1
|
Parent J, Highlander A, Loiselle R, Yang Y, McKee LG, Forehand R, Jones DJ. Technology-Enhanced BPT for Early-Onset Behavior Disorders: Improved Outcomes for Children With Co-Occurring Internalizing Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:246-259. [PMID: 37494309 PMCID: PMC10811290 DOI: 10.1080/15374416.2023.2222391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Early-onset behavior disorders (BDs) are common and costly. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early intervention for BDs in young children, is well-established; yet, common comorbidities such as internalizing symptoms are common and their impact, not well understood. The goal of the current study was to examine the potential for technology to improve BPT effects on observed parenting and child behavior outcomes for families of children recruited for clinically significant problem behavior who also presented with relatively higher internalizing symptoms. METHOD Families with low incomes (N = 101), who are overrepresented in statistics on early-onset BDs, were randomized to an evidence-based BPT program, Helping the Noncompliant Child (HNC), or Technology-Enhanced HNC (TE-HNC). Children were ages 3 to 8 years (55.4% were boys). Child race included White (64.0%), Black or African American (21.0%), more than one race (14.0%), and Hispanic/Latinx (13.9%). RESULTS Families in both groups evidenced improvement in internalizing symptoms at posttreatment; however, TE-HNC yielded the greatest improvement in positive parenting and child compliance at posttreatment and follow-up for children with the highest internalizing symptoms at baseline. CONCLUSIONS TE-HNC resulted in improved parenting and child behavior outcomes for children with elevated levels of co-occurring internalizing symptoms at baseline relative to standard HNC. We posit that these added benefits may be a function of TE-HNC, creating the opportunity for therapists to personalize the treatment model boosting parent skill use with more complex presentations, although a formal test of mediation will be important in future work.
Collapse
Affiliation(s)
- Justin Parent
- Warren Alpert Medical School, Brown University, Providence, RI
- Bradley/Hasbro Children’s Research Center, E. P. Bradley Hospital, East Providence, RI
| | | | - Raelyn Loiselle
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yexinyu Yang
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | |
Collapse
|
2
|
Rodriguez J, Radjack R, Moro MR, Lachal J. Migrant adolescents' experience of depression as they, their parents, and their health-care professionals describe it: a systematic review and qualitative meta-synthesis. Eur Child Adolesc Psychiatry 2024; 33:1-19. [PMID: 35301589 DOI: 10.1007/s00787-022-01971-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/03/2022] [Indexed: 11/27/2022]
Abstract
Migrant youth are vulnerable and face a risk of internalised disorders such as depression. This qualitative meta-synthesis explores migrant adolescents' experience of depression. 14 studies (7 qualitative studies and 7 case reports) were selected after a systematic search of PubMed, Embase, Scopus and PsycInfo. Their quality was assessed with the Critical Appraisal Tool (CASP) for qualitative studies and the Joanna Briggs Institute (JBI) checklist for case reports. The analysis identified six themes describing the experience of depression among migrant adolescents: (1) the vulnerability factors underlying depressive distress, before, during and after migration; (2) the subjective experience of depression, combining symptoms associated with a form of depression common in the West with symptoms more common in other cultures; (3) two types of aetiological hypotheses to make sense of their distress; (4) attitudes adopted in response to distress; (5) experience of care, especially reasons discouraging investment in care; and (6) impairment of identity construction by breaks in cultural transmission and intergenerational conflicts. The threat of losing their connections both at the interpersonal (connection to family, peers and community) and intrapsychic levels (construction of identity) is inherently linked to migrant adolescents' experience of depression. We propose to adapt Brandenberger's 3C model (communication, continuity of care, and confidence) for the care of young migrants to promote a therapeutic alliance, foster construction of a coherent bicultural identity, and support the family.
Collapse
Affiliation(s)
- Juliette Rodriguez
- APHP, Hôpital Cochin, Maison de Solenn, 75014, Paris, France.
- Université de Paris, Paris, France.
| | - Rahmeth Radjack
- APHP, Hôpital Cochin, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Marie Rose Moro
- APHP, Hôpital Cochin, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Jonathan Lachal
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Clermont-Ferrand, 63000, Clermont-Ferrand, France
- Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| |
Collapse
|
3
|
Cooper J, Donovan K, Michel H, Peterson L, Todd-Thompson M, Gillette C, Hussaini SS. Screening for post-traumatic stress disorder among Latinx immigrant children. JAAPA 2023; 36:1-6. [PMID: 37884045 DOI: 10.1097/01.jaa.0000979516.10361.7d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
ABSTRACT Latinx children face psychosocial, linguistic, and economic challenges that put them at an increased risk of developing mental health conditions. Primary care providers should be equipped to recognize the complex mental health needs of this growing population. This article explores some of the barriers to mental health screenings in Latinx children and presents culturally sensitive, validated screening tools for primary care providers.
Collapse
Affiliation(s)
- Josseline Cooper
- At the time this article was written, Josseline Cooper, Kelsey Donovan, Halee Michel, Lindsey Peterson , and Megan Todd-Thompson were students in the PA program at Wake Forest School of Medicine in Winston-Salem, N.C. Josseline Cooper now practices in internal medicine palliative care at Cone Health in Greensboro, N.C. Kelsey Donovan practices in hospital medicine at Atrium Health Wake Forest Baptist in Winston-Salem, N.C. Halee Michel practices in internal medicine with Scripps Clinic Medical Group in San Diego, Calif. Lindsey Peterson practices at Legacy Meridian Park Medical Center in Portland, Ore. Megan Todd-Thompson practices at Randolph Health Medical Group in Asheboro, N.C. Chris Gillette is an associate professor and director of scholarship and research at Wake Forest University School of Medicine in Winston-Salem, N.C. Sobia Shariff Hussaini is an assistant professor and director of admissions and academic practice partnerships in the PA program at Wake Forest University School of Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | | | | | |
Collapse
|
4
|
Nayak SS, Carpenito T, Zamechek L, Roper K, Méndez-Peñate L, Arty M, Moulin C, Mirand D, Molnar BE. Predictors of Service Utilization of Young Children and Families Enrolled in a Pediatric Primary Care Mental Health Promotion and Prevention Program. Community Ment Health J 2022; 58:1191-1206. [PMID: 35043286 DOI: 10.1007/s10597-021-00929-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
Understanding early childhood mental health service utilization in community-based clinical settings is important. Project Linking Actions for Unmet Needs in Children's Health (Project LAUNCH) provided mental health-related services for young children and families within pediatric medical homes. Using data from the Project LAUNCH evaluation (n = 106), we implemented negative binomial regression models to determine if baseline variables were associated with service utilization, defined as the number of encounters between the family and the team. Past-year homelessness emerged as a significant predictor of service utilization. Encounters for families with children who experienced homelessness within the last 12 months occurred at a rate 34.5% lower than those who had not experienced homelessness. Results highlight the importance of addressing homelessness as a barrier to mental health service utilization for families. Screening for recent housing insecurity and developing interventions that integrate housing support services into mental health programs may inform strategies to increase attendance for families with young children.
Collapse
Affiliation(s)
- Sameera S Nayak
- Institute for Health Equity and Social Justice Research, Northeastern University, 360 Huntington Ave, Mail Stop 314 INV, Boston, MA, 02115, USA
| | - Thomas Carpenito
- Institute for Health Equity and Social Justice Research, Northeastern University, 360 Huntington Ave, Mail Stop 314 INV, Boston, MA, 02115, USA
| | - Lynn Zamechek
- Institute for Health Equity and Social Justice Research, Northeastern University, 360 Huntington Ave, Mail Stop 314 INV, Boston, MA, 02115, USA
| | - Kate Roper
- Massachusetts Department of Public Health, Bureau of Family Health and Nutrition, Boston, MA, USA
| | - Larisa Méndez-Peñate
- Massachusetts Department of Public Health, Bureau of Family Health and Nutrition, Boston, MA, USA
| | - Malika Arty
- Early Childhood and Family Mental Health Program, Boston Public Health Commission, Boston, MA, USA
| | - Christy Moulin
- Early Childhood and Family Mental Health Program, Boston Public Health Commission, Boston, MA, USA
| | - Daphney Mirand
- Institute for Health Equity and Social Justice Research, Northeastern University, 360 Huntington Ave, Mail Stop 314 INV, Boston, MA, 02115, USA
| | - Beth E Molnar
- Institute for Health Equity and Social Justice Research, Northeastern University, 360 Huntington Ave, Mail Stop 314 INV, Boston, MA, 02115, USA.
| |
Collapse
|
5
|
Diaz Maldonado A, Simon A, Barry C, Hassler C, Lenjalley A, Giacobi C, Moro MR, Lachal J. Adolescent attendance at transcultural psychotherapy: a retrospective cohort study. Eur Child Adolesc Psychiatry 2022; 31:1-8. [PMID: 33751239 DOI: 10.1007/s00787-021-01760-3] [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: 09/24/2020] [Accepted: 03/11/2021] [Indexed: 11/27/2022]
Abstract
Migrant adolescents in therapy for psychological problems are at risk of poor attendance or even of dropping out. Transcultural psychotherapy has been developed in France to take cultural diversity into account in psychological treatment and to deal with the specific difficulties encountered in the psychotherapeutic treatment of this population. This study aims to assess adolescents' attendance rates to this form of psychotherapy and to explore the association of these rates with demographic, cultural, and clinical variables. We conducted a retrospective clinical cohort study of 148 adolescents aged from 11 to 20 years treated between 2008 and 2018 at two transcultural psychotherapy centers in Paris. Statistical analyses tested demographic, cultural, and clinical hypotheses. The main result was the high attendance rate at transcultural psychotherapy sessions among adolescents (77.8%). Attendance rates were not associated with age, gender, family size, generation of migration, or cultural area of origin, but were significantly linked to support in therapy, specifically, the presence at the first transcultural psychotherapy session of the first-line therapist, an interpreter, or both. Transcultural psychotherapy appears to be an effective method for addressing the complex symptoms experienced by migrant adolescents. Better attendance at sessions is statistically significantly associated with factors favoring a therapeutic alliance, specifically, the presence of the first-line therapist or an interpreter in TPT sessions and the existence of support from a social worker. The holistic approach of transcultural psychotherapy to adolescent care may explain the high attendance rates observed.
