Psychology as Mental Health Practice in the United States, 1945–1980

Author(s):  
Wade E. Pickren ◽  
Ingrid G. Farreras

In a relatively brief period of time, the discipline of psychology in the United States changed from being mostly concerned with its status as a legitimate science, qua physics or biology, to a rapidly growing field caught up in the tensions between academic science and the practice of psychology as a mental health profession. The numerical growth of the field’s members was heavily concentrated in the professional areas of mental health application. This was due primarily to the changed conditions of postwar life and the concerns of policymakers about the mental health of citizens in a dynamic, fast-changing, and fast-paced society. Government funding for psychology dramatically increased, especially funds for training clinical psychologists and for conducting research on mental health problems. It was not long before many of the clinical psychologists moved away from solely academic work and into the private practice of providing psychotherapy to clients. The discipline’s main organizational body of the time was the American Psychological Association, which came under pressure to allocate intellectual, organizational, and financial resources to the support of its practitioner members. One of the most intense battles of this period was that of creating different training models for clinical psychology. The early postwar model placed priority on training clinical psychology students to be scientists first, but by the 1960s, the demand for greater emphasis on training for practice had to be addressed for the field to remain coherent. Along with the internal tensions, psychology had to come to terms with external pressures as well. Among its challenges were those from competing professions, such as medicine, to its legal and cultural authority to provide professional services. Psychology eventually won those battles, but only after a state-by-state fight. Psychology was also presented with the challenges of a society wrestling with social problems, such as the demands for equal civil rights and opportunities. By the late 1960s, there were increasing demands for inclusion of students and faculty of color in graduate training and while there were some successes, there remained challenges that endured into the 21st century.

Author(s):  
Hans Oh ◽  
Ai Koyanagi ◽  
Jordan DeVylder ◽  
Andrew Stickley

Seasonal allergies have been associated with mental health problems, though the evidence is still emergent, particularly in the United States. We analyzed data from the National Comorbidity Survey Replication and the National Latino and Asian American Survey (years 2001–2003). Multivariable logistic regression models were used to examine the relations between lifetime allergies and lifetime psychiatric disorders (each disorder in a separate model), adjusting for socio-demographic variables (including region of residence) and tobacco use. Analyses were also stratified to test for effect modification by race and sex. A history of seasonal allergies was associated with greater odds of mood disorders, anxiety disorders, and eating disorders, but not alcohol or substance use disorders, after adjusting for socio-demographic characteristics and tobacco use. The associations between seasonal allergies and mood disorders, substance use disorders, and alcohol use disorders were particularly strong for Latino Americans. The association between seasonal allergies and eating disorders was stronger for men than women. Seasonal allergies are a risk factor for psychiatric disorders. Individuals complaining of seasonal allergies should be screened for early signs of mental health problems and referred to specialized services accordingly.


Author(s):  
Elizabeth M. Moore ◽  
Theresa H. Cheng ◽  
Roya Ijadi-Maghsoodi ◽  
Lillian Gelberg

An estimated 100 million people globally suffer from absolute homelessness. The estimated number of people who are homeless in the United States at any given point in time is about 550,000. Mortality and disease severity of people who are homeless far exceed those of the general population because of extreme poverty, delays in seeking medical care, nonadherence to therapy, substance use disorders, and psychological impairment. Many of their health problems, such as infections due to crowded living conditions in shelters, hypothermia from exposure to extreme cold, and malnutrition due to limited access to food and cooking facilities are a direct result of homelessness. This chapter addresses in detail infectious diseases, substance abuse, obesity, mental health problems, and causes of death in this population. It also addresses access to and use of healthcare services. It addresses the roots of and underlying issues related to these problems. Finally, it addresses what needs to be done.


Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 18 ◽  
Author(s):  
Katharine Mark ◽  
Dominic Murphy ◽  
Sharon Stevelink ◽  
Nicola Fear

Little is known about ex-serving military personnel who access secondary mental health care. This narrative review focuses on studies that quantitatively measure secondary mental health care utilisation in ex-serving personnel from the United States. The review aimed to identify rates of mental health care utilisation, as well as the factors associated with it. The electronic bibliographic databases OVID Medline, PsycInfo, PsycArticles, and Embase were searched for studies published between January 2001 and September 2018. Papers were retained if they included ex-serving personnel, where the majority of the sample had deployed to the recent conflicts in Iraq or Afghanistan. Fifteen studies were included. Modest rates of secondary mental health care utilisation were found in former military members—for mean percentage prevalence rates, values ranged from 12.5% for at least one psychiatric inpatient episode, to 63.2% for at least one outpatient mental health appointment. Individuals engaged in outpatient care visits most often, most likely because these appointments are the most commonly offered source of support. Post-traumatic stress disorder, particularly re-experiencing symptoms, and comorbid mental health problems were most consistently associated with higher mental health care utilisation. Easily accessible interventions aimed at facilitating higher rates of help seeking in ex-serving personnel are recommended.


2020 ◽  
pp. 088626052094372
Author(s):  
Penelope K. Morrison ◽  
Chelsea Pallatino ◽  
Rachel A. Fusco ◽  
Tanya Kenkre ◽  
Judy Chang ◽  
...  

Intimate partner homicide (IPH) is a leading cause of maternal mortality in the United States. However, very little information exists as to the circumstantial factors associated with IPH during pregnancy. We conducted a descriptive study of the demographic characteristics, psychosocial service engagement, and crises experiences (i.e., life and relationship stressors) among pregnant and nonpregnant victims to understand what differences, if any, exist in their risk profile for IPH. Data from the Centers for Disease Control and Prevention’s National Violent Death Reporting System (NVDRS) were used for this study. The NVDRS is a national opt-in tracking system of all violent deaths in the United States. Pregnant victims ( N = 293) were significantly more likely to be 5 years younger than nonpregnant victims, African American, and never married. Pregnant victims were more likely to be seen in the emergency room following the fatal incident. Nonpregnant victims ( N = 2,089) were significantly more likely to have suspected alcohol use at the time of their death. In strictly proportional terms, we also observed higher rates of mental health problems, a history of mental health treatment, and a reported history of intimate partner violence (IPV), crisis, or family problems among nonpregnant victims. A wider range of IPH-related risk factors (e.g. substance abuse) need to be included IPV assessments. Future studies should seek to develop effective interventions to prevent IPH, particularly among reproductive aged women.


1984 ◽  
Vol 65 (10) ◽  
pp. 600-609 ◽  
Author(s):  
May Kwan Lorenzo ◽  
David A. Adler

Serious mental health problems exist within the Chinese population of the United States. This article describes one center's attempt to meet the psychiatric needs of both nonpsychotic and psychotic Chinese patients through bilingual, culturally relevant treatments.


2017 ◽  
Vol 20 (6) ◽  
pp. 707-713 ◽  
Author(s):  
Michael J Zvolensky ◽  
Charles Jardin ◽  
Melanie M Wall ◽  
Misato Gbedemah ◽  
Deborah Hasin ◽  
...  

Abstract Introduction Decline in smoking in the United States has slowed over the past 25 years. Mental health problems are common among smokers, and may be an impediment to quitting and remaining abstinent. The study investigated the relationship between serious (past-30-day) psychological distress (SPD) and smoking, estimated trends in the prevalence of SPD among current, former, and never smokers in the United States from 2008 to 2014, and investigated whether heterogeneity in these trends varied by sociodemographic characteristics. Methods Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N = 270 227). SPD and smoking in the past 30 days were examined using logistic regression models among adults 18 and older. The prevalence of SPD was examined annually among current, former, and never smokers from 2008 to 2014. Results SPD increased among smokers in the United States from 2008 to 2014. An increase in SPD was more rapid among non-daily smokers than daily smokers. The prevalence of SPD was higher among younger smokers, those with less formal education and lower annual family income and higher among current smokers than former and never smokers. The relationships between SPD and smoking were stronger among smokers with higher education levels and annual family income. Conclusions Our findings suggest an increase in SPD among smokers over time and that as smoking has declined, those with SPD are comprising a greater proportion of the remaining smokers. Results suggest that mental health must be integrated into mainstream tobacco control efforts. Implications The greater prevalence and increasing rate of Serious Psychological Distress among smokers, relative to former- and never-smokers, from 2008 to 2014 provides support that the greater mental health burden among smokers may be contributing to the slowed reduction in smoking prevalence in the United States. In addition, relationships between SPD and smoking were consistently stronger among smokers with higher levels of education and annual family income. Such results suggest the necessity of incorporating mental health treatments in tobacco use reduction efforts.


