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Lee AK, Wade J, Teixeira-Poit S, McCain D, Doss C, Shrestha S, Aiken-Morgan AT. Contextualizing the racial gradient in covid-19 outcomes: Narratives from HBCU students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1759-1767. [PMID: 35728257 DOI: 10.1080/07448481.2022.2089849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 spread across the nation with Black Americans experiencing twice of the prevalence of deaths than White Americans. Black American college students are facing a unique set of biopsychosocial costs including less retention and poorer mental health. Therefore, the purpose of this study was to examine how Historically Black College or University (HBCU) students contextualize COVID-19. Interviews were conducted with 19 participants and lasted 40-60 minutes. They discussed topics including: their COVID-19 knowledge, precautionary measures, and barriers and promoters of school success were covered. Data were coded through semi-open coding and discussed among the research team. Responses were summarized by eight themes: emotional responses, colorblind rhetoric, lack of healthcare, essential work, distrust for the medical field, barriers to precautions like supply shortages and environmental factors, and poor baseline health. These findings may be used to develop interventions that moderate the impact of COVID-19 and future pandemics on mental health.
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Affiliation(s)
- Anna K Lee
- Department of Psychology, North Carolina A&T State University, Greensboro, North Carolina, USA
| | - Jeannette Wade
- Department of Sociology, North Carolina A&T State University, Greensboro, North Carolina, USA
| | - Stephanie Teixeira-Poit
- Department of Sociology, North Carolina A&T State University, Greensboro, North Carolina, USA
| | - Dextiny McCain
- Department of Psychology, North Carolina A&T State University, Greensboro, North Carolina, USA
| | - Christopher Doss
- School of Nursing, North Carolina A&T State University, Greensboro, North Carolina, USA
| | - Smriti Shrestha
- Department of Electrical and Computer Engineering, North Carolina A&T State University, Greensboro, North Carolina, USA
| | - Adrienne T Aiken-Morgan
- Department of Psychology, North Carolina A&T State University, Greensboro, North Carolina, USA
- Center on Health and Society, Duke University, Durham, North Carolina, USA
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2
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Goldschen L, Peng CS, Mufson MJ, Feldman CH, Case SM, Costenbader KH, Amonoo HL. Barriers, Facilitators, and Preferences for Mental Health Services Among Patients With Systemic Lupus Erythematosus: A Qualitative Study. Arthritis Care Res (Hoboken) 2024; 76:914-925. [PMID: 38433607 PMCID: PMC11209808 DOI: 10.1002/acr.25321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 02/09/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Although patients with systemic lupus erythematosus (SLE) experience high levels of depression and anxiety disorders, evidence concerning patient perceptions of facilitators and barriers to effective uptake of mental health services (eg, referral to therapists and psychiatrists, psychoeducational interventions, or support groups) is limited. METHODS We conducted semistructured qualitative interviews with 15 adults with SLE to explore patient experiences and perceptions of mental health services to identify facilitators and barriers to accessing mental health care among patients with SLE. Qualitative interviews were conducted via telephone and audio recorded for transcription and directed content analysis using NVivo software by two coders. RESULTS The median age of the 15 participants was 48 years, 87% were female, 33% identified as Black or African American, and 33% identified as Hispanic or Latino. Qualitative themes were organized into three domains: barriers, facilitators, and preferences for mental health services. Barriers to the use of mental health services include mental health stigma, sociodemographic factors, lack of autonomy, and time commitment. Facilitators to the use of mental health services included strong relationships with their rheumatologists and mental health care clinician experience with patients with SLE. Preferences for mental health services included education-based formats, mental health providers who work with patients with SLE, peer group formats, demographically and disease-matched psychological resources, and an emphasis on non-disease-related activities. CONCLUSION In the setting of persistent unmet psychosocial needs of patients living with SLE, data from this qualitative study will inform the development and refinement of mental health interventions that bolster psychological wellbeing in the SLE population.
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Affiliation(s)
- Lauren Goldschen
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Cynthia S. Peng
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Michael J. Mufson
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Candace H. Feldman
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Siobhan M. Case
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Karen H. Costenbader
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
| | - Hermioni L. Amonoo
- Brigham and Women’s Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA. Harvard Medical School, Boston, MA, USA
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Borelli JL, Zhou E, Russo LN, Li FH, Tironi M, Yamashita KS, Smiley PA, Campos B. Culturally adapting relational savoring: A therapeutic approach to improve relationship quality. FAMILY PROCESS 2024; 63:667-690. [PMID: 38533758 PMCID: PMC11245364 DOI: 10.1111/famp.12989] [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] [Received: 11/01/2023] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 03/28/2024]
Abstract
Relational savoring (RS) is a brief, strengths-based approach to heightening attentional focus to moments of positive connectedness within relationships. RS can be administered preventatively or within an intervention context when a therapist aspires to foster more optimal relational functioning. Typically administered within a one-on-one therapy setting, RS has demonstrated efficacy in enhancing intra- and interpersonal outcomes. To increase access to mental health services, the developers of RS are committed to engaging in an iterative approach of enhancing the cultural congruence and accessibility of this intervention within various cultural contexts, beginning with Latine groups in Southern California. In this article, we describe relational savoring and its theoretical and empirical support, including the process of culturally adapting the intervention within the context of three major studies, each with a distinct focus on Latine groups, a community that is underserved in mental health care settings. We then provide a vision for future research to improve upon the intervention's compatibility for Latine families and other populations.
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Affiliation(s)
- Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Elayne Zhou
- Department of Psychology, University of Southern California, California, Los Angeles, USA
| | - Lyric N Russo
- Department of Social Ecology, University of California, Irvine, California, USA
| | - Frances H Li
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Marta Tironi
- Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Ken S Yamashita
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Patricia A Smiley
- Department of Psychological Science, Pomona College, Pomona, California, USA
| | - Belinda Campos
- Department of Psychological Science, University of California, Irvine, California, USA
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Zafar M, H Zaidi T, Zaidi NH, Ahmed MWN, Memon S, Ahmed F, Siddiqui A, Fatima A, Shahid A, Hussain B, Salam A. Attitude towards seeking professional help for mental health among medical students In Karachi, Pakistan. Future Sci OA 2024; 10:FSO916. [PMID: 38817368 PMCID: PMC11137801 DOI: 10.2144/fsoa-2023-0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/04/2023] [Indexed: 06/01/2024] Open
Abstract
Aim: In Pakistan, seeking help for mental health is considered a social stigma and a large number of medical students are suffering from mental health. This study aimed to investigate the attitude toward seeking professional care for mental health issues among medical students. Methodology: A cross-sectional study was conducted with a total of 316 students selected through multistage stratified cluster sampling. With each academic year 500 students were enrolled. Linear regression analysis was used to find the association of outcome and independent variables. Results: Around 56% of students had a negative attitude toward seeking professional help. Common predictors associated with a negative attitude were age (p < 0.001), academic year (p < 0.001) and with self-harm behavior (p < 0.001). Conclusion: University students generally had moderate intentions to seek counseling regarding mental health.
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Affiliation(s)
- Mubashir Zafar
- Family and Community Medicine Department, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Tafazzul H Zaidi
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Nadira H Zaidi
- Shaheed Zulfiqar Ali Bhutto Institute of Science & Technology, Karachi, Pakistan
| | - Muhammad WN Ahmed
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Sobia Memon
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Faheem Ahmed
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Amal Siddiqui
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Abeen Fatima
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Ayesha Shahid
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Balaj Hussain
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
| | - Anosha Salam
- Department of Community Medicine, Sindh Medical College, Jinnah Sind Medical university, Karachi, Pakistan
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Ahuvia IL, Sung JY, Dobias ML, Nelson BD, Richmond LL, London B, Schleider JL. College student interest in teletherapy and self-guided mental health supports during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:940-946. [PMID: 35427460 DOI: 10.1080/07448481.2022.2062245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/24/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
Objective The COVID-19 pandemic has worsened college students' mental health while simultaneously creating new barriers to traditional in-person care. Teletherapy and online self-guided mental health supports are two potential avenues for addressing unmet mental health needs when face-to-face services are less accessible, but little is known about factors that shape interest in these supports. Participants: 1,224 U.S. undergraduate students (mean age = 20.7; 73% female; 40% White) participated. Methods: Students completed an online questionnaire assessing interest in teletherapy and self-guided supports. Predictors included age, sex, race/ethnicity, sexual minority status, and anxiety and depression symptomatology. Results: Interest rates were 20% and 25% for at-cost supports (teletherapy and online self-help, respectively) and 70% and 72% for free supports (teletherapy and online self-help, respectively). Patterns emerged by age, anxiety symptom severity, and race/ethnicity. Conclusions: Results may inform universities' efforts to optimize students' engagement with nontraditional, digital mental health supports, including teletherapy and self-guided programs. The SARS-CoV2 (COVID-19) pandemic has taken a severe toll on public health, with effects reaching far beyond unprecedented illness and mortality. Levels of mental health difficulties appear to be rising broadly as the pandemic has progressed, both in the general U.S. population and among college students specifically.1,2 The COVID-19 pandemic and its repercussions may undermine college student mental health in myriad ways.2 Concurrently, students now face the potential for serious illness, loss of loved ones, financial strain, social isolation, loss of on-campus resources, and sudden disruption of routines-creating a "perfect storm" for the emergence or exacerbation of psychological distress.
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Affiliation(s)
- Isaac L Ahuvia
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Jenna Y Sung
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Mallory L Dobias
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Lauren L Richmond
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Bonita London
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
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Bangudi S, Stanek C, Shankar D, Hart L, Nahata L, Cronin RM, Creary SE. Primary care use and depression screening among young adults with sickle cell disease during their final year of pediatric hematology care. Pediatr Blood Cancer 2024; 71:e30784. [PMID: 38037196 DOI: 10.1002/pbc.30784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/25/2023] [Accepted: 11/11/2023] [Indexed: 12/02/2023]
Abstract
Depression may contribute to transition risk among young adults with sickle cell disease (SCD). It is unclear if they receive depression screening because primary care providers (PCPs) routinely perform this screening, but PCP use declines with age. This retrospective study of young adults with SCD during their final year of pediatric hematology care identified 51 (91%) had PCPs. Among those with hospital system PCPs, 20% saw their PCP and 50% of those were screened for depression by the PCP. This suggests young adults with SCD may not receive depression screening or see PCPs, leading to potential missed opportunities for intervention.
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Affiliation(s)
- Suzy Bangudi
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Charis Stanek
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Divya Shankar
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Laura Hart
- The Ohio State University College of Medicine, Columbus, Ohio, USA
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Leena Nahata
- The Ohio State University College of Medicine, Columbus, Ohio, USA
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Robert M Cronin
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Susan E Creary
- The Ohio State University College of Medicine, Columbus, Ohio, USA
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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Fuller H, King-Okoye M. Improving Pathways to Care for Ethnic Minority Communities. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:157-173. [PMID: 39102196 DOI: 10.1007/978-3-031-61943-4_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
It is well established that the COVID-19 pandemic has had a substantial impact on ethnic minority communities and has worsened existing health inequalities experienced by these populations globally. Individuals from ethnic minority backgrounds have not only been more likely to become infected with COVID-19 throughout the pandemic, but they have also higher risk of adverse symptoms and death following infection. Factors responsible for these discrepancies are wide reaching and encompass all aspects of the social determinants of health (SDoH). Although always an area of concern among healthcare professionals, barriers to health care experienced by ethnic minority populations became a more pertinent issue during the COVID-19 pandemic when all individuals required sufficient and sustained access to a healthcare system (whether this be for COVID-19 testing, vaccination or treatment). These healthcare barriers exacerbated the increased COVID-19 burden experienced by minority populations and will continue to detrimentally impact the health of these populations during future COVID-19 waves or indeed, future novel pandemics. This chapter aims to summarise the major healthcare barriers experienced by minority populations throughout the COVID-19 pandemic, including COVID-19 prevention, vaccine rollout, care during hospitalisation and post-COVID care for long COVID patients. To end, this chapter will summarise lessons learned and future directions that need to be taken to improve health disparities and healthcare access for minority populations in relation to the COVID pandemic and beyond.
