Mental health problems among homeless adolescents

This paper reviews 18 surveys of mental health problems among homeless adolescents and reports on a pilot study of the same topic conducted in Amsterdam. Sampling methods and measures of mental health are discussed. The reported estimates of mental health problems vary greatly, very probably because of methodological differences. Despite the different methods used, there seems to be considerable research evidence to support a high prevalence of mental disorders among homeless adolescents. The results of the pilot study of 50 homeless adolescents in Amsterdam are consistent with the surveys reviewed. A highly structured interview was conducted at all four services sites for homeless adolescents in Amsterdam. Of the homeless adolescents interviewed, 78% had at least one lifetime DIS/DSM-III-R diagnosis, and 64% had at least one 1-month diagnosis.     

Children's reactions in the early months after the death of a parent.

The reactions of a nonclinical group of 125 dependent children aged 6-17 years were examined within four months of the death of a parent. Focus was on normative behavior in the domains of the children's reactions to the death itself, their affective experience, their efforts at remaining connected to the deceased, their social network and support system, and changes in their families resulting from the death.     

Mental health of children and adolescents in Great Britain

The findings described in this report and summarized here focus on the prevalence of mental disorders among 5-15 year olds and on the associations between the presence of a mental disorder and biographic, sociodemographic, socio-economic, and social functioning characteristics of the child and the family. Causal relationships should not be assumed for any of the results presented in this report.     

Mental health of children and adolescents in Great Britain

The findings described in this report and summarized here focus on the prevalence of mental disorders among 5-15 year olds and on the associations between the presence of a mental disorder and biographic, sociodemographic, socio-economic, and social functioning characteristics of the child and the family. Causal relationships should not be assumed for any of the results presented in this report.     

Mental health problems in early adolescents in the Netherlands

OBJECTIVE: A large representative sample of early adolescents in the Netherlands was investigated to assess mental health problems in a school survey. These results were compared to results from former household surveys. In addition, several socio-demographic determinants were analysed. METHOD: A random sample of schools in the Netherlands was approached for participation in the Health Behaviour in School-aged Children Survey study (response rate at school level, 60% in primary education and 45% in secondary education). Within schools, a random selection of classes from the schools participated in the study (response rate within schools >95%). We analysed the percentage of children scoring in the problem range on each of the syndromes of the Youth Self Report and compared these to the percentages found in a former population study. The impact of several socio-demographic background variables was assessed. RESULTS: Approximately 20% of the boys and 23% of the girls have total problem scores in the problem range. These percentages are much higher than those found in population studies in the Netherlands so far, particularly in girls. In multivariate analyses, gender, socio-economic status and family composition were found to be of influence. Migrant status does not appear to be of importance once other background variables are taken into account. CONCLUSIONS: In school surveys on mental health problems, higher problem rates may be found than in population surveys conducted in household settings. This effect has seldom been discussed. It is suggested that this survey context has to be taken into account more explicitly when comparing results of surveys.     

Mental health of adolescents with currently and formerly incarcerated parents

Reliable information about children of incarcerated people is difficult to obtain, and major gaps exist in our understanding of their well-being. This study aims to determine whether adolescents with incarcerated parents report higher levels of mental health problems than those without an incarcerated parent, and whether the relationship between parental incarceration and adolescent mental health is moderated by parent-child relationships. Using a statewide survey from one US state, we compared adolescents with a currently incarcerated parent to those with a formerly incarcerated parent and those with no history of parental incarceration on self-reported indicators of mental health, and examined whether strong parent-child relationships were protective against mental health concerns. Results indicate that adolescents with incarcerated parents are at elevated risk for mental health problems, and strong parent-child relationships partially buffer children from risk. Findings underscore the need for more investment in effective early interventions for adolescents in highly adverse contexts.     

Mental health problems in children and adolescents referred to a national epilepsy center

This study aimed to investigate the occurrence of psychiatric morbidity in children and adolescents referred to a tertiary national epilepsy center (inpatient unit) and the extent of the unmet need for psychiatric services in this group. Participants were 74 children and adolescents aged 9-15 referred from February 2001 to October 2002 (67% response rate). The multi-informant (parent, teacher, self-report) Strengths and Difficulties Questionnaires (SDQs) were answered before or at admission. Patients with severe mental retardation or pervasive developmental disorder were excluded. We found a large proportion (77%) with a possible or probable psychiatric disorder. The parents, teachers, and adolescents themselves had higher mean SDQ scores than a British community sample on total difficulties, emotional symptoms, conduct problems, hyperactivity-inattention, peer problems, and impairment, but not self-reported conduct problems. Nearly 80% of the children who probably had a psychiatric disorder had no contact with the psychiatric service.     

