Adolescents Seeking Mental Health Services

Summary

Inner-city adolescents receiving mental health services often get inadequate medical care. However, when those who seek counseling are asked about their health concerns, they say they want to discuss them with their therapists. Based on responses to a clinical self-assessment questionnaire (Adquest), adolescent mental health clients reported sleep difficulties, weight and eating concerns, and frequent headaches and stomachaches. Age and gender differences in patterns of vulnerability and willingness to talk were explored.     

Adolescents' Self-Reported Substance Risks and Need to Talk About Them in Mental Health Counseling

Summary

Although adolescents seeking mental health services may not consider them related, the prevalent co-morbidity of substance use and mental health problems makes it imperative that practitioners find ways of engaging troubled youth about substance issues. Based on their responses to a clinical self-assessment questionnaire (Adquest), this study shows that mental health service applicants are willing to disclose their substance use behaviors and are open to talking about them to intake workers. Age and gender differences in substance use patterns and willingness to talk are explored.     

Adolescents' Need to Talk About School and Work in Mental Health Treatment

Summary

School-aged adolescents spend much of their time in school. As a result, it is important for mental health practitioners who work with adolescents to address their clients' educational concerns and risks. Based on data “mined” from an adolescent intake questionnaire (Adquest), this study explores how adolescents view their educational life and their need to address educational risks clinically. Likewise, the world of work, also important to adolescents, is discussed. Overall, adolescents are concerned about their educational risk factors, want to be employed, and want to talk about both with clinicians in a mental health context.     

Multiple Risks,Multiple Worries,and Adolescent Coping

Summary

To describe the process that clinicians use to engage vulnerable urban adolescents in mental health counseling, the authors propose a tri-partite model of clinical engagement that takes into account: (1) consumer preference; (2) risk and worry; and (3) youth development (YD) perspectives. These conceptual lenses embody what adolescents want to talk about, their exposure to behavioral and environmental risks, and their coping and strengths. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this paper uses this tripartite model to summarize patterns of risk that service applicants experience, what they worry about, and how they cope. It explores the substructure of adolescent risk and vulnerability, through factor analysis of relevant items across a broad range of Adquest life areas, to develop a typology of adolescents by risk and worry. Patterns of coping and desire to talk across a range of life areas within this typology are described, as are the practice implications. The authors conclude that even those adolescents who most concern clinicians—because they have high environmental and behavioral risk and low worry-present many different opportunities for engagement.     

Adolescents' Self-Reported Risk Factors and Desire to Talk About Family and Friends

Summary

Adolescents entering an urban mental health program completed Adquest, an 80-item self-report inventory asking about important areas in their life such as school and education, work, health, sexuality, substance abuse, personal and family life. This article examines how much adolescents wanted to talk about family and friends with their counselors, gender and age differences in this desire, and how that is mediated by behavioral risk factors. Irrespective of the existence of coping problems and behavioral risks, adolescents expressed a strong desire to discuss family, and, to a lesser extent, friends, in counseling. From a clinical standpoint, this finding highlights Adquest's limitations because it is based on an individual, behavioral risk paradigm rather than on more systemic factors in the lives of these adolescents. Implications regarding the use of practice-based research to facilitate reflective practice are discussed.     

Lesbian,Gay, Bisexual,Sexual-Orientation Questioning Adolescents Seeking Mental Health Services

Summary

Lesbian, gay, bisexual, and sexual-orientation questioning (LGBQ) adolescents have many of the same health needs as straight adolescents. In addition, they must learn to manage a stigmatized identity that may create confusion, anxiety, and emotional turbulence for them. Beyond stigma, LGBQ youth are often found to be at higher risk for substance abuse, violence, depression, suicide, and sexual health problems. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this article examines the relationship between sexual identity and risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these in counseling. Findings indicate that LGBQ youth are at higher risk than straights, and express greater desire to talk about substance use, health, their personal lives, and their friends. Mental health practitioners working with these young persons must properly assess and address their risks by creating a sense of community and safe environment for open discussion.     

