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Abstract
Data from the US Department of Education clearly documents the chronic and persistent disproportionality of negative educational outcomes for students of color. To move closer to an antiracist system that provides all youth with the resources, protections, and opportunities to which they are entitled through public education, we recommend that mental health clinicians understand the social determinants of education; become familiar with the historical legacy of inequity in schools; identify current trends of racial disparities in education; engage in opportunities for antiracist school transformation; and reflect on their personal practices in providing access, diagnosis, and treatment to underresourced and minoritized youth.
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Affiliation(s)
| | - Michelle V Porche
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 1001 Potrero Avenue, 7M16, San Francisco, CA 94110, USA
| | - Roya Ijadi-Maghsoodi
- Division of Population Behavioral Health, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, #A8-224, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Sheryl H Kataoka
- Division of Population Behavioral Health, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, #48-240B, Los Angeles, CA 90024, USA
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Becker KD, Daleiden EL, Kataoka SH, Edwards SM, Best KM, Donohue A, Chorpita BF. Pilot Study of the MAP Curriculum for Psychotherapy Competencies in Child and Adolescent Psychiatry. Am J Psychother 2021; 75:82-88. [PMID: 34724809 DOI: 10.1176/appi.psychotherapy.20210010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This pilot study aimed to evaluate the relevance, feasibility, acceptability, and instructional efficacy of the Managing and Adapting Practice (MAP) curriculum for enhancing the teaching of psychotherapy to child and adolescent psychiatry (CAP) fellows. MAP is a system of resources and decision models that supports practitioners in selecting and implementing psychotherapeutic interventions for children and adolescents. The MAP curriculum includes modules to guide education about psychotherapeutic procedures (e.g., behavioral activation) common in evidence-based treatments for an array of childhood problems and to support development of competencies in assessment, treatment planning, and reflective practice. METHODS Curriculum coding was used to examine the relevance of MAP's core components to the skills articulated in the Accreditation Council for Graduate Medical Education (ACGME) CAP milestones. Feasibility, acceptability, and learning outcomes were examined after delivery of the MAP curriculum to 12 CAP fellows at two sites, with instructional features tailored according to faculty preferences and training program structure. RESULTS Coding suggested that the MAP curriculum was relevant to 95% of the 21 ACGME CAP training subcompetencies. Feasibility was indicated by the successful delivery of 100% of the planned MAP curriculum across the two sites. Acceptability was supported by positive feedback from the CAP fellows, and psychotherapy knowledge increased significantly. Finally, case review scores (mean±SD=2.21±0.15) showed positive posttraining application of MAP to two patients and exceeded scores achieved by other samples of mental health professionals. CONCLUSIONS This pilot study demonstrated the potential for the MAP curriculum to support CAP education. MAP's versatility as a curriculum supports broader adoption, with continuing rigorous empirical evaluation.
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Affiliation(s)
- Kimberly D Becker
- Department of Psychology, University of South Carolina, Columbia (Becker); PracticeWise, Satellite Beach, Florida (Daleiden); Department of Psychiatry and Biobehavioral Sciences, and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles (Kataoka, Best); Department of Psychiatry, University of Maryland, Baltimore (Edwards, Donohue); Department of Psychology, University of California, Los Angeles (Chorpita)
| | - Eric L Daleiden
- Department of Psychology, University of South Carolina, Columbia (Becker); PracticeWise, Satellite Beach, Florida (Daleiden); Department of Psychiatry and Biobehavioral Sciences, and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles (Kataoka, Best); Department of Psychiatry, University of Maryland, Baltimore (Edwards, Donohue); Department of Psychology, University of California, Los Angeles (Chorpita)
| | - Sheryl H Kataoka
- Department of Psychology, University of South Carolina, Columbia (Becker); PracticeWise, Satellite Beach, Florida (Daleiden); Department of Psychiatry and Biobehavioral Sciences, and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles (Kataoka, Best); Department of Psychiatry, University of Maryland, Baltimore (Edwards, Donohue); Department of Psychology, University of California, Los Angeles (Chorpita)
| | - Sarah M Edwards
- Department of Psychology, University of South Carolina, Columbia (Becker); PracticeWise, Satellite Beach, Florida (Daleiden); Department of Psychiatry and Biobehavioral Sciences, and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles (Kataoka, Best); Department of Psychiatry, University of Maryland, Baltimore (Edwards, Donohue); Department of Psychology, University of California, Los Angeles (Chorpita)
| | - Karin M Best
- Department of Psychology, University of South Carolina, Columbia (Becker); PracticeWise, Satellite Beach, Florida (Daleiden); Department of Psychiatry and Biobehavioral Sciences, and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles (Kataoka, Best); Department of Psychiatry, University of Maryland, Baltimore (Edwards, Donohue); Department of Psychology, University of California, Los Angeles (Chorpita)
| | - April Donohue
- Department of Psychology, University of South Carolina, Columbia (Becker); PracticeWise, Satellite Beach, Florida (Daleiden); Department of Psychiatry and Biobehavioral Sciences, and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles (Kataoka, Best); Department of Psychiatry, University of Maryland, Baltimore (Edwards, Donohue); Department of Psychology, University of California, Los Angeles (Chorpita)
| | - Bruce F Chorpita
- Department of Psychology, University of South Carolina, Columbia (Becker); PracticeWise, Satellite Beach, Florida (Daleiden); Department of Psychiatry and Biobehavioral Sciences, and Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles (Kataoka, Best); Department of Psychiatry, University of Maryland, Baltimore (Edwards, Donohue); Department of Psychology, University of California, Los Angeles (Chorpita)
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3
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Legha RK, Richards M, Kataoka SH. Foundations in Racism: a Novel and Contemporary Curriculum for Child and Adolescent Psychiatry Fellows. Acad Psychiatry 2021; 45:61-66. [PMID: 33575965 PMCID: PMC7929942 DOI: 10.1007/s40596-021-01396-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 01/07/2021] [Indexed: 05/16/2023]
Affiliation(s)
- Rupinder K Legha
- David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA.
| | - Misty Richards
- David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Sheryl H Kataoka
- David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Castillo EG, Ijadi-Maghsoodi R, Shadravan S, Moore E, Mensah MO, Docherty M, Aguilera Nunez MG, Barcelo N, Goodsmith N, Halpin LE, Morton I, Mango J, Montero AE, Koushkaki SR, Bromley E, Chung B, Jones F, Gabrielian S, Gelberg L, Greenberg JM, Kalofonos I, Kataoka SH, Miranda J, Pincus HA, Zima BT, Wells KB. Community Interventions to Promote Mental Health and Social Equity. Focus (Am Psychiatr Publ) 2020; 18:60-70. [PMID: 32015729 PMCID: PMC6996071 DOI: 10.1176/appi.focus.18102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
(Reprinted with permission from Current Psychiatry Reports (2020) 21: 35).
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5
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Affiliation(s)
- Erum Nadeem
- Columbia University & New York State Psychiatric Institute
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Castillo EG, Ijadi-Maghsoodi R, Shadravan S, Moore E, Mensah MO, Docherty M, Aguilera Nunez MG, Barcelo N, Goodsmith N, Halpin LE, Morton I, Mango J, Montero AE, Rahmanian Koushkaki S, Bromley E, Chung B, Jones F, Gabrielian S, Gelberg L, Greenberg JM, Kalofonos I, Kataoka SH, Miranda J, Pincus HA, Zima BT, Wells KB. Community Interventions to Promote Mental Health and Social Equity. Curr Psychiatry Rep 2019; 21:35. [PMID: 30927093 PMCID: PMC6440941 DOI: 10.1007/s11920-019-1017-0] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW We review recent community interventions to promote mental health and social equity. We define community interventions as those that involve multi-sector partnerships, emphasize community members as integral to the intervention, and/or deliver services in community settings. We examine literature in seven topic areas: collaborative care, early psychosis, school-based interventions, homelessness, criminal justice, global mental health, and mental health promotion/prevention. We adapt the social-ecological model for health promotion and provide a framework for understanding the actions of community interventions. RECENT FINDINGS There are recent examples of effective interventions in each topic area. The majority of interventions focus on individual, family/interpersonal, and program/institutional social-ecological levels, with few intervening on whole communities or involving multiple non-healthcare sectors. Findings from many studies reinforce the interplay among mental health, interpersonal relationships, and social determinants of health. There is evidence for the effectiveness of community interventions for improving mental health and some social outcomes across social-ecological levels. Studies indicate the importance of ongoing resources and training to maintain long-term outcomes, explicit attention to ethics and processes to foster equitable partnerships, and policy reform to support sustainable healthcare-community collaborations.
