Journal of mental health administration最新文献

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A global measure of access to mental health services for a managed care environment. 在管理式护理环境中获得精神卫生服务的全球衡量标准。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02832661
J A Pandiani, S M Banks, L Gauvin
{"title":"A global measure of access to mental health services for a managed care environment.","authors":"J A Pandiani,&nbsp;S M Banks,&nbsp;L Gauvin","doi":"10.1007/BF02832661","DOIUrl":"https://doi.org/10.1007/BF02832661","url":null,"abstract":"<p><p>The growing influence of managed care in mental health services has raised important questions about access to services. This article introduces and demonstrates a global measure of access that is based on the relationship between service utilization and the need for services. This measure has become practical because of recent advances in measurement technology that provide more valid and reliable estimates of the prevalence of mental illness in general populations and of the number of people who receive mental health services across service sectors. The methodology is used to produce a report card type profile of access to inpatient mental health services (in state, general, private, and veterans hospitals) by residents of one state. This global measure can provide a powerful and efficient tool for monitoring and comparing the impact of managed care plans on access to mental health services.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02832661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20174659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Policy-relevant program evaluation in a national substance abuse treatment system. 国家药物滥用治疗系统中与政策相关的项目评估。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790501
K Humphreys, E G Hamilton, R H Moos, R T Suchinsky
{"title":"Policy-relevant program evaluation in a national substance abuse treatment system.","authors":"K Humphreys,&nbsp;E G Hamilton,&nbsp;R H Moos,&nbsp;R T Suchinsky","doi":"10.1007/BF02790501","DOIUrl":"https://doi.org/10.1007/BF02790501","url":null,"abstract":"<p><p>This article discusses recent trends in public and private substance abuse services and offers suggestions on how the evaluation of such services can inform clinical practice and policy making. This analysis focuses particularly on the Department of Veterans Affairs (VA), which operates the largest substance abuse treatment system in the United States. In recent years, there has been an erosion of services for substance abuse outside the VA. In contrast, due to increased funding from the U.S. Congress, the VA significantly expanded substance abuse treatment from 1990 to 1994. However, efforts to \"reinvent\" and downsize government initiated a reversal of this growth trend in 1994, and VA services may shrink further as the system becomes more decentralized and adopts managed care strategies from the private sector. Drawing from the VA Program Evaluation and Resource Center's (PERC) experience of evaluating the VA system and working with federal policy makers, this article presents examples and suggestions for making evaluations of substance abuse treatment systems more useful in policy discussions and in day-to-day clinical practice.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20296539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
State health care reforms: how they affect children and adolescents with emotional disorders and their families. 国家卫生保健改革:它们如何影响患有情绪障碍的儿童和青少年及其家庭。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790502
B A Stroul, S A Pires, L Roebuck, R M Friedman, B Barrett, K L Chambers, M A Kershaw
{"title":"State health care reforms: how they affect children and adolescents with emotional disorders and their families.","authors":"B A Stroul,&nbsp;S A Pires,&nbsp;L Roebuck,&nbsp;R M Friedman,&nbsp;B Barrett,&nbsp;K L Chambers,&nbsp;M A Kershaw","doi":"10.1007/BF02790502","DOIUrl":"https://doi.org/10.1007/BF02790502","url":null,"abstract":"<p><p>This article reports on the Health Care Reform Tracking Project, a national study designed to describe and analyze state health care reforms and their impact on children and adolescents with emotional disorders and their families. It summarizes the results of the baseline survey of states conducted in 1995, exploring the nature and extent of the reforms in which states are engaged, most of which involve applying managed care technologies to their Medicaid programs. Trends across states are identified with respect to mental health service delivery, particularly with respect to children and adolescents. The article concludes with a discussion of issues and concerns related not only to mental health service delivery for children and adolescents with emotional disorders and their families but also to the systems of care that have been developing over the past decade to serve them. Some of these concerns include the lack of pilots or demonstrations, limited mental health coverage in some reforms, the lack of integration between mental health and substance abuse systems, the lack of special provisions for children, the need for more reliable bases for deriving capitation rates, the limited incorporation of systems of care, the need to incorporate interagency treatment planning and service delivery approaches, the lack of outcome measures specific to and appropriate for children, and the need for greater family involvement in the planning and implementation of these reforms.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20296540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Residency training in Massachusetts: a new approach to state-university collaboration. 马萨诸塞州住院医师培训:州立大学合作的新途径。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790486
M A Hanson, E L Stone, R B Flannery
