Clinical and Medical Social Work Commons^™

Mental Health Services In India, S. Rajkumar

The Journal of Sociology & Social Welfare

India has a population of over 800 million of which about 20 million are suffering from a mental illness. In terms of numbers of patients alone, mental health planners are presented with quite a challenge. How the challenge is being met is the topic of this article. Governmental efforts need to be augmented by voluntary agencies and private practitioners for optimal mental health care. Despite deficiencies, India is a pace setter for many developing countries. It has the political will to initiate needed changes. Aftercare services for the mentally ill should be a top future priority.

Mental Health Services In Japan, Kunihiko Asai

The Journal of Sociology & Social Welfare

Modern Japanese mental health services have their beginning with the conclusion of World War II. The system of services has since changed at all levels. New laws affording fundamental rights to mental patients were initiated in 1950, but reforms are in process even today that continue down the path toward more enlightened and specialized care. Demographic data are presented including the number of patients and their characteristics, and the number and kinds of service providers. An outline of the administration of mental health services is provided with special emphasis on institutional care. Future trends are highlighted.

The Development Of Mental Health Services In Sub-Saharan Africa: The Case Of Rwanda, Froduald Gatarayiha, Franz Baro, Morton O. Wagenfeld, Rene Stockman

The Journal of Sociology & Social Welfare

This paper considers several aspects of the evolution, organization and current status of the mental health system of Rwanda. The centerpiece of the Rwandan mental health system is the neuropsychiatric hospital in Ndera. Resource constraints preclude development of an extensive system of specialty mental health care. The World Health Organization has proposed that mental health services can best be delivered in developing countries through decentralization and integration with primary health care services. The accomplishments and problems encountered in implementing this model in Rwanda are described and, based on this experience, some recommendations are offered for other developing countries.

Mental Health Policy And Programs In Israel: Trends And Problems Of A Developing System, Uri Aviram

The Journal of Sociology & Social Welfare

Israel has an ancient history blended together with a relatively brief independent identity. An introductory section provides a backdrop for understanding mental health policies and programs in the context of the cultural and historical background of Israel's people. The second section portrays the nature of the mental health delivery system. The final section focuses on three interrelated issues: the limited development of community mental health services, the dominance of the mental hospital in the provision of mental health services, and the medicalization of mental health services.

Mental Health Services In Hong Kong: History, Modern Development, And Issues, Wai-Kwong Mak

The Journal of Sociology & Social Welfare

This paper provides a comprehensive account of the history, current mental health services, and related-issues in Hong Kong. Psychiatric services provided by the Government such as inpatient, outpatient, and daypatient treatments are highlighted. Community mental health services rendered by the voluntary sector such as the counseling and casework, care in half-way houses, and psychiatric nursing are also discussed. Recent statistical information provides a detailed picture of psychiatric institutions and characteristics of patients. Mental health issues typical of developed countries are discussed.

A Cross-Cultural Perspective On Selected Mental Health Systems, Gary Mathews, Morton O. Wagenfeld

The Journal of Sociology & Social Welfare

The information provided from authors around the world on their respective mental health systems is analyzed and compared. Several key dimensions are utilized, including the relationship of mental health services to other services, institutional care, community care, staffing, prevention and mental health promotion services, and accessibility. Resources and governmental priorities are identified as being essential to the provision of effective services. It is clear that the general trends identified by the experts for mental health in both developing and developed countries are by no means universal in applicability.

Self-Empowerment Among Adults With Severe Physical Disability: A Case Study, Nancy A. Brooks

The Journal of Sociology & Social Welfare

An independent living residential setting for severely physically disabled adults was studied through overt observation methods for twenty-two months. The purpose was observation of residents' council actions and expressions of group interests. The council displayed several phases of political structure and behavior. These phases were related to staff and administrative considerations as well as the residents emerging demonstrations of self-empowerment at the group level. The capacity for selfadvocacy emerges as a dynamic enterprise which is clearly related to the structure and interests of the service agency.

The Impact Of Drgs On Social Workers In A University-Affiliated, Teaching Hospital System, Joan M. Merdinger, Fredrick J. Garrity, Robert L. Treichler

The Journal of Sociology & Social Welfare

The impact of DRGs on social workers in four social work departments located in one Northeast State was assessed by interviews with all social work staff and administrators. The impact of DRGs was determined to be substantial. Implications for social work education and practice are considered.

