Professional Psychology: Research and Practice, Oct 1, 2013
Professional competence in psychology and other health care professions is fluid, contextual, and... more Professional competence in psychology and other health care professions is fluid, contextual, and vulnerable to degradation over time. Moreover, psychologists-üke all human beings-are often notably ineffective in self-evaluating competence. We introduce the competence constellation model (CCM) as a communitarian strategy for ensuring optimal functioning and protecting psychologists from unintended and unrecognized problems of professional competence. A competence constellation is defmed as a cluster of relationships with people who take an active interest in and engage in action to advance a professional's well-being and professional competence. Salient characteristics of a competence con.stellation include diversity, strength of ties, and intentional effort toward its development. Key structural elements include the inner core, collégial community, coUegial acquaintances, and the professional culture. We conclude with several implications of the CCM, as well as recommendations for the training of psychologists, credentiaHng and regulatory bodies, and modification of the protession's ethical principles and stajidards.
Journal of Emotional and Behavioral Disorders, Jul 1, 1993
Evaluation of the overlap in symptomatology of depressed, anxious, and depressed and anxious chil... more Evaluation of the overlap in symptomatology of depressed, anxious, and depressed and anxious children is described. Fifty-nine children from grades 4 through 7, including 14 who received a DSM-III-R diagnosis of a depressive disorder, 11 with a diagnosis of an anxiety disorder, 16 with a comorbid depressive and anxiety disorder, and 18 nondisturbed controls, completed the Children's Depression Inventory, Revised Children's Manifest Anxiety Scale, Hopelessness Scale for Children, and Coopersmith Self-Esteem Inventory. Diagnoses were determined by the children's responses to a well-respected semi-structured clinical interview. Results indicated that all three diagnostic groups differed significantly from the non-disturbed controls across all of the self-report paper-and-pencil measures. However, in general, the three diagnostic groups could not be differentiated based on their responses to these measures. Implications for the negative affectivity hypothesis and future research are discussed.
This investigation ascertained dimensions of a suicide attempt and psychological and historical r... more This investigation ascertained dimensions of a suicide attempt and psychological and historical risk factors that differentiate low-income, female, African American suicide attempters as a function of having made a single, first-time attempt versus multiple attempts. Two groups were compared: firsttime attempters (n = 135) and repeat attempters (n = 139). Participants were recruited from a large, urban hospital following a suicide attempt (i.e., index suicide attempt). Sociodemographic characteristics, details of the index attempt (i.e., the attempt that prompted entry into the study), psychological functioning, hopelessness, substance abuse, and trauma history were assessed. The two groups were largely similar across sociodemographic characteristics. Multivariate analyses of variance were used to test hypotheses. Relative to first-time attempters, the attempts of repeat attempters involved higher levels of intent, planning, and perceived lethality and were associated with more psychological distress, hopelessness, substance abuse, and childhood trauma. Research and clinical implications of the findings are discussed.
The purposes of this study were to identify risk factors for suicide attempts among 200 African A... more The purposes of this study were to identify risk factors for suicide attempts among 200 African American abused women (100 attempters, 100 nonattempters) and to test a cumulative risk model to determine if a woman's likelihood of making a suicide attempt increased as the number of risk factors increased. Results revealed that attempters were significantly more likely than nonattempters to report high levels of depressive symptoms, hopelessness, drug abuse, and childhood abuse and neglect. Results from the cumulative risk model revealed a linear association between the number of risk factors and the odds of making a suicide attempt. Compared to women with no risk factors, women with two risk factors, women with three risk factors, and women with four to five risk factors were 10, 25, and 107 times, respectively, more likely to attempt suicide. The identification of risk variables highlights the importance of designing interventions to address these factors in order to reduce the risk of suicidal behavior in abused, African American women.