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Affiliation(s)
- Harriett Fuller
- The Ethnicity and Covid-19 Research Consortium, Edinburgh, UK
| | - Michelle King-Okoye
- University of Edinburgh, The Ethnicity and Covid-19 Research Consortium, Edinburgh, UK.
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Graf MDC, McMahon Bullis M, Lopez AA, Snethen J, Silvestre E, Mkandawire-Valhmu L. A Qualitative Analysis of Latina Migrant Farmworkers' Perception of Mental Health: Voices From Wisconsin. J Transcult Nurs 2024; 35:11-20. [PMID: 37902599 DOI: 10.1177/10436596231207490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
INTRODUCTION Despite evidence showing Latinos' high prevalence of mental health, little is known about Latina migrant farmworkers' mental health experiences, especially those working in Midwestern states. Considering the multiple vulnerabilities observed among Latina migrant farmworkers, it is necessary to gain insight from own accounts and perceptions of mental health and mental health-seeking experiences. METHOD A qualitative descriptive approach, using in-depth semi-structured interviews with open-ended questions, served to retrieve data from 34 Latina migrant farmworkers. This study was informed by Chicana, postcolonial, and Black feminist epistemologies. RESULTS Thematic analysis identified themes within the data. These findings pertained to the conceptualization of mental health within the contexts of family, capacities, stigma, denial, and faith. DISCUSSION Our results demonstrate the need for health care providers to consider Latina migrant farmworkers' perceptions about mental health and apply those in designing and implementing culturally informed policy and practice.
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Wagner B, Snoubar Y, Mahdi YS. Access and efficacy of university mental health services during the COVID-19 pandemic. Front Public Health 2023; 11:1269010. [PMID: 38174076 PMCID: PMC10761424 DOI: 10.3389/fpubh.2023.1269010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024] Open
Abstract
Objective This study sought to understand the mental health issues, mental health support and efficacy of that support among university students. Participants All students enrolled in a College of Arts and Sciences at one mid-size university received an email that contained a link to an anonymous, online questionnaire developed and disseminated through PsychData. 162 students completed the questionnaire. Methods Mixed methods: Data was summarized using descriptive analysis, testing for significance, testing for differences, and content analysis. Results Participants reported high levels of anxiety (76%) and depression (65%). Results indicated that participant demographics were associated with types of mental access, and support. Unexpected results included lack of knowledge or information on cost, and how to access mental health services hindered access for participants, and although telehealth was the most widely used support, in contrast to other studies, participants indicated a preference for face-to-face mental health services. Conclusion Results highlight the need for improving communication about and access to mental health services in higher education Recommendations and implications for policy and support services are provided.
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Affiliation(s)
- Beverly Wagner
- Social Work Department, Texas Woman's University, Denton, TX, United States
| | - Yaser Snoubar
- Social Sciences Department, Qatar University, Doha, Qatar
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Santonja Ayuso L, Ruiz-Hontangas A, Cervantes JJG, Martínez CM, Pons EG, Pons SC, Pejó LA, Carmona-Simarro JV. The Promotion of Mental Health and Prevention of First-Episode Psychosis: A Pilot and Feasibility Non-Randomised Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7087. [PMID: 37998318 PMCID: PMC10671828 DOI: 10.3390/ijerph20227087] [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] [Received: 09/09/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Mental-health-related stigma prevents active help seeking and therefore early therapeutic approaches and the recovery of functionality. National and international agencies recommend the implementation of prevention and mental health promotion programs that support the elimination of stigma in the classroom, since most mental health problems usually start in the adolescent stage. In view of the evidence that teachers present stigmatizing attitudes towards mental health, it has been considered as convenient to carry out an anti-stigma program with the main objective of evaluating the impact of an intervention based on the education and promotion of mental health, aimed at teachers and counsellors of a secondary school. The specific objectives were to get to know which were the most stigmatising attitudes that prevailed in the sample before and after the intervention; to evaluate the knowledge of the teaching staff and counsellors on psychosis before the intervention; to analyse correlations between clinically relevant variables; and assess whether this programme was beneficial and feasible for alphabetising counsellors/teachers of educational centres on stigma and FEP. METHODS This was a non-randomised clinical trial in which a nursing intervention was performed. TOOLS a psychosis test (pre), Stigma Attribution Questionnaire (AQ-27) (pre-post), and satisfaction survey (post) were used. The inferential analysis included the Wilcoxon and the Pearson Correlation Test. RESULTS In the sample (n = 22), the predominant stigmatising attitude was "Help". The p-values obtained in the Wilcoxon Test were statistically significant, except for "Responsibility" and "Pity". The following constructs of interest were faced: "Fear"-"Age" and "Professional experience"; and "Help"-"Psychosis test". CONCLUSIONS Despite the scores obtained in "Responsibility" and "Pity", the intervention was useful for reducing stigma in the sample. Implications for the profession: There are adolescents who have suffered stigma from their teachers, and consequently have minimized their symptoms and not asked for help. For this reason, we implemented a nursing intervention based on the education and promotion of mental health, with the aim of expanding knowledge and reducing stigma. In fact, this intervention, which we carried out on high school teachers, managed to reduce the majority of stigmatizing attitudes measured on the stigma attribution scale.
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Affiliation(s)
- Lucia Santonja Ayuso
- Department of Nursing, Faculty of Health Sciences, Universidad Jaume I, 12006 Castellón, Spain; (L.S.A.)
| | - Antonio Ruiz-Hontangas
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain
| | | | | | - Eva Gil Pons
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain
| | - Sonia Ciscar Pons
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain
| | - Laura Andreu Pejó
- Department of Nursing, Faculty of Health Sciences, Universidad Jaume I, 12006 Castellón, Spain; (L.S.A.)
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Singh S, Melendez K, Sezginis N. Examining the effect of discrimination and stigma on utilization of mental health services among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2398-2405. [PMID: 34519631 DOI: 10.1080/07448481.2021.1970561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 06/30/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Even though onset of three-quarters of mental disorders occurs by age 25, few young adults seek help for their mental health needs. The objectives of this study are to examine the relationship of discrimination and stigma of mental illness on the help-seeking behavior for mental health among college students. METHOD Undergraduate students (N = 557) at a Midwestern university were surveyed online. Descriptive and logistic regression analysis was conducted using STATA15. RESULTS College students reporting higher discrimination were more likely to seek help for mental health services (OR = 1.04, CI = 1.01-1.06), after controlling for all covariates. Students with higher personal stigma reported lower odds of help-seeking behavior (OR = 89, CI = .80-.97). Students with higher perceived public stigma did not have an independent significant association on help-seeking behavior initially, but full model revealed a significantly association (OR = 1.02, CI = .99-1.05). CONCLUSION Developing targeted interventions addressing discrimination and stigma of mental illness is critical among college students.
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Affiliation(s)
- Shipra Singh
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - Krizia Melendez
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - Nilgun Sezginis
- School of Population Health, University of Toledo, Toledo, Ohio, USA
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Janelle Cambron-Mellott M, Way N, Pesa J, Adigun M, Jean Wright II H. Factors associated with patient activation among individuals with depression within racial/ethnic groups in the United States. Prev Med Rep 2023; 35:102299. [PMID: 37519446 PMCID: PMC10372381 DOI: 10.1016/j.pmedr.2023.102299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/19/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023] Open
Abstract
Increasing patient activation may be vital for improving quality of care for individuals with depression. Among adults with depression who reside in the United States, we sought to examine the association of depression severity, race/ethnicity, and household income with patient activation and within identify factors associated with patient activation within race/ethnicity groups. Data from the 2020 US National Health and Wellness Survey, a cross-sectional, general population survey, were used to identify White, Black/African American, Asian, and Hispanic respondents with self-reported physician-diagnosed depression. Generalized linear models were used to identify factors associated with patient activation. Analyses included 8,216 respondents (mean age = 44 years, 68.0% female). Depression severity was negatively associated with patient activation (β = -0.29, p < 0.001). Patient activation was significantly higher in Black vs. White respondents (β = 1.50, p = 0.001) and in respondents with a household income of $25,000-$49,999 (β = 0.96, p = 0.015), $50,000-$99,000 (β = 0.88, p = 0.031), and ≥$100,000 (β = 1.78, p < 0.001) vs. <$25,000. Adjusted mean patient activation scores were highest among Black respondents (61.1), followed by Hispanic (60.2), White (59.6), and Asian (59.0) respondents. Neither race/ethnicity nor household income moderated the relationship between depression severity and patient activation; however, the factors most strongly associated with patient activation differed by race/ethnicity. These results indicate that the pathway to improving patient activation in individuals with depression may vary by race/ethnicity. Understanding factors associated with patient activation can help inform the design of interventions to increase patient activation in individuals with depression.
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Affiliation(s)
| | - Nate Way
- Cerner Enviza, an Oracle Company, 2800 Rock Creek Parkway, Kansas City, MO 64117, USA
| | - Jacqueline Pesa
- Janssen Scientific Affairs, LLC, 1125 Trenton Harbourton Road, Titusville, NJ 08560, USA
| | - Muideen Adigun
- Janssen Scientific Affairs, LLC, 1125 Trenton Harbourton Road, Titusville, NJ 08560, USA
| | - H. Jean Wright II
- Behavioral Health and Justice Division, Department of Behavioral Health and Intellectual disAbility Services, City of Philadelphia, 1601 Market Street, Five Penn Center, 7th Floor, Philadelphia, PA 19103, USA
- Temple University, Psychology Department, Weiss Hall, 6th Floor, 1701 N 13th St, Philadelphia, PA 19122, USA
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Hunter EA, Meyer JM, Brown GM, Hanks MA. Stress indicators in minorities with multiple sclerosis. Mult Scler Relat Disord 2023; 78:104914. [PMID: 37499341 DOI: 10.1016/j.msard.2023.104914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/12/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
Black Americans with multiple sclerosis (MS) experience higher levels of disease-related disability compared to White Americans (Marrie et al., 2006). Comorbidities such as depression and anxiety, which are underdiagnosed and undertreated in this population, negatively impact quality of life and treatment outcomes for people living with multiple sclerosis (plwMS) (D'Alisa et al., 2006; Marrie et al., 2009; Stepleman et al., 2014). Acts of discrimination toward Black Americans is associated with stress, which is a contributing factor for depression (Carter, 2017; Nadimpalli, 2015; Williams and Mohammed, 2009). This study compared the severity of multiple sclerosis symptoms amongst Black Americans and White Americans, and whether worsened MS symptoms in Black Americans are associated with increased experiences of discrimination. Data was analyzed from 143 plwMS in the Stress Indicators in Minorities with Multiple Sclerosis (SiMMS) study. Using the Mann-Whitney U test, significant differences were found on the NIH Emotional Distress - Anxiety measure (U = 1466.500, p = 0.045) and NIH Sleep Disturbance measure (U = 1467.000, p = 0.044) between the Black participant and the White participant groups. Discrimination was significantly correlated with both NIH Emotional Distress - Anxiety (r = 0.677, p < .001) and NIH Sleep Disturbance (r = 0.446, p = .007) in Black MS individuals. Additionally, several physiological condition and psychological outcome measures were correlated with the NIH Emotional Distress - Anxiety and NIH Sleep Disturbance measures. This study contributes to literature highlighting the negative impacts of discrimination and race related stress on the physical and mental health of Black Americans.