Differential Perception And Adolescent Drinking In The United States: Preliminary Considerations, John B. Harms, James L. Wolk

The Journal of Sociology & Social Welfare

This paper addresses adolescent drinking from a perspective very similar to Sutherland's differential association theory. Drinking occurs when positive perceptions of drinking outweigh or outnumber negative ones. Our research focuses on images of drinking communicated by rationalized sources organized specifically to shape perceptions of drinking. We call these organizations "agencies" and assess their impact on perceptions of drinking. It is our contention that the political economic context of the United States in which these agencies function is such that positive images of drinking outnumber and outweigh negative ones, and that this is an important factor contributing to adolescent drinking.

A Redefinition Of The Problem Of Homelessness Among Persons With A Chronic Mental Illness, Donald M. Linhorst

The Journal of Sociology & Social Welfare

Two definitions of the problem of homelessness among persons with a chronic mental illness are examined, along with their implied solutions and ramifications for policy. Homelessness among this group is first viewed as the result of deinstitutionalization, and secondly, as the outcome of a critical shortage of low-income housing. Solutions stemming from the deinstitutionalization definition of homelessness, reinstitutionalization or improvement in the mental health system, are seen as inadequate to deal with the problem of homelessness among the mentally ill. Instead, state departments of mental health are called upon to provide a leadership role in the development of affordable housing.

Advocacy/Empowerment: An Approach To Clinical Practice For Social Work, Stephen M. Rose

The Journal of Sociology & Social Welfare

Social Work has been embedded in a structural and ideological contradiction throughout its history. The profession, its employing institutions, and the problems confronted by its clients are all produced by the same political economy that pays its workers and supports its schools. Ideologically, the profession has avoided the confrontation implied by its dependency upon individual defect explanatory or causal analysis frameworks that constitute a betrayal of its real constituencies. An advocacy! empowerment paradigm is offered as an alternative.

Trends In Hospital And Nursing Home Care Expenditures, Maine, 1982 To 1986, Maine Department Of Human Services

Maine Collection

Trends in Hospital and Nursing Home Care Expenditures, Maine, 1982 to 1986

Maine Department of Human Services - Office of Data, Research, and Vital Statistics

John R. McKernan, Jr., Governor, Rollin Ives, Commissioner, Brenda Smith, Planning and Research Associate, May, 1989.

"This report produced under Appropriation No. 1310-4010."

Contents: Introduction / Hospital Care Expenditures / Nursing Home Care Expenditures / Comparison of Hospital and Nursing Home Care Expenditure Trends / Concluding Remarks / References

Introducing The Living With Illness Group: A Specialized Treatment For Patients With Chronic Schizophrenic Conditions, Thomas G. Plante, Stephanie L. Pinder, David Howe

Psychology

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.

A Cross-Cultural Analysis Of Psychiatric Symptom Expression Using Langner's Twenty-Two Item Index, Robert Nishimoto

The Journal of Sociology & Social Welfare

An analysis of psychiatric symptom response using Langner's twentytwo item index was conducted across three cultural settings. Respondents were Anglo-American, Vietnamese Chinese, and Mexican. Some similarities did exist in response patterns and in those symptom items highly correlated with the total psychiatric screening score. Close examination revealed between-group differences indicating that not all twenty-two items were valid indicators of psychological disorder across cultures. The study highlights issues in the development and use of symptom checklists to measure and assess mental health constructs across cultures.

Community Mental Health: A View From American History, Mary Ann Jimenez

The Journal of Sociology & Social Welfare

The limitations of the movement for deinstitutionalization of the chronically mentally disordered have been the subject of a repeated series of investigations and analyses in the last 10 years. These critiques can be summed up in the undeniable observation that the chronically mentally disordered have by and large failed to benefit from deinstitutionalization in the ways that the original advocates and planners of this policy had hoped. The promise of community mental health, at least as articulated by the scores of witnesses before Congressional committees in the early 1960's, has not been realized for this population.

