Transforming Mental Health Care for Children and Their Families.

In April 2002, the President's New Freedom Commission on Mental Health was created by executive order to study the mental health care delivery system in our nation and to make recommendations for improvements so that individuals with serious mental disorders can live, work, learn, and fully participate in their homes and communities. In its report, "Achieving the Promise: Transforming Mental Health Care in America," the commission provided strategies to address critical infrastructure, practice, and research issues. This article focuses on the work of the commission's Subcommittee on Children and Families, describing its vision for mental health service delivery for children and providing suggestions for strengthening community-based care for youths with or at risk of behavioral health disorders. Training, research, practice, and policy implications for psychologists are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How Stigma Interferes With Mental Health Care.

Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities. Given the existing literature in this area, recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma-care seeking link. Implications for the development of antistigma programs that might promote care seeking and participation are also reviewed (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital distress and mental health care service utilization.

Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. Results: Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. Conclusion: The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inmate Perceptions of Mental Health Services.

With the increasing rise in the U.S. prison population, meeting the mental health needs of inmates before, during, and after incarceration remains an obstacle. What are the mental health experiences of inmates? For what types of problems are inmates willing to seek help, and what are the barriers to their service utilization? This study investigated inmates' attitudes and perceptions toward mental health services and examined whether these attitudes and perceptions vary with respect to ethnic group membership or among inmates of differing security levels. Implications of these findings for psychologists, including psychologists not employed in correctional settings, are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serious Emotional Disturbance in Children and Adolescents: Opportunities and Challenges for Psychologists.

Approximately 4.5 to 6.3 million children and adolescents in the United States have a serious emotional disturbance that undermines their present functioning and imperils their future. However, at least two thirds of young people with a diagnosable mental disorder receive no services at all. Responding to this unmet need, psychologists are assuming new roles in a changing mental health marketplace and are adopting new intervention strategies to work with these children, adolescents, and their families. This article addresses the scope of the problem, opportunities and challenges for practitioners, the larger context of professional practice, future directions, and suggestions for psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural and contextual influences in mental health help seeking: A focus on ethnic minority youth.

In this article, a mental health help-seeking model is offered as a framework for understanding cultural and contextual factors that affect ethnic minority adolescents' pathways into mental health services. The effects of culture and context are profound across the entire help-seeking pathway, from problem identification to choice of treatment providers. The authors argue that an understanding of these help-seeking pathways provides insights into ethnic group differences in mental health care utilization and that further research in this area is needed, (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's Mental Health as a Primary Care and Concern: A System for Comprehensive Support and Service.

In response to the serious crisis in mental health care for children in the United States, this article proposes as a priority for psychology a comprehensive approach that treats mental health as a primary issue in child health and welfare. Consistent with the principles of a system of care and applying epidemiological, risk-development, and intervention-research findings, this approach emphasizes 4 components: easy access to effective professional clinical services for children exhibiting disorders; further development and application of sound prevention principles for high-risk youths; support for and access to short-term intervention in primary care settings; and greater recognition and promotion of mental health issues in common developmental settings and other influential systems. Integral to this approach is the need to implement these components simultaneously and to incorporate family-focused, culturally competent, evidence-based, and developmentally appropriate services. This comprehensive, simultaneous, and integrated approach is needed to achieve real progress in children's mental health in this country. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infant Mental Health: Making a Difference.

Practicing psychologists are increasingly identifying serious problems in behavior, emotional development, and regulation in infants and very young children that result in impaired family functioning and relationships. Often these child challenges are in combination with a range of parental concerns including addictions, homelessness, teen parenthood, and unresolved feelings from the past. Infant mental health (IMH) is a broad field encompassing theory, research, and interventions with very young children and their families. This article provides an overview of IMH concepts, with special focus on assessment and interventions that can be integrated into the psychologist's current practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, Depression, Coping, and Mental Health Service Seeking Among Impoverished Women.

The authors examined the relationship among trauma, coping, depression, and mental health service seeking in a probability sample of sheltered homeless and low-income housed women. Results highlight the diversity of trauma. In a longitudinal analysis, women who lived in shelters or experienced major violence had a twofold increase in their risk of depression over the 6-month follow-up. In a cross-sectional analysis, childhood sexual abuse, living in a shelter, physical violence, childhood physical abuse, and death or injury of a friend or relative predicted avoidant coping and symptoms of depression. Active coping and depression predicted mental health service seeking among traumatized women. Modifying coping strategies may ameliorate some of the negative impact of trauma and potentially enhance mental health service use among at-risk women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Geriatric Mental Health Policy: Impact on Service Delivery and Directions for Effecting Change.

The treatment of mental health problems in older adults has advanced considerably over the past several decades. Nevertheless, the mental health needs of the nation's elderly population remain substantially unmet. This article identifies the significant but previously neglected role of regulatory policies and administrative practices in limiting the use and provision of geriatric mental health services. Such factors are the least recognized and understood by psychologists, although they are the very factors on which psychologists can have the most potential influence. This article subsequently identifies salient legislative proposals and regulatory developments, while addressing the importance of advocacy on agenda setting and policy change. The final section provides specific proposals and mechanisms at micro and macro levels for improving the geropsychology service system. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicide and gambling: Psychopathology and treatment-seeking.