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Affiliation(s)
- Evelyn A Hunter
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States.
| | - J M Meyer
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
| | - G M Brown
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
| | - M A Hanks
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
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14
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Lopez D, Escalante GS, de Mamani AW. The Role of Religious Coping on Suicidality Among Latinx and Black/African American Individuals with Schizophrenia Spectrum Disorders. SPIRITUALITY IN CLINICAL PRACTICE 2023; 10:219-232. [PMID: 37997582 PMCID: PMC10664829 DOI: 10.1037/scp0000317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Introduction The suicide rate for individuals with schizophrenia spectrum disorders (SSDs) is over 20 times greater than that of the general population. Many people turn to religion in times of illness or stress. Religiosity is also deeply embedded into the culture, community life, and identity of many Latinx and Black/African American (B/AA) individuals. Religiosity has historically been associated with a lower risk of suicide. However, research also finds that, adaptive and maladaptive religious coping differentially impact mental health. Therefore, it is pertinent to examine religious coping's role on suicidality among Latinx and B/AA individuals with SSDs. Methods This study examined relationships between adaptive and maladaptive religious coping, depression/anxiety, and suicidality among 91 Latinx and B/AA individuals with SSDs (M= 38.05 years old, SD = 11.92 years). Results Maladaptive religious coping was positively associated with suicidality and was partially mediated through depression/anxiety. Moreover, adaptive religious coping moderated the relationship between maladaptive religious coping and depression/anxiety. Only when adaptive religious coping was at the mean observed level or below was maladaptive religious coping positively associated with depression/anxiety and suicidal ideation. Conclusion Findings underscore the need to take religiosity into account when shaping therapies for Latinx and B/AA individuals with SSDs.
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Affiliation(s)
- Daisy Lopez
- University of Miami, Department of Psychology, 5665 Ponce de Leon, Coral Gables, FL, USA, 33146
| | - Genesis Saenz Escalante
- University of Miami, Department of Psychology, 5665 Ponce de Leon, Coral Gables, FL, USA, 33146
| | - Amy Weisman de Mamani
- University of Miami, Department of Psychology, 5665 Ponce de Leon, Coral Gables, FL, USA, 33146
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15
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Allen EC, Goslawski MM, Taple BJ, Sakowicz A, Alvarado-Goldberg M, Miller ES. The association between adverse childhood experiences and perinatal depression symptom trajectories. Am J Obstet Gynecol MFM 2023; 5:101039. [PMID: 37247667 DOI: 10.1016/j.ajogmf.2023.101039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/13/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Having a history of adverse childhood experiences is associated with an increased risk for treatment-resistant depression in the general population. Whether this relationship is true in the perinatal context is unknown. OBJECTIVE This study aimed to examine the association between adverse childhood experiences and the trajectories of antenatal and postpartum depression among people enrolled in a perinatal collaborative care program for mental healthcare. STUDY DESIGN This retrospective cohort study included all pregnant and postpartum people who were referred to and enrolled in a perinatal collaborative care program for mental healthcare and who delivered at a single, quaternary care institution between March 2016 and March 2021. Individuals referred to the collaborative care program were linked with a care manager and had access to evidence-based mental health treatment such as a psychiatric consult, pharmacotherapy, and psychotherapy. All individuals enrolled in the collaborative care program underwent adverse childhood experience screens at intake. A score of >3 on the validated Adverse Childhood Experiences Questionnaire was defined as a high adverse childhood experience score. Depression symptom monitoring occurred via electronic Patient Health Questionaire-9 screening every 2 to 4 weeks, and escalation of care was recommended for those without evidence of improvement. Antenatal depression trajectories were determined by comparing the earliest available prenatal Patient Health Questionaire-9 score closest to the time of referral to collaborative care with the latest Patient Health Questionaire-9 score before delivery. Postpartum trajectories were determined by comparing the earliest postpartum Patient Health Questionaire-9 score after delivery with the latest score before 12 weeks' postpartum. Depression trajectories were categorized as improved, stable, or worsened based on whether the Patient Health Questionaire-9 scores changed by at least 2 standard deviations (ie, 5 points on the Patient Health Questionaire-9 scale). Bivariable and multivariable analyses were performed. RESULTS Of the 1270 people who met the inclusion criteria, 294 (23.1%) reported a high adverse childhood experience score. Those with a high adverse childhood experience score were more likely to experience a worsened antenatal depression trajectory than those with a low adverse childhood experience score (10.3% vs 4.3%; P=.008). This association persisted after adjusting for potential confounders (adjusted odds ratio, 2.39; 95% confidence interval, 1.05-5.46). There was no significant difference in the postpartum depression trajectories between those with a high and those with a low adverse childhood experience score. CONCLUSION Having a high adverse childhood experience score is associated with a worsened antenatal depression trajectory for those enrolled in a collaborative care program. Given its high prevalence, future research should evaluate effective modalities of perinatal depression prevention and treatment specific for pregnant people with a history of adverse childhood experiences.
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Affiliation(s)
- Emma C Allen
- Northwestern University Feinberg School of Medicine, Chicago, IL (Ms Allen and Ms Alvarado-Goldberg).
| | - Melissa M Goslawski
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Goslawski)
| | - Bayley J Taple
- Center for Behavioral Intervention Technologies, Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Taple)
| | - Allie Sakowicz
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC (Dr Sakowicz)
| | - Mayán Alvarado-Goldberg
- Northwestern University Feinberg School of Medicine, Chicago, IL (Ms Allen and Ms Alvarado-Goldberg)
| | - Emily S Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Miller)
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16
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Dare O, Jidong DE, Premkumar P. Conceptualising mental illness among University students of African, Caribbean and similar ethnic heritage in the United Kingdom. ETHNICITY & HEALTH 2023; 28:522-543. [PMID: 35912939 DOI: 10.1080/13557858.2022.2104817] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 07/18/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Students of African, Caribbean and similar ethnicity (ACE) encounter unique mental health challenges within the Western higher education system, such as feeling constrained in social spaces and perceiving greater stigma about mental health. Students of ACE are also resilient to mental health problems, such as depression, when enduring social inequality. This study aimed to conceptualise mental illness and help-seeking behaviours among university students in the United Kingdom (UK) in the context of their identity as ACE. DESIGN Six university students of ACE in the UK were interviewed about the meaning of mental illness, the influence of ACE culture on mental health and help-seeking by ACE students. Thematic analysis was applied from a socio-constructionist theoretical lens to interpret the interview transcripts. RESULTS Five main themes emerged, namely 'Perceived meanings and attitudes toward mental health problems', 'Beliefs about the non-existence of mental health problem and its spiritual attributions', 'Family dynamics and the 'silencing' of mental health problems', 'Help-seeking for mental health among people of ACE' and 'Stigma and discriminatory responses to mental health issues'. Participants expressed that mental health is an imported concept that people from ACE communities tend to shy away from. A reluctance to discuss mental health problems arose over fear of rejection from families and fear of not being understood by a mental health professional from a different cultural background. CONCLUSION University students of ACE and their families struggle to adopt the Western conceptualisation of mental health. Consequently, there is poor awareness of mental health issues and stigma of mental illness among university students of ACE which pose a barrier to help-seeking for mental health. The limited sample size constrains the ability to draw sound conclusions. Nonetheless, a culturally sensitive conceptualisation of mental health is needed to address poor help-seeking for mental health among people of ACE.
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Affiliation(s)
- Oluwateniayo Dare
- Department of Psychology, Nottingham Trent University, Nottingham, UK
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17
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Wagner KM, Chatham AA, Prado K, Walsdorf AA, Villatoro AP, Garcia D, de Snyder NS, Valdez CR. Emotional wellbeing and coping among Latinx young adults in the time of COVID-19. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1217-1232. [PMID: 36573877 PMCID: PMC9880755 DOI: 10.1002/jcop.22983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/01/2022] [Accepted: 12/05/2022] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has disrupted the wellbeing of the general US population, but even more so among Latinx young adults. The current study provides a detailed picture of the emotional wellbeing and coping of Latinx young adults during the first summer of the pandemic. Six virtual focus groups (n = 21) were conducted between May and August of 2020 with a community-based sample of Latinx young adults to explore (1) how the pandemic affected wellbeing and (2) how they coped with pandemic-related stress. Contextualistic thematic analysis identified important themes and subthemes. Perceived stressors impacting emotional wellbeing yielded one overarching theme: COVID-related disruptions in the participants' environment. To manage this heightened stress, another overarching theme was self-care and intentionality during the pandemic. Future studies should examine the wellbeing of young adults across social contexts and at more recent stages of the pandemic. Findings from this study suggest culturally- and developmentally-tailored interventions are needed as this population navigates contextual stress during a sensitive period in their life.
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Affiliation(s)
- Kevin M. Wagner
- Department of Educational PsychologyThe University of TexasAustinTexasUSA
- Department of Population Health, Dell Medical SchoolThe University of TexasAustinTexasUSA
| | - Ana A. Chatham
- Department of Population Health, Dell Medical SchoolThe University of TexasAustinTexasUSA
- Steve Hicks School of Social WorkThe University of TexasAustinTexasUSA
| | - Kimberly Prado
- Steve Hicks School of Social WorkThe University of TexasAustinTexasUSA
| | - Ashley A. Walsdorf
- Couple and Family TherapyAlliant International UniversitySan DiegoCaliforniaUSA
- The Latino Research InstituteThe University of TexasAustinTexasUSA
| | | | | | - Nelly Salgado de Snyder
- The Latino Research InstituteThe University of TexasAustinTexasUSA
- Instituto Nacional de Salud PúblicaCuernavacaMexico
| | - Carmen R. Valdez
- Department of Population Health, Dell Medical SchoolThe University of TexasAustinTexasUSA
- Steve Hicks School of Social WorkThe University of TexasAustinTexasUSA
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18
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Moyce S, Claudio D, Velazquez M. Using the PDCA cycle to uncover sources of mental health disparities for Hispanics. Int J Ment Health Nurs 2023; 32:556-566. [PMID: 36533717 DOI: 10.1111/inm.13100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
The Hispanic population is growing rapidly in U.S. rural states, yet limitations in Spanish-speaking behavioural health providers are a barrier to accessing care. In Montana, a new immigrant destination, mental health disparities may not yet be fully understood. We describe an interprofessional approach of nurses and engineers using the Plan-Do-Check-Act (PDCA) cycle to identify disparities in mental health access in a Hispanic community in a rural state. We recruited a community advisory board to inform researchers about potential disparities and to design interventions. The Plan phase consisted of naming the problem and its root causes. Researchers and a community advisory board created flowsheets and diagrams to uncover personal, environmental, political, and procedural contributors to poor mental health outcomes. The Do phase included implementation of a community screening for depression and anxiety. The Check phase revealed 43 mental health screenings where 21% screened positive for depression and 16% screened positive for anxiety. We made 16 referrals to a mental health intervention study. The Act phase led to plans for regular implementation of the health fairs and a study designed to provide Spanish-language mental health services. The success of our interprofessional work provides an example of how the PDCA cycle can be used to uncover potential causes for poor health outcomes and design and evaluate interventions targeted to mitigate those outcomes.
