The 1974 U.S. Budget—Past, Present, and Future

1973 ◽  
Vol 3 (2) ◽  
pp. 261-273 ◽  
Author(s):  
I. J. Lewis
Keyword(s):  
Mental Health ◽  
Health Care ◽  
The United States ◽  
Mental Health Research ◽  
Political Support ◽  
Power Struggle ◽  
Health Services Planning ◽  
Hospital Construction ◽  
Economic Philosophy ◽  
Rational Organization

This paper argues that the bleak budgetary outlook in the United States is not unexpected and will be difficult to change. Present conservative fiscal policy has substantial economic merit and widespread political support. The President has presented a reasonably consistent political and economic philosophy to which viable alternatives have yet to be offered. Backing up his budget with threats of vetoes and impoundments, the President is polarizing a power struggle with Congress which overshadows substantive issues. The nearly $4 billion increase in federal health outlays, in conjunction with major cuts in hospital construction, mental health, research, manpower, and health services planning and delivery, highlights the mortgaging of the budget by uncontrollable expenditures for pensions, Medicare, interest, etc. Acceptance of a crisis in health care is no longer a basis for developing federal health policy, which now contemplates a limited federal role and reliance upon states and the marketplace. But the federal budgetary situation will worsen as Medicare and Medicaid contribute to a situation of ever-rising prices unconstrained by rational organization.

scholarly journals Use of Korean dramas to facilitate precision mental health understanding and discussion for Asian Americans

2021 ◽  
Author(s):  
Van My Ta Park ◽  
Cate Jongkyung Park ◽  
Charles Kim ◽  
Nhi Cristina Y Nguyen ◽  
Anh T Tran ◽  
...  
Keyword(s):  
Mental Health ◽  
San Francisco ◽  
Asian Americans ◽  
Health Knowledge ◽  
The United States ◽  
Mental Health Research ◽  
Educational Tool ◽  
Convenience Sample ◽  
Language Groups ◽  
Precision Health

Summary Precision mental health holds great potential for revolutionizing care and reducing the burden of mental illness. All races and ethnicities such as Asian Americans, the fastest growing racial group in the United States (U.S.), need to be engaged in precision mental health research. Owing to its global popularity, Korean drama (‘K-drama’) television shows may be an effective educational tool to increase precision mental health knowledge, attitudes and behaviors among Asian Americans. This qualitative study examined the participants’ perspectives about and acceptance of using K-dramas to educate and engage Asian Americans about precision mental health. Twelve workshops were conducted in English, Vietnamese and Korean with a convenience sample in the San Francisco Bay Area in the U.S. (n = 122). Discussions were coded for themes. Findings revealed that all language groups reported positive reactions to using K-dramas to learn about precision health, genetics and mental health. Overall, participants shared that they learned about topics that are not generally talked about (e.g. precision health; genetic testing; mental health), from other people’s perspectives, and the importance of mental health. Participants expressed how much they enjoyed the workshop, how they felt relieved due to the workshop, thought the workshop was interesting, and had an opportunity for self-reflection/healing. This pilot test demonstrated that K-dramas has promise to be used as a health educational tool in a workshop format focused on mental health among a diverse group of Asian Americans. Given the widespread access to K-dramas, they present a scalable opportunity for increasing awareness about specific health topics.

Religion and Spiritual Advice as Surrogate Care Provision for Mental Health Problems in the ESEMED Survey

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Kovess ◽  
R. de Graaf ◽  
J.M. Haro ◽  
R. Bruffaerts ◽  
F. Gilbert ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Religious Affiliation ◽  
Religious Practice ◽  
The United States ◽  
Health Problems ◽  
Sample Survey ◽  
Seeking Help

