Assessment of study abroad outcomes in Chinese as a second language: gains in cross-cultural adaptability,language contact and proficiency

Participants were 109 American college students studying Chinese in a study-abroad programme in Beijing. Following Kelley and Meyer, intercultural competence was defined as cross-cultural adaptability involving four dimensions (emotional resilience, flexibility/openness, perceptual acuity and personal autonomy) and was measured with a survey. A language contact questionnaire was used to document the amount of time spent on social activities. Language proficiency was measured with a standardised Chinese test. Results revealed that intercultural competence and language contact combined explained 37.7% of the proficiency gains. Language contact had direct effects on proficiency, but intercultural competence had indirect effects, mediated by language contact.     

Considering child care and parenting needs in Veterans Affairs mental health services

Child care and parenting needs of adults with mental illness are of growing concern, especially among those seeking Department of Veterans Affairs (VA) mental health services. One area of interest concerns the possible benefits that on-site child care could have for improving veterans’ access to VA mental health care. Child care programs are currently being piloted at the VA for the first time, although the need for them has not been evaluated. We conducted a brief survey of a convenience sample of 147 veterans (132 men, 15 women) seeking mental health care at outpatient clinics and/or at a psychiatric rehabilitation center at one VA. Participants were asked about their attitudes and experiences regarding child care and parenting support at the VA. Of the 52 (35.4%) participants who responded and had children under 18, the majority of both men and women surveyed agreed that the VA should offer child care services and that they would use child care services at the VA if it were available. These results are based on a small sample of participants, but they may contribute to ongoing discussion and efforts to develop “family-friendly” mental health services.     

Parent-adolescent concordance on perceived need for mental health services and its impact on service use

Mental health service underutilization among African American adolescents is well documented, yet not fully understood. Discordance between adolescents and their parents on perceived need for seeing a counselor for an emotional need or psychiatrist for psychiatric or medical services may help explain low service use among this population. This exploratory, prospective study examined the relationship between parent-adolescent concordance on perceived need for emotional counseling or psychiatric services and mental health service use. The relationships between gender and perceived service need and concordance and adolescent severity of depressive symptoms were also explored. Parent-adolescent dyads (n = 108) receiving community-based adolescent outpatient mental health services responded to interview questions concerning their perception of whether an emotional counselor and a psychiatrist were needed in the past six months. Findings revealed low parent-adolescent concordance on perceived need for an emotional counselor and a psychiatrist. A greater proportion of adolescents reported a need than parents. There was no association between gender and perceived need for an emotional counselor and a psychiatrist. Lower rates of parent-adolescent concordance were found among youth reporting elevated depressive symptoms compared to youth reporting normal range symptoms. Concordant dyads kept a higher number of appointments than discordant dyads. Implications for clinical social work practice and future research are discussed.     

Former system youth with mental health needs: Routes to adult mental health care, insight, emotions, and mistrust

Objective

Public health concern surrounding the mental health needs of former system youth is escalating. We know very little about mental health service utilization on the other side of the developmental transition to adulthood. The purpose of this study was to explore the mental health service use experiences among former system youth with childhood histories which included mental disorder, use of publicly-funded mental health services, and use of additional public systems of care.

Methods

In-depth face-to-face interviews were conducted with 60 participants currently struggling with mental health difficulties regarding their service use experiences over the transition. Participants were recruited from one Midwestern state. Multi-phase analysis was conducted utilizing immersion/crystallization, constant comparison and concept matrices.

Results

Few participants received continuous mental health care across the transition, with the majority experiencing interruptions or discontinuation of care. Important facilitators of service use emerged, such as physicians, former caseworkers and family. Health clinics and parenting programs emerged as potential entrée points for reconnecting disengaged young adults to mental health services. Insight, mistrust, and emotions emerged as novel factors associated with service utilization among young adults.

Conclusions

Mental health service utilization remains a complicated phenomenon over the developmental transition to adulthood. Future research is needed that closely examines the associations between insight, emotion, mistrust and service use among young adults.     

Perceptions of transition-related health and mental health services among transgender adults

The opportunity to live authentically is critical for the well-being of transgender individuals. For many this requires accessing transition-related services. Current knowledge of transition-related care is limited. This study aims to elucidate experiences and needs of transgender individuals (N = 65) related to (a) therapeutic support, (b) medical care, and (c) aspects of living authentically in order to inform the development and delivery of trans-affirmative services. Findings reveal challenges accessing health care providers with trans-specific competency; gaps between critical aspects of transition-related care and receipt of services; and heterogeneity of experiences and needs. Recommendations for improving transgender-affirmative services are provided.     

