Desired mental health resources for urban, ethnically diverse, impoverished women struggling with anxiety and depression.

PubMed

Doornbos, Mary Molewyk; Zandee, Gail Landheer; DeGroot, Joleen; Warpinski, Mary

2013-01-01

Depression and anxiety are mental health issues that disproportionately affect women-particularly when access to culturally sensitive care is limited. The purpose of this study was to identify mental health concerns in three urban, ethnically diverse, underserved, and impoverished neighborhoods using the ideological perspective of community-based participatory research. In the context of long-term partnerships between a department of nursing and these neighborhoods, we recruited 61 women aged 18 to 69 years and collected data via homogeneous focus groups comprised of Black, Hispanic, and White women, respectively. We conducted five of the focus groups in English and one in Spanish. The women perceived anxiety and depression as significant concerns for themselves, their families, and their communities. They used unique community resources to manage mental health issues and desired new resources, including support groups and education.

Mental health and gambling in urban female adolescents

PubMed Central

Martins, Silvia S.; Storr, Carla L.; Ialongo, Nicholas S.; Chilcoat, Howard D.

2007-01-01

This study explores differences in mental health and behavioral disturbances between female gamblers versus nongamblers from a community sample of 232 female urban youth. Female adolescent recreational gambling was associated with high levels of childhood hyperactivity measured at age 6, past-year substance use, and past-year anxiety symptoms. PMID:17448407

Contextualizing mental health: gendered experiences in a Mumbai slum.

PubMed

Parkar, Shubhangi R; Fernandes, Johnson; Weiss, Mitchell G

2003-12-01

Urban mental health programmes in developing countries remain in their infancy. To serve low-income communities, research needs to consider the impact of common life experience in slums, including poverty, bad living conditions, unemployment, and crowding. Our study in the Malavani slum of Mumbai examines afflictions of the city affecting the emotional well-being and mental health of women and men with respect to gender. This is a topic for which mental health studies have been lacking, and for which psychiatric assumptions based on middle-class clinical experience may be most tenuous. This study employs ethnographic methods to show how environmental and social contexts interact in shaping local experience with reference to common mental health problems. Focusing on the social and environmental context of the mental health of communities, rather than psychiatric disorders affecting individuals, findings are broadly applicable and sorely needed to guide the development of locally appropriate community mental health programmes. Identified afflictions affecting mental health include not only access to health care, but also sanitation, addictions, criminality, domestic violence, and the so-called bar-girl culture. Although effective clinical interventions are required for mental health services to treat psychiatric disorders, they cannot directly affect the conditions of urban slums that impair mental health.

Cultural Capital and Self-Rated Health in Low Income Women: Evidence from the Urban Health Study, Beirut, Lebanon

PubMed Central

Mowafi, Mona

2006-01-01

This paper examines the association between cultural capital and self-rated psychosocial health among poor, ever-married Lebanese women living in an urban context. Both self-rated general and mental health status were assessed using data from a cross-sectional survey of 1,869 women conducted in 2003. Associations between self-rated general and mental health status and cultural capital were obtained using χ2 tests and odds ratios from binary logistic regression models. Cultural capital had significant associations with self-perceived general and mental health status net of the effects of social capital, SES, demographics, community and health risk factors. For example, the odds ratios for poor general and mental health associated with low cultural capital were 4.5 (CI: 2.95–6.95) and 2.9 (CI: 2.09–4.05), respectively, as compared to participants with high cultural capital. As expected, health risk factors were significantly associated with both measures of health status. However, demographic and community variables were associated with general health but not with mental health status. The findings pertaining to social capital and measures of SES were mixed. Cultural capital was a powerful and significant predictor of self-perceived general and mental health among women living in poor urban communities. PMID:16739047

Cultural capital and self-rated health in low income women: evidence from the Urban Health Study, Beirut, Lebanon.

PubMed

Khawaja, Marwan; Mowafi, Mona

2006-05-01

This paper examines the association between cultural capital and self-rated psychosocial health among poor, ever-married Lebanese women living in an urban context. Both self-rated general and mental health status were assessed using data from a cross-sectional survey of 1,869 women conducted in 2003. Associations between self-rated general and mental health status and cultural capital were obtained using chi (2) tests and odds ratios from binary logistic regression models. Cultural capital had significant associations with self-perceived general and mental health status net of the effects of social capital, SES, demographics, community and health risk factors. For example, the odds ratios for poor general and mental health associated with low cultural capital were 4.5 (CI: 2.95-6.95) and 2.9 (CI: 2.09-4.05), respectively, as compared to participants with high cultural capital. As expected, health risk factors were significantly associated with both measures of health status. However, demographic and community variables were associated with general health but not with mental health status. The findings pertaining to social capital and measures of SES were mixed. Cultural capital was a powerful and significant predictor of self-perceived general and mental health among women living in poor urban communities.

Not just a walk in the park: efficacy to effectiveness for after school programs in communities of concentrated urban poverty.

PubMed

Frazier, Stacy L; Mehta, Tara G; Atkins, Marc S; Hur, Kwan; Rusch, Dana

2013-09-01

This study examined a model for mental health consultation, training and support designed to enhance the benefits of publicly-funded recreational after-school programs in communities of concentrated urban poverty for children's academic, social, and behavioral functioning. We assessed children's mental health needs and examined the feasibility and impact of intervention on program quality and children's psychosocial outcomes in three after-school sites (n = 15 staff, 89 children), compared to three demographically-matched sites that received no intervention (n = 12 staff, 38 children). Findings revealed high staff satisfaction and feasibility of intervention, and modest improvements in observed program quality and staff-reported children's outcomes. Data are considered with a public health lens of mental health promotion for children in urban poverty.

The Changing Context of Rural America: A Call to Examine the Impact of Social Change on Mental Health and Mental Health Care.

PubMed

Carpenter-Song, Elizabeth; Snell-Rood, Claire

2017-05-01

Recent social changes and rising social inequality in the rural United States have affected the experience and meaning of mental illness and treatment seeking within rural communities. Rural Americans face serious mental health disparities, including higher rates of suicide and depression compared with residents of urban areas, and substance abuse rates in rural areas now equal those in urban areas. Despite these increased risks, people living in rural areas are less likely than their urban counterparts to seek or receive mental health services. This Open Forum calls for a research agenda supported by anthropological theory and methods to investigate the significance of this changed rural social context for mental health.

Online Information Searches and Help Seeking for Mental Health Problems in Urban China.

PubMed

Chen, Juan; Zhu, Shizhan

2016-07-01

In recent years, the Internet has emerged as an alternative information source on mental health problems. Yet, the profile of the typical Internet help seeker is to be determined. Based on data from a household survey of 2558 Beijing residents, the study investigates online information searches and help seeking for mental health problems. Multinomial logistic regressions are estimated for respondents' access to the Internet, and mental-health-related information searches and help seeking on the Internet for the whole community sample and the most psychologically distressed subsample. The study identifies a digital divide in online help seeking for mental health issues based on age, migration and hukou status, and socio-economic factors. Youth and high socio-economic status are significant predictors of Internet access and use. Among the whole community sample, rural-to-urban migrants are less likely to have access to the Internet and search information or seek help online. Among the most psychologically distressed subsample, urban-to-urban migrants are significantly more likely to have access to the Internet and search information or seek help online. Given the shortage of mental health professionals in China, online information dissemination and guided self-help, if properly designed, could offer a means to reach large numbers of individuals in a cost-effective manner.

Redesigning community mental health services for urban children: Supporting schooling to promote mental health.

PubMed

Atkins, Marc S; Shernoff, Elisa S; Frazier, Stacy L; Schoenwald, Sonja K; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-10-01

This study examined a school- and home-based mental health service model, Links to Learning, focused on empirical predictors of learning as primary goals for services in high-poverty urban communities. Teacher key opinion leaders were identified through sociometric surveys and trained, with mental health providers and parent advocates, on evidence-based practices to enhance children's learning. Teacher key opinion leaders and mental health providers cofacilitated professional development sessions for classroom teachers to disseminate 2 universal (Good Behavior Game, peer-assisted learning) and 2 targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by mental health providers and parent advocates for children in kindergarten through 4th grade diagnosed with 1 or more disruptive behavior disorders. Services were Medicaid-funded through 4 social service agencies (N = 17 providers) in 7 schools (N = 136 teachers, 171 children) in a 2 (Links to Learning vs. services as usual) × 6 (pre- and posttests for 3 years) longitudinal design with random assignment of schools to conditions. Services as usual consisted of supported referral to a nearby social service agency. Mixed effects regression models indicated significant positive effects of Links to Learning on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-groups effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum-based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high-poverty urban communities. (c) 2015 APA, all rights reserved).

Can't Have One without the Other: Mental Health Providers and Community Parents Reducing Barriers to Services for Families in Urban Poverty

ERIC Educational Resources Information Center

Frazier, Stacy L.; Abdul-Adil, Jaleel; Atkins, Marc S.; Gathright, Tamara; Jackson, Maudette

2007-01-01

University-community partnerships are widely recognized as critical to the success of community research and advocacy work but difficult to form and sustain. This article will describe a unique facet of that partnership, namely the collaboration between mental health clinicians and community consultants, a partnership that our data suggest was a…

Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

ERIC Educational Resources Information Center

Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

2012-01-01

Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to…

Correlates of Externalizing Behavior Symptoms among Youth within Two Impoverished, Urban Communities

ERIC Educational Resources Information Center

Gopalan, Geetha; Cavaleri, Mary A.; Bannon, William M.; McKay, Mary M.

2009-01-01

This study examines whether risk factors associated with child externalizing behavior symptoms differ between two similar low-income, urban communities, using baseline parent data of 154 African American youth (ages 9-15) participating in the Collaborative HIV-Prevention and Adolescent Mental Health Project (CHAMP) family program. Separate…

Exploring the Impacts of Housing Condition on Migrants’ Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach

PubMed Central

Xiao, Yang; Sarkar, Chinmoy; Geng, Huizhi

2018-01-01

Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers’ mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities. PMID:29382174

Exploring the Impacts of Housing Condition on Migrants' Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach.

PubMed

Xiao, Yang; Miao, Siyu; Sarkar, Chinmoy; Geng, Huizhi; Lu, Yi

2018-01-29

Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers' mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities.

Creating Mechanisms for Meaningful Collaboration Between Members of Urban Communities and University-Based HIV Prevention Researchers.

PubMed

McKay, Mary M; Hibbert, Richard; Lawrence, Rita; Miranda, Ana; Paikoff, Roberta; Bell, Carl C; Madison-Boyd, Sybil; Baptiste, Donna; Coleman, Doris; Pinto, Rogério M; Bannon, William M

2007-01-01

This article provides a description of a Community/University Collaborative Board, a formalized partnership between representatives from an inner-city community and university-based researchers. This Collaborative Board oversees a number of research projects focused on designing, delivering and testing family-based HIV prevention and mental health focused programs to elementary and junior high school age youth and their families. The Collaborative Board consists of urban parents, school staff members, representatives from community-based agencies and university-based researchers. One research project, the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study, an urban, family-based HIV prevention project will be used to illustrate how the Collaborative Board oversees a community-based research study. The process of establishing a Collaborative Board, recruiting members and developing subcommittees is described within this article. Examples of specific issues addressed by the Collaborative Board within its subcommittees, Implementation, Finance, Welcome, Research, Grant writing, Curriculum, and Leadership, are detailed in this article along with lessons learned.

Gender differences in the effects of urban neighborhood on depressive symptoms in Jamaica.

PubMed

Mullings, Jasneth Asher; McCaw-Binns, Affette Michelle; Archer, Carol; Wilks, Rainford

2013-12-01

To explore the mental health effects of the urban neighborhood on men and women in Jamaica and the implications for urban planning and social development. A cross-sectional household sample of 2 848 individuals 15-74 years of age obtained from the Jamaica Health and Lifestyle Survey 2007-2008 was analyzed. Secondary analysis was undertaken by developing composite scores to describe observer recorded neighborhood features, including infrastructure, amenities/services, physical conditions, community socioeconomic status, and green spaces around the home. Depressive symptoms were assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Bivariate and multivariate methods were used to explore the associations among gender, neighborhood factors, and risk of depressive symptoms. While no associations were found among rural residents, urban neighborhoods were associated with increased risk of depressive symptoms. Among males, residing in a neighborhood with poor infrastructure increased risk; among females, residing in an informal community/unplanned neighborhood increased risk. The urban neighborhood contributes to the risk of depression symptomatology in Jamaica, with different environmental stressors affecting men and women. Urban and social planners need to consider the physical environment when developing health interventions in urban settings, particularly in marginalized communities.

Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2-8 Years in Rural and Urban Areas - United States, 2011-2012.

PubMed

Robinson, Lara R; Holbrook, Joseph R; Bitsko, Rebecca H; Hartwig, Sophie A; Kaminski, Jennifer W; Ghandour, Reem M; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A

2017-03-17

Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. 2011-2012. The National Survey of Children's Health (NSCH) is a cross-sectional, random-digit-dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged <18 years in the United States. Interviews included indicators of health and well-being, health care access, and family and community characteristics. Using data from the 2011-2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2-8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2-8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18.6%) than in urban areas (15.2%). In urban and the majority of rural subtypes, children with an MBDD more often lacked a medical home, had a parent with poor mental health, lived in families with financial difficulties, and lived in a neighborhood lacking physical and social resources than children without an MBDD within each of those community types. Only in urban areas did a higher percentage of children with MBDDs lack health insurance than children without MBDDs. After adjusting for race/ethnicity and poverty among children with MBDDs, those in rural areas more often had a parent with poor mental health and lived in resource-low neighborhoods than those in urban areas. Certain health care, family, and community disparities were more often reported among children with MBDDS than among children without MBDDs in rural and urban areas. Collaboration involving health care, family, and community services and systems can be used to address fragmented services and supports for children with MBDDs, regardless of whether they live in urban or rural areas. However, addressing differences in health care, family, and community factors and leveraging community strengths among children who live in rural areas present opportunities to promote health among children in rural communities.

Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2–8 Years in Rural and Urban Areas — United States, 2011–2012

PubMed Central

Holbrook, Joseph R.; Bitsko, Rebecca H.; Hartwig, Sophie A.; Kaminski, Jennifer W.; Ghandour, Reem M.; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A.

2017-01-01

Problem/Condition Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. Reporting Period 2011–2012. Description of System The National Survey of Children’s Health (NSCH) is a cross-sectional, random-digit–dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged <18 years in the United States. Interviews included indicators of health and well-being, health care access, and family and community characteristics. Using data from the 2011–2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2–8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2–8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. Results A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18.6%) than in urban areas (15.2%). In urban and the majority of rural subtypes, children with an MBDD more often lacked a medical home, had a parent with poor mental health, lived in families with financial difficulties, and lived in a neighborhood lacking physical and social resources than children without an MBDD within each of those community types. Only in urban areas did a higher percentage of children with MBDDs lack health insurance than children without MBDDs. After adjusting for race/ethnicity and poverty among children with MBDDs, those in rural areas more often had a parent with poor mental health and lived in resource-low neighborhoods than those in urban areas. Interpretation Certain health care, family, and community disparities were more often reported among children with MBDDS than among children without MBDDs in rural and urban areas. Public Health Action Collaboration involving health care, family, and community services and systems can be used to address fragmented services and supports for children with MBDDs, regardless of whether they live in urban or rural areas. However, addressing differences in health care, family, and community factors and leveraging community strengths among children who live in rural areas present opportunities to promote health among children in rural communities. PMID:28301449

Gender differences in the effects of community violence on mental health outcomes in a sample of low-income youth receiving psychiatric care.

PubMed

Javdani, Shabnam; Abdul-Adil, Jaleel; Suarez, Liza; Nichols, Sara R; Farmer, A David

2014-06-01

Previous research suggests that community violence impacts mental health outcomes, but much of this research has not (a) distinguished between different types of community violence, (b) examined gender differences, and (c) focused on youth living in urban poverty. The current study addresses these questions. Participants were 306 youth (23 % girls) and one parent/guardian receiving outpatient psychiatric services for disruptive behavior disorders in a large urban city. Youth and parents reported on youth's experience of different types of community violence (being a direct victim, hearing reports, and witnessing violence), and whether violence was directed toward a stranger or familiar. Outcomes included youth externalizing, internalizing, and posttraumatic stress symptoms assessed via parent and youth reports. Being a direct victim of violence accords risk for all mental health outcomes similarly for both boys and girls. However, gender differences emerged with respect to indirect violence, such that girls who hear reports of violence against people they know are at increased risk for all assessed mental health outcomes, and girls who witness violence against familiars are at increased risk for externalizing mental health symptoms in particular. There are gender differences in violence-related mental health etiology, with implications for intervention assessment and design.

How Service Learning Addresses the Mental Health Needs of Students in Urban Schools

ERIC Educational Resources Information Center

Wilczenski, Felicia L.; Cook, Amy L.

2009-01-01

Service learning promotes social-emotional and academic development through active engagement in community activities. It empowers students to think beyond themselves and to develop a commitment to serve others. In so doing, service learning builds connections with school and community that are critically important in urban settings. This paper…

Witnessing Community Violence in Residential Neighborhoods: A Mental Health Hazard for Urban Women

PubMed Central

Ryan, Louise; Kawachi, Ichiro; Canner, Marina J.; Berkman, Lisa; Wright, Rosalind J.

2007-01-01

We examined the prevalence and psychological correlates of witnessing community violence among women of low socioeconomic status living in urban neighborhoods in the northeastern United States. Three hundred eighty-six women receiving their health care at an urban community health center were sampled to assess their violence exposures. Women were asked to report the location and timing of their exposure to witnessing violent neighborhood events in which they were not participants. The Brief Symptoms Inventory was used to assess anxiety and depressive symptoms. Controlling for marital status, educational attainment, age, and intimate partner violence victimization, women who witnessed violent acts in their neighborhoods were twice as likely to experience depressive and anxiety symptoms compared to women who did not witness community violence. Central American-born women had particularly high exposures. We conclude that witnessing neighborhood violence is a pervasive experience in this urban cohort, and is associated with anxiety and depressive symptoms, even among women who are not direct participants in violence to which they are exposed. Community violence interventions must incorporate efforts to protect the mental health of adult women who witness events in their neighborhoods. PMID:17965940

Asian Community Mental Health Services at 35: a pioneering ethnic organization (1973-2008).

PubMed

Vu, Catherine M; Schwartz, Sara L; Austin, Michael J

2011-01-01

Asian Community Mental Health Services is a nonprofit organization that delivers mental health services to primarily Asian and Pacific Islander communities. From its early beginnings and over its 35-year history, the agency has had to overcome numerous challenges, including gaining legitimacy as a culturally specific nonprofit, combating stigma surrounding mental health issues within the Asian Pacific Islander community, building resources to fund service delivery, and developing an educated and culturally sensitive workforce. The history of the organization highlights the multiple challenges and rewards of developing a culturally specific nonprofit in an urban area as well as the important role that internal operations play in relation to nonprofit expansion and growth.

Re-Designing Community Mental Health Services for Urban Children: Supporting Schooling to Promote Mental Health

PubMed Central

Atkins, Marc S.; Shernoff, Elisa S.; Frazier, Stacy L.; Schoenwald, Sonja K.; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G.; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-01-01

Objective This study examined a school- and home-based mental health service model, Links to Learning (L2L), focused on empirical predictors of learning as primary goals for services in high poverty urban communities. Method Teacher key opinion leaders (KOLs) were identified through sociometric surveys and trained, with mental health providers (MHPs) and parent advocates (PAs), on evidence-based practices to enhance children’s learning. KOLs and MHPs co-facilitated professional development sessions for classroom teachers to disseminate two universal (Good Behavior Game, Peer Assisted Learning) and two targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by MHPs and PAs for K-4th grade children diagnosed with one or more disruptive behavior disorder. Services were Medicaid-funded through four social service agencies (N = 17 providers) in seven schools (N = 136 teachers, 171 children) in a two (L2L vs. services-as-usual SAU]) by six (pre- and post-tests for three years) longitudinal design with random assignment of schools to conditions. SAU consisted of supported referral to a nearby social service agency. Results Mixed effects regression models indicated significant positive effects of L2L on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-group effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Conclusions Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high poverty urban communities. PMID:26302252

Help-Seeking Behavior among Urban Black Adults.

ERIC Educational Resources Information Center

And Others; Hendricks, Leo E.

1981-01-01

Data were gathered from adult urban Blacks to identify and describe sources of help in dealing with serious problems. Results indicated that the most frequently consulted sources of help were hospitals, community mental health centers, and hotlines. (RC)

Prevalence of Mental Health Problems and Associated Risk Factors among Rural-to-Urban Migrant Children in Guangzhou, China

PubMed Central

Liu, Ke; Zheng, Jing; Liu, Jiali; You, Liming

2017-01-01

Rural-to-urban migration, which has achieved a huge scale during China’s economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen’s behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical. PMID:29135949

Prevalence of Mental Health Problems and Associated Risk Factors among Rural-to-Urban Migrant Children in Guangzhou, China.

PubMed

Wang, Jun; Liu, Ke; Zheng, Jing; Liu, Jiali; You, Liming

2017-11-14

Rural-to-urban migration, which has achieved a huge scale during China's economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen's behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical.

Bridging Mental Health and Education in Urban Elementary Schools: Participatory Research to Inform Intervention Development

ERIC Educational Resources Information Center

Cappella, Elise; Jackson, Daisy R.; Bilal, Caroline; Hamre, Bridget K.; Soule, Carles

2011-01-01

Guided by participatory research and implementation science, we conducted a two-phase study to contextualize a school mental health intervention for its implementation settings. Drawing from research and existing programs, we created a teacher consultation and coaching intervention delivered by indigenous school and community mental health…

The impact of realignment on utilization and cost of community-based mental health services in California.

PubMed

Scheffler, R; Zhang, A; Snowden, L

2001-11-01

Decentralization of California's public mental health system under program realignment has changed the utilization and cost of community-based mental health services. This study examined a sample of 75,951 users, representing 1.5 million adults who visited California's public mental health services during a 6-year period (FY 1988-1990 and FY 1992-1994). Regression analysis was performed to examine cost and utilization reduction over time, across regions, and across psychiatric diagnoses. Overall utilization and cost of community-based mental health services dropped significantly after the implementation of realignment. They were significantly lower for (a) 24-hour services in the urban industrialized Southern Region and (b) outpatient services in the agricultural Central Region of the state. Users diagnosed with mood disorders took a greater portion, but were associated with significantly less treatment and cost than other users in the post-realignment period. When local communities bear the financial risks and rewards, they find more efficient methods of delivering community-based mental health services.

24 CFR 582.100 - Program component descriptions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... organizations. A sponsor may be a private, nonprofit organization or a community mental health agency... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES SHELTER PLUS CARE Assistance Provided § 582.100 Program...

Beyond "Landscapes of Despair": the need for new research on the urban environment, sprawl, and the community integration of persons with severe mental illness.

PubMed

Yanos, Philip T

2007-09-01

The purpose of this commentary is to discuss important trends in the housing of people with severe mental illness in the past 20 years that require the attention of mental health geographers and other experts on the effects of place on mental health. Issues that are worthy of consideration in new research include: assessing the impact of place effects on community integration, the impact of sprawl, and the emergence of the independent scatter-site housing model. Possible implications of these trends for the effects of place on people with severe mental illness are discussed.

Drought and its effect on mental health--how GPs can help.

PubMed

Sartore, Gina-Maree; Kelly, Brian; Stain, Helen J

2007-12-01

Drought has been a major stressor affecting rural New South Wales communities since late 2001. While much is known about the effects on mental health of acute natural disasters, there is less research available on the effect to communities of chronic natural disasters. Of great concern for Australian rural communities is that independent of drought, the rate of suicide for some groups is higher in rural than urban communities, while access to mental health services is less. This article explores how general practitioners can identify and respond to the drought related mental health needs of farming residents. Limited availability of mental health services to rural communities increases reliance on GPs for mental health care. Residents of farming communities report experiencing substantial distress in relation to the drought. The local GP is a key source of consultation, advice and treatment. Early intervention is a critical task in improving the mental health of rural communities. Early intervention provided by GPs will be enhanced through: working closely with other community agencies to promote early effective intervention for mental health problems, improve access to advice and initial consultation, and facilitate urgent consultation when needed; increasing access to services for farmers and responding promptly to needs; and utilising the support of rural organisational workers.

24 CFR 576.56 - Homeless assistance and participation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... treatment, mental health treatment, counseling, supervision, and other services essential for achieving... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY...

Preventing HIV Among U.S. Women of Color With Severe Mental Illness: Perceptions of Mental Health Care Providers Working in Urban Community Clinics

PubMed Central

Agénor, Madina; Collins, Pamela Y.

2013-01-01

Given their knowledge of the behavioral issues related to psychiatric illness, mental health care providers are in a unique position to help prevent HIV among women with severe mental illness (SMI). We conducted in-depth interviews with providers at two New York City community clinics. We identified three major, interrelated themes pertaining to HIV prevention among women of color with SMI. Interventions that address the barriers that clinicians face in discussing sex, sexuality, and HIV with patients and train providers in the cultural considerations of cross-cultural mental health care are needed to help prevent HIV among women of color with SMI. PMID:23394326

Preventing HIV among U.S. women of color with severe mental illness: perceptions of mental health care providers working in urban community clinics.

PubMed

Agénor, Madina; Collins, Pamela Y

2013-01-01

Given their knowledge of the behavioral issues related to psychiatric illness, mental health care providers are in a unique position to help prevent HIV among women with severe mental illness (SMI). We conducted in-depth interviews with providers at two New York City community clinics. We identified three major, interrelated themes pertaining to HIV prevention among women of color with SMI. Interventions that address the barriers that clinicians face in discussing sex, sexuality, and HIV with patients and train providers in the cultural considerations of cross-cultural mental health care are needed to help prevent HIV among women of color with SMI.

Beyond “Landscapes of Despair:” The Need for New Research on the Urban Environment, Sprawl, and the Community Integration of Persons with Severe Mental Illness

PubMed Central

Yanos, Philip T

2007-01-01

The purpose of this commentary is to discuss important trends in the housing of people with severe mental illness in the past 20 years that require the attention of mental health geographers and other experts on the effects of place on mental health. Issues that are worthy of consideration in new research include: assessing the impact of place effects on community integration, the impact of sprawl, and the emergence of the independent scatter-site housing model. Possible implications of these trends for the effects of place on people with severe mental illness are discussed. PMID:17178251

Utilizing community-based participatory research to adapt a mental health intervention for African American emerging adults.

PubMed

Mance, Gishawn A; Mendelson, Tamar; Byrd, Benjamin; Jones, Jahon; Tandon, Darius

2010-01-01

Adapting mental health interventions to heighten their cultural and contextual appropriateness may be critical for engaging ethnic/racial groups that have been traditionally excluded or marginalized. Community-based participatory research (CBPR) is a collaborative research approach that highlights unique strengths and expertise of those involved. Although intervention adaptations have garnered much attention there is little previous work specifically describing the adaptation process of mental health interventions using CBPR. This article summarizes the use of a CBPR approach to adapt a mental health intervention for urban adolescents and young adults disconnected from school and work, a population at elevated risk for poor mental health owing to the presence of numerous chronic stressors. We describe the process undertaken to modify the content and delivery format of an evidence-based intervention. Unique challenges of working with urban African American adolescents and young adults in a job training program are highlighted. By incorporating principles of co-learning and shared responsibility, this partnership was able to achieve positive outcomes. Our experience suggests that a CBPR approach can be used effectively to adapt a mental health intervention in collaboration with African American adolescents and emerging adults in a job training program.

Attitudes toward the mentally ill among community health-related personnel in South Korea.

PubMed

Jung, Wook; Choi, Eunkyung; Yu, Jaehak; Park, Doo-Heum; Ryu, Seung-Ho; Ha, Jee Hyun

2017-01-01

Prejudice and negative attitudes toward mental illness are major obstacles in the rehabilitation and functional recovery of patients. The objective of this study was to evaluate the attitudes of health-related personnel toward mentally ill patients in a local urban community in South Korea. In total, 401 participants (men, 132; women, 269; mean age, 37.3 ± 9.5 years) were recruited. The participants were health-related personnel in a district of Seoul, who were recruited from three different workplaces: a local administration office, a public health center, and a community welfare center. Sociodemographic data were gathered, and the community attitudes toward the mentally ill (CAMI) inventory were administered. Comparisons of the CAMI subscales were conducted among participants using statistical analysis. Community welfare center workers showed more authoritarianism and social restriction and less community mental health ideology than the other two groups. Among the demographic variables, a shorter working career, higher education, female gender, and younger age were also related to a more negative attitude toward mentally ill patients. Community health-related personnel who have contact with patients with mental illness should be encouraged to have a fair, hospitable, and open-minded attitude. It is advisable for these workers to receive interventions such as regular educational programs early in their careers.

Leveraging After-School Programs to Minimize Risks for Internalizing Symptoms Among Urban Youth: Weaving Together Music Education and Social Development.

PubMed

Hedemann, Erin R; Frazier, Stacy L

2017-09-01

This study examined a university-community partnership, focusing on mental health promotion within an after-school music program. We pursued two goals: (a) supporting staff around student engagement and behavior management; (b) integrating social-emotional activities into the curriculum. We assessed youth's mental health needs and examined feasibility of social-emotional activities delivered. One-hundred sixty-two youth participated in activities, while a subset of youth (n = 61) and their parents provided information on mental health need. Rates of anxiety and depression symptoms were high, and youth reported high satisfaction with the activities. Results suggest promise of this model for mental health promotion for urban youth.

A Return to "The Clinic" for Community Psychology: Lessons from a Clinical Ethnography in Urban American Indian Behavioral Health.

PubMed

Hartmann, William E; St Arnault, Denise M; Gone, Joseph P

2018-03-01

Community psychology (CP) abandoned the clinic and disengaged from movements for community mental health (CMH) to escape clinical convention and pursue growing aspirations as an independent field of context-oriented, community-engaged, and values-driven research and action. In doing so, however, CP positioned itself on the sidelines of influential contemporary movements that promote potentially harmful, reductionist biomedical narratives in mental health. We advocate for a return to the clinic-the seat of institutional power in mental health-using critical clinic-based inquiry to open sites for clinical-community dialogue that can instigate transformative change locally and nationally. To inform such works within the collaborative and emancipatory traditions of CP, we detail a recently completed clinical ethnography and offer "lessons learned" regarding challenges likely to re-emerge in similar efforts. Conducted with an urban American Indian community behavioral health clinic, this ethnography examined how culture and culture concepts (e.g., cultural competence) shaped clinical practice with socio-political implications for American Indian peoples and the pursuit of transformative change in CMH. Lessons learned identify exceptional clinicians versed in ecological thinking and contextualist discourses of human suffering as ideal partners for this work; encourage intense contextualization and constraining critique to areas of mutual interest; and support relational approaches to clinic collaborations. © Society for Community Research and Action 2017.

Myths, beliefs and perceptions about mental disorders and health-seeking behavior in Delhi, India

PubMed Central

Kishore, Jugal; Gupta, Avni; Jiloha, Ram Chander; Bantman, Patrick

2011-01-01

Objectives: To assess the myths, beliefs and perceptions about mental disorders and health-seeking behavior in general population and medical professionals of India. Materials and Methods: A cross-sectional study was carried out with a sample of 436 subjects (360 subjects from urban and rural communities of Delhi and 76 medical professionals working in different organizations in Delhi). A pre-tested questionnaire consisting items on perceptions, myths, and beliefs about causes, treatment, and health-seeking behavior for mental disorders was used. The collected data were statistically analyzed using computer software package Epi-info. Appropriate tests of significance were applied to detect any significant association. Results: The mental disorders were thought to be because of loss of semen or vaginal secretion (33.9% rural, 8.6% urban, 1.3% professionals), less sexual desire (23.7% rural, 18% urban), excessive masturbation (15.3% rural, 9.8% urban), God's punishment for their past sins (39.6% rural, 20.7% urban, 5.2% professionals), and polluted air (51.5% rural, 11.5% urban, 5.2% professionals). More people (37.7%) living in joint families than in nuclear families (26.5%) believed that sadness and unhappiness cause mental disorders. 34.8% of the rural subjects and 18% of the urban subjects believed that children do not get mental disorders, which means they have conception of adult-oriented mental disorders. 40.2% in rural areas, 33.3% in urban areas, and 7.9% professionals believed that mental illnesses are untreatable. Many believed that psychiatrists are eccentric (46.1% rural, 8.4% urban, 7.9% professionals), tend to know nothing, and do nothing (21.5% rural, 13.7% urban, 3.9% professionals), while 74.4% of rural subjects, 37.1% of urban subjects, and 17.6% professionals did not know that psychiatry is a branch of medicine. More people in rural areas than in urban area thought that keeping fasting or a faith healer can cure them from mental illnesses, whereas 11.8% of medical professionals believed the same. Most of the people reported that they liked to go to someone close who could listen to their problems, when they were sad and anxious. Only 15.6% of urban and 34.4% of the rural population reported that they would like to go to a psychiatrist when they or their family members are suffering from mental illness. Conclusion: It can be concluded from this study that the myths and misconceptions are significantly more prevalent in rural areas than in urban areas and among medical professionals, and the people need to be communicated to change their behavior and develop a positive attitude toward mental disorders so that health-seeking behavior can improve. PMID:22303041

Identification Reduces Stigma of Mental Ill-Health: A Community-Based Study.

