Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship between illness disclosure and mental health among an ethnically‐diverse group of women with HIV/AIDS. In the first, and commonly accepted model, illness disclosure predicts enhanced mental health status. In the second or alternate model, based on the stigmatization that accompanies HIV/AIDS infection, illness disclosure predicts poorer mental health. We also explore an alternate interpretation for this second model, namely that the mental health status of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed during the baseline visit for a comprehensive longitudinal study. Results showed that these women constituted a highly‐disclosed population; over one‐third of them had disclosed their HIV status to their entire social networks. Contrary to expectation, disclosure was unrelated to mental health among the African‐American (n = 72) and European‐American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher levels of depression, psychological distress, and reported pain. Regression analyses controlling for age, education, and illness severity showed that disclosure makes a small but independent contribution to the prediction of mental health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wider disclosure. General patterns of disclosure are described and possible explanations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright © 2000 John Wiley & Sons, Ltd.     

Non-binary and binary transgender youth: Comparison of mental health,self-harm,suicidality, substance use and victimization experiences

ABSTRACT

?Background: Little research has compared the mental health and victimization experiences of non-binary youth depending on their sex assigned at birth (SAAB), or compared these two groups with binary transgender youth.

Aims: To compare mental health, self-harm and suicidality, substance use and victimization experiences between non-binary and binary transgender young adults, both male assigned at birth (MAAB) and female assigned at birth (FAAB).

Methods: Online survey data from 677 participants from the “Youth Chances” community study of 16 to 25 year olds in the United Kingdom was analyzed, comparing across binary participants (transgender females (n = 105) and transgender males (n = 210)) and non-binary participants (MAAB (n = 93) and FAAB (n = 269)).

Results: Female SAAB participants (binary and non-binary) were more likely to report a current mental health condition and history of self-harm than male SAAB participants (binary and non-binary). Similarly, female SAAB participants (binary and non-binary) were more likely to report childhood sexual abuse than male SAAB participants (binary and non-binary); the reverse pattern was found for lifetime physical assault relating to being LGBTQ. Non-binary MAAB participants were less likely than the other groups to report past suicide attempts and previous help-seeking for depression/anxiety. Binary participants reported lower life satisfaction than non-binary participants. For all four groups, mental health problems, self-harm, suicidality, alcohol use and victimization experiences were generally higher than that of youth in general population studies.

Conclusions: These findings highlight the importance of considering both non-binary versus binary gender identity and SAAB in relation to mental health problems, self-harm, suicidality and substance use in transgender youth. The roles of sexual abuse, other abuse and discrimination in contributing to increased rates of mental illness and self-harm in non-binary and binary transgender individuals, particularly those who were assigned female at birth, relative to those assigned male, require investigation.     

Well-being and Need for Support of Adolescents with a Chronically Ill Family Member

This study investigates whether there are differences in the well-being, need for help and use of support services between adolescents with and without a chronically ill or disabled family member. It also examines the role played by the type of illness, the relationship to the family member and the nature and intensity of the help provided by the adolescent. A Dutch sample of 1581 adolescents (average age 14.6?years) completed a questionnaire in 2010 about mental health problems, pro-social behavior, need for and use of support and the illness of family members and any care tasks performed by the respondent. Young people with a sick family member had more mental health problems than their counterparts without a chronically ill family member. They also reported a greater need for and use of help and support. Performing domestic tasks was found to be a predictor for overall mental health problems. The intensity of the help given was related to the need for help by the adolescent. It is concluded that growing up with a chronically ill family member and spending a lot time performing (domestic) tasks are risk factors for adolescent mental health problems and adolescents’ need for help. Special attention is warranted for those who need support but who do not translate that need into reality by seeking help.     

Factors Associated with Achieving Complete Mental Health among Individuals with Lifetime Suicidal Ideation

The objective of this study was to identify factors associated with complete mental health among Canadians who had ever seriously considered suicide. Data for this study were obtained from Statistics Canada's 2012 Canadian Community Health Survey–Mental Health (N = 2,844). The outcome variable examined in this study was complete mental health and was analyzed using binary logistic regression. Of the 2,844 respondents with lifetime suicidal ideation, 1,088 (38.2%) had complete mental health (i.e., had flourishing mental health, no mental illness, and no suicidal ideation in the past 12 months). Those who had a confidant were seven times more likely to have complete mental health. Other factors associated with achieving complete mental health among formerly suicidal respondents include being older, being a woman, having higher income, use of religious coping, and never previously having a mental illness. Considering the importance of these protective factors in formulating public health policies will allow for a more wide‐reaching approach to suicide prevention.     

