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.     

Social Inclusion as an Agenda for Mental Health Social Work

Summary

Following New Labour's election to office in the UK in 1997, policy initiatives have proliferated relating to mental health. Much of this policy innovation emphasises the social dimensions of mental health and distress, with an emphasis on employment and social inclusion. Paradoxically, this modernization of the mental health agenda comes at a time when mental health social work is struggling to establish its role and contribution within recently integrated health and social services. The paper considers whether New Labour's flagship programme, Mental Health and Social Exclusion, constitutes a “New Deal” for mental health, and whether it provides a perspective that will help mental health social work to define its distinctive contribution to integrated services.     

Peer Support Among Consumers of Professional Mental Health Services

ABSTRACT

Peer-support services have become increasingly prevalent in mental health; consumers now deliver many services once provided by professional mental health providers. Recognizing this key asset in mental health consumers' service environment is critical for social workers. This exploratory study examines differences among 311 consumers of professional mental health services, half of whom also used peer-support services. The two groups (peer support compared with non-peer-support) were compared on a number of dimensions related to their utilization of and satisfaction with professional mental health services. Users of peer-support services perceived greater availability of professional services and used more professional services, but found professional services to be less useful than those not participating in peer support. No differences between the two groups were found for overall satisfaction with professional services. Findings related to policy, practice, and research are discussed.     

Family Intervention and Services for Persons with Mental Illness in the People's Republic of China

ABSTRACT

Family services and intervention for persons with mental illness is crucial in mental health services. In this paper, the writer attempts to describe family intervention and services for persons with mental illness in the People's Republic of China. Family intervention and services like home-based care, guardianship network, family counseling, and psychoeducational programs are only preliminarily developed. Their effectiveness and challenges in future development are discussed.     

HMOs and the Future of Student Mental Health Services

Abstract

The health maintenance organization (HMO) is likely to have a prominent position under national health insurance, which will have a strong systematizing effect on the nation's health services. Over the past two years the University of Massachusetts mental health services have provided benefits at both the university and a private medical group practice. Experience has shown that a university which already provides broad services to a large student population can extend itself to the university community including its faculty and staff. Several advantages of this development, as well as some significant problems, are discussed. As the HMO grew and quality services were established, it became feasible for the private medical group to develop its own mental health component. Based on this and other experiences in mental health delivery systems, certain conclusions are drawn about the ways universities can develop HMOs and some recommendations are made for national mental health planning.     

Older Lesbians and Gays Accessing Health and Aged-Care Services

Abstract

The present paper examines older lesbian and gay people's experiences of and expectations for the delivery of health and aged-care services. In-depth narrative interviews were conducted with older gays and lesbians in the Blue Mountains, west of Sydney (NSW, Australia). Data were analysed by identifying evaluative statements within specific narratives and grouping these statements into themes. Participants reflected on the meaning of their sexual identity and how they would like it to be acknowledged when in contact with health and aged-care service providers. In addition to direct discrimination, participants reported a more indirect form of discrimination in providers’ assumption of heterosexuality among clients and their failure to provide lesbian- or gay friendly services. The findings highlight the need for health and aged-care services to better understand and acknowledge older gay and lesbian people's sexual identities to enable improved access to services in the future.     

The Life Course: A Sociological Introduction

Abstract

Recognition of the deleterious effects of domestic violence on women's mental health has highlighted the potential benefits for women of collaboration between mental health and domestic violence services. Yet the different histories, knowledge bases, and organisational cultures of the mental health and domestic violence sectors present formidable challenges to the development of effective collaborative work. This article draws on a large research enquiry, involving four separate but related studies, which explored aspects of collaboration between these two service sectors. It focuses particularly on data collected in interviews with practitioners from mental health and domestic violence services who were participants in an action research study (one of the four studies), which was aimed at discovering the factors that contributed to enhanced collaboration and the benefits of this for women who experience both domestic violence and mental health issues.     

Elders and the Courts

Abstract

This article examines how trial courts should address complex issues of an aging society. More older people, living longer, will enter courthouses with underlying problems that will impede effective access and court processes and will require judges to enhance linkages with community health, mental health, and social services providers. The article analyzes how court systems perceive these issues and explores how they have begun to address them. It concludes with an argument in support of innovative new approaches to assist courts in responding to emerging issues of older adults.     

