Evaluating outcome measures for deinstitutionalization programs.

This paper presents preliminary data on repeated services to the same patients, provided in one county mental health program in California. It indicates the effects on inferences drawn from mental health service data as a result of failure to identify such repeated services. In order to ascertain accurately the costs of services provided to suchpatients, and in order to compare costs under different kinds of service systems, it is essential to identify patients and to identify all services provided to them over time. These data suggest that costs reported per “patient” are seriously underestimated because of the failure to make the kinds of identifications mentioned.

I was raised in a Mexican immigrant household and experienced the poverty and witnessed the social discrimination and disease that accompanied it in East Los Angeles during the mid-20th century during my early childhood. These childhood and adolescent experiences were a powerful influence on my professional interests and activities throughout my life. My academic preparation at Berkeley was in sociology and criminology—I credited myself with having a good understanding of social deviance from personal observation. It was this preparation that exposed me to theory and research about immigration, social adaptation, marginality, social psychological theory, and field research methods. Although my work is interdisciplinary in scope, the template remains sociological and social psychological. My primary interest as a researcher has been two-fold, to understand the impact of immigrant adjustment on health for the total Latino population of the United States, and to improve interventions to prevent or reduce disease burden. Depression and substance use have been the focal areas of my research, and adolescents, adults, and families have been units of study. I have conducted my depression research in many settings including state mental hospitals, county mental health programs, managed behavioral health, and community epidemiologic and prevention studies in the United States and Mexico. Even after many years I continue to find depression research very interesting, and the related areas of social stress, genetics, and family research provide a wonderful opportunity for personal growth in a new era of behavioral, gene-environment, and treatment improvement research.

In the mid-1980s, states expanded their initiatives of scholarships, loan repayment programs, and similar incentives to recruit primary care practitioners into underserved areas. With no national coordination or mandate to publicize these efforts, little is known about these state programs and their recent growth. To identify and describe state programs that provide financial support to physicians and midlevel practitioners in exchange for a period of service in underserved areas, and to begin to assess the magnitude of the contributions of these programs to the US health care safety net. Cross-sectional, descriptive study of data collected by telephone, mail questionnaires, and through other available documents, (eg, program brochures, Web sites). All state programs operating in 1996 that provided financial support in exchange for service in defined underserved areas to student, resident, and practicing physicians; nurse practitioners; physician assistants; and nurse midwives. We excluded local community initiatives and programs that received federal support, including that from the National Health Service Corps. Number and types of state support-for-service programs in 1996; trends in program types and numbers since 1990; distribution of programs across states; numbers of participating physicians and other practitioners in 1996; numbers in state programs relative to federal programs; and basic features of state programs. In 1996, there were 82 eligible programs operating in 41 states, including 29 loan repayment programs, 29 scholarship programs, 11 loan programs, 8 direct financial incentive programs, and 5 resident support programs. Programs more than doubled in number between 1990 (n = 39) and 1996 (n = 82). In 1996, an estimated 1306 physicians and 370 midlevel practitioners were serving obligations to these state programs, a number comparable with those in federal programs. Common features of state programs were a mission to influence the distribution of the health care workforce within their states' borders, an emphasis on primary care, and reliance on annual state appropriations and other public funding mechanisms. In 1996, states fielded an obligated primary care workforce comparable in size to the better-known federal programs. These state programs constitute a major portion of the US health care safety net, and their activities should be monitored, coordinated, and evaluated. State programs should not be omitted from listings of safety-net initiatives or overlooked in future plans to further improve health care access. JAMA. 2000;284:2084-2092.

ObjectiveTo analyze the mental health and erectile function status of men using sperm donor during pregnancy after ICSI failure in severe oligoasthenospermia and to provide reference for clinical implementation of more targeted psychological intervention and nursing for this group.MethodsA total of 410 sterile men who received assisted pregnancy treatment in our hospital from December 2020 to December 2022 and met the inclusion and exclusion criteria were collected as the study subjects. Among them, 68 patients with severe oligoasthenospermia who used donor assisted pregnancy after ICSI failure were used as the study group. Sixty-eight patients with severe oligoasthenospermia who continued to receive ICSI assisted pregnancy were matched by propensity score 1:1 as control group. General data questionnaire, self-rating Anxiety Scale (SAS), self-rating Depression Scale (SDS), Chinese version of perceived Stress Scale (CPSS) and International Erectile Function Index Rating Scale (IIEF-5) were used to conduct a cross-sectional investigation to compare the mental health and erectile function status of the two groups.ResultsThere were statistical differences in age and occupational status between the two groups before PSM (P < 0.05), but there was no statistical significance in social demographic data between the two groups after matching (P > 0.05). The incidence of anxiety, depression, stress and erectile dysfunction (ED) in the study group was higher than that in the control group, and there were statistical differences between the two groups (P < 0.05).ConclusionThe use of donor sperm to assist pregnancy has a great impact on the mental health and erectile function of infertile men. Medical personnel should pay attention to the mental health and erectile function of these men, and formulate targeted measures to help these patients actively cope with infertility, so as to improve the life and marriage quality of this group and improve their mental health status.

