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.     

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

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

Adverse Childhood Experiences and Substance Use History among Vulnerable Older Adults Living in Public Housing

ABSTRACT

Previous research shows strong correlations between adverse childhood experiences (ACE) and later life health. The current study examines the relationship between ACEs and substance use among older adults living in public housing. Results show that about one-third of participants had four or more ACEs, and ACE score predicted likelihood of substance use history. Over half of older adults with four or more ACEs experienced substance abuse in their lifetime compared to one out of ten older adults with less than four ACEs. Findings shed light on a vulnerable group and point to next steps in research and practice.     

The global healthy ageing agenda: The impact of education,gender, childhood conditions and social engagement in rural South Africa

This paper examines factors associated with the likelihood of healthy ageing and the propensity to utilise health care resources for a rural community in South Africa and the associated policy implications. Our results suggest education exerts a positive influence, and its marginal impact is more prominent for females than males. Further, we show that better childhood health is associated with increased likelihood of ageing well. We also demonstrate an inverse relationship between health care utilisation and healthy ageing. The results presented here suggest that strategic policy investments across life courses in education and child-health fosters not only broader development goals but also enhances healthy ageing trajectories and improve the health and wellbeing of individuals across life stages. This study contributes to informing on the UN’s healthy ageing global strategic agenda in the context of a poor rural region.     

Racial Differences in Attitudes Toward Professional Mental Health Treatment: The Mediating Effect of Stigma

Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.     

Mentors' attachment dimensions,the quality of mentoring relationship and protégés' adjustment: a moderated mediation model

The relationships between mentors' (n = 168) attachment dimensions, the quality of mentoring relationship and protégés' (n = 187) level of adjustment after 8 months of mentoring intervention were explored. Unexpectedly, protégés of mentors with moderately negative childhood experiences and an insecure state of mind had higher levels of adjustment at the end of mentoring, whereas mentors' positive emotional childhood experiences contributed negatively to levels of adjustment. Furthermore, a dependent mother–protégé relationship moderated the relationship between mentors' attachment anxiety or avoidance and the quality of the relationship, such that it mediated the relationship between mentors' attachment anxiety and avoidance and led to a decrease in protégés' level of adjustment at the end of the intervention. The findings suggest that the disadvantages of a dependent mother–protégé relationship as regard protégés' level of adjustment interact with mentors' avoidance or anxiety, and that there may be an advantage in a mentor–protégé mismatch in terms of an anxious/dependent relational history.     

Conventional and expanded adverse childhood experiences (ACEs) and maternal functioning among low-income Black mothers

A paucity of research has examined the individual and cumulative effects of conventional and expanded adverse childhood experiences (ACEs) on maternal functioning, especially among low-income Black mothers. Using self-report data from a subsample of Black mothers (N = 157) who participated in a larger study to evaluate the effectiveness of an urban public prekindergarten program in the mid-Atlantic region of the United States, we examined the prevalence of ACEs and the individual and cumulative effects of conventional (i.e., family trauma and dysfunction) and expanded (i.e., community stressors) ACEs on depression and health among low-income Black mothers. Findings indicated that Black mothers had more exposure to expanded than conventional ACEs. Hierarchical regression analyses revealed that experience of physical neglect was significantly associated with depression and physical abuse with compromised health, and perceived experience of racism was a predictor of depression and compromised health. More conventional and expanded ACEs were associated with clinical levels of depression and compromised health. Findings highlight the need for more research related to the impact of ACEs, especially expanded ACEs, on mental and behavioural health outcomes. Additionally, our findings indicate the need for more trauma-informed care to reduce and address the impact of individual and community-level adversities on low-income Black mothers.     

Mental health and wellbeing of care leavers: Making sense of their perspectives

Despite considerable quantifiable data about the circumstances of care leavers in the United Kingdom, there is less qualitative data about how these circumstances are experienced. This article is underpinned by positioning theory, with a particular focus on the unfolding personal narratives of young care leavers in relation to their mental health and wellbeing and the role of a life‐skills programme in supporting them in this respect. The research illustrates that leaving care projects, such as the one in the current study, are more focused on employment and housing issues than on addressing the mental health and wellbeing needs of young people. Our analysis of interviews with young people illustrates the ambiguity of understandings of concepts such as “mental health” and “wellbeing,” and the complexity of responses to questioning around this area. This illustrates one of the major problems in evaluating the outputs and outcomes of such projects in terms of simplistic targets, where mental health and wellbeing are not clearly defined or understood by young people themselves. The current research provides a more complex picture. More research is needed that involves in‐depth and longitudinal assessment of specific mental health needs of care leavers and how they can be addressed successfully.     