Collapse
Affiliation(s)
- Andrea Diaz Maldonado
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
| | - Amalini Simon
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
- Assistance publique-Hôpitaux de Paris (AP-HP), Université de Paris 13, Hôpital Avicenne, service de psychopathologie, 3413, 93009, Bobigny cedex, EA, France
| | - Caroline Barry
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Christine Hassler
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Adrien Lenjalley
- Centre Hospitalier de Niort, Unité Pour Adolescent, 79000, Niort, France
| | - Carole Giacobi
- Groupe Hospitalier Littoral Atlantique, Service de pédopsychiatrie, 17019, La Rochelle, France
| | - Marie Rose Moro
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Jonathan Lachal
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France.
- CHU de Clermont-Ferrand, Service de Psychiatrie de L'Enfant Et de L'Adolescent, 63000, Clermont-Ferrand, France.
- Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
| |
Collapse
|
6
|
Luo J, Raat H, Franse CB, Bannink R, Bai G, van Grieken A. Correlates of help-seeking by parents for the socioemotional development of their 3-year-old children: a longitudinal study. BMJ Open 2022; 12:e052595. [PMID: 35017243 PMCID: PMC8753387 DOI: 10.1136/bmjopen-2021-052595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/07/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Timely parental help-seeking regarding their child's socioemotional development is associated with a lower rate and lower severity of psychosocial problems in later life. This study aimed to examine the correlates of parental help-seeking for the socio-emotional development of 3-year-old children. DESIGN Retrospective cohort study. SETTING Community-based survey in Rotterdam. PARTICIPANTS Of 2305 parents and their 2-year-old children at baseline, 1507 who completed follow-up questionnaires were included in the analyses when children were 3 years old. OUTCOME MEASURES Parental help-seeking regarding their child's socioemotional development and types of formal and informal help sources (eg, general practitioner, internet) used in the past 12 months were measured. Hierarchical logistic regression models were applied to identify factors correlates of parental help-seeking among 13 predisposing, enabling and need factors according to Andersen's behavioural model. RESULTS In total, 22.6% of parents reported help-seeking in the past 12 months for socioemotional development of their 3-year-old child; 6.8% addressed formal help sources and 17.5% addressed informal help sources. General practitioner (2.7%) and family (12.5%) were the most frequently used formal and informal sources, respectively. In the full model, predisposing factors associated with higher odds of parental help-seeking were child's other western ethnic background (OR=1.66, 95% CI 1.02 to 2.68) and parental age ≤29 years old (OR=1.71, 95% CI 1.01 to 2.92). No associated factors were found among enabling factors. The need factors associated with higher odds of parental help-seeking were having previous help-seeking (OR=2.52, 95% CI 1.83 to 3.48) and discussing child's socioemotional development in the well-child visit (OR=2.47, 95% CI 1.73 to 3.53). CONCLUSIONS Predisposing and need factors were associated with parental help-seeking for socioemotional development of 3-year-old children. The findings can be used to further develop support for parents accessing adequate information, prevention and anticipatory care with regards to the child's socio-emotional development.
Collapse
Affiliation(s)
- Jie Luo
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carmen Betsy Franse
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Guannan Bai
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Amy van Grieken
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
7
|
Duarte CS, Lovero KL, Sourander A, Ribeiro WS, Bordin IAS. The Child Mental Health Treatment Gap in an Urban Low-Income Setting: Multisectoral Service Use and Correlates. Psychiatr Serv 2022; 73:32-38. [PMID: 34106744 DOI: 10.1176/appi.ps.202000742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To efficiently target capacity-building efforts for child mental health services in low- and middle-income countries (LMICs), it is critical to define how care is structured across sectors and individual-level factors. METHODS In a community-based sample of 1,408 children and adolescents (ages 6-15 years) from Itaboraí, Brazil, the authors assessed need and service use across four care systems (mental health specialty, health, welfare, and informal). Individual-level factors included child gender and age, maternal perception of child mental health need, paternal absence, maternal education, and maternal anxiety and depression. RESULTS The mental health treatment gap was 88%, with only 12% of children with psychiatric problems using mental health services. Children with mental health problems were more likely than those without these problems to use health and other sectors of care and to use services in more than one sector of care. Overall, 46% of the children with any clinical mental health problems and 31% of those with only internalizing problems were identified by their mothers as having a mental health need. Among those with clinical mental health problems, factors associated with mental health service use were being a boy and paternal absence but not mental health problem type or maternal awareness. CONCLUSIONS Closing the child mental health treatment gap in urban settings in LMICs where resources are scarce will likely require system-level changes, such as engagement of diverse service sectors of care. Interventions need to target increased maternal awareness about mental health problems and encourage provision of mental health services to girls.
Collapse
Affiliation(s)
- Cristiane S Duarte
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York City (Duarte, Lovero, Sourander); Care Policy and Evaluation Centre, London School of Economics and Political Science, London (Sourander); Department of Child Psychiatry, University of Turku, Turku, Finland (Ribeiro); Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Bordin)
| | - Kathryn L Lovero
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York City (Duarte, Lovero, Sourander); Care Policy and Evaluation Centre, London School of Economics and Political Science, London (Sourander); Department of Child Psychiatry, University of Turku, Turku, Finland (Ribeiro); Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Bordin)
| | - Andre Sourander
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York City (Duarte, Lovero, Sourander); Care Policy and Evaluation Centre, London School of Economics and Political Science, London (Sourander); Department of Child Psychiatry, University of Turku, Turku, Finland (Ribeiro); Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Bordin)
| | - Wagner S Ribeiro
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York City (Duarte, Lovero, Sourander); Care Policy and Evaluation Centre, London School of Economics and Political Science, London (Sourander); Department of Child Psychiatry, University of Turku, Turku, Finland (Ribeiro); Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Bordin)
| | - Isabel A S Bordin
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York City (Duarte, Lovero, Sourander); Care Policy and Evaluation Centre, London School of Economics and Political Science, London (Sourander); Department of Child Psychiatry, University of Turku, Turku, Finland (Ribeiro); Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Bordin)
| |
Collapse
|
8
|
Moore D, Castagnini E, Mifsud N, Geros H, Sizer H, Addington J, van der Gaag M, Nelson B, McGorry P, O'Donoghue B. The associations between migrant status and ethnicity and the identification of individuals at ultra-high risk for psychosis and transition to psychosis: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1923-1941. [PMID: 33641006 DOI: 10.1007/s00127-021-02047-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Migrant and ethnic minority populations exhibit a higher incidence of psychotic disorders. The Ultra-High Risk for psychosis (UHR) paradigm provides an opportunity to explore the stage at which such factors influence the development of psychosis. In this systematic review, we collate and appraise the literature on the association between ethnicity and migrant status and the rate of identification of individuals at UHR, as well as their rate of transition to psychosis. METHODS We conducted a systematic review in the Ovid Medline, PsychINFO, Pubmed, CINAHL and EMBASE databases according to PRISMA guidelines. We included studies written in English that included an UHR cohort, provided a measure of ethnicity or migrant status, and examined the incidence, rate, or risk of UHR identification or transition to psychosis. RESULTS Of 2182 unique articles identified, seven fulfilled the criteria. One study found overrepresentation of UHR individuals from black ethnic groups, while another found underrepresentation. Two studies found increased rates of transition among certain ethnic groups and a further two found no association. Regarding migrant status, one study found that first-generation migrants were underrepresented in an UHR sample. Lastly, a lower transition rate in migrant populations was identified in one study, while two found no association. CONCLUSION Rates of UHR identification and transition according to ethnic and migrant status were inconsistent and insufficient to conclusively explain higher incidences of psychotic disorders among these groups. We discuss the clinical implications and avenues for future research, which is required to clarify the nature of the associations.
Collapse
Affiliation(s)
- Danielle Moore
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Emily Castagnini
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Nathan Mifsud
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Hellen Geros
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Holly Sizer
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mark van der Gaag
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Barnaby Nelson
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Patrick McGorry
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia.
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
| |
Collapse
|
9
|
Green JG, Oblath R, Kessel Schneider S, Miller M. Assessing Adolescent Mental Health Service Use: Developing the Adolescent Mental Health Support Scale (AMHSS). SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09460-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
10
|
Lu W, Todhunter-Reid A, Mitsdarffer ML, Muñoz-Laboy M, Yoon AS, Xu L. Barriers and Facilitators for Mental Health Service Use Among Racial/Ethnic Minority Adolescents: A Systematic Review of Literature. Front Public Health 2021; 9:641605. [PMID: 33763401 PMCID: PMC7982679 DOI: 10.3389/fpubh.2021.641605] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: Mental disorders represent serious public health concerns in the U.S. Compared with Whites, racial/ethnic minority adolescents are more likely to be affected by mental disorders but less likely to use mental health services. This systematic review aimed to summarize factors related to mental health service use among minority adolescents in the U.S. as identified in previous research. Methodology: Following the PRISMA guideline, we systematically searched seven databases for peer reviewed articles related to barriers and facilitators of mental health service use among racial/ethnic minority adolescents. Results: Thirty-two quantitative studies met our inclusion criteria, among which 12 studies (37.5%) sampled mostly Blacks or African Americans, 6 studies (18.7%) focused primarily on Hispanics or Latin/a/x, including Mexican Americans and Puerto Ricans, and 4 studies (12.5%) were mostly Asian Americans (e.g., Chinese, Vietnamese). Based on the socio-ecological framework, 21 studies (65.6%) identified adolescent-related barriers and facilitators of mental health service use, including biological (e.g., age, gender), clinical (e.g., symptom severity), behavioral (e.g., drug/alcohol use), and psychological characteristics (e.g., internal asset) of minority youth. Ten studies (31.3%) identified parents-related factors that influenced minority adolescent mental health service use, including parental perceptions and beliefs, family and parenting issues, and demographic characteristics. Primary factors at the therapist level included ethnic match between patient and practitioner, relationship with healthcare practitioners, and patient-therapist co-endorsement of etiological beliefs. Fifteen studies (46.9%) identified factors influencing minority adolescent mental health service use at the contextual/structural level, including household income, insurance status, and family structure. Lastly, acculturation and school experiences were major factors at the social/cultural level that influence minority adolescent service use. Conclusion: More empirical studies are needed to understand the mechanism underlying minority adolescents' unmet mental health service needs. Culturally competent interventions are warranted to engage minority adolescents with mental disorders into treatment.
