Regulatory policy and information deficiencies in the market for mental health services

This paper addresses issues related to the regulation of the delivery of mental health services. The focus is primarily on regulations that are aimed at dealing with the consequences of imperfect information in the marketplace. The paper reviews and assesses what is known about the impact of regulations on efficiency and equity. One conclusion is that we know a fair amount about impacts of regulation on prices for mental health service and very little about effects on quality of care. A research agenda is proposed based on the knowledge available in 1988.     

WHAT DO YOU TEACH POLICY STUDIES EDUCATORS ABOUT COMPUTERS?

Computers are no longer an idea of the future. They are, rather, a common and even expected tool of the public administrator. The authors assert that students of the discipline must have a practical knowledge of computer applications. While it is not necessary that advanced computer engineering be studied, students should nevertheless be made familiar with the uses of the computer in administration. Beyond learning how to operate a computer, the article states that students, especially adult learners, first have to be made not to fear this instrument of the age of information so that they will be comfortable when learning its applications.     

Book reviews

E. Glyn Lewis, Multilingualistn in the Soviet Union: aspects of language policy and its implementation. The Hague and Paris: Mouton, 1971. xx+332pp. Dfl 62.

L. G. Churchward, The Soviet Intelligentsia. An essay on the social structure and roles of Soviet intellectuals during the 196os. London and Boston: Routledge & Kegan Paul, 1973. xiii + 204 pp. £3.25.

Galia Golan, Reform Rule in Czechoslovakia. The Dubcek Era 1968–1969. Cambridge: at the University Press, 1973. Vii + 327 pp. £5.80. $18.50.

Otto Ul?, The Judge in a Communist State. A View from Within. Athens, Ohio: Ohio UP, 1972. xiv + 307 pp. $8.75.

Robert M. Slusser, The Berlin Crisis of 1961: Soviet‐American relations and the struggle for power in the Kremlin, June‐November 1961. Baltimore and London: The Johns Hopkins UP, 1973. xvi + 509 pp. $17.50. £7.90.

Edward Taborsky, Communist Penetration of the Third World. New York: Robert Speller & Sons, 1973. iii + 500 pp. $12.50.

Philip R. Pryde, Conservation in the Soviet Union. London: Cambridge UP, 1972. xv + 301 pp. £5.00.

Marshall I. Goldman, The Spoils of Progress: Environmental Pollution in the Soviet Union. Cambridge, Mass, and London: The M.I.T. Press, 1972. xi + 372 pp. $7.95. £3.60.

Robert H. McNeal, Bride of the Revolution. Krupskaya and Lenin. London: Victor Gollancz, 1973. 326 pp. £3.60.

George Katkov et al. (eds.), Russia Enters the Twentieth Century 1894–1917. London: Methuen, 1973. 352 pp. £1.50 (paperback).

Paul Craig Roberts and M. Stephenson, Marx's Theory of Exchange, Alienation and Crisis. Stanford, Calif.: Hoover Institution Press, 1973. 127 pp. $5.50.

W. H. Parker, The Russians: How They Live and Work. Newton Abbot: David & Charles, 1973. 179 pp. £2.50.

Wright Miller, Who are the Russians? A History of the Russian People. London: Faber & Faber, 1973. 240 pp. £3.95.     

Predictors of Early Engagement in Home Visitation

Predictors of engagement in mothers receiving home visitation in the first year of service was examined. Early engagement was studied in three ways: (1) length of time active in the program during the first year of service (duration), (2) number of visits received (quantity), and (3) gaps in service between visits (consistency). Examined visits received in 515 first-time mothers in a Healthy Families America (HFA) program. Parameters of engagement were investigated, and predictors of engagement were identified using demographics and the Kempe Family Stress Inventory. Inclusive of the Assessment Visit, 31.8% of mothers disengaged prior to the first month of service. Remaining active in the program was associated with being Caucasian, and increased parenting risk (mental health/substance abuse history, low social support, increased stress). Most mothers had fewer home visits than prescribed. Gaps in prescribed service were common, with 89.4% of mothers experiencing gaps between visits of 1 month, and dropping to 16.4% having gaps of 2 months. In contrast to findings from clinic-based interventions, early engagement in home visitation is associated with lower levels of functioning and acute needs. These findings add to a growing body of literature suggesting that increased adversity promotes engagement in prevention programs in general, and home visitation programs in particular. To the extent that mothers who are actively engaged in home visitation are likely to have increased psychosocial needs, curricula may require modification and augmentation to address these needs and optimize program effectiveness.