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Affiliation(s)
- Enrico G Castillo
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
- Center for Social Medicine and Humanities, UCLA, Los Angeles, CA, USA.
- Los Angeles County Department of Mental Health, Los Angeles, CA, USA.
| | - Roya Ijadi-Maghsoodi
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Division of Population Behavioral Health, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- VA Health Service Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Sonya Shadravan
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Elizabeth Moore
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Michael O Mensah
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Mary Docherty
- Harkness Fellow in Healthcare Policy and Practice, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Maria Gabriela Aguilera Nunez
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Nicolás Barcelo
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Nichole Goodsmith
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Laura E Halpin
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Isabella Morton
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Joseph Mango
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
| | - Alanna E Montero
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
| | - Sara Rahmanian Koushkaki
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
| | - Elizabeth Bromley
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
- UCLA Department of Anthropology, Los Angeles, CA, USA
- Rand Corporation, Santa Monica, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Bowen Chung
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
- Rand Corporation, Santa Monica, CA, USA
- Los Angeles Biomedical Research Institute, Los Angeles, CA, USA
- Healthy African American Families II, Los Angeles, CA, USA
| | - Felica Jones
- Healthy African American Families II, Los Angeles, CA, USA
| | - Sonya Gabrielian
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- VA Health Service Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Lillian Gelberg
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- UCLA Jonathan Fielding School of Public Health, Los Angeles, CA, USA
| | - Jared M Greenberg
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- VA Health Service Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Ippolytos Kalofonos
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Social Medicine and Humanities, UCLA, Los Angeles, CA, USA
- UCLA International Institute, Los Angeles, CA, USA
| | - Sheryl H Kataoka
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
- Division of Child and Adolescent Psychiatry, UCLA, Los Angeles, CA, USA
| | - Jeanne Miranda
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
- UCLA Jonathan Fielding School of Public Health, Los Angeles, CA, USA
| | - Harold A Pincus
- Rand Corporation, Santa Monica, CA, USA
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, NewYork-Presbyterian Hospital, Irving Institute for Clinical and Translational Research, New York, NY, USA
| | - Bonnie T Zima
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
- Division of Child and Adolescent Psychiatry, UCLA, Los Angeles, CA, USA
| | - Kenneth B Wells
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Center for Health Services and Society, UCLA, Los Angeles, CA, USA
- Rand Corporation, Santa Monica, CA, USA
- UCLA Jonathan Fielding School of Public Health, Los Angeles, CA, USA
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Castillo EG, Chung B, Bromley E, Kataoka SH, Braslow JT, Essock SM, Young AS, Greenberg JM, Miranda J, Dixon LB, Wells KB. Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives. Harv Rev Psychiatry 2019; 26:70-81. [PMID: 29381527 PMCID: PMC5843494 DOI: 10.1097/hrp.0000000000000178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers', consumers', and other stakeholders' roles in shaping policy reform and community change to facilitate recovery.
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Affiliation(s)
- Enrico G Castillo
- From the Center for Health Services and Society (Drs. Chung, Bromley, Kataoka, Young, Miranda, and Wells), Center for Social Medicine and Humanities (Drs. Braslow and Castillo), Division of Child and Adolescent Psychiatry (Dr. Kataoka), Department of Psychiatry and Biobehavioral Sciences (Dr. Greenberg), David Geffen School of Medicine, and School of Public Health (Drs. Miranda and Wells), University of California, Los Angeles; Los Angeles County Department of Mental Health (Dr. Castillo); RAND Corporation (Drs. Chung and Wells); Los Angeles Biomedical Research Institute (Dr. Chung); Healthy African American Families II (Dr. Chung); Health Services Research & Development Center of Innovation (Dr. Young), Desert Pacific MIRECC Health Services Unit (Drs. Bromley and Greenberg), VA Greater Los Angeles Healthcare System; Division of Behavioral Health Services and Policy Research, Department of Psychiatry, Columbia University College of Physicians and Surgeons (Drs. Essock and Dixon); New York State Psychiatric Institute (Drs. Essock and Dixon)
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Bromley E, Figueroa C, Castillo EG, Kadkhoda F, Chung B, Miranda J, Menon K, Whittington Y, Jones F, Wells KB, Kataoka SH. Community Partnering for Behavioral Health Equity: Public Agency and Community Leaders' Views of its Promise and Challenge. Ethn Dis 2018; 28:397-406. [PMID: 30202193 DOI: 10.18865/ed.28.s2.397] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective To understand potential for multi-sector partnerships among community-based organizations and publicly funded health systems to implement health improvement strategies that advance health equity. Design Key stakeholder interviewing during HNI planning and early implementation to elicit perceptions of multi-sector partnerships and innovations required for partnerships to achieve system transformation and health equity. Setting In 2014, the Los Angeles County (LAC) Board of Supervisors approved the Health Neighborhood Initiative (HNI) that aims to: 1) improve coordination of health services for behavioral health clients across safety-net providers within neighborhoods; and 2) address social determinants of health through community-driven, public agency sponsored partnerships with community-based organizations. Participants Twenty-five semi-structured interviews with 49 leaders from LAC health systems, community-based organizations; and payers. Results Leaders perceived partnerships within and beyond health systems as transformative in their potential to: improve access, value, and efficiency; align priorities of safety-net systems and communities; and harness the power of communities to impact health. Leaders identified trust as critical to success in partnerships but named lack of time for relationship-building, limitations in service capacity, and questions about sustainability as barriers to trust-building. Leaders described the need for procedural innovations within health systems that would support equitable partnerships including innovations that would increase transparency and normalize information exchange, share agenda-setting and decision-making power with partners, and institutionalize partnering through training and accountability. Conclusions Leaders described improving procedural justice in public agencies' relationships with communities as key to effective partnering for health equity.
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Affiliation(s)
- Elizabeth Bromley
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; Desert Pacific MIRECC Health Services Unit, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Chantal Figueroa
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA
| | - Enrico G Castillo
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles County Department of Mental Health, Los Angeles, CA
| | - Farbod Kadkhoda
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA
| | - Bowen Chung
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; RAND Corporation; Los Angeles Biomedical Research Institute; Healthy African American Families II, Los Angeles, CA
| | - Jeanne Miranda
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA
| | - Kumar Menon
- Los Angeles County Department of Mental Health, Los Angeles, CA
| | | | - Felica Jones
- Healthy African American Families II, Los Angeles, CA
| | - Kenneth B Wells
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; RAND Corporation; University of California, Los Angeles School of Public Health, Los Angeles, CA
| | - Sheryl H Kataoka
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; UCLA Division of Child and Adolescent Psychiatry, Los Angeles, CA
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Arevian AC, Springgate B, Jones F, Starks SL, Chung B, Wennerstrom A, Jones L, Kataoka SH, Griffith K, Sugarman OK, Williams P, Haywood C, Kirkland A, Meyers D, Pasternak R, Simmasalam R, Tang L, Castillo EG, Mahajan A, Stevens M, Wells KB. The Community and Patient Partnered Research Network (CPPRN): Application of Patient-Centered Outcomes Research to Promote Behavioral Health Equity. Ethn Dis 2018; 28:295-302. [PMID: 30202181 DOI: 10.18865/ed.28.s2.295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective We describe the rationale, development, and progress on the Community and Patient Partnered Research Network (CPPRN). The CPPRN builds on more than a decade of partnered work and is designed to promote health equity by developing partnered research on behavioral health and social risk factors in Los Angeles and New Orleans. Setting A community-academic partnership across Los Angeles County and New Orleans. Methods Review of rationale, history, structure, activities and progress in applying community partnered participatory research (CPPR) to CPPRN. Findings Patient and community stakeholders participated in all phases of development, including local and national activities. Key developments include partnered planning efforts, progress on aggregating a large, de-identified dataset across county agencies, and development of an information technology-supported screening approach for behavioral and social determinants in health care, social, and community-based settings. Conclusion The CPPRN represents a promising approach for research data networks, balancing the potential benefit of information technology and data analytic approaches while addressing potential risks and priorities of relevant stakeholders.
