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Nelson T, Gebretensay SB, Sellers AM, Moreno O. Contextualizing Help-Seeking Attitudes and Help-Seeking Intention: The Role of Superwoman Schema among Black College Women. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02075-0. [PMID: 38954399 DOI: 10.1007/s40615-024-02075-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
Black women are less likely to seek psychological help and underutilize mental health services. Although help-seeking attitudes and intentions are associated in the general population, less is known about this relationship among Black women in college. In this cross-sectional study, we investigated the relationship between help-seeking attitudes and intention among 167 self-identified Black women in college. We also investigated if dimensions of the Superwoman Schema (i.e., an obligation to display strength, resistance to being vulnerable, an obligation to suppress emotions, an intense motivation to succeed despite limited resources, and an obligation to help others) moderated this relationship. Findings indicated a significant positive relationship between help-seeking attitudes and help-seeking intention. Regarding moderation, an obligation to suppress emotions, resistance to vulnerability, and an obligation to help others interacted with help-seeking attitudes in predicting help-seeking intention. Notably, low adherence to an obligation to suppress emotions, resistance to vulnerability, and an obligation to help others were associated with high levels of help-seeking intention. However, more favorable help-seeking attitudes improved help-seeking intention for participants high in adherence to these dimensions. Our findings suggest that understanding the relevance of the Superwoman Schema among Black women is critical for increasing help-seeking behavior.
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Affiliation(s)
- Tamara Nelson
- Department of Psychology, Rutgers University Camden, 311 N. Fifth Street, Camden, NJ, 08102, USA.
| | - Samrawit B Gebretensay
- Department of Psychology, Rutgers University Camden, 311 N. Fifth Street, Camden, NJ, 08102, USA
| | - Andrea M Sellers
- Department of Psychology, Rutgers University Camden, 311 N. Fifth Street, Camden, NJ, 08102, USA
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin St., Richmond, VA, 23284, USA
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Vance MM, Gryglewicz K, Nam E, Richardson S, Borntrager L, Karver MS. Exploring Service Use Disparities among Suicidal Black Youth in a Suicide Prevention Care Coordination Intervention. J Racial Ethn Health Disparities 2023; 10:2231-2243. [PMID: 36100810 DOI: 10.1007/s40615-022-01402-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this study is to examine service utilization disparities among Black youth participating in Linking Individuals Needing Care (LINC), a 90-day research-informed suicide care coordination intervention. METHODS An open trial pilot was conducted to examine the effectiveness of LINC in increasing access to and engagement in mental health and non-mental health services among suicidal youth (N = 587). Other variables of interest included service use facilitators and service use barriers. Generalized linear mixed models with binomial distribution and logit link were performed to ascertain if service use facilitators and barriers were associated with service utilization and if disparities in service use and engagement existed between Black and White suicidal youth through a comparative analysis. RESULTS Service utilization differences were found between Black and White youth. While Black and White youth were both likely to engage in individual therapy (OR = 1.398, p < .001) and non-mental health services (OR = 1.289, p < .001), utilization rates for mental health and medication management services were lower for Black (55.1% to 60.6%) youth compared to White (66.0% to 71.0%) youth. Specifically, Black youth were significantly less likely than Whites to receive medication management (OR = .466, p = .002). Systemic barriers such long waitlists for care (OR = 1.860, p = .039) and poor relationship with providers (OR = 7.680, p = .028) increased odds of engagement in non-mental health services. Clinical disorders and engagement in suicide-related behaviors increased the likelihood of obtaining care from both medication management and non-mental health services. CONCLUSION Care coordination services for suicidal youth can increase access and engagement in mental health and non-mental health services. Culturally adapted models attending to cultural and social assets of Black families are needed to reduce disparities and suicide risk among Black youth.
