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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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2
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Zechmeister-Koss I, Strohmaier C, Hölzle L, Bauer A, Goodyear M, Christiansen H, Paul JL. Economic Evaluation of Family-Focused Programs When Parents Have a Mental Health Problem: Methodological Considerations. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:704-711. [PMID: 36503037 DOI: 10.1016/j.jval.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES The nature of adverse effects of parental mental health problems and of the interventions to address them may require specific designs of economic evaluation studies. Nevertheless, methodological guidance is lacking. We aim to understand the broad spectrum of adverse effects from parental mental health problems in children and the economic consequences on an individual and societal level to navigate the design of economic evaluations in this field. METHODS We conducted a systematic literature search of empirical studies on children's adverse effects from parental mental illness. We clustered types of impact, identified individual and public cost consequences, and illustrated the results in an impact inventory. RESULTS We found a wide variety of short- and long-term (mental) health impacts, impacts on social functioning and socioeconomic implications for the children individually, and adverse effects on the societal level. Consequently, public costs can occur in various public sectors (eg, healthcare, education), and individuals may have to pay costs privately. CONCLUSIONS Existing evaluations in this field mostly follow standard methodological approaches (eg, cost-utility analysis using quality-adjusted life-years) and apply a short-time horizon. Our findings suggest applying a long-term time horizon (at least up to early adulthood), considering cost-consequence analysis and alternatives to health-related quality of life and quality-adjusted life-years as outcome measures, and capturing the full range of possible public and private costs.
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Affiliation(s)
| | | | - Laura Hölzle
- Village Research Group, Medical University Innsbruck, Innsbruck, Austria
| | - Annette Bauer
- London School of Economics, Care Policy and Evaluation Centre (CPEC), London, England, UK
| | - Melinda Goodyear
- Monash University Australia, School of Rural Health, Melbourne, VIC, Australia
| | | | - Jean L Paul
- Village Research Group, Medical University Innsbruck, Innsbruck, Austria
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3
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Lange S, Gossmann E, Hofmann S, Fegert JM. Condemn or Treat? The Influence of Adults' Stigmatizing Attitudes on Mental Health Service Use for Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15951. [PMID: 36498023 PMCID: PMC9740034 DOI: 10.3390/ijerph192315951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Stigmatizing attitudes towards mental disorders influence parents’ help-seeking behavior for their child’s mental health problems. As untreated mental disorders can cause morbidity and mortality, such parental attitudes are a serious barrier for public health promotion. Therefore, the help-seeking readiness in a distressed child’s broad social environment is essential. However, the role of stigma was unexplored in this context. This study empirically investigated the influence of adults’ stigmatizing attitudes towards mentally disabled people on their readiness to seek professional help for children’s mental health issues. Data from a representative German sample (N = 1906; 52% female) were collected between July and October 2021. A heteroscedastic ordered probit model was used for estimation. An empirical analysis provides evidence for a significant negative relationship between adults’ stigmatizing attitudes and their readiness to initiate mental health support for children (ß = −0.01; p < 0.001). Support acceptance seems to be independent of having children. To tackle stigmatizing attitudes and to promote public health, mental health literacy should be fostered through broad-based approaches. Awareness should be raised that children are also entitled to mental health care, just as they are in other health areas. Policy makers need to promote comprehensive information about mental illnesses and create incentives for acute and preventive service use.