This study examined social support and attachment in women with and without drug misuse. Data wer... more This study examined social support and attachment in women with and without drug misuse. Data were collected from 146 African American female suicide attempters who presented at an inner-city hospital. MANOVAs revealed that compared to their counterparts who did not misuse drugs, women who reported drug misuse had lower levels of family and friend support (Social Support Behaviours Scale), lower scores on secure attachment and higher scores on fearful and dismissive attachments (Relationship Style Questionnaire). Low-social support and less secure attachments make treatment engagement challenging and require interventions designed to enhance participation.
Professional Psychology: Research and Practice, 2000
Over the past several yean, students, academic program faculty, and internship training directors... more Over the past several yean, students, academic program faculty, and internship training directors have become increasingly concerned about the inequity between the demand for predoctoral internship slots and the limited supply of those placements. This article presents data from the 1999 Association of Psychology Postdoctoral and Internship Centers' (APPIC) Match, along with the results of 2 studies conducted by the authors. Results indicate that the number of internship positions available in the U.S. and Canada may be nearly balanced with the number of first-time internship applicants and that the current imbalance may result, in large part, from a carryover of unplaced applicants from previous selection processes. Furthermore, approximately % of unmatched applicants are able to find internship positions subsequent to the conclusion of the matching process, although many of these positions are in non-American Psychological Association-accredited and non-APPlC-member programs. Implications of these findings for the profession and for student applicants are discussed. Almost all applied psychologists have experienced applying to, and subsequently attending, a predoctoral internship. Over the past several years, concerns have increased over a perceived shortage in the supply of predoctoral internship training opportunities relative to the number of applicants (Dixon & Thorn,
Cultural Diversity & Ethnic Minority Psychology, Feb 1, 2004
This study compared person risk factors among the following groups of low-income, African America... more This study compared person risk factors among the following groups of low-income, African American adults in an urban, public hospital: (a) suicide attempters and nonattempters, (b) male and female attempters, and (c) all 4 groups (50 female attempters, 50 female nonattempters, 50 male attempters, and 50 male nonattempters). Participants completed psychological distress, aggression, substance use, cognitive processes, religiosity/spirituality, and ethnic identity measures. Compared with nonattempters, attempters reported more psychological distress, aggression, substance use, and maladaptive coping strategies; less religiosity/spirituality; and lower levels of ethnic identity. Male attempters endorsed more substance use than female attempters. No person risk factors differentiated among the 4 groups. Assessment of person risk factors and implementation of commensurate culturally competent interventions are recommended. • suicidal behavior • risk factors • African Americans • low income Historically, suicide rates for European Americans have exceeded those of African Americans by a ratio of 2:1 (Maris, Berman, & Silverman, 2000). These low rates for African Americans are attributable to misclassification of suicides for African Americans, underreporting due to the heightened stigma associated with suicidal behavior in this population, and the presence of a number of protective factors (Gibbs, 1997; Maris et al., 2000; Nisbet, 1996; Phillips & Ruth, 1993). Further, the actual number of suicides among African Americans may be higher if the number of deaths misclassified as homicides or accidents was included (Poussaint & Alexander, 2000; Satcher, 1998). The rates of suicide in the African American community, particularly among younger men, are on the rise (Morbidity and Mortality Weekly Report, 1998). Across racial and ethnic groups, men are four times more likely than women to commit suicide (www.cdc.gov/ncipc/osp/ aboutmrt.htm). This sex difference may be even more pronounced within the African American community, with a 6:1 ratio (www .cdc.gov/ncipc/osp/aboutmrt.htm). Suicide attempts are a leading risk factor for completions (Tejedor, Diaz, Castillon, & Pericay, 1999). A study of urban, African American young adults found lifetime, lastyear, and 6-month prevalence rates for suicide attempts to be 5.3%, 1.2%, and 0.4%, respectively (Ialongo et al., 2002). Women across all racial, ethnic, and age groups are two to three times more likely than men to attempt suicide (
Training and Education in Professional Psychology, Nov 1, 2009
A "toolkit" for professional psychology to assess student and practitioner competence is presente... more A "toolkit" for professional psychology to assess student and practitioner competence is presented. This toolkit builds on a growing and long history of competency initiatives in professional psychology, as well as those in other health care disciplines. Each tool is a specific method to assess competence, appropriate to professional psychology. The methods are defined and described; information is presented about their best use, psychometrics, strengths and challenges; and future directions are outlined. Finally, the implications of professional psychology's current shift to a "culture of competency," including the challenges to implementing ongoing competency assessment, are discussed.
