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1.
Mental health services have been routinely underutilized. This study investigated the influence of parents' gender, race, and psychopathology on perceived barriers and attitudes toward mental health utilization for themselves and for their children. A unique contribution of this study is the examination of father, mother, and child factors influencing service utilization from the parents' perspective. A total of 194 African American and Caucasian parents were recruited from the community to participate. Parents completed measures on barriers and attitudes toward treatment for themselves and for their children, history of mental health service utilization for themselves and for their children, and their own current psychological symptoms. Results indicated that 36.3% and 19.4% of parents and children, respectively, had used mental health services during their lifetime. Parents perceived fewer barriers and had more positive attitudes toward seeking services for their children than for themselves. Race and gender differences were found in parents' perceptions of barriers and attitudes toward treatment. Furthermore, barriers, attitudes, and psychopathology predicted parents' plans for future utilization of mental health services. The clinical implications of this study and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

2.
This study examines factors related to the utilization of services for mental health reasons by Montreal residents. Data were drawn from telephone interviews. A random sample of 893 respondents completed a questionnaire on service utilization and the Diagnostic Interview Schedule Self Administered to assess DSM-III-R psychiatric disorders. Results indicate that 12.8% of the population had used such services in the past year. Medical doctors and psychiatrists, whose services are free of charge under universal health coverage, were consulted, respectively, by 4.1% and 2.0% of respondents. Psychologists, whose services are not free, were seen by 3.4% of respondents. In all, 42.0% of respondents who presented a current diagnosis used services in the past year. The highest proportion of users (48.0%) was found among respondents who presented both current and lifetime diagnoses and among respondents with comorbidity. The choice of caregiver was related also to pattern of disorders: respondents with current and comorbid disorders tended to consult general practitioners, while respondents with lifetime disorders or with lifetime and current disorders favoured specialized care. In line with other studies, self-perception of mental health, gender and marital status were related to utilization; unlike other studies, attitudes and age were not. It is argued that particularities found in this study stem not only from methodological considerations, but also from the configuration of the mental health system in Quebec, where the greater availability of psychologists may facilitate service utilization.  相似文献   

3.
This study compared methadone maintenance patients with and without pathological gambling (n = 167). Participants completed a self-report survey assessing lifetime pathological gambling and past-2-month gambling behavior, and they completed the SF-12v2 Health Survey (J. E. Ware, M. Kosinski, & S. D. Keller, 1996), a measure of current mental and physical health. In the sample, 52.7% were classified as lifetime pathological gamblers, and the majority of pathological gamblers were actively gambling within the past 2 months. Multivariate analysis of covariance revealed that methadone maintenance patients with pathological gambling had significantly poorer mental and physical health than methadone maintenance patients without pathological gambling. These results suggest that pathological gamblers receiving methadone maintenance may benefit from additional psychosocial services. In fact, most pathological gamblers in the sample expressed interest in gambling-related services. These results extend previous research in other populations that has found that pathological gamblers report poorer mental and physical health than nonpathological gamblers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

4.
OBJECTIVE: To determine the association of parent, family, and child factors with mental health services need and utilization. METHOD: Possible determinants of services need and utilization were assessed in a general population sample of 2,227 children aged 4 to 18 years. RESULTS: 3.5% of the total sample had been referred for mental health services within the past year. The most potent factors associated with service need and utilization were the child's problem behaviors (both internalizing and externalizing) and academic problems and family stress. Socioeconomic factors and the child's sex were not in itself associated with help-seeking factors. Parental psychopathology, life events, and family psychopathology lowered the parents' threshold for evaluating the child's behavior as problematic but did not increase the likelihood of referral. CONCLUSION: Referred children are more likely to live in families under stress than are children with the same level of problems who live in well-functioning families. Clinicians and researchers who make inferences from findings in clinical samples should realize, therefore, that children from problem families are overrepresented in their samples.  相似文献   

