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The objective of this study was to evaluate community-based outpatient mental health services for young adults. Participants were interviewed at ages 21, 24, 27, and 30. Outcomes included: (1) symptoms of depression, generalized anxiety, social phobia, dysthymia and post traumatic stress individually and as a global scale; and (2) a dichotomous diagnosis variable inclusive of all above disorders. Treatment was indicated by an outpatient visit to a psychiatrist or other professional. Treatment did not reduce mental disorder or symptoms. Substance use, violence, poverty, community disorganization, and family history of antisocial behavior increased risks for negative outcomes, while social support was protective. The absence of positive findings associated with outpatient treatment is troubling given the empirically supported interventions for the conditions examined. Practitioners, agencies, and managed care organizations share a responsibility to implement effective and comprehensive interventions.  相似文献   

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The prevalence of psychiatric disorders among incarcerated juveniles in Mississippi was examined. A total of 482 adolescents completed a diagnostic questionnaire and a subset (N = 317) was assessed with face-to-face semi-structured interview. Most of the study participants met criteria for one mental disorder, 71-85% depending on assessment method, one-third have co-occurring mental health and substance abuse disorders. Gender and placement site differences in rates of some psychiatric disorders were also noted. Routine mental health screening should be performed on all juveniles placed in secure detention facilities to identify those who need treatment services.  相似文献   

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In light of healthcare reforms, the study aims to assess variables associated with mental healthcare service utilization in general and in both primary and specialized care by patients with severe mental disorders (SMD, mainly schizophrenia). The study is based on a sample of 140 patients with SMD from five regions in Quebec (Canada). Variables were organized in accordance with Andersen’s conceptual model into four factors: predisposing, enabling, needs, and service utilization. Secondary analyses were also conducted comparing patients who were hospitalized or used emergency rooms (H.ER-Group) with patients who did not use such services (WH.ER-Group). Accessibility of services, continuity of care, and having a case manager appear to be core variables that enable service utilization. Compared with the WH.ER-Group, the H.ER-Group used twice as many services. The study highlights the importance of developing a gamut of coordinated services, easily accessible in local networks, including case managers, family physicians, and shared-care development.  相似文献   

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ObjectivesWe surveyed older adults about their perceived mental health and their comfort discussing and engaging in mental health treatment.MethodsA nationally representative survey of community-dwelling older adults aged 50–80 (N = 2,021), with respondents asked to rate their current mental health as compared to 20 years ago, comfort discussing their mental health, and potential hesitations to seeking treatment in the future.ResultsAbout 79.6% reported their mental health as the same or better than 20 years ago; 18.6% reported their mental health to be worse. Most respondents reported that they were comfortable (87.3%) discussing their mental health, preferring to discuss such concerns with their primary care provider (30.6%). About 28.5% of respondents did endorse some hesitation seeking mental health care in the future.ConclusionsMost older adults reported that their mental health was as good if not better than it was 20 years ago and felt comfortable discussing mental health concerns.  相似文献   

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There is a significant gap in understanding the risk of sexual victimization in individuals with autism spectrum disorders (ASD) and the variables that contribute to risk. Age appropriate sexual interest, limited sexual knowledge and experiences, and social deficits, may place adults with ASD at increased risk. Ninety-five adults with ASD and 117 adults without ASD completed questionnaires regarding sexual knowledge sources, actual knowledge, perceived knowledge, and sexual victimization. Individuals with ASD obtained less of their sexual knowledge from social sources, more sexual knowledge from non-social sources, had less perceived and actual knowledge, and experienced more sexual victimization than controls. The increased risk of victimization by individuals with ASD was partially mediated by their actual knowledge. The link between knowledge and victimization has important clinical implications for interventions.  相似文献   

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Adults with serious mental illness (SMI) experience criminal victimization at rates higher than the general population whether they reside in the community or correctional settings. This study examines the past-six month prevalence and correlates of criminal victimization among a large community sample (N = 2,209) of consumers with SMI newly admitted to outpatient mental health services during 2005 through 2008. A cross-sectional design was used with self-report and clinical data collected from administrative records. Victimization was determined by responses to direct questions about experiences in the previous 6 months with respect to victimization of a non-violent and/or violent crime. Socio-demographic, clinical and criminal correlates of victimization were abstracted from a quality of life survey and clinical assessment interview conducted at admission. Overall, 25.4 % of consumers reported being a victim of any crime (violent or non-violent) in the past 6 months, with 20.3 % reporting non-violent and 12.3 % violent victimization. The risk of victimization was elevated for those who were female, White, not taking atypical psychotropic medication, not feeling safe in their living arrangement, and were arrested or homeless in the six-months prior to engaging in mental health outpatient treatment. Policy and practice implications of these findings are discussed.  相似文献   

