Stakeholder Perspectives on Children's Mental Health Needs and Supports in Six Low‐ and Middle‐Income Countries

Low‐ and middle‐income countries (LMIC) are faced with disproportionately high levels of unmet child mental health needs. This study explored through interviews the perspectives of 17 inter‐agency service stakeholders from Brazil, Indonesia, Kenya, Pakistan, Rwanda and Turkey on existing supports and challenges. Four themes emerged on the holistic nature of children's mental health needs linked with disadvantage; limited resources and skilled workforce; stigma; and strategies for future implementation, including awareness, parental engagement, skills‐based programmes and cultural adaptation. Stakeholder input is essential in conceptualising, developing and evaluating culturally appropriate interventions for vulnerable children in LMIC.     

Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Knowledge of Suicide Risk Factors,But Not Suicide Ideation Severity,Is Greater Among College Students Who Viewed 13 Reasons Why

Abstract

Objective: To test associations between viewing 13 Reasons Why, Season 1 and past week suicide ideation severity, behavior risk, stigma, and knowledge in college students. To explore whether personal exposure to suicide and depressive symptom severity moderated these associations. Participants: Eight-hundred and eighteen college students, 64% (n?=?522) of whom watched 13 Reasons Why. Methods: Students completed surveys online. Multivariate negative binomial regressions were used to test associations between watching 13 Reasons Why and suicide-related variables, and interaction terms. Results: Suicide ideation severity and suicide behavior risk were not significantly associated with viewing 13 Reasons Why; however, there was limited statistical power to detect associations. The association between watching 13 Reasons Why and greater suicide knowledge was stronger among those who did not have personal exposure to suicide. Conclusions: 13 Reasons Why may be a platform for psychoeducation on suicide, particularly among those who do not have personal exposure.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache. Methods: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. Results: This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. Conclusions: As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.     

A qualitative investigation of risk and protective factors for interpersonal violence in adults on the autism spectrum

Abstract

Individuals on the autism spectrum are at an increased risk of experiencing violence. This study sought to understand the opinions of adults on the spectrum regarding potential risk and protective factors for interpersonal violence. Twenty-two adults (12 men; 18 to 53 years of age) participated in semi-structured qualitative interviews. Interviews were recorded, transcribed, and analysed. The results of the qualitative analysis identified individual and contextual risk and protective factors. Protective themes focused on individual needs (awareness of the self and the environment, interpersonal knowledge/skills, skill building strategies) and supportive contexts (benefits of a trusted person, advocates, fostering acceptance and inclusion). There is a need for strategies to decrease the vulnerability to, and the impact of, interpersonal violence. Individuals on the spectrum have the capacity to provide important information regarding safety promotion and risk factors for interpersonal violence, and their expertise should play a role in guiding efforts that promote safety.     

Substance use among older youth transitioning from foster care: Examining the protective effects of religious and spiritual capital

Among older youth transitioning from the foster care system, this longitudinal study examined the association of religious and spiritual capital to substance use in the past year at age 19. Participants consisted of African American (N = 179) and White non‐Hispanic (N = 133) older youth in foster care. Drawing from social capital theory, it was posited that religious service attendance (a proxy for religious capital) and belief in a spiritual force (a proxy for spiritual capital) would be inversely associated with substance use. Multiple logistic regression results indicated support for the first and second hypothesis for White foster youth only. Among White foster youth, more frequent religious service attendance and greater belief in a spiritual force were associated with a lower likelihood of illegal substance and polysubstance use. No association between religious or spiritual capital and substance use was found among African American foster youth. The findings underscore the importance of conducting spiritual assessments to help ensure older foster youth who have strong religious or spiritual orientations are in environments where they are accommodated and supported.     

Let the right one in: A Bourdieusian analysis of gender inequality in universities’ senior management

This article examines the lack of gender diversity in senior management positions in professional staff in universities. These results are analysed via a Bourdieusian analysis of economic, social, cultural and symbolic capital. Through a purposeful sample of senior professional staff working in universities in three countries: Australia, Canada and the UK, six career‐enhancing strategies needed for career success were determined. The article critiques the resource‐based view of career capital and argues that capitals accumulation for career success can be understood by considering the concepts of symbolic violence and habitus as a way of understanding intra‐cohort differences. It proposes that by considering both the subjective and objective cultural constructs via habitus, and by acknowledging the importance of symbolic capital and symbolic violence towards women, this may be one way of increasing female representation in senior management.     

Coalition-building and the forging of solidarity across difference and inequality

Diverse coalitions hold great potential for social movements, but they also face tremendous challenges. In this article, I review the literature on diverse alliances with a focus on how trust, commitment, and ultimately, solidarity can be developed and sustained across divides. The article begins by discussing the needs of diverse alliances to build trust and commitment, and the coalitional characteristics deemed vital for doing so, with a focus on shared neutral space, ongoing interaction, and social ties and bridgebuilders. Five coalitional processes and practices are identified and discussed that have been empirically found or theorized to be imperative for cultivating solidarity across difference and inequality. These processes include (a) uniting around shared principles while engaging difference; (b) acknowledging and managing inequalities; (c) making space for each other; (d) attention to managing conflicts; and (e) actions that confirm the shared commitments and negotiated identity. I conclude by evaluating the state of research on developing and sustaining alliances across divides.