A macro level needs assessment for a community mental health agency

The present study was designed to assess the mental health needs of children in a large urban area. This was done by contacting three groups of people connected with Children's Mental Health Services (CMHS) in Houston, Texas. Specifically, the investigator solicited the opinions of those served (or potentially served) by the agency, service professionals from the agency, and mental health professionals from the community at large. A two-step Focus Delphi technique was utilized to determine areas of agreement and disagreement among these individuals about important characteristics of mental health in children, mental health problems of children in Houston, and possible solutions to the existing problems. Specifically, this procedure involved contacting a total of 102 individuals and administering an open-ended interview soliciting their ideas about the three areas under investigation. Once these data had been gathered, all of the ideas were compiled and condensed into three lists, corresponding to the three major topics. These lists were then mailed back to the 102 subjects in the form of a questionnaire, asking them to respond to each idea on a scale and to indicate which ideas they considered to be most important. Opinions from the entire sample indicated that self awareness and a positive self image were generally considered to be the most important elements of mental health in children. Other mental health characteristics stressed included independence, responsibility, and the capacity to form warm. trusting relationships with family and friends. Least emphasis was placed upon caution, religiosity, ambitiousness, and good grooming. Mental health needs eliciting greatest concern were lack of self awareness and negative self images among children. Also emphasized frequently were problems of physical and sexual abuse of children, as well as children feeling generally unloved. Relatively little concern was voiced about bedwetting, inter-racial strife among children, sexual acting out, financial difficulties in families, and a need for increased discipline. An increase in convenient, low cost mental health facilities was most widely believed to be a necessary solution. Additional training for school personnel in dealing with problem children and mental health teams working in schools were also stressed. On the other hand, relatively few respondents emphasized more bilingual mental health services, family life education, better law enforcement, home and school visits by mental health professionals, censorship of media for children, or additional church activities. All three areas evidenced some disagreement between mental health professionals and community parents. In terms of positive mental health parents stressed discipline, honesty, and industriousness more strongly while professionals were more concerned with fostering independence and a sense of responsibility. Parents were significantly more adamant about problems of drug abuse, inadequate law enforcement, and poor school performance by their children, while professionals put greater stress on problems of parental awareness and understanding of children. In addition, parents place more emphasis on potential solutions which involved censorship and control, whereas professionals asked more often for family life education programs. Four additional areas received brief treatment in the study: (a) an overview of opinions expressed by CMHS staff members, (b) a compilation of agencies and services actually utilized by respondents, (c) a critique of this particular method of needs assessment, and (d) specific program recommendations for CMHS based upon the present findings.