abstracts Hall, Charles P., Jr. Financing mental health services t h r o u g h insurance. A m e r i c a n J o u r n a l of P s y c h i a t r y , 131 (10):1079-1087, 1974. The author sketches the historical development of health insurance in the U.S. stating how the social, technological and financial constraints on the treatment of mental illness during the early years of private health insurance led to gaps in coverage for treatment of mental illness. He examines the insurability of mental health benefits by reviewing the limited evidence from plans that have provided such benefits. After reviewing some of the recent legislative proposals for national health insurance, he sets forth the major issues requiring research and resolution and makes some recommendations to mental health professionals. The Human Services Shortfall: Specia~ Issue, Evaluation, Spring, 1974. This special issue of Evaluation addresses the problem of the "human services shortfall," that "large and growing gap between what we expect from government-supported human service systems and what these systems in fact deliver." The editors elicited the opinions of experts from a number of fields on the shortfall and possible solutions, with particular reference to issues and possible solutions presented in a specially prepared position paper. The summary article, "Shortfall: What Next for Evaluation?" explores the practical significance of the social scientist's work to the shortfall crisis. The authors offer three

suggestions to help evaluators strengthen their impact on alleviating this problem. They conclude that the consumer of human services must be brought into the planning, evaluation, and change process. To provide an overview of respondents' discussions, one article, "Gasoline Shortages and Human Services Shortages: What is the Difference?" (38-45), discusses the human service crisis, why it is ignored and why it exists. Abstracts of respondent statements are presented that converge around four views: 1) expectations are inflated; 2) resources are scarce; 3) consumers must determine service needs; and 4) a realistic appraisal will point to the hard work that still remains. The author concludes that the President and Congress have a key role to play in realistically defining choices and commitments, in eliminating program subversion from within, and in providing direction. Citizen participation and the courts will also play a forceful role in the resolution of the shortfall. Huffine, Carol L. and Craig, Thomas J. Social factors in the utilization of an urban psychiatric emergency service. Archives of General Psychiatry, 30(2):249-255, 1974. Admissions to the psychiatric emergency service of an inner-city university hospital were analyzed from two perspectives: (1) characteristics of patients and the areas in which they reside are described with focus directed toward social characteristics found to be associated with high admission rates; and (2) the ways in which a hospital, by virtue of its organizational structure, might II5

contribute to misuse of its emergency facilities by patients are explored. Based on both modes of analysis, suggestions are offered for ways in which services may be altered to more effectively meet the treatment needs of inner-city populations. Darley, Philip J. Who shall hold the couch? Some thoughts on community control of mental health programs. Community Mental Health Journal, 10(2):185-191, 1974. Experience at an English day center for recovered psychotics led the writer to see a need for mental patients to be given considerable control over their own program or else succumb to the Queequeg Syndrome. This syndrome results from patients accepting and adapting to unrealistic roles that a prejudiced society has thrust upon them. It appears to the writer that the syndrome applies equally to other disadvantaged groups, notably to the poor, and he suggests that one appropriate form of treatment will be to give consumers a large measure of control over mental health programs.

Ulett, George A. Automation in a state mental health system. Hospital & Community Psychiatry, 25 (2): 77-79, 1974. Missouri was one of the first states to link its mental health facilities through a computer network. It is based atthe Missouri Institute of Psychiatry in St. Louis and has terminals at ten other major facilities across the state. The system is used for both clinical and administrative data. The Missouri mental health program turned to automation to solve major problems involving the most efficient allocation of scarce resources--manpower and money. In his description of the first five years of a seven-year program aimed at developing statewide automation, the author deals with the advantages of using the computer for .the storage and retrieval of clinical and managerial data, prerequisites to initiating a computer-based program, ways to 116

increase staff acceptance of automation, and decisions about ordering hardware.

Feldman, Saul. Community mental health centers: A decade later. International Journal of Mental Health, 3(2-3): 19-34, Summer-Fall, 1974. In a retrospective view of ten years of community mental health programs, the author evaluates their accomplishments, particularly in decreasing the number of patients in mental hospitals and in increasing the quantity of available mental health services. Problems still awaiting afull solution are also examined, including inaccessibility of services and lack of public understanding of the p r o g r a m ' s aims. S p e c i f i c recommendations for the future are offered.

Austin, Michael J. Evaluating the training of m e n t a l h e a l t h a d m i n i s t r a t o r s . Administration in Mental Health, Fall: 6272, 1975. Training programs in mental health administration must explore and develop new areas and methods of training more relevant to the demands of the job. Effective administrative practice must be defined and assessed in order to identify desirable traits and skills to be taught to the trainee. One approach relies on an evaluation model used to test for knowledge, attitudes, and values gained from a formal educational program and to identify which of those factors predict administrative performance. Another approach uses situational testing in an "assessment center" as a means of assessing the management potential of new c a n d i d a t e s . T h e a d v a n t a g e s and disadvantages of both approaches are discussed. Situational tests, based on jobrelated criteria, involve management simulations and have encouraged the use of the simulation model of training in administrative training programs. This new training method emphasizes participation and experiential learning and utilizes techniques such as role-playing, leaderless groups, and the in-basket exercise.