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Affiliation(s)
- Stephanie Lange
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
- Competence Area Mental Health Prevention in the Competence Network Preventive Medicine Baden-Württemberg, Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
| | - Emily Gossmann
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
- Competence Area Mental Health Prevention in the Competence Network Preventive Medicine Baden-Württemberg, Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
| | - Sophie Hofmann
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
- Competence Area Mental Health Prevention in the Competence Network Preventive Medicine Baden-Württemberg, Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), University Ulm, Kornhausgasse 9, 89073 Ulm, Germany
| | - Jörg M. Fegert
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
- Competence Area Mental Health Prevention in the Competence Network Preventive Medicine Baden-Württemberg, Clinic for Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075 Ulm, Germany
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4
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Sawrikar V, Diaz AM, Tully L, Hawes DJ, Moul C, Dadds MR. Bridging the gap between child mental health need and professional service utilisation: Examining the influence of mothers' parental attributions on professional help-seeking intentions. Eur Child Adolesc Psychiatry 2022; 31:239-251. [PMID: 33211203 PMCID: PMC8837521 DOI: 10.1007/s00787-020-01682-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/30/2020] [Indexed: 11/30/2022]
Abstract
There is a significant gap between the need for child mental health services and use of these services by families. Parental attributions may play a role in this. This study examined whether mothers' attributions about their child's problems influence professional help-seeking intentions in a general sample of community mothers. Secondary analysis re-examined this hypothesis in a subgroup of mothers of children with clinically elevated mental health symptoms. Cross-sectional survey data were collected from mothers (N = 184) of children aged between 2 and 12 years recruited from the community. Mothers completed self-report questionnaires measuring parental attributions: child-responsible attributions and parental self-efficacy; professional help-seeking intentions; and psychosocial covariates: child mental health, mothers' anxiety and depression, child age, gender, marital status, education, and professional help-seeking experience. Hierarchical regression modelling indicated that parental attributions explained professional help-seeking intentions after controlling for covariates in both the general sample (ΔF = 6.07; p = .003) and subgroup analysis (ΔF = 10.22, p = .000). Professional help-seeking intentions were positively associated with child-responsible attributions (β = .19, p = .002) but not parental self-efficacy (β = - .01, p = .865) in the general sample, while positively associated with child-responsible attributions (β = .20, p = .009) and negatively associated with parental self-efficacy (β = - .16, p = .034) in the subgroup analysis. Findings were independent of the presence of clinically elevated symptoms, problem type, and severity. Overall, the findings support models suggesting that parental attributions have a role in professional help-seeking for child mental health problems.
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Affiliation(s)
- Vilas Sawrikar
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia. .,Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom.
| | - Antonio Mendoza Diaz
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia ,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Lucy Tully
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - David J. Hawes
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Caroline Moul
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Mark R. Dadds
- School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
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Barnett ML, Klein CC, Gonzalez JC, Sanchez BE, Rosas YG, Corcoran F. How do Lay Health Worker Engage Caregivers? A Qualitative Study to Enhance Equity in Evidence-Based Parenting Programs. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2021; 8:221-235. [PMID: 37323826 PMCID: PMC10266647 DOI: 10.1080/23794925.2021.1993111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Engaging caregivers in their children's mental health treatment is critical for delivering high quality, evidence-based care, particularly for young children with externalizing behaviors. Lay health workers (LHWs), including peer providers and promotoras de salud, have been identified as important workforces in addressing structural and stigma-related barriers to engagement in mental health services. Importantly, research has suggested that LHWs may be integral in efforts to address engagement disparities in evidence-based behavioral parent training programs (BPTs) for Latinx caregivers. The purpose of the study was to understand how different LHW workforces engage caregivers within their usual services, in order to inform strategies that improve access to and engagement in BPTs. Qualitative interviews were conducted with two different LHW workforces: volunteer LHWs (i.e., promotoras de salud) (n = 14), who were part of a community-embedded network, and paid LHWs (i.e., parent support partners, home visitors) (n = 9) embedded within children's mental health agencies. Participants were predominately Latinx (79%) and female (96%). Qualitative analyses revealed three primary themes related to engagement strategies used by LHWs to address barriers to care: 1.) Building Trust, 2.) Empowerment, 3.) Increasing Access. Although the majority of themes and sub-themes were consistent across the two LHW workforces, agency-embedded LHWs often discussed having the means to provide resources through their organizations, whereas community-embedded LHWs discussed acting as a bridge to services by providing information and conducting outreach. Findings have implications for partnering with different workforces of LHWs to increase equity in access to BPTs.
