Perspectives of South African caregivers in receipt of Child Support Grants: Implications for family strengthening interventions

Cash transfers have delivered measurable benefits for poor and vulnerable children in low‐ and middle‐income countries. However, on its own, a cash transfer is insufficient to promote holistic child well‐being. In the quest for appropriate complementary family support services, known as ‘cash plus’ programing, this qualitative study sought to explore the perspectives of a group of South African caregivers, all of whom were in receipt of a Child Support Grant (CSG), in relation to their own caregiving and family functioning. Critical areas of support to families were identified to further scale up the already positive impacts of the CSG, such as mental health services, social supports for caregivers, decreasing levels of poverty and growing caregiving knowledge and skills. Key conclusions are that improving the quality and integration of public services and developing culturally appropriate and evidence‐based family strengthening programmes are critical to complement and boost the positive impacts of the CSG.     

Economic distress and health: A fixed effects analysis of low‐income persons in Singapore

Using fixed effects regressions, this study examined the transactional effects of different types of economic status on the physical and mental health of low‐income persons in Singapore. Among the economic variables considered, unemployment and arrears had the most significant effects. This signals the physical and psychological distress of being out of work and possessing arrears while income is low. The insignificant effects of poor health on household earnings suggest possible earnings supplementation by other household members. The findings imply the fruitfulness of dually improving employment prospects and health, work activation that takes into consideration mental health effects, increasing affordability of health services in liberal welfare systems, improving mental bandwidth through reducing arrears accounts, and short lag time from application to receipt of assistance. These implications point to a larger question on health and welfare systems in an increasingly uncertain economic environment for households in poverty. Key Practitioner Message: ? Employment and health are inter‐related: employment assistance incorporating physical and mental health interventions and vice versa can be more effective than either alone; ? Compared with decreasing arrears amounts, reducing the number of arrears can more effectively relieve mental distress; ? Effects between economic distress and health materialise quickly; minimising the lag time between application and receipt of assistance will provide great relief.     

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.     

More than therapy: The link between adverse childhood experiences,social support,and therapeutic services

Adverse childhood experiences (ACEs) have a cumulative effect on physical, emotional, and social well‐being throughout the life course. ACEs also impact parenting practices, which may contribute to intergenerational cycles of trauma. Access to child mental health services and caregiver social support are two protective factors that may reduce the burden of ACEs. To advance understanding of the relationships between caregiver social support and child mental health services among caregivers with ACEs, we interviewed 13 caregivers of young children receiving outpatient mental health services. Thematic analysis revealed the integral role of therapeutic providers in the social support circles of caregivers with high ACE scores. Caregivers frequently named therapeutic providers as the first point of contact in a problem situation. Implications for social work research, clinical practice, and advocacy are discussed.     

“It's hard work,believe me!”: Active efforts to optimise housing by people who live with mental illness and access housing assistance

Secure and appropriate housing is critical for the well‐being of people living with mental illness (consumers). Yet it is often difficult to achieve. Housing assistance is available, but is often difficult for consumers to access and negotiate. While the need for support is well‐recognised, little is known about the active part consumers play in finding and keeping appropriate accommodation. This paper addresses the research question: How do consumers who use housing assistance actively manage their housing situations? In‐depth interviews were conducted with 18 consumers who had used housing assistance within the past five years. These were analysed using constant comparative analysis, based on a grounded theory approach. Participants engaged in a range of activities to address six major concerns: working toward my home; following the rules to keep what I have; managing and improving my accommodation; working with housing services; living within my current situation; and finding and using supports. All participants described times when their mental health negatively affected their ability to do these activities. The findings highlight the need for housing services and mental health services to collaborate to develop policies and protocols that place reasonable demands on consumers and support their abilities to actively manage their housing situations.     

