Community Mental Health Programs

Community Mental Health Programs

Community Mental Health Programs

Community mental health centers, which offer a wide range of mental health services and psychiatric care and are a bright spot in the area of mental health care. Such centers try to help people avoid hospitalization and find answers to mental health problems (Burns, 2004; Teed et al., 2007). Typically, they do this by providing short- term treatment, counseling, outpatient care, emergency services, and suicide prevention.

Mental health centers are also concerned with prevention. Consultation, education, and crisis intervention (skilled management of a psychological emergency) are used to prevent problems before they become serious. Also, some centers attempt to raise the general level of mental health in a community by combating unemployment, delinquency, and drug abuse (Tausig, Michello, & Subedi, 2004).

Have community mental health centers succeeded in meeting their goals? In practice, they have concentrated much more on providing clinical services than they have on preventing problems. This appears to be primarily the result of wavering government support (translation: money). Overall, community mental health centers have succeeded in making psychological services more accessible

than ever before. Many of their programs rely on paraprofessionals (individuals who work in a near-professional capacity under the supervision of more highly trained staff ). Some paraprofessionals are ex-addicts, ex-alcoholics, or ex-patients who have “been there.” Many more are persons (paid or volunteer) who have skills in tutoring, crafts, or counseling or who are simply warm, under- standing, and skilled at communication. Often, paraprofessionals are more approachable than “doctors.” This encourages people to seek mental health services that they might otherwise be reluctant to use (Everly, 2002). Community Mental Health Programs.

Therapies—Human to the Core Gateway

Are various psychotherapies effective, and what do they have in common? In this section, let’s ask whether the psychotherapies work and what, if anything, they have in common. We have put this section after the section on medical therapies to stress that human relations are at the core of healing. Whether or not a patient under medical care is receiving a somatic treatment, that treatment is administered in a human context. In that sense, it doesn’t matter if the healer is a psychotherapist, psychiatrist, social worker, hospital worker, or whatever. No matter what helping specialty you might be considering as a career, information you’ll encounter in this section might prove invaluable.

A well-run halfway house can be a humane and cost-effective way to ease former mental patients back into the community (Soyez & Broekaert, 2003).

Community Mental Health Programs

Knowledge Builder Medical Therapies

RECITE

1. Major tranquilizers are also known as

a. anxiolytics b. antipsychotics c. antidepressants d. prefrontal sedatives

2. ECT is a modern form of pharmacotherapy. T or F? 3. Currently, the frontal lobotomy is the most widely used form of

psychosurgery. T or F? 4. Deinstitutionalization is an advanced form of partial hospitalization.

T or F?

REFLECT Think Critically

5. Residents of Berkeley, California, once voted on a referendum to ban the use of ECT within city limits. Do you think that the use of certain psychiatric treatments should be controlled by law?

Self-Reflect

Keeping in mind that all therapies, and especially medical therapies, have side effects (see, e.g., Casselle, 2009), when is it appropriate to use a medical therapy to treat someone with a mental illness? Why not use psychotherapy instead?

Why might you choose to combine a medical therapy and psychotherapy? Can you frame your reasons in terms of the stress- vulnerability model introduced in Chapter 14?

Answers: 1. b 2. F 3. F 4. F 5.

Community Mental Health Programs

The question of who can prescribe drugs, perform surgery, and administer ECT is controlled by law. However, psychiatrists strongly object to residents, city councils, or government agencies making medical decisions.

9781285519517, Introduction to Psychology: Gateways to Mind and Behavior with Concept Maps and Reviews, Thirteenth Edition, Coon/Mitterer – © Cengage Learning. All rights reserved. No distribution allowed without express authorization.

 

Halfway house

A community-based facility for individuals making the transition from an institution (mental hospital, prison, and so forth) to independent living.

Community mental health center

A facility offering a wide range of mental health services, such as prevention, counseling, consultation, and crisis intervention.

Crisis intervention

Skilled management of a psychological emergency. Paraprofessional An individual who works in a near-professional capacity under the supervision of a more highly trained person. Therapeutic alliance A caring relationship that unites a therapist and a client in working to solve the client’s problems.

OK.

So how effective is psychotherapy? Judging the outcome of therapy is tricky. In a national survey, 9 out of 10 people who have sought mental health care say their lives improved as a result of the treatment (Consumer Reports, 2010; Kotkin, Daviet, & Gurin, 1996). Unfortunately you can’t just take people’s word for it (see “How Do We Know Therapy Actually Works?”).

Psychologists are making steady progress in identifying “empirically supported” (or “evidence-based”) therapies (Westen & Bradley, 2005). Rather than just relying on intuition, clinicians are seeking guidance from research experiments and guidelines developed through clinical practice (Carroll & Rounsaville, 2007; Miller & Binder, 2002). The end result is a better understanding of which therapies “work” best for specific types of problems. This trend is also helping to weed out fringe “therapies” that have little or no value.

Fortunately, there is direct evidence that therapy is beneficial. Hundreds of studies show a strong pattern of positive effects for psychotherapy, counseling, and other psychological treatments (Barlow, 2004; Lambert & Cattani-Thompson, 1996; Moras, 2002). Of course, results vary in individual cases. For some people, therapy is immensely helpful; for others, it is unsuccessful. Overall, it is effective for more people than not. Speaking more subjectively, a real success, in which a person’s life is changed for the better, can be worth the frustration of several cases in which little progress is made.

Although it is common to think of therapy as a long, slow process, this is not normally the case (Shapiro et al., 2003). Research shows that about 50 percent of all clients feel better after between 13 and 18 weekly 1-hour therapy sessions (Howard et al., 1986). This means that the majority of clients improve after 6 months of therapy. Such rapid improvement is impressive in view of the fact that people often suffer for several years before seeking help. Unfortunately, because of high costs and limited insurance cover- age, the average client receives only 5 therapy sessions, after which only 20 percent of all patients feel better (Hansen, Lambert, & Forman, 2002).