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Affiliation(s)
- Armen C Arevian
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | | | - Felica Jones
- Healthy African American Families II, Los Angeles, CA
| | - Sarah L Starks
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Bowen Chung
- Los Angeles County Department of Mental Health Services; Harbor-UCLA Medical Center; UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | | | - Loretta Jones
- Healthy African American Families II; Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Sheryl H Kataoka
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Krystal Griffith
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Olivia K Sugarman
- LSU Health Sciences Center New Orleans School of Medicine, New Orleans, LA
| | - Pluscedia Williams
- Healthy African American Families II; Charles R Drew University of Medicine and Science, Los Angeles, CA
| | | | | | | | - Ryan Pasternak
- LSU Health Sciences Center New Orleans School of Medicine, New Orleans, LA
| | - Rubinee Simmasalam
- LSU Health Sciences Center New Orleans School of Medicine, New Orleans, LA
| | - Lingqi Tang
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Enrico G Castillo
- UCLA David Geffen School of Medicine; Los Angeles County Department of Mental Health, Los Angeles, CA
| | | | - Max Stevens
- Los Angeles County Chief Executive Office, Los Angeles, CA
| | - Kenneth B Wells
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
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Kataoka SH, Ijadi-Maghsoodi R, Figueroa C, Castillo EG, Bromley E, Patel H, Wells KB. Stakeholder Perspectives on the Social Determinants of Mental Health in Community Coalitions. Ethn Dis 2018; 28:389-396. [PMID: 30202192 PMCID: PMC6128346 DOI: 10.18865/ed.28.s2.389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Although evidence supports the potential for community coalitions to positively address social determinants of mental health, little is known about the views of stakeholders involved in such efforts. This study sought to understand county leaders' perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Design Descriptive, qualitative study, 2014. Setting Community coalitions, located in a large urban city, across eight service planning areas, that serve under-resourced, ethnic minority populations. Procedures We conducted key informant interviews with 49 health care and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders' views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results County leaders described multiple social determinants of mental health that were relevant to the HNI community coalitions: housing and safety, community violence, and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve mental health. Conclusions Community coalitions have an opportunity to address multiple social determinants of health to meet social and mental health needs of low-resourced communities. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.
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Affiliation(s)
- Sheryl H. Kataoka
- Center for Health Services and Society, Department of Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Roya Ijadi-Maghsoodi
- Division of Population Behavioral Health, Department of Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, VA Greater Los Angeles Health care System, Los Angeles, CA
| | - Chantal Figueroa
- Center for Health Services and Society, Department of Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Enrico G. Castillo
- David Geffen School of Medicine, University of California, Los Angeles; Los Angeles County Department of Mental Health, Los Angeles, CA
| | - Elizabeth Bromley
- Center for Health Services and Society, Department of Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Heather Patel
- Center for Health Services and Society, Department of Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Kenneth B. Wells
- Center for Health Services and Society, Department of Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
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Kataoka SH, Vona P, Acuna A, Jaycox L, Escudero P, Rojas C, Ramirez E, Langley A, Stein BD. Applying a Trauma Informed School Systems Approach: Examples from School Community-Academic Partnerships. Ethn Dis 2018; 28:417-426. [PMID: 30202195 DOI: 10.18865/ed.28.s2.417] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives Schools can play an important role in addressing the effects of traumatic stress on students by providing prevention, early intervention, and intensive treatment for children exposed to trauma. This article aims to describe key domains for implementing trauma-informed practices in schools. Design The Substance Abuse and Mental Health Administration (SAMHSA) has identified trauma-informed domains and principles for use across systems of care. This article applies these domains to schools and presents a model for a Trauma-Informed School System that highlights broad macro level factors, school-wide components, and tiered supports. Community partners from one school district apply this framework through case vignettes. Results Case 1 describes the macro level components of this framework and the leveraging of school policies and financing to sustain trauma-informed practices in a public health model. Case 2 illustrates a school founded on trauma-informed principles and practices, and its promotion of a safe school environment through restorative practices. Case 3 discusses the role of school leadership in engaging and empowering families, communities, and school staff to address neighborhood and school violence. Conclusions This article concludes with recommendations for dissemination of trauma-informed practices across schools at all stages of readiness. We identify three main areas for facilitating the use of this framework: 1) assessment of school staff knowledge and awareness of trauma; 2) assessment of school and/or district's current implementation of trauma-informed principles and practices; 3) development and use of technology-assisted tools for broad dissemination of practices, data and evaluation, and workforce training of clinical and non-clinical staff.
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Affiliation(s)
- Sheryl H Kataoka
- UCLA Semel Institute; Child and Adolescent Psychiatry; Center for Health Services and Society; Los Angeles, CA
| | - Pamela Vona
- University of Southern California; Suzanne Dworak-Peck School of Social Work; Los Angeles, CA
| | - Alejandra Acuna
- Department of Social Work, California State University Northridge; Northridge, CA
| | | | - Pia Escudero
- School Mental Health and Crisis Counseling & Intervention Services; Los Angeles Unified School District; Los Angeles, CA
| | - Claudia Rojas
- Augustus Hawkins/Community Health Advocates School; Los Angeles, CA
| | - Erica Ramirez
- Augustus Hawkins/Community Health Advocates School; Los Angeles, CA
| | - Audra Langley
- UCLA Semel Institute; Child and Adolescent Psychiatry; Center for Health Services and Society; Los Angeles, CA
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Ashwood JS, Kataoka SH, Eberhart NK, Bromley E, Zima BT, Baseman L, Marti FA, Kofner A, Tang L, Azhar GS, Chamberlin M, Erickson B, Choi K, Zhang L, Miranda J, Burnam MA. Evaluation of the Mental Health Services Act in Los Angeles County: Implementation and Outcomes for Key Programs. Rand Health Q 2018; 8:2. [PMID: 30083423 PMCID: PMC6075804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Los Angeles County used Mental Health Services Act (MHSA) funds to greatly expand access to Full-Service Partnership (FSP) services and offer new prevention and early intervention (PEI) services. This study examines the reach of key MHSA-funded activities and what the impact of those activities has been, with a focus on PEI programs for children and transition-age youth (TAY) and FSP programs for children, TAY, and adults. The evaluation found evidence that the Los Angeles County Department of Mental Health (LAC DMH) is reaching the highly vulnerable population it seeks to reach with its FSP and youth PEI programs. Furthermore, those reached by the programs experience improvements in their mental health and life circumstances. Refining data collection will enable more-thorough evaluation of processes of care and would inform the program's quality-improvement efforts.
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Lai K, Guo S, Ijadi-Maghsoodi R, Puffer M, Kataoka SH. Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers. Psychiatr Serv 2016; 67:1328-1333. [PMID: 27417895 PMCID: PMC5831516 DOI: 10.1176/appi.ps.201500401] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. METHODS The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. RESULTS Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. CONCLUSIONS Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.