5.
OBJECTIVE: To examine the feasibility of conducting a reverse record-check study to validate parent reporting on child mental health service use and to examine the accuracy of parent reports of child mental health services. METHOD: Information about child service use was abstracted from medical records and subsequently compared with reports provided by caregivers in telephone interviews. A sample of children using outpatient psychiatric services was compared with a sample of children using outpatient orthopaedic services. Rates and correlates of successful caregiver tracking and of service use reporting accuracy were explored. RESULTS: Caregivers of nearly 30% of all index children were contacted and interviewed. Parent reports of lifetime mental health service use were more accurate than reports of lifetime receipt of orthopaedic services. Elapsed time between survey interview and last treatment episode was negatively associated with reporting accuracy. Number of clinic visits was positively associated with reporting accuracy. Preliminary findings suggested that questions about mental health services may be considered sensitive by parents whose children use them. CONCLUSIONS: Reverse record-check studies based on telephone interviews are potentially problematic with a sample drawn from a large, inner-city medical center. Findings suggest that memory difficulties may be a more important correlate of reporting accuracy than response editing (social desirability). Potential discomfort with disclosure of mental health service use does not result in service use underreporting.  相似文献   

6.
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)  相似文献   

7.
OBJECTIVES: As access of women to mental health services has become increasingly important, empirical research has begun to examine the determinants of mental health care utilization across gender. This article examines the effect of being an extreme minority on utilization of Department of Veterans Affairs (VA) health services by female veterans. METHODS: Data were collected on a representative national sample of veterans in 1992 as part of the National Survey of Veterans. These data included information on sociodemographic variables, military service variables, physical health and disability, and health services utilization. The authors examined whether women who used health services in 1992, and who were eligible for VA care, differed from men on the likelihood of using any VA health services and on the likelihood of use of VA outpatient and inpatient health services. In addition, we compared VA health care utilization among subgroups of veterans with physical and mental disorders, and compared self-reported reasons for choice of health care provider, across gender. RESULTS: Results indicated that female veterans were less likely than male veterans to use VA health services. This difference was explained by lower utilization by women of VA outpatient services, since inpatient admission rates were the same across gender. The lower outpatient utilization was specific to women with self-reported mental disorders. Women with physical conditions did not differ from men with similar conditions in their VA outpatient utilization. Finally, men and women did not differ on their reasons for choosing VA or non-VA care. CONCLUSIONS: The authors conclude that extreme gender minority status appears to affect outpatient utilization rates at the VA among women with mental disorders, perhaps because of the more personal or sensitive nature of the services involved. Further research is needed to understand why certain women may be underutilizing VA outpatient services and on the consequences of minority gender status for health service utilization, more generally.  相似文献   

8.
Few studies investigate gambling problems at the symptom level; even fewer investigate how symptom patterns change throughout the course of a gambling disorder. The current study utilized the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; Grant et al., 2004) to investigate how the specific symptoms of disordered gambling relate to its severity and course. Results demonstrated that symptom patterns and stability changed as the number of symptoms endorsed increased. Symptom patterns varied considerably from prior to past year (PPY) to past year (PY) timeframes. Certain symptoms were more stable than others and held predictive value as markers of emerging pathological gambling (PG). In particular, gambling to escape problems was one of the most stable symptoms and also predictive of progression to PG; reliance on others to support gambling was predictive of progression to PG among participants at-risk for PG. The differential diagnostic value of various reported symptoms, as well as their lack of stability, has implications for both researchers and clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

9.
Following Hurricanes Katrina and Rita, Louisiana school-based health centers (SBHCs) were called on to respond to a sharp increase in mental health needs, especially for displaced students coping with grief, loss, trauma, and uncertainty. To assess the impact of the hurricanes on the students and the needs of SBHC mental health providers (MHPs), we surveyed MHPs in each of the SBHCs under the auspices of the Louisiana Department of Health and Hospitals, Office of Public Health. SBHC practitioners from around the state reported that mental health service utilization rose during the 2005-2006 school year, but utilization of services increased most significantly in schools receiving the majority of displaced students. Anxiety and adjustment problems were noted as increasing the most following the hurricanes. A multitude of other conditions was also reported. By the time of this survey in April 2006, the reported prevalence of most symptoms had declined, but all remained above their pre-hurricane levels. Self-reported needs of SBHC MHPs are also discussed in light of the major natural disasters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

10.
Aggregate-level prevalences and individual-level developmental trajectories of untreated problem gambling were examined in an 11-year, 4-wave longitudinal study spanning the adolescent through young adult years. The past-year prevalences, 3-4 year incidences, and lifetime prevalences of problem gambling from adolescence through young adulthood were relatively stable at 2%-3%, 1%-2%, and 3%-5%, respectively. Despite the stability of the prevalences at the aggregate level, problem gambling appeared to be more transitory and episodic than enduring and chronic at the individual level. The present study is consistent with the limited evidence available on the natural history of problem gambling in the community in suggesting that natural recovery may be the rule rather than the exception. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

