Some effects of positive life events on community mental health

Measures of positive and negative events were derived from a life-event inventory to test the predictions of an equilibrium model and a positive mental health model of psychological well-being. These measures were related to indicators of individual and community well-being with data obtained through a household survey of 454 residents. Residents who reported more negative events also reported more psychological distress and less positive adjustment. Positive events were associated with reports of positive adjustment. An analysis of census tract scores on life events revealed that the relative absence of positive events in census tracts was associated with higher service utilization rates to the community mental health center serving those tracts. The number of negative events was unrelated to service rates for census tracts but was related to several demographic indicators of well-being.     

Economic predictors of mental health service utilization: A time-series analysis

This research was designed to understand the relationships between economic indicators and mental health service utilization. Six monthly and three quarterly time-series analyses were done to assess the time-dependent association between three state-level economic indices and two measures of mental health service utilization. Consistent with the existing literature, increases in manufacturing employment were inversely related to both first admissions in state hospitals and case openings in community outpatient facilities. Labor force participation was also inversely related to first admissions to state hospitals. No relationship was found between service employment and either of the mental health service use indices. The specific findings suggest that two processes may be operating in the relationship of labor force participation and manufacturing employment with mental health service utilization. Some of the findings suggest a "crisis" process, in which service use increases rapidly following an economic stressor, whereas other findings suggest a more insidious process, in which economic stressors slowly weaken the mental health of the community and eventually lead to increased mental health service use. These results can be used to better inform social policy and preventive interventions by highlighting the human costs of changes in economic well-being. The need for more ecological research is discussed.     

Characteristics of useful evaluation data: An example from community mental health centers

The results of an empirical study of the use of evaluation data in community mental health centers are reported. A mailed survey on evaluation use was conducted among the directors of 164 community mental health centers in 19 states; 140 completed questionnaires were returned. Results indicate that certain types of data have important impacts in a majority of centers. Systems resources management data were most highly used, followed by need assessment data, and client utilization data. Least used were data on outcomes of intervention and community impact. Data use appears closely tied to the utility of the data in carrying out priority management tasks in a center. Findings have important implications for community psychologists who plan, administer, or evaluate mental health services. The broader role of evaluation in community psychology is also discussed.     

Creating a Mentally Healthy Community Through the Use of Behavioral Health Indicators

Recent decades have seen the development of robust systems of community health indicators, but those indicator sets tend to have few indicators related to behavioral health. Gauging community behavioral health can be complex, but given the interconnectedness of health and behavioral health and the high social and financial cost of unaddressed behavioral health needs, it is essential to develop meaningful indicators. A community-based participatory research project in Austin, Texas developed behavioral health indicators based on a review of social indicators movements across the globe, existing sets of proposed key indicators of mental health and mental illness, and ongoing community initiatives in Austin relevant to behavioral health. The community behavioral health indicators have been refined through the challenging process of implementing them in the face of competing efforts and imprecise communication about their use. While indicators should always be adapted to suit local conditions, this indicator set should provide a good starting point for researchers and communities to assess and improve the behavioral health of their community.     

Identification Reduces Stigma of Mental Ill‐Health: A Community‐Based Study

The stigma surrounding mental ill‐health is an important issue that affects likelihood of diagnosis and uptake of services, as those affected may work to avoid exposure, judgment, or any perceived loss in status associated with their mental ill‐health. In this study, we drew upon social identity theory to examine how social group membership might influence the stigma surrounding mental ill‐health. Participants from two urban centers in Ireland (N = 626) completed a survey measuring stigma of mental health, perceived social support as well as identification with two different social groups (community and religion). Mediation analysis showed that subjective identification with religious and community groups led to greater perceived social support and consequently lower perceived stigma of mental ill‐health. Furthermore, findings indicated that high identification with more than one social group can lead to enhanced social resources, and that identification with a religious group was associated with greater community identification. This study thus extends the evidence base of group identification by demonstrating its relationship with stigma of mental ill‐health, while also reinforcing how multiple identities can interact to enhance social resources crucial for well‐being.     

