Implementing a college mental health program – an overview of the first twelve months

Objective: To evaluate the demographics and clinical utilization patterns among college students during the initial 12 months of a novel, multi-disciplinary, collaborative, college mental health program (CMHP). Participants: Undergraduate and graduate students receiving treatment at the CMHP from Jan-Dec 2015. Methods: De-identified data was obtained via electronic health records for all students receiving care through the CMHP. Results: 1.2 FTE clinical providers treated 278 undergraduate and graduate students during the year (65.1% < age 26, 53.6% female, 49.6% caucasian). There were 1822 CMHP outpatient visits, 318 other medical visits and 103 total emergency room (ER)/inpatient visits. Ten students were identified as high utilizers of ER/inpatient services, while charges to the CMHP totaled $470,157 and total charges to the Health System were $2,378,315. Conclusions: Students with complex psychiatric/medical co-morbidities received cost effective, convenient and integrative treatment. Over time, we hope to intervene earlier and decrease ER/inpatient visits.     

Albinism,spiritual and cultural practices,and implications for health,healthcare, and human rights: a scoping review

Persons with albinism – a disability found worldwide – are particularly at risk for human rights violations in Africa. The purpose of this scoping review was to establish the current state of knowledge on albinism, spiritual and cultural practices, and implications for health and health services. Electronic searches of nine databases were conducted. After screening, 40 articles were reviewed. Four themes emerged: health implications of albinism; health-related cultural and spiritual meanings attached to albinism; health-related experiences of persons with albinism; and human rights and albinism. The findings reveal that African ontologies, including witchcraft beliefs and practices, are implicated by their construction of the person with albinism as an ontologically different entity, although few studies explicated this relationship. How broader social structures influence persons with albinism disproportionately, resulting in health and social inequities, is another under-researched area. This scoping review lays the groundwork for intersectoral, interdisciplinary research.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.     

Associations between Students’ Perceptions of the Psychosocial School Environment and Indicators of Subjective Health in Finnish Comprehensive Schools

The study examined how far students’ perceptions of the psychosocial school environment are associated with self‐rated health, life satisfaction and subjective health complaints. Students’ perceptions were associated with one or more indicators of subjective health. Perceived health was better in direct proportion to positive perceptions. Student relations and school strain were the factors that stood out in both genders, with regard to all the health indicators. School engagement, parental support and educational aspiration were found to be important for overall perceived health of the students. This study indicates the importance of the psychosocial school environment for students’ health.     

Self-Stigma of seeking help and job burnout in mental health care providers: the comparative study of Lithuanian and the USA samples

This study aimed to explore the correlation between job burnout and self-stigma of seeking help among nonmedical mental health care providers (psychologists, social workers, and counselors) in two countries – Lithuania and the US. The study included 234 professionals (111 social workers and 123 psychologists) from Lithuania and 93 professionals (33 counselors, 23 social workers, and 37 psychologists) from the US on a voluntary basis (93% females, mean age – 39.81?years). They completed a self-reported questionnaire with the Self-Stigma of Seeking Help Scale (SSOSH) and the Maslach Burnout Inventory-General Survey (MBI-GS). The results revealed a statistically significant positive correlation between self-stigmatization and burnout in the Lithuanian sample, but only weak positive correlation between depersonalization and self-stigma of seeking help in the US sample. The relationship between the self-stigma of seeking help and burnout was stronger in the Lithuanian sample of professionals when compared to their colleagues in the US.     