Twenty-nine children 9 to 12 years old who were identified as moderately to severely depressed us... more Twenty-nine children 9 to 12 years old who were identified as moderately to severely depressed using the Children's Depression Inventory were randomly assigned to either a self-control, behavioral problem-solving, or waiting list condition. The self-control treatment focused on teaching children self-management skills. The behavioral problem-solving therapy consisted of education, self-monitoring of pleasant events, and group problem solving directed toward improving social behavior. Subjects were assessed pre- and posttreatment and at 8-week follow-up with multiple assessment procedures and from multiple perspectives. At posttreatment, subjects in both active treatments reported significant improvement on self-report and interview measures of depression while subjects in the waiting list condition reported minimal change. Results were maintained at follow-up. The general success of the experimental treatments was discussed and recommendations for further treatment components were provided.
Objective: To design, implement, and evaluate a multidimensional, interdisciplinary, educational ... more Objective: To design, implement, and evaluate a multidimensional, interdisciplinary, educational training module that enables residents to deliver an effective and empathic death disclosure in the emergency setting. The Accreditation Council for Graduate Medical Education (ACGME) ''Toolbox of Assessment Methods'' to assess competency was adopted as the foundation of this project. Methods: Sixteen emergency medicine residents, eight postgraduate year 1 (PGY-1) and eight PGY-2, underwent a one-day training and evaluation exercise. The exercise consisted of: 1) a large-group didactic session, 2) a small-group didactic session, and 3) two standardized patient (SP) examinations. Changes in comfort levels, training helpfulness, and competency were measured. Inter-rater agreement between evaluators was examined. Results: Trainees reported improvement in comfort levels and high levels of satisfaction regarding the helpfulness of the training. Good interrater agreement was obtained regarding resident competency to perform a death
Responds to the comments by A. M. Pomerantz (see record 2013-31242-013) on the current authors&am... more Responds to the comments by A. M. Pomerantz (see record 2013-31242-013) on the current authors' original article, "The competent community: Toward a vital reformulation of professional ethics" (see record 2012-04007-001). Here, the current authors address Pomerantz's two main questions regarding the size of and admission to competent communities in professional psychology.
Despite some recent improvements in public health preparedness in many communities, efforts to in... more Despite some recent improvements in public health preparedness in many communities, efforts to incorporate mental health plans and services into bioterrorism response planning remain in their infancy. A recent report from the Institute of Medicine recommended that "to address the prevention, health care, and promotion needs related to psychological consequences of terrorism, this area must be integrated into national, state, and local planning." 1 Bioterrorism events may produce unique consequences compared to other manmade or natural disasters. 2 Fear-inducing threats of contamination, the likelihood of covert release of poisonous agents, and the possibility of contagion may result in large numbers of adverse emotional/psychological reactions. These "psychological casualties" of a bioterrorism event will likely far outnumber the medical casualties; nevertheless, response planners have been relatively slow to incorporate mental health considerations into terrorism response plans. Psychological consequences 1,3-7 can be classified as distress responses (e.g., insomnia, fear, sense of vulnerability), behavioral changes (e.g., acting out, social withdrawal, increased consumption of nicotine, alcohol, or other drugs), 4,5 psychosomatic symptoms and outbreaks of medically unexplained symptoms, 8 psychiatric/psychological symptoms (e.g., sadness, irritability, dissociation), and psychiatric illnesses such as depression and posttraumatic stress disorder. 6,7 The protection and promotion of mental health in the community is a critical component of pre-event planning for bioterrorism events. Mental health elements should be included in all disaster response plans, and should be regarded with equal weight and immediacy as other elements of the plans. These mental health functions should include: 9-14 • Assessing and providing appropriate services; • Preparing content for and advising on the process of risk communication; • Creatively using assets belonging to the public trust (such as mental health facilities); • Consulting with community mental health leaders on the psychology of epidemics, managing fear and uncertainty, and managing responder and leadership distress; • Training local community thought leaders in group coping methods; and