{"title":"Residency training in Massachusetts: a new approach to state-university collaboration.","authors":"M A Hanson,&nbsp;E L Stone,&nbsp;R B Flannery","doi":"10.1007/BF02790486","DOIUrl":"https://doi.org/10.1007/BF02790486","url":null,"abstract":"<p><p>Traditional state-university collaborations, known as public-academic liaisons (PALs), have resulted in improved quality of service and enhanced residency training. Recent national trends for treating persons with serious mental illness, including moving services from institutional settings to community-based care and emphasizing the use of rehabilitative approaches as well as changes in the health care delivery system itself, have led to preliminary rethinking of some discrete aspects of more traditional approaches. Rather than discrete changes, Massachusetts has responded to these emerging trends with a new and comprehensive initiative that emphasizes one set of statewide standards in these emerging content areas for all residency training programs. Consistent with new practices in health care delivery, this new initiative was fielded through a process of competitive bidding rather than through traditional allocation of service positions. The development, implementation, and initial outcomes of this new approach are presented and implications for mental health administrators are discussed.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9472178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Children's mental health in a continuum of care: clinical outcomes at 18 months for the Fort Bragg demonstration. 连续护理中的儿童心理健康:布拉格堡示范18个月的临床结果。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790507
K M Hamner, E W Lambert, L Bickman
{"title":"Children's mental health in a continuum of care: clinical outcomes at 18 months for the Fort Bragg demonstration.","authors":"K M Hamner,&nbsp;E W Lambert,&nbsp;L Bickman","doi":"10.1007/BF02790507","DOIUrl":"https://doi.org/10.1007/BF02790507","url":null,"abstract":"<p><p>This article uses data collected at 18 months from the evaluation of the continuum of mental health services of the Fort Bragg Child and Adolescent Mental Health Demonstration Project (the Demonstration) to address the hypotheses that longer term follow-up (beyond 12 months) will show that the Demonstration is more effective and more successful for children with serious emotional disturbance (SED). The effects of the Demonstration are examined in comparison to those of traditional care by analyzing 12 key mental health outcomes with a random regression model, and the potential impact of attrition on results is explored. Results show neither hypothesis is supported, and the attrition analysis showed that the influence of missing data on the outcome analyses is negligible. Implications of these results for mental health policy are discussed.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20293923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
The relationship of patient-administered outcome assessments to quality of life and physician ratings: validity of the BASIS-32. 患者管理的结果评估与生活质量和医生评分的关系:BASIS-32的有效性。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02898514
J Russo, P Roy-Byrne, C Jaffe, R Ries, C Dagadakis, E Dwyer-O'Connor, D Reeder
{"title":"The relationship of patient-administered outcome assessments to quality of life and physician ratings: validity of the BASIS-32.","authors":"J Russo,&nbsp;P Roy-Byrne,&nbsp;C Jaffe,&nbsp;R Ries,&nbsp;C Dagadakis,&nbsp;E Dwyer-O'Connor,&nbsp;D Reeder","doi":"10.1007/BF02898514","DOIUrl":"https://doi.org/10.1007/BF02898514","url":null,"abstract":"<p><p>The reliability and validity of a patient-administered version of the Behavior and Symptom Identification Scale (BASIS-32) was compared to the original interviewer-administered version. The construct validity of BASIS-32 subscales was assessed by examining their relationship with functional and satisfaction quality of life and physician ratings of functional and clinical status. A total of 361 acute psychiatric inpatients were given a self-administered BASIS-32, nurse-administered Lehman's Quality of Life Interview (QOLI), and Psychiatrist Assessment Form at admission and discharge. The original factor structure, internal consistency reliability, discriminant validity, and sensitivity to change were replicated. The patient-administered BASIS-32 is equally as reliable and valid as the interview. Construct validity analyses revealed that functional and satisfaction QOLI indices were moderately related to the BASIS-32 in the hypothesized directions. All satisfaction scales were associated with significantly less severity. Physician ratings were only mildly related to the subscales. The BASIS-32 used in outcome assessments with inpatients provides important and unique perspectives on functional and clinical status that are not tapped by clinician-rated assessments.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02898514","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20059983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
Services for clients of community support programs in rural Wisconsin. 为威斯康星州农村社区支持项目的客户提供服务。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790480
E J Hollingsworth