PubMed

Kearns, Michelle; Muldoon, Orla T; Msetfi, Rachel M; Surgenor, Paul W G

2018-03-01

The stigma surrounding mental ill-health is an important issue that affects likelihood of diagnosis and uptake of services, as those affected may work to avoid exposure, judgment, or any perceived loss in status associated with their mental ill-health. In this study, we drew upon social identity theory to examine how social group membership might influence the stigma surrounding mental ill-health. Participants from two urban centers in Ireland (N = 626) completed a survey measuring stigma of mental health, perceived social support as well as identification with two different social groups (community and religion). Mediation analysis showed that subjective identification with religious and community groups led to greater perceived social support and consequently lower perceived stigma of mental ill-health. Furthermore, findings indicated that high identification with more than one social group can lead to enhanced social resources, and that identification with a religious group was associated with greater community identification. This study thus extends the evidence base of group identification by demonstrating its relationship with stigma of mental ill-health, while also reinforcing how multiple identities can interact to enhance social resources crucial for well-being. © Society for Community Research and Action 2017.

Unique Practice, Unique Place: Exploring Two Assertive Community Treatment Teams in Maine.

PubMed

Schroeder, Rebecca A

2018-06-01

Assertive Community Treatment (ACT) is a model of care that provides comprehensive community-based psychiatric care for persons with serious mental illness. This model has been widely documented and has shown to be an evidence-based model of care for reducing hospitalizations for this targeted population. Critical ingredients of the ACT model are the holistic nature of their services, a team based approach to treatment and nurses who assist with illness management, medication monitoring, and provider collaboration. Although the model remains strong there are clear differences between urban and rural teams. This article describes present day practice in two disparate ACT programs in urban and rural Maine. It offers a new perspective on the evolving and innovative program of services that treat those with serious mental illness along with a review of literature pertinent to the ACT model and future recommendations for nursing practice. The success and longevity of these two ACT programs are testament to the quality of care and commitment of staff that work with seriously mentally ill consumers. Integrative care models such as these community-based treatment teams and nursing driven interventions are prime elements of this successful model.

Neighbourhood influences on mental health in master planned estates: a qualitative study of resident perspectives.

PubMed

Francis, Jacinta; Giles-Corti, Billie; Wood, Lisa; Knuiman, Matthew

2014-12-01

Neighbourhood characteristics have been linked to a range of health outcomes, including mental health. Despite the growth of master planned estates (MPEs) within Australia, few studies have investigated the physical and social correlates of mental health in residents of new housing developments. Methods This study aimed to identify the facilitators of, and barriers to, mentally healthy neighbourhoods using focus groups with residents of MPEs in metropolitan Perth, Western Australia. Focus group interviews were analysed using qualitative research software package QSR NVivo. Results and Conclusions Results suggest that mental health is strongly influenced by a sense of community and security, as well as an aesthetically pleasing environment. Residents of MPEs may experience a strong sense of community due to similarities in life-stage and the community building efforts of property developers. Expanding population size, social exclusion, and insufficient services may negatively affect the mental health of residents in MPEs. SO WHAT?: Identifying correlates of mentally healthy neighbourhoods may help urban planners design residential areas that promote healthy living.

A Sexual Assault Primary Prevention Model with Diverse Urban Youth

ERIC Educational Resources Information Center

Smothers, Melissa Kraemer; Smothers, D. Brian

2011-01-01

In this study, a nonprofit community mental health clinic developed a socioecological model of sexual abuse prevention that was implemented in a public school. The goal of the program was to promote and create community change within individuals and the school community by reducing tolerance of sexual violence and sexual harassment. Participants…

Epidemiological study of mental morbidity in an urban slum community in India for the development of a community mental health programme.

PubMed

Silvanus, V; Subramanian, P

2012-03-01

A crossectional field study was carried out in an urban slum in order to assess the prevalence and nature of mental morbidity and identify stressors in the community. A face to face interview was conducted with the help of a questionnaire. The interview consisted of three sections as follows: Data identifying the informant by age, sex, marital status, education, occupation, age at marriage, number of members, children and monthly income. General Health Questionnaire (GHQ) 5- item version used as a screening instrument to assess the present mental health status of the informant and data of past illnesses in self or family and questions framed to elicit perceptions regarding mental illness, alcoholism, their causation and treatment. The subjects who scored above 2 ie 3,4,and 5 in the GHQ were requested to follow up at the Mental Health OPD and subjected to a standardized psychiatric interview by a Psychiatrist. The Diagnostic and Statistical Manual Third Revised (DSM 3 R) criteria were used for diagnosis. After the interview and examination, the appropriate treatment was instituted. A total of 443 individuals were screened. The overall prevalence rate of mental illness in the community was 61 per thousand. It is estimated that the case rate ranges from 38 to 84 per thousand within 95% confidence limits. The overall severity ranged from mild to severe morbidity. The prevalence of severe mental morbidity which includes psychosis, depressive illness, mental retardation was 22.5 per thousand. Neurosis (63.31%) especially Major Depression and Adjustment disorder, Psychosis (10.00%), Somatization disorder (6.66%) and Psychiatric symptoms secondary to physical illness were the major groups of illness. Women were found to have more mental health problems than men. The morbidity pattern also differs significantly with the gender. Neurosis was seen more among the female subjects. There was a significant association of mental health problems with low educational status, unemployment and large family size. Financial problems, marital conflicts, interpersonal conflicts and housing problems were the major stressors as perceived by the respondents. There exists significant mental health problems in the community which can be due to deleterious sociocultural factors and we recommend the integration of mental health care with general health care.

More than jobs and houses: mental health, quality of life and the perceptions of locality in an area undergoing urban regeneration.

PubMed

Rogers, Anne; Huxley, Peter; Evans, Sherrill; Gately, Claire

2008-05-01

Urban regeneration initiatives are considered to be one means of making a contribution to improving people's quality of life and mental health. This paper considers the relationship between lay perceptions of locality adversity, mental health and social capital in an area undergoing urban regeneration. Using qualitative methods as part of a larger multi-method study, perceptions of material, and non-material aspects of the locality and the way in which people vulnerable to mental health problems coped with living in adversity were identified as being more highly valued than intended or actual changes to structural elements such as the provision of housing or employment. Themes derived from narrative accounts included concerns about the absence of social control in the locality, the reputation of the area, a lack of faith in local agencies to make changes considered important to local residents, a reliance on personal coping strategies to manage adversity and perceived threats to mental health which reinforced a sense of social isolation. We suggest these elements are implicated in restricting opportunities and enhancing feelings of 'entrapment' contributing to low levels of local collective efficacy. The gap between social capital capacity at an individual level and links with collective community resources may in part have accounted for the absence of improvements in mental health during the early life of the urban regeneration initiative. In order to enhance quality of life or mental health, agencies involved in urban initiatives need as a basic minimum to promote security, increase leisure opportunities, and improve the image of the locality.

What are the factors associated with good mental health among Aboriginal children in urban New South Wales, Australia? Phase I findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH).

PubMed

Williamson, Anna; D'Este, Catherine; Clapham, Kathleen; Redman, Sally; Manton, Toni; Eades, Sandra; Schuster, Leanne; Raphael, Beverley

2016-07-05

To identify the factors associated with 'good' mental health among Aboriginal children living in urban communities in New South Wales, Australia. Cross-sectional survey (phase I of a longitudinal study). 4 Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban communities in New South Wales, Australia. 1005 Aboriginal children aged 4-17 years who participated in phase I of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Carer report version of the Strengths and Difficulties Questionnaire. Scores <17 were considered to indicate 'good' mental health for the purposes of this article. The majority (72%) of SEARCH participants were not at high risk for emotional or behavioural problems. After adjusting for the relative contributions of significant demographic, child and carer health factors, the factors associated with good mental health among SEARCH children were having a carer who was not highly psychologically distressed (OR=2.8, 95% CI 1.6 to 5.1); not suffering from frequent chest, gastrointestinal or skin infections (OR=2.8, 95% CI 1.8 to 4.3); and eating two or more servings of vegetables per day (OR=2.1, 95% CI 1.2 to 3.8). Being raised by a foster carer (OR=0.2, 95% CI 0.01 to 0.71) and having lived in 4 or more homes since birth (OR=0.62, 95% CI 0.39 to 1.0) were associated with significantly lower odds of good mental health. Slightly different patterns of results were noted for adolescents than younger children. Most children who participated in SEARCH were not at high risk for emotional or behavioural problems. Promising targets for efforts to promote mental health among urban Aboriginal children may include the timely provision of medical care for children and provision of additional support for parents and carers experiencing mental or physical health problems, for adolescent boys and for young people in the foster care system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Teacher key opinion leaders and mental health consultation in low-income urban schools.

PubMed

Atkins, Marc S; Frazier, Stacy L; Leathers, Sonya J; Graczyk, Patricia A; Talbott, Elizabeth; Jakobsons, Lara; Adil, Jaleel Abdul; Marinez-Lora, Ane; Demirtas, Hakam; Gibbons, Robert B; Bell, Carl C

2008-10-01

Diffusion theory posits that information is disseminated throughout a social network by the persuasion of key opinion leaders (KOLs). This study examined the relative and combined influence of peer-identified KOL teachers (n = 12) and mental health providers (n = 21) on classroom teachers' (n = 61) self-reported use of commonly recommended classroom practices for children with attention-deficit/hyperactivity disorder in 6 low-income urban African American communities, relative to teachers (n = 54) at 4 matched schools who received mental health provider consultation only. Mixed-effects regression models showed that KOLs in collaboration with mental health providers promoted higher rates of teachers' self-reported use of recommended strategies than mental health providers alone, and that these effects were mediated by KOL support but not by mental health provider support. The results suggest an expanded role for KOL teachers as indigenous and natural supports for the dissemination and implementation of school-based mental health programs. (c) 2008 APA, all rights reserved.

Teacher consultation and coaching within mental health practice: classroom and child effects in urban elementary schools.

PubMed

Cappella, Elise; Hamre, Bridget K; Kim, Ha Yeon; Henry, David B; Frazier, Stacy L; Atkins, Marc S; Schoenwald, Sonja K

2012-08-01

To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. © 2012 American Psychological Association

Using Common Themes: Cost-Effectiveness of Permanent Supported Housing for People with Mental Illness

ERIC Educational Resources Information Center

McLaughlin, Thomas Chalmers

2011-01-01

This article examines the cost-effectiveness of providing permanent supported housing to homeless people with mental illness. Through the use of billing records and frequency of use charts, researchers were able to map the service usage of a cohort of 268 homeless individuals from both urban and rural communities. The results suggest that…

Walking the Worlds: The Experience of Native Psychologists in Their Doctoral Training and Practice

ERIC Educational Resources Information Center

Elliott, S. Auguste

2010-01-01

American Indian and Alaska Native psychologists are in demand. They hold promise to meet the mental health needs of tribal and urban Indian communities by bridging Native worldview and the Euro-American stance of psychology in assessing, designing, and delivering mental health services to Native peoples. Individual stories of Native psychologists…

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

ERIC Educational Resources Information Center

McKay, Mary M.; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Chacko, Anil; Jackson, Jerrold M.; Fuss, Ashley

2011-01-01

This article presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within 13 urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this article focuses on parent…

Longitudinal Course of Clients With Co-occurring Schizophrenia-Spectrum and Substance Use Disorders in Urban Mental Health Centers: A 7-Year Prospective Study

PubMed Central

Drake, Robert E.; Luciano, Alison E.; Mueser, Kim T.; Covell, Nancy H.; Essock, Susan M.; Xie, Haiyi; McHugo, Gregory J.

2016-01-01

Objective. A previous longitudinal study in rural New Hampshire showed that community mental health center clients with co-occurring schizophrenia-spectrum and substance use disorders (SZ/SUD) improved steadily and substantially over 10 years. The current study examined 7 years of prospective clinical and functional outcomes among inner-city Connecticut (CT) community mental health center clients with SZ/SUD. Method. Participants were 150 adults with SZ/SUD, selected for high service needs, in 2 inner-city mental health centers in CT. Initially, all received integrated mental health and substance abuse treatments for at least the first 3 years as part of a clinical trial. Assessments at baseline and yearly over 7 years measured progress toward 6 target clinical and functional outcomes: absence of psychiatric symptoms, remission of substance abuse, independent housing, competitive employment, social contact with non-users of substances, and life satisfaction. Results. The CT SZ/SUD participants improved significantly on 5 of the 6 main outcomes: absence of psychiatric symptoms (45%–70%), remission of substance use disorders (8%–61%), independent housing (33%–47%), competitive employment (14%–28%), and life satisfaction (35%–53%). Only social contact with nonusers of substances was unimproved (14%–17%). Conclusions. Many urban community mental health center clients with SZ/SUD and access to integrated treatment improve significantly on clinical, vocational, residential, and life satisfaction outcomes over time, similar to clients with SZ/SUD in rural areas. Thus, the long-term course for people with SZ/SUD is variable but often quite positive. PMID:26294706

Understanding Latino Parents' Child Mental Health Literacy: Todos a bordo/All Aboard

PubMed Central

Umpierre, Mari; Meyers, Laura V.; Ortiz, Aida; Paulino, Angela; Rodriguez, Anita Rivera; Miranda, Ana; Rodriguez, Raquel; Kranes, Stephanie; McKay, Mary M.

2015-01-01

Objective This article describes Phase 1 of a pilot that aims to develop, implement, and test an intervention to educate and simultaneously engage highly stressed Latino parents in child mental health services. A team of Spanish-speaking academic and community co-investigators developed the intervention using a community-based participatory research approach and qualitative methods. Method Through focus groups, the team identified parents' knowledge gaps and their health communication preferences. Results Latino parents from urban communities need and welcome child mental health literacy interventions that integrate printed materials with videos, preferably in their native language, combined with guidance from professionals. Conclusion A 3-minute video in Spanish that integrates education entertainment strategies and a culturally relevant format was produced as part of the intervention to educate and simultaneously engage highly stressed Latino parents in child mental health care. It is anticipated that the intervention will positively impact service use among this group. PMID:26412954

Community violence, protective factors, and adolescent mental health: a profile analysis.

PubMed

Copeland-Linder, Nikeea; Lambert, Sharon F; Ialongo, Nicholas S

2010-01-01

This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring, and parental involvement and to examine whether these profiles differentially predict adolescents' depressive symptoms and aggressive behavior. Three classes were identified-a vulnerable class, a moderate risk/medium protection class, and a moderate risk/high protection class. The classes differentially predicted depressive symptoms but not aggressive behavior for boys and girls. The class with the highest community violence exposure also had the lowest self-worth.

Randomized Trial of Supported Employment Integrated With Assertive Community Treatment for Rural Adults With Severe Mental Illness

PubMed Central

Gold, Paul B; Meisler, Neil; Santos, Alberto B; Carnemolla, Mark A; Williams, Olivia H; Keleher, Jennie

2006-01-01

Urban-based randomized clinical trials of integrated supported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited, loosely linked, and geographically dispersed. In addition, SE's ability to replicate the work outcomes of urban programs in rural economies with scarce and less diverse job opportunities remains unknown. In a rural South Carolina county, we designed and implemented a program blending Assertive Community Treatment (ACT) with an SE model, Individual Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS subteams that tightly integrated vocational with mental health services within each self-contained team. In a 24-month randomized clinical trial, we compared ACT-IPS to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults with SMI (N = 143; 69% schizophrenia, 77% African American). More ACT-IPS participants held competitive jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income (median [Mdn] = $549, interquartile range [IQR] = $0–$5,145, versus Mdn = $0, IQR = $0–$40; p < .001, ES = 0.70) than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs. However, achieving economic self-sufficiently and developing careers probably require increasing access to higher education and jobs imparting marketable technical skills. PMID:16177278

The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients' views.

PubMed

Barke, Antonia; Nyarko, Seth; Klecha, Dorothee

2011-11-01

Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. A convenience sample of 403 participants (210 men, mean age 32.4±12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9±11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes.

A Cross-Sectional Study of Nutrient Intake and Health Status among Older Adults in Yogyakarta Indonesia

PubMed Central

Arjuna, Tony; Soenen, Stijn; Hasnawati, Rasita Amelia; Lange, Kylie; Chapman, Ian; Luscombe-Marsh, Natalie D.

2017-01-01

Many communities around the world, particularly developing countries including Indonesia, are experiencing population ageing. There is little knowledge regarding the impact of malnutrition, or its prevalence within rural compared to urban areas, on the nutritional, functional and mental status of community-living older residents in these countries. Hence, a cross-sectional study was conducted to determine socio-demographic and anthropometric characteristics, nutritional, mental and functional status, and energy and nutrient intake of community-dwelling Indonesians from both rural and urban areas of Yogyakarta. Older individuals were included in the study if they had been living in Yogyakarta for the last year and were aged ≥65 years (n = 527; mean ± SD age of 74 ± 7 years). Rural compared with urban participants had a lower level of education and income, more hospital admissions, less dietary protein intake, lower cognitive function, poorer nutritional status and grip strength, but faster gait speed while being more dependent on assistance to perform daily activities (all p < 0.05). Cognitive function was more strongly associated than nutritional status with physical function. Rural older Indonesians living in Yogyakarta were more likely than urban older people to be malnourished and cognitively impaired, and to have associated reductions in functional capacity and independence. Strategies to improve cognitive function and nutritional status are therefore important for the wellbeing of Indonesian citizens. PMID:29137185

Seeking systemic change: risk and protective factors affecting low-income urban youth.

PubMed

Meyerson, David A; Grant, Kathryn E

2014-01-01

This themed issue presents five articles tackling the topic of risk and protective processes affecting children and adolescents living in urban poverty. Through their research, the authors seek understanding of the particular challenges that low-income urban youth face, with the ultimate goal of understanding how best to intervene at various levels of the ecological system. Within this broad theme, studies examine specific stressors, mediators, and moderators that impact the mental health of youth living in urban poverty. The final article presents a data-driven, community-based intervention for this population.

The Designed Environment and How it Affects Brain Morphology and Mental Health.

PubMed

Golembiewski, Jan A

2016-01-01

The environment is inextricably related to mental health. Recent research replicates findings of a significant, linear correlation between a childhood exposure to the urban environment and psychosis. Related studies also correlate the urban environment and aberrant brain morphologies. These findings challenge common beliefs that the mind and brain remain neutral in the face of worldly experience. There is a signature within these neurological findings that suggests that specific features of design cause and trigger mental illness. The objective in this article is to work backward from the molecular dynamics to identify features of the designed environment that may either trigger mental illness or protect against it. This review analyzes the discrete functions putatively assigned to the affected brain areas and a neurotransmitter called dopamine, which is the primary target of most antipsychotic medications. The intention is to establish what the correlations mean in functional terms, and more specifically, how this relates to the phenomenology of urban experience. In doing so, environmental mental illness risk factors are identified. Having established these relationships, the review makes practical recommendations for those in public health who wish to use the environment itself as a tool to improve the mental health of a community through design. © The Author(s) 2015.

Exposure to Community Violence and the Trajectory of Internalizing and Externalizing Symptoms in a Sample of Low-Income Urban Youth.

PubMed

Taylor, Jeremy J; Grant, Kathryn E; Zulauf, Courtney A; Fowler, Patrick J; Meyerson, David A; Irsheid, Sireen

2018-01-01

This study examined trajectories of psychopathology in a sample of low-income urban youth and tested exposure to community violence as a predictor of these trajectories. Self-report and parent-report survey measures of psychological problems and exposure to community violence were collected annually over 3 years from a sample of 364 fifth- to ninth-grade low-income urban youth (64% female; 95% youth of color). Linear growth models showed that youth experienced declines in both internalizing and externalizing symptoms across adolescence. Exposure to community violence was more strongly associated with externalizing symptoms than with internalizing symptoms but predicted declines in both types of symptoms. Results also indicated that youth reported more internalizing and externalizing symptoms than their parents reported for them. Exposure to community violence may explain unique trajectories of mental health problems among low-income urban youth. In addition, youth efforts to adopt a tough façade in the face of community violence could lead to higher rates of externalizing problems relative to internalizing problems, whereas desensitization processes may better explain reductions in both types of symptoms over time. Finally, youth report may be more valid than parent report in the context of urban poverty.

Rural residence is not a risk factor for frequent mental distress: a behavioral risk factor surveillance survey

PubMed Central

Rohrer, James E; Borders, Tyrone F; Blanton, Jimmy

2005-01-01

Background Residents of rural areas may be at increased risk of mental health problems. If so, public health programs aimed at preventing poor mental health may have to be customized for delivery to rural areas. The purpose of this study was to examine the relationship between residing in a rural area and frequent mental distress, which is one indicator of poor mental health. Methods The Behavioral Risk Factor Surveillance System (BRFSS) survey for the state of Texas was the source of information about obesity, demographic characteristics, and frequent mental distress (FMD). FMD was defined as poor self-rated mental health during at least half of the days in the last month. Adjusted odds for FMD were computed for rural and suburban respondents relative to urban respondents. Results FMD was found to be independently associated with lower education, being younger, being non-Hispanic, being unmarried, and being female. FMD also was associated with being obese or underweight and suburban residence (relative to metro-central city). FMD was not more common among rural respondents than in the metro-central city. Conclusion Rural respondents were not at greater risk of frequent mental distress than urban respondents in this sample. Programs seeking to improve community mental health should target persons with less education and extremes in body weight, along with women and single persons, regardless of whether they live in rural or urban areas. PMID:15904511

Consideration of the influence of place on access to employment for persons with serious mental illness in northeastern Ontario.

PubMed

Rebeiro Gruhl, K L; Kauppi, C; Montgomery, P; James, S

2012-01-01

Despite increasing attention to employment within the mental health sector, reports indicate that people with serious mental illness (SMI) continue to experience limited employment success in the province of Ontario, Canada. Research specifies that people with SMI who live in rural places are less likely than those living in urban centers to have access to satisfactory employment services or to become gainfully employed. The objective of this study was to examine access to employment from the perspectives of people with SMI, mental health and vocational service providers, and decision-makers, and to explore whether place influenced their access to work in northeastern Ontario. A qualitative case study using community-based participatory research methods was chosen to examine the experience of access to competitive employment in two northeastern Ontario communities. The cases selected for study were two geographic areas in northeastern Ontario which provided best-practice, mental health services to persons with SMI. Community-based site partners advertised and recruited participants, and a consumer advisory provided input on key stakeholders, questions, findings and the study action plan. The study findings were informed by individual and group interviews conducted with 46 individuals who resided in both rural and urban settings in the case communities, and feedback from 49 participants who attended town hall forums for presentation of study findings and development of an action plan. The qualitative data was supported by a secondary data source reporting on the employment outcomes of 4112 people with SMI who received disability income support and who resided in the case communities. Qualitative data were analyzed inductively, and categories and themes were developed. Findings were member checked with all informants and town hall participants in each case community. This article draws on the findings of a larger study and reports on the influence of place to the low employment success experienced by people with SMI who reside in the case communities; 91.3% of those receiving disability income support are unemployed, and rural residents experience higher levels of unemployment than those in urban places. Place was found to influence access to employment in five ways: by limited access to employment support services in rural places, and to recommended ratios in urban places; by the use of different models and practices that were inconsistent with best practices for people with SMI; by the lack of a plan for the implementation of employment services in the case communities; by limited use of the available, dedicated vocational resources for employment purposes; and by inadequate supports provided to persons with SMI who wish to enter the workforce. The results also underscore how people with SMI continue to be perceived negatively regarding their capacity for employment. Such stereotypical attitudes additionally contributed to employment marginalization of people with SMI from the workforce, especially in rural communities. The study highlights the influence of geography and human resources to the implementation of best practice employment services and supports for persons with SMI. Important policy implications include the need to consider place when implementing evidence-based practices in places where geography, distance and human health resources limit the communities' capacity to successfully do so. The study also underscores the need to build community capacity for supported employment, especially in rural places, in order to improve the participation of people with SMI in employment, and subsequently, to help shift the communities' thinking about their capacity for work.

Mental illness stigma and engagement in an implementation trial for Cognitive Processing Therapy at a diverse community health center: a qualitative investigation.

PubMed

Valentine, Sarah E; Dixon, Louise; Borba, Christina P C; Shtasel, Derri L; Marques, Luana

The present study aimed to describe associations between various types of mental health stigma and help-seeking behaviors among ethnically diverse clients with posttraumatic stress disorder (PTSD) served by an urban community health clinic. The present study draws qualitative data from a parent National Institute of Mental Health Study that aims to identify barriers and facilitators of implementing Cognitive Processing Therapy (CPT) for PTSD. A total of 24 participants from the initial phase of the trial were included in the present study. Mental health stigma emerged as one notable barrier to seeking mental health treatment, as participants described how experiences of environment-level stigma, internalized (self-)stigma and perceived (felt) stigma from their family, friends and previous healthcare providers influenced their decisions to seek care. Despite these barriers to help seeking, many clients also reported that positive interactions with informal and formal support systems, and encouragement from study therapists, helped to combat mental health stigma and facilitate decisions to participate in an implementation trial for CPT. Findings suggest that providers in community health settings may need to attend directly to stigma at the initiation of mental health treatment.

Meeting the Complex Needs of Urban Youth and Their Families through the 4Rs 2Ss Family Strengthening Program: The "Real World" Meets Evidence-Informed Care

ERIC Educational Resources Information Center

Small, Latoya A.; Jackson, Jerrold; Gopalan, Geetha; McKay, Mary McKernan

2015-01-01

Background: Youth living in poverty face compounding familial and environmental was challenges in utilizing effective community mental health services. Ongoing stressors increase their drop-out rate in mental health service use. Difficulties also exist in staying engaged in services when involved with the child welfare system. This study examines…

Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment.

PubMed

Amaro, Hortensia; Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

2007-07-01

This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology.

Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

PubMed Central

Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

2007-01-01

This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology. PMID:17356904

Rural psychiatric services. A collaborative model.

PubMed Central

Kaufmann, I. M.

1993-01-01

Psychiatric services are difficult to obtain in rural communities because few psychiatrists practise outside urban centres. Family physicians who are willing to develop their skills with the support of their psychiatrist colleagues could alleviate this problem. This article describes a community mental health clinic where a family physician acts as psychiatric consultant. Images p1958-a p1961-a PMID:8219844

Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

PubMed Central

Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

2012-01-01

Objective To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method Thirty-six classrooms within five urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Results Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Conclusions Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. PMID:22428941

Attending to Communication and Patterns of Interaction: Culturally Sensitive Mental Health Care for Groups of Urban, Ethnically Diverse, Impoverished, and Underserved Women.

PubMed

Molewyk Doornbos, Mary; Zandee, Gail Landheer; DeGroot, Joleen

2014-07-01

The United States is ethnically diverse. This diversity presents challenges to nurses, who, without empirical evidence to design culturally congruent interventions, may contribute to mental health care disparities. Using Leininger's theory of culture care diversity and universality, this study documented communication and interaction patterns of ethnically diverse, urban, impoverished, and underserved women. Using a community-based participatory research framework, 61 Black, Hispanic, and White women participated in focus groups around their experiences with anxiety/depression. Researchers recorded verbal communication, nonverbal behavior, and patterns of interaction. The women's communication and interaction patterns gave evidence of three themes that were evident across all focus groups and five subthemes that emerged along ethnic lines. The results suggest cultural universalities and cultural uniquenesses relative to the communication and interaction patterns of urban, ethnically diverse, impoverished, and underserved women that may assist in the design of culturally sensitive mental health care. © The Author(s) 2014.

Promoting Effective Parenting Practices and Preventing Child Behavior Problems in School among Ethnically Diverse Families from Underserved, Urban Communities

ERIC Educational Resources Information Center

Brotman, Laurie Miller; Calzada, Esther; Huang, Keng-Yen; Kingston, Sharon; Dawson-McClure, Spring; Kamboukos, Dimitra; Rosenfelt, Amanda; Schwab, Amihai; Petkova, Eva

2011-01-01

This study examines the efficacy of "ParentCorps" among 4-year-old children (N = 171) enrolled in prekindergarten in schools in a large urban school district. "ParentCorps" includes a series of 13 group sessions for parents and children held at the school during early evening hours and facilitated by teachers and mental health…

Jail Mental Health Resourcing: A Conceptual and Empirical Study of Social Determinants.

PubMed

Helms, Ronald; Gutierrez, Ricky S; Reeves-Gutierrez, Debra

2016-07-01

U.S. county jails hold large populations of mentally ill inmates but have rarely been researched quantitatively to assess their collective capacity for providing mental health treatment. This research uses ordinal logit and a partial parallel slopes model and a large sample of U.S. counties to assess conceptualized links between local institutional and structural indicators and jail mental health resourcing. Strong church networks and high rates of adult education completion are associated with enhanced jail mental health resourcing. Urbanized areas and areas with deep economic ties to manufacturing appear supportive of a strong jail mental health system. Conversely, conservative political environments and areas with strong medical and mental health networks based in the community are correlated with reduced jail mental health resourcing. Evidence from this research adds to a growing understanding of the need for enhanced community mental health service and diagnostic capabilities in our nation's jails, noting the characteristics and correlates of model program jurisdictions and jurisdictions where program enhancements are most likely in order. © The Author(s) 2015.

Perceptions of mental health and help-seeking behavior in an urban community in Vietnam: an explorative study.

PubMed

van der Ham, Lia; Wright, Pamela; Van, Thang Vo; Doan, Vuong D K; Broerse, Jacqueline E W

2011-10-01

This explorative study assesses perceptions of mental health and help-seeking behavior among adults in Vietnam. Methods included questionnaires (200) and focus group discussions (eight). Respondents were often unable to name specific mental illnesses. Frequently mentioned symptoms of mental illness were talking nonsense, talking/laughing alone and wandering. Pressure/stress and studying/thinking too much were often identified causes. Most respondents showed a preference for medical treatment options, often in combination with family care. The results show that perceptions of mental health and help-seeking behaviour are influenced by a lack of knowledge and a mix of traditional and modern views.

Nursing Philosophy of community mental health nurses in Japan: A qualitative, descriptive study.

PubMed

Tanaka, Koji; Hasegawa, Masami; Nagayama, Yutaka; Oe, Masato

2018-04-01

The present study reports the findings of a qualitative, descriptive study that sought to clarify nursing philosophy for community mental health nurses (CMHN) working at independent psychiatric home-visit nursing agencies in Japan. We carried out participant observation and semistructured interviews with 13 CMHN in rural and urban areas. We identified eight subthemes and three higher-order themes based on these subthemes. CMHN embraced a nursing philosophy in which they: (i) have respect for consumers' ways of life and their self-realization; (ii) find harmony between view of life and work; and (iii) build communities where residents support each other beyond their roles. Together, these themes constitute a valuable nursing philosophy that supports the recovery of people with mental illness. The themes could also help educate professionals about principles and meanings relevant to recovery, which are regarded as key to changing the professional's care paradigm from a biomedical model to a recovery model. © 2017 Australian College of Mental Health Nurses Inc.

The influence of nondisclosure on the mental health of urban African-American adolescents exposed to community violence.

PubMed

Dinizulu, Sonya Mathies; Grant, Kathryn E; McIntosh, Jeanne M

2014-01-01

African-American youth residing in urban poverty have been shown to be at increased risk for exposure to violence and internalizing symptoms, but there has been little investigation of moderating processes that might attenuate or exacerbate this association. The current study examined nondisclosure as a possible moderator of the association between community violence and internalizing symptoms with a sample of 152 low-income urban African-American early adolescents using hierarchical regression analyses. Results revealed that nondisclosure for relationship reasons (e.g., adults could not be trusted to provide needed support) moderated the association between exposure to community violence and internalizing symptoms. Unexpectedly, however, results of simple effects analyses revealed a stronger association between exposure to violence and internalizing symptoms for youth who disclosed more to adults. Although unexpected, this pattern builds upon prior research indicating that adult-child relationships are compromised within the context of urban poverty and that protective factors may lose their power under conditions of extreme stress.

Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women.

PubMed

Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R

2011-07-22

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.

Clinical Epidemiology of Urban Violence: Responding to Children Exposed to Violence in Ten Communities

ERIC Educational Resources Information Center

Harpaz-Rotem, Ilan; Murphy, Robert A.; Berkowitz, Steven; Marans, Steven; Rosenheck, Robert A.

2007-01-01

This study explores the clinical epidemiology of children's exposure to violence as addressed by a program in which mental health clinicians work with law-enforcement agents in 10 U.S. cities. Data were collected on all participants contacted by the Child Development Community Policing Program (N = 7,313 individuals involved in 2,466 community…

Collaborating With an Urban Community to Develop an HIV and AIDS Prevention Program for Black Youth and Families

ERIC Educational Resources Information Center

Baptiste, Donna R.; Paikoff, Roberta L.; McKay, Mary McKernan; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl

2005-01-01

This article describes a collaboration between academic researchers and residents of a low-income, inner-city community to develop and deliver an HIV and AIDS prevention program for Black youth. The Chicago HIV Prevention and Adolescent Mental Health Project (CHAMP) Program was developed and implemented to decrease HIV and AIDS risk exposure among…

Effects of labeling and interpersonal contact upon attitudes towards schizophrenia: implications for reducing mental illness stigma in urban China.