11.
This study examined the factor structure of the Canadian Problem Gambling Index (CPGI), a measure used to assess severity of gambling behaviour in the general population. It subsequently looked at its associations with past-year psychopathology using a subsample (n = 742) of moderate-to-high-risk problem gamblers within the large, nationally representative Canadian Community Health Survey, Cycle 1.2 sample. An exploratory analysis found support for a unifactorial model of the CPGI. Positive associations between problem gambling and various past-year disorders and mental health behaviours were found, with the strongest association being for suicide attempts. These findings help to define the range of maladaptive behaviours associated with problem gambling and their mental health correlates in the Canadian population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

12.
The number of female inmates in state and federal correctional institutions has increased dramatically over the past several years. In addition to this overall increase in number, women have greater levels of mental health service use than men, both in the community and during incarceration. It is important to understand what factors are associated with varying amounts of mental health service use as this population continues to grow. This study explores the influence of female inmate characteristics, including demographic variables and mental health service use before incarceration, on a continuous dependent measure of overall psychological services use during incarceration. Results indicate that for a sample of female inmates within the federal prison system, U.S. citizenship, prior community-based receipt of mental health services, and history of substance abuse were the strongest predictors of increased service use while incarcerated. Findings concerning routine versus volitional services suggest that female inmates with less severe mental health problems are among those who volitionally seek mental health services during incarceration. Recommendations for correctional mental health services training, practice, and research are made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

13.
Reexamined the prevalence of depressive symptoms among 1,724 rural, noninstitutionalized older adults (aged 59–99 yrs) and documented the need for mental health services as they relate to depression and potential barriers to receiving needed services. A telephone survey was conducted in North Dakota, with a random sample drawn from each of 8 human service districts. Instruments included the Geriatric Depression Scale and the CAGE. Results indicate that the prevalence of depression was relatively low. Controlling for potential alcohol abuse, cognitive impairment, and medical problems, the study found that 5% of older adults reported current depressive symptomatology. When using a cutoff score that is likely to correspond to a diagnosis of major depression, the study found a prevalence rate of 1.6%. Of those reporting significant levels of depression, only 27.6% were currently being treated for an emotional problem. The survey data suggested that cost, transportation, and concern about stigma are not major barriers to receiving needed mental health services. Rather, lack of awareness of available services and a lack of routine contact with mental health service providers are important factors that limit service utilization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

14.
In Norway 1990-1992, the suicide rate was 18.6 per 100,000 individuals per year for boys 15-19 years old and 6.3 for girls, and for 10-14 year olds the rate was 2.7 for boys and 0.5 for girls. Comparison of all completed suicides (N = 129) with gender- and age-matched control subjects identified depression (OR = 19.9; CI = 11.2, 35.5), disruptive disorders (OR = 6.0; CI = 3.1, 11.4), and previous suicidal behavior (OR = 3.4, CI = 2.0, 5.6) as main risk factors. Of the suicide completers, 74% had mental disorders. Suicidal intent was previously expressed by 48%, but few (24%) had received treatment, despite well-developed health services. A history of disruptive disorders (17%) and substance abuse (10%) were less frequently found than in previous studies, but binge drinking may contribute to the adolescent suicide rate.  相似文献   

15.
Problem gambling (PG) may be associated with depression, victimization, and violence characterizing a substance-abusing lifestyle. The study explored associations of PG with these correlates among heavy-drinking and drug-using out-of-treatment women recently enrolled in 2 National Institutes of Health-funded, community-based HIV prevention trials. Female substance abusers with PG (n = 180) and without PG (NPG; n = 425) were examined according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Whereas PGs had higher rates of each correlate than did NPGs, significant associations existed for antisocial personality disorder, specifically for violent tendencies. Logistic regression indicated that substance abusers with violent tendencies were about 3 times as likely as those without such tendencies to be PGs, after controlling for sociodemographics. Future research addressing whether underlying constructs, confounding variables, or interactions exist will further specify PG risk and inform prevention and intervention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

