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.     

Finding the right connections: Peer support within a community‐based mental health service

Gray M., Davies K., Butcher L. Finding the right connections: Peer support within a community‐based mental health service This article reports on a qualitative study that examined the organisational enablers and barriers to implementing peer support work in an Australian, rural, community‐based mental health service. Interviews with 19 peer and non‐peer staff were conducted to identify attitudes towards peer support and whether there were organisational values, practices and strategies that might support the implementation of peer support. The findings revealed that peer support workers were valued for their ability to build trusting connections with clients and to accept client choice in a non‐judgemental way. However, peer support workers tended to ‘fill service gaps’ within intensive, administrative case‐management environments. These findings highlight the importance of an organisational‐wide approach to integrating peer support, where the responsibilities for adopting new ways of working fall to all staff, not just the peer support workers themselves. Key Practitioner Message: ? Practitioners placed high value on the peer support workers on their teams due to their unique personalised engagement with clients; ? The roles of peer support workers were poorly understood by team members; ? Organisational integration of peer support principles could improve the way all staff engage with clients to reflect a recovery orientation.     

Within- and between-person associations among internalizing and externalizing problems during middle childhood

Internalizing and externalizing problems are likely to co-occur in childhood and are related to concurrent and prospective mental health outcomes. We examined the longitudinal relations among internalizing and externalizing problems during middle childhood utilizing the Random Intercept – Cross Lagged Panel Model. We investigated three research questions: (1) how overall levels of internalizing and externalizing problems are related, (2) whether internalizing and externalizing problems predict each other longitudinally, and (3) whether girls and boys show different longitudinal associations among internalizing and externalizing problems. Mother-reported internalizing and externalizing problems were used through first to sixth grade (N = 1364). Results showed positive random intercepts and positive within-time correlations of internalizing and externalizing problems. Further, internalizing problems predicted externalizing problems at the within-person level. Although previous research mostly has shown a significant effect from externalizing problems to internalizing problems, the current study shows that when within- and between-person variance are disentangled, internalizing problems also may predict externalizing problems.     

Predicting the recipients of social work support,and its impact on emotional and behavioural problems in early childhood

This paper examines the recipients of social work support in the Millennium Cohort Study. Using panel analysis and fixed effects models, it investigates the factors that lead to the receipt of any type of social work support for individuals with young children and the effects of this support on changes in the prevalence of emotional and behavioural problems in these children. We find that divorce or separation, and episodes of homelessness are two important factors that lead to the receipt of social work support. Mothers with male children are also more likely to receive social work support. However, we find no clear evidence that social work support has any effect on changes in children's emotional and behavioural problems over time. The implications of these findings for social work research and for practice and policy are discussed.     

Parental mental health: disruptions to parenting and outcomes for children

The association between parental mental health problems and negative outcomes for children has been long known. This paper addresses three issues in relation to this. First, the scale of the problem is outlined, in terms of both the prevalence of mental health problems in parents and the likelihood of children exhibiting negative outcomes in these circumstances. Secondly, the specificity, or lack of it, of particular outcomes in the child in relation to different parental mental health problems is explored. Thirdly, the paper focuses on the importance of disruptions to parenting as a mechanism in the transmission of mental health problems to negative impacts on the child. Examples are given of how parenting is disrupted in non‐clinical community populations, and the subsequent impacts on the child. The case is made for the preventative importance of parenting and family support in mediating between parental mental health problems and negative impacts on the child.     

