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Biomedical subjects

R W Manderscheid

Publications and source records attributed to R W Manderscheid.

At least 73 records · Page 4Linked to original sources
PubMed1986

Referral patterns to and from inpatient psychiatric services: a social network approach.

Interorganizational linkages have assumed more import for mental health service systems during the past three decades because of increased levels of complexity in service delivery patterns. This analysis examines these linkages from a relational perspective, with network of patient referral patterns as the basic unit. Multidimensional scaling is employed to discern patterns of interorganizational linkages in national patient referral data collected by the National Institute of Mental Health in 1975 and 1980 for patient samples from inpatient psychiatric services of state and county mental hospitals, private psychiatric hospitals, and public and nonpublic general hospitals. The multidimensional scaling techniques distinguish two structural characteristics of the interorganizational linkages of psychiatric inpatient services--public vs private services, and drift over time in referral patterns. Public and private inpatient psychiatric services are differentiated principally in terms of degree of interaction with legal agencies and private practice psychiatrists. Chronological change in referral patterns is characterized principally by changes in the degree of interaction with other inpatient or outpatient psychiatric services. Methodologically and theoretically, the techniques and findings described can enhance our understanding of interorganizational linkages and dynamics.

Delivery of Health Care↗
PubMed1985

Federally funded CMHCs: the effects of period of initial funding and hospital affiliation.

Previous research on federally funded community mental health centers has largely failed to recognize fundamental differences among different types of centers. Here we show that such basic factors as the arrangement for providing inpatient services and the period of initial federal funding have large effects on the development and organization of a center. Although the centers joining the federal program from 1965-1970 are the largest, those facilities funded between 1971-1975 are generally smaller than those funded later. The arrangement for providing inpatient services has an important effect on staffing. This work suggests the national norms may not be the most useful data for evaluating past performance or planning the future of a specific center.

Budgets↗
PubMed1985

The chronically mentally ill in primary care.

The role of primary care physicians in addressing the needs of chronically mentally ill patients is examined from three perspectives: assessing community prevalence; treating chronic medical problems in the context of other human service needs; and treating specific types of chronic mental disorders. About 30% of primary care patients were found to have at least one Research Diagnostic Criteria mental disorder, five-sixths of which had a duration greater than 1 year. However, about 9% of patients had some impairment and 2% had severe impairment associated with a mental disorder. Although affective disorders have the highest overall rates, personality, psychotic, and anxiety disorders contribute the greatest proportion of severe disability.

Adolescent↗
PubMed1985

A method for estimating the chronic mentally ill population in state and local areas.

A practical method for estimating the size of the noninstitutionalized chronic mentally ill population in state and local areas, including those not currently receiving services, has been developed. The method relies on national and state counts by zip code area of persons receiving Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) because of mental illness, and on full or sample counts by SSI and SSDI status of chronic mentally ill persons in publicly funded community mental health programs.

Catchment Area, Health↗
PubMed1985

Correlates of acting-out behaviors among young adult chronic patients.

The authors studied how the abuse of alcohol and other drugs and the failure to take prescribed medications are related to behavior problems shown by young adult mentally ill persons at home and in the community. The study was based on information provided by case managers for 1,471 clients in the community support program (CSP) sponsored by the National Institute of Mental Health. The study found that alcohol abuse was strongly related to acting out among young CSP clients, but that drug abuse affected their behavior even more adversely. Failure to comply with prescribed medication regimens accounted for a considerable share of the behavior problems exhibited by the young clients, particularly acting out in the community. Age was found to have an attenuating effect on behavior problems. The authors emphasize the need to devise programs to meet the needs of young chronic mentally ill persons.

Acting Out↗
PubMed1983

A descriptive analysis of community support program case managers serving the chronically mentally ill.

