Alcohol Use Among Concerned Partners of Heavy Drinking Service Members and Veterans

Heavy drinking in relationships is complex and we focus on an understudied sample of concerned partners (CPs) worried about their U.S. service member/veteran partner's drinking. We evaluated the link between CP drinking and their own mental health, and how CP drinking moderated the efficacy of a web‐based intervention designed to address CPs' mental health and communication. CPs (N = 234) were randomly assigned to intervention or control and completed assessments at baseline and 5 months later. CP drinking was associated with greater CP depression, anxiety, and anger independent of partner drinking. Moreover, the intervention was more efficacious in reducing depression for heavy drinking CPs. CPs are often an overlooked population and resources to help support them are needed.     

Does self-help increase rates of help seeking for student mental health problems by minimizing stigma as a barrier?

Objective: This study examined whether self-help (books, websites, mobile apps) increases help seeking for mental health problems among college students by minimizing stigma as a barrier. Participants and Methods: A survey was conducted with 200 college students reporting elevated distress from February to April 2017. Results: Intentions to use self-help were low, but a significant portion of students unwilling to see mental health professionals intended to use self-help. Greater self-stigma related to lower intentions to seek professional help, but was unrelated to seeking self-help. Similarly, students who only used self-help in the past reported higher self-stigma than those who sought professional treatment in the past. Although stigma was not a barrier for self-help, alternate barriers were identified. Conclusions: Offering self-help may increase rates of students receiving help for mental health problems, possibly by offering an alternative for students unwilling to seek in-person therapy due to stigma concerns.     

On the Road to Resilience: The Help‐Seeking Experiences of Irish Emigrant Survivors of Institutional Abuse

Understanding how survivors of complex trauma navigate towards resources can inform the design of interventions and health promotion strategies. However, there are little data on the resilience and help‐seeking experiences of this group or others who have experienced institutional abuse in childhood. This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse (ICA). Twenty‐two survivors of ICA were purposefully recruited from community organisations in the UK and data were collected via semi‐structured interviews. As a result of negative initial help‐seeking experiences in Ireland, most participants engaged in long periods of self‐management and disclosed information about their childhood as part of a redress scheme in later life. Outside of this scheme, turning points, such as illness or family problems, and the needs of children were influential in seeking help. Peer support networks played an important role as a trusted signposting pathway towards formal interventions. Participants identified interpersonal barriers to formal help‐seeking as helping professionals' failure to share control, insensitivity to identity loss and literacy issues, and the lack of explicit boundaries. The paper concludes with a discussion about the implications for research and future practice.

‘This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse’

Key Practitioner Messages:

• Turning points, such as illness and bereavement, and the desire to provide for children, influence the help‐seeking of survivors of ICA.
• Irish emigrant survivors of ICA cite failure to share control, insensitivity to identity loss, literacy issues and the lack of explicit boundaries as barriers to help‐seeking.
• General awareness of ICA can help practitioners in low‐threshold services prevent against culturally insensitive practice.
• Peer support networks can provide uniquely trusted signposting towards formal interventions.

     

The effect of social anxiety,generalized anxiety,depression and substance abuse on child support payment compliance among non-custodial parents

Millions of children live with custodial parents (CPs) who have child support court orders for the non-custodial parent (NCP) to provide payments to the CP for care of the children. Unfortunately, less than half of CPs receives full child support. A key issue influencing the failure to pay child support is NCP unemployment. Despite a clear association between unemployment and several mental disorders, the nature and prevalence of mental disorders has not been investigated in the NCP population. The purpose of this study was to explore the association between mental health and substance use problems among non-custodial parents and their payment of child support. The study also investigated whether unemployment mediated the relationship between these variables.Surveys that included validated screening instruments to assess for generalized anxiety, social anxiety, depression, and substance use disorders were administered to a convenience sample of 633 NCPs. Survey respondents were matched with state support payment information.The results indicated that depression, generalized anxiety, social anxiety and substance use problems were present at a much higher rate than 12-month rates of these conditions found in the general population. This study also confirmed the strong association between child support payments and employment. Employment mediated the relationship between mental health problems and child support payments. The findings suggest that non-compliant NCPs, particularly those who are also unemployed, may experience clinically significant mental health conditions that contribute to unemployment and potentially, payment non-compliance. Future studies could explore if providing mental health assessment and employment-focused treatment for mental health-related barriers to employment may increase employment and child support compliance for NCPs, thereby improving children's economic stability and well-being.     