{"title":"Services for clients of community support programs in rural Wisconsin.","authors":"E J Hollingsworth","doi":"10.1007/BF02790480","DOIUrl":"https://doi.org/10.1007/BF02790480","url":null,"abstract":"<p><p>To improve understanding of services provided or coordinated by rural community support programs (CSPs) for people with severe mental illness, this article identifies services most used by clients and the amounts of services used. Data on publicly funded services for more than 900 clients in 13 rural CSPs in a midwestern state have been analyzed. Virtually all clients were Caucasian. Information about types and amounts of client services for 12 consecutive months was obtained from county information systems, local records, and Medicaid claims. Most CSP clients use case management, community support, medication checks, counseling, and medication counseling services. Much smaller percentages use other outpatient, residential, vocational, and inpatient services. Significant amounts of only two services, case management and community support, are reported. The findings emphasize the ability of rural mental health providers to supply general services, but some limitation in provision of specialized services and facilities.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Evaluating performance and change in mental health systems serving children and youth: an interorganizational network approach. 评估为儿童和青少年服务的精神卫生系统的表现和变化:组织间网络方法。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790476
J P Morrissey, M C Johnsen, M O Calloway
{"title":"Evaluating performance and change in mental health systems serving children and youth: an interorganizational network approach.","authors":"J P Morrissey,&nbsp;M C Johnsen,&nbsp;M O Calloway","doi":"10.1007/BF02790476","DOIUrl":"https://doi.org/10.1007/BF02790476","url":null,"abstract":"<p><p>Planning for the delivery of community mental health services has evolved from models of services within individual agencies to community-wide systems of care, but development of methodologies for assessing system performance has lagged behind. This article presents one approach to system-level assessment by viewing children's mental health systems as an interorganizational network. Data are presented on two county-based child mental health systems in North Carolina that participated in the Robert Wood Johnson Foundation Mental Health Services Program for Youth. Site-specific data on client referrals, fund exchanges, and information flows were collected at two time points (1991 and 1993) to measure the cohesiveness and concentration of the service system using network k-core analyses. In addition, stakeholder ratings of service adequacy, quality, availability, coordination, and overall demonstration project goal attainment were obtained at both time periods. Findings indicate that the rural system was outperforming the urban system at the time of the first survey, but the urban system caught up over the study interval. There was high agreement between the network and stakeholder ratings of system performance at both time periods. The method of data collection and analysis used in this study provides tools that can be used in a variety of settings to assess service system growth and development.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 40
Program environments of self-help agencies for persons with mental disabilities. 智障人士自助机构的项目环境。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02790506
S P Segal, C Silverman, T Temkin
{"title":"Program environments of self-help agencies for persons with mental disabilities.","authors":"S P Segal,&nbsp;C Silverman,&nbsp;T Temkin","doi":"10.1007/BF02790506","DOIUrl":"https://doi.org/10.1007/BF02790506","url":null,"abstract":"<p><p>Leaders of self-help agencies (SHAs) aspire to develop program environments that are different from community mental health agencies (CMHAs). This article addresses two questions. Do consumers' perceptions of SHAs approximate the characteristics leaders think ought to typify such agencies? Do SHA and CMHA consumers differ in their program perceptions? Using the Community-Oriented Program Environment Scale, leader expectations of ideal SHA environments were obtained from a national survey of 189 consumer-run agency heads, perceptions of actual environments from interviews with 310 SHA consumers, and perceptions of CMHAs from questionnaire responses of 779 consumers in 54 programs. SHA reality conforms to ideology in offering opportunities for consumers to experience involvement, support, and autonomy in the receipt of needed service. While showing only modest differences from CMHAs on relationship and treatment characteristics, SHA consumers differ in their perceived control over program rules, a fact previously found significant in promoting positive outcomes.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02790506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20293922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Developing clinical work processes in a state psychiatric hospital: a case study. 在州立精神病院发展临床工作流程:个案研究。
Journal of mental health administration Pub Date : 1997-01-01 DOI: 10.1007/BF02898515
D A Gilbert, W V Rago
{"title":"Developing clinical work processes in a state psychiatric hospital: a case study.","authors":"D A Gilbert,&nbsp;W V Rago","doi":"10.1007/BF02898515","DOIUrl":"https://doi.org/10.1007/BF02898515","url":null,"abstract":"<p><p>The Texas Department of Mental Health and Mental Retardation applied the continuous quality improvement (CQI) concept of work process to the delivery of clinical services in each of its eight state psychiatric hospitals. Two different clinical processes were involved: (1) individualized psychiatric treatment and (2) medical treatment. The processes were then benchmarked against national leaders in the delivery of public psychiatric hospital services. This case study demonstrates the applicability of the work process concept to a clinical environment where it can function as a management tool that can significantly improve the quality and efficiency of services provided to individual patients.</p>","PeriodicalId":73827,"journal":{"name":"Journal of mental health administration","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02898515","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20059984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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