The Geriatric Worker in a Community Mental Health Clinic:

Special geriatrics services are now a reality in many community mental health clinics, thus making it timely for clinicians and administrators to look at the problems faced by geriatric workers in that setting. This article addresses the problems in the worker's role by first comparing it to those of other special population mental health workers. Systemic difficulties and structural problems of the job are examined with emphasis on the worker's experiences and feelings. The author contends that the worker's issues parallel those of elderly clients. Solutions for changing negative aspects of the separate service role are discussed and their impact on service delivery described.     

Changing Places: Men Replace Women in Mental Health Beds in Britain

Based on census materials collected in England and Wales from 1921 to 1991, this study focuses on gender differences in occupancy rates in hospitals and other mental health facilities in Britain. The results suggest that since 1991, or for the first time in the twentieth century, there are more males than females in residential mental health facilities in Britain. Furthermore, this pattern of association holds for all age groups except those aged 65 years and over. Second, there are currently two distinct subpopulations in mental health facilities—a male group which is predominantly of working age, and a female group, which is predominantly of retirement age. The existence of these two "care" populations will impact significantly on current and future resourcing of mental health services. The policy implications of the research findings are discussed within the context of the debates on the changing relationship between gender and mental health.     

Marital status,social capital,economic stress,and mental health: A population-based study

The associations between marital status and poor mental health are investigated, and whether social capital, trust, and economic stress attenuate the associations between marital status and poor mental health. The public health survey in Skåne (southern Sweden) 2008 is a cross-sectional study including 28,198 persons aged 18–80. Logistic regression models investigate associations between marital status and mental health, adjusting for age, country of birth, education, emotional support, instrumental support, trust in others, and economic stress. A 13.8% prevalence of the men and 18.2% of the women had poor mental health. Significantly higher odds ratios of poor mental health for the unmarried, divorced and widows/widowers compared to married/cohabitating remained throughout the analyses. Trust and economic stress only moderately attenuated these associations.     

Poverty,Partner Abuse,and Women's Mental Health: New Knowledge for Better Practice

ABSTRACT.

To better understand how poverty and poor mental health impact women who are abused by intimate partners, a convenience sample of 300 abused women using shelters or justice services for the 1st time were interviewed. The 300 women were categorized as having no income, being above poverty, and being below poverty according to U.S. Poverty Guidelines. Results indicated that no direct effect of income on poor mental health was noted; however, an interaction between type and severity of abuse and income level had an impact on poor mental health. Abused women who were above poverty with the highest incomes reported the highest levels of depression in the presence of high physical and sexual abuse. In contrast, women reporting no income reported no significant effect of severity or type of abuse on depression scores. Women just above the poverty level who experienced severe abuse were at highest risk for mental health problems. Poverty impacts the mental health of abused women according to the degree of poverty and type and severity of abuse. More research is needed to specify programs to maximize the mental health functioning and economic solvency of abused women.     

Mental Health Problems Among Single Mothers: Implications for Work and Welfare Reform

Welfare reform's emphasis on work and self-sufficiency assumes that poor single mothers are similar in their status and functioning to the rest of the population. However, we find that their status is quite distinct. Logistic regression results reveal that the likelihood of working is 25% lower for those with a psychiatric disorder. Mental health problems may prevent women from undertaking the tasks necessary to find employment, or women with these problems may lack the self-confidence needed to take on new challenges. Our findings suggest that mental health problems among single mothers deserve greater attention as a barrier to self-sufficiency and highlight the need for more effective intervention and treatment efforts to improve economic and social outcomes.     

