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Biomedical subjects

C Windle

Publications and source records attributed to C Windle.

At least 19 recordsLinked to original sources
PubMed1998

Assessment of cage use by laboratory-bred common marmosets (Callithrix jacchus).

The way in which breeding families of laboratory-born marmosets used the space provided by their cages, and a small protruding 'veranda', was assessed in order to determine the popularity of the veranda as a form of environmental enrichment, and the extent to which the marmosets confined themselves to only part of the cage. The veranda was found to be of enduring interest to the marmosets whose occupancy of this space was an order of magnitude greater than the rest of the cage. The upper part of the cage was preferred to the bottom half. This preference was greater in larger cages and decreased when larger cages were temporarily reduced in size. It is unlikely, however, that the distribution of the occupancy of different parts of the cage resulted primarily from a fear of people in the holding room. The veranda, which was the most preferred place in the cage, was the nearest part of the cage to people in the room. Occupancy of the lower part of the cage increased when human observers sat on the floor, suggesting that some of the marmosets' behaviour comprised approaching, rather than avoiding, the observers, possibly for reasons of curiosity and social interaction.

Animals↗
PubMed1991

NIMH support of rural mental health.

The National Institute of Mental Health (NIMH) emphasizes improved mental health and mental health services in rural areas through funding for research projects and research centers. NIMH also supports related activities including state planning, improvement of state data systems, protection of and advocacy for mentally ill individuals, disaster relief, professional training, and education concerning depression. Other important components include surveys, analyses, and public information, including support for a public hearing on rural mental health.

Adolescent↗
PubMed1988

Types of patients served by various providers of outpatient care in CMHCs.

Representative community mental health center (CMHC) survey data showed that psychiatrists differed from other CMHC providers of mental health services by serving the more seriously impaired patients who are admitted and readmitted to outpatient services. Psychiatrists also shared more outpatients with providers from other disciplines than providers in other disciplines shared with one another. The results are consistent with previous research on differences between disciplines and with the flight of psychiatrists from CMHCs but cast doubt on the hypothesis that psychiatrists see sicker patients than psychologists see because of differences in reimbursement between the two disciplines.

Age Factors↗
PubMed1988

Treatment of patients with no diagnosable mental disorders in CMHCs.

Community mental health centers (CMHCs) have been criticized for directing resources that should be used to treat the seriously mentally ill to the treatment of less impaired patients. Many of the latter group are assigned one of the DSM-III V codes for conditions that do not meet criteria for a mental disorder. This study compared patients with V-code conditions and those with diagnosed mental disorders on clinical, social, and economic variables. V-code patients were significantly less likely to have had prior care and to rely on third-party payments. They were significantly more likely to have been self-referred or referred by friends or family and to be white, well-educated, female, and married. CMHCs that treated fewer V-code patients reported proportionally more staff hours worked by physicians, indicating a greater medical orientation. The authors believe CMHCs should periodically evaluate whether, by serving patients with less serious conditions, they are diverting badly needed resources away from the seriously mentally ill.

Adolescent↗
PubMed1987

The impact of federally funded CMHCs on local mental health service systems. Community Mental Health Centers.

To measure how much federally funded community mental health centers increased the quantity and range of mental health services, 63 catchment areas in which CMHCs began to receive federal funding in 1974-75 were matched individually with catchment areas that never received federal CMHC funding. The two groups of catchment areas were compared to determine average increases from 1973 to 1980 in amounts of services, mental health staff, expenditures, and accessibility and availability of services. Results showed that establishment of local CMHCs had a clear impact on the quantity and the availability and accessibility of services in the catchment area. The effect sizes resulting merely from the passage of time and from CMHC funding were compared.

Catchment Area, Health↗
PubMed1985

The contrasting careers of two structural types of CMHCs.

Changes in funding, clientele, and services from 1971 to 1980 were examined cross sectionally and with cohorts for two types of CMHCs that differ in their structure for providing inpatient service. Inpatient provider CMHCs grew in revenues and shifted from reliance on federal funds to revenues from services and states. Inpatient-affiliated CMHCs fell in revenues (in constant dollars) and changed little in their proportional reliance on federal dollars. Inpatient provider CMHCs averaged more additions and episodes of care than inpatient-affiliated CMHCs. Inpatient-affiliated CMHCs grew more from 1971 to 1976, but from 1976 to 1980 inpatient provider CMHCs grew, while inpatient-affiliated CMHCs dropped or grew less. The relatively poor final showing of inpatient-affiliated CMHCs parallels findings with total revenues.

