Cultural mistrust and mental health help-seeking attitudes among Filipino Americans.

As low as the rate of mental health help-seeking is among Asian Americans, Filipino Americans seek mental health services at a much lower rate even compared with other Asian Americans. Despite the field’s progress in identifying and understanding factors that may influence mental health help-seeking attitudes among Asian Americans, despite research on other minority groups suggesting that cultural mistrust may influence attitudes toward seeking professional psychological help, and despite the abundance of literature documenting the historical and contemporary experiences of oppression by Filipino Americans, the possibility that cultural mistrust may play a significant role in Filipino Americans’ mental health help-seeking attitudes have yet to be empirically investigated. Thus, using a sample of 118 Filipino Americans, the current study demonstrates that higher levels of cultural mistrust is related to lower likelihood of seeking professional psychological help. Furthermore, cultural mistrust predicted variance in mental health help-seeking attitudes that are not accounted for by income, generational status, loss of face, and adherence to Asian cultural values. Implications for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological consultation with primary care physicians: Obstacles and opportunities in the medical setting.

This article discusses the relationship between psychologists and primary care physicians and describes the training and practice of physicians in the areas of mental and behavioral health care. Issues affecting the relationship between psychologists and primary care physicians are then reviewed. Different models of psychological consultation are discussed, and an integrated behavioral systems model of psychological consultation is presented as a potentially effective model for consultation with primary care physicians. This model provides a framework for psychologists to function as coproviders of primary health care services. Practical strategies to enhance collaboration between psychologists and primary care physicians in private practice are discussed. The need for more research on primary care and for the inclusion of psychologists in managed care and health care reform are also highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responding to the psychological impact of war on the Iraqi people and U.S. veterans: Mixing icing, praying for cake.

The psychological impact of the war in Iraq stimulated major initiatives to build a modern mental health care system for the Iraqi people and to improve mental health services for U.S. veterans of the Iraq war. Although these two initiatives differ in important respects, they are both informed by general principles of psychology concerning the nature of social problem definition, the process of human adaptation to extreme stress and its aftermath, and the role and limits of mental health services. Building on these common themes and my own experiences, I describe how two nations are trying to address the colossal psychological damage wrought by the war in Iraq. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practising Psychology in Rural Settings: Issues and Guidelines.

Rural practice presents important yet challenging issues for psychology, especially given the North American and international distribution of the population, levels of need for psychological services in rural settings, limited availability of rural services, and migration of rural residents to urban centers. Direct service issues include the need to accommodate a wide variety of mental health difficulties, issues related to client privacy and boundaries, and practical challenges. Indirect service issues include the greater need for diverse professional activities, including collaborative work with professionals having different orientations and beliefs, program development and evaluation, and conducting research with few mentors or peer collaborators. Professional training and development issues include lack of specialized relevant courses and placements, and such personal issues as limited opportunities for recreation and culture, and lack of privacy. Psychology will need to address more fully these complex issues if rural residents are to receive equitable treatment and services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bilingual professionals in community mental health services

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.     

Transcultural therapy. 1: Mental health and learning disabilities

In this article, the first of two parts, the issues surrounding healthcare provision are discussed in the context of the UK as a multicultural society. Concerns relating to nurse education and training are identified in regard to the implications for practice surrounding diagnosis across cultures, classification of illness, and the status and influence of psychological assessments within the field of mental health and learning disability. Finally, the concept of empowerment is critically reviewed, emphasizing that service providers need to collaborate with communities. Community mental health and learning disability nurses are required to make dynamic alliances with communities, through the individual, and so redirect the power relationship to the community and subsequently respond to the demands for cultural diversity sensitively from within healthcare provision and services.     

Mental health services in health maintenance organizations: Implications for psychology.

Contends that roles for psychologists in health maintenance organizations (HMOs) are affected by the nature of HMOs, economic considerations, standards set by federal legislation, claims for the cost-effectiveness of mental health services, and the federal administration's goal of removing mental health services from those required in law. Legislation is not precise concerning the nature or extent of mandated mental health services, and administrative interpretation of this legislation encourages considerable latitude in services provided. Studies do not support arguments for mental health services on the basis of their claimed cost-offset effects as strongly as one might wish. It is concluded that if psychologists are to establish areas of unique worth to HMOs, they may have to do so by adding contributions other than traditional clinical services to meet the need structure of HMOs. Possible ways of doing this are discussed, drawing on contributions that are developing in the field of behavioral health and relating these contributions to the prime purposes of HMOs. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors predicting levels of female inmates’ use of psychological services.

