PR aside: Initial results from NIMH's service program evaluation studies

Abstract

NIMH's program evaluation studies assess the exlent and conditions utzder which services are provided according to community mental health center process goals of increasing quanti(v and range of service, decreasing use of state hospitals, responsiveness to needs, accessibiliO,, equiO', communiO, participation, and continuity and effectiveness of services. Completed contracts, annual inventories, and site visits indicate: (a) some developmeTzt of methods .for measuring processes," (b) evidence that the Centers Program is making progress toward some goals, [c) some suggestions of program options to facilitate this progress; (dj evidence that no goal has beet7 completely achieved; and (e) onh' a little evidence beyond that which initiated the Centers Program concerning the validiO, of the program's basic concepts.

Is Being “Sick” Really Better? Effect of the Disease View of Mental Disorder on Stigma

“…Community members may function at less than optimal levels rather than seek psychiatric treatment because of the stigma associ ated with doing so (Lee, Gianturco, & Eisdorfer, 1974;Windle, Bass, & Taube, 1974). Finally, public reluctance to have those with mental disorders in their midst hampers efforts to make psychiatric care more accessible, effective, and cost efficient (Aviram & Segal, 1973;Baron, 1981;Kiesler, 1982aKiesler, , 1982bKiesler et al, 1983;Morrison, 1980;Scott, Balch, & Flynn, 1983;Williams, Bellis, & Wellington, 1980).…”

Community Mental Health Centers and the decreasing use of state mental hospitals

“…To be properly understood these results should be put in the context of all other evaluations. Most of the other evaluation studies found that centers were making progress in the program's various service process goals, although none of these goals has been completely achieved (Windle, Bass, & Taube, 1974). Further, the reduction of state hospital utilization is a gross program goal that needs increasing refinement as the population of state hospitals declines (Taube, 1974) and state hospital services improve (Taube, 1970).…”

“…Most of the other evaluation studies found that centers were making progress in the program's various service process goals, although none of these goals has been completely achieved (Windle, Bass, & Taube, 1974). Further, the reduction of state hospital utilization is a gross program goal that needs increasing refinement as the population of state hospitals declines (Taube, 1974) and state hospital services improve (Taube, 1970). In addition, this paper has examined only a single mechanism for achieving the Community Mental Health Centers Program goals, the existence of federally funded centers.…”

Consumers or Citizens? Whose Voice Will Healthwatch Represent and Will It Matter? Comment on "Challenges Facing Healthwatch, a New Consumer Champion in England"

“…Reliance on a voluntary model is concerning, as prior PPI failures can be traced in part to challenges getting an adequate number of consumers to participate. 16 Furthermore, despite statutory requirements that local Healthwatch must be “inclusive and reflect the diversity of the community it serves,” 13 costs inherent in participation are likely to pose a barrier to those who may be lower income or otherwise disadvantaged. Consequently, these individuals may find that their voice is excluded from the discussion altogether.…”