‘I'm not a family therapist. OK?’ Working Constructively with Families in Aged Psychiatry

This paper reports on the first phase of a larger study aimed at investigating factors hindering family work and exploring ways to improve the amount and quality of family contact within a community aged mental health service in Melbourne, Australia. During the first phase of the project, 28 mental health professionals were interviewed about their views and experiences. Interviews were transcribed, coded, and analysed in terms of repeating themes. The range of attitudes, beliefs and feelings about family work is summarised in this paper. Polarities emerged around questions of whether or not to engage family members, and if so, what function family work fulfils. The interviews also provided useful information on clinicians' beliefs about what would increase the possibility of family work. The paper concludes with a discussion about how to recognize and value family work in this area and target sustainable interventions during the second phase of the study.     

Predictors of treatment outcome in a child and adolescent psychiatry clinic: A naturalistic exploration

We present data on predictors of treatment outcome for 3200 consecutive referrals to a child and adolescent psychiatry clinic. Using Reliable Change Index (RCI) methodology, we divided children into those who, between intake and discharge, improved, stayed the same, or got worse according to clinician-rated impairment. Most predictors of improvement were related to parent variables (marital status, maternal anxiety, and ethnicity), while those associated with deterioration were tied to child status (extent of psychiatric comorbidity, history of placement in a self-contained classroom, and a prior trial of psychotropic medications). The implications of these findings for data-driven program development, clinic management, treatment planning, and systems of care are discussed.     

A Mixed-Methods Inquiry Into Trans* Environmental Microaggressions on College Campuses: Experiences and Outcomes

ABSTRACT

The experiences, including with environmental microaggressions, and well-being of trans* collegians remain an under-researched topic. In this mixed-methods study of a survey sample of 152 trans* collegians, multivariable regression findings suggest that the frequency of experiencing select trans* environmental microaggressions (e.g., not having access to comfortable bathrooms as a trans* person) are associated with increased risk for poorer academic outcomes (e.g., developmental challenges) but are not associated with mental health outcomes. Furthermore, interviews with 18 trans* collegians suggest that students face several systemic microaggressions, including difficulties advancing trans* inclusion. Various reactions, including paths of resistance, were identified. Implications are discussed.     

Involvement in the Juvenile Justice System for African American Adolescents: Examining Associations with Behavioral Health Problems

While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health problems, substance abuse, and delinquent or youth offending behaviors. Additional findings documented that the higher the number of juvenile justice system contacts, the higher the rates of delinquent behaviors, alcohol and marijuana use, sex while high on drugs, and commercial sex. These findings suggest that identifying and targeting youth who have multiple juvenile justice system contacts, especially those in low-resourced communities for early intervention services, may be beneficial. Future research should examine whether peer network norms might mediate the relationships between juvenile justice involvement and youth problem behaviors.     

“Let’s Talk About Children” resource: A parallel mixed method evaluation

Psycho-education interventions for families affected by parental mental illness have been found to be effective. This study aimed to assess the feasibility of a psycho-educational resource for parents, designed to initiate family discussions about parental mental illness and educate parents about the impact of their illness on children. In a mixed methods design, 19 parents read the “Let’s Talk About Children” psycho-educational resource and completed pre-and-post questionnaires measuring their perspectives of mental illness and awareness of the impact of mental illness on their children and family. 18 of these participated in a follow-up, one hour, individual interview to obtain further feedback on the resource. After viewing the resource, changes in parents’ attitudes and/or behavior in relation to mental illness and parenting were recorded. Interview findings indicate that the resource gave parents an awareness of the skills and knowledge needed for initiating family discussions about parental mental illness. The results of this study can be used to inform future interventions targeting parents who experience mental illness.     

How can context and discourse affect teachers’ and mental health professionals’ interactions with adults with mental illness?

Patients with severe mental illness may have needs different from those of patients with more limited illnesses and might benefit from other types of intervention than traditional treatment. We interviewed health care professionals from two open, short-term psychiatric wards and teachers from two schools for adults with psychiatric diagnoses. The focus was to explore how differences in contextual factors such as time, tasks, and organizational demands might affect the actions and attitudes of health care professionals and teachers, as well as the potential consequences for patients and students. Data were collected through qualitative interviews. Participants included 14 health care professionals and 14 teachers. The informants worked with patients and students with similar diagnoses and illness durations. All interviews were conducted during the informants’ work time. Findings and interpretations showed that both teachers and health care professionals were engaged in their work and in the wellbeing of students and patients. However, they described marked differences in practice, including the amount of time spent with students/patients, the organization of their work, main tasks, amount of control over their tasks, and social structure. These differences seemed to affect relationships with students/patients, attitudes toward students/patients, norms and values, and opportunities for patient empowerment. Our findings suggest that while existing psychiatric health care might be appropriate for limited short-term problems such as single-episode depression, a model with a supportive environment, based on stable relations and possibility for learning, may improve personal development and mental health for persons with severe mental illness and disturbances in self-experience.     

Predicting the recipients of social work support,and its impact on emotional and behavioural problems in early childhood

This paper examines the recipients of social work support in the Millennium Cohort Study. Using panel analysis and fixed effects models, it investigates the factors that lead to the receipt of any type of social work support for individuals with young children and the effects of this support on changes in the prevalence of emotional and behavioural problems in these children. We find that divorce or separation, and episodes of homelessness are two important factors that lead to the receipt of social work support. Mothers with male children are also more likely to receive social work support. However, we find no clear evidence that social work support has any effect on changes in children's emotional and behavioural problems over time. The implications of these findings for social work research and for practice and policy are discussed.     

Spanish migrants to European Union countries: predictors of psychological adjustment / Españoles que emigran a países de la Unión Europea: predictores de su ajuste psicológico

In recent years, the migration of Spanish people to other countries in Europe has increased; however, there are hardly any studies on this phenomenon. The aim of this study is to identify the predictive sociodemographic and psychosocial factors of psychological adjustment (life satisfaction and absence of internalizing symptoms) of emigrants and to determine the indirect effects of these factors through perceived stress. This study also seeks to examine whether the psychological adjustment of Spanish emigrants was similar to Spanish non-emigrants. The sample was made up of a group of Spanish emigrants to Germany and England (n = 858) and an equivalent control group of Spanish non-emigrants (n = 328). The results show that fulfilment of expectations, emotional support and job quality are the best predictors of perceived stress and psychological adjustment. These factors are confirmed to have indirect effects on psychological adjustment through perceived stress. Finally, the mental health of emigrants and non-emigrants was similar, and the implications of these findings are discussed.     

Family Relationships,Social Connections,and Depressive Symptoms Among Chinese Older Adults in International Migrant Families

This study explored whether and how family relationships and social connections influence depressive symptoms of older migrants and older adults in transnational families using the data gathered from a cross-sectional survey in Los Angeles, California, United States, and Beijing, China. Regression results showed that the older migrants reported significantly higher levels of depression than the elders in transnational families. The findings highlight the importance of maintaining close family relations and having large friendship networks for older adults in international migrant families.