Dissertations / Theses on the topic 'Health services administration Mental health'
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1
Duff, Amanda. "Emergency Room Utilization of Participants with Mental Health Conditions Enrolled in Health Home Services." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3154.
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Large numbers of individuals utilize the ER each year for mental health reasons. The health home agency in this study was designed under the Affordable Care Act with the intention of increasing patient self-management thus decreasing high-cost service utilization. The effectiveness of health homes in reducing mental health-related ER visits has remained unexplored. In this study, the relationship between participation in this program and ER utilization was examined, using the theoretical framework of the Health Belief Model. The sample of 128 health home participants with documented mental health conditions was selected using systematic random sampling. A one-way, repeated-measures t-test and a one-way, repeated-measures ANCOVA were used to analyze hospital records for ER visits with a primary or secondary mental health diagnosis. The results indicated that health home participation did not have a statistically significant impact on ER utilization when comparing overall 12-month means or at quarterly anniversary dates when controlling for age, race, and gender. These findings suggested opportunities for improvement in professional practice, identified areas that require further research, and will be used to initiate discussion into the existing and potential value that health homes offer to the mental health clientele being served. Those discussions have the potential to create social change through infrastructure changes that lead to improved service coordination, increased resources for improving access and quality of care, and overall enhancement of outcomes for individuals with mental health conditions.
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Anderson, Lela Ann. "What factors influence client participation in mental health services." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2216.
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The purpose of the study is to develop a foundation of knowledge that could improve the current policies and procedures with regards to their implementation within the mental health services provided by the Children's Bureau.
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Jain, Swati. "PsychWeb online mental health service| Business plan." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10124519.
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Over the past several years, mental healthcare system in United States has evolved tremendously, however majority of people are still struggling with various forms of mental illness and find it difficult to get appropriate treatment at the right time due to barriers like lack of providers, poor access, high cost and, social stigma. This business plan proposes an online mental health service company PsychWeb, offering telemental health services, with the aim of improving access to mental healthcare in the comfort of one’s own living environment.
Chapter 1 of this business plan is about complete market analysis for the online mental health industry along with the business overview for PsychWeb and its services. It also sheds light on business target population, competitors, growth strategies and proposed future milestones. Chapter 2 shows an in depth feasibility analysis using SWOT that ensures business viability and success. In chapter 3, we have discussed the legal and regulatory issues, along with company formation, and laws around provider and patient use of PsychWeb services laying stress on HIPAA and provider licensure requirements at the state and federal level. Lastly, chapter 4 explains the financial analysis conducted to ensure the business profitability. It gives a detailed breakdown of monthly and yearly expenditures, revenues generated and profit margin projections. All financial statements generated in the process are provided in the appendix of this business plan.
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Mangwana, Thobeka Cikizwa. "An examination of the response of the Cape Mental Health Society to the mental health needs of blacks in the Western Cape." Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/17159.
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Includes bibliography.This study examined the response of the Cape Mental Health Society to the mental health problems of Blacks in the Western Cape. This response has been examined against the organisational and the community contexts in which such services are provided. Environmental constraints which surround service provision were examined at macro- and micro-level. The macro-level covered the unfavourable political, social and economic aspects as experienced by both the organisation and its clientele. The micro-level covered those aspects which impinge on service delivery but are within the scope of the organisation. It is agreed that these aspects affect the nature of the response of the organisation to mental health needs of blacks negatively. The study emphasizes the need to define mental health within the South African context from a psychiatric and socio-political perspective as such a definition allows for appropriate service provision. Data was collected from primary and secondary sources. Interviewing was used as a technique for collecting primary data. Structured and unstructured interviews were carried out with people from various disciplines, community members, and present and prospective service consumers. The exploratory-descriptive approach was used. The problems and needs of clients were quantified in terms of the organisation's waiting lists and other criteria. Services rendered by the Society were quantified in terms of clients being served and the number of projects and programmes undertaken to meet different mental health needs. Ideas have been developed about mental health services amongst the black communities and their cultural perception of mental health needs. The findings emphasize inadequacy of the response of the Cape Mental Health Society to mental health needs of blacks. The present facilities are insufficient and inappropriate to mental health needs of blacks. They are characterised by inaccessibility, inefficiency and ineffectiveness where they do exist. A marked inequality in the provision of services to the two population groups, that is, Coloureds and Blacks, has been identified. A framework for developing mental health services for blacks in the Western Cape has been recommended. This framework proposed various steps which can be taken in such development.
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Rorie, Terri. "Rural Environmental Factors and Lesbian, Gay, Bisexual, and Transgender Mental Health Services Utilization." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6659.
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The rates of mental health issues in the lesbian, gay, bisexual, and transgender (LGBT) communities are twice that of individuals who identify as heterosexual. Research in urban communities show lower mental health services utilization rates for LGBT individuals compared to their heterosexual counterparts. The purpose of the study was to examine how rural environmental factors affect the use of mental health services by LGBT individuals and provide information to improve mental health outcomes. Andersen's healthcare utilization model and the minority stress theory were the foundations of this study. This study examined the association of mental health providers' availability/characteristics and utilization of mental health services and the association of perceived sexual discrimination and mental health services utilization in rural LGBT communities. Questionnaires were used to collect data from a random sample of 121 LGBT participants in Virginia, and linear and multiple regression was used to analyze the data. The findings for the associations between environmental factors and mental health service use were p < .84 for perceived discrimination, p < .04 for fear of provider insensitivity, p < .02 for provider availability, p < .000 for provider insensitivity and hostility, and p < .003 for provider insensitivity and ridicule. The results showed a need for specialized and sensitivity training in the health community and the need for improved access for LGBT health consumers in rural communities. The results of this study might lead to social change by encouraging improvement in mental health services and mental health outcomes for the LGBT community.
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Dixon, Decia N. "Perceptions of school based mental health services by directors and supervisors of student services." [Tampa, Fla.] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0002079.
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Severo, Ana Kalliny de Sousa 1983. "A institucionalização da supervisão na reforma psiquiátrica brasileira : (re)produção de controles e desvios junto às equipes de saúde mental." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313097.
