Administration in Mental Health Vol. 5, No. 1 Fall/Winter 1977

abstracts client." Information rarely flows comprehensively, comprehensibly, or continuously between the evaluating system and the system from which the client is sent or to which he is referred. Factors that contribute to this situation are identified and analyzed and a change in strategy is suggested.

SPIRO, HERZL R., CROCETTI, GUIDO M., AND SIASSI, IRADJ. Feefor-service insurance versus cost financing: Impact on mental health care systems. American Journal of Public Health, 65(2):139-143, February 1975. T h e authors studied two patterns o f financing mental health c a r e - - a costfinanced mental heahh g r o u p practice and fee-for-service insurance--available to a large population of U A W workers and their families in Baltimore, Md. Patients had free choice of financing mechanisms. In the four-year study period, mental health care utilization rates did not exceed 1.3 percent p e r year, and costs did not exceed 50 cents p e r m o n t h p e r enrollee. T h e two systems are c o m p a r e d on availability, accessibility, continuity, and accountability o f the care system; preventive patterns; service patterns; and linkages. Authors draw implications o f utilization patterns on mental health insurance coverage and proposals for national heahh insurance.

ARAM, J. D., AND S T R A T T O N , W. E. The development of interagency cooperation. Social Service Review, 48(3):1221, 1974. In the health and social services area, successful interagency coordination occurs infrequently, while documentation o f successful efforts happens even more rarely. A successful planning effort involving 20 local agencies coordinating their services to the aged in a public housing project is described and analyzed. Factors in the origin o f the cooperative activity and in the planning process that contributed significantly to the progress and success o f the g r o u p are explored. Analysis o f interviews with persons involved in the planning suggest an initial "convergence o f interests" as the initiating process for cooperation. In addition, a clear leadership structure in the group was inferred from interview comments, and individuals perceived as key persons were found to see their agency goals as more immediate, more recent, and more n u m e r o u s than others. Results pertaining to agency leadership are presented. Conclusions o f the study point to the dynamic

HIRSCHOWITZ, RALPH G. The pace of patient processing in the mental health system. Community Mental Health Journal, 11(2):179-183, 1975. As a resuh o f his consultation to mental heahh agencies, the a u t h o r found the pace and quality o f patient processing is needlessly labored, discontinuous, and often redundant. Processing is too orten "for the record" rather than "for the 81

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quality of social processes involved in institutional change.

tailed influences of systems evaluation project evaluation data.

WAGENFELD, MORTON O., ROBIN, STANLEY S., AND JONES, JAMES D. Structural and professional correlates of ideologies of community mental health

BAKER, FRANK. AND BROSKOWSKI, ANTHONY. The search for integrality: New organizational forms for human services. In: Harshbarger, D., and Maley, R. F., eds. Behavior Analysis and

workers.Journal of Health and Social Behavior, 15(3):199-210, 1974. Ideological variations among community mental health staff were surveyed. Their perceptions of their organization's position on a social service-medical continuum, and relationships between ideology and organizational structures were examined. Findings indicate highest ideological adherence within rural areas, u n d e r agency board structures, among social workers and psychologists, and among those positioning their organizations closer to social than medical services. Theoretical and policy implications of these findings are discussed.

BIGELOW, DOUGLAS A. The impact of therapeutic effectiveness data on community mental health center management: The systems evaluation project.

Community Mental 11(1):64-73, 1975.

Heaith

Journal,

A major assumption of community mental health evaluation is that data fed back to center managers have an impact on the management, resulting in optimization of programs. This is the empirical question addressed in this paper. A study of the influences bearing on management decisions, the process of decision making, and the effects o f introducing evaluation data into that process are described. The concepts, procedures, and instruments are set out as possible models for further investigation of the complex hut fundamental question. The data presented are consistent with the hypotheses about the de-

Systems Analysis: An Integrative Approach to Mental Health Programs. Kalamazoo, Mich.: Behaviordelia, Inc., 1974. The desire for efficient and effective allocation of scarce resources and the recognition of the muhifaceted nature of human problems have created widespread pressure for a redefinition of the boundaries of traditional organizations and professional disciplines. New organizational forms for the human services, involving coordinated and comprehensive patterns of service, are required and this paper delineates some alternative organizational strategies and administrative mechanisms presently emerging in the delivery of human services. Hopefully, these new approaches will deal more realistically with the multiproblem family without the problems created by elaborate referral processes and will result in improved program effectiveness.

