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Salimi N, Gere B, Shahab A. State-Federal Vocational Rehabilitation Services, Demographic Characteristics and Employment Outcomes for Native Americans with Mental Illnesses. Community Ment Health J 2024; 60:442-456. [PMID: 37828363 DOI: 10.1007/s10597-023-01191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023]
Abstract
There were 9.7 million Native Americans (American Indian, Alaska Native-AI/AN- these acronyms will be used interchangeably with Native Americans throughout the paper) in 2019 comprising 2.9% of the U.S. population. Native American populations have disproportionately higher rates of mental illnesses compared to other racial groups in the U.S. Mental health is a significant public health concern for this population, impacting different areas of their lives including employment. Additionally, Native Americans continue to experience significant disparities in access to Vocational Rehabilitation (VR) services and have poor employment outcomes. However, little is known about the relationships among demographic factors, vocational rehabilitation services, and employment outcomes of Native Americans with mental illness. Consequently, the current study examined how demographic factors and VR services are related to successful employment outcomes for Native American VR clients with mental illnesses using data from the Rehabilitation Services Administration (RSA) program year (2019) Case Service Report (9-11). Both descriptive analysis and data mining approaches were used to answer the research questions. Chi-square Automatic Interaction Detector (CHAID) analysis was used to determine which of the VR services could best predict the successful employment outcome of Native Americans with mental illness. The findings of the data mining approach revealed that among all the vocational rehabilitation services, job placement assistance was the strongest predictor of successful employment among Native American clients with mental illnesses. The second most important service predicting successful employment for those who received job placement assistance was shown to be maintenance. Implications for rehabilitation counselors and future research are discussed.
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Affiliation(s)
- Nahal Salimi
- Rehabilitation Counseling & Disability Services, School of Interdisciplinary Health Professions, College of Health & Human Sciences, Northern Illinois University, 353 Wirtz Hall, DeKalb, IL, 60115, USA.
| | - Bryan Gere
- Department of Rehabilitation, School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Hazel Hall #1109, Princess Anne, MD, 21853, USA
| | - Amin Shahab
- Department of Computer Science and Operations Research, Université de Montréal, Québec City, Canada
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Muñoz AC, Rojano ÁEV, Caballero AR, Solé EP, Álvarez MG. Reprint of: Associations between mental health problems and Adverse Childhood Experiences ACEs in indigenous and non-indigenous Mexican adolescents. CHILD ABUSE & NEGLECT 2024; 148:106639. [PMID: 38242770 DOI: 10.1016/j.chiabu.2024.106639] [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: 11/30/2022] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have long-term consequences. The ACEs model has been extensively used in high-income countries. However, its effectiveness has yet to be demonstrated in low and middle-income countries and marginalized social groups. In indigenous populations, research has found inconsistent results in the prevalence and the relationship between ACEs and mental health outcomes. Therefore, the objectives of this study were 1) to determine the ACEs frequency among indigenous and non-indigenous Mexican adolescents; 2) to test the association between ACE scores and symptoms of Mental Health Problems (SMHP) in both groups; and 3) to review the ACEs model adequacy for the indigenous adolescents. PARTICIPANTS AND SETTINGS Data from an online survey in 20 of the 32 states of Mexico were analyzed. We selected an 87 adolescent sample from indigenous families and 174 non-indigenous matched for age, sex, and state of residence, with a mean age of 16 years; 60 % were women. METHODS ACE-IQ questionnaire and Youth Self Report instrument (eight SMHP) were used to collect data. ACEs' frequency was analyzed for each group, and Pearson correlations were used to identify the relationship between ACEs and SMHP. RESULTS There was no statistical significance between Indigenous and non-Indigenous adolescents in the ACEs report. ACE scores were associated with eight SMHP. Correlations between ACE score and SMHP were higher in non-indigenous adolescents. CONCLUSIONS ACEs were experienced similarly by both groups and were associated with mental health in all participants. Further research is needed to improve ACEs measurement in indigenous populations.