“老来得子”幸福吗？--农村地区大龄生子与心理健康分析

从生育行为主体出发、基于子女性别结构,利用2013年中国社会综合调查（ CGSS）数据,分析了大龄生子群体的心理健康状况。初步研究发现,大龄生子群体的心理健康低于非大龄生子群体,“老来得子”忧大于喜;“38岁前仅生女、38岁及以后生子”群体的心理健康低于“38岁前已生子、38岁及以后生子／女”群体。这说明,男孩偏好下的“老来得子”并不必然提高心理健康;生育作为复杂的人口事件,子女数量、子女性别以及生育年龄等均成为心理健康的扰动因素。     

上海流动儿童的精神健康：一项探索性研究

中国的农村劳动力流动持续到现在，流动儿童即第二代移民问题已经浮出水面。但是，流动儿童精神状况问题没有引起研究人员的特别重视并成为专门的研究领域，而这恰恰是一个关乎城市长期发展和社会稳定的重要议题。本研究对上海市某小学的儿童进行了问卷调查，问卷包括国际流行的儿童抑郁量表和焦虑量表。研究发现上海市流动儿童存在一定程度的抑郁和焦虑。论文最后部分提出对于如何干预流动儿童心理问题的对策和建议。     

Relations Among Gender Typicality,Peer Relations,and Mental Health During Early Adolescence

The current study examines whether being high in gender typicality is associated with popularity, whether being low in gender typicality is associated with rejection/teasing, and whether teasing due to low gender typicality mediates the association with negative mental health. Middle school children (34 boys and 50 girls) described hypothetical popular and rejected/teased peers, and completed self‐report measures about their own gender typicality, experiences with gender‐based teasing, depressive symptoms, anxiety, self‐esteem, and body image. Participants also completed measures about their peers' gender typicality, popularity, and likeability. Results indicated that popular youth were described as more gender typical than rejected/teased youth. Further, being typical for one's gender significantly predicted being rated as popular by peers, and this relationship was moderated by gender. Finally, low gender typicality predicted more negative mental health outcomes for boys. These relationships were, at times, mediated by experiences with gender‐based teasing, suggesting that negative mental health outcomes may be a result of the social repercussions of being low in gender typicality rather than a direct result of low typicality.     

Longitudinal Pathways between Maternal Mental Health in Infancy and Offspring Romantic Relationships in Adulthood: A 30‐year Prospective Study

Longitudinal pathways between maternal mental health in infancy and offspring romantic relationship outcomes in adulthood were examined using a 30‐year prospective longitudinal study of 196 mothers and their children. Structural equation modeling revealed that maternal mental health at 30 months was related to offspring relationship status and relationship attachment insecurity at 30 years. The adolescent variables of offspring mental health and parental relationship status mediated the link between maternal mental health and offspring relationship status. In addition, adolescent mental health and family conflict mediated the pathway between maternal mental health and offspring attachment insecurity. These results highlight the importance of individual and parental mental health to romantic relationship outcomes, and emphasize the value of taking a developmental approach to the study of romantic relationships.     

Mental Health Service Utilization Among Frail,Low-Income Elders

Abstract

This study was conducted to determine the extent to which service providers in a community-based care program accurately identified and referred elders with symptoms of depression. Interviews were conducted with 79 frail, low-income elders, with the CES-D used to gauge depressive symptomatology. Reviews of their case files were then conducted to determine first, the extent to which case managers recognized depressive symptoms and second, the extent to which respondents who screened with significant symptoms were referred for mental health services. Results suggest an imperfect association between CES-D scores and case managers' perceptions and referrals. Less than 1/3 (31%) of those who screened for depression received counseling.     

Chapter 17. Rural Mental Health

SUMMARY

Mental health services available in many rural communities are too limited in scope and availability to meet the needs of rural citizens. The future of mental health services for the rural poor will be impacted by state government decisions about Medicaid funding priorities. It is important that rural practitioners, especially those that work in the fields of mental health, health, and aging services, engage in advocacy for better coverage of the rural poor and low-income elderly persons. This chapter discusses issues of advocacy related to improving the provision of mental health services to older rural citizens as an important goal in the larger effort to expand and improve rural mental health service delivery throughout the nation.     

