大学生自杀危险性与心理健康水平关系的研究

目的考察大学生的自杀危险性与心理健康水平的关系。方法采用大学生自杀危险性评定问卷（SRRS）和症状自评量表（SCL-90），对甘肃省三所高校的300名大学生进行调查。结果对两组变量的典型相关分析发现，两组变量之间存在中等程度的相关（典型相关系数是0．584）。构建的结构模型发现，心理健康的强迫因子对自杀态度和自杀动机有显著的正向作用，心理健康水平的抑郁因子和敌对因子对自杀危险性的负性情绪因子、态度因子、动机因子有显著的正向作用，精神病因子对认知僵化有显著的正向作用。结论大学生的自杀危险性与大学生的心理健康水平有直接的关系。     

大学生自杀态度及心理健康状况的调查研究

目的旨在了解大学生对自杀的态度以及目前的心理健康状况,并分析自杀态度和心理健康状况之间的关系。方法随机抽取200名大学生采用QSA和SCL-90进行调查研究。结果QSA总均分为2.65分,以SCL-90的9因子为自变量,QSA中对自杀者行为态度为因变量,逐步回归统计结果显示:抑郁、焦虑、人际关系3因子进入回归方程。结论绝大多数人对自杀行为持矛盾、中立态度;抑郁、焦虑、人际关系等因子对大学生的自杀态度存在影响。     

大学生自杀态度及心理健康状况的调查研究

目的旨在了解大学生对自杀的态度以及目前的心理健康状况，并分析自杀态度和心理健康状况之间的关系。方法随机抽取200名大学生采用QSA和SCL-90进行调查研究。结果QSA总均分为2．65分，以SCL-90的9因子为自变量，QSA中对自杀者行为态度为因变量，逐步回归统计结果显示：抑郁、焦虑、人际关系3因子进入回归方程。结论绝大多数人对自杀行为持矛盾、中立态度；抑郁、焦虑、人际关系等因子对大学生的自杀态度存在影响。     

应对方式对医务人员心理健康的影响

目的探讨应对方式对心理健康的影响,为提高医务人员的心理健康水平提供帮助。方法用症状自评量表和简易应对方式问卷对某国有企业集团所属医院的198名医务人员进行测查,用相关和多元逐步回归方法进行分析。结果医务人员消极应对方式与SCL-90总分及除躯体化、焦虑、恐怖以外的各因子均显著正相关,相关系数分别为0．15,0．20,0．14,0．17,0．15,0．23,0．17;积极应对方式与强迫、焦虑显著负相关,相关系数为0．14、0．16;消极应对和积极应对均进入回归模型,偏回归系数分别为14．498,12．902。结论应对方式是心理健康的重要影响因素。     

Associations of Physical and Sexual Health with Suicide Attempts Among Female Sex Workers in South Korea

This study investigated suicidal behavior prevalence and its association with physical and sexual health, and behavior-related factors among female sex workers in South Korea. Using time location sampling, we recruited 1,083 sex workers for an interviewer-administered questionnaire regarding sexual behavior, sociodemographics, and self-rated health (SRH) status. Participants were also tested for sexually transmitted diseases (STDs). We used binary logistic regression analysis to define suicide attempt factors. Around 28 % of sex workers in the sample reported that they had attempted suicide in the past year. Suicide attempts were independently associated with drinking alcohol almost every day, not using condom regularly, STD infection experience, and unfavorable SRH status. Higher suicide attempt likelihood was associated with poor sexual and physical health, but there was no significant association with the number of customers per week. We thus need to revive STD screening programs provided by the government and to support mental health programs.     

Suicide and Organ Donors: Spillover Effects of Mental Health Insurance Mandates

This paper considers the effect of mental health insurance mandates on the supply of cadaveric donors. We find that enacting a mental health mandate decreases the count of organ donors from suicides and results are driven by female donors. Using a number of empirical specifications, we calculate that the mental health parity laws are responsible for an approximately 0.52% decrease in cadaveric donors. Additional regression results show that the mandates are not related to other types of organ donations, ruling out the possibility that the mandates are related to an overall trend in the supply of organ donations. The findings suggest that future policies aimed at reducing suicide in a large and significant way can potentially increase the inefficiency that currently exists in the organ donor market. Copyright © 2014 John Wiley & Sons, Ltd.     

