This study examined the relationship between the attitudes of counselors toward gays and lesbians and their ratings of this population, as compared to the heterosexual population, in terms of mental health. Participants (N=92) were masters and doctoral level graduate students at a midsized midwestern university. Counselors who were more prejudiced toward gay and lesbian targets rated them as less mentally healthy than heterosexual targets. Counselors who were less homophobic did not differ significantly from more homophobic participants in terms of their ratings of mental health. The implications and limitations of these findings are discussed, and future avenues of research are suggested. / Department of Counseling Psychology and Guidance Services

Thesis (D.P.H.)--University of Michigan.

Thesis (M.S.P.H.)--University of Michigan, 1931.

Thesis (M.S.P.H.)--University of Michigan, 1931.

Dissertation (D.P.H.)--University of Michigan.

Dissertation (D.P.H.)--University of Michigan.

In this study, systematic reflection in professional practice is seen as a dynamic process towards socio-political action, negating a navel-gazing critique. Positioned within nursing, the pioneering narrative inquiry approach will be highly valuable in medicine, education and other health fields. When I embarked on this study, research to guide me in homeless health care was limited and there is, even yet, insufficient evidence to demonstrate the effectiveness of advanced nursing practice in England particularly with homeless people. Through its reflexive narrative nature that research gap is addressed in a profound journey that illuminates my transformation over a three year period of being and becoming a Specialist Public Health Nurse (homelessness). The methodology draws dynamically on an eclectic, philosophical framework which includes reflective practice/guidance, narrative inquiry, hermeneutics, aesthetics, critical social science theory, storytelling, performance-ethnography and ancient wisdom. The Six Dialogical Movements (Johns, 2009) provides coherence to the twenty-one practice experiences that adequately marked my transformation towards my practice vision. I used the Being Available Template (Johns, 2009) as a reflexive framework which became the metaphoric net of my practice, showing where and how homeless people fall through the net of care, and my role in weaving a stronger net. I also drew on the work of Belenky et al's (1986) voice perspectives to show empowerment in my specialist role. Within the narrative, each story illuminates complexity and brings new knowledge about homeless health care. The study tangibly links childhood trauma to adult homelessness; it illuminates suffering in homelessness, showing where and how mainstream health professionals contribute to suffering when they do not grasp their role within the net, perpetuating homelessness. Appreciating precarious engagement in four quadrants: health services, homeless services, the homeless person and my SPHN role, is a concept that illuminates the precariousness of the net. The study concludes with a SPHN Homeless Health Care Model. Towards an ensuing social action through dialogue, I use the term 'audiencing' rather than transferability of findings. Hearing stories from 'street to boardroom' - making the invisible visible - has been profound in health services as evidenced in the narrative.

<p> This qualitative study explores the utilization of mental health services among Latinos in the United States. The sample included 15 Latino participants of various age groups who completed an 11-question questionnaire that provided data regarding demographics, perceptions about mental illness, consequences and improvements regarding mental illness, and known resources concerning mental health. Findings revealed that older generational Latinos were less receptive to utilizing mental health services than younger Latino generations. Majority of participants (54.5%) identified alcoholism as one of the most common family dysfunctions in their households while growing up. Participants indicated that although family members would benefit from mental health services their lack of awareness and education prevented family members from utilizing mental health services. Majority of participants, (66.7%) held a college degree and belonged to a younger Latino generation and were more receptive, educated, aware and open to accept mental health services.</p>

<p>Research has demonstrated that acculturative stress is an important influence on anxiety and depression in Latinos, however methodological issues limit generalizability of findings. The present study examines Latino subgroup (i.e., Cuban, Puerto Rican, Mexican) differences in the influence of acculturative stress on Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). Secondary data analysis of data from 2,554 Latino immigrants in the National Latino and Asian American Study (NLAAS) included stratified hierarchical logistic regression. The NLAAS collected data via in-person interviews at the participants' homes by bilingual interviewers in the participants&rsquo; language of choice. Acculturative stress was significantly related to MDD for Other Latinos (<i>p</i> &lt; .001), and to GAD for Mexicans (<i>p</i> = .040). Results provide empirical evidence for the need to disaggregate Latino subgroups. Subgroup heterogeneity may introduce important contextual factors that should be accounted for when exploring their mental health, particularly when examining acculturative stress. </p>

<p> The democratic decentralization of government administration in Indonesia from 1999 represents the most dramatic shift in governance in that country for decades. In this dissertation I explore how health managers in one kabupaten (regency) are responding to the new political environment. Kabupaten health managers experience decentralization as incomplete, pointing to the tendency of central government to retain control of certain health programs and budgets. At the same time they face competing demands for autonomy from puskesmas (health center) heads. Building on Scott&rsquo;s (1985) idea of a &ldquo;moral economy&rdquo; I delve beneath the political tensions of competing autonomies to describe a moral landscape of underlying beliefs about how government ought to behave in the health sector. Through this analysis certain failures and contradictions in the decentralization process emerge, complicating the literature that presents decentralization as a move in the direction of &ldquo;good governance&rdquo; (Mitchell and Bossert 2010, Rondinelli and Cheema 2007, Manor 1999). </p><p> Decentralization brings to the fore the internal divisions within government, yet health workers present a united front in their engagements with the public. Under increasing pressure to achieve global public health goals such as the Millennium Development Goals, health managers engage in multiple translations in converting global health discourses into national and local health policies and in framing these policies in ways that are comprehensible and compelling to the general public. Using the lens of a &ldquo;cultural theory of state&rdquo; (Corrigan and Sayer 1985) I describe how health professionals and volunteers draw on local cultural forms in order to render global frameworks compatible with local moralities. I introduce the term &ldquo;moral pluralism&rdquo; to describe how individual health workers interrelate several moral frameworks in their health promotion work, including Islam, evidence based medicine and right to health. My conclusion is that kabupaten health managers are engaging in two balancing acts. The first is between decentralization and (re)centralization and deals with the proper way to manage health programming. The second is between global health discourses and local cultural forms and concerns the most effective way to convey public health messages in order to bring about behavior change in line with national and global public health goals. This is the first anthropological study of how government officials at different levels negotiate the process of health decentralization in the face of increasing international pressure to achieve global public health goals.</p>