Mental Health and Clinical Correlates in Lesbian,Gay, Bisexual,and Queer Young Adults

Abstract

Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students during April and May of 2011. LGBQ students were compared with their heterosexual counterparts on psychological and physical status as well as academic performance. Results: LGBQ students reported worse depressive symptoms, higher levels of perceived stress, considered themselves less attractive, and were more likely to be overweight. LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior and compulsive buying. Conclusions: The higher rates of many psychiatric conditions among LGBQ students underscore the need for universities to provide LGBQ students a nonjudgmental environment to discuss sexual orientation and health issues.     

Exploring the Relationship Among Mental Health Concerns,Social Support,and Relationship Satisfaction in Female Same-Sex Couples

The purpose of this quantitative study was to examine the relationship among internal factors (mental health concerns) that affect relationship satisfaction and contextual factors (social support) that affect relationship satisfaction in female same-sex couples (N = 99). Correlation and regression analyses indicated significant relationships among the variables. Specifically, mental health concerns were negatively correlated with relationship satisfaction whereas social support was positively correlated with relationship satisfaction. Mental health concerns and social support were found to be significant predictors of relationship satisfaction. Implications for practitioners are provided.     

Eye Movement Desensitization and Reprocessing in the Treatment of Traumatized Gay Men

Summary

Gay men suffering from traumatic experiences can benefit from Eye Movement Desensitization and Reprocessing treatment (EMDR). In the past decade the theory and practice of EMDR has expanded to address acute and chronic childhood and adult traumas, substance misuse or abuse, identity issues including shame and self-esteem, and health issues. Through a process of accelerated information processing, traumatic memories are desensitized and reprocessed, resulting in less distress for the client in the present and future. EMDR can also be useful for developing internal resources and for exploration of relevant themes for the client. Further attention is needed in exploring the use of EMDR for gay men traumatized by hate crimes, sexual issues resulting from traumatic experiences, and internalized homophobia.     

Psychological Distress in Older Portuguese Gay and Bisexual Men: The Mediating Role of LGBT Community Connectedness

Abstract

Objectives: Examining Psychological Distress (PD) among older Portuguese gay and bisexual men (GBM), and the mediator role of LGBT community connectedness (LGBTCC) of minority stress variables on PD. Methods: We performed a mediation analysis with LGBTCC as mediator between minority stress variables and PD with a sample of 110 elderly GBM. Results: We found moderate PD levels; LGBTCC was a significant mediator between concealment of sexual orientation and PD, but not between internalized stigma and expectations of rejection and PD. Conclusions: More attention is needed to Older Portuguese GBM’s mental health. LGBTCC is an important ameliorating factor for older GBM.     

Relational Health and Masculine Gender-Role Conflict in the Friendships and Community Relationships of Bisexual,Gay, and Straight Men

This study examined how men's masculine gender-role conflict and the importance men placed on interpersonal relationships in defining their self-identities predicted their relational health experiences in same-sex, dyadic friendships and community relationships. Using an Internet sample of 283 self-identified bisexual, gay, and straight men, results of hierarchical linear regression analyses indicated that for men across sexual orientations, the more importance men placed on interpersonal relationships with other men, the greater the degree of relational health they experienced in dyadic friendships. Additionally, for bisexual and gay men in dyadic friendships with other men, gender-role conflict was inversely related to the relational health of their friendships. In the domain of community relationships, the importance that bisexual and straight men placed on interpersonal relationships in defining their self-identities and levels of gender-role conflict predicted relational health experiences. For gay men, however, feelings of masculine gender-role conflict, alone, predicted poorer relational health in community relationships. Study limitations, clinical implications for practice, and future research directions are discussed.     

Social Support and the Mental Health of Family Caregivers: Sons and Daughters Caring for Aging Parents in Japan

The prevalence of depressive symptoms among family caregivers has been documented as a serious social problem that could threaten the lives of the elderly and their family caregivers. Social support is considered to be a promising remedy for this problem, although a comprehensive examination of the availability and effectiveness of social support that includes both formal and informal support across multiple dimensions remains limited. In addition, little research has been conducted in Japan on gender differences in stress processes. This study tried to fill those gaps by analyzing recent survey data on sons and daughters who are caring for their elderly parents. The results indicate that sons and daughters have similar levels of formal and informal support for daily care and advice, while there are some gender differences in regard to the availability of other types of social support. It was also found that many types of informal support were significantly associated with a lower caregiver burden for daughters, although this was not necessarily the case for formal support. General instrumental support from formal sources was even associated with higher levels of distress. For sons acting as caregivers, daily caregiving support was the only formal support that was significantly associated with their lower level of distress. Issues of formal support are discussed, in order to reduce the psychological burdens borne by sons and daughters who care for their parents at home.     

Neither Silent nor Invisible: A Comparison of Two Participative Projects Involving Older Lesbians and Gay Men in the United Kingdom

This article offers a comparative review of two participative projects involving older lesbians and gay men (OLG) in different parts of the United Kingdom. Both projects set out to promote local networks of OLGs, support and facilitate their input and commentary on local services and act as a prototype model of consultation that might be taken up and used in other areas. The authors review some of the challenges and achievements of each project and critically compare the two initiatives. Discussion of each stage of the projects includes an appraisal of the relative strengths and weaknesses of their different elements. Emphasis is placed upon the concern to involve OLGs at every level and stage of each project and how this was achieved. Reference to relevant policy provides a backdrop to a discussion of the practical considerations in setting up time-limited projects of this nature. Consideration of some of the outcomes of each project with emphasis upon the implications for utilising similar participative approaches in future consultation and inclusion initiatives is provided.     

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.     