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Affiliation(s)
- Karen Lai
- Dr. Lai, Dr. Ijadi-Maghsoodi, and Dr. Kataoka are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute, and Ms. Guo is with the School of Psychology, all at the University of California, Los Angeles (UCLA). Dr. Ijadi-Maghsoodi is also with the Health Services Research and Development Center, Department of Veterans Affairs (VA), Los Angeles. Ms. Puffer is with L.A. Trust for Children's Health, Los Angeles. Send correspondence to Dr. Kataoka (e-mail: )
| | - Sisi Guo
- Dr. Lai, Dr. Ijadi-Maghsoodi, and Dr. Kataoka are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute, and Ms. Guo is with the School of Psychology, all at the University of California, Los Angeles (UCLA). Dr. Ijadi-Maghsoodi is also with the Health Services Research and Development Center, Department of Veterans Affairs (VA), Los Angeles. Ms. Puffer is with L.A. Trust for Children's Health, Los Angeles. Send correspondence to Dr. Kataoka (e-mail: )
| | - Roya Ijadi-Maghsoodi
- Dr. Lai, Dr. Ijadi-Maghsoodi, and Dr. Kataoka are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute, and Ms. Guo is with the School of Psychology, all at the University of California, Los Angeles (UCLA). Dr. Ijadi-Maghsoodi is also with the Health Services Research and Development Center, Department of Veterans Affairs (VA), Los Angeles. Ms. Puffer is with L.A. Trust for Children's Health, Los Angeles. Send correspondence to Dr. Kataoka (e-mail: )
| | - Maryjane Puffer
- Dr. Lai, Dr. Ijadi-Maghsoodi, and Dr. Kataoka are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute, and Ms. Guo is with the School of Psychology, all at the University of California, Los Angeles (UCLA). Dr. Ijadi-Maghsoodi is also with the Health Services Research and Development Center, Department of Veterans Affairs (VA), Los Angeles. Ms. Puffer is with L.A. Trust for Children's Health, Los Angeles. Send correspondence to Dr. Kataoka (e-mail: )
| | - Sheryl H Kataoka
- Dr. Lai, Dr. Ijadi-Maghsoodi, and Dr. Kataoka are with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute, and Ms. Guo is with the School of Psychology, all at the University of California, Los Angeles (UCLA). Dr. Ijadi-Maghsoodi is also with the Health Services Research and Development Center, Department of Veterans Affairs (VA), Los Angeles. Ms. Puffer is with L.A. Trust for Children's Health, Los Angeles. Send correspondence to Dr. Kataoka (e-mail: )
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Affiliation(s)
- Sheryl H Kataoka
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles
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15
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Nadeem E, Santiago CD, Kataoka SH, Chang VY, Stein BD. School Personnel Experiences in Notifying Parents About Their Child's Risk for Suicide: Lessons Learned. J Sch Health 2016; 86:3-10. [PMID: 26645415 PMCID: PMC4747656 DOI: 10.1111/josh.12346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/05/2015] [Accepted: 05/04/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Schools across the nation are increasingly implementing suicide prevention programs that involve training school staff and connecting students and their families to appropriate services. However, little is known about how parents are engaged in such efforts. METHODS This qualitative study examined school staff perspectives on parent involvement in the implementation of a district-wide suicide prevention program by analyzing focus group and interview data gathered on the program implementation processes. Participants included middle school teachers, administrators, and other school personnel. RESULTS Study results revealed that in the immediate wake of a crisis or concern about suicide, school staff routinely contacted parents. However, substantial barriers prevent some students from receiving needed follow-up care (eg, lack of consistent follow-up, financial strain, parental stress, availability of appropriate services). Despite these challenges, school staff identified strategies that could better support parents before, during, and after the crisis. In particular, school-based services increased the success of mental health referrals. CONCLUSIONS Our study suggests that systematic postcrisis follow-up procedures are needed to improve the likelihood that students and families receive ongoing support. In particular, school-based services and home visits, training and outreach for parents, and formal training for school mental health staff on parent engagement may be beneficial in this context.
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Affiliation(s)
- Erum Nadeem
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461.
- Department of Child & Adolescent Psychiatry, New York University School of Medicine, One Park Ave, 7th Floor, NYU Child Study Center, New York, NY 10016.
| | | | - Sheryl H Kataoka
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, 10920 Wilshire Boulevard, Los Angeles, CA 90024.
| | | | - Bradley D Stein
- RAND Corporation, Adjunct Associate Professor of Psychiatry, University of Pittsburgh School of Medicine, 4570 Fifth Ave., Pittsburgh, PA 15213.
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Santiago CD, Fuller AK, Lennon JM, Kataoka SH. Parent perspectives from participating in a family component for CBITS: Acceptability of a culturally informed school-based program. Psychol Trauma 2015; 8:325-33. [PMID: 26390104 DOI: 10.1037/tra0000076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study explored parents' responses to a family component developed as an addition to the Cognitive Behavioral Intervention for Trauma in Schools (CBITS). The family component was developed to improve engagement and participation in CBITS and to support parents' own skill-building. To evaluate the acceptability and feasibility of the family component from the perspective of parents who participated, qualitative interviews were conducted with 15 low-income, Latino parents (80% female; 80% immigrants; average age = 38.07). Themes emerged across 3 primary categories: Need for CBITS + Family, Results of Participating in CBITS + Family, and Implications for Feasibility. Parents agreed that there was a need for programs like CBITS and expressed a firm belief in the importance of parental involvement with their children and schools. Parents reported a high level of satisfaction with the family component and indicated that it was beneficial to them, culturally relevant, and that they would recommend it to others. Still, some logistical barriers to participation and areas for improvement were noted. Overall, the results of this study indicate that CBITS + Family is an appropriate, acceptable, and feasible intervention for Latino families. Supplemental data from children whose parents participated in the program provide further support for the value of the family component. Clinical implications for implementing culturally sensitive, school-based interventions with parents are discussed. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Sheryl H Kataoka
- Department of Psychiatry and Biobehavioral Sciences, Division of Child and Adolescent Psychiatry, Center for Health Services and Society, University of California, Los Angeles
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Abstract
Teachers can be vulnerable to secondary traumatic stress (STS) because of their supportive role with students and potential exposure to students' experiences with traumas, violence, disasters, or crises. STS symptoms, similar to those found in posttraumatic stress disorder, include nightmares, avoidance, agitation, and withdrawal, and can result from secondary exposure to hearing about students' traumas. This article describes how STS presents, how teachers can be at risk, and how STS can manifest in schools. A US Department of Education training program is presented, and thoughts on future directions are discussed.
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Affiliation(s)
- Stephen Hydon
- Field Education, University of Southern California School of Social Work, SWC Building, Room 223, Los Angeles, CA 90089, USA.
| | - Marleen Wong
- Field Education, University of Southern California School of Social Work, Los Angeles, CA 90089, USA
| | - Audra K Langley
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Westwood Plaza, Los Angeles, CA 90024, USA
| | | | - Sheryl H Kataoka
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Westwood Plaza, Los Angeles, CA 90024, USA
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Vona P, Wilmoth P, Jaycox LH, McMillen JS, Kataoka SH, Wong M, DeRosier ME, Langley AK, Kaufman J, Tang L, Stein BD. A web-based platform to support an evidence-based mental health intervention: lessons from the CBITS web site. Psychiatr Serv 2014; 65:1381-4. [PMID: 25124275 PMCID: PMC5361218 DOI: 10.1176/appi.ps.201300512] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the role of Web-based platforms in behavioral health, the study examined usage of a Web site for supporting training and implementation of an evidence-based intervention. METHODS Using data from an online registration survey and Google Analytics, the investigators examined user characteristics and Web site utilization. RESULTS Site engagement was substantial across user groups. Visit duration differed by registrants' characteristics. Less experienced clinicians spent more time on the Web site. The training section accounted for most page views across user groups. Individuals previously trained in the Cognitive-Behavioral Intervention for Trauma in Schools intervention viewed more implementation assistance and online community pages than did other user groups. CONCLUSIONS Web-based platforms have the potential to support training and implementation of evidence-based interventions for clinicians of varying levels of experience and may facilitate more rapid dissemination. Web-based platforms may be promising for trauma-related interventions, because training and implementation support should be readily available after a traumatic event.
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Affiliation(s)
- Pamela Vona
- Ms. Vona and Dr. Wong are with the School of Social Work, University of Southern California, Los Angeles (e-mail: ). Mr. Wilmoth and Dr. Stein are with the RAND Corporation, Pittsburgh, Pennsylvania. Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh. Dr. Jaycox is with the RAND Corporation, Arlington, Virginia. Dr. McMillen and Dr. DeRosier are with the 3C Institute for Social Development, Cary, North Carolina. Dr. Kataoka, Dr. Langley, and Dr. Tang are with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Mr. Kaufman is with the Los Angeles Unified School District, Los Angeles
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Wong MD, Coller KM, Dudovitz RN, Kennedy DP, Buddin R, Shapiro MF, Kataoka SH, Brown AF, Tseng CH, Bergman P, Chung PJ. Successful schools and risky behaviors among low-income adolescents. Pediatrics 2014; 134:e389-96. [PMID: 25049339 PMCID: PMC4187228 DOI: 10.1542/peds.2013-3573] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. METHODS By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug use, unprotected sex) and very risky health behaviors (e.g., binge drinking, substance use at school, risky sex, gang participation). We surveyed 521 ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered admission (control group) about their health behaviors and obtained their state-standardized test scores. RESULTS The intervention and control groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention effect) led to improved math (P < .001) and English (P = .04) standard test scores, greater school retention (91% vs. 76%; P < .001), and lower rates of engaging in ≥1 very risky behaviors (odds ratio = 0.73, P < .05) but no difference in risky behaviors, such as any recent use of alcohol, tobacco, or drugs. School retention and test scores explained 58.0% and 16.2% of the intervention effect on engagement in very risky behaviors, respectively. CONCLUSIONS Increasing performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors among low-income adolescents and to decrease health disparities across the life span.