Health and Social Services for Male-to-Female Transgender Persons of Color in San Francisco

SUMMARY

This article presents findings from an investigation of health needs, service utilization, and perceived barriers to services among male-to-female (MtF) transgender persons of color in San Francisco. Focus groups (n = 48) and survey interviews (n = 332) were conducted with convenience samples recruited from the community. Participants reported a range of health and social services needed during the previous year, with African-Americans and Latinas showing particularly strong service needs. Rates of utilizing services were high for basic health care but lower for social services, substance abuse treatment, psychological counseling, and gender transition-related medical services. No significant ethnic group differences in health service utilization were found. Qualitative findings evinced the call for transgender-specific programs and advanced provider training on transgender issues such as hormone use, gender transition, HIV/ AIDS care and prevention, substance abuse, and mental health problems.     

Contextualizing Acculturation: Gender, Family, and Community Reception Influences on Asian Immigrant Mental Health

This article investigates differences in the mental health among male and female immigrants from an ecological perspective, testing the influences of both individual acculturation domains and social contexts. Data from the first nationally representative psychiatric survey of immigrant Asians in the US is used (N = 1,583). These data demonstrate the importance of understanding acculturation domains (e.g., individual differences in English proficiency, ethnic identity, and time in the US), within the social contexts of family, community, and neighborhood. Results demonstrate that among immigrant Asian women, the association between family conflict and mental health problems is stronger for those with higher ethnic identity; among immigrant Asian men, community reception (e.g., everyday discrimination) was more highly associated with increases in mental health symptoms among those with poor English fluency. Findings suggest that both individual domains of acculturation and social context measures contribute to immigrant mental health, and that it is important to consider these relationships within the context of gender.     

Are Collective Efficacy,Disorder and Social Support Associated with One’s Quality of Life? Evidence from the Multilevel SWING Study in Belgium

The current study assesses the evidence for the association between several neighborhood social processes (collective efficacy and social disorder) and two important individual-level quality of life indicators, which are avoidance behaviour and mental health. In addition to these neighborhood characteristics, the study also assesses the impact of an individual’s social support network on these two outcomes. Hypotheses are derived from a theoretical framework that integrates insights from social capital theory, collective efficacy theory and broken windows theory. Hypotheses about both neighborhood- and individual-level effects are tested by applying multilevel analyses to data from the ‘Social capital and Well-being In Neighborhoods in Ghent’ (SWING) survey of 2011, which consists of face-to-face interviews among the adult population in the second largest municipality of Belgium. Results suggest that individuals living in neighborhoods with lower levels of social trust and higher levels of disorder report more avoidance behaviour. Neighborhood effects on mental health are rather negligible. Individuals who experience more social support report both a better mental health and fewer avoidance behaviour.     

The Glory of God is a Human Being Fully Alive: Predictors of Positive Versus Negative Mental Health Among Clergy

Clergy fulfill vital societal functions as meaning makers and community builders. Partly because of their important roles, clergy frequently encounter stressful situations. Further, studies suggest that clergy experience high rates of depression. Despite this, few studies have examined protective factors for clergy that may increase their positive mental health. We invited all United Methodist clergy in North Carolina to participate in a survey. Of church‐serving clergy, 85 percent responded (n = 1,476). Hierarchical multiple regression was used to assess the predictors of three positive and four negative mental health outcomes. The three sets of predictors were: demographics, which explained 2–10 percent of the variances; variables typically related to mental health (social support, social isolation, and financial stress), which explained 14–41 percent of the variances; and clergy‐specific variables, which explained 14–20 percent of the variances, indicating the importance of measuring occupation‐specific variables. Some variables (e.g., congregation demands) significantly related to both positive and negative mental health, whereas others (e.g., positive congregations, congregation support) significantly related primarily to positive mental health. In addition to their intervention implications, these findings support separate consideration for negative versus positive mental health.     