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Affiliation(s)
- Sally Moyce
- Mark and Robyn Jones College of Nursing, Montana State University, Bozeman, Montana, USA
| | - David Claudio
- Francis College of Engineering, University of Massachusetts, Lowell, Massachusetts, USA
| | - Maria Velazquez
- Francis College of Engineering, University of Massachusetts, Lowell, Massachusetts, USA
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19
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The Impact of a Culturally Meaningful Storytelling Intervention on Stigma and Attitudes About Mental Health Treatment. J Nerv Ment Dis 2023; 211:419-426. [PMID: 36878207 DOI: 10.1097/nmd.0000000000001640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
ABSTRACT The fear of being devalued or discriminated against is a salient deterrent to seeking mental health care, especially in communities of color where racial stigma also impacts mental health and perceptions of service utilization. To address this issue, our research team partnered with This Is My Brave Inc to develop and evaluate a virtual storytelling intervention to highlight and amplify the voices of Black and Brown Americans living with mental illness and/or addiction. We utilized a pretest-posttest survey design administered electronically to viewers of the series (n = 100 Black, indigenous, people of color and n = 144 non-Hispanic White). Results indicated that postintervention, scores on public stigma and perceived discrimination measures were significantly reduced. We identified significant interaction effects, such that Black, indigenous, people of color viewers showed a greater rate of improvement on outcomes. This study provides strong preliminary evidence of the impact of a culturally meaningful virtual approach to addressing stigma and improving attitudes about mental health treatment.
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20
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Evans L, Chang A, Dehon J, Streb M, Bruce M, Clark E, Handal P. The relationships between perceived mental illness prevalence, mental illness stigma, and attitudes toward help-seeking. CURRENT PSYCHOLOGY 2023:1-10. [PMID: 37359578 PMCID: PMC9975862 DOI: 10.1007/s12144-023-04329-2] [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: 01/25/2023] [Indexed: 03/05/2023]
Abstract
Previous research suggests that, despite the commonality of mental illness in the United States, the majority of U.S. individuals with mental illness do not seek treatment. One important factor that contributes to this lack of treatment utilization is mental illness stigma. Such stigma may result, in part, from many individuals in the U.S. underestimating the prevalence of mental illness. To test whether this is the case, 638 adults from across the U.S. completed measures related to perceived prevalence of mental illness, private stigma, perceived public stigma, and help-seeking. Findings indicated participants significantly underestimated the given-year prevalence rate of mental illness. The perceived given-year prevalence rate was significantly correlated with lower private stigma and more positive attitudes towards help-seeking. Personal stigma significantly predicted attitudes towards help-seeking. Findings also suggested that individuals who have received mental health services have a higher perceived prevalence rate of mental illness, as well as lower levels of personal stigma and more positive attitudes towards help-seeking. These findings support the notion that helping the general public recognize the true prevalence rate of mental illness could reduce personal mental illness stigma and facilitate help-seeking behaviors. However, future experimental studies are needed to test this hypothesis.
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Affiliation(s)
- Luke Evans
- Department of Psychology, Saint Louis University, 63108 Saint Louis, MO United States
- Understanding Minds Psychological Services , Saint Louis, United States
| | - Alexander Chang
- Department of Psychology, Saint Louis University, 63108 Saint Louis, MO United States
| | - Jewell Dehon
- Department of Psychology, Saint Louis University, 63108 Saint Louis, MO United States
| | - Madison Streb
- Department of Psychology, Saint Louis University, 63108 Saint Louis, MO United States
| | - Madeline Bruce
- Department of Psychology, Saint Louis University, 63108 Saint Louis, MO United States
| | - Eddie Clark
- Department of Psychology, Saint Louis University, 63108 Saint Louis, MO United States
| | - Paul Handal
- Department of Psychology, Saint Louis University, 63108 Saint Louis, MO United States
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21
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Tóth MD, Ihionvien S, Leduc C, Aust B, Amann BL, Cresswell-Smith J, Reich H, Cully G, Sanches S, Fanaj N, Qirjako G, Tsantila F, Ross V, Mathieu S, Pashoja AC, Arensman E, Purebl G. Evidence for the effectiveness of interventions to reduce mental health related stigma in the workplace: a systematic review. BMJ Open 2023; 13:e067126. [PMID: 36806140 PMCID: PMC9944311 DOI: 10.1136/bmjopen-2022-067126] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES Increasing access to mental health support is a key factor for treating mental disorders, however, important barriers complicate help-seeking, among them, mental health related stigma being most prominent. We aimed to systematically review the current evidence for interventions focusing on reducing stigma related to mental health problems in small and medium enterprises (SMEs). DESIGN Systematic review with a focus on interventions targeting mental health related stigma in the workplace in accordance with PRISMA guidelines. The methodological quality of included articles was assessed using the Quality Assessment Tool for Quantitative Studies Scale. DATA SOURCES PubMed, Ovid Medline, PsycINFO, Scopus, and Cochrane databases and Google Scholar were searched from January 2010 until November 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included experimental or quasi-experimental studies about workplace interventions aiming to reduce stigma, where the outcomes were measured in terms of stigmatisation against depression, anxiety and/or other mental health problems. DATA EXTRACTION AND SYNTHESIS Records were screened by two independent reviewers after inspecting titles and abstracts and a full-text read of the articles to assess whether they meet inclusion criteria. The results were synthesised narratively. RESULTS We identified 22 intervention studies, 3 with high quality, 13 with moderate quality and 6 with weak quality. Only 2 studies included SMEs, but no study focused on SMEs exclusively . The mode of delivery of the intervention was face to face in 15 studies, online in 4 studies and mixed in 3 studies. We found a significant reduction in stigmatising attitudes in almost all studies (20/22), using 10 different instruments/scales. Effects seemed to be independent of company size. Online interventions were found to be shorter, but seemed to be as effective as face-to-face interventions. CONCLUSIONS Although we did not find interventions focusing exclusively on SMEs, it is likely that antistigma interventions also will work in smaller workplaces. TRIAL REGISTRATION PROSPERO: ID: CRD42020191307.
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Affiliation(s)
- Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Sarah Ihionvien
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Benedikt L Amann
- Centro Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar Medical Research Institute (IMIM), Parc de Salut Mar, Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- University Pompeu Fabra, Barcelona, Spain
| | | | - Hanna Reich
- German Depression Foundation, Leipzig, Germany
- Department for Psychiatry, Psychosomatics and Psychotherapy, Depression Research Center of the German Depression Foundation, Goethe University, Frankfurt, Germany
| | - Grace Cully
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Sarita Sanches
- Phrenos Center of Expertise for Severe Mental Illness, Utrecht, The Netherlands
- Altrecht Mental Health Care, Utrecht, The Netherlands
| | | | - Gentiana Qirjako
- Department of Public Health, University of Medicine, Tirana, Albania
| | - Fotini Tsantila
- LUCAS, Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Arlinda Cerga Pashoja
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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22
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Liou-Johnson V, Merced K, Klyce DW, Agtarap S, Finn JA, Chung JS, Campbell T, Harris OA, Perrin PB. Exploring racial/ethnic disparities in rehabilitation outcomes after TBI: A veterans affairs model systems study. NeuroRehabilitation 2023; 52:451-462. [PMID: 36806517 DOI: 10.3233/nre-220225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Almost one-third of the U.S. military population is comprised of service members and veterans (SMVs) of color. Research suggests poorer functional and psychosocial outcomes among Black and Hispanic/Latine vs. White civilians following traumatic brain injury (TBI). OBJECTIVE This study examined racial/ethnic differences in 5-year functional independence and life satisfaction trajectories among SMVs who had undergone acute rehabilitation at one of five VA TBI Model Systems (TBIMS) Polytrauma Rehabilitation Centers (PRCs). METHODS Differences in demographic and injury-related factors were assessed during acute rehabilitation among White (n = 663), Black (n = 89) and Hispanic/Latine (n = 124) groups. Functional Independence Measure (FIM) Motor, FIM Cognitive, and Satisfaction with Life Scale (SWLS) scores were collected at 1, 2, and 5 years after injury. Racial/ethnic comparisons in these outcome trajectories were made using hierarchical linear modeling. RESULTS Black SMVs were less likely than White and Hispanic/Latine SMVs to have been deployed to a combat zone; there were no other racial/ethnic differences in any demographic or injury-related variable assessed. In terms of outcomes, no racial/ethnic differences emerged in FIM Motor, FIM cognitive, or SWLS trajectories. CONCLUSION The absence of observable racial/ethnic differences in 5-year outcome trajectories after TBI among SMVs from VA TBIMS PRCs contrasts sharply with previous research identifying disparities in these same outcomes and throughout the larger VA health care system. Individuals enrolled in VA PRCs are likely homogenized on key social determinants of health that would otherwise contribute to racial/ethnic disparities in outcome trajectories.
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Affiliation(s)
- Victoria Liou-Johnson
- Polytrauma Department, VA Palo Alto Healthcare Center, Palo Alto, CA, USA.,Clinical Excellence Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Kritzia Merced
- Central Virginia Veterans Affairs Health Care System, Richmond, VA, USA
| | - Daniel W Klyce
- Central Virginia Veterans Affairs Health Care System, Richmond, VA, USA.,Department of Physical Medicine and Rehabilitation, Virginia Common wealth University, Richmond, VA, USA.,Sheltering Arms Institute, Richmond, VA, USA
| | | | - Jacob A Finn
- Rehabilitation and Extended Care, Minneapolis VA Health Care System, Minneapolis, MN, USA.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Joyce S Chung
- Rehabilitation Department, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Thomas Campbell
- Central Virginia Veterans Affairs Health Care System, Richmond, VA, USA
| | - Odette A Harris
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.,Rehabilitation Department, Traumatic Brain Injury Center of Excellence, VA Palo Alto Health Care System, PaloAlto, CA, USA
| | - Paul B Perrin
- Central Virginia Veterans Affairs Health Care System, Richmond, VA, USA.,Department of Psychology, School of Data Science, University of Virginia, Charlottesville, VA, USA
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23
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Luna A, Zulauf-McCurdy CA, Harbin S, Fettig A. Latina Mothers of Young Children With Special Needs: Personal Narratives Capturing the Impact of the COVID-19 Pandemic. TOPICS IN EARLY CHILDHOOD SPECIAL EDUCATION 2023; 42:302-314. [PMID: 38603241 PMCID: PMC9614588 DOI: 10.1177/02711214221129240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The Latino community has been disproportionately impacted by the COVID-19 pandemic, resulting in unique challenges. This paper explores the lived experiences of five Spanish-speaking Latina mothers of young children receiving early childhood special education (ECSE) services during the pandemic. Through in-depth qualitative interviews, this paper focuses on the following research questions: (1) What barriers have Spanish-speaking Latino families encountered in ECSE service delivery during this pandemic? (2) How have families overcome those barriers? Latina mothers describe how despite encountering numerous barriers to ECSE service delivery during the pandemic, they also experienced key areas of support and strength. We discuss how ECSE professionals can leverage these sources of support and strength in a culturally responsive manner to better support the Latino community through the pandemic. By presenting interviews with Latina mothers, this paper offers a unique interpretation of their experience, which is often left out of educational research.
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24
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Olson R, Fryz R, Essemiah J, Crawford M, King A, Fateye B. Mental health impacts of COVID-19 lockdown on US college students: Results of a photoelicitation project. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:411-421. [PMID: 33760715 DOI: 10.1080/07448481.2021.1891921] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/24/2020] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
Objective: This study seeks to understand the experiences of college student as they completed their education during the COVID-19 lockdown. Participants: Students at a large 4-year college in Midwestern USA. Methods: We conducted a photo-survey of students' experiences during the lockdown. Student researchers and faculty collaborated to analyze images and texts in a way that privileged students' interpretation. Results: Students frequently reported worsening mental health during the lockdown. Nonacademic aspects of students' lives such as work and the home environment significantly contributed to perceived stress. Students, especially freshmen coped maladaptively with unmet psychosocial and educational needs. Faculty may underestimate the indirect impact of the pandemic on students' lives and academic outcomes. Conclusion: Perspectives presented herein add the crucial voice of students to ongoing conversations to meet pandemic-related mental health needs of college students.