Adult↗
PubMed1983

From programs to systems: implications for program evaluation illustrated by the Community Mental Health Centers Program experience.

Many approaches can be used to develop understanding of service programs. These approaches vary in how much they rely on technical vs. political procedures, who controls them, purpose, scope of content, and generality of results. Only some of these approaches are usually considered program evaluation. This diversity is illustrated by a description of the history of 10 program evaluation-like approaches to understanding as they operated during the 18-year life of the federal Community Mental Health Centers (CMHC) Program. When services were funded in federal categorical programs, information-gathering approaches focused narrowly on the program and its activities. It now appears that more widely useful information would result by shifting from the evaluation of "programs" to comparative analysis and evaluation of service systems.

Community Mental Health Centers↗
PubMed1982

Evaluation in the community mental health centers program: a bold new reproach?

The Federal Community Mental Health Centers Program (CMHC)-from 1963 to 1981-was heralded as a revolution in mental health care. Championed by many, and severely criticized by others, the actual impact of the program on the nation's mental health remains unclear. The authorization to evaluate the CMHC Program came originally from congressional legislation (PL 90-174), and later from the policies and regulations of NIMH under a series of Federal laws, notably PL 94-63. From 1976-1980, two dominant evaluation strategies were prevalent: funds expended by NIMH each year for studies of CMHC services or program-wide evaluations, and a much larger expenditure by CMHCs to conduct their own, independent evaluations following federal guidelines. As the Center's Program was turned over to the states in the form of block grants (PL 97-35), a group of professionals involved with setting and carrying out federal CMHC evaluation policy of both varieties met in public forum to debate the impact of these two evaluation approaches. While some participants cited gains in evaluation technology and impact upon local management of CMHCs, others found the lack of a coordinated and systematic approach to evaluating the CMHC Program to have been an opportunity missed. The impact of CMHC evaluation efforts are also discussed in terms of their major contribution to the field of evaluation research as a whole.

Community Mental Health Centers↗
PubMed1981

A framework for understanding participation in community mental health services.

Citizen participation has been associated with confusing rhetoric and conflicting philosophical rationales, both in its long history in America and in the community mental health movement. While CMHCs have emphasized participation less than many other social programs begun in the 1960s, participatory roles have evolved. Some of the confusion surrounding this complex topic can be clarified by distinguishing three dimensions of participation--power, participants and program functions. Conflicting societal trends have the future of participation in the community mental health movement uncertain.

Community Mental Health Services↗
PubMed1981

Client participation in CMHC program evaluation: increasing incidence, inadequate involvement.

Client satisfaction surveys and client complaint systems are used by more CMHCs since the Amendments of 1975 required centers to evaluate "acceptability of service," but clients are seldom actively involved in designing or administering these evaluations. The authors argue that greater control by clients is merited on technical and political grounds, and would increase the likelihood that program improvements would result from assessments of acceptability.

Community Mental Health Centers↗
PubMed1980

Correlates of community mental health center underservice to non-whites.

The relationships between relatively low utilization rates for non-whites and catchment area demography and center service characteristics were examined for 142 federally funded community mental health centers. Center characteristics were less strongly related to relative utilization by non-whites than were area demographic characteristics. Several characteristics of the black population were among those most highly associated with relative non-white utilization rates.

Black or African American↗
PubMed1980

Ethnic specificity in the relative minority use and staffing of community mental health centers.

One of the mechanisms proposed for remedying underuse of community mental health centers by ethnic minorities is the increased employment of these minorities on community mental health center staff. The relative use and staffing rates by minorities were examined separately for four minorities: blacks, Spanish Americans, Asian Americans, and American Indians. There were statistically reliable moderate relationships between relative use and staffing rates for particular minorities, but somewhat lower relationships between relative use by one minority and staffing by other minorities. No general pattern was found for all minorities either for a different relationship between utilization and staffing for males and females or for a sex specificity; rather, different patterns appear for different minorities. Service-area demography appears to have no consistent effect on these relationships.

Adult↗
PubMed1980

Performance measures for mental health programs: something better, something worse, or more of the same?

Current pressures for establishment of accountability systems based on performance measures for mental health programs are likely to improve services only if such systems are accompanied by supportive research, preparatory orientation, wide participation, tested data systems, and elimination of other redundant accountability procedures. A 4-phase, 3-functional level model is proposed to guide implementation.

Community Mental Health Services↗