State and federal aid payments to local governments have grown explosively over the last fifteen years. One reason for this growth is that the donor governments can alter a local government's budget choices through grants. Grants have not remedied social problems, however, because the local governments' responses to grants were not anticipated. Economists have broadened our understanding, but debates remain about the proper modeling of local buur grant impact knowledge. Accordingly, this study examined the effects of thdgeting and, because researchers used aggregated data, gaps exist in oree types of mental health grants on the budget allocations for Oregon counties. The theoretical literature on the expenditure effects of grants was first reviewed. The constrained maximization, median voter, and budget maximization models of local fiscal decision-making were described and then compared as to their predictions about the effects of different grants. It was concluded that too little was known about budgetary processes to use or compare the models' predictions. Empirical studies were then reviewed. Researchers, largely using demand frameworks, found that grants significantly affected local spending and that different grants induced different spending responses. Their estimates of the stimulus differed, though. Moreover, little or no research was undertaken on the employment, wage, and output effects of grants. The theoretical and statistical problems with these studies were examined. These problems were: (1) the misspecification of aid variables; (2) the aggregation of government units and public services; (3) the lack of institutional and political realism. A theoretical model of Oregon counties' expenditure and production decision-making for mental health services was developed based on the insights and criticisms of existing models. The model consists of eleven equations; some describing the "expenditure stage" of the budget process, others describing the "output stage". It was argued that county commissioners make the expenditure decisions, and that mental health administrators make the production decisions. The framework allowed us to examine the effects of mental health grants on expenditures, wages, staff numbers, patient numbers, and output and to study the determinants of grant participation. Using regression analysis, the equations were estimated from the observations for 31 Oregon counties in fiscal year 1975-1976. Ordinary least squares was used in the expenditure and grant participation equations. Two-stage and three-stage least squares were used in the rest. Regressions were run for western and eastern Oregon counties when possible. For all observations, the major findings suggested that a dollar of state matching mental health aid per capita stimulated per capita mental health expenditures by $1.37, increased the professional staff by .556 to .762 persons per 10,000 county residents and increased average professional salaries by $2,173. A dollar of federal matching aid per capita appeared to have an expenditure effect of $1.03, an employment effect of .722, and no salary effect. A dollar of non-matching aid per capita had an estimated expenditure effect of $1.00, an estimated employment effect of .35, and no salary effect. In eastern Oregon, the major findings indicated that the marginal expenditure effect of federal aid was $1.41, the marginal expenditure effect of non-matching aid was $.96, and that state matching aid had no expenditure effect. In western Oregon, a dollar of state matching aid per capita had an estimated expenditure effect of $2.23, a professional employment effect of 1.25, and no significant salary effect. A dollar of non-matching aid per capita had an estimated expenditure effect of $1.67, and no significant employment or salary effects. In all regressions, the mental health grant estimates were not statistically different from one another. Finally, a production function for mental health services was unsuccessfully estimated and discussed. / Graduation date: 1979

This thesis is a descriptive study of five child day treatment centers in Oregon. Its purpose was to generate hypotheses about the relationships between parent reactions to the day treatment center, the center’s theoretical orientation toward treatment, and the organizational structure of the center. The five centers involved in the study were: Poyama land in Independence, Oregon; the Child Psychiatric Day Center in Portland, Oregon; Mid-Columbia Children’s Center in the The Dalles, Oregon; the Child center in Eugene; and Edgefield Lodge in Troutdale, Oregon. These centers were selected for this study because of their proximity to the Portland area and their requirement that parents be involved in their child’s treatment program. Data were collected by a parent questionnaire, a staff questionnaire, and an interview with the executive director of each program. All three data collection instruments were designed specifically for use in this study.