PubMed

Yang, Lawrence H; Lo, Graciete; WonPat-Borja, Ahtoy J; Singla, Daisy R; Link, Bruce G; Phillips, Michael R

2012-09-01

As mental illness stigma contributes to poor outcomes for schizophrenia in China, locating strategies to reduce public stigma is imperative. It is currently unknown whether diagnostic labeling and contact with different help-seeking sources increase or decrease public stigma in China. Further, it remains unresolved whether prior personal contact acts to reduce stigma in this context. Advancing understanding of these processes may facilitate stigma-reduction strategies. We administered an experimental vignette randomly assigning one of four labeling conditions to respondents to assess social distance towards a psychotic vignette individual in a sample of 160 Northern, urban Chinese community respondents. As expected, respondents given a "non-psychiatric, indigenous label" + "lay help-seeking" condition endorsed the least social distance. Unexpectedly, the labeling condition with a "psychiatric diagnostic label" + "lay help-seeking" condition elicited the greatest social distance. Unlike Western studies, personal contact did not independently decrease community stigma. However, prior contact reduced social distance to a greater extent in the labeling condition with a "non-psychiatric, indigenous label" + "lay help-seeking" condition when compared with all other labeling conditions. The results indicate that cultural idioms do provide some protection from stigma, but only among respondents who are already familiar with what mental illness is. Our finding that the condition that depicted untreated psychosis elicited the greatest amount of stigma, while the "treated psychosis" condition was viewed relatively benignly in China, suggests that improved access to mental health services in urban China has the potential to decrease public stigma via labeling mechanisms.

Examining the Developmental Process of Risk for Exposure to Community Violence among Urban Youth

PubMed Central

Lambert, Sharon F.; Bradshaw, Catherine P.; Cammack, Nicole L.; Ialongo, Nicholas S.

2013-01-01

Considerable research has documented the effects of community violence exposure on adolescents’ behavior and mental health functioning, yet there has been less research on the process by which early risks increase the likelihood that youth will be exposed to community violence. The current study used data from a community epidemiologically-defined sample of 623 urban youth followed from first grade through adolescence to examine the process by which early-onset aggressive behavior and poor academic readiness influenced risk for community violence exposure. Consistent with transactional developmental theories, early-onset aggressive and disruptive behavior was associated with poor academic readiness; these early risks contributed to later peer rejection, and subsequent conduct problems and greater affiliation with deviant peers, which in turn increased youths’ exposure to community violence. Having an enhanced understanding of the risk process directs attention to potential targets for preventive interventions for youth at risk for subsequent exposure to violence. PMID:21480029

Mental health concerns of gay and bisexual men seeking mental health services.

PubMed

Berg, Michael B; Mimiaga, Matthew J; Safren, Steven A

2008-01-01

Little data exist about the mental health needs of gay and bisexual men. This is due to limitations of existing studies such as small and nonrepresentative samples, failure to assess sexual orientation, and concerns about stigmatization, possibly causing sexual minority individuals to be reluctant to disclose their sexual orientation to researchers. Fenway Community Health is a large urban health center that serves the LGBT community. The large number of gay and bisexual men who present for mental health treatment allows for a unique opportunity to gain insight into mental health, prevention, and intervention needs for this group. The current study is a review of the mental health information from all of the gay and bisexual men who reported that they were HIV-negative during their mental health intake over a six-month period at Fenway Community Health (January to June 2000; N = 92). The most frequent presenting problems were depression, anxiety, and relationship issues. Additionally, presenting problems included current or past abuse, substance abuse, finance and employment, recent loss, and family issues. The most frequent diagnoses were depression, anxiety disorders, and adjustment disorders. These findings support the notion that presenting problems and mental health concerns among gay and bisexual men are similar to those frequently reported by individuals in other mental health facilities, however, specific psychosocial stressors are unique to this population.

An ethnography of clinic "noise" in a community-based, promotora-centered mental health intervention.

PubMed

Getrich, Christina; Heying, Shirley; Willging, Cathleen; Waitzkin, Howard

2007-07-01

Community-based health interventions have emerged as a growing focus for anthropological research. The application of ethnographic approaches in clinical practice settings reveals that community-based interventions must grapple with "noise," or unanticipated factors such as patients' own perceptions of illness and treatment, primary care providers' non-adherence to guidelines-based treatment, the social dynamics of the clinic site itself, and incomplete understanding and acceptance of an intervention by a clinic's staff members. Such noise can influence the implementation and quality of treatment. Thus, identifying clinic-based noise is critical in assessments of fidelity to intervention protocols as well as outcomes of community-based interventions. This paper highlights findings from an evaluation of a mental health intervention focusing on the role of promotoras (briefly trained, non-professional community health workers) as mental health practitioners in two urban New Mexico, USA, community health centers. Our research identified three areas of clinic-based noise: the clinics' physical ability to "absorb" the intervention, the challenges of co-worker instability and interpersonal relationships, and balancing extra workplace demands. The findings demonstrate the value of ethnographic approaches in community-based intervention research.

"It's Kind of a Dichotomy": Thoughts Related to Calling and Purpose from Pastors Working and Counseling in Urban Resource-Poor Communities.

PubMed

Payne, Jennifer Shepard

2017-08-01

Pastors serving low-income urban areas are first-responders to emotional issues by default, since fewer mental health resources are available. Thus, it is important to understand how pastors serving urban resource-poor areas reflect on their counseling role. Forty-eight Black, Hispanic, and White pastors with urban congregations in Los Angeles or Chicago reflect on their pastoral calling and its relation to their counseling role. Through phenomenology, the pastors' lived experiences as they counseled in an urban context were explored. Analysis revealed complex feelings about their counseling role in light of their resource-poor environments. Recommendations are provided based on the findings.

A University--School Partnership to Examine the Adoption and Implementation of the Ohio Community Collaboration Model in One Urban School District: A Mixed-Method Case Study

ERIC Educational Resources Information Center

Anderson-Butcher, Dawn; Iachini, Aidyn L.; Ball, Annahita; Barke, Susan; Martin, Lloyd D.

2016-01-01

School improvement models are expanding to incorporate priorities around positive youth development, safe and supportive school climates, school mental health, and school-family community partnerships. A partnership was formed between researchers and district/school leaders to examine the 3-year adoption and implementation of 1 such exemplary…

The Impact of Community Design and Land-Use Choices on Public Health: A Scientific Research Agenda

PubMed Central

Dannenberg, Andrew L.; Jackson, Richard J.; Frumkin, Howard; Schieber, Richard A.; Pratt, Michael; Kochtitzky, Chris; Tilson, Hugh H.

2003-01-01

The design of a community’s built environment influences the physical and mental health of its residents. Because few studies have investigated this relationship, the Centers for Disease Control and Prevention hosted a workshop in May 2002 to help develop a scientific research agenda on these issues. Workshop participants’ areas of expertise included physical activity, injury prevention, air pollution, water quality, urban planning, transportation, architecture, epidemiology, land use, mental health, social capital, housing, and social marketing. This report describes the 37 questions in the resulting research agenda. The next steps are to define priorities and obtain resources. The proposed research will help identify the best practices for designing new communities and revitalizing old ones in ways that promote physical and mental health. PMID:12948970

Child and youth telepsychiatry in rural and remote primary care.

PubMed

Pignatiello, Antonio; Teshima, John; Boydell, Katherine M; Minden, Debbie; Volpe, Tiziana; Braunberger, Peter G

2011-01-01

Young people with psychological or psychiatric problems are managed largely by primary care practitioners, many of whom feel inadequately trained, ill equipped, and uncomfortable with this responsibility. Accessing specialist pediatric and psychological services, often located in and near large urban centers, is a particular challenge for rural and remote communities. Live interactive videoconferencing technology (telepsychiatry) presents innovative opportunities to bridge these service gaps. The TeleLink Mental Health Program at The Hospital for Sick Children in Toronto offers a comprehensive, collaborative model of enhancing local community systems of care in rural and remote Ontario using videoconferencing. With a focus on clinical consultation, collaborative care, education and training, evaluation, and research, ready access to pediatric psychiatrists and other specialist mental health service providers can effectively extend the boundaries of the medical home. Medical trainees in urban teaching centers are also expanding their knowledge of and comfort level with rural mental health issues, various complementary service models, and the potentials of videoconferencing in providing psychiatric and psychological services. Committed and enthusiastic champions, a positive attitude, creativity, and flexibility are a few of the necessary attributes ensuring viability and integration of telemental health programs. Copyright © 2011 Elsevier Inc. All rights reserved.

Case managers and the use of Medicare, Part D.

PubMed

Hensley, Melissa Anne

2011-01-01

The purpose of this study was to examine the experiences and opinions of community-based mental health case managers with the Medicare prescription drug benefit. A qualitative approach, consisting of analysis of data from 3 case manager focus groups, was used to achieve an understanding of the role that case managers played in beneficiaries' access to and use of prescription medicines. Two urban nonprofit community-based mental health agencies. Adults who are disabled by mental illness depend on case managers for information about their prescription drug insurance, help with formulary and plan switching information, and assistance with tasks related to medication adherence in the community. Common themes in the case managers' discussion were managing beneficiary problems, stress for beneficiaries, information and paperwork issues, and cynicism regarding health care reform. The critical role of case managers in the use of Medicare Part D is not well understood or appreciated. Case managers need to be informed about Medicare Part D and ready to advocate for their clients in the community. In addition, it is important for case managers to understand how Medicare Part D affects not only older adults, but also adults living with serious and persistent mental illness.

The theatre: an effective tool for health promotion.

PubMed

Seguin, A; Rancourt, C

1996-01-01

In Africa and in North America, in both rural and urban settings, theatre can be an effective means of health promotion. Projects on women's health, care for patients with mental disorders, and AIDS prevention show the usefulness of this medium for community action programmes.

24 CFR 576.400 - Area-wide systems coordination requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

...): (8) Head Start (45 CFR chapter XIII, subchapter B); (9) Mental Health and Substance Abuse Block..., if any, on the homelessness prevention or rapid re-housing assistance that each program participant... HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SOLUTIONS GRANTS PROGRAM Program Requirements...

24 CFR 576.400 - Area-wide systems coordination requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

...): (8) Head Start (45 CFR chapter XIII, subchapter B); (9) Mental Health and Substance Abuse Block..., if any, on the homelessness prevention or rapid re-housing assistance that each program participant... HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SOLUTIONS GRANTS PROGRAM Program Requirements...

24 CFR 576.400 - Area-wide systems coordination requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

...): (8) Head Start (45 CFR chapter XIII, subchapter B); (9) Mental Health and Substance Abuse Block..., if any, on the homelessness prevention or rapid re-housing assistance that each program participant... HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SOLUTIONS GRANTS PROGRAM Program Requirements...

Primary care and youth mental health in Ireland: qualitative study in deprived urban areas

PubMed Central

2013-01-01

Background Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15–24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people’s unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that primary care is well placed to address mental and substance use disorders in young people especially in deprived urban areas. This study aims to describe healthcare professionals’ experience and attitudes towards screening and early intervention for mental and substance use disorders among young people (16–25 years) in primary care in deprived urban settings in Ireland. Methods The chosen method for this qualitative study was inductive thematic analysis which involved semi-structured interviews with 37 healthcare professionals from primary care, secondary care and community agencies at two deprived urban centres. Results We identified three themes in respect of interventions to increase screening and treatment: (1) Identification is optimised by a range of strategies, including raising awareness, training, more systematic and formalised assessment, and youth-friendly practices (e.g. communication skills, ensuring confidentiality); (2) Treatment is enhanced by closer inter-agency collaboration and training for all healthcare professionals working in primary care; (3) Ongoing engagement is enhanced by motivational work with young people, setting achievable treatment goals, supporting transition between child and adult mental health services and recognising primary care’s longitudinal nature as a key asset in promoting treatment engagement. Conclusions Especially in deprived areas, primary care is central to early intervention for youth mental health. Identification, treatment and continuing engagement are likely to be enhanced by a range of strategies with young people, healthcare professionals and systems. Further research on youth mental health and primary care, including qualitative accounts of young people’s experience and developing complex interventions that promote early intervention are priorities. (350 words) PMID:24341616

Schooling and Children's Mental Health: Realigning Resources to Reduce Disparities and Advance Public Health.

PubMed

Atkins, Marc S; Cappella, Elise; Shernoff, Elisa S; Mehta, Tara G; Gustafson, Erika L

2017-05-08

Schools have long been the primary setting for children's mental health services but have neither the resources nor the expertise to manage these services independently. The critical importance of school success for children's adjustment provides a strong rationale for schooling as an essential component of children's mental health services. In this article, we review evidence for how schooling and mental health coalesce, suggesting an alignment of school and community mental health resources that prioritizes successful schooling as a key mental health outcome. We describe collaborative principles and ecological practices that advance a public health focus on children's mental health while also reducing the burden on schools to maintain mental health services. We close with a model of mental health services illustrating these principles and practices in high-poverty urban schools and propose future directions for research and practice to promote positive mental health for all children and youth.

Effects of labeling and interpersonal contact upon attitudes towards schizophrenia: implications for reducing mental illness stigma in urban China

PubMed Central

Lo, Graciete; WonPat-Borja, Ahtoy J.; Singla, Daisy R.; Link, Bruce G.; Phillips, Michael R.

2013-01-01

Purpose As mental illness stigma contributes to poor outcomes for schizophrenia in China, locating strategies to reduce public stigma is imperative. It is currently unknown whether diagnostic labeling and contact with different help-seeking sources increase or decrease public stigma in China. Further, it remains unresolved whether prior personal contact acts to reduce stigma in this context. Advancing understanding of these processes may facilitate stigma-reduction strategies. Methods We administered an experimental vignette randomly assigning one of four labeling conditions to respondents to assess social distance towards a psychotic vignette individual in a sample of 160 Northern, urban Chinese community respondents. Results As expected, respondents given a “non-psychiatric, indigenous label” + “lay help-seeking” condition endorsed the least social distance. Unexpectedly, the labeling condition with a “psychiatric diagnostic label” + “lay help-seeking” condition elicited the greatest social distance. Unlike Western studies, personal contact did not independently decrease community stigma. However, prior contact reduced social distance to a greater extent in the labeling condition with a “non-psychiatric, indigenous label” + “lay help-seeking” condition when compared with all other labeling conditions. Conclusion The results indicate that cultural idioms do provide some protection from stigma, but only among respondents who are already familiar with what mental illness is. Our finding that the condition that depicted untreated psychosis elicited the greatest amount of stigma, while the “treated psychosis” condition was viewed relatively benignly in China, suggests that improved access to mental health services in urban China has the potential to decrease public stigma via labeling mechanisms. PMID:22075964

Population Density and AIDS-Related Stigma in Large-Urban, Small-Urban, and Rural Communities of the Southeastern USA.

PubMed

Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira

2017-07-01

AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.

Co-occurring substance use and mental disorders in the criminal justice system: a new frontier of clinical practice and research.

PubMed

Peters, Roger H; Wexler, Harry K; Lurigio, Arthur J

2015-03-01

This editorial introduces this special section of the Psychiatric Rehabilitation Journal, which focuses on justice-involved persons with co-occurring mental and substance use disorders (CODs). It contains seven original articles examining CODs among justice-involved populations that vary by gender, age, setting (e.g., community/ court, jail, prison), environment (urban, rural), geographic region, and nationality. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Mental Health Among Help-Seeking Urban Women: The Relationships Between Adverse Childhood Experiences, Sexual Abuse, and Suicidality.

PubMed

Hamdullahpur, Kevin; Jacobs, Kahá Wi J; Gill, Kathryn J

2018-03-01

Adverse childhood experiences (ACEs) and adult mental health were explored in a sample of urban Aboriginal ( n = 83) and non-Aboriginal ( n = 89) women. Childhood sexual abuse (CSA) was associated with negative home environments, teenage pregnancy, lifetime suicide attempts, and treatment seeking. Aboriginal women with CSA witnessed higher levels of physical/sexual abuse of family members. The severity of current psychological distress was associated with a history of childhood neglect. The results indicate that CSA rarely occurs in isolation, and that multiple ACEs are strongly associated with suicide attempts and treatment seeking in adulthood. Future studies should focus on the role of CSA in suicidality, as well as familial, community, and cultural protective factors.

Intersections between polyvictimisation and mental health among adolescents in five urban disadvantaged settings: the role of gender.

PubMed

Kamndaya, Mphatso; Pisa, Pedro T; Chersich, Matthew F; Decker, Michele R; Olumide, Adesola; Acharya, Rajib; Cheng, Yan; Brahmbhatt, Heena; Delany-Moretlwe, Sinead

2017-07-04

Polyvictimisation (PV) - exposure to violence across multiple contexts - causes considerable morbidity and mortality among adolescents. Despite high levels of violence in urban disadvantaged settings, gender differences in associations between PV and mental health have not been well established. We analysed data from a survey with 2393 adolescents aged 15-19 years, recruited using respondent-driven sampling from urban disadvantaged settings in Baltimore (USA), Delhi (India), Ibadan (Nigeria), Johannesburg (South Africa) and Shanghai (China). PV was defined as exposure to two or more types of violence in the past 12 months with family, peers, in the community, or from intimate partners and non-partner sexual violence. Weighted logistic regression models are presented by gender to evaluate whether PV is associated with posttraumatic stress, depression, suicidal thoughts and perceived health status. PV was extremely common overall, but ranged widely, from 74.5% of boys and 82.0% of girls in Johannesburg, to 25.8 and 23.9% respectively in Shanghai. Community violence was the predominant violence type, affecting 72.8-93.7% across the sites. More than half of girls (53.7%) and 45.9% of boys had at least one adverse mental health outcome. Compared to those that did not report violence, boys exposed to PV had 11.4 higher odds of having a negative perception of health (95%CI adjusted OR = 2.45-53.2), whilst this figure was 2.58 times in girls (95%CI = 1.62-4.12). Among girls, PV was associated with suicidal thoughts (adjusted OR = 4.68; 95%CI = 2.29-9.54), posttraumatic stress (aOR = 4.53; 95%CI = 2.44-8.41) and depression (aOR = 2.65; 95%CI = 1.25-5.63). Among boys, an association was only detected between PV and depression (aOR = 1.82; 95%CI = 1.00-3.33). The findings demonstrate that PV is common among both sexes in urban disadvantaged settings across the world, and that it is associated with poor mental health outcomes in girls, and with poor health status in both girls and boys. Clearly, prevention interventions are failing to address violence exposure across multiple contexts, but especially within community settings and in Johannesburg. Interventions are needed to identify adolescents exposed to PV and link them to care, with services targeting a range of mental health conditions among girls and perhaps focusing on depression among boys.

An Olympic Legacy? Did the Urban Regeneration Associated With the London 2012 Olympic Games Influence Adolescent Mental Health?

PubMed

Clark, Charlotte; Smuk, Melanie; Cummins, Steven; Eldridge, Sandra; Fahy, Amanda; Lewis, Daniel; Moore, Derek G; Smith, Neil; Taylor, Stephanie J C; Stansfeld, Stephen A

2018-03-01

Public expenditure on large events such as the London 2012 Olympic Games is often justified by the potential legacy of urban regeneration and its associated health and well-being benefits for local communities. In the Olympic Regeneration in East London Study, we examined whether there was an association between urban regeneration related to the 2012 Games and improved mental health in young people. Adolescents aged 11-12 years attending schools in the Olympic host borough of Newham in London or in 3 adjacent comparison London boroughs completed a survey before the 2012 Games and 6 and 18 months after the Games (in 2013 and 2014, respectively). Changes in depressive symptoms and well-being between baseline and each follow-up were examined. A total of 2,254 adolescents from 25 randomly selected schools participated. Adolescents from Newham were more likely to have remained depressed between baseline and the 6- and 18-month follow-up surveys (for 6-month follow-up, relative risk = 1.78, 95% confidence interval: 1.12, 2.83; for 18-month follow-up, relative risk = 1.93, 95% confidence interval: 1.01, 3.70) than adolescents from the comparison boroughs. No differences in well-being were observed. There was little evidence that urban regeneration had any positive influence on adolescent mental health and some suggestion that regeneration may have been associated with maintenance of depressive symptoms. Such programs may have limited short-term impact on the mental health of adolescents.

Easier Said than Done: Intervention Sustainability in an Urban After-School Program

PubMed Central

Frazier, Stacy L.; Mehta, Tara; Atkins, Marc S.; Weisbach, Jessica

2011-01-01

Although sustainability is frequently described as a project goal in community-based programs, concentrated efforts to sustain interventions beyond the conclusion of research funding have only recently emerged as a focus of implementation research. The current paper describes a study of behavioral consultation to after-school program staff in low-SES, urban communities. Following consultation, staff use of four recommended tools and strategies was examined, emphasizing facilitators and barriers to sustainability. Results indicated high perceived utility and intention to use intervention components, but low sustainability at two follow-up time points within 1 year after the initial consultation concluded. Findings suggest that ongoing implementation support in community settings may be necessary to ensure the sustainability of interventions and meet the mental health needs of participating high-risk youth. PMID:21416160

Implementing a comprehensive program for the prevention of conduct problems in rural communities: the Fast Track experience. The Conduct Problems Prevention Research Group.

PubMed

Bierman, K L

1997-08-01

Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program.

Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience1

PubMed Central

Bierman, Karen L.

2012-01-01

Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program. PMID:9338956

Some implications of a community mental health model for developing countries.

PubMed

Mehryar, A; Khajavi, F

The aim of this paper is to call attention to certain problems facing many developing countries which are bound to lead to further difficulties in psychosocial adjustment. Almost all these problems are inherent in the process of socioeconomic change, urbanization, and industrialization. These changes may not only lead to an increase in the rate of mental illness, but because of their impact on the basic family structure and living conditions, will result in a reduced tolerance of deviation on the part of the community. Moreover, the spread of public education and mass media is also likely to lead to a change in the expectations and attitudes of developing nations making it no longer possible to endure psychological suffering as part of one's destiny. Even the improvement of public health services leading to reduction of infant mortality and a rise in life expectancy may lead to a gross increase in demands for mental health services by the very young and the aged sections of the population. It is the contention of this paper that a community mental health model, with certain modifications to fit the local culture, will best serve the increasing mental health needs of developing nations. Of particular relevance are such aspects of the model as population and prevention orientation, community involvement, extension of prefessional resources through consultation, utilization of non-professional manpower, continuity and comprehensiveness of care as well as an open systems conceptualization of the whole process of the organization and delivery of mental health services. The latter approach will help bring about an integration of mental health services within the wider framework of human service agencies, e.g., public health, general and adult education, family planning, and community development.

"Symptoms of something all around us": Mental health, Inuit culture, and criminal justice in Arctic communities in Nunavut, Canada.

PubMed

Ferrazzi, Priscilla; Krupa, Terry

2016-09-01

Rehabilitation-oriented criminal court mental health initiatives to reduce the number of people with mental illness caught in the criminal justice system exist in many North American cities and elsewhere but not in the mainly Inuit Canadian Arctic territory of Nunavut. This study explores whether the therapeutic aims of these resource-intensive, mainly urban initiatives can be achieved in criminal courts in Nunavut's resource constrained, culturally distinct and geographically remote communities. A qualitative multiple-case study in the communities of Iqaluit, Arviat and Qikiqtarjuaq involved 55 semi-structured interviews and three focus groups with participants representing four sectors essential to these initiatives: justice, health, community organizations and community members. These interviews explored whether the therapeutic jurisprudence (TJ) principles that guide criminal court mental health initiatives and the component objectives of these principles could be used to improve the criminal court response to people with mental illness in Nunavut. Interviews revealed 13 themes reflecting perceptions of Inuit culture's influence on the identification of people with mental illness, treatment, and collaboration between the court and others. These themes include cultural differences in defining mental illness, differences in traditional and contemporary treatment models, and the importance of mutual cultural respect. The findings suggest Inuit culture, including its recent history of cultural disruption and change, affects the vulnerability of Nunavut communities to the potential moral and legal pitfalls associated with TJ and criminal court mental health initiatives. These pitfalls include the dominance of biomedical approaches when identifying a target population, the medicalization of behaviour and culture, the risk of "paternalism" in therapeutic interventions, and shortcomings in interdisciplinary collaboration that limit considerations of Inuit culture. The pitfalls are not fatal to efforts to bring the rehabilitative benefits of these initiatives to Nunavut, but they require careful vigilance when employing TJ principles in an Indigenous circumpolar context. Copyright © 2016. Published by Elsevier Ltd.

Help-Seeking Behaviors and Depression among African American Adolescent Boys

ERIC Educational Resources Information Center

Lindsey, Michael A.; Korr, Wynne S.; Broitman, Marina; Bone, Lee; Green, Alan; Leaf, Philip J.

2006-01-01

This study examined the help-seeking behaviors of depressed, African American adolescents. Qualitative interviews were conducted with 18 urban, African American boys, ages 14 to 18, who were recruited from community-based mental health centers and after-school programs for youths. Interviews covered sociodemographic information, questions…

The relationship between urban forests and race: A meta-analysis

PubMed Central

Watkins, Shannon Lea; Gerrish, Ed

2018-01-01

There is ample evidence that urban trees benefit the physical, mental, and social health of urban residents. The environmental justice hypothesis posits that environmental amenities are inequitably low in poor and minority communities, and predicts these communities experience fewer urban environmental benefits. Some previous research has found that urban forest cover is inequitably distributed by race, though other studies have found no relationship or negative inequity. These conflicting results and the single-city nature of the current literature suggest a need for a research synthesis. Using a systematic literature search and meta-analytic techniques, we examined the relationship between urban forest cover and race. First, we estimated the average (unconditional) relationship between urban forest cover and race across studies (studies = 40; effect sizes = 388). We find evidence of significant race-based inequity in urban forest cover. Second, we included characteristics of the original studies and study sites in meta-regressions to illuminate drivers of variation of urban forest cover between studies. Our meta-regressions reveal that the relationship varies across racial groups and by study methodology. Models reveal significant inequity on public land and that environmental and social characteristics of cities help explain variation across studies. As tree planting and other urban forestry programs proliferate, urban forestry professionals are encouraged to consider the equity consequences of urban forestry activities, particularly on public land. PMID:29289843

The relationship between urban forests and race: A meta-analysis.

PubMed

Watkins, Shannon Lea; Gerrish, Ed

2018-03-01

There is ample evidence that urban trees benefit the physical, mental, and social health of urban residents. The environmental justice hypothesis posits that environmental amenities are inequitably low in poor and minority communities, and predicts these communities experience fewer urban environmental benefits. Some previous research has found that urban forest cover is inequitably distributed by race, though other studies have found no relationship or negative inequity. These conflicting results and the single-city nature of the current literature suggest a need for a research synthesis. Using a systematic literature search and meta-analytic techniques, we examined the relationship between urban forest cover and race. First, we estimated the average (unconditional) relationship between urban forest cover and race across studies (studies = 40; effect sizes = 388). We find evidence of significant race-based inequity in urban forest cover. Second, we included characteristics of the original studies and study sites in meta-regressions to illuminate drivers of variation of urban forest cover between studies. Our meta-regressions reveal that the relationship varies across racial groups and by study methodology. Models reveal significant inequity on public land and that environmental and social characteristics of cities help explain variation across studies. As tree planting and other urban forestry programs proliferate, urban forestry professionals are encouraged to consider the equity consequences of urban forestry activities, particularly on public land. Copyright © 2017. Published by Elsevier Ltd.

Assessing environmental features related to mental health: a reliability study of visual streetscape images.

PubMed

Wu, Yu-Tzu; Nash, Paul; Barnes, Linda E; Minett, Thais; Matthews, Fiona E; Jones, Andy; Brayne, Carol

2014-10-22

An association between depressive symptoms and features of built environment has been reported in the literature. A remaining research challenge is the development of methods to efficiently capture pertinent environmental features in relevant study settings. Visual streetscape images have been used to replace traditional physical audits and directly observe the built environment of communities. The aim of this work is to examine the inter-method reliability of the two audit methods for assessing community environments with a specific focus on physical features related to mental health. Forty-eight postcodes in urban and rural areas of Cambridgeshire, England were randomly selected from an alphabetical list of streets hosted on a UK property website. The assessment was conducted in July and August 2012 by both physical and visual image audits based on the items in Residential Environment Assessment Tool (REAT), an observational instrument targeting the micro-scale environmental features related to mental health in UK postcodes. The assessor used the images of Google Street View and virtually "walked through" the streets to conduct the property and street level assessments. Gwet's AC1 coefficients and Bland-Altman plots were used to compare the concordance of two audits. The results of conducting the REAT by visual image audits generally correspond to direct observations. More variations were found in property level items regarding physical incivilities, with broad limits of agreement which importantly lead to most of the variation in the overall REAT score. Postcodes in urban areas had lower consistency between the two methods than rural areas. Google Street View has the potential to assess environmental features related to mental health with fair reliability and provide a less resource intense method of assessing community environments than physical audits.

Community perceptions of mental health needs: a qualitative study in the Solomon Islands

PubMed Central

Blignault, Ilse; Bunde-Birouste, Anne; Ritchie, Jan; Silove, Derrick; Zwi, Anthony B

2009-01-01

Background Psychosocial and mental health needs in the aftermath of conflict and disaster have attracted substantial attention. In the Solomon Islands, the conceptualisation of mental health, for several decades regarded by policy makers as primarily a health issue, has broadened and been incorporated into the national development and social policy agendas, reflecting recognition of the impact of conflict and rapid social change on the psychosocial wellbeing of the community as a whole. We sought to understand how mental health and psychosocial wellbeing were seen at the community level, the extent to which these issues were identified as being associated with periods of 'tension', violence and instability, and the availability of traditional approaches and Ministry of Health services to address these problems. Methods This article reports the findings of qualitative research conducted in a rural district on the island of Guadalcanal in the Solomon Islands. Key informant interviews were conducted with community leaders, and focus groups were held with women, men and young people. Wellbeing was defined broadly. Results Problems of common concern included excessive alcohol and marijuana use, interpersonal violence and abuse, teenage pregnancy, and lack of respect and cooperation. Troubled individuals and their families sought help for mental problems from various sources including chiefs, church leaders and traditional healers and, less often, trauma support workers, health clinic staff and police. Substance-related problems presented special challenges, as there were no traditional solutions at the individual or community level. Severe mental illness was also a challenge, with few aware that a community mental health service existed. Contrary to our expectations, conflict-related trauma was not identified as a major problem by the community who were more concerned about the economic and social sequelae of the conflict. Conclusion Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation. The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context. PMID:19284638

Examining the relationship between social support availability, urban center size, and self-perceived mental health of recent immigrants to Canada: a mixed-methods analysis.

PubMed

Chadwick, Kathryn A; Collins, Patricia A

2015-03-01

The experiences of settlement in a new country (e.g., securing housing and employment, language barriers) pose numerous challenges for recent immigrants that can impede their health and well-being. Lack of social support upon arrival and during settlement may help to explain why immigrant mental health status declines over time. While most urban centers in Canada offer some settlement services, little is known about how the availability of social supports, and the health statuses of recent immigrants, varies by city size. The objective of this mixed-methods study was to examine the relationship between self-perceived mental health (SPMH), social support availability, and urban center size, for recent immigrants to Canada. The quantitative component involved analysis of 2009-2010 Canadian Community Health Survey data, selecting for only recent immigrants and for those living in either large or small urban centers. The qualitative component involved in-depth interviews with managers of settlement service organizations located in three large and three small urban centers in Canada. The quantitative analysis revealed that social support availability is positively associated with higher SPMH status, and is higher in small urban centers. In support of these findings, our interviews revealed that settlement service organizations operating in small urban centers offer more intensive social supports; interviewees attributed this difference to personal relationships in small cities, and the ease with which they can connect to other agencies to provide clients with necessary supports. Logistic regression analysis revealed, however, that recent immigrants in small urban centers are twice as likely to report low SPMH compared to those living in large urban centers. Thus, while the scope and nature of settlements services appears to vary by city size in Canada, more research is needed to understand what effect settlement services have on the health status of recent immigrants to Canada, especially in smaller urban centers. Copyright © 2015. Published by Elsevier Ltd.

Parenting style, individuation, and mental health of Egyptian adolescents.

PubMed

Dwairy, Marwan; Menshar, Kariman E

2006-02-01

Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female adolescents. In urban communities, on the other hand, the authoritarian style was more predominant in the parenting of female adolescents. The connectedness of all female adolescents with their family was stronger than that of male adolescents. The connectedness of girls was found to be more emotional and financial in villages and to be more functional in town. Female adolescents reported a higher frequency of psychological disorders. Mental health was associated with authoritative parenting, but not with authoritarian parenting. It seems that authoritarian parenting within an authoritarian culture is not as harmful as within a liberal culture.

Differences in Caregiver-Reported Health Problems and Health Care Use in Maltreated Adolescents and a Comparison Group from the Same Urban Environment

PubMed Central

Schneiderman, Janet U.; Kools, Susan; Negriff, Sonya; Smith, Sharon; Trickett, Penelope K.

2014-01-01

Maltreated youth have a high prevalence of acute and chronic mental and physical health problems, but it is not clear whether these problems are related to maltreatment or to a disadvantaged environment. To compare health status and health care use of maltreated youth receiving child protective services to comparison youth living in the same community, we conducted a secondary analysis of caregiver reports for 207 maltreated adolescents (mean age 11.9 years) and 142 comparison adolescents (mean age 12.3 years) living in urban Los Angeles, using questionnaire data from a larger longitudinal study framed in a socio-ecological model. Caregivers included biological parents, relatives, and unrelated caregivers. Analyses included t-test, MANOVA, chi-square, and multivariable logistic regression. Caregivers reported similar rates of physical health problems but more mental health problems and psychotropic medicine use in maltreated youth than in the comparison youth, suggesting that maltreated youths’ higher rates of mental health problems could not be attributed to the disadvantaged environment. Although there were no differences in health insurance coverage, maltreated youth received preventive medical care more often than comparison youth. For all youth, having Medicaid improved their odds of receiving preventive health and dental care. Attention to mental health issues in adolescents receiving child welfare services remains important. Acceptance of Medicaid by neighborhood-based and/or school-based services in low-income communities may reduce barriers to preventive care. PMID:25557881

Mental health professional experiences of the flexible assertive community treatment model: a grounded theory study.