16.
The family history (FH) method, which involves the use of an informant to gather information about one or more family members, has been used in a number of previous gambling studies. However, no evaluation of the reliability and validity has been conducted on the use of the FH method for assessing pathological gambling (PG) and gambling involvement. The current study examined the test-retest and inter-rater reliability and the validity of the FH method for assessing PG and gambling involvement among a large community-based sample of adult twins (N = 4,764) reporting on their parents, co-twins, and spouses. The test-retest and inter-rater reliabilities of the FH reports of PG were high. Validity of the FH reports of PG was low, primarily because of substantial underestimation of pathology (low sensitivity). The test-retest and inter-rater reliabilities of the FH reports of gambling involvement (ever gambled, ever gambled monthly, and ever gambled weekly) were moderate and the sensitivities were quite high. The results of this study support the use of the FH method for studies of PG and gambling involvement. A number of potential explanations for the low sensitivity of FH reports of PG are elaborated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

17.
The authors evaluated gambling behaviors, including Internet gambling, among patients seeking free or reduced-cost dental or health care. Three hundred eighty-nine patients at university health clinics completed a questionnaire that included the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. Blume, 1987). All respondents had gambled in their lifetimes, with 70% gambling in the past 2 months. On the basis of SOGS scores, 10.6% were problem gamblers, and 15.4% were pathological gamblers. The most common forms of gambling were lottery, slot machines, and scratch tickets. Internet gambling was reported by 8.1% of participants. Compared to non-Internet gamblers, Internet gamblers were more likely to be younger, non-Caucasian, and have higher SOGS scores. This study is among the first to evaluate the prevalence of Internet gambling and suggests that people who gamble on the Internet are likely to have a gambling problem. Results also illuminate the need to screen patients seeking health care services for gambling problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

18.
OBJECTIVES: To examine the circumstances surrounding the suicides during 1993 and 1994 of young men aged 20-29 from the Lothian region. METHODS AND MATERIALS: The list of suicides for Lothian residents in this group was obtained from the General Registry Office and information relating to these people abstracted from records held in General Practice and at the Forensic Medicine Unit at the University of Edinburgh. RESULTS: Thirty-nine men met the selection criteria which gave a suicide rate of 28.7/100,000. Twenty-five had zero blood alcohol recorded post mortem and ten had blood alcohol concentrations above the legal driving limit of 80 mg/100 ml. Ten (26%) had seen their General Practitioner (GP) in the week and 13 (33%) in the month before suicide. Previous suicide attempts (seven within a year of death) were recorded in 19 men. Ten men left suicide notes. CONCLUSION: Using an overall rate to describe suicide hides the complexity of the issues involved: the inclusion or not of undetermined deaths in numerical targets also causes confusion. Targets should be interpreted carefully and suicide rates should not be considered as a proxy for the mental health status of a population. Prevention cannot be the domain of only the GP. Assessment of suicide risk should be integrated as part of improved mental health training for all health service staff.  相似文献   

19.
OBJECTIVE: This paper presents results from research that explored the roles of bilingual professionals in community mental health services in the Sydney metropolitan area of New South Wales. There were two main objectives to the research: (i) to identify and describe the roles of bilingual professionals that are important in improving the quality of community mental health services for clients from non-English-speaking backgrounds (NESB); and (ii) to identify and describe the factors that facilitate and inhibit the conduct of these roles. METHOD: Data collection involved indepth interviews with bilingual professionals and team leaders in community mental health services and various other community health services; and various staff responsible for policy and service development with regard to cultural diversity. RESULTS: Bilingual mental health workers were found to have at least four critical roles. These were (i) direct clinical service provision to NESB clients; (ii) mental health promotion and community development; (iii) cultural consultancy; and (iv) service development. Respondents reported that the latter three roles were seriously underdeveloped compared to the clinical service provision role. CONCLUSIONS: It is critical that service managers implement strategies to make better use of the linguistic and cultural skills of bilingual professionals. In addition to their role in clinical service provision ways must be found to facilitate the community-focused, cultural consultancy and service development roles of bilingual professionals employed in mental health services.  相似文献   

20.
Examines the utilization and delivery of mental health services for Native Americans (NAs). Delivery systems discussed include the Indian Health Service, the Bureau of Indian Affairs, university- and urban-based care, and tribal mental health care. It is noted that many NAs view mental illness as a justifiable outcome of human weakness and as a result of excessively individualistic behavior. Treatment of disturbed individuals is considered a community matter. Psychologists often try to impose their values on NAs. It is suggested that psychologists need to become familiar with mental health prevention processes. Recommendations for improving service provision and policies toward NAs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

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