Mothers’ Mental Health Treatment Associated with Greater Adolescent Mental Health Service Use for Depression

Despite concerns surrounding depression in adolescence and the existence of effective treatments, adolescent depression often goes untreated. In 2014, only 41.2% of adolescents experiencing a major depressive episode (MDE) received mental health treatment. Parents play a key role in adolescents’ treatment utilization. We examined whether among mothers with any mental illness, mothers’ utilization of mental health treatment was associated with greater likelihood of their adolescent children who experienced an MDE receiving mental health treatment. Using nationally representative data from the National Survey on Drug Use and Health (2008–2014), we performed logistic regression analysis to model the odds of adolescents (aged 12 to 17 years) with a past year MDE receiving any mental health treatment in the past year as a function of their mothers’ mental health treatment utilization in the past year, adjusting for control variables. The rate of adolescent treatment utilization was 66% when mothers had utilized treatment, as compared to 45% when mothers did not utilize treatment (p?<?0.001). The odds of an adolescent with an MDE receiving mental health treatment were two times greater when the mother received mental health treatment as compared to adolescents whose mothers did not receive any mental health treatment (OR?=?2.09, 95% CI [1.04, 4.17]). There was no effect of adolescent gender (OR?=?1.15, 95% CI [0.40, 3.28]) or interaction between gender and mothers’ treatment (OR?=?0.95, 95% CI [0.26, 3.46]). Barriers to adolescent mental health treatment may be lower when mothers receive mental health treatment.     

Ethnic Differences in Children’s Entry into Public Mental Health Care via Emergency Mental Health Services

For children and youth making a mental health crisis visit, we investigated ethnic disparities in whether the children and youth were currently in treatment or whether this crisis visit was an entry or reentry point into mental health treatment. We gathered Medicaid claims for mental health services provided to 20,110 public-sector clients ages 17 and younger and divided them into foster care and non-foster care subsamples. We then employed logistic regression to analyze our data with sociodemographic and clinical controls. Among children and youth who were not placed in foster care, African Americans, Latinos, and Asian Americans were significantly less likely than Caucasians to have received mental health care during the three months preceding a crisis visit. Disparities among children and youth in foster care were not statistically significant. Ethnic minority children and youth were more likely than Caucasians to use emergency care as an entry or reentry point into the mental health treatment, thereby exhibiting a crisis-oriented pattern of care.     

How Adolescents’ Mental Health Predicts Their Physical Health: Unique Contributions of Indicators of Subjective Well-being and Psychopathology

Studies among youth have established a link between mental health and physical health, and highlight the importance of attending to these relationships to provide a more complete picture of functioning. However, most previous investigations have limited their focus to examining the relationship between physical health and either particular aspects of psychopathology or particular aspects of subjective well-being. The current study serves as a first examination that includes both positive (subjective well-being [SWB]) and negative (psychopathology) indicators of mental health in relation to physical health functioning, assessed via self-report measures completed by a sample of 401 early adolescents from the general population. Mental health indicators accounted for 30% of the variance in physical health ratings, and 4 of the 5 mental health indicators were unique predictors of physical health. Positive affect, a component of SWB, explained the most unique variance in physical health, followed by the other components of SWB. Results support the importance of attending to positive indicators of mental health when determining the link with physical health among youth. Implications for a research and practice focus on comprehensive wellness among youth are discussed.     

Institutional Values of Managed Mental Health Care: Efficiency or Oppression?

The authors suggest that many managed mental health care (MMHC) practices have oppressive effects on members of cultural and ethnic minority groups. They examine the dissonance between institutional practices and cultural traditions that reflect insensitivity and forced conformity, particularly regarding time, pace, and intervention uniformity as applied to clients and commonly required in the MMHC industry. Los autores sugieren que muchas prácticas del cuidado administrado de la salud mental (MMHC, por sus siglas en inglés) tienen efectos opresivos sobre los miembros de grupos de minorías étnicas y culturales. Examinan también la disonancia entre prácticas institucionales y tradiciones culturales que reflejan insensibilidad y una conformidad forzada, sobre todo en lo referente a tiempo, ritmo y uniformidad de intervención tal y como se aplica a clientes y normalmente requeridos por la industria de MMHC.     

Participatory Research in Systems of Care for Children’s Mental Health

The children’s system of care initiative in the United States requires the participation of caregivers of children with emotional or behavioral problems in conducting research and evaluation. This entails a restructuring of traditional power dynamics among families served by the community mental health system and other system stakeholders, including researchers. However, evidence indicates that system of care research may not currently embrace the different types of knowledge possessed by caregivers and may be frustrated by traditional power hierarchies, resulting in research findings that are not useful for the community. In this paper I examine a framework for power and knowledge and examine how, when viewed through this framework, participatory research in the system of care initiative thus far may be less than authentic. I conclude with improvements suggested by the framework that are expected to shift power to caregivers and result in more useful, actionable research findings for the community.     