Indirect effects of the Family Check‐Up on youth extracurricular involvement at school‐age through improvements in maternal positive behavior support in early childhood

Extracurricular involvement in the school‐age years has widespread potential benefits for children's subsequent socioemotional development, especially for low‐income youth. However, there is a dearth of research on interventions aimed at increasing school‐age extracurricular involvement in low‐income youth. Thus, the present study aimed to test the collateral effect of a brief, family‐focused intervention for low‐income families, the Family Check‐Up, on children's school‐age extracurricular involvement via improvements in maternal positive behavior support (PBS) in early childhood. The sample (n = 630, 50% female, 50% White, 28% Black/African American) represented a subsample of families from the Early Steps Multisite Study. At the age of two, families were randomly assigned to the Family Check‐Up or Women, Infants, and Children Nutritional Supplement Services as usual. Mother‐child dyads participated in observed interaction tasks at child ages 2 and 3 that were subsequently coded to assess PBS. Primary caregivers reported on children's school‐age extracurricular involvement at ages 7.5, 8.5, and 9.5. Results indicated that although there was not a direct path between intervention status and children's school‐age extracurricular involvement, a significant indirect path emerged from intervention group to changes in PBS between ages 2 to 3 to children's school‐age extracurricular involvement. The results are discussed in terms of implications for designing preventive interventions in early childhood that promote extracurricular involvement at school‐age, particularly for children at risk for maladaptive outcomes.     

Mental health and social support: a pioneering study on the physically disabled in southern China

This is a pioneering study examining the effect of different types of social support on the mental health of the physically disabled in mainland China. With a random sample of 204 physically disabled people in Guangzhou, the biggest metropolis in southern China, results of this study showed that perceived social support was more effective in maintaining the mental health of the physically disabled than received social support. With respect to received social support, the attitude of the supporters, satisfaction with the support, the reciprocity of support relationships and the personal agency of the support recipients were found to be predictive of mental health. However, received daily-care support unexpectedly showed a significantly negative effect on mental health, while received economic and emotional support appeared to be irrelevant to the mental health of the physically disabled.     

State attachment variability across distressing situations in middle childhood

Contemporary research suggests that attachment has both a trait‐like, stable component, and a state‐like component that varies across contexts. In the current study, we assessed state attachment variability across comparably distressing situations in middle childhood. In two samples, children reported their expectations of maternal support in each situation. Additionally, we administered trait attachment and psychological well‐being measures. Results indicated that, overall, children varied in their expectations across situations: more than half of the variance was explained by intra‐individual differences across situations. Results revealed two components underlying variability: a Signal‐and‐Support component reflecting expectations of support‐seeking and receiving, and a Back‐on‐Track component reflecting expectations of stress reduction and comfort. State attachment variability was related to individual differences in trait attachment: children who are more securely attached at the trait level, overall appear to vary less in their state attachment, likely due to their high mean state attachment scores across situations. When the mean state attachment scores are accounted for, more securely attached children seem to vary more, suggesting that their state attachment expectations are more sensitive to contextual fluctuations. Importantly, degree of state attachment variability explained psychological well‐being over and above trait attachment.     

Mothers' interoceptive knowledge predicts children's emotion regulation and social skills in middle childhood

Interoception, often defined as the perception of internal physiological changes, is implicated in many adult social affective processes, but its effects remain understudied in the context of parental socialization of children's emotions. We hypothesized that what parents know about the interoceptive concomitants of emotions, or interoceptive knowledge (e.g., “my heart races when excited”), may be especially relevant in emotion socialization and in supporting children's working models of emotions and the social world. We developed a measure of mothers' interoceptive knowledge about their own emotions and examined its relation to children's social affective outcomes relative to other socialization factors, including self‐reported parental behaviors, emotion beliefs, and knowledge of emotion‐relevant situations and non‐verbal expressions. To assess these, mothers (N = 201) completed structured interviews and questionnaires. A few months later, third‐grade teachers rated children's social skills and emotion regulation observed in the classroom. Results indicated that mothers' interoceptive knowledge about their own emotions was associated with children's social affective skills (emotion regulation, social initiative, cooperation, self‐control), even after controlling for child gender and ethnicity, family income, maternal stress, and the above maternal socialization factors. Overall, findings suggest that mothers' interoceptive knowledge may provide an additional, unique pathway by which children acquire social affective competence.     

