Capitalizing on Scientific Advances to Improve Access to and Quality of Children's Mental Health Care

Behavioral Health Services Outcomes That Matter Most to Caregivers of Children, Youth, and Young Adults with Mental Health Needs

This project documents the service outcomes that caregivers value most. A diverse group of caregivers, representing six regions of the United States, participated in two rounds of virtual one-hour focus groups. In round 1, participants identified what they hoped to gain from using behavioral health services for themselves, their families, and their child and discussed what made services a positive experience for them. They then reported their top-three most-hoped-for outcomes. In round 2, groups validated and refined summary findings from round 1. Caregivers prioritized service quality outcomes, primarily. They expressed a desire for an accessible, respectful, and supportive treatment environment, underpinned by well-trained and culturally responsive professionals. Caregivers also desire seamless cross-sector provider collaboration and care transitions, which integrate the insights and preferences of families and children themselves to craft a customized care plan. Priority outcomes not related to service quality included hoping to gain increased knowledge, resources, and tools and techniques to support the mental health needs of their children, to see their children improve their daily functioning and for their child develop more effective interpersonal communication skills. Caregivers also reported hoping to experience less stigma related to the mental health needs of their children and to achieve personal fulfillment for themselves and their children. Research, policies, and mental health services should prioritize and be designed to address the outcomes that matter to youth and families.

How to improve the system of care for adolescents with emotional and behavioural problems from the perspective of care providers: a concept mapping approach

BACKGROUND

Emotional and behavioural problems (EBP) are the most common mental health issues during adolescence, and their incidence has increased in recent years. The system of care for adolescents with EBP is known to have several problems, making the provision of care less than optimal, and attention needs to be given to potential improvements. We, therefore, aimed to examine what needs to be done to improve the system of care for adolescents with EBP and to assess the urgency and feasibility of the proposed measures from the perspective of care providers.

METHODS

We used Concept mapping, a participatory mixed-method research, based on qualitative data collection and quantitative data analysis. A total of 33 stakeholders from 17 institutions participated in our study, including psychologists, pedagogues for children with special needs, teachers, educational counsellors, social workers and child psychiatrists.

RESULTS

Respondents identified 43 ideas for improving of the system of care for adolescents with EBP grouped into 5 clusters related to increasing the competencies of care providers, changes at schools and school systems, support for existing services, transparency of the care system in institutions and public administration, and the adjustment of legislative conditions. The most urgent and feasible proposals were related to the support of awareness-raising activities on the topic of EBP, the creation of effective screening tools for the identification of EBP in adolescents, strengthening the role of parents in the process of care, comprehensive work with the family, creation of multidisciplinary support teams and intersectoral cooperation.

CONCLUSIONS

Measures which are more accessible and responsive to the pitfalls of the care system, together with those strengthening the role of families and schools, have greater potential for improvements which are in favour of adolescents with EBP. Care providers should be invited more often and much more involved in the discussion and the co-creation of measures to improve the system of care for adolescents with EBP.

Why do people share memories online? An examination of the motives and characteristics of social media users

ABSTRACTSocial media has become one of the most powerful and ubiquitous means by which individuals curate and share their life stories with the world at large. Not surprisingly then, researchers have started to examine the reasons why individuals post personal memories on social media and said individuals' characteristics. Across two studies, we extended this line of research by further testing the Purposes of Online Memory Sharing Scale (POMSS) and its subscales: self, social, therapeutic and directive. Additionally, we examined which of these motives led college students (Study 1) and adults of a community sample (Study 2) to post personal memories on social media and whether said motives were associated with the individuals' psychological characteristics. Overall, the results revealed that emerging adults and older adults posted personal experiences on social media primarily for social reasons. We also found that extraversion, disclosure and social media usage predicted each of the motives for posting personal experiences on social media. In addition, individuals who were more lonely and who had lower self-esteem were more likely to post personal experiences on social media for therapeutic reasons. We discuss these results in terms of their implications towards understanding the mnemonic consequences associated with social media use.

Children with Cerebral Palsy and Unmet Need for Care Coordination

OBJECTIVE

To examine the physical and functional health of children with cerebral palsy (CP) and determine the prevalence and correlates of unmet need for health care coordination among this population.

METHODS

We analyzed data from the 2016 to 2018 National Survey of Children's Health (n = 102,341). Bivariate and multivariable analyses were conducted to compare the prevalence of chronic health conditions, functional disabilities, and care coordination among children with and without CP. Multivariable logistic regression models were used to estimate the adjusted odds ratio of comorbid conditions, functional disabilities, and unmet need for care coordination. Associations between select sociodemographic factors and unmet need for care coordination were assessed.

RESULTS

Children with CP had significantly higher prevalence of all the comorbid conditions and functional disabilities examined. The most prevalent health conditions among children with CP were allergies (34.2%), anxiety (26.5%), and asthma (25.1%). Notably, children with CP had higher odds of autism spectrum disorder (adjusted odds ratio [aOR] = 2.97; 95% confidence interval [CI] 1.40-6.30) and mental health conditions (aOR = 3.65; 95% CI 2.15-6.21). More than half (53.8%) of children with CP had unmet need for care coordination. They also had higher odds of unmet need for care coordination than children without CP (aOR = 2.63; 95% CI 1.69-4.10).

CONCLUSION

Children with CP have high prevalence of chronic health conditions and are also more likely to have unmet need for care coordination. Given the complexity of CP, our study supports the need for robust efforts to ensure that all children with CP have effective care coordination.

Adolescent Enrollment in Psychosocial Care: Do Parents Make a Difference?

Care for adolescents with emotional and behavioral problems (EBP) is frequently unequally distributed. Parents may play a role in the access to this care. Therefore, the aim was to explore the association between parental characteristics and their adolescent's enrollment in psychosocial care. We used data from the Care4Youth cohort study. Our sample consisted of 446 adolescents (mean age 13.22 years, 48% boys) and 382 parents (mean age 42.95 years, 14% males). EBP combined with enrollment created four groups: 1, no EBP/no care; 2, no EBP/care; 3, EBP/no care; 4, EBP/care. We assessed differences in parental characteristics among the groups. Group 2 had a significantly lower socioeconomic position (p < 0.01), more psychological distress (p < 0.001), poorer supervision (p < 0.001) and lower family social support (p < 0.05) than Group 1. Group 4 had a significantly lower socioeconomic position (p < 0.01) and poorer supervision (p < 0.001) than Group 1. Group 3 had significantly poorer supervision (p < 0.001) than Group 4. The poor supervision in Group 3 requires attention, as these adolescents receive no care. The quality of parental supervision should be addressed generally, e.g., by providing better parenting support and more parental training.

Commentary on Community Mental Health and the Common Good

This article comments on the core question addressed by this Special Issue: "What's good about public sector mental health?" Theoretical, empirical, and programmatic insights derived from the Issue's six article contributions guide the overall commentary. Several points of thematic overlap are featured in these preliminary observations, and these themes are suggestive for directing future research (e.g., citizenship studies) in the field of community mental health. Copyright © 2017 John Wiley & Sons, Ltd.