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Caballero J, Xu J, Hall DB, Chen X, Young HN. Racial and ethnic differences in patterns of use and discontinuation of long-acting injectable antipsychotics using Medicaid claims data. Ment Health Clin 2023; 13:183-189. [PMID: 37860586 PMCID: PMC10583257 DOI: 10.9740/mhc.2023.08.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/23/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction In general, racial and ethnic differences exist in antipsychotic prescription practices. However, little is known about such differences between individual long-acting injectable (LAI) antipsychotic formulations, specifically. This study's primary objective was to determine racial and ethnic differences among LAI antipsychotic use. Secondary objectives were to identify if discontinuation rates differed between agents and by race or ethnicity. Methods International Classification of Diseases, 10th edition (ICD-10) codes were used to identify patients with schizophrenia and related disorders (18-64 years) who received an LAI antipsychotic between 2016 and 2020 using Merative Multi-State Medicaid databases. Using National Drug Code numbers for LAI antipsychotics, pharmacy claims were identified and data analyzed. Cochran-Mantel-Haenszel tests and odds ratio estimators were used to investigate conditional association between race or ethnicity and medication, while controlling for age, sex, health plan, and prescription year. Kaplan-Meier survival curves were examined, and stratified log-rank tests were conducted to compare the time until discontinuation distributions by race or ethnicity. Results The analysis included 37 712 patients. Blacks received an LAI first-generation antipsychotic more often than Whites (OR: 1.64, 95% CI: [1.56, 1.73], Hispanics (OR: 1.46, 95% CI: [1.21, 1.75]) and others (OR: 1.44, 95% CI: [1.20, 1.73]). Aside from fluphenazine decanoate showing earlier discontinuation rates for Whites over Blacks (P = .02), no significant differences in discontinuation across race or ethnicity were identified. Discussion Despite no significant differences in second-generation antipsychotic LAI discontinuation rates between Blacks and other racial or ethnic groups, Blacks received second-generation antipsychotic LAIs significantly less often than other groups. Further studies are needed to determine why differences may be occurring.
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Affiliation(s)
- Joshua Caballero
- (Corresponding author) Associate Professor – Limited Term, Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, Georgia,
| | - Jianing Xu
- PhD Student, Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Daniel B. Hall
- Professor and Director, Statistical Consulting Center, Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Xianyan Chen
- Senior Academic Professional, Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Henry N. Young
- Department Head and Kroger Professor, Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, Georgia
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Metzger IW, Turner EA, Jernigan-Noesi MM, Fisher S, Nguyen JK, Shodiya-Zeumault S, Griffith B. Conceptualizing Community Mental Health Service Utilization for BIPOC Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:328-342. [PMID: 37141546 DOI: 10.1080/15374416.2023.2202236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Historically, children and adolescents who identify as Black, Indigenous, and other people of Color (BIPOC) have had inequitable access to mental healthcare, and research shows that they are significantly less likely than their white American counterparts to utilize available services. Research identifies barriers that disproportionately impact racially minoritized youth; however, a need remains to examine and change systems and processes that create and maintain racial inequities in mental health service utilization. The current manuscript critically reviews the literature and provides an ecologically based conceptual model synthesizing previous literature relating to BIPOC youth barriers for service utilization. The review emphasizes client (e.g. stigma, system mistrust, childcare needs, help seeking attitudes), provider (e.g. implicit bias, cultural humility, clinician efficacy), structural/organizational (clinic location/proximity to public transportation, hours of operation, wraparound services, accepting Medicaid and other insurance-related issues), and community (e.g. improving experiences in education, the juvenile criminal-legal system, medical, and social service systems) factors that serve as barriers and facilitators contributing to disparities in community mental health service utilization for BIPOC youth. Importantly, we conclude with suggestions for dismantling inequitable systems, increasing accessibility, availability, appropriateness, and acceptability of services, and ultimately reducing disparities in efficacious mental health service utilization for BIPOC youth.