Pediatric Emergency Consultations: Prior Mental Health Service Use in Suicide Attempters

This study investigated the relationship between presenting complaints and prior mental health encounters in youth seen for emergency psychiatric consultation. Records of youths aged 9–17 years old receiving a psychiatric consultation in a pediatric emergency department from 2002 to 2007 were examined (N = 1,900). Youth were classified by presenting complaint: suicide attempt, suicidal ideation, and behavioral problems. Nearly half of the youth presented with behavior problems, and 39% presented with suicidal ideation and/or attempt. Those presenting with both suicide attempt and behavior problems were most likely to have made a prior suicide attempt. Those presenting with suicide attempt alone were least likely to report current mental health treatment, while youth presenting with behavior problems alone were the most likely to report current mental health treatment. Further research is needed to better understand the role that emergency departments play in the course of care and to maximize the opportunity to make lasting and effective community-based care connections.     

教师职业枯竭及心理健康状况对中小学生心理健康的影响

目的 探讨吉林地区中小学班主任职业枯竭及心理健康状况对学生心理健康的影响,为针对性地开展学生及教师的心理健康教育提供依据.方法 采用职业枯竭问卷和90项症状自陈量表,对占林地区19所中小学校共1 192名教师进行调查,随机抽取有职业枯竭和心理健康水平低于全国常模的班主任32人,无职业枯竭和心理健康水平高于全国常模的班主任30人;对2组班主任所教的3 346名学生,采用中小学生用<心理健康诊断测验(MHT)量表>进行调查分析.结果 中学生心理健康水平明显高于小学生.班主任职业枯竭和心理健康水平较低,导致男生孤独倾向和女生恐怖倾向、对人焦虑,小学生学习焦虑、孤独倾向、恐怖倾向和中学生对人焦虑、孤独倾向,差异均有统计学意义.结论 教师职业枯竭和心理健康状况对中小学生的心理健康有影响.     

Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners.Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13.Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison.Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison.Mental health disorders among prisoners have consistently exceeded rates of such disorders in the general population, and correctional facilities in the United States are often considered to be the largest provider of mental health services.1–3 Despite court mandates for access to adequate health care in prisons (these mandates are even further limited to “severe” and “serious” mental illness treatment requirements in prison settings), inmate access to health and mental health care has been sporadic.4,5 Treatment decisions often depend on the limited available resources, public support of correctional treatment, and correctional management decision-making.4,5 Some studies report that at least half of male inmates and up to three quarters of female inmates reported symptoms of mental health conditions in the prior year (compared with 9% or fewer in the general population).3,6–8 These rates underscore the importance of access to mental health treatment for inmates, because lack of access to treatment can have important policy implications, particularly when financial resources are limited for correctional intervention and treatment.Individuals with untreated mental health conditions may be at higher risk for correctional rehabilitation treatment failure and future recidivism on release from prison.2,9,10 In fact, Baillargeon et al.10 found that after release from prison, former inmates who received a professional diagnosis of any Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, mental health disorder were 70% more likely to return to prison at least once than were those who were not given a diagnosis. Furthermore, among those who have been previously incarcerated, the rates of recidivism are between 50% and 230% higher for persons with mental health conditions than for those without any mental health conditions, regardless of the diagnosis.The limited treatment options in many prison settings are directly reflected in the greater number of disciplinary problems, rule violations, and physical assaults among those who have mental health disorders,11 often compounded by the resulting solitary confinement as punishment for these behaviors.1 Although all prisons are required to provide some level of health care, we know very little about whether mental health treatment is actually available to inmates on a case-by-case basis.3,9 In fact, Wilper et al. found that most prisoners, even those who have chronic medical conditions (such as diabetes or hypertension), had limited access to health care in prison.3 Therefore, we used a nationally representative sample of US prisoners to assess whether all persons with a history of mental health conditions were screened and evaluated by a medical professional for these conditions and whether medication use was continuous from the community setting to the prison setting.Mental health conditions represent a different level of need when compared with physical health needs among prisoners. For instance, tuberculosis transmission is a physical health hazard to all inmates and staff. Therefore, correctional administrators ensure that individuals suspected of having tuberculosis obtain proper assessment and subsequent access to health care. Symptoms inherent to many mental health disorders, however, may be less obvious to prison staff, especially without assessment by trained mental health professionals. In addition, a report on mental health care in prison emphasized the need for screening and treatment of mental health conditions among inmates from both a legal and a humanitarian perspective.12 Specifically, several US Supreme Court decisions have supported the rights of prisoners to receive health care, including mental health care (see Bowring v Godiva, 551 F2d 44 [4th Cir 1977]; Laamon v. Helgemoe, 437 F Supp 269 [DNH 1977]; and Ruiz v Estelle, 503 F Supp 1265 [SD Tex 1980]). To date, however, a great deal of variation remains in screening for and treatment of mental health disorders in prison settings.13,14 The use of pharmacotherapy, in conjunction with counseling and self-help groups, to treat mental health conditions in correctional settings has been largely accepted in the correctional community; however, many medications are expensive and, therefore, not offered widely within institutions.4,12,13,15Several practical issues might explain why an individual in the correctional system would have difficulty receiving (or continuing to receive) pharmacotherapy for mental health conditions. First, psychologists and psychiatrists who may properly diagnose disorders are in short supply,12 and the screening tools that are typically used in prison settings are not diagnostic tests. Instead, the purpose of these tools is to gauge the security risk of a new inmate at the institution.4 Second, the continuously declining correctional budget may limit treatment access to those with only the most serious mental health conditions.5 In an ideal situation in which a licensed professional properly diagnoses inmates, specialized treatment programs (rarely located inside of prison facilities) are available. Unfortunately, the use of these outside treatment programs is limited, because correctional budgets do not have the extensive resources necessary to manage inmates enrolled in off-site treatment or to handle the logistics (such as secure transport) involved.15The incarceration experience itself poses a challenge to mental health treatment. Untreated mental health (and physical health) conditions are known to result in poor adjustment to life in prison.12 Furthermore, crowded living quarters, lack of privacy, increased risk of victimization, and solitary confinement within the institution have been identified as strong correlates for self-harm and adaptation challenges for those with mental health conditions in prison settings.16,17Given the strong relation between mental health and criminal behavior,18 the public health system has a great deal to gain from better mental health treatment among inmates, particularly in reducing the costs associated with high recidivism rates.5,10,19 Therefore, this study extends previous research on prisoner health conducted by Wilper et al.3 by assessing the continuity of pharmacotherapy (e.g., medication used to treat a mental health condition in prison), beyond the prevalence rates of pharmacotherapy in prison. Furthermore, we examined potential explanations for both continuity and discontinuity of treatment in the inmate population. Specifically, this study will contribute to the literature by evaluating 3 specific aims: (1) to assess medication continuity for a mental health condition since admission to prison; (2) to assess the correlates of medication continuity, medical screening, and receipt of examinations by medical personnel; and (3) to assess the degree to which medication continuity is predicted by screening prisoners for mental health conditions at intake to prison.     