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Affiliation(s)
- Mitchell D. Wong
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Karen M. Coller
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Rebecca N. Dudovitz
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | | | | | - Martin F. Shapiro
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Sheryl H. Kataoka
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Arleen F. Brown
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Chi-Hong Tseng
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Peter Bergman
- Teachers College, Columbia University, New York, New York
| | - Paul J. Chung
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California
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Santiago CD, Lennon JM, Fuller AK, Brewer SK, Kataoka SH. Examining the impact of a family treatment component for CBITS: when and for whom is it helpful? J Fam Psychol 2014; 28:560-570. [PMID: 25000134 DOI: 10.1037/a0037329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study compared the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), as it is typically delivered, to CBITS-plus-family treatment component (CBITS + Family), developed through a community partnership. This study used a quasi-experimental design, capitalizing on ongoing CBITS implementation within a school system. In total, 32 parent/student dyads were recruited in CBITS groups and 32 parent/student dyads were recruited in CBITS + Family groups. Parents and students in both conditions completed pre- and posttreatment measures, in addition to a 6-month posttreatment follow-up assessing symptoms. Families were low-income and predominately Latino. Children were 59% female with an average age of 11.70. Participating parents were 84% female with an average age of 38.18. The majority of parents (80%) were immigrants and 70% reported not finishing high school. Parents who received CBITS + Family showed significant improvements in attitudes toward mental health, school involvement, and primary control coping, while demonstrating significant reductions in involuntary engagement and inconsistent discipline. CBITS + Family appears to be most beneficial for children with high symptom severity in terms of reducing posttraumatic stress disorder symptoms and disengagement coping. Finally, greater improvements in parent variables predicted larger symptom reductions among children within the CBITS + Family group. This study suggests that CBITS + Family is beneficial for parents of children exposed to trauma and may be especially helpful for children with high initial symptom severity. Children in CBITS + Family appear to benefit most when their parents show larger improvements in school involvement and greater reductions in parental inconsistency and involuntary engagement.
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Affiliation(s)
| | | | | | | | - Sheryl H Kataoka
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Santiago CD, Pears G, Baweja S, Vona P, Tang J, Kataoka SH. Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS. School Ment Health 2013; 5. [PMID: 24273613 DOI: 10.1007/s12310-012-9100-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed.
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Kataoka SH, Podell JL, Zima BT, Best K, Sidhu S, Jura MB. MAP as a model for practice-based learning and improvement in child psychiatry training. J Clin Child Adolesc Psychol 2013; 43:312-22. [PMID: 24245855 DOI: 10.1080/15374416.2013.848773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Not only is there a growing literature demonstrating the positive outcomes that result from implementing evidence based treatments (EBTs) but also studies that suggest a lack of delivery of these EBTs in "usual care" practices. One way to address this deficit is to improve the quality of psychotherapy teaching for clinicians-in-training. The Accreditation Council for Graduate Medical Education (ACGME) requires all training programs to assess residents in a number of competencies including Practice-Based Learning and Improvements (PBLI). This article describes the piloting of Managing and Adapting Practice (MAP) for child psychiatry fellows, to teach them both EBT and PBLI skills. Eight child psychiatry trainees received 5 full days of MAP training and are delivering MAP in a year-long outpatient teaching clinic. In this setting, MAP is applied to the complex, multiply diagnosed psychiatric patients that present to this clinic. This article describes how MAP tools and resources assist in teaching trainees each of the eight required competency components of PBLI, including identifying deficits in expertise, setting learning goals, performing learning activities, conducting quality improvement methods in practice, incorporating formative feedback, using scientific studies to inform practice, using technology for learning, and participating in patient education. A case example illustrates the use of MAP in teaching PBLI. MAP provides a unique way to teach important quality improvement and practice-based learning skills to trainees while training them in important psychotherapy competence.
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Guo S, Kataoka SH, Bear L, Lau AS. Differences in School-Based Referrals for Mental Health Care: Understanding Racial/Ethnic Disparities Between Asian American and Latino Youth. School Mental Health 2013. [DOI: 10.1007/s12310-013-9108-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gudiño OG, Nadeem E, Kataoka SH, Lau AS. Reinforcement sensitivity and risk for psychopathology following exposure to violence: a vulnerability-specificity model in Latino youth. Child Psychiatry Hum Dev 2012; 43:306-21. [PMID: 22080366 PMCID: PMC3637687 DOI: 10.1007/s10578-011-0266-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Urban Latino youth are exposed to high rates of violence, which increases risk for diverse forms of psychopathology. The current study aims to increase specificity in predicting responses by testing the hypothesis that youths' reinforcement sensitivity-behavioral inhibition (BIS) and behavioral approach (BAS)-is associated with specific clinical outcomes and increases risk for the development of such problems following exposure to violence. Utilizing a short-term longitudinal design, Latino youth (N = 168) provided reports of BIS/BAS and emotional/behavioral problems at Time 1, exposure to violence between Time 1 and Time 2, and clinical symptoms at Time 2. Results suggested that reinforcement sensitivity moderated the relation between violence exposure and psychopathology, such that increasing levels of BIS were associated with elevated risk for internalizing and posttraumatic stress symptoms following exposure to violence whereas BAS increased risk for externalizing problems. The importance of building on existing knowledge to understand minority youth psychopathology is discussed.
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Affiliation(s)
- Omar G Gudiño
- Department of Psychology, University of California, Los Angeles, CA, USA.
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Nadeem E, Jaycox LH, Kataoka SH, Langley AK, Stein BD. Going to Scale: Experiences Implementing a School-Based Trauma Intervention. School Psych Rev 2011; 40:549-568. [PMID: 27346911 PMCID: PMC4917015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article describes implementation experiences "scaling up" the Cognitive Behavioral Intervention for Trauma in Schools (CBITS)-an intervention developed using a community partnered research framework. Case studies from two sites that have successfully implemented CBITS are used to examine macro- and school-level implementation processes and strategies used to address implementation issues and create a successful implementation support system. Key elements of the implementation support system include pre-implementation work, ongoing clinical and logistical implementation supports, promotion of fidelity to the intervention's core components, tailored implementation to fit the service context, and a value on monitoring child outcomes.
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Affiliation(s)
- Erum Nadeem
- Columbia University & New York State Psychiatric Institute
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Nadeem E, Kataoka SH, Chang VY, Vona P, Wong M, Stein BD. The Role of Teachers in School-Based Suicide Prevention: A Qualitative Study of School Staff Perspectives. School Ment Health 2011; 3:209-221. [PMID: 27042239 DOI: 10.1007/s12310-011-9056-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In response to concerns over youth suicide, there has been an increase in school-based suicide prevention programs. However, we know little about teacher perspectives on school-based suicide prevention and mental health programs. This study examined teacher roles in the implementation of a district-wide suicide prevention program through focus groups and interviews with middle school teachers, administrators, and other school personnel. Study results highlighted teachers' critical role in detecting students at risk for suicide. Factors that appeared to facilitate teacher participation in the suicide prevention program included well-defined crisis policies and procedures, communication of these procedures, collaboration across staff, and the presence of on-campus mental health resources. Participants identified a need for direct teacher training on risk factors for suicide, crisis response, and classroom management. Other strategies for improving suicide prevention efforts included in-school trainings on mental health resources and procedures, regular updates to these trainings, and greater visibility of mental health staff.
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Affiliation(s)
- Erum Nadeem
- Division of Mental Health Services and Policy Research, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Sheryl H Kataoka
- Division of Child and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA, UCLA Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Vickie Y Chang
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Pamela Vona
- UCLA Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marleen Wong
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Bradley D Stein
- RAND Corporation, Pittsburgh, PA, USA, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Gudiño OG, Nadeem E, Kataoka SH, Lau AS. Relative Impact of Violence Exposure and Immigrant Stressors on Latino Youth Psychopathology. J Community Psychol 2011; 39:316-335. [PMID: 24465062 PMCID: PMC3899355 DOI: 10.1002/jcop.20435] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Latino youth in a low-income urban community are at high risk of exposure to violence. Given an accumulation of factors before, during, and following migration, immigrant youth may be at increased risk of exposure to violence and other relevant stressors (e.g., acculturation stress, language proficiency, acculturation/enculturation, and parental separations). Utilizing a short-term longitudinal design, we assessed exposure to violence and immigrant stressors and examined their relative impact on psychopathology in a sample of 164 Latino youth. Immigrant youth reported greater exposure to immigrant stressors relative to native-born peers, but few differences in rates of exposure to violence emerged. When considered alongside relevant immigration stressors, exposure to violence emerged as the strongest predictor of youth psychopathology. Results suggest that some types of stressors have more consistently deleterious effects on mental health and understanding resilient outcomes may entail considering the meaning attributed to stressors and the resources available to cope with stressors.