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Affiliation(s)
- Michelle M Vance
- Department of Social Work & Sociology, North Carolina Agricultural & Technical State University, Greensboro, NC, USA.
| | - Kim Gryglewicz
- School of Social Work, University of Central Florida, Orlando, FL, USA
| | - Eunji Nam
- School of Social Welfare, Incheon National University, Incheon, South Korea
| | - Sonyia Richardson
- School of Social Work, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Lisa Borntrager
- School of Social Work, University of Central Florida, Orlando, FL, USA
| | - Marc S Karver
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Williams ED, Lateef H, Gale A, Boyd D, Albrecht J, Paladino J, Koschmann E. Barriers to School-Based Mental Health Resource Utilization Among Black Adolescent Males. CLINICAL SOCIAL WORK JOURNAL 2023; 51:1-16. [PMID: 37360754 PMCID: PMC10148625 DOI: 10.1007/s10615-023-00866-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 06/28/2023]
Abstract
Black adolescent males use available mental health services at a disproportionately lower rate compared to males of other racial groups. This study examines barriers to school-based mental health resource (SBMHR) use among Black adolescent males, as a means of addressing reduced usage of available mental health resources and to improve these resources to better support their mental health needs. Secondary data for 165 Black adolescent males were used from a mental health needs assessment of two high schools in southeast Michigan. Logistic regression was employed to examine the predictive power of psychosocial (self-reliance, stigma, trust, and negative previous experience) and access barriers (no transportation, lack of time, lack of insurance, and parental restrictions) on SBMHR use, as well as the relationship between depression and SBMHR use. No access barriers were found to be significantly associated with SBMHR use. However, self-reliance and stigma were statistically significant predictors of SBMHR use. Participants who identified self-reliance in addressing their mental health symptoms were 77% less likely to use available mental health resources in their school. However, participants who reported stigma as a barrier to using SBMHR were nearly four times more likely to use available mental health resources; this suggests potential protective factors in schools that can be built into mental health resources to support Black adolescent males' use of SBMHRs. This study serves as an early step in exploring how SBMHRs can better serve the needs of Black adolescent males. It also speaks to potential protective factors that schools provide for Black adolescent males who have stigmatized views of mental health and mental health services. Future studies would benefit from a nationally representative sample allowing for more generalizable results regarding barriers and facilitators to Black adolescent males' use of school-based mental health resources.
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Affiliation(s)
- Ed-Dee Williams
- School of Social Work, University of Michigan, 1080 South University Avenue, Office 3765, Ann Arbor, MI 48109-1106 USA
| | - Husain Lateef
- Washington University in St. Louis School of Social Work, St. Louis, MO USA
| | - Adrian Gale
- Rutgers University School of Social Work, New Brunswick, NJ USA
| | - Donte Boyd
- The Ohio State University School of Social Work, Columbus, OH USA
| | - Jeffrey Albrecht
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105 USA
| | - Jill Paladino
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105 USA
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Opara I, Assan MA, Pierre K, Gunn JF, Metzger I, Hamilton J, Arugu E. Suicide Among Black Children: An Integrated Model of the Interpersonal-Psychological Theory of Suicide and Intersectionality Theory for Researchers and Clinicians. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:232-240. [PMID: 37153126 PMCID: PMC10153497 DOI: 10.1176/appi.focus.22020003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 05/09/2023]
Abstract
Recently, research has reported that the rates of suicide among Black children between the ages of 5 to 12-years-old are increasing as they are now more likely to commit suicide than White children. Yet, there are very few, if any, frameworks being used by researchers to explain the risks of suicide among Black children. Suicide research has overwhelmingly been focused on White youth thus leaving a critical gap in suicide research. This conceptual paper provides an integrated framework using the Interpersonal-Psychological Theory of Suicide and Intersectionality theory, as a guide for researchers, clinicians, and practitioners to incorporate culturally appropriate techniques in their work as a way to prevent suicide among Black children. This framework highlights racial discrimination, mental health, socioeconomic status, and sexual/gender minority status to be the most preeminent, yet understudied factors leading to suicide risk among Black children in the United States. Reprinted with permission of SAGE Publications; Opara et al. J Black Stud (51:611-631), copyright 2020.