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Affiliation(s)
- Abigail Casas Muñoz
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Ángel Eduardo Velasco Rojano
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Aarón Rodríguez Caballero
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Eva Prado Solé
- Fondo de las Naciones Unidas para la Infancia, UNICEF, Mexico
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Muñoz AC, Rojano ÁEV, Caballero AR, Solé EP, Álvarez MG. Associations between mental health problems and Adverse Childhood Experiences ACEs in indigenous and non-indigenous Mexican adolescents. CHILD ABUSE & NEGLECT 2024; 147:106595. [PMID: 38061280 DOI: 10.1016/j.chiabu.2023.106595] [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: 11/30/2022] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have long-term consequences. The ACEs model has been extensively used in high-income countries. However, its effectiveness has yet to be demonstrated in low and middle-income countries and marginalized social groups. In indigenous populations, research has found inconsistent results in the prevalence and the relationship between ACEs and mental health outcomes. Therefore, the objectives of this study were 1) to determine the ACEs frequency among indigenous and non-indigenous Mexican adolescents; 2) to test the association between ACE scores and symptoms of Mental Health Problems (SMHP) in both groups; and 3) to review the ACEs model adequacy for the indigenous adolescents. PARTICIPANTS AND SETTINGS Data from an online survey in 20 of the 32 states of Mexico were analyzed. We selected an 87 adolescent sample from indigenous families and 174 non-indigenous matched for age, sex, and state of residence, with a mean age of 16 years; 60 % were women. METHODS ACE-IQ questionnaire and Youth Self Report instrument (eight SMHP) were used to collect data. ACEs' frequency was analyzed for each group, and Pearson correlations were used to identify the relationship between ACEs and SMHP. RESULTS There was no statistical significance between Indigenous and non-Indigenous adolescents in the ACEs report. ACE scores were associated with eight SMHP. Correlations between ACE score and SMHP were higher in non-indigenous adolescents. CONCLUSIONS ACEs were experienced similarly by both groups and were associated with mental health in all participants. Further research is needed to improve ACEs measurement in indigenous populations.
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Affiliation(s)
- Abigail Casas Muñoz
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico.
| | - Ángel Eduardo Velasco Rojano
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico.
| | - Aarón Rodríguez Caballero
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Eva Prado Solé
- Fondo de las Naciones Unidas para la Infancia, UNICEF, Mexico
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Goetz CJ, Mushquash CJ, Maranzan KA. An Integrative Review of Barriers and Facilitators Associated With Mental Health Help Seeking Among Indigenous Populations. Psychiatr Serv 2023; 74:272-281. [PMID: 36065579 DOI: 10.1176/appi.ps.202100503] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Indigenous populations, compared with majority populations, have a reduced likelihood of receiving professional help for mental health, contributing to health disparities. To increase use of and access to mental health services for Indigenous people, specific factors that affect service use need to be examined. An integrative review was undertaken of the barriers to and facilitators of help seeking and service use for Indigenous populations in Canada, the United States, Australia, and the Pacific Islands. METHODS Five databases-PsycINFO, PubMed, Web of Science, Social Services Abstracts, and Bibliography of Native North Americans-and gray literature were searched to identify original studies with data specific to Indigenous people. A qualitative analysis of common themes among the studies was conducted, along with a quality appraisal of included articles. Of the 1,010 records identified, the final synthesis included 41 articles. RESULTS Six main themes emerged: informal supports, which were often used as a first choice for help seeking compared with formal services; structural obstacles and supports; stigma and shame; self-reliance and uncertainty about services; cultural factors and mistrust of mainstream services; and the need for outreach and information regarding mental illness and services. CONCLUSIONS Policy implications include needed structural changes to decrease mistrust of mainstream systems and services and increased funding and resource availability. Along with technology-facilitated treatment, programs for Indigenous people, families, and communities that enhance education and foster positive relationships can serve as a first step toward Indigenous people becoming comfortable with the idea of talking about mental health and with seeking treatment.
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Affiliation(s)
- Christiana J Goetz
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | | | - K Amanda Maranzan
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
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Radford A, Toombs E, Zugic K, Boles K, Lund J, Mushquash CJ. Examining Adverse Childhood Experiences (ACEs) within Indigenous Populations: a Systematic Review. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:401-421. [PMID: 35600513 PMCID: PMC9120316 DOI: 10.1007/s40653-021-00393-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 06/03/2023]
Abstract
Health concerns in Indigenous people are often greater in comparison to those in non-Indigenous populations, including increased rates of chronic diseases and mental health concerns. Adverse childhood experiences (ACEs) may be an explanatory variable for such heightened rates of mental and physical health difficulties for Indigenous populations as these communities have experienced a lack of adequate health care due to remoteness, historical traumas, cultural insensitivity, racism, and perpetuating systemic discrimination. To date, relatively few studies have examined ACEs within an Indigenous population and their relevance to both physical and mental health outcomes. The present study explored existing ACE literature relevant to Indigenous populations and mental or physical health outcomes by retrieving and organizing available ACE literature. A systematic review was conducted using 14 electronic databases of peer-reviewed literature and 18 grey literature databases. Twenty-one publications investigating general health outcomes and prevalence of ACEs met eligibility criteria. ACEs were reported to be higher in Indigenous populations when compared to non-Indigenous population. Higher ACE scores for Indigenous participants were associated with increased rates of suicidality and psychological distress. Protective factors to reduce the impact of ACEs were cultural identity and connectedness, education, social support, and psychological resilience. Future research may further explore the relationship between ACE scores and protective factors, varying prevalence within specific sub-populations, and consistent reporting of outcomes across studies. Ongoing research has the potential to clarify existing dose-response relationships between early traumatic experiences and current health disparities experienced within some Indigenous communities.