Mental health status of adolescents after family confinement during the COVID-19 outbreak in the general population: a longitudinal survey

Few studies have examined the psychological impact on adolescents of family confinement and infection exposure during the COVID-19 pandemic. However, these surveys lacked follow-up data to determine how the family confinement affects participants’ depression and anxiety. The purpose of this study was to evaluate the psychological status and related risk and protective factors of adolescents after two months of family confinement for preventing COVID-19 in China, and compare them with baseline data. We surveyed teenagers in January 2020 before the COVID-19 outbreak (T1) and after home confinement (T2). We used the Patient Health Questionnaire (PHQ), the Generalized Anxiety Disorder (GAD) Scale and the Childhood Trauma Questionnaire (CTQ). 13,637 valid questionnaires were collected at T1, of which 22.34% reported depressive symptoms (PHQ-9 ≥ 10) and 14.42% reported anxiety symptoms (GAD-7 ≥ 10). At T2, the rates decreased to 14.86 and 7.44%, respectively (all P < 0.0001). Of the adolescents, 223 reported potential risk of exposure to COVID-19. We then compared them to the 9639 non-risk adolescents using a propensity score matching analysis. The adolescents with potential exposure risk had higher rates of depression (26.91 vs 15.32%, P = 0.0035) and anxiety (14.80 vs 7.21%, P = 0.01) than risk-free adolescents. Among adolescents with an exposure risk, psychological resilience was protective in preventing depression and anxiety symptoms, while emotional abuse, a poor parent–child relationship were risk factors. Long-term home confinement had minimal psychological impact on adolescents, but COVID-19 infection rates accounted for 50% of the variance in depression and anxiety among adolescents even with low community rates.

     

Health problems in children and adolescents before and after a man-made disaster

OBJECTIVE: The aims of this study were to examine health problems of children (4-12 years old at the time of the disaster) and adolescents (13-18 years old at the time of the disaster) before and after exposure to a fireworks disaster in the Netherlands (May 2000), to compare these health problems with a control group, and to identify risk factors for postdisaster psychological problems. METHOD: Because the electronic medical records of family practitioners were used, longitudinal monitoring of health problems from 1 year predisaster until 2 years postdisaster for both victims (N=1,628) and controls (N=2,856) was possible. Health problems were classified according to the International Classification of Primary Care. RESULTS: Postdisaster increases were significantly larger in victims than in controls for psychological problems, musculoskeletal problems, stress reactions, and symptoms of the extremities. Children 4-12 years old presented larger increases in sleep problems compared with controls, whereas children 13-18 years old showed larger increases in anxiety problems than their controls. Significant predictors for postdisaster psychological problems included being relocated, presenting predisaster psychological problems, and a low to medium socioeconomic status. CONCLUSIONS: Children and adolescents exposed to a disaster are at risk of long-lasting increases in both psychological and physical health problems. Postdisaster interventions should focus on those who were relocated and presented predisaster psychological problems.     

Mental health problems after stroke

We investigated the mental health of 47 subjects (30 men, mean age 63.8+/-7.7; 17 women, mean age 68.9+/-8.7) with the 60-item General Health Questionnaire (GHQ). All the subjects lived at home in a Japanese rural community and were examined from 2 to 3 years after suffering a stroke. Among the subjects, 18 (38.3%) had GHQ scores of 17 or more, which indicated a mental health problem (MHP). The following variables were included in multiple logistic regression analysis: age, sex (men/women), grade of motor paralysis (no/slight/moderate/severe), side of motor paralysis (no/left side/right side/both sides: in analysis, we used dummy variables), paresthesia (no/yes), rehabilitation (need no rehabilitation or participate in rehabilitation/fail to participate in rehabilitation), social support (not needed or sufficient/insufficient) and overall physical recovery (1/2/3: 1 = 67-100, 2 = 34-66, and 3 = 0-33 on a visual analog scale 100 mm long, 100 meaning full recovery). In univariate analysis all variables except age and sex showed statistically significant associations with MHP. In multivariate analysis, only one variable, overall physical recovery', had a statistically independent association with the status of MHP (Odds ratio 4.39, 95% confidence interval 1.46-13.19). The results of logistic regression analysis indicate that the presence of an MHP is more strongly dependent upon subjective assessment about overall physical recovery after stroke than upon physical impairments and the other psychosocial variables. Therefore, in the community setting, the visual analog scale of overall physical recovery is considered to be a simple, valid method for assessing MHP following stroke.     

