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.     

Mental health problems and symptoms among male adolescents attending a teen health clinic

The purpose of this study was to examine the frequency and nature of mental health problems and symptoms among a group of 51 inner-city male adolescents attending a teen health clinic at a large county hospital in the southwestern part of the United States. They were administered a problem area checklist and a problem symptom checklist. The problem area checklist covered a range of mental health issues, including peer/friendship, relationship, and family problems; problems with money, time, and the law; substance use; and eating disorders. The problem symptom checklist queried participants about anger, nervousness, depression, fear, loneliness, suicide, aggression, and self-esteem. The results indicated that these young males experienced significant mental health problems and symptoms, such as relationship problems, problems with time and money, and symptoms of anger, depression, and aggression. Further, scared/afraid feelings correlated with five of the eight problem areas. The authors recommend investigating ways to target young males who present at such clinics in order to address their mental health problems and symptoms, as well as studying how their environment affects their overall health.     

Racial disparities in mental health service use by adolescents who thought about or attempted suicide

Differences in rates and predictors of mental health service use among 2,226 Black, Hispanic, and White adolescents (aged 12-17) who reported recent suicidal thoughts or an attempt were examined. Black adolescents were 65% (OR = .65, p < .05), and Hispanic adolescents were 55% (OR = .55, p < .001), as likely as White adolescents to report service use, even when controlling for need for care and ability to secure services. Suicide attempt and psychiatric symptoms each interacted with race to increase the odds of service use uniquely for White adolescents. Results indicate that racial disparities characterize adolescents' mental health service use even when suicide risk increases.     

Perceived overqualification and health: a longitudinal analysis

The authors examined the effects of perceived overqualification on health and health decline by means of a 2-wave panel study of members of a midwestern American Postal Workers Union local. The 1st hypothesis was that overqualification was negatively related to health at Time 2 (T2); the second hypothesis was that overqualification was positively related to perceived health decline at T2. Neither was supported by the data. However, the relationships were in the expected direction for perceived mismatch but not for the perceived no grow dimension of overqualification. The results imply that perceived no grow may have immediate threats to health, whereas perceived mismatch may have longer term implications for health. The stability of perceived health between Time 1 (T1) and T2 could overshadow a longitudinal effect of overqualification on health and health decline at T2.     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

A latent transition analysis of the longitudinal stability of dual-factor mental health in adolescence

Dual-factor models of mental health are increasingly supported but little is known about longitudinal trends in dual-factor mental health. The current study used latent profile analysis (LPA) to empirically identify dual-factor mental health classes at each of Grades 9 through 12 and latent transition analysis (LTA) to examine stability of classes over four academic years. A sample of 875 adolescents from two cohorts reported on their social-emotional strengths and psychological distress. Cross-sectional LPAs for each grade year resulted in four mental health classes: complete mental health, moderately mentally healthy, symptomatic but content, and troubled. An LTA model indicated that the complete mental health class exhibited the most stability, followed by moderately mentally healthy and symptomatic but content classes. The troubled class exhibited the least stability. Less than 24% of participants remained in the same mental health class across all years. Findings support regular monitoring of students' dual-factor mental health to accurately inform mental health promotion, prevention, and intervention efforts.     

Cyberbullying status and mental health in Norwegian adolescents

The aim of the present study was to examine how the cyberbullying status (not involved, cyber-victim only, cyberbully only, cyber-victim and bully) is related to the mental health of the adolescents when controlled for traditional bullying experience. We also examined the potential moderator sex on the relationship between cyberbullying status and mental health. Univariate analyses of variance were conducted to predict mental health problems using the Strength and Difficulties Questionnaire total difficulties score and its five scales. The model consisted of five predictors in addition to an interaction term between cyberbully status and sex. Of the 2,117 adolescents, 50% were girls. The vast majority did not have any cyberbullying experience (87%), 9% of the adolescents were cyber-victims only, 1% were cyberbullies only and 3% were both cyber-victims and bullies. Overall, girl's mental health seems to be more compromised when exposed to or involved in cyberbullying than boys mental health. In general, adolescents who are not only cyberbullies and cyber-victims, but also cyber-victims only had a worse mental health compared to adolescents without cyberbullying experience. Being exposed to cyberbullying is a unique contributor to mental health problems. Preventing cyberbullying is therefore important. Especially girl's mental health seems to be negatively affected when exposed to cyberbullying.     