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Affiliation(s)
- Abbey Radford
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
| | - Katie Zugic
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
| | - Kara Boles
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
- Northern Ontario School of Medicine (NOSM), Lakehead University, Thunder Bay, ON Canada
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON Canada
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON Canada
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Mackenzie CS, Pankratz L. Perceived Need, Mental Health Literacy, Neuroticism and Self- Stigma Predict Mental Health Service Use Among Older Adults. Clin Gerontol 2022:1-14. [PMID: 35400301 DOI: 10.1080/07317115.2022.2058440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Older adults are the least likely age group to seek mental health services. However, few studies have explored a comprehensive range of sociodemographic, psychological, and social barriers and facilitators to seeking treatment in later life. METHODS A cross-sectional, national sample of Canadian older adults (55+, N = 2,745) completed an online survey including reliable and valid measures of predisposing, enabling, and need characteristics, based on Andersen's behavioral model of health, as well as self-reported use of mental health services. Univariate and hierarchical logistic regressions predicted past 5-year mental health service use. RESULTS Mental health service use was most strongly and consistently associated with greater perceived need (OR = 11.48) and mental health literacy (OR = 2.16). Less self-stigma of seeking help (OR = .65) and greater neuroticism (OR = 1.57) also predicted help-seeking in our final model, although their effects were not as strong or consistent across gender, marital status, and age subgroups. CONCLUSIONS The need category was crucial to seeking help, but predisposing psychological factors were also significant barriers to treatment. CLINICAL IMPLICATIONS Interventions that target older adults high in neuroticism by improving perceptions of need for treatment, mental health literacy, and self-stigma of seeking help may be particularly effective ways of improving access to mental health services.
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Affiliation(s)
- Corey S Mackenzie
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lily Pankratz
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
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Júnior JG, Moreira MM, Pinheiro WR, de Amorim LM, Lima CKT, da Silva CGL, Neto MLR. The mental health of those whose rights have been taken away: An essay on the mental health of indigenous peoples in the face of the 2019 Coronavirus (2019-nCoV) outbreak. Psychiatry Res 2020; 289:113094. [PMID: 32405114 PMCID: PMC7219388 DOI: 10.1016/j.psychres.2020.113094] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND : In Latin America there are about 45 million indigenous people in 826 communities that represent 8.3% of the population. An estimated 798,365 Aboriginal and Torres Strait Islander were in Australia, 5,2 million indigenous people living in America and 2,13 million in Canada. Racial/ethnic disparities in mental health service use have increased especially in the context of the new coronavirus pandemic. Thus, we aimed to describe the mental health situation of the indigenous population in the context of the COVID-19 pandemic. METHOD : The studies were identified in well-known international journals found in three electronic databases: PubMed, Scopus, and MEDLINE. The data were cross-checked with information from the main international newspapers. RESULTS : According to the literature, due to the COVID-19 pandemic there is a lack of specialized mental health services and professionals, a restricted access to quality information and a lack of access to inputs, causing negative feelings and it can exacerbate pre-existing mental problems (eg: depression, suicidal ideation, smoking and binge drink). The cultural differences are a risk factor to worsen the mental health of this already vulnerable population. CONCLUSION : providing psychological first aid is an essential care component for indigenous populations that have been victims COVID-19 pandemic.
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Affiliation(s)
- Jucier Gonçalves Júnior
- Department of Internal Medicine, Santa casa de Misericórdia de Fortaleza, Fortaleza, Ceará, Brazil
| | - Marcial Moreno Moreira
- School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil,School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil
| | | | | | | | - Claúdio Gleidiston Lima da Silva
- School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil,School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil
| | - Modesto Leite Rolim Neto
- School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil,School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil,Corresponding author
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