Biomedical subjects

Donald M Linhorst

Publications and source records attributed to Donald M Linhorst.

9 recordsLinked to original sources

PubMed2006

The use of logistic regression to enhance risk assessment and decision making by mental health administrators.

Development of policies and procedures to contend with the risks presented by elopement, aggression, and suicidal behaviors are long-standing challenges for mental health administrators. Guidance in making such judgments can be obtained through the use of a multivariate statistical technique known as logistic regression. This procedure can be used to develop a predictive equation that is mathematically formulated to use the best combination of predictors, rather than considering just one factor at a time. This paper presents an overview of logistic regression and its utility in mental health administrative decision making. A case example of its application is presented using data on elopements from Missouri's long-term state psychiatric hospitals. Ultimately, the use of statistical prediction analyses tempered with differential qualitative weighting of classification errors can augment decision-making processes in a manner that provides guidance and flexibility while wrestling with the complex problem of risk assessment and decision making.

Adult↗

PubMed2005

Drug courts and mental health courts: implications for social work.

In recent years communities across the United States have instituted specialized criminal courts for defendants with substance abuse disorders and mental illness. These specialized courts seek to prevent incarceration and facilitate community-based treatment for offenders, while at the same time protecting public safety. The authors describe two types of specialized courts: drug courts and mental health courts. They critically examine the strengths and weaknesses of these courts and conclude with implications for social work education, practice, research, and advocacy.

Criminal Law↗

PubMed2005

Promoting participation in organizational decision making by clients with severe mental illness.

This qualitative study assessed clients' participation in organizational decision making in a public long-term psychiatric hospital. Numerous examples were found in which clients meaningfully participated in the decision-making process and achieved favorable policy changes. Three means of involving clients were found to be especially useful: (1) using a consumer council, (2) involving clients in the formal policy review process, and (3) including clients in the hospital's performance improvement system. The authors offer guidelines for mental health organizations wishing to promote client participation in organizational decision making. Implications for social work are discussed.

Adult↗

PubMed2004

Assaultive behavior in state psychiatric hospitals: differences between forensic and nonforensic patients.

Forensic patients are occupying an increasingly large number of beds in state psychiatric hospitals. The presence of these mentally ill offenders has raised concerns about the risk they present to nonforensic patients. This study compared the rate of assaults and factors associated with assaultive behavior among 308 nonforensic patients and two groups of forensic patients including 469 patients found not guilty by reason of insanity and 76 pretrial patients. Consistent with other studies, nonforensic patients had higher rates of assaults than either group of forensic patients. However, being a forensic patient did not affect the odds of assault when controlling for the effects of demographic and clinical variables in a multivariate logistic regression analysis. Factors associated with assaults in each of the three patient groups were identified using multivariate analyses. Implications are presented for treatment of assaultive behavior, mixing of forensic and nonforensic patients within state hospitals, forensic release policies, and future research.

Adolescent↗

PubMed2002

Federalism and social justice: implications for social work.

Federalism is a system of government that divides power between two or more levels of government. During the current conservative political climate in the United States, power has shifted increasingly from the federal government to states, a move that has implications for the achievement of social justice. Consequently, it is now necessary for social workers to engage in political activity at the state and local levels, in addition to the federal level, to promote social justice. Implications for social work policy practice, research, and education for advancing social justice within the federal system of government are explored.

Consumer Advocacy↗

PubMed2002

Opportunities and barriers to empowering people with severe mental illness through participation in treatment planning.

Participation in treatment planning can be one means of empowering clients. However, significant barriers exist to empowering people with severe mental illness through treatment planning. This qualitative study reviewed documents and conducted focus groups with clients and staff of a public psychiatric hospital to identify barriers to empowerment and the conditions that must be present for client empowerment to occur through treatment planning. The conditions for empowerment were based on both psychological and organizational factors. For empowerment to occur, clients need psychiatric stability and decision-making skills. Organizations promote empowerment by ensuring that clinical staff have the time to involve clients in treatment planning, promoting staff attitudes that are respectful of clients' ability to participate in treatment planning, providing clients with a range of treatment options, designing programs that have a strong philosophical commitment to client empowerment, and implementing programs properly.

Data Collection↗

PubMed2002

Involving people with severe mental illness in evaluation and performance improvement.

This article argues for the increased involvement of people with severe mental illness and consumers of other health and mental health services in evaluation and performance improvement in the organizations from which they receive services. Among other reasons, consumers can bring a different perspective to the selection of areas to evaluate, such involvement is consistent with some models of program evaluation, and the process of participation itself can be empowering to consumers. Based on a review of the literature and the experiences of a public psychiatric hospital in involving consumers in evaluation and performance improvement, the authors exemplify how mental health consumers can participate in each stage of the evaluation process, ranging from the initial stage of posing evaluation questions to the final stage of acting on evaluation findings. Next, challenges to consumer involvement are described. Guidelines are then offered for involving consumers of health and mental health services in evaluation and performance improvement.

Community Participation↗

PubMed2002

Development and implementation of a program for offenders with developmental disabilities.

The need for a comprehensive range of services for persons with mental retardation and other developmental disabilities who enter the criminal justice system has been well-established. However, such services are unavailable to most offenders with developmental disabilities. Here we describe the services of one agency devoted to this population. Established in 1990, this agency has provided education and training to over 1,500 professionals, answered over 1,000 information and referral questions, and provided direct services to over 600 offenders with developmental disabilities. Recommendations for developing and implementing similar programs are offered. Areas addressed include assessing need, funding, composition of boards of directors, program philosophy, selection of program services, staffing, the referral process, and program evaluation.

Adolescent↗

PubMedDate not supplied

Recidivism among offenders with developmental disabilities participating in a case management program.

This study examined recidivism, defined as arrests, among 252 clients who were accepted into a case management program for offenders with developmental disabilities. Overall, 40% of clients were arrested while participating in the program, and 34% were arrested within 6 months after case closure. The crimes for which clients were arrested tended to be minor: 21% were for probation or parole violations not associated with new criminal acts, 39% were for misdemeanors, 27% were nonviolent felonies, and 12% were for felonies against persons. Clients who completed the program (N=115) were less likely to be arrested after case closure than those who dropped out of the program (N=112), 25 and 43%, respectively. Other factors associated with arrests after case closure included having a developmental disability other than mental retardation, living in an urban area, being referred to the program by a criminal justice agency or through a private referral rather than a social service agency, and being arrested while in the program. Implications are discussed for service provision and evaluation of programs that work with offenders with developmental disabilities.

Adolescent↗