Determinants of Perceived Safety Among the Elderly

Abstract

A survey of randomly selected elderly residents (N = 301) of a largely rural county in Northwest Ohio sought to explore the perception of the fear of crime victimization. Those who participated in the study were asked a series of questions about their community, actual experiences of crime victimization, perception of fear related to victimization, and social support. Logistic regression analyses were computed to explore perceptions of neighborhood safety. Most participants reported limited experiences of victimization. As expected, in this rural environment, there was more reliance on informal supports and limited use of existing formal services.     

Poverty,Partner Abuse,and Women's Mental Health: New Knowledge for Better Practice

ABSTRACT.

To better understand how poverty and poor mental health impact women who are abused by intimate partners, a convenience sample of 300 abused women using shelters or justice services for the 1st time were interviewed. The 300 women were categorized as having no income, being above poverty, and being below poverty according to U.S. Poverty Guidelines. Results indicated that no direct effect of income on poor mental health was noted; however, an interaction between type and severity of abuse and income level had an impact on poor mental health. Abused women who were above poverty with the highest incomes reported the highest levels of depression in the presence of high physical and sexual abuse. In contrast, women reporting no income reported no significant effect of severity or type of abuse on depression scores. Women just above the poverty level who experienced severe abuse were at highest risk for mental health problems. Poverty impacts the mental health of abused women according to the degree of poverty and type and severity of abuse. More research is needed to specify programs to maximize the mental health functioning and economic solvency of abused women.     

Mental Health Service Utilization Among Frail,Low-Income Elders

Abstract

This study was conducted to determine the extent to which service providers in a community-based care program accurately identified and referred elders with symptoms of depression. Interviews were conducted with 79 frail, low-income elders, with the CES-D used to gauge depressive symptomatology. Reviews of their case files were then conducted to determine first, the extent to which case managers recognized depressive symptoms and second, the extent to which respondents who screened with significant symptoms were referred for mental health services. Results suggest an imperfect association between CES-D scores and case managers' perceptions and referrals. Less than 1/3 (31%) of those who screened for depression received counseling.     

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.     

“They Kill People Over Nothing”: An Exploratory Study of Latina Immigrant Trauma

Abstract

This article presents findings from an exploratory, mixed methods study to: (1) Ascertain whether Latina immigrant clients of a healthcare clinic for uninsured patients suffer a higher rate of PTSD compared to the citizen population at large and (2) Explore whether factors unique to immigrants, such as surviving human smuggling, would predict PTSD. Two validated instruments were deployed with clients who agreed to be screened (n?=?62). Ten percent of U.S. women are expected to develop PTSD in a lifetime, a total tripled by immigrant women in this study. Women who scored high on the PTSD CheckList for Civilians (PCL-C) reported victimization from sexual assault, robberies and loss of friend/family member to violence, though no single assault predicted PTSD. Qualitative data, however, revealed that violence in countries of origin influenced decisions to immigrate. Among the avenues for future research identified by this study are (1) exploration of methods for linking Latina immigrants to mental health services, (2) determining the effects of smuggling violence on immigrants, and (3) Evaluate additive effects of multiple traumas.     

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.     

An agenda for future research regarding the mental health of young people with care experience

Young people who are currently or were previously in state care have consistently been found to have much higher rates of mental health and neurodevelopmental difficulties than the general youth population. While a number of high-quality reviews highlight what research has been undertaken in relation to the mental health of young people with care experience and the gaps in our knowledge and understanding, there is, until now, no consensus, so far as we aware, as to where our collective research efforts should be directed with this important group. Through a series of UK wide workshops, we undertook a consultative process to identify an agreed research agenda between those with lived experience of being in care (n = 15), practitioners, policy makers and researchers (n = 59), for future research regarding the mental health of young people with care experience, including those who are neurodiverse/have a neurodevelopmental difficulty. This consensus statement identified 21 foci within four broad categories: how we conceptualize mental health; under-studied populations; under-studied topics; and underused methodologies. We hope that those who commission, fund and undertake research will engage in this discussion about the future agenda for research regarding the mental health of young people with care experience.     

