Private regulation in mental health

General hospitals are increasingly important sources of care for chronic and acute mental patients. Joint Commission on Accreditation of Hospitals (JCAH) standards for staffing in general hospitals require the same degree of physician supervision and control for all services, including mental health. This paper considers the economic impact of JCAH standards on the practice of psychologists in hospitals. The “voluntariness” of the standards is assessed and the evidence that these standards foster economic protectionism is considered. We conclude that in light of the demonstrated capability of nonphysician professionals, methods of quality control appropriate for physician health care in general hospitals should be reconsidered as these instutions diversify into mental health services.     

Budget-maximizing governmental agencies: An empirical test

Niskanen's theory of government budgeting, involving powerful agencies interested in maximizing their budgets through bargaining with a weak, poorly informed governmental ‘Sponsor’, has received wide recognition. This paper presents the first direct empirical tests of Niskanen's ideas. One implication of Niskanen's model of budgeting is that the demand for public services will appear to be elastic. Niskanen's model also implies restrictions on the elasticity of the derived demand for labor in the public sector. Neither set of predictions is supported by existing empirical research on government activity.     

Effect sizes in the treatment of sexual offenders

This article considers the benefits of sexual offender treatment in terms of the magnitude of the effect size produced by these interventions. Comparisons are made of the effect sizes with those generated by treatment of other offenders, by treatment for mental health problems, and by treatment for physical health problems. In all cases, effect sizes with sexual offenders are comparable to (and in some cases better than) effect sizes for the treatment of the other groups. As a final note, it is suggested that using a harm reduction index to estimate effect sizes for treatment with sexual offenders would produce more meaningful results.     

Managing Networks: Propositions on What Managers Do and Why They Do It

Measuring management in networks is difficult because the allocation of managerial resources in network structures is fluid—that is, the utilization of management behaviors varies across time and space within a given program or project. As a means of focusing the network management research agenda, propositions based in contingency logic are suggested to test ideas regarding when, why, and how network managers undertake these behaviors. The propositions are intended to identify the vast inventory of network management behaviors and, most importantly, determine how the manager strategically matches behaviors with the governing context. Suggestions are also offered to help us understand how and why managerial resources are re allocated over time and space. The proposed research agenda is offered as a guide to help us determine which choices are most likely to be effective.     

A Jurisdiction-Based Model of Intergovernmental Management in U.S. Cities

Variations in levels of intergovernmental activity are explainedin terms other than standard "top-down" or "bottom-up" federalmanagement perspectives. Data from 237 cities on intergovernmentalmanagement by local managers of economic development policyindicate that differences are determined by the degree to whichmanagers assume a more mutually interactive approach throughbargaining, strategic activity, local adjustment, and otherinternal actions. The jurisdiction-based model is consistentwith growing diversity in the federal system and with changingmodels of public management.     

School Climate for Transgender Youth: A Mixed Method Investigation of Student Experiences and School Responses

Transgender youth experience negative school environments and may not benefit directly from interventions defined to support Lesbian, Gay and Bisexual (LGB) youth. This study utilized a multi-method approach to consider the issues that transgender students encounter in school environments. Using data from two studies, survey data (total n = 2260, 68 transgender youth) from study 1 and focus groups (n = 35) from study 2, we examine transgender youth’s experience of school harassment, school strategies implemented to reduce harassment, the protective role of supportive school personnel, and individual responses to harassment, including dropping out and changing schools. In both studies, we found that school harassment due to transgender identity was pervasive, and this harassment was negatively associated with feelings of safety. When schools took action to reduce harassment, students reported greater connections to school personnel. Those connections were associated with greater feelings of safety. The indirect effects of school strategies to reduce harassment on feelings of safety through connection to adults were also significant. Focus group data illuminate specific processes schools can engage in to benefit youth, and how the youth experience those interventions.     

Evaluation of structured cognitive–behavioural treatment programmes in reducing criminal recidivism

This paper reports the outcome of a 17-month follow-up of structured, community-based, offence-focused, intervention programmes designed to reduce rates of re-conviction amongst adjudicated offenders under probation supervision. Three separate programmes were examined, all derived from a cognitive social learning model of risk factors for repeated involvement in crime. Using a quasi-experimental design, the study compared male offenders who had completed programmes (n = 215) with a non-completion group (n = 181), a group allocated to programmes but who had not commenced them (n = 339), and a control sample (n = 194) not allocated to the programmes. Outcome data analysis employed (a) an “intent to treat” between-group comparison, (b) “treatment received” methodology. In order to take account of selection bias, data were further analysed using instrumental variables and propensity scores; results suggested a possible treatment effect for moderate and higher-risk cases. Factors influencing different interpretations of these findings were considered.

It depends whose data are being shared: considerations for genomic data sharing policies

There is an urgent need for consistent data sharing policies that promote the advancement of science while respecting the values and interests of those providing their genetic data for research. Responding to the article of Jalayne J. Arias, Genevieve Pham-Kanter, and Eric G. Campbell, ‘The Growth and Gaps of Genetic Data Sharing Policies in the United States’, this commentary further explores the challenges of human subjects’ protection in existing data sharing policies. We will elaborate on the need for data sharing policies to accommodate variation in individual and group preferences around data sharing and privacy concerns by comparing our previously published data on patients’ and parents’ consent to data sharing and attitudes about privacy to data from focus groups with HIV-positive, underserved individuals who were asked about their willingness to participate in genetic research and share their data broadly. These studies support the observation of Arias, Pham-Kanter, and Campbell that researchers, and funding agencies will need to balance the privacy interests of groups as well as individuals in future genomic data sharing policies.