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This paper evaluates and describes methods for making psychiatric distinctions. It is by means of psychiatric distinctions that individuals are labeled mentally ill or mentally well. Within the mentally ill category, patients are differentially placed according to the severity and type of their mental illness. The placement of individuals into psychiatric categories is an essential prerequisite not only to the clinical treatment of patients but also to any research where the objective is to determine empirical regularities associated with mental illness. Until the patient is categorized, the practitioner has no logical guide for how to perform treatment or even whether he should treat the patient—i.e, the patient may not be a patient. Similarly, unless the psychiatric researcher has categorized his subjects according to some notion of mental illness he has no way of making comparisons or of assessing change, the two essential processes in research. Thus, the logical first step for arty discovery of new knowledge in the field of mental illness is to appraise the reliability and validity of methods for making psychiatric distinctions. No research findings can be more reliable or valid than the psychiatric distinctions used in carrying oat the research. [ABSTRACT FROM AUTHOR]

Hospitalized mental patients are increasingly being discharged into the community. Yet, despite the construction of hundreds of community mental health centers, readmission rates continue to rise. This paper analyzes the reasons for this problem and provides suggestions for its solutions. [ABSTRACT FROM AUTHOR]

The article presents abstracts of various research papers published in the June 1961 issue of "Journal of Health and Human Behavior." One of the abstract discusses the relationship between and intrapsychic processes. Another abstract presents a study which attempts to ascertain, and account for, the presence of significant differences in knowledge of attitudes toward mental disease between a sample of high school boys and one from a boys' reformatory. The purpose of one of the papers on hospital-patient relationships is to clarify the precise nature of the relationship between mental hospitals and patients and to compare and contrast it with the relationship between medical hospitals and patients. Another paper on mental hospitals presents information about four types of "pathway" organizations which seek to assist in the transitional period between the discharge of a mental patient from a hospital and his re-entry into community life. The four general types considered are day hospitals, halfway houses, sheltered workshops, and ex-patient organizations.

The article reports on psychological research in the community mental health service in the United States. The need is obvious for the development of public health practices which will control the causes of mental ill health as effectively as is now done with many other diseases. It is the purpose of this paper to discuss the opportunities and the methodological problems for the psychologist doing research in the field of community mental hygiene. Research on community mental hygiene, it seems to the author, can best be attacked by studying those factors in total community life which prevent or promote the development of healthy patterns of adjustment by individuals or groups. Stating this a little differently, research in community mental hygiene might best be concerned with the nature and the origin of conflicts, frustrations, or confusions for persons or groups which are part of the community way of life.

The article reports the issue of position paper, "The Community and the Community Mental Health Center." The position paper was recently issued by the American Psychological Association (APA). The report, written by APA president Nicholas Hobbs and M. Brewster Smith, Director of the Institute of Human Development, University of California at Berkeley, analyzes the program of Community Mental Health Centers now being planned or started. This is the first position paper APA has addressed to the general public and community planners.

The article discusses the issues concerning the training and deployment of social work manpower in the U.S. Manpower problems involved in providing health and medical care services to the total population of the country has, for the first, been recognized by health professionals, the consumers of services and policy-makers. Another concern in the country's health system is the significant changes in the organization and structure of the health and mental health services, which will have great impact on the ultimate delivery of service.

A major objective in the development of mental health services has been to provide treatment as early as possible in the course of the illness. In order to achieve this objective, it is necessary both that adequate treatment services be available and that they be perceived as necessary by the patients and/or his family. This article focuses on the steps by which hospitalization itself is arrived at. These are clearly two aspects of the same phenomenon which cannot be wholly separated: actions taken depend on what the actors see as the nature of the problem facing them, and in turn perceptions as to the nature of the problem are modified by the actions and interpretations of others involved in the process of dealing with the patient.

Mental-health care is a major public-sector problem in the State of New York. We were asked by the Ways and Means Committee of the New York State Assembly to recommend a new fiscal structure with shared funding; between the state and the counties to better achieve the objective of the state's mental-health-care program. We developed a simulation model for the problem and used it to design new funding plans; the results of our analysis have been written into legislation introduced into the New York State Assembly. [ABSTRACT FROM AUTHOR]

Viewing comprehensive health centers and community mental health programs as links in a delivery system that may provide the framework for a possible national health system, five goals in planning and providing liaison-care are described. A case illustrating this interaction is presented. [ABSTRACT FROM AUTHOR]

The development of a coordinated program utilizing a team approach to care of discharged psychiatric patients is described. [ABSTRACT FROM AUTHOR]

Description and discussion are presented of a program for more than 76,000 employees to deal with mental health problems that have an effect on employment, work habits, and related matters. The broader significance of such activities is stressed. [ABSTRACT FROM AUTHOR]

A study was made to see what categories of cases were referred to mental health consultants by health agencies, and to see whether in the course of time there was any change in the distribution of cases among the categories. Findings are reported. Although the original intent was not completely fulfilled, the discussion of the problems encountered will be of value to other investigators. [ABSTRACT FROM AUTHOR]

The article examines relevant policy issues in context of citizen participation from a cross-cultural perspective, specifically in relation to community mental health centers, which are actively invoked with this process. The Community Mental Health Centers Act of 1963 addressed the problem of the availability of services to those persons who could not afford private psychiatric care and it developed a highly decentralized network of services tailored to suit local conditions and meet local needs. Citizen participation, which was viewed as desirable and was frequently part of the planning and design process, was mandated in 1972 to take place on a continuing basis. The Yugoslav programs described have special implications for community mental health centers in Yugoslavia, and findings can be generalized to other health and welfare services. The Yugoslav experience is examined in light of its philosophy and objectives, with little attention being given to problems and dilemmas within the political system; the material is descriptive rather than analytic. It is important to recognize that a different set of problems exists in the United States, where self-management and citizen participation are the exception rather than the rule.

