Mental Health on the Campus Revisited

Abstract

The author briefly reviews Mental Health on the Campus: A Field Study, published in 1973, noting areas of consensus and points of tension or disagreement that were reported in that study. He then assesses the extent to which the current state of mental health on the campus is an echo of that report. These comparisons form the basis for anticipating the probable direction of future developments in campus mental health. The areas and issues considered include the increased diversity of the student body, the stable incidence of psychotic disorders, the increased prevalence of gender-related diagnoses such as sexual abuse and eating disorders, the continuing financial pressures bearing on campus mental health programs, and the forms of care and treatment that fiscal and other circumstances are imposing. The author concludes that although the resources available and the particular challenges that are faced may have changed, the traditional goals of a campus mental health program, as articulated 75 years ago when the American College Health Association was founded, remain valid, even if they are difficult to attain.     

Gender, race-ethnicity, and psychosocial barriers to mental health care: an examination of perceptions and attitudes among adults reporting unmet need

Though researchers have described psychosocial barriers to mental health care-seeking, limited research has examined ways in which gender and race-ethnicity are associated with individuals' perceptions and attitudes. This study investigates correlates of psychosocial barriers to mental health care in a population of adults reporting unmet need for mental health care, focusing on gender and race-ethnicity. Data are from the 2002 National Survey on Drug Use and Health. Multivariate analyses show that non-Latino white male status is positively associated with stigma avoidance and mistrust/fear of the mental health care system. Persons of lower income or educational status are less likely to report negative attitudes towards care. Findings imply a need to reconsider the roles of gender race-ethnicity, and socioeconomic status within investigations of psychosocial barriers to care. Future research should examine the relationships among social status, help-seeking behaviors, and attitudes toward mental health care.     

Employer‐Supported Child Care: Who Participates?

Child‐care vouchers are becoming more common and can provide child‐care assistance to a wide spectrum of the population. There is little empirical research, however, on which workers participate in their employer's child‐care programs. In this exploratory study, employees with children at 1 large university completed questionnaires to gather information on their child‐care arrangements and their experience with the employer's child‐care voucher program (N = 949). Results indicate that the employees who were most in need of child‐care assistance in terms of family structure, job type, and child‐care expenses were more likely to receive vouchers. Federal policy limiting the structure of employer‐sponsored voucher programs appeared to present barriers to participation for certain groups of employees.     

Use of Various Health Care Services by Students in Helsinki

Abstract

Review of the working of various health care schemes has revealed predominant use by a certain group of “large-scale consumers.” The concomitant use of various services (health, dental, and mental health care) was studied within the Helsinki Health Center of the Finnish Student Health Service from January 1, 1980 to August 31, 1980. The group consisted of 16,174 students. The characteristics of the groups of patients who used only the mental health care service and of those who used all three services were also studied. Within each sector, there were fewer patients than expected who did not use the services of other sectors. The number of patients visiting dental and health care services, mental health and health care services, and all three services were greater than expected. The groups of patients who used only the mental health care service and those who used all three services were surprisingly similar. The greatest difference between the groups probably lay in their need for somatic and dental care. The organization, which incorporates mental health, dental, and health care services in the same building offers improved possibilities for care of the patient as a whole. On the basis of this study, there is no reason to think that such an organization leads to misuse of the various services.     

Study finds MAT combined with 12‐Step residential treatment is effective

To those who might assume a federal lawsuit seeking class status for treatment providers wronged by insurance company actions would be receiving immediate and universal acclaim in the provider community, a little caution may be in order. While the latest lawsuit against United Behavioral Health (UBH) certainly will be interpreted by some addiction treatment providers as an opportunity to recover payments that were inappropriately denied (see ADAW, Sept. 23), the case also could launch a broader discussion of how best to guarantee that insured patients receive the care to which they are entitled.     

Barriers to substance use disorder treatment in a sub-acute setting

ABSTRACT

With the changing times, it is essential integrate behavioral health within the primary care of patients. The need is based on the research that links a number of health issues being directly to substance use and mental health diagnosis. With the current opioid epidemic there is a need to address substance use disorders when treating patients in different health care settings. Despite the necessity of integrated care, there are barriers to addressing addiction in sub-acute care settings. With the lack of buy-in from the patients and health care providers and the stigma surrounding addiction it is time to address the barriers that prevents integration of care where it is most needed.     