A gender-informed model to train community health workers in maternal mental health

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers.     

Evaluation of a system designed to link people living with HIV/AIDS with mental health services at an AIDS-service organization

This study evaluated the Rapid Response System, an initiative designed to link people living with HIV/AIDS with mental health services at an AIDS service organization. Data were extracted from agency records for 314 clients who had contact with the Rapid Response System over a 6-month period. Of the 281 clients who scheduled an appointment for an evaluation to initiate mental health services, 64% completed the evaluation. In the multivariate analysis, Latinos were significantly less likely than whites to complete the mental health evaluation. Further, there was a significant decrease in the likelihood of completing the mental health evaluation as the number of days between the Rapid Response System contact and the date of the evaluation appointment increased.Strategies that reduce the period of time between the initial referral and initiation of services may facilitate linkage with mental health treatment, particularly in the context of larger multi-service organizations.     

Differential association between unemployment status and mental health among veterans and civilians

This study aims to examine the negative effect of unemployment on mental health among 2,762 veterans and 45,095 civilians aged 18 to 50 years. The data were from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) survey. We used ordinary least squares regression to test the interaction association between employment status and veteran/civilian status with mental health status. Findings revealed that long-term unemployed veterans had a significantly greater number of days with poor mental health than long-term unemployed civilians. The study highlights the need for future research concerning the negative effects of long-term unemployment on veterans’ mental health as well as the reciprocal relationships between mental health and occupational functioning for veterans. The findings challenge researchers to question the meanings that are associated with employment status for veterans as compared to those of their civilian peers. In addition to this, the study raises the need for further exploration into the topics of identity, self-perception, and the notion often present in the military/veteran culture that there is “dignity in labor.”     

Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

UPSTREAM! Together evaluation results from community efforts to prevent mental,emotional, and behavioral health problems

Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.     

Development of an intervention to improve mental health for obstetric fistula patients in Tanzania

Obstetric fistula is a debilitating childbirth injury that has been associated with high rates of psychological distress. Global efforts have helped to link women to surgical repair, but thus far no evidence-based interventions exist to address the psychological needs of these women during the hospital stay. In this paper, we describe the development of a psychological intervention for women in Tanzania who are receiving surgical care for an obstetric fistula. The intervention was developed based on theories of cognitive behavioral therapy and coping models. Content and delivery were informed by qualitative data collection with a range of stakeholders including women with fistula, and input from a study advisory board. The resulting intervention was six individual sessions, delivered by a trained community health nurse. The session topics were (1) recounting the fistula story; (2) creating a new story about the fistula; (3) loss, grief and shame; (4) specific strategies for coping; (5) social relationships; and (6) planning for the future. A trial run of the intervention revealed that the intervention could be delivered with fidelity and was acceptable to patients. A future randomized control trial will evaluate the efficacy of this intervention to address the mental health symptoms of this population.     

Limiting labels: Opportunities to learn and college readiness among English language learners

Over a fifth of California's public schools' students have limited access to college and career pathways due to being labeled an “English-language learner (ELLs).” As reported by the California Department of Education, in the 2017–2018 school year, of the over 6.2 million students in California, nearly 1.3 million students are categorized as ELLs. The ELL label states students “whose difficulties in speaking, reading, writing, or understanding English may (my emphasis) limit his or her ability to (1) achieve in classrooms where English is the language of instruction and (2) access opportunities to fully participate in society.” Aligned with deficit thinking models, the US school system interprets “may” as “will” and makes decisions that negatively impact a large body of students across the country. The growing body of research reveals that many with the ELL label have been and continue to be intentionally underserved, limited access to postsecondary education, tracked into low-rigor and stigmatizing course pathways, and are deliberately unsupported to become college-ready, furthering the inequities in education and limiting options for quality k-12 educational experiences. The system becomes blinded by the label and ignores students with ELL labels' abilities and capacities to learn. So how are students with ELL labels supposed to become college-ready, let alone career-ready? For the purposes of this critical literature review, I will focus on exploring the existing structures that define “college-readiness” and the disparities created by the intentional tracking of students with the ELL label in comparison to their non-ELL peers.     

Predicting job satisfaction of mental health peer support workers (PSWs)

ABSTRACT

The Mental Health Recovery Model is an empowering service philosophy which has been transforming the field of mental health. An important service approach to actualizing this model is hiring peer support workers (PSWs) who are peers advanced in recovery and employed to assist other peers in their recovery process. This study reports on factors hypothesized to affect PSW job satisfaction. Using multiple regression analyses, organizational culture and relationship with peers predicted 29% of job satisfaction. Based on these findings, suggestions are offered to assist social work administrators in effectively integrating and supporting PSWs in the workplace.     