The aim of this study was to evaluate suicides with a history of problem gambling (PG) and others with no such history (NPG) and to compare the two on mental health problems and service utilization. Data on a sample of 49 PG suicides and 73 NPG suicides were obtained from informants and hospital records. Psychopathology was prevalent in both groups, but problem gamblers were twice as likely to have a personality disorder. Moreover, PG suicides were less in contact with mental health services in their last month, their last year, and their lifetime. NPG suicides consulted specialized services from 3 (last month and last year) to 13 times (lifetime) as often as their PG counterparts. Lower service utilization associated with PG suicides argues in favor of stepping up detection, engagement in care and treatment with respect to problem gambling, especially when comorbidity is present. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of help seeking for emotional distress among Chinese Americans: Family matters.

Using data from the Chinese American Psychiatric Epidemiological Study, the authors examined longitudinal predictors of help seeking for emotional distress in a community sample of 1,503 Chinese Americans. Specifically, they assessed the relative contribution of family relational variables (e.g., levels of family support and family conflict) in predicting help seeking for medical, mental health, and informal services. After traditional need, predisposing, and enabling factors were controlled for in hierarchical logistic regression analyses, family conflict predicted both mental health and medical service use, whereas family support was not predictive of help seeking. In addition to family conflict, mental health service use was predicted by negative life events, emotional distress, and insurance coverage. Implications of the findings for assessing and treating Asian American clients are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Psychologist Connection: Service Linkage and Role Definition.

The mental health field is not always perceived in terms of benevolent experiences, and Gothic attitudes can still prevail. Although the stigma attached to mental illness has diminished, some lay and professional people, including physicians, still have difficulty recognizing mental health problems and/or if recognized, knowing where to refer patients for proper treatment. In addition, many people lack awareness of the range and role of mental health professionals who are available to deal with the complex issues of treatment and prevention surrounding mental illness. This commentary highlights some of the shortcomings that exist when professional roles are not clearly understood and how such a lack of understanding adds to the separation that already exists between professionals when attempting to provide appropriate service linkages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental Health Services for Native Americans in the 21st Century United States.

As the population of American Indians and Alaska Natives continues to expand in the 21st century United States, an increasing number of professional psychologists will be called upon to provide culturally appropriate mental health services for Native American people and their communities. This article provides a general overview of contemporary tribal America before describing the legal, political, and institutional contexts for mental health service delivery administered through the federally sponsored Indian Health Service. Recommendations for mental health professionals who desire to avoid a subtle but profound Western cultural proselytization in their therapeutic service to Native clients and their communities are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building Systems of Care for Children With Chronic Health Conditions.

Objective: To describe the leadership role that rehabilitation psychologists can play in improving the health care delivery system for children with special health care needs (CSHCN). Setting: Midwest academic health center and surrounding communities. Participants: Children with chronic health conditions and disabilities and their families. Intervention: A model research demonstration project designed to promote family-centered, comprehensive, coordinated, and community-based care for CSHCN. The project aims to enhance environmental supports for CSHCN and their families in 2 ways: (a) by improving the ability of primary care providers to deliver effective chronic care management and (b) by integrating this improved clinical practice into an enhanced Medicaid managed care service delivery system for persons with chronic illness and disabilities. Conclusions: Psychologists have the potential to improve the quality of life of CSHCN and their families by intervening not only through direct services but also by promoting positive changes in the larger health care environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial Mediators of Antiretroviral Nonadherence in HIV-Positive Adults With Substance Use and Mental Health Problems.

This study used data from 1,889 HIV-positive patients on antiretroviral (ARV) medications who participated in the HIV Cost and Services Utilization Study to investigate whether nonadherence to ARV medications among patients with mental health and substance use problems could be explained by difficulty getting and negative attitudes toward ARV medications, poor fit of the regimen with lifestyle, lack of instruction and cues for remembering the regimen from a health care provider, and poor support from others for taking ARV medications. Difficulty getting ARV medications and poor fit with lifestyle were significant mediators of nonadherence for patients with a probable psychiatric disorder. Difficulty getting medication was a mediator for heavy drinkers, and poor fit with lifestyle was a mediator for drug users who drank heavily. Further research is needed to identify and address the barriers to adherence in these populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Comprehensive Review of Prevention Groups for Children and Adolescents.

Primary prevention has increasingly become a focus of the child and adolescent research literature over the past 25 years. Groups are a natural milieu within which to work with children and adolescents. The current research reviews the literature on child and adolescent prevention-oriented group interventions for the decade 1990-2000 to follow up the work of previous reviews in this area, identify current trends, and suggest future directions for the literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health and development: Section introduction.

The articles in this section point to directions for action regarding children's health and their emotional and developmental well-being. More than this, the authors describe the kinds of problems children face and why they arise. Equally important, all acknowledge the progress already made. The 11 articles in this section are grouped into two major categories: the first pertains to risks to children's mental health and behavior, and the second deals with risk factors and risk-taking behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A step in the right direction: A resource for collaboration on health-related issues.

Reviews the book, Health-related disorders in children and adolescents edited by L. Phelps (see record 1998-07780-000). This edited text provides an overview of 96 medical conditions that place children at risk of developing psychological or educational problems. The central feature of this book is that it is intended as a reference tool for professionals who collaborate with medical professionals. Increasingly, there have been many vehicles for school psychologists to collaborate with medical professionals, including comprehensive school health care programs and school-based health clinics, and community-based coordinated services that provide children and youth comprehensive care. In this regard, school psychologists are likely to encounter increasing numbers of children who experience health disorders, along with more traditional areas of practice including mental health and educational issues. Although not a purely medically oriented text, Phelps has taken a perspective that school psychologists work within the context of a multidisciplinary team of professionals who are likely to provide services for these children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)