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Orientador: Solange L'AbbateTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-26T18:16:33Z (GMT). No. of bitstreams: 1 Severo_AnaKallinydeSousa_D.pdf: 2219412 bytes, checksum: 703c2f5ef1b03a2647c93d0435d1aff5 (MD5) Previous issue date: 2014
Resumo: A supervisão tem se assegurado como um dos principais dispositivos de fortalecimento dos processos de mudanças almejados no modelo de Atenção Psicossocial. Esse dispositivo tem sido utilizado para qualificação dos serviços substitutivos e da rede de Atenção Psicossocial na Reforma Psiquiátrica brasileira, apesar de receber muitas críticas no sentido de apontar seu caráter reprodutor das relações de saber-poder hierarquizadas. Este trabalho buscou analisar a institucionalização da supervisão clínico-institucional no processo da Reforma Psiquiátrica brasileira, tendo como foco a experiência de supervisão no estado do Rio Grande do Norte. Para tanto, o referencial teórico-metodológico escolhido foi o da Análise Institucional, tanto na perspectiva da análise no papel como da socioanálise. A análise no papel foi utilizada para a investigação dos documentos e entrevistas em uma perspectiva sócio-histórica e a socioanálise em sua vertente socioclínica. Para a realização deste estudo, adotei quatro estratégias de pesquisa principais: análise de artigos que apresentavam a inserção da supervisão nas experiências reformistas dos anos 1980 e 1990; análise dos relatórios finais das Conferências Nacionais de Saúde Mental e dos editais de supervisão lançados pelo Ministério da Saúde; e intervenção desenvolvida durante um ano de supervisão clínico-institucional na rede de Atenção Psicossocial em um município do interior do Nordeste. O processo de intervenção desenvolvido fez parte de um desses projetos financiados, com edital lançado, e desenvolveu-se em doze encontros mensais com trabalhadores da rede de saúde e dos dispositivos intersetoriais. Na análise das experiências, percebemos que a supervisão nos princípios da Atenção Psicossocial sofreu mudanças tensionadas principalmente pelas transformações na constituição das equipes, da gestão, da rede e no cuidado comunitário. Na análise no papel dos relatórios da terceira e da quarta Conferência Nacional de Saúde Mental e dos editais do Ministério da Saúde existiram encomendas muito amplas relacionadas à supervisão, tais como a política de recursos humanos, de funcionamento de rede, de qualificação e de construção de Projetos Terapêuticos Singulares, que foram respondidas de maneira ainda insuficiente pelas políticas governamentais. Na intervenção realizada, as principais dificuldades encontradas foram a rotatividade dos profissionais do serviço, múltiplos vínculos de trabalho entre os servidores, mudanças na gestão do serviço e a relação pouco dialogada com a gestão municipal. Como movimento instituinte, assinalamos uma maior reflexão crítica acerca do percurso do profissional de saúde mental para adequação ao contexto da Atenção Psicossocial, ampliação do diálogo e ações interprofissionais, e fortalecimento da parceria entre o gestor municipal e a equipe do Centro de Atenção Psicossocial. Retomar a historicidade de um dispositivo permitiu compreender suas diferentes funções e os efeitos de retorno do instituído e de desconhecimento gerados pela paralisação e burocratização da Reforma Psiquiátrica, e a necessidade de retomar e fortalecer seu processo instituinte
Abstract: Supervision has assured itself as one of the main dispositive of improving the processes of changes desired in the psychosocial care model. This dispositive has been used for qualification of replacement services and from the psychosocial care system in the Brazilian psychiatric reform, despite receiving many criticisms towards pointing its reproductive character of hierarchical knowledge-power. This work aimed at analyzing the institutionalization of institutional clinical-supervision in the process of the Brazilian Psychiatric Reform in the state of Rio Grande do Norte. To this end, the theoretical and methodological support chosen was the institutional analysis, both from the perspective of analysis of the role and social analysis. The analysis of the role was used for investigation on documents and interviews in the sociohistorical perspective and in the social analysis in its social clinical perspective. In order to do this study, I applied four main strategies of research: analysis of articles that presented the insertion of the supervision in the reforming experiences in 1980s an 1990s; analysis of the final reports of the National Conferences on Mental Health and the supervision announcements released by the Ministry of Health; and intervention developed during a year of clinical-institutional supervision in network of psychosocial care in a country city of Brazilian northeast. The intervention process developed was part of one of theses funded projects with announcements released, and developed in twelve monthly meetings with Health system and intersectoral dispositives workers. In the analysis of experiments, we noticed that supervision on the principles of Psychosocial Care suffered changes influenced primarily by the transformation of teams, management, system and community care constitution. In analyzing the role of the reports of the third and fourth National Conferences of Mental Health and the announcements of the Ministry of Health there were many orders widely related to supervision, such as the human resources policy, the operation of the network, construction of qualification and Unique Therapeutic Project that were still inadequately answered by the government policies. In interventions, the main difficulties were the turnovers of service professionals, multiple bonds of work between servers, changes in the management of the service and and the little dialogic relationship with the municipal administration. As establishing movement, we noticed a deeper critical reflection on the course of the mental health professional to fit the context of psychosocial care, expansion of dialogue and joint actions, and strengthening the partnership between the city manager and staff of the Center for Psychosocial Care. Retaking the historicity of a dispositive allowed to understand their different roles and effects of return established and ignorance generated by paralysis and bureaucratization of the Psychiatric Reform, and the need to retake and strengthen their instituting proceedings
Doutorado
Ciências Sociais em Saúde
Doutora em Saúde Coletiva
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Gardner, Lea Anne. "Factors Associated with Hospital Commitment to Provide Child/Adolescent Psychiatric Services." VCU Scholars Compass, 2006. https://scholarscompass.vcu.edu/etd/788.
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General acute care hospitals play a particularly important role in the delivery of children's mental health given the extant lack of alternatives to long term hospitals for patients requiring a restrictive treatment environment (Glied and Cuellar, 2003). This cross-sectional study identifies environmental and organizational factors associated with general acute care and children's hospitals in the United States that provide hospital-based child/adolescent psychiatric services and the number of services. Two macro-level theories, Resource Dependence Theory and Institutional Theory were used to identify environmental and organizational factors. A nationwide sample of hospitals was drawn from the 2003 AHA annual survey. Data from the 2002 AHA annual survey, Area Resource File and American College of Graduate Medical Education was used for the independent variables. There were three analyses, correlation, descriptive and logistic regression. Results demonstrate that hospitals in markets with a low percentage of non-white children, higher family median income, high hospital community orientation, and high percentage of not for profit hospitals are more likely to offer child psychiatric services. Organizational factors associated with an increased likelihood to providing child psychiatric services include hospitals identified as Catholic, public or children's and those with a child psychiatric residency program. Three factors were associated with hospitals providing a high number of child psychiatric services and include hospitals in metropolitan statistical areas, system affiliation, and general acute care hospitals. This study demonstrated that 1. large hospitals are more likely to offer child psychiatric services and a high number of services, 2. children's hospitals provide child psychiatric services, but not a high number of them, and 3. hospitals with a high number of service offerings are mainly located in MSA's and more likely to offer outpatient substance abuse services. Significant results were obtained in the analysis of hospital characteristics and the provision of child psychiatric services, but weaker results were observed when analyzing the number of services. Further research is needed to identify factors with stronger associations to the level of service offerings.
9
Hodge, Patricia Ann. "The family support services study." CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/547.
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Côté, Réjean. "Vers un plan d'organisation des services en santé mentale à dimension socio-territoriale dans L'Est de Montréal /." Thèse, Chicoutimi : Université du Québec à Chicoutimi, 1992. http://theses.uqac.ca.
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Teixeira, José Pedro Novais de Carvalho Dias. "Desenvolvimento de um serviço local de Saúde Mental em Famalicão." Master's thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2012. http://hdl.handle.net/10362/8172.
