George J. Warheit

Psychiatric symptomatology among Mexican American farmworkers

The paper presents findings from an epidemiologic field survey of 500 Mexican American farmworkers conducted in central California. The survey was intended as a health needs assessment of this population and the Health Opinion Survey was used to establish normative psychiatric symptom distributions. Analyses of the data by gender, age and income revealed that these socio-demographic variables were not important predictors of symptom levels, although the highest mean scores were reported in the 40-59 age group. Income levels were modest and fairly uniform, which contributed to the lack of mean score variation. Symptom distributions were analyzed for the variables age and sex using the HOS criteria of caseness and it was found that approx. 20% of the sample reached the criteria of caseness. A comparison of HOS mean scores with a national sample of surveys indicated that Mexican American farmworkers had symptom levels which resemble those of other low income socio-economic groups, such as southern blacks. Another analysis was conducted which reported a striking correspondence between self perception of health with psychiatric symptoms. A conclusion reached from the survey is that the Mexican American farmworkers in this sample appear to be experiencing psychiatric symptom levels which place them at extraordinary risk. Stresses associated with this group, i.e., limited social mobility, transience, poverty, discrimination and a high rate of traumatic life events were identified as possible contributors to this risk proneness.

A critique of social indicators analysis and key informants surveys as needs assessment methods

This paper reports data from a pilot study designed to determine the practicality and utility of two differing needs assessment methodologies: social indicators analysis and key informants surveys. The authors found social indicators analysis successfully identified differential areas of need within the SMSA which served as the research site. They suggest it is a practical and valid means for assessing human service needs at a general level. The key informants survey was judged to be less useful. Informants generally were unable to identify the extent of differing types of needs or their geographic distribution. It is suggested additional research utilizing differing designs must be completed before meaningful conclusions can be reached about the utility of the key informants survey as a needs assessment method.

Relationships between physical and mental illness.

Abstract A random sample of the general population of a southeastern county was studied to examine some relationships between reported physical illness and mental disorders. Results, obtained from epidemiologic data, indicate that lower socioeconomic status is probably the most fundamental factor associated with high risk for both physical and mental illness.

Social indicators and mental health planning: An empirical case study

This paper reports data from a series of studies designed to provide an empirical basis for making judgments regarding the utility and validity of social indicators as a method for assessing the need for mental health services. The following findings are included: (a) The methodological sophistication of the social indicators approach used did not greatly affect the utility of the technique as a means of identifying low- and high-need subareas in a large standard metropolitan statistical area. (b) Correlations between social indicator rankings of tracts/enumeration districts and mental health needs as determined by psychiatric scale scores varied in two different counties. (c) The degree of tract/district socioecological homogeneity appears to account for the diverse correlations. (d) Tract and enumeration district social indicator rankings uniquely account for less than .50% of the explained variance of individual mental health scores when analyzed in a regression equation which includes socioeconomic status as a variable.

The Clergy as a Mental Health Resource: Parts I and II

Parts I and II of this article contain some of the results of a recent research project conducted in an area of mid-Florida. The group surveyed was predominantly parish clergy. This article gives some indication of the results of this survey as it speaks to the issue of the clergy as a mental health resource. There is a good deal of serendipity data that spin off from the central theme. The article has immediate relevance for clinical pastoral education supervisors, parish clergy, and others in the field of health care delivery.

BEHAVIORAL AND MENTAL HEALTH EFFECTS OF THE THREE MILE ISLAND ACCIDENT ON NUCLEAR WORKERS: A PRELIMINARY REPORT

This study of nuclear workers was conducted by the Task Force on Behavioral Effects of the President’s Commission on the Accident at Three Mile Island (TMI). The study was one of four that the task force had conducted to examine effects on “the mental health of the public and the workers directly involved in the accident at TMI-2.”’ Determining the behavioral responses of nuclear workers under stress during the accident was of particular interest. Examining the potential impacts of the TMI accident on nuclear workers involved considering a wide variety of factors. To begin with, disaster research [e.g., References 2-41 clearly demonstrates the power of disaster situations to cause symptoms of psychological distress among high proportions of affected populations.’ Hence, the disaster literature provided one theoretical base for the research. It was also necessary, however, to consider the special status of nuclear workers in this situation. Since the nuclear workers were permanent members of the organization that experienced the accident, they had both a psychological and an economic stake in its outcome. And, to varying degrees, these workers were directly involved in the incident and had responsibility for controlling the plant and bringing it to a safe condition. Consequently, organizational behavior literature on key dimensions of employee reactions under stress [e.g., perceived workplace hazards, job-related stress, and job security] served as the second major conceptual base of the study. In short, nuclear workers were involved in the accident situation both as members of the general population and, more directly, as employees of TMI. Therefore, it was essential to examine key aspects of likely worker experiences from both perspectives.

Crowding and mental health.

An epidemiologic investigation of the mental needs and services of 1645 respondents, aged 17 to 92 years and living in a representative southeastern county in Florida, revealed that 7.8% of the sample lived in crowded conditions. The crowded respondents scored significantly higher than did the uncrowded on both a depression scale and on the Health Opinion Survey. Associations between crowding and high scores on both scales were strongest among: (1) respondents in the childrearing and middle years of life, (2) blacks at all income levels, (3) whites in the intermediate annual family income range of

The Differential Perception of Anxiety in Medical Patients: Sociodemographic Aspects

6000 to

Fire Departments Operations During Major Community Emergencies

9999, and especially, females rather than males. Consistently, the crowded black population, and particularly, crowded white women, had much higher scores than did the uncrowded women. A multiple regression analysis showed that three variables—being a female, having a lower income, and crowding—accounted for 16.5% of the variance. The discussion emphasizes that the relationship between crowding and higher scores on indices of emotional distress is quite complicated. In crowded situations, depression may be a costly, semi-adaptive reaction to excessive interpersonal stimulation. Women living in crowded situations appear to be at high risk for depressive illness; their plight brings to mind the classic animal experiments which showed that the maternal behavior of females deteriorated in crowded situations.

Redundancy among indicators in the mental health demographic profile system

An investigation of anxiety in 100 general medical inpatients showed that the attending physicians rated about one-third of the patients as highly anxious. Comparisons between the physicians and nurses ratings and the patients scores on four standardized anxiety scales revealed that there was differential perception of the patients anxiety levels. An analysis of the physicians ratings, nurses ratings, and the scores on the anxiety scales, in terms of the patients sociodemographic characteristics, pointed to factors associated with the differential perception of anxiety. Physicians tended to overrate young patients and high SES patients as having greater anxiety than the scales indicated and both physicians and nurses consistently underrated the blacks and the lower SES patients anxiety levels. The results demonstrated clinicians problems with the identification of anxious patients and indicate some factors associated with differential perception of patients anxiety levels. We suggest social distance and counter-transference as partial explanations for the difficulties in identification and with differential perception.