Collapse
Affiliation(s)
- Wenhua Lu
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, New York, NY, United States
| | | | | | - Miguel Muñoz-Laboy
- School of Social Welfare, Stony Brook University, New York, NY, United States
| | | | - Lei Xu
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, United States
| |
Collapse
|
11
|
Socioeconomic Status, Race and Parental Initial Response to Children's Mental Illness. J Immigr Minor Health 2020; 23:463-469. [PMID: 33037550 DOI: 10.1007/s10903-020-01098-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
To examine how socioeconomic status (SES) and race affect parents' initial response (IR) to their child's mental illness (MI) including 1. Parental confidant(s); 2. Lag time in professional help-seeking; and 3. Referral source. 70 parents of patients new to a Child Psychiatry clinic completed a survey to assess their IR to their child's MI. SES was determined using the United States Census Bureau median income by zip codes. Summary statistics are frequencies and percentages for categorical data, and medians and quartiles for continuous data. Twenty-five percent of parents reported low SES and 31% Non-Caucasian Children (NCC). Confidants of Caucasian and NCC were Pediatrician (77% vs 50%, p = 0.03), and family (73% vs 32%, p = 0.002). Comparing help-seeking Lag Times 66% reported a delay of 1 year or more (p = 0.040). Overall Pediatricians were the leading confidant. Lag times were one year or more with stronger trends in NCC.
Collapse
|
12
|
Duong MT, Bruns EJ, Lee K, Cox S, Coifman J, Mayworm A, Lyon AR. Rates of Mental Health Service Utilization by Children and Adolescents in Schools and Other Common Service Settings: A Systematic Review and Meta-Analysis. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 48:420-439. [PMID: 32940884 DOI: 10.1007/s10488-020-01080-9] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/21/2023]
Abstract
A meta-analysis was conducted to examine the relative rates of youth mental health service utilization across settings among the general population and among those with elevated mental health symptoms or clinical diagnoses. Rates of school-based mental health were compared to outpatient, primary care, child welfare, juvenile justice, and inpatient. Nine studies presented rates of mental health service use for general-population youth in the U.S., and 14 studies presented rates for youth with elevated symptoms or clinical diagnoses. Random effects meta-analysis was used to calculate mean proportions of youth receiving care in each sector. Of general population youth, 7.28% received school mental health services. Rates for other sectors are as follows: 7.26% in outpatient settings, 1.76% in primary care, 1.80% in inpatient, 1.35% in child welfare, and 0.90% juvenile justice. For youth with elevated mental health symptoms or diagnoses, 22.10% of youth were served by school-based mental health services, 20.56% outpatient settings, 9.93% primary care, 9.05% inpatient, 7.90% child welfare, and 4.50% juvenile justice. Schools and outpatient settings are the most common loci of mental health care for both the general population and samples of youth with elevated symptoms or clinical diagnoses, although substantial amounts of care are also provided in a range of other settings. Results hold potential for informing resource allocation, legislation and policy, intervention development, and research. Given that mental health services are delivered across many settings, findings also point to the need for interconnection across child-serving sectors, particularly schools and outpatient clinics.
Collapse
Affiliation(s)
- Mylien T Duong
- Education, Research, and Impact, Committee for Children, Seattle, USA.
| | - Eric J Bruns
- University of Washington School of Medicine, Seattle, USA
| | - Kristine Lee
- University of Washington School of Medicine, Seattle, USA
| | - Shanon Cox
- University of Washington School of Medicine, Seattle, USA
| | | | | | - Aaron R Lyon
- University of Washington School of Medicine, Seattle, USA
| |
Collapse
|
13
|
Lachal J, Simon A, Hassler C, Barry C, Camara H, Massari N, Franchitti R, Mao SF, Roy Edward T, Carballeira Carrera L, Rouchon JF, Moro MR. Epidemiological description of 529 families referred for French transcultural psychotherapy: A decade of experience. PLoS One 2020; 15:e0236990. [PMID: 32750077 PMCID: PMC7402487 DOI: 10.1371/journal.pone.0236990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 07/17/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Transcultural psychotherapy (TPT) is an original therapeutic method developed in various forms in France and several other countries in Europe as well as North America to address issues of migrant mental health care when psychosocial, economic, or cultural barriers hinder its accessibility and effectiveness. This study aims to describe the patients referred for TPT in Paris and its suburbs over the past decade, to examine intercultural differences and associations with social, demographic, and clinical variables, and to assess TPT in terms of patient adherence, attendance, and duration of care. METHOD Retrospective study of 529 patients referred for TPT care, classified in three categories-no treatment, initiated treatment, engaged and continuing treatment. Collection and analysis of social, demographic, cultural, and clinical data, as well as of country of origin, duration of treatment, number of sessions attended (adherence), and number of sessions scheduled. RESULTS In all, 301 patients from 45 countries participated in an 11-month course of care lasting an average of 8 sessions. Most were children, accompanied by their families. The main psychiatric symptoms at the beginning of treatment were depressive, and the main cultural problem identified was the existence of a traditional theory explaining the illness in the family's culture. Patients kept 80% of their appointments for sessions, and attendance was not associated with socio-cultural or clinical variables. CONCLUSION The high level of treatment adherence and attendance over time suggest that TPT is an effective method for addressing complex symptoms experienced by migrant families. Results highlighted the potential richness and originality of studies based on retrospective medical data.
Collapse
Affiliation(s)
- Jonathan Lachal
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Amalini Simon
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Christine Hassler
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Caroline Barry
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Hawa Camara
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Nelly Massari
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
| | - Roberta Franchitti
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
- Sapienza Università di Roma, Rome, Italy
| | - Sann-Fou Mao
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
- Département Etudes Psychanalytiques, UFR IHSS, Université de Paris, Paris, France
| | - Tony Roy Edward
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
- Institut de Psychologie, Université de Paris, Boulogne-Billancourt, France
| | | | - Jeanne-Flore Rouchon
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
- Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Avicenne, Service de Psychopathologie, Université de Paris, France
| | - Marie Rose Moro
- AP-HP, Cochin Hospital, Maison de Solenn, Paris, France
- Université de Paris, PCPP, Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| |
Collapse
|
14
|
Dixon De Silva LE, Ponting C, Ramos G, Guevara MVC, Chavira DA. Urban Latinx parents' attitudes towards mental health: Mental health literacy and service use. CHILDREN AND YOUTH SERVICES REVIEW 2020; 109:104719. [PMID: 37842164 PMCID: PMC10575228 DOI: 10.1016/j.childyouth.2019.104719] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Latinx youth report elevated internalizing symptomatology as compared to their non-Latinx White counterparts and are less likely to access mental health care for these problems. This qualitative study examined the knowledge, beliefs and perceptions that Latinx parents (86% foreign-born; 66.7% monolingual Spanish speakers) living in urban communities have about mental health and service use for anxiety and depression in children. We used thematic analysis to analyze interview data from 15 Latinx parents who expressed concerns about their child's (age 6-13) worry or sadness. Analyses revealed that Latinx parents often have difficulty identifying mental health problems, report stigma about mental health problems and help-seeking and want more information about how they can help their children. Although Latinx parents report significant mental health and treatment-seeking stigma, the majority were open to seeking mental health services for their children or were already receiving services. Findings suggest that stigma although prevalent, may not deter service utilization for some Latinx families. Implications for community health and future research are discussed.
Collapse
Affiliation(s)
| | - Carolyn Ponting
- Department of Psychology, University of California Los Angeles
| | - Giovanni Ramos
- Department of Psychology, University of California Los Angeles
| | | | | |
Collapse
|
15
|
"Not Just One, It's Both of Us": Low-Income Mothers' Perceptions of Structural Family Therapy Delivered in a Semi-rural Community Mental Health Center. Community Ment Health J 2019; 55:1152-1164. [PMID: 31325002 DOI: 10.1007/s10597-019-00444-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
Qualitative methods were used to explore mothers' perceptions of structural family therapy (SFT) delivered in a semi-rural community mental health clinic. In-depth, semi-structured interviews were conducted with sixteen mothers who received SFT after seeking services for their children. Thematic analysis suggests mothers found SFT acceptable and valuable. Mothers reported using SFT strategies to regain parental authority, which they believed improved their ability to manage their child's needs and decreased their own stress. SFT also increased some mothers' receptivity to individual treatment. Mothers identified their low dose of treatment and lack of father involvement as impediments to improvement, raising concerns about intervention sustainability.
