Mental Health Beliefs Among Ghanaian Immigrants in the United States and Mental Health Systems in Ghana

Purpose: This study assessed the impact of Mental Health First Aid (MHFA) in the United States with a theoretically based and psychometrically sound measure, the Mental Health Beliefs and Literacy Scale (MBLS). Design: Online MBLS surveys were administered pre-MHFA training, 3-weeks post-training, and 6-months posttraining. Setting: Mental Health First Aid trainings carried out across the United States. Participants: Six hundred sixty-two trainees were contacted, and 273 (41%) completed the presurvey. Of those, 63% filled out the postsurvey and 35% completed the 6-month survey. Seventy-six individuals completed all 3 surveys. Intervention: Mental Health First Aid is an 8-hour education program to help the general public identify, understand, and respond to signs of mental illness and substance abuse; to date, almost 1 million people have been trained. Measure: The MLBS, based on the Unified Theory of Behavior Change framework, consists of attitudinal, social-, and skill-based constructs affecting the intention to perform and achievement of MHFA actions and reports of their actual completion. Analysis: Change across time points was assessed using multivariate repeated measures analysis of variance. Results: Significant short- and longer term changes were found in internally consistent constructs tapping positive beliefs about MHFA actions, the confidence and intention to perform them as well as mental health literacy. Conclusion: The MBLS documented strong positive effects of MHFA training that were greater in individuals without prior mental health training, the intended targets of MHFA efforts.

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Competence to stand trial and criminalization: an overview of the research

CNS Spectrums ◽

10.1017/s1092852919001597 ◽

2019 ◽

Vol 25 (2) ◽

pp. 161-172

Author(s):

Amanda Beltrani ◽

Patricia A. Zapf

Keyword(s):

Mental Health ◽

United States ◽

Health Systems ◽

The United States ◽

Steady Increase ◽

Competence To Stand Trial ◽

Forensic Mental Health ◽

Mental Health Systems ◽

National Organizations ◽

Psychiatric Beds

Beginning in the 1960s, a steady decline in the number of inpatient psychiatric beds has occurred across the United States, primarily as a result of stricter civil commitment criteria and a societal movement toward deinstitutionalization. Concomitant with this decrease in psychiatric beds has been a steady increase in the number of mentally ill individuals who are arrested and processed through the criminal justice system as defendants. One consequence of this has been an explosion in the number of defendants referred for evaluations of their present mental state—adjudicative competence—and subsequently found incompetent and ordered to complete a period of competency restoration. This has resulted in forensic mental health systems that are overwhelmed by the demand for services and that are unable to meet the needs of these defendants in a timely manner. In many states, lawsuits have been brought by defendants who have had their liberties restricted as a result of lengthy confinements in jail awaiting forensic services. The stress on state-wide forensic systems has become so widespread that this has reached the level of a near-national crisis. Many states and national organizations are currently attempting to study these issues and develop creative strategies for relieving this overburdening of forensic mental health systems nationwide. The purpose of this article is to review the current state of the research on competence to stand trial and to highlight those issues that might be relevant to the issue of criminalization of individuals with mental illness in the United States.

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