Chaplaincy and Mental Health Care in Aotearoa New Zealand: An Exploratory Study

This paper summarizes an initial exploratory study undertaken to consider the ministry of New Zealand chaplaincy personnel working within the mental health care context. This qualitative research (a first among New Zealand mental health care chaplains) was not concerned with specific health care institutions per se, but solely about the perspectives of chaplains concerning their professional contribution and issues they experienced when trying to provide pastoral care to patients, families, and clinical staff involved in mental health care. Data from a single focus group indicated that chaplains were fulfilling various WHO-ICD-10AM pastoral interventions as a part of a multidisciplinary and holistic approach to mental health care; however, given a number of frustrations identified by participants, which either impeded or thwarted their professional role as chaplains, a number of improvements were subsequently identified in order to develop the efficiency and effectiveness of chaplaincy and thus maximize the benefits of pastoral care to patients, families, and clinical staff. Some implications of this exploratory study relating to mental health care chaplaincy, ecclesiastical organizations, health care institutions, and government responsibilities and the need for further research are noted.     

Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services

This mixed method study examined factors associated with parents not attending their child’s mental health treatment after initially seeking help for their 2–5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents who initiated mental health treatment (71?% African American or multi-racial; 97.6?% low-income), 36 (29.3?%) never attended their child’s first treatment session. Socio-demographic characteristics, parenting stress, depression, severity of child behavior problems, and length of treatment delay from intake to first scheduled treatment session were compared for families who did and did not attend their first treatment session. Parents who never attended their child’s first treatment session were more likely to live with more than four adults and children (p?=?.007) and have more depressive symptoms (p?=?.003). Median length of treatment delay was 80 days (IQR?=?55) for those who attended and 85 days (IQR?=?67.5) for those who did not attend their child’s first treatment session (p?=?.142). Three themes emerged from caregiver interviews: (a) expectations about the treatment, (b) delays in getting help, and (c) ambivalence about research participation. Findings suggest the need to develop better strategies for addressing risk factors early in the treatment process and reducing the length of time families with adverse psychosocial circumstances must wait for child mental health treatment.     

Psychotherapeutic work at the Maternity and Child Health centers in Stockholm,Sweden

Preventive mental health work has for many years been a cornerstone in child psychiatric work in Sweden. Psykologverksamheten, a program at Psykiska Barn och Ungdomsvarden (PBU), is the out-patient child psychiatry unit in Stockholm County. The aim of the program is to promote infant mental health and to prevent children from becoming future patients at the psychiatric child and adolescent clinics. Located in the residential areas, the Maternal and Child Health (MCH) centers reach almost 100% of infant families and are the platform for the preventive work. The pediatric staff at the MCH centers have been encouraged to apply a psycho-social working model in which not only the pediatric but also the psychological needs of the families are considered. In regular case-consultations child psychologist have offered training and support to the medical staff. This has been bases on the theoretical assumption that if the MCH staff are better equipped in dealing with mental health issues, the support they give to infant families will improve and the referrals to the psychologist at the Psykologverksamheten will decrease. However, through the working alliance established between the MCH staff and the psychologist, the latter has become a professional “secure base,” making the MCH staff more sensitive and observant than earlier. Because the Swedish welfare system is at present undergoing changes due to Government economic restraints, the stress put on families has increased. The referrals to the psychologists have almost doubled. The paper discusses the qualitative development of the relationship between the Psykologverksamheten and the MCH staff, and, with reference to a clinical vignette, discusses the importance of not only supporting general preventive work but also of specifying early dyadic therapeutic interventions. © 1998 Michigan Association for Infant Mental Health     

Factors Impacting the Mental Health of the Caregivers of Children with Asthma in China: Effects of Family Socioeconomic Status,Symptoms Control,Proneness to Shame,and Family Functioning

Caregiver mental health is widely considered to be an important factor influencing children's asthma symptoms. The present study aimed to examine key factors that contribute to caregiver mental health in pediatric asthma with a Chinese sample. Two hundred participants reported their family socioeconomic status (SES), proneness to shame, asthma symptoms control of their child, family functioning, and their depression and anxiety symptoms. Results suggested that low family SES, low family functioning, and a high level of shame proneness were associated with high levels of anxiety and depression for caregivers. Family functioning mediated the effects of SES and shame on caregiver mental health and also moderated the effects of SES and shame on caregiver depression. This study highlights the importance of reducing experience of shame and enhancing family functioning in families affected by pediatric asthma.     