The Ecology of Adolescent Substance Abuse Service Utilization

This paper presents an ecological-community model toward the explanation of variation in patterns of substance abuse (SA) service utilization among adolescents who are enrolled in Tennessee's Medicaid program (TennCare). Guided by a theoretical framework that draws from the social ecology work of Bronfenbrenner and health services utilization models promoted by Aday and Andersen, we apply a social indicators approach toward explaining the impact of community ecology on identification of SA and treatment engagement. Both county-level rates and individual-level treatment utilization are examined and hierarchical linear modeling is incorporated to examine the individual-in-community phenomenon. This study is an expansion of previous service utilization research and suggests that explanations of youth's service utilization must necessarily include not only individual, familial, and service system characteristics, but community factors, as well.     

1996至2016年中国老年人心理健康变迁的横断历史研究

为探究中国老年人心理健康水平随年代的变迁,运用横断历史研究方法对1996至2016年间160篇采用90项症状自评量表（SCL-90）的研究报告进行元分析。研究发现：（1）SCL-90各因子与年代均呈显著正相关,说明我国老年人心理健康水平在逐年下降。（2）SCL-90各因子与3项社会指标（离婚率、死亡率和犯罪率）有显著正相关。（3）不同性别老年人的心理健康水平均呈逐年下降趋势,但心理健康水平得分的性别差异并不显著。（4）城市老年人的心理健康水平呈逐年下降的趋势,而农村老年人的心理健康水平则呈逐年上升趋势。     

1996至2016年中国老年人心理健康变迁的横断历史研究

为探究中国老年人心理健康水平随年代的变迁,运用横断历史研究方法对1996至2016年间160篇采用90项症状自评量表（SCL-90）的研究报告进行元分析。研究发现：（1）SCL-90各因子与年代均呈显著正相关,说明我国老年人心理健康水平在逐年下降。（2）SCL-90各因子与3项社会指标（离婚率、死亡率和犯罪率）有显著正相关。（3）不同性别老年人的心理健康水平均呈逐年下降趋势,但心理健康水平得分的性别差异并不显著。（4）城市老年人的心理健康水平呈逐年下降的趋势,而农村老年人的心理健康水平则呈逐年上升趋势。     

Mental Health and Incarcerated Youth. II: Service Utilization

The incarceration of mentally ill youth is a serious problem not receiving the same attention as in adults. In this study, we examine the level of prior service utilization in incarcerated youth versus youth receiving community mental health services. We randomly recruited youth from middle South Carolina served by a local community mental health center (CMHC; n = 60), hospitalized in the state adolescent inpatient program (n = 50), and incarcerated in the S.C. Dept. of Juvenile Justice facilities (n = 75). We used a Services History to evaluate episodes of prior utilization of mental health, social service, educational, residential, and volunteer services, as well as the DISC-PC 2.3 to evaluate DSM-III-R diagnoses and symptoms and the CBCL and YSR to evaluate behavioral symptomatology. Incarcerated, hospitalized, and CMHC youth utilized similar levels of educational services and social services. Incarcerated youth had a significantly lower lifetime utilization of outpatient and acute mental health services and significantly higher utilization of out-of-home residential services than the other groups. These services utilization variables, along with gender and age, significantly distinguish incarcerated youth from the clinical groups, with clinical variables not serving to significantly distinguish them. Our results indicate the need to develop programs to prevent the entry of mentally ill/emotionally disturbed youth into the juvenile justice system. Youth who are at risk for incarcenation may benefit from intensive mental health services to prevent out-of-home placement and later incarceration.     

A Proposal for a Synthetic Health Indicator in the European Union: an Analysis of Gender Health Inequalities

Health has been measured using different indicators such as self-rated health, mental health, psychological wellbeing, depressive symptoms, limiting longstanding illness or mortality rates, among others. In this framework, this paper aims to create a Synthetic Health Indicator using the P₂ distance method which offers an alternative to measure individuals’ health in the European Union covering different dimensions: physical health, mental health, psychosocial resources, capacity of health services and community health status. As a secondary aim, the paper also explores the existence of gender health inequalities in the 28 European Union countries. Results suggest that physical, mental and psychosocial dimensions of health are more correlated with the Synthetic Health Indicator and also point to the presence of a territorial pattern throughout Europe. Northern and southern European countries had better average levels of health than eastern European countries, which showed poorer levels of health. Moreover, gender health gaps were not generally statistically significant in countries with higher scores in the Synthetic Health Indicator, with some exceptions, namely Spain, Ireland and Finland, although for most of the countries analyzed the differences favored women. Once the outcomes have been explained, the findings suggest that the different health regimes, as well as the family and social policies implemented by various governments as tools to mitigate gender inequalities, play an essential role.