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Affiliation(s)
- Ijeoma Opara
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Maame Araba Assan
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Kimberly Pierre
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - John F Gunn
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Isha Metzger
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Jahi Hamilton
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
| | - Eileen Arugu
- Stony Brook University School of Social Welfare, Stony Brook, New York (Opara)
- Public Health Management Corporation, Pennsauken, New Jersey (Assan)
- School of Public Health, Rutgers University, Newark, New Jersey (Pierre)
- Center on Gun Violence Research, Rutgers University, Newark, New Jersey (Gunn)
- Department of Psychology, University of Georgia, Athens, Georgia (Metzger, Hamilton)
- School of Social Work, Columbia University, New York, New York (Arugu)
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Alegría M, O'Malley IS, DiMarzio K, Zhen-Duan J. Framework for Understanding and Addressing Racial and Ethnic Disparities in Children's Mental Health. Child Adolesc Psychiatr Clin N Am 2022; 31:179-191. [PMID: 35361358 PMCID: PMC9382888 DOI: 10.1016/j.chc.2021.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this framework, we synthesize the results of studies addressing racial/ethnic disparities in children's mental health through 4 domains hypothesized to impact minoritized children and their families: (1) policies, (2) institutional systems, (3) neighborhoods/community system, and (4) individual/family-level factors. We focus on children and adolescents, presenting findings that may impact mental health outcomes for major racial/ethnic groups in North America: Black/African American, Latinx, Asian, and American Indian youth. We conclude by suggesting areas for needed research, including whether certain domains of influence demonstrate differential impact for inequities reduction depending on the youth's race/ethnicity.
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Affiliation(s)
- Margarita Alegría
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, 2 West, Room 305, Boston, MA 02215, USA.
| | - Isabel Shaheen O'Malley
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA 02114, USA
| | - Karissa DiMarzio
- Department of Psychology, Center for Children and Families, Florida International University, 11200 SW 8th St, AHC-1, Miami, FL 33199, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital, 50 Staniford St, Suite 830, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
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Marraccini ME, Lindsay CA, Griffin D, Greene MJ, Simmons KT, Ingram KM. A Trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-Informed Approach to Suicide Prevention in School: Black Boys' Lives Matter. SCHOOL PSYCHOLOGY REVIEW 2022; 52:292-315. [PMID: 37484214 PMCID: PMC10358449 DOI: 10.1080/2372966x.2021.2010502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/23/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
Black boys have been dying by suicide at an increasing rate. Although the reasons for this increase are unknown, suicide in Black boys is likely influenced by multiple, intersecting risk factors, including historical and ongoing trauma. Schools can serve as an important mechanism of support for Black boys; however, without intentional anti-racist frameworks that acknowledge how intersecting identities can exacerbate risk for suicide, schools can overlook opportunities for care and perpetuate a cycle of racism that compromises the mental health of Black youth. By recognizing their own implicit biases, modeling anti-racist practices, listening to and recognizing the strengths and diversity of Black youth, and fostering school-family-community partnerships, school psychologists can help transform the school environment to be a safe and culturally affirming place for Black youth. This paper outlines how school psychologists can apply a trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-informed approach to suicide prevention in order to more holistically support Black boys, disrupt patterns of aggressive disciplinary procedures, and improve school-based suicide prevention programs. By applying this lens across a multitiered systems of support (MTSS) framework, school psychologists can help to prevent the deaths of Black boys and begin to prioritize the lives of Black boys.
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Affiliation(s)
| | | | - Dana Griffin
- School of Education, University of North Carolina at Chapel Hill
| | - Meghan J Greene
- School of Education, University of North Carolina at Chapel Hill
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Clayton MG, Pollak OH, Owens SA, Miller AB, Prinstein MJ. Advances in Research on Adolescent Suicide and a High Priority Agenda for Future Research. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:1068-1096. [PMID: 34820949 DOI: 10.1111/jora.12614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Suicide is the second leading cause of death for adolescents in the United States, yet remarkably little is known regarding risk factors for suicidal thoughts and behaviors (STBs), relatively few federal grants and scientific publications focus on STBs, and few evidence-based approaches to prevent or treat STBs are available. This "decade in review" article discusses five domains of recent empirical findings that span biological, environmental, and contextual systems and can guide future research in this high priority area: (1) the role of the central nervous system; (2) physiological risk factors, including the peripheral nervous system; (3) proximal acute stress responses; (4) novel behavioral and psychological risk factors; and (5) broader societal factors impacting diverse populations and several additional nascent areas worthy of further investigation.
