An evaluation of a mental health program for homeless men

Article Abstract:

Surveys of homeless adults in the U.S. reveal that many of them are suffering from mental illness, with an estimated 25 to 33 percent having histories of psychiatric hospitalizations or being in need of psychiatric treatment. It is commonly believed that these people have been poorly served by the mental health system. In response to this belief, an on-site psychiatric and rehabilitative delivery program was developed for men in crisis shelters. Presbyterian Hospital in New York City provides a Psychiatry Shelter Program at the Washington Heights Armory Municipal Shelter which is across the street from the hospital. This mental health day treatment service includes counseling, recreational therapy, medication maintenance, and housing placement for men with psychiatric problems who are referred by the shelter's staff. This article contains two case studies of men helped by this program. To evaluate the efficacy of the program, 32 men were interviewed who had been placed in community-based housing by the program between the summer of 1986 and January 1988. They contrasted their life situations from six months prior to entering the program to six months after community placement. There was a sevenfold reduction in total days spent in shelters, and a marked reduction in the number of criminal justice contacts in this after phase. The number of men with no income also decreased markedly. There was an increase in hospitalizations among these men during the after phase, and this might reflect an increased awareness by the patient of his problems, or it might indicate inadequate attention to substance abuse problems. Since a high percentage of the rehospitalized men had gone back to living with their families, this may be an important factor, either in that these men were too sick to be accepted into community residences, or the family settings were influential in leading to hospitalization. There was also a decrease in employment among the men in the after phase, maybe due to an increase in supplemental income provided. Many men voiced the desire for work rehabilitation to be a part of the Psychiatry Shelter Program. Overall, this was considered a positive step towards the implementation and evaluation of a treatment program for a homeless mentally ill population. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Community psychiatric services, Community mental health services, Homeless persons

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A critical review of epidemiological studies of Puerto Rican mental health

Article Abstract:

A review of the literature on the mental health status of Puerto Ricans and members of other Hispanic groups who are living in the United States was undertaken. Although this topic has been the focus of research for three decades, a comprehensive understanding of the mental health of this group has not yet been achieved. As a group, Puerto Ricans living in this country (and in New York City especially) have higher than average rates of mental disorders. Early research in this area first identified the language barrier and poverty as significant factors in the development of mental illness in this group. In addition to social stressors, an increased rate of mental illness in migratory populations has been suggested as a contributing factor. Another aspect which has not been fully explored is the two frequently observed forms of mental illness among Puerto Ricans, 'nervios' and 'ataques de nervios'. Nervios is a chronic condition characterized by a general sense of distress as a response to different life stresses. The symptoms are largely psychosomatic and include headaches, heart palpitations, and chest pain. Ataques de nervios is a specific response to a stressful event and may be triggered by grief, fear, or family tensions. Attacks, or seizure-like episodes, are observed with ataques de nervios; they often occur at culturally appropriate times, such as at funerals or during family quarrels. This behavior is culturally acceptable, and although it has been investigated by both anthropologists and mental health professionals, ataques de nervios is still poorly understood. The results of research identify the role of culture as a strong influential factor in response style within this population group. Few of the current methods available for investigation adequately address the cultural issues involved. Cultural effects need to be taken into consideration when evaluating the mental health of Puerto Ricans in this country, and modification of some existing methodology is recommended to better assess this group. (Consumer Summary produced by Reliance Medical Information, Inc.)

United States, Demographic aspects, Mental illness, Mental disorders, Hispanic Americans, Puerto Ricans, Puerto Ricans in the United States

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World Health Organization Division of Mental Health and Prevention of Substance Abuse

Article Abstract:

The field of mental health is finally being given due recognition by the World Health Organization (WHO) through expansion of major mental health programs. The WHO has appointed a regional advisor for mental health for each of the WHO regional offices while collaborating centers have increased to include psychiatry leaders from 80 countries. The Programme on Prevention of Substance Abuse has been incorporated into the WHO Division of Mental Health.

Management, Psychiatric services, Mental health services, World Health Organization, Psychiatric facilities

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