Differences in Distress and Utilization of Mental Health Services between 2005 and 2018: a Potential Trend?

This study examined possible differences in self-reported psychological distress and need of treatment in two samples of well-educated adults, which were obtained from two larger studies that were conducted separately in 2005 and 2018. Psychological distress and need for treatment were reported using the Langner Symptom Survey, a psychometrically robust measure of nonspecific distress that provides validated cutoff scores for those in need of receiving mental healthcare services. Treatment utilization was examined through self-report in which respondents indicated whether they had never received treatment, previously received treatment, or were currently receiving treatment. Results suggested that a larger percentage of respondents from the 2018 sample reported current counseling (11.8%) compared to the 2005 sample (4.0%), and they were almost twice as likely to be classified as distressed and in need for treatment than their 2005 counterparts (51.9% compared to 33.2% in 2005; odds ratio?=?2.17, 95% CI: 1.59–2.97). Implications for these findings are discussed at length.

     

Community Mental Health Services and the Prevalence of Severe Mental Illness in Local Jails: Are They Related?

The excessive prevalence of severe mental illness noted in correctional settings has sometimes been attributed to the inadequacy of community based mental health services. This study examines the prevalence of severe mental illness in two jails situated within catchment areas featuring markedly different levels of community mental health services. We use these settings to test the hypothesis that greater levels of services in a community are associated with lower prevalence of severe mental illness in the community's jail. An epidemiologic approach, using standardized field instruments, was used to estimate the prevalence of major mental illness in detainees arriving at the two sites over a 6-month period. The hypothesis that greater levels of mental health resources in a community would be associated with lower prevalence of mental illness in the community's jail was not supported. These findings suggest that community-based mental health services by themselves do not affect the prevalence of mental illness in jail.     

State Policies that Impact the Design of Children’s Mental Health Services: A Modified Delphi Study

To identify the state-level policies and policy domains that state policymakers and advocates perceive as most important for positively impacting the use of children’s mental health services (CMHS). We used a modified Delphi technique (i.e., two rounds of questionnaires and an interview) during Spring 2021 to elicit perceptions among state mental health agency officials and advocates (n?=?28) from twelve states on state policies that impact the use of CMHS. Participants rated a list of pre-specified policies on a 7-point Likert scale (1?=?not important, 7?=?extremely important) in the following policy domains: insurance coverage and limits, mental health services, school and social. Participants added nine policies to the initial list of 24 policies. The “school” policy domain was perceived as the most important, while the “social” policy domain was perceived as the least important after the first questionnaire and the second most important policy domain after the second questionnaire. The individual policies perceived as most important were school-based mental health services, state mental health parity, and Medicaid reimbursement rates. Key stakeholders in CMHS should leverage this group of policies to understand the current policy landscape in their state and to identify gaps in policy domains and potential policy opportunities to create a more comprehensive system to address children’s mental health from a holistic, evidence-based policymaking perspective.

     

Unlicensed Boarding House Managers’ Experiences and Perceptions of Need in Residents with Mental Health and Substance Use Problems

Unlicensed boarding houses provide low cost accommodation for many people who have mental health and/or alcohol or other drug problems. The present study explored the needs and experiences of owners and managers of unlicensed boarding houses who have residents with MH and AOD problems. Twenty-three boarding house managers (BHMs) from Illawarra and Sydney areas participated in semi-structured interviews which were recorded and transcribed. Content analysis revealed most BHMs had very limited understanding of different types of mental health and substance use disorders. Almost all reported problems with individuals who they believed had such problems. Several BHMs found themselves in the role of ??accidental counsellors??, but their responsiveness to residents needs was highly variable. BHMs?? inconsistent reactions to rule violations may create high levels of uncertainty amongst residents. The discussion describes options for addressing residents?? needs including educational strategies for BHMs and facilitating links with support agencies.     

Racial/Ethnic Differences in Emotional Health: A Longitudinal Study of Immigrants’ Adolescent Children

First, discrimination was conceptualized as a major source of stress for immigrants’ adolescent children. Next, such children’s emotional health (indicated by measures of self-esteem and depression) was examined for possible associations with discrimination, psychosocial supports, and social structure; additionally, race/ethnicity’s possible moderating role in such associations was evaluated. Data from the first 2 waves of the Children of Immigrants Longitudinal Study (1991–2006) were employed, focusing on 3 groups: Asians, Hispanics, and Whites. Linear regression analyses were used to weigh how discrimination, psychosocial supports, and social structure measured at Wave 1 and Wave 2 related to self-esteem and depression measured at Wave 2. Asians exhibited the highest level of depression and were most likely to perceive discrimination; Asians’ self-esteem was also low, compared to other groups’. Discrimination and psychosocial supports appeared to operate differentially in explaining the 3 groups’ emotional health.     

Mental Health Service Users’ Perceptions of Stigma,From the General Population and From Mental Health Professionals in Mexico: A Qualitative Study

Community Mental Health Journal - Negative attitudes towards people with mental health disorders have been widely studied and identified in the general population, and even within health care...     