Associations Between Maternal Mental Health and Child Emotional and Behavioral Problems: Does Prenatal Mental Health Matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10–11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers’ but not teachers’ reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.     

On the Role of Mental Health Activities for Teachers’ Work and Life

Everyday behavior is getting increasingly attention, both in the prevention of mental impairment and the promotion of mental health – within and beyond the work context. The present study aimed to identify the importance of mental health activities for well-being and positive functioning of teachers, while taking affectivity into account. Teachers are confronted with various stressors, and identifying predictors of teachers’ well-being and positive functioning is important, not only for teachers’ personal health, but also for their students’ well-being and achievement. Based on the Broaden and Build (B&B) theory and Conservation of Resources (COR) theory, we assumed that (1) the practice of mental health activities is associated with well-being (i.e., positive mental health) and positive functioning (i.e., healthy and unhealthy work-related behavior and experiences), and that (2) mental health activities mediate the association between affectivity and the respective outcomes. These assumptions were tested in a sample of 326 German teachers (75% female, age: M = 44, SD = 11.85). The practice of mental health activities was associated with more positive mental health, more healthy work-related behavior and experiences, and less unhealthy work-related behavior and experiences. Moreover, mental health activities partly explained the relationship between affectivity and the respective outcomes. The present findings indicate the potential of mental health activities for mental health promotion in teachers but future studies are recommended in order to establish causal effects.

     

Efficacy of a Train-the-Trainer Curriculum for Increasing Occupational Therapists’ Mental Health Knowledge

The marked prevalence and under detection of affective disorders including depression in older adults is associated with poor functional outcomes and patient mortality. Although occupational therapists are trained in mental health assessment and intervention, these skills are underutilized in practice. A two-group wait-list control design was used to test a DVD-based educational curriculum to increase knowledge about depression in a sample of occupational therapists. The educational intervention was delivered using a train-the-trainer model. The train-the-trainer model was found to be effective and study results showed that knowledge increased significantly after the DVD training.     

Discrimination and Women’s Mental Health: The Mediating Role of Control

Perceived discrimination is a stressor, related to both negative physical and mental health outcomes. Utilizing a sample of 259 undergraduate females from the northeast region of the U.S., the present study examined a model that tested the direct, indirect, and mediated relations among perceived sexist discrimination, psychological distress, self-esteem, and sense of personal control. Path analysis of the model indicated that (a) perceived sexism was related to greater psychological distress, with personal control partially mediating this link and (b) perceived sexism was not related to self-esteem. The path model accounted for 28% of the variance in self-esteem and 37% of the variance in psychological distress. Implications of the findings for women’s health are discussed.     

What Happens to Mental Health Court Noncompleters?

Mental health court (MHC) research consistently finds that defendants who successfully complete and graduate from the court are less likely to recidivate than those who do not. However, research has not assessed what happens to these noncompleters once they are sent back to traditional court. Using follow-up data on six years of noncompleters from pre-adjudication MHC, we examine what happens to these defendants in traditional court. Findings suggest that 63.7% of defendants' charges were dismissed, 21.0% received probation, and 15.3% were sentenced to incarceration. We examine the time to disposition and differences in defendant characteristics and disposition outcome as well as the relationship between disposition and subsequent recidivism. Results suggest that more severe punishments in traditional court are associated with recidivism. Logistic regression analysis shows that defendants whose charges were dismissed in traditional court were less likely to recidivate than those who were sentenced to probation or incarceration. Our findings highlight the need for future MHC evaluations to consider traditional court outcomes and support trends towards post-adjudication courts. Copyright © 2015 John Wiley & Sons, Ltd.     

Economic Hardship, Neighborhood Context, and Parenting: Prospective Effects on Mexican�CAmerican Adolescent��s Mental Health

This study examined family and neighborhood influences relevant to low-income status to determine how they combine to predict the parenting behaviors of Mexican-American mothers and fathers. The study also examined the role of parenting as a mediator of these contextual influences on adolescent internalizing and externalizing symptoms. Study hypotheses were examined in a diverse sample of Mexican-American families in which 750 mothers and 467 fathers reported on their own levels of parental warmth and harsh parenting. Family economic hardship, neighborhood familism values, and neighborhood risk indicators were all uniquely associated with maternal and paternal warmth, and maternal warmth mediated the effects of these contextual influences on adolescent externalizing symptoms in prospective analyses. Parents' subjective perceptions of neighborhood danger interacted with objective indicators of neighborhood disadvantage to influence maternal and paternal warmth. Neighborhood familism values had unique direct effects on adolescent externalizing symptoms in prospective analyses, after accounting for all other context and parenting effects.     

