Suicide among American Indian adolescents: an overview

Suicide has become a major concern of many Indian tribes and pueblos, as the rates in these tribes have increased dramatically in the last decade. One of the critical research questions is how to explain the vastly different rates of adolescent suicide among tribes. Research has identified some common patterns in experience and behavior among Indian adolescent suicides; these patterns are similar in many ways to those found in Los Angeles suicide research of Teicher (1979). Chronic versus acute stress factors in suicide are examined. Recent research has also identified a number of factors characterizing tribes with high suicide rates; these include failure to adhere to traditional ways of living, to traditional religion, and to clans and societies, and the resulting chaotic family structure and adult alcoholism. The roles of adoption of Indian children, boarding schools, and high unemployment in many tribes are also discussed. Suicide prevention and intervention programs are briefly described.     

The Papago Psychology Service: A community mental health program on an American Indian reservation

A community psychology service run by the Papago Indian tribe and staffed largely by Papago Indians who have been trained as mental health workers is described. This service is unique among mental health services for Indians in that the tribe has complete control of the funds for the service and sets its own policies. It was developed for a rather traditional Indian group, and the culture, the traditions, and the wishes of the Papago community were respected. Consultation with medicine men was built into the program from the start, and adaptation of mental health techniques to fit the culture is stressed. Before this clinic was established, few mental health resources were directly available to the reservation. Similar to other Indian tribes, the Papagos are economically disadvantaged, with an unemployment rate of over 50%, low educational attainment, and very high rates of alcoholism, suicide, and vehicular accidents. The topics covered are the tribe's view of health programs for its people, the present Papago community and traditional means of treatment, traditional psychotherapy adapted to Papago culture, the indigenous Papago mental health worker, and the non-Indian professional consultant.     

Factors Associated with Suicide Ideation among American Indian Adolescents: Does Culture Matter?

Data from self-report surveys of 1,353 high school students representing three culturally distinct American Indian tribes were analyzed for tribal differences in factors associated with suicidal ideation. In the multivariate analysis, no single correlate of suicide ideation was common to all three tribes. The correlates of suicide ideation were consistent with each tribe's social structure, conceptualization of individual and gender roles, support systems, and conceptualization of death. These results underscore the heterogeneity of suicide ideation across three distinct American Indian tribes consistent with their cultural heterogeneity. Suicide prevention and screening programs may be difficult to adapt from one tribe to another.     

Evidence‐Based Human Trafficking Policy: Opportunities to Invest in Trauma‐Informed Strategies

Human trafficking is a critical social issue characterized by chronic trauma among victims, and frequently preceded by traumatic experiences that contribute to risk of victimization. Therefore, the research‐based practice of trauma‐informed care is a highly appropriate lens for both prevention and intervention. This work examines federal legislation in the United States related to human trafficking for references to trauma, as well as how the use of research could implicitly direct public policy responses toward trauma‐informed approaches. Legislation on human trafficking has risen substantially since 1989, and the use of research and trauma language within these policies has also observed substantial increases. While the use of trauma language was associated with limited progression in the policy process, legislation using research language was more likely to pass out of Committee and become enacted. Moreover, legislation may leverage research in ways that have the potential to bolster trauma‐informed practice among human trafficking victims. Specifically, research can be used to describe the problem and causal mechanisms (e.g., impact of trauma), guide “best practice” for service delivery, and generate knowledge through studies and evaluations that guide future policy. Therefore, human trafficking legislation that implicitly guides trauma‐informed practice via the use of research may be particularly promising for the field.     

Ideology,Prejudice, and Attitudes Toward Sexual Minority Social Policies and Organizations

This study tested the effects of multiple ideologies on support for restrictive policies against gay and lesbian individuals and organizations and if these effects were mediated by sexual prejudice. Social dominance orientation (SDO), conservatism, and right‐wing authoritarianism (RWA) each had significant direct and indirect effects. SDO had the most consistent direct effects in addition to its effects through sexual prejudice. The direct effects of conservatism were smaller and similar in size to its indirect effects through prejudice. Although the direct effect of RWA was significant for policy attitudes, its effect was entirely mediated through sexual prejudice for organization opposition. Results suggest that high‐RWA individuals adopt their positions largely because of prejudice toward sexual minorities, while high‐SDO individuals adopt their positions partly out of prejudice and partly because these positions perpetuate hierarchies between heterosexuals and sexual minorities. Results also diminish the principled conservatism argument that conservative positions on these policies and organizations are absent of prejudice. As policies continue to be enacted that affect the sexual minority community, research is needed to identify the underlying motivations for individuals' positions toward these policies.     

When the luck runs out: Policy challenges confronting careers guidance in Australia

The policy challenges confronting careers guidance in Australia arise from economic stringency, changes in working, and social change. Current responses include rationalising services, linking counselling with training, targeting services, and providing evidence for effectiveness. Other responses needed by both counsellors and administrators are anticipating changes, marketing, and co-ordinating services.     

