Public and private responsibility for mental health services.

Relative to public services, private sector corporate mental health care has significantly increased since the late 1960s. The many tensions encountered in assigning public and private responsibility for mental health service give rise to significant value-laden questions for psychologists. These questions go to the heart of community mental health, deinstitutionalization, mental health policy development and evaluation, and many other areas in which psychologists are playing major roles. The public-private issue should be understood historically, from the twin vantage points of developments in general medicine and in mental health. Among the many public interest and public policy matters psychologists and others concerned with mental health should address are the emergence of corporate chains; the nature, cost, and quality of private sector services; the compatibility of profit motivation and the motivation to provide care; and patient selection issues (e.g., cream-skimming). Public and private cooperation and planning are certainly in order if the public interest is to be served in addressing the nation's mental health problems.

Pediatric AIDS, developmental disabilities, and education: a review.

The increasing incidence and prevalence of pediatric HIV infection and associated morbidity suggest that HIV-related neurological impairments and concomitant developmental disabilities are likely to present major societal problems. This article reviews and discusses (a) issues associated with the variable course and multidetermined nature of the development of children with HIV and (b) contemporary education and policy issues associated with HIV-related developmental disabilities in children. Collaborative service delivery and case management are proposed for organizing social and educational responses to children with HIV and their families.

A transactional perspective on the interrelationship of the societal power structure, the mental health establishment, the individual, and the community: a commentary on Nassi.

While agreeing in part with Nassi's (1978) radical position on the failure of community control to be meaningfully implemented by the mental health establishment, a complementary analysis is proposed as being more complete by virtue of integrating a variety of societal and individual perspectives. This analysis builds on transactional epistemology and a multi-level model of service delivery, also bringing to bear developmental and social evolutionary theory. A new service delivery role, the human development liaison specialist, is advanced as consistent with these notions.

Parent and health care provider communication and decision making in the intensive care nursery.

This study investigated parents' and health care providers' perspectives of their communicative interactions when a seriously ill infant is treated in an intensive care nursery. Both parents and health care providers stressed the importance of keeping parents informed of their child's condition. Concerns regarding the provision of medical information to parents in an understandable manner, the lack of time health care providers have to spend interacting with parents, and the possibility that parents' emotional involvement interferes with their understanding of the child's condition were raised. Implications for pediatric health care providers relative to their interactions with parents of young chronically ill children are raised.