Adolescents show positive changes in distress and hope after single session,post-based,anonymous counselling at kids help phone

Adolescents face barriers to mental health services and value confidentiality when seeking help. Kids Help Phone (KHP) is Canada's only free and confidential service for adolescents seeking help over the Internet. 188 participants responded to questionnaires to determine the client characteristics in terms of gender, age, culture, generational status, and socioeconomic status (SES), as well as their risk levels and types of presenting problems. Efficacy of service was also evaluated. Clients' posts were analyzed qualitatively for symptomology indicative of the Youth Self Report (YSR) syndromes, as well as for the level of risk and topics discussed. Level of distress, level of difficulty of the problem, and self-efficacy were evaluated using client self-report scales and found to improve after counselling. A non-significant positive trend was found in clients' self-efficacy after counselling. Distributions of demographic characteristics are presented alongside youths' reasons for choosing the Internet instead of the telephone. Implications for service delivery are discussed.     

Perceived barriers to mental health treatment among men enrolled in a responsible fatherhood program

ABSTRACT

Low-income men may experience elevated risk for mental health concerns and be less likely to seek treatment; this may be due in part to perceived barriers to accessing and receiving treatment. Men who enrolled in a community based responsible fatherhood program self-identified their health and mental health conditions. Although participants reported serious health conditions at rates consistent with the general population, we found higher than expected rates of depression, anxiety, or other mental health conditions and explored perceived barriers to mental health treatment among this sample. Findings suggest that low income men face a variety of perceived psychosocial and structural barriers impacting access to and compliance with mental health treatment.     

Stifled Voices: Barriers to Help-Seeking Behavior for South African Childhood Sexual Assault Survivors

In South Africa, females under the age of 18 comprise approximately 40% of the rapes and other forms of sexual assault that occur. However, South African girls face multiple barriers to seeking help in the aftermath of sexual assault. This literature review provides an overview of childhood sexual assault in South African girls and addresses barriers to help-seeking behaviors. Risk factors as well as relevant sociocultural, economic, structural, and psychological perceptions regarding childhood sexual assault among South African girls are also discussed. Finally, clinical implications, culturally relevant psychotherapeutic techniques, and suggestions for future research are provided in an effort to reduce the negative mental health consequences for the victims.     

Online Mental Health Information Seeking in Young Adults with Mental Health Challenges

Barriers such as stigmatization and access to health care may lead young adults with mental health conditions (YAMHC) to try to find alternatives to more traditional means of obtaining care. One possible alternative is to seek information online. The purpose of this article is to better understand how YAMHC use the Internet to access information about mental health, and the challenges they face when trying to access that information. Semistructured focus groups were conducted to investigate how YAMHC use the Internet for information and support regarding their mental health. Three major themes about mental health information seeking emerged from the data: (a) Topics searched, (b) Motivations for going online to search for information, and (c) Barriers to successful searching. Findings indicate that YAMHC look up information related to their mental health for a variety of reasons that are unique to the online experience, and use that information to help them with their care, despite at times feeling overwhelmed by, and not always trusting of, the information available.     

“A Very Steep Climb”: Therapists’ Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men

ABSTRACT

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.     

Rural and urban women's perceptions of barriers to health, mental health, and criminal justice services: implications for victim services

The purpose of this study was to examine rural and urban women's perceptions of barriers to health and mental health services as well as barriers to criminal justice system services. Eight focus groups were conducted, two in a selected urban county (n = 30 women) and two in each of three selected rural counties (n = 98 women). Results were classified into a barrier framework developed in the health service utilization literature which suggests there are four main dimensions of barriers: affordability, availability, accessibility, and acceptability. Results indicate that: (1) women face many barriers to service use including affordability, availability, accessibility, and acceptability barriers; (2) it takes an inordinate level of effort to obtain all kinds of services; however, women with victimization histories may face additional barriers over and above women without victimization histories; (3) barriers to health and mental health service utilization overlap with barriers to utilizing the criminal justice system; and (4) there are many similarities in barriers to service use among rural and urban women; however, there are some important differences suggesting barriers are contextual. Future research is needed to further clarify barriers to service use for women with victimization histories in general, and specifically for rural and urban women. In addition, future research is needed to better understand how women cope with victimization in the context of the specific barriers they face in their communities.     