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RESUMO: O desenvolvimento de serviços locais adequados deve ser baseado numa avaliação
sistemática das necessidades e resultados obtidos nos cuidados a uma população de
indivíduos identificados como apresentando uma doença mental na área de
referenciação do serviço. Neste sentido foram utilizados os seguintes métodos: dados
epidemiológicos acerca das necessidades locais e taxas de utilização de serviços a nível nacional e local, este último com base no case-register.
Os diagnósticos de maior prevalência em ambulatório são as perturbações de humor e
as perturbações neuróticas de stress ou somatoformes, com uma preponderância de
doenças mentais comuns (depressão e ansiedade) em serviços de psiquiatria.
Constatam-se baixas taxas de abandono da consulta (12%). A idade, a doença e a
escolaridade estão correlacionados com o risco de drop-out, mas utilizada a regressão
logística, a idade e a escolaridade perdem o seu significado estatístico. Encontram-se
taxas reduzidas de drop-out dos indivíduos com psicose ou perturbações bipolares, em
virtude da intervenção activa da equipa.
Os custos de transporte, a distância ao local de consulta e o tempo de espera para a
primeira consulta são barreiras no acesso aos cuidados a nível local. Os cuidadores não
se sentem apoiados pela rede de suporte social e queixam-se sobretudo da
acessibilidade, mas exibem elevadas taxas de satisfação com os serviços prestados.
Decidiu-se apostar numa organização do serviço baseada na comunidade, com
intervenções baseadas na evidência, dando prioridade ao doente mental grave e à
qualidade dos cuidados.----------- ABSTRACT: The development of appropriate local services should be based on a systematic
assessment of the needs and outcomes of the population of individuals identified as
mentally ill within the service’s catchment area. A number of methods may be used as
proxies in assessing local needs for services, such as service utilization rates found
nationally and locally, by case-register.
The most prevalent diagnoses in ambulatory care are mood disorders and neurotic,
stress and somatoform disorders, with a majority of common mental disorders
(depression and anxiety) in psychiatric services.
Low dropout rates (12%) are found in ambulatory care. Age, disease and education are
correlated with the risk of drop-out, but after using logistic regression, age and
education lose their statistical significance. Low drop-out rates are found in individuals with psychosis or bipolar disorders, because the active intervention from the team.
The costs of transportation, distance and the waiting time for the first consultation are barriers in access of care locally. Carers do not feel supported by the network of social support and complain primarily of accessibility, but exhibit high levels of satisfaction with the services provided.
It was decided to invest in a service organization based in the community with
evidence-based interventions, giving priority to severe mental illness and quality of care.
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Jones, Anita Payne. "Caregivers' Challenges in Accessing Services for Children with Autism." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7021.
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The perspective of the caregiver is vital to understanding the experiences of raising a child with autism, including the challenges faced in accessing services. The purpose of this qualitative, transcendental phenomenological study was to examine the lived experiences of primary caregivers raising a school-age child with autism and to bring about an understanding of the challenges faced in accessing services. Resiliency theory provided the conceptual framework for the study. Semi-structured, in-depth interviews were conducted with 11 participants raising a child with autism in the Washington, DC metropolitan area. Data were analyzed using Moustakas's descriptive approach. Results yielded 5 themes: overall experience, challenges, relationships, access to services, and stressors. Findings revealed effective ways to support caregivers through programs and services and highlighted the importance of supportive relationships and family connections. Implications for social change include opening conversations regarding the unique perspectives and needs of primary caregivers of children with autism, supporting awareness of the stressors associated in daily caregiving, and engaging in broader discussions regarding the importance of establishing supportive relationships among physicians, mental health providers, specialists, social workers and care managers in order to support the advocacy efforts of caregivers.
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Leung, Yat (Gary) Hung. "Behavioral Health Disorders and the Quality of Diabetes Care: A Dissertation." eScholarship@UMMS, 2010. https://escholarship.umassmed.edu/gsbs_diss/456.
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Both diabetes and behavioral health disorders (mental and substance use disorders) are significant health issues in the United States. While previous studies have shown worse health outcomes in people with diabetes and co-occurring behavioral health disorders (BHDs) than those with diabetes alone, it is unclear whether the quality of diabetes care was poorer in the presence of co-occurring BHDs. Although previous research has observed a trend of positive outcomes in people with comprehensive diabetes care, there is a lack of evidence about whether that mode of care delivery can improve outcomes in people with co-occurring BHDs. Therefore, further studies are necessary.
Using a combined dataset from Medicare and Medicaid claims for Massachusetts residents, this study compared the quality of diabetes care (e.g., having at least 1 hemoglobin A1c test) and diabetes outcomes (e.g., eye complications) among Medicare and Medicaid beneficiaries with diabetes and co-occurring BHDs to those with diabetes alone in Massachusetts in 2005. The results showed a mixed picture on the relationships between BHDs and diabetes outcomes. While substance use disorders had adverse impact on adherence to quality measures (e.g., 20% less likely to attain full adherence, p0.05).
Findings from this dissertation research suggest that disparities exist in the quality of diabetes care and health outcomes between people with substance use disorders and those without. The mode of care delivery needs to be further examined so that interventions can be designed to improve the outcomes of people with diabetes.
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Burch-Hubbard, Lorri. "Managing Stress in a Constantly-Changing Workforce." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etd/3694.
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When staffing reductions occur in the workplace, staff left behind may face increased stress, may not be given the support they need to manage the feelings caused by the reduction. This study was conducted to evaluate the impact of stress caused by staffing reductions has on medical technologists (MT), medical technicians (MLT) and respiratory therapists (RT), and to identify any common methods of stress management used by those staff who remain in the organization.
Literature research showed the negative impact stress can have on individuals when it is not addressed, such as decreased work performance, health issues, and even the inability to lead a normal life.
After an extensive review of the data, no statistically significant common methods of coping strategies were identified between these two professions using prescribed variables. However, the same three strategies used to cope with staffing reduction-related stress were ranked at the top in both professions.
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Waters, Heidi C. "Evaluating the Impact of Integrated Care on Service Utilization in Serious Mental Illness." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3374.
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Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality. Use of high-cost healthcare services is common, including hospitalizations and emergency department (ED) visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study addressed the impact of integrated care on physical health and ambulatory care sensitive (ACS) utilization via a program evaluation of an integrated health clinic (IHC) at a community mental health center (CMHC). The research questions assessed whether there was a predictive relationship between IHC enrollment and physical health and ACS-specific service utilization for consumers with SMI when controlling for demographic characteristics and disease severity. Secondary administrative healthcare data, including authorization and electronic medical record data, were provided by the CMHC. Logistic regressions assessed the odds of experiencing an inpatient admission or ED visit before or after IHC enrollment; the predictive relationship between IHC enrollment and service utilization was assessed using multiple linear and Poisson regression analyses. There was no statistically significant impact of integrated care clinic enrollment on physical health or ACS-specific utilization. The sample had lower levels of physical health utilization than would have been expected. In terms of positive social change, results may help the CMHC assess the IHC program, overall clinic success, and use of data. Since policy and payment structures continue to support integrated care models, further research on different programs are encouraged, as each setting and practice pattern is unique.