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Affiliation(s)
- Reilly Olson
- Biomedical Science Department, Grand Valley State University, Allendale, Michigan, USA
| | - Rylin Fryz
- Biomedical Science Department, Grand Valley State University, Allendale, Michigan, USA
| | - Judith Essemiah
- Biomedical Science Department, Grand Valley State University, Allendale, Michigan, USA
| | - Miranda Crawford
- Biomedical Science Department, Grand Valley State University, Allendale, Michigan, USA
| | - Adedipupo King
- Biomedical Science Department, Grand Valley State University, Allendale, Michigan, USA
| | - Babasola Fateye
- Biomedical Science Department, Grand Valley State University, Allendale, Michigan, USA
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Willis HA, Neblett EW. Developing culturally-adapted mobile mental health interventions: a mixed methods approach. Mhealth 2023; 9:1. [PMID: 36760787 PMCID: PMC9902238 DOI: 10.21037/mhealth-22-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/29/2022] [Indexed: 01/28/2023] Open
Abstract
Background Black young adults suffer from psychological distress at either similar or greater rates than that of White Americans, yet they are seven times less likely to have access to or receive effective treatments. Fortunately, mobile-health (mHealth) technology may transform mental health services and address disparities in mental healthcare. The current study utilized focus groups of Black young adults to inform the development of culturally-adapted mHealth using quantitative and qualitative approaches. Methods The study utilized a mixed-methods approach, in that qualitative (i.e., mini focus groups, n=11) and quantitative methods (i.e., self-report surveys) were used to explore the research questions. Participants included African American young adults (n=38, Mage =21). Participants completed self-report questionnaires prior to focus group facilitation. Correlational analyses were used to answer the quantitative research questions, and thematic analysis was used to answer the qualitative research questions. Results The qualitative findings highlighted that sociocultural experiences impact mental health and treatment seeking attitudes. Despite these findings, participants highlighted a variety of desired features and content that should be incorporated into future culturally-adapted mHealth interventions. Participants also highlighted both positive and negative aspects of current mHealth technologies for mental health. Finally, the study found that on average, participants had positive attitudes towards mental health, mental health treatments, and utilizing mHealth for mental health. Participants also had strong desires for culturally-adapted mHealth interventions. Bivariate correlations also revealed significant associations between vicarious online racial discrimination and mHealth attitudes, as well as racial identity and mHealth attitudes. Conclusions In summary, the current study highlights that there is an urgent need for mHealth technology for mental health symptoms for African American young adults and presents a variety of features, content, and design/development considerations for future researchers.
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Affiliation(s)
- Henry A Willis
- University of Pennsylvania, School of Social Policy and Practice, Philadelphia, PA, USA
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Hoskin JM, Vogeler H, Kirchhoefer J, Merrill BM, Erekson D, Beecher ME, Griner D. Comparing Psychotherapeutic Treatment Rates in University Counseling Centers between American Latinx and International Latinx University Students. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2023. [DOI: 10.1080/87568225.2022.2163953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jason M. Hoskin
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Heidi Vogeler
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Jessica Kirchhoefer
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Brett M. Merrill
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - David Erekson
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Mark E. Beecher
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Derek Griner
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
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Understanding the Association Between Mental Health Knowledge and Mental Health Service Utilization Among Black Adults. Community Ment Health J 2023; 59:57-67. [PMID: 35794413 PMCID: PMC10371774 DOI: 10.1007/s10597-022-00988-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/16/2022] [Indexed: 01/07/2023]
Abstract
Mental health knowledge limitations may contribute to the treatment gap among Black adults. We conducted an online cross-sectional study of Black adults in the United States (n = 262, aged 18-65 years) from diverse ethnic backgrounds (African-Americans, African immigrants, Afro-Caribbean immigrants). Gamma regression using generalized linear models was used to estimate the associations between mental health knowledge and willingness to seek help from mental health professionals. After adjusting for age, education and ethnicity, participants with higher specific knowledge about mental health (such as recognition of schizophrenia as a mental illness) were 26% more likely to report willingness to seek help from a mental health professional for personal and emotional problems (RR = 1.26, CI 1.12-1.41, p < 0.001). Knowledge building interventions (such as psychoeducation) that seek to increase specific knowledge (rather than general knowledge) may correlate more strongly with utilization of mental health services among Black adults.
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Jaramillo N, Felix ED. Understanding the psychosocial impact of the COVID-19 pandemic on Latinx emerging adults. Front Psychol 2023; 14:1066513. [PMID: 36891204 PMCID: PMC9987515 DOI: 10.3389/fpsyg.2023.1066513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
There is growing evidence about the potential negative psychosocial impact of the COVID-19 pandemic on ethnoracially minoritized young adults. Emerging adulthood is a developmental stage (ages 18-29 years old) that is characterized by identity exploration, instability, self-focus, feeling "in between" and having a sense of possibilities. Latinx emerging adults have reported significant socio-emotional consequences as a result of the COVID-19 pandemic. The aim of this study was to explore the psychosocial impact of the COVID-19 pandemic on Latinx emerging adults (N = 31; ages 18-29) in California and Florida through online focus group interviews. A qualitative constructivist grounded theory approach was used in an effort to develop empirical knowledge, as research on the psychosocial impact of the COVID-19 pandemic on Latinx young adults is limited. This method served to capture the richness of the experiences of participants by allowing analytic codes and categories to drive theory development. In total, seven focus groups were held and participants attended a virtual focus group with other Latinx emerging adults from their state. The focus groups were transcribed verbatim and coded using constructivist grounded theory. Five themes were identified from the data concerning the impact of the pandemic on Latinx emerging adults, which centered around mental health experiences, navigating family factors, pandemic-related communication, career and academic disruptions, and systemic and environmental factors. A theoretical model was constructed to generate an understanding about factors influencing psychosocial functioning for Latinx emerging adults during the pandemic. The study has implications for advancing science on the consequences of pandemics on mental health and cultural considerations that may influence disaster recovery. Examples of these cultural considerations that emerged from this study include multigenerational values, heightened responsibilities, and mediating pandemic information. Results can inform efforts to increase support and resources for Latinx emerging adults in order to address the psychological difficulties resulting from the COVID-19 pandemic.
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Affiliation(s)
- Natalia Jaramillo
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Erika D Felix
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, Santa Barbara, CA, United States
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Ritter LJ, Hilliard T, Knox D. "Lovesick": Mental Health and Romantic Relationships among College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:641. [PMID: 36612961 PMCID: PMC9819681 DOI: 10.3390/ijerph20010641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
This research investigated the interpersonal impact of self-reported mental health diagnoses and/or perceptions on undergraduate students' current or most recent romantic relationship. Analysis of data from a 43-item online questionnaire completed by 267 undergraduates revealed that 68.3% of women and 52.5% of men reported having either been professionally diagnosed with a mental illness or perceive themselves to be mentally ill based on DSM criteria, with women and white students reporting significantly higher levels. Sociologically speaking, mental illness was found to influence relationship initiation, maintenance, and dissolution in this study. The mental health of the respondents' potential partners was an important consideration in deciding to form a relationship, particularly for male, white, heterosexuals. When the respondents reported relationship problems, men were more likely to blame such problems on mental health issues than women. Finally, though more respondents reported having broken up with a romantic partner who had mental health issues than had romantic partners break up with them, there were no significant gender, race, or sexual orientation differences in the termination of these romantic relationships. Study findings emphasize the importance of acknowledging and providing mental health resources-particularly interpersonal options-for emerging adults in the college setting.
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Affiliation(s)
- Lacey J. Ritter
- Department of Psychology, Sociology, & Social Work, Mount Mercy University, Cedar Rapids, IA 52402, USA
| | - Taylor Hilliard
- Department of Sociology, East Carolina University, Greenville, NC 27858, USA
| | - David Knox
- Department of Sociology, East Carolina University, Greenville, NC 27858, USA
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Atkins R, Kelly TA, Johnson S, Deatrick JA, Wunnenberg M, Joseph PV, Pudasainee-Kapri S, Gage G, Pontes NMH, Cresse N, Williams W. Beliefs and willingness towards participating in genetic testing for depression in low-income and racial/ethnic minority mothers at-risk. Arch Psychiatr Nurs 2022; 41:153-165. [PMID: 36428043 PMCID: PMC11036348 DOI: 10.1016/j.apnu.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 06/03/2022] [Accepted: 07/03/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To identify mothers' salient normative, behavioral and control beliefs and willingness towards participating in genetic salivary testing for depression. DESIGN A qualitative, descriptive design was employed. 41 multi-ethnic mothers completed surveys that underwent directed content analysis according to The Theory of Planned Behavior. Percentages and frequency counts were used to categorize responses and calculate willingness. FINDINGS Salient beliefs included: Behavioral: Finding a cure/treatment for depression (29.3 %), Normative: Family would approve (46.3 %), and Church associates would disapprove (19.5 %). CONTROL Lacking information/explanations (34.1 %) as barriers, convenient locations (24.4 %) as facilitators. Most mothers indicated a willingness to participate (90.2 %). CONCLUSIONS Interventions should target families, emphasize benefits, explain purposes and procedures, and use community based participatory methods.
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Affiliation(s)
- Rahshida Atkins
- The College of New Jersey, School of Nursing and Health Sciences, 2000 Pennington Road, Room 113, Ewing, NJ 08102, USA.
| | - Terri-Ann Kelly
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Shanda Johnson
- New Jersey City University, 2039 John F. Kennedy Blvd, Jersey City, NJ 07305, USA.
| | - Janet A Deatrick
- The University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA, USA.
| | - Mary Wunnenberg
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Paule V Joseph
- Section of Sensory Science and Metabolism (SenSMet), National Institute on Alcohol Abuse and Alcoholism & National Institute of Nursing Research, National Institutes of Health, Bethesda, MD.
| | - Sangita Pudasainee-Kapri
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Gale Gage
- Essex County College, Division of Nursing & Health Sciences, 303 University Avenue, Newark, NJ 07102, USA
| | - Nancy M H Pontes
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Nancy Cresse
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Wanda Williams
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
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Voith LA, Lee H, Salas Atwell M, King J, McKinney S, Russell KN, Withrow A. A phenomenological study identifying facilitators and barriers to Black and Latinx youth's engagement in hospital-based violence intervention programs. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4873-e4884. [PMID: 35801394 PMCID: PMC10084157 DOI: 10.1111/hsc.13900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/31/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
Black and Latinx youth are disproportionately affected by violence in the United States. Hospital-based violence intervention programs (HVIPs) have emerged as an effective response to this epidemic; however, participation rates remain low. This study aimed to identify facilitators and barriers to recruitment and engagement amongst black and Latinx youth from the perspective of HVIP staff. Employing a phenomenological approach, a purposive sample of key informants was recruited. Focus groups and semi-structured interviews lasting approximately 90 min were conducted with representatives (N = 12) from five HVIPs in U.S. cities across the Midwest and Northeast, making up 15% of all HVIPs in the United States. Each interview was recorded and transcribed verbatim. The research team employed rigorous content analysis of the data. Three themes and subsequent categories resulted from the analysis: (1) Interpersonal/Relational Facilitators (building rapport; connecting with youth; enhancing the teachable moment; building relational health); (2) Structural/Systemic Barriers (lack of reinforcement; difficulties connecting after discharge from the hospital; hospital workflow; institutional challenges); (3) Structural/Systemic Facilitators (embedding the HVIP; trauma-informed practices and policies). Given the limited research on black and Latinx youth and the disproportionate rate of violent injuries amongst these groups, an evidence-based systematic approach to engage youth is essential to promote health equity. The findings from this study suggest that there are several steps that HVIPs and hospitals can take to enhance their recruitment and engagement of youth and their families.
