Improving public mental health services for trauma victims in South Carolina.

Studies have shown that trauma and posttraumatic stress disorder are highly prevalent among persons with serious mental illness who are treated in state-funded mental health systems. Nevertheless, there is strong evidence that many of these persons receive inadequate mental health services. South Carolina recently became one of at least 15 states whose departments of mental health have initiated efforts to better address these needs. The goals of this initiative are to sensitize stakeholders, influence policies, educate and train clinicians, and increase knowledge by supporting a strong empirical research platform. Current progress and future directions are described in this article.

A community-based public-academic liaison program.

OBJECTIVE: The authors discuss obstacles and incentives associated with successful community-based public-academic liaison activities and illustrate their conclusions by describing their public-academic liaison program, which received the American College of Psychiatrists' first annual Award for Creativity in Psychiatric Education. METHOD: The first 8 years of a state/university collaboration are described in which the parties involved first developed a variety of innovative services designed to fill specific gaps in the public service delivery system and subsequently integrated academic research and training components. RESULTS: The carefully planned and monitored process resulted in the exponential growth of interest in public sector work, the realization of the university's primary goals of developing high quality training and research sites, a substantial increase in the number of graduates accepting positions in the public sector, several projects funded by the National Institute of Mental Health, and two national awards. CONCLUSIONS: These collaborations illustrate the highly complementary relationship of public-academic liaison activities and their potential capacity to improve access to services, substantially improve the quality of these services, generate extramural support for services research, and increase the number of well-trained professionals in the public sector.

Providing assertive community treatment for severely mentally ill patients in a rural area.

OBJECTIVE: The authors' goals were to describe an assertive community treatment program developed for patients in rural South Carolina and to evaluate the effect of the program on rates of hospital utilization and cost of care. METHODS: Twenty-three patients with chronic psychotic disorders living in rural areas of South Carolina were assigned to an assertive community treatment program. The patients' average number of days per year in the hospital, length of stay per admission, number of admissions per year, and estimated annual cost of care during the five years before assignment to the program and during a period from four to 26 months after assignment were compared. RESULTS: The intervention was associated with a 79 percent decrease in hospital days per year, a 64 percent decrease in the number of admissions per year, a 75 percent decrease in the average length of stay per admission, and a 52 percent reduction in estimated direct cost of care. CONCLUSIONS: Although the methods of assertive community treatment may need to be modified to suit the travel requirements and other characteristics of rural settings, the study results suggest that the model can be successfully used in rural areas.

From the benches to the trenches : training residents to provide emergency outreach services-a public/academic project.

The Charleston Area Mental Health Center and the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina have collaborated to form a comprehensive emergency service with mobile capacity. The service is staffed by an interdisciplinary team of professionals from public and academic psychiatry. Psychiatric residents are fully integrated into the service. A description of the program demonstrates how such liaisons can promote improved access to high-quality services, while enriching the training of psychiatrists through outreach experiences.

Social decentering and locus of control in children.

Relationships beteen social decentering, personality variables, and social competence were investigated for children attending a seven-week therapeutic summer camp. Ss were 23 males and females ranging in age from 10 to 13 years old had been referred to the camp because they lacked age-appropriate social skills. Feffer's Role Taking Task was used to measure social decentering, and counselor ratings of camper adjustment were measures of social competence. Predicted positive relationships between decentering and competence were found. Striking sex differences were found, however, when comparisons were made between social decentering and two personality variables--the Nowicki-Strickland Locus of Control Scale and the Kiddie Mach. Predicted negative correlations were found between Role Taking Task scores and externality and machiavellianism for females, but not for males. Implications concerning age by sex interactions in the study of personality correlates of social decentering were discussed.