Perceptions of domestic abuse in same-sex relationships and implications for criminal justice and mental health responses

Male and female university students (N = 171) read scenarios describing a domestic abuse incident that systematically varied the sex of victim and perpetrator to produce four between-participants conditions. Results were consistent with and extended previous findings about perceptions of heterosexual domestic abuse to include gay and lesbian domestic abuse. Findings suggest that participant perceptions of abuse in same-sex and heterosexual relationships are similar. Where they differ, the differences have significant implications: (a) participants considered male against female abuse to be more serious than same-sex domestic abuse, (b) participants were more likely to recommend that the victim press charges in male against female abuse than in same-sex domestic abuse, (c) participants perceived same-sex victims to be less believable than heterosexual victims, and (d) victim believability was correlated with sentencing recommendations. Implications for criminal justice and mental health intervention are considered. Directions for future research are outlined.     

Violent crime and victim compensation: implications for social justice

Restorative justice offers several innovative methods designed to heal the injury that the offender may have caused to the victim. One of these innovative methods is victim compensation, a form of income redistribution designed to redistribute wealth from offenders to victims of crime. Restitution, particularly through the Victim of Crime Act (VOCA), is a needs-based form of justice designed to assist the most needy victims of violent crime. Recent studies suggest that while state-level compensation programs may target poor, young, African American men, compensation at the national level tends to be received more by older, White women who experienced domestic violence. The author suggests that this disparity between state and local resource distribution in the allocation of victim compensation is a reflection of the ideological differences between the established theoretical frameworks of liberalism and radical feminism.     

Access barriers to mental health services for older adults from diverse populations: perspectives of leaders in mental health and aging

This project is based on the results of telephone surveys with 52 local, state, and national informed respondents including policymakers, county leaders, planners, and advocates in mental health and aging with a particular focus on the states of California and Florida. This article addresses challenges to access to mental health services for diverse older adults including barriers related to race and ethnicity, socioeconomic status, location, age, gender, immigrant status, language, sexual orientation, and diagnosis. The article also highlights broad themes that emerged including (1) the importance of outreach and transportation tailored to diverse elders, and (2) recruitment of diverse staff and training related to diversity. The article concludes with policy and practice recommendations to reduce these disparities in access to mental health services for diverse populations of older adults.     

Intimate partner violence: the effect of gender and contextual factors on community perceptions of harm, and suggested victim and criminal justice responses

Using a vignette to depict physical violence by an intimate partner, a 2 (perpetrator gender) X 2 (participant gender) X 2 (frequency) X 2 (intent to cause harm) between subjects factorial design was used to examine under what circumstances individuals perceive: an incident should be illegal, the extent of harm, and appropriate victim and criminal justice responses. There were 868 participants from the Brisbane (Australia) community (48.5% males). The actions of male perpetrators were viewed more seriously and the victims were recommended to seek more forms of assistance when the perpetrator was male. There were few differences in perceptions of violence according to participant gender. The frequency of the violence affected the participant's responses but the intentions of the perpetrator did not. Results are discussed in terms of stereotypes of intimate partner violence (IPV) and the implications for help-seeking behavior by victims.     

Gender, race-ethnicity, and psychosocial barriers to mental health care: an examination of perceptions and attitudes among adults reporting unmet need

Though researchers have described psychosocial barriers to mental health care-seeking, limited research has examined ways in which gender and race-ethnicity are associated with individuals' perceptions and attitudes. This study investigates correlates of psychosocial barriers to mental health care in a population of adults reporting unmet need for mental health care, focusing on gender and race-ethnicity. Data are from the 2002 National Survey on Drug Use and Health. Multivariate analyses show that non-Latino white male status is positively associated with stigma avoidance and mistrust/fear of the mental health care system. Persons of lower income or educational status are less likely to report negative attitudes towards care. Findings imply a need to reconsider the roles of gender race-ethnicity, and socioeconomic status within investigations of psychosocial barriers to care. Future research should examine the relationships among social status, help-seeking behaviors, and attitudes toward mental health care.     

Providers' perceptions of how rural consumers access and use mental health services

This article describes the third phase of a research study undertaken within a Canadian provincial regional health authority to explore and analyze mental health services and other resources used by rural consumers after discharge from inpatient mental health programs. The focus of this article is the qualitative research findings obtained from mental health service providers and members of allied agencies. This article will discuss the literature on rural consumers' access and use of mental health programs and services; describe the context and method used to conduct the focus groups with rural service providers; characterize access and use problems from the service providers' perspectives; and suggest strategies to address these problems.     