2021 ◽  
Vol 12 ◽  
Author(s):  
William D. S. Killgore ◽  
Sara A. Cloonan ◽  
Emily C. Taylor ◽  
Natalie S. Dailey

Background: By March 2020, the World Health Organization declared the COVID-19 crisis as a worldwide pandemic and many local governments instituted stay-at-home orders and closed non-essential businesses. Within the United States, tens of millions of workers lost their jobs and financial security during the first few weeks of the national response, in an attempt to slow the global pandemic. Because of the enormity of the pandemic and its potential impact on mental health, the objective of the present study was to document the prevalence of mental health problems and their association with pandemic-related job loss during the third week of the nationwide shutdown.Methods: Mental health was assessed via online questionnaires among a representative sample of 1,013 U.S. adults on April 9–10, 2020. Rates of clinically significant mental health outcomes were compared between participants who lost their job as a result of COVID-19 restrictions (17.4%) vs. those who did not (82.6%). Bivariate multiple logistic regression identified factors that were predictive of, and protective against, mental health problems.Results: The prevalence of clinically significant symptoms was significantly higher than prior population estimates, ranging from 27 to 32% for depression, 30 to 46% for anxiety disorders, 15 to 18% for acute/post-traumatic stress, 25% for insomnia, and 18% for suicidal ideation. Prevalence estimates were 1.5–1.7 times higher for those who reported job loss due to COVID-19 restrictions than those who did not. Mental health problems were predicted by worry over financial instability, insomnia, social isolation, and alcohol consumption, while getting outside more often, perceived social support, and older age were protective against these problems.Conclusions: During the first 3 weeks of lockdowns/stay-at-home restrictions, mental health problems, including depression, anxiety, insomnia, and acute stress reactions were notably elevated relative to prior population estimates. Job loss related to the nationwide shutdown was particularly associated with poorer mental health. These findings provide a baseline of mental health functioning during the first weeks of the national emergency and lockdown orders in response to COVID-19.


Author(s):  
Gopal K Singh ◽  
Hyunjung Lee ◽  
Romuladus E. Azuine

Background: The COVID-19 pandemic has led to substantial socioeconomic disruptions and increases in mental health problems in the United States (US) and globally. Whether social inequalities in job losses and resultant physical and mental health problems have worsened over the course of the pandemic are not well studied. Using temporal, nationally representative data, this study examines racial/ethnic and socioeconomic inequalities in job-related income losses and their associated health impact among US adults aged 18-64 years during the pandemic. Methods: Using April, August, and December 2020 rounds of the US Census Bureau’s Household Pulse Survey (N = 56,788 for April; 83,244 for August; and 52,150 for December), social determinants of job-related income losses and associated impacts on self-assessed fair/poor health and depression were analyzed by multivariate logistic regression. Results: In December, more than 108 million or 55.5% of US adults reported that they or someone in their household experienced a loss of employment income since March 13, 2020. An additional 68 million or 34.6% of adults reported expecting this economic hardship in the next four weeks due to the pandemic. Blacks/African Americans, Hispanics, other/multiple-race groups, low-income, and low-education adults, and renters were significantly more likely to experience job-related income losses. Controlling for covariates, those reporting job-related income losses had 51% higher odds of experiencing fair/poor health and 106% higher odds of experiencing serious depression than those with no income losses in December 2020. The prevalence of fair/poor health varied from 11.6% for Asians with no job/income losses to 28.8% for Hispanics and 32.3% for Blacks with job/income losses. The prevalence of serious depression varied from 6.5% for Asians with no income losses to 21.6% for Non-Hispanic Whites and 21.8% for Blacks with job/income losses. Conclusion and Implications for Translation: Job-related income losses and prevalence of poor health, and serious depression increased markedly during the pandemic. More than half of all ethnic-minority and socially disadvantaged adults reported job-related income losses due to the coronavirus pandemic, with 20-45% of them experiencing poor health or serious depression.   Copyright © 2021 Singh, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.


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