Violent offenses associated with co‐occurring substance use and mental health problems: Evidence from CJDATS

The present study examines the relationship between substance use, mental health problems, and violence in a sample of offenders released from prison and referred to substance abuse treatment programs. Data from 34 sites (n = 1,349) in a federally funded cooperative, the Criminal Justice Drug Abuse Treatment Studies (CJDATS), were analyzed. Among parolees referred to substance abuse treatment, self‐reports for the six‐month period before the arrest resulting in their incarceration revealed frequent problems with both substance use and mental health. For most offenders with substance use problems, the quantity of alcohol consumed and the frequency of drug use were associated with a greater probability of self‐reported violence. Mental health problems were not indicative of increases in violent behavior, with the exception of antisocial personality problems, which were associated with violence. The paper emphasizes the importance of providing substance abuse treatment in relation to violent behavior among offenders with mental health problems being discharged to the community. Copyright © 2009 John Wiley & Sons, Ltd.     

Use of mental health services among severely emotionally disturbed children and adolescents in San Francisco

This study examined the mental health services available to severely emotionally disturbed children and adolescents in San Francisco. Social, familial, developmental, and clinical data—as well as service use histories—on 192 youths were collected. Results indicated high levels of family dysfunction, physical and sexual abuse, and neglect in the total study population. The study also identified case history and demographic factors that were associated with repeated psychiatric inpatient hospitalizationand high annual rates of change in residential placement. These factors included being male, older, non-English-speaking, and having a history of physical and sexual abuse. The impact of the service system on the lives and course of illness of these youth is discussed and future directions for research are suggested.     

Race-Related Differences in the Experiences of Family Members of Persons with Mental Illness Participating in the NAMI Family to Family Education Program

Families play an important role in the lives of individuals with mental illness. Coping with the strain of shifting roles and multiple challenges of caregiving can have a huge impact. Limited information exists regarding race-related differences in families’ caregiving experiences, their abilities to cope with the mental illness of a loved one, or their interactions with mental health service systems. This study examined race-related differences in the experiences of adults seeking to participate in the National Alliance on Mental Illness Family-to-Family Education Program due to mental illness of a loved one. Participants were 293 White and 107 African American family members who completed measures of problem- and emotion-focused coping, knowledge about mental illness, subjective illness burden, psychological distress, and family functioning. Multiple regression analyses were used to determine race-related differences. African American caregivers reported higher levels of negative caregiving experiences, less knowledge of mental illness, and higher levels of both problem-solving coping and emotion-focused coping, than White caregivers. Mental health programs serving African American families should consider targeting specific strategies to address caregiving challenges, support their use of existing coping mechanisms and support networks, and increase their knowledge of mental illness.     

Collaborative competence,social capital,and mental health: A cross‐sectional analysis of a community‐based intervention for older adults

Social capital interventions for the mental health of older adults have been inconclusive to date, and have rarely investigated the psychological resources that are important to having social capital. This study focused on the “Neighborhoods in Solidarity” (NS), which are a series of Swiss community‐based interventions that aim to empower older adults to participate in their communities. Our goal was to understand whether the NS were associated with collaborative competence, social capital, and subsequently, symptoms of depression. Cross‐sectional data were collected from 947 individuals aged 55 and over (M_age = 68.66, SD = 9.04) in 10 Swiss neighbourhoods (five with the NS [n = 479] and five control neighbourhoods [n = 468]). Structural equation modelling was used to model the relationship between the NS intervention, collaborative competence, cognitive and structural dimensions of social capital, and symptoms of depression (measured by the CESD‐R‐10). Individual participation in the NS had total and indirect effects on symptoms of depression via collaborative competence and both social capitals. These findings suggest that existing community‐based interventions can be indirectly associated with better mental health outcomes in the ageing population.     

Managing a stigmatized identity—evidence from a longitudinal analysis about people with mental illness

Previous research about coping with the stigma of mental illness mostly relied on cross‐sectional or qualitative research designs. In the present study, the consequences of ten identity management strategies for mental illness stigma were observed in a longitudinal design. Cross‐lagged analyses were used to describe the influence of the strategies on the frequency of stigma experiences and on mental health in a two‐wave panel of people with mental illness (n = 367, 79% repeated response rate). Selective disclosure and information seeking emerged as adaptive identity management strategies, whereas overcompensation and withdrawal led to lower mental health. Results were mostly unaffected by demographic and psychiatric variables. The results support an empowerment model of stigma resilience that portrays stigmatized people as active constructors of their social world.     