Collapse
|
16
|
Kikuzawa S, Pescosolido B, Kasahara-Kiritani M, Matoba T, Yamaki C, Sugiyama K. Mental health care and the cultural toolboxes of the present-day Japanese population: Examining suggested patterns of care and their correlates. Soc Sci Med 2019; 228:252-261. [PMID: 30946981 DOI: 10.1016/j.socscimed.2019.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 01/26/2023]
Abstract
An extensive body of literature has documented the under-utilization of mental health services among Asian populations, regardless of where they live. Japan is one Asian country where the mental health care system has improved substantially in the recent decades. Yet, Japan continues to report greater under-utilization of mental health services than other developed countries. One primary reason for this is hypothesized to be the cultural climate, which includes the stock of social, cultural and medical knowledge surrounding mental illness. Previous studies have not examined the cultural toolkit (Swidler, 2001) of the Japanese public, nor have they linked these to public attributions or assessments surrounding mental health. The Stigma in Global Context - Mental Health Study (SGC-MHS), a multi-stage probability sample of Japanese residents aged 18-64 years (N = 994) in 2006 provides data to describe the unprompted care suggestions from the general population regarding case scenarios meeting psychiatric criteria for schizophrenia and depression. Guided theoretically by the Network Episode Model, we analyze if and how respondents socially organize solutions into patterns of culturally acceptable care for mental health problems in Japan. Six cultural utilization patterns appear to be shaped by beliefs about underlying attributions, perceived severity of conditions, and type of mental health problem. Further, women, older individuals and those with differing education levels suggest different care patterns than their counterparts. In sum, the findings indicate unique patterns of mental health care recommendations among the Japanese public, which are culturally and socially constrained.
Collapse
Affiliation(s)
- Saeko Kikuzawa
- Department of Sociology, Faculty of Social Sciences, Hosei University, Tokyo, Japan.
| | | | | | - Tomoko Matoba
- Department of Human Care and Support, Faculty of Human Life Design, Toyo University, Saitama, Japan
| | - Chikako Yamaki
- Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Katsumi Sugiyama
- Department of Social Welfare, Aomori University of Health and Welfare, Aomori, Japan
| |
Collapse
|
17
|
Harris VC, Links AR, Walsh J, Schoo DP, Lee AH, Tunkel DE, Boss EF. A Systematic Review of Race/Ethnicity and Parental Treatment Decision-Making. Clin Pediatr (Phila) 2018; 57:1453-1464. [PMID: 30014706 PMCID: PMC6460468 DOI: 10.1177/0009922818788307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Patient race/ethnicity affects health care utilization, provider trust, and treatment choice. It is uncertain how these influences affect pediatric care. We performed a systematic review (PubMed, Scopus, Web of Science, PsycINFO, Cochrane, and Embase) for articles examining race/ethnicity and parental treatment decision-making, adhering to PRISMA methodology. A total of 9200 studies were identified, and 17 met inclusion criteria. Studies focused on treatment decisions concerning end-of-life care, human papillomavirus vaccination, urological surgery, medication regimens, and dental care. Findings were not uniform between studies; however, pooled results showed (1) racial/ethnic minorities tended to prefer more aggressive end-of-life care; (2) familial tradition of neonatal circumcision influenced the decision to circumcise; and (3) non-Hispanic Whites were less likely to pursue human papillomavirus vaccination but more likely to complete the vaccine series if initiated. The paucity of studies precluded overarching findings regarding the influence of race/ethnicity on parental treatment decisions. Further investigation may improve family-centered communication, parent engagement, and shared decision-making.
Collapse
Affiliation(s)
- Vandra C. Harris
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Anne R. Links
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Jonathan Walsh
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Desi P. Schoo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Andrew H. Lee
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - David E. Tunkel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Emily F. Boss
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland,Department of Health Policy and Management, Johns Hopkins Medical Institutions, Baltimore, Maryland
| |
Collapse
|
18
|
Longitudinal Determinants of School-Based Mental Health Service Use for Girls and Boys with Externalizing Behavior Problems. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9249-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Posserud M, Hysing M, Helland W, Gillberg C, Lundervold AJ. Autism traits: The importance of "co-morbid" problems for impairment and contact with services. Data from the Bergen Child Study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:275-283. [PMID: 26826893 DOI: 10.1016/j.ridd.2016.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/08/2015] [Accepted: 01/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Co-occurring problems are common in individuals with clinical autism spectrum disorder (ASD) but their relevance for impairment and contact with health services in ASD is largely unexplored. AIMS We investigated the extent of co-occurring problems in children with high ASD traits from a total population sample. We explored the contribution of co-occurring problems to impairment and service contact, and whether there were children without co-occurring problems in this group; as proxy for "ASD only". METHODS AND PROCEDURES Children screening positive on the Autism Spectrum Screening Questionnaire (ASSQ) were used as proxy for ASD. Attention Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) were operationalised using symptom counts. A parent or teacher report above the 95th percentile counted as "problem" present for other symptom domains. OUTCOMES AND RESULTS 92% of ASSQ high-scorers had a minimum of two other problems. Emotional problems, ADHD symptoms and learning problems were the most commonly reported problems, also predicting impairment and contact with services. CONCLUSIONS AND IMPLICATIONS Co-occurring problems were common in ASD screen positive children and contributed strongly to both impairment and to contact with services. Gender differences indicated that female symptoms were perceived as less impairing by parents and teachers.
Collapse
Affiliation(s)
- M Posserud
- Department of Child and Adolescent Mental Health, Division of Psychiatry, Haukeland University Hospital, Norway.
| | - M Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway
| | - W Helland
- Section of Research and Innovation Helse Fonna HF, Haugesund, Norway; Department of Speech and Language Disorders, Statped Vest, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
| | - C Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden
| | - A J Lundervold
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
| |
Collapse
|
20
|
Chavira DA, Bustos CE, Garcia MS, Ng B, Camacho A. Delivering CBT to Rural Latino Children with Anxiety Disorders: A Qualitative Study. Community Ment Health J 2017; 53:53-61. [PMID: 26119534 PMCID: PMC5730360 DOI: 10.1007/s10597-015-9903-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/16/2015] [Indexed: 11/29/2022]
Abstract
Qualitative methods were used to understand community perspectives about ways to deliver cognitive behavior therapy (CBT) to rural Latino youth with anxiety. First, four focus groups were conducted with 28 bilingual Latino mental health providers to examine perceptions of CBT using telephone based, therapist supported bibliotherapy, and bibliotherapy without therapist support. Second, qualitative interviews were conducted with 15 Latino parents from a rural community to better understand attitudes toward CBT, and modes of service delivery. Qualitative findings revealed that parents were mostly positive about psychotherapy, and the core elements of CBT for anxiety. However, both parents and providers emphasized the need for adaptations to address practical and perceived barriers to treatment, such as time, convenience, homework, and literacy. Many parents spoke favorably of a telephone-based approach that could address many of their perceived barriers, while providers were expressed more negative views. Such findings are important for data-driven treatment development efforts.
Collapse
Affiliation(s)
- Denise A Chavira
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA. .,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
| | - Cristina E Bustos
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Maritza S Garcia
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Bernardo Ng
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Sun Valley Research Center, Imperial, CA, USA
| | - Alvaro Camacho
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Sun Valley Research Center, Imperial, CA, USA
| |
Collapse
|
21
|
Mian ND, Godoy L, Eisenhower AS, Heberle AE, Carter AS. Prevention Services for Externalizing and Anxiety Symptoms in Low-Income Children: the Role of Parent Preferences in Early Childhood. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:83-92. [PMID: 26306610 DOI: 10.1007/s11121-015-0601-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Dissemination of prevention programs targeting young children is impeded by challenges with parent engagement. Matching program characteristics to parent preferences is associated with increased retention in clinical/intervention settings, but little is known about the types of prevention programs that interest parents. The objectives of this study were to better understand parents' preferences for services designed to prevent externalizing and anxiety disorders and to identify factors associated with preferences. Ethnically diverse, low-income caregivers (n = 485) of young children (11-60 months) completed surveys on child anxiety and externalizing symptoms, parental worry about their children, parent anxiety symptoms, and preferences for prevention group topics. Parents were more likely to prefer a group targeting externalizing behaviors compared to anxiety. Cluster analysis revealed four groups of children: low symptoms, moderate anxiety-low externalizing, moderate externalizing-low anxiety, and high anxiety and externalizing. Parents' preferences varied according to co-occurrence of child anxiety and externalizing symptoms; interest in a program targeting externalizing problems was associated with elevated externalizing problems (regardless of anxiety symptom level), parent anxiety symptoms, and parent worry about their child. Only parent anxiety symptoms predicted parents' interest in an anxiety-focused program, and preference for an anxiety-focused program was actually reduced if children had co-occurring anxiety and externalizing symptoms versus only anxiety symptoms. Results suggest that parents' interest in a program to prevent externalizing problems was well-aligned with the presenting problem, whereas preferences for anxiety programming suggest a more complex interplay among factors. Parent preferences for targeted programming are discussed within a broader framework of parent engagement.
Collapse
Affiliation(s)
- Nicholas D Mian
- Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA. .,University of New Hampshire Manchester, 88 Commercial Street, Manchester, NH, USA.
| | - Leandra Godoy
- Children's National Health System, Washington, DC, USA
| | | | | | | |
Collapse
|
22
|
Liang HY, Chang HL. Disabled Children in Special Education Programs in Taiwan: Use of Mental Health Services and Unmet Needs. Psychol Rep 2016; 100:915-23. [PMID: 17688111 DOI: 10.2466/pr0.100.3.915-923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite national health insurance coverage in Taiwan, many health care needs remain unmet. In the current study, the behavior and emotional problems of 1,042 disabled children in special education programs were evaluated using the Chinese version of the Child Behavior Checklist (CBCL-C) and the Teacher's Report Form (TRF). Using the 60th percentile on the two tests as a cutoff representing a clinical indication, students who reached this cutoff point but did not receive mental health services in the past six months were considered to have “unmet mental health needs.” Of the special education students in the study 73.9% reached clinical indications, but did not receive mental health care.
