published_or_final_version / Social Work / Master / Master of Social Work

The Mexican American population is the largest and fastest growing Latino subgroup in the United States. Research has indicated Mexican Americans experience as many, if not more, mental health problems as other ethnic groups, including anxiety, depression, agoraphobia, simple phobia, drug and alcohol abuse, and increased rates of suicide. Mexican Americans, however, are among some of the most underserved by the mental health community. Little research, however, has focused on parents’ beliefs about their adolescents’ mental health, their utilization of mainstream mental health services, or their use of alternative resources for addressing their adolescent’s problems. This is particularly troubling given Mexican American youth have disproportionately high rates of substance abuse, delinquency, depression and suicide. Mexican American youth’s utilization patterns mirror those of adults, with lower rates of utilization than their peers of other ethnicities, and higher rates of early termination of treatment. The purpose of this qualitative study was to examine a number of topics related to Mexican American mothers’ perspectives on adolescent mental health, including factors that contribute to problems, steps parents would be willing to take to help their adolescent, their beliefs about the use of mental health professionals, and their use of alternatives such as curanderos, priests, or family reliance to address their adolescent mental health problems. Participants were 27 mothers of adolescents who identify themselves as being of Mexican descent (Mexican; Mexican American). Mothers who agreed to participate were interviewed in person using a semi-structured interview format. The results revealed considerable consistency in the participants’ views regardless of family history, adolescent problems faced, language spoken, and their generation in the U.S. The results of this study indicated that the Mexican American mothers who participated were attuned to adolescent functioning, with a keen sense for determining whether their adolescent is experiencing problems. The participants were able to navigate a complex system that involved considering other resources in their surroundings to address their adolescent’s problems. Overall, participants indicated positive regard toward the use of family, church, schools, and professionals in helping their adolescent, while the use of traditional folk healers, such as curanderos, was only minimally indicated. / text

Professional literature in the past five years regarding the care and treatment of deinstitutionalized chronic mentally ill (CMI) persons has presented growing concerns that services for some CMI persons are inadequate or nonexistent. A number of previous authors have suggested that there may be a consistent, as opposed to a random, bias in the traditional mental health service delivery system whose services are contingent upon client characteristics that, in the very least, assume foresight, independence, initiative, and consistency. Lacking these qualities, clients may not seek services to which they are entitled or they may be frustrated in maintaining those services. This study provides a description of a CMI population (n = 142) that received outreach services from a small county psychiatric hospital. These clients were selected because they were evaluated as severely disturbed, potentially impulsive, and had a history of not following through with traditional mental health services, i.e., they did not make or keep prescribed appointments for therapy or education. This group served as a model against which to compare characteristics of the traditionally engaged clients. Previous authors as well as this study found that the dropout populations were younger, less compliant with prescribed anti-psychotic medication, engaged in more alcohol and drug use, were more likely to live independently and to be rehospitalized with greater frequency. Increased hospitalization also correlated with less functional independent living skills. In other reported research several variables were found to discriminate the younger CMI. This study could only confirm an increase in substance abuse although several confounding factors are discussed. Finally, the outreach program itself was examined, some services were quantified, and some were related to specific client characteristics. For instance, 40 percent of this CMI population was primarily reliant on their outreach worker for all transportation beyond walkable distances; and those clients receiving the most number of outpatient visits were those rated most rejecting of services and those with the poorest independent living skills. The treatment population was found to have reduced their total number of admissions and days hospitalized during the two-year period of investigation.

No description available.

Research in community management of the severely mentally ill has been scarce. Two primary components of community care in particular need evaluation, residential arrangements and styles of "case management." The purpose of this study was to evaluate the interaction of two types of residential arrangements (single- and double-occupancy) and two types of case management ("assertive" and "limited") in a 2 X 2 design. Participants were individuals with a severe mental illness served by CMHS, Inc. Individuals were matched on DSM-III-R diagnoses and sex: 8 had roommates and received assertive case management, 5 had roommates and limited case management, 5 lived alone and received assertive case management, and 5 lived alone with limited case management. Data were obtained from three independent sources: (1) each client was interviewed using the Denver Community Mental Health Questionnaire (DCMHQ) and the Inventory of Socially Supportive Behaviors (ISSB) on four separate occasions over three consecutive months; (2) frequency of client contact with family members over the same time interval was tracked by case managers; and (3) concurrent attendance in day treatment sessions, diagnosis, number of previous hospitalizations, and approximate number of months of previous hospitalization were obtained from community mental health center records. DCMHQ scores for acute symptoms and interpersonal conflict were combined into an index called problems, while ISSB scores measured social support received. Monthly follow-ups for three consecutive months were used to obtain stable estimates of problems and support. Significant positive correlations were found between family involvement and problems, family involvement and residential arrangements, social support and problems, group attendance percentage and age, problems and social support, and a marginal relationship between residence and social support. Statistically significant negative correlations were found between case management and problems, social support and number of previous hospitalizations, group attendance percentage and problems, and residence and age. In multiple regression involving all predictors, the variables other than roommating and case management, (i.e., average family involvement, number of previous hospitalizations, program attendance, and age, considered together) predicted both problems reported and support received, while as second and third steps in the regression analysis case management and residence did not significantly predict problems or social support. In other words, once chronicity (i.e., number of previous hospitalizations), family contact, age, and group attendance were controlled, case management and residence both vanished as predictors. Future studies should consider these factors, and other aspects of the natural context, when evaluating community interventions for the mentally ill in a more controlled experimental design. With respect to developing new research for community adjustment, recommendations for more controlled studies were made and two new community intervention procedures were described. / Department of Psychological Science