The link between involuntary non-regular employment and poor mental health: A cross-sectional study of Japanese workers

Involuntary non-regular employment is a severe inequity problem worldwide, and it may significantly affect the mental health of employees. The present study aimed to examine the relationship between employment type and mental health. Additionally, the characteristics of involuntary non-regularly employed workers were explored. An online-based cross-sectional study was conducted in Japan, and 1566 participants were included in the data analysis. The eligible participants were divided into four categories: regularly employed (n = 1092), voluntary (n = 134), average (n = 233) and involuntary (n = 107) non-regularly employed individuals, respectively. Involuntary non-regular employment was associated with greater lack of vigour, anger-irritability, fatigue, anxiety, and depression. It was higher among women, those who were single or had no childcare, and those who had lower personal income or shorter working hours, or who tended not to practice relaxation activities. Lower personal income was associated with a risk of anxiety and depressive symptoms. Those individuals experiencing involuntary non-regular employment had a higher risk of poor mental health; subgroup analysis showed that this was particularly true among men. Both encouragement of employment stability via policy reform and workplace mental health support for involuntary non-regularly employed individuals are urgent health concerns.     

Evaluation of a mental health treatment court with assertive community treatment

Without active engagement, many adults with serious mental illnesses remain untreated in the community and commit criminal offenses, resulting in their placement in the jails rather than mental health facilities. A mental health treatment court (MHTC) with an assertive community treatment (ACT) model of case management was developed through the cooperative efforts of the criminal justice and mental health systems. Participants were 235 adults with a serious mental illness who were booked into the county jail, and who volunteered for the study. An experimental design was used, with participants randomly assigned to MHTC or treatment as usual (TAU), consisting of adversarial criminal processing and less intensive mental health treatment. Results were reported for 6 and 12 month follow-up periods. Clients in both conditions improved in life satisfaction, distress, and independent living, while participants in the MHTC also showed reductions in substance abuse and new criminal activity. Outcomes are interpreted within the context of changes brought about in the community subsequent to implementation of the MHTC.     

Feminist and community mental health center psychotherapists' expectations of mental health for women

Female (n=75) and male (n=55) community mental health center psychotherapists and feminist therapists (n=82) were given the Rosenkrantz, Vogel, Bee, Broverman, and Broverman (1968) Sex-Role Stereotype Questionnaire and were asked to rate either mentally healthy adults, females, wives, or mothers. Female community mental health center therapists and feminist therapists were found to maintain one standard of mental health; that is, their perceptions of mental health for adults, females, wives, and mothers did not differ. In contrast, male therapists perceived mentally healthy adults in more male-valued terms than they perceived mentally healthy females, wives, and mothers. Additionally, both feminist and other female therapists differed from male therapists in their perceptions of health for mothers, but not for adults and wives.This report is based on a dissertation submitted in partial fulfillment of the requirements for the doctoral degree at the College of Education, University of Maryland, 1974. The author wishes to express her appreciation to her dissertation chairperson, Dr. Janice M. Birk, for her invaluable assistance during all phases of this study.     

Adolescent males' view on the use of mental health counseling services

This study investigated adolescent males' view on mental health counseling. Additionally, participants were asked if they had ever used mental health counseling services, if they expected to use such services in the future, and what types of services/activities would constitute a successful counseling experience. The participants' responses indicated that they associated mental health counseling with mental illness and pathology. Eighty-eight percent of the participants reported having never used mental health counseling services. Surprisingly, 69% reported a willingness to use mental health counseling services for life's concerns. Finally, the participants identified a preference for action-oriented counseling strategies. Implications for mental health counseling practice are discussed.     

The Relationship Between Family Stress and Behavioral Health Among African American Adolescents

African American youth, especially those who live in low-income communities, are at increased risk for experiencing higher juvenile justice involvement, poorer mental health, low school engagement, higher illicit drug use, and STIs, relative to their higher income peers and those from other ethnic backgrounds. However, few studies have examined the relationship between family stressors and these multiple youth concerns. This study examines the relationship between family stress (i.e., having an adult in the home with a history of mental illness, substance use, and incarceration) and youth concerns such as substance use, mental health challenges, low school engagement, juvenile justice involvement, and STI risk behaviors. A total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on the above constructs. Logistic regressions controlling for age, gender, socioeconomic status, and sexual orientation indicated that adolescents who reported higher rates of family stress were significantly more likely to report mental health problems, delinquent behaviors, juvenile justice involvement, drug use, risky sex, and lower school engagement factors. Findings suggest that attending to the developmental concerns of youth also requires addressing the needs of the family unit.     

