The article provides recommendations to personnel at residential schools for children who are blind and visually impaired, concerning (1) the impact of the difficult child (erosion of trust, increased demands on personnel); (2) the difficult child as policymaker; and (3) the role of consultants in helping the residential school and the difficult…

Service-planning issues necessary for successful implementation of an indirect needs-assessment model to estimate geographical differences in the prevalence of needs for alcohol, drug abuse, and mental health services are discussed. The issues include selection of need categories as target groups, estimation model selection, and understanding…

Chapters included are (1) introduction; (2) mental health problems affecting Indian people; (3) impact of mental health problems on Indian communities; (4) the service delivery system; (5) treatment modalities; (6) mental health providers; (7) holding the system together; and (7) a model Indian mental health system. (KS)

This retrospective study of 217 medical students who had sought psychiatric consultation was designed to verify earlier findings. It was hypothesized that more women seek psychiatric consultation; problems would differ according to gender and academic class; women would show more evidence of role strain and remain in treatment longer; etc.…

This lesson addresses the unique issues confronting child and adolescent psychiatrists in prescribing medication for children and adolescents. Issues of consent, off-label use of medications, safety, and efficacy are discussed, along with problems that may arise when treating high-risk populations. This lesson aims to encourage safe and ethical…

Psychiatric inpatients admitted for suicidal danger were surveyed regarding their views on the benefits/limitations of written no-suicide agreements. These inpatients, for the most part, rated written no-suicide agreements in a positive manner and in ways consistent with clinical opinion expressed in a number of qualitative/expert opinion…

Data from the federal Center for Mental Health Services indicate that one in every 33 children and one in eight adolescents may be suffering from depression. Up to 70% of children with diagnosable mental, emotional, or behavioral disorders are not receiving mental health services, according to the U.S. Surgeon General's Report on Mental Health.…

The primary telehealth technology described in these articles is interactive video teleconferencing (IVTC), which allows parties at both ends of the communication to see and hear each other. The author have used this application during the past decade for consultation with rural practitioners and schools, and it has become a primary focus of our…

This study examines the associations among substance use and psychiatric disorders on arrests in a sample of 187 former recipients of Supplemental Security Income for drug addiction and alcoholism. Participants were interviewed at baseline and at 12, 18, and 24 months. Primary measures included urine tests for recent drug use, psychiatric and…

Objective: To determine the concordance between the Structured Clinical Interview for DSM-IV (SCID) and the Patient Health Questionnaire (PHQ) in diagnosing anxiety and depressive disorders. Method: Fifty women seeking psychiatric services for their children at two mental health centers in western Pennsylvania were assessed for anxiety and…

This article examines the use of outpatient mental health services in a sample of low-income women (Mothers' Well-Being Study [MWS]) and compares the findings with a sample of similar-aged women in the general population (National Comorbidity Survey [NCS]). Overall, the prevalence of any 12-month mental health disorder was significantly greater…

This study used data from 1994 to 1999 from one large county in Pennsylvania to estimate the Medicaid expenditures of children diagnosed with autism spectrum disorders (ASD) and to compare these expenditures with those of other Medicaid-eligible children. On average, children diagnosed with ASD had expenditures 10 times those of other children.…

This study assesses the extent of residential segregation among 15,246 people diagnosed with psychiatric disabilities and receiving Medicaid (MA) in Philadelphia, and an identically sized group of MA recipients serving as matched controls. Results indicate that overall levels of residential segregation among this group were modest at their most…

The mental health care delivery system is undergoing a metamorphosis of unprecedented proportion as a result of managed care. Few empirical assessments of practitioner response exist. Utilizing managed care provider and telephone directories, agency lists, and the Internet, 200 managed mental health care providers were anonymously surveyed.…

This report from a study group on long-term mental illness (LTMI) examines three components of the vocational rehabilitation process (the client, the counselor, and the programs) and the systems through which the three components interact. The first chapter discusses the history and evolution of the vocational rehabilitation (VR) and mental health…