Ethnic Differences in Children’s Entry into Public Mental Health Care via Emergency Mental Health Services

For children and youth making a mental health crisis visit, we investigated ethnic disparities in whether the children and youth were currently in treatment or whether this crisis visit was an entry or reentry point into mental health treatment. We gathered Medicaid claims for mental health services provided to 20,110 public-sector clients ages 17 and younger and divided them into foster care and non-foster care subsamples. We then employed logistic regression to analyze our data with sociodemographic and clinical controls. Among children and youth who were not placed in foster care, African Americans, Latinos, and Asian Americans were significantly less likely than Caucasians to have received mental health care during the three months preceding a crisis visit. Disparities among children and youth in foster care were not statistically significant. Ethnic minority children and youth were more likely than Caucasians to use emergency care as an entry or reentry point into the mental health treatment, thereby exhibiting a crisis-oriented pattern of care.     

Associations Between Maternal Mental Health and Child Emotional and Behavioral Problems: Does Prenatal Mental Health Matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10–11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers’ but not teachers’ reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.     

What Happens to Mental Health Court Noncompleters?

Mental health court (MHC) research consistently finds that defendants who successfully complete and graduate from the court are less likely to recidivate than those who do not. However, research has not assessed what happens to these noncompleters once they are sent back to traditional court. Using follow-up data on six years of noncompleters from pre-adjudication MHC, we examine what happens to these defendants in traditional court. Findings suggest that 63.7% of defendants' charges were dismissed, 21.0% received probation, and 15.3% were sentenced to incarceration. We examine the time to disposition and differences in defendant characteristics and disposition outcome as well as the relationship between disposition and subsequent recidivism. Results suggest that more severe punishments in traditional court are associated with recidivism. Logistic regression analysis shows that defendants whose charges were dismissed in traditional court were less likely to recidivate than those who were sentenced to probation or incarceration. Our findings highlight the need for future MHC evaluations to consider traditional court outcomes and support trends towards post-adjudication courts. Copyright © 2015 John Wiley & Sons, Ltd.     

Parental Migration and Rural Left-Behind Children’s Mental Health in China: A Meta-Analysis Based on Mental Health Test

Parental migration has been an important predictor of left-behind children’s developmental outcomes. Based on the ecological model of rural left-behind children’s development, we systematically reviewed studies related to rural left-behind children’s mental health in China and investigated left-behind children’s mental health and its influencing factors. Thirty-two studies involving 28,629 participants met the inclusion criteria were included in our meta-analysis to compare mental health of left-behind children and non-left-behind children. Twenty-two studies involving 8,634 participants were included in gender difference meta-analysis. The results indicated that left-behind children report more mental health problems than non-left-behind children, left-behind girls were confronted with higher level of mental health problems than left-behind boys, left-behind children in primary school and junior high school reported more mental health problems than those in senior high school, and self-guardian children have more serious mental health problems than children guarded by grandparents, former generation, and single parent. Implications for future practice were analyzed from family, school, and government perspectives.     

Do State Mental Health Plans Address the New Freedom Commission’s Goals for Children’s Mental Health?

The latest initiative to address mental health needs of the nation, including those of children and youth, is the President’s New Freedom Commission on Mental Health (NFC). The NFC formulated a benchmark of six goals and related recommendations toward which the U.S. should strive, including the recommendation that each state develop a comprehensive mental health plan. It is not clear, however, whether the states’ developed plans address the goals established by the NFC and to what degree. This project provides a summary of 50 state mental health plans regarding children and youth in the U.S. by examining components that address each of the six NFC goals and is a test of federal leadership on a state issue. Results indicate that state mental health plans addressed the NFC goals to differing degrees with specific attention to children and youth mental health services. Overall, the NFC goal of eliminating disparities in mental health services was addressed most completely, while the NFC goal of understanding that mental health and physical health are associated was addressed least often. The information provided by this analysis represents a first step in gaining a comprehensive picture about public policies for the mental health of children, adolescents, and their families.     

Bulimia: New Mental Health Problem on the Campus?

Thomas Hohenshil and Rodney K. Goodyear : Special Assignment Editors Regina C. Casper, Elke D. Eckert, Katherine A. Halmi, Solomon C. Goldberg, and John M. Davis, Bulimia: Its Incidence and Clinical Importance in Patients with Anorexia Nervosa. Archives of General Psychiatry, 1980, 37, 1030–1035. Paul E. Garfinkel, Harvey Moldofsky, and David M. Garner, The Heterogeneity of Anorexia Nervosa: Bulimia as a Distinct Subgroup. Archives of General Psychiatry, 1980, 37, 1036–1040.     

African American Children’s Racial Discrimination Experiences and Mental Health

Journal of Child and Family Studies - The current study examined how African American children’s experiences of perceived personal racial discrimination and perceived vicarious racial...     

