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.     

Early outcomes for young adults transitioning from out-of-home care in the USA

This paper describes the well‐being of participants in the Midwest Evaluation of the Adult Functioning of Former Foster Youth (n = 603), a study of youth leaving out‐of‐home care in the USA, at the point where they have been ‘young adults’ for about 1 year. Although some of these young adults are in stable situations and either moving forward with their education or employed in promising jobs, more of them are having significant difficulties during the early stages of the transition to adulthood. Too many are neither employed nor in school, have children that they are not able to parent, suffer from persistent mental illness or substance use disorders, find themselves without basic necessities, become homeless, or end up involved with the criminal justice system. They are doing worse than other young adults across a number of important dimensions. Most of these young adults continue to maintain relations with members of their family of origin, with many finding themselves living with family at age 19. Importantly, those young people who chose to remain under the care and supervision of the child welfare system experienced better outcomes than those who either chose to or were forced to leave care.     

Supporting young people from care to adulthood: International practice

This paper explores practice examples relating to young people's transitions from care to adulthood. It discusses examples drawn from young people's pathways to adulthood, leaving care law and policy and participation. The paper concludes with a discussion of the research evidence on promoting the resilience of young people from care to adulthood, by proposing a framework for evaluating the impact of practice. It is suggested that practice should be interrogated in respect of the contribution made to stability and continuity, educational achievement, involving young people, preparation and support into adulthood, and health and well‐being.     

Going It Alone: Comparing Subtypes of Withdrawal on Indices of Adjustment and Maladjustment in Emerging Adulthood

Scholars have distinguished conceptually between multiple forms of social withdrawal among children and adolescents, but this distinction has yet to be investigated fully during emerging adulthood. Therefore, the overarching goal of this study was to employ a person‐oriented approach to examine differences between subtypes of withdrawal on indicators of internalizing issues and relationships in emerging adulthood. The sample for the current study (M_age = 19.60, SD = 1.85, range = 18–29) consisted of 791 undergraduate students (548 women, 243 men). Results revealed that three distinct forms of social withdrawal (shyness, avoidance, unsociable) can be identified in emerging adulthood, with each one uniquely related to indices of maladjustment in regard to internalizing problems and relationship difficulties. In general, both shy and avoidant individuals reported more problems of an internalizing nature and in their relationships. Far fewer problems appear to exist for unsociable individuals.     

Self-reported health, self-esteem and social support among young unemployed people: a population-based study

A population-based study was performed in southern Sweden in the autumn of 1998. The aim was to study connections between self-reported health, self-esteem and social support among unemployed (≥ three months) young people. The sample consisted of 264 unemployed individuals aged 20–25 years, and 528 individuals of the same age, randomly selected from the population register and not registered as unemployed. The response rate was 72%. Defined by means of factor analysis, mental health consisted of the symptoms tearfulness, dysphoria, sleeping disturbance, restlessness, general fatigue and irritability. The unemployed had more mental health problems than young people who were working or studying. Restlessness and dysphoria were significantly over-represented in the unemployed among both sexes. However, good social support seemed to predict mental health. Support from parents was most important, particularly in males. Those with low self-esteem and poor parental support were especially vulnerable.     

The impact of childhood maltreatment on young adults’ mental health: Evidence from the Philippines

Using a new retrospective data set on young Filipino adults, this study aims to quantify the prevalence, risk factors, and mental health consequences in later life of childhood maltreatment in the Philippines. A survey was conducted with a sample of 155 adults (83 women, 72 men) aged 18–24 living in Quezon City, the largest metropolitan city in the Philippines. Findings show that four out of five young Filipino adults experience minor physical violence during childhood, while one out of four suffer severe physical violence. Boys from less educated families that grow up in urban environments face the highest risks. While we find a strong link between childhood physical abuse and young adults’ mental health, no such effect was found for experiences of psychological aggression. Childhood physical abuse was further found to have negative effects on young adults’ family relations, social relations, and overall satisfaction with life.     

Contingent Self‐worth in Chinese Adolescents and Young Adults: Relations with Global Self‐Esteem and Depressive Symptoms

Contingent self‐worth (CSW) is the extent to which an individual's sense of self‐worth is dependent on performance in a particular domain. CSW has been linked to poorer psychological health (e.g., lower global self‐esteem, greater depression and anxiety). However, the majority of work on CSW has been conducted with US college students. Far less is known about the influence of CSW for younger individuals or for non‐Western populations. This study examined relations between CSW domains and two indicators of well‐being (depressive symptoms and global self‐esteem) with Chinese adolescents (ages 13–16) and young adults (ages 19‐22). Results indicated that CSW in the domains of academic performance and others’ approval were positively related to depressive symptoms, whereas CSW in the domain of family support was negatively related to depressive symptoms. Others’ approval CSW was negatively related to self‐esteem for both adolescents and young adults, whereas CSW in the domains of academic performance and family support were related to self‐esteem for adolescents but not young adults. This study indicates that CSW is a meaningful and predictive construct for Chinese youth, and that cultural, environmental, and developmental factors may impact the relations between CSW and psychological health.     