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Affiliation(s)
| | - Erum Nadeem
- Columbia University and New York State Psychiatric Institute
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Nelson BB, Chung PJ, DuPlessis HM, Flores L, Ryan GW, Kataoka SH. Strengthening families of children with developmental concerns: parent perceptions of developmental screening and services in Head Start. Ethn Dis 2011; 21:S1-93. [PMID: 22352085 PMCID: PMC3715307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE The authors investigated perceptions of parents with children in the Head Start program about the processes of detection and intervention for developmental concerns. DESIGN Descriptive, qualitative study. SETTING A large, urban Head Start agency, operating 14 centers and annually serving more than 1200 predominantly Latino children. During 2008-2009, a collaborative partnership with academicians from UCLA was created to evaluate their model of developmental screening and referrals. PARTICIPANTS AND PROCEDURES: We conducted 5 focus groups with a total of 30 parents of Head Start children with developmental concerns. Parents were asked about where they go for information when they have concerns, how they perceived the developmental screening process and services, and how children and families have changed after being in the Head Start program. Focus groups were recorded, transcribed and translated into English, then coded in ATLAS.ti using the domains above and sorted into themes for analysis. RESULTS Parents perceived the screening process as both diagnostically and therapeutically important, with multiple benefits ranging from closer parent-teacher relationships to improved parenting and understanding of developmental interventions. Families focused their discussion on the importance of social-emotional and behavioral development, with school readiness and improved expressive language as important but secondary outcomes. CONCLUSIONS For families of children with developmental and behavioral risks or concerns, a structured developmental screening process in a preschool setting, such as that provided by Head Start, may serve as a vital gateway for identifying and addressing concerns and promoting social-emotional learning, parent engagement, language development and school readiness.
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Affiliation(s)
- Bergen B Nelson
- Robert Wood Johnson Foundation Clinical Scholars Program, University of California, Los Angeles, USA.
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Stein BD, Kataoka SH, Hamilton AB, Schultz D, Ryan G, Vona P, Wong M. School personnel perspectives on their school's implementation of a school-based suicide prevention program. J Behav Health Serv Res 2010; 37:338-49. [PMID: 19291410 PMCID: PMC3711023 DOI: 10.1007/s11414-009-9174-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Accepted: 02/07/2009] [Indexed: 10/21/2022]
Abstract
Youth suicide is a national public health priority, with policymakers highlighting schools as an ideal setting in which to deliver suicide prevention programs. Over the past decade, the number of schools implementing such programs has grown substantially, yet little is known about how successfully such programs are being implemented. This study examines the implementation of a district-wide suicide prevention program through key informant interviews with school personnel. Schools with higher rates of implementing district protocols for at-risk students had an organized system to respond to at-risk students, a process for effectively responding to students who were at-risk for suicide, and strong administrative support. In contrast, schools that had lower rates of implementing district protocols relied on a handful of individuals for suicide prevention activities and had limited administrative support. Attention to organizational factors leading to successful implementation of school-based suicide prevention programs may enhance the role of schools in national adolescent suicide prevention efforts.
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Affiliation(s)
- Bradley D. Stein
- University of Pittsburgh 4570 Fifth Avenue, Suite 600 Pittsburgh, PA 15213 Phone: (412) 683-2300 x4476 Fax: (412) 682-2800
| | - Sheryl H. Kataoka
- Division of Child and Adolescent Psychiatry UCLA Semel Institute 10920 Wilshire Boulevard, Suite 300 Los Angeles, CA 90024 Phone: (310) 794-3727 Fax: (310) 794-3724
| | - Alison B. Hamilton
- UCLA 1640 S. Sepulveda Blvd., Suite 200 Los Angeles, CA 90025 Phone: 310-267-5421 Fax: 310-473-7885
| | - Dana Schultz
- RAND Corporation 4570 Fifth Avenue, Suite 600 Pittsburgh, PA 15213 Phone: (412) 683-2300 x4613 Fax: (412) 683-2800
| | - Gery Ryan
- RAND Corporation 1776 Main Street Santa Monica, CA 90407 Phone: (412) 683-2300 x4613
| | - Pamela Vona
- UCLA Health Services Research Center 10920 Wilshire Blvd. Suite 300 Los Angeles, CA 90024 (310) 825-0495
| | - Marleen Wong
- Crisis Counseling and Intervention Services Los Angeles Unified School District 333 South Beaudry, 20 Floor Los Angeles, CA 90017 Phone: (213) 241-2174 Fax: (213) 241-6816
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Langley AK, Nadeem E, Kataoka SH, Stein BD, Jaycox LH. Evidence-Based Mental Health Programs in Schools: Barriers and Facilitators of Successful Implementation. School Ment Health 2010; 2:105-113. [PMID: 20694034 PMCID: PMC2906726 DOI: 10.1007/s12310-010-9038-1] [Citation(s) in RCA: 189] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although schools can improve children’s access to mental health services, not all school-based providers are able to successfully deliver evidence-based practices. Indeed, even when school clinicians are trained in evidence-based practices (EBP), the training does not necessarily result in the implementation of those practices. This study explores factors that influence implementation of a particular EBP, Cognitive Behavioral Intervention for Trauma in Schools (CBITS). Semi-structured telephone interviews with 35 site administrators and clinicians from across the United States were conducted 6–18 months after receiving CBITS training to discuss implementation experiences. The implementation experiences of participants differed, but all reported similar barriers to implementation. Sites that successfully overcame such barriers differed from their unsuccessful counterparts by having greater organizational structure for delivering school services, a social network of other clinicians implementing CBITS, and administrative support for implementation. This study suggests that EBP implementation can be facilitated by having the necessary support from school leadership and peers.
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Affiliation(s)
- Audra K. Langley
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 300 UCLA Medical Plaza, Suite 1315, Los Angeles, CA 90095 USA
| | - Erum Nadeem
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 300 UCLA Medical Plaza, Suite 1315, Los Angeles, CA 90095 USA
- Division of Mental Health Services and Policy Research, New York State Psychiatric Institute, Columbia University, New York, NY USA
| | - Sheryl H. Kataoka
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 300 UCLA Medical Plaza, Suite 1315, Los Angeles, CA 90095 USA
| | - Bradley D. Stein
- University of Pittsburgh School of Medicine, Pittsburgh, PA USA
- RAND Corporation, Santa Monica, CA USA
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Kataoka SH, Nadeem E, Wong M, Langley AK, Jaycox LH, Stein BD, Young P. Improving disaster mental health care in schools: a community-partnered approach. Am J Prev Med 2009; 37:S225-9. [PMID: 19896023 PMCID: PMC2822649 DOI: 10.1016/j.amepre.2009.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 07/24/2009] [Accepted: 08/05/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although schools are often the first institutions to provide recovery efforts for children post-disaster, few studies have involved the school community in research to improve the delivery of these mental health services on campuses. This community-partnered study explores post-disaster counseling services 10 months following Hurricane Katrina. METHODS In July 2006, nine focus groups, consisting of 39 school-based mental health counselors and six program administrators (10 men, 35 women), were conducted following a 2-day clinical training regarding a youth trauma intervention following Hurricane Katrina. Participants discussed the types of services they had been providing prior to the training and potential barriers to delivering services. RESULTS Participants identified high mental health needs of students and described populations that did not seem to be adequately supported by current funding sources, including those with pre-existing traumatic experiences and mental health issues, indirect psychological and social consequences of the storms, and those students relocated to communities that were not as affected. Participants also described the need for a centralized information system. CONCLUSIONS Participants described the need for greater organizational structure that supports school counselors and provides system-level support for services. Implications for next steps of this community-partnered approach are described.