Characteristics related to family involvement in youth residential mental health treatment

This study examined family involvement among youth in residential mental health treatment facilities in Florida. Data were obtained from the provider reports from January 2005 through December 2007. Treatment episodes were divided into 30-day periods with family involvement measured by the number of contacts by all family members, the mother, and the father. In addition, we examined contacts by all family members for in-person treatment, treatment-related phone contacts, treatment planning, campus visits, and therapeutic home passes. Families averaged 3.4 contacts per 30 days for the 1333 treatment episodes. Sixty-seven percent of the contacts included mothers, while 22% of the contacts involved fathers. A majority of contacts were for family therapy, either by phone (29% of contacts) or in person (43%). Nearly twenty percent of residential stays had no family contact. After the first 30 days of treatment, contacts did not vary significantly over the course of the treatment episode, although there was some evidence that youth with longer treatment episodes had fewer contacts throughout the residential stay. Total contacts were lower for girls than boys, for blacks than whites, and for older youth, and were higher when the youth lived in the same county as the residential treatment provider. Outreach programs could target specific demographic groups with low involvement, and the alternative methods for involvement that use internet conferencing tools should be explored for parents that live far from the treatment provider.     

Responsive engagement in mental health services for foster youth transitioning to adulthood

ABSTRACT

As youth near the transition to adulthood and aging out of the foster care system, exposure to stress increases, especially for youth who have less-than-adequate support systems. Although mental health problems among foster youth often continue into adulthood, service use decreases dramatically within a year of turning age 18. Understanding how foster youth experience mental health services as they transition from care provides social workers and other mental health professionals important insight that can lead to specific, targetable strategies. This study sought to explore what situations were helpful in supporting mental health as foster youth transitioned to adulthood. Focus groups and interviews with former foster youth and professionals informed the development of a quantitative instrument, which was used to identify the most supportive and frequently encountered situations former foster youth experienced. Findings indicate the most helpful situations were those in which professionals and mentors were flexible and responsive to their individual needs and trusted their ability to make decisions. Supportive adults who honored their choices and collaborated in decision-making were also helpful. Engaging, empowering, and partnering with transition-age youth may increase the likelihood of positive mental health outcomes for this population, offering implications for family-centered, strengths-based practice.     

Trends in college students’ mental health diagnoses and utilization of services, 2009–2015

Abstract

Objective: To examine changes in diagnoses/treatment for 12 mental health (MH) conditions, previous use of campus MH services, and willingness to seek MH services in the future. Participants: ACHA–NCHA II participants from 2009 to 2015 (n?=?454,029). Methods: Hierarchical binary logistic regression with step 1 controlling for demographics and step 2 considering time. Results: Time was significant except for bipolar disorder, bulimia, and schizophrenia with increases for all conditions except substance abuse. Anxiety (OR?=?1.68), panic attacks (OR?=?1.61), and ADHD (OR?=?1.40) had the highest odd ratios. Use of MH services at current institution (OR?=?1.30) and willingness to utilize services in the future (OR?=?1.37) also increased over time. Conclusions: Based on a national sample, self-reported diagnoses/treatment of several MH conditions are increasing among college students. This examination of a variety of MH issues can aid college health professionals to engage institutional stakeholders regarding the resources needed to support college students’ MH.     

Legal capacity and the mental health social worker role: an international comparison

ABSTRACT

New capacity laws have been introduced to many jurisdictions over the last decade. These laws have substantially changed the way in which mental health social workers and other professionals approach decisions about, and for, clients. Most notably, there is now an expectation that mental health social workers engage more in supported decision-making to prevent the need for substitute decision-making. This article describes the legal and policy drivers that have led to these changes in practice, with a particular emphasis on the significance of the United Nations Convention on the Rights of Persons with Disabilities (the UNCRPD) and the importance of recovery approaches in mental health services. It then uses selected literature to explore the efficacy of the laws and decision-making in this area. The second part of the article identifies the role that mental health social workers can play in supporting legal capacity, drawing from the authors’ experience and knowledge of mental health social work and law in four jurisdictions: Victoria, Australia; Ontario, Canada; England and Wales; and Northern Ireland. It is concluded that mental health and other social workers need to refine skills, knowledge and values to accommodate this paradigm shift in law, policy and practice.