The Age of Uncertainty: Parent Perspectives on the Transitions of Young People with Mental Health Difficulties to Adulthood

For young people aged 16–24, the transition from adolescence to young adulthood involves predictable and unpredictable changes and they may encounter challenges in their roles, relationships, and responsibilities. Young people with mental health difficulties face additional challenges as they and their families navigate this transition. As a result, families commonly experience anxiety, uncertainty, frustration, and turbulent relationships. After learning to become advocates to secure appropriate services for their children, in late adolescence and young adulthood, parents are likely to find themselves excluded from their children’s treatment planning and services. This article reports findings from a recent qualitative study of the experiences and perceptions of 42 family members supporting their children with mental health difficulties during the transition years. Family members described their goals for their children, their frustrations trying to access appropriate services for their children, and their strategies to provide the support their children needed. Recommendations are for service providers to connect transition age youth with practical assistance and supportive mentoring relationships. Family members requested service providers to consider them as resources and potential collaborators in supporting young people with mental health difficulties to live successful lives in the community.     

Understanding the Nature and Consequences of Children’s Exposure to Violence: Research Perspectives

The National Institutes of Health (NIH) has a long history of supporting research to enhance the scientific understanding of and effective interventions for a range of problems associated with children’s exposure to violence. Recently, funded research has improved our understanding of the nature and consequences of children’s exposure to violence. This article describes an NIH initiative for research on children’s exposure to violence, examples of projects supported by the initiative, and emerging research topics for this important scientific area.

Capturing system level activities and impacts of mental health consumer-run organizations

Since the 1970s mental health consumer-run organizations have come to offer not only mutual support, but they have also adopted agendas for broader social change. Despite an awareness of the need for system level efforts that create supportive environments for their members, there has been limited research demonstrating how their system level activities can be documented or their impacts evaluated. The purpose of this paper is to feature a method of evaluating systems change activities and impacts. The paper is based on a longitudinal study evaluating four mental health consumer-run organizations in Ontario, Canada. The study tracked system level activities and impacts using both qualitative and quantitative methodologies. The article begins by describing the development and implementation of these methods. Next it offers a critical analysis of the methods used. It concludes by reflecting on three lessons learned about capturing system level activities and impacts of mental health consumer-run organizations.     

“We Never was Happy Living Like a Whiteman” : Mental Health Disparities and the Postcolonial Predicament in American Indian Communities

In the context of increasing attention to disparities in health status between U.S. ethnoracial groups, this article examines the dilemma of divergent cultural practices for redressing disparities in mental health status in American Indian communities. Drawing upon an ethnographic interview with a tribal elder from a northern Plains Indian reservation, a prototypical discourse of distress is presented and analyzed as one exemplar of the divergence between the culture of the clinic and the culture of the community. Situated in the context of continuing power asymmetries between tribal nations and the U.S. federal government, the implications of this cultural divergence for the efforts of mental health professionals, practitioners, and policymakers are identified as a predicament that only the conventions and commitments of a robust community psychology have the potential to resolve.     

Building an active citizenry: the role of neighborhood problems, readiness, and capacity for change

Community-building initiatives strive to involve residents as the drivers of the change process, involving them in an array of activities including collective action efforts. Recent evaluations of many of these initiatives, however, suggest that developing the levels of resident involvement needed in such efforts is challenging. This study examines the neighborhood conditions that are related to whether and how much residents become involved in individual activism and collective action efforts. A random-digit-dial phone survey of 460 residents in 7 distressed neighborhoods suggested that while demographic variables were relatively unimportant, resident perceptions of neighborhood readiness (i.e., hope for the future and collective efficacy) and capacity for change (i.e., social ties and neighborhood leadership), and the level of neighborhood problems were strongly related to whether and how much residents were involved in individual and collective action efforts. Moreover, different elements of these neighborhood conditions were more or less important depending on the type and level of resident involvement. For example, while perceptions of neighborhood problems was the strongest predictor of whether an individual became involved at all, perceived strength of neighborhood leadership was the strongest predictor of an individual's level of activity. The implications of these findings for practitioners and scientists are discussed.     

The nonequivalence of behavioral and mathematical equivalence.

Sidman and his colleagues derived behavioral tests for stimulus equivalence from the axiom in logic and mathematics that defines a relation of equivalence. The analogy has generated abundant research in which match-to-sample methods have been used almost exclusively to study interesting and complex stimulus control phenomena. It has also stimulated considerable discussion regarding interpretation of the analogy and speculation as to its validity and generality. This article reexamines the Sidman stimulus equivalence analogy in the context of a broader consideration of the mathematical axiom than was included in the original presentation of the analogy and some of the data that have accumulated in the interim. We propose that (a) mathematical and behavioral examples of equivalence relations differ substantially, (b) terminology is being used in ways that can lead to erroneous conclusions about the nature of the stimulus control that develops in stimulus equivalence experiments, and (c) complete analyses of equivalence and other types of stimulus-stimulus relations require more than a simple invocation of the analogy. Implications of our analysis for resolving current issues and prompting new research are discussed.     