Why Does Disaster Recovery Work Influence Mental Health?: Pathways through Physical Health and Household Income

Disaster recovery work increases risk for mental health problems, yet the mechanisms underlying this association are unclear. We explored links from recovery work to post‐traumatic stress (PTS), major depression (MD), and generalized anxiety disorder (GAD) symptoms through physical health symptoms and household income in the aftermath of the Deepwater Horizon oil spill. As part of the NIEHS GuLF STUDY, participants (N = 10,141) reported on cleanup work activities, spill‐related physical health symptoms, and household income at baseline, and mental health symptoms an average of 14.69 weeks (SD = 16.79) thereafter. Cleanup work participation was associated with higher physical health symptoms, which in turn were associated with higher PTS, MD, and GAD symptoms. Similar pattern of results were found in models including workers only and investigating the influence of longer work duration and higher work‐related oil exposure on mental health symptoms. In addition, longer worker duration and higher work‐related oil exposure were associated with higher household income, which in turn was associated with lower MD and GAD symptoms. These findings suggest that physical health symptoms contribute to workers’ risk for mental health symptoms, while higher household income, potentially from more extensive work, might mitigate risk.     

Do Spiritual Struggles Predict Poorer Physical/Mental Health Among Jews?

Although spirituality and religion are generally associated with higher levels of physical and mental well-being, spiritual struggles, which involve tension in regard to spiritual issues, have been identified as a risk factor for poorer physical and mental health, especially among individuals with greater levels of personal religiousness. However, studies in this area have utilized predominantly Christian samples and the importance of spiritual struggles to Jews is not known. We proposed and tested two competing models in an adult Jewish community sample: (a) the Universal Effects model in which spiritual struggles were proposed to be associated with decreased levels of physical/mental health, and more problematic for more religious Jews, and (b) the Differential Effects model in which spiritual struggles were proposed to be generally unrelated to the physical/mental health of Jews, and even less impactful on religious Jews. We found some support for both models. Spiritual struggles were modestly associated with lower levels of physical/mental health in the sample as a whole, even after controlling for demographic covariates. However, at the highest levels of spiritual struggle, Orthodox Jews exhibited an increase in physical and mental health whereas non-Orthodox Jews' health continued to decrease.     

Stakeholders’ Perspectives on Community-Based Participatory Research to Enhance Mental Health Services

Historically, consumers of mental health services have not been given meaningful roles in research and change efforts related to the services they use. This is quickly changing as scholars and a growing number of funding bodies now call for greater consumer involvement in mental health services research and improvement. Amidst these calls, community‐based participatory research (CBPR) has emerged as an approach which holds unique promise for capitalizing on consumer involvement in mental health services research and change. Yet, there have been few discussions of the value added by this approach above and beyond that of traditional means of inquiry and enhancement in adult mental health services. The purpose of this paper is to add to this discussion an understanding of potential multilevel and multifaceted benefits associated with consumer‐involved CBPR. This is accomplished through presenting the first‐person accounts of four stakeholder groups who were part of a consumer‐involved CBPR project purposed to improve the services of a local community mental health center. We present these accounts with the hope that by illustrating the unique outcomes associated with CBPR, there will be invigorated interest in CBPR as a vehicle for consumer involvement in adult mental health services research and enhancement.     

Institutional Values of Managed Mental Health Care: Efficiency or Oppression?

The authors suggest that many managed mental health care (MMHC) practices have oppressive effects on members of cultural and ethnic minority groups. They examine the dissonance between institutional practices and cultural traditions that reflect insensitivity and forced conformity, particularly regarding time, pace, and intervention uniformity as applied to clients and commonly required in the MMHC industry. Los autores sugieren que muchas prácticas del cuidado administrado de la salud mental (MMHC, por sus siglas en inglés) tienen efectos opresivos sobre los miembros de grupos de minorías étnicas y culturales. Examinan también la disonancia entre prácticas institucionales y tradiciones culturales que reflejan insensibilidad y una conformidad forzada, sobre todo en lo referente a tiempo, ritmo y uniformidad de intervención tal y como se aplica a clientes y normalmente requeridos por la industria de MMHC.     

Participatory Research in Systems of Care for Children’s Mental Health

The children’s system of care initiative in the United States requires the participation of caregivers of children with emotional or behavioral problems in conducting research and evaluation. This entails a restructuring of traditional power dynamics among families served by the community mental health system and other system stakeholders, including researchers. However, evidence indicates that system of care research may not currently embrace the different types of knowledge possessed by caregivers and may be frustrated by traditional power hierarchies, resulting in research findings that are not useful for the community. In this paper I examine a framework for power and knowledge and examine how, when viewed through this framework, participatory research in the system of care initiative thus far may be less than authentic. I conclude with improvements suggested by the framework that are expected to shift power to caregivers and result in more useful, actionable research findings for the community.     