Why spouses depress each other: A cross‐national study to test the shared resource hypothesis in depressive symptom concordance within older adult couples

The shared resource hypothesis suggests that married couples share the same environmental resources, which shape their health concordance. This study tests its cross‐national applicability. Cross‐sectional 2012–2013 Health and Retirement Study data from China, England, Mexico, and the United States were analyzed. Heterosexual couples (age ≥60) who were married or partnered were studied (N = 20,565 pairs). Dyadic data were analyzed by multilevel models to examine the effect of self and spousal social and physical health statuses on depressive symptoms. Regression models were used to test the relationship between couples' shared resources and depressive symptom concordance. Results indicated both husbands and wives' depressive symptoms were associated with their own and spouses' social and health statuses. Most couple‐level resources were insignificant predictors for Chinese and Mexican couples' concordance, but having more social and financial resources was associated with higher concordance among British and American couples. Self‐reported health was the most consistent predictor in all countries. The shared resource hypothesis was more applicable to depressive symptom concordance within couples in the United States and England, but not in China and Mexico. Couple‐centered intervention is suggested for clinical practice, and the spousal effect should be considered in policymaking.     

Comparison on predictors of mental health service use among Asian older adults

Studies have mostly examined mental health service use of older Asian immigrant combining all Asian Americans into one group whereas immigration backgrounds and socioeconomic status of each Asian minority group are different. Therefore, this study aimed to identify predictors of mental health service use within specific ethnic groups among older Asian adults focusing on Chinese, Japanese, Korean, Filipino, and Vietnamese in California. The Behavioral Model for Vulnerable Populations (BMVP) is used to guide the secondary data analysis of a sample of 3,453 older Asian immigrants from the California Health Interview Survey (CHIS). Logistic and linear regression analyses are performed to examine predictors of mental health service use and the frequency of mental health service use, respectively. As results, mental health‐seeking patterns differ by ethnicity within the older Asian immigrant sample, not being married (Korean), higher levels of acculturation (Filipino), lower levels of neighborhood cohesion (Korean and Vietnamese), higher levels of perceived safety (Korean) and lower levels of perceived safety (Vietnamese), higher levels of mental distress (Korean and Filipino), and having perceived need (all) were related to more visits for mental health services. The study findings highlight the necessity of cultural competency services and programs for each Asian ethnicity.     

The female aging body: A systematic review of female perspectives on aging,health, and body image

While most body image research has focused on young female populations, evidence has shown that as few as 12% of older women are satisfied with their body size. Recent studies have also highlighted how anti-aging discourses are promoting unrealistic body norms, which have shown to contribute to poor body image and altered health behaviors. A systematic review of empirical studies focused on older women’s perspectives of health, body image, and the aging body is presented. Findings support that body image is a persistent, lifelong issue for women and should be considered when implementing healthy aging policies and practices.     

Bioecological Implications of Narrative Exposure Therapy in Low‐Resource Settings: Individual,Family, Community,and Socio‐Political Contexts

Traumatic stress can have detrimental effects on individuals, families, and communities. Narrative exposure therapy (NET) is an evidence‐based intervention for decreasing individuals’ post‐traumatic stress disorder (PTSD) symptoms and has been tested in some of the most challenging contexts, such as in post‐conflict refugee camps. Although the focus of NET is on reducing individual PTSD symptoms, the impact of NET can be seen beyond the individual level. The purpose of this paper is to examine some of the ecological implications of using NET with trauma‐affected populations in low‐resource settings. We describe the implications of NET at the family, community, and sociopolitical levels using several case examples. Finally, we outline limitations and future directions for improving the delivery of NET in settings with limited resources.     

Social health protection in Cambodia: Challenges of policy design and implementation

The Government of Cambodia is implementing ambitious reform initiatives to improve the country's social health protection system. In January 2018, it was announced that the Health Equity Fund (HEF), which is fully subsidized by a joint government‐donor initiative for the reimbursement of user fees for the poor at public health facilities, is to be expanded to some segments of informal workers belonging to associations, as well as to commune and village chiefs. Since 2017, the National Social Security Fund (NSSF) has provided social health insurance for formal economy workers in enterprises with eight employees or more. In January 2018, it was expanded to civil servants and all employees regardless of the size of the enterprise. However, this article highlights that the new ambitious reforms are not accompanied by careful planning as regards funding, service delivery, human resources and institutional design. This article therefore aims to examine key policy issues and challenges for Cambodia's ambitious reform of its social health protection system in terms of resource generation, population coverage, strategic purchasing and governance.