Involvement in the Juvenile Justice System for African American Adolescents: Examining Associations with Behavioral Health Problems

While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health problems, substance abuse, and delinquent or youth offending behaviors. Additional findings documented that the higher the number of juvenile justice system contacts, the higher the rates of delinquent behaviors, alcohol and marijuana use, sex while high on drugs, and commercial sex. These findings suggest that identifying and targeting youth who have multiple juvenile justice system contacts, especially those in low-resourced communities for early intervention services, may be beneficial. Future research should examine whether peer network norms might mediate the relationships between juvenile justice involvement and youth problem behaviors.     

Correlates of Psychological Distress and Major Depressive Disorder Among African American Men

This study examines the demographic correlates of depressive symptoms, serious psychological distress (SPD), and major depressive disorder (MDD; 12-month and lifetime prevalence) among a national sample of African American men. Analysis of the National Survey of American Life (NSAL) data set provides first-time substantiation of important demographic differences in depressive symptoms (measured by the Center for Epidemiological Studies Depression scale [CES-D]), SPD (measured by the K6), and 12-month and lifetime MDD among African American men. Findings illuminate the heterogeneity within the African American male population. Findings also demonstrate the need for additional research focusing on within-group differences and a comprehensive research and mental health promotion agenda that recognizes the importance of improving access to education and employment and promoting healthy coping behaviors, while acknowledging the larger social context in which African American men live.     

Rural African American Clergy: An Exploration of Their Attitudes and Knowledge of Alzheimer's Disease

Rural African American clergy's ability to recognize Alzheimer's Disease (AD) and their capacity to provide support to elders with this illness has been neglected in the literature. Using a mental health literacy framework, the purpose of this research was to explore rural African American clergy knowledge and beliefs of AD. In-depth interviews were conducted with 9 African American clergy who oversaw churches in central Kentucky. Although few had direct experience with providing pastoral care to elders with AD, all clergy were literate and aware of the need for additional training. This study seeks to further clarify the role of African American clergy and their understanding of AD to inform the future development of appropriate interventions and establish better collaborative community treatment relationships.     

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

This paper presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within thirteen urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this paper focuses on parent reports of child oppositional behavior and parenting stress over time. MFG is a flexible, protocol-driven approach designed to address the most common reason for referral to outpatient child mental health clinics, childhood behavioral difficulties. The MFG also aims to enhance family-level engagement and retention in ongoing care. Further, the service delivery model was collaboratively developed with intensive input from parents rearing children with conduct difficulties, parent advocates, community-based child mental health providers and services research staff in order to ultimately expand the number of effective service models that can be situated within "real world," urban child mental health settings.     

Racial Differences in Attitudes Toward Professional Mental Health Treatment: The Mediating Effect of Stigma

Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.     

Predicting Retention in Three Substance Abuse Treatment Modalities Among Anglo,African American,and Mexican American Juvenile Offenders

Abstract

Many of the same factors that predict delinquent behavior also predict adolescent drug use. This study examined factors that predict, and interventions that maximize, substance abuse treatment retention in three modalities among high-risk Anglo, Mexican American, and African American juvenile offenders. The study sample includes youth (N = 211) who were discharged from probation supervision and who received substance abuse services through a CSAT-funded federal demonstration project. The key predictors examined included the stage-of-change (i.e., precontemplation, contemplation, preparation) in which a juvenile fell, various dimensions captured by the Comprehensive Addiction Severity Index for Adolescents, and other intervention status (probation, case management, and mental health treatment). The research questions were addressed using statistical models known as survival analysis that treated time from entry into substance abuse treatment to exit from substance abuse treatment as the outcomes. Among key findings were that females were 73% more likely to leave day treatment relative to males; for each additional family problem ever experienced, Mexican American adolescents were 15% more likely to leave residential treatment compared with African American adolescents; and African American and Mexican American adolescents in the contemplation stage-of-change were 50% less likely to leave day treatment compared with Anglo adolescents. Applications for practice and research with this population are discussed.     

