Mental Health Services in Juvenile Correctional Facilities: A National Survey of Clinical Staff

This study determined the use of best practices in providing mental health services to youth within juvenile correctional facilities. A national sample of 94 (49.7 %) lead clinical staff from all available and qualifying facilities responded to a mail and on-line survey. There were no statistically significant differences across respondents versus nonrespondents for security level, gender served, or census region of facilities. Specifically, we examined the provision of facility-wide mental health programming, individual, group, and family counseling, and case management services. Examination of these services included the use of evidence-based interventions provided through an established curriculum and methods used to evaluate the effectiveness of the interventions. We also examined staff involvement, and the perceived quality of services and barriers to providing interventions. Participants reported using a variety of evidence-based interventions; however, participants also acknowledged using other approaches that may not have empirical support. Additionally, although at least half of the participants reported mandatory individual and group counseling, less than a third of the participants reported that their facilities required family counseling. Clinical staff also reported a variety of methods used for evaluating the effectiveness of mental health services. Additional findings, as well as implications for research and practice, are discussed.     

Effects of diversion on adults with co-occurring mental illness and substance use: outcomes from a national multi-site study

This quasi-experimental non-equivalent comparison group study examines outcomes for participants in eight programs conducting criminal justice diversion for people with co-occurring serious mental illness and substance use disorders compared with jail detainees eligible for diversion, but who were processed through standard criminal justice methods without diversion. Nearly 2000 participants were interviewed at baseline, and 1500 at 3 month and 1300 at 12 month follow-up to baseline. In these interviews, outcome measures of re-arrest, mental health functioning, substance abuse, quality of life, and service utilization were obtained. Those diverted were more likely to have received mental health counseling, mental health medication, and mental health hospitalization than those not enrolled in a diversion program, but were equally likely to have received substance abuse counseling. Overall, the differences in proportions receiving services between the two groups were small, even when these differences were statistically significant. The effect associated with diversion differed somewhat across the individual sites. However, overall cross-site pooled analyses revealed no outcome differences between groups on measures of mental health symptoms, substance use, criminal justice recidivism, or quality of life. Although the immediate benefit of diversion as an access mechanism to community treatment is indicated in pooled cross-site results, such access was driven by more coercive (pre-booking and court) models and results suggest that effecting substantially greater access to services or services use did not occur. The findings also suggest that mental health, substance abuse, and criminal justice outcomes remain dependent on the treatment intervention received, perhaps moderated by type of diversion intervention, rather than on a generic and initial diversion event.     

The Use of Mental Health Services Among Victims of Partner Violence on College Campuses

The present study investigated the relationship between past victimization of different types of intimate partner violence (IPV; physical, psychological, and sexual) and the likelihood of using mental health services. Results indicate 86% of participants reported experiencing some form of IPV, but only 16% of those victims used mental health services to address emotional problems. The participants reported embarrassment, expense, ineffectiveness, and social stigma as the most prominent barriers to seeking help from a mental health professional. The study also found that participants who experienced physical and psychological IPV, but not sexual IPV, reported using mental health services. Sexual IPV may elicit different barriers in help-seeking behaviors. Implications for college IPV prevention programs and mental health services are discussed.     

Perceptions of South Florida Hispanic and Anglo Catholics: From Whom Would They Seek Help?

Hispanic and Anglo Catholics in South Florida who attended Sunday services (N = 473) were surveyed to determine their help-seeking preferences for moral concerns, mental disorders, and practical life/family problems. Respondents were asked to indicate whether they would seek help from a priest; a priest with a degree and license in one of the helping professions (clinical social work, psychology, psychiatry, or mental health counseling); a layperson with a degree and license in one of the helping professions (clinical social work, psychology, psychiatry, or mental health counseling); or if they believed they could deal with the situation without external assistance. The findings suggest that Anglo Catholics prefer assistance from a person who was credentialed in one of the helping professions, whereas Hispanic Catholics would seek help from a priest with or without a background in the helping professions.     