The interaction effects of scheduling control and work–life balance programs on job satisfaction and mental health

Jang SJ, Park R, Zippay A. The interaction effects of scheduling control and work–life balance programs on job satisfaction and mental health Int J Soc Welfare 2011: 20: 135–143 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. The demands of balancing employment and family responsibilities strain the health and welfare of many employees worldwide, and social welfare policy analysts are increasingly attending to the factors that can alleviate such stress. The present study examined associations between the availability of work–life balance programs, employees' authority to arrange their own work hours, job satisfaction, and mental health among 1,293 employees in 50 companies in South Korea. The study is unique in its use of multilevel analysis in examining individual‐ and company‐level variables. The results add to the evidence regarding the positive relationship between the availability of scheduling control and work–life balance policies on the one hand, and job satisfaction and mental wellbeing, on the other.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

Longitudinal Pathways between Maternal Mental Health in Infancy and Offspring Romantic Relationships in Adulthood: A 30‐year Prospective Study

Longitudinal pathways between maternal mental health in infancy and offspring romantic relationship outcomes in adulthood were examined using a 30‐year prospective longitudinal study of 196 mothers and their children. Structural equation modeling revealed that maternal mental health at 30 months was related to offspring relationship status and relationship attachment insecurity at 30 years. The adolescent variables of offspring mental health and parental relationship status mediated the link between maternal mental health and offspring relationship status. In addition, adolescent mental health and family conflict mediated the pathway between maternal mental health and offspring attachment insecurity. These results highlight the importance of individual and parental mental health to romantic relationship outcomes, and emphasize the value of taking a developmental approach to the study of romantic relationships.     

High Life Satisfaction: Exploring the Role of Health,Social Integration and Perceived Safety among Mexican Midlife and Older Adults

We sought to investigate the relationship of high life satisfaction with important physical health, mental health, social integration and perceived safety factors among midlife and older Mexican adults. We examined 2,200 midlife and older adults (aged 50–101 years) from the Mexican arm of the Study on global AGEing and adult health (SAGE) and used binary logistic regression models to identify key factors associated with high LSA. Our final logistic regression model revealed self-rated health, affect, interpersonal activities and perceived safety on street to be significantly associated with high life satisfaction. Results from this study add to the nascent literature on subjective well-being of midlife and older Mexicans. Although social work with older adults is not well established in Mexico, researchers and practitioners should collaborate on the development and implementation of social worker-led strategies for prevention and intervention to enhance well-being among midlife and older Mexicans.     

Pre–Post Release Health in US Adult Male Convicts

Abstract

This study sought to determine whether need for healthcare and reported health status among adult men (N?=?1,113) in US Federal prisons (in 12 states) changed from pre-release to 15?months after release by analyzing data collected by the Serious and Violent Offender Reentry Initiative (SVORI). Specifically, the study was guided by three questions: (1) were there changes in treatment for specific diseases; (2) were there changes in health status, need for care, and access to and satisfaction with healthcare; and (3) did various social determinants of health predict any of the health outcomes at 15-month follow-up. The analysis of SVORI data found that men reported lower physical and mental health status and declines in receiving treatment following release, but greater satisfaction with healthcare. Further, analysis found the best predictors of health status as being satisfied with access to health care as well as employment. The greatest declines were in mental health treatment, however those ceasing treatment did not report worse physical health status, mental health scores, housing, employment, or recidivism. Future research is needed to determine the significance of the link between employment, satisfaction with access to health care, and health status among ex-prisoners.     