Introduction/ObjectivesThe healthcare intake process plays a significant role in informing medical personnel about patients’ demographic information, subjective health status, and health complaints. Intake forms can help providers personalize care to assist patients in getting proper referrals and treatment. Previous studies examined factors that could be included in intake forms independently, but this study analyzed loneliness, religiousness, household income, and social integration together to see how the combined effect influences mental and physical health status. This study aims to determine which of those 4 variables better inform patients’ mental versus physical health status.MethodsOne hundred and seventy-nine participants completed surveys, including the SF-12® Health Survey, measuring perceived physical and mental health, UCLA 3-item Loneliness Scale, and a demographics questionnaire with questions about household income and time spent dedicated to religious practice, if applicable. Additionally, individuals answered social integration questions about how often they contact close family and friends or volunteer in the community. Using loneliness, household income, religiousness, social integration as independent variables, and controlling for demographic variables such as age, gender, and race, 2 regression models were built with Mental and Physical Health Composite Scores from the the SF-12® Health Survey as dependent variables.ResultsLoneliness was associated with mental health measures (b = −2.190, P < .001), while household income was associated with physical health measures (b = 0.604, P = .019) above and beyond other variables in the regression models.ConclusionsIntegrating the 3 loneliness questions into intake forms can help approximate an individual’s mental health status. This would allow the provider to be able to assess mental health problems more effectively and provide needed resources.

Exposure to trauma and extensive changes in daily life circumstances and occupations as a result of an ongoing armed conflict can significantly affect mental health. To examine factors related to the mental health status of Israeli students during the Swords of Iron war. A cross-sectional study. Online survey. Students in higher education institutions across Israel (N = 863). Self-report validated questionnaires were used to assess students' mental health status, resilience, satisfaction with life, executive functions, environmental factors, and occupations. Moderate levels of depression (Mdn = 18, interquartile range [IQR] = 10-28), anxiety (Mdn = 10, IQR = 4-20), and stress (Mdn = 24, IQR = 14-34) were found for 50% of participants, along with extensive changes in daily life occupations, occupational balance, and meaning. Using structured equation modeling, χ2(15) = 15.969, p = .384, the authors found that satisfaction with life, psychological resilience, religious status, executive functions, occupational balance, and variability in occupational change were directly associated with mental health status, whereas occupational balance and occupational change mediated these connections. The modifiable factors related to reduced mental health after exposure to traumatic threat included change in occupational patterns, occupational balance, and sense of belonging, which may all serve as goals for occupation-based interventions and contribute to better coping mechanisms with traumatic events. This study used a cross-sectional design and an online survey with self-reported data, which may limit the generalizability of the findings. Plain-Language Summary: Higher education students in Israel were exposed to traumatic events and changes in daily life because of war. This study aimed to understand their mental health, resilience, executive functions, environments, and changes in their occupational patterns and the complex interplay between these factors. An online survey showed a notable decline in the students' mental health status, with around 50% experiencing at least moderate levels of depression, anxiety, and stress. Changes in occupations, occupational meaning, and balance were also common. The study found that satisfaction with life, mental resilience, occupational balance, religious status, executive functions, and variability in occupational change all contributed directly to the students' mental health status. The findings suggest that modifiable factors such as occupational balance and belongingness could be addressed through interventions to enhance mental health and coping mechanisms of students facing trauma and stressful life events.