Refugee family reunification and mental health in resettlement

Family reunification is widely recognised as a vital issue for people from refugee backgrounds, but relatively little research has been reported on its relation to mental health or resettlement outcomes. A study was carried out over the course of 2011 involving 46 participants from refugee backgrounds with direct experience of the family reunification process in New Zealand. Participants from multiple ethnic communities in Auckland, Wellington and Hamilton were invited to discuss and share their experiences. Structured individual interviews were carried out with 15 individual participants, as well as 13 focus groups, in addition to detailed reviews of case histories. Research questions focused on the perceived impacts of family reunification on resettlement outcomes, health and wellbeing. Eighty-five percent of participants reported family reunification issues as the paramount obstacle to their successful resettlement. Potential practical applications, limitations and priorities for future studies are discussed.     

A critical review of mental health and mental health‐related policies in China: More actions required

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services. Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy‐related questions concerning the lack of community‐based psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.     

Personal financial situation during unemployment and mental health

The main purpose of this study was to investigate the personal financial situation during unemployment and the connection between financial situation and mental health in a sample ( n =213) of unemployed Norwegians. The results indicate that the unemployed suffered high financial deprivation compared with their own subjective standards, their situation when working, their neighbors and friends, and the average population. However, the unemployed did not constitute a homogeneous group in financial terms. In particular, the young unemployed experienced substantial financial problems. Among men, the reduction in income, few leisure facilities and many financial adjustments were closely related to mental health problems. Women who experienced that their income was substantially reduced compared with that of neighbors and friends and women who had carried out many financial adjustments were in poorer mental health than the other women in the sample. The findings are discussed in relation to relevant aspects of the life situation of the unemployed and other research results.     

Unemployment and mental health: evidence from research in the Nordic countries

In this article we examine research on effects of unemployment on mental health in Denmark, Finland, Norway and Sweden. We describe studies that use cross-sectional, longitudinal and time-series data, and we discuss studies that investigated the duration-dependence issue in exit rates out of unemployment. Not surprisingly, cross-sectional studies reveal that unemployed persons have worse mental health than do others. Most longitudinal studies suggest that unemployment is associated with deteriorating mental health, even though it is somewhat unclear how long such an effect persists. Most duration-dependence studies were done using Swedish data. It turns out that unemployment benefits and labour-market policies affect the pattern of exit rates out of unemployment.     

The role of interactions with teachers and conflict with friends in shaping school adjustment

Fifth grade children (N = 346) identified school friends and reported on levels of conflict in relationships with these friends as well as perceived stress in relationships with teachers. Teachers and children provided ratings of problem behaviors at school, and children reported on their own perceptions of stress at school. Both less conflictual school friendships and less stressful relationships with teachers were linked with fewer feelings of stress and lower levels of problem problems at school. For the problem behaviors outcome, having more positive relationships with one set of others (teachers or friends) buffered children from experiencing negative consequences of poor relationships with the other set of individuals. The interaction effect involving friendship conflicts and stressful teacher interactions in relation to school stress was more complicated, differing for boys versus girls.     

Collective citizenship: From citizenship and mental health to citizenship and solidarity

Although the concept of citizenship is a widely used theoretical framework within political philosophy, its use in the field of mental health remains underexplored. Within this context, citizenship emphasises the social inclusion and participation of people who are marginalized and offers a more social and relational view of services and support for people with mental health problems than has been common in mental health systems of care. At the same time, however, the citizenship approach has operated in the context of systems of care in the United States that favour highly individualized conceptions of, and approaches to, care, and these systems of care operate in the social and political context of highly individualized concepts of the citizen. In this article building on the work of other citizenship scholars, we argue that a collective form of citizenship, grounded in the 5Rs framework, holds the individual and collective in creative tension. Furthermore, the paper applies this model to the domain of mental health, where people are treated in individualistic ways and experience marginalisation, making the collective dimension imperative and promoting participation, empowerment and the contribution for social change to people with mental health problems. Our theoretical framework of collective citizenship, while geared toward the needs of persons with mental health problems, also contributes to recent citizenship theory on the inclusion of marginalized, stigmatised, and excluded groups. We illustrate the application of this approach through an ethnographic-participant observation case study of a collective citizenship group with which we are associated.     