Adolescents' perceptions of outpatient mental health services

Thirty-three adolescents from three mental health service settings were interviewed regarding their perceptions of the purpose, goals, expectations, frustrations and benefits of mental health experiences. They provided satisfaction ratings and importance rankings of seven domains of satisfaction: (a) Convenient/Accessible, (b) Meeting Needs, (c) Staff Competence, (d) Personal Relationship with Staff, (e) Effectiveness of Treatment, (f) Comfort/Appropriateness of Center, and (g) Costs and Paperwork. In addition, participants completed the Client Satisfaction Questionnaire (CSQ-8). Results indicated that, in general, the adolescents were very satisfied with the services they received. Gender, race/ethnicity and treatment site were not related to satisfaction scores, nor was the adolescent's perceived choice in seeking services. Some significant gender differences were found both in terms of the rankings of satisfaction domains, as well as in the adolescents' perceptions of their reasons for initiating counseling and the perceived goals and benefits of counseling. Additional differences in perceptions of services were found for treatment site and race/ethnicity. In general, adolescents were able to generate informative, sophisticated responses to questions regarding their perceptions of mental health services, and demonstrated that they are capable of evaluating services they receive.     

Psychological Care Provided by the Church: Perceptions of Christian Church Members

Spirituality and religion are integral parts of a person's belief system and support network. Although there are many avenues a person can take when seeking mental health care, conservative Protestant clients have a tendency to seek assistance through their church. There is a paucity of literature about conservative Protestant church members’ perceptions of mental health care. The authors used phenomenology to understand participants’ perceptions of mental health care provided by the church. Themes found within participants’ stories included the importance of the relationship when seeking care, the use of knowledgeable practitioners, and the use of religious practices in counseling.     

Predictors of Recent Mental Health Service Use in a Medical Population: Implications for Integrated Care

This study investigated the relationship between physical and mental health and psychosocial variables and recent (within the last 12 months) mental health service use among 240 medical patients recruited from general and specialty outpatient clinics at an academic medical center. Results indicated 43.3% of the participants had recently received mental health services in the form of psychotropic medication (75%), psychotherapy (2%), or a combination of these treatments (20.2%). Among patients with moderate to severe symptoms of anxiety or depression, approximately two-thirds were receiving mental health treatment. Moreover, four variables (healthcare provider referral for mental health services, perceived need for mental health services, prior use of mental health services, and frequency of medical appointments) were significant unique predictors of recent mental health service use. This suggests collaborative/integrated medical care may increase needed mental health service use.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

What Young People Want: A Qualitative Study of Adolescents’ Priorities for Engagement Across Psychological Services

This article examined commonalities in adolescents’ priorities for engagement with psychological support in the context of contemporary youth culture in New Zealand. These were explored across a range of different services including a face-to-face hospital-based mental health service, a face-to-face school-based counseling service, a telephone counseling service and a new form of counseling using mobile phone text. Interviews were conducted with 63 young people aged 13–18 who had used at least one of these services. A thematic analysis identified that there were common priorities for participants across the different services including their need to keep control; not to have their parents involved; to have a relationship with a counselor which was more like a friendship than a professional relationship; to talk freely and be listened to; and to have the service be accessible and flexible enough to fit around their lives. Text and telephone counseling were seen to be particularly appropriate for meeting some of these needs. Professionals working with young people should consider offering a suite of options for psychological support, allowing young people to balance their different needs and priorities and thus facilitate their engagement.     

CAUCASIAN LESBIANS' USE OF PSYCHOTHERAPY: A Matter of Attitude?

Evidence suggests that a high proportion of lesbians seek psychological counseling. This study represents an empirical investigation of the disproportionate use of mental health services by lesbians, focusing on the hypothesis that lesbians place a greater value on psychotherapy than do nonlesbian women. Participants (100 lesbians and 309 nonlesbian women, 97% Caucasian) completed Surgenor's revision of the Attitudes Toward Seeking Professional Psychological Help Scale. Results indicate that the lesbian group had a significantly more positive attitude toward seeking psychological counseling than did the nonlesbian sample, regardless of whether or not they had experienced psychological counseling.     

addressing career issues online: perceptions of counselor education professionals

The Internet is the latest arena in which counseling services are available for a variety of issues. This study surveyed counselor education professionals about their perceptions regarding the use of online counseling to address various mental health issues including career counseling. It also examined their perceptions about 3 formats of online counseling: e‐mail, text‐based chat, and videoconferencing. Results indicated that counselor education professionals were open to the use of online counseling to address career issues. The implications for the practice of online career counseling and for the training of counselors are discussed.     

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.     