An effect of noise on mental health indicator using voice

BackgroundIn Tak province of Thailand, a number of adolescent students who migrated from Burma have resided in the boarding houses of migrant schools. This study investigated mental health status and its relationship with perceived social support among such students.MethodsThis cross-sectional study surveyed 428 students, aged 12–18 years, who lived in boarding houses. The Hopkins Symptom Checklist (HSCL)-37 A, Stressful Life Events (SLE) and Reactions of Adolescents to Traumatic Stress (RATS) questionnaires were used to assess participants’ mental health status and experience of traumatic events. The Medical Outcome Study (MOS) Social Support Survey Scale was used to measure their perceived level of social support. Descriptive analysis was conducted to examine the distribution of sociodemographic characteristics, trauma experiences, and mental health status. Further, multivariate linear regression analysis was used to examine the association between such characteristics and participants’ mental health status.ResultsIn total, 771 students were invited to participate in the study and 428 students chose to take part. Of these students, 304 completed the questionnaire. A large proportion (62.8%) indicated that both of their parents lived in Myanmar, while only 11.8% answered that both of their parents lived in Thailand. The mean total number of traumatic events experienced was 5.7 (standard deviation [SD] 2.9), mean total score on the HSCL-37A was 63.1 (SD 11.4), and mean total score on the RATS was 41.4 (SD 9.9). Multivariate linear regression analysis revealed that higher number of traumatic events was associated with more mental health problems.ConclusionsMany students residing in boarding houses suffered from poor mental health in Thailand’s Tak province. The number of traumatic experiences reported was higher than expected. Furthermore, these traumatic experiences were associated with poorer mental health status. Rather than making a generalized assumption on the mental health status of migrants or refugees, more detailed observation is necessary to elucidate the unique nature and vulnerabilities of this mobile population.

Background: Globally, mental health has become a major issue in health development today. Campus communities cannot be separated from the problem of mental health. Aims: This study aims to describe the relationship between demographic and lifestyle factors with mental health status in campus communities. Method: This study used a quantitative method with a cross-sectional design. Data collection was conducted through an online survey on 11-30 October 2021 at one of the universities in Yogyakarta. There were 503 respondents consisting of students, lecturers, and education staff. The instrument of mental health was the Self-Reporting Questionnaire-29 (SRQ-29). Result: There were indications of needing referral due to anxiety and depression as much as 33.4%, and there were 5.28% of respondents requiring referral due to psychotic disorders, drugs, and PTSD. Demographic factors associated with mental health status were job status, sex, and age. Meanwhile, lifestyle aspects that are associated with mental health status are physical activity duration and fruit and vegetable consumption per day. This was indicated by the respective p-values of 0.000 (job status), 0.042 (sex), 0.027 (age), 0.003 (duration of physical activity), and 0.011 (consumption of fruits and vegetables per day). Furthermore, multivariate analysis showed that the duration of physical activity, as well as fruit and vegetable consumption, had a negative linear effect on the incidence of mental health disorders. Conclusion: The main findings provide baseline data for developing healthy campuses as part of sustainable development goals (SDGs), particularly for mental health programs.

Background The global population of patients with mental illness continues to expand. Their mental health is not only affected by the disease itself, but also aggravates negative emotions due to the lack of medical rights, privacy leaks, discrimination and other issues that damage their rights and interests. Existing research mostly focuses on drug and psychological intervention. Research on the application of health law in the field of mental health is relatively scattered, and its specific impact and action path on mental health have not yet been clarified. In order to fill this gap, the study will construct a health law intervention system to explore its actual impact on patients' mental health and help improve patients' mental health. Methods Stratified sampling was conducted to select 180 patients from 2 tertiary mental health institutions and 1 community health service center who met the relevant diagnostic criteria, had a disease duration of ≥1 year, and were aged 18-60 years old. Patients with cognitive impairment and severe organic diseases were excluded. Among them, 98 were male and 82 were female; 65 had depression, 58 had schizophrenia, and 57 had bipolar disorder. Implement a three-month health law intervention, covering the core rights and interests provisions of the Mental Health Law of the People's Republic of China; provide one-on-one consultation and rights protection on the online platform, and provide free legal assistance. The study used the Self-Rating Symptom Scale and the Depression Anxiety Stress Scale to collect and analyze data before, 1 month and 3 months after the intervention. Results The results show that the degree of awareness of health law is positively correlated with patients' mental health status (r = 0.45, p&amp;lt;.01), and the degree of legal implementation is positively correlated with patients' mental health status (r = 0.50, p&amp;lt;.01). In addition, the degree of legal implementation is the main factor affecting patients' mental health (β = 0.40, p&amp;lt;.01), followed by the degree of public awareness (β = 0.25, p&amp;lt;.05). The patient return rate increased from 75.3% to 91.2%, and the incidence of rights damage incidents dropped from 22.6% to 5.1%. The results show that inadequate implementation of laws and insufficient public awareness are the main negative factors affecting patients' mental health, and health law intervention can effectively improve the mental health of patients with mental illness. Discussion Research has clarified the positive impact of health law on mental health, providing patients with another way to improve mental health in addition to drug treatment and psychological intervention. Patients can improve their mental health by learning health law knowledge and proactively safeguarding their own rights and interests. At the same time, the research provides an innovative direction for mental health services to integrate medical treatment with law, proving that the implementation of health law can directly benefit patients' mental health. Future research can expand the sample coverage, extend the follow-up period, explore personalized intervention plans for patients with different types of mental illness, further deepen the integration mechanism of health law and mental health services, and promote the formation of a more complete patient rights protection and mental health promotion system.