Assessing the Effect of an Electronic Decision Support System on Children's Mental Health Service Outcomes

This study examined the effect of clinician adoption on an agency built Electronic Discussion Support System on the reduction of youth risk factors. This exploratory study is the first of its kind to assess an agency-built Electronic Decision Support Systems (EDSS) within a children's mental health program to see how it is utilized in a treatment as usual climate. The results showed a significant difference between the reduction-in-risk rating for two of the domains of the North Carolina Family Assessment Scale (Parental Capability and Environment). Yet findings showed that only a few staff utilized the EDSS regularly. Based on the findings, it appears there was a break down in the implementation process. Although the agency had the best of intentions by building the Dashboard, without proper emphasis on implementation their goal was never fully actualized.     

Ethnographic Study of Gay and Bisexual Working-Class Men in the United States

SUMMARY

Thirty-nine working-class gay and bisexual men were interviewed using ethnographic techniques to better understand their resilience in light of homophobia, heterosexism, classism, AIDS, violence and discrimination. Several themes emerged: heterosexual assumption, sense of difference, socialized to hide, gay identity confusion, coming-out as an ongoing process, managing stigma, conflict with religion, family support, relationships, self-concept, working-class attitudes, and drug and alcohol abuse.     

Jerk: A Tic-Inspired View of the Self-Determination Paradox in Our Mental Health System

Historically, the mental health field has been dominated by the medical model, placing the “patient” into the backseat of their own treatment. Sometimes this aspect of being controlled can be as hurtful as the out-of-control experience individuals with mental health conditions often face. In recent years, a number of people with mental health conditions have stepped up, showing not only that they can recover but also that they can lead the way in recovery-oriented mental health services. This article provides a commentary on this form of input that is rooted in the author's personal experiences with the system of care.     

The Evolution of Mental Health Care Policy and the Implications for Social Work

Abstract

The focus of this article is on the evolution of mental health care policy in the United States from the eighteenth century to the present. To the extent that social work practice enacts policy, this article focuses particularly on the ways 20th century social workers have reflected, interpreted, and forged mental health care initiatives and reforms. The article includes a discussion of how the cycles of mental health reform (moral treatment, mental hygiene, and community mental health) have influenced not only the roles but also the actual practices of social workers. The article concludes with a consideration of the impact of managed care on mental health policy and the implications for social work.     

Caregivers' Endorsement of Barriers to Mental Health Services for Children and Youth in Child Welfare

The purpose of this study was to examine the three most common types of caregivers in the child welfare system (birth parents, relative caregivers, and foster parents), an active child welfare case, caregivers' endorsement of barriers to mental health services and mental health service use by caregivers for the children under their care. The sample consisted of 430 dyads (caregivers and their children). Results indicate that an active child welfare case, provider characteristics, and accessibility of services predicted mental health service use for children. Implications for the child welfare and mental health systems are discussed.     

Unfair to Me or Unfair to My Spouse: Men's and Women's Perceptions of Domestic Equity and How They Relate to Mental and Physical Health

Research examining the relationship between household labor and health has not sufficiently considered perceptions of domestic equity, physical health, or potential gender differences in these relationships. Using survey data from 1,234 lawyers, we examine how perceptions of domestic equity are related to mental and physical health and whether these relationships differ by gender. The results indicate that perceiving the division of household labor as unfair to oneself is related to poorer mental health, whereas perceiving the division as unfair to one's spouse is related to poorer physical health, regardless of gender. This article demonstrates the importance of treating perceptions of unfairness to oneself and one's spouse as distinct experiences, while also considering the wider context wherein these relationships exist.     

Child Welfare and Juvenile Justice: Examining the Unique Mental Health Needs of Girls

This study investigated the prevalence of mental health problems among girls who are involved in child welfare or juvenile justice systems. The sample consisted of 1,193 girls ranging in age from 4 to 18, the majority (82.3%, n = 982) of which were older than age 12. Differences based on race/ethnicity and developmental age groups were examined. Consistent with other research, this study found that the mental health needs of girls involved in the child welfare or juvenile justice systems are several times higher than in the general population. Intervention approaches must be developed that take into consideration differences in gender, age, and racial and ethnic group.     

The Impact of Neighborhood Factors on Mental Health and Academic Outcomes for Adolescents Participating in the Prodigy Program

The Prodigy Cultural Arts program provides art classes embedded with three types of self-regulation skills (problem solving, social skills, and anger management) in an after school community setting to at-risk youths. Empirical evidence supports the effectiveness of self-regulation skills programs and the arts in programs for at-risk youths, yet the impact of the environment on the youth participants is often ignored. This study examines neighborhood structural characteristics along with previously identified individual, mental health variables in school outcomes for adolescents attending the Prodigy Program. Findings suggest that neighborhood structural characteristics have some influence in program outcomes. Limitations of the study and future research are discussed.     

Mental health in vietnam and the move to incorporate social work: A mixed methods study of staff perceptions and expectations

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs’ perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems.     

Using E-Health Programs to Overcome Barriers to the Effective Treatment of Mental Health and Addiction Problems

E-Health programs for mental illness and addictive behaviors have recently emerged as potentially useful self-help resources. Health care professionals will soon have the option of referring clients to free-to-end-user online, expert-moderated e-health programs as complementary means of assisting clients. Such programs will have significant implications for developing improved stepped models of care. This article describes various e-health programs and lessons learned related to access, promotion, user demographics, and patterns of use. In addition, validation procedures, effectiveness and attrition rates, fitting and tailoring, and qualitative analyses of social networks are described. It is difficult to validate e-health programs that are completely anonymous and do not require registration, personal interaction, or membership fees. As competition emerges in the budding e-health industry, best practice guidelines will need to be developed for collecting data and evaluating the utility of these programs.