enhanced by undergoing a trauma such as an HIV/AIDS diagnosis. Some HIV-positive individuals have stated that through the process of enduring the hardships of AIDS, such as revealing their condition to others and coping with the physical repercussions of the virus, they have experienced transcendence and growth. By learning from the experiences disclosed by some of those afflicted with the virus, we, as a society, can infuse value, meaning, and growth into our own lives.