Young and Poor: The Well-Being of Adolescent Girls Living in Families Receiving Temporary Assistance for Needy Families Program

We present our findings on the current well-being of 125 adolescent girls living in families receiving Temporary Assistance for Needy Families Program (TANF) in terms of their health, mental health, and substance abuse status, academic performance, and teenage behaviors. This mixed-method study included separate structured face-to-face interviews with each adolescent and her mother. In addition, 20 daughters were randomly selected and completed more in-depth qualitative interviews. The findings suggest that generally the daughters were in good physical health although they reported mental health problems at about twice the rate that would be expected in a general pediatric sample. Further, about 3–5% of the daughters had a potential serious substance abuse problem. With respect to school, about 28% were not currently attending school although the majority of daughters who were attending school maintained a B average or better. Nearly two-thirds of the daughters reported being sexually active and almost 17% of the adolescents had children of their own, much higher than the 2.9% national rate of girls in this age cohort. While many of these daughters life circumstances may not be optimal, findings from both the quantitative and qualitative interviews with both mothers and daughters indicate that these daughters possess many strengths, abilities, and desires.     

2010~2020中国内地大学生心理健康问题检出率的元分析

估计我国大学生心理健康问题的检出率, 能够为心理健康政策完善和教育活动开展提供证据支持。对2010~2020年我国大学生主要心理健康问题检出率及影响因素进行元分析, 结果表明, 睡眠问题、抑郁、自我伤害在大学生中较为突出; 近10年, 大学生焦虑、抑郁、睡眠问题和自杀未遂的检出率显著上升, 自我伤害的检出率显著下降; 测量工具、检出标准和检出时间是导致检出率大小不一的关键因素; 整体而言, 东北和中部地区大学生的心理健康情况优于西部和东部大学生; 性别、生源地、独生与否对大学生心理健康问题检出率的影响均不显著。未来应重视研制适合我国大学生的心理健康测评工具并确定检出标准, 同时据此积极开展心理行为问题的筛查与控制。     

2010~2020中国内地高中生心理健康问题检出率的元分析

我国高中生心理健康问题的检出率亟需关注, 许多研究对此进行了探究, 但结果并不一致。为明确近10年来我国高中生心理健康问题的检出状况及其影响因素, 对检索后获得的252项研究进行了元分析。结果发现: 检出率由高到低依次是抑郁(28.0%)、焦虑(26.3%)、睡眠问题(23.0%)、自我伤害(22.8%)、自杀意念(17.1%)、躯体化(9.8%)、自杀计划(6.9%)、自杀企图(未遂) (2.9%)。我国高中生心理健康问题检出率受出版年代、测量工具、检出标准、检出时间、年级和区域影响。未来应着力编制标准化测评工具、构建心理健康教育长效机制并对高年级、欠发达地区高中生的心理健康问题予以重点关注。     

Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors.

Childhood cancer patients have a greater likelihood of long-term survival than ever before. This study examined both the perceived family functioning of adolescents who had successfully completed treatment for pediatric cancer and the relationship between family functioning and post-treatment adjustment. Eighty-eight adolescent survivors of hematologic malignancies were assessed regarding their family functioning, mental health, self-esteem, global competence, and problem behaviors. Contrary to expectations about the influence of cancer on these families, adolescent cancer survivors reported lower levels of family cohesion than the normative sample of healthy adolescents and their families. While current age, gender, age at diagnosis, and time since treatment completion were generally not associated with adolescents' adjustment, perceived family cohesion and adaptability were strongly related to post-treatment psychological adjustment.     

Maternal-Related Predictors of Self-Regulation Among Low-Income Youth

The association between self-regulation and various adaptive outcomes has become a topic of growing interest to researchers. Yet, there is not much research on predictors of self-regulation in children. Using a cross-sectional design and an array of psychometrically sound scales and measures from multiple informants, this study examined whether maternal characteristics, namely maternal mental health, substance abuse, parenting practices, and child monitoring predicted self-regulation in children. Participants included a culturally diverse group of 155 youths (ages 8–17) and their mothers, all of whom were part of a larger investigation of low-income families in a mid-sized Northeastern city in the United States. Results showed that maternal substance abuse, parenting practices and parental monitoring independently predicted children’s self-regulation, accounting for 23% of the variance. Additional analyses indicated that parenting practices may partly mediate the effect of maternal mental health on children’s self-regulation. Implications for intervention and practice, especially those aimed to mitigate the detrimental effects of maternal mental health problems on children’s self-regulation, are discussed. Further research, both longitudinal and experimental, is warranted in order to extend this line of investigation.     