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Affiliation(s)
- Miya L Barnett
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, CA
| | - Corinna C Klein
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, CA
| | - Juan Carlos Gonzalez
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, CA
| | - Berta Erika Sanchez
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, CA
| | - Yessica Green Rosas
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, CA
| | - Frederique Corcoran
- Department of Counseling, Clinical and School Psychology, University of California, Santa Barbara, CA
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6
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Crane ME, Atkins MS, Becker SJ, Purtle J, Olino TM, Kendall PC. The effect of caregiver key opinion leaders on increasing caregiver demand for evidence-based practices to treat youth anxiety: protocol for a randomized control trial. Implement Sci Commun 2021; 2:107. [PMID: 34556182 PMCID: PMC8460198 DOI: 10.1186/s43058-021-00213-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. Direct-to-consumer marketing offers a different approach to address the unmet need for youth receiving effective treatments. Involving a local caregiver key opinion leader in direct-to-consumer initiatives may be an effective strategy to increase caregiver demand for CBT. Research indicates that key opinion leaders improve health promotion campaigns, but key opinion leaders have not been studied in the context of increasing caregiver demand for evidence-based treatments. Method Project CHAT (Caregivers Hearing about Anxiety Treatments) will test the role of key opinion leader participation in conducting outreach presentations to increase caregiver desire to seek CBT for their youth’s anxiety. Caregiver attendees (N = 180) will be cluster randomized by school to receive one of two different approaches for presentations on CBT for youth anxiety. Both approaches will involve community outreach presentations providing information on recognizing youth anxiety, strategies caregivers can use to decrease youth anxiety, and how to seek CBT for youth anxiety. The researcher-only condition will be co-facilitated by two researchers. In the key opinion leader condition, a caregiver key opinion leader from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. In line with the theory of planned behavior, caregiver attendees will complete measures assessing their knowledge of, attitudes towards, perceived subjective norms about, and intention to seek CBT pre- and post-presentation; they will indicate whether they sought CBT for their youth at 3-month follow-up. Results will be analyzed using a mixed method approach to assess the effectiveness of a key opinion leader to increase caregiver demand for CBT. Discussion This study will be the first to examine the potential of key opinion leaders to increase caregiver demand for CBT. If proven effective, the use of key opinion leaders could serve as a scalable dissemination strategy to increase the reach of evidence-based treatments. Trial registration This trial was registered on clinicaltrials.gov (NCT04929262) on June 18, 2021. At the time of trial registration, pre/post-presentation data had been collected from 17 participants; thus, it was retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00213-x.
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Affiliation(s)
- Margaret E Crane
- Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA, 19122, USA.
| | - Marc S Atkins
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois, Chicago, 1747 West Roosevelt Road, Suite 155, Chicago, IL, 60608, USA
| | - Sara J Becker
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI, 02912, USA
| | - Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Nesbitt Hall, Room 351, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA, 19122, USA
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7
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Goodwin AKB, Chen GL, Long ACJ. Mental health, well‐being, and help‐seeking in schools among black adolescents: The role of discrimination in high‐achieving academic settings. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Aijah K. B. Goodwin
- Department of Psychology Louisiana State University Baton Rouge Louisiana USA
| | - Grace L. Chen
- Department of Psychology Louisiana State University Baton Rouge Louisiana USA
| | - Anna C. J. Long
- Department of Psychology Louisiana State University Baton Rouge Louisiana USA
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8
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Turner EA, Plitt C, Gamez Y, Godfrey C. Therapy Fears and Help-Seeking Behaviors among Mothers: Examining Racial Differences in Mental Health Services. Community Ment Health J 2021; 57:808-813. [PMID: 32951113 DOI: 10.1007/s10597-020-00711-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/12/2020] [Indexed: 11/24/2022]
Abstract
In the United States, approximately 20% of children and adolescents meet diagnostic criteria for a mental health diagnosis, but few receive treatment. The purpose of the current study was to explore the factors that contribute to help-seeking among mothers from diverse ethnic groups (52.5% European American/White, 23% African American/Black, and 24.6% Latinx). Participants were 122 mothers recruited from 2014 to 2017 through a convenience sample in Central Texas. Using MANOVA, results indicated that mother with no history of therapy use reported more fears about seeking therapy for children. Additionally, there was a trend towards African American mothers reporting more fears about therapists' responsiveness and image concerns. Finally, therapy fears significantly predicted mother's intentions to delay seeking therapy in the future. Implications for research and practice are discussed.