Collapse
Affiliation(s)
- Hsin-Yi Liang
- Department of Child Psychiatry Chang Gung Children's Hospital, Kweishan, Taoyuan, Taiwan
| | | |
Collapse
|
23
|
Fidalgo TM, Sanchez ZM, Caetano SC, Maia LO, Carlini EA, Martins SS. The association of psychiatric symptomatology with patterns of alcohol, tobacco, and marijuana use among Brazilian high school students. Am J Addict 2016; 25:416-25. [PMID: 27437619 DOI: 10.1111/ajad.12407] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 05/29/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Studies have highlighted psychosocial factors associated with drug use among adolescents. Association of specific psychiatric comorbidity with substance use has not been properly established in Brazil. This study aimed to investigate alcohol, tobacco, and marijuana use by 15-18-year-old high school Brazilian students and to estimate associations with psychiatric symptoms. METHODS A cross-sectional survey of 4,034 students from 128 public and private schools in São Paulo State was carried out using a two-step probability sample. Data were collected through self-report standardized questionnaires including questions on substance use patterns and the Strengths and Difficulties Questionnaire (SDQ). Key outcome variables were past-month use and past-month frequent use of alcohol, tobacco and marijuana. Questionnaires with missing information were excluded, resulting in a final sample of 2,532 adolescents. Weighted data was analyzed through logistic regressions, adjusted by gender and by socio-economic status (SES). RESULTS Regarding SDQ total score, 43.6% of students had no psychiatric symptoms, 7.9% had subclinical symptoms and 48.5% presented clinically significant symptoms. Respondents with a clinically significant SDQ score were more likely to be past month alcohol (aOR = 1.51; 95%CI 1.22-1.88), tobacco (aOR = 1.82; 95%CI 1.25-2.66), and marijuana (aOR = 1.79; 95%CI 1.21-2.64) users as compared to those with no symptomatology. DISCUSSION AND CONCLUSIONS Psychopathological symptoms were associated with alcohol, tobacco and marijuana use by 15-18-year-old adolescents. These associations should also be considered when planning public policies of mental health promotion. SCIENTIFIC SIGNIFICANCE This study discusses the importance of the association between psychopathological symptoms and substance use in a middle-income country, with high level of social inequalities, in a state representative sample. (Am J Addict 2016;25:416-425).
Collapse
Affiliation(s)
- Thiago M Fidalgo
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine, Brazilian Center of Information on Psychotropic Drugs (CEBRID), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sheila C Caetano
- Department of Psychiatry, Child and Adolescent Psychiatry Unit (UPIA), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lucas O Maia
- Department of Preventive Medicine, Brazilian Center of Information on Psychotropic Drugs (CEBRID), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elisaldo A Carlini
- Department of Preventive Medicine, Brazilian Center of Information on Psychotropic Drugs (CEBRID), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| |
Collapse
|
24
|
Liang J, Matheson BE, Douglas JM. Mental Health Diagnostic Considerations in Racial/Ethnic Minority Youth. JOURNAL OF CHILD AND FAMILY STUDIES 2016; 25:1926-1940. [PMID: 27346929 PMCID: PMC4916917 DOI: 10.1007/s10826-015-0351-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Misdiagnoses of racial/ethnic minority youth's mental health problems can potentially contribute to inappropriate mental health care. Therefore, we conducted a systematic review that focuses on current theory and empirical research in an attempt to answer the following two questions: 1) What evidence exists that supports or contradicts the idea that racial/ethnic minority youth's mental health problems are misdiagnosed? 2) What are the sources of misdiagnoses? Articles were reviewed from 1967 to 2014 using PsychINFO, PubMed, and GoogleScholar. Search terms included "race", "ethnicity", "minority", "culture", "children", "youth", "adolescents", "mental health", "psychopathology", "diagnosis", "misdiagnosis", "miscategorization", "underdiagnosis", and "overdiagnosis". Seventy-two articles and book chapters met criteria and were included in this review. Overall, evidence was found that supports the possibility of misdiagnosis of ethnic minority youth's emotional and behavioral problems. However, the evidence is limited such that it cannot be determined whether racial/ethnic differences are due to differences in psychopathology, mental health biases, and/or inaccurate diagnoses. Cultural and contextual factors that may influence misdiagnosis as well as recommendations for research and practice are discussed.
Collapse
Affiliation(s)
- June Liang
- University of California, San Diego, Department of Pediatrics
| | - Brittany E. Matheson
- University of California, San Diego, Department of Pediatrics
- San Diego State University/University of California Joint Doctoral Program in Clinical Psychology
| | - Jennifer M. Douglas
- University of California, San Diego, Department of Pediatrics
- San Diego State University/University of California Joint Doctoral Program in Clinical Psychology
| |
Collapse
|
25
|
Acri MC, Bornheimer LA, O’Brien K, Sezer S, Little V, Cleek AF, McKay MM. A model of integrated health care in a poverty-impacted community in New York City: Importance of early detection and addressing potential barriers to intervention implementation. SOCIAL WORK IN HEALTH CARE 2016; 55:314-27. [PMID: 27070372 PMCID: PMC5545980 DOI: 10.1080/00981389.2015.1137256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Disruptive behavior disorders (DBDs) are chronic, impairing, and costly behavioral health conditions that are four times more prevalent among children of color living in impoverished communities as compared to the general population. This disparity is largely due to the increased exposure to stressors related to low socioeconomic status including community violence, unstable housing, under supported schools, substance abuse, and limited support systems. However, despite high rates and greater need, there is a considerably lower rate of mental health service utilization among these youth. Accordingly, the current study aims to describe a unique model of integrated health care for ethnically diverse youth living in a New York City borough. With an emphasis on addressing possible barriers to implementation, integrated models for children have the potential to prevent ongoing mental health problems through early detection and intervention.
Collapse
Affiliation(s)
- Mary C. Acri
- McSilver Institute for Poverty Policy & Research, New York University Medical Center, New York, New York, USA
| | - Lindsay A. Bornheimer
- McSilver Institute for Poverty Policy & Research, New York University Medical Center, New York, New York, USA
| | - Kyle O’Brien
- McSilver Institute for Poverty Policy & Research, New York University Medical Center, New York, New York, USA
| | - Sara Sezer
- The Institute for Family Health, New York, New York, USA
| | - Virna Little
- The Institute for Family Health, New York, New York, USA
| | - Andrew F. Cleek
- McSilver Institute for Poverty Policy & Research, New York University Medical Center, New York, New York, USA
| | - Mary M. McKay
- McSilver Institute for Poverty Policy & Research, New York University Medical Center, New York, New York, USA
| |
Collapse
|
26
|
Godoy L, Mian ND, Eisenhower AS, Carter AS. Pathways to service receipt: modeling parent help-seeking for childhood mental health problems. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 41:469-79. [PMID: 23504296 DOI: 10.1007/s10488-013-0484-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Understanding parent appraisals of child behavior problems and parental help-seeking can reduce unmet mental health needs. Research has examined individual contributors to help-seeking and service receipt, but use of structural equation modeling (SEM) is rare. SEM was used to examine parents' appraisal of child behavior, thoughts about seeking help, and receipt of professional services in a diverse, urban sample (N = 189) recruited from women infant and children offices. Parents of children 11-60 months completed questionnaires about child behavior and development, parent well-being, help-seeking experiences, and service receipt. Child internalizing, externalizing, and dysregulation problems, language delay, and parent worry about child behavior loaded onto parent appraisal of child behavior. Parent stress and depression were positively associated with parent appraisal (and help-seeking). Parent appraisal and help-seeking were similar across child sex and age. In a final model, parent appraisals were significantly associated with parent thoughts about seeking help, which was significantly associated with service receipt.
Collapse
Affiliation(s)
- Leandra Godoy
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA, 02125, USA,
| | | | | | | |
Collapse
|
27
|
Umpierre M, Meyers LV, Ortiz A, Paulino A, Rodriguez AR, Miranda A, Rodriguez R, Kranes S, McKay MM. Understanding Latino Parents' Child Mental Health Literacy: Todos a bordo/All Aboard. RESEARCH ON SOCIAL WORK PRACTICE 2015; 25:607-618. [PMID: 26412954 PMCID: PMC4582782 DOI: 10.1177/1049731514547907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE This article describes Phase 1 of a pilot that aims to develop, implement, and test an intervention to educate and simultaneously engage highly stressed Latino parents in child mental health services. A team of Spanish-speaking academic and community co-investigators developed the intervention using a community-based participatory research approach and qualitative methods. METHOD Through focus groups, the team identified parents' knowledge gaps and their health communication preferences. RESULTS Latino parents from urban communities need and welcome child mental health literacy interventions that integrate printed materials with videos, preferably in their native language, combined with guidance from professionals. CONCLUSION A 3-minute video in Spanish that integrates education entertainment strategies and a culturally relevant format was produced as part of the intervention to educate and simultaneously engage highly stressed Latino parents in child mental health care. It is anticipated that the intervention will positively impact service use among this group.
Collapse
Affiliation(s)
- Mari Umpierre
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Aida Ortiz
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Angela Paulino
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Ana Miranda
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | |
Collapse
|
28
|
Niec LN, Acevedo-Polakovich ID, Abbenante-Honold E, Christian AS, Barnett ML, Aguilar G, Peer SO. Working together to solve disparities: Latina/o parents' contributions to the adaptation of a preventive intervention for childhood conduct problems. Psychol Serv 2015; 11:410-20. [PMID: 25383995 DOI: 10.1037/a0036200] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Left untreated, conduct problems can have significant and long-lasting negative effects on children's development. Despite the existence of many effective interventions, U.S. Latina/o children are less likely to access or receive evidence-based services. Seeking to build the foundation to address these service disparities, the current study used a Community-Based Participatory Research approach to examine U.S. Latina/o parents' perceptions of the need for interventions to prevent childhood disruptive behaviors in their community in general, and of an existing evidence-based intervention-parent-child interaction therapy (PCIT)-in particular. Results suggest that parents recognize a need for prevention resources in their community and value most of the core features of PCIT. Nevertheless, important directions for potential adaptation and expansion of PCIT into a prevention approach were identified. Results point to several goals for future study with the potential to ameliorate the unmet mental health needs experienced by U.S. Latina/o families with young children at risk for developing conduct problems.