Parental Migration and Rural Left-Behind Children’s Mental Health in China: A Meta-Analysis Based on Mental Health Test

Parental migration has been an important predictor of left-behind children’s developmental outcomes. Based on the ecological model of rural left-behind children’s development, we systematically reviewed studies related to rural left-behind children’s mental health in China and investigated left-behind children’s mental health and its influencing factors. Thirty-two studies involving 28,629 participants met the inclusion criteria were included in our meta-analysis to compare mental health of left-behind children and non-left-behind children. Twenty-two studies involving 8,634 participants were included in gender difference meta-analysis. The results indicated that left-behind children report more mental health problems than non-left-behind children, left-behind girls were confronted with higher level of mental health problems than left-behind boys, left-behind children in primary school and junior high school reported more mental health problems than those in senior high school, and self-guardian children have more serious mental health problems than children guarded by grandparents, former generation, and single parent. Implications for future practice were analyzed from family, school, and government perspectives.     

Do State Mental Health Plans Address the New Freedom Commission’s Goals for Children’s Mental Health?

The latest initiative to address mental health needs of the nation, including those of children and youth, is the President’s New Freedom Commission on Mental Health (NFC). The NFC formulated a benchmark of six goals and related recommendations toward which the U.S. should strive, including the recommendation that each state develop a comprehensive mental health plan. It is not clear, however, whether the states’ developed plans address the goals established by the NFC and to what degree. This project provides a summary of 50 state mental health plans regarding children and youth in the U.S. by examining components that address each of the six NFC goals and is a test of federal leadership on a state issue. Results indicate that state mental health plans addressed the NFC goals to differing degrees with specific attention to children and youth mental health services. Overall, the NFC goal of eliminating disparities in mental health services was addressed most completely, while the NFC goal of understanding that mental health and physical health are associated was addressed least often. The information provided by this analysis represents a first step in gaining a comprehensive picture about public policies for the mental health of children, adolescents, and their families.     

Higher Order Structure of Personality and Mental Health: Does General Affectivity Matter?

The higher order personality model, namely the Big Two, was tested in 2 studies (Ns = 878 and 467, respectively) by controlling for the effects of both general affectivity and common method variance. Study 2 also examined the associations of the metatraits with different mental health indicators through regression analyses. The results consistently provided support for the validity of the Big Two model in the latent space, with and without the effects of general affectivity and the common method variance. Moreover, in both studies, the high correlation between stability and plasticity decreased when these 2 method effects were controlled statistically. The regression analyses also showed that the associations of plasticity and stability with the indicators of both subjective and psychological well-being, as well as psychopathology, were consistent with the theoretical arguments behind the Big Two.     

A Community Mental Health Implementation of Parent–Child Interaction Therapy (PCIT)

Parent–Child Interaction Therapy (PCIT) has been identified as an evidence-based practice in the treatment of externalizing behavior among preschool-aged youth. Although considerable research has established its efficacy, little is known about the effectiveness of PCIT when delivered in a community mental health setting with underserved youth. The current pilot study investigated an implementation of PCIT with primarily low-socioeconomic status, urban, ethnic minority youth and families. The families of 14 clinically referred children aged 2–7 years and demonstrating externalizing behavior completed PCIT initial assessment, and 12 began treatment. Using standard PCIT completion criteria, 4 families completed treatment; and these families demonstrated clinically significant change on observational and self-report measures of parent behavior, parenting stress, and child functioning. Although treatment dropouts demonstrated more attenuated changes, observational data and parent-reported problems across sessions indicated some improvements with lower doses of intervention. Attendance and adherence data, referral source, barriers to treatment participation, and treatment satisfaction across completers and dropouts are discussed to highlight differences between the current sample and prior PCIT research. The findings suggest that PCIT can be delivered successfully in an underserved community sample when families remain in treatment, but that premature dropout limits treatment effectiveness. The findings suggest potential directions for research to improve uptake of PCIT in a community service setting.     

Rabbis and Health: A Half-Century Review of the Mental and Physical Health Care Literature:1950–1999

Electronic searches were conducted on PubMed and the American Psychological Association's database (PsycINFO) for articles that discussed the role of rabbis in relation to some aspect of healthcare. The two searches were conducted in each electronic database using the search-terms: (1) (rabbi OR rabbinical OR synagogue) OR (2) (Judaism OR Jewish) AND (clergy OR chaplain). Articles were classified by the year of their publication, professional discipline, type of journal (either religious or secular), and type of article: either research, or narrative and expositional. Rabbis were discussed most often in psychology, psychiatry, and behavior-related fields, and close to two-thirds of the articles dealt with mental health concerns. A statistically significant increase in articles across decades was found in the secular journals, r=.98, p≤.01, with over 70% of the articles about rabbis in the secular journals being published between 1980 and 1999. Many of the articles addressed collaboration between rabbis, psychiatrists, and other and mental health professionals and discussed previously identified themes related to professional collaboration and referral.