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Affiliation(s)
| | | | | | - Sycarah Fisher
- Department of Educational Psychology, University of Georgia
| | | | | | - Brian Griffith
- Graduate School of Education and Psychology, Pepperdine University
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Bauer AG, Berkley-Patton JY. Recruitment of Young Black Men into Trauma and Mental Health Services Research: Recommendations and Lessons Learned. JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE 2023; 16:2. [PMID: 38284106 PMCID: PMC10812841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Young Black/African American men are more likely to experience repeated trauma that escalates throughout young adulthood, compared to young White men. Exposure to trauma has impacts on mental health outcomes, but young Black men face substantial barriers to mental health care. In order to begin to address these disparities, it is imperative to increase understanding of the needs, preferences, and priorities of young Black men for mental health care services following trauma. Yet, young Black men are often underrepresented in mental health services research. The purpose of the current study was to describe strategies for recruitment of young Black men with previous trauma exposure from broad urban community settings in Kansas City, Missouri, for participation in a qualitative study exploring beliefs, attitudes, and norms regarding mental health care. A total of 70 young Black/African American men aged 18-30 completed the initial recruitment process, and 55 of these men were consented as participants who completed the study. The majority of participants were recruited from barbershops (n = 21), followed by community-wide events (n = 11) and referrals (n = 11). Few participants were recruited from faith-based settings. Strategies for facilitation of study recruitment and focus group attendance are discussed. These practices may contribute to development of mental health interventions that are relevant, feasible, and sustainable, as well as restoring and advancing research relationships with racial/ethnic minority populations and contributing to racial equity.
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Banks A. Black Adolescent Experiences with COVID-19 and Mental Health Services Utilization. J Racial Ethn Health Disparities 2021; 9:1097-1105. [PMID: 33909283 PMCID: PMC8080856 DOI: 10.1007/s40615-021-01049-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/01/2022]
Abstract
Background COVID-19 is disproportionately impacting communities of color. Black adolescents are among the most vulnerable to COVID-19, have high mental health service needs, and have low mental health services utilization. During this time of great physical threat due to COVID-19, it is equally important to understand and support the mental health of Black adolescents. Method This study collected open-ended survey item responses from adolescents (12–17 years old) that identified as Black, living in a city in the Southeastern United States (n = 33). Grounded theory was used to analyze the data, revealing details of the lived experience of these Black adolescents during the COVID-19 pandemic. Results Black adolescents reported that COVID-19 has been both positive and negative for them. Family is of utmost importance to them, as are their peers, whom they do not get to interact with due to changes in the operation of schools. Despite experiencing stress, adaptive responses to COVID-19 are reported. Black adolescents continue to cite issues with mental health services and providers. Financial issues were a common theme for these youth, blocking access to services and causing issues in the home environment. Conclusions Mental health service providers must address the service access and quality issues repeatedly reported by Black adolescents. Direct action must be taken to facilitate an increase in Black adolescents mental health services utilization and satisfaction. Changes are needed at the individual and macro levels to alter the experience of one of our most vulnerable groups. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01049-w.
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Affiliation(s)
- Andrae Banks
- Department of Social Work, North Carolina Central University, 1801 Fayetteville Street, Durham, NC, 27707, USA.
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Expectations and Preferences for Psychotherapy Among African American and White Young Adults. J Racial Ethn Health Disparities 2020; 8:678-689. [PMID: 32729105 DOI: 10.1007/s40615-020-00827-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/22/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study examined beliefs, expectations, and preferences related to mental health problems and treatment in a sample of young adults who are in a developmental period when many types of psychopathology emerge. Prior studies on this topic have primarily included samples that are older and predominately White. It is not clear whether results from that research generalize to diverse samples of young adults. METHODS Participants were 370 undergraduate students (41.3% African American; 76.5% female) who completed questionnaires about expectations and preferences for psychotherapy and therapists. RESULTS Findings regarding racial differences include African Americans having less experience with mental health services and different goals for psychotherapy than did Whites. Additionally, African Americans, relative to Whites, demonstrated stronger preferences for couple, family, and group psychotherapy, a male therapist their same race, and a therapist who is assertive and structured in session. CONCLUSIONS The results of this study provide information about young adults' perceptions, expectations, and preferences related to mental health problems and psychotherapy. Findings suggest some barriers to treatment that might be addressed to improve treatment engagement and utilization of psychological services among young adults in general and among African American young adults specifically.
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Akbari M, Alavi M, Maghsoudi J, Irajpour A, Lopez V, Cleary M. Mastering the Art of Collaboration: Supporting Family Caregivers of Mental Health Patients by Service Providers in Iran. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:54-61. [PMID: 30171394 DOI: 10.1007/s10488-018-0893-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Responsive support systems, designed and promoted by policy makers, are critical in supporting family caregivers. The purpose of this study was to explore viewpoints of service providers in supporting family caregivers of mental health patients in Iran. In this qualitative study, a purposive sample of 29 service providers and policy makers consented to participate in semi-structured interviews. Data were analyzed through qualitative content analysis and three main categories and seven sub-categories were identified. The main categories were: interpersonal collaboration, intra-organization collaboration and inter-sectorial collaboration. A common theme in this study was that service providers play a key role in coordinating responsive support services for Iranian family caregivers of mental health patients across all levels. The increasing complexity of the health care system and resource limitations have created complex problems, which require the use of participatory approaches by the various specialties, disciplines and departments to provide complementary services and mutual support. This approach is the best way of ensuring that service users receive the most relevant services from the right service providers in the right place as and when needed.