PubMed

Lexén, Annika; Svensson, Bengt

2016-08-01

Despite the lack of evidence for effectiveness of the Flexible Assertive Community Treatment (Flexible ACT), the model is considered feasible and is well received by mental health professionals. No current studies have adequately examined mental health professional experiences of working with Flexible ACT. The aim of this study was to explore mental health professional experiences of working with the Flexible ACT model compared with standard care. The study was guided by grounded theory and based on the interviews with 19 theoretically chosen mental health professionals in Swedish urban areas primarily working with consumers with psychosis, who had worked with the Flexible ACT model for at least 6 months. The analysis resulted in the core category: "Flexible ACT and the shared caseload create a common action space" and three main categories: (1) "Flexible ACT fills the need for a systematic approach to crisis intervention"; (2) "Flexible ACT has advantages in the psychosocial working environment"; and (3) "Flexible ACT increases the quality of care". Mental health professionals may benefit from working with the Flexible ACT model through decreased job-strain and stress, increased feeling of being in control over their work situation, and experiences of providing higher quality of care.

Positive Attitude Change toward Psychiatry in Pharmacy Students Following an Active Learning Psychopharmacology Course

ERIC Educational Resources Information Center

Einat, Haim; George, Angela

2008-01-01

Objective: Psychiatric care in many rural communities has been demonstrated to be less adequate compared with urban environments partially because of attitudes and stigmatization issues. Educated pharmacists with professional attitudes can have a major impact in helping mental health patients receive more accurate diagnostic assessments and safe…

Stimulus Generalization of Parenting Skills during Parent-Child Interaction Therapy

ERIC Educational Resources Information Center

Naik-Polan, Anjali T.; Budd, Karen S.

2008-01-01

This study investigated the generalization of parenting skills to the home from PCIT delivered in a community mental health setting with four urban, low-income, single mothers at risk for child maltreatment. Using a multiple baseline design and direct observation in the home, the research examined changes in positive attention skills (praise,…

Building a national model of public mental health preparedness and community resilience: validation of a dual-intervention, systems-based approach.

PubMed

McCabe, O Lee; Semon, Natalie L; Thompson, Carol B; Lating, Jeffrey M; Everly, George S; Perry, Charlene J; Moore, Suzanne Straub; Mosley, Adrian M; Links, Jonathan M

2014-12-01

Working within a series of partnerships among an academic health center, local health departments (LHDs), and faith-based organizations (FBOs), we validated companion interventions to address community mental health planning and response challenges in public health emergency preparedness. We implemented the project within the framework of an enhanced logic model and employed a multi-cohort, pre-test/post-test design to assess the outcomes of 1-day workshops in psychological first aid (PFA) and guided preparedness planning (GPP). The workshops were delivered to urban and rural communities in eastern and midwestern regions of the United States. Intervention effectiveness was based on changes in relevant knowledge, skills, and attitudes (KSAs) and on several behavioral indexes. Significant improvements were observed in self-reported and objectively measured KSAs across all cohorts. Additionally, GPP teams proved capable of producing quality drafts of basic community disaster plans in 1 day, and PFA trainees confirmed upon follow-up that their training proved useful in real-world trauma contexts. We documented examples of policy and practice changes at the levels of local and state health departments. Given appropriate guidance, LHDs and FBOs can implement an effective and potentially scalable model for promoting disaster mental health preparedness and community resilience, with implications for positive translational impact.

CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

PubMed

Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

2018-05-01

The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

Assessing the Relationship between Parental Influences and Wellbeing among Low Income African American Adolescents in Chicago

ERIC Educational Resources Information Center

Voisin, Dexter R.; Harty, Justin; Kim, Dong Ha; Elsaesser, Caitlin; Takahashi, Lois M.

2017-01-01

Background: African American youth in urban centers often reside in poorly resourced communities and face structural disadvantage, which can result in higher rates of poor behavioral health factors such as mental health problems, juvenile justice system involvement, substance use, risky sex and lower school engagement. While parental monitoring…

Feasibility, Acceptability, and Initial Efficacy of a Knowledge-Contact Program to Reduce Mental Illness Stigma and Improve Mental Health Literacy in Adolescents

PubMed Central

Pinto-Foltz, Melissa D.; Logsdon, M. Cynthia; Myers, John A.

2011-01-01

The purpose of this school-based cluster-randomized trial was to determine the initial acceptability, feasibility, and efficacy of an existing community-based intervention, In Our Own Voice, in a sample of US adolescent girls aged 13–17 years (n=156). In Our Own Voice is a knowledge-contact intervention that provides knowledge about mental illness to improve mental health literacy and facilitates intergroup contact with persons with mental illness as a means to reduce mental illness stigma. This longitudinal study was set in two public high schools located in a southern urban community of the U.S. Outcomes included measures of mental illness stigma and mental health literacy. Findings support the acceptability and feasibility of the intervention for adolescents who enrolled in the study. Findings to support the efficacy of In Our Own Voice to reduce stigma and improve mental health literacy are mixed. The intervention did not reduce mental illness stigma or improve mental health literacy at one week follow up. The intervention did not reduce mental illness stigma at 4 and 8 weeks follow up. The intervention did improve mental health literacy at 4 and 8 weeks follow up. Previous studies have assessed the preliminary efficacy In Our Own Voice among young adults; rarely has In Our Own Voice been investigated longitudinally and with adolescents in the United States. This study provides initial data on the effects of In Our Own Voice for this population and can be used to further adapt the intervention for adolescents. PMID:21624729

Predictors of Mental Health Resilience in Children who Have Been Parentally Bereaved by AIDS in Urban South Africa.

PubMed

Collishaw, Stephan; Gardner, Frances; Lawrence Aber, J; Cluver, Lucie

2016-05-01

Children parentally bereaved by AIDS experience high rates of mental health problems. However, there is considerable variability in outcomes, and some show no mental health problems even when followed over time. Primary aims were to identify predictors of resilient adaptation at child, family and community levels within a group of AIDS-orphaned children, and to consider their cumulative influence. A secondary aim was to test whether predictors were of particular influence among children orphaned by AIDS relative to non-orphaned and other-orphaned children. AIDS-orphaned (n = 290), other-orphaned (n = 163) and non-orphaned (n = 202) adolescents living in informal settlements in Cape Town, South Africa were assessed on two occasions 4 years apart (mean age 13.5 years at Time 1, range = 10-19 years). Self-report mental health screens were used to operationalise resilience in AIDS-orphaned children as the absence of clinical-range symptoms of PTSD, anxiety, depression, conduct problems, and suicidality. A quarter of AIDS-orphaned children (24 %) showed no evidence of mental health problems at either wave. Child physical health, better caregiving quality, food security, better peer relationship quality, and lower exposure to community violence, bullying or stigma at baseline predicted sustained resilience. There were cumulative influences across predictors. Associations with mental health showed little variation by child age or gender, or between orphaned and non-orphaned children. Mental health resilience is associated with multiple processes across child, family and community levels of influence. Caution is needed in making causal inferences.

Psychosocial well-being of people living with HIV and the community before and after a HIV stigma-reduction community "hub" network intervention.

PubMed

Prinsloo, Catharina D; Greeff, Minrie; Kruger, Annamarie; Ellis, Suria

2016-09-01

The purpose of the research was to determine whether an HIV stigma-reduction community "hub" network intervention in a South African urban area would bring about a difference in the psychosocial well-being of people living with HIV (PLWH), as well as their community (living in the same municipal ward). A single case pre-test post-test design was implemented. The sample for this study included 62 PLWH who were selected through accessibility sampling and 570 community members who were selected through random voluntary sampling. Participants completed the Patient Health Questionnaire (PHQ-9) and the Mental Health Continuum-Short Form (MHC-SF) before and after the intervention. A dependent t-test as well as Cohen's d-values were used to calculate the differences between the pre- and post-test results for depression and well-being. Levels of languishing, moderate mental health and flourishing before and after the intervention were determined. Although the focus of the HIV stigma-reduction community "hub" intervention that was followed in this study was on the involvement of PLWH and people living close to them (PLC) to share their knowledge as community mobilisers and to mobilise and empower their own community to reduce HIV stigma, it can be concluded that a secondary gain was the effect it had on both depression and mental health of the PLWH as well as the community. Of interest is how these effects differed for PLWH and the community. It is thus recommended that future interventions should give special attention to aspects of depression and well-being.

Vegetarian diet and mental disorders: results from a representative community survey.

PubMed

Michalak, Johannes; Zhang, Xiao Chi; Jacobi, Frank

2012-06-07

The present study investigated associations between vegetarian diet and mental disorders. Participants were drawn from the representative sample of the German Health Interview and Examination Survey and its Mental Health Supplement (GHS-MHS). Completely vegetarian (N = 54) and predominantly vegetarian (N = 190) participants were compared with non-vegetarian participants (N = 3872) and with a non-vegetarian socio-demographically matched subsample (N = 242). Vegetarians displayed elevated prevalence rates for depressive disorders, anxiety disorders and somatoform disorders. Due to the matching procedure, the findings cannot be explained by socio-demographic characteristics of vegetarians (e.g. higher rates of females, predominant residency in urban areas, high proportion of singles). The analysis of the respective ages at adoption of a vegetarian diet and onset of a mental disorder showed that the adoption of the vegetarian diet tends to follow the onset of mental disorders. Vegetarian diet is associated with an elevated risk of mental disorders. However, there was no evidence for a causal role of vegetarian diet in the etiology of mental disorders.

Differential impacts of social support on mental health: A comparison study of Chinese rural-to-urban migrant adolescents and their urban counterparts in Beijing, China.

PubMed

Zhuang, Xiao Yu; Wong, Daniel Fu Keung

2017-02-01

The number of internal migrant children in China has reached 35.8 million by the end of 2010. Previous studies revealed inconsistent findings regarding the mental health status of rural-to-urban migrant adolescents, as well as the impact of peer, teacher and parental support on the mental health of Chinese adolescent migrants. Using a comparative approach, this study attempted to compare the mental health status between migrant and urban-born adolescents and to clarify the specific roles of different sources of social support in the mental health of migrant and urban adolescents. A cross-sectional survey using a cluster convenience sampling strategy was performed in Beijing, China. A structured questionnaire was filled out by 368 rural-to-urban migrant adolescents and 325 urban-born adolescents. A significant difference was found only for positive affect (PA) but not for negative affect (NA) between the two groups, favouring the urban-born adolescents. Social support from all the three sources were all predictive of PA among rural-to-urban migrant adolescents, while only peer support contributed to PA among urban-born adolescents. Unexpectedly, teachers' support contributed to an increase in NA among urban-born adolescents. The findings contribute to understanding of the mental health status of migrant adolescents in China and the differential impact of the various sources of social support on migrant and urban-born adolescents. Also the findings may inform the development of mental health services and programmes that can potentially benefit a large number of internal migrant adolescents in China.

Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study

PubMed Central

Reisner, Sari L.; Vetters, Ralph; Leclerc, M; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J.

2014-01-01

Purpose Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exists to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the current study aimed to fill this gap. Methods A retrospective cohort study of electronic health record (EHR) data from 180 transgender patients age 12–29 years seen between 2002–2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM to MTF youth on mental health outcomes. Results The sample (n=360) had a mean age of 19.6 (SD=3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared to cisgender matched controls, transgender youth had a two- to three-fold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p<0.05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Conclusions Transgender youth were found to have a disparity in negative mental health outcomes compared to cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. PMID:25577670

Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study.

PubMed

Reisner, Sari L; Vetters, Ralph; Leclerc, M; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J

2015-03-01

Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exist to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the present study aimed to fill this gap. A retrospective cohort study of electronic health record data from 180 transgender patients aged 12-29 years seen between 2002 and 2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM with MTF youth on mental health outcomes. The sample (N = 360) had a mean age of 19.6 years (standard deviation, 3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared with cisgender matched controls, transgender youth had a twofold to threefold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p < .05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Transgender youth were found to have a disparity in negative mental health outcomes compared with cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

History of postpartum depression and the odds of maternal corporal punishment.

PubMed

Knox, Michele; Rosenberger, Ryan; Sarwar, Sajjad; Mangewala, Vikas; Klag, Natalie

2015-12-01

Corporal punishment is closely related to physical abuse of children and is associated with several negative characteristics and experiences in children and youths. This study examined the relative unique contribution of 6 variables (social support, socioeconomic status, depression, self-efficacy, knowledge of child development, and history of postpartum depression) to maternal corporal punishment of children. A sample of 76 mothers was dichotomized into those who never spanked or hit with an object and those who have spanked or hit with an object. The mothers were recruited from a community mental health agency, an urban community center, and a court of common pleas. The measures in the present study were administered prior to mothers' participation in a parent training program. Mothers referred by the court of common pleas were mandated to participate in the parent training program, and the mothers from the community mental health agency and the urban community center volunteered to participate in the parent training program. However, all participants voluntarily completed the research measures. Binary logistic regression identified postpartum depression as the only variable to significantly increase the odds of corporal punishment (odds ratio = 6.307, 95% confidence interval = 1.098-36.214, p = .039). The findings demonstrate increased odds of corporal punishment among a high-risk sample of women with postpartum depression. The generalizability of these findings may be limited to low socioeconomic class and White and African American mothers enrolled in parent-training programs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Screening and Follow-Up Monitoring for Substance Use in Primary Care: An Exploration of Rural-Urban Variations.

PubMed

Chan, Ya-Fen; Lu, Shou-En; Howe, Bill; Tieben, Hendrik; Hoeft, Theresa; Unützer, Jürgen

2016-02-01

Rates of substance use in rural areas are close to those of urban areas. While recent efforts have emphasized integrated care as a promising model for addressing workforce shortages in providing behavioral health services to those living in medically underserved regions, little is known on how substance use problems are addressed in rural primary care settings. To examine rural-urban variations in screening and monitoring primary care- based patients for substance use problems in a state-wide mental health integration program. This was an observational study using patient registry. The study included adult enrollees (n = 15,843) with a mental disorder from 133 participating community health clinics. We measured whether a standardized substance use instrument was used to screen patients at treatment entry and to monitor symptoms at follow-up visits. While on average 73.6 % of patients were screened for substance use, follow-up on substance use problems after initial screening was low (41.4 %); clinics in small/isolated rural settings appeared to be the lowest (13.6 %). Patients who were treated for a mental disorder or substance abuse in the past and who showed greater psychiatric complexities were more likely to receive a screening, whereas patients of small, isolated rural clinics and those traveling longer distances to the care facility were least likely to receive follow-up monitoring for their substance use problems. Despite the prevalent substance misuse among patients with mental disorders, opportunities to screen this high-risk population for substance use and provide a timely follow-up for those identified as at risk remained overlooked in both rural and urban areas. Rural residents continue to bear a disproportionate burden of substance use problems, with rural-urban disparities found to be most salient in providing the continuum of services for patients with substance use problems in primary care.

Early childhood development in deprived urban settlements.

PubMed

Nair, M K C; Radhakrishnan, S Rekha

2004-03-01

Poverty, the root cause of the existence of slums or settlement colonies in urban areas has a great impact on almost all aspects of life of the urban poor, especially the all-round development of children. Examples from countries, across the globe provide evidence of improved early child development, made possible through integrated slum improvement programs, are few in numbers. The observed 2.5% prevalence of developmental delay in the less than 2 year olds of deprived urban settlements, the presence of risk factors for developmental delay like low birth weight, birth asphyxia, coupled with poor environment of home and alternate child care services, highlights the need for simple cost effective community model for promoting early child development. This review on early child development focuses on the developmental status of children in the deprived urban settlements, who are yet to be on the priority list of Governments and international agencies working for the welfare of children, the contributory nature-nurture factors and replicable working models like infant stimulation, early detection of developmental delay in infancy itself, developmental screening of toddlers, skill assessment for preschool children, school readiness programs, identification of mental sub-normality and primary education enhancement program for primary school children. Further, the review probes feasible intervention strategies through community owned early child care and development facilities, utilizing existing programs like ICDS, Urban Basic Services and by initiating services like Development Friendly Well Baby Clinics, Community Extension services, Child Development Referral Units at district hospitals and involving trained manpower like anganwadi/creche workers, public health nurses and developmental therapists. With the decentralization process the local self-government at municipalities and city corporations are financially equipped to be the prime movers to initiate, monitor and promote early child development programs, to emerge as a part and parcel of community owned sustainable development process.

The Urban Teaching Cohort: Pre-Service Training to Support Mental Health in Urban Schools

ERIC Educational Resources Information Center

Schwartz, Tammy; Dinnen, Hannah; Smith-Millman, Marissa K.; Dixon, Maressa; Flaspohler, Paul D.

2017-01-01

Supporting students' mental health needs is critical in high-poverty urban school districts where many students are at risk for mental health problems. Although teacher-student relationships are at the core of student mental health promotion in the classroom, many teacher preparation programmes do not adequately prepare pre-service teachers…

Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks.

PubMed

Al-Delaimy, W K; Webb, M

2017-06-01

The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

The Mental Health Needs of Low-Income Pregnant Teens: A Nursing-Social Work Partnership in Care

ERIC Educational Resources Information Center

Payne, Nancy A.; Anastas, Jeane W.

2015-01-01

While the rates of teen childbearing have declined in the United States, adolescents who become pregnant and decide to bear and rear their babies are often from low-income, highly stressed families and communities. This article will describe the psychosocial problems of pregnant urban teens and how exposure to interpersonal trauma and current…

Symptoms of reproductive tract infections and mental distress among women in low-income urban neighborhoods of Beirut, Lebanon.

PubMed

Khawaja, Marwan; Kaddour, Afamia; Zurayk, Huda; Choueiry, Nathalie; El-Kak, Faysal

2009-10-01

The aim of this study was to examine the association between symptoms of reproductive tract infections (RTIs) and mental distress among women residing in three low-income urban neighborhoods in Greater Beirut. A cross-sectional survey of currently married women aged 15-49 years (n = 1506) from the 2003 Urban Health Study was undertaken. The dependent variables were complaining of vaginal discharge, pelvic pain, and pain during intercourse. The main independent variable was mental distress, measured using the General Health Questionnaire-12 (GHQ). Other variables included decision-making power, "comfort" with husband, age, education, income, household wealth, employment, community of residence, displacement by war, presence of chronic disease, reported reproductive health problem, membership in any group, receipt of favor last month, and smoking. Analysis was conducted using logistic regression models on the complaint of any symptom of RTIs and on individual complaints. Forty-two percent of the interviewed women reported at least one symptom of RTIs. Vaginal discharge was the most commonly reported symptom, with 33% of currently married women complaining from it. Mental distress was significantly associated with any reported RTI symptom (odds ratio [OR] = 1.41; 95% confidence interval [CI] = 1.09-1.83), pelvic pain (OR = 2.38; CI = 1.71-3.30), vaginal discharge (OR = 1.35; CI = 1.03-1.77), and pain during intercourse (OR = 2.37; CI = 1.66-3.40) after adjusting for demographic, socioeconomic, and health risk factors. A significant association between mental distress and reported RTI symptoms was established by this study. A new approach to gynecological morbidity is needed, one that integrates biomedical and psychosocial factors into a unified framework.

The Perfect Storm: Collision of the Business of Mental Health and the Implementation of Evidence-Based Practices.

PubMed

Stewart, Rebecca E; Adams, Danielle R; Mandell, David S; Hadley, Trevor R; Evans, Arthur C; Rubin, Ronnie; Erney, Joan; Neimark, Geoffrey; Hurford, Matthew O; Beidas, Rinad S

2016-02-01

Financing has been hypothesized to be an important driver of the implementation of evidence-based practices (EBPs), yet there has been little systematic investigation of financing as a factor in EBP implementation. This column presents findings from a qualitative study of the effects of financial factors on the implementation of EBPs in a large urban publicly funded mental health system. Interviews with 33 agency leaders and 16 policy makers identified financial distress in community mental health agencies, leading to concerns about complex and expensive implementation of EBPs. Stakeholders agreed that the cost of EBP implementation should be shared between the agencies and the system; however, the stakeholders did not agree on how EBPs should be financed.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

PubMed

Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Delbaere, Kim; Daylight, Gail; Cumming, Robert G; Bennett, Hayley; Broe, Gerald A

2015-01-01

Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population. © 2015 S. Karger AG, Basel.

Use and Quality of Mental Health Services for Haitian Youth

PubMed Central

Carson, Nicholas J.; Stewart, Mark; Lin, Julia Y.; Alegria, Margarita

2011-01-01

Objective To describe the mental health service use of Haitian, African American, and non-Latino White youth in a community mental health setting. Groups are compared on adherence to treatment guidelines for attention-deficit/hyperactivity disorder (ADHD) and depressive disorders. Design Retrospective review of outpatient mental health charts (n=252) from five community sites in an urban area of the Northeastern United States. We recorded total number and treatment type of sessions during the first six months of treatment. Guideline-adherent treatments were compared and predicted after controlling for clinical need. Results Most Haitian and African American youth stopped treatment by six months, with the majority attending less than eight sessions. One third of Haitian and African American patients attended just one session. Haitians patients who presented with less severe symptoms and dysfunction were more likely to have single-session treatments. Guideline-adherent treatment for ADHD and depression was less likely for Haitians. Older patients were more likely to receive adequate depression treatment. Haitian youth were relatively underinsured, had more family separations documented, and received Adjustment Disorder diagnoses more often. Conclusions Haitian youth use outpatient mental health services in similar proportion to African American youth, and at lower rates than White youth. Guideline-adherent treatment for ADHD and depression is limited by low retention in care for Black youth. Low insurance coverage is likely an important contributor to reduced use of services, especially for Haitians. These findings are discussed in the context of providing culturally sensitive mental health care to diverse communities. PMID:22050537

The role of maternal acceptance in the relation between community violence exposure and child functioning.

PubMed

Bailey, Beth Nordstrom; Hannigan, John H; Delaney-Black, Virginia; Covington, Chandice; Sokol, Robert J

2006-02-01

Children in the United States are exposed to considerable community violence that has been linked to child functioning. However, not all those exposed, experience negative outcomes. Recent research has focused on factors that "buffer" or protect children from negative consequences of violence exposure. The purpose of this investigation was to examine the potential buffering or moderating role of maternal acceptance in the relationship between community violence exposure and internalizing and externalizing problems. Subjects were 268 urban African American first graders. Community violence exposure was significantly related to symptoms of post-traumatic stress, but did not correlate with either internalizing or externalizing problems for all children, after control for demographics, maternal mental health, and general life stress. However, children's perceptions of maternal acceptance moderated the relationship between violence exposure and internalizing and externalizing problems which included being withdrawn, anxious-depressed, and demonstrating delinquent behavior. Children with the lowest levels of self-reported maternal acceptance were most impacted by community violence. In this sample of urban first graders, low levels of maternal acceptance placed children at greater risk for adverse outcomes associated with community violence exposure compared to moderate and high levels of maternal acceptance.

Relationship of Stigma to HIV Risk Among Women with Mental Illness

PubMed Central

Collins, Pamela Y.; Elkington, Katherine S.; von Unger, Hella; Sweetland, Annika; Wright, Eric R.; Zybert, Patricia A.

2009-01-01

Urban women with severe mental illness (SMI) are vulnerable to stigma and discrimination related to mental illness and other stigmatized labels. Stigma experiences may increase their risk for negative health outcomes, such as HIV infection. This study tests the relationship between perceived stigma and HIV risk behaviors among women with SMI. The authors interviewed 92 women attending community mental health programs using the Stigma of Psychiatric Illness and Sexuality Among Women Questionnaire. There were significant relationships between personal experiences of mental illness and substance use accompanying sexual intercourse; perceived ethnic stigma and having a riskier partner type; and experiences of discrimination and having a casual or sex-exchange partner. Higher scores on relationship stigma were associated with a greater number of sexual risk behaviors. The findings underscore the importance of exploring how stigma attached to mental illness intersects with other stigmatized labels to produce unique configurations of HIV risk. HIV risk reduction interventions and prevention research should integrate attention to stigmatized identities in the lives of women with SMI. PMID:19123772

Public health perspectives on postwar mental health: gender, housing and family in Kitimat, British Columbia, 1950s.

PubMed

Lucyk, Kelsey; McLaren, Lindsay; Stahnisch, Frank

2014-07-11

The aftermath of World War II brought rapid change to the ways in which Canadian communities were designed and how their populations experienced their lives. The purpose of this study is to explore how mental health was understood and experienced in the context of the postwar period using the well-documented construction (in 1953) of the comprehensively planned, resource-based community of Kitimat, British Columbia as a case example. A qualitative content analysis of primary sources from Kitimat's archival collections was conducted, and eight semi-structured, in-depth interviews were held with long-term residents to enrich the historical data. Findings were then interpreted to construct a historical narrative informed by an operationalized definition of mental health. Kitimat residents in the 1950s understood and experienced their lives in ways consistent with contemporary holistic conceptualizations of mental health, namely, their daily living experiences. A historic interpretation revealed that mental health was understood as something achieved and maintained through conformance with postwar ideals for gendered norms and the family unit, as well as being experienced through issues like housing and expectations of community living. Understanding mental health demands consideration of local circumstances of time and place. The use of historical analysis in public health provides important evidence for how mental health was understood in the past, in a place and at a time when explicit modern language was limited, and illustrates the prominent role of the social determinants of health vis-à-vis population well-being. This article may be of special interest to those working collaboratively in the fields of public health and urban planning.

Research on Relationship Among Internet-Addiction, Personality Traits and Mental Health of Urban Left-Behind Children

PubMed Central

Ge, Ying; Se, Jun; Zhang, Jingfu

2015-01-01

Aim: In this research, we attempted at exploring the relationships among urban left-behind children’s internet-addiction, personality traits and mental health. Methods: In the form of three relevant questionnaires (Adolescent Pathological Internet Use Scale, Eysenck Personality Questionnaire, Children’s Edition in Chinese and Mental Health Test), 796 urban left-behind children in China were investigated, concerning internet-addiction, personality traits and mental health. Results: (1) The internet-addiction rate of urban left-behind children in China reached10.8%—a relatively high figure, with the rate among males higher than that among females. In terms of internet-addition salience, the figure of urban left-behind children was obviously higher than that of non-left-behind children. (2) In China, the personality deviation rate of the overall left-behind children was 15.36%; while the personality deviation rate of the internet-addicted urban left-behind children was 38.88%, a figure prominently higher than that of the non-addicted urban left-behind children group, with the rate among females higher than that among males. (3) The mental health problem rate of the overall urban left-behind children in China was 8.43%; while the rate of the internet-addicted urban left-behind children was 27.77%, a figure significantly higher than that of the non-addicted urban left-behind children. (4) There were significant relationships among internet-addiction, personality traits and mental health. The total score of internet-addiction and its related dimensions can serve as indicators of personality neuroticism, psychoticism and the total scores of mental health. PMID:25946911

Newcomers health in Brantford and the counties of Brant, Haldimand and Norfolk: perspectives of newcomers and service providers.

PubMed

Sethi, Bharati

2013-10-01

The Canadian government's plan to support a balanced distribution of immigrants throughout the nation has contributed to newcomers' dispersion to small town communities and rural areas. However, very little work has examined the health experiences of immigrants settling in smaller urban and rural regions. Even less literature exists on the perspectives of service providers working with newcomers in Canada's urban-rural communities. This paper focuses on a part of a larger Community-based study on 'Newcomer Settlement and Integration in Education, Training, Employment, Health and Social Support' in Brantford--a middle-sized urban/rural region in Ontario, Canada--and discusses the findings in the health domain. Data were generated from 212 service providers and 237 newcomers using both qualitative and quantitative research tools. Newcomers identified several barriers in accessing mental and/or physical health services including lack of culturally appropriate services and discrimination. The striking differences between newcomers' and service providers' responses to the survey questionnaires bring to light cultural variations between the newcomers' and the service providers' perceptions of 'health'. The findings reinforce the need for including newcomers in developing more inclusive and culturally-appropriate health services and programs.

[A basic health care center. Care oriented at the community].

PubMed

Marquilles Bonet, C; Quesada Santaulaira, L; Florensa Roca, C; Piñol Jové, M A; Cruz Esteve, I; Rodríguez Rosich, A

1997-01-01

Principle problems of a basic health care area (Lérida) are identified. This area, which has a patient case load of 22,244 people, was studied during the winter of 1993-94 by using information from various sources. Results indicate that the population of this community are basically young, urban, have a high cultural and social level, and are mostly employed. The principle causes of mortality are the same as in the rest of Cataluña. Diseases that cause the most working days lost to illness are: respiratory, mental and bone-joint problems. The most frequent diseases seen in the clinic are: hypertension, respiratory infections, endocrine and mental. An overall look at the state of health of these patients show that the principle problems are: tobacco use, high blood pressure, arthritis, lumbago, depression, stroke, diabetes and breast cancer.

Comparative characteristics of the home care nursing services used by community-dwelling older people from urban and rural environments.

PubMed

Borowiak, Ewa; Kostka, Tomasz

2013-06-01

To compare home care nursing services use by community-dwelling older people from urban and rural environments in Poland. In the current literature, there is a lack of data based on multidimensional geriatric assessment concerning the provision of care delivered by nurses for older people from urban and rural environments. Cross-sectional random survey. Between 2006-2010, a random sample of 935 older people (over 65 years of age) from an urban environment and 812 from a neighbouring rural environment were interviewed in a cross-sectional survey. The rural dwellers (82·8%) nominated their family members as care providers more often than the city inhabitants (51·2%). Home nursing care was provided to 4·1% of people in the city and 6·5% in the county. Poststroke condition, poor nutritional status, and low physical activity level, as well as low scores for activities of daily living, instrumental activities of daily living, and Mini-Mental State Examination values, were all determinants of nursing care, both in urban and rural areas. In the urban environment, additional predictors of nursing care use were age, presence of ischaemic heart disease, diabetes and respiratory disorders, number of medications taken, and a high depression score. Poor functional status is the most important determinant of nursing care use in both environments. In the urban environment, a considerable proportion of community-dwelling elders live alone. In the rural environment, older people usually have someone available for potential care services. The main problem seems to be seeking nursing care only in advanced deterioration of functional status. © 2012 Blackwell Publishing Ltd.

[Response of primary care teams to manage mental health problems after the 2010 earthquake].

PubMed

Vitriol, Verónica; Minoletti, Alberto; Alvarado, Rubén; Sierralta, Paula; Cancino, Alfredo

2014-09-01

Thirty to 50% of people exposed to a natural disaster suffer psychological problems in the ensuing months. To characterize the activities in mental health developed by Primary Health Care centers after the earthquake that affected Chile on february 27th, 2010. A cross-sectional study analyzing 16 urban centers of Maule Region, was carried out. A questionnaire was developed to know the preparatory and supportive activities directed to the community and the training and self-care activities directed to Health Care personnel that were made during the 12 months following the catastrophe. In addition, a questionnaire evaluating structural aspects was designed. Only 1/3 of the centers made some preparatory activity and none of them made a diagnosis of population vulnerability. The average of protective Mental Health interventions coverage reached 35% of the population estimated to be most affected. The activities lasted 31 to 62% of the optimal duration standards set by experts (according to the type of action). Important differences between centers in economic and geographical accessibility, construction and professional resources were found. This study shows the difficulties faced by urban centers of Maule Region to deal with mental health problems caused by the earthquake, which were attributable to the absence of local planning and drills, and to the lack of intra and inter sectorial coordination.

Rural and Urban/Suburban Families' Use of a Web-Based Mental Health Intervention.

PubMed

Bunnell, Brian E; Davidson, Tatiana M; Dewey, Daniel; Price, Matthew; Ruggiero, Kenneth J

2017-05-01

Background/Introduction: Access to mental healthcare among rural residents is a national concern because unique barriers (e.g., fewer providers, distance to services) create significant challenges for the 60 million Americans who live in these settings. There is now a large body of literature demonstrating the efficacy of a wide range of Internet-based interventions. However, little is known about the extent to which individuals in rural settings will use these approaches and find them acceptable. Research with youths and their caregivers within this scope is particularly limited and, therefore, of great importance. We examined access and completion of a Web-based disaster mental health intervention in a population-based sample of 1,997 rural (n = 676) and urban/suburban (n = 1,321) adolescents and their caregivers who were affected by the Spring 2011 tornadoes that touched down in parts of Missouri and Alabama. Results indicated no differences in the rate of access or completion of Web-based modules based on geographical location. Furthermore, for those who did not access the Web-based resource, no differences were observed with respect to reasons for not accessing modules based on geographical location. These data have promising implications for the reach of Web-based resources to both rural and urban/suburban communities, as well as the willingness of adolescents and their caregivers to access and complete such resources, regardless of geographical location.

Prevalence and regional correlates of road traffic injury among Chinese urban residents: A 21-city population-based study.

PubMed

Rockett, Ian R H; Jiang, Shuhan; Yang, Qian; Yang, Tingzhong; Yang, Xiaozhao Y; Peng, Sihui; Yu, Lingwei

2017-08-18

This study estimated the prevalence of road traffic injury among Chinese urban residents and examined individual and regional-level correlates. A cross-sectional multistage process was used to sample residents from 21 selected cities in China. Survey respondents reported their history of road traffic injury in the past 12 months through a community survey. Multilevel, multivariable logistic regression analysis was used to identify injury correlates. Based on a retrospective 12-month reporting window, road traffic injury prevalence among urban residents was 13.2%. Prevalence of road traffic injury, by type, was 8.7, 8.7, 8.5, and 7.7% in the automobile, bicycle, motorcycle, and pedestrian categories, respectively. Multilevel analysis showed that prevalence of road traffic injury was positively associated with minority status, income, and mental health disorder score at the individual level. Regionally, road traffic injury was associated with geographic location of residence and prevalence of mental health disorders. Both individual and regional-level variables were associated with road traffic injury among Chinese urban residents, a finding whose implications transcend wholesale imported generic solutions. This descriptive research demonstrates an urgent need for longitudinal studies across China on risk and protective factors, in order to inform injury etiology, surveillance, prevention, treatment, and evaluation.

