Social and Emotional Functioning of Older Asian American Adolescents

This study identified a constellation of psychosocial problems reported by older Asian American adolescents that was different from their Caucasian peers. When compared to 386 Caucasian American adolescents from the same community, Asian American students performed better academically and reported fewer delinquent behaviors. However, these Asian American youth reported higher levels of depressive symptomatology, withdrawn behavior, and social problems. They also perceived themselves more poorly and were more dissatisfied with their social support. These differences highlight the unique mental health needs of older Asian American youth. Practice recommendations are made that consider traditional Asian values and the role that family members can play in the development of effective treatment plans.     

Violence, coping, and mental health in a community sample of adolescents

The current study examined the coping strategies, exposure to violence and psychological trauma symptoms of violent adolescents compared to less violent and nonviolent adolescents in a community sample. An anonymous self-report questionnaire was administered to students in six public high schools (grades 9-12). The 10% most violent adolescents were identified and compared to their less violent and nonviolent peers. A total of 3724 students represented 68% of adolescents in all targeted schools. Ages ranged from 14 to 19 years; 52% were female; and 35% were African-American, 34% Caucasian and 23% Hispanic. Analyses revealed that violent adolescents compared to their less violent and nonviolent peers employed more maladaptive coping strategies, were exposed to higher levels of violence and reported higher clinical levels of psychological trauma symptoms. Maladaptive coping was also significantly associated with psychological trauma symptoms and violent behavior, even after controlling for the influence of demographic factors. The findings support the importance of appropriate identification, assessment and referral services for adolescents in nonclinical settings, and the role that coping strategies play in contributing to adolescent mental health and well-being.     

FAMILY ASSESSMENT DEVICE: REPORTS FROM MOTHERS, FATHERS, AND ADOLESCENTS IN COMMUNITY AND CLINIC FAMILIES

This study compared responses on the 60-item version of the Family Assessment Device (FAD) obtained from mothers, fathers, and adolescents in two groups of families. The clinic group consisted of 94 families in which the adolescent had been referred to a mental health service in metropolitan Adelaide, South Australia. The community group consisted of 94 families, also containing an adolescent, living in the Adelaide community. Members of the clinic families consistently rated their families as less healthy than did families in the community. Importantly however, adolescents in both groups of families rated their families as significantly less healthy than their parents. Thus, while the results of the study provide support for the discriminative validity of the FAD, they also emphasize the need to consider separately self-reports on family functioning obtained from different members of the same family.     

Divorce Disclosures and Adolescents' Physical and Mental Health and Parental Relationship Quality

Two studies were constructed to examine the associations between custodial parents' negative disclosures about the other parent after a divorce and parent–adolescent relational quality (closeness and satisfaction) and adolescents' physical and mental health. In general, the results suggested that even though negative disclosures about the other parent might be associated with more cohesive relationships between custodial parents and adolescents, it does not mean that adolescents are immune to the physical and psychological effects of such disclosures. In Study 2, negative disclosures about the other parent were associated with adolescents' increased reports of physical and mental health symptoms. The results revealed a similar effect for general divorce information and adolescents' mental health. However, there was no association for catharsis and adolescents' physical and mental health. The results from both studies also revealed that adolescents perceived that their custodial parents disclosed more negative information about the other parent than the parents perceived that they disclosed.     

Lesbian,Gay, Bisexual,Sexual-Orientation Questioning Adolescents Seeking Mental Health Services

Summary

Lesbian, gay, bisexual, and sexual-orientation questioning (LGBQ) adolescents have many of the same health needs as straight adolescents. In addition, they must learn to manage a stigmatized identity that may create confusion, anxiety, and emotional turbulence for them. Beyond stigma, LGBQ youth are often found to be at higher risk for substance abuse, violence, depression, suicide, and sexual health problems. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this article examines the relationship between sexual identity and risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these in counseling. Findings indicate that LGBQ youth are at higher risk than straights, and express greater desire to talk about substance use, health, their personal lives, and their friends. Mental health practitioners working with these young persons must properly assess and address their risks by creating a sense of community and safe environment for open discussion.     