Consumer response to tobacco smoke in service settings

• Establishing smoking policies which accommodate customers' smoking preferences is a major problem for restaurants, bars, hotels, and other firms in the service industry. This study is based on the premise that tobacco smoke can be considered a component of both the physical and ambient retail service environment. Because of legal and ethical concerns, the presence or absence of environmental tobacco smoke (ETS) in two types of eating facilities (bar and fine dining restaurant) was operationalized by the presentation to respondents of photographs which pictured customers in a setting where smoking was either present or absent. The success of this method of manipulation of the treatment variable was assessed with a thought listing procedure. Thought listing responses indicate that both treatments (type of facility and smoking policy) were adequately conveyed by the photographs. Results indicate that cognitive, emotional, and behavioral responses were all negatively affected by the presence of tobacco smoke. The conclusion is that managers who permit smoking in their facilities risk losing non‐smoking patrons while smokers are little affected by either the presence or absence of smoke.
• The major contributions of this study include both the exploration of tobacco smoke as part of the retail service environment for eating establishments and the use of thought listings as a manipulation check for variables which were manipulated through use of photographs depicting the treatment conditions.

Copyright © 2010 John Wiley & Sons, Ltd.     

Policy conflict, policy consistency, and interpersonal understanding

Abstract.— A number of studies have shown that inconsistency in the subjects' policies is a major reason for disagreement in policy conflict. It has been hypothesized that the lack of consistency makes it hard for subjects to understand each other's policies. The present results provided evidence for this hypothesis by showing that subjects asked each other more questions about policy when their policies were less consistent in an experiment where policy consistency was manipulated by varying the predictability of the conflict task.     

National Ambulatory Medical Care Survey: Tobacco intervention practices in outpatient clinics

Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Ethical Challenges Inherent in the Evaluation of an American Indian/Alaskan Native Circles of Care Project

This article provides first‐person accounts of ethical issues inherent in an evaluation of the Native American Indian Center of Central Ohio (NAICCO) Circles of Care project. Circles of Care is a three‐year, infrastructure development program funded through the Substance Abuse and Mental Health Services Administration (SAMHSA) which is part of the federal Department of Health and Human Services (DHHS). The grant program is for American Indian and Alaskan Native (AI/AN) tribes and urban Indian communities and includes a strong emphasis on community engagement and community ownership. The Native American Indian Center of Central Ohio received a Circles of Care grant in the fifth cohort of the program. The first author (Project Evaluator) presents views that typically represent a western approach to evaluation, while the second author (Project Director) presents a Native perspective. Ethical issues are defined as well as the authors’ efforts to address these concerns.     

Social pressure and policy change in the "lens model" interpersonal conflict paradigm

Abstract.— The effects of conflict and policy inaccuracy on policy change in the "lens model" interpersonal conflict paradigm were investigated in an experiment which compared amount of policy change for subjects who were paired with a stooge who did not change his policy even though it was incorrect with the amount of policy change for subjects whose opponents changed their policies to reduce the inaccuracy of these policies. The amount of policy change was the same in both of these conditions, indicating that task adaptation is a more important goal to the subjects than conflict reduction in these experiments.     

Symbolic Politics and the Prediction of Attitudes Toward Federal Regulation of Reduced‐Exposure Tobacco Products1

The present study relies on symbolic politics theory to predict public attitudes toward the federal regulation of conventional tobacco products (a familiar attitude object) and reduced‐exposure tobacco products (a relatively novel attitude object). We predicted that attitudes toward most forms of regulation would be more strongly influenced by symbolic beliefs about the role of government in society than by self‐interested concerns, with the exception of taxation. We predicted that the financial consequences of taxation policies would be less ambiguous for those who are affected, resulting in a stronger relationship between self‐interest and policy attitudes. The results strongly supported our hypotheses, suggesting a process by which symbolic beliefs and self‐interested concerns influence attitude formation. Theoretical and policy implications are discussed.     

Improving Medicare coverage of psychological services for older Americans

Professional psychology's ability to meet older Americans' psychological needs and to simultaneously thrive as a profession will be closely tied to the federal Medicare program over the coming decades. Despite legislative changes in the 1980s providing professional autonomy to psychologists and expanding coverage for mental health services, Medicare coverage policies, reimbursement mechanisms, and organizational traditions continue to limit older Americans' access to psychological services. This article describes how psychologists can influence Medicare coverage policy. Specifically, the authors examine widely unrecognized policy processes and recent political developments and analyze the recent creation of a new Medicare counseling benefit, applying J. W. Kingdon's (1995) well-known model of policy change. These recent developments offer new opportunities for expanding Medicare coverage of psychological services, particularly in the areas of prevention, screening, and early intervention. The article provides an analysis to guide psychologists in engaging in strategic advocacy and incorporating psychological prevention and early intervention services into Medicare. As Medicare policy entrepreneurs, psychologists can improve the well-being of millions of Americans who rely on the national health insurance program and, in so doing, can help shape the future practice of psychology.     

