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Biomedical subjects

C T Mowbray

Publications and source records attributed to C T Mowbray.

43 records · Page 3Linked to original sources

An empirically derived typology of mentally ill group home residents.

The classification of clients in terms of psychiatric diagnosis or level of functioning is a logical prerequisite to the conduct of quality of care assessments in mental health care. This article reports on efforts to create a typology of mentally ill group home residents based on a variety of measures of functioning. Subjects for the study come from a probability sample of 253 group home residents in Michigan. A three group typology, derived through cluster analytic procedures, is presented along with-evidence supporting its validity. Implications of the typology for program evaluators and service system planners are briefly addressed.

Activities of Daily Living↗

Evaluation approaches in mental health: implications of the new federalism.

Since the introduction of federal mental health legislation in 1963, there has been a changing emphasis on evaluation and accountability. With direct federal funding of community mental health services, accountability demands were met through expectations for local agency evaluation activities which were overseen by federal authorities. The advent of the New Federalism and the shift to block grant funding of mental health services to state mental health authorities have shifted responsibility for evaluation to the states and local programs. This paper reviews federal mental health statutes to trace the extent and locus of required evaluation activities and discusses two approaches to carrying out program evaluation: "top-down" where the evaluation topic, method, and data collection are mandated by an administering or funding body; and "bottom-up" approaches where the subject, method of study, and data to be collected are developed in response to a felt need at the local agency level. A case study of each approach as used at the state level in mental health is examined. Based on the literature and the case studies, conclusions are presented on the pro's and con's of each method in meeting accountability demands and the barriers which must be overcome for either method to be successful.

Community Mental Health Centers↗

The impact of the Health Professions Educational Assistance Act on state mental health systems.

One effect of the Health Professions Educational Assistance Act of 1976 is to severely limit the number of foreign medical graduates entering the United States. To examine the impact of the law in Michigan, the authors gathered data on the number of psychiatrists practicing in the state and projected future manpower needs. They conclude that it is unlikely that, given other provisions in the law, American medical graduates can numerically replace foreign medical graduates, and that alternative manpower resources will have to be developed. State mental health systems must form new relationships with universities and the private psychiatric sector, and new methods of training personnel and sharing resources must be developed. The authors emphasize the importance of giving state mental health systems sufficient time and resources to develop effective manpower plans.

Education, Medical↗

Treatment for mental illness and substance abuse in a public psychiatric hospital. Successful strategies and challenging problems.

Although the literature on dual diagnosis has grown considerably over the last several years, report describing inpatient treatment models are less common. We describe some of the major treatment concerns in the dural diagnosis literature, such as using 12-step self-help programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), dealing with different stages of treatment, and developing a program with integrated substance abuse and psychiatric treatment. The practical application of these treatment issues is featured by showing how they are incorporated into an innovative inpatient dual diagnosis treatment program at a public psychiatric hospital. Finally, the treatment program is described in detail regarding administrative issues, staff training, daily treatment schedules, and patient demographics.

Adult↗

An analysis of allegations of sexual abuse in a multi-victim day-care center case.

Sexual abuse in day-care centers is a phenomenon of increasing concern, both in terms of its prevalence and its serious effects on child victims. Legal intervention in this area is problematic because criminal investigations are usually beset with difficulties: Characteristics of children and of the abuse situation affect disclosure rates and credibility. Research on children as witnesses is amassing; however, so far, little systematic analysis has been conducted on multi-victim child sexual abuse cases. The present study concerns a case of sexual abuse in a day-care center with over 100 alleged victims. Criteria derived from Statement Validity Analysis (SVA) protocols were applied to aggregate record review data to assess the veritability of the abuse allegations. Individual children's abuse disclosures were also analyzed, vis-à-vis characteristics of the children (age, gender, recency of attendance) and of the investigation (agency doing the interview, number of interviews, use of anatomically detailed dolls). The use of SVA criteria supported the veritability of allegations in this day-care abuse case. Even acknowledging the limitations of archival data collected for other purposes, the aggregate data analysis reflected consistency, logical structure, and spontaneity; however, little evidence of accommodation was found. Multivariate comparison of disclosing and nondisclosing children found an unexpected inverse relationship of disclosure with age, as well as positive associations with number of interviews and use of dolls. Alternative interpretations of these results are discussed.

Age Factors↗