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Affiliation(s)
- Mohammad Akbari
- Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mousa Alavi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Jahangir Maghsoudi
- Nursing & Midwifery Care Research Center, Mental Health Nursing Department, Faculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Irajpour
- Nursing & Midwifery Care Research Center, Critical Care Nursing Department, Faculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Violeta Lopez
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michelle Cleary
- School of Health Sciences, University of Tasmania, Sydney, NSW, Australia
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Oluwoye O, Kriegel L, Alcover KC, Compton MT, Cabassa LJ, McDonell MG. The impact of early family contact on quality of life among non-Hispanic Blacks and Whites in the RAISE-ETP trial. Schizophr Res 2020; 216:523-525. [PMID: 31902559 PMCID: PMC7239728 DOI: 10.1016/j.schres.2019.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/10/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Oladunni Oluwoye
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, Spokane, WA 99202, United States of America.
| | - Liat Kriegel
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, Spokane, WA 99202, United States of America.
| | - Karl C. Alcover
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, Spokane WA 99202
| | | | - Leopoldo J. Cabassa
- George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis MO, 63130
| | - Michael G. McDonell
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, Spokane WA 99202
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Jon-Ubabuco N, Dimmitt Champion J. Perceived Mental Healthcare Barriers and Health-seeking Behavior of African-American Caregivers of Adolescents with Mental Health Disorders. Issues Ment Health Nurs 2019; 40:585-592. [PMID: 30917089 DOI: 10.1080/01612840.2018.1547803] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
African-American adolescents with mental health disorders are more likely to experience higher rates of depressive moods but are less likely to utilize mental health resources. Mental healthcare providers inform caregivers of adolescents with mental health issues about appropriate resources to facilitate appropriate treatment decisions. Although we understand rates of utilization of services, little understanding exists concerning socio-ecological barriers African-American caregivers experience when seeking mental health care for their adolescents. This study explores African-American caregiver perceptions of barriers to mental health care for adolescents with mental health disorders. We sought to understand how these perceptions influence African-American caregiver mental health-seeking behavior. This qualitative study utilized semi-structured interviews using a grounded theory approach to identify common themes describing experiences of African-American caregivers accessing mental health care for their adolescents. Previous caregiver experiences with mental illness, perceptions of social support, early intervention by educators and extrinsic behavior requiring medication compliance affected caregiver decision-making. Stigma associated with mental illness was a potential barrier to access to mental health care. Financial barriers that prevent access to care and an overall belief that mental health may not be as important as other issues was not identified as affecting health-seeking behaviors for mental health care. Caregivers who struggled with mental health issues themselves recognized these in adolescents and sought mental healthcare services. Caregiver previous experiences with mental healthcare services influenced their decision-making. Healthcare provider ability to engage adolescents, caregivers, and support systems increases the possibilities for positive experiences and continuation of treatment.
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Affiliation(s)
- Nneka Jon-Ubabuco
- a School of Nursing, The University of Texas at Austin , Austin , Texas , USA
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9
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Reardon T, Harvey K, Baranowska M, O'Brien D, Smith L, Creswell C. What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies. Eur Child Adolesc Psychiatry 2017; 26:623-647. [PMID: 28054223 PMCID: PMC5446558 DOI: 10.1007/s00787-016-0930-6] [Citation(s) in RCA: 277] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 12/05/2016] [Indexed: 11/21/2022]
Abstract
A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.