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Smith, Eric G. "Comparative Effectiveness of Lithium and Valproate for Suicide Prevention and Associations With Nonsuicide Mortality: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/737.
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Background: The mood stabilizer lithium has long been reported to be associated with reduced suicide risks, but many studies reporting associations between lithium and reduced suicide risks also have been nonrandomized and lacked adjustment for many potential confounders, active controls, uniform follow-up, or intent-to-treat samples. Concerns also have been raised that medications being considered as potential suicide preventative might increase risks of nonsuicide mortality while reducing risks of suicide.
Methods: Three studies of Veterans Health Administration (VHA) patients were conducted combining high-dimensional propensity score matching with intent-to-treat analyses to examine the associations between lithium and valproate and one-year suicide and nonsuicide mortality outcomes.
Results: In intention-to-treat analyses, initiation of lithium, compared to valproate, was associated with increased suicide mortality over 0-365 days among patients with bipolar disorder (Hazard Ratio (HR) 1.50 [95% Confidence Interval 1.05, 2.15]) Nonsuicide mortality among VHA patients with or without bipolar disorder was not significantly associated with the initiation of lithium compared to valproate ( HR 0.92 [0.82-1.04]). Rates of treatment discontinuation, however, were very high (≈ 92%). Longitudinal analyses revealed that the increased suicide risks associated with initiating lithium among patients with bipolar disorder occurred exclusively after discontinuation of lithium vii treatment. In secondary analyses restricted to patients still receiving their initial treatment, there was no difference in suicide risk between the initiation of lithium or valproate.
Conclusions: Significantly increased risks of suicide were observed at one year among VHA patients with bipolar disorder initiating lithium compared to valproate, related to risks observed after the discontinuation of lithium treatment Since these studies are nonrandomized, confounding may account for some or all of our findings, including the risks observed after lithium discontinuation. Nevertheless, these results suggest that health systems and providers consider steps to minimize any potential lithium discontinuation-associated risk. Approaches might include educating patients about possible risks associated with discontinuation and closely monitoring patients after discontinuation if feasible. Given the obvious importance of any substantive difference between lithium and valproate in suicide or nonsuicide mortality risk, our studies also suggest that further research is needed, especially research that can further minimize the potential for confounding.
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Varner, Tangrill D. "A comparative analysis among dual-diagnosis: Schizophrenic substance abusers' perceived satisfaction with mental health service delivery and perceived social support systems." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 1996. http://digitalcommons.auctr.edu/dissertations/1149.
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The overall objective of this study is to explore, examine, assess and compare perceived satisfaction with service delivery and perceived social support systems among dual-diagnosis: schizophrenic clients. To attain this objective, the following areas were examined by the researcher: (1) Identifying data/demographic data; (2) Support systems, i.e., family and friends among dual-diagnosis: schizophrenic clients; and (3) Satisfaction with mental health service delivery. Fragmentation and gaps in service delivery were also examined. An exploratory descriptive research design was used in the study. A two-part questionnaire was administered by the researcher to thirty-four Dual-diagnosed Schizophrenic Consumers in two separate Mental Health Facilities in Fulton County.
This study was an attempt to compare perceived satisfaction with service delivery and perceived social support systems among Dual-diagnosis: Schizophrenic Substance Abusers. The Null Hypothesis was accepted in this study. It was found that there were no statistical significance in perceived satisfaction with service delivery and perceived social support among Dual-diagnosis: Schizophrenic Substance Abusers.
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Haglund, Kristina. "Patient and Staff Perceptions of Medication Administration and Locked Entrance Doors at Psychiatric Wards." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6133.
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Maegli, Marta Maria. "Impact of an appreciative inquiry intervention on compassion fatigue among social service workers." Thesis, Pepperdine University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1571609.
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This action research study examined the impact of participation in an appreciative inquiry (AI) intervention on social service workers' level of compassion fatigue. Five workers plus two of their managers took part in the study. A 6-hour AI intervention was held and participants completed pre- and post-tests of the Professional Quality of Life Scale to measure their compassion satisfaction, compassion fatigue, and burnout. A focus group also was held to gather qualitative data about the impact of the intervention. Results indicated that the intervention was highly valuable for strengthening working relationships, underscoring the positives in otherwise emotionally difficult work, and learning how to avoid or reduce compassion fatigue. Based on these findings, periodic AI interventions are advised to reduce social service workers' compassion fatigue by sharing their experiences and focusing on the positive. Future research should eliminate the limitations of the present study by expanding the sample and gathering multiple forms of data.
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Hill, Elizabeth B. "Comprehensive services for students with serious emotional disturbance: An analysis of state legislation and policy." W&M ScholarWorks, 1996. https://scholarworks.wm.edu/etd/1539618502.
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The purpose of this study was to examine state legislation and policy related to comprehensive, integrated services for students with serious emotional disturbance. Legislation and policy documents from nine states, Virginia (the pilot study), Indiana, Maryland, New Jersey, North Dakota, Oklahoma, Utah, Vermont, and Wisconsin, were examined. These documents were compared to a set of components extracted from the literature as recommended practice. The document analysis was confirmed through telephone interviews with state-level policymakers in each state's department of education, department of mental health, and/or department of children's services. Support documents were also examined to establish a history for each initiative and describe the model of service delivery created by each state's legislation.;Results indicated a core set of four components common to all 9 states studied: family focused services, full array of services, individualized services and an interagency collaborative structure. Two additional components were found to be present in the legislation of many of the states studied. Community-based services was found in seven states and flexible funding was found in six states. Three components were not found in the legislation of any of the nine states studied: co-location of services, unconditional care, and wraparound services. The degree of congruence between each state's legislation and the set of components ranged from 61% for New Jersey to 30% for Vermont.
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Aldeham, Khalid. "Needs Assessment of Users of Psychiatric Services in Saudi Arabia." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1904.
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Background: the aims of this study were to assess the outpatients needs among 155 patients at Al-Amal Complex for Mental Health in Riyadh, Saudi Arabia, and identifying the demographic variables that are associated with these needs. Method: the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) was used to assess the needs and the demographic questionnaire was used to identify the patient’s demographic variables includes gender, age, income and level of education. Results: patient who meets any one of these criteria; being elderly, poor, and the uneducated are more likely to have higher total number of needs. Men and women are more likely to report similar met needs, but women are more likely expressed more unmet needs.
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Bey, Ganga S. "Interpersonal Discrimination, Gendered Race, and Cardiovascular Disease Inequities: Application of the Emerging Identity Pathology Model." eScholarship@UMMS, 2019. https://escholarship.umassmed.edu/gsbs_diss/1009.