Relationships among parental reports of child, parent, and family functioning.

Most children with psychosocial problems do not present for treatment in mental health settings. They are managed by primary care physicians. Children with psychosocial problems often have parents and/or families with psychosocial distress. The present study measured associations between parental reports of child, parent, and family functioning in individuals in the general population. Participants were 226 parents of children, aged 2-16 years, who presented for routine primary care. Parents reported on the psychosocial functioning of themselves, their child, and their family. All correlations of measures were significant, ranging from .55 to .23. Similar to data from psychiatric samples, the psychological functioning of children, parents, and families were significantly correlated. Unlike in psychiatric settings, child mental health problems were not as closely related to parent or family distress as parent and family distress were related to each other and to child behavior problems.     

Family characteristics as mediators of the influence of problem drinking and multiple risk status on child mental health

Structural equation modeling was used to test a theoretical model in which family cohesion and family reframing coping were hypothesized as mediators between family drinking problems, multiple risk factors, negative life events, and child mental health (conduct disorder, depression, anxiety) in two-parent families. Family cohesion mediated the relationships of family drinking problems and negative life events to child conduct disorder and depression. Negative life events mediated the relationships of family drinking problems and family multiple risk to child conduct disorder. Family reframing coping did not function as a mediator nor was it related to child mental health when other factors were considered simultaneously. Results indicate that increasing family cohesion and reducing sources of stress within the family (negative life events) represent promising areas for interventions for children with problem-drinking parents. Work on this study was funded in part by the National Institute for Mental Health Grant 2-P50-MH39246-06 to support a Preventive Intervention Research Center. The authors gratefully acknowledge contributions made by Rita Shell, Marcia Michaels, Joanne Gersten, George Knight, and Carolyn Berg.     

Integrating Narrative Family Therapy in an Outdoor Behavioral Healthcare Program: A Case Study

Adolescent mental health is a significant societal concern in the United States. Diagnosable mental health disorders have been reported at rates of 10–20 % among children and adolescents and this does not include adolescents experiencing personal and interpersonal distress not meeting diagnostic criteria. Adolescents who do not respond to traditional mental health services are often placed in residential treatment centers or other out-of-home treatment programs. Outdoor Behavioral Healthcare (OBH) is growing as a viable treatment option for adolescents who struggle with emotional, behavioral or substance related problems; however, questions have been raised about how to integrate the family into an OBH treatment setting. This article describes a case study illustrating how techniques from Narrative Family Therapy can be used to accomplish this integration, and offers a view of using Narrative Family Therapy to further involve families in the treatment and post-treatment process in an OBH program.     

学校心理健康教育教师胜任特征结构及测量

摘要 本研究旨在分析我国学校心理健康教育教师胜任特征结构并编制适合我国学校心理健康教育教师胜任特征测量问卷。在文献分析基础上,通过开放式问卷,行为事件访谈,确立了学校心理健康教育教师胜任特征理论结构。采用项目分析、探索性和验证性因素分析对860名学校心理健康教育教师进行施测,形成了《学校心理健康教育教师胜任特征问卷》。该问卷共57个题项,包含专业知识、普通文化知识、宜人性、尽责性、职业价值观、学生观、评估反思能力、协作沟通能力、专业发展能力9个维度,编制的我国学校心理健康教育教师胜任特征问卷信效度良好,适合用来分析我国学校心理健康教育教师胜任特征状况。     

Interparental conflict and adolescent emotional security across family structures

This study investigated whether interparental conflict was differentially related to forms of emotional security (i.e., family, interparental, parent–child) and whether forms of emotional security were differentially associated with mental health problems for adolescents in married versus divorced/separated families. Participants were 1032 adolescents (ages 10–15; 51% male, 49% female; 82% non-Hispanic White, 9% Black/African American, 5% Hispanic, 2% Asian or Pacific Islander, 2% Native American) recruited from a public school in a middle-class suburb of a United States metropolitan area. We used multiple group multivariate path analysis to assess (1) associations between interparental conflict and multiple measures of emotional insecurity (i.e., family, interparental, and parent–child), (2) associations between measures of emotional insecurity and internalizing and externalizing problems, and (3) moderation effects of parent–child relationships. The patterns of association were similar across family structures. A high-quality parent–child relationship did not mitigate the harmful effects of interparental conflict on emotional insecurity or mental health problems. Findings suggest that regardless of family structure, emotional security across multiple family systems may be a critical target for intervention to prevent youth mental health problems, in addition to interventions that reduce conflict and improve parent–child relationships.     