Public health care in the balance: exploring popular support for health care systems in the European Union

Which factors explain intra‐ and inter‐country variations in levels of public support for national health care systems within the European Union, and why? We propose that public opinion towards public health care is dependent on (1) the type of welfare state regime to which the various European welfare states belong, (2) typical features of the national care system and (3) individual social and demographic characteristics, which are related to self‐interest or morality oriented motives. To assess the explanatory power of these factors, data from the Eurobarometer survey series are analysed. Support for public health care appears to be particularly positively related to social‐democratic attributes of welfare states, whereas support drops with increasing degrees of liberalism and conservatism. Further, support for public health care proves to be associated with wider coverage and public funding of national care services. We also find higher levels of support in countries with scarce social services for children and the elderly, and larger proportions of female (part‐time) employment. Lastly, with respect to individual characteristics, we find remarkably little evidence for self‐interest oriented motives affecting the preference for solidary health care arrangements.     

Exploring intergenerational communication and stress in refugee families

More than half of the refugees who have resettled to the United States in recent years have been youth. Refugee youth have often witnessed or experienced violence and family separation prior to resettlement and face barriers to successful resettlement such as language and educational challenges. These factors elevate risk for mental and emotional distress, and protective factors like strong familial relationships are important to promoting mental well‐being. This study utilized focus groups with 36 refugees ages 18 to 25 from four ethnic groups to explore conceptualizations of and communication about mental and emotional distress within and outside of family systems. Youth reported a nuanced conceptualization of their premigration and postmigration stressors and their patterns of communication about distress in three domains: (a) exposure to traumatic stress prior to resettlement, (b) stressful experiences in resettlement, and (c) communication about mental health inside and outside of family groups.     

Care without coercion – mental health rights,personal recovery and trauma‐informed care

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.     

‘Problematising’ Australian policy representations in responses to the physical health of people with mental health disorders

Australia, like other jurisdictions, is recognising the poorer physical health of people with mental health disorders. This paper explores policy responses to this issue through discourse analysis of 22 Australian Federal and State government policy documents published in 2006–2011. The paper utilises Bacchi's ‘what's the problem represented to be?‘ approach to explore policy solutions in relation to the representation of the issue, enabling identification of issues which are not problematised and policy solutions that have not been considered. The poor physical health of people with mental health disorders is attributed in policy to poor lifestyle habits and limited access to monitoring of physical health care. Three policy solutions are offered: collaborative care delivery involving greater use of fee‐for‐service primary care to manage physical health; the monitoring of physical health status by mental health teams; and the promotion of lifestyle change. These solutions fail to address ongoing issues with collaboration between specialist mental health and primary care services. Reliance upon fee‐for‐service primary mental health care may, in fact, reduce rather than increase access to services. The strategies are discussed in light of neoliberal ideals of governance and personhood which are underpinned by informed consumer choice and personal responsibility for health.     

Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults

Nyqvist F, Nygård M. Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults The study examined the association between structural and cognitive social capital and self‐rated health among 65‐ and 75‐year‐olds in Västerbotten in Sweden and Österbotten and Pohjanmaa in Finland. Data were retrieved from a cross‐sectional postal questionnaire survey conducted in 2005 and was answered by 3,370 persons, yielding a total response rate of 69 per cent. The association between self‐rated health and interpersonal trust and membership in organisations was tested by logistic regression analysis. The results showed that older adults in Västerbotten in Sweden experienced better self‐rated health than in Finland. Furthermore, interpersonal trust and active membership in organisations were associated with self‐rated health among 65‐ and 75‐year olds even after having controlled for the influence of region. We therefore conclude that the association between social capital and self‐rated health tends to be robust across contextually similar regions, but that further analyses are warranted in order to clarify the nature of this relationship. Key Practitioner Message: ?Health status can be indirectly strengthened through investments in social capital, such as group participation and active networks; ?When working with older adults, more focus needs to be put on how to develop trustful relationships; ?The Nordic welfare state, with its universal and subsidised social and health care services, has an indirect and positive effect on health among older adults.     

A Leadership Training Group for at Risk Fifth & Seventh Graders: Results from A Brief Strength-Based Group Program

ABSTRACT

An increasing number of youth are exhibiting social, emotional, and behavioral problems that hinder their ability to function at grade level. Subsequently, school mental health services have not been able to address the need for services particularly among students who are minority and poor. A mixed methodology study was conducted to determine the treatment outcomes from a brief strength-based leadership training group for primarily students who are African American and poor. Pre–post scores on three scales and focus group data revealed significant positive changes in regard to internal areas of functioning and social skills, anger management skills, and school attitude. Gender and age significantly impacted outcomes.     

