Tesi sul tema "Sociology of mental health"

A considerable deficit of Licensed Mental Health Professionals (LMHPs) is expected in the United States because of the rapid professional burnout and turnover. Research has related various leadership styles to job satisfaction, organizational commitment, and retention. This study focused on authentic leadership theory and the relationship between authentic leadership and burnout. The researcher conducted a causal-comparative study with a convenience sample of 116 licensed mental health professionals to assess the relationship between authentic leadership and LMHP leader burnout in an attempt to identify a solution to the systemic burnout and turnover problems in community mental health centers. The results indicated that authentic leadership was a statistically significant predictor of all three subscales of the MBI. The multiple linear regression analysis indicated that the subcomponents of authentic leadership had a relationship with the three subscales of the MBI. The transparency sub-component of authentic leadership was particularly important because it was a statistically significant predictor of the emotional exhaustion subscale, while the balanced processing and self-awareness subcomponents were also statistically significant predictors of the depersonalization subscale. The moral sub-component of authentic leadership was a statistically significant predictor of the personal accomplishment subscale, which makes this study useful for development of leadership trainings designed to promote work environments that are able to minimize burnout and turnover in LMHPs.

Investigation of the variations in aspirant juvenile probation officers' recommendations for a juvenile offender who may suffer from a mental health disorder was the purpose of this study. Two hypotheses were developed to test this purpose: a) there was a significant difference between the recommendations of mental health evaluations and b) there was a significant difference in the recommendations for a mental health evaluation prior to and after the mental health overview administered among two groups. A survey was administered to 13 undergraduate students with an aspiration to be juvenile probation officers. The survey consisted of a pretest and posttest questionnaire following a case vignette where a juvenile offender meeting the criteria for conduct disorder was described to measure if the mental health overview would increase the participant's likelihood of recommending a mental health evaluation. A Chi Square and McNemar Test were completed. The statistical analyses and implications are discussed.

Scholars have used studies of “street-level organizations” to examine how policy is implemented, adapted, and changed through the practices of workers in real-world contexts. This dissertation follows in that tradition, tracing the ways in which Medicaid reforms work their way down to the street-level in a community mental health center with its origins in the clubhouse model of treatment. Based on twelve months of direct observation of street-level practices, interviews with workers, and analysis of agency documents and reports, I examine how new managerial reforms shape the strategies that workers use to provide access to community mental health services and to advance the clubhouse logic of recovery. These findings have implications for scholarship across the domains of community mental health practice, organizational studies, and policy research, suggesting the need for further investigation into how policy reform is produced through the everyday practices of street-level organizations.

This dissertation uses organizational ethnographic methods to study workers’ practices at Community Club, a community mental health center located in Chicago, Illinois. The clubhouse is based on the idea that individuals whose lives have been adversely affected by severe mental illness can benefit from treatment in a setting that functions as a social club, where members experience themselves as valued and needed. At the same time, community mental health reforms have been advanced largely by new managerial arrangements that emphasize accountability and performance measurement. These reforms in governance and management produced considerable uncertainty for workers in how Community Club would adapt to changes in policy. This site provides an opportunity to examine how reforms “worked” in this particular setting and what became of the clubhouse model under new managerial arrangements.

Data were collected from November 2009 until November 2010. I directly observed therapeutic interactions at Community Club and attended weekly team and managers meetings. Interviews were recorded with frontline workers, team leaders, and program administrators as questions emerged from my day-to-day observations of direct practices. I had access to multiple sources of organizational documentation, including corrective actions, internal notices, and training materials. I attended meetings, webinars, and teleconferences at the Illinois Division of Mental Health for a year. I also attended monthly meetings at the largest community behavioral health trade association in Illinois for two years. Interviews were conducted with key informants at the state and trade levels to better understand how community mental health policy reforms took shape in Illinois. Data were analyzed in an ongoing and iterative fashion for thematic connections. Multiple data sources allowed for triangulation and fact-checking as hypotheses emerged over the course of this study.

This study finds that workers adjusted to reforms in governance and management in ways that were not reducible to formal statutes alone. First, new managerial reforms restructured the tensions that played out at the street-level as workers negotiated the competing demands of access to care. This study suggests that reforms may place pressure on workers to limit flexibility and openness, may produce both direct and indirect forms of rationing, and may introduce barriers that unevenly affect individuals who are “harder to serve.” Second, reforms in governance and management restructured three key logics of the clubhouse. Street-level practices that advanced community participation, informal group arrangements, and client self-determination were reshaped by organizational incentives and penalties that increased the costs for workers of providing these services. These changes had observable implications for individuals’ access to services and for workers’ ability to act in consonance with manifest principles of the clubhouse and recovery models of treatment.