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Affiliation(s)
- Sheryl H Kataoka
- Division of Child and Adolescent Psychiatry, UCLA Health Services Research Center, University of California-Los Angeles, 10920 Wilshire Boulevard, Los Angeles CA 90024-6523, USA.
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Shetgiri R, Kataoka SH, Ryan GW, Askew LM, Chung PJ, Schuster MA. Risk and resilience in Latinos: a community-based participatory research study. Am J Prev Med 2009; 37:S217-24. [PMID: 19896022 DOI: 10.1016/j.amepre.2009.08.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 07/24/2009] [Accepted: 08/05/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Latino youth in low-income households have a higher likelihood of poor educational and health outcomes than their peers. Protective factors, such as parental support, improve chances of success for youth. A community-academic partnership used community-based participatory research principles to examine perceptions of resilience among Latino young people in low-income households. METHODS Semi-structured qualitative interviews were conducted in 2007 with Latino young people living in an urban low-income housing complex (n=20); their parents (n=10); and representatives from local community-based organizations (n=8) to explore their definitions of youth "success," and barriers to and facilitators of success. Interviews were audiotaped, transcribed, coded, and analyzed using content-analysis and grounded theory in 2007. RESULTS Participants identified self, family, and community factors as potential sources of support. Parents appeared to de-emphasize community resources, expressing that success resulted primarily from a child's individual desire, bolstered by family support. All stakeholder groups perceived peers more as potential barriers to achieving success than as potential sources of support. CONCLUSIONS These findings raise the possibility that in this community, low-income Latino parents' beliefs about community resources may act as a barrier to seeking assistance outside the family. Results also suggest that Latino youth recognize the benefits of interacting with adults outside the family and are accepting of help from the community. Resilience promotion programs in this population may benefit from engaging parents and community members in addition to young people. Parent-focused programs could explore parental beliefs about youth success, and youth programs could engage adult community members to generate positive interactions and messages.
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Affiliation(s)
- Rashmi Shetgiri
- Robert Wood Johnson Clinical Scholars Program, University of California-Los Angeles, CA, USA.
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Kataoka SH, Rowan B, Hoagwood KE. Bridging the divide: in search of common ground in mental health and education research and policy. Psychiatr Serv 2009. [PMID: 19880470 DOI: 10.1176/appi.ps.60.11.1510] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is growing evidence that mental health and school functioning for children are intertwined. This article summarizes historical perspectives on U.S. child mental health policies and their interface with education and discusses trends in educational policy relevant to children's mental health, specifically the Individuals With Disabilities Education Act and No Child Left Behind. The traditional approach of mental health research in schools, which focuses on program and intervention development, has become stagnant. New paradigms are needed. These include attending to indigenous school resources, to the organizational context of learning, and to participatory models for constructing environments conducive to mental health promotion and learning. Persistent underfunding and fragmented fiscal support, however, render new approaches meaningless. If progress is to be made, new funding structures to support integrative educational and mental health practices are needed.
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Affiliation(s)
- Sheryl H Kataoka
- Health Services Research Center, Division of Child and Adolescent Psychiatry, Semel Institute for Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA.
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Abstract
There is growing evidence that mental health and school functioning for children are intertwined. This article summarizes historical perspectives on U.S. child mental health policies and their interface with education and discusses trends in educational policy relevant to children's mental health, specifically the Individuals With Disabilities Education Act and No Child Left Behind. The traditional approach of mental health research in schools, which focuses on program and intervention development, has become stagnant. New paradigms are needed. These include attending to indigenous school resources, to the organizational context of learning, and to participatory models for constructing environments conducive to mental health promotion and learning. Persistent underfunding and fragmented fiscal support, however, render new approaches meaningless. If progress is to be made, new funding structures to support integrative educational and mental health practices are needed.
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Affiliation(s)
- Sheryl H Kataoka
- Health Services Research Center, Division of Child and Adolescent Psychiatry, Semel Institute for Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA.
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Dean KL, Langley AK, Kataoka SH, Jaycox LH, Wong M, Stein BD. School-based disaster mental health services: Clinical, policy, and community challenges. ACTA ACUST UNITED AC 2008. [DOI: 10.1037/0735-7028.39.1.52] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Stein BD, Jaycox LH, Langley A, Kataoka SH, Wilkins WS, Wong M. Active parental consent for a school-based community violence screening: comparing distribution methods. J Sch Health 2007; 77:116-20. [PMID: 17302853 DOI: 10.1111/j.1746-1561.2007.00180.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Students are unable to benefit from many school programs designed to address their mental health needs if their parents do not consent to their participation. As part of an ongoing effort in a large urban school district to meet the mental health needs of students traumatized by violence exposure, this paper examines the impact of alternative approaches on parental response and consent rates for an initial screening to participate in a school mental health program. METHODS Two alternative approaches were used to obtain consent for students to participate in a school-based intervention for students exposed to violence. For one cohort, consent forms were distributed along with school information and other school forms during a parent orientation meeting. In the other cohort, school mental health clinicians visited student homerooms to distribute consent forms and explain the program and evaluation to students. RESULTS There were significantly higher rates of return of consent forms (89.8% vs 53.2%) and parents consenting to participate (69.6% vs 27.9%) among parents receiving consent forms at a school meeting than among parents whose forms were distributed to children in a classroom, with comparable rates of active refusals to participate (20.1% vs 25.3%). CONCLUSIONS Overall return rates and rates of consent for screening participation were substantially higher when the consent form and accompanying materials were provided directly to parents rather than distributed in the classroom and sent home with students. These findings have implications for efforts to obtain active consent from parents for students to participate in school mental health programs.
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Affiliation(s)
- Bradley D Stein
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
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Kataoka SH, Fuentes S, O'Donoghue VP, Castillo-Campos P, Bonilla A, Halsey K, Avila JL, Wells KB. A community participatory research partnership: the development of a faith-based intervention for children exposed to violence. Ethn Dis 2006; 16:S89-97. [PMID: 16681132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
When an inner city Latino immigrant faith community in Los Angeles identified mental health care as an area of need, a community-research partnership was formed that resulted in the adaptation of an intervention for children who have trauma-related symptoms from violence exposure. This participatory research partnership includes St. Thomas the Apostle School and Church community; QueensCare Health and Faith Partnership, an organization that provides health services and outreach to faith communities; and mental health researchers from UCLA. During the planning phase of this project, parent focus groups were conducted, and an evidence-based intervention for traumatized students was adapted for this community. Focus group participants described significant concerns about community violence and multiple ways in which this ongoing violence has affected their children's functioning and child-parent relationships. The partnership has collaborated on each aspect of the research study, from design and adaptation, implementation, data analyses, and identification of areas for future research. This paper, a participatory process written in the words of the community and research partners, describes the experience of and challenges met by this partnership in adapting the Cognitive Behavioral Intervention for Trauma in Schools program for use in this Catholic school.
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Affiliation(s)
- Sheryl H Kataoka
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
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Affiliation(s)
- Kristin L Dean
- RAND, 1700 Main Street, Santa Monica, California 90407, USA.
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Affiliation(s)
- Sheryl H Kataoka
- Health Services Research Center, University of California Los Angeles, 10920 Wilshire Boulevard, Los Angeles, CA 90024, USA.