This article presents a description of case managers who serve community-based chronically mentally ill (CMI) persons through the Community Support Program (CSP). Information is presented on case managers' demographic characteristics, education, job training, job history, current job activities, and locus of employment. Data were generated through the Case Manager Background Questionnaire, a 23-item self-administered instrument developed in conjunction with the CSP, a pilot Federal-State collaboration project designed to explore strategies for improving the delivery of community-based mental health and related services to the CMI. Results of the study suggest that a typical CSP case manager is white, female and in the mid-thirties. Case managers are a highly educated group; nearly one-half have graduate degrees and about two-thirds have participated in an in-service or continuing education program. Currently, two out of three CSP case managers are employed at Community Mental Health Centers and about one-third of their time is spent in direct service provision. While CSP case managers have been working at their present location for about one and one-half years, they have been in the community-based mental health system for about four years, and with the mentally disabled an average of seven years. A critical issue emerging from this analysis is the need for future research on the relationships among job training, education, job functions, and service delivery.

Adult↗
PubMed1983

Conducting state and local health needs assessments. Designs and strategies.

A comprehensive set of five needs assessment techniques designed to facilitate informed decisions about mental health services planning at the state or local level are presented. These include: (1) estimating the size of the target population based on statistical extrapolations from prevalence rates or inferences from indirect indicators; (2) surveys of institution-based populations; (3) surveys of service providers; (4) client-targeted surveys; and (5) surveys of key informants. Each technique is discussed in terms of its unique design considerations, strengths and weaknesses, the phase's association with its application, and estimated resource requirements. Mental health needs assessments can be conducted in a cost-effective manner, especially important in an era when rational decisions about the allocation of scarce resources are essential.

Data Collection↗
PubMed1982

Factors affecting adjustment of community living.

The authors draw on sociological writings to develop a theoretical model of adjustment to community living in terms of personal attributes, and test the model with data descriptive of a representative sample of 1,471 chronically mentally ill adults participating in the National Institute of Mental health community support program. According to the model, poor community adjustment results from deficits in basic living skills, from behaviors and traits that offend others, and from somatic problems that restrict independent activity. The model is used in the prediction of four distinct facets of community adjustment: clients' work status social activity, and need for hospitalization and for crisis assistance. In addition, the model is also used to explain work performance of a subsample of 371 clients who had jobs at the time of the study. While in most instances only a modest amount of the variance is explained, the results provide some empirical support for the theoretical model, and suggest that different components of the model are predictive of varying facts of community adjustment.

Adult↗
PubMed1981

The Psychological Stress Evaluator as a clinical assessment instrument. Evaluation and implications.

Efficient clinical assessment of anxiety and hostility could be facilitated through the use of a mechanical measurement instrument with known validity and reliability. Preliminary evaluation of the Psychological Stress Evaluator (PSE) has indicated that it could be used for this purpose. The present study reports the results of a correlational analysis between a PSE generated stress indicator (blocking pattern mode III) and the Gottschalk-Gleser Free Association Test, a verbal content-analysis measure of anxiety and hostility in psychotherapy patients. Findings do not show any correlation between these measures and suggest that the PSE may have only limited use as a valid and reliable assessment instrument for anxiety and hostility. Methodological problems inherent in the calculation and interpretation of PSE scores are elaborated in a review of current PSE scoring systems. A brief discussion of the theoretical assumptions underlying the development of the PSE and associated scoring protocols suggests directions for future research.

Adult↗
PubMed1980

Marital role dynamics during brief group psychotherapy: assessment of verbal interactions.

Examined the impact of brief group psychotherapy on the marital and sex roles of five volunteer couples who participated in two, 15-session, model therapy groups conducted approximately 2 years apart. Assessments are based on Hill Interaction Matrix (HIM) analysis of the style and content of marital partners' verbal behavior during the assessions. Results show that interactional correlates of traditional marital and sex role variations are attenuated, that communication between spouses is improved, and that the therapeutic quality of verbal behavior is enhanced over the course of therapy. Generally, from the perspective of interactional dynamics, these findings suggest that the group psychotherapy model that was being evaluated is an effective mode of brief, precrisis intervention for married couples.

Adult↗