A study of first admissions to all state and three large private mental hospitals in the state of Michigan from 1938 to ]942 reveals a concentration of high rates in the Upper Peninsula counties. These counties are part of what has been delineated as a rural problem area—an area of cut-over forests, decadent mining industry and marginal or submarginal agriculture. Exploratory correlations between the county mental disease rates and selected indices of socio-economic disorganization, such as percentage of population on relief, percentage of tax-delinquent land, and average value of land, proved to be non-significant. However, the high rates did seem to be related to nativity composition of the population. Foreign born and second generation immigrants were found to have much higher rates than native born populations. Correlations between mental disease rates and the number of foreign born in each county were inversely significant, both for the total foreign born and the constituent nationalities. The findings would seem to support the culture- conflict, social isolation theory of mental disease. [ABSTRACT FROM AUTHOR]

The article focuses on the level of mental health services offered at hospitals and health departments in the U.S. It assess the interest of health planners and administrartors in the development of mental health services. The author has identified the significant community, organization, and personal variables associated with different implementation levels. Services and activities selected for study include outpatient diagnosis, treatment services, inpatient diagnosis and treatment services, follow-up care after hospitalization, integration of mental health services with other health services and the use of indigenous workers for case-finding and information dissemination.

The evaluation of a new community mental health service is discussed in four parts. One, the theoretical, ethical, and practical considerations in designing the described evaluation systems are reviewed. Two, the rationale or goals for the program are specified. Three, the therapy system and built-in evaluation is described. And finally, staff reactions and problems related to the procedures and evaluation in general are discussed. [ABSTRACT FROM AUTHOR]

This study was made to determine consumer attitudes toward health needs in an Appalachian community, and to find out what are the priorities of such consumers for health care. A gap between the priorities of consumers and those of physicians is discussed and its implications for planning and providing services is stressed. [ABSTRACT FROM AUTHOR]

The integration of community mental health with the comprehensive community health center is discussed. Reasons for earlier separation are explained and means for achieving integration are explored. [ABSTRACT FROM AUTHOR]

The employment of a nurse within the context of a local health department is the model used to demonstrate the possibility of delivering mental health services despite a critical personnel shortage. Various aspects are discussed operationally. [ABSTRACT FROM AUTHOR]

Reorganization of the Illinois Department of Mental Health with revised programming during the period 1960-1970 should have improved patient services in the State of Illinois, and should be reflected in the Department's operating statistics. Several indices bearing on patient services are reviewed together with some speculative comment on the future of mental health services in the state. [ABSTRACT FROM AUTHOR]

A report is presented on a project to identify program costs for community mental health centers, and to establish principles for relating cost of input to types of services received by beneficiaries. Problem areas are delineated, discussed, and relation to possible measurement indicated. [ABSTRACT FROM AUTHOR]

In this article we describe an attempt to meet a university community's needs for emergency menial health services through the establishment of a student-operated telephone emergency service. The service provides an interesting model for use of nonprofessionals in mental health services, in which the professional functions primarily as a trainer and consultant rather than offering direct services. We describe the structure of the center and then discuss further innovations and projects. [ABSTRACT FROM AUTHOR]

The article presents several research on the role of classroom interactions and teachers influence in combating mental illness of children in the U.S. The report of the Joint Commission on Mental Illness and Health contained recommendations in combating mental illness which include balanced portfolio of mental health services and research, suggestion for increasing government spending for all levels of mental health services, encourage towards health and helping professions. Ralph Rabinovitch, director of Hawthorne Center, indicated that schools must offer psychological guide through organize and challenging programs of academic studies and routines for emotionally handicapped children.

The article focuses on the social work for the mental patients. Although rates of discharge from public mental hospitals are high, approximately two-thirds of the patients in public mental hospitals are difficult to discharge and maintain in the community, even with follow-up mental health services. The purpose of the program was to maintain patients who demonstrated a high potential for chronic hospitalization in the community and use the community as the treatment agent. A redefinition of mental health problems and perceptions regarding clients has precipitated changes in the delivery of social services. Social workers are now concerned with environmental stress and its effects on clients' ability to function. The worker was directly involved with the patients during individual conferences, group therapy sessions, and family meetings oriented toward preparing patients for discharge.