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Opara I, Assan MA, Pierre K, Gunn JF, Metzger I, Hamilton J, Arugu E. Suicide among Black Children: An Integrated Model of the Interpersonal-Psychological Theory of Suicide and Intersectionality Theory for Researchers and Clinicians. JOURNAL OF BLACK STUDIES 2020; 51:611-631. [PMID: 34305168 PMCID: PMC8301214 DOI: 10.1177/0021934720935641] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Recently, research has reported that the rates of suicide among Black children between the ages of 5 to 12-years-old are increasing as they are now more likely to commit suicide than White children. Yet, there are very few, if any, frameworks being used by researchers to explain the risks of suicide among Black children. Suicide research has overwhelmingly been focused on White youth thus leaving a critical gap in suicide research. This conceptual paper provides an integrated framework using the Interpersonal-Psychological Theory of Suicide and Intersectionality theory, as a guide for researchers, clinicians, and practitioners to incorporate culturally appropriate techniques in their work as a way to prevent suicide among Black children. This framework highlights racial discrimination, mental health, socioeconomic status, and sexual/gender minority status to be the most preeminent, yet understudied factors leading to suicide risk among Black children in the United States.
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Affiliation(s)
- Ijeoma Opara
- Stony Brook University School of Social Welfare, Stony Brook, NY, USA
| | | | - Kimberly Pierre
- School of Public Health, Rutgers University, Newark, NJ, USA
| | - John F. Gunn
- Center on Gun Violence Research, Rutgers University, Newark, NJ, USA
| | - Isha Metzger
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Jahi Hamilton
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Eileen Arugu
- School of Social Work, Columbia University, New York, NY, USA
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Fontanella CA, Warner LA, Steelesmith DL, Brock G, Bridge JA, Campo JV. Association of Timely Outpatient Mental Health Services for Youths After Psychiatric Hospitalization With Risk of Death by Suicide. JAMA Netw Open 2020; 3:e2012887. [PMID: 32780122 PMCID: PMC7420244 DOI: 10.1001/jamanetworkopen.2020.12887] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE Timely outpatient follow-up care after psychiatric hospitalization is an established mental health quality indicator and considered an important component of suicide prevention, yet little is known about whether follow-up care is associated with a reduced risk of suicide soon after hospital discharge. OBJECTIVE To evaluate whether receipt of outpatient care within 7 days of psychiatric hospital discharge is associated with a reduced risk of subsequent suicide among child and adolescent inpatients and examine factors associated with timely follow-up care. DESIGN, SETTING, AND PARTICIPANTS This population-based, retrospective, longitudinal cohort study used Medicaid data from 33 states linked with National Death Index data. The study population included all youths aged 10 to 18 years who were admitted to a psychiatric hospital from January 1, 2009, to December 31, 2013. Data analysis was completed from October 9, 2019, through May 15, 2020. EXPOSURE Mental health follow-up visits received within 7 days of hospital discharge. MAIN OUTCOMES AND MEASURES Suicides occurring in the 8 to 180 days after hospital discharge. Logistic regression modeled the association between demographic, clinical, and mental health service history factors and receipt of an outpatient visit within 7 days after discharge. Poisson regression estimated the association between suicide risk and outpatient visits within 7 days after discharge, adjusting for confounding using inverse probability of treatment weights from the logistic model. RESULTS Of the total 139 694 youths admitted to a psychiatric hospital, 51.9% were female, 31.1% were aged 10 to 13 years, and 68.9% were aged 14 to 18 years. A total of 56.5% of the youths received a mental health follow-up visit within 7 days of discharge, and this was associated with a significantly lower odds of suicide (adjusted relative risk, 0.44; 95% CI, 0.23-0.83; P = .01) during the 8 to 180 days postdischarge period. Youths with longer lengths of stay (4-5 days: adjusted odds ratio [AOR], 1.20 [95% CI, 1.17-1.24]; 6-7 days: AOR, 1.47 [95% CI, 1.43-1.52]; 8-12 days AOR, 1.75 [95% CI, 1.69-1.81]; 13-30 days: AOR, 1.71 [95% CI, 1.63-1.78]), prior outpatient mental health care (AOR, 1.58; 95% CI, 1.51-1.65), and foster care placement (AOR, 1.32; 95% CI, 1.28-1.37) were more likely to receive 7-day follow-up, whereas those who were non-Hispanic Black (AOR, 0.82; 95% CI, 0.79-0.84), were older (AOR, 0.82; 95% CI, 0.80-0.84), were medically ill (AOR, 0.77; 95% CI, 0.74-0.81), and had managed care insurance (AOR, 0.88; 95% CI, 0.87-0.91) were less likely to receive follow-up visits. CONCLUSIONS AND RELEVANCE In this cohort study, risk of suicide during the 6 months after psychiatric hospitalization was decreased among youth who had an outpatient mental health visit within 7 days after discharge. Addressing disparities in timely continuity of care may help advance health equity agendas.