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Few studies estimate rural psychiatric disorder rates. No study has reported either DSM-III-R or DSM IV disorder prevalence and mental health service use among US rural young adults. This paper reports psychiatric disorder prevalence, comorbidity, service utilization, and disorder correlates in a community sample of 536 young adults, aged 19 to 23 years, living in the rural Midwestern US. More than 60% of the sample met criteria for a lifetime disorder. Substance use disorders were most prevalent. Results indicate that young adults living in the rural Midwest demonstrate substantial rates of psychiatric disorder that are comparable to other population groups. Martha A. Rueter is affiliated with the Department of Family Social Science, University of Minnesota, St. Paul, MN 55108, USA Kristen E. Holm is affiliated with the National Jewish Medical and Research Center, Denver, CO, USA Rebecca Burzette is affiliated with the Iowa State University, Ames, IA, USA Kee Jeong Kim and Rand D. Conger are affiliated with the University of California, Davis, CA, USA  相似文献   

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BACKGROUND: There are concerns that ethnic minority patients are over-represented in inpatient mental health settings, but under-utilise community services. This study aims to compare the use of community mental health services between African-Caribbean and White patients with psychosis, before and after the introduction of new community services, and to investigate their impact on inpatient treatment. METHODS: The sample was drawn from epidemiologically representative patients with psychotic disorders living in two catchment areas in South London, one of which was developing intensive community treatments. Service utilisation was measured at baseline and at 2-year follow-up using the Client Service Receipt Interview (CSRI). The mean number of contacts with specific services was compared between the two groups over time. RESULTS: A total of 92 White and 48 African-Caribbean patients were compared. The latter were more likely to be younger (P = 0.004), have shorter illness duration (P < 0.001), and had more detentions under the Mental Health Act (P = 0.003). No significant differences were seen in use of community services over time. However, intensive treatment led to a significant reduction in hospital days for African Caribbean patients compared to White patients in the intensive sector and all patients in the standard sector. CONCLUSIONS: Intensive community treatments reduced inpatient days in African Caribbean patients. Further effort is needed to improve the cultural sensitivity of community mental health services.  相似文献   

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International Journal of Mental Health and Addiction - The evidence on the predictors of mental health in the COVID-19 pandemic has revealed contradictory findings, which prevent effective...  相似文献   

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This study investigates the sociodemographic factors associated with self-report of common mental problems by the psychologically distressed in order to gain insight into the profile of the population subgroups least likely to receive mental health support whenever needed. Data from the 2006–2008 french National Survey on Health, Health Care and Insurance, were used, measuring psychological distress based on the Mental Health Inventory MHI-5. The patterns associated with education, employment situation and living arrangement were investigated in a sample of 11,543 subjects aged 30–54 years. Men with lower educational level were found to be doubly disadvantaged, as they were more subjected to distress than those with higher educational level and at the same time less likely to report common mental problems whenever distressed. While in both genders subjects not living with a spouse and non-employed subjects were also more subjected to distress, they were more likely than the others to report common mental problems in presence of distress. The findings were discussed in terms of living conditions, stigma, mental health literacy and help-seeking behaviour. Mental health promotion programmes should aim at educating the public, and particularly men and the lower educated public, on the signs of distress and their significance.  相似文献   

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This study examined (1) adolescent mental health literacy (MHL) and stigma for depression, anxiety and obsessive-compulsive and related disorders (OCRDs), and (2) demographic moderators. Participants were 383 high school students (50.9% boys) aged 11–18 years (M?=?14.12, SD?=?1.91) in El Salvador. Participants read vignettes of adolescents with mental health problems and reported on their beliefs about (1) what was wrong with the young person, (2) expected recovery time, (3) help-seeking beliefs and recommendations, and (4) stigma and preferred social distance associated with each condition. Results suggested that recognition of mental health conditions, especially anxiety disorders and OCRDs, was limited, although one third could recognize depression in a peer. Help-seeking attitudes were favorable. Adolescents were only somewhat willing to be affiliated with someone experiencing a mental health problem. Girls showed better MHL and lower stigma than boys. Stigma was lower among those with exposure to mental health problems.

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There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.  相似文献   

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