Psychiatric emergency services are recognized as an essential component in the provision of mental health care. This study describes the delivery of psychiatric emergency services in selected Oregon comm.unities. The theoretical framework was developed to consider the problem of psychiatric emergency service delivery from the perspective of the individual experiencing the emergency, the social milieu, and the health care system. The literature describing psychiatric emergency service programs, the characteristics of those who use these services and the roles of direct service providers was reviewed. On the basis of the review a study was undertaken to describe the delivery of psychiatric emergency services in selected Oregon counties, to identify variables that determine the nature of psychiatric emergency services provided and to develop recommendations for existing psychiatric emergency services.

This thesis is based on a study conducted for the state of Oregon's Office of Mental Health Services (OMHS). OMHS' primary research objectives included 1) the identification of the unfunded population (individuals who are uninsured and ineligible for Medicaid) who seek services at community mental health programs and 2) an examination of this group's access to atypical antipsychotic and antidepressant medications. OMHS sought this data in order to inform legislative decisions regarding a forthcoming state budget proposal for a specialized atypicals fund. The author collected ethnographic data through semi-structured interviews with 57 mental health clinicians and 41 mental health advocates throughout Multnomah, Linn and Lincoln counties. While answers to the primary research objectives were inconclusive, the qualitative data characterizes the target population and contextualizes the unfunded client's medication access issues at county-related mental health clinics. Specifically, the study results indicate that 1) the complex characteristics of the unfunded population and the inadequacies of the available medication resource programs should be examined more thoroughly before allocating appropriated funds, 2) insufficient mental health services in general is the foremost problem for unfunded clients, and that which contributes to difficulties in accessing psychotropic medications, and 3) appropriated funds from the state's budget would not adequately resolve the medication needs for the target population. The study findings suggest that the state's concern with atypical medications overshadows existing practical, everyday problems in the clinics. The author analyzes the study from a Critical Medical Anthropology perspective, examining the relationships between the global and local contexts surrounding atypical medications, and discussing the practical use of the research data. From this perspective, the state's preoccupation with supplying atypical medications for the target population appears to be driven more by the pharmaceutical industry's profit-making interests and the historical role of the public psychiatric field than by quality health care decisions. The author also discusses medical hegemony in terms of the psychiatric field, and the ways in which this effects the asymmetrical power within the Oregon mental health system. / Graduation date: 2000

Practicum focusing on the history of the planning and development of children's mental health services in Oregon, with special emphasis on the training of pediatricians and how pediatricians address children's mental health issues. Offers a detailed look at the legislative processes surrounding mental health program development, as the heightened role that referrals play in how treatment is identified and administered.

Portland Youth Advocates is a nonprofit organization in Portland, Oregon that since 1969 has supervised nearly a dozen innovative service programs for young people. One of these programs was a counseling and referral program that evolved in August 1970 and closed in September 1979. Although it used different names at various times, it was most often known as the Contact Center. Three of PYA's former programs are operating in 1981, having each incorporated separately since 1979. To address the problem of why the Contact Center was unable to continue as well, an ex post facto case study of the program is undertaken. To facilitate the study, the program's history is divided into five representative time periods. Four categories of sources are then consulted to indicate the program's performance in five fixed factors during each time period. Findings are initially presented for each factor in each time period. They are subsequently comprehensively analyzed from the viewpoint of two factors over time, a collective factor over time, and three special attitudes. A conclusion is then drawn regarding the Contact Center's demise. Data is sufficiently indicative as to suggest a reply to the problem. The Contact Center appears to have been a fairly well organized program that generally provided good service. Its difficulties seemed to derive from its increasingly troubled mediation with the external landscape--government officials, foundation executives, and other private human service agencies. Some of the disturbance the center encountered in this regard was a consequence of its acknowledged preference for clinical as opposed to political activity. But the evidence also implies that distinguishing attitudes assumed by program members may have exacerbated already tenuous relationships between the program and external entities. Because these attitudes roughly identify the Contact Center program with what is often called "alternative human service," the work concludes with a prescriptive essay regarding the perpetuation of such service. In this manner, the particular experience of the Contact Center inspires an informed contribution to the consideration of a national phenomenon in human service.