Mental health attitudes among Middle Eastern/North African individuals in the United States

ABSTRACT

Middle Eastern/North African (MENA) individuals may have heightened risk for developing mental health problems due to unique cultural stressors. However, traditional cultural and religious practices and beliefs socialised within the family environment may reduce the likelihood of seeking mental health services. This qualitative study aimed to better understand the intersection of cultural, religious, and mental health attitudes among MENA individuals. Semi-structured telephone interviews were conducted with MENA adults who had received therapy services (N?=?13) and were analysed for emergent themes. Respondents reported lack of understanding of mental illness within their communities, and prominent levels of perceived and self-stigma. Families and religious practices/beliefs played an important role in responding to mental illness. Results suggest that incorporating psychoeducation and community awareness campaigns alongside religious services may help to reduce barriers to receiving mental health treatment.     

Mental health matters: a multi-family framework for mental health intervention

This paper reports a collaborative project, developed jointly by a group of community mental health workers in association with a specialist team commissioned to initiate family work throughout a central London mental health provider. The result of this project – The 'Mental Health Matters Workshops'– was a series of day workshops for patients who had experienced a major mental illness, and their families, carers and mental health workers. The positive impact of the workshops on attenders is reported, as well as the development of a 'multi-family' and social network culture.     

Stigma by Association Among Family Members of People with a Mental Illness: A Qualitative Analysis

People with mental illness are not the sole recipients of stigmatisation; their immediate family members may be subjected to stigma by association. Through semi‐structured interviews, we investigated experiences of stigma by association among 23 immediate family members of people with mental illness. Participants reported experiencing stigma by association from community members, mental health professionals, and civil servants. Familial relationship, co‐residence, and the gender of participants appeared to play a role in their stigma experiences; parents and spouses reported different manifestations of stigma by association than siblings and children, participants who lived together with their family member with mental illness reported increased experiences of stigma by association, and in contrast to male participants, female participants reported others thinking they are overprotective and as such perpetuated, maintained, or sustained their family members' mental illness. The relevance of these factors points to the need for tailored education and emotional support provision to family members of people with mental illness. Moreover, in‐service training for mental health professionals should include the development of relevant social skills that enable the recognition of familial relationships and roles, and family members' fears, concerns, and problems. Copyright © 2014 John Wiley & Sons, Ltd.     

Immigration Enforcement Policies and the Mental Health of US Citizens: Findings from a Comparative Analysis

We examined the differential impact of having a family member, friend, or co-worker/community member detained or deported on the mental health of US citizens. In 2019, a sample of 3446 adult participants of White, Black, and Latinx racial/ethnic descent were recruited to complete an online questionnaire. Participants completed the Patient Health Questionnaire-4 to screen for anxiety, depression, and psychological distress. Analyses were restricted to US citizens (n = 3282). Multivariable logistic and linear regressions were conducted to examine the mental health of US citizens who reported personally knowing a migrant who has been detained or deported and by their relationship to the migrant, overall and among Latinxs only. Among US citizens, 32% reported personally knowing someone who has been detained or deported. In multivariable analyses, US citizens who personally knew a detained or deported migrant were more likely to report anxiety, depression, and greater psychological distress. Associations were more pronounced among those who reported having a family member detained or deported. US-citizen Latinxs with social ties to migrants who have been detained or deported were especially more likely to report poor mental health than White and Latinx participants who did not personally know a migrant who has been detained or deported. It is critical that policy makers consider the potential mental health harms on migrants and its own citizens when designing policies targeting migrant communities.     

Parental reports of global physical health at ages 3 and 6 predict self‐reported depressive symptoms 17 years later

Research studies testing longitudinal relations between childhood physical health measures and adulthood sub‐clinical depressive symptoms are rare. In the Cardiovascular Risk in Young Finns Study, longitudinal relations of parental reports of the global physical health of the child (1 = good, 2 = moderately good, 3 = average/not good) and of absent days from daycare due to physical illness during the past year (1 = no absent days, 2 = 1–5 days, 3 = 6–10 days, 4 = 11 days or more) with self‐reported depressive symptoms (a modified version of the Beck Depression Inventory) were studied over 17 years. The sample was population‐based, consisting at the study entry of 3‐ and 6‐year‐olds (n = 567) free of any chronic physical or mental illnesses. The results indicated that parent‐reported global physical health of the child during the childhood period significantly predicted the participant's self‐reported depressive symptom scores at follow‐up 12 and 17 years from the baseline (ps < .03). The risk of having depressive symptom scores at the top quartile of age‐ and gender‐specific distributions at follow‐up 12 and 17 years from the baseline, and both follow‐ups simultaneously was 1.97‐ to 4.49‐fold (95% confidence intervals: 1.15–11.96) for participants with a moderately good to average/not good global physical health at the study entry relative to participants with a good global physical health. Absent days from daycare were not associated with depressive symptoms. Despite its subjectivity, the results support the validity of parental reports and suggest that parent‐reported global physical health rating of the child early in development may indicate a risk for later depressive symptoms.