Cultural aspects of mental health and mental health service delivery with a focus on Nigeria within a global community

With an endless range of subgroups and individual variations, culture bears upon what all people bring to the clinical setting. Culture could account for health-seeking behaviour, type of services and support system and variations in how people communicate their health concerns. Culture may underlie presentation of sets of symptoms that are peculiar to certain societies – culture-bound syndromes. Culture also influences the meanings that people impart to their illness and also stigma associated with such illnesses. Culture must be viewed from the patients, clinicians and health system dimensions. Changes in mental health service delivery in last few decades have yielded culturally competent mental health services. The aim of this paper was to discuss culture and mental health with a focus on Nigeria and from a global perspective.     

Losing hope: mental health and religious service non-attendance in Australia

Religious beliefs and practices are related to mental health. Many individuals report a religious affiliation, but do not have specific religious beliefs or practices such as attending religious services. These non-attendees are often assumed to resemble the non-religious, but are poorly studied. This study explored the demographic characteristics and mental health outcomes associated with being a non-attendee using data from a nationally representative Australian sample. Non-attendees were more likely to be non-Christian than attendees at religious services. They had worse mental health than both non-religious individuals and attendees, especially compared to the non-religious. Whether non-attendance is a result of or cause of poor mental health outcomes is not clear and deserves further investigation. Non-attendees clearly differed in our sample from both non-religious individuals and attendees. Our results do not support the hypothesis that individuals who report a religious affiliation, but are not actively religious, are similar to non-religious individuals.     

Lifestyle and mental health among school-going adolescents in Namibia

This study examined the association between lifestyle behaviours and psychological distress indicators among school-going adolescents. The analysis included 4 531 school children, 11–18 years of age, who completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Multivariable logistic regression analysis found that engaging in a greater number of harmful consumptive, sedentary and sexual risk behaviours carried an elevated risk for anxiety, suicide attempt and loneliness. Adolescents with co-occurring health risk behaviours have poorer mental health outcomes with socio-economic vulnerability.     

Exposure to violent video games and aggression in German adolescents: a longitudinal analysis

The relationship between exposure to violent electronic games and aggressive cognitions and behavior was examined in a longitudinal study. A total of 295 German adolescents completed the measures of violent video game usage, endorsement of aggressive norms, hostile attribution bias, and physical as well as indirect/relational aggression cross‐sectionally, and a subsample of N=143 was measured again 30 months later. Cross‐sectional results at T1 showed a direct relationship between violent game usage and aggressive norms, and an indirect link to hostile attribution bias through aggressive norms. In combination, exposure to game violence, normative beliefs, and hostile attribution bias predicted physical and indirect/relational aggression. Longitudinal analyses using path analysis showed that violence exposure at T1 predicted physical (but not indirect/relational) aggression 30 months later, whereas aggression at T1 was unrelated to later video game use. Exposure to violent games at T1 influenced physical (but not indirect/relational) aggression at T2 via an increase of aggressive norms and hostile attribution bias. The findings are discussed in relation to social‐cognitive explanations of long‐term effects of media violence on aggression. Aggr. Behav. 35:75–89, 2009. © 2008 Wiley‐Liss, Inc.     