One Hundred Years of College Mental Health

Abstract

Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, “mental hygiene” was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.     

Ethical Issues in Child Custody and Dependency Cases

Abstract

The emotional and psychological risks to children of high conflict divorce have led to the increased involvement of mental health professionals in child custody cases. Numerous service models (Greenberg & Gould, 2001; Johnston, 2000; Johnston & Roseby, 1997) have been developed to assist divorcing families in minimizing family conflict and supporting children'S needs. This underscores the need for judges and attorneys to understand the ethical and professional standards that underlie competent mental health practice in forensic cases. The practices of mental health professionals providing court-related services may have a substantial impact on the validity of their professional opinions, the effectiveness of services provided to children and families, and children'S development and adjustment. The authors suggest core ethical and clinical issues to be considered by all psychologists who work in the context of custody disputes. It is hoped that these professional practice suggestions will also be useful to attorneys and judicial officers in assessing the quality of mental health professionals' opinions.     

The Need for Web-Based Cognitive Behavior Therapy Among University Students

ABSTRACT

This study investigates students' need for a web-based cognitive-behavior therapy (CBT) intervention program for preventing depression, the mental health status of those who felt a need for such a program, and underlying factors of the intention to use web-based self-help. A conceptual model for explaining intention to use web-based self-help is proposed. Nearly half of the participants reported a need for help with psychological problems, but only a third of these actually sought help from traditional mental health services. In conclusion, there is a need for web-based self-help, and web-based CBT has the potential to attract a group of students who, so far, have not been reached by traditional mental health services.     

Chapter 2. Intervention Continued

SUMMARY

This chapter describes the case management process-a process for assisting individuals and families with multiple service needs-and its use in various fields of practice including mental health, human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS), and services for older adults. It addresses the role of the case manager as the person responsible for ensuring the timely and adequate delivery of suitable community-based services. The integration of formal services with informal care by family and friends as an intervention strategy is also discussed.     

Medicare Funded Mental Health Social Work: Better Access to What?

ABSTRACT

Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Scheme initiative (Better Access), is an Australian Federal Government scheme aiming to improve access to mental health services. Accredited mental health social workers have been involved in the delivery of services under Better Access for more than a decade. In this time, there have been significant changes in the field of mental health services, with consequent increases in size and costs for Better Access. Better Access now represents public spending of more than one billion dollars per annum, yet there is no ongoing account of its impact. In this paper we consider the policy chronology and evaluation of the program, using current available data to question the impact of Better Access on both the service system and the nature of mental health social work practice. This case highlights the importance of a clear articulation of the scope of mental health social work, and ongoing monitoring of the impact of policy in a policy environment increasingly characterised by individualised funding and service delivery structured according to the principles of New Public Management.

IMPLICATIONS

• Social workers' increasing involvement with Better Access has reshaped the scope of mental health social work practice.

• The impact of Better Access on outcomes for service users and mental health social work is not currently a focus of research attention.

• Better Access is a case study illustrating the potential of the policy context to directly shape social work practice, therefore critical engagement with the impact of Better Access is an essential professional imperative.

     

Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment

Objective: We modeled design factors influencing the intent to use a university mental health service. Participants: Between November 2012 and October 2014, 909 undergraduates participated. Method: Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Results: Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. Conclusions: E-Mental Health options could engage students who may not wait for standard services.     

Mental health service utilization in children adopted from US foster care,US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

Aims

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization.

Data

As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17 years old (N = 1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse).

Results

For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services.     

Reflections of the Annual Meeting

Abstract

In preparation for planning counseling and mental health services at Columbia University, the authors conducted a mental health needs assessment survey that sampled representative numbers of students. Respondents were most concerned about academic and school-related issues, followed by concerns in the area of love relationships. Multiple regression analysis revealed certain subgroups that were more likely to have these concerns and certain health and mental health problems that were significantly associated with these concerns. The study identified serious psychological problems, including suicidal/homicidal thoughts and sexual abuse, and surveyed respondents' treatment preferences. Finally, the authors discuss how the study findings contributed to sharpening and expanding focus on different aspects of program development in the collaboration between mental health and health education.     