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An emerging framework, the Identity Pathology (IP) model, partially addresses persistent uncertainties about the primary causes of disparities in cardiovascular health (CVH) between black and white women and men through outlining how identity beliefs associated with social group membership lead to predictable differences in the health-damaging effects of discrimination exposure. Using data from the CARDIA cohort, this doctoral thesis seeks to: 1) propose a novel psychosocial characteristic, identity pathology, that drives the distribution of reported race and gender discrimination in health-relevant ways, 2) assess whether there are group differences in the effects of multiple versus single forms of discrimination on future CVH, and 3) assess variation between these groups in the relationships of reported racial and gender discrimination in a variety of daily life settings with future CVH. The IP framework suggests that beliefs about identity unique to each gendered race group influence the perception of discrimination and whether reported exposure will be associated with CVH. Simultaneous reports of racial and gender discrimination in multiple settings (compared with no discrimination) were negatively associated with future CVH only among white men. Further, the setting in which discrimination was reported appeared to be a significant indicator of whether experiencing multiple forms of discrimination negatively impacted CVH in each group. Our findings contribute to the literature through introducing a novel framework for assessing the effects of interpersonal discrimination. This work also provides preliminary evidence that compounded experiences of interpersonal racial and gender discrimination may not substantially contribute to poorer CVH among black women.
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Mucci, Nicola B. "The Efficacy of Psychosocial Services in Comprehensive Cancer Care: A Program Evaluation." Antioch University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1483579015227832.
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Tucciarone, Joseph T. Jr. "Adverse Childhood Experiences, Homeless Chronicity, and Age at Onset of Homelessness." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etd/3534.
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Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area of Northeast Tennessee responded to a brief instrument that includes measures of homeless chronicity, Adverse Childhood Experiences (ACEs), and age of onset of homelessness. Although relationships between ACEs and homeless chronicity was not observed, a relationship did emerge between number of ACEs and number of episodes and number of ACEs and age at initial onset of homelessness.
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Lucchesi, Maurício. ""A gestão de unidades de saúde mental em hospitais gerais na grande São Paulo"." Universidade de São Paulo, 2001. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-09082005-141938/.
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Apesar de terem surgido há mais de um século na Europa, o crescimento do número de unidades de saúde mental em hospitais gerais no Brasil veio de encontro às diretrizes das reformas sanitária e psiquiátrica propaladas partir da década de setenta. Desde então, essas unidades não foram submetidas a uma avaliação sistemática. O presente trabalho teve por objetivo conhecer os modos de funcionamento, a inserção na rede de assistência à saúde mental e o compromisso populacional de algumas dessas unidades na Região Metropolitana da Grande São Paulo. Para isso buscou-se obter, segundo a lógica de um processo avaliatório, as premissas que norteariam o uso de informações por gestores situados em diversos níveis em relação às unidades estudadas. Os resultados evidenciaram falta de clareza quanto ao papel desse tipo de equipamento dentro da rede assistencial, o que parece ser fruto da ausência de uma política de saúde mental na região. As dificuldades mais freqüentemente relatadas, como a impossibilidade de garantir a vinculação de pacientes em serviços extra-hospitalares especializados após a internação e a grande proporção de pacientes que chegam aos pronto-atendimentos sem necessitarem de um cuidado de urgência, não foram tidas como passíveis de algum tipo de resposta por parte dos hospitais gerais. Nas unidades, onde se privilegiam informações sobre a produção dos serviços em detrimento da avaliação do acesso e do impacto no estado de saúde da população que reside na área de abrangência do hospital, há um funcionamento independente do restante da rede, o que contribui para a fragmentação e iniqüidade da assistência à saúde mental. Um dos principais exemplos é a exclusão de pacientes das enfermarias psiquiátricas dos hospitais gerais, particularmente os cronificados, cuja patologia impossibilita a efetividade da terapêutica médica dentro do prazo estipulado para a internação. Em contrapartida, foram identificadas iniciativas que pretendem resgatar a integralidade da atenção, prioritariamente aos pacientes que merecem intervenções de maior complexidade e de longo prazo. Quanto ao cuidado aos pacientes portadores de transtornos mentais mais prevalentes, uma alternativa seria utilizar mecanismos de pressão entre os quais informações sobre a utilização dos pronto-atendimentos psiquiátricos para que os gestores municipais passem a investir nesse sentido.Although having appeared more than a century ago in Europe, the increase in the number of mental health units in general hospitals in Brazil met the guidelines of the public health and psychiatric reforms propagated since the early seventies. Since then, these units haven't been submitted to a systematic assessment. The objective of present work was to be acquainted with the functioning modes of some of these units in São Paulo metropolitan area, their insertion in the mental health assistance system and their commitment to the population. In order to do so, there was an attempt to obtain, according to an assessment logic, the premisses guiding the use of information by the managers situated in different levels in relation to the studied units. The findings showed little clarity concerning the uses of such instruments inside the assistance system, which seems to be connected to the lack of a mental health policy for the studied region. The most frequently mentioned difficulties, like the impossibility to guarantee the patient the continuity of the treatment in the extra hospital services, after he has left the hospital, and the great proportion of patients that arrive at urgency services without having the need to receive urgent care, were not seen as something that general hospitals themselves could contribute to. The units, where the information about the services' production were privileged to the prejudice of the assesment of the services' access and the impact of the unit on the healthconditions of the population living under its referal areas, function independently of the rest of the mental health services, which contributes to the mental health care fragmentation and iniquity. One of the principal examples is the exclusion of patients from the the general hospitals' psychiatric inpatient services, especially the chronically mentally ill, whose pathologies make an effective treatment impossible, considering the period of time set for hospitalization. On the other hand, there has been identified initiatives that wish to redeem the integrate care, especially for the patients that require a more complex and long run treatment. An alternative for the care of the patients that have the most prevalent disabilities would be the use of pressure mechanisms like information concerning the uses of psychiatric urgency services to estimulate local managers investments.
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Carbone, Lisa Ann S. "Autonomy in the California Disability Services System." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1818.
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Legislation concerning California residents with intellectual and developmental disabilities (ID/DD) requires recipients of services to be treated as independent individuals while emphasizing self-determination. At the same time, under regulatory procedures, recipients are considered dependent on the delivered services and not self-determinant. Neither the California Department of Developmental Services nor the trade associations representing community service providers have established a unified, systematic practice to support self-determination. This phenomenological study explored the experience of adults with ID/DD working toward self-determination.
Specifically, it explored how medical and social models contribute to shaping and actualizing the independence of this population. Interviews with eight adults with ID/DD explored the perceived barriers to, and opportunities for, achieving independence through self-determination. Under the current statutory regulations, the study viewed two conceptual lenses. The first lens, social role valorization, is based on the study of normalization. The second lens, social reaction, emphasizes a response to the disparities that acknowledge the political, cultural, and social beliefs associated with theories of deviance and social role valorization. The findings demonstrated that self-determination requires collaboration between coordinated services, primary social systems, and theoretical services supporting social role value. The discovery of these key elements may help California's disability service system fulfill legislative requirements to increase opportunities for personal choice.