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Affiliation(s)
- Cynthia A. Fontanella
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus
| | - Lynn A. Warner
- University at Albany–State University of New York School of Social Welfare, Albany
| | - Danielle L. Steelesmith
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus
| | - Guy Brock
- Department of Biomedical Informatics, The Ohio State University, Columbus
| | - Jeffrey A. Bridge
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
| | - John V. Campo
- Rockefeller Neuroscience Institute, Behavioral Medicine and Psychiatry, West Virginia University, Morgantown
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Wang C, Barlis J, Do KA, Chen J, Alami S. Barriers to Mental Health Help Seeking at School for Asian– and Latinx–American Adolescents. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09344-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wang N, Ouedraogo Y, Chu J, Liu Y, Wang K, Xie X. Variable reduction for past year alcohol and drug use in unmet need for mental health services among US adults. J Affect Disord 2019; 256:110-116. [PMID: 31174026 DOI: 10.1016/j.jad.2019.05.069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/24/2019] [Accepted: 05/28/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND No previous study has focused on the inter-relationship among alcohol and drug use variables in the past year. This study aimed to classify the past year alcohol and drug use variables and investigate the selected variables in past year alcohol and drug use with the unmet need for mental health services among US adults. METHODS Data came from the 2015 National Survey on Drug Use and Health (NSDUH). Oblique principal component cluster analysis (OPCCA) was used to classify 37 variables on alcohol and drug use in the past year into disjoint clusters. Weighted multiple logistic regression analysis was used to examine the associations of selected variables with the unmet need. RESULTS 37 alcohol and drug use variables were divided into 7 clusters. The variable with the lowest 1-R2 ratio (R2 is the squared correlation) from each cluster was selected as follows: tobacco use, pain reliever use, tranquilizer use, stimulant use, zolpidem products use, illicit drug and alcohol use, and benzodiazepine tranquilizers misuse. Multiple logistic regression analysis showed that pain reliever use (OR = 1.33, 95% CI = 1.17-1.50), tranquilizer use (OR = 2.49, 95% CI = 2.16-2.86), stimulant use (OR = 1.22, 95% CI = 1.01-1.47), and illicit drug and alcohol use (OR = 1.54, 95% CI = 1.34-1.77) revealed positive associations with the unmet need for mental health services. CONCLUSION This is the first study using OPCCA to reduce the dominations of alcohol and drug use; several alcohol and drug use variables in the past year were associated with unmet need of mental health services.
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Affiliation(s)
- Nianyang Wang
- Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Youssoufou Ouedraogo
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Jun Chu
- Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Ying Liu
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Kesheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, PO Box 70686, 227 Sam Wilson Hall, Johnson City, TN 37614, USA.
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Wang N, Xie X. Associations of health insurance coverage, mental health problems, and drug use with mental health service use in US adults: an analysis of 2013 National Survey on Drug Use and Health. Aging Ment Health 2019; 23:439-446. [PMID: 29469591 DOI: 10.1080/13607863.2018.1441262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To estimate the prevalence of mental health service use among US adults, examine the associations of mental health service use with health insurance coverage, mental health problems and drug use, and detect health disparities. METHODS This was a cross-sectional study with 5,434 adults receiving mental health service out of 37,424 adult respondents from the 2013 National Survey on Drug Use and Health. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors with mental health service use. RESULTS The overall prevalence of mental health services use was 14.7%. Our results showed that being female, aging, having a major depressive episode, serious psychological distress, and illicit drug or alcohol abuse/dependence were positively associated with mental health service use; whereas being African American, Asian or Hispanic ethnicity, married, and having any form of insurance were negatively associated with mental health service use . Stratified analysis by insurance types showed that Medicaid/CHIP, CHAMPUS, and other insurance were positively associated with mental health service use. CONCLUSIONS Health insurance coverage, mental health problems, and drug abuse or dependence were associated with mental health service use in US adults. Furthermore, adults with different insurances had disparities in access of mental health service.