Religiosity and the mental health of adolescents in Great Britain

Most studies show that religion is a protective factor for mental health. A few argue that it is detrimental and the remainder conclude it makes no difference. We investigate the religiosity correlates of childhood psychopathology – strength of belief, importance of being able to practice one’s religion, and worship frequency. Questions on religiosity were included in the mental health survey of children in Great Britain administered to 2992 11–19-year-olds in 2007. The Development and Well-Being Assessment was used to generate rates of clinically recognisable mental disorders. Logistic regression analysis was used to establish the magnitude of the religiosity correlates of emotional and conduct disorders. Young people with a stated religion who had weakly held beliefs or who regarded religious practice as unimportant were those with the greater likelihood of having emotional disorders. Regular attendance at religious services or prayer meetings reduced the likelihood of having a conduct disorder.     

Cost-effective use of Rational Emotive Behavior Therapy in a public mental health service

With the advanced deinstitutionalization of the treatment of the mentally ill, the public mental health services in many parts of Australia are facing serious difficulties in providing adequate community-based treatment to the large numbers of individuals in need. Overreliance on medication and a diminishing supply of suitably trained therapists may result in an increasing proportion of patients being denied the benefit of optimal treatment and care which should include evidence-based psychological and behavioral approaches. In this communication we describe a day program, designed and implemented in Perth, Western Australia, which combines individual and group therapy provision, and is closely integrated with both primary care and the specialist mental health services. The program provides an alternative to in-patient admission and is cost-effective by reducing the demand for acute hospital beds. It is acceptable to patients and produces measurable improvements in symptoms, functioning and subjective well-being. Address correspondence to Anthony Mander, ENHANCE, Inner City Mental Health Service, Royal Perth Hospital, Box X2213, Perth 6000, Western Australia.     

Clinical issues in mental health service delivery to refugees

Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.     

Economic indicators of mental health service utilization in rural Appalachia

This exploratory study examined the relative predictive strengths of selected economic factors (welfare cases, banking activity, unemployment, retail sales, motor vehicle sales) for utilization of mental health services (hotline calls, intake at community mental health centers and admissions at mental hospitals) over a 78-month period in rural Appalachia. Monthly data were tested for autocorrelation and adjusted for seasonality and inflation. Regression analyses indicated that (a) economic factors did account for a considerable portion of variance in mental health factors; (b) these factors predicted mental hospital admissions and hotline calls; (c) strengths of these relationships were quite consistent across the areas sampled, but the directions sometimes were different; (d) welfare factors were the best predictors of utilization; (e) Aid to Families with Dependent Children was generally the best single predictor of utilization, especially when mental health factors were lagged by 3 months. A causative model describing the decision-making process involved in the utilization of mental health services was presented. This research was supported by grant number 1R01 MH34382 01 from the National Institute of Mental Health, Division of Biometry and Epidemiology, 1980–1981. The empirical data were collected with the help of the Shawnee Mental Health Services of Marietta, Ohio, Western District Guidance Center of Parkersburg, West Virginia, the Ohio Department, the Administrative Office of the U.S. Court, the Federal Reserve Banks of Public Welfare, the West Virginia Department of Health, the West Virginia Tax DEpartment, the Administrative Office of the U.S. Court, the Federal Reserve Banks of Cleveland and of Richmond, and Parkersburg National Bank. Robert Kirkbride of Marietta College and Robert Evans of People's Bank of Marietta, Ohio, provided economic advice. The computer facilities of Marietta College were used to store and analyze data. Barrie Gardner and Lucinda Pyatt, as research assistants, collected and analyzed much of the data.     

Online mental health resources for adolescents: Overview of research and theory

Adolescents use the Internet at higher rates than any other age group. The Internet therefore offers an obvious opportunity for the provision of mental health information for them. Little is known, however, about adolescent behaviour online, especially access of age‐appropriate mental health resources. This review of the published literature examines theoretical and research studies to develop an understanding of adolescent mental health‐seeking behaviour on the Internet. It is clear that adolescents do seek health information online, but little is known about its content, nature or mode of delivery. There appears to be no research specific to mental health resources for adolescents online.