Abstract This study proposes a model for meeting increasingly mandated outcome research objectives in a university counseling center setting. It is proposed that counseling centers utilize their existing intake forms, along with an annual satisfaction survey to determine the effectiveness of counseling services. Effectiveness is defined as improvement and measured by the reduction of the symptoms or presenting concerns with which the client initially presented. It also introduces the Relative-Change Index (R-Chi) as an objective way to quantify intra-individual change occurring as a result of therapy. This new mathematical procedure allows for a more meaningful assessment of the client's degree of improvement, relative to their potential for improvement. By re-administering the problem checklist, routinely included as part of the initial paperwork for each client at intake, again post-therapy, it is possible to quantify improvement by measuring the difference in distressing concerns. Additionally, including a subjective, retrospective survey question asking the client to indicate their perceived rate if improvement at follow-up provides construct validity and allows for correlational comparisons with R-Chi. Results suggest that student/client ratings of the degree to which the services they received satisfactorily addressed their presenting concerns were significantly rated to their R-Chi score. This model suggests that the framework guiding client outcome research should include measures of the client's level of distress, improvement in reducing the distress, and satisfaction with services.

A research report submitted in partial fulfilment of the requirements for the degree of Master of Arts in Psychological Research in the Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2017. / Mental ill-health constitutes a substantial burden of disease worldwide, representing more than the burden of disease caused by all cancers combined. However, the provision of mental health care remains inadequate around the world. To address the shortages in mental health care expenditures, the WHO-HEN (2003) proposed treatment priorities and policy goals in different contexts, based on their financial resources. This study investigates the state of mental health treatment provision in high-, middle-, low-income and the South African contexts, in order to assess the efforts that have been made in these contexts to counter the shortages in mental health care provision, and to promote public mental health, following the WHO-HEN (2003) suggestions. This study uses the mixed methods approach to review literature published between 2004 and 2016 within the AJCP, AJP, CMHJ, SAJPs and SAJP. The findings reveal that treatment trends across contexts align with, and extend beyond the WHO-HEN (2003) suggestions in most cases, and that the balanced care approach is progressively being implemented in the delivery of integrated mental health services in highincome countries and South Africa specifically. These results prove that efforts are being made across contexts to provide effective mental health care, and to ensure the promotion of mental health and prevention of mental disorders. / XL2018

No description available.

Since the 1990s there have been continued drives in England to integrate National Health Services and Local Authorities’ social care within a single mental health service, with the aim of bringing about improvements in health and social care (Local Government Association et al., 2016). This is underpinned by the belief that through bringing the different professional health (such as psychiatrists and mental health nurses) and social care disciplines together, people in need will have a single point of access to a range of skills and knowledge, that no one system could deliver alone (Cooper, 2017). However, the very unique professional approaches that have been stated as the reason to place social workers in NHS Mental Health Services have been the ones that mental health social workers have struggled to hold onto in this setting (Allen et al., 2016). This is a thesis of how mental health social workers constructed a professional self within the context of the NHS mental health services. I used a Foucauldian approach and the notion that professional identity is a socially constructed sense of self, produced from discourses, subject positions and a process of subjectification. Twelve social workers were interviewed; seven mental health social workers and five social workers who held positions as managers or educationalists. I asked social workers questions about their professional identity, their answers provided a rich source of ‘talk’ that I could analyse using Parker’s steps to discourse analysis. The findings discuss the nature of social work as a profession, generic and specialist social work, and suggests a typology of subject positions drawn from the mental health social workers’ discourses. These findings provide a useful resource to support critical social work practice, both as an example of how Foucauldian theory and concepts can be a rich toolbox for understanding practice in complex settings, and through the use of the typology of subject positions as a source to prompt self-reflection for mental health social workers’ practice.

Chow Wai Ling Karen. / "Architecture Department, Chinese University of Hong Kong, Master of Architecture Programme 1997-98, design report." / program / INTRODUCTION --- p.1 / EXISTING STATE --- p.1 / SOCIAL BACKGROUND --- p.1 / CULTURAL BACKGROUND --- p.2 / USER PROFILE --- p.2 / CLIENT --- p.3 / MISSION --- p.3 / OBJECTIVE --- p.3 / FUNCTIONAL PROGRAM --- p.4 / ARCHITECTURAL PROGRAM --- p.4 / PROGRAM REQUIREMENT --- p.5 / SCHEDULE OF ACCOMODATION --- p.6 / BUBBLE DIAGRAM --- p.7 / SITE ANALYSIS --- p.8-10 / MENTAL HEALTH AND ARCHITECTURE --- p.11-12 / process / DESIGN PROCESS --- p.1 / IMAGES --- p.2 / ZONING --- p.3 / PSYCHOLOGICAL --- p.4 / RESPONSES TO SPACES / SKETCHES --- p.5-6 / NATURAL FEATURES --- p.7-10 / 1st review --- p.11 / 2nd review --- p.13 / 3rd review --- p.14 / 4th review --- p.16 / final review / concepts --- p.1 / diagrams --- p.2 / site plan --- p.3-4 / ground floor plans --- p.5-7 / 1st floor plan --- p.8-9 / details --- p.10 / index --- p.11 / site sketches --- p.12 / perspectives --- p.13-14 / photographs --- p.15 / lighting study of activity hall / photographs --- p.16 / spatial quality of rooms / sectional perspectives --- p.19 / model photographs --- p.21-22 / development calculation --- p.23-25