影响农民工精神健康的社会因素

本项研究运用定量数据从个体的社会经济地位、迁移压力和社会资本三个角度,分析了影响农民工精神健康的社会因素。研究发现：（1）相对社会经济地位对农民工的精神健康产生的影响远大于绝对社会经济地位的影响;（2）农民工群体的迁移过程面临的压力,例如被排斥、不公平待遇等会对他们的精神健康产生较大的消极影响;（3）相较于其他群体,社会资本和精神健康的关系在农民工群体中的表现更为复杂。有的社会资本对精神健康有积极的影响,例如信任和网络密度;而有的社会资本则对精神健康产生消极影响。     

Minimizing Social Desirability Bias in Measuring Sensitive Topics: The Use of Forgiving Language in Item Development

Abstract

Social science research has long been concerned with attitudes, beliefs, and behaviors that are potentially objectionable, immoral, or illegal. These types of topics include, for example, racism, ableism, cheating, and stealing, among others. Referred to as “sensitive topics,” their investigation usually involves questions that require respondents to admit to attitudes, beliefs, and behaviors that violate social norms, making their assessment susceptible to error due to social desirability bias. This article describes an empirical investigation of an approach to minimize this bias, the use of “forgiving language” in survey item development and the effect on item variability. Using secondary data initially collected as part of a measurement development study of mental health providers’ stigmatization of service users, 15 pairs of similar, thematically targeted items, varying with respect to wording approach were tested using a purposive sample of mental health providers (N?=?220). Findings indicate that items crafted in a forgiving manner were not significantly influenced by social desirability bias, in contrast to items developed in more traditional language. Additionally, forgiving language-items produced higher levels of agreement, on average, when compared to those written in more traditional language. More research is indicated, including systematic variation of wording approaches, but these results seem promising.     

Longitudinal health and disaster impact in older New Zealand adults in the 2010–2011 Canterbury earthquake series

ABSTRACT

Pre-existing longitudinal studies of people affected by disasters provide opportunities to examine the effects of these events on health. Data used in the current investigation were provided by participants in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2010, 2012 and 2014 (n = 428; aged 50–83), who lived in the Canterbury region of New Zealand during the 2010–2011 earthquakes. Latent profile growth analyses were used to identify groups of respondents who had similar pre–post-disaster physical and mental health profiles. These groups were compared in terms of demographic factors, personal impact of the earthquakes assessed in 2012 and the overall negative–positive impact of the earthquake assessed in 2014. There was little evidence of change in health status overtime. Groups did not differ in their experiences of threat or disruption, however those in poorest health reported greatest distress and a more negative overall impact of the earthquake. Although results suggest little impact of disasters on health of surviving older adults, pre-disaster vulnerabilities were associated with distress. Social workers and agencies responsible for disaster response can play a key role in pre-disaster planning and assessment of vulnerabilities of older adults to enhance potential for positive outcomes post-disaster.     

Differences by Race in Social Work Students’ Social Distancing,Treatment Options,and Perceptions of Causes of Mental Illness

ABSTRACT

Research has shown that racial and cultural differences are related to the degree of social distancing associated with mental illness, beliefs about what causes mental illness, and what treatment options are best; however, there is little information on how this may manifest in social workers’ perceptions of these issues. This cross-sectional survey analyzed the differences in perceptions by race of 835 students enrolled in social work classes in the United States. Results indicated that individuals who self-identify as African American/Black expressed the greatest social distance concerning mental illness. Whites were most likely to endorse the use of medication and were least likely to normalize mental illness. The most frequently endorsed mental health provider varied according to racial/ethnic groups. Our findings show that future research may be needed to further investigate the conceptualization of the role of social work among different groups. The need for self-reflection and keeping biases in check are discussed as implications for social work practice and education. Suggestions for working with diverse clients, including religious diversity, are offered as well.     

Impact of Support Groups on Well-Being of Older Women

ABSTRACT

The goal of this study was to determine whether differences in incidence of depression and level of well-being are manifested between older women, aged 60 and older, who attend either (a) a peer-run support group, (b) a staff-run support group, or (c) a comparison group (i.e., who do not attend a support group).

Thirty-six women participating in peer-run and staff-run support groups and 9 women receiving nongroup support were administered the Geriatric Depression Scale and the Philadelphia Geriatric Center Morale Scale. Separate analyses of variance were employed on each scale to determine the significance of differences in scores according to facilitator type (i.e., peer-run vs. staff-run vs. comparison group).

Analysis of scores on the Geriatric Depression Scale indicated significant differences between women in the peer-run groups and women in the comparison group, but no significant differences between women in the peer-run groups and women in the staff-run groups or between women in the staff-run groups and women in the comparison group. Analysis of scores on the Philadelphia Geriatric Center Morale Scale did not indicate any significant differences between women based on facilitator type.

Results of this study have implications for those who run face-to-face support groups for older adults, for those who train peer group facilitators, and for community agencies that desire to initiate a support group system for their clientele.     