Collapse
Affiliation(s)
- Larissa N Niec
- Center for Children, Families and Communities, Central Michigan University
| | | | | | | | - Miya L Barnett
- Center for Children, Families and Communities, Central Michigan University
| | | | - Samuel O Peer
- Center for Children, Families and Communities, Central Michigan University
| |
Collapse
|
29
|
Wiesner M, Windle M, Kanouse DE, Elliott MN, Schuster MA. DISC Predictive Scales (DPS): Factor structure and uniform differential item functioning across gender and three racial/ethnic groups for ADHD, conduct disorder, and oppositional defiant disorder symptoms. Psychol Assess 2015; 27:1324-36. [PMID: 25774639 DOI: 10.1037/pas0000101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The factor structure and potential uniform differential item functioning (DIF) among gender and three racial/ethnic groups of adolescents (African American, Latino, White) were evaluated for attention deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD) symptom scores of the DISC Predictive Scales (DPS; Leung et al., 2005; Lucas et al., 2001). Primary caregivers reported on DSM-IV ADHD, CD, and ODD symptoms for a probability sample of 4,491 children from three geographical regions who took part in the Healthy Passages study (mean age = 12.60 years, SD = 0.66). Confirmatory factor analysis indicated that the expected 3-factor structure was tenable for the data. Multiple indicators multiple causes (MIMIC) modeling revealed uniform DIF for three ADHD and 9 ODD item scores, but not for any of the CD item scores. Uniform DIF was observed predominantly as a function of child race/ethnicity, but minimally as a function of child gender. On the positive side, uniform DIF had little impact on latent mean differences of ADHD, CD, and ODD symptomatology among gender and racial/ethnic groups. Implications of the findings for researchers and practitioners are discussed.
Collapse
Affiliation(s)
- Margit Wiesner
- Department of Educational Psychology, University of Houston
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University
| | | | | | - Mark A Schuster
- Division of General Pediatrics, Boston Children's Hospital/ Harvard Medical School
| |
Collapse
|
30
|
Acevedo-Polakovich ID, Niec LN, Barnett ML, Bell KM, Aguilar G, Vilca J, Abbenante-Honold ES, Christian AS, Peer SO. Exploring the role of Natural Helpers in efforts to address disparities for children with conduct problems. CHILDREN AND YOUTH SERVICES REVIEW 2014; 40:1-5. [PMID: 24910488 PMCID: PMC4041872 DOI: 10.1016/j.childyouth.2014.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The incorporation of natural helpers into services has been suggested as an innovative strategy to address disparities for historically underserved children with conduct problems. In order to inform incorporation efforts, this study examined the perceptions of natural helpers serving one U.S. Latina/o community regarding need for services for children with conduct problems, their reactions to a specific parent training intervention, and the training and support needed to deliver this intervention successfully. Participants identified a need for culturally-responsive services for children with conduct problems, and felt that parent training would be appropriate for the families they serve. Participants further identified specific training and support that they would require in order to deliver parent training with fidelity and effectiveness. Findings support the suggestion that natural helpers have the potential to address service disparities among Latina/o children with conduct problems. Recommendations from natural helpers should guide the development of culturally-adapted preventive interventions that help address existing service disparities.
Collapse
Affiliation(s)
| | - Larissa N Niec
- Central Michigan University Center for Children, Families and Communities
| | - Miya L Barnett
- Central Michigan University Center for Children, Families and Communities
| | | | | | - Jeanette Vilca
- Central Michigan University Center for Children, Families and Communities
| | | | | | - Samuel O Peer
- Central Michigan University Center for Children, Families and Communities
| |
Collapse
|
31
|
Paula CS, Bordin IAS, Mari JJ, Velasque L, Rohde LA, Coutinho ESF. The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions. PLoS One 2014; 9:e88241. [PMID: 24558382 PMCID: PMC3928169 DOI: 10.1371/journal.pone.0088241] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 01/08/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. Objectives To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU. Methods Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721). Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1) children/adolescent characteristics [(1.1) Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL)-psychiatric disorders; (1.2) Ten Questions Screen-neurodevelopment problems; (1.3) two subtests of WISC-III-estimated IQ; (1.4) Academic Performance Test-school performance)], (2) factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression), (3) family (Brazilian Research-Companies-Association's Questionnaire-SES). Results Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions) regardless of the presence of any psychiatric disorders/neurodevelopmental problems. Conclusions Only a small proportion of children/adolescents with psychiatric disorders had been seen by a mental health specialist in the previous 12 months. Structural/psychosocial/demographic factors were associated with uneven access to service for certain groups of children/adolescents. These results call attention to the urgent need to implement programs to help reduce this large unmet mental health need; inequalities must be considered by policy makers when planning strategies to address barriers for care.
Collapse
Affiliation(s)
- Cristiane S. Paula
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, São Paulo, Brasil
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, São Paulo, Brasil
- * E-mail:
| | - Isabel A. S. Bordin
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, São Paulo, Brasil
| | - Jair Jesus Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, São Paulo, Brasil
| | - Luciane Velasque
- Departamento de Matemática de Estatística. Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Luis A. Rohde
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | - Evandro S. F. Coutinho
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Escola Nacional de Saúde Pública-FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brasil
| |
Collapse
|
32
|
Mian ND. Little Children with Big Worries: Addressing the Needs of Young, Anxious Children and the Problem of Parent Engagement. Clin Child Fam Psychol Rev 2013; 17:85-96. [DOI: 10.1007/s10567-013-0152-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
33
|
Disparity of care for children with parent-reported autism spectrum disorders. Acad Pediatr 2013; 13:334-9. [PMID: 23830019 DOI: 10.1016/j.acap.2013.03.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 03/07/2013] [Accepted: 03/16/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Although children with autism spectrum disorders (ASDs) are eligible to receive special education services via an individualized education program (IEP), approximately 12% to 20% do not. Our objective was to determine which clinical and demographic characteristics are associated with IEP receipt among a nationally representative sample of children with ASD. METHODS Using data from the 2007 National Survey of Children's Health, we determined which clinical and demographic covariates are associated with IEP receipt for children ages 6 to 17 years with a current, parent-reported ASD diagnosis (n = 759). Logistic regression models were used to assess the association of covariates with IEP receipt. Application of weighting techniques made the findings representative of the noninstitutionalized population of US children 6 to 17 years old. RESULTS In the weighted model, 90% of children with ASD receive an IEP. Maternal education level above high school (adjusted odds ratio [aOR] 4.08, P = .01) and presence of perceived need for coordination of care (aOR 3.62, P = .02) were associated with IEP receipt, while Hispanic children were less likely to receive an IEP compared with white children (aOR 0.12, P = .001). The following factors were not associated with IEP receipt: severity of ASD, speech, and behavior problems. CONCLUSIONS For children with ASD in the United States, socioeconomic factors, not disability severity, are associated with IEP receipt. Future research should address methods to overcome this disparity in care. Health care providers may help to advocate for appropriate educational services for patients with ASD.
Collapse
|
34
|
Toppelberg CO, Hollinshead MO, Collins BA, Nieto-Castañon A. Cross-Sectional Study of Unmet Mental Health Need in 5- to 7-Year Old Latino Children in the United States: Do Teachers and Parents Make a Difference in Service Utilization? SCHOOL MENTAL HEALTH 2013; 5:59-69. [PMID: 23667398 DOI: 10.1007/s12310-012-9089-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the study is to examine the rates of mental health service utilization in young Latino children of immigrants in relation to maternal and teacher reports of child mental health need. Specific knowledge is lacking about gaps in service utilization among young Latino children, the fastest growing and possibly the most underserved segment of the US child population. The associations of mental health service utilization (Service Assessment for Children and Adolescents) and mental health need (clinical levels of internalizing, externalizing, or total problems reported by mothers [Child Behavior Checklist] and teachers [Teacher's Report Form]) were examined in a community sample of young Latino children of immigrants (n = 228; mean age = 6) and compared across mothers' and teachers' responses. Mother-teacher agreement was also studied. Sixty-five children (28.5 %) had a mental health need; most (76.9 %) of these received no services. For all types of mental health need, service utilization was more likely when need was reported by mothers rather than teachers (p = .03). Teachers' reports were not associated with service utilization. Mother-teacher agreement was low for externalizing (r = .23; p ≤ 0.01) and total problems (r = .21; p ≤ 0.05), and nonsignificant for internalizing problems. This study is the first in the United States to document, in such a young Latino group, high rates of unmet need comparable to those among older Latino youth; low or no mother-teacher agreement on which children had a mental health need; low utilization of school-based services; and a lack of association between service utilization and teacher-reported mental health need-both for externalizing and internalizing problems. These findings suggest that schools are not effectively leveraging mental health services for young Latino children. Potential factors responsible for the findings are discussed.