Nursing home admissions and long-stay conversions among persons with and without serious mental illness

The appropriateness of nursing homes for individuals with serious mental illness remains a controversial issue in long-term care policy more than a decade since the landmark U.S. Supreme Court Olmstead decision in 1999 , which affirmed the rights of persons with disabilities to live in their communities. Using national nursing home Minimum Data Set assessments from 2005, the authors compared the demographic, clinical, and functional characteristics of persons with and without serious mental illness newly admitted to nursing homes. They found that newly admitted people with serious mental illness were younger and more likely to become long-stay residents than those admitted with other conditions, despite a higher proportion of residents with serious mental illness, including the elderly, classified as low-care status. The most substantial and clinically significant difference for rates of low-care status 90 days after initial admission are for persons younger than 65 with serious mental illness versus those younger than 65 without serious mental illness (33% vs. 8.5%, or 3.9 times greater). There is a notable difference in low-care status between persons aged 65 and older with serious mental illness and those aged 65 and older without serious mental illness (14% vs. 6.6%, or 2.1 times greater). These results suggest that a substantial number of adults with serious mental illness residing in nursing homes may have the functional capacity to live in less restrictive environments.     

Self-report of health problems and health care use among maltreated and comparison adolescents

The study aims were to compare maltreated and comparison adolescents' health problems and to identify how individual, family and home characteristics and maltreatment status affect adolescents' self-report of health status and health care use. The sample was 224 maltreated adolescents (mean age = 18.3 years) and 128 comparison adolescents (mean age = 18.15 years). Comparison adolescents reported more cold and pain symptoms during the previous 30 days but no differences in other physical health problems, self-assessment of their physical and mental health or health care use compared to maltreated adolescents. Girls were more likely to have had a dental checkup, to have seen a psychological counselor, and to self-identify their physical health as poor compared to boys. Older adolescents were less likely to have had a medical checkup or seen a psychological counselor than younger adolescents. A history of maltreatment was not related to health or health care disparities for adolescents growing up in the same low-income environment as adolescents without a maltreatment report. The environmental context and geographical location in which these adolescents grew up may be the primary driver in their health behaviors and health problems and not the experience of maltreatment.     

Counseling Brazilian Undergraduate Students: 17 Years of a Campus Mental Health Service

Objective: The authors reviewed demographic and clinical characteristics of undergraduates at a Brazilian public university (UNICAMP) who visited the campus mental health service (SAPPE) and compared their demographics with those from all undergraduate students enrolled in the university. Participants: The authors looked at data from all undergraduates who sought counseling or mental health care at SAPPE over a 17-year period (N = 2,203; 1987-2004). Methods: They obtained this information from clinical charts and a UNICAMP database. Results: Women, students from other Brazilian states, students living in the campus residence hall, and students whose main source of income was a scholarship were overrepresented. Female student-clients complained about family conflicts more frequently than did their male counterparts, and male student-clients reported concern about poor academic performance more frequently than did their female counterparts. Conclusions: Sex, living in a university residential facility, and reliance on a scholarship grant were predictive of undergraduates' mental health-seeking behavior and pattern of complaints.     

Is it the family or the neighborhood? Evidence from sibling and neighbor correlations in youth education and health

In this paper, we present sibling and neighbor correlations in school grades and cognitive skills, as well as indicators of physical and mental health, for a sample of German adolescents. In a first step, we estimate sibling correlations and find a substantial influence of shared family and community background on all outcomes. To further disentangle the influence of family background and neighborhood, we estimate neighbor correlations. Our results show that for all outcomes, the estimated neighbor correlations are clearly lower than the estimated sibling correlations. However, especially for cognitive skills and mental health, neighbor correlations are still substantial in relation to sibling correlations. Thus, compared to existing results from other countries, the influence of the neighborhood on these outcomes is not negligible in Germany.     