Dilemmas in provision of urban mental health services for latency age children

Urban mental health facilities are increasingly overwhelmed by the sheer number of cases, at a time when federal, state and local funding cutbacks are greater than ever before. Additional to the numbers of cases needing care, is a growing number of cases presenting overwhelming social problems, i.e., emotional and medical pathology, economic deprivation, and substance abuse, with resultant family violence and child abuse. The case-loads in mental health agencies have become almost indistinguishable from those on the roles of child protection, juvenile justice, and child welfare agencies. Mental health service is near to impossible to provide, prior to major environmental manipulation, via educational planning, and frequent placement of children in day treatment programs, day care, or securing of in-home assistance, via home-maker services. These needed referrals take inordinate time, given the unresponsive, poorly coordinated bureaucracies providing such services. Many of the families seen are burdened by overwhelming social pathology, e.g., poverty, huge numbers of children per family, single-parenthood, drugs, and neighborhood violence. Treatment is increasingly difficult to provide, given the poor access to child serving systems, by parents and professionals, alike. Token services and worker burn-out in response to overwhelming difficult cases and excessive assignments, suggest a situation of crisis proportion. Clearly coalitions must be formed by over-burdened professionals, to better educate governing bodies, politicians, boards and administrators, and parents regarding this growing crisis. Professionals, battle-weary, are retreating from agency practice, simultaneous with agency cut-backs of staff and service. Agency administrators are cowed by local and state directives regarding budgetary cuts, and the situation worsens daily, as overburdened line staff struggle with an impossible challenge. Some sort of advocacy and social action must be taken by leaders in the field, to better inform and educate those responsible for budgetary allocations. Latency age children are among the most vulnerable, caught in deteriorating schools and neighborhoods, living with incredible daily violence, and pressures from drug dealers, pushers, adolescent gangs, and inadequate supports in their homes. This group of children is being pushed to become the violent adolescents of tomorrow. Major innovations and changes in delivery of services is necessary in health and mental health agencies serving this at-risk population. Proposed is a school based model of practice to provide access, coordination and collaboration of needed services.This paper was presented at the National Health Policy Forum, National Academies of Practice, April 1992.Ph.D. Specialization in the treatment of Children and Adolescents, Ph.D. Program.     

Socioeconomic and ecological perceptions and barriers to urban tree distribution and reforestation programs

Tree planting and reforestation initiatives in urban and peri-urban areas often use tree distribution or “giveaway” programs as a strategy to increase tree cover and subsequent benefits. However, the effectiveness of these programs in terms of increasing overall tree cover and providing benefits to low-income and disadvantaged communities has been little studied. We assess these programs by exploring community participation in, and barriers to, an urban tree distribution program in Fort Lauderdale, United States and the role socioeconomic background and tree functional types have on participation. We use a mixed-methods approach, panel data, choice experiments, and econometrics to quantitatively analyze respondent’s ranking of program options. High income, White respondents had the highest level of awareness and participation while low income, African Americans (AA) had the lowest level. Monetary rebates were perceived as positive and significant as the compensation value increased to US$8.00 - $12.00. Fruit-bearing and native tree functional types were more preferred than flowering or shade trees. Latinos, AA, and high income respondents preferred fruit trees, while White, high income preferred native trees. Overall, low income respondents perceived the greatest barriers towards participation. 20% of Broward County residents who participated in the survey were aware of the tree giveaway programs and 13% had previously participated. Findings indicate an adaptive governance mismatch between program objectives to equitably increase city tree cover via planting shade trees versus individual’s knowledge and preference for other tree types and functions. Results can be used for developing and evaluating reforestation initiatives to equitably increase tree cover and improve the governance of urban ecosystems.     

Mental health and criminal justice issues among perpetrators of elder abuse

ABSTRACT Recent studies on elder abuse suggest that the pathology or impairment of the abuser may be a stronger predictor of elder abuse than characteristics of the victim. To examine the relationship between elder abuse, abuser pathology, and the criminal justice system, the New York City Department for the Aging (DFTA) undertook a survey of older victims of reported domestic abuse seeking assistance from the DFTA Elderly Crime Victims Resource Center. Preliminary findings from the survey indicate that impaired abusers were significantly younger than unimpaired abusers and more likely to live with their elderly victims, to be unemployed, and to have a history of involvement with the criminal justice system.     