Health System Reform and the Elderly: The Case of Israel

Abstract

Following the implementation of the National Health Insurance Law in January 1995, major changes have taken place in the provision of health services by Israel's sick funds and the way these services are funded. This article presents the principal changes that have occurred and assesses their impact on those aged 65 and older, using findings of a survey conducted one year after the law's enactment. While the findings show that the elderly's situation has improved in some areas, they also raise concerns that the elderly are having difficulty navigating the reformed health system and that they are not benefiting from the new competition among the sick funds.     

Mental health services for children and caregivers remaining at home after suspected maltreatment

ObjectiveBehavioral problems are common among children remaining at home after suspected maltreatment, but the effectiveness of current mental health services to improve these behavioral problems is unknown. The objective was to determine whether receipt of child and caregiver mental health services was associated with improvements in behavioral problems in maltreated children remaining at home.MethodsWe retrospectively analyzed Second National Survey of Child and Adolescent Well-being data. We included 1117 children ages 2–17 remaining at home after a maltreatment investigation, excluding children with missing outcome, covariate, or survey weight data. We compared mean Child Behavioral Checklist (CBCL) change scores from baseline to 18 months between children who did and did not receive mental health services, before and after adjusting for child, caregiver, and child welfare agency factors using survey-weighted linear regression.ResultsNearly one-quarter (22.6%) of children and 16.0% of caregivers received mental health services. Children receiving services had worse unadjusted baseline and 18-month CBCL scores than children not receiving services (all P < 0.001). Adjusted CBCL change scores revealed behavioral worsening among children receiving services but improvement among children not receiving services (all P < 0.001). However, children had improved behavior, regardless of their own service receipt, if their caregivers received services and reported an absence of depression at 18 months.ConclusionsChildren receiving mental health services had worse behavioral changes than children not receiving services. Caregiver receipt of services was associated with improved child behavior, suggesting that a family-centered approach may be most influential in improving behavioral outcomes among this population.     

Caseworkers' perspective on risk factors in the family environment influencing mothers' difficulties in meeting children's needs

ObjectivesThis study examines, from the caseworkers' point of view, which needs of children are the most difficult for parents in neglectful contexts to respond to and which risk factors make this response more difficult.MethodA sample of 55 parents being followed by child protection services for neglect or high risk of neglect accepted to participate in the study. Their caseworker filled out a grid regarding the response provided to the children's needs and the risk factors in the family environment.ResultsThe results indicate that the children's age is related to the difficulties of responding to their needs. The caseworkers are particularly concerned about guidance and boundaries provided to preschool-age children, but less so about that provided to school-age children. When the children's age is controlled for, parents' mental health problems explains a significant proportion of the variance in parents' response to their children's need for stimulation, emotional warmth, and guidance and boundaries. Caseworkers' worries about drug and alcohol misuse also explain a significant proportion of their concerns about the mothers' ability to ensure their child's safety.ConclusionCaseworkers are more worried about the parental response offered to preschool children than to school-age ones. However, a constant and coherent response to growing children is still important for their developmental trajectories. Moreover, mental health and substance abuse explain caseworkers' concerns about mothers' engagement toward their child. These data raise questions about which type of services to offer, because intervening in families where parents deal with personal issues while addressing child neglect is complex.     

Personal control and service connection as paths to improved mental health and exiting homelessness among severely marginalized homeless youth

ObjectiveNon-service connected, continuously homeless youth are arguably one of the most vulnerable populations in the U.S. These youth reside at society's margins experiencing an accumulation of risks over time. Research concludes that as vulnerabilities increase so do poor long-term outcomes. This study tested the mediating effects of service connection and personal control as mediators of cumulative risk and housing, health and mental health outcomes. By understanding the processes associated with therapeutic change among those with the most vulnerabilities, service providers and researchers can target those factors to enhance positive outcomes.MethodSeventy-nine, non-service connected, substance using homeless youth were offered a strengths-based outreach and engagement intervention and were assessed at baseline 3, 6 and 9 months post-baseline.ResultsPersonal control mediated the effects of cumulative risk on housing stability, and service utilization mediated the effects of cumulative risk on mental health.ConclusionsThis study specifies important targets of intervention for a population at high risk for continuing homelessness. In particular, service providers should target youths' sense of personal control and link them to needed community-based services in order to help them exit street life and improve mental health outcomes.