Self-reported mental health problems and post-traumatic growth among children in Pakistan care homes

ABSTRACT

Children in care experience multiple risk factors, particularly in low-income countries such as Pakistan. The aim was to establish rates of mental health problems and their relationship with posttraumatic growth, as reported by 132 children aged 9–19 years, living in three care homes in Pakistan. Children reported high rates of posttraumatic stress (70.45%) and common mental health symptoms (43.94%) within the clinical range, but also high levels of posttraumatic growth. These findings highlight the high levels of mental health needs among children in residential care, as well as the importance of understanding factors that promote their posttraumatic growth and resilience.     

Results of an Intervention to Reduce Perinatal Depression Among Low-Income Minority Women in Community Primary Care

Abstract

With little past research on interventions to reduce perinatal depression among minority women, we tested a multicomponent psychosocial intervention that spanned the puerperium. We recruited 187 low-income African American and Hispanic women from three innercity community health centers. Women with depressive symptoms were randomly assigned to a multicomponent psychosocial intervention or to the usual health center social services. The two intervention conditions were equally effective in reducing depression. Lack of difference may be due to the similarity of the two treatment conditions and logistical barriers in delivering full “doses” of the specialized intervention. Continued research to identify characteristics of effective interventions during pregnancy and postpartum is recommended.     

An exploration of mental health literacy among African American clergy

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) typology of pastoral counseling and Jorm et al.'s (1997) 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.     

Gender Differences in Determinants of Self-Rated Health Among African American in Omaha Nebraska: A Church-Based Study

Abstract

This study assessed the gender differences in determinants of fair/poor self-rated health among African American churchgoers in Omaha, Nebraska. Using data collected from 353 African American (245 women and 108 men) by the Center for Reducing Health Disparities at the University of Nebraska Medical Center in 2017, univariate and multivariate logistic regressions were performed to examine the gender differences in the relationships between fair/poor self-rated health and potential health determinants. Overall, 14.3% of women and 17.6% of men reported fair/poor self-rated health. There was a significant association between depression and poor/fair self-rated health among women (p?=?0.044) and men (p?=?0.001). For women, the fully controlled model confirmed the crude association between perceived poor/fair self-rated health and heart disease (OR = 3.10) and education (OR = 2.19). For men, the final model identified significant determinants of perceived fair/poor self-rated health such as depression (OR = 12.51) and diabetes (OR = 3.89). When assessing gender differences in determinants of self-rated health, similarities are higher than differences between the two groups. In both groups, the presence of depression was the strongest determinant of poor health. Future research should assess the immunological aspects of the association between psychological factors and perceived chronic diseases.     

A racial comparison of Family Group Decision Making in the USA1

This study examined Family Group Decision Making (FGDM) among a nationally representative sample of African‐American and White children investigated for maltreatment in the US. While FGDM was developed for work with ethnic minority families, there is no research on how this is being carried out in the US, where African‐American children are overrepresented in child welfare services. The study views racial differences in child, caregiver and maltreatment characteristics related to FGDM; composition of FGDM meetings; service referrals and receipt; and service satisfaction. Data are from the National Survey of Child and Adolescent Well‐being (NSCAW), a study of 5501 children ages 0–14. Current analyses include African‐American and White children (n= 4129). Stratified, bivariate and multivariate regression analyses were used. Results showed that while race was not related FGDM receipt, different characteristics lead to FGDM among African‐American and White families. Surprisingly, caregivers report feeling no more involved in decision‐making in association with FGDM. FGDM is provided at low rates overall (10%) and less frequently among White caseworkers. Child access to mental health services increases in relation to FGDM. Implications are discussed.     

Development of a Multimodal Assessment Framework for Helping Older African American Women Transition Out of Homelessness

Increasingly vulnerability to homelessness is affecting older African American women because more than any other group these women are susceptible to even minor changes in socioeconomic conditions. This article describes the evolution of an assessment strategy and process found to be useful in planning older African American women's transition from homelessness. The assessment strategy was developed as part of a multimethod, multilevel research and development program the purpose of which is to identify and test tools and interventions useful in helping older African American women leave homelessness. The article offers background on the action research project in which the assessment framework was developed, examines the method for the construction of the framework, describes the assessment process, and considers the integration of specific assessment tools into the advocacy process.     