Correlates of Mental Health Treatment Receipt Among Asian Americans with Perceived Mental Health Problems

The Journal of Behavioral Health Services & Research - Compared with other ethnic groups, Asian Americans report the lowest rates of mental health treatment and service utilization. This is...     

高校体育社团对大学新生心理健康干预效果评价

目的研究不同高校体育社团活动对大学新生心理健康的干预效果,为高校大学生心理健康干预提供依据。方法采用症状自评量表(SCL-90)和艾森克人格问卷(EPQ)对高校参加体育舞蹈社团、排球社团、网球社团的210名大学新生进行为期4个月的随访测评。结果神经质高分者参加体育舞蹈社团活动后在躯体化、人际敏感、焦虑、抑郁、敌对因子上有显著性改善,参加排球社团后在人际敏感、抑郁、焦虑、恐怖因子上有显著性改善,参加网球社团后在强迫、抑郁、焦虑、恐怖因子上有显著性改善;而神经质低分者参加体育社团活动对心理症状改善效果相对不明显。结论3个高校体育社团活动对不同人格特征的大学新生产生不同的心理干预效果,有助于指导大学新生选择适合自己的体育社团项目。     

迷恋网络对医学生心身健康的影响

目的了解迷恋网络对高职医学生心身健康的影响状况。方法采用匿名问卷调查法,对1475名医学生进行调查。结果 70.1%男生、56.1%女生有迷恋上网的各种表现,73.7%、56.4%的男女生均存在不同程度心身健康问题。结论加强网络心理健康教育势在必行。     

Spanish-Language Community-Based Mental Health Treatment Programs,Policy-Required Language-Assistance Programming,and Mental Health Treatment Access Among Spanish-Speaking Clients

Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities.Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences.Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities.Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.Among the roughly 55.5 million persons in the United States speaking a non-English language at home in 2007, about 34.5 million spoke Spanish; of those Spanish speakers, more than 10 million spoke English “not well” or “not at all”1 and were thus considered persons with limited English proficiency (LEP). Persons with LEP “are unable to communicate effectively in English because their primary language is not English and they have not developed fluency in the English language.”2 In California, the state with the largest Spanish-speaking population in the United States, about 40% of persons aged 5 years or older among the state’s 14 million Latino/Hispanic population are considered persons with LEP.3LEP intersects with sociocultural and immigration-related barriers, thus preventing mentally ill persons with LEP from receiving needed care. Being uninformed about mental illness and interpreting and expressing symptoms of mental illness as something other than mental illness by using a culturally preferred idiom of distress, as well as turning to family and community network members when seeking help who reinforce nonpsychiatric perspectives, can divert persons with LEP from the path to mental health specialty care.4 The stigma associated with mental illness,5 distrust of treatment bureaucracies (S. Leask and L. R. Snowden, unpublished data, 2012), and, for immigrants, fear of being challenged by authorities and asked to account for their immigration status6 create additional barriers.Nonetheless, LEP introduces a significant barrier of its own. Persons with LEP find it difficult to communicate in English language–oriented health care settings,7–9 and they often either do not receive needed health care or receive ineffective care.10–20 Language proficiency may be especially challenging in mental health treatment because psychiatric evaluation hinges on obtaining a thorough history, and because key symptoms are not reflected in directly observable behaviors or signs of morbidity and can be elicited only via self-report.21 Language barriers can prevent recognizing and labeling mental health problems and can interfere with successful communication about treatment needs and care options.22–26According to legal interpretations, executive-branch directives, and US Office of Civil Rights enforcement actions, Title VI of the 1964 Civil Rights Act27 requires recipients of federal funds to provide language assistance services to persons with LEP.28,29 By 2008, every state had passed laws supplementing federal law, further requiring language assistance for persons with LEP seen in health care settings.30To assist in compliance, the US Office of Civil Rights issued guidelines for implementing Title VI requirements. These guidelines call for assessment of the language needs of service-eligible populations and development of written policies to meet needs; training of staff in language assistance policies and procedures; monitoring of the implementation of policy and procedures; provision of trained interpreters; translation of written materials; and notification of beneficiaries that they are entitled to translation assistance free of charge.31Like other mental health agencies, in 1997 the California Department of Mental Health (DMH) adopted a “threshold language access policy” to meet its Title VI obligation for treating persons insured through the state’s Medicaid program, called Medi-Cal.32 Under the policy, threshold status is reached when either 3000 Medi-Cal enrollees in a county or 5% of the county’s Medi-Cal residents, whichever is greater, speak a non-English language. For threshold languages, the policy directs county mental health plans toward a 4-part response: (1) a 24-hour, toll-free phone line with linguistic capability; (2) translated written materials to assist beneficiaries in accessing medically necessary specialty mental health services, including personal correspondence; (3) bilingual clinicians or other bilingual nonstaff, or interpreters or telephonic translation capacity at intake appointments, assessment interviews, treatment sessions, and at other key points of contact; and (4) information to consumers and communities about the availability of these linguistic services, free of charge.One previous study of the threshold policy’s impact in California found that the policy’s mandated language assistance programming increased access to mental health treatment for Vietnamese-speaking and Russian-speaking Medi-Cal beneficiaries, but it found no evidence that access increased for Spanish-speaking beneficiaries.33 However, the study did not examine how counties implemented threshold language programming and could not detect differences associated with the mode of implementation.Contracting with community-based organizations (CBOs) operating specialized treatment programs for non-English-language speakers34,35 is an attractive option for implementing the required language assistance programming. CBOs are

not-for-profit organizations such as non-governmental, civil society organizations, or other grassroots organizations, overseen by an elected board of directors and guided by a strategic plan developed in consultation with community stakeholders.36^(p33)

They operate health and social programs, as well as LEP-focused mental health programs, to fulfill a wider community service mission.36 CBOs seek strong community ties and pursue community oversight and governance; they also practice social, economic, and political advocacy, thereby promoting credibility and community trust.36 Seeking the advantages enjoyed by CBO-operated programs, mental health officials sometimes establish specialized LEP-serving programs operating directly under their authority.A handful of past reports indicated that specialized mental health programs for persons with LEP may be especially effective at bringing them into treatment. In 1 study, Latino and Asian persons with LEP received more outpatient care in such programs than their counterparts seen elsewhere, and their initial contact with a treatment program was significantly less likely to come about via emergency service encounters.37 A second study found that mental health programs specializing in clients speaking Asian languages provided an alternative to threshold language policy requirements for bringing Asian-language speakers into treatment.38We investigated whether access rates for Spanish-language mental health treatment rose for persons with LEP when CBOs’ mental health treatment programs implemented the language assistance programming required by threshold language policy. We hypothesized that, because their goals are closely aligned with addressing the cultural and linguistic orientation and interests of Spanish-speaking communities, and because this enables them to reach out effectively to LEP community members, CBOs’ language assistance programs will promote greater treatment entry than programs that are directly county operated.We also explored whether CBOs’ implementation of language assistance programming was effective and widespread enough to bring about a statewide reduction in the disparity in access between English and Spanish speakers.39 We evaluated any potential increased access experienced by Spanish speakers within a larger framework of disparities in access to mental health treatment. To our knowledge, this study was the first covering a large and diverse region, including a substantial Spanish-speaking population, to assess the effect of CBOs’ implementation of language assistance programming on the accessibility of mental health services for Spanish speakers with LEP. We also assessed reductions in disparities in access to mental health treatment for Spanish versus English speakers.