Multiple Risks,Multiple Worries,and Adolescent Coping

Summary

To describe the process that clinicians use to engage vulnerable urban adolescents in mental health counseling, the authors propose a tri-partite model of clinical engagement that takes into account: (1) consumer preference; (2) risk and worry; and (3) youth development (YD) perspectives. These conceptual lenses embody what adolescents want to talk about, their exposure to behavioral and environmental risks, and their coping and strengths. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this paper uses this tripartite model to summarize patterns of risk that service applicants experience, what they worry about, and how they cope. It explores the substructure of adolescent risk and vulnerability, through factor analysis of relevant items across a broad range of Adquest life areas, to develop a typology of adolescents by risk and worry. Patterns of coping and desire to talk across a range of life areas within this typology are described, as are the practice implications. The authors conclude that even those adolescents who most concern clinicians—because they have high environmental and behavioral risk and low worry-present many different opportunities for engagement.     

Contracting in College Health Instruction

This ten-year survey of the use of student mental health services offered by the University of North Carolina suggests that increased usage over time has been due to greater availability of staff and a broadening of services offered rather than to an increase of the prevalence of mental illness among the student body. The authors believe that college psychiatry, as one of the earliest examples of the provision of mental health services to a community, can be used as a model for other aspects of public health psychiatry.     

College psychiatry as public health psychiatry. 1967

This ten-year survey of the use of student mental health services offered by the University of North Carolina suggests that increased usage over time has been due to greater availability of staff and a broadening of services offered rather than to an increase of the prevalence of mental illness among the student body. The authors believe that college psychiatry, as one of the earliest examples of the provision of mental health services to a community, can be used as a model for other aspects of public health psychiatry.     

A pilot study of Latinos with multiple sclerosis: demographic, disease, mental health, and psychosocial characteristics

In this study the authors present results from a survey of 99 Latinos with multiple sclerosis (MS), including demographic, disease, and mental health characteristics. Four in 10 respondents reported depressive symptoms; half thought they had more worries than other people due to their MS; and about 29?% thought they needed mental health care in the past year. Whereas 76?% of respondents were highly satisfied with their access to MS-focused care, only 61% were highly satisfied with their access to mental health care. These findings highlight the role of mental health and social services in the comprehensive care needed by Latinos with MS.     

Preface to the Special Issue on Child and Adolescent Attachment

The implications of John Bowlby’s attachment theory resound through the mental health community. While we know now that much of what Bowlby posited was true, we are still discovering the value of such findings for our clinical work with children and adolescents. Our special issue in Clinical Social Work Journal explores how attachment theory is being used in clinical settings throughout the country. It presents articles relevant to work with infants and toddlers, children and adolescents and families. How can we translate what we know about attachment theory and research into practice? Our special issue authors have attempted to answer this question.     

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.     

Exploring the specific needs of an understudied group: Children with intellectual disability in residential child care

Children and adolescents who live in out of home care in the child protection system are considered to be vulnerable to manifesting mental health disorders as well as other types of difficulties. This risk is greater in the case of children who display any type of disability. The aim of this study is to profile the state of health and well-being of a group of children presenting intellectual disability who live in residential care in a Spanish autonomous community and to compare these results with their non-disabled peers.     

Comparison of Treatment Response among GLB and non-GLB Street Living Youth

Researchers have found that adolescents who identify as gay, lesbian, or bisexual (GLB) are at a higher risk for increased substance use and mental health symptoms. The current study is a secondary analysis of two clinical trials for street-living youth. This analysis examines self-identification as GLB as a moderator of treatment effects and addresses whether street-living GLB youth respond differently to a therapeutic intervention than non-GLB street-living youth. Comparisons were made of treatment outcomes on two categories of variables (drug use and mental health symptoms) among 244 homeless GLB and non-GLB identified adolescents. Overall, GLB and non-GLB adolescents showed similar reductions in drug use and mental health symptoms. However, compared to non-GLB adolescents, GLB adolescents showed greater improvement in reduction of drug use and internalizing and depressive symptom scores. While both groups reported less drug use and fewer mental health symptoms from baseline to post-intervention, GLB youth's scores improved more drastically. Implications of using the identified treatment intervention are discussed.