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Ott, Kenneth Brad. "The Closure of New Orleans' Charity Hospital After Hurricane Katrina: A Case of Disaster Capitalism." ScholarWorks@UNO, 2012. http://scholarworks.uno.edu/td/1472.
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Abstract
Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, took advantage of the mass internal displacement of New Orleans’ populace in the aftermath of Hurricane Katrina in an attempt to abandon Charity Hospital’s iconic but neglected facility and to supplant its original safety net mission serving the poor and uninsured for its neoliberal transformation to favor LSU’s academic medical enterprise.
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Pusateri, Cassandra G. "Mental Health Services in Appalachia." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/3160.
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Jormfeldt, Henrika. "Dimensions of Health among Patients in Mental Health Services." Doctoral thesis, Lund University, Sweden, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-16873.
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Empirical studies focusing on the subjective experience of health among patients in contact with the mental health services are rare and most questionnaires are based on a medical model that emphasizes objectively observed disease-oriented health indicators. In studies I and II perceptions of the concept of health among patients and nurses in mental health services were explored and described using a phenomenographic approach. The perceptions and description categories that emerged from these studies were transformed into a number of items forming a questionnaire intended to measure subjectively experienced health among patients in mental health services. In study III, a randomly selected sample was used to test the psychometric properties of the new Health Questionnaire. A factor analysis revealed three factors labelled Autonomy, Social Involvement and Comprehensibility. The purpose of study IV was to examine the construct validity of the Health Questionnaire. The hypothesis was that subjectively experienced health would be positively associated to self-esteem, empowerment and quality of life, and negatively associated to psychiatric symptoms, perceived stigmatization experiences and perceived attitudes of devaluation and discrimination. This hypothesis was mainly confirmed insofar that overall health was positively correlated to self-esteem, empowerment and quality of life and negatively correlated to symptoms, attitudes of devaluation and discrimination and rejection experiences. The results of this thesis show that health is more than just an absence of disease and support a focus on health promotion interventions in mental health care.Medicine doktorsexamen
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Jefferies, Natalie. "Young people moving on from child and adolescent mental health services to adult mental health services." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3715/.
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There is a sound evidence base on the effects of the therapeutic alliance on outcome in psychotherapy for adults. In comparison, there is a smaller amount of literature on the effects of the therapeutic alliance on outcomes for adolescents. Adolescents rarely are seen individually for therapy and instead are often seen by family therapists as part of a system with other members of the family. At present, it is uncertain what the effects of the therapeutic alliance on outcome for adolescents in family therapy are. This paper presents a systematic review that aims to investigate the effects of the therapeutic alliance on outcome in adolescents in family therapy and what factors influence the therapeutic alliance with adolescents in family therapy. A systematic review of electronic databases was carried out using a quality assurance checklist adapted from the American Academy of Neurology Clinical Practice Guidelines (2004). This checklist was used as it assessed aspects of the studies’ theoretical basis, design, measures, analysis and results. Eleven studies met the inclusion criteria and were reviewed. The findings of this review suggest that the therapeutic alliance affects outcome for adolescents in family therapy. The presence of identifiable features of the therapeutic alliance, such as task, goal and bond can strengthen the therapeutic alliance with adolescents. Research into this area is still in its preliminary stages. However, important factors have been identified that affect outcome. Further research is necessary before more substantial claims of the therapeutic alliance on outcome can be made. The limitations of this review are presented, followed by clinical, training and supervision implications and suggestions for future research.
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Harley, Judith Ann. "Mental Health Consumers' Perspectives on Traditional Mental Health Services Versus Peer-Run Services: A Qualitative Study." Ashland University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ashland1352125523.
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Jones, Siobhan. "Adolescent engagement in mental health services." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14807/.
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Despite older adolescence being a risk period for the development of mental health concerns, mental health service engagement is low amongst 16-18 year olds. As therapeutic attendance is linked to clinical outcome, it is important to understand engagement in this population. There is a paucity of research looking specifically at the older adolescent engagement phenomenon. Previous qualitative research into adolescent experiences has provided rich and detailed results. Ten 16-18 years olds, engaged in Child and Adolescent Mental Health Services, were recruited from two London-based services. Each young person was interviewed in order to understand their personal experience of engaging in mental health services. Interviews were transcribed and underwent Interpretative Phenomenological Analysis. Analysis produced twelve subthemes subsumed within five superordinate themes: engagement begins at help seeking, strength of inner resolve, evolution of the self, in the clinic room, and, existing within service walls: physical and policy-based boundaries. Themes are discussed in detail. Conclusions are drawn in relation to previous theory and research. When considering 16-18 year understandings of the engagement phenomena, key elements include: clinician and service developmental appropriateness, negotiation of developmental tasks in relation to engagement, experience of the physical building environment, and awareness of service policy limitations. Suggestions for clinical practice in relation to engagement facilitators and threat are made, and recommendations for future research proposed.
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Curtis, Kathryn. "Mental health services and American expatriates." Manhattan, Kan. : Kansas State University, 2008. http://hdl.handle.net/2097/670.
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Lovell, Jonathan. "Self-disclosure in mental health services." Thesis, University of York, 2017. http://etheses.whiterose.ac.uk/19278/.
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Sharing lived experience of mental health experiences by mental health practitioners is a topic of increasing relevance in statutory UK mental health settings, in part because of the rise in recent years of the employment of peer workers who share their lived experience by default. Literature to date has suggested that self-disclosure can have a range of benefits and risks, but existing studies have tended to focus on general rather than mental health disclosure, have not taken place in statutory settings, have studied a narrow section of the workforce, or have used analogue methodology. The current study used quantitative and qualitative methods through surveys and focus groups to explore statutory UK mental health practitioners’ and service-users’ views about the helpfulness of sharing personal mental health lived experience versus other types of lived experience. Service-users indicated that personal mental health lived experience was the most helpful disclosure topic, was valued when disclosed by all types of qualified practitioner, but it was shared least often. Practitioners who rate disclosure as helpful may be more reflective than practitioners who rate disclosure as unhelpful. Practitioners may be deterred from disclosing by a range of pressures, including risk of negative disclosure effects; adherence to therapeutic models; negative judgements from colleagues; pre-qualifying training; and perceived direction from professional codes of conduct and ethics. Despite perceived risks associated with hypothetical disclosure, most practitioners disclosed to some extent. Respondents gave almost 500 examples of real life disclosures which were almost exclusively helpful. It is recommended that practitioners are afforded greater autonomy, respect and permission to make decisions about disclosure without fear of judgment about professionalism. Training and guidance may be beneficial to help practitioners make best use of disclosures in statutory mental health service delivery.
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Murphy, K. "Recovery-orientation in mental health services." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11184/.