Materialist/postmaterialist values and their association with psychological health and health locus of control: A population-based study

This study investigates the association between Ronald Inglehart's materialist/postmaterialist index, a psychological aspect of the material pathway to inequalities in health, and health locus of control and psychological health. The data used is from the 2008 public health survey in Skåne, a cross-sectional postal questionnaire study with 28,198 respondents (response rate 54%), conducted in southern Sweden during the fall of 2008. Psychological health (GHQ12), health locus of control (external vs. internal) and the four-item Inglehart's index were assessed. A Multiple Logistic Regression Model was used to control for age, sex, country of origin, socioeconomic status and interpersonal trust. External locus of control was observed among 32.7% of the respondents. Poor psychological health was found in 18.2% of the women and 13.8% of the men. Materialist values were positively associated with low socioeconomic status, while a reverse association between postmaterialist values and low socioeconomic status was observed. External health locus of control was strongly and positively associated with materialist values among both men and women. Psychological health was not associated with materialist/postmaterialist values. The materialist/postmaterialist index, a psychological aspect of the material pathway to inequalities in health, is associated with health locus of control but not with mental health.     

Transitions of Youth in Mental Health Residential Care to Less Restrictive Settings: The Role of Strengths and Gender

ABSTRACT

Changes in youth's behavioral/psychosocial functioning has been found to play an important role in the transitions from mental health residential care to less restrictive settings, and this functioning differs significantly by gender. However, there has been little attention paid to the roles played by psychosocial strength and gender in transitions out of residential care. The current study examined gender differences in the role of strengths in transitions to less restrictive settings using data on 675 youth's admission and discharge records collected from Illinois Residential Treatment Outcome System during 2005–2007 (Mean age = 15 years, SD = 2.0; 57.5% = boys). The results of multivariate logistic regression model indicated that positive recreational activities and lack of chronic illness were related to a higher likelihood of transitions to less restrictive settings among girls, while appropriate sexual development, psychological strengths, and strong spiritual/religious strengths were related to the transitions among boys. This study demonstrates the potential importance of youth strengths in the provision of mental health services and suggests a need to develop models of outcomes that take gender into account. Additional research based on multiple informants including youth self-report is needed to understand the role of gender in transitions out of residential care.     

Prevention Programmes in Community Mental Health: A Review

Allocation of resources to community mental health care in Australia has escalated rapidly in recent years. The major conceptual advance has been the balancing of traditional therapeutic or remedial intervention with the goal of preventing psychological distress. The authors argue that the implementation of preventive programmes has fallen short of expectation. Two reasons are advanced: the differing status accorded the two activities, and the lack of goal definition in prevention programme development. Recommendations are made for the successful implementation of prevention programmes in community mental health care.     

The Spinster Stereotype: A Demographic Refutation?

Data on Australia's older single women are assembled into a demographic profile to question the legitimacy of the prevailing negative spinster stereotype and to make comparisons with US trends in the status of single women'. The socioeconomic status (SES) of single and married women in Melbourne is analysed and it is subsequently argued that high SES single women have satisfying careers which may provide them with a stable source of identity, but some lower SES single women lack this source and may assume the spinster identity as the only clearly defined role available to them.     

An Exploration of Mental Health Literacy Among African American Clergy

ABSTRACT

The purpose of this qualitative study was to explore African American clergy's mental health literacy with older congregants 60 years of age and older. Using a grounded theory approach, we recruited a purposive sample of 9 African American clergy representing diverse ages, denominations, locales, and educational levels. Data was coded and classified according to Kevin's (1976) Kevin, R. C. 1976. Factors influencing the judgment and referral of mental health presenting problems by clergymen and psychologists, Unpublished doctoral dissertation: University of Texas, Austin.  [Google Scholar] typology of pastoral counseling and Jorm et al.'s (1997) Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B. and Pollitt, P. 1997. “Mental health literacy”: A survey of the public's ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166: 182–186. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] conceptual model of mental health literacy. Findings from data analysis revealed study respondents were adherents of Kevin's Religious–Community (R–C) model. Additionally, the following themes emerged: loss of cognitive functioning, psychosocial stressors, religiosity, and appreciation for professional assistance, cultural barriers, and key informants/familiarity with formal mental health providers which partially maps onto Jorm et al.'s conceptual model of mental health literacy.     