Nativity Status and Depressive Symptoms among Hispanic Young Adults: The Role of Stress Exposure

OBJECTIVE: This article documents nativity differentials in depressive symptoms among Hispanics during their initial years of adulthood and explores how ethnicity, socio-demographic characteristics, and exposure to stressful life events and changes in social roles help to explain those differentials. METHODS: Data is drawn from a large-scale two-wave community study of stress, psychiatric well-being, and substance use disorders among young adults. Our analytic sample includes 553 Hispanic respondents and we employ multivariate regression techniques. RESULTS: Regardless of age at immigration, foreign-born women experience greater declines in depressive symptoms than native-born women during early adulthood. This advantage is explained by differences in perceptions of discrimination, family-based stress, and social role changes. The association between nativity and depressive symptoms is not conditioned by ethnicity, but ethnicity does condition the association between stressful events and depressive symptoms. CONCLUSIONS: The findings suggest that mental health treatment and prevention efforts should focus more heavily on stress exposure.     

Health and Well–Being in the Young Old and Oldest Old

Most individuals experience a decline in health status during old age. Paradoxically, there are proposals that older adults nevertheless maintain a positive sense of well–being, an indicator of successful aging. Data from the Berlin Aging Study (BASE: Baltes & Mayer, 1999), a locally representative sample of men and women aged 70 to 100+ ( N = 516, M = 85 years), suggest that cumulative health–related chronic life strains set a constraint on the potential of oldest old individuals to experience the positive side of life. The young old in BASE reported significantly higher positive SWB than did the oldest old. Chronic illness and functional impairments (e.g., vision, hearing, mobility, strength) limit well–being especially in very old age.     

Integrating Mental Health Parity for Homebound Older Adults Under the Medicare Home Health Care Benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Integrating mental health parity for homebound older adults under the medicare home health care benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Qualitative exploration of supporting figures in the lives of emerging adults who left care compared with their noncare‐leaving peers

Studies on youth leaving care have emphasized their limited social support and their need for continuing support after emancipation. However, less is known about the nature of their existing social networks after emancipation and their roles during their transition to adulthood compared with their noncare‐leaving peers. With this in mind, 32 young adults aged 18 to 25 participated in semi‐structured interviews regarding their current support figures in order to learn whether they were congruent with their needs after emancipation. Thematic analysis revealed four main features of the two groups' social networks: (a) stability versus uncertainty as to the lasting presence of the supportive figure, (b) reliance on parents as main supportive figures versus relying on different supportive figures, (c) confidence versus uncertainty in the supportive figures' ability to help, and (d) holistic versus fragmented support of the young adults' needs. The discussion addresses the unique characteristics of care leavers in emerging adulthood and the implications of their social networks' features for their adjustment after emancipation. One of the study's recommendations is to proactively connect them to new supportive figures such as professionals or mentors by offering them mentoring programs cognizant of the instrumental and developmental tasks of emerging adulthood.     

Loneliness in senior housing communities

There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities. This study examines the extent and correlates of loneliness in three public senior housing communities in the St. Louis area. Data for this project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement, and social support. Missing data for the hierarchical multivariate regression models were imputed using multiple imputation methods. Results showed approximately 30.8% of the sample was not lonely, 42.7% was moderately lonely, and 26.6% was severely lonely. In the multivariate analyses, loneliness was primarily associated with depressive symptoms. Contrary to popular opinion, our study found the prevalence of loneliness was high in senior housing communities. Nevertheless, senior housing communities could be ideal locations for reducing loneliness among older adults. Interventions should focus on concomitantly addressing both an individual’s loneliness and mental health.     