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Affiliation(s)
- Laura A. Voith
- Jack, Joseph, and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandOhioUSA
- Center on Trauma and AdversityClevelandOhioUSA
| | - Hyunjune Lee
- Jack, Joseph, and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandOhioUSA
- Center on Trauma and AdversityClevelandOhioUSA
| | - Meghan Salas Atwell
- Jack, Joseph, and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandOhioUSA
- Center on Urban Poverty and Community DevelopmentClevelandOhioUSA
| | - Jasmine King
- Jack, Joseph, and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandOhioUSA
| | - Sherise McKinney
- Jack, Joseph, and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandOhioUSA
- National Initiative on Mixed‐Income CommunitiesClevelandOhioUSA
| | - Katie N. Russell
- Jack, Joseph, and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandOhioUSA
- Center on Trauma and AdversityClevelandOhioUSA
| | - Ashley Withrow
- Jack, Joseph, and Morton Mandel School of Applied Social SciencesCase Western Reserve UniversityClevelandOhioUSA
- Center on Trauma and AdversityClevelandOhioUSA
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Nguyen LH, Anyane-Yeboa A, Klaser K, Merino J, Drew DA, Ma W, Mehta RS, Kim DY, Warner ET, Joshi AD, Graham MS, Sudre CH, Thompson EJ, May A, Hu C, Jørgensen S, Selvachandran S, Berry SE, David SP, Martinez ME, Figueiredo JC, Murray AM, Sanders AR, Koenen KC, Wolf J, Ourselin S, Spector TD, Steves CJ, Chan AT. The mental health burden of racial and ethnic minorities during the COVID-19 pandemic. PLoS One 2022; 17:e0271661. [PMID: 35947543 PMCID: PMC9365178 DOI: 10.1371/journal.pone.0271661] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 07/05/2022] [Indexed: 11/29/2022] Open
Abstract
Racial/ethnic minorities have been disproportionately impacted by COVID-19. The effects of COVID-19 on the long-term mental health of minorities remains unclear. To evaluate differences in odds of screening positive for depression and anxiety among various racial and ethnic groups during the latter phase of the COVID-19 pandemic, we performed a cross-sectional analysis of 691,473 participants nested within the prospective smartphone-based COVID Symptom Study in the United States (U.S.) and United Kingdom (U.K). from February 23, 2021 to June 9, 2021. In the U.S. (n=57,187), compared to White participants, the multivariable odds ratios (ORs) for screening positive for depression were 1·16 (95% CI: 1·02 to 1·31) for Black, 1·23 (1·11 to 1·36) for Hispanic, and 1·15 (1·02 to 1·30) for Asian participants, and 1·34 (1·13 to 1·59) for participants reporting more than one race/other even after accounting for personal factors such as prior history of a mental health disorder, COVID-19 infection status, and surrounding lockdown stringency. Rates of screening positive for anxiety were comparable. In the U.K. (n=643,286), racial/ethnic minorities had similarly elevated rates of positive screening for depression and anxiety. These disparities were not fully explained by changes in leisure time activities. Racial/ethnic minorities bore a disproportionate mental health burden during the COVID-19 pandemic. These differences will need to be considered as health care systems transition from prioritizing infection control to mitigating long-term consequences.
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Affiliation(s)
- Long H. Nguyen
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Adjoa Anyane-Yeboa
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Kerstin Klaser
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Jordi Merino
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Broad Institute of MIT and Harvard, Cambridge, MA, United States of America
| | - David A. Drew
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Wenjie Ma
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Raaj S. Mehta
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Daniel Y. Kim
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Erica T. Warner
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Amit D. Joshi
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Mark S. Graham
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Carole H. Sudre
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Ellen J. Thompson
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | | | | | | | | | - Sarah E. Berry
- Department of Nutritional Sciences, King’s College London, London, United Kingdom
| | - Sean P. David
- Department of Family Medicine, University of Chicago, Evanston, IL, United States of America
| | - Maria Elena Martinez
- Moores Cancer Center, University of California at San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California at San Diego, La Jolla, CA, United States of America
| | - Jane C. Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - Anne M. Murray
- Division of Geriatrics, Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN, United States of America
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN, United States of America
| | - Alan R. Sanders
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem, Evanston, IL, United States of America
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | | | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Claire J. Steves
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Andrew T. Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Immunology and Infectious Disease, Harvard T.H. Chan School of Public Health,
Boston, MA, United States of America
- Massachusetts Consortium on Pathogen Readiness, Cambridge, MA, United States of America
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Nakajima M, Jama S, Noor N, Albee R, Ali SA, Ali SF, Pratt R, al’Absi M. Attitudes Toward Mental Health, Addiction, and Biobehavioral Research in the Somali Community in Minnesota, United States. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00851-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yu J. Research on the Intervention and Prevention of College Students' Mental Health Crisis From the Perspective of Ideological and Physical Education. Front Public Health 2022; 10:905905. [PMID: 35812494 PMCID: PMC9257002 DOI: 10.3389/fpubh.2022.905905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Present study has aimed to understand the intervention and prevention of the mental health crisis of college students. For this purpose, this study has checked the effect of trust in wellbeing information on preventive behavior and mental wellbeing. The target population taken for this study is the students of colleges situated in Mainland in China. The data was collected from the 458 students of the college. Smart PLS has been employed on the data to get the results using partial least square structural equation modeling. For this purpose, the data were analyzed in two stages, i.e., measurement model stage and the structural model stage. Results of this study have revealed that trust in wellbeing information plays a significant and positive role in setting preventive behavior and the mental wellbeing of students. Further, it has also been revealed that preventive behavior also plays a significant and positive role in mental wellbeing. Additionally, preventive behavior has been found as an important mediating variable among the relationship of trust in wellbeing information and mental wellbeing. Moreover, family support is crucial by positively moderating the relationship between preventive behavior and mental wellbeing. Many practical implications have been found among which the foremost is that the education institutes must undertake those efforts that aim to ensure the fairness in the information spread regarding the mental wellbeing during seminars, workshops and administration should play a positive role responsible for strengthening the mental health of students by managing ideas, improving student education management, innovating management techniques and methods.
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Affiliation(s)
- Jiang Yu
- College of Sports and Leisure, Guangdong Ocean University, Zhanjiang, China
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35
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Crowe A, Averett P, Harris J’RA, Crumb L, Dietz SS. “The Problem Will Pass:” Attitudes of Latinx Adults Toward Mental Illness and Help Seeking. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2022. [DOI: 10.1007/s10447-021-09425-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Moyce S, Thompson S, Metcalf M, Velazquez M, Aghbashian E, Sisson N, Claudio D. Rural Hispanic Perceptions of Mental Health: A Qualitative Study. J Transcult Nurs 2022; 33:346-354. [PMID: 35075920 DOI: 10.1177/10436596211070592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In 2020, 18.4% of Hispanics experienced mental illness, yet only about a third received treatment compared with nearly half of non-Hispanic Whites. In Montana, where only 11% of the mental health needs are currently met, service utilization is low. The purpose of this study was to determine the perceptions of the Hispanic immigrant population in a rural state on mental health and professional service utilization. METHODS Using a descriptive phenomenological approach, we conducted semi-structured telephone interviews in Spanish. Audio recordings were transcribed, translated to English, and analyzed for themes. RESULTS We recruited a sample of 14 participants from Mexico, Ecuador, Colombia, and Venezuela ranging in age from 33 to 59. We identified five themes: definitions of mental health, maintaining mental health, familismo/socialization, stigma, and acculturation stress. DISCUSSION Novel findings point to the need for Spanish-language services focused on reducing stigma around mental illness and incorporating the importance of social connections.
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DeLuca JS, Novacek DM, Adery LH, Herrera SN, Landa Y, Corcoran CM, Walker EF. Equity in Mental Health Services for Youth at Clinical High Risk for Psychosis: Considering Marginalized Identities and Stressors. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:176-197. [PMID: 35815004 PMCID: PMC9258423 DOI: 10.1080/23794925.2022.2042874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Prevention and early intervention programs have been initiated worldwide to serve youth at Clinical High Risk for Psychosis (CHR-P), who are adolescents and young adults experiencing subclinical psychosis and functional impairment. The primary goals of these efforts are to prevent or mitigate the onset of clinical psychosis, while also treating comorbid issues. It is important to consider issues of diversity, equity, and inclusion in CHR-P work, especially as these programs continue to proliferate around the world. Further, there is a long history in psychiatry of misdiagnosing and mistreating psychosis in individuals from racial and ethnic minority groups. Although there have been significant developments in early intervention psychosis work, there is evidence that marginalized groups are underserved by current CHR-P screening and intervention efforts. These issues are compounded by the contexts of continued social marginalization and significant mental health disparities in general child/adolescent services. Within this narrative review and call to action, we use an intersectional and minority stress lens to review and discuss current issues related to equity in CHR-P services, offer evidence-based recommendations, and propose next steps. In particular, our intersectional and minority stress lenses incorporate perspectives for a range of marginalized and underserved identities related to race, ethnicity, and culture; faith; immigration status; geography/residence; gender identity; sexual orientation; socioeconomic status/class; and ability status.
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Affiliation(s)
- Joseph S. DeLuca
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Derek M. Novacek
- Desert Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, , Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Laura H. Adery
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Shaynna N. Herrera
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Yulia Landa
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Cheryl M. Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Elaine F. Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Lehmann CS, Whitney WB, Un J, Payne JS, Simanjuntak M, Hamilton S, Worku T, Fernandez NA. Hospitality Towards People with Mental Illness in the Church: a Cross-cultural Qualitative Study. PASTORAL PSYCHOLOGY 2021; 71:1-27. [PMID: 34728861 PMCID: PMC8554182 DOI: 10.1007/s11089-021-00982-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 06/13/2023]
Abstract
Mental illness is a prevalent concern that affects Christian churches in North America in significant ways. Previous studies on the relationship between mental illness and the church have found that beliefs and practices within the church can contribute to stigma towards people with mental illness. Yet, the typical experience of people with mental illness who attend church has been found to be positive, suggesting that there are considerable resources within the church for supporting those who experience mental health problems. One such resource is the concept of hospitality, which promotes a sense of belonging for those with mental illness in the church. This qualitative study advances the construct of hospitality as a helpful paradigm for addressing mental health needs within the church, capturing perspectives and practices that are currently in place or seen as necessary by church attendees. The study methodology also emphasized the need to incorporate cultural considerations that are appropriate for the racial and ethnic make-up of particular churches. Semistructured focus group interviews were conducted with participants from eight churches that were either predominantly African American, Asian American, Latinx, or multi-ethnic. Findings resulting from content analysis of transcripts indicated that hospitality was a broadly helpful construct for addressing mental health concerns in the church, though some cultural differences existed in the understanding and application of hospitality. Both the interface of the findings with the existing scholarly literature and the relevance of findings for church leaders are discussed.