Objective:To complete missing information on the influence of spiritual and religious advisors as informal providers for mental health problems in Europe.Methods:Recourse to religious practice or belief when coping with mental health problems was evaluated using data from the ESEMED survey. This was a stratified, multistage, clustered-area probability sample survey of mental health carried out in six European countries which included 8796 subjects. Between countries differences in sociodemographic characteristics, religious affiliation, and prevalence of mental disorders and management of mental disorders were evaluated.Results:Religion appears to play a limited role in coping with mental health problems in Europe. Only 7.9% of individuals seeking help for such problems turned to a religious advisor. This proportion differed between countries from 13% in Italy, 12.5% in Germany, 10.5% in the Netherlands, 5.8% in France, 4.7% in Belgium to 4% in Spain. In addition, seeking help exclusively from religion was reported by only 1.3% of subjects. Practicing religion at least once a week and considering religion as important in daily life were predictors of using religion versus conventional health care only. Use of religion was not influenced by gender and age. Non-Christian respondents and individuals with alcohol disorders were more likely to use religion. In Spain, the use of religion is much lower than average.Conclusions:Unlike the situation in the United States, organised religion does not provide alternative informal mental health care in Europe. At best, it could be considered as an adjunct to conventional care.

scholarly journals Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory

10.2196/23660 ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. e23660
Author(s):  
Markus W Haun ◽  
Isabella Stephan ◽  
Michel Wensing ◽  
Mechthild Hartmann ◽  
Mariell Hoffmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Diffusion Of Innovations ◽  
Significant Proportion ◽  
The United States ◽  
Diffusion Of Innovations Theory ◽  
Early Adopters ◽  
Adopter Categories

Background Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. Objective This mixed method preimplementation study aims to assess GPs’ intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). Methods Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. Results This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, P<.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. Conclusions A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.

scholarly journals Psycho-economics: managed care in mental health in the new millennium

2002 ◽  
Vol 25 (2) ◽  
pp. 199
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Managed Care ◽  
United States Of America ◽  
Private Practice ◽  
The United States ◽  
New Millennium

Book Review - Psycho-economics: managed care in mental health in the new millennium Edited by Robert D WeitzThis book comprises ten separately authored chapters on the general theme of managed care, and the way that it has affected mental health care in the United States of America. The main focus is on the role of the psychologist in private practice.

scholarly journals Graduate Medical Education on the Frontlines during the COVID-19 Pandemic in New York City- A Response to Promote Well-being

2021 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Health Program ◽  
Mental Health Program ◽  
Well Being ◽  
The United States ◽  
Personal Factors ◽  
Graduate Medical

Introduction: The COVID-19 pandemic has driven many health care institutions in the United States beyond their capacity. Physicians-in-training in graduate medical education programs have suffered the strain of providing patient care during this unprecedented time of crisis. The significant prevalence of pre-existing resident and fellow burnout and depression makes the need for action by institutions to support the well-being of residents and fellows even more urgent. We aim to describe innovative adaptations our Office of Graduate Medical Education implemented with the support of institutional leadership as responses to promote the well-being of residents and fellows on the frontlines during the COVID-19 pandemic. Methods: The Office of Graduate Medical Education (GME), in collaboration with the Office of Well-being and Resilience, developed a set of resources and interventions to support trainees during the pandemic based on four major categories: workplace culture, personal factors and health, mental health support, and workplace efficiency and function. Examination of the capacity of existing services and gaps that needed to be filled in the rapidly evolving early days of the COVID pandemic led to a robust growth in resources. For example, the already established Student and Trainee Mental Health program was able to expand and adapt its role to serve trainee needs more effectively. Results: We expanded resources to target trainee well-being across a broad array of domains within a short time frame. With investment in access to the Student and Trainee Mental Health program, utilization increased by 25.7%, with 1,231 more visits in 2020 compared to the number of visits in 2019, prior to the COVID-19 pandemic. The creation of Recharge Rooms had a positive impact on the well-being of health care workers. After a single fifteen-minute experience in the Recharge Room, an average 59.6% reduction in self-reported stress levels was noted by users. Other interventions were noted to be helpful in regular town hall meetings with trainees. Conclusion: Addressing trainee well-being is an essential aspect of a crisis response. The Mount Sinai Health System was able to care for the physical, mental, psychosocial, and safety needs of our trainees thanks to the collaborative effort of a pre-existing institutional well-being program and the GME Office. The ability to implement such a response was enabled by our well-being foundation, which allowed leadership at the highest institutional level and the Office of GME to provide support in response to this unprecedented crisis.

