How Psychological Telehealth Can Alleviate Society's Mental Health Burden: A Literature Review

Mental health professionals must establish new means to reach those in need that face obstacles related to geographical location, time limitations, and health. With the high incidence of mental illness, as well as the hypothesized increase in coming years, telehealth modalities propose a novel and far-reaching alternative to traditional therapy. This article outlines the positive aspects and interdisciplinary possibilities when telehealth is incorporated into mental health practice. Novel outlets including mHealth and the utilization of computer tablets as mental health facilitators are outlined. Considerations for practice including training are discussed, as well as potential future directions for the field. Available data supports telehealth as an effective mode for the treatment of clients who are unable to pursue mental health services in their current form. However, careful consideration and training for the mental health professional is needed if telehealth is to be effectively used to alleviate the mental health burden.     

Development Guidelines from a Study of Suicide Prevention Mobile Applications (Apps)

Every day, Americans are inundated with advertisements and appeals to purchase the latest mobile technology in the form of smart phones, tablets, and their accompanying applications (apps). Human service organizations (HSOs) across the United States have begun to recognize that apps can provide a valuable resource for individuals and communities by addressing social issues. Additionally, forward-thinking HSOs are aware that apps are a fresh and important way of reaching a rapidly changing, tech-savvy population. But just like the marketplace at large yields a variety of apps that range from useful and engaging to poorly contrived and ineffective, HSOs' foray into app development has achieved mixed results. This report analyzes existing mobile applications available for one specific field of HSO service delivery—suicide prevention—in order to describe what is currently available and to generate beginning guidelines for the development, implementation, and evaluation of new suicide prevention apps for underserved populations. Twenty-seven apps were analyzed and recommendations for HSOs and future research are presented.     

Factors Influencing Uptake and Use of a New Health Information App for Young People

Abstract

When young people need health information they are increasingly likely to use online sources and health apps (applications). Yet, these are not necessarily well-designed, reliable or appropriate, and research has primarily focused on adult use. Our study is the first to use qualitative mixed methods (focus groups and interviews) to apply the Technology Acceptance Model (TAM) to understand 26 young people’s uptake and use of a new, clinically-approved health app (application) for 16–25?year olds. We found that perceived usefulness, perceived ease-of-use, social influences and trust, all differently impacted children and young people health-app acceptance and effectiveness. Implications for future research and young-person health-app development are discussed.     

On the Need for an Ethical Understanding of Health-Care Accountability

Abstract

In Sweden, as in many other Western countries, public health care is challenged by increasing demands for care and continuing budget deficits. Person-centred care (PCC) has been introduced as a new strategy to ameliorate the perceived fragmentation in care and is expected to decrease treatment time, reduce the need for return visits, as well as increase patient satisfaction. However, the changing clinical practices necessary for the PCC approach are assumed to require new accountability practices. This article is primarily an attempt to provide a conceptual analysis of ethical accountability, i.e. a type of accountability that takes into account the human relational responsibility, partial incoherence, and power of reflection. On the grounds of this characterisation, the article aims to provide a basis, among other things, for a discussion of the possibilities of identifying and empirically studying the multimodal expressions in communication that are relevant for this type of accountability. After an initial discussion of the debate on the limits of viewing accountability as transparency, we then turn to our methodological approach and introduce a conceptual analysis of accountability. Next, we discuss some additional features of accountability. Finally, we discuss the possibilities of empirically studying the institutionalisation of ethically informed accountability within person-centred health care.     

A Knowledge Based System for Assisting in Differential Diagnosis of Chemically Dependent/Mentally Ill Patients

Summary

This paper discusses the use of Knowledge Base 2.1, a computer program that administers a response dependent, structured interview to evaluate the presence of psychiatric disorders within the chemical dependency treatment setting. The writer reviews the problems commonly encountered when conducting clinical interviews, psychometric examinations and differentially diagnosing psychiatric disorders within this special population. Knowledge Base 2.1 utilizes combined computer techniques of rule driven logic, pattern matching, and an original algorithm that accomplishes a “real time retandardization” of the complete database. With each administration, standardization is implemented in an effort to adequately consider the effects of chemical dependency on psychological test performance and normative information regarding symptoms. Knowledge Base 2.1 also functions as a research tool inasmuch as all patient responses to this structured interview are permanently stored in computer files for ongoing analysis.     

A Profile of Adolescent Health

SUMMARY

As the adolescent population living in this country undergoes dramatic demographic changes in the 21st Century, increasing both in numbers and ethnic/racial diversity, practitioners and policy makers need to understand the prevalence of and trends in adolescent risk-taking behaviors, morbidity and mortality. Significant disparities in health status exist by ethnicity/race and gender in areas including: unintentional injury, violence, mental health, substance use, sexual behavior, and disease prevention. The epidemiological profile can help mobilize communities to address adolescent health issues. Developing effective interventions will require an ecological approach that builds on adolescents' assets and takes into account the contexts in which they live.     

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.     

The Influence of Managed Care on Job-Related Attitudes of Social Workers

This study explores the relationships between the levels of conflict that social workers experience when interfacing with managed care organizations and outcome variables including job satisfaction, organizational commitment, emotional exhaustion, and turnover intentions. A total of 591 social workers practicing in mental health agencies in New York State completed self-administered and anonymous questionnaire packets that included several measures: Level of conflict that workers experience when interfacing with managed care organizations (CMC), job satisfaction, organizational commitment, emotional exhaustion, and turnover intentions. Results showed that CMC had statistically significant correlations with organizational commitment and with emotional exhaustion. The author discusses the role of social work schools and agencies in offering new educational opportunities and training in order to improve workers' skills, which are necessary for communicating and negotiating with managed care organizations.     

Mental Health Practice and Children

SUMMARY

In the field of mental health, debates range along opposing axes with the protection of the public on one axis and the citizenship and human rights of the individual on the other. There is also considerable contestation for ideological and theoretical dominance about how mental distress should be viewed and responded to. Discourses alternatively emphasising protection, control and compulsion, and rights, citizenship autonomy and self-determination have added impetus when applied to children and young people. This is also a grouping denied a voice both in terms of individual treatment programmes and in the formulation of policy and practice. This article addresses the key debates and appraises the implications of changing policy and practice for children and young people experiencing mental distress in the UK. Although the discussion is located in a particular national context, the emergent themes have a much broader relevance for debates, policy and practice in the international arena.