Needs and preferences for employer supported child care: A feasibility study

Employees of a large suburban health care center were asked to identify their needs and preferences for child care, and existing fringe benefits that they would be willing to give up in order to obtain employer supported child care services. Results indicate that a majority of the 41 employees in the sample with children under 12 years of age experience problems relating to child care and that those problems affect their work performance. There is no clear preference for type of child care, however, and employees are unwilling to give up existing fringe benefits to obtain child care services. Results are discussed with implications for provision of employer supported child care that is sensitive to the individual needs of employees.Terese Dressel is a clinician/consultant with the DuPage County Health Department, 111 North County Farm Road, Wheaton, Illinois 61087. The research reported was conducted as part of her Masters thesis in the Department of Human and Family Resources, Northern Illinois University.Michael Martin is an Associate Professor in the Department of Human and Family Resources, Northern Illinois University, DeKalb, Illinois 60115. Research interests include child maltreatment and family violence.     

Perceptions of Family-Friendly Policies: University Versus Corporate Employees

This study adds to a growing literature examining the impact of family-friendly policies in a variety of industries by examining the differences between corporate and university employees in their subjective perceptions of work-family policies. Differences by gender and dependent care responsibility in these perceptions in the university sample are examined and compared to results that have been found in corporate settings. Data collected in a university setting was compared to similar data of thirty-seven Business Week 1000 companies. The results show that the university sample employees were significantly more negative toward their workplace's work-family climate than were the corporate sample employees. In addition, significant gender and dependent care responsibility differences exist within the university sample.     

Collaborative mental health in rural and isolated Canada: stakeholder feedback

This article presents research findings from the Rural and Isolated Working Group, one of six groups established by the Canadian Collaborative Mental Health Initiative (CCMHI). Funded through Health Canada's Primary Health Care Transition Fund, the goal of the CCMHI is to improve the mental health and well-being of Canadians by increasing collaboration among primary health care and mental health care providers, consumers, families, and caregivers. Qualitative data obtained from mental health care providers and consumers across all regions of Canada are presented in this article. Policy and regulation problems, barriers to mental health care access, service providers' perspectives of the challenges to consumer involvement, and solutions for addressing these issues are discussed. The article concludes by identifying how this research has informed and influenced initial steps toward mental health promotion and treatment of mental illness in rural and isolated Canada.     

The MHSIP mental health report card. A consumer-oriented approach to monitoring the quality of mental health plans. Mental Health Statistics Improvement Program

Health care report cards have been endorsed as a mechanism for efficiently comparing key quantifiable aspects of performance across a range of health systems or plans. There are challenges in determining what to measure; how to gather and analyze data; and how to report, interpret, and use findings. Mental health has received little attention, and a consumer perspective is typically not included. The proposed MHSIP mental health report card (MMHRC) addresses these concerns. General issues for report cards are discussed, and the MMHRC is described in terms of content, data sources and quality, and analysis and reporting.     

Family caregivers of the elderly: quality of life and coping in Estonia

The purpose of the study was to analyse the assessments of elderly people aged 65 and more about family caregiving as a factor influencing their quality of life and coping. The study is based on the project SUFACARE—‘Supporting family carers and care receivers in Estonia and in Finland’—in the framework of which the Institute of Social Work of Tallinn University carried out postal surveys in 2010. The Estonian survey was conducted in Tallinn and Lääne-Viru County. The total number of respondents was 581 (70% female and 30% male), of whom 98 (n=74 female and n=24 male) were family caregivers. Caregiving has not influenced the physical and mental health of caregivers, the reason being that many people who receive care are not of very ill health or suffer from dementia. People mostly take care of their spouses. Based on the Estonian Family Law Act (RT I 2009, 60, 395), adult descendants are required to provide maintenance if their relatives are not able to care for themselves. Caregivers whose health is below average consider caring to be physically demanding. We cannot speak of the social isolation of respondents who have care duties—they communicate actively and do not feel lonely. Women report caregiving to be physically strenuous more often than men. The mental health of male caregivers is better—fewer male respondents claimed to feel unhappy or depressed compared to female respondents.     

Lesbian Health

ABSTRACT

Health care research suggests that lesbians may face unique physical and mental health risks, yet few studies make use of gender and sexuality theories to explain lesbian health. In this study, a social constructionist view of sexuality is used to examine the impact of lesbian identity on well-being. Drawing from nineteen intensive interviews with women who self-identify as lesbians, the results show that individuals' sexual identities change over time and are affected by their social environments. The data also demonstrate that sexual identity and social context have implications for well-being. Specifically, hostile environments, which are characterized by animosity toward gay men, lesbians, and others who do not conform to heteronormative gender expectations, are associated with distress over lesbian identity and with physical and mental health problems. By contrast, supportive environments, which many women report finding through feminism, facilitate the construction of a positive lesbian identity and enhance well-being.     