Into adulthood: a follow-up study of 718 young people who were placed in out-of-home care during their teens

In this study, national register data were used to analyse long‐term outcomes at age 25 for around 700 Swedish young people placed in out‐of‐home care during their teens. The sample consisted of 70% of all 13‐ to 16‐year olds who entered out‐of‐home care in 1991. Results revealed a dividing line between young people placed in care for behavioural problems and those placed for other reasons. Young woman and men from the first group had – in comparison with peers who did not enter care – very high rates of premature death, serious involvement in crime, hospitalizations for mental‐health problems, teenage parenthood, self‐support problems and low educational attainment. Young people who were placed for other reasons had better outcomes, but still considerably worse than non‐care peers. Young women tended to do better than young men, regardless of reasons for placement. Very high rates of hospitalizations for mental health problems were found among young people placed for behavioural problems. Breakdown of placement was found to be a robust indicator of poor long‐term prognosis.     

Psychological distress among women who were sexually abused as children

One of the aims of the study was to investigate how participants in self‐help groups (SHG) for women (n = 87) who had been sexually abused in childhood rated their mental health and to what extent they were at risk of developing posttraumatic stress disorder (PTSD). A further aim was to investigate the relationship between the ratings of mental health, occurrence of PTSD, women's interpersonal relationships, reasons for participating in an SHG and characteristics of the childhood sexual abuse (CSA). The participants completed questionnaires regarding their personal relationships, reasons for joining a group, abuse characteristics, mental health (Symptom Checklist‐90‐Revised) and PTSD (Impact of Event Scale‐Revised). The women showed poor mental health, and more than half of them were at risk of developing PTSD. Lack of social support and feelings of shame correlated with poor mental health, whereas guilt did not. Relationships with female friends had a positive association. Further research is needed to determine whether participating in an SHG could provide adequate social support and reduce feelings of shame, thereby contributing to the healing process in the aftermath of CSA. Key Practitioner Message: ? Child abuse is a significant component of the global burden of disease; ? Both social workers and public health care providers meet sexually abused girls and it is important that they have knowledge about the subject; ? An important clinical implication for adequate treatment would be to assess and recognise childhood sexual abuse and to link diagnosis to trauma.     

Comparison on predictors of mental health service use among Asian older adults

Studies have mostly examined mental health service use of older Asian immigrant combining all Asian Americans into one group whereas immigration backgrounds and socioeconomic status of each Asian minority group are different. Therefore, this study aimed to identify predictors of mental health service use within specific ethnic groups among older Asian adults focusing on Chinese, Japanese, Korean, Filipino, and Vietnamese in California. The Behavioral Model for Vulnerable Populations (BMVP) is used to guide the secondary data analysis of a sample of 3,453 older Asian immigrants from the California Health Interview Survey (CHIS). Logistic and linear regression analyses are performed to examine predictors of mental health service use and the frequency of mental health service use, respectively. As results, mental health‐seeking patterns differ by ethnicity within the older Asian immigrant sample, not being married (Korean), higher levels of acculturation (Filipino), lower levels of neighborhood cohesion (Korean and Vietnamese), higher levels of perceived safety (Korean) and lower levels of perceived safety (Vietnamese), higher levels of mental distress (Korean and Filipino), and having perceived need (all) were related to more visits for mental health services. The study findings highlight the necessity of cultural competency services and programs for each Asian ethnicity.     

Individualized education programmes and parental behaviours for children with disabilities: moderation effects of head start on children's developmental outcomes

This study examined associations among Head Start attendance, individualized education programmes (IEPs), parental behaviours and child outcomes in a sample of five‐hundred and seventy 3‐ to 4‐year‐old children with disabilities. Home language, number of disabilities and Head Start enrollment were associated with having an IEP. Parents of children with IEPs and those who participated in Head Start used more social services, while social support was more prevalent for parents of non‐Head Start children with IEPs. For all children, frequent parental book reading, greater number of books in the home and greater perceived social support among parents were associated with favourable cognitive and social–emotional outcomes. Greater social service use was adversely associated with reading scores only for non‐Head Start children. Findings highlight the need for inclusive IEP policies and Head Start programmes for parents regarding access to special education supports for children who demonstrate developmental concerns. Participation in Head Start may buffer negative effects of social service use on children's reading skill development, although more research is needed to uncover the specific mechanisms responsible for this association.     