BackgroundChina has the world’s largest aging population and the number of empty-nest older adults is on the rise. In comparison to the aging population in general, empty-nest older adults have a lower level of subjective well-being and poorer mental health status due to a lack of emotional support from their children. The aim of this study is to conduct an empirical study to evaluate the efficacy of the ‘Path-oriented Psychological Self-help Intervention’ (P-oPSI) led by nurses on the mental health of empty-nest older adults in the community, to provide a scientific foundation for improving their quality of life.MethodsA Quasi-Experimental controlled intervention study was conducted from 2015 to 2017.A total of 76 empty-nest older adults from 2 districts were recruited using a convenience sampling and assigned to 2 groups based on their residential communities in the city of Chifeng in the Inner Mongolia Autonomous Region, China. The wait list control group participated in a mental health lecture to gain knowledge and learn techniques of mental health promotion. The intervention group additionally received 1 month of training in a nurse-led ‘P-oPSI’ for a month. Both groups were followed-up for 3 months. Mental health status, coping styles, and psychological self-help ability of the participating empty nest older adults were assessed at the baseline, 1 month, and 3-months follow up, respectively. Two-way analysis of variance and a simple effect test were used to analyse the differences of the two groups.ResultsThe P-oPSI yielded a greater benefit for the mental health status, coping styles, and psychological self-help ability of the participants in the intervention group. Combined with a simple effect test, the scores of the mental health status, positive coping style, and psychological self-help ability of those in the intervention group significantly increased at 1 month after the baseline (F mental health status = 7.59, F positive coping style = 7.24, F psychological self-help ability = 7.07); and the sustainable effect of this program lasted for 3 months after the intervention (F mental health status = 13.24, F positive coping style = 10.42, F psychological self-help ability = 10.45), which reached statistical significance (P < 0.01).ConclusionsThe P-oPSI program significantly improved the level of mental health of empty-nest older adults in China. This intervention provides a new approach of self-management to improve mental health of older adults in community settings.Trial registrationchictr.org.cn: ChiCTR1900025552. Retrospectively registered 1 September 2019.

The push and pull factors related to early retirees’ mental health status: A comparative study between Italy and Spain

