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Biomedical subjects

J A Talbott

Publications and source records attributed to J A Talbott.

At least 37 records · Page 2Linked to original sources
PubMed1987

CMHC's: relationships with academia and the state.

We have surveyed all community mental health centers (CMHC's), state departments of mental health, and university departments of psychiatry in the country to ascertain the status of their relationships with one another. The response rate to a one page questionnaire was 33%. An overwhelming percentage, 88%, of CMHC's have relationships with state hospitals and/or academia. Most often they consist of a service relationship. The control for such relationships is most often shared or there is no one controlling organization. The benefits of such relationships include improved communication, improved access to state hospitals, and improved quality of inpatient and outpatient care. CMHC's who responded to our survey did not think that relationships with the state or academia resulted in improved recruitment of psychiatrists and improved residency training--but state and academic respondents did. All, however, agreed that research, long-term care, and recruitment of other staff are minimally improved by collaborative relationships.

Combined Modality Therapy↗
PubMed1987

Management, administration, leadership: what's in a name?

In summary, I have argued that while research and publications in the field have tended to deal with management and administration--examining issues as if they were predominately structural, organizational and authority-oriented, the area that cries out for further attention is that of leadership. For, while managers can do, and administrators oversee--it is only leaders who can move us ahead. The field is in for a turbulent, difficult, but I suspect, exhilarating next new years. Our work is truly very different from that in most businesses--and while good "managers" may make money for business enterprises, for us, leadership is the critical ingredient. (I'm not even so sure that despite some experts disclaimer of the lack of importance of leadership in business, a closer look would not inevitably reveal a Kroc, Hewlett, DiLorenzo or Iacocca behind every successful corporate initiative anyway). With that in mind, we should increase both our study of the development of leaders and our attention to their development. To do less is to increase our difficulties, court further new disasters, and have even less control over our work and our future. We deserve and can achieve a better destiny.

Community Mental Health Services↗
PubMed1986

The homeless mentally ill. The perspective of the American Psychiatric Association.

The homeless mentally ill have become one of the greatest problems of present-day society. The American Psychiatric Association's Task Force on the Homeless Mentally Ill concluded that this is not the result of deinstitutionalization per se but of the way it has been carried out; homelessness among the chronically and severely mentally ill is symptomatic of the grave problems facing them generally in this country. Thus, the problem will not be solved until the basic underlying problems are addressed and a comprehensive and integrated system of care for the chronically mentally ill is established. Specific recommendations of the Task Force include an ample range of graded, supervised community housing; comprehensive and accessible psychiatric care and rehabilitation; the availability of general medical assessment and care, crisis services, and a dependable source of income; a system of case management in which one mental health worker is responsible for each patient; changes in commitment laws to make them more responsive to clinical needs; coordination between the various community resources; and ongoing asylum and sanctuary for that small proportion who require it.

Chronic Disease↗
PubMed1986

The inpatient care of the chronically mentally ill.

The inpatient treatment of the chronically mentally ill as it has been practiced in the past, is practiced at the present, and may be practiced in the future is discussed. The reasons for admitting the chronically ill to inpatient services; the steps of such treatment and treatment modalities employed; and considerations for discharge are presented. In addition, the indications as well as pros and cons for long-term inpatient hospitalization are included.

Activities of Daily Living↗
PubMed1986

A proposal for future funding of chronic and episodic mental illness.

The estimated 1.7 to 2.4 million Americans who suffer from chronic mental illness are poorly served by the current nonsystem of services. No agency at any level is responsible for coordination of funding, treatment, and care. Since the mid-1950s funding has become increasingly fragmented as state mental hospitals have been depopulated, community services have been developed, and federal entitlement programs such as Medicaid, Medicare, and Social Security Disability Insurance have been introduced. To overcome the problems of fragmented funding and uncoordinated services, the authors propose establishment of a new federal entitlement program for the chronic mentally ill that would pool all existing funds regardless of the source. States would be empowered to develop a single administrative agency with responsibility for coordinating a comprehensive program of services.

Chronic Disease↗
PubMed1985

The fate of the public psychiatric system.

Psychiatry faces a vast array of problems today, including its inability to implement programs for the chronic mentally ill and to apply principles of differential therapeutics, the lack of funds for community services, and the continuing severe fragmentation of the psychiatric delivery nonsystem. Old solutions will not suffice. If the public mental health system is to survive, it must first be defined as comprising all settings, services, and funding for the severely and chronically mentally ill. And it must shift the balance of resources and services from institutional to community-based care. A range of financial and administrative mechanisms, such as various kinds of aggregate funding and a division of responsibility among levels of government, are available to accomplish that shift.

Chronic Disease↗
PubMed1985

Community care for the chronically mentally ill.

This article has presented the background, history, examples, and analyses of community care programs for the chronically mentally ill. From these data, it is concluded that such programs are as if not more effective an cost-efficient than conventional inpatient programs plus conventional follow-up for this population. The future, however, may depend much more on current political and economic trends than the scientific data available.

Chronic Disease↗
PubMed1984

The patient: first or last?

Too often mental health care professionals consider bureaucratic constraints rather than patient needs when making clinical, administrative, and public policy decisions. This sort of "top-down" decision-making leads to solutions that emphasize procedures and regulations rather than clinical results. After examining the disastrous effects of top-down planning in areas such as care of the chronic mental patient, the author concludes that in approaching current policy issues mental health professionals must forge solutions that meet the needs of patients rather than those of the external environment.

Aged↗