"I Think About It All The Time": A 12-Year-Old Girl's Internal Crisis With Racism and the Effects on her Mental Health

ERIC Educational Resources Information Center

Masko, Amy L.

2005-01-01

I conducted an ethnographic study, situated within the conceptual framework of Critical Race Theory, which illustrates one child's experiences with racism. The study was conducted in an urban after-school program, and explores issues of racism in both the school and community settings. Utilizing the storytelling aspect of Critical Race Theory, I…

Causes of schizophrenia reported by urban African American lay community members.

PubMed

Compton, Michael T; Esterberg, Michelle L; Broussard, Beth

2008-01-01

Although mental health professionals' "etiologic beliefs" concerning schizophrenia have evolved in accordance with diathesis-stress and neurodevelopmental models, little is known about etiologic attributions in nonclinical general population samples in the United States. Yet, course and outcome for people with the illness may be indirectly influenced by beliefs about causes in the larger community. Because of very limited research in this area, especially among African Americans in particular, this descriptive study investigated the causes of schizophrenia reported by 127 urban African Americans from the general population. The aim of this study was to assess the most commonly reported causes of schizophrenia, as well as the frequency of endorsing items from a list of 30 factors, some of which are congruent with current psychiatric conceptualizations of schizophrenia, whereas others are not. Results of this report complement previously reported findings from the same setting involving family members of patients with schizophrenia [Esterberg ML, Compton MT. Causes of schizophrenia reported by family members of urban African American hospitalized patients with schizophrenia. Compr Psychiatry 2006;47:221-226]. The 5 most commonly reported causes were disturbance of brain biochemistry (49.6%), drug/alcohol abuse (42.5%), hereditary factors (40.9%), brain injury (40.2%), and avoidance of problems in life (37.8%). The mean number of likely or very likely causes endorsed by participants was 7.5 +/- 5.7. Some 47.9% reported one or more esoteric factors as a cause. Of the 6 esoteric factors, possession by evil spirits (28.3%), radiation (20.2%), and punishment by God (19.7%) were most common. Esoteric causes were more commonly chosen by male participants, those with 12 years of education or less, and participants who reported never having known someone with schizophrenia. Future research should seek to better understand how esoteric beliefs about causation affect attitudes toward people with mental illnesses and acceptance of mental health treatment by those individuals. Beliefs about debunked personality, societal, family, and esoteric causes in this nonclinical sample indicate the need for improved psychoeducation of the community at large.

Financial Health and Mental Health Among Clients of a Community Mental Health Center: Making the Connections.

PubMed

Harper, Annie; Clayton, Ashley; Bailey, Margaret; Foss-Kelly, Louisa; Sernyak, Michael J; Rowe, Michael

2015-12-01

This study evaluated financial challenges, satisfaction with financial-management supports, and interest in additional or alternative supports among clients of a mental health center. Six focus groups were held with 39 clients of an urban community mental health center who reported having difficulty with their finances. Five focus groups were held with direct-care staff who provided services to the clients. Investigators used an inductive analytical approach to distill themes from notes taken during the focus groups. Clients emphasized the challenges of living in poverty and described using complex strategies to sustain themselves, including negotiating benefits systems, carefully planning purchases, and developing and relying on social relationships. They spoke of having uneven access to tools and services for managing their money, such as advice from direct-care staff, representative payees, and bank accounts, and had varying opinions about their value. Noting concerns similar to those of clients, direct-care staff expressed frustration at the lack of support services for helping clients manage their finances. Both clients and staff expressed the need for more services to help clients with their finances. Findings suggest a need for more services to support people with mental illness to manage their finances, particularly a more flexible and broader range of options than are provided by current representative-payee mechanisms.

Engagement processes in model programs for community reentry from prison for people with serious mental illness.

PubMed

Angell, Beth; Matthews, Elizabeth; Barrenger, Stacey; Watson, Amy C; Draine, Jeffrey

2014-01-01

Linking prisoners with mental illness with treatment following release is critical to preventing recidivism, but little research exists to inform efforts to engage them effectively. This presentation compares the engagement process in two model programs, each representing an evidence-based practice for mental health which has been adapted to the context of prison reentry. One model, Forensic Assertive Community Treatment (FACT), emphasizes a long-term wrap-around approach that seeks to maximize continuity of care by concentrating all services within one interdisciplinary team; the other, Critical Time Intervention (CTI), is a time-limited intervention that promotes linkages to outside services and bolsters natural support systems. To compare engagement practices, we analyze data from two qualitative studies, each conducted in a newly developed treatment program serving prisoners with mental illness being discharged from prisons to urban communities. Findings show that the working relationship in reentry services exhibits unique features and is furthered in both programs by the use of practitioner strategies of engagement, including tangible assistance, methods of interacting with consumers, and encouragement of service use via third parties such as families and parole officers. Nevertheless, each program exhibited distinct cultures and rituals of reentry that were associated with fundamental differences in philosophy and differences in resources available to each program. Copyright © 2014 Elsevier Ltd. All rights reserved.

Teachers' challenges, strategies, and support needs in schools affected by community violence: a qualitative study.

PubMed

Maring, Elisabeth F; Koblinsky, Sally A

2013-06-01

Exposure to community violence compromises teacher effectiveness, student learning, and socioemotional well-being. This study examined the challenges, strategies, and support needs of teachers in urban schools affected by high levels of community violence. Twenty teachers from 3 urban middle schools with predominantly low-income African American students completed open-ended interviews. Selected schools were in geographic areas with high violent crime levels. Consistent with an ecological risk and resilience framework, findings revealed that teachers experienced challenges and adopted coping strategies at the individual, family, school, and community levels. Teachers employed a number of strategies associated with resilience, such as prayer and seeking support from family and colleagues, but also engaged in some avoidant strategies, such as emotional withdrawal and avoiding difficult students. Findings suggest interventions to improve school safety and reduce the negative impact of violence-related stressors. Teacher training in behavior management, effective school leadership, improved school security, peer mediation, expanded mental health services, and parent involvement may promote resilience among both teachers and their students. © 2013, American School Health Association.

Social Network Influences on Service Use among Urban, African American Youth with Mental Health Problems

PubMed Central

Lindsey, Michael A.; Barksdale, Crystal L.; Lambert, Sharon F.; Ialongo, Nicholas S.

2010-01-01

Objective To examine the associations between the size and quality of African American adolescents' social networks and their mental health service use, and to examine whether these social networks characteristics moderate the association between need for services due to emotional or behavioral difficulties and use of services. Method Participants were a community sample of African American adolescents (N=465; 46.2% female; mean age 14.78) initially recruited in 1st grade for participation in an evaluation of two preventive intervention trials. Social network influences and adolescents' mental health service use in schools and the community were accessed. Results A significant positive association between adolescents' perception that their social network was helpful and their use of school mental health services was identified. The significant associations between need for services for anxiety, depression, or behavior problems, and school and outpatient service use were moderated by size of the social network. Specifically, among youth in need of services for anxiety or depression, school-based service use was higher for those with larger social networks. Conclusions Implications for enhancing access to formal mental health services include further examination of key social network influences that potentially serve as facilitators or barriers to formal help-seeking. The findings also suggest that it might be important to integrate social network members into interventions to address the mental health needs of adolescents. PMID:20864006

Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights.

PubMed

Labys, Charlotte A; Susser, Ezra; Burns, Jonathan K

2016-01-01

Growing interest in strategies regarding early intervention for psychosis has led to a parallel interest in understanding help-seeking behavior, especially in low- and middle-income countries (LMICs). Nevertheless, few LMIC studies have examined individuals with psychosis in non-urban, non-hospital settings. Using the perspective of formal and informal community service providers, we aimed to uncover descriptions of people with psychosis in a rural South African community and illuminate the potential complexities of their help-seeking journeys. We conducted a qualitative study of 40 key informant interviews and seven focus groups with stakeholders (traditional leaders, traditional healers, religious leaders, health care nurses, heads of non-governmental organizations, schoolteachers, community caregivers) in a rural Zulu community (Vulindlela). Thematic analysis of the data was performed using the inductive analysis approach. Interviewees discussed 32 individuals with probable psychosis in their community and provided rich descriptions of their symptoms. A complex picture of help-seeking behavior, primarily involving informal mental health service providers, emerged. Over half of the reported cases had no contact with formal health services in the course of their help-seeking journey; while more than two-thirds never attended a hospital and only 1 in 8 accessed a psychiatric hospital. Our results highlight the important role of informal care providers in LMICs as well as the need for more research on mental illness and local providers in non-hospital contexts. Community stakeholders can contribute to a fuller understanding of these issues, thereby assisting in the creation of appropriate and effective mental health interventions for rural South African communities like Vulindlela.

Thinking inside the bubble: evidence for a new contextual unit in urban mental health

PubMed Central

Whitley, R.; Prince, M.; Cargo, M.

2005-01-01

Objective: Previous quantitative research has suggested that there is a link between housing, the urban environment, and mental health. However, methodological and design issues make it difficult to disentangle the relative influence of dwelling specific and wider urban environmental influences on individual mental health. The aim of this study was to explore the link between the dwelling, the immediate urban environment, and mental health to generate a new conceptual framework by which understanding of dwelling and urban environmental influences on mental health can be advanced. Design and participants: Qualitative interviews and focus groups were conducted with 32 inner city residents. Participants, stratified by sex and mental health status, were randomly recruited from a wider quantitative survey. An almost equal number of men and women as well as people with or without mental health problems participated, allowing for comparison of experience. Data were analysed inductively to generate an appropriate theoretical framework regarding dwelling and urban environmental influences on mental health. Setting: An inner city neighbourhood of about 6200 people in north west London. Most of that population live in public housing. Main results: The principal study finding is that between the dwelling unit and the neighbourhood unit, evidence was found for another meaningful contextual unit of analysis, the "residential bubble" through which effects on mental health can be mediated. The residential bubble describes a limited area of three dimensional space that surrounds a dwelling, encompassing immediate neighbours (above, below, and adjacent) and shared public space bordering the dwelling. Positive events and processes within the bubble had a beneficial influence on mental health whereas negative ones tended to have a damaging influence. These seemed to disproportionately have an impact on people with pre-existing mental health problems. Conclusion: The concept of the "residential bubble" may be a meaningful new contextual unit of analysis in urban mental health. This may have important implications with regards to interventions and measurement development. PMID:16166366

Vegetarian diet and mental disorders: results from a representative community survey

PubMed Central

2012-01-01

Background The present study investigated associations between vegetarian diet and mental disorders. Methods Participants were drawn from the representative sample of the German Health Interview and Examination Survey and its Mental Health Supplement (GHS-MHS). Completely vegetarian (N = 54) and predominantly vegetarian (N = 190) participants were compared with non-vegetarian participants (N = 3872) and with a non-vegetarian socio-demographically matched subsample (N = 242). Results Vegetarians displayed elevated prevalence rates for depressive disorders, anxiety disorders and somatoform disorders. Due to the matching procedure, the findings cannot be explained by socio-demographic characteristics of vegetarians (e.g. higher rates of females, predominant residency in urban areas, high proportion of singles). The analysis of the respective ages at adoption of a vegetarian diet and onset of a mental disorder showed that the adoption of the vegetarian diet tends to follow the onset of mental disorders. Conclusions In Western cultures vegetarian diet is associated with an elevated risk of mental disorders. However, there was no evidence for a causal role of vegetarian diet in the etiology of mental disorders. PMID:22676203

Everyday discrimination and physical health: Exploring mental health processes.

PubMed

Earnshaw, Valerie A; Rosenthal, Lisa; Carroll-Scott, Amy; Santilli, Alycia; Gilstad-Hayden, Kathryn; Ickovics, Jeannette R

2016-10-01

Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in serial mediation. Associations were consistent across members of different racial/ethnic groups and were observed even after controlling for indicators of stressors associated with structural discrimination, including perceived neighborhood unsafety, food insecurity, and financial stress. © The Author(s) 2015.

The ties that bind - A case report about restraining a mentally unwell family member at home for over a decade.

PubMed

Tay, Jing Ling; Chan, Christopher Yi Wen; Ho, Zhen Chong; Lal, Manu

2017-04-01

This is a case report describing a patient, with schizophrenia, who was physically chained by her mother in their house for more a decade. Illness factors, family dynamics, stigma, lack of mental health literacy and cultural roles contributed to her chaining. To our knowledge, this is the first case report that examines the prolonged use of physical restraints by family members on a patient in a developed urban setting and that explores the cultural and ethical issues surrounding this phenomenon. We have concluded that there remains a need for a national level approach to increase mental health literacy, reduce stigma and promote existing psychiatric community health services in a culturally sensitive manner. Copyright © 2017 Elsevier B.V. All rights reserved.

Rural–urban migration and mental and sexual health: a case study in Southwestern China

PubMed Central

Yang, Xiushi

2014-01-01

Massive rural–urban temporary migration has taken place amid China's rapid economic growth and development. Much has been written about the economic causes and consequences of this massive migration; less studied are the potential health and behavioral impacts of migration on migrants. Using data from a population-based sample survey conducted in southwestern China, this paper examines the potential impact of rural–urban migration and post-migration urban living on migrants' mental health and sexual risk behavior. The results suggest that regardless of places of origin and destination temporary migrants had on average poorer mental health and riskier sexual behavior than non-migrants. Compared to living in rural areas, living in urban areas does not make statistical difference in residents' mental health; it is only marginally associated with riskier sexual behavior. Rural–urban temporary migrants' mental health and health risk sexual behavior deserve more immediate research attention. Both selectivity of temporary migrants and migration-induced psycho-socio-behavioral changes may have contributed to migrants' poorer mental health and riskier sexual behavior. However, more theory-driven research with longitudinal design is needed before firm conclusions can be drawn about the underlying mechanisms that mediate or moderate the impact of temporary migration on migrants' mental health and sexual risk behavior. PMID:25932350

The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women

PubMed Central

Staton-Tindall, Michele; Duvall, Jamieson; Stevens-Watkins, Danelle; Oser, Carrie B.

2013-01-01

This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n=206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included. PMID:24041186

The Role of Stigma in Parental Help-Seeking for Perceived Child Behavior Problems in Urban, Low-Income African American Parents.

PubMed

Dempster, Robert; Davis, Deborah Winders; Faye Jones, V; Keating, Adam; Wildman, Beth

2015-12-01

Significant numbers of children have diagnosable mental health problems, but only a small proportion of them receive appropriate services. Stigma has been associated with help-seeking for adult mental health problems and for Caucasian parents. The current study aims to understand factors, including stigma, associated with African American parents' help-seeking behavior related to perceived child behavior problems. Participants were a community sample of African American parents and/or legal guardians of children ages 3-8 years recruited from an urban primary care setting (N = 101). Variables included child behavior, stigma (self, friends/family, and public), object of stigma (parent or child), obstacles for engagement, intention to attend parenting classes, and demographics. Self-stigma was the strongest predictor of help-seeking among African American parents. The impact of self-stigma on parents' ratings of the likelihood of attending parenting classes increased when parents considered a situation in which their child's behavior was concerning to them. Findings support the need to consider parent stigma in the design of care models to ensure that children receive needed preventative and treatment services for behavioral/mental health problems in African American families.

Pragmatic replication trial of health promotion coaching for obesity in serious mental illness and maintenance of outcomes.

PubMed

Bartels, Stephen J; Pratt, Sarah I; Aschbrenner, Kelly A; Barre, Laura K; Naslund, John A; Wolfe, Rosemarie; Xie, Haiyi; McHugo, Gregory J; Jimenez, Daniel E; Jue, Ken; Feldman, James; Bird, Bruce L

2015-04-01

Few studies targeting obesity in serious mental illness have reported clinically significant risk reduction, and none have been replicated in community settings or demonstrated sustained outcomes after intervention withdrawal. The authors sought to replicate positive health outcomes demonstrated in a previous randomized effectiveness study of the In SHAPE program across urban community mental health organizations serving an ethnically diverse population. Persons with serious mental illness and a body mass index (BMI) >25 receiving services in three community mental health organizations were recruited and randomly assigned either to the 12-month In SHAPE program, which included membership in a public fitness club and weekly meetings with a health promotion coach, or to fitness club membership alone. The primary outcome measures were weight and cardiorespiratory fitness (as measured with the 6-minute walk test), assessed at baseline and at 3, 6, 9, 12, and 18 months. Participants (N=210) were ethnically diverse (46% were nonwhite), with a mean baseline BMI of 36.8 (SD=8.2). At 12 months, the In SHAPE group (N=104) had greater reduction in weight and improved fitness compared with the fitness club membership only group (N=106). Primary outcomes were maintained at 18 months. Approximately half of the In SHAPE group (51% at 12 months and 46% at 18 months) achieved clinically significant cardiovascular risk reduction (a weight loss ≥5% or an increase of >50 meters on the 6-minute walk test). This is the first replication study confirming the effectiveness of a health coaching intervention in achieving and sustaining clinically significant reductions in cardiovascular risk for overweight and obese persons with serious mental illness.

Demographic Characteristics Associated with Pregnant and Postpartum Youth Referred for Mental Health Services in a Community Outreach Center

PubMed Central

Norris, Sandhaya; Norris, Mark L.; Sibbald, Emily; Aubry, Tim; Harrison, Megan E.; Lafontaine, Genevieve; Gandhi, Jasmine

2016-01-01

Objective Pregnancy in youth is considered high risk from a number of different standpoints. At present, limited data has explored demographic factors associated with Canadian cohorts of pregnant and postpartum youth seeking mental health services. We aimed to describe demographic characteristics associated with pregnant and postpartum youth and young adults referred for mental health services in the community and to compare this with data drawn from a hospital-based perinatal mental health clinic. Method Patients were recruited at a young parents’ outreach center (YPOC) in a large urban Canadian city. The patients completed questionnaires at the time of initial assessment. The number of attended and missed appointments was tracked and compared to a hospital-based control group in an effort to determine whether the community-based clinic would result in fewer missed appointments. Results A total of 28 patients were assessed at the YPOC. The mean age of all participants was 19.4 years (+/− 2.3 years) as compared to 18.57 years (± 1.81 years) for the hospital-based group. Rates of poverty were high, and high school completion and level of social support low for many patients. Patients attending the YPOC clinic missed fewer appointments overall. Conclusions Pregnant and postpartum adolescents and young adults possess multiple risk factors across various domains that threaten short and long term health outcomes. Establishment of outreach mental health clinics may help minimize barriers to care as demonstrated in the present study by fewer missed appointments and should be investigated further as a means of improving mental health access and outcomes. PMID:27924145

Identifying Unmet Mental Health Needs in Children of Formerly Homeless Mothers Living in a Supportive Housing Community Sector of Care

ERIC Educational Resources Information Center

Lee, Susanne S.; August, Gerald J.; Gewirtz, Abigail H.; Klimes-Dougan, Bonnie; Bloomquist, Michael L.; Realmuto, George M.

2010-01-01

This study reports psychosocial characteristics of a sample of 111 children (K to 2nd grade) and their mothers who were living in urban supportive housings. The aim of this study was to document the various types and degree of risk endemic to this population. First, we describe the psychosocial characteristics of this homeless sample. Second, we…

Nebraska's rural behavioral healthcare workforce distribution and relationship between supply and county characteristics.

PubMed

Nguyen, Anh T; Trout, Kate E; Chen, Li-Wu; Madison, Lynda; Watkins, Katherine L; Watanabe-Galloway, Shinobu

2016-01-01

Specific attention is needed to improve mental health outcomes in rural communities. Rural communities continue to have higher unmet mental health needs than their urban counterparts. Quantifying workforce supply and shortages can aid in identifying areas in need of the recruitment, training, licensure, and retention of behavioral health professionals. However, workforce analyses have presented a challenge as comprehensive workforce data are limited. This study examines the geographic distribution of behavioral healthcare professionals and the relationship between supply and county characteristics in Nebraska in 2012. Practice location data for behavioral healthcare professionals were obtained from the 2012 University of Nebraska Medical Center's Health Profession Tracking Service Survey. Behavioral healthcare professionals included were psychiatric prescribers, independent behavioral professionals, mental health practitioners, and addiction counselors. The rural and urban distribution of professionals was examined using descriptive statistics. The relationships between county-level provider-to-population ratios and county characteristics were examined using multivariate Poisson regression analyses. In 2012, there were 2468 behavioral health professionals actively practicing in Nebraska. The majority (71.2%) of all behavioral professionals in Nebraska were actively practicing in metropolitan areas as compared to 27.3% in rural and 1.5% in frontier areas. For all categories of professions, excluding physician assistants, Nebraska's urban areas had the highest ratios of provider to 100 000 population as compared to rural and frontier areas in Nebraska. The total supply of behavioral health professionals was positively associated with metropolitan areas and the percentage of populations in poverty. The total supply of behavioral health professionals was negatively associated with the percentage of children under 18 years of age and the percentage of elderly aged 65 years or older. Rural counties and areas with high proportions of children and aging populations in Nebraska face significant challenges in recruiting and retaining behavioral healthcare professionals. The findings from this study have implications for quantifying the need and demand for behavioral healthcare professionals in workforce planning and policy analysis.

Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China.

PubMed

Lin, Danhua; Li, Xiaoming; Wang, Bo; Hong, Yan; Fang, Xiaoyi; Qin, Xiong; Stanton, Bonita

2011-04-01

Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being.

Telepsychiatry: Promise, potential, and challenges

PubMed Central

Malhotra, Savita; Chakrabarti, Subho; Shah, Ruchita

2013-01-01

Despite the high prevalence and potentially disabling consequences of mental disorders, specialized mental health services are extremely deficient, leading to the so-called ‘Mental Health Gap’. Moreover, the services are concentrated in the urban areas, further worsening the rural-urban and tertiary primary care divide. Strengthening of and expanding the existing human resources and infrastructure, and integrating mental health into primary care appear to be the two major solutions. However, both the strategies are riddled with logistic difficulties and have a long gestation period. In such a scenario, telepsychiatry or e-mental health, defined as the use of information and communication technology to provide or support psychiatric services across distances, appears to be a promising answer. Due to its enormous potential, a review of the existing literature becomes imperative. An extensive search of literature was carried out and has been presented to delineate the modes of communication, acceptability and satisfaction, reliability, outcomes, cost-effectiveness, and legal and ethical challenges related to telepsychiatry. Telepsychiatry has been applied for direct patient care (diagnosis and management), consultation, and training, education, and research purposes. Both real-time, live interaction (synchronous) and store–forward (asynchronous) types of technologies have been used for these purposes. A growing amount of literature shows that training, supervision, and consultation by specialists to primary care physicians through telepsychiatry has several advantages. In this background, we have further focused on the models of telepsychiatry best suited for India, considering that mental health care can be integrated into primary care and taken to the doorstep of patients in the community. PMID:23441027

Mental health, employment and gender. Cross-sectional evidence in a sample of refugees from Bosnia-Herzegovina living in two Swedish regions.

PubMed

Blight, Karin Johansson; Ekblad, Solvig; Persson, Jan-Olov; Ekberg, Jan

2006-04-01

Large regional differences regarding access to employment have been observed amongst persons from Bosnia-Herzegovina coming to Sweden in 1993-1994. This has led to questions about the role of mental health. To explore this further, postal survey questionnaires were distributed to a community sample (N = 650) that was stratified and, within strata, randomly selected from a sampling frame of persons coming to Sweden from Bosnia-Herzegovina in 1993-1994. Four hundred and thirteen persons returned the questionnaire providing a response rate of 63.5%. The aim was to increase knowledge about the relationship between mental health and employment in the chosen population. The main mental health outcome measure was the Göteborg Quality of Life instrument from which 360 respondents were grouped according to low or high symptom levels. Data were cross tabulated (chi2-tested) against background variables such as age, gender and occupational status, and then tested using binary logistic regression. Binary logistic regression revealed unemployed men but not women, and women who had been working for longer periods during 1993-1999, to be associated with high levels of symptoms of poor mental health. Women living in the urban region were also overrepresented in the high symptom group. These findings indicate that, job occupancy is important to the health of men in the study. However, for the women, further understanding is needed, as job occupancy at some level as well as living in the urban region appear to be associated with poor mental health.

Rural-Urban Differences in Suicide Rates for Current Patients of a Public Mental Health Service in Australia

ERIC Educational Resources Information Center

Sankaranarayanan, Anoop; Carter, Gregory; Lewin, Terry

2010-01-01

Rural versus urban rates of suicide in current patients of a large area mental health service in Australia were compared. Suicide deaths were identified from compulsory root cause analyses of deaths, 2003-2007. Age-standardized rates of suicide were calculated for rural versus urban mental health service and compared using variance of…

Study protocol: Mobilizing Asian men in Canada to reduce stigma of mental illness.

PubMed

Guruge, Sepali; Fung, Kenneth Po-Lun; Sidani, Souraya; Este, David; Morrow, Marina; McKenzie, Kwame; Wong, Josephine Pui-Hing

2018-06-19

The available evidence on interventions addressing the stigma of mental illness is limited because of small samples, lack of diversity in study samples, and exclusion of people living with mental illness. To date, no published studies have evaluated anti-stigma interventions for Asian men in Canada. Aim This paper describes the protocol of a study to evaluate psychological and collective empowerment interventions (ACT, CEE, and ACT+CEE) in addressing self-stigma and social stigma in Asian communities in three urban settings in Canada: Toronto, Calgary and Vancouver. The study targets Asian men living with or affected by mental illness, and community leaders interested in stigma reduction and advocacy. Guided by a population health promotion framework and an ecological approach to health, the study will use a repeated measure design with mixed methods for data collection. In total, 2160 participants will be enrolled to detect moderate-to-large effect sizes, while accounting for possible attrition. Participants will be randomly assigned to one of three interventions or a control group, using a randomization matrix. Established measures will be used to collect outcome data at pretest, post-test, and 3 and 6 months follow-up, along with focus group discussions and monthly activity logs. Mixed linear models will compare participants' stigma, psychological flexibility, valued life domains, mindfulness, and empowerment readiness within and between groups. The project will generate new knowledge on the applicability and effectiveness of evidence-based psychological and collective empowerment interventions (ACT, CEE, and ACT+CEE) in addressing stigma of mental illness and mobilizing community leadership. Copyright © 2018 Elsevier Inc. All rights reserved.

Social distance and stigma toward individuals with schizophrenia: findings in an urban, African-American community sample.

PubMed

Broussard, Beth; Goulding, Sandra M; Talley, Colin L; Compton, Michael T

2012-11-01

Because schizophrenia is arguably among the most stigmatized health conditions, research assessing correlates of stigma is essential. This study examined factors associated with stigma in predominantly Protestant, low-income, urban African Americans in the Southeastern United States. A survey was distributed to 282 patrons of an inner-city food court/farmers' market. Associations were assessed between two measures of stigma--an adapted version of the Social Distance Scale (SDS) and a Semantic Differential Measure (SDM) of attributes such as dangerousness, dirtiness, and worthlessness--and several key variables addressing sociodemographic characteristics and exposure to/familiarity with mental illnesses. Independent predictors of scores on the two measures were identified using linear regression modeling. Higher stigma (as measured by the SDM) was predicted by a family history of psychiatric treatment, whereas lower stigma (as indicated by the SDS) was predicted by personal psychiatric treatment history and higher annual income. The results suggest special considerations when working with disenfranchised populations, especially family members of individuals with mental illnesses, in treatment settings.

Impact of postpartum anxiety and depression on child's mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study.

PubMed

Ali, Niloufer Sultan; Mahmud, Sadia; Khan, Asia; Ali, Badar Sabir

2013-10-22

Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children's mental development on all sub-scales in a Pakistani population. A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children's growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family relationship variables were collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed at 1, 2, 6, 12, 18, 24, and 30 months of childbirth. An indigenous, validated screening instrument- Aga Khan University Anxiety and Depression scale was used and diagnostic confirmation was done through a psychologist's interview, based on DSM IV criteria. Children's growth and development was monitored in the same sequence using an Early Childhood Development tool that consists of five subscales; socio emotional, language, cognitive, gross motor and fine motor development. Physical growth was monitored by measuring height and weight of the child. Data was analyzed using SAS 9.2. Multivariable Generalized Estimating Equations (GEE) logistic regression was conducted to identify association of postpartum anxiety and depression with each early childhood development indicator, adjusting for parental and child factors. A significant association of postpartum anxiety and depression with delayed development on all five subscales of children's mental development was found in our study. Interestingly, our study found that higher maternal age had adverse effects on child's emotional whereas positive impact on child's cognitive development. Children's stunting had an adverse impact on all five subscales of children's development. Male children were at higher risk for delayed language and gross motor development relative to female children. Our study found that postpartum anxiety and depression is associated with adverse outcomes regarding children's mental development on all sub-scales. The impact was accentuated by low family income or child's increasing age.

Rural and Urban Living in Persons with Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes.

PubMed

Glennie, R Andrew; Batke, Juliet; Fallah, Nader; Cheng, Christiana L; Rivers, Carly S; Noonan, Vanessa K; Dvorak, Marcel F; Fisher, Charles G; Kwon, Brian K; Street, John T

2017-10-15

There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure ® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher's exact or χ 2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge,10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings.

Rural and Urban Living in Persons with Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes

PubMed Central

Batke, Juliet; Fallah, Nader; Cheng, Christiana L.; Rivers, Carly S.; Noonan, Vanessa K.; Dvorak, Marcel F.; Fisher, Charles G.; Kwon, Brian K.; Street, John T.

2017-01-01

Abstract There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher's exact or χ2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge,10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings. PMID:28462633

Rural and urban married Asian immigrants in Taiwan: determinants of their physical and mental health.

PubMed

Chen, Walter; Shiao, Wen-Been; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh

2013-12-01

Different geographical areas with unique social cultures or societies might influence immigrant health. This study examines whether health inequities and different social factors exist regarding the health of rural and urban married Asian immigrants. A survey was conducted on 419 rural and 582 urban married Asian immigrants in Taiwan in 2009. Whereas the descriptive results indicate a worse mental health status between rural and urban married Asian immigrants, rural married immigrants were as mentally healthy as urban ones when considering different social variables. An analysis of regional stratification found different social-determinant patterns on rural and urban married immigrants. Whereas social support is key for rural immigrant physical and mental health, acculturation (i.e., language proficiency), socioeconomics (i.e., working status), and family structure (the number of family members and children living in the family) are key to the mental health of urban married immigrants in addition to social support. This study verifies the key roles of social determinants on the subjective health of married Asian immigrants. Area-differential patterns on immigrant health might act as a reference for national authorities to (re)focus their attention toward more area-specific approaches for married Asian immigrants.

Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study.

PubMed

Rabbani, Ali; Mahmoudi-Gharaei, Javad; Mohammadi, Mohammad Reza; Motlagh, Mohammad Esmaeil; Mohammad, Kazem; Ardalan, Gelayol; Maftoon, Farzaneh; Shahryari, Safiyeh; Khodaei, Shahnaz; Sotoudeh, Aria; Ziaaldini, Hassan; Kamali, Kobra; Motaghian, Molouk

2012-01-01

Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire (SDQ). The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 ± 2.19 years. The mean total score of difficulties in participants was 14.34 ± 5.81. According to these results 813 (17.8%) adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems (20.5%). According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle.

Rural and Urban/Suburban Families' Use of a Web-Based Mental Health Intervention

PubMed Central

Davidson, Tatiana M.; Dewey, Daniel; Price, Matthew; Ruggiero, Kenneth J.

2017-01-01

Abstract Background/Introduction: Access to mental healthcare among rural residents is a national concern because unique barriers (e.g., fewer providers, distance to services) create significant challenges for the 60 million Americans who live in these settings. There is now a large body of literature demonstrating the efficacy of a wide range of Internet-based interventions. However, little is known about the extent to which individuals in rural settings will use these approaches and find them acceptable. Research with youths and their caregivers within this scope is particularly limited and, therefore, of great importance. Methods: We examined access and completion of a Web-based disaster mental health intervention in a population-based sample of 1,997 rural (n = 676) and urban/suburban (n = 1,321) adolescents and their caregivers who were affected by the Spring 2011 tornadoes that touched down in parts of Missouri and Alabama. Results: Results indicated no differences in the rate of access or completion of Web-based modules based on geographical location. Furthermore, for those who did not access the Web-based resource, no differences were observed with respect to reasons for not accessing modules based on geographical location. Discussion: These data have promising implications for the reach of Web-based resources to both rural and urban/suburban communities, as well as the willingness of adolescents and their caregivers to access and complete such resources, regardless of geographical location. PMID:27753542

Unmet needs among men with human immunodeficiency virus in community mental health care: a cross-sectional study.

PubMed

Durbin, Anna; Sirotich, Frank; Antoniou, Tony; Roesslein, Kay; Durbin, Janet; Lunsky, Yona

2016-07-01

While community-based mental health services play an important role in caring for persons with HIV (human immunodeficiency virus) and co-existing mental health disorders, the extent to which their support needs are addressed in this setting is unknown. Accordingly, we examined if HIV infection was associated with unmet support needs among men living with and without HIV receiving community mental health care. This cross-sectional study examined 215 men (135 living with HIV and 80 without HIV) receiving case management services in urban Ontario. Using the Camberwell Assessment of Need, we ascertained the prevalence of support needs in 13 domains grouped into three clusters: Basic needs (accommodation, food, benefits, and money management); self-care/functional needs (daytime activities, self-care, and looking after the home); and health/safety needs (physical, psychological distress, psychotic symptoms, safety to self, and safety to others). We used generalized estimating equations with a logit link to examine the association between HIV and unmet need in each domain. Compared to HIV-negative men, men with HIV were more likely to have mood and concurrent disorders, and intellectual and developmental disabilities. Following multivariable analyses, men with HIV had greater unmet needs related to food (odds ratio + 95% confidence interval: 9.36 (4.03, 21.75), p < 0.001); money (OR: 1.90 (1.04, 3.47), p = 0.036) [basic need domains]; psychological distress (OR: 2.39 (1.68, 3.41), p < 0.001); drug use (OR: 5.10 (2.16, 12.08) p < 0.001); and safety to self (OR: 3.35 (1.51, 7.52), p < 0.003) [health and safety domains]. Despite living in a setting with universal health insurance, men with HIV receiving community mental health support had greater unmet need in basic and health domains than HIV-negative men receiving such support. Further research is required to develop and evaluate interventions to best support community-dwelling persons with HIV and mental health disorders.

