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Biomedical subjects

H T Harbin

Publications and source records attributed to H T Harbin.

13 recordsLinked to original sources
PubMed1991

Evaluation of a Maryland fiscal incentive plan for placing state hospital patients in nursing homes.

In Maryland a six-month fiscal incentive to promote nursing homes' acceptance of chronic patients discharged from state psychiatric hospitals was evaluated after one year. During the fiscal year of the incentive program, such placements (N = 182) increased an average of 38 percent from previous years. Of 163 patients whose placements were evaluated, 22 were returned to the state hospital during the six-month period that the incentive was in place. Ten of the 22 were returned within 30 days of placement. Contrary to expectation, the return rate did not rise after the incentive was discontinued; four patients were returned during the second six months of the study period. Most returns during the first six months were due to patients' physical and verbal threats. The results supported the use of short-term fiscal incentives and emphasized the importance of intensive supportive interventions with chronic mentally ill patients early in the nursing home placement.

Aged↗
PubMed1984

The Maryland plan for recruiting psychiatrists into public service.

A joint initiative by the University of Maryland and the Maryland Mental Hygiene Administration succeeded in recruiting 116 university-trained psychiatrists into state employment in a period of 7 years. The program emphasizes the creation of an academic environment in state treatment facilities, integration of university and state residency training programs, part-time faculty status for state psychiatrists, and rapid promotion of talented young psychiatrists to positions of authority. The program has been successfully implemented at no cost to either the university or the state.

Foreign Medical Graduates↗
PubMed1983

Assaultive adolescents: family decision-making parameters.

This article presents the results of a pilot study that investigated the family decision-making styles of families with a violent adolescent (17) and families with a normal adolescent (12). The results, utilizing an unrevealed differences family interactional test, showed that families with an assaultive teenager when contrasted with normal families had: (a) less agreement when making choices as a group; (b) less agreement between mother and violent son when making choices about activities; (c) sons who had less influence in the families' choice of activities; and, (d) mothers who "dictated" the families' decisions more often. The meanings of these findings and others are discussed by the authors as they relate to the problem of assaultive youths.

Adolescent↗
PubMed1982

Psychiatric manpower and public mental health: Maryland's experience.

From July of 1976 through December 1981, 67 psychiatrists who graduated primarily from American medical schools and who had completed university residency training programs were recruited into Maryland's state mental health system. As of 1981, 43 of these psychiatrists still worked in inpatient facilities; they represented 33 per cent of all state hospital psychiatrists in Maryland. The Maryland Mental Hygiene Administration and the University of Maryland have used two general strategies to develop psychiatric manpower and improve employment conditions. They established close linkages between academia and the public sector and demonstrated positive, effective leadership by psychiatrists within the state mental health system.

Attitude of Health Personnel↗
PubMed1980

Family therapy training for psychiatric residents.

The author describes a comprehensive four-year educational program for training psychiatric residents in marital and family therapy. Residents receive an average of 70 hours of didactic instruction and 175 hours of one-on-one supervision in family therapy; they conduct approximately 500 hours of family and marital therapy with 75--85 outpatient and inpatient families. The author identifies faculty and resident resistance to an additional theoretical model and the major involvement of nonphysician faculty but stresses that residents now have the opportunity to truly understand and implement a biopsychosocial model and that psychiatrists must increase their experience in specialized therapeutic modalities to remain clinical leaders.

Curriculum↗
PubMed1979

A family-oriented psychiatric inpatient unit.

This article presents the structure and policies of a psychiatric inpatient unit that was developed with the goal of fully integrating family-oriented treatment approaches into its therapeutic program. There is an explanation of different methods to involve families in the hospital treatment process and delineation of a variety of treatment techniques specific for families of inpatients. The role of the nursing staff is described as well as some of the contradictions and paradoxes that are inherent in this type of inpatient unit.

Adolescent↗
PubMed1979

Battered parents: a new syndrome.

The authors identify a new syndrome of family violence--parent battering. Relevant dynamics include individual characteristics of the parent batterer, distortions in the generational authority hierarchy, the role of secrets and denial, and cultural influences. The authors conclude, on the basis of their clinical work with these families, that this subtype of family violence is distinct from child and spouse abuse.

Adolescent↗
PubMed1978

Families and hospitals: collusion or cooperation?

The author describes the therapeutic problems that can arise on a family-oriented psychiatric inpatient service. The stress emerging from the therapeutic demands on and changes in the internal structure of the family may cause the family to seek to reestablish its internal equilibrium by changing the hospital staff and structure at the ward level, department level, and the hospital administration level. These transactions between the hospital and families, which are complex, are extremely important to recognize because they can undermine the therapeutic process.

Administrative Personnel↗
PubMed1977

Episodic dyscontrol and family dynamics.

The author describes characteristics of patients, primarily adolescents, who suffer from episodic violent behavior and their relations with their families. Typical family patterns include overly close alliances by the adolescent with one or both parents and transmission by parents of inconsistent values regarding aggression. Family therapy is the preferred treatment approach; treatment should be active, should initially focus on ways of handling dyscontrol episodes, and should emphasize that the patient is responsible for his or her actions.

Adolescent↗
PubMed1975

Some considerations in the formulation of psychiatric diagnoses.

This paper attempts to show that psychiatric diagnosis depends to a significant degree on not only the patient's presenting symptoms but also on the psychiatrist's psychosocial biases. The importance of a psychiatric diagnosis is seen in terms of the potential social restrictions and prejudices that can be a consequence of a person labeled with a mental illness. Also, current treatment techniques and valid statistics for research are based on reliable and consistent psychiatric diagnoses. A study of 267 cases from a major psychiatric hospital revealed over 12 per cent discrepancy between the official discharge diagnosis and a resident's training report diagnosis that is used only for teaching purposes. This discrepancy is statistically significant and the paper attempts to elucidate some of the characteristics of the special population that had its diagnosis made less severe on discharge. Of the 267 charts surveyed, 33 patients had their diagnosis changed from a psychotic diagnosis on the resident's training report to a neurotic or characterological diagnosis on the official discharge summary. In addition, interviews were arranged with the 18 psychiatric residents who had been involved in changing the diagnosis of target group patients. The results obtained from these interviews definitely confirm that psychiatric diagnoses are changed due to social conditions unrelated to the psychopathological state. From the demographic data of the patient groups, a pattern evolved showing that men were generally more protected than women, that black males were more protected than black females, that unskilled laborers and those on the lower end of the socioeconomic scale were more protected than professionals, and that housewives were less protected than other categories. A number of conclusions were made by the authors concerning the data. The authors hope that these findings will enable other mental health workers to be more aware of their psychosocial biases that may be influencing their diagnostic skills.

Attitude of Health Personnel↗