Policy Changes in Community Mental Health: Interventions and Strategies Used in Sweden over 20 Years

The deinstitutionalization of mental health care has changed the responsibilities of involved authorities and has led to a continuous need for new treatment forms and interventions. This article describes this development in Europe, and in particular how these new conditions have been handled in Sweden over the past 20 years at the level of governmental policy‐making. Three major policy documents from 1994, 2009 and 2012 were included in this study. To increase our understanding of the policies' contents, we have used theoretical concepts concerning governance, implementation and political risk management. Although our main interest was to find out how the government handles interventions for users of the mental health care system, we found that the policy work is progressing stepwise. The first document, from the deinstitutionalization era, did not discuss interventions clearly. Instead, it was mainly concerned with both practical and economical areas of responsibility. The second document, from the post‐deinstitutionalization era, was more focused on what services should be delivered to the users, while the most recently published document to a greater extent addressed the question of how the support is supposed to be designed. The trend in European community mental health policy has been to advocate services in open forms that are integrated into the society's other care systems. This is also the case in Sweden, and continuous work is being done by the government to find strategies to support the development, and to meet the needs at both political and local levels.     

An Inclusive Approach to Knowledge for Mental Health Social Work Practice and Policy

As the integration of health and social care services progressesin the mental health sector, there is concern that mental healthsocial workers are disadvantaged, relative to health professionals,because they cannot identify the knowledge base for their practice.This paper argues that this concern is partly the product ofassuming that the knowledge base has to be premised upon randomizedcontrolled trials. Instead, it proposes a non-hierarchical frameworkbased on that developed in health research in Canada by Upshurand colleagues that generates a typology of knowledge whichis congruent with the main forms of inquiry that are relevantto mental health social work practice. The framework recognizesthe contribution of randomized controlled trials to the knowledgebase but also validates knowledge drawn from qualitative, epidemiological,practitioner and user knowledge. It is argued that the frameworkprofiles a wider knowledge base than that promoted by conventionalevidence-based practice, and also could be a basis for futuredevelopment of the research agenda in mental health social work.     

Mental Health Problems and Behavioral Disruptions in Nursing Homes:

This paper describes a study that examines knowledge of mental health problems and management of behavioral disruptions by social workers in nursing homes. Since a significant number of nursing home patients have mental health problems (estimates range from 50 to 80 percent) which present behavioral disruptions, this knowledge is critical. Results indicate that social workers are not prepared to provide needed services because they do not have adequate knowledge about the management of behavioral disruptions or the identification of mental health problems of nursing home patients. Recommendations are that social workers employed in nursing homes should have gerontological training and that national policy changes are needed to develop guidelines for qualifications of nursing home social workers. Nursing homes are not meeting the needs of older adults with mental health problems when social workers do not have the knowledge needed to provide nursing home services.     

Food Insufficiency,Food Stamp Participation,and Mental Health*

Objectives. This study examines whether the mental health consequences associated with food insufficiency vary by food stamp participation status and/or the value of the food stamp benefit received. Methods. We use longitudinal data from the Panel Study of Income Dynamics along with fixed‐effect methods that control for unobserved heterogeneity to test our hypotheses. Results. We find that, conditional on the food stamp benefit amount, the emotional distress associated with food insufficiency is higher among food stamp participants. Moreover, we find evidence of a dosage effect such that food‐insufficient individuals who receive higher amounts of food stamp benefits suffer greater emotional distress than food‐insufficient individuals who receive lower levels of food stamp benefits. However, the negative mental health effects of food insufficiency and food stamp participation are driven primarily by periods of transition onto the Food Stamp Program and into food insufficiency. Conclusions. The negative mental health aspects of participating in the Food Stamp Program seem to outweigh the positive mental health aspects, at least during the period of application and initial receipt, suggesting that programmatic reform is needed to improve overall well‐being among new participants.