Community participation in health services

This study critically analyzes and synthesizes community participation (CP) theory across disciplines, defining and beginning to map out the elements of CP according to a preliminary framework of structure, process, intermediate outcomes, and ultimate outcomes. The first study component sought to determine the impact of Sight N' Soul, a CP project utilizing neighborhood health workers (NHWs), on appointment missing in an indigent urban African-American population. It found that persons entering the vision care system through contact with an NEW were about a third less likely to miss an appointment than those persons entering the system through some other avenue. While theory in this area remains too poorly developed to hypothesize causal relationships between structure, process, and outcomes, a summary of the elements of Sight N' Soul's structure and process both developed the preliminary framework and serves as a first step to mapping these relationships. The second component of the study uncovered the elements of structure and process that may contribute to a sustained egalitarian partnership between community people and professionals, a CP program called Project HEAL. Elements of Project HEAL's structure and process included a shared belief in the program; spirituality; contribution, ownership, and reciprocation; a feeling of family; making it together; honesty, trust, and openness about conflict; the inevitability of uncertainty and change; and the guiding interactional principles of respect; love, care, and compassion; and personal responsibility. The third component analyzed the existing literature, identifying and addressing gaps and inconsistencies and highlighting areas needing more highly developed ethical analysis. Focal issues include the political, economic, and historical context of CP; the power of naming; the issue of purpose; the nature of community; the power to muster and allocate resources; and the need to move to a systems view of health and well-being, expanding our understanding of the universe of potential outcomes of CP, including iatrogenic outcomes. Intermediate outcomes might include change in community, program, and individual capacity, as well as improved health care delivery. Ultimate outcomes include increased positive interdependencies and opportunities for contribution; improved mental, physical, and spiritual health; increased social justice; and decreased exploitation. ^

Has implementation of integrated mental health services in primary care programs positively impacted health outcomes among the mentally ill in developing countries?

Objective. The World Health Organization (WHO) estimates that nearly 450 million people suffer from a mental disorder in the world. Developing countries do not have the health system structure in place to support the demand of mental health services. This study will conduct a review of mental health integration in primary care research that is carried out in low-income countries identified as such from the World Bank economic analysis. The research follows the standard of care that WHO has labeled appropriate in treatment of mental health populations. Methods. This study will use the WHO 10 principles of mental health integration into primary care as the global health standard of care for mental health. Low-income countries that used these principles in their national programs will be analyzed for effectiveness of mental health integration in primary care. Results. This study showed that mental health service integration in primary care did have an effect on health outcomes of low-income countries. However, information did not lead to significant quantitative results that determined how positive the effect was. Conclusion. More ethnographic research is needed in low-income countries to truly assess how effective the program is in integrating with the health system currently in place.^ ^

PREPAID MENTAL HEALTH SERVICES: A NATIONAL PERSPECTIVE

The purpose of this 1982 national survey of all operational prepaid health plans, or PHPs (including health maintenance organizations), was to provide information on the current coverage of PHP mental health and substance abuse services, benefits and service provision, general and mental health organization characteristics, mental health service costs, and physical and mental health service utilization.^ Two survey instruments were designed, pretested and distributed to all operational PHPs throughout the United States. A total of 237 PHPs were surveyed, of which 205 (86.50 percent) completed and returned both questionnaires.^ One result of the rapid growth in the PHP field over the past ten years has been the expansion in both the number of PHPs as well as the organizational characteristics of these PHPs. However, little attention in the research literature has been given to the application of empirical results to the PHP arrangements. This project has attempted to contribute to current knowledge regarding prepaid mental health services from a national perspective, and explore, on a preliminary descriptive basis, the variety of potential service delivery arrangements for physical and mental health services (total services) and for mental health services.^ The study emphasized that PHPs must continue to monitor the costs and utilization of mental health services, particularly in light of the apparent elimination of data collection and statistical summary responsibilities within the federal government regarding PHP activities as well as the proposed legislation to eliminate mandated mental health and substance abuse services from basic health plan benefits for federally qualified PHPs. ^

A report on public and community health personnel : prepared for the Committee on Interstate and Foreign Commerce, House of Representatives and the Committee on Labor and Human Resources, United States Senate, as required by section 793 of the Public health service act

"December 7, 1979."

Costs and benefits of occupational health nursing /

Mode of access: Internet.

Reauthorization of the Substance Abuse and Mental Health Services Administration : hearing before the Subcommittee on Substance Abuse and Mental Health Services of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eighth Congress, first session, on examining proposed legislation authorizing funds for the Substance Abuse and Mental Health Services Administration, focusing on the importance of substance abuse prevention, July 15, 2003.

Shipping list no.: 2004-0105-P.

The health care crisis and the American family : hearing before the Committee on Labor and Human Resources, United States Senate, One Hundred Second Congress, first session ... January 10, 1991.

Item 1043-A, 1043-B (MF)

Evaluating community mental health services : principles and practice /

Mode of access: Internet.

NIOH and NIOSH basis for an occupational health standard : grain dust : health hazards of storing, handling, and shipping grain /

Summary in Swedish.

Medicaid prescription drug diversion : a major problem, but state approaches offer some promise : statement of Janet L. Shikles, Director, Health Financing and Policy Issues, Human Resources Division, before the Select Committee on Narcotics Abuse and Control, House of Representatives /

"July 29, 1992."

Health insurance : more resources needed to combat fraud and abuse : statement of Janet L. Shikles, Director, Health Financing and Policy Issues, Human Resources Division, before the Committee on the Judiciary, United States Senate /

"July 28, 1992."

Child welfare and juvenile justice : federal agencies could play a stronger role in helping states reduce the number of children placed solely to obtain mental health services : report to congressional requesters /

"GAO-03-397."

Health and educational effects of marijuana on youth : hearing before the Subcommittee on Alcoholism and Drug Abuse of the Committee on Labor and Human Resources, United States Senate, Ninety-seventh Congress, first session on examination of the health and educational effects of marijuana or youth, October 21, 1981.

Mode of access: Internet.