NeuroPlace: Categorizing urban places according to mental states

PubMed Central

2017-01-01

Urban spaces have a great impact on how people’s emotion and behaviour. There are number of factors that impact our brain responses to a space. This paper presents a novel urban place recommendation approach, that is based on modelling in-situ EEG data. The research investigations leverages on newly affordable Electroencephalogram (EEG) headsets, which has the capability to sense mental states such as meditation and attention levels. These emerging devices have been utilized in understanding how human brains are affected by the surrounding built environments and natural spaces. In this paper, mobile EEG headsets have been used to detect mental states at different types of urban places. By analysing and modelling brain activity data, we were able to classify three different places according to the mental state signature of the users, and create an association map to guide and recommend people to therapeutic places that lessen brain fatigue and increase mental rejuvenation. Our mental states classifier has achieved accuracy of (%90.8). NeuroPlace breaks new ground not only as a mobile ubiquitous brain monitoring system for urban computing, but also as a system that can advise urban planners on the impact of specific urban planning policies and structures. We present and discuss the challenges in making our initial prototype more practical, robust, and reliable as part of our on-going research. In addition, we present some enabling applications using the proposed architecture. PMID:28898244

Discrimination, Perceived Social Inequity, and Mental Health Among Rural-to-Urban Migrants in China

PubMed Central

Lin, Danhua; Wang, Bo; Hong, Yan; Qin, Xiong; Stanton, Bonita

2010-01-01

Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004–2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being. PMID:20033772

Understanding Motivators and Challenges to Involving Urban Parents as Collaborators in HIV Prevention Research Efforts.

PubMed

McKay, Mary M; Pinto, Rogério M; Bannon, William M; Guilamo-Ramos, Vincent

2007-01-01

This study was designed to explore the experiences of urban parents in their role as Collaborative Board members as part of the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study. The CHAMP Collaborative Board is comprised of urban parents, representatives from schools and community-based agencies and university-based researchers and is charged with overseeing the design, delivery and testing of a family-based HIV prevention program for pre and early adolescent youth. The current qualitative study, guided by the Theory of Unified Behavior Change, is meant to elucidate: (1) pathways to involvement by urban parents; (2) benefits and costs of participating in this collaborative HIV prevention research effort; and (3) the role of social relationships in influencing initial and ongoing participation by parent participants. Twenty-nine parent Collaborative Board members were interviewed for this study. In-depth interviews were audio recorded and ranged from 30 to 90 minutes in length. Transcripts were coded and analyzed using NUD*IST, computerized software used for examining narratives. Findings include community parent members identifying social support and learning opportunities as major reasons for involvement with the Collaborative Board. Prior involvement with other community-based projects and knowledge of at least one other person on the Board also influenced members to join the Board and remain involved over time. Further, recommendations for future collaborative partnerships are made. Findings have direct implication for participatory HIV prevention research activities.

Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services

ERIC Educational Resources Information Center

Gamble, Brandon E.; Lambros, Katina M.

2014-01-01

This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…

The associations between interpersonal violence and psychological distress among rural and urban young women in South Africa.

PubMed

Manyema, M; Norris, S A; Said-Mohamed, R; Tollman, S T; Twine, R; Kahn, K; Richter, L M

2018-05-01

Approximately 25% of the world's population consists of young people. The experience of violence peaks during adolescence and the early adult years. A link between personal experience of violence and mental health among young people has been demonstrated but rural-urban differences in these associations are less well known in low to middle income countries. The aim of this study was to investigate the associations between interpersonal violence and psychological distress among rural and urban young women. Data on experiences of violence and psychological distress were collected from a total of 926 non-pregnant young women aged between 18 and 22 years of age in rural and urban sites in South Africa. The General Health Questionnaire-28 was used to assess psychological distress as an indicator of mental health. Generalised structural equation models were employed to assess potential pathways of association between interpersonal violence and psychological distress. Thirty-four percent of the urban young women (n = 161) reported psychological distress compared to 18% of rural young women (n = 81). In unadjusted analysis, exposure to interpersonal violence doubled the odds of psychological distress in the urban adolescents and increased the odds 1.6 times in the rural adolescents. In adjusted models, the relationship remained significant in the urban area only (OR 1.84, 95% CI 1.13-3.00). Rural residence seemed protective against psychological distress (OR 0.41, 95% CI 0.24-0.69). Structural equation modelling did not reveal any direct association between exposure to interpersonal violence and psychological distress among rural young women. Stressful household events were indirectly associated with psychological distress, mediated by violence among young women in the urban area. The relationship between violence and psychological distress differs between urban and rural-residing young women in South Africa, and is influenced by individual, household and community (contextual) factors. Copyright © 2018 Elsevier Ltd. All rights reserved.

Individual and Area Level Socioeconomic Status and Its Association with Cognitive Function and Cognitive Impairment (Low MMSE) among Community-Dwelling Elderly in Singapore.

PubMed

Wee, Liang En; Yeo, Wei Xin; Yang, Gui Rong; Hannan, Nazirul; Lim, Kenny; Chua, Christopher; Tan, Mae Yue; Fong, Nikki; Yeap, Amelia; Chen, Lionel; Koh, Gerald Choon-Huat; Shen, Han Ming

2012-01-01

Neighborhood socioeconomic status (SES) can affect cognitive function. We assessed cognitive function and cognitive impairment among community-dwelling elderly in a multi-ethnic urban low-SES Asian neighborhood and compared them with a higher-SES neighborhood. The study population involved all residents aged ≥60 years in two housing estates comprising owner-occupied housing (higher SES) and rental flats (low SES) in Singapore in 2012. Cognitive impairment was defined as <24 on the Mini Mental State Examination. Demographic/clinical details were collected via questionnaire. Multilevel linear regression was used to evaluate factors associated with cognitive function, while multilevel logistic regression determined predictors of cognitive impairment. Participation was 61.4% (558/909). Cognitive impairment was found in 26.2% (104/397) of residents in the low-SES community and in 16.1% (26/161) of residents in the higher-SES community. After adjusting for other sociodemographic variables, living in a low-SES community was independently associated with poorer cognitive function (β = -1.41, SD = 0.58, p < 0.01) and cognitive impairment (adjusted odds ratio 5.13, 95% CI 1.98-13.34). Among cognitively impaired elderly in the low-SES community, 96.2% (100/104) were newly detected. Living in a low-SES community is independently associated with cognitive impairment in an urban Asian society.

Improving community health through marketing exchanges: A participatory action research study on water, sanitation, and hygiene in three Melanesian countries.

PubMed

Barrington, D J; Sridharan, S; Saunders, S G; Souter, R T; Bartram, J; Shields, K F; Meo, S; Kearton, A; Hughes, R K

2016-12-01

Diseases related to poor water, sanitation and hygiene (WaSH) are major causes of mortality and morbidity. While pursuing marketing approaches to WaSH to improve health outcomes is often narrowly associated with monetary exchange, marketing theory recognises four broad marketing exchange archetypes: market-based, non-market-based, command-based and culturally determined. This diversity reflects the need for parameters broader than monetary exchange when improving WaSH. This study applied a participatory action research process to investigate how impoverished communities in Melanesian urban and peri-urban informal settlements attempt to meet their WaSH needs through marketing exchange. Exchanges of all four archetypes were present, often in combination. Motivations for participating in the marketing exchanges were based on social relationships alongside WaSH needs, health aspirations and financial circumstances. By leveraging these motivations and pre-existing, self-determined marketing exchanges, WaSH practitioners may be able to foster WaSH marketing exchanges consistent with local context and capabilities, in turn improving community physical, mental and social health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Food insecurity and mental health: surprising trends among community health volunteers in Addis Ababa, Ethiopia during the 2008 food crisis.

PubMed

Maes, Kenneth C; Hadley, Craig; Tesfaye, Fikru; Shifferaw, Selamawit

2010-05-01

The 2008 food crisis may have increased household food insecurity and caused distress among impoverished populations in low-income countries. Policy researchers have attempted to quantify the impact that a sharp rise in food prices might have on population wellbeing by asking what proportion of households would drop below conventional poverty lines given a set increase in prices. Our understanding of the impact of food crises can be extended by conducting micro-level ethnographic studies. This study examined self-reported household food insecurity (FI) and common mental disorders (CMD) among 110 community health AIDS care volunteers living in Addis Ababa, Ethiopia during the height of the 2008 food crisis. We used generalized estimating equations that account for associations between responses given by the same participants over 3 survey rounds during 2008, to model the longitudinal response profiles of FI, CMD symptoms, and socio-behavioral and micro-economic covariates. To help explain the patterns observed in the response profiles and regression results, we examine qualitative data that contextualize the cognition and reporting behavior of AIDS care volunteers, as well as potential observation biases inherent in longitudinal, community-based research. Our data show that food insecurity is highly prevalent, that is it associated with household economic factors, and that it is linked to mental health. Surprisingly, the volunteers in this urban sample did not report increasingly severe FI or CMD during the peak of the 2008 food crisis. This is a counter-intuitive result that would not be predicted in analyses of population-level data such as those used in econometrics simulations. But when these results are linked to real people in specific urban ecologies, they can improve our understanding of the psychosocial consequences of food price shocks. Copyright 2010 Elsevier Ltd. All rights reserved.

Pre-Implementation Strategies to Adapt and Implement a Veteran Peer Coaching Intervention to Improve Mental Health Treatment Engagement Among Rural Veterans.

PubMed

Koenig, Christopher J; Abraham, Traci; Zamora, Kara A; Hill, Coleen; Kelly, P Adam; Uddo, Madeline; Hamilton, Michelle; Pyne, Jeffrey M; Seal, Karen H

2016-09-01

Telephone motivational coaching has been shown to increase urban veteran mental health treatment initiation. However, no studies have tested telephone motivational coaching delivered by veteran peers to facilitate mental health treatment initiation and engagement. This study describes pre-implementation strategies with 8 Veterans Affairs (VA) community-based outpatient clinics in the West and Mid-South United States to adapt and implement a multisite pragmatic randomized controlled trial of telephone peer motivational coaching for rural veterans. We used 2 pre-implementation strategies, Formative Evaluation (FE) research and Evidence-Based Quality Improvement (EBQI) meetings to adapt the intervention to stakeholders' needs and cultural contexts. FE data were qualitative, semi-structured interviews with rural veterans and VA clinic staff. Results were rapidly analyzed and presented to stakeholders during EBQI meetings to optimize the intervention implementation. FE research results showed that VA clinic providers felt overwhelmed by veterans' mental health needs and acknowledged limited mental health services at VA clinics. Rural veteran interviews indicated geographical, logistical, and cultural barriers to VA mental health treatment initiation and a preference for self-care to cope with mental health symptoms. EBQI meetings resulted in several intervention adaptations, including veteran study recruitment, peer veteran coach training, and an expanded definition of mental health care outcomes. As the VA moves to cultivate community partnerships in order to personalize and expand access to care for rural veterans, pre-implementation processes with engaged stakeholders, such as those described here, can help guide other researchers and clinicians to achieve proactive and veteran-centered health care services. © 2016 National Rural Health Association.

The Effect of Racial Socialization on Urban African American Use of Child Mental Health Services

PubMed Central

Cavaleri, Mary A.; Rodriguez, James; McKay, Mary M.

2009-01-01

SUMMARY Objective To examine how parental endorsement of racial socialization parenting practices relates to child mental health service use among an urban sample of African American families. Methods A cross-sectional sample of urban African American parents (n = 96) provided ratings of their beliefs concerning various dimensions of racial socialization constructs, i.e., spiritual or religious coping (SRC), extended family caring (EFC), cultural pride reinforcement (CPR), and assessed regarding their use of child mental health services. Results At the multivariate level, the use of child mental health services was significantly positively associated with moderate levels of endorsement of SRC and EFC. Inversely, scores in the moderate range of CPR were associated with a reduced likelihood of child mental health service use. Conclusion Parental endorsement of racial socialization parenting practices appear to play a salient role in child mental health service use among an urban African American families. Further research with larger and more representative samples should be pursued. PMID:20228964

Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre.

PubMed

Stergiopoulos, Vicky; Saab, Dima; Francombe Pridham, Kate; Aery, Anjana; Nakhost, Arash

2018-01-24

Across many jurisdictions, adults with complex mental health and social needs face challenges accessing appropriate supports due to system fragmentation and strict eligibility criteria of existing services. To support this underserviced population, Toronto's local health authority launched two novel community mental health models in 2014, inspired by Flexible Assertive Community Team principles. This study explores service user and provider perspectives on the acceptability of these services, and lessons learned during early implementation. We purposively sampled 49 stakeholders (staff, physicians, service users, health systems stakeholders) and conducted 17 semi-structured qualitative interviews and 5 focus groups between October 23, 2014 and March 2, 2015, exploring stakeholder perspectives on the newly launched team based models, as well as activities and strategies employed to support early implementation. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using thematic analysis. Findings revealed wide-ranging endorsement for the two team-based models' success in engaging the target population of adults with complex service needs. Implementation strengths included the broad recognition of existing service gaps, the use of interdisciplinary teams and experienced service providers, broad partnerships and collaboration among various service sectors, training and team building activities. Emerging challenges included lack of complementary support services such as suitable housing, organizational contexts reluctant to embrace change and risk associated with complexity, as well as limited service provider and organizational capacity to deliver evidence-based interventions. Findings identified implementation drivers at the practitioner, program, and system levels, specific to the implementation of community mental health interventions for adults with complex health and social needs. These can inform future efforts to address the health and support needs of this vulnerable population.

Expanding the Circle: Decreasing American Indian Mental Health Disparities through Culturally Competent Teaching about American Indian Mental Health

ERIC Educational Resources Information Center

Mays, Vickie M.; Gallardo, Miguel; Shorter-Gooden, Kumea; Robinson-Zanartu, Carol; Smith, Monique; McClure, Faith; Puri, Siddarth; Methot, Laurel; Ahhaitty, Glenda

2009-01-01

Recognizing that there has been a lack of systematic teaching about the unique mental health experiences of urban American Indians, this article examines data from national studies and specific case studies to illustrate some issues regarding the mental health of American Indians in urban areas. Some studies have reported that when American…

Relationships between familial HIV/AIDS and symptoms of anxiety and depression: the mediating effect of bullying victimization in a prospective sample of South African children and adolescents.

PubMed

Boyes, Mark E; Cluver, Lucie D

2015-04-01

South African children and adolescents living in HIV/AIDS-affected families are at elevated risk of both symptoms of anxiety and depressive symptoms. Poverty and HIV/AIDS-related stigma are additional risk factors for these negative mental health outcomes. Community level factors, such as poverty and stigma, are difficult to change in the short term and identifying additional potentially malleable mechanisms linking familial HIV/AIDS with mental health is important from an intervention perspective. HIV/AIDS-affected children are also at increased risk of bullying victimization. This longitudinal study aimed to determine whether prospective relationships between familial HIV/AIDS and both anxiety symptoms and depressive symptoms operate indirectly via bullying victimization. Adolescents (M = 13.45 years, 56.67 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up one year later (n = 3,401, 96.70 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces, and door-to-door sampling included all households with a resident child/adolescent. Familial HIV/AIDS at baseline assessment was not directly associated with mental health outcomes 1 year later. However, significant indirect effects operating via bullying victimization were obtained for both anxiety and depression scores. Importantly, these effects were independent of poverty, HIV/AIDS-related stigma, and baseline mental health, which highlight bullying victimization as a potential target for future intervention efforts. The implementation and rigorous evaluation of bullying prevention programs in South African communities may improve mental health outcomes for HIV/AIDS-affected children and adolescents and this should be a focus of future research and intervention.

The association between socioeconomic status and health-related quality of life among Polish postmenopausal women from urban and rural communities.

PubMed

Kaczmarek, M; Pacholska-Bogalska, J; Kwaśniewski, W; Kotarski, J; Halerz-Nowakowska, B; Goździcka-Józefiak, A

2017-01-01

In recent years, more scholarly attention has been paid to a growing range of geographic characteristics as antecedents of inequalities in women's health and well-being. The purpose of this study was to evaluate differences in health-related quality of life between rural and urban Polish postmenopausal women. Using a data set from a reproductive health preventive screening of 660 postmenopausal women aged 48-60 years, inhabitants of Wielkopolska and Lublin provinces, the association of place of residence, socioeconomic status and lifestyle factors with health-related quality of life (the SF-36 instrument) was evaluated using ANCOVA models and multiple logistic regression analysis with backward elimination steps. A consistent rural-to-urban gradient was found in all indices of physical health functioning and well-being but not in vitality, social functioning, emotional role and mental health scales with women in large cities being likely to enjoy the highest and those in villages the lowest quality of life. The rural-urban disparities in health-related quality of life were mediated by women's socioeconomic status. The likelihood of worse physical and mental functioning and well-being was 2-3 times greater for the low socioeconomic status rural women than their counterparts from more affluent urban areas. The educational attainment and employment status were the most powerful independent risk factors for health-related quality of life in both rural and urban women. Better understanding of the role of socioeconomic status that acts as a mediator in the association between area of residence and health-related quality of life may be useful in developing public health policies on health inequalities among women at midlife. Copyright © 2016. Published by Elsevier GmbH.

PREVALENCE OF MENTAL AND BEHAVIOURAL DISORDERS IN INDIA : A META-ANALYSIS

PubMed Central

Reddy, Venkataswamy M.; Chandrashekar, C.R.

1998-01-01

A meta-analysis of 13 psychiatric epidemiological studies consisting of 33572 persons in 6550 families yielded an estimate prevalence rate of 58.2 per thousand population. Organic psychosis (prevalence rate 0.4), schizophrenia (2.7), affective disorders (12.3) contributed a rate of 15.4 for psychoses. The prevalence rate for mental retardation (6.9), epilepsy (4.4), neurotic disorders (20.7), alcohol/drug addiction (6.9; and miscellaneous group (3.9) were estimated. Higher prevalence for urban sector, females, age group of 35-44, married/widowers/divorced, lower socioeconomic status, and nuclear family members were confirmed. Epilepsy and hysteria were found significantly high in rural communities. Manic affective psychosis, mental retardation, alcohol/ drug addiction and personality disorders were significantly high in males. The findings indicated that there are 1.5 crore people suffering from severe mental disorders (psychoses) in India, and that severe diseases have higher representation at specialized as well as general hospital clinics. Among other things, the results aid in conducting morbidity surveys by more methodological approach. PMID:21494462

Utilization of psychiatric services by postpartum women in a predominantly minority, low-socioeconomic-status, urban population.

PubMed

Seplowitz, Rhoda; Miller, Harold; Ostermeyer, Britta; Sangi-Haghpeykar, Haleh; Silver, Elana; Kunik, Mark E

2015-04-01

This study describes the utilization of health care services related to psychiatric diagnoses in an inner city community health organization with a largely Hispanic population of low socioeconomic status. We reviewed the frequency and timing of postpartum mental health diagnoses among 5,731 patients who delivered babies and were followed-up for postpartum care. 286 women (5 %) had at least one mental health diagnosis. The rates in white, black, and Hispanic women were 12, 8, and 5 % respectively (p < .05). White and black women were 2.5 (95 % CI 1.24, 5.07), and 1.62 (95 % CI 1.09, 2.40) times more likely to have a mental health diagnosis, respectively, compared to Hispanic women. The most common diagnoses were mood disorders (64 %) followed by anxiety disorders (29 %). 87 % of cases were diagnosed after 4 weeks postpartum. The postpartum mental health diagnosis rate seen here is lower than might be expected, particularly among Hispanic women. Possible explanations are discussed.

Prevalence of Sarcopenia and Associated Factors in Chinese Community-Dwelling Elderly: Comparison Between Rural and Urban Areas.

PubMed

Gao, Langli; Jiang, Jiaojiao; Yang, Ming; Hao, Qiukui; Luo, Li; Dong, Birong

2015-11-01

To compare the prevalence of sarcopenia in urban and rural Chinese elderly adults and to identify the risk factors related to sarcopenia. A cross-sectional study. Urban and rural communities in western China. A total of 887 community-dwelling elderly adults aged 60 years or older. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). Cognitive function, depression, and nutrition status were assessed using the Chinese version of the Mini-Mental Status Examination (MMSE), the Chinese version of the 30-item Geriatric Depression Scale (GDS-30), and the revised Mini Nutritional Assessment short-form (MNA-SF), respectively. A total of 612 individuals aged 70.6 ± 6.7 years (range, 60-91 years) were included in this study. The prevalence of sarcopenia in the study population was 9.8% (women, 12.0%; men, 6.7%; P = .031). The prevalence of sarcopenia was 13.1% in rural elders and 7.0% in urban elders (P = .012). Age (odds ratio [OR] 1.22; 95% confidence interval [CI] 1.15-1.29), women (OR 1.71; 95% CI 1.20-5.65), malnutrition or at risk for malnutrition (OR 3.53; 95% CI 1.68-7.41), rural residence (OR 2.15; 95% CI 1.33-4.51), and the number of medications (OR 1.23; 95% CI 1.06-1.44) were independently associated with sarcopenia. Rural elders are more vulnerable to sarcopenia than urban elders in a sample of western China's elderly population. More attention should focus on rural populations in future sarcopenia studies. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Utilization of Standardized Mental Health Assessments in Anthropological Research: Possibilities and Pitfalls.

PubMed

Mendenhall, Emily; Yarris, Kristin; Kohrt, Brandon A

2016-12-01

In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars' ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of psychological suffering by analyzing symptomatology. Such integrative methodologies illustrate how incorporating results from standardized mental health assessments can corroborate meaning-making in anthropology while advancing anthropological contributions to mental health treatment and policy.

Utilization of Standardized Mental Health Assessments in Anthropological Research: Possibilities and Pitfalls

PubMed Central

Mendenhall, Emily; Yarris, Kristin; Kohrt, Brandon A.

2017-01-01

In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars’ ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of psychological suffering by analyzing symptomatology. Such integrative methodologies illustrate how incorporating results from standardized mental health assessments can corroborate meaning-making in anthropology while advancing anthropological contributions to mental health treatment and policy. PMID:27553610

The impact of methamphetamine (“tik”) on a peri-urban community in Cape Town, South Africa

PubMed Central

Watt, Melissa H.; Meade, Christina S.; Kimani, Stephen; MacFarlane, Jessica C.; Choi, Karmel W.; Skinner, Donald; Pieterse, Desiree; Kalichman, Seth C.; Sikkema, Kathleen J.

2014-01-01

Background Over the last decade, South Africa’s Western Cape has experienced a dramatic increase in methamphetamine (“tik”) use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. Methods We conducted individual in-depth interviews with 55 women and 37 men who were regular attendees of alcohol-serving venues. Interviews were recorded and transcribed. A content analysis approach was used to identify themes related to the impact of tik use based on levels of the socio-ecological framework (individual, inter-personal and community). Results Tik use was reported to be a greater issue among Coloureds, compared to Blacks. At an individual level, respondents reported that tik use had adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration. At an inter-personal level, respondents reported that tik use contributed to physical and sexual violence as well as increased rates of sexual risk behaviour, particularly through transactional sex relationships. Respondents described how tik use led to household conflict, and had negative impacts on children, including neglect and poor birth outcomes. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. Conclusions Our results highlight the negative impact that tik is having on individuals, households and the overall community in a peri-urban setting in South Africa. There is a clear need for interventions to prevent tik use in South Africa and to mitigate and address the impact of tik on multiple levels. PMID:24246503

The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women from one southern state.

PubMed

Staton-Tindall, Michele; Duvall, Jamieson; Stevens-Watkins, Danelle; Oser, Carrie B

2013-09-01

This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n = 206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included.

Cohesive Neighborhoods Where Social Expectations Are Shared May Have Positive Impact On Adolescent Mental Health.

PubMed

Donnelly, Louis; McLanahan, Sara; Brooks-Gunn, Jeanne; Garfinkel, Irwin; Wagner, Brandon G; Jacobsen, Wade C; Gold, Sarah; Gaydosh, Lauren

2016-11-01

Adolescent mental health problems are associated with poor health and well-being in adulthood. We used data from a cohort of 2,264 children born in large US cities in 1998-2000 to examine whether neighborhood collective efficacy (a combination of social cohesion and control) is associated with improvements in adolescent mental health. We found that children who grew up in neighborhoods with high collective efficacy experienced fewer depressive and anxiety symptoms during adolescence than similar children from neighborhoods with low collective efficacy. The magnitude of this neighborhood effect is comparable to the protective effects of depression prevention programs aimed at general or at-risk adolescent populations. Our findings did not vary by family or neighborhood income, which indicates that neighborhood collective efficacy supports adolescent mental health across diverse populations and urban settings. We recommend a greater emphasis on neighborhood environments in individual mental health risk assessments and greater investment in community-based initiatives that strengthen neighborhood social cohesion and control. Project HOPE—The People-to-People Health Foundation, Inc.

Toward a New Model for Promoting Urban Children's Mental Health: Accessible, Effective, and Sustainable School-Based Mental Health Services

ERIC Educational Resources Information Center

Atkins, Marc S.; Graczyk, Patricia A.; Frazier, Stacy L.; Abdul-Adil, Jaleel

2003-01-01

A program of research related to school-based models for urban children's mental health is described, with a particular focus on improving access to services, promoting children's functioning, and providing for program sustainability. The first study in this series responded to the urgent need to engage more families in mental health services, and…

Children's cognitive performance and selective attention following recent community violence.

PubMed

McCoy, Dana Charles; Raver, C Cybele; Sharkey, Patrick

2015-03-01

Research has shown robust relationships between community violence and psychopathology, yet relatively little is known about the ways in which community violence may affect cognitive performance and attention. The present study estimates the effects of police-reported community violence on 359 urban children's performance on a computerized neuropsychological task using a quasi-experimental fixed-effects design. Living in close proximity to a recent violent crime predicted faster but marginally less accurate task performance for the full sample, evolutionarily adaptive patterns of "vigilant" attention (i.e., less attention toward positive stimuli, more attention toward negative stimuli) for children reporting low trait anxiety, and potentially maladaptive patterns of "avoidant" attention for highly anxious children. These results suggest that community violence can directly affect children's cognitive performance while also having different (and potentially orthogonal) impacts on attention deployment depending on children's levels of biobehavioral risk. Implications for mental health and sociological research are discussed. © American Sociological Association 2015.

Children's Cognitive Performance and Selective Attention Following Recent Community Violence

PubMed Central

McCoy, Dana Charles; Raver, C. Cybele; Sharkey, Patrick

2015-01-01

Research has shown robust relationships between community violence and psychopathology, yet relatively little is known about the ways in which community violence may affect cognitive performance and attention. The present study estimates the effects of police-reported community violence on 359 urban children's performance on a computerized neuropsychological task using a quasi-experimental fixed-effects design. Living in close proximity to a recent violent crime predicted faster but marginally less accurate task performance for the full sample, evolutionarily adaptive patterns of “vigilant” attention (i.e., less attention toward positive stimuli, more attention toward negative stimuli) for children reporting low trait anxiety, and potentially maladaptive patterns of “avoidant” attention for highly anxious children. These results suggest that community violence can directly affect children's cognitive performance while also having different (and potentially orthogonal) impacts on attention deployment depending on children's levels of biobehavioral risk. Implications for mental health and sociological research are discussed. PMID:25663176

A Multi-Level Examination of Stakeholder Perspectives of Implementation of Evidence-Based Practices in a Large Urban Publicly-Funded Mental Health System

PubMed Central

Beidas, Rinad S.; Stewart, Rebecca E.; Adams, Danielle R.; Fernandez, Tara; Lustbader, Susanna; Powell, Byron J.; Aarons, Gregory; Hoagwood, Kimberly E.; Evans, Arthur C.; Hurford, Matthew O.; Rubin, Ronnie; Hadley, Trevor; Mandell, David; Barg, Frances

2015-01-01

Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices. PMID:26658692

Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City.

PubMed

Lim, Sungwoo; Chan, Pui Ying; Walters, Sarah; Culp, Gretchen; Huynh, Mary; Gould, L Hannah

2017-01-01

As gentrification continues in New York City as well as other urban areas, residents of lower socioeconomic status maybe at higher risk for residential displacement. Yet, there have been few quantitative assessments of the health impacts of displacement. The objective of this paper is to assess the association between displacement and healthcare access and mental health among the original residents of gentrifying neighborhoods in New York City. We used 2 data sources: 1) 2005-2014 American Community Surveys to identify gentrifying neighborhoods in New York City, and 2) 2006-2014 Statewide Planning and Research Cooperative System. Our cohort included 12,882 residents of gentrifying neighborhoods in 2006 who had records of emergency department visits or hospitalization at least once every 2 years in 2006-2014. Rates of emergency department visits and hospitalizations post-baseline were compared between residents who were displaced and those who remained. During 2006-2014, 23% were displaced. Compared with those who remained, displaced residents were more likely to make emergency department visits and experience hospitalizations, mainly due to mental health (Rate Ratio = 1.8, 95% confidence interval = 1.5, 2.2), after controlling for baseline demographics, health status, healthcare utilization, residential movement, and the neighborhood of residence in 2006. These findings suggest negative impacts of displacement on healthcare access and mental health, particularly among adults living in urban areas and with a history of frequent emergency department visits or hospitalizations.

Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample.

PubMed

Hatch, S L; Gazard, B; Williams, D R; Frissa, S; Goodwin, L; Hotopf, M

2016-05-01

Few studies have examined discrimination and mental health in the UK, particularly by migrant status and in urban contexts with greater demographic diversity. This study aims to (1) describe the prevalence of discrimination experiences across multiple life domains; (2) to describe associations between discrimination experiences and common mental disorder (CMD); (3) to determine whether or not the relationship between discrimination and CMD varies by migrant status and ethnicity. Data on major, anticipated and everyday discrimination and CMD symptoms were collected from an ethnically diverse prospective sample of 1052 participants followed up from 2008 to 2013 in the South East London Community Health study, a population-based household survey. With few exceptions, discrimination was most prevalent among those in the Black Caribbean group. However, those in the White Other ethnic group had similar or greater reporting major and anticipated discrimination to Black or mixed ethnic minority groups. The effects of discrimination on CMD were most pronounced for individuals who had recently migrated to the UK, an ethnically heterogeneous group, and for Black and Mixed ethnic minority groups in partially adjusted models. Prior CMD accounted for differences between the Mixed and White British ethnic groups, but the strength of the association for the most recent migrant group and the Black ethnic groups remained two or more times greater than the reference groups. The strength of the relationship suggests a need for more consideration of migration status along with ethnicity in examining the impact of discrimination on mental disorder in community and clinical samples.

Urban Mind: Using Smartphone Technologies to Investigate the Impact of Nature on Mental Well-Being in Real Time

PubMed Central

Bakolis, Ioannis; Hammoud, Ryan; Smythe, Michael; Gibbons, Johanna; Davidson, Neil; Tognin, Stefania

2018-01-01

Abstract Existing evidence on the beneficial effects of nature on mental health comes from studies using cross-sectional designs. We developed a smartphone-based tool (Urban Mind; www.urbanmind.info) to examine how exposure to natural features within the built environment affects mental well-being in real time. The tool was used to monitor 108 individuals who completed 3013 assessments over a 1-week period. Significant immediate and lagged associations with mental well-being were found for several natural features. These associations were stronger in people with higher trait impulsivity, a psychological measure of one's tendency to behave with little forethought or consideration of the consequences, which is indicative of a higher risk of developing mental-health issues. Our investigation suggests that the benefits of nature on mental well-being are time-lasting and interact with an individual's vulnerability to mental illness. These findings have potential implications from the perspectives of global mental health as well as urban planning and design. PMID:29599549

Murug, Waali, and Gini: Expressions of Distress in Refugees From Somalia

PubMed Central

Carroll, Jennifer K.

2004-01-01

Objective: To study how mental illness is understood, expressed, and treated among Somali refugees and how these factors influence use of health services for mental problems. Method: Seventeen adult Somali refugees (9 women, 8 men) were recruited by mail or by word-of-mouth to participate in the study. The study setting was an urban community health center in Rochester, N.Y., that provides family practice patient care to local Somali refugees. A qualitative design was used that incorporated a combination of methods, chiefly semistructured interviews. Interviews focused on the ways in which sadness, depression, and anxiety are expressed and on the participants' understanding of the origins of and treatment strategies for these problems. Interview transcripts were analyzed to identify recurrent themes. Results: Nearly all participants felt that mental illness was a new problem for their community that did not exist to the same extent in prewar Somalia. Themes that emerged to explain the causes of mental illness included the shock and devastation of war; dead, missing, or separated family members; and spirit possession or a curse. Three major types of mental problems were identified that were associated with specific behaviors and treatment strategies: murug (sadness or suffering), gini (craziness due to spirit possession), and waali (craziness due to severe trauma). Rather than seek help from a clinician, participants preferred to first use family support, prayer, or traditional therapies for most situations. Conclusion: Somali refugees have distinct ways of conceptualizing, expressing, and treating commonly understood mental problems. Participants differed in their opinions about whether they would consult a doctor to discuss feelings of sadness or craziness. Effective mental health care of refugees should address culture-specific belief systems in diagnosis and treatment. PMID:15361926

Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi.