Mental Health Treatment Refusal In Correctional Institutions: A Sociological And Legal Analysis, Rudolph Alexander Jr.

The Journal of Sociology & Social Welfare

Recently, the courts have recognized the right to a minimum level of mental health treatment for individuals confined in both mental and correctional institutions, utilizing a different rationale for each system. As mental health administrators in state mental hospitals accepted that they were responsible for providing an increased level of mental health services, they were disappointed that courts had subsequently ruled that individuals in state hospitals had a right to refuse treatment. The purpose of this paper is to elaborate, sociologically and legally, upon treatment refusal in the correctional system since most of the attention on treatment refusal has focused …

What Social Workers Do: Implications For The Reclassification Debate, Charles Green

The Journal of Sociology & Social Welfare

The reclassification trend is one of the most formidable issues facing American social work today. Social work's vulnerability stemming from a general ambiquity about its distinct role and boundaries, competition from emerging helping occupations, and its debated professionalism is a major contributing factor. Often ignored in recent efforts to address reclassification is empirical evidence of social work's distinct performance in the human services versus other occupational groups. In this article comparative research findings supporting social work's unique performance are presented and their relevance for reclassification discussed.

The Social Class And Mental Illness Correlation: Implications Of The Research For Policy And Practice, Christopher G. Hudson

The Journal of Sociology & Social Welfare

Ongoing efforts to unravel the causal issues involved in the correlation between socioeconomic status and mental illness suggest that the hypothesis of a recursive or interactive relationship may be the most tenable, at least with the psychoses. Implications of this research are explored, with particular attention paid to the mental health costs of economic policies, the principles with which states allocate mental health resources, and the use of this knowledge-base in service planning.

Technology In Clinical Practice And The "Technological Ethic", John W. Murphy, John T. Pardeck

The Journal of Sociology & Social Welfare

Computers are being introduced into practically every area of clinical practice. The use of this technology by practitioners has not gone unchallenged. Specifically, new ethical problems are thought to be associated with using computers to make clinical assessments. Logistical and procedural difficulties, however, have been the primary focus of concern. In this paper the critique of computerized evaluation is expanded, with attention directed to the computer "micro-world." Because the computer micro-world consists of several unwarranted assumptions about the nature of social reality, clinical practice may be affected in many undesireable ways. The theoretical underside of computer use is illustrated to …

A Commentary On The Social Class And Mental Illness Correlation: Implications Of The Research For Policy And Practice, Julius A. Roth

The Journal of Sociology & Social Welfare

This paper represents an extraordinary review of literature on the association between SES and mental illness. I think most social scientists would find it impressive. It also conveys some cogent reasoning about the relevance of these findings for social policy. I think most social workers would find it impressive.

Report Of The Commissioner's Task Force On Self-Destructive Behaviors And Teen Suicide, Department Of Mental Health And Mental Retardation

Maine Collection

Report of the Commissioner's Task Force on Self-Destructive Behaviors and Teen Suicide.

Susan B. Parker, Commissioner - Department of Mental Health and Mental Retardation, Augusta, Maine (December 1987).

Contents: Foreward / Task Force Members / Introduction / Characteristics of Self-Destructive Teens / Factors Contributing to Self-Destructive Behaviors / Findings and Recommendations / References

Reconsidering Drug Involvement Among Youth And Young Adults: Implications For Targeted Primary Prevention, Mark W. Fraser

The Journal of Sociology & Social Welfare

The purpose of this; paper is to review two dominant social perspectives on the etiology of substance abuse among youths and young adults-the stage and risk factor outlooks-and to discuss them in light of recent demographic and ecological research. The differential demography of drug abuse strongly suggests that the environmental context influences the use and abuse of substances. In an era of great public concern about substance abuse, the use of individually-focused perspectives appears to have resulted in person-centered skills training programs and "say no" media campaigns. Consideration of community-level factors in the etiology of drug abuse permits the identification …

Historical Perspectives On The Care And Treatment Of The Mentally Ill, Albert R. Roberts, Linda Farms Kurtz

