Why hospital mental health staff terminate employment.

TOPIC: How hospital mental health staff make the decision to terminate employment. METHODS: Subjects (N = 30) included mental health professionals formerly employed at a large Canadian psychiatric hospital. They were interviewed using Ebaugh's model of the role exit process to determine different dimensions of the existing process. FINDINGS: The role exit process tended to cover a considerable time span, with notable potential for reversing the decisions. CONCLUSION: Staff who terminate employment due to job-related circumstances could be retained if active problem-solving measures were undertaken by the staff member and appropriate administrative personnel.

The health and wellbeing of mental health professionals.

We examine dimensions of job satisfaction, occupational burnout and general health of a sample of 123 mental health care professionals (psychiatric nurses and nursing assistants, and smaller professional groups such as social workers, occupational and recreational therapists and psychologists) employed at a large Canadian psychiatric hospital. Psychiatric nursing assistants exhibit more of the consequences of job-related stress (less job satisfaction, greater occupational burnout, greater incidence of negative physical and psychological symptoms of stress) relative to the other professional groups in the sample. This may be linked with their position within the hospital organization (having less authority and professional autonomy relative to the other groups), affecting their ability to cope with job-related problems and stresses experienced by all direct care workers. We examine attitudes of mental health professionals towards organized support groups at the hospital, which could provide one forum for the open discussion (and potential resolution) of job-related stresses and problems experienced in hospital settings.

A Canadian Indian Health Status Index.

Health care services for registered "band" Indians in Ontario are provided primarily by the Canadian Federal Government. Complex management methods preclude the direct involvement of Indian people in the decisions for their health resource allocation. Health indicators, need, and health status indexes are reviewed. The biostatistics of mortality and demography of the Indian and reference populations are aggregated with hospitalization/morbidity experience as the Chen G'1 Index, as an indicator of normative and comparative need. This is weighted by linear measurements of perceived need for preventive medicine programs, as ranked and scaled values of priorities, Zj. These were determined by community survey on 11 Indian reserves using a non-probabilistic psychometric method of "pair comparisons," based upon "Thurstone's Law of Comparative Judgement.," The calculation of the aggregate single unit Indian Health Status Index [Log.G'1].Zj and its potential application in a "zero-base" budget is described.

A Family Physician's Guide to Sewage Sludge.

The potential environmental and personal health effects from the agricultural uses of domestic sewage sludge may increasingly require the guidance of the family physician, especially in farming communities. This article summarizes the potential health hazards and outlines the tripartite risk phenomenon-hazard identification, risk assessment, and social evaluation. For the agricultural use of dewatered sewage sludge, strict adherence to regulated procedures should not increase risk beyond that of agriculture generally. Confirmation by prospective epidemiological studies is recommended.