Promoting and protecting mental health as flourishing: a complementary strategy for improving national mental health

This article summarizes the conception and diagnosis of the mental health continuum, the findings supporting the two continua model of mental health and illness, and the benefits of flourishing to individuals and society. Completely mentally healthy adults--individuals free of a 12-month mental disorder and flourishing--reported the fewest missed days of work, the fewest half-day or greater work cutbacks, the healthiest psychosocial functioning (i.e., low helplessness, clear goals in life, high resilience, and high intimacy), the lowest risk of cardiovascular disease, the lowest number of chronic physical diseases with age, the fewest health limitations of activities of daily living, and lower health care utilization. However, the prevalence of flourishing is barely 20% in the adult population, indicating the need for a national program on mental health promotion to complement ongoing efforts to prevent and treat mental illness. Findings reveal a Black advantage in mental health as flourishing and no gender disparity in flourishing among Whites.     

Effects of workshop trainings on evidence-based practice knowledge and attitudes among youth community mental health providers

Enhancing the public health impact of evidence-based practices (EBPs) in usual care settings is a key priority of the National Institute of Mental Health. Longitudinal data from community mental health providers (N = 268) participating in a series of state-sponsored workshops in modular approaches to EBPs for youth are presented. EBP workshop attendance for youth anxiety resulted in increased knowledge for EBPs for anxiety (and not other conditions) and EBP workshop attendance for youth disruptive behaviors resulted in increased knowledge for EBPs for disruptive behaviors (and not other conditions). Providers' tendencies toward incorrectly classifying non-EBP therapies as evidence-based increased over time, suggesting that providers over-generalize the EBP label as a result of attending these types of workshops. Regarding EBP attitudes, most measures of attitudes improved when providers attended a workshop. Additionally, an overly inclusive view of what constitutes an EBP at intake was related to significant decreases in openness to trying EBPs over time, whereas more positive attitudes at intake was related to achieving a more refined view of what constitutes an EBP over the course of attending trainings. Study limitations and implications for implementation of EBPs in usual care settings are discussed.     

School absenteeism and mental health among sexual minority youth and heterosexual youth

Adolescent school absenteeism is associated with negative outcomes such as conduct disorders, substance abuse, and dropping out of school. Mental health factors, such as depression and anxiety, have been found to be associated with increased absenteeism from school. Sexual minority youth (youth who are attracted to the same sex or endorse a gay, lesbian, or bisexual identity) are a group at risk for increased absenteeism due to fear, avoidance, and higher rates of depression and anxiety than their heterosexual peers. The present study used longitudinal data to compare sexual minority youth and heterosexual youth on excused and unexcused absences from school and to evaluate differences in the relations between depression and anxiety symptoms and school absences among sexual minority youth and heterosexual youth. A total of 108 14- to 19-years-old adolescents (71% female and 26% sexual minority) completed self-report measures of excused and unexcused absences and depression and anxiety symptoms. Compared to heterosexual youth, sexual minority youth reported more excused and unexcused absences and more depression and anxiety symptoms. Sexual minority status significantly moderated the effects of depression and anxiety symptoms on unexcused absences such that depression and anxiety symptoms were stronger predictors of unexcused absences for sexual minority youth than for heterosexual youth. The results demonstrate that sexual minority status and mental health are important factors to consider when assessing school absenteeism and when developing interventions to prevent or reduce school absenteeism among adolescents.     

Utah youth suicide study: barriers to mental health treatment for adolescents

Forty-nine suicide cases were drawn from an original sample of 151 consecutive youth suicide deaths. We used information from 270 interviews with parents and other survivors to evaluate mental health treatment sought for and by the decedent and barriers to mental health treatment. Participants reported the same primary barriers for the decedent: belief that nothing could help, seeking help is a sign of weakness or failure, reluctance to admit to having mental health problems, denial of problems, and too embarrassed to seek help. It is suggested that the stigma of mental illness is a considerable barrier to mental health treatment.     