The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

中国军人心理健康状况的横断历史研究：1990~2007

使用1990~2007年18年间的142组数据, 以横断历史研究的元分析方法, 研究了108736位中国军人的心理健康状况随年代的变化趋势。这些数据来自94篇相关研究报告, 这些研究都使用了90项症状自评量表(SCL-90)作为心理健康的测评工具。结果发现：(1)世纪之交的18年间, 中国军人的心理健康越来越好; (2)18年间, 中国军人在“人际敏感”方面变化最大, 而在“躯体化”方面变化最小; (3)18年间, 中国军人在“恐怖”方面最没问题, 而在“强迫症状”和“人际敏感”方面所表现出的问题一直突出; (4)中国独生子女军人(N = 1944)的心理健康状况低于非独生子女军人(N = 2649); (5)中国城市籍军人(N = 7808)的心理健康状况低于农村籍军人(N = 11459); (6)中国高中学历军人(N = 10189)的心理健康状况低于初中(N = 8407)和大学学历(N = 863)的军人。     

The Starting Early Starting Smart Integrated Services Model: Improving Access to Behavioral Health Services in the Pediatric Health Care Setting for At-Risk Families with Young Children

We evaluated the Starting Early Starting Smart (SESS) national initiative to integrate behavioral health services (parenting, mental health, and drug treatment) into the pediatric health care setting for families with young children. Data are presented from five pediatric care (PC) sites, drawing from families at risk due to demographic and behavioral health factors, with infants less than 12 months of age (n = 612). Families were randomly assigned to either the SESS program or a standard care Comparison group. We utilized longitudinal analyses to estimate differences in utilization rates for parenting, mental health, and drug treatment over 6 follow-up time points (3, 6, 9, 12, 15 and 18 months). Our findings indicate that SESS caregiver participants were 4.6 times (p < 0.001; CI = 3.33–6.26) more likely to receive parenting services, 2.1 times (p < 0.001; CI = 1.48–2.86) more likely to receive outpatient mental health treatment, and 1.8 times (p = 0.025; CI = 1.08–3.14) more likely to receive drug treatment than Comparison group participants. Our results demonstrate the success of the SESS program in coordinating and improving access to behavioral health services for high-risk caregivers within the pediatric health care setting and highlight the importance of continuing to focus public health policy on the behavioral health care needs of families with young children.     

Parents' Sense of "Entitlement" in Adoptive and Nonadoptive Families

The literature suggests that problems with developing a sense of entitlement are unique to adoptive families, but this assumption has not been examined empirically. In this study, a questionnaire was constructed to define operationally those characteristics associated with the construct of entitlement, and was administered to adoptive and nonadoptive families with children averaging 11.5 years in age who presented either for mental health service or were recruited as a comparison-control sample. Factor analysis yielded four factors on which the four groups of subjects were compared. Results indicated that problems with entitlement are not specific to adoptive families. Instead, differences in sense of entitlement occurred primarily between clinic and nonclinic control families, regardless of whether the target child had been adopted. Findings are discussed in terms of methodological shortcomings in the adoption research literature and how problems in entitlement may be associated with other family characteristics.     

Prevalence of mental health problems in Australian university health services

General practice patients report greater mental health problems than the general population, and students attending one university health service have reported greater prevalence rates at the end of the academic year. This study assessed the overall prevalence rate of mental health problems in university students using a cross‐sectional survey design of 1,168 students from three large, predominantly urban, Australian university health services. Approximately half of the students attending university health services reported elevated levels of psychological distress. The majority of severely distressed students had not sought any professional assistance for mental health problems. While there is scope for general practitioners to take a lead role in the identification of mental health problems in tertiary students, adequate treatment pathways need to be available. Implications for the role of universities in prevention work are discussed.