Mental health of lesbian, gay, bisexual, and heterosexual siblings: effects of gender, sexual orientation, and family

Self-identified lesbian, gay male, and bisexual (LGB) individuals were recruited via convenience sampling, and they in turn recruited their siblings (79% heterosexual, 19% LGB). The resulting sample of 533 heterosexual, 558 lesbian or gay male, and 163 bisexual participants was compared on mental health variables and their use of mental health services. Multilevel modeling analyses revealed that sexual orientation predicted suicidal ideation, suicide attempts, self-injurious behavior, use of psychotherapy, and use of psychiatric medications over and above the effects of family adjustment. Sexual orientation was unrelated to current psychological distress, psychiatric hospitalizations, and self-esteem. This is the 1st study to model family effects on the mental health of LGB participants and their siblings.     

Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help‐Seeking Among East Asian Immigrants to North America

Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro‐Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help‐seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help‐seeking and use of services. This paper reviews the literature on help‐seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified.     

Evidence for Relationships Between Hope,Resilience, and Mental Health Among Youth

Predictive modeling was used to evaluate the associations between hope, resilience, happiness, and mental health in 449 middle and high school students. Model results indicated large effect sizes for middle school (R² = .28) and high school (R² = .36) participants, with hope and resilience tending to predict self‐reported mental health symptoms. These findings and their application to counseling practice are explained.     

Revisiting relationships between sex-related variables and continuation in counseling

This study examined the relationships between three sex-related variables (client sex, therapist sex, and dyad matching on sex) and continuation in counseling. 245 college students who were clients at three university counseling centers participated. Consistent with previous studies, women comprised 68.2% of the clients seeking services at these counseling centers. Clients' sex was significantly related to counseling duration, explaining 2.2% of the common variance. Female clients, on the average, attended 1.8 more sessions than male clients. However, neither the therapists' sex nor dyad matching on sex was significantly related to the duration of counseling. None of the sex-related variables correlated with premature termination of counseling. The results have implications for providing counseling and outreach services to male students. Despite relatively equivalent rates in the incidence of mental health problems, female students continue to comprise the majority of clients. Therefore, university counseling centers need to communicate their services better to male students in need of mental health services.     

Serving Clients With Hearing Loss: Best Practices in Mental Health Counseling

This article examines the risk factors and characteristics of clients with hearing loss, including inequitable access to education and mental health care services, financial barriers, communication problems, and societal discrimination. Culturally specific counseling approaches and techniques for mental health counselors serving clients with hearing loss are presented, with a focus on building counselor competency and client employment skills. The use of interpreters in therapeutic settings is also discussed.     

Play Therapy in a Natural Setting: A Case Example

Play therapy is commonly used when working with children in counseling. Play therapists work at a developmentally appropriate level to assist children with a variety of mental health and behavioral concerns. Traditionally, play therapy and many counseling methods occur in office settings. We propose that play therapists and other mental health professionals working with children integrate nature and natural settings into their work. The use of nature has been shown to be effective in helping people cope with mental health and physical ailments. In this article, we explore the benefits of the use of nature in mental health and provide a case example of the use of nature and natural settings in counseling.     

The Representation of Left-Right Orientation: A Dissociation Between Imagery and Perceptual Recognition

Eight experiments were conducted to determine whether visual mental imagery preserves left-right orientation in conditions where recognition memory apparently does not. Such a dissociation would suggest that information in memory preserves left-right orientation, but the process that matches input to such representations does not respect this distinction. In the experiments reported here, participants were asked to use one of two methods to indicate which way Abraham Lincoln faces on a US penny: Either they selected the correct profile from two sketches, or they formed a mental image and then specified the direction. If participants had just viewed pennies and were asked to visualize a particular one, they performed far better than chance; in contrast, if imagery was discouraged, they performed poorly when recognizing the profiles perceptually. However, unless actively discouraged from doing so, most participants reported spontaneously visualizing pennies prior to perceptual recognition if they had recently seen pennies.     

Culture, trauma, and wellness: a comparison of heterosexual and lesbian, gay, bisexual, and two-spirit native americans

In a community-based sample of urban American Indian and Alaska Native adults, 25 lesbian, gay, bisexual, and two-spirit participants were compared with 154 heterosexual participants with respect to sociodemographic characteristics, Native, cultural participation, trauma, physical and mental health, and substance use. Compared with their heterosexual counterparts, two-spirit participants reported higher rates of childhood physical abuse and more historical trauma in their families, higher levels of psychological symptoms, and more mental health service utilization. Two-spirit participants reported differences in patterns of alcohol use and were more likely to have used illicit drugs other than marijuana. Discussion and recommendations for health promotion interventions and future research are presented in consideration of an "indigenist" health model and the multiple minority status of two-spirit people.