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Affiliation(s)
- Erlanger A Turner
- Graduate School of Education and Psychology, Pepperdine University, 6100 Center Drive, 5th Floor, Los Angeles, CA, 90045, USA.
| | - Corina Plitt
- University of Houston-Downtown, Houston, Texas, USA
| | - Yadira Gamez
- University of Houston-Downtown, Houston, Texas, USA
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9
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Parent help-seeking behaviour: Examining the impact of parent beliefs on professional help-seeking for child emotional and behavioural difficulties. THE EDUCATIONAL AND DEVELOPMENTAL PSYCHOLOGIST 2020. [DOI: 10.1017/edp.2019.8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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10
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Reeder K, Park AL, Chorpita BF. Turning Back to Treatment: The Effect of Attendance and Symptom Outcomes on Subsequent Service Use. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 47:641-647. [PMID: 32170492 DOI: 10.1007/s10488-020-01032-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study explored whether post-treatment symptom severity moderated the association between session attendance during an initial treatment episode and subsequent mental health service use. Data on attendance, symptom severity, and service use were gathered from an effectiveness trial testing a modular treatment for youth anxiety, depression, disruptive behavior, and traumatic stress. Multilevel logistic regression analyses showed a significant interaction between attendance and post-treatment symptom severity on subsequent service use, such that attendance significantly predicted subsequent service use when post-treatment symptom severity was in the normal range. Implications regarding the influence of treatment engagement on future help-seeking are discussed.
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Affiliation(s)
- Kendal Reeder
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0812, USA.
- Child and Adolescent Services Research Center, San Diego, CA, 92123, USA.
| | - Alayna L Park
- University of California, Los Angeles, Los Angeles, USA
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11
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Hurley D, Swann C, Allen MS, Ferguson HL, Vella SA. A Systematic Review of Parent and Caregiver Mental Health Literacy. Community Ment Health J 2020; 56:2-21. [PMID: 31541315 DOI: 10.1007/s10597-019-00454-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 09/07/2019] [Indexed: 12/14/2022]
Abstract
This study aimed to systematically review the current body of research on parent and caregiver mental health literacy. Electronic databases were searched in January 2018 with 21 studies meeting inclusion criteria. A narrative synthesis of quantitative and qualitative studies was conducted. Findings across studies suggest that parents and caregivers had limited mental health knowledge. Factors associated with help-seeking included cultural and religious beliefs, financial and knowledge barriers, fear and mistrust of treatment services, and stigma. Notable limitations include non-representative samples, cross-sectional research designs, and use of inconsistent and non-validated study measures. Research would benefit from more diverse samples, an increased focus on prevention, and controlled trials of educational programmes targeting mental health literacy.
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Affiliation(s)
- Diarmuid Hurley
- School of Psychology, University of Wollongong, Wollongong, Australia. .,Global Alliance for Mental Health and Sport, School of Psychology, University of Wollongong, Wollongong, Australia.