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Abstract
CONTEXT No randomized controlled studies have been conducted to date on the effectiveness of psychological interventions for children with symptoms of posttraumatic stress disorder (PTSD) that has resulted from personally witnessing or being personally exposed to violence. OBJECTIVE To evaluate the effectiveness of a collaboratively designed school-based intervention for reducing children's symptoms of PTSD and depression that has resulted from exposure to violence. DESIGN A randomized controlled trial conducted during the 2001-2002 academic year. SETTING AND PARTICIPANTS Sixth-grade students at 2 large middle schools in Los Angeles who reported exposure to violence and had clinical levels of symptoms of PTSD. INTERVENTION Students were randomly assigned to a 10-session standardized cognitive-behavioral therapy (the Cognitive-Behavioral Intervention for Trauma in Schools) early intervention group (n = 61) or to a wait-list delayed intervention comparison group (n = 65) conducted by trained school mental health clinicians. MAIN OUTCOME MEASURES Students were assessed before the intervention and 3 months after the intervention on measures assessing child-reported symptoms of PTSD (Child PTSD Symptom Scale; range, 0-51 points) and depression (Child Depression Inventory; range, 0-52 points), parent-reported psychosocial dysfunction (Pediatric Symptom Checklist; range, 0-70 points), and teacher-reported classroom problems using the Teacher-Child Rating Scale (acting out, shyness/anxiousness, and learning problems; range of subscales, 6-30 points). RESULTS Compared with the wait-list delayed intervention group (no intervention), after 3 months of intervention students who were randomly assigned to the early intervention group had significantly lower scores on symptoms of PTSD (8.9 vs 15.5, adjusted mean difference, - 7.0; 95% confidence interval [CI], - 10.8 to - 3.2), depression (9.4 vs 12.7, adjusted mean difference, - 3.4; 95% CI, - 6.5 to - 0.4), and psychosocial dysfunction (12.5 vs 16.5, adjusted mean difference, - 6.4; 95% CI, -10.4 to -2.3). Adjusted mean differences between the 2 groups at 3 months did not show significant differences for teacher-reported classroom problems in acting out (-1.0; 95% CI, -2.5 to 0.5), shyness/anxiousness (0.1; 95% CI, -1.5 to 1.7), and learning (-1.1, 95% CI, -2.9 to 0.8). At 6 months, after both groups had received the intervention, the differences between the 2 groups were not significantly different for symptoms of PTSD and depression; showed similar ratings for psychosocial function; and teachers did not report significant differences in classroom behaviors. CONCLUSION A standardized 10-session cognitive-behavioral group intervention can significantly decrease symptoms of PTSD and depression in students who are exposed to violence and can be effectively delivered on school campuses by trained school-based mental health clinicians.
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Kataoka SH, Stein BD, Jaycox LH, Wong M, Escudero P, Tu W, Zaragoza C, Fink A. A school-based mental health program for traumatized Latino immigrant children. J Am Acad Child Adolesc Psychiatry 2003; 42:311-8. [PMID: 12595784 DOI: 10.1097/00004583-200303000-00011] [Citation(s) in RCA: 288] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To pilot-test a school mental health program for Latino immigrant students who have been exposed to community violence. METHOD In this quasi-experimental study conducted from January through June 2000, 198 students in third through eighth grade with trauma-related depression and/or posttraumatic stress disorder symptoms were compared after receiving an intervention or being on a waitlist. The intervention consisted of a manual-based, eight-session, group cognitive-behavioral therapy (CBT) delivered in Spanish by bilingual, bicultural school social workers. Parents and teachers were eligible to receive psychoeducation and support services. RESULTS Students in the intervention group ( = 152) had significantly greater improvement in posttraumatic stress disorder and depressive symptoms compared with those on the waitlist ( = 47) at 3-month follow-up, adjusting for relevant covariates. CONCLUSIONS A collaborative research team of school clinicians, educators, and researchers developed this trauma-focused CBT program for Latino immigrant students and their families. This pilot test demonstrated that this program for traumatized youths, designed for delivery on school campuses by school clinicians, can be implemented and evaluated in the school setting and is associated with a modest decline in trauma-related mental health problems.
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Abstract
OBJECTIVE Policy discussions regarding the mental health needs of children and adolescents emphasize a lack of use of mental health services among youth, but few national estimates are available. The authors use three national data sets and examine ethnic disparities in unmet need (defined as having a need for mental health evaluation but not using any services in a 1-year period) to provide such estimates. METHOD The authors conducted secondary data analyses in three nationally representative household surveys fielded in 1996-1998: the National Health Interview Survey, the National Survey of American Families, and the Community Tracking Survey. They determined rates of mental health service use by children and adolescents 3-17 years of age and differences by ethnicity and insurance status. Among the children defined as in need of mental health services, defined by an estimator of mental health problems (selected items from the Child Behavior Checklist), they examined the association of unmet need with ethnicity and insurance status. RESULTS In a 12-month period, 2%-3% of children 3-5 years old and 6%-9% of children and adolescents 6-17 years old used mental health services. Of children and adolescents 6-17 years old who were defined as needing mental health services, nearly 80% did not receive mental health care. Controlling for other factors, the authors determined that the rate of unmet need was greater among Latino than white children and among uninsured than publicly insured children. CONCLUSIONS These findings reveal that most children who need a mental health evaluation do not receive services and that Latinos and the uninsured have especially high rates of unmet need relative to other children. Rates of use of mental health services are extremely low among preschool children. Research clarifying the reasons for high rates of unmet need in specific groups can help inform policy and clinical programs.
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Affiliation(s)
- Sheryl H Kataoka
- Department of Psychiatry and Behavioral Sciences, Research Center on Managed Care for Psychiatric Disorders, University of California, Los Angeles, USA.
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Jaycox LH, Stein BD, Kataoka SH, Wong M, Fink A, Escudero P, Zaragoza C. Violence exposure, posttraumatic stress disorder, and depressive symptoms among recent immigrant schoolchildren. J Am Acad Child Adolesc Psychiatry 2002; 41:1104-10. [PMID: 12218432 DOI: 10.1097/00004583-200209000-00011] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Many recent immigrant children are at risk for violence exposure and related psychological distress resulting from experiences before, during, and after immigration. This study examines the rates of violence exposure and associated symptoms among recent immigrant children in Los Angeles. METHOD 1,004 recent immigrant schoolchildren (aged 8-15 years) were surveyed about their prior exposure to violence and symptoms of posttraumatic stress disorder (PTSD) and depression. Participants included children whose native language was Spanish, Korean, Russian, or Western Armenian. RESULTS Participants reported high levels of violence exposure, both personal victimization and witnessing violence, in the previous year and in their lifetimes. Thirty-two percent of children reported PTSD symptoms in the clinical range, and 16% reported depressive symptoms in the clinical range. Although boys and older children were more likely to have experienced violence, girls reported more PTSD and depressive symptoms. Linear multiple regressions revealed that PTSD symptoms were predicted by both recent and lifetime violence exposure (p values < .001 and p < .05, respectively), when depressive symptoms and gender were controlled. On the other hand, depressive symptoms were predicted by recent victimization only (p < .001) when PTSD and gender were controlled. CONCLUSION These findings document the need for interventions addressing the psychological sequelae of violence exposure in immigrant children.
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Abstract
Affective disorders are common among children and adolescents but may often remain untreated. Primary care providers could help fill this gap because most children have primary care. Yet rates of detection and treatment for mental disorders generally are low in general health settings, owing to multiple child and family, clinician, practice, and healthcare system factors. Potential solutions may involve 1) more systematic implementation of programs that offer coverage for uninsured children; 2) tougher parity laws that offer equity in defined benefits and application of managed care strategies across physical and mental disorders; and 3) widespread implementation of quality improvement programs within primary care settings that enhance specialty/primary care collaboration, support use of care managers to coordinate care, and provide clinician training in clinically and developmentally appropriate principles of care for affective disorders. Research is needed to support development of these solutions and evaluation of their impacts.
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Affiliation(s)
- K B Wells
- Department of Psychiatry, University of California, Los Angeles, California 90024-6505, USA
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Kataoka SH, Zima BT, Dupre DA, Moreno KA, Yang X, McCracken JT. Mental health problems and service use among female juvenile offenders: their relationship to criminal history. J Am Acad Child Adolesc Psychiatry 2001; 40:549-55. [PMID: 11349699 DOI: 10.1097/00004583-200105000-00014] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe (1) the level of mental health problems and lifetime use of specialty mental health services and special education programs among incarcerated female juvenile offenders and (2) how these indices relate to their criminal history. METHOD Between 1997 and 1998, fifty-four female youths incarcerated in California were interviewed on-site using standardized self-report measures of depression and anxiety symptoms and substance use problems. RESULTS Eighty percent of the youths had symptoms of an emotional disorder or substance use problem, and almost two thirds (63%) had a history of recidivism. Of those with emotional symptoms or a substance use problem, 51% had used specialty mental health services and 58% had been in a special education program during their lifetime. In addition, among recidivistic youths, 82% had a history of a substance use problem and 47% had used specialty mental health services during their lifetime. CONCLUSIONS A substantial proportion of female juvenile offenders merit a mental health evaluation. Interventions for these high-risk youths should include an assessment for substance use disorders because of the association of recidivism and substance use problems in this population.
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Affiliation(s)
- S H Kataoka
- Department of Psychiatry, University of California, Los Angeles 90095-1736, USA
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