The dilemma of primary prevention in mental health services: Rationalize the status quo or bite the hand that feeds you

That primary prevention has been ‘inappropriately marginalised’ is seen to be an inevitable outcome of reliance on government support. Policy makers and service providers can never be expected to give prevention a higher priority than direct service. Preventionists have developed two strategies for doing their work. One, based on the logical positivist ideal, seeks specific causal models for specific disorders. This sort of prevention research, while it will always remain less well funded than direct services, tends not to challenge the status quo belief in individual responsibility, or the acceptable methods of mainstream science, and thus will tend to be more acceptable than other forms of prevention research and services. An alternative, based on a social constructivist paradigm engages in social action research through collaboration with a variety of grass roots organizations and people outside the mainstream of power. This latter approach, brings to preventionists ideas from feminists, ethnic minority leaders, neighborhood organizers, and self and mutual help group leaders. It is a sensible way to use the resources available to those professionals interested in social change oriented prevention.     

Speed analyses of stimulus equivalence.

The functional substitutability of stimuli in equivalence classes was examined through analyses of the speed of college students'' accurate responding. After training subjects to respond to 18 conditional relations, subjects'' accuracy and speed of accurate responding were compared across trial types (baseline, symmetry, transitivity, and combined transitivity and symmetry) and nodal distance (one- through five-node transitive and combined transitive and symmetric relations). Differences in accuracy across nodal distance and trial type were significant only on the first tests of equivalence, whereas differences in speed were significant even after extended testing. Response speed was inversely related to the number of nodes on which the tested relations were based. Significant differences in response speed were also found across trial types, except between transitivity and combined trials. To determine the generality of these comparisons, three groups of subjects were included: An instructed group was given an instruction that specified the interchangeability of stimuli related through training; a queried group was queried about the basis for test-trial responding: and a standard group was neither instructed nor queried. There were no significant differences among groups. These results suggest the use of response speed and response accuracy to measure the strength of matching relations.     

Choice As A Function Of Reinforcement Ratios In Delayed Matching-to-sample

Pigeons were studied in two experiments using a delayed matching-to-sample task. In Experiment 1, 4 subjects were exposed to a task in which the proportion of reinforcement associated with matching and nonmatching, and the overall proportion of reinforcement associated with selecting each choice, regardless of the sample stimulus, were varied. Choice was sensitive to both proportions. A least squares regression analysis showed that Wixted's (1989) proportions of reinforcement model closely fit the data from Experiment 1; however, the model failed to make accurate qualitative predictions for some test conditions. In Experiment 2, 4 subjects were exposed to a delayed matching-to-sample task in which the retention intervals and the reduction in delay to reinforcement signaled by the onset of the sample stimulus were independently varied. When the retention interval was short and when the delay-reduction value of the sample stimulus was high, the sample exerted greater control over choice; the control by the overall proportion of reinforcements for selecting each choice stimulus was correspondingly low. Conversely, when the retention interval was long and the delay-reduction value of the sample stimulus was low, the sample exerted relatively less control over choice; control by the overall proportion of reinforcements obtained for selecting each choice stimulus was correspondingly high. A signal detection analysis found that sensitivity to reinforcement varied directly with retention interval. Data were also consistent with misallocation models. No evidence was found to suggest that pigeons ignore the rate at which selecting individual choice stimuli is reinforced, as has been reported in studies with human subjects.     

Visual search by chimpanzees (Pan): assessment of controlling relations.

Three experimentally sophisticated chimpanzees (Pan), Akira, Chloe, and Ai, were trained on visual search performance using a modified multiple-alternative matching-to-sample task in which a sample stimulus was followed by the search display containing one target identical to the sample and several uniform distractors (i.e., negative comparison stimuli were identical to each other). After they acquired this task, they were tested for transfer of visual search performance to trials in which the sample was not followed by the uniform search display (odd-item search). Akira showed positive transfer of visual search performance to odd-item search even when the display size (the number of stimulus items in the search display) was small, whereas Chloe and Ai showed a transfer only when the display size was large. Chloe and Ai used some nonrelational cues such as perceptual isolation of the target among uniform distractors (so-called pop-out). In addition to the odd-item search test, various types of probe trials were presented to clarify the controlling relations in multiple-alternative matching to sample. Akira showed a decrement of accuracy as a function of the display size when the search display was nonuniform (i.e., each "distractor" stimulus was not the same), whereas Chloe and Ai showed perfect performance. Furthermore, when the sample was identical to the uniform distractors in the search display, Chloe and Ai never selected an odd-item target, but Akira selected it when the display size was large. These results indicated that Akira's behavior was controlled mainly by relational cues of target-distractor oddity, whereas an identity relation between the sample and the target strongly controlled the performance of Chloe and Ai.