The Business of Caring: Women's Self‐Employment and the Marketization of Care

Our goal in this article is to contribute to a differentiated analysis of paid caring work by considering whether and how women's experiences of such work is shaped by their employment status (for example, self‐employed versus employee) and the nature of care provided (direct or indirect). Self‐employed care workers have not been widely studied compared with other types of care workers, such as employees providing domestic or childcare in private firms or private homes. Yet their experiences may be quite distinct. Existing research suggests that self‐employed workers earn less than employees and are often excluded from employment protection. Nonetheless, they often report greater autonomy and job satisfaction in their day‐to‐day work. Understanding more about the experiences of self‐employed caregivers is thus important for enriching existing theory, research and policy on the marketization of care. Addressing this gap, our article explores the working conditions, pay and levels of satisfaction of care workers who are self‐employed. We draw on interviews from a small‐scale study of Canadian women engaged in providing direct care (for example, childcare) and indirect care (for example, cleaning).     

Philadelphia says smoking ban has not led to treatment impact

Despite charges by Brooke Feldman and others (see “Advocate: Philadelphia smoking ban shuts some patients out of treatment,” https://onlinelibrary.wiley.com/doi/10.1002/adaw.32388 , ADAW, June 10), the number of people leaving addiction treatment in Philadelphia is up, not down, after the smoking ban, the Department of Behavioral Health and Intellectual disAbility services (DBHIDS) stated last week in a press release. The statement came out June 24, the day before a planned protest spearheaded by Feldman.     

The use of mental health care,psychotropic drugs and social services by divorced people: does informal support matter?

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.     

Response to Shaffer (1996): The Case for a 'Complex Systems' Conceptualisation of Addiction

This paper responds to some of the issues raised by Shaffer's (1996) paper, Understanding the Means and Objects of Addiction. The authors agree with, and in many respects support, the assertions made by Shaffer with respect to the conceptualisation of the problem of addiction. In particular, that it is the relationship of the addicted person with the object of their behaviour that defines addiction. However, it is argued that in addition to providing an operational definition for addiction, it is important to provide an explicit framework for the development of insight into the 'synergistic nature' of the multiple factors affecting the addiction process. That is, it is necessary to account for both the commonalities and the differences found across the spectrum of addictive behaviours. It is proposed that this might be provided by a 'complex systems' approach to the field of addiction.     

Some obstacles to the effective investigation and registration of children at risk—issues gleaned from a worker's perspective

Abstract

This paper describes a woman who is both damaged and damaging. The mental disorder/disturbance felt by this woman generates levels of anxiety that she cannot contain, and this anxiety is passed onto the others who constitute her community. For community care to work it must be possible within the community system to identify, think about and manage the anxieties generated by such mental disturbance. The new legislation of community care may encourage us to ignore the reality of mental illness and issues of power, conflict and pain, and their underlying anxieties. Current examples are given of the acute anxieties felt by many workers in the field which, if uncontained, lead to defensive anti-task strategies. When disturbance is projected and disowned it is put out of mind and may then be passed between parts of the system. Even though it may no longer be possible, except as a short term measure, to put the mentally ill out of sight in mental hospitals, the mental disturbance and those in whom it is located may still be marginalised. The paper proposes a model of community care which encompasses mental illness, professional workers and the community. These three elements are seen as the corners of a triangular space which theoretically becomes the container of mentally disturbing anxieties and within which these anxieties can be addressed, thought about and managed

It is argued that this model could enable workers to foresee some difficulties and to address others in a manner that would lead to greater containment and more effective management of mental illness in the community     

Resisting the pull of the health insurance tarbaby: An organizational model for surviving managed care

Insurance company managed mental health care makes a basic change in the clinical process, transforming what had been a therapeutic dyad into a three-party process. The newly formed San Fernando Valley Alliance of Mental Health Professionals for the Preservation of Privacy and Self Determination in Psychotherapy seeks to preserve the practice of traditional psychotherapy and keep it accessible to a middle-income clientele by a public education process in which the privacy and autonomy of the therapeutic dyad are presented as thesine qua non of psychotherapy.