John Langrod

The role of folk healers in community mental health services.

This paper deals with the relationship between sociocultural factors and psychopathology in Hispanic groups in a disadvantaged urban area. The data were drawn from a 6-year collaborative undertaking between the Lincoln Community Mental Health Center and two local spiritualistic centers in the Southeast Bronx, New York. Comparisons are offered between classical mental health personnel and indigenous folk healers with emphasis on terminology, means of communication, and diagnosis techniques, as well as the utilization of social behavior and moral values. Relevant inferences are drawn regarding the broader relationship between religion and psychiatry. The importance of understanding and of utilization of local folk resources in the planning and implementation of mental health services in urban ghettos is documented.

A comparison by ethnic group and city of the criminal activities of narcotic addicts

In an effort to update the results of earlier studies concerning the amounts and types of crimes committed by urban, male narcotic addicts, confidential interviews were conducted with addicts attending methadone maintenance clinics in Baltimore and New York. Samples were stratified by ethnic group (black and white in Baltimore; black, white, and Hispanic in New York), and the amounts and types of crimes committed were compared across groups, cities, and narcotic addiction status (actively addicted/not actively addicted) using six different measures all based on the concept of crime-days per year at risk. Consistent with previous findings, addicts were found to engage in a great deal of criminal activity, especially during periods of active addiction to narcotics. Differences in the amounts and types of crimes committed were found among ethnic groups and, to a lesser extent, between cities as well. For the Baltimore sample, comparison of findings with those derived from an earlier (1973-78) data base suggests that the amount of crime committed by addicts has increased in several categories as well as overall. However, minor differences in data collection procedures render this finding suggestive rather than conclusive.

Methadone Treatment and Physical Complaints: A Clinical Analysis

In this study 102 male patients on the Harlem Hospital Methadone Maintenance Treatment Program were asked about physical complaints which they attributed to taking methadone. The most common complaints were sweating, constipation, drowsiness, sexual problems, and aches in bones and joints. There were no statistically significant differences between new patients and long-term patients, but long-term patients appear more likely to be bothered by sweating than new patients, and constipation occurs most frequently during the initial stages of treatment. Complaints were found, in general, to be minor and did not constitute a barrier to patient retention in treatment.

Detoxification of Long-Term Methadone Patients: Problems and Prospects

Various aspects of the detoxification of rehabilitated methadone patients are considered in the light of experience at the Albert Einstein College of Medicine-Bronx Psychiatric Center MMTP and the reports of others in the field. Patients studied met certain eligibility requirements which were thought to enhance the probability of successful detoxification. A total of 228 (10.4%) of 2,814 patients were included in the project. Sixty-three patients have completed detoxification. A follow-up on these patients indicates that 22.2% claim abstinence from all drugs and are reporting to the clinic, 47.6% claim abstinence but have not reported to the clinic, 14.3% returned to methadone maintenance, and 15.9% are lost to contact. This and other studies emphasize the importance of adequate counseling during detoxification.

Rehabilitation of the Puerto Rican Addict: A Cultural Perspective

Drug addiction has assumed major proportions in the Hispanic population. This paper questions whether treatment programs in Puerto Rican communities adequately relate their rehabilitative services to the realities of Hispanic culture. The experience of a clinic in the South Bronx is reviewed, and it is suggested that programs need to be aware of cultural differences, provide Hispanic staff to treat Hispanic patients, and build up acknowledged strengths, values, and folkways.

Changes in future time perception of day hospital psychiatric patients in response to small group treatment approaches

Attempted to assess the effects of small group approaches on future time perception of psychiatric patients in a day hospital. The research employed two patient groups within the day hospital: A control group, (N = 12) which received routine day hospital treatment, and an experimental group, (N = 12) which received, in addition, the small group treatment. Measures of future time perception were administered to both groups before and after a 12-week treatment. Results indicated significant positive changes in response to group treatment on Future Events and the dimension of Importance. However, no positive significant differences were found on Time Extension, Directionality, and Quality of Affect. While it is not within the scope of this research to evaluate whether the secured change can be maintained, it was clear that in immediate posttesting important changes had resulted from the treatment strategy.

Social rehabilitation of addicts: A two-year evaluation

This paper points out the relationship that exists between treatment approaches with drug addicts and sociodemographic characteristics of the communities affected. It has been shown that while poor and middle class communities show good results with methadone maintenance approaches, in the area of secondary drug abuse they show marked dissimilarities. Also, the reasons for discharge are markedly different. It is speculated that the different attitudes existing at the two clinics studied provide contrasting environments that are selectively detrimental to program dropouts.

Issues of Transference in Methadone Maintenance Treatment

Methadone maintenance treatment involves a great deal of governmental regulations and controls which have to be enforced by the clinician, thus having important transferential implications for therapy. This issue is explored on the basis of a case example, and recommendations are made to detach rule enforcement from therapy.