Engaging Australian Aboriginal youth in mental health services

It is currently estimated that up to 40% of Aboriginal youth (aged 13–17) will experience some form of mental health problem within their lifetime. Of greater concern is the evidence that indicates that Aboriginal youth fail to access mental health services commensurate with this need. This is due, in part, to the characteristically monocultural nature of service delivery of existing services. This paper overviews a model that has been developed specifically for the engagement of Aboriginal youth (aged 13–17 years) in mental health settings. Importantly, a mix of urban (N = 43) and rural (N = 68) Aboriginal youth were represented within the sample to determine its efficacy across different language and tribal groups. The model proved to be effective in engaging 97% of Aboriginal youth (n = 108), with only a small number not effectively engaged (n = 3). The model provides a foundation for the further development of evidence‐based models of best practice that have so far provided to be elusive within this complex field.     

Barriers to evidence-based treatment: developmental psychopathology and the interdisciplinary disconnect in school mental health practice

Reframing the role of school psychologists and related school professionals in a public health and primary prevention model represents a proactive antidote to their more traditional reactive stance to mental health problems. Two additional concepts, developmental psychopathology and complex comorbidity, are suggested as critical to complete this transition, and illustrations of these concepts for more effective school mental health services are provided.     

The cultural adjustment and mental health of Japanese immigrant youth

Interviews were conducted with eight Japanese immigrant youth about their experiences with respect to adjusting to life in the United States, dealing with discrimination, and coping with cultural challenges. They were also questioned about their mental health and family and peer relations. Results indicate that participants managed to maintain bicultural identities and to cope with the problems that they encountered. Nevertheless, they experienced the following difficulties: racism and prejudice, language barriers, and conflict regarding identity and values. In terms of coping, participants mostly relied on friends for support; only one had sought the help of a professional counselor. The implications of the findings are discussed in terms of working with immigrant youth from Japan.     

Adolescent mental health: the role of youth and college pastors

The present study investigates the gatekeeping role of youth and college pastors, specifically exploring their psychological training, perceptions, attitudes, and interactions concerning adolescent congregants' mental illness. Texas youth and college pastors were anonymously surveyed regarding referral patterns, mental health interventions and contact, adolescent mental health perceptions, and means of collaboration. While the sample reported actively working with numerous adolescent mental health issues, the majority did not feel qualified to work with significant psychopathology. Despite this, they reported using various intervention methods, with the most common being initial counselling followed by a referral. Although the sample frequently referred to other professionals, they described many perceived barriers in collaborating with others in the mental health field. Overall, a positive role exists for youth and college pastors in adolescent mental health; however, tensions and conflicts between pastors and mental health professionals hinder the usefulness of these unique gatekeepers. Implications and recommendations for mental health professionals are highlighted.     

The effects of poverty on the mental, emotional, and behavioral health of children and youth: implications for prevention

This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral health. Second, we offer a conceptual framework that incorporates selection processes that affect who becomes poor as well as mechanisms through which poverty appears to influence child and youth mental health. Third, we use this conceptual framework to selectively review the growing literatures on the mechanisms through which family poverty influences the mental, emotional, and behavioral health of children. We illustrate how a better understanding of the mechanisms of effect by which poverty impacts children's mental, emotional, and behavioral health is valuable in designing effective preventive interventions for those in poverty. Fourth, we describe strategies to directly reduce poverty and the implications of these strategies for prevention. This article is one of three in a special section (see also Biglan, Flay, Embry, & Sandler, 2012; Mu?oz, Beardslee, & Leykin, 2012) representing an elaboration on a theme for prevention science developed by the 2009 report of the National Research Council and Institute of Medicine.     

The faith community and mental health resilience amongst Australian Ismaili Muslim youth

The religio-cultural community of minority ethnic migrants can strongly affect post-migration adaptation. Whilst religion itself may influence resilience, the social support network it provides may also play a role. Extant literature on resilience and migrant communities has largely focused on refugees whilst the experience of younger voluntary migrants and second-generation immigrants, who may experience “acculturative stress”, has been overlooked. This study examines 18–25 year old diasporic and post-diasporic Ismaili Muslim youth in Australia. Of the 11 youth respondents, five were Australian-born/raised (“post-diasporic”) and six were recent immigrants (“diasporic”). Five community leaders were also interviewed for triangulation. Respondents were obtained using purposive and convenience sampling in two Australian cities. Results demonstrate how faith engagement and civic participation were utilised in developing resilience when facing mental health stressors encountered during the migratory and acculturative processes.     