| | - Christian Swann
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia.,Centre for Athlete Development, Experience & Performance, Southern Cross University, Coffs Harbour, Australia
| | - Mark S Allen
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Helen L Ferguson
- School of Psychology, University of Wollongong, Wollongong, Australia.,English Institute of Sport, Manchester, England, UK
| | - Stewart A Vella
- School of Psychology, University of Wollongong, Wollongong, Australia.,Global Alliance for Mental Health and Sport, School of Psychology, University of Wollongong, Wollongong, Australia
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12
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Barnett ML, Bernal NA, Luis Sanchez BE. Direct-to-Consumer Marketing for Parent-Child Interaction Therapy: Impact of Language and Messenger. JOURNAL OF CHILD AND FAMILY STUDIES 2020; 29:71-81. [PMID: 33311965 PMCID: PMC7728243 DOI: 10.1007/s10826-019-01575-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVES Parent-Child Interaction Therapy (PCIT) is an effective therapy to treat early onset disruptive behavior problems and child physical maltreatment. In order to support the successful implementation and sustainment of PCIT, strategies are needed to recruit parents into care, especially for racial and ethnic minority families, who often have lower rates of access and utilization of mental health services. METHODS This study investigated the impact of direct-to-consumer advertisements on parents' attitudes towards PCIT. Advertisements were delivered in Spanish and English, with either a parent testimony or therapist explaining the treatment. Participants were parents of children between the ages of 2 and 7, who were recruited through Amazon Mechanical Turk. Participants (N = 204) were 38.2% female and 49.5% Spanish speaking. RESULTS There were no main effects for language or messenger related to PCIT Help-Seeking Intentions, Attitudes, or Stigmatization. However, there was an interaction effect for language and messenger for PCIT Help-Seeking Intentions. Specifically, Spanish-speaking participants had higher intentions when the messenger was a therapist rather than a parent, and had lower intentions than English-speaking parents when the messenger was a parent. CONCLUSIONS These findings are promising for direct-to-consumer advertising strategies that may help recruit more Spanish-speaking families into PCIT, which could help address disparities in access to mental health services.
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Affiliation(s)
- Miya L Barnett
- Department of Counseling, Clinical and School Psychology University of California Santa Barbara
| | - Natalie A Bernal
- Department of Counseling, Clinical and School Psychology University of California Santa Barbara
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13
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Yonek JC, Dauria EF, Kemp K, Koinis-Mitchell D, Marshall BDL, Tolou-Shams M. Factors Associated With Use of Mental Health and Substance Use Treatment Services by Justice-Involved Youths. Psychiatr Serv 2019; 70:586-595. [PMID: 31138054 PMCID: PMC6713457 DOI: 10.1176/appi.ps.201800322] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Nonincarcerated (community-supervised) youths who are first-time offenders have high rates of mental and substance use disorders. However, little is known about their use of psychiatric services (mental health and substance use) or factors associated with service use. This study examined the prevalence, determinants, and barriers to service use among community-supervised youths. METHODS Data were from a longitudinal study of mental health and substance use outcomes among adolescents ages 12-18 from a northeastern family court in which caregivers and youths completed assessments (N=423 dyads). The Behavior Assessment System for Children, Second Edition, assessed youths' psychiatric symptoms. The Child and Adolescent Services Assessment assessed service use and barriers. Family functioning and caregiver-adolescent communication were assessed with the McMaster Family Assessment Device and the Parent-Adolescent General Communication Scale, respectively. Multivariable regression analyses examined the cross-sectional relationship between youths' service use and determinants of use at baseline. RESULTS Of the 423 youths, 49% experienced psychiatric symptoms and 36% used psychiatric services in the past 4 months. The highest adjusted odds of service use were associated with youths' psychiatric symptoms and caregivers' history of a psychiatric diagnosis. The lowest odds were associated with caregivers' identifying as being from racial and ethnic minority groups. Caregiver-reported barriers to service use differed according to prior service use and by caregiver race-ethnicity. CONCLUSIONS Results suggest a need for interventions to increase access to and engagement in psychiatric services for community-supervised youths and the importance of caregiver factors in designing such interventions.
