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首页> 外文学位 >Mental health in the United States through the lens of one city's mental health system: Organizational roles and inter-organizational dynamics of a multi-institutional system.
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Mental health in the United States through the lens of one city's mental health system: Organizational roles and inter-organizational dynamics of a multi-institutional system.

机译：从一个城市的心理健康系统的角度来看，美国的心理健康：多机构系统的组织角色和组织间动态。

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摘要

In this dissertation, I take a multi-method qualitative approach to examine one city's ("Elkgate") adult mental health system. Using a combination of observation and in-depth and informal interviews of police officers, jail employees, private and public outpatient mental health clinicians and emergency room staff, and archival analysis of official forms and state and federal legislation, I consider this Elkgate's mental health system an amalgamation of correctional and medical organizations based on environmental necessity as opposed to organizational will. Beyond providing a detailed examination of one mental health system and identifying effective and strained inter-organizational interactions in place---an important contribution in the present political climate criticizing the "broken" mental health system nationwide---this research questions traditional beliefs surrounding health disparities and applies a multi-level analysis to examine and explain complaints and frustrations of professionals. For example, I analyze the benefits of Elkgate's public mental health services available to the poor and indigent over private services. Contextualizing the structure of care of these two service types within the role of a federal Act regarding patient information and privacy (Health Insurance Portability and Accountability Act), I also question how continuity of care may both positively and negatively affect patient care. This research also considers the consequences of poor inter-organizational integration across the system on consumer populations identified by professionals as disproportionately underserved. Combining organizational and intersectionality literatures, I propose that underserved populations in Elkgate's mental health system are the result of gaps between organizations that do not serve populations located at intersections of mental health who are both mentally ill and have other needs. I argue that this results in consumers who face greater disadvantage across multiple statuses. Finally, the timeliness of this research in terms of national and international interest in mental illness and systems of mental health, lends itself to significant policy implications presented in this dissertation for organizations involved in mental health, mental health systems and state and federal legislation.
机译：在本文中，我采用了一种多方法定性的方法来研究一个城市（“ Elkgate”）的成人心理健康系统。通过结合对警察，监狱工作人员，私人和公共门诊心理健康临床医生以及急诊室工作人员的观察，深入和非正式访谈，以及对正式表格以及州和联邦法律的档案分析，我认为这是Elkgate的心理健康系统基于环境必要性而非组织意愿的教养和医疗组织的合并。除了对一个心理健康系统进行详细检查并确定有效和紧张的组织间互动之外，这是当前政治环境中对全国“破碎的”心理健康系统提出批评的重要贡献。健康差异，并应用多层次分析来检查和解释专业人员的抱怨和挫败感。例如，我分析了Elkgate的公共精神卫生服务对穷人和穷人提供的私人服务的好处。在有关患者信息和隐私的联邦法（《健康保险可移植性和责任法案》）的作用下，将这两种服务类型的护理结构具体化，我还质疑护理的连续性如何对患者的护理产生积极和消极的影响。这项研究还考虑了整个系统中组织间整合不佳对专业人士认为服务不足的消费者群体的后果。结合组织和交叉性文献，我认为Elkgate的心理健康系统服务不足的人群是组织之间的差距的结果，这些组织不为处于精神疾病交叉口且又有其他需求的人群提供服务。我认为这将导致消费者在多种状态下面临更大的劣势。最后，就精神疾病和精神卫生系统的国家和国际利益而言，本研究的及时性使其对参与精神卫生，精神卫生系统以及州和联邦立法的组织具有重大的政策意义。

著录项

  • 作者

    Deyell, Tracy Anne.;

  • 作者单位

    University of Colorado at Boulder.;

  • 授予单位 University of Colorado at Boulder.;
  • 学科 Mental health.;Organizational behavior.
  • 学位 Ph.D.
  • 年度 2015
  • 页码 282 p.
  • 总页数 282
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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