Depressive Symptoms and Economic Outcomes of Low-Income Women: A Review of the Social Causation, Social Selection, and Interactionist Hypotheses

We review research that connects depression and depressive symptoms to employment and economic factors for low-income women. Women who have low incomes and are unemployed or underemployed are vulnerable to mental health distress. The strain of balancing work and family life can be exacerbated by poor psychological health or nonsufficient economic resources. Research on the barriers that impede self-sufficiency can lead to policies that improve the economic and psychological health of low-income populations.
The discussion is framed by contrasting evidence for three theoretical perspectives: the social causation, social selection, and interactionist (bidirectional) hypotheses. The only causal relation reported is an effect of increased income on reduced depressive symptoms. Yet strong associations are found among psychological distress, earnings, employment stability, income, and job characteristics. The effects of programs to increase employment and the benefits of (and barriers to) depression treatment are also discussed. A bidirectional or interactionist perspective best conceptualizes the relationship between depression and economic factors. The reported negative effects of both poor mental well-being and low-quality employment suggest the need for stronger policies in the areas of mental health and work supports. We present policy recommendations addressing mental health treatment and outreach, employment placement, and workplace flexibility.     

Returning to the nest: Emerging adults living with parents during the COVID-19 pandemic

Changes in the working, study and social lives of emerging adults due to the COVID-19 pandemic have led to greater need for external supports. Many who lived independently may have sought that support by returning to live with parents. This study identifies factors associated with returns made between 2019 and 2020. It describes supports needed and obtained, relationships between parents and their resident emerging adults and identifies correlates of poor coping and high psychological distress. Data from the Longitudinal Surveys of Australian Youth and the Longitudinal Study of Australian Children were used and showed half of the emerging adults who moved did so due to COVID-19 restrictions. Loss of work and increased need for emotional and financial support were key drivers of moves. Nineteen per cent who returned found spending more time with family difficult and over half did not have their support needs fully met, increasing their odds of poor coping at that time (OR = 2.9, 4.3, respectively) and subsequent psychological distress (OR = 6.0). Families were an important source of support but could not necessarily mitigate all challenges; for some emerging adults, returning to live with parents gave rise to additional difficulties which negatively affected mental health.     

‘Genuine’ refugees or illegitimate ‘boat people‘: Political constructions of asylum seekers and refugees in the Malaysia Deal debate

Immigration to Australia has long been the focus of negative political interest. In recent times, the proposal of exclusionary policies such as the Malaysia Deal in 2011 has fuelled further debate. In these debates, Federal politicians often describe asylum seekers and refugees as ‘illegal’, ‘queue jumpers’, and ‘boat people’. This article examines the political construction of asylum seekers and refugees during debates surrounding the Malaysia Deal in the Federal Parliament of Australia. Hansard parliamentary debates were analysed to identify the underlying themes and constructions that permeate political discourse about asylum seekers and refugees. We argue that asylum seekers arriving in Australia by boat were constructed as threatening to Australia's national identity and border security, and were labelled as ‘illegitimate’. A dichotomous characterisation of legitimacy pervades the discourse about asylum seekers, with this group constructed either as legitimate humanitarian refugees or as illegitimate ‘boat arrivals’. Parliamentarians apply the label of legitimacy based on implicit criteria concerning the mode of arrival of asylum seekers, their respect for the so‐called ‘queue’, and their ability to pay to travel to Australia. These constructions result in the misrepresentation of asylum seekers as illegitimate, undermining their right to protection under Australia's laws and international obligations.     

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.     

A critical review of mental health and mental health‐related policies in China: More actions required

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services. Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy‐related questions concerning the lack of community‐based psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.