Family Support in Children’s Mental Health: A Review and Synthesis

A comprehensive review of structured family support programs in children’s mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met criteria for inclusion. Programs were categorized by whether they were delivered by peer family members, clinicians, or teams. Five salient components of family support were identified: (a) informational, (b) instructional, (c) emotional, (d) instrumental, and (e) advocacy. Clinician-led programs were heavily represented (n = 33, 66%), followed by family-led (n = 11, 22%), and team-delivered (n = 6, 12%) programs. Key differences between programs delivered by clinicians or by peer family members were found in the degree of emphasis, research methodology, and outcomes. However, the content of the components was similar across all three program types. There are both important differences in emphasis across typologies of family support provided by clinicians, family members, or teams as well as important similarities in content. Family-delivered support may be an important adjunct to existing services for parents, although the research base remains thin. A research agenda to promote more rigorous evaluations of these services especially those delivered by peer family members is critical.     

On the Role of Mental Health Activities for Teachers’ Work and Life

Everyday behavior is getting increasingly attention, both in the prevention of mental impairment and the promotion of mental health – within and beyond the work context. The present study aimed to identify the importance of mental health activities for well-being and positive functioning of teachers, while taking affectivity into account. Teachers are confronted with various stressors, and identifying predictors of teachers’ well-being and positive functioning is important, not only for teachers’ personal health, but also for their students’ well-being and achievement. Based on the Broaden and Build (B&B) theory and Conservation of Resources (COR) theory, we assumed that (1) the practice of mental health activities is associated with well-being (i.e., positive mental health) and positive functioning (i.e., healthy and unhealthy work-related behavior and experiences), and that (2) mental health activities mediate the association between affectivity and the respective outcomes. These assumptions were tested in a sample of 326 German teachers (75% female, age: M = 44, SD = 11.85). The practice of mental health activities was associated with more positive mental health, more healthy work-related behavior and experiences, and less unhealthy work-related behavior and experiences. Moreover, mental health activities partly explained the relationship between affectivity and the respective outcomes. The present findings indicate the potential of mental health activities for mental health promotion in teachers but future studies are recommended in order to establish causal effects.

     

How Adolescents’ Mental Health Predicts Their Physical Health: Unique Contributions of Indicators of Subjective Well-being and Psychopathology

Studies among youth have established a link between mental health and physical health, and highlight the importance of attending to these relationships to provide a more complete picture of functioning. However, most previous investigations have limited their focus to examining the relationship between physical health and either particular aspects of psychopathology or particular aspects of subjective well-being. The current study serves as a first examination that includes both positive (subjective well-being [SWB]) and negative (psychopathology) indicators of mental health in relation to physical health functioning, assessed via self-report measures completed by a sample of 401 early adolescents from the general population. Mental health indicators accounted for 30% of the variance in physical health ratings, and 4 of the 5 mental health indicators were unique predictors of physical health. Positive affect, a component of SWB, explained the most unique variance in physical health, followed by the other components of SWB. Results support the importance of attending to positive indicators of mental health when determining the link with physical health among youth. Implications for a research and practice focus on comprehensive wellness among youth are discussed.     

From Mental Health to Juvenile Justice: What Factors Predict This Transition?

We identify youth who are at risk for a critical transition from mental health to juvenile justice. A statewide longitudinal sample of Medicaid-eligible youth (aged 10–17) in the public mental health system (n = 5,455), during approximately one fiscal year (July 1, 1994–August 30, 1995), was used to determine the risk factors for, and timing of, a subsequent juvenile justice detention or commitment during the three subsequent fiscal years (1994–1997). Logistic regression and Cox Proportional Hazards modeling were used. Risk factors for juvenile justice detention or commitment included being: male, black or Hispanic, in junior high school, involuntarily admitted to mental health, having a DSM-IV diagnosis of conduct disorder, alcohol problems, a constellation of risk behavior, and receiving prior mental health services. Factors that accelerate the timing of detention or commitment in the juvenile justice system after a mental health visit included most of the general risk factors except risk behavior and involuntary admission were no longer significant and having a DSM-IV nonalcohol drug use diagnosis, antisocial behavior, and school problems became significant. Our study helps to identify youth who are at risk for multiple system use so that they may be provided appropriate services to prevent multiple system use.     

Multiproblem Families Referred to Youth Mental Health: What's in a Name?

The purpose of this study was threefold, namely (1) to differentiate between multiproblem families and control families on characteristics and processes within the family based on a theoretical framework, (2) to identify multiproblem families by establishing cut‐off scores on various questionnaires, and (3) to categorize multiproblem families into subtypes by cluster analyses. Various questionnaires were administered to multiproblem families (n = 85) and control families (n = 150). Results showed that what we propose to refer to as multiproblem families present a broad range of problems on seven domains: (1) child factors, (2) parental factors, (3) childrearing problems (inadequate or inconsistent parenting), (4) family functioning problems, (5) contextual problems, (6) social network problems, and (7) mental health care problems. Further, reliable cut‐off scores were established for various questionnaires. Finally, three types of families were found: (1) community‐problem families, (2) multiproblem families, and (3) child‐focused mild‐problem families. This paper looks to advance an evidence‐based definition and assessment of “multiproblem families” suggesting the possible value of defining and assessing multiproblem families in relation to these seven dimensions. Moreover, the classification of multiproblem families stresses the importance of providing tailored treatments.