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Affiliation(s)
- Juliet C Yonek
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Emily F Dauria
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Kathleen Kemp
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Daphne Koinis-Mitchell
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Brandon D L Marshall
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
| | - Marina Tolou-Shams
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, and Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco (Yonek, Dauria, Tolou-Shams); Bradley/Hasbro Children's Research Center, Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island (Kemp, Koinis-Mitchell); Department of Psychiatry and Human Behavior, Warren Alpert Medical School (Kemp) and Department of Epidemiology, School of Public Health (Marshall), Brown University, Providence
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14
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Hoffer R, Fröhlich-Gildhoff K. Inanspruchnahme von Hilfe und Versorgung bei psychischen Auffälligkeiten im Kindergartenalter. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Trotz Gefahr der Chronifizierung ist die Inanspruchnahme professioneller Unterstützung beim Vorliegen von psychischen Auffälligkeiten im Kindergartenalter gering. In der vorliegenden Übersichtsarbeit wird die Studienlage zu subjektiven Barrieren aus Elternperspektive sowie zu Prädiktoren der Inanspruchnahme von Unterstützungsmaßnahmen zusammengefasst. Neben äußeren Hindernissen benennen Eltern mangelnde Kenntnisse über das Hilfesystem sowie negative Überzeugungen gegenüber Inanspruchnahme als Barrieren. Als elternbezogene Prädiktoren der Inanspruchnahme zeigen sich v. a. positive Einstellungen bzw. Vorbehalte gegenüber Inanspruchnahme sowie eigenes elterliches Inanspruchnahmeverhalten bei psychischen Schwierigkeiten. Ein höheres Alter der Kinder, die Schwere der Psychopathologie sowie Entwicklungsverzögerungen sind kindbezogene Prädiktoren. Als Hauptprädiktor stellt sich die elterliche Problemerkennung und Sorge heraus. Die Rolle der Fachkräfte in der Kindertagesbetreuung sollte in zukünftigen Studien systematischer berücksichtigt werden.
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Affiliation(s)
- Rieke Hoffer
- Zentrum für Kinder- und Jugendforschung an der Evangelischen Hochschule Freiburg
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15
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Thurston IB, Hardin R, Decker K, Arnold T, Howell KH, Phares V. Black and White Parents' Willingness to Seek Help for Children's Internalizing and Externalizing Symptoms. J Clin Psychol 2017. [PMID: 28620969 DOI: 10.1002/jclp.22495] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Understanding social and environmental factors that contribute to parental help-seeking intentions is an important step in addressing service underutilization for children in need of treatment. This study examined factors that contribute to parents' intentions to seek formal and informal help for child psychopathology (anxiety and attention-deficit/hyperactivity disorder [ADHD]). METHOD A total of 251 parents (N = 128 mothers, N = 123 fathers; 49% Black, 51% White) read 3 vignettes describing children with anxiety, ADHD, and no diagnosis. Measures of problem recognition, perceived barriers, and formal (pediatricians, psychologists, teachers) and informal (religious leaders, family/friends, self-help) help seeking were completed. Four separate hierarchical logistic regression models were used to examine parental help-seeking likelihood from formal and informal sources for internalizing and externalizing symptoms. Predictors were socioeconomic status, parent race, age, and sex, parent problem recognition (via study vignettes), and perceived barriers to mental health service utilization. RESULT Mothers were more likely than fathers to seek help from pediatricians, psychologists, teachers, and religious leaders for child anxiety and pediatricians, religious leaders, and self-help resources for child ADHD. Black parents were more likely to seek help from religious leaders and White parents were more likely to use self-help resources. Problem recognition was associated with greater intentions to seek help from almost all formal and informal sources (except from friends/family). CONCLUSION Understanding factors that contribute to parental help seeking for child psychopathology is critical for increasing service utilization and reducing the negative effects of mental health problems. This study highlights the importance of decreasing help-seeking barriers and increasing problem recognition to improve health equity.