PubMed

Chepuka, Lignet; Taegtmeyer, Miriam; Chorwe-Sungani, Genesis; Mambulasa, Janet; Chirwa, Ellen; Tolhurst, Rachel

2014-01-01

This study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV) and the capacity of health services for addressing these. In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes. The significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for 'counselling'. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity. Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.

An approach to mental health in low and middle income countries: a case example from urban India

PubMed Central

Maitra, Shubhada; Brault, Marie A.; Schensul, Stephen L.; Schensul, Jean J.; Nastasi, Bonnie K.; Verma, Ravi K.; Burleson, Joseph A.

2015-01-01

Women in low and middle income countries (LMICs) facing poverty, challenging living conditions and gender inequality often express their emotional difficulties through physical health concerns and seek care at primary health facilities. However, primary care providers in LMICs only treat the physical health symptoms and lack appropriate services to address women's mental health problems. This paper, presents data from the counseling component of a multilevel, research and intervention project in a low income community in Mumbai, India whose objective was to improve sexual health and reduce HIV/STI risk among married women. Qualitative data from counselor notes shows that poor mental health, associated with negative and challenging life situations, is most often expressed by women as gynecological concerns through the culturally-based syndrome of tenshun. A path analysis was conducted on baseline quantitative data that confirmed the relationships between sources of tenshum, emotional status and symptoms of common mental disorders (CMDs). Based on these findings, the authors propose a need for culturally appropriate primary care services for LMICs that would integrate mental and physical health. This approach would reduce mental health morbidity among women through early intervention and prevention of the development of CMDs. PMID:26834278

Urbanization and Mental Health in China: Linking the 2010 Population Census with a Cross-Sectional Survey.

PubMed

Chen, Juan; Chen, Shuo; Landry, Pierre F

2015-07-31

Along with the rapid urbanization in China, the state of mental health also receives growing attention. Empirical measures, however, have not been developed to assess the impact of urbanization on mental health and the dramatic spatial variations. Innovatively linking the 2010 Chinese Population Census with a 2011 national survey of urban residents, we first assess the impact of urbanization on depressive symptoms measured by the Center of Epidemiological Studies Depression Scale (CES-D) of 1288 survey respondents. We then retrieve county-level characteristics from the 2010 Chinese Population Census that match the individual characteristics in the survey, so as to create a profile of the "average person" for each of the 2869 counties or city districts, and predict a county-specific CES-D score. We use this county-specific CES-D score to compute the CES-D score for the urban population at the prefectural level, and to demonstrate the dramatic spatial variations in urbanization and mental health across China: highly populated cities along the eastern coast such as Shenyang and Shanghai show high CES-D scores, as do cities in western China with high population density and a high proportion of educated ethnic minorities.

Social relationships and depression among people 65 years and over living in rural and urban areas of Quebec.

PubMed

Mechakra-Tahiri, Samia; Zunzunegui, Maria Victoria; Préville, Michel; Dubé, Micheline

2009-11-01

To compare the prevalence of depression within the elderly Quebec population residing in rural areas, urban areas and metropolitan Montreal, and to assess differences in the associations between social relationships and depression across these urban and rural settings. Data originate from the first wave of the ESA (Etude de Santé des Ainés) longitudinal study on mental health of community dwelling older persons aged over 65 (n = 2670). Depression, including major and minor depression, measured using a computer questionnaire; the ESA-Q developed by the research team and based on the DSM-IV criteria. Assessments of associations between depression and geographic area, informal social networks and community participation were estimated adjusting for demographic, socioeconomic and health characteristics. The prevalence of depression was higher in rural (17%) and urban areas (15.1%) than in metropolitan Montreal (10.3%). The odds ratio of rural (OR = 2.01 95% CI 1.59-2.68) and urban (OR = 1.75; 95% CI 1.25-2.45) areas compared to the metropolitan area increased slightly after adjustment by all social and health covariates. Our study indicated that social support and the lack of conflict in intimate relationships were associated with lower prevalence of depression in all areas. Geographic differences in depression exist within the elderly population in Quebec that may generate significant impact on their health and functional abilities. Further research should be conducted to explain these differences. Copyright 2009 John Wiley & Sons, Ltd.

Help-seeking preference of college students in urban China after the implementation of the "open-door" policy.

PubMed

Boey, K W

1999-01-01

A sample of 466 college students (228 males, 238 females) in urban China completed a questionnaire to indicate their help-seeking preferences with respect to 8 types of problem. The results indicated that our subjects, particularly male students, preferred to rely on their own in resolving their problems, although this self-reliant tendency was less obvious for problems of future employment and severe psychological distress. When help was sought, the tendency to rely on parents was found to be stronger among females than males. Male students were more likely than their female counterparts to seek help from friends and psychiatric consultation. Nevertheless, there was still great reluctance among the college students to use mental health services, particularly psychiatric consultation. Lack of credibility of the professionals was a barrier more negative than stigmatization which prevented students from seeking psychiatric consultation. Moral rather than psychosocial attribution of psychiatric illness was most predictive of the tendency to use mental health services. Findings inconsistent with those reported in other Chinese communities are discussed.

Public stigma against family members of people with mental illness: findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia.

PubMed

Girma, Eshetu; Möller-Leimkühler, Anne Maria; Müller, Norbert; Dehning, Sandra; Froeschl, Guenter; Tesfaye, Markos

2014-02-21

Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma. A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma. Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (± 0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. β = 0.43, P < 0.001) than urban residents. As the number of perceived signs (std. β = -0.07, P < 0.05), perceived supernatural (std. β = -0.12, P < 0.01) and psychosocial and biological (std. β = -0.11, P < 0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status. Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented.

Impact of postpartum anxiety and depression on child’s mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study

PubMed Central

2013-01-01

Background Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children’s mental development on all sub-scales in a Pakistani population. Methods A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children’s growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family relationship variables were collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother’s levels of anxiety and depression were assessed at 1, 2, 6, 12, 18, 24, and 30 months of childbirth. An indigenous, validated screening instrument- Aga Khan University Anxiety and Depression scale was used and diagnostic confirmation was done through a psychologist’s interview, based on DSM IV criteria. Children’s growth and development was monitored in the same sequence using an Early Childhood Development tool that consists of five subscales; socio emotional, language, cognitive, gross motor and fine motor development. Physical growth was monitored by measuring height and weight of the child. Data was analyzed using SAS 9.2. Multivariable Generalized Estimating Equations (GEE) logistic regression was conducted to identify association of postpartum anxiety and depression with each early childhood development indicator, adjusting for parental and child factors. Results A significant association of postpartum anxiety and depression with delayed development on all five subscales of children’s mental development was found in our study. Interestingly, our study found that higher maternal age had adverse effects on child’s emotional whereas positive impact on child’s cognitive development. Children’s stunting had an adverse impact on all five subscales of children’s development. Male children were at higher risk for delayed language and gross motor development relative to female children. Conclusions Our study found that postpartum anxiety and depression is associated with adverse outcomes regarding children’s mental development on all sub-scales. The impact was accentuated by low family income or child’s increasing age. PMID:24148567

Urban planning and public health at CDC.

PubMed

Kochtitzky, Chris S; Frumkin, H; Rodriguez, R; Dannenberg, A L; Rayman, J; Rose, K; Gillig, R; Kanter, T

2006-12-22

Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and public health share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, public health most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and public health have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and public health. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept that community design contributes to physical and mental health; serving as President Lincoln's U.S. Sanitary Commission Secretary; and designing hundreds of places, including New York's Central Park. By 1872, the disciplines were so aligned that two of the seven founders of the American Public Health Association were urban designers (an architect and a housing specialist). In 1926, the U.S. Supreme Court, in validating zoning and land-use law as a legal government authority in Village of Euclid v. Ambler Realty, cited the protection of public health as part of its justification. Other connections have included 1) pioneering urbanist Jane Jacobs, who during the 1960s, called for community design that offered safe and convenient options for walking, biking, and impromptu social interaction; and 2) the Healthy Cities movement, which began in Europe and the United States during the 1980s and now includes projects in approximately 1,000 cities that in various ways highlight the role of health as much more than the presence of medical care.

Mental health status and related characteristics of Chinese male rural-urban migrant workers.

PubMed

Yang, Tingzhong; Xu, Xiaochao; Li, Mu; Rockett, Ian R H; Zhu, Waner; Ellison-Barnes, Alejandra

2012-06-01

To explore mental health status and related characteristics in a sample of Chinese male rural-urban migrants. Subjects were 1,595 male rural-urban migrant workers selected though a multi-stage sample survey conducted in two cities (Hangzhou and Guangzhou). Data were collected by means of a self-administered questionnaire. Both life and work stressors were examined. Stress and mental health status were measured by the Chinese Perceived Stress Scale (CPSS) and the Chinese Health Questionnaire (CHQ), respectively. Unconditional logistic regression analysis was performed to identify factors associated with probable mental disorders. There are approximately 120 million rural-urban migrants in China. The prevalence of probable mental disorders in the sample population was 24.4% (95% CI: 23.3-25.5%), which was higher than among urban residents (20.2%, 95% CI: 18.8-21.7%). Logistic regression analysis revealed that five characteristics were positively associated with risk for probable mental disorders: originating in the South (OR = 2.00; 95% CI = 1.02, 4.00), higher life stress (OR = 7.63; 95% CI = 5.88, 10.00), staying in the city for 5-9 months each year (OR = 2.56; 95% CI = 1.67, 3.85), higher work stress (OR = 2.56; 95% CI = 1.96, 3.33), and separation from wife (OR = 2.43; 95% CI = 1.61, 3.57). Employment in machinery and transportation (OR = 0.54; 95% CI = 0.36, 0.81) and higher self-worth (OR = 0.42; 95% CI = 0.28, 0.62) were negatively associated. Findings support an urgent need to develop specific policies and programs to address mental health problems among Chinese rural-urban migrants.

Effects of stigma on the mental health of adolescents orphaned by AIDS.

PubMed

Cluver, Lucie D; Gardner, Frances; Operario, Don

2008-04-01

By 2010, an estimated 18.4 million children in Sub-Saharan Africa will be orphaned by AIDS. Research in South Africa shows that AIDS orphanhood is independently associated with heightened levels of psychological problems. This study is the first to explore the mediating effects of stigma and other factors operating on a community level, on associations between AIDS orphanhood and mental health. We assessed the associations of four risk factors that can potentially be addressed at a community level (bullying, stigma, community violence, and lack of positive activities) with psychological problems and orphanhood status. One thousand twenty-five participants aged 10-19 were recruited from deprived urban settlements in South Africa. The sample included adolescents orphaned by AIDS (n = 425), adolescents orphaned by non-AIDS causes (n = 241), and nonorphaned adolescents (n = 278). Participants were interviewed using standardized psychological measures of depression, anxiety, posttraumatic stress, peer problems, delinquency, and conduct problems. Information on risk factors and demographic characteristics were also assessed. AIDS-orphaned adolescents reported higher levels of stigma and fewer positive activities than other groups. There were no reported differences on bullying or community violence. All community-level risk factors were associated with poorer psychological outcomes. Multivariate analyses controlling for age and gender showed that experience of stigma significantly mediated associations between AIDS orphanhood and poor psychological outcomes. Reduction of AIDS-related stigma could potentially reduce adverse psychological outcomes among AIDS-orphaned adolescents.

Women's Perceptions of Reproductive Health in Three Communities around Beirut, Lebanon

PubMed Central

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2006-01-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities. A 2005 Reproductive Health Matters. All rights reserved. PMID:16035595

Women's perceptions of reproductive health in three communities around Beirut, Lebanon.

PubMed

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2005-05-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities.

Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

PubMed

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

2016-12-01

School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

Influence of urbanity on perception of mental illness stigma: a population based study in urban and rural Hanoi, Vietnam.

PubMed

Ta, Thi Minh Tam; Zieger, Aron; Schomerus, Georg; Cao, Tien Duc; Dettling, Michael; Do, Xuan Tinh; Mungee, Aditya; Diefenbacher, Albert; Angermeyer, Matthias C; Hahn, Eric

2016-12-01

To examine, for the first time in Vietnam, whether urbanity of respondents among other socio-demographic factors affects the public perception of stigma attached to persons with mental illness in Hanoi. A general population-based survey was carried out in 2013 in the greater Hanoi area. The perception of stigma attached to people with mental illness was elicited using Link's perceived discrimination and devaluation scale (PDDS) carried out in Vietnamese language. The survey sample (n = 806) was stratified for gender, urban/rural location, age, household size and marital status, in accordance with the 2013 Vietnamese census. Comparing the total score of the PDDS and its single items, we found less perceived stigma and discrimination among the rural population of Hanoi and in respondents who reported religious attainment to either Buddhism or Christianity. Logistic regression analyses found no significant influences of gender, age, household size or marital status regarding the perceived stigma toward persons with mental illness. Less negative perception of stigma attached to persons with mental illness that was observed among the rural population in the Hanoi area may be interpreted in the light of possibly more demanding living conditions in modern urban Vietnam with less opportunities for mentally ill patients and points toward a dynamic interaction with rapidly changing living conditions in Asian megacities. © The Author(s) 2016.

Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas

ERIC Educational Resources Information Center

Baldwin, Laura-Mae; Patanian, Miriam M.; Larson, Eric H.; Lishner, Denise M.; Mauksch, Larry B.; Katon, Wayne J.; Walker, Edward; Hart, L. Gary

2006-01-01

Context: Ensuring an adequate mental health provider supply in rural and urban areas requires accessible methods of identifying provider types, practice locations, and practice productivity. Purpose: To identify mental health shortage areas using existing licensing and survey data. Methods: The 1998-1999 Washington State Department of Health files…

Quality of life in China rural-to-urban female migrant factory workers: a before-and-after study.

PubMed

Zhu, Chunyan; Geng, Qingshan; Yang, Hongling; Chen, Li; Fu, Xianhua; Jiang, Wei

2013-07-23

Rural-to-urban female migrant workers have a lower quality of life compared to the general population. Improving these conditions remains highly challenging. This paper reports the health-related quality of life (HRQoL) of the female migrant workers in an educational project. In this before-and-after study, a community-based health education intervention was developed to improve female migrant workers' HRQoL and job satisfaction. A factory was selected as the location to implement the trial, using a before-and-after design. The education intervention included distribution and free access to study materials, monthly lectures, and counseling. The primary endpoint was HRQoL, and gynecological disease and job satisfaction were secondary endpoints. We assessed HRQoL at baseline and at 6-month follow-up using the Health Survey Short Form (SF-36). Compared to the baseline assessment, the participants at the 6-month survey reported higher General Health scores (standardized-β coefficients (Betas) of β = 0.056; P <0.001), Vitality scores (β = 0.066; P <0.001), Mental Health scores (β = 0.062; P <0.001), mental component summary scores (β = 0.040; P <0.001), and job satisfaction (Odds Ratio [OR] 2.104, 95% confidence interval [CI] 1.837-2.408; P <0.01). A community-based educational intervention, targeted at female migrant workers, appears effective in improving HRQoL and job satisfaction.

Prevalence of psychiatric morbidity at Mobile Health Clinic in an urban community in North India.

PubMed

Salve, Harshal; Goswami, Kiran; Nongkynrih, Baridalyne; Sagar, Rajesh; Sreenivas, V

2012-01-01

The objective was to estimate the prevalence of psychiatric morbidity amongst patients attending Mobile Health Clinic (MHC) in an urban community in South Delhi. Adult subjects were recruited by systematic random sampling at outpatient MHC. Primary Care Evaluation of Mental Disorder Patient Health Questionnaire (PHQ) was used for screening, and Mini International Neuropsychiatric Interview (M.I.N.I.) was used for the confirmation of diagnosis of psychiatric disorder of all PHQ-positive and 20% of PHQ-negative patients. Association of selected sociodemographic factors with psychiatric morbidity was also assessed. In total, 350 subjects were recruited, out of which 92 (26.3%) [95% confidence interval (CI) 21.7-31.0] were found to be PHQ positive. M.I.N.I. was administered to 141 subjects (92 PHQ positives and 52 PHQ negatives). Total estimated magnitude of psychiatric morbidity by M.I.N.I. was 25.4% (95% CI 20.9-29.9). Depression (15.7%) was observed to be the most common psychiatric disorder followed by generalized anxiety disorder (11.1%) and phobic disorders (10.1%). Suicidal ideation was reported by 37 (10.6%) patients. Literate status [odds ratio (OR)=0.43] and duration of migration >20 years to study area (OR=1.27) were found to be significantly associated with psychiatric morbidity. In resource-poor country like India, high psychiatric morbidity at MHC justifies the use of MHC for providing outreach mental health services in difficult areas. Copyright © 2012 Elsevier Inc. All rights reserved.

Association between perceived neighborhood environment and health of middle-aged women living in rapidly changing urban Mongolia.

PubMed

Shagdarsuren, Tserendulam; Nakamura, Keiko; McCay, Layla

2017-05-31

This study was conducted in rapidly urbanizing Ulaanbaatar, Mongolia, to examine patterns of perceived neighborhood quality by residents and the associations between these patterns and self-reported general and mental health in middle-aged women. A questionnaire survey was administered to 960 women aged 40-60 years. Demographic and socio-economic characteristics, subjects' perception of their neighborhood environment, general health status, and mental health as measured using a 12-item General Health Questionnaire (GHQ12) were reported. A total of 830 women completed the questionnaire. Subjects reporting their general health as very good or good accounted for 80.3% and those with a GHQ12 ≥16, which reflects psychological distress or severe distress, accounted for 16.1%. A principal component analysis of the perceptions of neighborhood environment by the residents identified six qualities: physical environment, designed environment, neighborhood community, public safety, natural environment, and citizen services. The perception of better-quality citizen services in the neighborhood was associated with better self-reported general health (odds ratio [OR] = 1.330, 95% confidence interval [CI] 1.093-1.618), and the perception of better-quality public safety was associated with less psychological distress (OR = 0.718, 95% CI 0.589-0.876); these associations were independent of education, income, occupation, type of residential area, and number of years living in the current khoroo. The perception of the quality of a neighborhood environment can affect the self-reported general and mental health of residents, even after accounting for the type of residential area and individual socio-economic status. Developing high-quality neighborhoods is an essential component of good planning to promote population health in urban environments.

Measuring the effects of socioeconomic factors on mental health among migrants in urban China: a multiple indicators multiple causes model.

PubMed

Guan, Ming

2017-01-01

Since 1978, rural-urban migrants mainly contribute Chinese urbanization. The purpose of this paper is to examine the effects of socioeconomic factors on mental health of them. Their mental health was measured by 12-item general health questionnaire (GHQ-12). The study sample comprised 5925 migrants obtained from the 2009 rural-to-urban migrants survey (RUMiC). The relationships among the instruments were assessed by the correlation analysis. The one-factor (overall items), two-factor (positive vs. negative items), and model conducted by principal component analysis were tested in the confirmatory factor analysis (CFA). On the basis of three CFA models, the three multiple indicators multiple causes (MIMIC) models with age, gender, marriage, ethnicity, and employment were constructed to investigate the concurrent associations between socioeconomic factors and GHQ-12. Of the sample, only 1.94% were of ethnic origin and mean age was 31.63 (SD = ±10.43) years. The one-factor, two-factor, and three-factor structure (i.e. semi-positive/negative/independent usefulness) had good model fits in the CFA analysis and gave order (i.e. 2 factor>3 factor>1 factor), which suggests that the three models can be used to assess psychological symptoms of migrants in urban China. All MIMIC models had acceptable fit and gave order (i.e. one-dimensional model>two-dimensional model>three-dimensional model). There were weak associations of socioeconomic factors with mental health among migrants in urban China. Policy discussion suggested that improvement of socioeconomic status of rural-urban migrants and mental health systems in urban China should be highlighted and strengthened.

The mental health gender-gap in urban India: patterns and narratives.

PubMed

Das, Jishnu; Das, Ranendra Kumar; Das, Veena

2012-11-01

Women report significantly higher levels of mental distress than men in community studies around the world. We provide further evidence on the origins of this mental health gender-gap using data from 789 adults, primarily spousal pairs, from 300 families in Delhi, India. These data were collected between 2001 and 2003. We first confirm that, like in other studies, women report higher levels of mental distress and that gender differences in education, household expenditures and age do not explain the mental health gender-gap. In contrast, women report significantly higher levels of distress than men in families with adverse reproductive outcomes, particularly the death of a child. Controlling for adverse reproductive outcomes sharply reduces the mental health gender-gap. Finally, mental health is strongly correlated with physical health for both men and women, but there is little evidence of a differential response by sex. We complement this empirical description with anthropological analysis based on ethnographic interviews with 100 men and 100 women. With the help of these ethnographic interviews we show how adverse life events for women are experienced as the inability to maintain the domestic, which seems to be at stake within their life worlds. We raise issues for further research on the apparent finding that the mental health of women and men are differentially affected by adverse reproductive events in the family in this sample. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mental Health Disorders, Psychological Distress, and Suicidality in a Diverse Sample of Lesbian, Gay, Bisexual, and Transgender Youths

PubMed Central

Garofalo, Robert; Emerson, Erin M.

2010-01-01

Objectives. We examined associations of race/ethnicity, gender, and sexual orientation with mental disorders among lesbian, gay, bisexual, and transgender (LGBT) youths. Methods. We assessed mental disorders by administering a structured diagnostic interview to a community sample of 246 LGBT youths aged 16 to 20 years. Participants also completed the Brief Symptom Inventory 18 (BSI 18). Results. One third of participants met criteria for any mental disorder, 17% for conduct disorder, 15% for major depression, and 9% for posttraumatic stress disorder. Anorexia and bulimia were rare. Lifetime suicide attempts were frequent (31%) but less so in the prior 12 months (7%). Few racial/ethnic and gender differences were statistically significant. Bisexually identified youths had lower prevalences of every diagnosis. The BSI 18 had high negative predictive power (90%) and low positive predictive power (25%) for major depression. Conclusions. LGBT youths had higher prevalences of mental disorder diagnoses than youths in national samples, but were similar to representative samples of urban, racial/ethnic minority youths. Suicide behaviors were similar to those among representative youth samples in the same geographic area. Questionnaires measuring psychological distress may overestimate depression prevalence among this population. PMID:20966378

A Comparative Study of Self-Efficacy for Social Participation of People with Mental Illness in Japan and China.

PubMed

Amagai, Manami; Li, Conghong; Kobayashi, Noriko; Hiroshima, Mayo

2016-06-01

Self-efficacy for social participation (SESP) of people with mental illness was examined in urban areas of Japan and China. The subjects were 266 people (140 Japanese, 126 Chinese) with mental illness who were living in their local community. Our SESP scale (SESP27) and the Rosenberg Self-Esteem Scale, Norbeck Social Support Questionnaire (NSSQ), Sense of Coherence measure (SOC13), General Health Questionnaire (GHQ12), and a self-administered questionnaire related to living conditions were used for data collection. Data were analyzed descriptively, correlations between scales were examined, and multiple regression analysis was performed by country. The results showed that annual income was related to SESP in Japan and China. Therefore, improvement of welfare and employment support for economic independence is likely to improve SESP of people with mental illness in both countries. In addition, SESP in people with mental illness is affected by self-esteem in Japan, and coping skills such as improvement of life functions in China. Thus, SESP is affected differently by the social, cultural and institutional characteristics of each country. Copyright © 2016 Elsevier Inc. All rights reserved.

Investigating tangible and mental resources as predictors of perceived household food insecurity during pregnancy among women in a South African birth cohort study.

PubMed

Pellowski, Jennifer A; Barnett, Whitney; Kuo, Caroline C; Koen, Nastassja; Zar, Heather J; Stein, Dan J

2017-08-01

Food insecurity during pregnancy is concerning given the increased nutritional needs of the mother for proper fetal development. However, research is lacking within the South African context to investigate the association of economic and psychosocial factors and food insecurity among pregnant women, using comprehensive, conceptually driven models. This study applies the Network-Individual-Resource (NIR) Model to investigate individual, intimate dyadic, and family level predictors of perceived household food insecurity for pregnant women. 826 pregnant women enrolled in the Drakenstein Child Health Study (DCHS), a birth cohort in two communities in a peri-urban area of South Africa. Hierarchical logistic regressions were used to investigate the impact of household/family, intimate dyads, and individual tangible and mental resources on perceived household food insecurity during the critical period of pregnancy. Perceived household food insecurity was assessed through an adapted version of the USDA Household Food Security Scale - Short Form. Among 826 pregnant women in South Africa, individual-level tangible resources (e.g. income, social assistance, HIV status) and mental resources (e. g. depression, childhood trauma) predicted perceived household food insecurity and these predictors differed by community. Intimate dyadic and family level resources did not predict household food insecurity. Our findings of the economic and psychosocial predictors of perceived household food insecurity among pregnant women in South Africa, mirror findings in general populations. This study provides support for the extension of the NIR model to perceived household food insecurity, particularly regarding individual-level mental and tangible resources, as well as the impact of community-level factors. Future research should investigate the extent to which resource sharing occurs within networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Roles of Individual and Organizational Factors in Burnout among Community-Based Mental Health Service Providers

PubMed Central

Green, Amy E.; Albanese, Brian J.; Shapiro, Nicole M.; Aarons, Gregory A.

2014-01-01

Public sector mental health care providers are at high risk for burnout which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health sub-disciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, Wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among Wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families. PMID:24564442

Hope and Burden among Latino Families of Adults with Schizophrenia

PubMed Central

HERNANDEZ, MERCEDES; BARRIO, CONCEPCIÓN; YAMADA, ANN-MARIE

2016-01-01

This study examined hope and family burden among Latino families of individuals with schizophrenia. The sample consisted of 54 family members, one family member per outpatient adult recruited from public mental health programs in a diverse urban community. Hierarchical linear regression analyses were used to test the hypothesis that the family member’s increased hope for the patient’s future would be associated with decreased family burden beyond effects explained by the patient’s length of illness and severity of symptoms. Results supported the study hypothesis. Family hope for the patient’s future was associated with four of five types of family burden. Findings point to the prominent role of hope as a source of resilience for Latino families dealing with severe mental illness of a loved one. PMID:24329411

Future Directions for Dissemination and Implementation Science: Aligning Ecological Theory and Public Health to Close the Research to Practice Gap

PubMed Central

Rusch, Dana; Mehta, Tara G.; Lakind, Davielle

2015-01-01

Dissemination and implementation science (DI) has evolved as a major research model for children’s mental health in response to a longstanding call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools, and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an over-emphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children’s healthy development, and utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation’s mental health burden by supporting the needs and values of families and communities within their own unique social ecologies. PMID:26155972

Future Directions for Dissemination and Implementation Science: Aligning Ecological Theory and Public Health to Close the Research to Practice Gap.

PubMed

Atkins, Marc S; Rusch, Dana; Mehta, Tara G; Lakind, Davielle

2016-01-01

Dissemination and implementation science (DI) has evolved as a major research model for children's mental health in response to a long-standing call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an overemphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children's healthy development and for utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation's mental health burden by supporting the needs and values of families and communities within their own unique social ecologies.

Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City

PubMed Central

Walters, Sarah; Culp, Gretchen; Huynh, Mary; Gould, L. Hannah

2017-01-01

Objectives As gentrification continues in New York City as well as other urban areas, residents of lower socioeconomic status maybe at higher risk for residential displacement. Yet, there have been few quantitative assessments of the health impacts of displacement. The objective of this paper is to assess the association between displacement and healthcare access and mental health among the original residents of gentrifying neighborhoods in New York City. Methods We used 2 data sources: 1) 2005–2014 American Community Surveys to identify gentrifying neighborhoods in New York City, and 2) 2006–2014 Statewide Planning and Research Cooperative System. Our cohort included 12,882 residents of gentrifying neighborhoods in 2006 who had records of emergency department visits or hospitalization at least once every 2 years in 2006–2014. Rates of emergency department visits and hospitalizations post-baseline were compared between residents who were displaced and those who remained. Results During 2006–2014, 23% were displaced. Compared with those who remained, displaced residents were more likely to make emergency department visits and experience hospitalizations, mainly due to mental health (Rate Ratio = 1.8, 95% confidence interval = 1.5, 2.2), after controlling for baseline demographics, health status, healthcare utilization, residential movement, and the neighborhood of residence in 2006. Conclusions These findings suggest negative impacts of displacement on healthcare access and mental health, particularly among adults living in urban areas and with a history of frequent emergency department visits or hospitalizations. PMID:29272306

Insurance status of urban detained adolescents.

PubMed

Aalsma, Matthew C; Blythe, Margaret J; Tong, Yan; Harezlak, Jaroslaw; Rosenman, Marc B

2012-10-01

The primary goal was to describe the health care coverage of detained youth. An exploratory second goal was to describe the possible relationship between redetention and coverage. Health care coverage status was abstracted from electronic detention center records for 1,614 adolescents in an urban detention center (October 2006 to December 2007). The majority of detained youth reported having Medicaid coverage (66%); 18% had private insurance and 17% had no insurance. Lack of insurance was more prevalent among older, male, and Hispanic youth. A substantial minority of detained youth were uninsured or had inconsistent coverage over time. While having insurance does not guarantee appropriate health care, lack of insurance is a barrier that should be addressed to facilitate coordination of medical and mental health care once the youth is released into the community.

High prevalence of cardiovascular risk factors in Peruvian adolescents living in a peri-urban shantytown: a cross-sectional study.

PubMed

Abbs, Elizabeth S; Viñoles, José; Alarcón, Jorge O; Johnson, Heather M; Zunt, Joseph R

2017-05-22

Adults of the peri-urban Peruvian shantytown of Lomas de Zapallal have a high prevalence of risk factors for developing cardiovascular disease (CVD)-likely due to behavioral choices established during childhood and adolescence. To guide the development of community-based risk reduction programs, we assessed the prevalence of risk factors for developing CVD among adolescents. We collected cross sectional data from adolescents of Peruvian peri-urban shantytown to evaluate four domains of CVD risk factors: (1) clinical (blood pressure, fasting blood glucose, and blood lipids), (2) anthropometric (height, weight, and waist circumference), (3) behavioral (physical activity, diet, and substance abuse), and (4) psychosocial (mental health and violence). We enrolled 275 adolescents (56.4% female, mean age 14 years). Prevalence of overweight or obese status was 27.8%. High blood pressure was more common in males (37.4%) than females (20.5%) (p = 0.002). Total cholesterol was elevated (>170 mg/dL) in nearly half (45.5%) of the adolescents, and 71% had impaired fasting blood glucose (>100 mg/dL). Females were less likely to exercise daily (95.4%) than males (84.2%) (p = 0.002) but reported higher rates of depression (66.4%), anhedonia (67.6%), and self-harm behavior (37.9%) (all p < 0.01). Adolescents living in the peri-urban population of Puente Piedra had high prevalence of risk factors for future development of CVD; preventative efforts focused on improving nutrition, increasing physical inactivity, and addressing mental health conditions could reduce such risk factors.

[Performance of cognitive brief test in elderly patients with dementia in advanced stage living in an urban community of Lima, Peru].

PubMed

Custodio, Nilton; Alva-Diaz, Carlos; Becerra-Becerra, Yahaira; Montesinos, Rosa; Lira, David; Herrera-Pérez, Eder; Castro-Suárez, Sheila; Cuenca-Alfaro, José; Valeriano-Lorenzo, Elizabeth

2016-01-01

Evaluate the performance of clock drawing test- Manos versión (PDR-M) and Mini Mental State Examination -Peruvian version (MMSE) to detect dementia in a sample based on urban community of Lima, Peru. This study is a secondary analysis database, observational, analytical and cross-sectional, the gold standard was the clinical and the neuropsychological evaluations together. Performance testing individually and in combination were evaluated.. Data were obtained from prevalence study conducted in 2008 in Cercado de Lima. MMSE performance for evaluation of patients with dementia of any kind showed sensitivity of 64,1%, specificity of 84,1%, PPV of 24.4%, NPV of 96.7%, PLR of 4,03 and NLR of 0,43. PDR-M showed sensitivity of 89,3%, specificity of 98,1%, PPV of 79.3%, NPV of 99.1%, PLR of 47,79 and NLR of 0,11. When both tests were applied, and at least one of them was positive, they showed sensitivity 98.1%, specificity 84.1%, PPV of 33.1%, NPV of 99.8%, PLR of 6,17 and NLR of 0,02. When performing separate analysis of Alzheimer-type dementia and non- Alzheimer dementia, the values of the parameters do not differ substantially from those obtained for dementia of any kind. The combination of MMSE and PDR-M show good discriminative ability to detect moderate and severe dementia in population living in urban community in Lima.

Community Schools: a Public Health Opportunity to Reverse Urban Cycles of Disadvantage.

PubMed

Diamond, Catherine; Freudenberg, Nicholas

2016-12-01

Community schools link students, families, and communities to educate children and strengthen neighborhoods. They have become a popular model for education in many US cities in part because they build on community assets and address multiple determinants of educational disadvantage. Since community schools seek to have an impact on populations, not just the children enrolled, they provide an opportunity to improve community health. Community schools influence the health and education of neighborhood residents though three pathways: building trust, establishing norms, and linking people to networks and services. Through such services as school-based health centers, nutrition education, family mental health counseling, violence prevention, and sexuality education, these schools build on the multiple reciprocal relationships between health and education. By developing closer ties between community schools and neighborhood health programs, public health professionals can help to mobilize a powerful new resource for reducing the health and educational inequalities that now characterize US cities. We suggest an agenda for research, practice, and policy that can build the evidence needed to guide such a strategy.