HIV prevention with persons with mental health problems

The HIV seroprevalence rate among persons with mental health problems (PMHP) is substantially higher than that of the general population in the United States. This study examines the efficacy over 12 months of an HIV prevention program with 99 individuals attending outpatient mental health clinics who were randomly assigned to receive either: (a) a seven-session, small-group intervention of Project LIGHT (Living in Good Health Together); or (b) a one-session video intervention. Regression analyses of data from 87% of the sample interviewed at 1-year follow-up revealed that intervention group membership was associated with significantly fewer sexual risk acts. A significant intervention effect for condom use was found for 72% of the sample who were African American, but not for Latino or Caucasian participants. Results from this study suggest that HIV risk reduction groups such as Project LIGHT may have utility in public mental health care settings.     

Cultural competence and evidence-based practice in mental health services: a complementary perspective

The need for cultural competence and the need for evidence-based practice in mental health services are major issues in contemporary discourse, especially in the psychological treatment of people of color. Although these 2 paradigms are complementary in nature, there is little cross-fertilization in the psychological literature. The present article illustrates the complementary nature of these 2 paradigms. A main point of convergence is related to the development of culturally adapted interventions in the move from efficacy research to effectiveness studies. The implications of cultural adaptations of empirically supported treatments for mental health services in terms of research and practice with ethnic/racial minority populations are discussed.     

Evidence-based mental health interventions for traumatized youth: a statewide dissemination project

Psychological trauma in childhood has been shown to increase a variety of psychological disturbances and psychiatric disorders. Although evidence-based treatments for children who have been traumatized exist, they are infrequently used by clinicians treating children. The present paper describes the creation of the Treatment Collaborative for Traumatized Youth (TCTY) which is a statewide partnership in North Dakota designed to disseminate efficacious treatments for traumatized children and monitor outcomes across a broad, rural, geographic expanse. The paper reviews the dissemination strategy developed by the TCTY, reports outcomes regarding both clinicians and child participants, and highlights problems identified in the project and solutions that were generated.     

The relationships between religiosity,stress, and mental health for Muslim immigrant youth

Acculturation, or the process of change that takes place as a result of intercultural contact, can cause a range of stressors. The task of managing this acculturative stress is particularly difficult for Muslim immigrants in Western contexts due to the global rise of Islamophobia. Research investigating the experiences of young migrant Muslims has found inconsistent results regarding the moderating influences of religious identity and religious practices on the relationship between stress and mental health. The current study examined whether levels of religiosity interacted with distinct forms of acculturative stress in the prediction of depression and well-being for Muslim youth in New Zealand. Results painted a complex picture of the relationships between religiosity and mental health, finding that greater religiosity is generally positive for youth outcomes, but it also carries the risk lowering levels of mental health through its interactions with acculturative stress.     

Evidence-based treatment of stuttering: IV. Empowerment through evidence-based treatment practices

Assertion-based treatments for stuttering have historically been more popular than evidence-based treatments. In this paper it is argued that the use of evidence-based treatments for stuttering is professionally empowering for clinicians, but that the use of assertion-based treatments is a circular process that inhibits professional development. The arguments in favor of evidence-based treatment are elaborated under headings of "professional investment," "professional development and diversity," and "optimizing treatment efficacy." EDUCATIONAL OBJECTIVES: The reader will understand and be able (1) to describe the distinction between assertion-based and evidence-based treatment practices (2) to present a series of arguments that evidence-based treatment practices are professionally empowering.     

Introduction to the Special Section: Advances in psychological prevention and treatment interventions to promote children's mental health

This paper introduces the Special Section on Advances in Psychological Prevention and Treatment Interventions to Promote Children's Mental Health. The three articles in the Special Section provide perspectives on the adaptation, evaluation, and implementation of evidence‐based psychological interventions for children in countries in Northern and Eastern Europe, and Latin America. The articles highlight disparate methodologies for the examination of intervention data, including addressing causal inference in the absence of availability of true experiment data (i.e., randomised controlled trial data), randomised trial data from a school‐based prevention programme, and predictors of change in an evidence‐based treatment programme. Together, the articles highlight the movement of evidence‐based practices into routine care settings and emerging strategies for settings in which randomised trial data are not yet available. They demonstrate the contribution of psychological research to the advancement of practices for improving children's mental health.