     

Mental Health Utilization Among Diverse Parenting Young Couples

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social–personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor–Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow‐up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse’s influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.     

Physical health and social network characteristics as determinants of mental health across cultures

This study examines cross-cultural differences in the etiology of depression and anxiety, two common indicators of mental health problems. Using an ethnically diverse sample of 162 college students, we found that chronic physical symptoms and social network characteristics, particularly network quality, were predictive of both depression and anxiety, yet their effects were mediated by ethnicity. Multiple regression analyses showed that social network quality, compared to physical health, was a much stronger predictor of mental health in Caucasian students, whereas among students of Asian/Pacific descent, physical health was a much stronger predictor of mental health than the social network characteristics. The observed differences were particularly strong for anxiety, which was not significantly associated with physical health in Caucasian students or social network size and quality in the Asian/Pacific group. Theoretical and clinical implications of the results are discussed.     

Physical health and social network characteristics as determinants of mental health across cultures

This study examines cross-cultural differences in the etiology of depression and anxiety, two common indicators of mental health problems. Using an ethnically diverse sample of 162 college students, we found that chronic physical symptoms and social network characteristics, particularly network quality, were predictive of both depression and anxiety, yet their effects were mediated by ethnicity. Multiple regression analyses showed that social network quality, compared to physical health, was a much stronger predictor of mental health in Caucasian students, whereas among students of Asian/Pacific descent, physical health was a much stronger predictor of mental health than the social network characteristics. The observed differences were particularly strong for anxiety, which was not significantly associated with physical health in Caucasian students or social network size and quality in the Asian/Pacific group. Theoretical and clinical implications of the results are discussed.     

1993至2016年医学生心理健康变迁的横断历史研究

为考察我国医学生心理健康水平随年代的变迁趋势, 运用横断历史研究的方法, 对1993至2016年间181篇采用90项症状自评量表(SCL-90)测量医学生心理健康水平的研究报告(被试为129613名医学生)进行元分析。研究发现：(1)除恐怖因子外, SCL-90其余8个因子均与年代呈显著负相关, 这说明, 我国医学生的心理健康水平在逐年提升。(2)当年和5年前的2个社会指标(卫生总费用和注册医师数)与SCL-90的8个因子均值呈显著负相关, 说明这些社会指标可能是预测医学生心理健康水平的重要因素。(3)与男生相比, 女生心理健康水平的上升趋势更为明显, 但心理健康水平的性别差异并不显著。(4)医学新生心理健康水平的上升趋势要比非新生更明显和全面。     

Factors contributing to the utilization of mental health services in a rural setting

The purpose of this study was to examine if age, attitudes toward help-seeking, education, and sex were related to previous or intended future mental health utilization in a rural population. Data were collected via a mail survey from 438 adults. Regression analyses suggested that positive attitudes toward help-seeking, being female, and being younger were significantly related to both previous and intended future mental health service utilization. In addition, prior mental health use was significantly related to whether one would seek out mental health services in the future, Implications for mental health practitioners in rural settings are addressed, and limitations of the study discussed.     

Effect of Poverty on Mental Health of Children in Rural China: The Mediating Role of Social Capital

Underprivileged children are a relatively special vulnerable group in rural China, but the relationship between poverty and children’s mental health has been rarely examined. This study aimed to investigate the effect of poverty on children’s mental health and the mediating role of social capital in their family, peer, school, and community level. Data used in this study were collected in 2015 from a school-based survey of 1314 children in grades 4–9 through a multi-stage cluster random sampling method in Xiushui, a poverty-stricken city in Mainland China. The result of structural equation modeling indicated that poverty elicited a significant predictive effect on children’s negative and positive mental health. Family social capital and peer social capital played intermediary effects between poverty and children’s mental health. However, the mediating effects of school and community social capital are not significant. The implications of these findings on theory, social policy, and social work services were also discussed.