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Affiliation(s)
- Tessa Reardon
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
| | - Magdalena Baranowska
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Doireann O'Brien
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Lydia Smith
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Ofonedu ME, Belcher HME, Budhathoki C, Gross DA. Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 26:863-876. [PMID: 28584498 PMCID: PMC5456294 DOI: 10.1007/s10826-016-0603-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This mixed method study examined factors associated with parents not attending their child's mental health treatment after initially seeking help for their 2-5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents who initiated mental health treatment (71% African American or multi-racial; 97.6% low-income), 36 (29.3%) never attended their child's first treatment session. Socio-demographic characteristics, parenting stress, depression, severity of child behavior problems, and length of treatment delay from intake to first scheduled treatment session were compared for families who did and did not attend their first treatment session. Parents who never attended their child's first treatment session were more likely to live with more than 4 adults and children (p=.007) and have more depressive symptoms (p=.003). Median length of treatment delay was 80 days (IQR =55) for those who attended and 85 days (IQR =67.5) for those who did not attend their child's first treatment session (p=.142). Three themes emerged from caregiver interviews: (a) expectations about the treatment, (b) delays in getting help, and (c) ambivalence about research participation. Findings suggest the need to develop better strategies for addressing risk factors early in the treatment process and reducing the length of time families with adverse psychosocial circumstances must wait for child mental health treatment.
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Affiliation(s)
- Mirian E Ofonedu
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1750 East Fairmount Avenue, Baltimore, MD 21231, USA
| | - Harolyn M E Belcher
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | | | - Deborah A Gross
- Johns Hopkins University School of Nursing, Baltimore, MD 21205
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Burkett CA. Obstructed Use: Reconceptualizing the Mental Health (Help-Seeking) Experiences of Black Americans. JOURNAL OF BLACK PSYCHOLOGY 2017. [DOI: 10.1177/0095798417691381] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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12
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McCann TV, Mugavin J, Renzaho A, Lubman DI. Sub-Saharan African migrant youths' help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study. BMC Psychiatry 2016; 16:275. [PMID: 27484391 PMCID: PMC4971683 DOI: 10.1186/s12888-016-0984-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/28/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Many young migrants and their parents are reluctant to seek help for mental health and substance use problems. Help-seeking delays can result in longer duration of untreated problems and poorer outcomes. In this study, we aimed to identify the help-seeking barriers and facilitators for anxiety, depression and alcohol and drug use problems in young people from recently established sub-Saharan African migrant communities. METHODS A qualitative study, incorporating individual, in-depth interviews and focus group discussions, was undertaken in Melbourne, Australia. Twenty-eight young sub-Saharan African migrants participated in the individual interviews, and 41 sub-Saharan African-born parents and key community leaders participated in 4 focus groups. All participants were aged 16 years or over. A thematic analysis of the data was undertaken. RESULTS Themes and related sub-themes were abstracted from the data, reflecting the young people's, parents' and key community leaders' beliefs about barriers and facilitators to help-seeking for mental health and substance use problems. Four help-seeking barriers were identified: stigma of mental illness, lack of mental health literacy in parents and young people, lack of cultural competency of formal help sources, and financial costs deterring access. Five help-seeking facilitators were abstracted: being open with friends and family, strong community support systems, trustworthiness and confidentiality of help-sources, perceived expertise of formal help-sources, increasing young people's and parents' mental health literacy. CONCLUSION Programs that identify and build on help-seeking facilitators while addressing help-seeking barriers are needed to address mental health issues among young sub-Saharan African migrants. Strategies to address help-seeking barriers should consider counteracting stigma and increasing mental health literacy in sub-Saharan African communities, increasing health providers' cultural competency and perceived trustworthiness, and addressing financial barriers to accessing services.
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Affiliation(s)
- Terence V. McCann
- Discipline of Nursing, Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 1428, Melbourne, 8001 VIC Australia
| | - Janette Mugavin
- Turning Point and Eastern Health, Melbourne, Australia ,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | | | - Dan I. Lubman
- Turning Point and Eastern Health, Melbourne, Australia ,Monash University, Melbourne, Australia
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Kim RE, Becker KD, Stephan SH, Hakimian S, Apocada D, Escudero PV, Chorpita BF. Connecting Students to Mental Health Care: Pilot Findings from an Engagement Program for School Nurses. ACTA ACUST UNITED AC 2015; 8:87-103. [PMID: 26251671 DOI: 10.1080/1754730x.2015.1021821] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Schools function as the major provider of mental health services (MHS) for youth, but can struggle with engaging them in services. School nurses are well-positioned to facilitate referrals for MHS. This pilot study examined the feasibility, acceptability, and preliminary efficacy of an engagement protocol (EP) designed to enhance school nurses' utilization of evidence-based engagement practices when referring youth to MHS. Participants were six school nurses and twenty-five adolescents in a large, urban school district. School nurses reported positive attitudes towards the EP, suggesting that they found it feasible and acceptable. Though there were small increases in school nurses' use of engagement practices and in adolescents' readiness for services following training, due to limited sample size, differences were not statistically significant. Still, pilot results suggest preliminary efficacy of training school nurses to strategically implement evidence-based engagement practices to increase adolescents' engagement in MHS.