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Policy initiatives are calling for mental health services to change their ways of working to prioritising the promotion of service users’ personal recovery. This requires a major re-negotiation of working practices and the relationship between service users and staff/services and their respective social positions. Preliminary research has shown that change has been problematic. The present study aimed to explore the construction of recovery and the positioning of service users and staff during the adoption of recovery-oriented practices in a community support and recovery team. Transcripts of two rounds of focus groups with service users (n=9) and staff (n=5) held six months apart, service user care plans and Recovery Star notes were analysed using a Foucauldian Discourse Analysis. The study found that recovery was constructed as clinical/medical and personal recovery, at different times and in tension with each other. These constructions positioned service users as dependent, passive and hopeless or empowered and hopeful, and staff as helpless or facilitative. It was also apparent that a discourse of personal recovery was not available to service users. Staff oscillated between the constructions of recovery as medical and personal resulting in different subject positions and opportunities for action. The study concluded that adopting a recovery-orientation in services should lead to service users being positioned as more influential in decisions about their treatment and modes of support from the service, and services less likely to dictate their treatment. However, this can only happen if the recovery-orientation constitutes a widely shared discourse with all its assumptions and associated practices. The problematic aspects of the medical discourse and how it can position people socially and how those positions impact on the potential for personal recovery needs to be highlighted.
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Hajduk, Alexandra M. "Cognitive Status and Initiation of Lifestyle Changes Following Acute Coronary Heart Syndrome: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/701.
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Background: Cognitive impairment is prevalent in survivors of acute coronary syndrome (ACS) and increases risk for poor outcomes. Lifestyle changes are recommended to patients after ACS to reduce their risk for recurrent events, but cognitively impaired patients may encounter difficulties initiating these changes. This dissertation had three aims: (1) to examine cognitive status as a predictor of lifestyle changes after ACS, (2) to examine whether caregiver support moderates the association of cognitive status and initiation of lifestyle changes, and (3) to assess the reliability of self-reported lifestyle changes in cognitively impaired patients through comparison of their reports of lifestyle change with those from their caregivers.
Methods: For aims 1 and 2, Poisson regression with robust error variance was used to examine the association of cognitive status and caregiver support with patient-reported initiation of five lifestyle changes (improving diet, increasing exercise, quitting smoking, reducing stress, and attending cardiac rehabilitation) in 881 patients from TRACE-CORE, a prospective longitudinal observational study of outcomes in ACS. For aim 3, pilot data from 78 patient-caregiver dyads from TRACE-CARE, an ancillary substudy, were used to examine whether patient-caregiver congruence on reports of lifestyle changes varied according to patients’ cognitive function.
Results: Patient-reported rates of lifestyle change did not vary according to cognitive status, except for participation in cardiac rehabilitation. Caregiver support improved patient-reported rates of lifestyle change among cognitively intact patients but not cognitively impaired patients. Patients’ cognitive function was positively associated with patient-caregiver congruence on reports of initiation of lifestyle changes and patients with decreased cognitive function tended to over-report initiation of lifestyle changes compared to reports by their caregivers.
Conclusion: Although cognitive status was not associated with initiation of most lifestyle changes and the influence of caregiver support on initiation of lifestyle changes was only beneficial to cognitively intact patients in this cohort of ACS patients, these null findings may be explained by the questionable validity of self-report in cognitively impaired patients. This dissertation yields new knowledge about secondary prevention in ACS patients and provides insight into the challenges of conducting patient-reported outcomes research in cognitively compromised populations.
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Hajduk, Alexandra M. "Cognitive Status and Initiation of Lifestyle Changes Following Acute Coronary Heart Syndrome: A Dissertation." eScholarship@UMMS, 2003. http://escholarship.umassmed.edu/gsbs_diss/701.
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Background: Cognitive impairment is prevalent in survivors of acute coronary syndrome (ACS) and increases risk for poor outcomes. Lifestyle changes are recommended to patients after ACS to reduce their risk for recurrent events, but cognitively impaired patients may encounter difficulties initiating these changes. This dissertation had three aims: (1) to examine cognitive status as a predictor of lifestyle changes after ACS, (2) to examine whether caregiver support moderates the association of cognitive status and initiation of lifestyle changes, and (3) to assess the reliability of self-reported lifestyle changes in cognitively impaired patients through comparison of their reports of lifestyle change with those from their caregivers.
Methods: For aims 1 and 2, Poisson regression with robust error variance was used to examine the association of cognitive status and caregiver support with patient-reported initiation of five lifestyle changes (improving diet, increasing exercise, quitting smoking, reducing stress, and attending cardiac rehabilitation) in 881 patients from TRACE-CORE, a prospective longitudinal observational study of outcomes in ACS. For aim 3, pilot data from 78 patient-caregiver dyads from TRACE-CARE, an ancillary substudy, were used to examine whether patient-caregiver congruence on reports of lifestyle changes varied according to patients’ cognitive function.
Results: Patient-reported rates of lifestyle change did not vary according to cognitive status, except for participation in cardiac rehabilitation. Caregiver support improved patient-reported rates of lifestyle change among cognitively intact patients but not cognitively impaired patients. Patients’ cognitive function was positively associated with patient-caregiver congruence on reports of initiation of lifestyle changes and patients with decreased cognitive function tended to over-report initiation of lifestyle changes compared to reports by their caregivers.
Conclusion: Although cognitive status was not associated with initiation of most lifestyle changes and the influence of caregiver support on initiation of lifestyle changes was only beneficial to cognitively intact patients in this cohort of ACS patients, these null findings may be explained by the questionable validity of self-report in cognitively impaired patients. This dissertation yields new knowledge about secondary prevention in ACS patients and provides insight into the challenges of conducting patient-reported outcomes research in cognitively compromised populations.
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Senior, Jane. "The development of prison mental health services based on a community mental health model." Thesis, University of Manchester, 2005. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:85467.
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Iveson, Claire. "From primary care to mental health services:." Thesis, University of Liverpool, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490634.
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Beecham, Jennifer Kate. "Community mental health services : resources and costs." Thesis, University of Kent, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319222.
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Rodriguez, Adriana. "Stakeholder Views on Children’s Mental Health Services." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2891.
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Identification of evidence-based treatments (EBTs) has been an important development; however recently, some shortcomings of the approach have been highlighted. These complexities have led to a surge in transportability research in mental health services science with goals of identifying needed strategies to encourage the adoption of innovations. The mental health system ecological (MHSE) model is an approach necessary to assist with closing this gap effectively as it integrates mental health contexts: client-level, provider-level, intervention-specific, service delivery, organizational, and service system characteristics. The aim of this study is to use the MHSE model to examine perspectives of mental health stakeholders on their needs. Data consists of qualitative transcripts from parent, therapist, and administrator interviews/focus groups. Mixed methods were used to develop and analyze codes according to the MHSE model. Results suggested that stakeholder groups mentioned needs relevant to the group of interest and thus have implications for future dissemination efforts.
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McGill, Fox Eileen. "Mental health services and late-onset depression." Manhattan, Kan. : Kansas State University, 2009. http://hdl.handle.net/2097/2361.
