Rethinking and expanding the theory of change underlying systems of care are recommended to support development of the knowledge base for understanding what systems of care can be expected to accomplish. Three domains of knowledge are presented as necessary to understanding the relationship between systems-level change and services. (Contains…

The special needs of young adults with concurrent mental health and substance abuse problems are discussed. This article presents federal initiatives and research findings, and describes state-of-the-art approaches to treatment and rehabilitation. Strategies for training mental health professionals to diagnose and treat dually disabled persons are…

Reviews the current state of mental health services to children, youth, and families. The development of a continuum of care coordinated across the mental and non-mental health systems that naturally occur in all children's lives may vastly improve mental health services to children, youth, and families. (Author/BJV)

Individual effectiveness studies and reviews of studies are described for eight mental health service components for children and adolescents with severe emotional disturbances and their families. Components discussed include residential services, outpatient services, day treatment services, crisis and emergency management services, case…

The 'rural' definitions applied by the Federal Government, especially by two data-gathering agencies, the Bureau of the Census and the Office of Management and Budget (OMB), emphasize different dimensions of the concept, and delineate the rural-urban continuum in different ways. This report discusses the inconsistency of curent "rural"…

Alcohol and drug abuse have serious physical, psychological, and social consequences, and employees who abuse alcohol and/or drugs ultimately reduce their companies' profits. Employee substance abuse leads to reduced productivity as well as to increased absenteeism, health care and health insurance costs, and liability claims against employers of…

This paper focuses on participation of labor unions in health promotion and health promotion programs. It begins by discussing labor unions' impact on today's work force. An overview of unions' historical concern for worker health serves as an introduction to consideration of the labor movement's current involvement in employee health. A look at…

A basic tenet of this paper is that the concept of crisis and crisis management has developed as a central issue within the fields of community psychiatry, psychology, and mental health, but that little systematic attention has been devoted to a particular subgroup at risk, i.e., older persons. Both theoretical background and clinical implications…

This paper discusses the complex issues faced by clinicians providing counseling to chemically dependent individuals who are deaf or hard of hearing and who are from ethnic, racial, or cultural minority groups. It shares specific examples from the Minnesota Chemical Dependency Program for Deaf and Hard of Hearing Individuals, as well as…

Adolescent use of alcohol, tobacco, and other drugs is currently increasing. Three out of four adolescents report regular drinking. Significant alcohol, inhalant, and cigarette use is reported as early as fourth grade, and alcohol experimentation increases from 6 to 17 percent between fourth and sixth grades. Adolescence is a high risk stage for…

By acquiring health-related knowledge, values, skills, and practices, children can be empowered to pursue a healthy life and to work as change agents for community health. This report of the WHO Expert Committee on Comprehensive School Health Education and Promotion reviews the global state of school health; identifies opportunities for and…

This monograph explores the development of comprehensive systems of care for severely emotionally disturbed children and adolescents. It is intended as a technical assistance tool for states and communities interested in improving services and as a review of the state of the art for developing systems of care. A generic model of a system of care…

This document consists of two articles on sex education programs aimed at reducing sexually transmitted diseases (STDs) and unintended pregnancies among American Indians. Both articles describe the problems of unwanted pregnancies and STDs, including acquired immune deficiency syndrome. During 1987, there were more than 3,000 live births to Native…

Cited as the largest single cause of lost work time and on-the-job fatalities for U.S. workers, motor vehicle crashes cause major nonrecoverable losses for U.S. businesses. Workplace programs to encourage employees to wear safety belts can thus help employers reduce traffic accident-related losses of work time and can substantially reduce the…

The monograph advances a conceptual framework for the evaluation of mental health services provided to chronically mentally ill persons by psychosocial rehabilitation programs. Evaluation mechanisms consistent with the philosophy and programmatic aims of psychosocial rehabilitation programs are identified. An introductory section provides a brief…