This dissertation supports the assertion that formal policy is changed through its implementation in real-world contexts of practice. By revealing the structures that shape most decisively what policy becomes in practice, this study enhances the visibility of social welfare reforms that may otherwise obfuscate how reforms “work” in practice. This study suggests that social policies should focus not only on accountability and performance measurement, but also on supplying workers with adequate resources to do their jobs well. If, as advocates and researchers have long suggested, there remains significant need for services that support social connection among people with severe mental illness, then it is important for scholars and policymakers to think about how to better equip organizations with the resources they need to facilitate this dimension of care. This dissertation is based on a single case study, which limits the generalizability of its findings. Street-level organizational studies build validity over multiple iterations of case selection, using a comparative perspective to distinguish particular from systematic features of organizational practice. More studies are needed that examine how community mental health policies are produced in the everyday life of organizations, in order to better understand how polices give shape to the nature and distribution of care.

The purpose of this study was to explore the association between adolescent characteristics, community factors and mental health. This was achieved by completing a quantitative study analyzing secondary data obtained from a mental health agency in Orange County, California, and an online database, City-Data.com. The results rendered a statistically significant relationship between age and those who had the presenting problem of depression, relational problems, and poor coping. A statistically significant relationship between females and poor coping was also revealed. The most interesting finding, however, was the statistically significant relationship between presenting problems in relation to their community factors. Both poverty levels and educational attainment less than high school among the residents in the communities where these adolescents live were associated with depression and relational problems. The findings of this study are beneficial in identifyirig the need for further research regarding the relationship between educational attainment and mental health.

The purpose of this project was to develop and fund a project to add a mental health component that will serve former gang members and their families. The host agency for this project is Aztecs Rising in Los Angeles. A comprehensive review of the literature was conducted to build insight and knowledge about the gang culture, risk factors for joining gangs, risk factors for leaving gangs, and mental health needs that pertain to the gang population. A thorough search for potential funding sources led to the California Endowment as the funding source for this project. A grant application was developed to support this project. Submission of the actual grant was not a requirement of this thesis project.

College student mental health is a significant issue for educational leaders, as mental health needs are increasing in prevalence and severity (ACHA, 2013; Gallagher, 2013). Eisenberg, Downs, Golberstein, and Zivin (2009) note that mental health issues cause adverse occupational, academic and social outcomes, impacting student success, retention, and persistence (Belch, 2011; Cleary, Walter, & Jackson, 2011). Anxiety and depression, which are more prevalent in women (ADAA, 2007; APA, 2013), are the most common mental health issues affecting college students (ACHA, 2013; Gallagher, 2013).

Coyne and Downey (1991) correlated social support with improved mental health outcomes. Baron (2010) indicated that involvement in student organizations may promote development and connection, thereby enhancing learning and retention (Chambliss & Takacs, 2014). Female students may engage in campus life by joining sororities, which are prominent and influential on many campuses (Lien, 2002). The purpose of this research was to investigate sorority member mental health, specifically anxiety and depression. The relationships between anxiety, depression, and student characteristics were examined.

This correlational, ex-post facto study explored the presence and severity of anxiety and depression of women (N =72) who self-identified as living in sorority housing. Permission was obtained to review data from the 2013-2014 Healthy Minds Study (Eisenberg & Lipson, 2014), including demographic information and results from the PHQ-9 (Kroenke, Spitzer, & Williams, 2001) and the GAD-7 (Spitzer, Kroenke, Williams, & Löwe 2006). Data analyses produced frequencies, correlations, and t-tests.

Findings revealed the following: 20% of respondents reported anxiety, with 8% percent reporting severe anxiety; 15% of respondents reported depression, with 5% reporting major depression. Financial difficulty was correlated with depression (r =.27, r²=.07, p=.008) and a significant relationship existed between the presence of anxiety and depression (r²=.36, r2=.13, p=.004). No statistically significant difference existed in reported symptoms of anxiety and depression of women residing in sorority housing compared to those residing elsewhere. Information about mental health may assist sororities in providing support and resources to members. Educational leaders, mental health practitioners, faculty, and student affairs staff can also benefit from this information as they work to help address student mental health needs, student retention, persistence, and success.