The subject of drug and alcohol abuse on college campuses across the country is the concern of many college administrators. There exists a relatively high consumption pattern of drug and alcohol abuse among college students when compared to the general population. This pattern of alcohol abuse has remained stable despite the presence of substance abuse programs on campuses that are specifically targeted toward the student population. There exists little research on how these programs operate and how they address the problem of substance abuse on campuses. Most of the research that exists is of survey design. This study examined through a descriptive case study, the substance abuse programs in three public universities in Oregon. The study used descriptive case study to describe what components comprised the programs as well as how the programs functioned under the various organizational structures. Three organizational structures were identified. The first university's organizational structure was under the health center, both administratively and physically. The second university studied had part of the program under the counseling center and other components under the athletic department and the health center. The third university had what was termed as a de-centralized structure, with the treatment component under the health center, the prevention component under an academic department, and the peer education component under the health center. The various organizational structures were also examined for their influence on the respective program. The 1989 Drug-Free Schools and Campuses Act Amendment, required institutions of higher education receiving federal funds to have programs. The impact of the Act on both the program and the organizational structure of the program was also examined. The study demonstrated an impact of the legislation on the programs in the form of funding that made possible new services. The study also suggested an influence of the organizational structure on the programs in the form of the funding of new program components that changed the organizational structure. Implications for programming as well as research as a result of this study's findings are presented. Recommendations for program models are also presented. / Graduation date: 1994

Today taxpayers (those who pay for services) and clients (those who receive services) wish the best use for the money that they invest. The public is not as accepting of generalities, observations or intuitive success measures of social agencies' performance. Emotional problems are costly. Often they can lead to loss of employment, inefficiency, break-up of marriages, retarding the emotional development of children and use of monies invested by other agencies, i.e., welfare, juvenile courts, etc. Social agencies, in response to the general public, are raising issues around what are appropriate measures tor evaluating treatment outcome. The instant study is one such response on the part of Delaunay Institute for Mental Health. The study. attempts to ascertain treatment outcome in the Delaunay program and at the same time test out the PARS (Personal Adjustment and Role Skill) as an evaluative instrument in making treatment assessment.

The social problem of intimate partner violence affects approximately one-half to two million individuals each year in the United States (Catalano, 2007; Tjaden & Thoennes, 2000). Commonly the criminal justice system mandates completion of a group-based intervention intended to prevent violent behavior (Dalton, 2007). These groups are typically referred to as a batterer intervention program (BIP). Despite the popularity of this intervention approach, research findings examining the efficacy of these programs remain inconsistent (Babcock, Green & Robie, 2004). Nonetheless, 45 U.S. states including the District of Columbia, have implemented standards that aim to proscribe and regulate elements of program functioning. To gain insight regarding the effects that standards implemented in the state of Oregon in 2006 have had on the functioning and characteristics of BIPs, this study examined survey data collected in 2001, 2004, and 2008 from a total of 76 BIPs functioning in Oregon. Several hypotheses were tested. First, it was hypothesized that program compliance with state standards would increase from 2001 to 2004 and from 2004 to 2008. Overall compliance did increase, though this change was not statistically significant. Consistent with this hypothesis, a statistically significant increase in one component of compliance, program length, was found between 2004 and 2008. Additionally, some components, such as collaboration with community partners, did not change in the expected direction. Second, the analyses tested whether programs that began functioning after the creation of the standards in 2006 would be more compliant with the standards than those operating prior to 2006. This was not the case; there was not a significant difference in the compliance ratios for programs that began functioning before and after 2006. Third, it was hypothesized that program characteristics of program size, location, and barriers to compliance would predict program compliance. This hypothesis was not supported; program size, location and barriers did not predict program compliance. These results indicate that some portions of the standards are being met by programs regardless of their program characteristics, while other components are not. Understanding which components of state standards programs are and are not in compliance with provides valuable insight into which components of standards may be difficult for programs to adhere. This information is important for understanding how programs may need assistance to comply with specific components and whether enforcement or formal monitoring of programs is necessary.