scholarly journals Mental health services in Nicaragua: Ten years of revolution

1990 ◽  
Vol 14 (6) ◽  
pp. 346-350 ◽  
Author(s):  
Alison Harris ◽  
Tammy Shefer
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
The United States ◽  
Democratic Society ◽  
A Priority

Nicaragua is celebrating ten years of revolution since the overthrow of the 45 year long Somoza dictatorship∗. In this time, the Sandinista government has attempted to construct a more democratic society with considerable achievements in the area of health, welfare and education. Indeed, health care has been a priority in spite of severe economic difficulties caused by the United States economic blockade and by the need for defence against the war waged by the counter-revolutionaries (the Contra).

scholarly journals Psychological Distress Among the U.S. General Population During the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Christi J. Guerrini ◽  
Sophie C. Schneider ◽  
Andrew G. Guzick ◽  
Gifty N. Amos Nwankwo ◽  
Isabel Canfield ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Psychological Distress ◽  
Online Survey ◽  
Well Being ◽  
The United States ◽  
Healthy Behaviors ◽  
Factors Associated ◽  
Clinically Significant ◽  
Amazon's Mechanical Turk

The COVID-19 pandemic is taking a significant global toll on emotional well-being, but evidence of mental health impacts in the United States remains limited. In April 2020, we conducted an exploratory survey of U.S. residents to understand prevalence of and factors associated with psychological distress during the pandemic. Data collection was conducted using Qualtrics, an online survey platform, and U.S. adult respondents were recruited via Amazon's Mechanical Turk platform. Among 1,366 respondents, 42% (n = 571) reported clinically significant anxiety and 38% (n = 519) reported clinically significant depression. Factors associated with anxiety and depressive symptoms included Hispanic/Latino ethnicity; younger age; lower income; employment as or living with a health care worker-first responder; caregiver status; SARS-CoV-2 infection status; decreased frequency of engagement in healthy behaviors; and changed frequency of engagement in unhealthy behaviors. That some of these factors are associated with elevated distress during the pandemic is not yet widely appreciated and might be useful in informing management of mental health care resources.

Hispanics, Mental Health, and Suicide: Brief Report

2019 ◽  
Vol 17 (3) ◽  
pp. 133-136 ◽  
Author(s):  
Francisco Brenes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Hispanic Americans ◽  
Social Issues ◽  
The United States ◽  
Health Concern ◽  
Care Providers ◽  
Provider Attitudes ◽  
Health Crisis

A global health crisis exists surrounding suicide. In the United States, suicide rates have increased by nearly 30% in most states since 1999. Although the suicide rate among Hispanic Americans is significantly lower than non-Hispanic Whites, reasons for the lower rate are unclear. Current literature suggests that the lower rate may be due to underreporting, a lack of suicide screening and a number of complex social issues, including the stigma surrounding suicide in Hispanic culture. Health care provider attitudes toward suicidal individuals may also negatively affect mental health outcomes. This brief report focuses on suicide as a public health concern, addresses key issues arising from the phenomenon, and provides a perspective on health care providers’ attitudes toward suicide. Recommendations for future research, as well as implications for clinical practice and policy, are suggested.

scholarly journals Rates and Associated Factors of Secondary Mental Health Care Utilisation among Ex-Military Personnel in the United States: A Narrative Review

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 18 ◽  
Author(s):  
Katharine Mark ◽  
Dominic Murphy ◽  
Sharon Stevelink ◽  
Nicola Fear
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Mental Health Care ◽  
Military Personnel ◽  
Mental Health Problems ◽  
The United States ◽  
Health Care Utilisation ◽  
Narrative Review ◽  
Care Utilisation

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.

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