Referrals, language proficiency, and enrolment for children's mental health services

Alberta Health Services maintains a database of children, adolescents and adults referred to the child and adolescent mental health and psychiatry intake service. In this study, we sought to systematically assess the impact, if any, of English language proficiency on enrolment of children for mental health services. Specifically, we assessed the extent to which children referred for mental health services were enrolled. In doing so, we categorized our sample (12,143) as English Proficient (EP), or Less English Proficient (LEP). Overall, we found that LEP children were significantly less likely to be enrolled compared to EP children. This disparity in enrolment was only present when other variables were not taken into account. English Proficiency is an important factor for some subgroups.     

Barriers and facilitators for access to mental health services by traumatized youth

Polytrauma is a highly prevalent public health problem in the U.S. with even higher rates in urban areas. Children with polytrauma often end up in multiple child-serving systems (e.g., mental health, child welfare, education, juvenile justice) with needs that are both complex and severe. Providers within these child-serving systems have potential to serve as gatekeepers to trauma services by linking youth with trauma-informed treatments and supports that promote recovery. The purpose of our study was to assess the perspective of providers who participated in a nine-month, trauma-informed care (TIC) training intervention on 1) their capacity to make referrals to trauma-specific services following the training, and 2) factors external to the training intervention that supported or hindered their ability to link traumatized youth with services. A subset of sixteen participants from the TIC training completed individual interviews. These participants were predominantly female, African American, and based in the social services sector. The constant comparative method was used to derive three thematic domains related to participant perceptions regarding youth referrals: 1) Organizational and provider capacity to provide trauma treatment or to make referrals to trauma-specific services, 2) Barriers to youth accessing trauma services, and 3) Suggestions for improving coordination of care and referrals. Our study highlights the influence of contextual factors on whether a TIC training can improve the capacity of agencies and individual providers to support traumatized youth in accessing appropriate services. The development of a structure that formally connects youth-serving agencies and providers with specialists trained in addressing traumatized youth is recommended.     

Evaluating health outcomes of criminal justice populations using record linkage: the importance of aliases

Individuals in contact with the criminal justice system are a key population of concern to public health. Record linkage studies can be useful for studying health outcomes for this group, but the use of aliases complicates the process of linking records across databases. This study was undertaken to determine the impact of aliases on sensitivity and specificity of record linkage and how this affects ascertainment of mortality. Records for a cohort of prisoners were linked to methadone maintenance treatment (MMT) and mortality records. The record linkage was conducted in two stages. First, the linkage was undertaken using the participant's name and date of birth as recorded in a prior study. Then, a second linkage was undertaken using these identifiers, plus all known aliases. Sensitivity was 64%, and specificity 100%, for the first linkage. When aliases were added to the linkage, sensitivity increased to 86% and specificity remained 100%. The standardized mortality ratio was 4.3 for the first linkage, increasing to 6.1 when aliases were used. These results suggest that the potential effects of participant aliases on linkage outcomes, and methods for mitigating these effects should be carefully considered when planning and undertaking record linkage studies with criminal justice populations.     

Patient satisfaction with mental health services: a meta-analysis to establish norms

Patients typically express high rates of satisfaction with their mental health care. This finding and the lack of well controlled studies on patient satisfaction in the literature underscore the need for meaningful guidelines for clinicians and program evaluators in interpreting patient satisfaction data. To address this problem a meta-analysis was undertaken to establish norms on patient satisfaction for various types of mental health programs. Programs were categorized according to three dimensions: inpatient vs. outpatient vs. residential care; chronic vs. non-chronic; and conventional vs. innovative. Meta-analysis procedures were modified to accommodate the single-group study designs that dominate the literature. The analysis revealed that chronic patients express less satisfaction with their treatment compared to non-chronic patients. Innovative programs are viewed more positively than conventional ones. No differences were found in rates of patient satisfaction between inpatient and outpatient programs. Acceptably reliable norms and confidence intervals of patient satisfaction were established for conventional inpatient programs serving either chronic or non-chronic patients; conventional outpatient programs for non-chronic patients; and for all programs combined according to chronic vs. non-chronic, inpatient vs. outpatient, and conventional vs. innovative. However, data were insufficient to compute norms for other program types. The norms thus established can be used for comparative purposes by program evaluators. A cumulative, national data base on patient satisfaction is recommended to further refine these norms.     

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.