Differences in white-nonwhite community mental health center service utilization patterns

Routinely collected computerized data were used to study the process of service delivery in terms of admission patterns, type and quantity of services rendered, and status at termination for whites and nonwhites in two community mental health centers. Social area analysis techniques were employed to control for socio-economic status, ethnicity and life style variables, and an epidemiologic model was used to analyze admission and service delivery rate differences. It was found that nonwhite admission rates were at least twice as great as white rates. Service delivery rates to the population at large were considerably greater for nonwhites than for whites. Delivery of direct services within the centers differed for whites and nonwhites, but no consistent trends emerged when types and amounts of services rendered were analyzed, controlling for sex, ethnicity, age, diagnosis and social area. Disruption of care indices were greater for nonwhites than for whites. Highlighted were some of the complexities involved in interpreting results of utilization studies.     

Development and accuracy of projections of population and households in the united states

The history of the official U. S. projections of population and house-holds in recent decades is briefly reviewed, with particular attention to methodology and the relation of the methodology to the accuracy of the projections. The introduction of the cohort-component procedure in the 1930’s opened the way for separate analysis of the trend of the components of births, deaths, and net immigration in connection with making population projections. As a further development, the period-fertility method of projecting births gave way in the 1960’s to the cohort-fertility method. Consideration is now being given to various methods involving parity-progression procedures. Some alternative methods and problems of measuring the accuracy of population projections are then considered. The percent “error” in the projected population growth, by components and age, and the range from high to low expressed as a percent should also be examined in addition to the percent “error” in the total population. However accuracy is measured, the projections made in the 1930’s and 1940’s were often wide of the mark, and those made in the 1950’s and 1960’s failed to anticipate the sharp changes which occurred, even though the actual figures usually fell within the range projected. Elaboration of projection methodology has not resulted in any great increase in the precision of the projections, largely because birth rates have fluctuated widely, and the fluctuations have proven difficult, if not impossible, to predict. The projections of households have had a roughly similar history, and the methods and problems of evaluation are somewhat similar. Their development has been characterized by the introduction of alternative and changing “headship” rates and increasing disaggregation of the data and procedures. The paper concludes with some generalizations based on U. S. experience. Although refinement of methods may contribute little to accuracy, accuracy is only one aspect of the usefulness of projections. The need for conditional projections and their analytical usefulness are such that there is no question that we should confidently continue to make them.     

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.     

Stigma Management Among Gay/Bisexual Men with HIV/AIDS

People with HIV infection are subjected to prejudice, discrimination and hostility related to the stigmatization of AIDS. To manage the stigma of their disease, they mount complex coping strategies. This paper reports results from a qualitative study that examined gay/bisexual men's experiences of living with HIV infection. Unstructured interviews from a diverse sample of 139 men were analyzed to examine how men coped with AIDS-related stigma. We discerned a variety of stigma management strategies that could be arranged along a continuum from reactive to proactive based on the extent to which they implicitly accepted or challenged the social norms and values that underlie the stigmatization of HIV/AIDS. Reactive strategies to cope with stigma involve defensive attempts to avoid or mitigate the impact of stigma, but imply acceptance of the underlying social norms and values that construct the stigma. Examples of reactive strategies include hiding one's HIV status, presenting one's illness as a less stigmatizing one (e.g., cancer), or distancing one's self from more damaging aspects of AIDS-stigma (e.g., attributing infection to blood transfusion). Proactive strategies challenge the validity of the stigma and imply disavowal and resistance of the social norms and values that underlie the stigma. Examples of proactive strategies include engaging in public educational efforts that address misperceptions about HIV transmission and social activism to change the social and political conditions that affect PWA/HIV.     

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.     

Drinking Game Participation Among Undergraduate Students Attending National Alcohol Screening Day

Abstract

Objectives, Participants, Methods: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007. Results: A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption. Conclusions: These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.