BACKGROUND: Little is known about health care and service utilization patterns among low-income A... more BACKGROUND: Little is known about health care and service utilization patterns among low-income African-American women, particularly those who report intimate partner violence (IPV). OBJECTIVES: (1) Identify utilization patterns among low-income African-American women. (2) Demonstrate utilization differences by IPV status. PARTICIPANTS: One hundred and fifty-three African-American women from medical care clinics at a large inner-city public hospital. DESIGN: Case-control study. Predictor variable IPV assessed by the Index of Spouse Abuse. Outcome variables, health care, and service utilization, determined using the Adult Service Utilization Form. RESULTS: Of the 153 participants, 68 reported high IPV levels. The mean age was 32 years, majority were poor and unemployed, and 15.7% were homeless. The overall utilization rates were low. When controlled for homelessness and relationship status, high IPV levels were associated with greater psychiatric outpatient utilization. We found differences in the use of other medical or community services by IPV group. CONCLUSIONS: Women reporting high IPV levels are more likely to receive mental health services than women reporting low IPV levels, but may not have access to other needed services. Primary care providers should assess the mental health, legal, and social service needs of abused women, which will facilitate receipt of services.
... J. Leake , D. Houry , N. Kaslow , R. Schultz , H. Mintz , S. Heron , K. Rhodes and A. Kellerm... more ... J. Leake , D. Houry , N. Kaslow , R. Schultz , H. Mintz , S. Heron , K. Rhodes and A. Kellermann. Emory University, Atlanta, GA; Emory School of Medicine, Atlanta, GA; University of Chicago, Chicago, IL. 313. Available online 25 September 2004. ...
Professional Psychology: Research and Practice, Oct 1, 2013
Professional competence in psychology and other health care professions is fluid, contextual, and... more Professional competence in psychology and other health care professions is fluid, contextual, and vulnerable to degradation over time. Moreover, psychologists-üke all human beings-are often notably ineffective in self-evaluating competence. We introduce the competence constellation model (CCM) as a communitarian strategy for ensuring optimal functioning and protecting psychologists from unintended and unrecognized problems of professional competence. A competence constellation is defmed as a cluster of relationships with people who take an active interest in and engage in action to advance a professional's well-being and professional competence. Salient characteristics of a competence con.stellation include diversity, strength of ties, and intentional effort toward its development. Key structural elements include the inner core, collégial community, coUegial acquaintances, and the professional culture. We conclude with several implications of the CCM, as well as recommendations for the training of psychologists, credentiaHng and regulatory bodies, and modification of the protession's ethical principles and stajidards.
Journal of Emotional and Behavioral Disorders, Jul 1, 1993
Evaluation of the overlap in symptomatology of depressed, anxious, and depressed and anxious chil... more Evaluation of the overlap in symptomatology of depressed, anxious, and depressed and anxious children is described. Fifty-nine children from grades 4 through 7, including 14 who received a DSM-III-R diagnosis of a depressive disorder, 11 with a diagnosis of an anxiety disorder, 16 with a comorbid depressive and anxiety disorder, and 18 nondisturbed controls, completed the Children's Depression Inventory, Revised Children's Manifest Anxiety Scale, Hopelessness Scale for Children, and Coopersmith Self-Esteem Inventory. Diagnoses were determined by the children's responses to a well-respected semi-structured clinical interview. Results indicated that all three diagnostic groups differed significantly from the non-disturbed controls across all of the self-report paper-and-pencil measures. However, in general, the three diagnostic groups could not be differentiated based on their responses to these measures. Implications for the negative affectivity hypothesis and future research are discussed.
