Gail Gamache

Family Experiences with Mental Illness

Preface Introduction Mental Illness and the Family Family Experiences in Ohio: 1989-1992 The Research Landscape What Basic Needs Did Family Members Provide? What Troublesome Behaviors Did Family Members Try to Control? How Much Did Family Members Spend? What Were the Emotional Costs for Family Members? What Were the Positive Aspects for Family Members? How Involved Were Other Members of the Family Household? Family Experiences in Ohio: 1995-1997 The Research Landscape Revisited How Much Involvement Do Family Members Want? How Did Family Members Evaluate Professionals, Services, and Systems? What Did Family Members Know about Mental Health Insurance? Implications Dilemmas of Kinship Bibliography Index

The proportion of veterans among homeless men: a decade later

Background: The purpose of this report is to evaluate the risk of homelessness among veterans as compared to non-veterans, and to ascertain whether the exceptionally high risk of homelessness among post-Vietnam era veterans first observed in 1987 was still evident one decade later. Method: Data from the 1996 National Survey of Homeless Assistance Providers and Clients and the 1996 Current Population Survey were used to examine the risks of homelessness among veteran men as compared to non-veteran men, stratified by age and race. Results: The present results show that the cohort of veterans aged 20–34 that was most at risk in the 1980 s, although no longer the youngest, still has the highest risk for homelessness. In 1996, the youngest cohort of veterans is also over-represented, but not to the extent found among young men 10 years before. Veterans over the age of 55 showed no increased risk of homelessness as compared to non-veterans. Conclusions: The observed cohort effect, which demonstrates an especially high risk of homelessness among veterans of the immediate post-Vietnam era, even as they age, may reflect the continuing influence of the early problems in recruiting for the All Volunteer Force (AVF). In contrast to the national draft, which promised a fair representation of the entire population of draft-eligible young men, the AVF also had the potential to attract young men with fewer alternative opportunities.

Substance abuse and the need for money management assistance among psychiatric inpatients

Patients who mismanage their funds may benefit from financial advice, case management or the involuntary assignment of a payee who restricts direct access to funds. Data from a survey of psychiatric inpatients at four VA hospitals (N = 236) was used to evaluate the relationship between substance abuse and clinician-rated need for money management assistance. Multivariate analytic techniques were used to control for sociodemographic factors and psychopathology. Alcohol and drug use severity both were modestly associated with need for assistance. The effect of substance use severity was greater in patients who were also diagnosed with a major mental illness. Clinicians indicated that 27 patients (11% of the sample) required an involuntary payee and 21 of the 27 (78%) had a Substance Abuse diagnosis. Only drug use severity was significantly associated with need for a payee. These data describe a substantial unmet need for money management assistance in psychiatric inpatients, particularly among those with substance abuse disorders. There is a need to examine the process by which the Social Security and Veterans Benefits Administrations assign payees to determine whether patients with co-morbid substance abuse are not being assigned a payee in spite of their discernible need for one.