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)     

Roles of perceived sexist events and perceived social support in the mental health of women seeking counseling.

The authors of the present study contribute to research on the role of sexist events in women's mental health by examining the sexism-distress relation (a) with a sample of women who are seeking mental health services and (b) in the context of the additional roles of perceived social support in positive self-appraisal (i.e., empowerment and self-esteem) and psychological distress. A path analysis was conducted with data from 157 women who were seeking counseling services. Results supported the generalizability of previously observed links between the frequency of perceived sexist events and psychological distress. Results also indicated that the sexism-distress link was significant in the context of an additional significant indirect relation of perceived social support with psychological distress, which was mediated through empowerment but not through self-esteem. Implications for future research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the Special Section: The case for training in the provision of psychological therapy.

Recent trends, such as the national health care initiative, have brought into focus the importance of identifying the qualifications of those who provide mental health services. This special section explores the research evidence for the value of professional training among those who provide psychological therapy. The set of articles describes what is known about the relationship to therapeutic efficacy of professional training, training in ethnic diversity, and clinical supervision. These articles suggest that professional training enhances clinical efficacy, especially if type of training, setting of practice, and nature of patient problems are considered. They also suggest that supervision and specific training in ethnic diversity enhance knowledge and sensitivity among psychotherapists. It is anticipated that this special section will promote a dialogue about these conclusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction: Methodological issues in school-based mental health services research.

New research directions on the effectiveness of mental health services for children and adolescents offer the opportunity for school psychology to apply its knowledge base to the systemic juncture between mental health and school systems. Models of service delivery to children, adolescents, and their families that integrate school, mental health, and other service sectors are being actively studied to answer questions about the outcomes of these services for children with mental health problems. The papers in this journal were first presented at the 6th Annual Research Conference of the Florida Mental Health Institute on "A System of Care for Children's Mental Health: Expanding the Research Base." The papers describe state-of-the art studies of school-based mental health interventions for children, adolescents, and their families. In each of the papers, particular attention is paid to the salient methodological issues researchers face in conducting these studies within school settings. It is hoped that these articles will foreground the healthy and creative tensions that exist between different research paradigms and multiple service communities, especially mental health and school systems, by encouraging new research on important and as yet unanswered questions about the effectiveness of school-based service delivery to children and adolescents with mental health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Congruence between culturally competent treatment and cultural needs of older Latinos.

This study investigated a new 2-factor construct, termed cultural congruence, which is related to cultural competence in the delivery of mental health services to ethnic minority clients. Cultural congruence was defined as the distance between the cultural competence characteristics of the health care organization and the clients’ perception of those elements according to their cultural needs. The measure evidenced both reliability and validity in predicting criterion-related indicators. Older Hispanic/Latino clients (N = 272) receiving mental health services either through integrated primary care or referral to specialized mental health care were assessed for depression and anxiety symptomatology and health status at baseline, 3-, and 6-month follow-up treatment. Results indicated that cultural congruence predicted treatment outcomes (reduction of symptomatology) independent of treatment and evidenced moderator effects with respect to depression, suicidality, anxiety, and physical health criteria. Cultural congruence was more effective under the condition of the enhanced specialty referral model than under the integrated primary care model. Results are discussed in terms of how the new construct of cultural congruence extends knowledge of culturally competent mental health practice among the older Hispanic/Latino population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Organizational structures and service delivery in Nova Scotia.

Surveyed 16 clinical settings in Nova Scotia to determine the nature of the psychological services offered and examined their organizational context. 13 surveys were returned. The majority of the settings provide traditional mental health services. The majority of clinical psychologists are found in general regional hospitals rather than in mental health settings. Psychologists offer a wide array of services, such as those to medical patients. Psychologists practice independently; they are able to assess and treat patients in the absence of either assessment or referral by other professionals. The interests of psychologists tend to be represented at the highest level of their institutions by professionals other than psychologists. There were no organized psychology departments in more than half the settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women, sex roles, and alcohol problems.

Notes that, although the percentage of female social drinkers has risen, female intoxication still elicits more negative response then does male intoxication. The existing research on genetic/biological, psychological, and sociological explanations of alcoholism are examined expressly in light of the female perspective. Female alcoholic behaviors are identified in terms of initial intoxication, association with a stressful event, tendency to drink privately, nature of drinking habits, and tendency to use other drugs. The implications of research for clinical practice are seen to include consideration of related psychological and health problems, the need for adjunctive services, an emphasis on family treatment and restoration of social networks, and the therapist's need to achieve a balance between acceptance of the client and refusal to accept the client's acting-out behavior. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and health care.