Moving Beyond the Individual: Examining the Effects of Domestic Violence Policies on Social Norms

To be effective, criminal justice policies should affect the underlying social norms for which the policies were enacted. This study sought to determine whether public perceptions of criminal justice policies on domestic violence affected social norms. Two waves of data were collected via a telephone survey where a random probability sample of 973 residents was drawn from 4 communities. A structural equation model was tested and confirmed. Results provided strong support for the hypothesis that perceptions of criminal justice policies have direct effects on attitudes toward criminal justice response, and indirect effects on victim-blaming attitudes, both underlying social norms related to domestic violence. The enactment of criminal justice policies, therefore, may have an impact beyond victims and perpetrators and lead to a transformation of the community through the emergence of new social norms. Public awareness campaigns designed to disseminate criminal justice policies may be instrumental in provoking social change.     

An Analysis of Factors Influencing the International Migration of Indian Nurses

Based on our survey conducted in Tamil Nadu, this paper analyses the characteristics of Indian migrant nurses and the factors influencing their migration. India is considered the second largest exporter of nurses after the Philippines. Many Indian nurses have migrated to work in OECD countries, the Gulf countries and some ASEAN countries. While Indian nurses are migrating overseas to fill shortages at their destinations, India has itself been suffering from an acute scarcity of nurses since its independence in 1947. Therefore, the large scale of nurse migration is a serious threat to the Indian healthcare system. The results of the survey imply that international migration by nurses can be explained in part by the gap between the private sector and the public sector in terms of salary and working environment. Since the impact of social status on the migration decisions of nurses has lessened, economic factors are the crucial determinant of international migration of nurses. Policy intervention in this area is the necessary first step to solving this long-standing problem. The priority in any policies formulated should be given to nurses working in the private sector whose salaries are considerably lower than those in the public sector and whose voices are unheard.     

Missed Opportunity: International Students in Canada Face Barriers to Permanent Residence

With their youth, Canadian post-secondary credentials, fluency in an official language, and time already spent in Canada, international students represent an ideal immigration source for this country. In many cases, they have lived in communities where they would be happy to continue living and working if provided the opportunity. Yet, despite recognition by the federal government of the attractiveness of international students, federal policies enacted in 2015 have inadvertently created barriers for international students wishing to become permanent residents of Canada. The Express Entry processing system has left international students in Canada in precarious situations at risk of losing their ability to work and to immigrate. This policy brief describes the challenges that Express Entry poses for international students and makes recommendations to the federal government to address these barriers.     

The Role of Friends’ Disruptive Behavior in the Development of Children’s Tobacco Experimentation: Results from a Preventive Intervention Study

Having friends who engage in disruptive behavior in childhood may be a risk factor for childhood tobacco experimentation. This study tested the role of friends’ disruptive behavior as a mediator of the effects of a classroom based intervention on children’s tobacco experimentation. 433 Children (52% males) were randomly assigned to the Good Behavior Game (GBG) intervention, a universal preventive intervention targeting disruptive behavior, and facilitating positive prosocial peer interactions. Friends’ disruptive behavior was assessed from age 7–10 years. Participants’ experimentation with tobacco was assessed annually from age 10–13. Reduced rates in tobacco experimentation and friends’ disruptive behavior were found among GBG children, as compared to controls. Support for friends’ disruptive behavior as a mediator in the link between intervention status and tobacco experimentation was found. These results remained after controlling for friends’ and parental smoking status, and child ADHD symptoms. The results support the role of friends’ disruptive behavior in preadolescents’ tobacco experimentation.     

Actions taken by schools when tobacco policies are violated: associations with adolescent smoking prevalence

This study examined the association of adolescent smoking prevalence with actions taken by schools (i.e., informing parents or disciplining pupils at school) for violating the school tobacco policy. Interaction terms between actions taken by schools and role models' smoking behavior or support for adolescents were also examined. Data were collected using self-completed questionnaires from a nationally representative Norwegian sample of 15-year-olds (1,404 pupils, 51% males) and 73 staff members. Informing parents when the school tobacco policy was violated by contrast with other actions taken by schools was not associated with lower levels of adolescent smoking. Disciplining pupils was associated with lower levels of adolescent smoking but the association was no longer significant when examined together with parents' and teachers' smoking behavior or support. Exposure to parents' and teachers' smoking, and teachers' support were associated with adolescent smoking prevalence, irrespective of actions taken by schools. Identifying the mechanism under which these different home and school factors relate to adolescent smoking may be worthwhile to inform intervention initiatives.     

印度农村医疗的现状与对策

自印度独立以来,政府就致力于采取各种有力措施来改善人们的健康情况并已卓见成效。尽管印度政府采取了一系列的发展政策,经济、地区发展不平衡及男女不平等还是为医疗部门带来了巨大的挑战。分析印度政府在农村所面临的问题以及为解决这些问题政府颁布的新政策。     

Family Policies in Eastern Europe: A Focus on Parental Leave

Family policy is an issue of concern for many Governments. Family policies are organized around the four main functions of the family: marriage, childrearing, financial support and family care. Eastern Europe is an area with significant socio-economic and political changes in the last decades that determined revisions of social policies. The goal of this article is to review the most relevant family policies in this region. Using feminist and family systems theoretical perspectives the paper also provides an in-depth examination of childcare policies with a focus on parental leave. Maternity, paternity and parental leave and child care services in the region are explored. Recommendations for family policy development, implementation and evaluation in Eastern Europe are provided.