This investigation ascertained dimensions of a suicide attempt and psychological and historical r... more This investigation ascertained dimensions of a suicide attempt and psychological and historical risk factors that differentiate low-income, female, African American suicide attempters as a function of having made a single, first-time attempt versus multiple attempts. Two groups were compared: firsttime attempters (n = 135) and repeat attempters (n = 139). Participants were recruited from a large, urban hospital following a suicide attempt (i.e., index suicide attempt). Sociodemographic characteristics, details of the index attempt (i.e., the attempt that prompted entry into the study), psychological functioning, hopelessness, substance abuse, and trauma history were assessed. The two groups were largely similar across sociodemographic characteristics. Multivariate analyses of variance were used to test hypotheses. Relative to first-time attempters, the attempts of repeat attempters involved higher levels of intent, planning, and perceived lethality and were associated with more psychological distress, hopelessness, substance abuse, and childhood trauma. Research and clinical implications of the findings are discussed.
The purposes of this study were to identify risk factors for suicide attempts among 200 African A... more The purposes of this study were to identify risk factors for suicide attempts among 200 African American abused women (100 attempters, 100 nonattempters) and to test a cumulative risk model to determine if a woman's likelihood of making a suicide attempt increased as the number of risk factors increased. Results revealed that attempters were significantly more likely than nonattempters to report high levels of depressive symptoms, hopelessness, drug abuse, and childhood abuse and neglect. Results from the cumulative risk model revealed a linear association between the number of risk factors and the odds of making a suicide attempt. Compared to women with no risk factors, women with two risk factors, women with three risk factors, and women with four to five risk factors were 10, 25, and 107 times, respectively, more likely to attempt suicide. The identification of risk variables highlights the importance of designing interventions to address these factors in order to reduce the risk of suicidal behavior in abused, African American women.
This study examined social support and attachment in women with and without drug misuse. Data wer... more This study examined social support and attachment in women with and without drug misuse. Data were collected from 146 African American female suicide attempters who presented at an inner-city hospital. MANOVAs revealed that compared to their counterparts who did not misuse drugs, women who reported drug misuse had lower levels of family and friend support (Social Support Behaviours Scale), lower scores on secure attachment and higher scores on fearful and dismissive attachments (Relationship Style Questionnaire). Low-social support and less secure attachments make treatment engagement challenging and require interventions designed to enhance participation.
Professional Psychology: Research and Practice, 2000
Over the past several yean, students, academic program faculty, and internship training directors... more Over the past several yean, students, academic program faculty, and internship training directors have become increasingly concerned about the inequity between the demand for predoctoral internship slots and the limited supply of those placements. This article presents data from the 1999 Association of Psychology Postdoctoral and Internship Centers' (APPIC) Match, along with the results of 2 studies conducted by the authors. Results indicate that the number of internship positions available in the U.S. and Canada may be nearly balanced with the number of first-time internship applicants and that the current imbalance may result, in large part, from a carryover of unplaced applicants from previous selection processes. Furthermore, approximately % of unmatched applicants are able to find internship positions subsequent to the conclusion of the matching process, although many of these positions are in non-American Psychological Association-accredited and non-APPlC-member programs. Implications of these findings for the profession and for student applicants are discussed. Almost all applied psychologists have experienced applying to, and subsequently attending, a predoctoral internship. Over the past several years, concerns have increased over a perceived shortage in the supply of predoctoral internship training opportunities relative to the number of applicants (Dixon & Thorn,
Cultural Diversity & Ethnic Minority Psychology, Feb 1, 2004
