Mental health has a long history of proving to be a tough concept to define. Multiple forms of knowledge and representation seek to inform as to the nature of mental health, all contributing to the production of immense complexity as to the experience of living with mental health difficulties. This thesis sets out to explore this, by getting as close as possible to mental health service users' actual experiences. A range of forms of knowledge that pertain to inform as to service users' experiences are explored, prior to analysing a corpus of interviews with service users. These are analysed through the development of a Deleuzian Discourse Analysis. Service users' experiences are analysed in terms of the relation between discursive and non-discursive factors, which include forms of mainstream psychiatric discursive practice, such as the application of diagnostic criteria and administration of treatments, along with how such practices are experienced in non-discursive dimensions of service user embodiment and space. The challenges facing service users are seen to operate around identity and control in relation to forms of psychiatric knowledge, along with presenting particular problems with regard to how user embodiment is felt, primarily in relation to psychiatric medication, and how these are driven into the production of service user spaces, i.e. day centres. Finally, a politics of affectivity is offered, as a way to unfold the complexity of service user experience, and to emphasise the existence and potential for change that can be gained through deterritorialising mental health.

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The intent of this study was to examine the perceived resources and obstacles which were related to the utilization of mental health services by chronically mentally ill Mexican American clients. Specifically, the study identified resources and obstacles encountered by six chronically mentally ill clients and six family members as they accessed various mental health services. The study was conducted in the fall of 1985 from clients currently receiving services from La Frontera Center, Inc., Tucson, Arizona. Data were interpreted through content analysis to conceptualize and categorize client and family member responses. Chronically mentally ill clients relied heavily on individuals such as friends, therapist and priest as resources for mental health service support. In contrast, family members focused primarily on institutions for resource support. Financial resources, institutional policies, denial, and the lack of personal direction were listed as obstacles to seeking mental health services by clients and family members. Study results suggested that the perceptions of traditional and nontraditional obstacles and resources by Mexican American clients and family members continue to strongly influence utilization of mental health services In particular, the issue of "stigma" and the personal qualities and abilities of the therapist emerged as significant descriptors in client and family member self statements.

Adverse childhood experiences (ACEs) are linked to increased mental health problems in children, but their association with mental health services utilization is not well known. This secondary analysis used 2016 National Survey of Children’s Health data from two samples: children aged 6-17-years-old with a mental or behavioral condition in need of treatment or counseling (N = 5,723); and a subsample of children who experienced at least one ACE (n = 3,812). Multiple logistic regression and latent class analysis (LCA) were performed to examine the association between ACEs and mental health services utilization. Multiple logistic regressions also examined the associations of parent/caretaker vulnerability, school-system, and medical-system factors on mental health services utilization for children with ACEs using the Gelberg-Andersen Behavioral Model for Vulnerable Populations and a Systems of Care approach as the framework for model building. Children with increased ACE scores did not have higher odds of utilizing mental health services compared to children at lower levels of or no ACEs. For children who experienced adversity, increased parent/caretaker vulnerability was associated with lower odds and the current receipt of special education services with increased odds of mental health services utilization in adjusted models. Strengths of this study included the large dataset and generalizability to the U.S. population. There were limitations to the measurement of ACEs and other key variables. The current study identified children who experienced adversity as an underserviced population for mental health services.

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Thesis (Ph. D.)--University of Hawaii at Manoa, 1991. / Includes bibliographical references (leaves 83-96) / Microfiche. / ix, 96 leaves, bound ill. 29 cm

Broadly speaking, the purpose of this study is to: 1. Assess the functioning of the psychiatric hospital aftercare service delivery system by examining community service utilization patterns of Dammasch Hospital releases. 2. Obtain descriptive information relating to Washington County's chronic aftercare population. 3. Provide an objective data base that can be used to further develop the Aftercare Service Delivery System in Washington County.

Contingency management has been utilized to improve treatment compliance and attendance in a medical setting. A related question involves the effect of contingency management on attendance in outpatient psychotherapy. Sixty-nine individuals ranging in age from 8 to 50 years agreed to participate in such a study. These individuals agreed to sign a contract specifying consequation for failure to notify the centers 24 hours in advance of an impending absence. Data on attendance and notification of impending absences were collected weekly for five sessions. After five sessions, dropouts and remainers were interviewed and the course of treatment was discussed. For the purpose of this study, a "dropout" occurred whenever an individual terminated therapy by missing an appointment and not rescheduling, or whenever an individual missed three consecutive appointments.

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