The Social Construction of Reality in the Realm of Children's Mental Health Services

ABSTRACT

Across the United States, systems of care have emerged to provide mental health care to children and their families; fragmentation inhibiting the success of collaboration by stakeholders is common and compromises these systems of care. Survey data were collected from 1,428 respondents in a Midwestern state to examine problems that exist within systems of care from the perspective of the different stakeholder groups. Stakeholder group membership was based upon the respondent's employment or involvement within various child-serving systems and included those in child welfare, juvenile justice, and education, mental health providers, and consumers (i.e., caregivers/parents). Group differences revealed patterns of “finger pointing” by the stakeholder groups on where specific problems exist within systems of care. The findings provide insight into how the social construction of service delivery and practice emerges as stakeholder groups describe, understand, and evaluate problems within the system of care as a function of their own practice location within the system of care. Future research should consider exploring methods that might minimize the competitive nature of disparate child-serving systems and its potentially negative impact upon system performance and treatment outcomes.     

Experiencing breast cancer in the context of mental illness in New Zealand

ABSTRACT

This study aimed to explore the experiences of women with mental illness who had also experienced breast cancer diagnosis and treatment, in particular, to identify barriers and facilitators to cancer treatment. Semi-structured interviews were conducted with ten breast cancer survivors who had had contact with secondary mental health services prior to their cancer diagnosis. Thematic analysis was used to identify key themes. Participants described positive experiences of cancer treatment, expressing surprise at both how well they coped with diagnosis and treatment and how well they were treated by services. Many contrasted this with their less positive experience of mental illness and mental health services. The women interviewed were active participants in their cancer treatment and did not report feeling stigmatised because of their mental health experiences. A lack of connection between cancer and mental health services was described, but this was not regarded as necessarily a bad thing. This study begins to counter the stereotypes of the difficult patient or the person unable to understand and cooperate in their own care which are prevalent in the literature. Further work is needed to understand the reasons for disparities in cancer outcomes.     

Living Arrangements,Depression, and Health Status Among Elderly Russian-Speaking Immigrants

Abstract

This study examines the relationship between living arrangements, depression, and health status in a community-based sample of 300 elderly Russian-speaking immigrants. Data were collected via a self-administered questionnaire survey method. The questionnaire was designed to investigate various aspects of health, mental health, health services utilization, and health behaviors. A team of bilingual professionals was involved in the construction and translation of the survey instrument. The sample consists of 150 females and 150 males. The respondents' average age was 73.2 years. The regression analysis reveals that elderly Russian-speaking immigrants who live alone are more likely to experience a higher level of depression than those living with others. This relationship remains statistically significant after controlling for age, education, income, ability to speak English, years residing in the United States, gender, and health status. Since health status appears to influence depression, we performed further regression analyses and found that living arrangements had no statistically significant relationship with health status. Health status serves as an intermediate variable between the block of demographic variables and depression. Implications for future research are discussed.     

Young Adult Outcomes of Juvenile Court–Involved Girls

ABSTRACT

The recent increase in the number of girls involved in the juvenile justice system has resulted in increased academic and public attention. Thus far, this attention has focused on entry into the juvenile justice system rather than longer-term consequences. This research helps fill this gap by examining a sample of 700 maltreated and/or impoverished juvenile court–involved females. Competing risks models were used to control for time from juvenile-court entry to adult outcomes: criminal justice system involvement, use of public mental health or substance use services, and income maintenance use. Results indicate that there are distinct predictors associated with the different outcomes, although learning disability and adolescent parenthood were associated with higher risk of both mental health/substance use services and income maintenance. Individualized services for juvenile court–involved girls are suggested. Prospective, longitudinal research is needed to investigate intrapsychic and behavioral dynamics associated with females' young adult outcomes.     

Chapter 17. Rural Mental Health

SUMMARY

Mental health services available in many rural communities are too limited in scope and availability to meet the needs of rural citizens. The future of mental health services for the rural poor will be impacted by state government decisions about Medicaid funding priorities. It is important that rural practitioners, especially those that work in the fields of mental health, health, and aging services, engage in advocacy for better coverage of the rural poor and low-income elderly persons. This chapter discusses issues of advocacy related to improving the provision of mental health services to older rural citizens as an important goal in the larger effort to expand and improve rural mental health service delivery throughout the nation.     

The Smith College Program in Psychiatric Social Work: A Pioneering Contribution to Veteran Mental Health

ABSTRACT

On 7 July 1918, 68 women arrived on the Smith College campus in Northampton, Massachusetts, to learn how to assist in the treatment of shell-shocked soldiers and veterans of the Great War. The Training School of Psychiatric Social Work was the first academic program organized to teach mental health professionals about what today is called posttraumatic stress disorder (PTSD) and to equip them to treat those suffering from it. This essay addresses three questions about this program: How and why did the Smith College Training School of Psychiatric Social Work come into being? What was the experience of those who taught and learned there? What effect did the Training School have on the treatment of PTSD in the postwar years?