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The task of determining the needs of a community precedes the possibility of planning services or developing relevant social programs and action for that community. The approaches used in the assessment of community needs respond to methodologies that are informed by theoretical frameworks containing particular implications as to their implicit purposes. Historically, the methods which have been used are characterized by the relative, if not total, lack of participation of the community in this assessment process. The outcome of these methods which intend to develop programs for the community, while negating active community participation, is to maintain people as marginal and passive recipients of these services and to maintain an oppressive and colonizing ideology. Such methods serve the purpose of controlling people and legitimizing the present social order (Aponte, 1978). They are hierarchical and non-participatory, and in relation to the minority communities in the United States they further contribute to an alienating reality which not only mystifies the sources of conflict and stress in community life, but also fosters oppressive experiences and relationships.

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Hotlines are a telephone service through which people who feel themselves to be in a state of crisis can receive immediate contact with interested and helpful volunteer listeners. Hotlines are a relatively new phenomenon in the field of mental health services. They are representative of a new type of response to the growing realization of the need for innovative approaches to expanding the reach of preventive mental health care services. Hotlines represent one of the ways in which persons without formal training in mental health are being utilized in roles which previously did not exist at all in the mental health field.

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Thesis advisor: Sara Moorman / Thesis advisor: Lacee Satcher / The well-being of students is pivotal to the success of higher education institutions, yet students are experiencing an unsettling rise in mental health issues. This study aims to examine the mental health status of Boston College undergraduates and how different institutional and social factors shape variance in mental health. Undergraduate students (N=919) completed an anonymous online survey asking about mental well-being, campus attitudes/culture, and support resources on campus. significant relationships between mental health outcomes and self-rated mental health, feeling tired or having little energy, poor appetite or overeating, thoughts of self-harm, and seeking support for mental health difficulties. Additionally, There are statistically significant relationships between the prevalence of mental health diagnoses and school, race/ethnicity, and sex. Attempting to access University Counseling Services also varies by sex, race/ethnicity, and graduation year. I provide strategies to improve future research, support the well-being of undergraduates, and increase student engagement with mental health resources and practices. / Thesis (BA) — Boston College, 2023. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Departmental Honors. / Discipline: Sociology.

Background. Psychotic Disorders affect more than 1% of the South African adult population and have a chronic course that is associated with high rates of morbidity and mortality. The implementation of early intervention strategies may reduce the severity of these disorders. Little is known about the effectiveness of these interventions in South Africa and few longerterm studies have been undertaken internationally. Aim. This study aimed to measure the effectiveness of an Early Intervention and Support (EISH) service at reducing readmission to hospital in patients with psychotic disorders. Setting. Valkenberg Psychiatric Hospital, Cape Town. The EISH Team is an outpatient service consisting of psychiatrists, a psychologist, an occupational therapist, psychiatric nurses and social workers. Methods. Retrospective cohort study. Hospitalisation during the two years after discharge from the index admission was measured in 100 subjects who attended EISH and 100 who had treatment as usual (TAU). Readmission rate, average length of stay (ALOS), and time to readmission to District Hospitals (DH) and Tertiary Psychiatric Hospitals (TPH) were calculated. Results. Readmission Rates were three times higher in TAU compared to EISH patients for both types of Hospital. For TAU subjects compared to EISH subjects: ALOS was longer (59 vs 13 days), and days to readmission were fewer (187 vs 320 days). All differences were statistically significant (ps < .05). Conclusion. EISH intervention at Valkenberg Hospital was useful in reducing readmission rate, ALOS, and time to readmission in patients with Psychotic disorders. Prospective controlled trials are required to confirm the efficacy of this intervention.

Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation.

This work explored the ways in which the theoretical constructs of gay identity development, relational satisfaction, and outness interact in gay-male emerging adults. Informed by the literature on these constructs, the researcher developed a structural model to evaluate the interactive and mediating roles within the model. Three instruments were selected to assist in measuring these theoretical constructs. The Lesbian, Gay, and Bisexual Identity Scale (LGBIS) measured gay identity development, the Gay and Lesbian Relationship Satisfaction Scale (GLRSS) measured relational satisfaction, and the Nebraska Outness Scale (NOS) measured outness. A sample of 206 cisgender gay men in Emerging Adulthood (ages 19-29) were recruited from LGBTQ+ Community Centers, Post-secondary Pride Centers, and electronically through the MTurk crowd sourcing platform. Data gathered from these participants was evaluated via Structural Equation Modeling (SEM) to examine the relationship between the variables and understand how outness (NOS) and relationship satisfaction (GLRSS) mediate gay identity development (LGBIS). Results of confirmatory factor analysis of all three measures show considerable concerns. This study was unable to confirm author supplied factor structures for any of the instruments used in this work. Results of this study should be considered with extreme caution as the instrumentation used may be flawed and may not have actually measured the intended theoretical constructs. Discussion, consideration of findings, limitations, and areas for future research are given with caution.