A Rural Youth Consumer Perspective of Technology to Enhance Face-to-Face Mental Health Services

The imbalance between need and available resources with respect to youth mental ill-health has encouraged a growing body of literature around technology to support existing face-to-face services. However, this literature has not adequately investigated the perspective of youth as consumers and no data exists on the views of rural youth. In response to this gap, in-depth qualitative study investigated the perspectives of rural youth who were currently seeking help at a mental health service. Semi-structured interviews were carried out with a clinical sample of 10 young people (5 female), aged 16–22 years. Participants were recruited from two different mental health services located in two rural South Australian regions. Data were analysed via inductive thematic analysis. Results highlighted a young person’s desire for self-determination around their health and help-seeking within a service current environment that systematically subverts it. Overall, participants had long and complex histories of help-seeking associated with a history of isolation, disadvantage and trauma. A strong need for personal connection in the context of help-seeking was evident. Preferences for, and actual use of, the internet for mental healthcare existed on a continuum from no current (or future desire) to use technologies through to active interest in, and current use of, technologies as an adjunct to face-to-face care. Limited financial and infrastructural resourcing made it more difficult to access help online. Understanding and actively seeking out these views in design and implementation of technologies is in line with the current shift toward more consumer-focused and inclusive service design and delivery.     

Multilevel Perspectives on Community Intervention: An Example from an Indo-US HIV Prevention Project in Mumbai, India

This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.     

Foster Children and ADHD: Anger, Violence, and Institutional Power

This paper explores the ways in which foster children and attention deficit hyperactivity disorder (ADHD) intersect as social and medical categories. Through the method of interpretive biography based on the official case file, this paper shows how the experiences of violence and ADHD become linked in the child's life through the emotion of anger. In this way, it is possible to see how the power dynamics of the medical, educational and welfare systems lock the diagnosis with its embedded meanings into the child's life. It is also possible to see how counter forces like a caring foster family can challenge medical and welfare authorities.