The Journal of Sociology & Social Welfare

An examination of the history of mental illness and its treatment over the centuries reveals that the mentally ill have few advocates except each other and that their treatment has consisted of confinement and neglect. Reformers have pioneered for change, experienced brief success, but ultimately conditions for the mentally ill regress. Society continues to abhor mental illness as though its collective consciousness still believes in possession by evil spirits. Discussion of the early history moves from banishment to ships of fools, to European asylums, and to institutions run by the states in America. More recent history focuses on the National …

Community-Based Self-Help Groups For The Treatment Of Agoraphobia, Bruce A. Thyer

The Journal of Sociology & Social Welfare

The design and conduct of community-based self-help groups for the treatment of agoraphobia are discussed. Such groups incorporate procedures encouraging members to engage in prolonged therapeutic exposure to anxiety-evoking situations. Exposure therapy and its variants have been empirically established as the treatment of choice for agoraphobia, and self-help groups lend themselves extremely well to community mental health outreach and service efforts.

Spreadsheet Analysis In Human Service Administration, Roger A. Lohmann

Faculty & Staff Scholarship

One of the most useful genres of personal computer software for human service administrators is the electronic spreadsheet. Despite its status as the single most important reason for the commercial success of the personal computer (or PC), spreadsheets have received scant attention in human service administration. An extended search of the major electronic bibliographies and information services turned up no references to spreadsheets in the human service literature. We are already building an extensive knowledge and experience base in the application of spreadsheets to the problems of human service administration. However, as the paucity of literature on this subject shows, …

Stress Of The Caregiver: Effective Management Of Dementia Patients In Hospital And Community Settings, Ruth E. Dunkle, Michael Nevin

The Journal of Sociology & Social Welfare

This study explores the management problems among elders with dementia and their medical and family caregivers. Twenty-five patients were interviewed as well as professional health care personnel and a family member. Findings indicated that professional assessment facilitates home caregiving but has little bearing on successful coping by the caregiver. Variability of coping relates to the strategy employed.

Professional Autonomy In Community Mental Health Centers, William E. Buffum

The Journal of Sociology & Social Welfare

Professional community mental health workers want considerable autonomy in doing their work, but too much autonomy can lead to frustration and less satisfaction with work. This finding of a study of 93 mental health professionals in three community mental health centers is in sharp contrast with a comparison group of 60 professionals in a chemical plant. The article cautions against the direct translation of research on all professionals to community mental health professionals.

Holidays As Multiple Realities: Experiencing Good Times And Bad Times After A Disabling Injury, Mary Jo Deegan

The Journal of Sociology & Social Welfare

Holidays are idealized as times of celebration. They are embedded in cultural symbols, family patterns, and lived experience. Because all holidays are not good times, however, the lived experience of holidays is considerably more complex than its symbolization. This ambivalence is dramatically deepened for recently disabled adults who view holidays as a specially strained time of remembrance. Past holidays are often idealized in a new way as one's biography is placed into a new embodied reality. Simultaneously, holidays remain days when one is supposed to celebrate, and often denote some celebration for the injured. The resulting experience is a melange …

A Perspective On Differential Services In Counseling: Altruism And Likeness, James Latimore

The Journal of Sociology & Social Welfare

In this exploratory study using a small sample, an attempt is made to understand the differential services provided by vocational counselors in a non-profit agency, a setting in which a strong identification with clients is encouraged. The services are measured and the unequal measures of service are related to the degree to which the client is seen as an image of the counselor in certain respects. Counseling is viewed as an altruistic occupation and the differential services are analyzed in this context. In general, it is suggested that the differential counseling and psycho-therapeutic services noted by other writers all reflect …

Measuring Domestic Violence In An Alcoholic Population, Larry R. Livingston

The Journal of Sociology & Social Welfare

A survey of 107 adults receiving residential treatment for substance abuse was conducted, to determine characteristics of domestic violence in relationships. The survey incorporated instruments to measure the degree of substance abuse (the Michigan Alcoholism Screening Test or MAST) as well as types and frequencies of domestic violence (the Conflict Tactics Scale or CTS-N). Findings are then compared to a national study of 2143 normals (Straus, Gelles, & Steinmetz, 1980) to ascertain differences in domestic violence.

Findings indicate that 83% of alcoholic subjects behaved violently in past relationships, compared to 28% of the normal population. Fifty-five percent of the alcoholics …