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Affiliation(s)
| | | | - Jean Un
- Department of Social Work, Azusa Pacific University, Azusa, CA USA
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Lee V, Albaum C, Tablon Modica P, Ahmad F, Gorter JW, Khanlou N, McMorris C, Lai J, Harrison C, Hedley T, Johnston P, Putterman C, Spoelstra M, Weiss JA. The impact of COVID-19 on the mental health and wellbeing of caregivers of autistic children and youth: A scoping review. Autism Res 2021; 14:2477-2494. [PMID: 34591373 PMCID: PMC8646541 DOI: 10.1002/aur.2616] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 12/30/2022]
Abstract
Caregivers and families of autistic people have experienced stress and increase in demands due to the COVID‐19 pandemic that may have long‐term negative consequences for both their own and their children's mental health. A scoping review was conducted to identify pandemic related demands experienced by caregivers and families of autistic children and youth. The review also consolidated information on coping strategies and parenting‐related guidelines that have emerged to help parents meet these demands. Search strategies were approved by a research librarian and were conducted in peer‐reviewed and gray literature databases between May 2020 and February 2021. Additional resources were solicited through author networks and social media. All articles were published between December 2019 and February 2021. Article summaries were charted, and a thematic analysis was conducted with confirmation of findings with our knowledge users. Twenty‐three published articles and 14 pieces of gray literature were included in the review. The majority of articles characterized and highlighted the increase in demands on caregivers of autistic children and youth during the pandemic globally. Both quantitative and qualitative studies suggest that parents have experienced an increase in stress and mental health‐related symptoms during lockdown measures. Findings suggest that families are employing coping strategies, but there no evidence‐based supports were identified. The review highlighted the potential long‐term impact of prolonged exposure to increasing demands on the mental health and wellbeing of caregivers and families of autistic people, and pointed to a need for the rapid development and evaluation of flexible and timely support programs.
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Affiliation(s)
- Vivian Lee
- Department of Psychology, Carleton University, Ottawa, Canada
| | - Carly Albaum
- Department of Psychology, York University, Toronto, Canada
| | | | - Farah Ahmad
- School of Health Policy and Management, York University, Toronto, Canada
| | | | | | - Carly McMorris
- Werklund School of Education, University of Calgary, Calgary, Canada
| | - Jonathan Lai
- Canadian Autism Spectrum Disorder Alliance, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Delgado-Romero EA, Mahoney GE, Muro-Rodriguez NJ, Atilano R, Cárdenas Bautista E, De Los Santos J, Durán MY, Espinoza L, Fuentes J, Gomez SN, Ingram Estevez RE, Jimenez-Ruiz J, Monroig Garcia MM, Mora-Ozuna CJ, Ordaz AC, Rappaport B, Suazo-Padilla K, Vazquez M. La Clinica In LaK’ech: Establishing a Practicum Site Integrating Practice, Advocacy, and Research With Latinx Clients. COUNSELING PSYCHOLOGIST 2021. [DOI: 10.1177/00110000211025270] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This article concerns the establishment and development of La Clinica In LaK’ech, a bilingual mental health clinic collectively founded and staffed by a counseling psychologist and doctoral students in a counseling psychology doctoral program in the Southeast United States. During over 5 years of existence, the clinic has blended bilingual counseling psychology services, advocacy, interdisciplinary collaboration, and research with the Latinx population. The authors describe the development of the clinic and resultant clinical, training, and ethical issues that confronted the clinic in terms of providing services to a marginalized community in a state where anti-immigrant rhetoric, detention, and deportations were escalating. Also discussed are implications for training in practice, advocacy, service, and research for counseling psychologists working with Latinx communities.
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Vassilopoulos A, DeLucia C, Torres C. Do mothers and fathers agree? Examining interparental ratings of youth externalizing behaviors among ethnically diverse families. J Clin Psychol 2021; 77:2653-2667. [PMID: 34214193 DOI: 10.1002/jclp.23200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/05/2021] [Accepted: 06/02/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined the association between youth, parent, and family characteristics in mother-father agreement of youth externalizing behaviors among ethnically diverse families. METHOD Eighty-eight mother-father dyads of youth (44% Latino, 38% European-American, 17% African American) 6-16 years participated. RESULTS Overall associations between parent's reports of youth behavior problems were positively correlated. Significant predictors of parent difference scores in regression analyses included mother's depression scores (negatively), mother and father parenting stress scores (positively and negatively, respectively), and child's symptom severity (positively in the Inattention and Learning Problems models; negatively in the Defiance/Aggression model). CONCLUSIONS Results highlight the need for psychosocial screening of youth's parents during child psychological assessment to identify situations in which both parent reports are needed for youth assessment. Further, it contributes to the small literature base of discrepancies in parent reports in minority youth and expands upon the minimal research involving paternal caregivers.
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Affiliation(s)
- Areti Vassilopoulos
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Christian DeLucia
- College of Psychology, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Cynthia Torres
- College of Psychology, Nova Southeastern University, Fort Lauderdale, Florida, USA.,Division of Behavioral Health, Nemours/A.I. duPont Hospital for Children, Wilmington, Delaware, USA
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Rivera KJ, Zhang JY, Mohr DC, Wescott AB, Pederson AB. A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States. JOURNAL OF MENTAL HEALTH & CLINICAL PSYCHOLOGY 2021; 5:20-31. [PMID: 34632464 PMCID: PMC8496896 DOI: 10.29245/2578-2959/2021/2.1235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Among African Americans, the chronicity and severity of mental illness correlates with worse health outcomes and widens health disparities. Stigma related to mental illness compounds mental health disparities by creating barriers to help-seeking behavior. We examine the current tools designed to reduce mental illness stigma and promote improved mental health outcomes among African Americans. The authors reviewed the current evidence in the literature for such stigma reduction interventions. The review team developed a focused search across four databases: PubMed, Embase, Scopus, and APA PsycINFO. Initial searches identified 120 articles, from which six studies were included as reporting on mental illness stigma reduction interventions among African Americans. We describe these four quantitative and two qualitative studies. There have been various interventions used among African Americans to reduce mental illness stigma, and the level of efficacy and effectiveness is not well studied. Our review demonstrated a need for more robust studies to yield strong evidence on effectiveness among stigma reduction interventions in this target population. The evidence does support tailoring intervention studies to this population. Effectively engaging and partnering with key stakeholders, including schools, community organizations, and faith-based institutions enhances the acceptance and delivery of stigma reduction interventions.
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Affiliation(s)
- Kevin J. Rivera
- Department of Psychiatry, Carver College of Medicine, University of Iowa. 200 Hawkins Dr, Iowa City, Iowa, 52242, United States
| | - Jenny Y. Zhang
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University. 446 E. Ontario St, #7-200, Chicago, Illinois, 60611, United States
| | - David C. Mohr
- Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University. 680 N. Lake Shore Dr, Suite 1400, Chicago, Illinois, 60611, United States
| | - Annie B. Wescott
- Galter Health Sciences Library, Feinberg School of Medicine, Northwestern University. 320 E Superior St, Chicago, Illinois, 60611, United States
| | - Aderonke Bamgbose Pederson
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University. 446 E. Ontario St, #7-200, Chicago, Illinois, 60611, United States
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Martinez-Hollingsworth A, Hamilton N, Choi K, Heilemann M. The Secret-Self Management Loop: A grounded theory of provider mistrust among older Latinas with type 2 diabetes and mental health symptoms. Diabetes Res Clin Pract 2021; 175:108787. [PMID: 33845050 DOI: 10.1016/j.diabres.2021.108787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/20/2021] [Accepted: 03/29/2021] [Indexed: 11/20/2022]
Abstract
AIMS The purpose of this study was to examine how older Latina women emotionally experience type 2 diabetes mellitus and interactions with care providers using a grounded theory approach. METHODS Sixteen English-speaking, Latina women, 60 years and older, diagnosed with type 2 diabetes mellitus and experiencing symptoms of depression or anxiety participated in 21 phone interviews guided by a semi-structured interview guide. Data was collected and analyzed using Grounded Theory methodology; theoretical sampling was used to achieve data saturation. RESULTS Participant data informed the creation of a theory, The Secret Self-Management Loop, with four interconnected phases: 1) having a negative relationship origin story; 2) doubting provider motivation; 3) reacting to doubts about provider; and 4) engaging in secret self-management. These phases reflected participants' lost trust in their providers and the medical system, resulting in undisclosed self-management strategies that complicated clinical management of their type 2 diabetes mellitus diagnosis. Primary sources of loss of trust were interactions that lacked empathy or caused them to question their providers' motivation. CONCLUSION The Secret Self-Management Loop negatively influences patient disclosure and distorts providers' ability to adequately render care for this group.
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Affiliation(s)
| | - Nalo Hamilton
- University of California, Los Angeles, 5-659 Factor Building, Los Angeles, CA, USA.
| | - Kristen Choi
- University of California, Los Angeles, Factor Building 3-238, Los Angeles, CA, USA.
| | - MarySue Heilemann
- University of California, Los Angeles, Factor Building: 5-252, Los Angeles, CA, USA.
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Sileo KM, Kershaw TS. Dimensions of Masculine Norms, Depression, and Mental Health Service Utilization: Results From a Prospective Cohort Study Among Emerging Adult Men in the United States. Am J Mens Health 2021; 14:1557988320906980. [PMID: 32079448 PMCID: PMC7036518 DOI: 10.1177/1557988320906980] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to examine the role of multidimensional masculine
norms (“status,” “toughness,” “anti-femininity”) on depression and mental health
service utilization among emerging adult men in the Northeast United States.
This study examines substance use and hostility as secondary outcomes and
depression status as an effect moderator on the relationship between masculine
norms and mental health service utilization. This study used data from a
prospective cohort study that followed 18- to 25-year-old heterosexual men over
6 months. At baseline and 6 months, approximately 29% and 25% of the sample met
the criteria for depression. The results of multivariate linear and logistic
regression models found that greater endorsement of masculine status was
associated with less depressive symptoms at baseline and 6 months, masculine
toughness was associated with more substance use at baseline, and masculine
anti-femininity was associated with greater hostility at baseline and 6 months.
The multivariate Poisson model found that greater endorsement of status was
associated with greater mental health service utilization in the prior year,
especially for men not meeting the criteria for depression. In contrast, greater
endorsement of anti-femininity and toughness norms was associated with less
mental health service utilization; for men endorsing toughness norms, this
effect was greater for those who were depressed. This study sheds light on the
harmful and protective effects of masculine norms on depression, related mental
health outcomes, and mental health service utilization, with implications for
gender-tailored approaches to engage and retain young men in mental health
services.
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Affiliation(s)
- Katelyn M Sileo
- The University of Texas at San Antonio, TX, USA.,The Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
| | - Trace S Kershaw
- The Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Hadler NL, Bu P, Winkler A, Alexander AW. College Student Perspectives of Telemental Health: a Review of the Recent Literature. Curr Psychiatry Rep 2021; 23:6. [PMID: 33404975 PMCID: PMC7785477 DOI: 10.1007/s11920-020-01215-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW We review the recent literature regarding college student experiences with and attitudes toward telemental health (TMH). We examine their perspectives of the advantages and drawbacks to this form of mental healthcare and their willingness to engage in TMH. RECENT FINDINGS College students view TMH as convenient, accessible, easy to use, and helpful. TMH helps to overcome the barrier of stigma associated with seeking mental health treatment. Despite positive reviews, many students find a lack of customization or connection to the provider to be drawbacks to some forms of TMH. Willingness to engage in TMH varies based on prior experience with mental health treatment, ethnicity, and severity of symptoms. The recent literature highlights the potential for TMH to play a key role in mental health services for college students. It also highlights some of its shortcomings, which are indicative of the continued need for in-person services. Future studies should continue to track college student perspectives toward and utilization of TMH.