Back to table of contents Previous article Next article Professional NewsFull AccessMHA Ranks States on Prevalence of MH Disorders, Access to CareLinda M. RichmondLinda M. RichmondSearch for more papers by this authorPublished Online:18 Dec 2018https://doi.org/10.1176/appi.pn.2018.12a16AbstractThe report concluded that far too many people are not receiving the services they need to live healthy and productive lives. The states that ranked highest overall on access to mental health care—with the lowest prevalence of mental illness—were Minnesota, Maine, Massachusetts, New Jersey, and Vermont, according to the “State of Mental Health in America 2019” report by Mental Health America (MHA).States were assigned an overall mental health ranking based on 15 measures involving prevalence of mental illness, including serious thoughts of suicide and substance use disorder, and access to care, including health insurance status, mental health coverage, and mental health workforce availability.The state that ranked lowest was Nevada, followed by Idaho, Oregon, Mississippi, and Alaska.Now in its fifth year, the annual report provides a snapshot of mental health status and access to care among youth and adults and monitors trends. The report analyzes national survey results from all 50 states and the District of Columbia from the Substance Abuse and Mental Health Services Administration, Centers for Disease Control and Prevention, as well as other state and federal sources.The report also ranked states based on their availability of “mental health providers,” defined as psychiatrists, psychologists, social workers, counselors, marriage/family therapists, and advanced practice nurses specializing in mental health care. In the top-ranked states, the ratio of state residents to mental health providers was close to 200 to 1 (Massachusetts, District of Columbia, Maine, Oregon, and Vermont), but in the lowest-ranked states there were at least four to six times as many residents for every provider (Alabama, Texas, West Virginia, Georgia, and Arizona).Key PointsOther findings in the Mental Health America report “State of Mental Health in America 2019” include the following:Adults with any mental health illness: 18 percentAdults with any mental illness who are uninsured: 12 percentAdults with a severe mental illness: 4 percentAdults with serious thoughts of suicide: 4 percentAdults who reported a past-year substance use disorder: 8 percentYouth who reported a past-year substance use disorder: 5 percentThe shortage of mental health providers has resulted in many individuals not accessing care or relying on emergency room services for psychiatric care. More than half of psychiatrists will reach retirement age within seven years, which could exacerbate the shortage if many of them decide to retire.“Integrating primary care and behavioral health services is key for early identification and intervention but is only part of the solution. Primary care providers cannot fill the void created by a lack of psychiatrists,” the MHA report noted.Twenty percent of adults with any mental illness were not able to receive the treatment they needed, and this number has not declined since 2011, MHA reported. Some barriers included cost of care, lack of insurance or limited coverage of mental health services, and a shortage of mental health providers.The report showed alarming increases in serious suicidal ideation among adults and major depression among youth. The number of adults reporting serious thoughts of suicide was more than 9.8 million (4 percent nationwide) this year, an increase of 200,000 people since 2017. Among young people, nearly 13 percent of youth had at least one past-year major depressive episode, up from 9 percent in 2017.“Despite mental health being something that more and more people are talking about, far too many people are still suffering,” said Paul Gionfriddo, MHA president and CEO. “People are simply not receiving the treatment they need to live healthy and productive lives—and too many don’t see a way out.”When it comes to unmet mental health needs, there was a wide disparity between the highest ranked states (Hawaii, Alabama, Texas, Nebraska, and Maine), where nearly 16 percent to 17 percent of adults reported unmet mental health care needs, and the lowest ranked states (Nevada, New Hampshire, Oregon, and Idaho) and the District of Columbia, where 25 percent to 26 percent did not receive needed services.The report also uncovered some good news: Under the Affordable Care Act, the U.S. continues to see a decline in the number of Americans who are uninsured, with a nearly 3 percent reduction from last year. In fact, 46 states reported a reduction in the number of adults with any mental illness who lack insurance. The largest reductions were seen in South Carolina, Missouri, Arkansas, and Arizona, all of which had a 6 percent to 7 percent decline in adults with mental illness who had no insurance coverage.Youth with mental illness seemed to fare far worse than adults when it came to access to care: Close to two-thirds of youth with major depression (62 percent) did not receive any mental health treatment, MHA reported. Only one-quarter of youth with severe depression receive consistent treatment, defined as seven to 21 visits in a year. Late recognition of mental illness in primary care settings and limited coverage of mental health services often prevent youth from receiving timely and effective treatment.Nationwide, less than 1 percent of students (0.8) were identified as having an Individual Education Program (IEP) for emotional disturbance (ED). “If states were doing a better job of identifying whether youth had emotional difficulties that could be better supported through an IEP, the average rate would be closer to 8 percent instead of 0.8 percent,” MHA wrote. “Early identification for IEPs is critical. IEPs provide the services and support students with ED need to receive a high-quality education.” The top five states (Vermont, Minnesota, Massachusetts, Wisconsin, and Pennsylvania) identified 15 students to 27 students per 1,000 as having an IEP for ED, and the lowest-performing five states (Alabama, Arkansas, Louisiana, Utah, South Carolina) identified 2 students to 4 students per 1,000.■The report, “The State of Mental Health in America 2019,” can be accessed here. ISSUES NewArchived

Impact of the CATIE Findings on State Mental Health Policy

Objective: This study sought to investigate the relationship between personal, university, home and community influences on Australia’s university students’ mental health status. Design: Positioned within a qualitative, interpretivist paradigm, the study collected data from participants ( n = 934) by means of an online survey requesting lived or witnessed experiences concerning mental health concerns. Bronfenbrenner’s socio-ecological model informed the design of the study. Setting: Five major Australian higher educational settings. Method: Leximancer software was used for concept development. Data were analysed using thematic coding. Results: Findings provide qualitative data of university students’ experiences concerning mental health status, as measured across four domains. Themes identified include personal (stress, anxiety, life skills), university (grades/free physical activity) and home (closer to home, support networks) dimensions. There was no unprompted reference to the community domain. Results reinforce the need to ensure that current and future student mental health policies and initiatives are implemented within each of the domains addressed – to ensure a more holistic approach to students’ well-being and care. Conclusion: Findings highlight challenges concerning Australia’s university students’ mental health status. Findings present an opportunity for the university sector, community health services, and sports and fitness organisations to develop and implement future collaborative health promotion in higher education settings.