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Affiliation(s)
- Nianyang Wang
- a Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA
| | - Xin Xie
- b Department of Economics and Finance, College of Business and Technology , East Tennessee State University , Johnson City , TN , USA
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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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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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Bains RM, Diallo AF. Mental Health Services in School-Based Health Centers: Systematic Review. J Sch Nurs 2015; 32:8-19. [PMID: 26141707 DOI: 10.1177/1059840515590607] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services in SBHCs. Databases were searched extensively for research studies published between January 1990 and March 2014. Data analysis was based on the method proposed by the Centre for Reviews and Dissemination. Twenty-three studies were selected for review. Each study was explored for accessibility and content of mental health services in SBHCs. SBHCs provide access and eliminate barriers to mental health services. Students who exhibited high-risk behaviors were more likely to have sought services at the SBHC. However, there is a lack of high-quality research evaluating mental health services in the SBHCs and their effect on children and adolescents.
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Trends in psychological distress, depressive episodes and mental health treatment-seeking in the United States: 2001-2012. J Affect Disord 2015; 174:556-61. [PMID: 25556674 DOI: 10.1016/j.jad.2014.12.039] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 12/11/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND There has been an increase in the use of mental health services in a number of industrialized countries over the past two decades with little impact on mental health status of the populations. Few studies, however, have examined recent trends in mental health status in the US. METHODS Using data from three large general annual population surveys in the US-the National Health Interview Survey, Behavioral Risk Factor Surveillance System, and National Survey on Drug Use and Health-we examined temporal trends in non-specific psychological distress, depressive episodes and mental health treatment seeking over the 2001-2012 period. RESULTS Prevalence of past-month significant psychological distress and past-year depressive symptoms changed little over time. However, a larger percentage of participants reported poor mental health for ≥15 days or 30 days in the past month in 2011-2012 (8.7% and 5.7%, respectively) than in 2001-2002 (6.6% and 4.6%). A larger percentage of participants in the later period also reported receiving mental health treatments. LIMITATIONS Possible changes in mental health status may have been missed due to the limited scope of assessments or the small magnitude of changes. Potential reciprocal influences between service use and mental health status could not be investigated because of cross-sectional data. CONCLUSIONS Despite increasing use of mental health treatments in the US in the first decade of this century, there is no evidence of decrease in prevalence of psychological distress or depression. Poor match between need for treatment and actual treatments received in usual care settings may partly explain the findings.
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Thurston IB, Phares V, Coates EE, Bogart LM. Child problem recognition and help-seeking intentions among black and white parents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2014; 44:604-15. [PMID: 24635659 DOI: 10.1080/15374416.2014.883929] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Parents play a central role in utilization of mental health services by their children. This study explored the relationship between parents' recognition of child mental health problems and their decisions to seek help. Participants included 251 parents (49% Black, 51% White; 49% fathers, 51% mothers) recruited from community settings. Parents ranged in age from 20 to 66 years old with at least one child between ages 2 and 21. Parents read three vignettes that described a child with an anxiety disorder, ADHD, and no clinically significant diagnosis. Parents completed measures of problem recognition, perception of need, willingness to seek help, and beliefs about causes of mental illness. Findings from Generalized Estimating Equations revealed that parents were more likely to report intentions to seek help when they recognized a problem (odds ratio [OR] = 41.35, p < .001), 95% confidence interval (CI) [14.81, 115.49]; when it was an externalizing problem (OR = 1.85, p < .05), 95% CI [1.14, 3.02]; and when parents were older (OR = 1.04, p < .05), 95% CI [1.01, 1.08]. Predictors of parental problem recognition included perceived need, prior experience with mental illness, and belief in trauma as a cause of mental illness. Predictors of help-seeking intentions included problem recognition, perceived need, externalizing problem type, and being female. Given the relationship between parental problem recognition and willingness to seek help, findings suggest that efforts to address disparities in mental health utilization could focus on problem-specific, gender-sensitive, mutable factors such as helping parents value help-seeking for internalizing as well as externalizing problems.