COVID-19 pandemic and the determinants of depressive symptoms among senior citizens of India: An empirical investigation

The COVID-19 pandemic inflicted multiple threats to individuals' physical, mental, and financial health conditions. The pandemic-related restrictive behaviors pose serious consequences for public health and increase the risk of mental illness among individuals, particularly among older citizens. The combination of their pre-existing illnesses, social isolation, COVID fear, and financial adversity frequently aggravates their condition and leads to depression and mental illness. Thus, the present study investigates the mental health status and the determinants of depressive symptoms among older adults of Bhubaneswar during the COVID pandemic context. The study used the Geriatric Depression Scale (GDS-15) to measure their depressive symptoms. The social isolation parameter is measured with the De Jong Gierveld Loneliness Scale. Financial self-efficacy, COVID-19-related psychological fear, and comorbidity health status are other determinants considered. A chi-square test and multinomial logistic regression (MLR) models are adopted to find the probable risk factors that may influence depressive symptoms among older people. The results indicate that comorbidity health conditions, a social isolation mindset, and financial efficacy issues are the significant determinants that drive an older person towards different depression categories. The improvement of these influential factors can lead senior citizens to avoid any health emergency like COVID pandemic. In the event of a public health emergency, such as COVID pandemic, the government could use the study's findings to devise methods for assisting the elderly. Society as a whole should be aware of these findings, which can lead to depressive symptoms, and offer support to the elderly. Future research may concentrate on identifying the causes of depressive symptoms in different age groups or in the presence of specific comorbidity health conditions. Future research may also investigate the factors influencing depressive symptoms in a specific occupation.     

Rising food security concerns among New Zealand adolescents and association with health and wellbeing

The current paper explores recent changes in food insecurity among adolescents and determine if food security concerns are associated with poorer wellbeing. Data were collected as part of two nationally representative surveys of the health and wellbeing of high-school students in New Zealand in 2007 and 2012. In 2012, 11% of young people reported food security concerns often or always, with 33% reporting food security concerns occasionally/sometimes. The prevalence of food security concerns at both frequencies increased significantly from 2007 (8% and 28%, respectively). Young people with food security concerns were more likely to report poor indicators of health and wellbeing, including truancy, poor general health, mental health concerns and obesity. Our findings highlight the growing concerns of food insecurity reported by adolescents in New Zealand. Interventions that address food security for families may provide a tangible means of promoting the healthy development of children and young people.     

Unemployment and psychological distress among young adults in the Nordic countries: A review of the literature

This article reviews Nordic research, published from 1995 and onwards, on the relationship between unemployment and mental health among young adults. Cross‐sectional, longitudinal and time‐series studies are included. Cross‐sectional studies show that the unemployed experience more mental health problems than the non‐unemployed. Leaving unemployment is associated with increased well‐being. Economic problems, feelings of shame and poor social support increase the likelihood of psychological distress. The longitudinal studies show that unemployment increases the risk of psychological distress and attempted suicide, after initial mental health status and confounding factors are accounted for. The relationship remains significant when time‐invariant characteristics of the individuals are controlled for. The time‐series studies found no relationship between unemployment and suicide, but levels of psychological distress were found to vary with changes in the labour market. This relationship remained significant after excluding the non‐employed, indicating that unemployment trends have effects beyond those directly associated with unemployment.     

Socio‐Economic Factors and Mental Health of Young People in India and China: An Elusive Link with Globalization

Globalization and its related social, cultural, and economic changes have significant mental health outcomes for young people. However, mental health disorders among youth are seldom included in the range of problems linked to globalization. It is imperative that these multifaceted associations are considered in light of the substantial and increasing burden of disease caused by mental illness, particularly in Asian countries, which are comparatively young and in next few decades will be the major sources of the growth of world’s young population. The evidence reviewed in this study makes an argument that globalization has increased [relative] poverty and deprivation, social and income inequality, migration, occupational stress, educational competition, and educated unemployment in India and China. Simultaneously there is evidence which shows that these variables are causally linked with mental health of young people. Altogether, these phenomena are accompanied by higher rates of suicide among lower class, migrant, and student youth. This substantiates the proposition that globalization has significant consequences for the mental health of young people. Some interventions for debate and discussion are considered.     

Social Context in Mental Health Service Use Among Young Adults

Examining the sources of health communication that young adults with mental health challenges receive regarding service use is critical to curbing the societal concern of unmet mental health needs of this population. Semistructured interviews were conducted with 59 young adults, all of whom were diagnosed with a mood disorder and used public mental health services and additional public systems of care during childhood. Thematic analysis was utilized. Of the 59 participants, 45 nominated at least one supportive adult, with a total of 97 relationships analyzed. Results indicate that the majority of messages came from informal supports (e.g., family) who spoke positively about mental health services. Fewer messages came from formal supports (e.g., professionals). Messages included statements surrounding beliefs toward services, social norms (approval and disapproval), self-efficacy, and image considerations around using services. These findings can suggest ways that mental health service engagement interventions can leverage communication from informal supports. Future research can explore what messages young adults find most influential in persuading them to use mental health care consistently and the relationship between messages and health behavior.