The invisibility of adolescent sexual development in foster care: Seriously addressing sexually transmitted infections and access to services

Adolescents residing in foster care are at higher risk for acquiring sexually transmitted infections (STIs) and human immune deficiency virus (HIV) compared to their non-foster care peers. A literature review was conducted to determine whether youth residing in foster care face different barriers to sexual health care compared to their peers in the general population and, if so, what those barriers are. The review revealed barriers common to adolescents in general as well as additional barriers specific to the ecosystem of adolescents in foster care. Systemic issues that decreased access to sexual health services included child welfare policies that were either missing or implemented without fidelity; complicated financial factors; barriers to service utilization; lack of collaboration between child welfare and medical professionals; and limited information provided to foster youth on their sexual health and development. Consent and confidentiality issues that foster youth face in seeking sensitive health services also need to be resolved. More research is needed on how to facilitate development of coherent policies and effective practices that promote sexual health care access for adolescents in foster care.     

The use of mental health care,psychotropic drugs and social services by divorced people: does informal support matter?

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.     

Herculean efforts are not enough: diversifying the teaching profession and the need for systemic change

Internationally educated teachers (IETs) seeking to resume their careers in Canada often demonstrate tremendous endurance, fortitude, and resilience in the process of navigating their new professional landscapes, yet neoliberalism and the myth of meritocracy obscure the pervasive systemic barriers characterizing their professional experiences. Critical action research undertaken with graduates of an academic and professional bridging program for IETs in Manitoba reveals a complex interplay of challenges with respect to diversifying the teaching force in intercultural settings. Data collected with IETs seeking full-time teaching positions suggest resuming their careers is by no means guaranteed for many IETs who, in spite of what can be deemed herculean efforts to follow the advice of mentors and make themselves as ‘marketable’ as possible, continue to face significant barriers to employment in a context largely characterized by an over-supply of qualified applicants. Guided by Cummins’ work on collaborative relations of power and a Polanyian critique of economic determinism, my analysis illuminates a multi-pronged systemic approach that has the potential to help ensure the numerous contributions of IETs in Canadian schools can be fully realized.     

Health Insurance,from a Child Language Broker's Perspective

In the midst of dramatic changes to American health care law there is need to understand the challenges that vulnerable populations encounter in obtaining and managing health insurance. Research has found that child language brokers, children who mediate language and culture for their immigrant families, assist with health‐related matters. We report on focus groups with 17 language brokers living in Central Los Angeles. In this article we detail their experiences language brokering for health insurance and their knowledge of health insurance and policies that apply to their immigrant families. We illuminate some barriers immigrant families face as well as how they navigate them. We conclude with policy implications, particularly in relation to making health insurance more accessible to non‐English speaking and immigrant populations.     

Condom use,frequency of sex,and number of partners: Multidimensional characterization of adolescent sexual risk‐taking

Sexual health research often relies on single risk indicators. However, multi‐variable composites may better capture the underlying construct of risk‐taking. Latent Profile Analysis identified subgroups based on condom use consistency, partner numbers, and sex frequency among 605 adolescents. Three profiles were identified for each of grades 8 to 10 (Condom Users, Few Partners, and Risk‐Takers) and 4 in grades 11 and 12 (Condom Users, One Partner, Two Partners, and Risk‐Takers). Inconsistent condom use groups reported more non‐condom (and often less effective) birth control use and STD and pregnancy histories. Females had greater representation in the Few Partners, One Partners, and Two Partners groups, which also contained increasing proportions of participants in each subsequent year. Males had greater representation in the Risk‐Takers group. A profile approach to measurement has methodological advantages, can add to substantive knowledge, and can inform content, timing, and targets of sexual health interventions.     