This study compared person risk factors among the following groups of low-income, African America... more This study compared person risk factors among the following groups of low-income, African American adults in an urban, public hospital: (a) suicide attempters and nonattempters, (b) male and female attempters, and (c) all 4 groups (50 female attempters, 50 female nonattempters, 50 male attempters, and 50 male nonattempters). Participants completed psychological distress, aggression, substance use, cognitive processes, religiosity/spirituality, and ethnic identity measures. Compared with nonattempters, attempters reported more psychological distress, aggression, substance use, and maladaptive coping strategies; less religiosity/spirituality; and lower levels of ethnic identity. Male attempters endorsed more substance use than female attempters. No person risk factors differentiated among the 4 groups. Assessment of person risk factors and implementation of commensurate culturally competent interventions are recommended. • suicidal behavior • risk factors • African Americans • low income Historically, suicide rates for European Americans have exceeded those of African Americans by a ratio of 2:1 (Maris, Berman, & Silverman, 2000). These low rates for African Americans are attributable to misclassification of suicides for African Americans, underreporting due to the heightened stigma associated with suicidal behavior in this population, and the presence of a number of protective factors (Gibbs, 1997; Maris et al., 2000; Nisbet, 1996; Phillips & Ruth, 1993). Further, the actual number of suicides among African Americans may be higher if the number of deaths misclassified as homicides or accidents was included (Poussaint & Alexander, 2000; Satcher, 1998). The rates of suicide in the African American community, particularly among younger men, are on the rise (Morbidity and Mortality Weekly Report, 1998). Across racial and ethnic groups, men are four times more likely than women to commit suicide (www.cdc.gov/ncipc/osp/ aboutmrt.htm). This sex difference may be even more pronounced within the African American community, with a 6:1 ratio (www .cdc.gov/ncipc/osp/aboutmrt.htm). Suicide attempts are a leading risk factor for completions (Tejedor, Diaz, Castillon, & Pericay, 1999). A study of urban, African American young adults found lifetime, lastyear, and 6-month prevalence rates for suicide attempts to be 5.3%, 1.2%, and 0.4%, respectively (Ialongo et al., 2002). Women across all racial, ethnic, and age groups are two to three times more likely than men to attempt suicide (
Training and Education in Professional Psychology, Nov 1, 2009
A "toolkit" for professional psychology to assess student and practitioner competence is presente... more A "toolkit" for professional psychology to assess student and practitioner competence is presented. This toolkit builds on a growing and long history of competency initiatives in professional psychology, as well as those in other health care disciplines. Each tool is a specific method to assess competence, appropriate to professional psychology. The methods are defined and described; information is presented about their best use, psychometrics, strengths and challenges; and future directions are outlined. Finally, the implications of professional psychology's current shift to a "culture of competency," including the challenges to implementing ongoing competency assessment, are discussed.
Twenty-nine children 9 to 12 years old who were identified as moderately to severely depressed us... more Twenty-nine children 9 to 12 years old who were identified as moderately to severely depressed using the Children's Depression Inventory were randomly assigned to either a self-control, behavioral problem-solving, or waiting list condition. The self-control treatment focused on teaching children self-management skills. The behavioral problem-solving therapy consisted of education, self-monitoring of pleasant events, and group problem solving directed toward improving social behavior. Subjects were assessed pre- and posttreatment and at 8-week follow-up with multiple assessment procedures and from multiple perspectives. At posttreatment, subjects in both active treatments reported significant improvement on self-report and interview measures of depression while subjects in the waiting list condition reported minimal change. Results were maintained at follow-up. The general success of the experimental treatments was discussed and recommendations for further treatment components were provided.
Objective: To design, implement, and evaluate a multidimensional, interdisciplinary, educational ... more Objective: To design, implement, and evaluate a multidimensional, interdisciplinary, educational training module that enables residents to deliver an effective and empathic death disclosure in the emergency setting. The Accreditation Council for Graduate Medical Education (ACGME) ''Toolbox of Assessment Methods'' to assess competency was adopted as the foundation of this project. Methods: Sixteen emergency medicine residents, eight postgraduate year 1 (PGY-1) and eight PGY-2, underwent a one-day training and evaluation exercise. The exercise consisted of: 1) a large-group didactic session, 2) a small-group didactic session, and 3) two standardized patient (SP) examinations. Changes in comfort levels, training helpfulness, and competency were measured. Inter-rater agreement between evaluators was examined. Results: Trainees reported improvement in comfort levels and high levels of satisfaction regarding the helpfulness of the training. Good interrater agreement was obtained regarding resident competency to perform a death
Responds to the comments by A. M. Pomerantz (see record 2013-31242-013) on the current authors&am... more Responds to the comments by A. M. Pomerantz (see record 2013-31242-013) on the current authors' original article, "The competent community: Toward a vital reformulation of professional ethics" (see record 2012-04007-001). Here, the current authors address Pomerantz's two main questions regarding the size of and admission to competent communities in professional psychology.