Household stress and adolescent behaviours in urban families: the mediating roles of parent mental health and social supports

Using exploratory data analysis techniques, we propose a model of parent psychosocial well‐being that links financial strains and household stressors to adolescents' pro‐social behaviours and vulnerability through parent mental health and social supports. Parents of urban youth (n = 781) who planned to attend a summer camp for at‐risk youth responded to questions surveying household, parent and child factors related to early adolescent development. We expected that the relationship of household stressors – including financial strain and household difficulties – with adolescent behaviours would be mediated by parent depression and anxiety. We also anticipated that parent social supports would have both direct and indirect effects (via parent mental health) on adolescents' pro‐social behaviours. Study findings are consistent with our hypotheses and the model performed similarly for both adolescent males and females. Implications for practice and policy in the context of programmes for urban youth are discussed.     

Resilience among older caregivers in rural Namibia: The role of financial status,social support and health

Background: Namibia has one of the highest human immunodeficiency virus (HIV) prevalence rates and one of the highest rates of orphanhood in the world, and older caregivers provide much of the care to Namibians living with HIV and acquired immune deficiency syndrome (AIDS) (UNAIDS, 2014). In this study, the authors explore how financial status, social support, and health were related to the resilience of caregivers caring for people affected by HIV and AIDS in rural northern Namibia, Africa. Method: Data were collected through a structured interview from (N = 147) caregivers from the Zambezi region. Results: Findings from this study show that employment and physical health were significantly associated with increased resilience in older caregivers. Discussion: Our findings point to the need for employment assistance and health services to improve the resilience of caregivers caring for people living with HIV and AIDS. We conclude that there is a need for more vigorous concerted efforts from public and private sector practitioners and policy makers to create more sustained formal employment opportunities and intervention programs aimed at improving the overall health of older HIV caregivers, especially those residing in rural HIV endemic communities in developing countries.     

Exploring perceptions of mental health clients and professionals about Buddhism‐based therapies at mental health hospitals in Vietnam

With 80% of Vietnamese people holding key Buddhist beliefs, Buddhism has great impact on the thoughts, emotions, and behavior of Vietnamese people. However, almost no Buddhism‐based psychosocial interventions are offered at formal psychiatric hospitals across Vietnam, nor is there any plan to incorporate these interventions into mental health care. This exploratory study examines the perceptions of mental health clients and staff regarding the effectiveness of Buddhism‐based therapies (BBTs) in mental health treatment in Vietnam, using ethnographic observation and in‐depth interviews with 24 patients and eight professionals at the only psychiatric hospital employing BBT. Participants strongly believed in the positive impact of BBT to help clients manage or improve their symptoms. However, clients and staff advised that BBT should not be used alone; rather it should be used in combination with medication and was best employed for stress‐related disorders. They unanimously supported incorporating BBT into the formal mental health system, especially if the therapies were well developed through collaboration between Buddhist monastics and mental health professionals. Results of the paper suggest that Vietnam should think strategically about developing and incorporating BBT into the formal mental health care system.     

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.     

Outcomes of the ON FIRE peer support programme for children and adolescents in families with mental health problems

Children in families with mental health problems may encounter multiple risks to their well‐being. General aims of peer support programmes for these children include fostering resilience and effective coping strategies, and enhancing self‐esteem and social skills. This study aimed to evaluate outcomes from a pilot multi‐site implementation of the ON FIRE peer support programme. The purpose of ON FIRE is to cultivate hope, resilience and well‐being in children and adolescents aged 8–17 years living in families affected by sibling or parental mental health problems. We employed a pre‐post test (baseline and 4 months) evaluation using a suite of outcome measures. The Strengths and Difficulties Questionnaire (SDQ), Children's Hope Scale, Kids Connections Scale and Positive and Negative Affect Scale for Children (PANAS‐C) were completed for 64 child/adolescent participants. At baseline, participants had significantly greater difficulties compared with Australian norms. At 4 months, there were significant differences in children's hope and in connections outside the family. There were no significant differences in the SDQ or the PANAS‐C.