Evidence of Empowerment in Resident Council Groups: An Examination of Two Leadership Models in Assisted Living

Individuals living in long-term care facilities and the professionals working with them are seeking methods to enhance resident choice and self-direction in personal care and internal community planning. This article presents findings from a study examining the incidence of empowerment opportunities in two resident council groups in assisted living facilities; one group used a resident leadership model and the other used an administrative leadership model by residents' choice. Results indicate that even with health and mental health challenges, residents were able to exercise choice in complicated situations under both leadership models, suggesting that resident council groups are a beneficial empowerment strategy.     

Employment Exits and the Race Gap in Young Women's Employment*

Objective. A race gap in employment that disadvantages young African‐American women has emerged for the first time in U.S. history. This article addresses the extent to which race differences in employment entry, exits, or both are responsible for the gap. Methods. The article relies on event‐history analysis using NLSY data. Results. Analyses show that differences in rates of exit, not entry, explain the race gap. Factors encouraging higher exit rates among African‐American than white women include lower AFQT scores and greater numbers of children. Conclusion. These findings raise questions about the utility of focusing on employment processes at the point of employment entry, at least for processes involving young women. The importance of exits in understanding race differences in women's employment calls attention to processes within firms that present barriers to African‐American women.     

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers’ self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers’ self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers’ self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.     

Exploring perceptions of mental health clients and professionals about Buddhism‐based therapies at mental health hospitals in Vietnam

With 80% of Vietnamese people holding key Buddhist beliefs, Buddhism has great impact on the thoughts, emotions, and behavior of Vietnamese people. However, almost no Buddhism‐based psychosocial interventions are offered at formal psychiatric hospitals across Vietnam, nor is there any plan to incorporate these interventions into mental health care. This exploratory study examines the perceptions of mental health clients and staff regarding the effectiveness of Buddhism‐based therapies (BBTs) in mental health treatment in Vietnam, using ethnographic observation and in‐depth interviews with 24 patients and eight professionals at the only psychiatric hospital employing BBT. Participants strongly believed in the positive impact of BBT to help clients manage or improve their symptoms. However, clients and staff advised that BBT should not be used alone; rather it should be used in combination with medication and was best employed for stress‐related disorders. They unanimously supported incorporating BBT into the formal mental health system, especially if the therapies were well developed through collaboration between Buddhist monastics and mental health professionals. Results of the paper suggest that Vietnam should think strategically about developing and incorporating BBT into the formal mental health care system.     

Cardiac conditions

Cardiovascular disease (CVD) is the leading cause of death in the US. The growth of the older population in coming decades will inevitably increase the incidence of age-related cardiac disease. Increasing evidence has shown the prevalence of co-morbid mental health conditions in CVD patients. Specifically, depression and anxiety have been linked with CVD mortality. Due to the risk of psychosocial conditions with cardiac patients, mental health practitioners in health and gerontology need to be well-informed about CVD-related mental health comorbidity and current research developments. Accordingly, this article provides a systematic review of the clinical evidence about the efficacy, cost-effectiveness, and any potential risk of psychosocial intervention with cardiac patients.     

Protecting children from nutritional and medical neglect in sub‐Saharan Africa: A five‐country study

This study critically considers the applicability of conceptions of child neglect that have been theorised by British and American scholars and promulgated in African countries through the domestication of the Convention on the Rights of the Child. The child protection legislation of five sub‐Saharan nations was compared in order to examine the presumptions embedded in their provisions concerning child neglect. These were then appraised in relation to the socio‐economic conditions pertaining in each country. Food insecurity, over‐reliance on staples and high infection rates among children in conjunction with hard to access health care and poor quality services contest the validity and relevance of dominant Anglo‐centric definitions of child neglect and methods for detecting it. The study concluded that greater congruence between national child protection legislation and the socio‐economic challenges faced by families in sub‐Saharan countries would better protect children against neglect. Key Practitioner Message: ● Child neglect is an ethnocentric concept that requires interrogation to test its relevance before applying it to developing country contexts. ● In sub‐Saharan countries, conditions of absolute poverty and grossly inadequate public services profoundly affect the ability of parents or guardians to meet their children's basic needs. ● Laws that frame child protection systems need to recognise the inter‐relationship between public services, poverty and parental care in the neglect of children.