PATTI, R. J. Organizational resistance and change: The view from below. Social Service Review. 48(3):367-83, 1974. An analytic framework is presented for assessing certain elements of resistance to organizational change proposals emanating from low-power practitioners in social agencies in which the changes sought must be approved by an administrative superior. It is assumed that resistance to practitioner-initiated proposals is not a constant phenomenon hut varies witb the nature o f the change suggested, the personal goals of the decision maker, the ad-

A bstracts

ministrative distance bewteen the practitioner and the decision maker, and the previous investment the organization has made in the a r r a n g e m e n t to be modified. Each of these variables is discussed, and their implications for goal selection and organizational change strategies are presented.

SILBER, STANLEY. Strategies for developing multisource funding for community mental health centers. Hospital and Community Psychiatry, 25(4):221225, 1974. Federal pressures to phase out categorical assistance for community mental health centers have dramatized the need for developing multiple sources o f financial s u p p o r t for the centers. T h e author explores the funding potential o f thirdparty payments, social service and rehabilitation programs, and o t h e r sources of public and private support. He describes the f u n d i n g development process used in Kentucky, where all 22 centers are operating in the black, and notes major features that can be a d a p t e d by other centers. Basic to the Kentucky system is its techrfical assistance service, whose staff maintain close contacts with state agencies and keep s t a l l i n f o r m e d about federal legislation and regulations. T h e i r knowledge has enabled the state to put together f u n d i n g packages to support a variety o f mental-health-related programs.

BROOKS, C. M. New mental health perspectives in the black community. Social Casework, 55(8):489-496, 1974. Mental health services to the urban p o o r require the creation o f a new concept o f service delivery. Utilization o f the traditional, tested methods o f middle-class mental health centers will not work. Blacks, especially, are not willing to accept such services. Only after the services fit

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into their pattern of behavior can blacks come to see that they can benefit from such a program. Deliverers o f programs need to recognize the strengths and positive mental health adaptations already imb e d d e d in black culture. Many o f the socalled pathological behaviors are good examples o f healthy behaviors that enable clients to survive in a difficult and humiliating environment. Importance should be placed on reinforcing those strengths. An emphasis on building up self-esteem and working to improve the d e g r a d i n g conditions u n d e r which the p o o r live are two of the ways that professionals can promote good mental health a m o n g today's urban poor. T h e develo p m e n t a l history of a workable model' of a mental health p r o g r a m in a predominantly black urban area is described.

U N I T E D STATES DEPARTMENT O F HEALTH, EDUCATION AND WELFARE, HEALTH SERVICES ADMINISTRATION. Inclusion of Mental Health Services in Health Maintenance and Related Organizations: A Review of Supplemental Benefits. Publication No. (HSA)75-13019. Rockville, Md: The Administration, 1974. T h e benefits, staffing patterns, services, and utilization of mental health services found in prototype health maintenance organizations are examined. O f particular importance is the finding that travel time has different return effects on different groups. T h e implications for mental health services is discussed. An annotated bibliography is included.

MARTENS, HARVEY A. The Organization and Administration of Federally Funded Community Mental Health Centers. Document No. 74-17,596. Ann Arbor, Mich.: Xerox University Microfilms, 1974. This dissertation is a study o f the organization and administration o f community

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mental health centers receiving federal funding assistance. This study examines a variety of organizational models among those centers to evaluate the impact of various administrative arrangements and health delivery systems on the effectiveness and long-term viability of the centers.

BURGESS, JOHN. Who has the administrative skills in mental health? Public Administration Review, 164-167, March/ April 1974. The assumption that administrative skills in mental health are most naturally coupled with clinical and therapeutic skills is no longer valid, particularly in

light of the increasing emphasis on total human needs and on innovative orientations. Neither the psychologist nor the psychiatrist is necessarily trained in administrative skills needed for an era of new approaches in mental health; instead, the professional administrator, trained in management science, is required to orchestrate well-planned, innovative mental health pilot projects. The well-trained professional manager will possess skills in such areas as Personnel Management, Planning, Computer Use and Justification, Documentation, Performance Evaluation Review, and Operations Research Studies and Review. The psychologist and psychiatrist will become part of the multidisciplinary team, functioning as components of a total human service system.