Evaluation in mental health : a review of the problem of evaluating mental health activities / report of the Subcommittee on Evaluation of Mental Health Activities, Community Services Committee, National Advisory Mental Health Council.

  • United States. National Advisory Mental Health Council. Community Services Committee.
Date:
1955
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Licence: Public Domain Mark

Credit: Evaluation in mental health : a review of the problem of evaluating mental health activities / report of the Subcommittee on Evaluation of Mental Health Activities, Community Services Committee, National Advisory Mental Health Council. Source: Wellcome Collection.

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    to this question is rarely known, since studies of prevalence and inci- dence are indeed rare, community health and welfare leaders continue to grope, and improvise on a year-to-year basis. At times, those who pay the bills for services lose heart and faith when we cannot demon- strate a lessening incidence of adjustment problems. The fact that a rise in the incidence of such problems may have little or no bearing on how effectively the psychiatric clinic and social agency system per- form their services is not too generally understood. Thus the need for studies of prevalence and incidence continues to be a crucial factor for effective interpretation of what kind and how much service a community needs. Another approach in evaluating the aggregate of activities in- fluencing mental health is the technique of the family count, indicating the exposure over a period of years of the family unit to the various services and activities. From such data conclusions are drawn as to the effectiveness of the individual activities and particularly as to the total effectiveness of the community program. Illustrative of such studies in this area is the study carried on by Community Research Associates at St. Paul (47). The following figures are of significance: Among the 41,000 families under the care of St. Paul agencies in November 1948, about 7,000—7 percent of the community’s families—were dependent, nearly 11,000 had problems of maladjustment, well over 15,000 had problems of ill health, and almost 19,000 were being served by public and private recreation agencies. It can be seen at a glance that some families had more than one kind of problem. Seventy-seven percent of the dependent families also had problems of ill health or maladjustment. Fifty-eight percent of the families with problems of maladjustment were known to agencies in the other service fields. Thirty- eight percent of the families with health problems also had other problems. The most dramatic evidence of the vicious circling of problems in St. Paul’s families came with the discovery that a group of 6,600 families, about 6 percent of the city’s families, were suffering from such a compounding of serious problems that they were absorbing well over half of the combined services of the community’s dependency, health, and adjustment agencies. (P. 9.) Based on such observation Buell, the principal investigator, comments as follows: A communitywide program should be designed to utilize available services with the maximum of effectiveness and economy. Much of the present waste is due to misdirection. In most communities within our knowledge, a dis- proportionate amount of time and effort is spent upon families discovered too