Elder Abuse and Barriers to Help Seeking in Chennai,India: A Qualitative Study

This qualitative study attempts to understand why older persons abused by their family members in India do not seek help. In-depth interviews over three visits were conducted with six adults aged 65 years and above who had been physically abused by their sons/daughters-in-law. The interviews were transcribed and themes identified using a thematic analysis method. The barriers preventing a person from seeking help were service-related (accessibility, lack of trust); religious (Karma); family (deleterious effects on family, family members’ responses to help seeking); and individual (socioeconomic dependency, self-blame). The unique findings that surfaced were fear of losing one's identity by losing one's family, attributing abuse to past sins, and concern over not attaining salvation if one's sons did not perform funeral rites. The authors propose a checklist to explore and assess the barriers to seeking help. Recommendations for geroprofessionals in overcoming barriers include implementing outreach programs and changing the misconceptions regarding Karma.     

Bridging help-seeking options to Vietnamese Americans with parent–child conflict and depressive symptoms

To help practitioners bridge services to their clients who face family problems, this research aims to identify help-seeking behaviors among Vietnamese Americans who have experienced parent–child conflict and depression. The 2008 Asian Survey found that 46.3% of 572 Vietnamese Americans experienced parent–child conflict and 30.2% reported depressive symptoms. Having parent–child conflicts or depressive symptoms did not predict help-seeking from mental health professionals. Logistic regression results show that having parent–child conflict would increase the likelihood by 81.7% of a thinking that the problem will be naturally resolved; having depressive symptoms would increase the likelihood of seeking help from herbalists by 1.718 times and from medical doctors by 39.7%. Service strategies should include offering educational programs by multidisciplinary professionals with a focus on the natural aspect of building parent–child bonding.     

Symptoms of Mental Health Problems: Children’s and Adolescents’ Understandings and Implications for Gender Differences in Help Seeking

Amidst concerns that young people’s mental health is deteriorating, it is important to explore their understandings of symptoms of mental health problems and beliefs around help seeking. Drawing on focus group data from Scottish school pupils, we demonstrate how they understood symptoms of mental health problems and how their characterisations of these symptoms as ‘rare’ and ‘weird’ informed participants’ perceptions that peers, teachers and parents would respond to disclosure in stigmatising ways. Consequently, participants suggested that they would delay or avoid disclosing symptoms of mental health problems. We highlight subtle gender and age differences and outline implications for policy and practice.     

Motivators for Seeking Gambling-Related Treatment Among Ontario Problem Gamblers

A random digit dialing telephone survey was used to interview 8,467 adults in Ontario, Canada. The NODS-CLiP was used to identify a representative sample of 730 gamblers (54.3% male, mean age 45.3 years) with possible past year gambling problems in order to explore factors that might affect disordered gamblers’ motivators for seeking gambling-related help. A final sample of 526 gamblers provided useable data on possible reasons for and barriers to seeking help, awareness of services, self-perception of gambling problems and experience with help-seeking. Financial and relationship issues were the most frequently volunteered motivators. However, over two-thirds of the respondents could not think of a reason for seeking help. Gamblers who had self-admitted or more severe problems, who knew how to get help, who were employed and had more education, and who identified possible barriers to seeking help were more likely to suggest motivators, especially financial ones. More research is recommended on gamblers’ trajectory towards recognition of a gambling problem, the process of overcoming specific barriers to treatment, and the role of social advantage (e.g., education and employment), in order to devise educational campaigns that will encourage earlier help-seeking among disordered gamblers.     

‘The Bad People Go and Speak to Her’: Young People’s Choice and Agency when Accessing Mental Health Support in School

Concerns about the mental health and well‐being of children and young people have been articulated in health and education policy fields as a call for closer working between schools and providers of mental health support services. Drawing from a Scottish study, this article explores issues of access, when mental health initiatives are sited in formal educational settings. In particular, it focuses on the implications for the agency of children and young people seeking support from those services when and how they choose. The study argues that over‐reliance on teachers as the main referral route to service influences what is deemed to be a problem, who is thought to need support and how the interventions are viewed by the children and young people. Alternative approaches are discussed, which offer opportunities for children and young people to explore the available services and make their own choices about their level of engagement.