‘Recovery’ in the Real World: Service User Experiences of Mental Health Service Use and Recommendations for Change 20 Years on from a First Episode Psychosis

Little is known about how recovery oriented policy and legislative changes influence service users’ perceptions of mental health care over time. Although the recovery approach is endorsed in many countries, qualitative research examining its impact on service use experiences has been lacking. This study aimed to explore this impact as well as experiences of service utilisation and suggestions for change with people diagnosed with a First Episode Psychosis between 1995 and 1999. Participants had used services during the 10 year period prior to, and 10 years post, policy and legislative shifts to the recovery approach. Semi-structured interviews were conducted with 10 participants who met criteria for ‘full functional recovery’ and 10 who did not. Data were analysed using Thematic Networks Analysis to develop Basic, Organising, and Global Themes. Over time, recovered participants perceived an improvement in service quality through the ‘humanising’ of treatment and non-recovered participants experienced their responsibility in recovery being recognised, but felt abandoned to the recovery approach. Findings suggest the importance of viewing service users as demonstrating personhood and having societal value; examining the personal meaning of psychotic experiences; and matching expectations with what services can feasibly provide. The implementation and the principal tenets of the recovery approach warrant further investigation.     

Factors Influencing Perceptions of Need for and Decisions to Solicit Child Mental Health Services by Parents of 9–12 Year-Old Korean Children

As children with emotional or behavioral problems often fail to receive the treatment available to them, this study examined (1) the degree of perceived need (PN) among Korean parents regarding mental health services for their children, (2) the factors associated with such perceptions, (3) the degree to which Korean parents actually engage mental health services for their children, and (4) the factors associated with such use. To determine the degrees of PN and actual use, 1,058 children aged between 9 and 12 years were asked to complete the Children’s Depression Inventory, while their parents completed the Child Behavior Checklist. About 11.4% of the parents demonstrated PN, compared to 2.7% who actually engaged child mental health services. While most of the CBCL factors were associated with PN, the child’s self-report significantly affected the perception as well. The attention problem score in the CBCL was the only factor that strongly corresponded to the actual use of services in Korea, a country where academic achievement is considered paramount, which suggests that cultural forces may play a powerful role in determining parents’ decisions regarding child mental health care.     

Community Mental Health Center Visits and Community Mobility of People with Serious Mental Illnesses: A Facilitator or Constraint?

Mental health services and interventions have increasingly focused on the importance of community participation and mobility for people with serious mental illnesses (SMI). This study examined the role that visits to community mental health centers (CMHCs) may play in increasing community mobility of people with SMI. Eighty-nine adults with SMI receiving services at three CMHCS were tracked with GPS-enabled phones over a 13-day period. Findings revealed that participants visited more destinations on days they went to a CMHC compared to days they did not. They also spent more time out of the home and traveled greater distances. Results suggest that the benefits of visiting a mental health center appear to go beyond treatment outcomes, but also point to the possibility that obligations, whether to a clinic appointment or possibly vocational, educational, leisure, faith, or social commitments, may be an important stepping stone to more mobility and intentional, sustained community participation.

     

“Straight Up”: Enhancing Rapport and Therapeutic Alliance with Previously-Detained Youth in the Delivery of Mental Health Services

A strong therapeutic alliance has been shown to improve mental health treatment outcomes in adults, but this topic has not been fully explored with youth. Adolescents, particularly justice-involved youth, stand to benefit greatly from an improved treatment experience. One quality which can improve treatment is mental health providers’ interpersonal skills when attempting to build a therapeutic rapport with adolescent clients. Semi-structured interviews were conducted with 19 youth who screened positive for mental health concerns while in juvenile detention. Four themes were identified as important to improving the therapeutic alliance: Empathy, client-directed care, sequencing, and positive rapport. Suggestions for strengthening a therapeutic alliance are provided.     

Improving the Quality of Children’s Mental Health Care with Progress Measures: A Mixed-Methods Study of PCIT Therapist Attitudes

Progress measures are an evidence-based technique for improving the quality of mental health care, however, clinicians rarely incorporate them into treatment. Research into how measure type impacts clinician preference has been recommended to help improve measure implementation. Parent–Child Interaction Therapy (PCIT) is an assessment-driven treatment that serves as an ideal intervention through which to investigate measure preferences given its routine use of two types of assessments, a behavioral observation (the Dyadic Parent–Child Interaction Coding System) and a parent-report measure (the Eyberg Child Behavior Inventory). This study investigated PCIT therapist attitudes towards progress measures used within PCIT and children’s mental health treatment generally. A mixed-method (QUAN?+?QUAL) study design examined PCIT therapist attitudes towards two types of progress measures and measures used in two contexts (PCIT and general practice). Multi-level modeling of a survey distributed to 324 PCIT therapists identified predictors of therapist attitudes towards measures, while qualitative interviews with 23 therapists expanded and clarified the rationale for differing perceptions. PCIT therapists reported more positive attitudes towards a behavioral observation measure, the DPICS, than a parent-report measure, the ECBI, and towards measures used in PCIT than in general practice. Clinician race/ethnicity was significantly related to measure-specific attitudes. Qualitative interviews highlighted how perceptions of measure reliability, type of data offered, ease of use, utility in guiding sessions and motivating clients, and embeddedness in treatment protocol impact therapist preferences. Efforts to implement progress monitoring should consider preferences for particular types of measures, as well as how therapists are trained to embed measures in treatment.

     

Disordered Eating Behaviors and Substance Use in Women: A Comparison of Perceived Adverse Consequences∗

The study investigated the adverse consequences on varied life domains of dieting, bingeing, vomiting and laxative use and compared them to the adverse consequences of alcohol drinking, tobacco smoking, and marijuana use. Results showed that the percentages of women who reported adverse consequences related to eating disordered behaviors were often comparable, if not higher, than the percentages of women who reported adverse consequences related to their substance use. This is the first study to compare the adverse consequences of disordered eating patterns and substance use behaviors. Results suggest the importance of recognizing the adverse consequences of disordered eating patterns.