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Becker KD, Buckingham SL, Brandt NE. Engaging youth and families in school mental health services. Child Adolesc Psychiatr Clin N Am 2015; 24:385-98. [PMID: 25773331 DOI: 10.1016/j.chc.2014.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this article, an overview is provided of strategies to engage youth and their families in school mental health (SMH) services throughout the course of treatment. Resources are outlined to help SMH providers determine which strategies are most suitable for youth and their families, based on outcomes desired, barriers to engagement, and stage of treatment. Four case vignettes are presented to describe implementation of these strategies.
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Affiliation(s)
- Kimberly D Becker
- Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, Room 424, Baltimore, MD 21201, USA.
| | - Sara L Buckingham
- Human Services Psychology Program, University of Maryland, Baltimore County, 1000 Hilltop Circle, Math/Psych Room 312, Baltimore, MD 21250, USA
| | - Nicole Evangelista Brandt
- Department of Psychology, Columbus State Community College, 550 East Spring Street, Room 335B, Columbus, OH 43215, USA
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Castro F, AhnAllen CG, Wiltsey-Stirman S, Lester-Williams K, Klunk-Gillis J, Dick AM, Resick PA. African American and European American veterans' perspectives on receiving mental health treatment. Psychol Serv 2015; 12:330-8. [PMID: 25822316 DOI: 10.1037/a0038702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Little is known about client attitudes, especially veterans', toward the types of structured interventions that are increasingly being offered in public sector and U.S. Department of Veterans Affairs mental health clinics, nor is the possible impact these attitudes may have on treatment engagement well understood. Previous work indicates that attitudes of African Americans and European Americans toward treatment may differ in important ways. Attitudes toward treatment have been a proposed explanation for lower treatment engagement and higher dropout rates among African Americans compared with European Americans. Yet to date, the relationship between race and attitudes toward treatment and treatment outcomes has been understudied and the findings inconclusive. The purpose of this study was to explore African American and European American veteran attitudes toward mental health care, especially as they relate to structured treatments. Separate focus groups were conducted with 24 African American and 37 European American military veterans. In general, both groups reported similar reasons for seeking 0treatment and similar thoughts regarding the purpose of therapy. Differences emerged primarily regarding therapist preferences. In both groups, some participants expressed favorable opinions of structured treatments and others expressed negative views; treatment preferences did not appear to be influenced by race.
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Schubert JR, Coles ME, Heimberg RG, Weiss BD. Disseminating treatment for anxiety disorders step 2: peer recommendations to seek help. J Anxiety Disord 2014; 28:712-6. [PMID: 25145571 PMCID: PMC4160353 DOI: 10.1016/j.janxdis.2014.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 07/20/2014] [Indexed: 11/27/2022]
Abstract
Despite the high prevalence of and significant psychological burden caused by anxiety disorders, as few as 25% of individuals with these disorders seek treatment, and treatment seeking by African-Americans is particularly uncommon. This purpose of the current study was to gather information regarding the public's recommendations regarding help-seeking for several anxiety disorders and to compare Caucasian and African-American participants on these variables. A community sample of 577 US adults completed a telephone survey that included vignettes portraying individuals with generalized anxiety disorder (GAD), social phobia/social anxiety disorder (SP/SAD), panic disorder (PD), and for comparison, depression. The sample was ½ Caucasian and ½ African American. Respondents were significantly less likely to recommend help-seeking for SP/SAD and GAD (78.8% and 84.3%, respectively) than for depression (90.9%). In contrast, recommendations to seek help for panic disorder were common (93.6%) and similar to rates found for depression. The most common recommendations were to seek help from a primary care physician (PCP). African Americans were more likely to recommend help-seeking for GAD than Caucasians. Findings suggested that respondents believed individuals with anxiety disorders should seek treatment. Given that respondents often recommended consulting a PCP, we recommend educating PCPs about anxiety disorders and empirically-supported interventions.
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Affiliation(s)
| | - Meredith E. Coles
- Binghamton University (4400 Vestal Parkway East, Vestal, NY 13902, Department of Psychology, Clearview Hall ; )
| | - Richard G. Heimberg
- Temple University (1701 North 13th Street, Philadelphia, PA, USA, 19122, Department of Psychology, Weiss Hall, )
| | - Barry D. Weiss
- University of Arizona College of Medicine (1642 East Helen Street, Tuscon, AZ, USA 85719, Department of Family & Community Medicine, )
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