The hard-to-reach poor, hostile toward social agencies and defiant of authority, are not, the author maintains, rejecting services as a matter of choice but as an act of despair. The poor have never in fact had any options from which they could make a choice. When they are offered full participation in the choice of specific services and in the evaluation of the results of these services, they will not only accept but co-operate in and profit from these services, as is shown in the case illustrations presented. [ABSTRACT FROM AUTHOR]

In recent years it has become increasingly apparent to professional persons in the field of social work that the needs of the public far exceed the facilities available. The public is becoming increasingly aware of the nature and implications of emotional disturbance and the part this plays in the life of the individual and of the family. Professional persons in the various helping agencies are recognizing the vast emotional implications of the problems of their clients and are concerned that those needing extensive casework or other service have this available to them. Every agency in the broad field concerned with problems of an emotional nature is faced with the question of how to balance quantity and quality, how to meet demands with services that are effective. Many agencies are making some efforts in this direction. In many mental health agencies where intensive treatment is undertaken, it has become necessary to make some estimate of success of treatment and to put effort into the selection of cases on the basis of prognosis.

The article presents information on directive psychotherapy. Holistic viewpoints in psychological science stress the importance of evaluating the organism as a whole with proper emphasis on the interaction of constitutional and acquired factors in development. This study is concerned with the attempt to outline a system of constitutional analysis to permit the objective evaluation of the biological adequacy of the organism as a scientific basis for rational diagnosis and therapy.

The development of a standardized instrument designed to measure the treatment environment of the mental hospital provided the basis for two separate works of Jay Jackson (1964, 1969). The present study is in part a partial re-analysis of this standardized instrument known as the "Characteristics of the Treatment Environment Scale" (CTE Scale). The analysis is based on a heterogeneous national sample of 18 state mental hospitals and results in the construction of a new instrument called the "Treatment Milieu Scales" (TMS). This present analysis includes shortening of the Jackson CTE instrument, the development of new factors, and a test of their predictive ability with respect to the therapeutic orientation of the treatment environment as measured by hospital effectiveness. These effectiveness measures include in-hospital indicators such as staff morale, quality of over-all care, psychiatric care, patient movement, and net release, as well as in-community measures including social adjustment, and medical (mental status) adjustment. Significant findings are obtained for the patient movement measures, while several partial correlations were found to be significant in all the other in-hospital measures except staff morale. The findings suggest the "humanistic" tradition of therapy is not necessarily the most appropriate when viewed from the perspective of in-community patient rehabilitation. [ABSTRACT FROM AUTHOR]

In a study of 1,045 state mental hospital patients released on leave of absence during the calendar year of 1956 to the Oakland California Bureau of Social Work, a large amount of evaluative information was collected on post-hospital adjustment. Data from case records, administrative files, and hospital records were reviewed. They clearly demonstrated that most ex-patients did not possess a sufficient number of social resources to allow them to adapt to the world outside the state hospital. On the basis of these findings, one can easily understand why seven out of ten of these patients returned to the hospital. [ABSTRACT FROM AUTHOR]

The article focuses on the six-year study of the mental health services of a correctional mental hospital conducted by the National Institute of Mental Health Hospital Improvement Program (HIP) grant between 1967 and 1972 in New York. According to the authors, the program was served by a consulting team consisting of psychiatrists, psychologists and social workers. At the start of the HIP scheme, the Dannemora State Hospital (DSH) was found to be operating in a deteriorated condition. The study also indicated that the HIP staff was instructed to originate recommendations for rehabilitating the entire institutional clinical program.

A description is presented of the development of mental health services for Mexican-Americans in a Texas city, and of the changes that occurred in the program in terms of philosophy and personnel. [ABSTRACT FROM AUTHOR]

The article attempts to determine how veterans who apply for outpatient treatment differ from veterans who do not, as indicated by certain variables which showed promise of predicting requests for clinic treatment. The variables studied were role in the family, rated percent of psychiatric disability, degree of urbanization, and decreased disability benefits. These results strongly indicate that rated percent of disability is the critical factor of those studied in identifying clinic corners, whereas the other variables appear to gain in importance mainly by virtue of their interaction with the disability dimension.

The article discusses the conceptual framework for embarking on the design of objectives for a community mental health plan, where a number of administratively independent facilities provide mental health services to the population. Each component unit must determine and submit its own goals and objectives in designing a mental health plan subscribed to by various service organizations. The health plan's objectives should be proposed with due recognition for three characteristics, including relevancy, practicability and measurability.

The article explores some practical difficulties that have emerged concerning the status of paraprofessionals or lay mental workers in the U.S. These difficulties include their utilization and selection, job roles, identification problems and troubles concerning research and evaluation. In practice, most paraprofessionals are potential consumers of community mental health services like the poor and the black. There do not seem to be very many middle and upper class paraprofessionals. The article also proposes a greater emphasis to be placed on middle class volunteer workers.

The article offers information on the ways to establish a clinic in response to the existing demand for physical and mental health services for women in San Pedro, California. The author offers several steps to be taken in the establishment of women's health facilities including the assessment of both physical and mental health needs of those whom the clinic is set up to serve and the determination of its objective and methods of achieving it. The article also emphasizes the maintenance of the clinic's responsiveness through the control of its participants, and the implementation of the theoretical clinic into operation.