Collapse
Affiliation(s)
- Claudio O Toppelberg
- Judge Baker Children's Center, Children's Hospital Boston, Harvard Medical School, 53 Parker Hill Avenue, Boston, MA 02120, USA
| | | | | | | |
Collapse
|
35
|
Mental health services use predicted by number of mental health problems and gender in a total population study. ScientificWorldJournal 2013; 2013:247283. [PMID: 23690740 PMCID: PMC3654282 DOI: 10.1155/2013/247283] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 03/13/2013] [Indexed: 11/17/2022] Open
Abstract
We examined the relationship between service use and the number of problem areas as reported by parents and teachers on questionnaires among children aged 7–9 years old in the Bergen Child Study, a total population study including more than 9000 children. A problem area was counted as present if the child scored above the 95th percentile on parent and/or teacher questionnaire. A total number of 13 problem areas were included. Odd ratios (ORs) for contact with child and adolescent mental health services (CAMH), school psychology services (SPS), health visiting nurse/physician, and school support were calculated with gender as covariate. The number of symptom areas was highly predictive of service use, showing a dose-response relationship for all services. Children scoring on ≥4 problem areas had a more than hundredfold risk of being in contact with CAMH services compared to children without problems. The mean number of problem areas for children in CAMH and SPS was 6.1 and 4.4 respectively, strongly supporting the ESSENCE model predicting multisymptomatology in children in specialized services. Even after controlling for number of problem areas, boys were twice as likely as girls to be in contact with CAMH, replicating previous findings of female gender being a strong barrier to mental health services.
Collapse
|
36
|
Godoy L, Carter AS. Identifying and addressing mental health risks and problems in primary care pediatric settings: a model to promote developmental and cultural competence. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2013; 83:73-88. [PMID: 23330625 DOI: 10.1111/ajop.12005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Young children, particularly uninsured children of color, suffer from mental health disturbances at rates similar to older children and adults, yet they have higher rates of unmet needs. To address unmet needs, efforts to identify mental health problems in primary care pediatric settings have grown in recent years, thanks in large part to expanded screening efforts. Yet, health disparities in early detection remain. Enhancing understanding of how early childhood mental health problems can be identified and addressed within pediatric settings is an important and growing area of research. The authors draw on theoretical models from public health policy, health psychology, and child development, including health beliefs, help seeking, transtheoretical, motivation to change, and dynamic systems, to better understand and address challenges to and disparities in identifying and addressing mental health problems in pediatric settings. These theories have not previously been applied to early mental health screening and identification efforts. Developmental and sociocultural considerations are highlighted in an effort to address and reduce higher rates of unmet needs among young, uninsured children of color.
Collapse
|
37
|
Racial and Ethnic Disparities in the Continuation of Community-Based Children’s Mental Health Services. J Behav Health Serv Res 2011; 39:116-29. [DOI: 10.1007/s11414-011-9261-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
38
|
Olafsdottir S, Pescosolido BA. Constructing illness: how the public in eight Western nations respond to a clinical description of "schizophrenia". Soc Sci Med 2011; 73:929-38. [PMID: 21802185 PMCID: PMC3767137 DOI: 10.1016/j.socscimed.2011.06.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 06/02/2011] [Accepted: 06/10/2011] [Indexed: 11/18/2022]
Abstract
According to classic and contemporary social theory, the community is crucial to how individuals respond to the onset of health problems. Cultural response to symptoms provides the foundation for lay diagnosis; offers a gauge for marking individual and societal health literacy; and reflects the cultural embeddedness of modern medical knowledge. Using data collected between 2004 and 2007 from the Stigma in Global Context - Mental Health Study (SGC-MHS) on the recognition of schizophrenia from vignettes describing individuals meeting DSM-IV criteria, we examine the nature and correlates of lay diagnosis. Focusing on Western societies in the SGC-MHS, we ask three questions regarding problem recognition in Bulgaria (N = 255), Cyprus (N = 253), Germany (N = 382), Hungary (N = 352), Iceland (N = 291), Spain (N = 327), Great Britain (N = 289), and the United States (N = 449): (1) What is the cross-national variation in recognition of schizophrenia as a mental illness? (2) Is lay diagnosis associated with individuals' socio-demographic characteristics and/or their evaluation of underlying causes? (3) Are lay diagnoses likely to shape the nature and direction of the illness career? We find lay diagnosis of "mental illness" to be high across these Western nations with some, though modest, difference across countries. Variation for the more specific diagnosis of "schizophrenia" is greater, though fairly consistent in country ordering. Lay diagnoses are shaped most consistently by attributions, inconsistently by socio-demographics, and generally associated with respondents' treatment recommendations and expected outcomes. In light of assumptions about public beliefs and knowledge that often underlie research, community efforts, clinical programs, and health policy, these findings suggest that a greater understanding of the complexities of lay diagnosis is warranted.
Collapse
|
39
|
Urban and rural immigrant Latino youths' and adults' knowledge and beliefs about mental health resources. J Immigr Minor Health 2011; 13:500-9. [PMID: 20835762 DOI: 10.1007/s10903-010-9389-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Immigrant Latino youth experience mental health problems in the U.S. Cultural beliefs and knowledge may influence help-seeking behaviors. Two hundred thirty-four immigrant Latino respondents between 12 and 44 years of age completed a questionnaire assessing knowledge of and cultural beliefs regarding mental health resources for adolescents, symptoms, and help-seeking. Multivariate analyses showed that rural respondents were significantly less likely to know of mental health resources than urban-based immigrant Latinos. Knowledge and belief outcomes were also affected by age, gender, and length of time living in the community. Immigrant Latinos appear willing to seek professional help for mental health problems but may not know how to access this type of care, or may lack available services. Future research to inform interventions that increase awareness of accessible mental health services is suggested. Findings support systems-level changes including increased availability of culturally-specific mental health services, especially in rural areas.
Collapse
|
40
|
Proctor LJ, Van Dusen Randazzo K, Litrownik AJ, Newton RR, Davis IP, Villodas M. Factors associated with caregiver stability in permanent placements: a classification tree approach. CHILD ABUSE & NEGLECT 2011; 35:425-436. [PMID: 21645922 PMCID: PMC3740351 DOI: 10.1016/j.chiabu.2011.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 02/16/2011] [Accepted: 02/18/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Identify individual and environmental variables associated with caregiver stability and instability for children in diverse permanent placement types (i.e., reunification, adoption, and long-term foster care/guardianship with relatives or non-relatives), following 5 or more months in out-of-home care prior to age 4 due to substantiated maltreatment. METHODS Participants were 285 children from the Southwestern site of Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Caregiver instability was defined as a change in primary caregiver between ages 6 and 8 years. Classification and regression tree (CART) analysis was used to identify the strongest predictors of instability from multiple variables assessed at age 6 with caregiver and child reports within the domains of neighborhood/community characteristics, caregiving environment, caregiver characteristics, and child characteristics. RESULTS One out of 7, or 14% of the 285 children experienced caregiver instability in their permanent placement between ages 6 and 8. The strongest predictor of stability was whether the child had been placed in adoptive care. However, for children who were not adopted, a number of contextual factors (e.g., father involvement, expressiveness within the family) and child characteristics (e.g., intellectual functioning, externalizing problem behaviors) predicted stability and instability of permanent placements. CONCLUSIONS Current findings suggest that a number of factors should be considered, in addition to placement type, if we are to understand what predicts caregiver stability and find stable permanent placements for children who have entered foster care. These factors include involvement of a father figure, family functioning, and child functioning. PRACTICE IMPLICATIONS Adoption was supported as a desired permanent placement in terms of stability, but results suggest that other placement types can also lead to stability. In fact, with attention to providing biological parents, relative, and non-relative caregivers with support and resources (e.g., emotional, financial, and optimizing father involvement or providing a stable adult figure) the likelihood that a child will have a stable caregiver may be increased.
Collapse
Affiliation(s)
- Laura J Proctor
- Department of Psychology, San Diego State University, San Diego, CA 92183, USA
| | | | | | | | | | | |
Collapse
|
41
|
Ho P, Tsao JCI, Bloch L, Zeltzer LK. The impact of group drumming on social-emotional behavior in low-income children. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2011; 2011:250708. [PMID: 21660091 PMCID: PMC3095989 DOI: 10.1093/ecam/neq072] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 05/19/2010] [Indexed: 11/13/2022]
Abstract
Low-income youth experience social-emotional problems linked to chronic stress that are exacerbated by lack of access to care. Drumming is a non-verbal, universal activity that builds upon a collectivistic aspect of diverse cultures and does not bear the stigma of therapy. A pretest-post-test non-equivalent control group design was used to assess the effects of 12 weeks of school counselor-led drumming on social-emotional behavior in two fifth-grade intervention classrooms versus two standard education control classrooms. The weekly intervention integrated rhythmic and group counseling activities to build skills, such as emotion management, focus and listening. The Teacher's Report Form was used to assess each of 101 participants (n = 54 experimental, n = 47 control, 90% Latino, 53.5% female, mean age 10.5 years, range 10-12 years). There was 100% retention. ANOVA testing showed that intervention classrooms improved significantly compared to the control group in broad-band scales (total problems (P < .01), internalizing problems (P < .02)), narrow-band syndrome scales (withdrawn/depression (P < .02), attention problems (P < .01), inattention subscale (P < .001)), Diagnostic and Statistical Manual of Mental Disorders-oriented scales (anxiety problems (P < .01), attention deficit/hyperactivity problems (P < .01), inattention subscale (P < .001), oppositional defiant problems (P < .03)), and other scales (post-traumatic stress problems (P < .01), sluggish cognitive tempo (P < .001)). Participation in group drumming led to significant improvements in multiple domains of social-emotional behavior. This sustainable intervention can foster positive youth development and increase student-counselor interaction. These findings underscore the potential value of the arts as a therapeutic tool.
