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Lecture 5

PSYC*3690 Lecture Week 5.doc

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PSYC 3690
Benjamin Gottlieb

Tuesday, Feb 5, 2013 PSYC*3690 Community Mental Health Lecture #9 - for the proposal, feedback is most important is the program you selected to analyze - published prevention program that has data on his effectiveness - students make mistakes are choosing literatures reviews Hotlines - get services to people as fast as possible - we want to try to use non-traditional personnel to deliver services What advantages do these hotlines have? - anonymity - less costly - easy access What are the goals of these distress centers? - reduce distress - provide referrals to services - reduce suicide How do you evaluate this? (whether an organization is effective in reducing stress) Reduce Distress - follow up calls to people - self-rated effectiveness - biased, is worth it for help with clients who are hard to help - workers are better at handling certain types of issues and clients and less com- fortable with others, this is good when the worker feels anxious - caller ratings of effectiveness - biased - assessment by judges of taped actual calls - this has been done, ethical concerns, the only issue is whether the audience is worried their identity will be discovered - assessment by judges of pseudo-callers - this has been done, can rate these calls on active listening, warmth, paraphrasing, empathy, problem solving Provide Referrals - to see whether the people who are referred actually go to the places to which they have been referred - is it fair to judge distress workers on the basis of people acting on the referral - people have to decide whether they want to go - you cannot make the distress centre responsible for people getting to the place that they referred - referral accuracy - did the worker make the correct referral given the clients problem Reduce Suicide - this has been problem which has been resolved in a couple of ways: - the call-back approach - find 2 communities that are similar in their population size and demographics, one with a distress centre and the other without and compare their rates - this is tough to find an exact match and the fact that one community has a distress centre might be reflective of it - guelph is a compassionate city - an approach where they do random digit dialing - a way to find a random sample in the community based on the area codes of that community - calls are made with a caller saying is there anyone in your household who has used the distress centre in the last 6 months, this is expensive with a relatively low hit-rate - you can trace the number and alert the police if you are very very sure that the person will commit suicide - a study he found looked at significant reductions in the callers’ psychological pain, hopelessness, and intent to die - hotline workers get training, special training the the area of suicide, one of them is how to make an assessment of how serious this person is about taking their own life - this is called a lethality index - how lethal is this persons state - there are 22 people in the military in the US committing suicide everyday - what are the indicators of lethality? giving away possessions, having a specific plan, isolation, have they removed all possible barriers (e.g. in a locked room), suicide note, whether they have taken any action to get help, their conception of their methods effec- tiveness, previous attempts - talked to people in this study 3 times, assess people at the beginning of the call, the end of the call and then the follow-up - 30% agreed for a follow-up call - there was a significant reduction in suicide status from the beginning of the call to the end of the call in all 3 factors Risk Factors for Adolescent Suicide - men are way more successful in dying when they make a suicide attempt - they use guns - aboriginals and first nations people have the highest rate of suicide Thursday, Feb 7, 2013 PSYC*3690 Community Mental Health Lecture #10 - 3 articles - what are the outcomes? - what are the intervention strategies? - mediators may not always be clear but listen for them Prevention 1 - Avance - prevents child neglect and abuse - work with the families to stabilize them, educate them and motivate them so they can concentrate on their role as a parent - be able to pay more attention to their children and nurturing - 95% of the families live below the poverty line, 75% haven’t finished high school - poverty and deprivation are major contributors - parents learn about child development, effective parenting and appropriate forms of punishment - home visits provide support to the family - 85% of avance staff are graduates of the program - children have school success and higher self esteem - neglected children often live in very disorganized families - parent learn how to set goals, take charge and reduce chaos - parents are more likely to be less restrictive, less punitive, less aggravated by children (mediators) - less school delinquency and academic failure (o
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