Electronic current awareness for mental health facilities

INTRODUCTION

Since 1969, the Missouri Institute of Mental Health (MIMH) Library in St. Louis has provided a current information dissemination service to individuals at Missouri Department of Mental Health (DMH) facilities statewide. The project inaugurating this service and its initial outcomes is described in a 1971 article by Matheson [1], the first librarian at MIMH, then the Missouri Institute of Psychiatry (MIP).

MIMH is an eighty-person research division of the University of Missouri–Columbia, School of Medicine, and is located on the campus of the St. Louis Psychiatric Rehabilitation Center (SLPRC), the second oldest psychiatric hospital in the state. The center is a 215-bed, long-term treatment facility with approximately 800 staff members. A large percentage of SLPRC clients (i.e., patients) are considered forensic or mentally ill offenders. Although MIMH has no formal affiliation with SLPRC, as part of the institute's legislatively mandated mission to “conduct research that will improve services for persons served by the Department of Mental Health and to foster excellence … through employee training” [2], the MIMH Library provides free library services to SLPRC as well as to all other DMH facilities and agencies throughout the state.

BACKGROUND

Over the years the library's current awareness service has included the routing of issues of Current Contents: Social & Behavioral Sciences, the development of a manual personalized selective dissemination of information (SDI) service using Index Medicus described by Yunis [3], and a table of contents service. These strategies allowed public mental health providers throughout Missouri to keep abreast of new developments. However, staff workload factors, copyright concerns regarding copying journal contents pages, and expenses of commercial services have changed the extent of current awareness services provided. By the mid-1990s, the cost for the needed number of Current Contents subscriptions was nearing $7,500 and usage had tumbled from over 6,300 requests in 1984 to less than 2,000 requests statewide in 1998. Many people indicated they were “just too busy” to review the issues that were being routed and if information on a specific topic was needed, they would contact the library for a literature search. The aspect of browsing the literature for the serendipitous find was lost in the vastness of paperwork and client workload. With fewer users, the library ordered and routed fewer copies of Current Contents, resulting in even fewer requests. The dilemma became how to provide a useful, yet cost-effective current awareness service.

LITERATURE REVIEW

The results of a Dialog search including Library and Information Science Abstracts (LISA), Information Science Abstracts, ERIC, MEDLINE, and PsycINFO indicated that current awareness and SDI services are commonly employed by libraries to keep their patrons apprised of new information. Mottorn [4] and Rowley [5] reviewed a variety of commercial services. Additional descriptions and analyses of individualized projects were given by Cox and Hanson [6], Shipman [7], and Deardorff and Garrison [8]. Timbal [9] discussed how journal accessibility on the Internet might affect library current awareness services. Overall, the research showed that many libraries tailored services to allow their clientele to keep up to date with the literature in their various areas of interest or expertise.

PROJECT PLAN AND IMPLEMENTATION

Because the MIMH Library extended its service statewide to a great number of individuals not directly affiliated with the institute, using site-license-based commercial electronic SDI services to replace the routing of print issues of Current Contents was not feasible. However, a simple solution was decided upon to “add value” proactively to the traditional current awareness services. While continuing to route a few copies of Current Contents, the librarian regularly sent the titles of selected current titles to SLPRC staff via e-mail. Requests for copies of articles from the selected list could be requested by return e-mail. The titles chosen were based on the librarian's extensive experience in providing mental health information and her knowledge about SLPRC's clients, goals, programs, and activities. The project began on August 1, 1996, and has continued to the present. This report on the service covers twenty-nine months, from the beginning of the project to December 15, 1998.

The MIMH Library has a staff of eight, with two professional librarians and a collection of over 27,000 volumes of books and journals. It subscribes to approximately 375 serials with approximately thirty-five new issues arriving each week. Incoming journals have always been reviewed daily for articles of interest to individuals with established topical profiles, so selecting articles for the e-mail service was not a significant additional task. Chosen titles and their citations are regularly added to an MS Word document and formatted once a month to e-mail as an attached file.

When the project began, the library and SLPRC were using the same e-mail system, although not all SLPRC staff had e-mail access. At first, few of the psychiatrists, psychologists, or other professional treatment staff were on the system. Clerical and administrative personnel used e-mail more, although over the months the number of clinical staff with e-mail access increased. However, fourteen months into the project, the hospital and the library moved into separate buildings and began using different e-mail systems. The library, not closely affiliated with SLPRC, did not have global e-mail access to all SLPRC employees, due to firewall security measures, and while the number of center personnel with e-mail access grew as the center added more and more people to its system, those who could receive e-mail from the library remained about the same. During the twenty-nine months of the study, the number of people receiving the current awareness lists via e-mail ranged from 130 to 160. Approximately half were therapists, nurses, or other clinical staff.