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16
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Gardner K, Ruest S, Cummings B. Diagnostic Uncertainty and Ethical Dilemmas in Medically Complex Pediatric Patients and Psychiatric Boarders. Hosp Pediatr 2016; 6:689-692. [PMID: 27803074 DOI: 10.1542/hpeds.2016-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Kelly Gardner
- MassGeneral Hospital for Children, Boston, Massachusetts; and
| | - Stephanie Ruest
- MassGeneral Hospital for Children, Boston, Massachusetts; and
- Hasbro Children's Hospital, Brown University, Providence, Rhode Island
| | - Brian Cummings
- MassGeneral Hospital for Children, Boston, Massachusetts; and
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17
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Child Mental Health Services and Psychotherapy Attitudes Among Asian Indian Parents: An Exploratory Study. Community Ment Health J 2016; 52:989-997. [PMID: 26694054 DOI: 10.1007/s10597-015-9976-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
This exploratory study examined how parents' past personal use of psychotherapy related to perceived stigma and attitudes on intentions to use child mental health services among Asian Indian parents living in the United States. Participants were 89 Asian Indian parents recruited from 2009 to 2010 through a convenience sample. Descriptive analyses showed that Asian Indian parents reported similar attitudes as their American counterparts, but more stigma than European American and Latino parents. Using t-tests, results indicated that Asian Indian parents who previously used psychotherapy reported more positive attitudes than parents with no history of service use. Additionally, findings indicated that mothers reported more openness to seeking services than fathers. Finally, psychotherapy attitudes significantly predicted parents' intentions to seek services for their child in the future. Implications for research, practice, and policy are discussed.
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18
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Gronholm PC, Ford T, Roberts RE, Thornicroft G, Laurens KR, Evans-Lacko S. Mental health service use by young people: the role of caregiver characteristics. PLoS One 2015; 10:e0120004. [PMID: 25811867 PMCID: PMC4374853 DOI: 10.1371/journal.pone.0120004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/19/2015] [Indexed: 12/21/2022] Open
Abstract
AIMS Many children and adolescents experiencing mental health problems do not receive appropriate care. Strategies to encourage appropriate access to services might be improved by a more detailed understanding of service use determinants within this group. In view of caregivers' key role in young people's pathways to care, this study aimed to advance understanding of caregiver-related characteristics that influence service use among young people. METHODS We interviewed 407 primary caregivers of young people aged 9-18 years, recruited from a Greater London (United Kingdom) community sample. Caregivers reported on young people's service use in health care sector and/or education settings, and caregivers' intended stigmatising behaviours, help-seeking attitudes, and personal service use. Logistic regression analyses examined the relationship between these caregiver characteristics and young people's service use, controlling for young people's clinical and socio-demographic factors. RESULTS Caregivers' intended stigmatising behaviours in particular exerted a strong influence on young people's service use within each service setting. The impact of this characteristic interacted with caregivers' service use in influencing young people's service use across health care and education settings and health care settings specifically. For young people's service use within education settings, caregivers' intended stigmatising behaviours score had a main effect. CONCLUSIONS This study highlights the key role caregivers' attitudes and experiences hold in young people's service use. The findings indicate that strategies aiming to bridge the gap between young people's service needs and utilisation might be improved by targeting stigma amongst caregivers.
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Affiliation(s)
- Petra C. Gronholm
- Health Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Tamsin Ford
- Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom
| | - Ruth E. Roberts
- Department of Forensic and Neurodevelopmental Science, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Graham Thornicroft
- Health Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Kristin R. Laurens
- Department of Forensic and Neurodevelopmental Science, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
| | - Sara Evans-Lacko
- Health Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
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19
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Morris M. Diagnosis in Young Children: How a Father's Perceptions of Mental Health Change. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2014; 27:52-60. [DOI: 10.1111/jcap.12069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Marian Morris
- School of Nursing; The University of Texas at Austin; Austin TX USA
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20
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Thompson R, Dancy BL, Wiley TRA, Najdowski CJ, Perry SP, Wallis J, Mekawi Y, Knafl KA. African American families' expectations and intentions for mental health services. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2013; 40:371-83. [PMID: 22791083 PMCID: PMC3482279 DOI: 10.1007/s10488-012-0429-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans' engagement in mental health services.
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Affiliation(s)
- Richard Thompson
- Juvenile Protective Association, 1707 N Halsted, Chicago, IL 60614, USA.