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Guo S, Kataoka SH, Bear L, Lau AS. Differences in School-Based Referrals for Mental Health Care: Understanding Racial/Ethnic Disparities Between Asian American and Latino Youth. SCHOOL MENTAL HEALTH 2013. [DOI: 10.1007/s12310-013-9108-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kaushik G, Plax KL, Constantino JN, Lewis L, Mamah D. Mental health care utilization at a free drop-in youth center in St. Louis, Missouri. MISSOURI MEDICINE 2012; 109:475-481. [PMID: 23362652 PMCID: PMC6179606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We review demographic and mental health data from 1,729 youths aged 13 to 24 who attended the SPOT (Supporting Positive Opportunities with Teens), a free multi-resource drop-in youth center in St. Louis, within an 18-month period. Logistic regression analysis showed an association of increased mental health utilization and younger age, male gender, unemployment, lower educational attainment, having Medicaid, drug problems, and HIV positive status. Decreased mental health utilization was associated with black or mixed ethnicity, and living with a roommate.
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Affiliation(s)
- Gaurav Kaushik
- Department of Psychiatry, Washington University, St. Louis, USA
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Motivation for youth's treatment scale (MYTS): a new tool for measuring motivation among youths and their caregivers. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2012; 39:118-32. [PMID: 22407559 DOI: 10.1007/s10488-012-0408-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Treatment motivation can be important for treatment adherence and outcomes, yet few measures of motivation are available for youths in mental health settings. These authors describe the psychometric properties of the motivation for youth's treatment scale (MYTS), an 8-item measure with forms for youths and caregivers that assesses their problem recognition and treatment readiness. Results indicate that the MYTS offers practitioners and researchers a brief, psychometrically sound tool for assessing treatment motivation of youths and their caregivers. Multivariate analyses of clinical and non-clinical characteristics of youths and caregivers show that youths' symptom severity consistently predicts treatment motivation for both groups. However, the strain of caring for the youth adds significantly to caregivers' recognition of the youth's troubles. While caregiver and youth motivations correlate, their agreement is low. Caregivers are nearly always more treatment motivated than youths. The authors discuss the implications of their findings for measurement, treatment planning, and future research.
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Gender differences in patterns of child risk across programmatic phases of the CMHI: a multiple group latent class analysis (LCA). J Behav Health Serv Res 2011; 38:265-77. [PMID: 20526691 DOI: 10.1007/s11414-010-9219-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Data from 18,437 children enrolled in the national evaluation of the Children's Mental Health Initiative between 1994 and 2005 were used to examine the evolution of patterns of risk among boys and girls across funding phases using multigroup latent class analysis. Consistent with previous research, this study identified four subgroups of children with similar patterns of child risk. Membership to these risk subgroups varied as a function of age and was associated with differences in impairment levels. Changes in the distribution of boys and girls in the risk classes suggest that, over time, an increasing proportion of boys have entered the system of care program with complex histories of risk. Information on children's exposure to child risk factors can aid policy makers, service providers, and clinicians in identifying children who may need more intensive services and tailoring services to their needs.
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Thompson R, Dancy BL, Wiley TRA, Perry SP, Najdowski CJ. The experience of mental health service use for African American mothers and youth. Issues Ment Health Nurs 2011; 32:678-86. [PMID: 21992259 DOI: 10.3109/01612840.2011.595534] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Little is known about African American families' experiences with mental health services. A purposive sample of 40 dyads of African American youth (aged 13 to 19) and their mothers participated in a cross-sectional qualitative research design using semi-structured interviews that elicited information about their past experiences and satisfaction with mental health services. Though rarely received, group and family therapy were perceived favorably. However, both mothers and youth reported dissatisfaction centered on medication and lack of professionalism, confidentiality, and concern by providers. The failure of mental health services providers to meet basic standards of quality and professionalism may explain the low rate of service use by African Americans.
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