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Affiliation(s)
- Nicole L Hadler
- University of Michigan Medical School, 1301 Catherine Street, Ann Arbor, MI, 48109, USA.
| | - Paula Bu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aaron Winkler
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Amy W Alexander
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Neece C, McIntyre LL, Fenning R. Examining the impact of COVID-19 in ethnically diverse families with young children with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:739-749. [PMID: 32808424 PMCID: PMC7461180 DOI: 10.1111/jir.12769] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 05/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic introduced challenges to families with young children with developmental delays. Beyond the widespread concerns surrounding illness, loss of employment and social isolation, caregivers are responsible for overseeing their children's educational and therapeutic programmes at home often without the much needed support of professionals. METHOD The present study sought to examine the impact of COVID-19 in 77 ethnically, linguistically and socioeconomically diverse families with young children with intellectual and developmental disabilities (IDDs) in California and Oregon, who were participating in larger intervention studies. Parents responded to five interview questions about the impact of the pandemic, services for their child, silver linings or positive aspects, coping and their concerns about the long-term impact of the pandemic. RESULTS Parents reported that their biggest challenge was being at home caring for their children with the loss of many essential services. Parents reported some positive aspects of the pandemic, especially being together as a family. Although there were positive aspects of the situation, many parents expressed concern about long-term impacts of the pandemic on their children's development, given the loss of services, education and social engagement opportunities. CONCLUSION Results suggest that parents of young children with IDD report significant challenges at home during the pandemic. Professional support, especially during the reopening phases, will be critical to support family well-being and child developmental outcomes.
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Affiliation(s)
- C. Neece
- Department of PsychologyLoma Linda UniversityLoma LindaCAUSA
| | - L. L. McIntyre
- Special Education & Clinical SciencesUniversity of OregonEugeneORUSA
| | - R. Fenning
- Department of Child and Adolescent StudiesCalifornia State University FullertonFullertonCAUSA
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Horwitz AG, McGuire T, Busby DR, Eisenberg D, Zheng K, Pistorello J, Albucher R, Coryell W, King CA. Sociodemographic differences in barriers to mental health care among college students at elevated suicide risk. J Affect Disord 2020; 271:123-130. [PMID: 32479307 PMCID: PMC7266827 DOI: 10.1016/j.jad.2020.03.115] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/04/2020] [Accepted: 03/29/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND College student mental health (MH) problems and suicide risk have steadily increased over the past decade and a significant number of students with MH problems do not seek treatment. While some barriers to mental health care service utilization (MHSU) have been identified, very little is known regarding how these barriers differ among sociodemographic subgroups of students. METHOD Participants were 3,358 college students from four US universities who screened positive for elevated suicide risk (defined as 2 or more of: depression, alcohol misuse, suicidal ideation, suicide attempt) and were not actively receiving MH services. Reported barriers to MHSU were categorized into: Low perceived need, privacy/stigma concerns, questioning helpfulness of treatment, logistics, time constraints, finances, and cultural issues. RESULTS Adjusted odds ratios indicated that finances were a greater barrier for women, sexual and gender minority students, and Black and Hispanic students. Privacy/stigma concerns were more prominent for men and young undergraduate students. White students and older undergraduate and graduate students were more likely to report a lack of time, and cultural sensitivity issues were significant barriers for sexual and gender minority, and racial/ethnic minority, students. LIMITATIONS Participating sites were not nationally representative. The barriers assessment did not examine the degree to which a specific barrier contributed to lack of MHSU relative to others. CONCLUSIONS In light of the significant variation in barriers based on age, gender identity, race/ethnicity, and sexual orientation, efforts to increase MHSU should be tailored to meet the unique needs of specific sociodemographic student subgroups.
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Affiliation(s)
- Adam G Horwitz
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, United States.
| | - Taylor McGuire
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, United States
| | - Danielle R Busby
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, United States
| | - Daniel Eisenberg
- School of Public Health, Institute for Social Research, University of Michigan, United States
| | - Kai Zheng
- School of Information and Computer Sciences, University of California, Irvine, United States
| | | | - Ronald Albucher
- Counseling and Psychological Services, Stanford University, United States
| | | | - Cheryl A King
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, United States
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Glassgow AE, Gerges M, Atkins M, Martin M, Caskey R, Sanders K, Mirza M, Van Voorhees B, Kim S. Exploring Racial Disparities in Mental Health Diagnoses and Neighborhood Disorganization Among an Urban Cohort of Children and Adolescents with Chronic Medical Conditions. Health Equity 2019; 3:604-611. [PMID: 31763576 PMCID: PMC6873349 DOI: 10.1089/heq.2019.0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: This article describes the demographic distribution of, and association between, neighborhood disorganization and mental health diagnosis by race in a large cohort of urban children with chronic medical conditions. Methods: Data for this study were from Coordinated Healthcare for Complex Kids (CHECK), a health care demonstration project funded by the Center for Medicare and Medicaid Innovation. We conducted regression analyses to examine the relationship between neighborhood disorganization and mental health diagnosis among 6,458 children enrolled in CHECK. Results: The most common mental health diagnoses were mood disorders (8.6%), Attention-Deficit/Hyperactivity Disorder (7.4%), conduct disorders (6.1%), and anxiety disorders (4.8%). Black children had the highest neighborhood disorganization scores compared with other racial/ethnic categories. However, Black children had the lowest proportion of mental health diagnoses. Lower neighborhood disorganization was associated with having a mental health diagnosis; however, when adding race/ethnicity to the model, neighborhood disorganization no longer was significant. Conclusions: Level of neighborhood disorganization was highly correlated with racial/ethnic composition of the neighborhoods, and Black children disproportionately resided in highly disorganized neighborhoods compared with other groups. Neighborhood disorganization may not have sufficient variability within the racial/ethnic categories, which may explain the absence of an interaction between race/ethnicity and mental health diagnosis.
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Affiliation(s)
- Anne Elizabeth Glassgow
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Michael Gerges
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Marc Atkins
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Molly Martin
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Rachel Caskey
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Krista Sanders
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Mansha Mirza
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Benjamin Van Voorhees
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Sage Kim
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
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Kaparounaki CK, Koraka CA, Kotsi ES, Ntziovara AMP, Kyriakidis GC, Fountoulakis KN. Greek university student's attitudes and beliefs concerning mental illness and its treatment. Int J Soc Psychiatry 2019; 65:515-526. [PMID: 31311387 DOI: 10.1177/0020764019864122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Stigma concerning mental disorder is a widespread phenomenon concerning the beliefs and attitudes of the public toward mental patients with a significant negative impact on state policy and the outcome of the patients. MATERIAL AND METHODS The study included 1,363 students of the Aristotle University of Thessaloniki. The survey was based on an Internet-based electronic platform. The statistical analysis included analysis of variance (ANOVA) and Yates corrected chi-square test. RESULTS Approximately, 87% of students responded that they know what mental disorder is, 70% were informed from the Internet, 30% consider mental patients responsible for their condition, more than 95% blame the way they were raised and almost 60% consider mental disorder to be heritable. Only a minority feel negatively with a mental patient around and close to 80% would socialize with them. More than 80% accept the need for psychiatric medication treatment but the opinion is split concerning compulsory treatment, and one-third consider medication to be harmful. DISCUSSION The results of this study suggest that most students believe they know much about mental illness; however, overall their responses are contradictory. They reply with confidence although they are informed mainly by the media and the Internet in an unreliable way. A number of factors including gender, specific school or personal experience of mental disorder in the family seem to influence the result. A combined educational plus contact might be necessary to reduce stigma, since education alone seems to exert a weak effect.
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Affiliation(s)
- Chrysi K Kaparounaki
- 1 Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chrysoula A Koraka
- 1 Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni S Kotsi
- 1 Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna-Maria P Ntziovara
- 1 Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Gerasimos C Kyriakidis
- 1 Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos N Fountoulakis
- 2 3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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50
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Chiang M, Chang J, Nakash O, Cruz-Gonzalez M, Fillbrunn MK, Alegría M. Change in Patient Activation and Mental Illness Symptoms After Communication Training: A Multisite Study With a Diverse Patient Sample. Psychiatr Serv 2019; 70:696-702. [PMID: 31084292 PMCID: PMC6675648 DOI: 10.1176/appi.ps.201800216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Patient activation involves patients' ability and motivation to communicate about their health and health care. Research has demonstrated that clinician or patient interventions may improve patient activation. This study explored the degree to which clinician and patient interventions affected both patient activation and symptoms of depression and anxiety in a racially and ethnically diverse clinical sample. METHODS Data were from a randomized clinical trial that included 312 patients and 74 clinicians from 13 Massachusetts community- and hospital-based outpatient behavioral health clinics. Patients completed measures of patient activation and depression and anxiety symptoms. Secondary data analyses were conducted to examine the effect of patient and clinician interventions (DECIDE-PA and DECIDE-PC, respectively) on depression and anxiety symptoms and patient activation. A multilevel, mixed-effects simultaneous-equation model was estimated to assess the relationship between the interventions, changes in patients' symptoms, and patient activation. RESULTS Clinicians' greater intervention dosage (i.e., more completed DECIDE-PC training sessions) was associated with patients' decreased anxiety symptoms, but associations with patient activation or depression symptoms were not significant. The effect of clinician training dosage on anxiety symptoms was stronger when patients and clinicians were not of the same race-ethnicity. The reduction in patients' anxiety symptoms appeared to increase patient activation. CONCLUSIONS Clinician interventions designed to boost patient-clinician communication and the therapeutic alliance may serve to lessen patients' anxiety and may ultimately improve patient activation.
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Affiliation(s)
- Mengchun Chiang
- Counseling and Psychological Services, Carnegie Mellon University, Pittsburgh (Chiang); Department of Psychology, West Chester University, West Chester, Pennsylvania (Chang); School for Social Work, Smith College, Northampton, Massachusetts (Nakash); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston (Cruz-Gonzalez, Fillbrunn, Alegría); Department of Medicine and Psychiatry, Harvard Medical School, Boston (Alegría)
| | - Janet Chang
- Counseling and Psychological Services, Carnegie Mellon University, Pittsburgh (Chiang); Department of Psychology, West Chester University, West Chester, Pennsylvania (Chang); School for Social Work, Smith College, Northampton, Massachusetts (Nakash); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston (Cruz-Gonzalez, Fillbrunn, Alegría); Department of Medicine and Psychiatry, Harvard Medical School, Boston (Alegría)
| | - Ora Nakash
- Counseling and Psychological Services, Carnegie Mellon University, Pittsburgh (Chiang); Department of Psychology, West Chester University, West Chester, Pennsylvania (Chang); School for Social Work, Smith College, Northampton, Massachusetts (Nakash); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston (Cruz-Gonzalez, Fillbrunn, Alegría); Department of Medicine and Psychiatry, Harvard Medical School, Boston (Alegría)
| | - Mario Cruz-Gonzalez
- Counseling and Psychological Services, Carnegie Mellon University, Pittsburgh (Chiang); Department of Psychology, West Chester University, West Chester, Pennsylvania (Chang); School for Social Work, Smith College, Northampton, Massachusetts (Nakash); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston (Cruz-Gonzalez, Fillbrunn, Alegría); Department of Medicine and Psychiatry, Harvard Medical School, Boston (Alegría)
| | - Mirko K Fillbrunn
- Counseling and Psychological Services, Carnegie Mellon University, Pittsburgh (Chiang); Department of Psychology, West Chester University, West Chester, Pennsylvania (Chang); School for Social Work, Smith College, Northampton, Massachusetts (Nakash); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston (Cruz-Gonzalez, Fillbrunn, Alegría); Department of Medicine and Psychiatry, Harvard Medical School, Boston (Alegría)
| | - Margarita Alegría
- Counseling and Psychological Services, Carnegie Mellon University, Pittsburgh (Chiang); Department of Psychology, West Chester University, West Chester, Pennsylvania (Chang); School for Social Work, Smith College, Northampton, Massachusetts (Nakash); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston (Cruz-Gonzalez, Fillbrunn, Alegría); Department of Medicine and Psychiatry, Harvard Medical School, Boston (Alegría)
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