Clinical Uses of an Adolescent Intake Questionnaire

Summary

Open dialogue concerning behavioral and environmental risks is key to effective, holistic intervention with urban adolescents. Topics for discussion must include substance use, sexual behaviors and abuse, health concerns, exposure to violence and racism, school performance, and relationships with family and peers. Clinical engagement of adolescents requires focusing the therapeutic relationship on issues of their own choice, at their own pace. This article describes the clinical uses and practice impacts of a comprehensive adolescent self-assessment questionnaire (Adquest). By normalizing sensitive topics and allowing clients to exercise control over the therapeutic agenda and pace, Adquest serves as a “bridge to engagement,” a device for keeping the clinical dialogue open and a mode of induction to the client role. For staff, it represents a way of standardizing and broadening clinical assessment, identifying treatment objectives, and framing psycho-educational interventions.     

Chapter 7: Johns Hopkins University

SUMMARY

This article discusses the need for integration between different models of mental health, as seen through a “diary” of the events in a typical week of EAP supervision. Clinical and supervisory examples are offered as an example of integrating perspectives in the clinical setting. The overall process of integration in a clinical setting is discussed from both a philosophical and psychoanalytic perspective, and several examples of integration are related for the sake of discussion. Complementarity is invoked as a central theme of key importance for integration.     

Literary clinical practice: desire,depression and toxic masculinity in Hamlet

ABSTRACT

This essay introduces the notion of a literary clinical practice for which it remains essential to continue to consider those texts that open up a place for a readership, or audience, or even a civilization to consider the endlessly generative failure of its literature to write mental health. Concerned with mental illness that is an effect of language on the subject, the body, and of the enigma of the truth as cause, psychoanalysis is the crucial interlocutor for any literary clinical concern with the maladies of literature and society. In order to re-assess the utility of Shakespeare’s Hamlet to contemporary problems such as depression – perhaps the dominant symptom of our time – this essay attempts a reconsideration of Jacques Lacan’s famous seminar on Hamlet from the perspective of the contemporary clinic of the Lacanian orientation in psychoanalysis led by Jacques-Alain Miller.     

Social work and pastoral counseling: Empowering each other

ABSTRACT

This article addresses the divergent outcomes which can result from counseling services offered pastorally versus clinically. As faith leaders often have greater direct access than social workers to supporting religious populations, it is important to explore the intersection between religious pastoral support and clinical social work. Presenting six scenarios from the author’s own experiences as both a rabbi and social worker, this article processes each scenario first through the pastoral lens of an Orthodox rabbi, followed by the clinical lens of a social worker or other mental health professional. The client outcomes which are produced from each modality are radically different. This contrast demonstrates the distinction between the goals, values, and training of each profession, and highlights importance for future work to be done in linking religious and pastoral training to mental health services, as well as broadening the scope of cultural competence for social workers and therapists who may engage with tight-knit religious populations.     

Implementation of a Mental Health Task Force in a collegiate-based emergency medical services organization

Abstract

Objective: A Mental Health Task Force (MHTF) was implemented in 2016 by a collegiate-based emergency medical services (CBEMS) organization to (1) improve mental health emergency response and to (2) address concerns for the mental health of CBEMS providers. Participants: Skidmore College EMS is a Basic Life Support First Response service staffed by volunteer undergraduate students. Methods: In coordination with faculty and staff, students in the MHTF developed trainings, peer support structures, community events, policies, and informational resources. Results: Sixteen students joined the MHTF within 1 year. Over 35 Skidmore College EMS members received training on mental health emergency response, peer-support, and self-care. Debriefing programs, mindfulness-based events, shift-length limitations, and access to informational resources promoted the mental health of Skidmore College EMS members. Conclusions: Implementing an MHTF is an innovative, student-led approach to coupling education on emergency response with programming that supports the mental health of CBEMS providers.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