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Belt, Leslie Marie, and Leslie Paul Schellbach. "Perceptions of mental health services among marines." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3141.
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Ohaeri, Frances Ahunna. "Parental satisfaction with child mental health services." CSUSB ScholarWorks, 2008. https://scholarworks.lib.csusb.edu/etd-project/3343.
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The purpose of this study was to identify to what degree specific factors influence the level of satisfaction experienced by foster parents whose foster children are recieving mental health services from agencies that they have been referred to by a Coming of Age Foster Family Agency.
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Soto, Sally Alejandra. "Utilization of Mental Health Services Among Hispanics." CSUSB ScholarWorks, 2016. https://scholarworks.lib.csusb.edu/etd/359.
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ABSTRACT
In the United States, Hispanics have the same prevalence of mental illness as any other group however researchers have found that they are less likely to seek mental health services. This population’s lack of mental health utilization is due to various barriers hindering the population’s need for help, a substantial for social work practitioners. To better understand the factors that lead up to that, the current study explored and identified perceptions toward seeking and receiving mental health services among Hispanic members. Using a qualitative data collection, ten participants were interviewed to elicit their perceptions about mental health services ranging from what they believed addressed their lack of seeking services and what they thought about services. Data analysis revealed five core themes among the participants’ responses: Closeness to Family as a reason for people not seeking professional help. Another theme found was environment as a reason for Mental Illness making them feel that there is no need to seek services since they can simply remove the environmental stressor and the illness will seize to exist. Existing support systems were found such as involvement in church as a form of therapy, they talked about their faith providing them a form of support for stressors. Shared culture was a theme that was found to be a necessity for therapy, they felt they did not seek services because they felt mental health practitioners would not validate their culture. The final theme was access and that theme encompassed : not knowing mental health services existed in their community, to lack of Spanish speaking clinicians. The recognition of these themes could potentially guide social work practitioners’ when they are trying to engage the Hispanic community to receive mental health services. Social workers can be aware of the obstacles toward engaging this population into professional therapy, by having an understanding of what they believe about therapy and helping to alleviate or use some of those perceptions as a form of engagement and validating existing strengths that the population has causing them to feel professional services are not needed.
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Sandbulte, Natalie J. "Rural communities and mental health care." Theological Research Exchange Network (TREN), 2007. http://www.tren.com/search.cfm?p088-0180.
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White, Bradley Patrick. "Mental Health and Mental Health Treatment Experiences of Transgender and Gender Diverse Persons:." Thesis, Boston College, 2021. http://hdl.handle.net/2345/bc-ir:109141.
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Thesis advisor: Susan Kelly-WeederBackground: Stigma, discrimination, and victimization are common occurrences in the lives of TGGD persons (e.g. non-binary, genderqueer, agender, and other non-cisgender identities) in the U.S., including occurrences in healthcare settings. Additionally, TGGD people in the U.S. experience numerous disparities related to physical health, mental health, substance use, and health risk behaviors. Suicide prevalence data provide the strongest and most urgent indication that healthcare organizations, and mental health providers specifically, are not optimally meeting the needs of this marginalized, at-risk population. TGGD persons have experiences of stigma and discrimination in healthcare settings, and these experiences are directly associated with provider behaviors, staff cultural competence, and institutional policies/practices. Minority Stress Theory suggests that experiences of stigma are directly linked to health outcomes and health disparities. It also suggests disparities may be mitigated by one’s internal coping skills and by level of support available from affirming others. Purpose: This dissertation’s research sought to better understand the relationship between stigma/discrimination and sexual/gender minority (SGM) population health and to better understand the experiences of TGGD persons who receive mental health services in the United States. Therefore, this dissertation begins to address this critical need and fill the gap in science. Three discrete manuscripts are proposed to fully explicate three concepts: 1) How state-level policies may affect SGM mental health (a secondary data analysis); 2) A comprehensive understanding of TGGD persons’ mental healthcare experiences (an integrative review); and 3) TGGD persons’ inpatient mental healthcare experiences (a qualitative study). Methods: First, we conducted a secondary data analysis examining state-level inclusivity for SGM populations, and relationships with indicators of mental health and health risk behaviors in those states; we sought to determine whether and to what extent there is a relationship between states’ SGM policies and practices, and the mental health and health risk behaviors of those states’ SGM residents. Second, we conducted an integrative review examining the mental health treatment experiences of TGGD adults; we sought to synthesize and characterize the existing health literature regarding the mental health experiences of TGGD adults. Third, we conducted a qualitative descriptive study examining the inpatient mental health and substance disorder treatment experiences of TGGD adults; we sought to better understand the inpatient mental health and/or substance treatment experiences of TGGD persons and to identify and characterize facilitators of/barriers to gender-affirming care in inpatient mental health and/or substance treatment settings. Results: In Chapter Two of this dissertation, an ecological secondary analysis of the BRFSS data set showed statistically significant relationships between LGBTQ persons’ state of residence and self-reported mental health symptoms and risk behaviors of the LGBTQ persons who live there. Restrictive state policy environments were shown to function as a distal stress factor and inclusive state policy environments were shown to function as a resilience factor. In Chapter Three of this dissertation, integrative review results suggest that TGGD persons experience incidents of stigma and discrimination in mental health treatment settings. In Chapter Four of this dissertation, participants reported both stigmatizing aspects and welcoming/affirming aspects of inpatient mental health/substance treatment experiences. Conclusions: This dissertation explored the mental health of TGGD persons through a Minority Stress Theory conceptual framework, including potential distal stress factors, proximal stress factors, and resiliency factors. This program of research has made substantial and meaningful contributions towards an enhanced understanding of TGGD mental health experiences, sources of TGGD stigma, and sources of coping/resiliency. In each chapter, findings suggested the presence of MST concepts of distal stress factors, proximal stress factors, and resiliency factors. Nursing remains underrepresented in health literature, and dissertation results highlight ample opportunities to advance TGGD population health through nursing practice, nursing education, nursing scholarship, and nursing policy
Thesis (PhD) — Boston College, 2021
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Miller, James P. "Analysis of inpatient psychiatric hospital diversion projects in Pennsylvania." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1993. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1993.Source: Masters Abstracts International, Volume: 45-06, page: 2951. Abstract precedes thesis as 4 preliminary leaves. Typescript. Includes bibliographical references (leaf 75).
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Atlas, Robin Michelle. "Treatment of mentally ill juvenile offenders in the criminal justice system." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2927.
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Mentally ill juveniles who are incarcerated in correctional facilities receive minimal or no treatment services. The research in this thesis determines that mentally ill juvenile offenders receive inadequate treatment. It also determined that juvenile correctional officers as well as others in the criminal justice system are not trained properly to deal with mentally ill juveniles.
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Eldridge, Sarah Marie. "The Barriers To Mental Health Services: How Facility Factors Impact Perceived Barriers To Mental Health Services In Nursing Facilities." Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1409246124.
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