Recent advances in health care psychology are noted, especially those involving the conceptualization and treatment of lifestyle and chronic health problems. The contributions to health care psychology of community psychology, brief psychological treatments, behavioral medicine, and health psychology are outlined. The central task of both organized psychology and individual psychologists is to create an underlying structure of clear boundaries and standards for clinical practice and training in health care psychology. Initially, this task should involve an inventory of Canadian psychologists currently providing health care services and the nature and amount of those services. Subsequently, a need exists for the profession to examine and create guidelines in psychological service delivery, professional role models, training, and scientific methods pertaining to general health care. (French abstract) (27 ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Who requests psychological services upon admission to prison?

Structuring a system of psychological services for offenders and releasees requires an understanding of the offenders who voluntarily seek psychological services upon admission. To begin to develop such an understanding, a sample set of responses to the Psychological Services Inmate Questionnaire (PSIQ) from 2,674 newly committed male and female federal offenders were examined. About one-tenth of the sample made a request for psychological services upon admission to prison without a mandate or referral, and confirm that a combination of prior mental health treatment and current symptoms are among the factors associated with making the request. Logistic regression analysis indicated male gender, receipt of mental health treatment prior to current incarceration, history of a head injury, current symptoms of depression, hopelessness, nervousness, sleeping problems, and racing thoughts, were independent and significant predictors of service request. Implications for future corrections research, clinical training and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Awards for distinguished contribution to research in psychology: Linda A. Teplin.

The Board for the Advancement of Psychology in the Public Interest confers the Award for Distinguished Contribution to Research in Public Policy upon a psychologist who has made a distinguished empirical and/or theoretical contribution to research in public policy, either through a single extraordinary achievement or a lifetime of work. This contribution might include research leading others to view specific national policies differently, research demonstrating the importance of the application of psychological methods and theory to public policy, or research clarifying the ways scientific knowledge of human behavior informs public policy. One of the two winners of this award is Linda A. Teplin. She pioneered the introduction of rigorous psychological field methodologies into real-world criminal justice contexts. Her widely cited studies of how police interact with citizens they perceive as mentally disordered have become the gold standard for research on police behavior. Her more recent but equally definitive work on the prevalence of mental disorder among urban jail populations has firmly established the extraordinary need for mental health services within these community institutions. Her creation of an empirically derived scale to facilitate the referral of inmates for psychological evaluation has the potential to transform jail mental health services in the United States. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problems with managed mental health care for multicultural populations

Managed mental health care has developed a system of care-giving that does not recognize that acceptable and effective services must acknowledge individual differences and cultural or racial identities. This approach is unacceptable in an era when a psychology of differences is necessary to provide services for nearly one-third of the population. This paper suggests that the adequacy of contemporary psychoparmacological and psychological interventions for multicultural populations is either unknown or unsatisfactory. Historically, interventions in the United States were designed primarily for Euro-Americans and thus were culture-specific in derivation. Managed care has reduced the availability and quality of these interventions for all patients and further limited the range of possible options. Culturally competent mental health services are described and related to quality of care. A societal agenda for implementing cultural competence is suggested.     

Working with foreign language interpreters: Recommendations for psychological practice.

Given the growing linguistic diversity in the United States, many practicing psychologists will work with foreign language interpreters. However, few clinicians receive formal training in providing interpreter-aided psychological services. By federal law (88th Congress, 1964; PL-88-352), psychologists or their agencies are responsible for providing interpreter services. To maintain a patient-centered, rather than interpreter-centered dialogue, psychologists should initiate pre- and postsessions to orient the interpreter to the pending encounter, clarify expectations, and discuss cultural issues. Psychological testing, diagnostic interviewing, crisis intervention, family, child, and individual adult therapy present distinct challenges when an interpreter is involved. Mental health is a specialized area requiring advanced interpreter knowledge and skills. According to the American Psychological Association’s (2002) “Ethical Principles,” psychologists are responsible for ensuring that interpreters demonstrate competence and professionalism. Because there are relatively few interpreters trained specifically for mental health practice, psychologists and health care institutions may need to assist in providing specialized interpreter education. (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)