Counseling Brazilian Undergraduate Students: 17 Years of a Campus Mental Health Service

Objective: The authors reviewed demographic and clinical characteristics of undergraduates at a Brazilian public university (UNICAMP) who visited the campus mental health service (SAPPE) and compared their demographics with those from all undergraduate students enrolled in the university. Participants: The authors looked at data from all undergraduates who sought counseling or mental health care at SAPPE over a 17-year period (N = 2,203; 1987-2004). Methods: They obtained this information from clinical charts and a UNICAMP database. Results: Women, students from other Brazilian states, students living in the campus residence hall, and students whose main source of income was a scholarship were overrepresented. Female student-clients complained about family conflicts more frequently than did their male counterparts, and male student-clients reported concern about poor academic performance more frequently than did their female counterparts. Conclusions: Sex, living in a university residential facility, and reliance on a scholarship grant were predictive of undergraduates' mental health-seeking behavior and pattern of complaints.     

Mental Health Among College Students: Do Those Who Need Services Know About and Use Them?

Objective: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. Participants and Methods: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. Results: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. Conclusions: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Cultural Competency and Achieving Styles in Clinical Social Work

Abstract

This paper attempts to build a cultural competency framework by reviewing the literature and laying a conceptual foundation for professional standards in clinical social work. It also explores the implications of cultural competency by relating some important factors to clinical decisions, alliance, and outcome in the mental health field. The pathways and directions of the relationships as well as the potential factors affecting cross-cultural clinical alliance are illuminated in a general model to guide hypothesis formulation in further research. Empirical data are presented on clinical social work practice with Asian American clients in light of a key factor in shaping cultural competency, i.e., clinicians' personal achieving styles. The findings suggest that such styles are culturally bound.     

Depressive Symptoms and Mental Health Treatment in an Ethnoracially Diverse College Student Sample

Abstract

Objectives: To study (a) the prevalence of depressive symptoms and (b) the utilization of mental health treatment in an ethnoracially diverse sample consisting primarily of Asian Americans, European Americans, Native Hawaiians, and Pacific Islanders. Participants: Five hundred eighty-nine college students. Method: A questionnaire packet that included the Center for Epidemiological Studies Depression Scale (CES-D) was administered to students in introductory psychology courses. Results: (a) There were no differences among ethnoracial groups in levels of depressive symptoms as measured by the CES-D; (b) 71% of participants with high levels of depressive symptoms had not received any mental health treatment in the previous 12 months; and (c) European Americans were 3.7 times more likely to have received mental health treatment in the previous 12 months than other students. Conclusion: Outreach efforts designed to improve utilization of mental health treatment services by depressed college students, especially by members of ethnoracial minority groups, should be increased.     

Cyber Counseling for Queer Clients and Clinicians

Abstract

As the Internet grows, so does its use by mental health professionals and by clients seeking mental health services. Drawing on his own experience as an example, the author describes how the Internet can enhance clinical practice. Social service professionals can utilize the Internet to provide a supportive forum for patients grappling with issues of self-identity; facilitate communication between therapist and client; provide community education about mental health issues; provide referrals to local social service professionals; market a private psychotherapy practice; and provide patient billing, scheduling, and record keeping.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

An Interview with Joyce Edward: Exemplary Clinician, Advocate, and Scholar

Over the years, noteworthy social workers have been interviewed for the Clinical Social Work Journal. This article features an interview with Joyce Edward who is recognized for her many extraordinary contributions to clinical social work. Joyce has co-written or co-edited three exceptional books for the social work clinician, she has been an esteemed teacher and a vocal activist for quality mental health care. In this interview Joyce reflects on family influences, her work as a social caseworker, the psychoanalytic luminaries with whom she trained, her concerns about the clinical education of today's social work students, and finally, her perspective on managed mental health care.