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21
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Cappon L, Vander Laenen F. Mental health in juvenile judges' decision-making: review of literature. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2013; 36:65-72. [PMID: 23218170 DOI: 10.1016/j.ijlp.2012.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The purpose of this study is to provide an overview of the (strength of the) association between mental health aspects in juvenile offenders and the decision-making process of the juvenile judge. In particular, the presence of a mental disorder in the juvenile offender, the presence of a mental health report, and the mental health orientation of the juvenile judge were studied. METHODS A literature review was performed in order to identify relevant studies on the basis of three selection criteria: (i) the decision-making process of the juvenile judge concerning juvenile offenders, (ii) the use of quantitative methodology and (iii) the focus on the three mental health aspects. RESULTS Eight studies were found to meet the criteria (n=4318). The association between a mental disorder in the juvenile offender, a mental health report, and the decision of the juvenile judge was rather strong. There was no evidence of an association between mental health orientation of the juvenile judge and his/her decision. DISCUSSION Mental health aspects seem to be associated with the decision-making process of the juvenile judge. Future research should further examine the association between these aspects and the decision of the juvenile judge, particularly in the subgroup of juvenile offenders with mental disorders.
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Affiliation(s)
- Leen Cappon
- Department of Criminal Law and Criminology (IRCP), Ghent University, Ghent, Belgium.
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The parental attitudes toward psychological services inventory: adaptation and development of an attitude scale. Community Ment Health J 2012; 48:436-49. [PMID: 21691821 DOI: 10.1007/s10597-011-9432-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
Abstract
The purpose of this paper is to provide psychometric data on the Parental Attitudes Toward Psychological Services Inventory (PATPSI), which is a revised measure to assess parents' attitudes toward outpatient mental health services. Using a sample of adults (N = 250), Study 1 supported a 3-factor structure (RMSEA = .05, NNFI = .94, and CFI = .94), adequate internal consistency (ranging from .72 to .92), and test-retest reliability (ranging from .66 to .84). Additionally, results indicated that individuals with previous use of mental health services reported more positive views toward child mental health services. Study 2 provided confirming evidence of the 3-factor structure (NNFI = .94, RMSEA = .08, and the CFI = .95) and adequate reliability (ranging from .70 to .90) using a parent-sample (N = 260). Additionally, discriminate validity of the PATPSI was supported. Implications for research and clinical practice are discussed.
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23
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Horwitz S, Demeter C, Hayden M, Storfer-Isser A, Frazier TW, Fristad MA, Arnold LE, Youngstrom EA, Birmaher B, Axelson D, Findling RL. Parents' perceptions of benefit of children's mental health treatment and continued use of services. Psychiatr Serv 2012; 63:793-801. [PMID: 22660888 PMCID: PMC3448336 DOI: 10.1176/appi.ps.201100460a] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors examined the association of demographic and clinical characteristics, family history, and type of treatment among children receiving outpatient mental health services and parents' perception of treatment benefit. They also examined whether perceived benefit was related to continued use of services at six-month follow-up. METHODS Parents of children age six to 12 years who were first-time patients at one of nine clinics participating in the Longitudinal Assessment of Manic Symptoms (LAMS) study completed the Parent General Behavior Inventory Ten-Item Mania Scale. Parents of children with scores of 12 or higher (N=1,124) were invited to participate in a follow-up study, and 621 agreed. During baseline assessment after the first outpatient visit and at six-month follow-up, the parents were asked about children's sociodemographic and diagnostic characteristics and use of services and asked to rate how much their children had benefited from the most recent outpatient treatment. RESULTS Data were available for 573 children. At baseline, parents of 167 (29%) children reported that the treatment provided a lot of benefit, and perceived benefit was related to receiving medication (with or without therapy) versus just therapy, higher scores on functioning, LAMS site, no history of comorbid diagnoses, living with both biological parents, and having no parents or siblings with a prior hospitalization for a psychiatric illness. At six-month follow-up, perceived benefit was related to continued use of services (p<.001). CONCLUSIONS Medication with or without therapy was perceived as more beneficial than therapy alone. Perceived benefit was strongly related to continued use of treatment.
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Affiliation(s)
- Sarah Horwitz
- Department of Pediatrics and the Center for Health Policy, Stanford University, 117 Encina Commons, MC 6019, Stanford, CA 94305, USA.
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