Collapse
Affiliation(s)
- Ping Ho
- Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Jennie C. I. Tsao
- Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Lian Bloch
- Clinical Science Program, Department of Psychology, University of California, Berkeley, CA, USA
| | - Lonnie K. Zeltzer
- Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, USA
| |
Collapse
|
42
|
Moses T. Parents' conceptualization of adolescents' mental health problems: who adopts a psychiatric perspective and does it make a difference? Community Ment Health J 2011; 47:67-81. [PMID: 19847647 DOI: 10.1007/s10597-009-9256-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Accepted: 10/02/2009] [Indexed: 11/29/2022]
Abstract
How parents give meaning to the problems of adolescents diagnosed with mental disorders and receiving treatment is likely related to important outcomes including parental well-being and commitment to treatment, as well as their own behaviors and reactions to their child. The aim of this cross-sectional, mixed-method study of 70 parents of adolescents receiving wraparound mental health services is to examine: (1) how parents conceptualize their child's MH problems; (2) factors related to parents' conceptualization of youths' problems using medical model terms; and (3) associations between parents' problem conceptualization and their emotional or coping responses to their child having psychiatric problem(s). Content analysis indicated that 54.3% of parents definitively conceptualized adolescents' problems using psychiatric terms, 37.1% reported uncertainty about the nature of their child's problems, and 8.6% gave alternative, non-psychiatric explanations for their child's problems. We found significant relationships between parents' problem conceptualization and their attitudes and experience with MH treatment, demographics, as well as with adolescents' clinical characteristics. Parents who conceptualized problems using psychiatric terminology were more likely to express sadness and pessimism relative to other parents, though there were no differences in expressions of worry, guilt, pragmatism and optimism by problem conceptualization.
Collapse
Affiliation(s)
- Tally Moses
- School of Social Work, University of Wisconsin-Madison, 1350 University Ave., Madison, WI 53706, USA.
| |
Collapse
|
43
|
Abstract
Latino children in the U.S. have high rates of unmet need for mental health services, perhaps due to biased perceptions of impairment and need for care by parents and providers. We tested this argument using an experimental vignette design. Vignettes described children with problems that varied on severity (mild vs. serious), nature of the problem (internalizing vs. externalizing), as well as gender and ethnicity (Latino vs. Anglo). Raters were Latino and Anglo parents (N = 185) and providers (N = 189). Vignettes with Latino names were viewed as more impaired by both parents and providers, and this effect was significantly stronger in Latino vignettes with less severe problems. Severity and Latino features of vignettes also interacted with judgments of need for service. At higher severity, vignettes with Anglo names were judged to need service more than vignettes with Latino names, despite the same judged levels of impairment. Results are discussed in the light of the unmet need for Latinos.
Collapse
|
44
|
Atagun M, Balaban O, Atagun Z, Elagoz M, Ozpolat A. Caregiver Burden in Chronic Diseases. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2011. [DOI: 10.5455/cap.20110323] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
45
|
Villagrana M. Mental Health Services for Children and Youth in the Child Welfare System: A Focus on Caregivers as Gatekeepers. CHILDREN AND YOUTH SERVICES REVIEW 2010; 32:691-697. [PMID: 20419079 PMCID: PMC2857415 DOI: 10.1016/j.childyouth.2010.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Caregivers serve as gatekeepers for children while in the child welfare system, but few studies have focused on the caregiver and the factors that influence the use of mental health services for the children under their care. The purpose of this study was to examine the child's mental health need, the caregiver's level of stress, depression, and social support, and the utilization of mental health services by children using the three most common types of caregivers in the child welfare system (i.e., birth parent, relative caregiver, and foster parent). Data comes from the Patterns of Care (POC) study of five public sectors of care. The present study examined parents/caregivers and youth from the child welfare sector. Findings suggest that while birth parents were more likely to endorse more risk factors for themselves, and the children under their care had a higher level of mental health need, they were the least likely to utilize mental health services for the children under their care. Implications for the child welfare and mental health systems are discussed.
Collapse
Affiliation(s)
- Margarita Villagrana
- Postdoctoral Research Fellow, Southwest Interdisciplinary Research Center, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ 85004-0693,
| |
Collapse
|
46
|
Lopez I, Ramirez R, Guarnaccia P, Canino G, Bird H. Ataques de nervios and somatic complaints among island and mainland Puerto Rican children. CNS Neurosci Ther 2010; 17:158-66. [PMID: 20370802 DOI: 10.1111/j.1755-5949.2010.00137.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
UNLABELLED Previous research has documented the association between the Latino cultural idiom of distress, ataques de nervios (i.e., "attacks of nerves"), and unexplained neurological symptoms among adults. However, the associations between ataques and somatic complaints in children have not been sufficiently explored. AIMS In this study, we assessed the relation between this anxiety-related experience, henceforth ataques, and somatic complaints in a probability sample of Puerto Rican youth, ages 5-13 years, living in San Juan, Puerto Rico (N = 1353) and in the South Bronx, New York (N = 1138). When both sites were combined, children with ataques were significantly more likely to have either a lifetime prevalence of asthma or headaches, and tended to have more stomach aches and a history of epilepsy or seizure than children without ataques. Further within site analyses showed a similar patterning of complaints for the South Bronx sample as for the combined sample. However, children in San Juan with ataques were only slightly more likely to experience headaches, and at risk for injury, than those without ataques. In addition, comparisons between ataque sufferers across sites indicated that children in San Juan with ataques were at elevated risk for serious illness or injury in comparison to those in the South Bronx with ataques. Ataques are significantly associated with a wide range of physical complaints in Puerto Rican youth. However, their pattern of associations differs by context.
Collapse
Affiliation(s)
- Irene Lopez
- Department of Psychology, Kenyon College, OH 43022, USA
| | | | | | | | | |
Collapse
|
47
|
Ataques de Nervios and their psychiatric correlates in Puerto Rican children from two different contexts. J Nerv Ment Dis 2009; 197:923-9. [PMID: 20010029 DOI: 10.1097/nmd.0b013e3181c2997d] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Among Latino adults and children, ataques de nervios has been associated with an array of psychiatric disorders. Using data from a probability sample of Puerto Rican children, aged 5 to 13 years (N = 2491), we assessed the lifetime prevalence and psychiatric correlates of ataques in youth residing in the South Bronx, New York and San Juan, Puerto Rico. Baseline site comparisons indicated that between 4% and 5% of children had a lifetime prevalence of ataques (either by child or parent report) and that ataques were associated with greater global impairment and a host of childhood disorders within the previous twelve months. Ataques were also correlated with greater exposure to violence, as well as more stressful life events for the South Bronx sample. After controlling for several covariates, ataques continued to be significantly associated with psychopathology. Ataques are, therefore, a significant correlate of global impairment and childhood psychopathology among Puerto Rican youth.
Collapse
|
48
|
Chavira DA, Garland A, Yeh M, McCabe K, Hough RL. Child anxiety disorders in public systems of care: comorbidity and service utilization. J Behav Health Serv Res 2009; 36:492-504. [PMID: 18688725 PMCID: PMC3058305 DOI: 10.1007/s11414-008-9139-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Accepted: 06/19/2008] [Indexed: 10/21/2022]
Abstract
Little is known about mental health service use among children with anxiety disorders, and even less is known about these children in public sectors of care. In this study, 1,715 children were randomly sampled from one of five public service systems. Psychiatric diagnoses were assessed with a structured interview, and standardized measures were used to assess mental health service utilization. Data from a subsample (n = 779) of youth with psychiatric disorders were analyzed. Analyses revealed that comorbidity among children with anxiety disorders was substantially higher than general population estimates. Approximately 26% of children with anxiety had a comorbid mood disorder, and 62% had a disruptive behavior disorder. Among children with anxiety disorders, those who had comorbid conditions were more likely to receive inpatient services than those without comorbidity. Comorbidity, caregiver strain, and service sector were associated with inpatient and nonspecialty service use in this group. Findings underscore the substantial comorbidity among children with anxiety disorders in public sectors of care and the potential need to adapt evidence-based interventions to meet the complex and multiple needs of these children.
Collapse
Affiliation(s)
- Denise A Chavira
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92037, USA.
| | | | | | | | | |
Collapse
|
49
|
Ohan JL, Visser TAW. Why Is There a Gender Gap in Children Presenting for Attention Deficit/Hyperactivity Disorder Services? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2009; 38:650-60. [DOI: 10.1080/15374410903103627] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
50
|
Olafsdottir S, Pescosolido BA. Drawing the line: the cultural cartography of utilization recommendations for mental health problems. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2009; 50:228-244. [PMID: 19537462 DOI: 10.1177/002214650905000208] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In the 1990s, sociologists began to rethink the failure of utilization models to explain whether and why individuals accessed formal treatment systems. This effort focused on reconceptualizing the underlying assumptions and processes that shaped utilization patterns. While we have built a better understanding of how social networks structure pathways to care and how disadvantaged sociocultural groups face substantial barriers to treatment, we have less understanding of the larger cultural context in which individuals recognize and respond to symptoms. Drawing from recent innovations in the sociology of culture, we develop the concept of "cultural mapping" to describe if and how individuals discriminate among different available sources of formal treatment. Using data from the 1996 Mental Health Module of the General Social Survey, we compare Americans' willingness to recommend providers in the general medical and specialty mental health sectors. The results indicate that, despite unrealistically high levels of endorsement, individuals do discriminate between providers based on their evaluation of the problem, underlying causes, and likely consequences. While perceived severity leads individuals to suggest any type of formal care, problems attributed to biological causes are directed to general or specialty medical providers (doctors, psychiatrists, and hospitals); those matching symptoms for schizophrenia or seen as eliciting violence are allocated to the specialty mental health sector (psychiatry, mental hospital); and those seen as being caused by stress are sent to nonmedical mental health providers (i.e., counselors). These findings help to explain inconsistencies in previous utilization studies, and they suggest the critical importance of maintaining a dialogue between medical sociology and the sociology of culture.
Collapse
Affiliation(s)
- Sigrun Olafsdottir
- Department of Sociology, Boston University, 96 Cummington Street, Boston, Massachusetts 02115, USA.
| | | |
Collapse
|