Despite some recent improvements in public health preparedness in many communities, efforts to in... more Despite some recent improvements in public health preparedness in many communities, efforts to incorporate mental health plans and services into bioterrorism response planning remain in their infancy. A recent report from the Institute of Medicine recommended that "to address the prevention, health care, and promotion needs related to psychological consequences of terrorism, this area must be integrated into national, state, and local planning." 1 Bioterrorism events may produce unique consequences compared to other manmade or natural disasters. 2 Fear-inducing threats of contamination, the likelihood of covert release of poisonous agents, and the possibility of contagion may result in large numbers of adverse emotional/psychological reactions. These "psychological casualties" of a bioterrorism event will likely far outnumber the medical casualties; nevertheless, response planners have been relatively slow to incorporate mental health considerations into terrorism response plans. Psychological consequences 1,3-7 can be classified as distress responses (e.g., insomnia, fear, sense of vulnerability), behavioral changes (e.g., acting out, social withdrawal, increased consumption of nicotine, alcohol, or other drugs), 4,5 psychosomatic symptoms and outbreaks of medically unexplained symptoms, 8 psychiatric/psychological symptoms (e.g., sadness, irritability, dissociation), and psychiatric illnesses such as depression and posttraumatic stress disorder. 6,7 The protection and promotion of mental health in the community is a critical component of pre-event planning for bioterrorism events. Mental health elements should be included in all disaster response plans, and should be regarded with equal weight and immediacy as other elements of the plans. These mental health functions should include: 9-14 • Assessing and providing appropriate services; • Preparing content for and advising on the process of risk communication; • Creatively using assets belonging to the public trust (such as mental health facilities); • Consulting with community mental health leaders on the psychology of epidemics, managing fear and uncertainty, and managing responder and leadership distress; • Training local community thought leaders in group coping methods; and
BACKGROUND: Little is known about health care and service utilization patterns among low-income A... more BACKGROUND: Little is known about health care and service utilization patterns among low-income African-American women, particularly those who report intimate partner violence (IPV). OBJECTIVES: (1) Identify utilization patterns among low-income African-American women. (2) Demonstrate utilization differences by IPV status. PARTICIPANTS: One hundred and fifty-three African-American women from medical care clinics at a large inner-city public hospital. DESIGN: Case-control study. Predictor variable IPV assessed by the Index of Spouse Abuse. Outcome variables, health care, and service utilization, determined using the Adult Service Utilization Form. RESULTS: Of the 153 participants, 68 reported high IPV levels. The mean age was 32 years, majority were poor and unemployed, and 15.7% were homeless. The overall utilization rates were low. When controlled for homelessness and relationship status, high IPV levels were associated with greater psychiatric outpatient utilization. We found differences in the use of other medical or community services by IPV group. CONCLUSIONS: Women reporting high IPV levels are more likely to receive mental health services than women reporting low IPV levels, but may not have access to other needed services. Primary care providers should assess the mental health, legal, and social service needs of abused women, which will facilitate receipt of services.
... J. Leake , D. Houry , N. Kaslow , R. Schultz , H. Mintz , S. Heron , K. Rhodes and A. Kellerm... more ... J. Leake , D. Houry , N. Kaslow , R. Schultz , H. Mintz , S. Heron , K. Rhodes and A. Kellermann. Emory University, Atlanta, GA; Emory School of Medicine, Atlanta, GA; University of Chicago, Chicago, IL. 313. Available online 25 September 2004. ...
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