Generally, one list was sent each month, although, early in the project occasionally more than one list was sent in a four-week period. A total of thirty-six lists were sent with a total of 703 article titles. The number of titles on the lists ranged from 10 to 32, with an average of 19. The average number of individuals requesting from each list was 18 (11%–14% of list recipients), with 638 people overall making requests. Many of the same people responded month after month. The number of article copies made was 2,315, for an average of 80 per month—a third more than the number of monthly requests received during the 1990s as a result of the routing of the paper issues of Current Contents [10].

RESULTS

The tailored e-mail current alerting service was well accepted, judging by the number of requests received and the many favorable comments made by users. However, to sharpen the selection focus, an effort was made to determine the subject areas that were of greatest reader interest. An analysis was done using the 703 distributed article titles. It was found that there were 86 articles (12%) that no one requested. Six hundred and seventeen titles (88%) were requested by at least one person; five to nine people requested 171 of those titles (28%); and ten or more people requested 23 articles (4%).

On eleven of the thirty-six distributed lists all articles were requested. On an additional seven lists all but one article was requested; on another five lists, all but two articles were requested; and on an additional six lists, all but three articles were requested. On the remaining seven lists, an additional fifty-one articles were not requested, with one list having sixteen out of twenty-four articles for which no one asked. An examination of the contents of this particular list did not reveal any reason for such a significant decrease in requests, as the topics were similar to both earlier and later lists.

An analysis was done using the eighty-six unrequested titles to determine if a pattern existed. The major areas that did not appear to be of interest were community or outpatient care (12 articles), HIV (9 articles), managed care (8 articles), and dual diagnosis (4 articles). The remainder of the unselected articles were scattered by subject.

An analysis of the 194 articles (31% of all requests) for which five or more people had asked was also done. From this set, twenty-three had been requested ten or more times. Overall, the major areas of interest were articles about patient violence (16 articles), psychosocial rehabilitation or client education (16 articles), sex offenders (14 articles), employee training or stress (12 articles), and personality disorders (11 articles). The remainder of the articles requested by five or more individuals focused on themes primarily related to treatment or law.

DISCUSSION

The topics that were of most common interest came as no surprise and provided evidence that the librarian was selecting articles in subject areas of interest to SLPRC staff. General requests from the librarian to the individuals on the distribution list asking for suggestions for additional topics to include never received any responses nor did anyone ever ask to be removed from the list.

While it is important to know what topics will usually get “hits” (i.e., result in photocopy requests) and to include those types of articles in a selected current awareness service, at the same time it is the librarian's responsibility to make some attempt at providing structured serendipity by making available those unique articles that may not be of general interest but may provoke a new paradigm of thinking. Therefore, while articles on topics of known interest and of direct work-related value will continue to be included in significant numbers in the MIMH Library's current awareness service, articles that are believed to be of less overall interest, but may be thought provoking or pique the interest of just a few people will also be included.

EXTENSION OF THE PROJECT

The current awareness service was extended to the Department of Mental Health Central Office in Jefferson City in June 1998. Because central office staff included individuals working in the areas of substance abuse, developmental disabilities, and child mental health, as well as comprehensive psychiatry, the scope of the article titles selected was broadened to encompass those areas. The fifty individuals receiving the current awareness electronic file were either self-selected or chosen by a department head. The number of articles per list averaged twenty-eight, with about ten individuals (20%) responding per list. In eight months, this e-mail service made 231 new article titles available, but only 147 (64%) have been requested. This lower percentage was due in part to the librarian not being personally aware of or involved in the specific activities and programs at the DMH Central Office (over 100 miles away) and, therefore, basing the selection of titles on only a general knowledge of the department's mental health program issues.

Believing that this service would be also useful at other sites, it was expanded once again to include the state psychiatric hospital in Fulton, Missouri. The articles selected for Fulton were ones that have been highly requested by staff at SLPRC or the central office, with a few new ones added. Another difference in the Fulton service was that the Fulton-based hospital librarian received the electronic file of article titles from St. Louis and then distributed the file through the local e-mail system to several hundred hospital staff with an indication of locally held titles. Requests not held locally were e-mailed back to the MIMH Library for fulfillment. While this service has only been in operation for five months, the percentage of articles requested has been 95%.

CONCLUSION

While “push technology” is a new, in-vogue term, the concept behind it has been around a long time. Providing access to information has always been one of the responsibilities of the librarian, and now technology allows skills to be honed and wider audiences reached. Librarians are no longer limited to a one-on-one relationship with a single library user who has a specific need, but are able to extrapolate individual needs to serve wider audiences on different sites. Today, through the use of electronic technology and subject familiarity, librarians can enable hundreds of people at one time to become library users by providing them with access to a broad spectrum of useful information.