Networks of Attachment Relationships in Low-income Children of Mexican Heritage: Infancy through Preschool

Eighty-three low-income Mexican-heritage children (44 girls) and their mothers participated in this research. Children were observed with alternative caregivers at 14, 24, and 36 months of age using the Attachment Q-Set. Most children received regular care from infancy through preschool from relatives and childcare providers. Children had high attachment security scores with both mothers and caregivers. Child–mother and child-alternative caregiver attachment security scores were independent of each other. Children whose mothers did not participate in family clusters were lowest in child–mother attachment security at 14 months. More emotionally sensitive mothers and responsive alternative caregivers were associated with more secure child–adult attachments. Mothers who had more contact with relatives still in Mexico were more likely to have somewhat more positive relations between intrusive interaction and positive attachment relationships than mothers who had less contact.     

The significance of a secure base: a psychosocial model of long-term foster care

ABSTRACT Long‐term foster care has been a much neglected area of social work practice and research. Yet there are obvious challenges that need to be understood when building a family for life in foster care. Is it possible for foster families, where there are no biological or legal ties between carers and children, to provide care, concern and family membership not only through childhood but also into adult life? The study on which this paper is based set out to explore that question by investigating the experiences of 40 adults, aged 18–30, who grew up in foster families. Qualitative interviews were conducted, transcribed and analysed. Theoretical frameworks from attachment and resilience were brought together with concepts such as ‘belonging’ and ‘family membership’ to make sense of the narratives provided. An integrated and dynamic psychosocial model of long‐term foster care was developed, which emphasizes the significance of a secure base and has some important implications for practice.     

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.     

Determinants of outcome in the pathways through care for children hearing voices

Auditory hallucination, or hearing voices, is generally associated with psychopathology. In psychiatry it is inter-preted as a symptom of an illness, with no connection to the individual's life history. Voice hallucinations in childhood occur in a variety of contexts and have variable long-term outcomes. Little is known about the course of the experience. In this study, 80 children and youngsters hearing voices were interviewed on four occasions over a period of three years about the content of the voices and their overall experience of voices, focusing on the determinants for a promising outcome in the pathways through care. The results indicate that the need for care in the context of the experience of voices is associated not only with high levels of problem behaviour and associated negative symptoms of psychosis, but also, independently, with an appraisal of the voices in terms of anxiety, depression, dissociation and frequency of occurrence. In 60 per cent of the participants the voices disappeared during the three-year research period. The relationship between the disappearance of voices and the course of mental health treatment is, however, ambiguous.     

Relationships Among Caregiving,Income, Gender,and Health: A Cross-Sectional Examination of a Representative Sample of Older Americans

Although there is substantial evidence to support the effect of burden on caregivers, few studies have compared caregivers to their noncaregiving counterparts on the basis of health and well-being outcomes. This study examines the relationship between caregiving and health and whether other factors may have stronger influence on well-being measures. Using a nationally representative sample of older adults in the United States (N = 3,005), this study examines relationships between caregiving status, gender, and income, and 9 outcomes (self-rated physical and mental health, time since seeing a doctor, time since most recent pap smear or prostate-specific antigen [PSA] test, depression, loneliness, stress, anxiety), using logistic and linear regression models. Results support that paradoxically, caregiving was associated with increased likelihood of PSA test in male caregivers, although data also indicated higher levels of anxiety and stress, as might be expected. Income was associated with 8 of 9 outcomes, and gender predicted depression, anxiety, stress, and self-rated mental health. The study highlighted the importance of psychosocial stressors, such as income and gender, on the health outcomes of older adults who may be caregiving. Considering complexity of unique experience is necessary to accurately assess vulnerability to poor mental health or health-related outcomes.     

How Effective are Helpers to Older Adults’ Life Satisfaction?

The effectiveness of help received from home care workers and volunteers to the life satisfaction of community-dwelling older adults is vital but uncharted. To address the effectiveness, this study aims to optimize the use of social resources for the older adults’ life quality. The study thus surveyed 398 community-dwelling older adults in a city of China about the help and life satisfaction. Results showed a significant positive effect of help from home care workers, but not that from volunteers, on the older adult’s life satisfaction. Moreover, the effect of help from volunteers was significantly greater when the older adult had higher education or lower family income. These effects are explicable with resource theory and need fulfillment theory. They imply the worth of promoting help from home care workers generally and volunteers conditionally to champion older adults’ life satisfaction.