Mental health services for Latino adolescents with psychiatric disorders

OBJECTIVES: The major objectives of this study were to examine the prevalence of mental disorders and the use of mental health services among Latino adolescents who were receiving services in at least one of five public sectors of care in San Diego County. METHODS: Survey data were gathered for a random sample of adolescents aged 12 to 18 years (N=1,164) who were receiving public-sector care. Mental disorders were assessed with the Diagnostic Interview Schedule for Children, and use of mental health services was assessed with the Service Assessment for Children and Adolescents. RESULTS: Rates of disruptive disorders were significantly lower among Latino adolescents than among white adolescents. Although more than half of the Latino sample received specialty mental health services, those with psychiatric disorders were significantly underserved compared with their white counterparts. Latino adolescents with psychiatric disorders entered specialty mental health services at a later age and had made significantly fewer specialty mental health service visits in the previous year. In multivariate analyses, Latino youths were significantly less likely than white youths to use specialty mental health services independent of diagnosis, gender, age, and the service sector from which they were selected. CONCLUSIONS: Public service systems need to ensure that Latino youths are appropriately assessed for disruptive disorders and that they are provided with appropriate specialty mental health care.     

Mental health literacy about depression and schizophrenia among adolescents in Sweden

BackgroundMental health literacy (MHL) refers to an individual's knowledge of mental disorders, including the ability to recognize psychopathology and being aware of help options. Most studies of MHL have focused on adults.ObjectiveThe purpose of this study was to examine levels of MHL among adolescents.MethodsMHL was examined using two pre-established vignettes that presented an adolescent with symptoms of either depression or schizophrenia. The respondents were 426 adolescents (age mean = 16). Vignette data were analyzed both qualitatively and quantitatively.ResultsThe data showed that 42.7% and 34.7% of the respondents identified depression and schizophrenia, respectively. Depression was recognized more often by females than males. Professional help was suggested by a minority of the respondents for managing symptoms of depression (22.5%) or schizophrenia (32.6%). Altruistic behaviors, examined through the willingness to help an acquaintance with mental illness symptoms, were apparent among 58.2% of the respondents and to a greater extent in females than males. Answers following the schizophrenia vignette also revealed stigmatizing attitudes in 11.5% of the participants.ConclusionsThere are relatively low levels of MHL among teenagers in Sweden. Awareness campaigns and the implementation of psychoeducation in the school curriculum could increase MHL in this group.     

Mental health care use in adolescents with and without mental disorders

The aim of the study was to estimate the proportion of adolescents with and without a psychiatric diagnosis receiving specialist mental health care and investigate their problem levels as well as utilization of other types of mental health care to detect possible over- and undertreatment. Care utilization data were linked to psychiatric diagnostic data of 2230 adolescents participating in the TRAILS cohort study, who were assessed biannually starting at age 11. Psychiatric diagnoses were established at the fourth wave by the Composite International Diagnostic Interview. Self-, parent- and teacher-reported emotional and behavioral problems and self-reported mental health care use were assessed at all four waves. Of all diagnosed adolescents, 35.3 % received specialist mental health care. This rate increased to 54.5 % when three or more disorders were diagnosed. Almost a third (28.5 %) of specialist care users had no psychiatric diagnosis; teachers gave them relatively high ratings on attention and impulsivity subscales. Diagnosed adolescents without specialist mental health care also reported low rates of other care use. We found no indication of overtreatment. Half of the adolescents with three or more disorders do not receive specialist mental health care nor any other type of care, which might indicate unmet needs.     

Mental health service use by adolescents in the 1970s and 1980s

Shifts in the use of mental health services by adolescents between 1975 and 1986 are examined by levels of care--outpatient, partial hospitalization, residential treatment center, and inpatient. Data from National Institute of Mental Health surveys of U.S. facilities include client characteristics (age, sex, race, diagnosis, clinical history) and treatment characteristics (referral source, type of intervention, length of stay). Major increases in mental health service use were observed for all levels of care during this period. Nonetheless, a relatively small percent (less than 2%) of adolescents in the U.S. received any type of mental health service in 1986. The clinical and treatment variables available were only moderately helpful in differentiating levels of care.