Facilitators and barriers to doing workplace mental health research: Case study of acute psychological trauma in a public transit system.

PubMed

Links, Paul S; Bender, Ash; Eynan, Rahel; O'Grady, John; Shah, Ravi

2016-03-10

The Acute Psychological Trauma (APT) Study was a collaboration between an acute care hospital, a specialized multidisciplinary program designed to meet the mental health needs of injured workers, and a large urban public transit system. The overall purpose was to evaluate a Best Practices Intervention (BPI) for employees affected by acute psychological trauma compared to a Treatment as Usual (TAU) group. The specific purpose is to discuss facilitators and barriers that were recognized in implementing and carrying out mental health research in a workplace setting. Over the course of the APT study, a joint implementation committee was responsible for day-to-day study operations and made regular observations on the facilitators and barriers that arose throughout the study. The facilitators to this study included the longstanding relationships among the partners, increased recognition for the need of mental health research in the workplace, and the existence of a community advisory committee. The significant barriers to doing this study of mental health research in the workplace included differences in organizational culture, inconsistent union support, co-interventions, and stigma. Researchers and funding agencies need to be flexible and provide additional resources in order to overcome the barriers that can exist doing workplace mental health research.

[Community mental health networks and doors at a Health and Community Center (CeSAC No 24) in the south of the Autonomous City of Buenos Aires (CABA)].

PubMed

Corin, Marcela

2013-01-01

The history of the Health and Community Center (CeSAC) No 24 began 21 years ago in the Ramón Carrillo district, in Villa Soldati neighborhood. This is a marginal urban area in the south of the CABA with a population with urgent needs. The work started with a group of professionals dealing with primary care practices, and it continues up to the present. The goal of our community mental health project is the creation of spaces for prevention and well-being including art in all its expressions, with the active participation of neighbors in the coordination of many activities. Through the symbolic opening of doors and making networks visible, we opened the CeSAC to universities, scientific societies, foundations, NGOs, neighbor committees, neighborhood boards, human rights organizations, formal and informal education centers, cultural centers, churches, community radios, in order to show the vital movements of the community, as we -as a team- are an integral part of it. Our spaces, workshops and programs are a collective socio-historical construction that achieves milestones such as thinking, thinking of us, getting together and achieving the participation from the community and the continuous training for everybody working and living in Soldati. The decentralization and democratization trend, and the heterarchical management of our organization favors the possibility of catalyzing the wishes, motivations and efforts of the healthcare team, neighbors and network nodes, thus benefiting the creative work that turns a dream into a hopeful reality.

Experiencing Community: Perspectives of Individuals Diagnosed as Having Serious Mental Illness

PubMed Central

Bromley, Elizabeth; Gabrielian, Sonya; Brekke, Benjamin; Pahwa, Rohini; Daly, Kathleen A.; Brekke, John S.; Braslow, Joel T.

2013-01-01

Objective Community integration is recognized as a crucial component of recovery from serious mental illness. Although the construct of community integration can be measured with structured instruments, little is known about the subjective and experiential meaning of community and community involvement for persons with serious mental illness. Methods In 2010, 30 individuals with serious mental illness treated in two public mental health clinics completed semistructured interviews that elicited the places and people that they associate with the experience of community and the larger meaning of community in their lives. Results Participants described four experiences as integral to their concepts of community: receiving help, minimizing risk, avoiding stigma, and giving back. Participants looked for communities that provide reliable support, and they described the need to manage community contact in order to protect themselves and others from their symptoms and from discrimination. Most participants experienced communities centered on mental health treatment or mentally ill peers as providing opportunities for positive engagement. Conclusions The experience of having a serious mental illness shapes preferences for and perceptions of community in pervasive ways. Participants describe community involvement not as a means to move away from illness experiences and identities but as a process that is substantially influenced by them. Mental health communities may help individuals with serious mental illness to both manage their illness and recognize and enjoy a sense of community. The findings indicate the need for further research on the relationship between community integration and outcome in serious mental illness. PMID:23545784

Words have power: (re)-defining serious emotional disturbance for American Indian and Alaska Native children and their families.

PubMed

Simmons, Teisha M; Novins, Douglas K; Allen, James

2004-08-12

Circles of Care grantees were provided the opportunity to develop a locally relevant definition of serious emotional disturbance that would be used to define what type of emotional, behavioral, and mental disability would be required to receive services. After conducting detailed assessments of the definition in the guidance for applicants GFA and the definitions used by others in their respective states, seven of the nine grantees developed their own local, project-specific definitions through the participation of community focus groups and Advisory Councils. The six definitions for SED developed by rural grantees all included American Indian and Alaska Native concepts specific to each tribal community's culture; the urban grantee's definition was purposely focused for reaching out to non-professional members of the community. This opportunity for the communities to redefine SED not only provided each community with a definition which would be more culturally specific, but also proved to be an extraordinarily exercise in empowerment and self-determination.

Community Psychology and Community Mental Health: A Call for Reengagement.

PubMed

Townley, Greg; Brown, Molly; Sylvestre, John

2018-03-01

Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well-being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area. The issue includes 12 articles authored by diverse stakeholder groups. Following a review of the state of community mental health scholarship in the field's two primary journals since 1973, the remaining articles center on four thematic areas: (a) the community experience of individuals with serious mental illness; (b) the utility of a participatory and cross-cultural lens in our engagement with community mental health; (c) Housing First implementation, evaluation, and dissemination; and (d) emerging or under-examined topics. In reflection, we conclude with a series of challenges for community psychologists involved in future, transformative, movements in community mental health. © Society for Community Research and Action 2018.

A Multi-Level Examination of Stakeholder Perspectives of Implementation of Evidence-Based Practices in a Large Urban Publicly-Funded Mental Health System.

PubMed

Beidas, Rinad S; Stewart, Rebecca E; Adams, Danielle R; Fernandez, Tara; Lustbader, Susanna; Powell, Byron J; Aarons, Gregory A; Hoagwood, Kimberly E; Evans, Arthur C; Hurford, Matthew O; Rubin, Ronnie; Hadley, Trevor; Mandell, David S; Barg, Frances K

2016-11-01

Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices.

Rupture, resilience, and risk: relationships between mental health and migration among gay-identified men in North America.

PubMed

Lewis, Nathaniel M

2014-05-01

An established body of research in psychology, psychiatry and epidemiology links social stigma and stress with poor mental and sexual health outcomes among gay-identified men. Less work considers how these linkages are mediated by place and almost none considers the role of movement across places. This qualitative study, based on the migration narratives of 48 gay-identified men living in Ottawa, Ontario, Canada, and Washington, D.C., U.S.A. gives more careful consideration to the ways in which mental and emotional health issues (e.g., anxiety, depression, substance use) in this population both precipitate migration and stem from migration. The narratives show that decisions to migrate often emerge from men׳s experiences of place-based minority stress and associated health outcomes. At the same time, moving to urban gay communities, when coupled with other life circumstances, can create or reinforce physical and emotional insecurities that lead to low self-esteem, substance use and sexual risk-taking. Copyright © 2014 Elsevier Ltd. All rights reserved.

Gender patterns in the contribution of different types of violence to posttraumatic stress symptoms among South African urban youth.

PubMed

Kaminer, Debra; Hardy, Anneli; Heath, Katherine; Mosdell, Jill; Bawa, Umesh

2013-05-01

Identifying the comparative contributions of different forms of violence exposure to trauma sequelae can help to prioritize interventions for polyvictimized youth living in contexts of limited mental health resources. This study aimed to establish gender patterns in the independent and comparative contributions of five types of violence exposure to the severity of posttraumatic stress symptoms among Xhosa-speaking South African adolescents. Xhosa-speaking adolescents (n=230) attending a high school in a low-income urban community in South Africa completed measures of violence exposure and posttraumatic stress symptoms. While witnessing of community violence was by far the most common form of violence exposure, for the sample as a whole only sexual victimization and being a direct victim of community violence, together with gender, contributed independently to the severity of posttraumatic stress symptoms. When the contribution of different forms of violence was examined separately for each gender, only increased exposure to community and sexual victimization were associated with symptom severity among girls, while increased exposure to direct victimization in both the community and domestic settings were associated with greater symptom severity in boys. The findings provide some preliminary motivation for focusing trauma intervention initiatives in this community on girls who have experienced sexual abuse compounded by victimization in the community, and boys who have been direct victims of either domestic or community violence. Further research is required to establish whether the risk factors for posttraumatic stress symptoms identified among adolescents in this study are consistent across different communities in South Africa, as well as across other resource-constrained contexts. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mental health and substance abuse characteristics among a clinical sample of urban American Indian/Alaska native youths in a large California metropolitan area: a descriptive study.

PubMed

Dickerson, Daniel L; Johnson, Carrie L

2012-02-01

This study analyzes descriptive data among a clinical sample of American Indian/Alaska Native (AI/AN) youths receiving mental health services in a large California metropolitan area. Among 118 urban AI/AN youths, mood disorders (41.5%) and adjustment disorder (35.4%) were the most common mental health diagnoses. Alcohol (69.2%) and marijuana (50.0%) were the most commonly used substances. Witnessing domestic violence (84.2%) and living with someone who had a substance abuse problem (64.7%) were reported. The majority of patients demonstrated various behavior and emotional problems. Enhancing culturally relevant mental health and substance abuse treatment and prevention programs for urban AI/AN youth is suggested.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme.

PubMed

Shah, Arya; Wheeler, Lydia; Sessions, Kristen; Kuule, Yusufu; Agaba, Edwin; Merry, Stephen P

2017-10-11

To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Qualitative thematic analysis revealed two major themes: (1) belief that any given patient's metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness.

Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

PubMed Central

2017-01-01

Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

Church attendee help seeking priorities after Hurricane Katrina in Mississippi and Louisiana: a brief report.

PubMed

Aten, Jamie D; Gonzalez, Rose A; Boan, David M; Topping, Sharon; Livingston, William V; Hosey, John M

2012-01-01

After a disaster, survivors find themselves seeking many types of help from others in their communities. The purpose of this exploratory study was to assist in mental health service planning by determining the type and priority of support services sought by church attendees after Hurricane Katrina. Surveys were given to church attendees from two Mississippi coast and four New Orleans area churches that were directly affected by Hurricane Katrina participants were asked to review a list of 12 potential sources of help and were asked to rank the items chronologically from whom they had sought help first after Hurricane Katrina. Overall, participants sought out assistance from informal social networks such as family and friends first, followed by governmental and clergy support. This study also showed there may be differences in help-seeking behaviors between church attendees in more urban areas versus church attendees in more rural areas. Moreover, findings highlighted that very few church attendees seek out mental health services during the initial impact phase of a disaster. Since timely engagement with mental health services is important for resolving trauma, strategies that link professional mental health services with clergy and government resources following a disaster could improve the engagement with mental health professionals and improve mental health outcomes. Disaster mental health clinical implications and recommendations are offered for psychologists based on these findings.

Bringing Wellness to Schools: Opportunities and Challenges to Mental Health Integration in School Health Centers

PubMed Central

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.

2016-01-01

Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895

Mental illness in Bwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme.

PubMed

Sessions, Kristen L; Wheeler, Lydia; Shah, Arya; Farrell, Deenah; Agaba, Edwin; Kuule, Yusufu; Merry, Stephen P

2017-11-30

Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues. This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme. Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District. Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area. Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness. Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.

An Academic-Government-Faith Partnership to Build Disaster Mental Health Preparedness and Community Resilience

PubMed Central

Semon, Natalie L.; Lating, Jeffrey M.; Everly, George S.; Perry, Charlene J.; Moore, Suzanne Straub; Mosley, Adrian M.; Thompson, Carol B.; Links, Jonathan M.

2014-01-01

Objectives Faculty and affiliates of the Johns Hopkins Preparedness and Emergency Response Research Center partnered with local health departments and faith-based organizations to develop a dual-intervention model of capacity-building for public mental health preparedness and community resilience. Project objectives included (1) determining the feasibility of the tri-partite collaborative concept; (2) designing, delivering, and evaluating psychological first aid (PFA) training and guided preparedness planning (GPP); and (3) documenting preliminary evidence of the sustainability and impact of the model. Methods We evaluated intervention effectiveness by analyzing pre- and post-training changes in participant responses on knowledge-acquisition tests administered to three urban and four rural community cohorts. Changes in percent of correct items and mean total correct items were evaluated. Criteria for model sustainability and impact were, respectively, observations of nonacademic partners engaging in efforts to advance post-project preparedness alliances, and project-attributable changes in preparedness-related practices of local or state governments. Results The majority (11 of 14) test items addressing technical or practical PFA content showed significant improvement; we observed comparable testing results for GPP training. Government and faith partners developed ideas and tools for sustaining preparedness activities, and numerous project-driven changes in local and state government policies were documented. Conclusions Results suggest that the model could be an effective approach to promoting public health preparedness and community resilience. PMID:25355980

An academic-government-faith partnership to build disaster mental health preparedness and community resilience.

PubMed

McCabe, O Lee; Semon, Natalie L; Lating, Jeffrey M; Everly, George S; Perry, Charlene J; Moore, Suzanne Straub; Mosley, Adrian M; Thompson, Carol B; Links, Jonathan M

2014-01-01

Faculty and affiliates of the Johns Hopkins Preparedness and Emergency Response Research Center partnered with local health departments and faith-based organizations to develop a dual-intervention model of capacity-building for public mental health preparedness and community resilience. Project objectives included (1) determining the feasibility of the tri-partite collaborative concept; (2) designing, delivering, and evaluating psychological first aid (PFA) training and guided preparedness planning (GPP); and (3) documenting preliminary evidence of the sustainability and impact of the model. We evaluated intervention effectiveness by analyzing pre- and post-training changes in participant responses on knowledge-acquisition tests administered to three urban and four rural community cohorts. Changes in percent of correct items and mean total correct items were evaluated. Criteria for model sustainability and impact were, respectively, observations of nonacademic partners engaging in efforts to advance post-project preparedness alliances, and project-attributable changes in preparedness-related practices of local or state governments. The majority (11 of 14) test items addressing technical or practical PFA content showed significant improvement; we observed comparable testing results for GPP training. Government and faith partners developed ideas and tools for sustaining preparedness activities, and numerous project-driven changes in local and state government policies were documented. Results suggest that the model could be an effective approach to promoting public health preparedness and community resilience.

Public stigma against family members of people with mental illness: findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia

PubMed Central

2014-01-01

Background Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma. Methods A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma. Results Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (±0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. β = 0.43, P < 0.001) than urban residents. As the number of perceived signs (std. β = -0.07, P < 0.05), perceived supernatural (std. β = -0.12, P < 0.01) and psychosocial and biological (std. β = -0.11, P < 0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status. Conclusions Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented. PMID:24555444

The relationships between urban parks, residents' physical activity, and mental health benefits: A case study from Beijing, China.

PubMed

Liu, Hongxiao; Li, Feng; Li, Juanyong; Zhang, Yuyang

2017-04-01

The role of urban parks in improving public health has been analyzed in the context of urban design in developed countries, but has seldom been considered in developing countries such as China. Previous studies have found positive correlations between parks and residents' physical activity and mental health status. In this study, we conducted a questionnaire survey to investigate respondents' physical activity status and its relationship with urban parks. The impact of different activities engaged in during park use on positive mental health was examined. The average physical activity level of the sample was 92.7 min of moderate to vigorous physical activity per day. Park users were more active in all forms of physical activity, except transport walking, than non-users. The presence of a park within 500 m from home and park use were significantly associated with total physical activity. Physical activity in parks significantly restored visitors' moods and energy levels, and interaction with nature brought mental health benefits in terms of relaxation and self-perceived confidence. Overall, this study found a positive correlation of urban parks with public physical activity and positive mental health benefits. However, further research is needed to improve the understanding of this relationship in the context of China. Copyright © 2016 Elsevier Ltd. All rights reserved.

Supporting patients with mental illness: Deconstructing barriers to community pharmacist access.

PubMed

Calogero, Samantha; Caley, Charles F

To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

MINDMAP: establishing an integrated database infrastructure for research in ageing, mental well-being, and the urban environment.

PubMed

Beenackers, Mariëlle A; Doiron, Dany; Fortier, Isabel; Noordzij, J Mark; Reinhard, Erica; Courtin, Emilie; Bobak, Martin; Chaix, Basile; Costa, Giuseppe; Dapp, Ulrike; Diez Roux, Ana V; Huisman, Martijn; Grundy, Emily M; Krokstad, Steinar; Martikainen, Pekka; Raina, Parminder; Avendano, Mauricio; van Lenthe, Frank J

2018-01-19

Urbanization and ageing have important implications for public mental health and well-being. Cities pose major challenges for older citizens, but also offer opportunities to develop, test, and implement policies, services, infrastructure, and interventions that promote mental well-being. The MINDMAP project aims to identify the opportunities and challenges posed by urban environmental characteristics for the promotion and management of mental well-being and cognitive function of older individuals. MINDMAP aims to achieve its research objectives by bringing together longitudinal studies from 11 countries covering over 35 cities linked to databases of area-level environmental exposures and social and urban policy indicators. The infrastructure supporting integration of this data will allow multiple MINDMAP investigators to safely and remotely co-analyse individual-level and area-level data. Individual-level data is derived from baseline and follow-up measurements of ten participating cohort studies and provides information on mental well-being outcomes, sociodemographic variables, health behaviour characteristics, social factors, measures of frailty, physical function indicators, and chronic conditions, as well as blood derived clinical biochemistry-based biomarkers and genetic biomarkers. Area-level information on physical environment characteristics (e.g. green spaces, transportation), socioeconomic and sociodemographic characteristics (e.g. neighbourhood income, residential segregation, residential density), and social environment characteristics (e.g. social cohesion, criminality) and national and urban social policies is derived from publically available sources such as geoportals and administrative databases. The linkage, harmonization, and analysis of data from different sources are being carried out using piloted tools to optimize the validity of the research results and transparency of the methodology. MINDMAP is a novel research collaboration that is combining population-based cohort data with publicly available datasets not typically used for ageing and mental well-being research. Integration of various data sources and observational units into a single platform will help to explain the differences in ageing-related mental and cognitive disorders both within as well as between cities in Europe, the US, Canada, and Russia and to assess the causal pathways and interactions between the urban environment and the individual determinants of mental well-being and cognitive ageing in older adults.

[Relationships between mental health and psychosocial factors with single-child high school students in an urban city of Korea].

PubMed

Lee, Young-Sun; Kim, Kwang-Hwan; Cho, Young-Chae

2006-09-01

This study was performed to determine the mental health of high school students, and specifically that of children with no siblings in urban areas, and we aimed at revealing the various potential influences of different psycho-social factors. The participants were, 514 high school students who were the 1st- to 3rd-graders in Daejon City; they were, given self-administered questionnaires that required no signature during the period of March through June 2005. The analyzed items included the general character of the subjects, the symptoms of stress and depression for mental health, self-esteem as a psychological component, anxiety, dependent behavioral traits and, social support of family members and friends. The study results suggested that the group of urban high school children with no siblings had a higher tendency for stress and depression than did the urban high school children with siblings. The mental health and psychosocial factors were found to be influenced by friends, a sense of satisfaction at school and home life, and emotional support as well. In conclusion, emotional support by the family members can improve mental health by reducing anxiety, stress and depression.

Social Stigma and Mental Health among Rural-to-Urban Migrants in China: A Conceptual Framework and Future Research Needs

PubMed Central

Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Lin, Danhua

2007-01-01

There are over 100 million individuals in China who have migrated from rural villages to urban areas for jobs or better lives without permanent urban residency (e.g., “rural-to-urban migrants”). Our preliminary data from ongoing research among rural-to-urban migrants in China suggest that the migrant population is strongly stigmatized. Moreover, it appears that substantial numbers of these migrants experience mental health symptoms (e.g., depression, anxiety, hostility, social isolation). While the population potentially affected is substantial (more than 9% of the entire population or about one-quarter of the rural labor in mainland China) and our data seem to indicate that the issue is pervasive in this population, there is limited literature on the topic in China or elsewhere. Therefore, in the current article, we utilize secondary data from public resources (e.g., scientific literature, governmental publication, public media) and our own qualitative data to explore the issues of stigmatization and mental health, to propose a conceptual model for studying the association between the stigmatization and mental health among this population, and to identify some future needs of research in this area. PMID:18277106

Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi

PubMed Central

Chepuka, Lignet; Taegtmeyer, Miriam; Chorwe-Sungani, Genesis; Mambulasa, Janet; Chirwa, Ellen; Tolhurst, Rachel

2014-01-01

Background and objectives This study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV) and the capacity of health services for addressing these. Design In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes. Results The significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for ‘counselling’. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity. Conclusion Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience. PMID:25226420

Teachers' Perspectives of Children's Mental Health Service Needs in Urban Elementary Schools

ERIC Educational Resources Information Center

Williams, James Herbert; Horvath, Violet E.; Wei, Hsi-Sheng; Van Dorn, Richard A.; Jonson-Reid, Melissa

2007-01-01

This study uses a phenomenological approach to investigate elementary school teachers' perspectives on children's mental health service needs. Focus groups were conducted at two elementary schools with differing levels of available social services in a moderate-sized urban midwestern school district. Data collection centered on six prominent…

Urban Families and Adolescent Mental Health.

ERIC Educational Resources Information Center

Stern, Susan B.; Smith, Carolyn A.; Jang, Sung Joon

1999-01-01

This study investigates the effects of social and economic disadvantage on parent distress, family processes, and adolescent mental health in a longitudinal, multiethnic sample of 800 urban adolescents and parents. Findings show that poverty, life stressors, and isolation affect parent mood and disrupt family processes, which, in turn, are linked…

Trauma and Substance Use Disorders in Rural and Urban Veterans

ERIC Educational Resources Information Center

Nash, David L.; Wilkinson, Jamie; Paradis, Bryce; Kelley, Stephanie; Naseem, Ahsan; Grant, Kathleen M.

2011-01-01

Context: Disparities in the prevalence, morbidity, and mortality of multiple mental health conditions have been described between rural and urban populations. However, there is limited information regarding differences in exposure to trauma and trauma-related mental health conditions in these populations. Given the number of veterans who are…

Direct and indirect effects of caregiver social support on adolescent psychological outcomes in two South African AIDS-affected communities

PubMed Central

Casale, Marisa; Cluver, Lucie; Crankshaw, Tamaryn; Kuo, Caroline; Lachman, Jamie M.; Wild, Lauren G.

2015-01-01

Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV-endemic, resource-scarce Southern African communities. A cross-sectional household survey was conducted over 2009-2010 with 2477 South African adolescents aged 10-17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu-Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (p<.001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network. PMID:25623784

Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

PubMed

Ayano, Getinet

2018-03-29

 Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

The roles of individual and organizational factors in burnout among community-based mental health service providers.

PubMed

Green, Amy E; Albanese, Brian J; Shapiro, Nicole M; Aarons, Gregory A

2014-02-01

Public-sector mental health care providers are at high risk for burnout, which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public-sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health subdisciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families. PsycINFO Database Record (c) 2014 APA, all rights reserved.

[Effects of urban noise on mental health].

PubMed

Belojević, G; Jakovljević, B; Kocijancić, R; Pjerotić, L; Dimitrijević, J

1995-01-01

The results of the latest studies on the effects of urban noise on mental health are presented in this paper. Numerous psychiatric symptoms have been frequently noticed in the population of the settlements with a high level of urban noise: fatigue, headaches, tension, anxiety, irritability, bad concentration, insomnia, whith a consequently high consumption of psychotropic medicines. Higher admission rates in psychiatric hospitals have been noticed from noisy areas in comparison with low noise regions. By use of diagnostic psychiatric interviews it has been shown as well, that in sensitive categories of population positive correlation can be expected between the number of persons with mental disorder and the level of environmental noise. Noise annoyance and sleep disturbance, namely shortening or absence of the sleep phase 4 and REM, are the basic negative psychological effects of noise, with an adverse effect on mental health in general.

Posttraumatic Stress among Young Urban Children Exposed to Family Violence and Other Potentially Traumatic Events

PubMed Central

Crusto, Cindy A.; Whitson, Melissa L.; Walling, Sherry N.; Feinn, Richard; Friedman, Stacey R.; Reynolds, Jesse; Amer, Mona; Kaufman, Joy S.

2014-01-01

This study examines the relationship between the number of types of traumatic events experienced by children 3 to 6 years old, parenting stress, and children’s posttraumatic stress (PTS). Parents/caregivers provided data for 154 urban children admitted into community-based mental health and/or developmental services. By parent/caregiver report, children experienced an average of 4.9 different types of potentially traumatic events. Nearly one-quarter of the children evidenced clinically significant PTS. PTS was positively and significantly related to family violence and other family-related trauma exposure, nonfamily violence/trauma exposure, and parenting stress. Additionally, parenting stress partially mediated the relationship between family violence/trauma exposure and PTS. This study highlights the need for early violence/trauma exposure screening in help-seeking populations so that appropriate interventions are initiated. PMID:21171132

Training to reduce behavioral health disparities: How do we optimally prepare family medicine residents for practice in rural communities?

PubMed

Robohm, Jennifer S

2017-05-01

Family physicians are a critical part of the healthcare system in rural areas, but little is known about the training they need to more effectively address behavioral health disparities. Practicing family physicians in Montana were surveyed about the behavioral health needs of their patients, the behavioral resources at their disposal, their prioritization of a number of behavioral skills and interventions in the training of family physicians, factors that limit their own use of behavioral skills, and the extent of their behavioral science training. Respondents across the state reported high rates of mental/emotional health issues and high need for health behavior change in their patients. Surprisingly, although rural family physicians reported access to significantly fewer behavioral health resources, they did not rate any of the behavioral skills as higher training priorities than their urban counterparts and they were more likely to identify limitations (lack of patient interest, lack of confidence or competence, and inadequate knowledge or training) on their own use of such skills in practice. Family physicians, both rural and urban, whose residency programs had a higher emphasis on behavioral science felt better prepared to use behavioral skills in practice. Consequently, rural training programs are encouraged to emphasize behavioral science training for their family medicine residents, particularly training that focuses on mental health stigma reduction, emphasizes time savings and practicality, covers more severe psychiatric presentations, promotes cultural sensitivity to rural values of autonomy and self-sufficiency, and teaches skills to advocate for individual and community health with regard to behavioral health disparities.

U-Shaped Relationship between Years of Residence and Negative Mental Health Outcomes among Rural-to-Urban Children in Migrant Schools in Beijing, China: The Moderating Effects of Socioeconomic Factors.

PubMed

Cheng, Jin; Wang, Ri-Chu; Yin, Xing; Fu, Lin; Liu, Zheng-Kui

2017-01-01

This study aimed to test the relationship between length of residence and mental health in a school-based sample of migrant children who studied in migrant schools. A total of 7,296 rural-to-urban migrant children were recruited from 58 schools in Beijing and assessed by the State-Trait Anxiety Inventory and Children's Depression Inventory. A quadratic relationship was found between mental health and length of residence. The results suggested that the scores for anxiety and depression were high during the initial resettlement after migrating and then decreased. However, after approximately 8 years, the scores increased. Our findings also showed a significant moderating effect of family socioeconomic status on the relation between mental health and length of residence. This study provided empirical evidence for a better understanding of psychosocial factors on the mental health of migrant children during the process of urbanization in China.

Exploring new kinds of relationships using generative music-making software.

PubMed

Dillon, Steve; Jones, Anita

2009-08-01

This project focuses upon the use of jam2jam, a generative computer system, to increase access to improvization experiences for children and to facilitate new kinds of relationships with artists. The network jamming system uses visual and audio cultural materials to enable communities to be expressive with artistic materials that they value as a community. As the system is part of a network, performances can be shared between communities at great distances and recordings of performances can be uploaded to a digital social network (http://www.jam2jam.com/) and shared both locally and with the wider community. This paper examines a preliminary project where artwork made by Indigenous mental health clients in Far North Queensland was digitized and given to a group of 8-12-year-old urban Indigenous children to 'improvize' with and make music/video clips using the jam2jam instrument. It seeks to generate a discussion and identify applications within creative arts-led community health settings to facilitate new kinds of relationships with self, peers, local community, culture and artists through collaborative improvization.

Partnerships for community mental health in the Asia-Pacific: principles and best-practice models across different sectors.

PubMed

Ng, Chee; Fraser, Julia; Goding, Margaret; Paroissien, David; Ryan, Brigid

2013-02-01

Stage Two of the Asia-Pacific Community Mental Health Development Project was established to document successful partnership models in community mental health care in the region. This paper summarizes the best-practice examples and principles of partnerships in community mental health across 17 Asia-Pacific countries. A series of consensus workshops between countries identified best-practice exemplars that promote or advance community mental health care in collaboration with a range of community stakeholders. These prototypes highlighted a broad range of partnerships across government, non-government and community agencies, as well as service users and family carers. From practice-based evidence, a set of 10 key principles was developed that can be applied in building partnerships for community mental health care consistent with the local cultures, communities and systems in the region. Such practical guidance can be useful to minimize fragmentation of community resources and promote effective partnerships to extend community mental health services in the region.

Public stigma associated with mental illnesses in Pakistani university students: a cross sectional survey

PubMed Central

Zubair, Muhammad; Ghulam, Hamzah; Wajih Ullah, Muhammad; Zubair Tariq, Muhammad

2014-01-01

Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan. Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences). Results. Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). Four hundred and eighteen respondents (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p < .05). Conclusion. Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a role in treatment. PMID:25548734

[A study of factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas].

PubMed

Takai, Itsushi

2012-01-01

It is important to promote self-efficacy for exercise for developing exercise habit. The purpose of this study was to investigate factors influenced by self-efficacy for exercise among community-dwelling elderly men in urban areas. The subjects were 69 elderly men (mean age of 74.2±2.0 SD) who had given approval for participation in the study. We examined the following factors: family situation, history of falls, frequency of going out, stage model of a change, self-efficacy for exercise, fall efficacy scale (FES), geriatric depression scale (GDS), subjective health, functional ability and motor function (5 m walking time, chair stand test-5times). Analysis of variance was used to assess a stage model of a change differences in self-efficacy for exercise and other measures. Correlation analysis and multiple regression analysis were performed to determine the relationships between self-efficacy for exercise and other measures. We found that self-efficacy of exercise, FES, GDS (p<0.01) and CST (p<0.05) vary depending on the stage model of change. Self-efficacy for exercise was found to correlate with psychological factors and functional ability (|r|=0.47-0.67). Multiple regression analysis revealed that the independent factors related to self-efficacy for exercise were FES and GDS. FES and GDS were found to be significant and independent predictors of self-efficacy for exercise in community-dwelling elderly men in urban areas. We should consider not only the approach based on behavioral science but also mental support for depression and fear of falling to promote exercise self-efficacy.

Community partnership for healthy sleep: Research protocol.

PubMed

Redeker, Nancy S; Ordway, Monica R; Banasiak, Nancy; Caldwell, Barbara; Canapari, Craig; Crowley, Angela; Fenick, Ada; Jeon, Sangchoon; O'Connell, Meghan; Sude, Leslie; Sadler, Lois S

2018-02-01

Beginning early in life, sleep health, including adequate quality, quantity, and consistent sleep routines, is critical to growth and development, behavior, and mental and physical health. Children who live in economically stressed urban environments are at particular risk for sleep deficiency and its negative consequences. Although efficacious sleep health interventions are available, few address the context of economically stressed urban environments. The purpose of this paper is to describe a two-phase protocol for an ongoing NIH/NINR-funded community-engaged study designed to understand the perspectives of parents, community child care and pediatric health care providers about sleep habits, factors that contribute to sleep and sleep habits, sleep difficulty, and potentially useful sleep promotion strategies among children living in economically stressed urban environments. The social-ecological model guides this study. Phase I employs a convergent mixed-methods design, in which we are conducting semi-structured interviews with parents, childcare providers, and primary health care providers. We are collecting 9 days of objective sleep data (wrist actigraphy) from children who are 6-18 months (n = 15) and 19-36 months of age (n = 15) and parent reports of sleep and sleep-related factors using standard questionnaires. In Phase I, we will use a qualitative descriptive approach to analyze the interview data, and descriptive statistics to analyze the survey and actigraph data. In Phase II, we will use the information to develop a contextually relevant program to promote sleep health. Our long-term goal is to improve sleep health and sleep-related outcomes in these children. © 2017 Wiley Periodicals, Inc.

Environmental factors associated with adolescent antisocial behavior in a poor urban community in Brazil.

PubMed

Curto, Bartira Marques; Paula, Cristiane Silvestre; do Nascimento, Rosimeire; Murray, Joseph; Bordin, Isabel A

2011-12-01

Investigating risk factors for anti-social behavior (ASB) is particularly relevant in a poor urban and violent community of a developing country where homicide is the primary cause of death among 15-24-year olds. To identify individual and environmental factors associated with ASB in adolescents from an urban poor community in the outskirts of São Paulo City, Brazil. This cross-sectional study was based on a probabilistic sample of clusters that included all eligible households (women aged 15-49 years with a son or daughter <18 years of age). One mother-child pair was randomly selected per household (n = 813; response rate: 82.4%). This study is focused on the age group 11-17 years (n = 248). ASB was identified by externalizing scores in the clinical range on the Child Behavior Checklist and/or the Youth Self Report. Potential correlates included individual, maternal, paternal, and familial characteristics. Backward logistic regression analysis identified independent correlates and significant interactions. Youths with high ASB scores were more likely to be victims of severe physical punishment and have an absent father/substitute. Maternal anxiety/depression was a risk factor only among older adolescents (15-17 years), while the presence of internalizing problems was a risk factor only among younger adolescents (11-14 years). Having a non-working mother increased the risk for ASB only among low-income adolescents. The recognition that certain environmental factors may have harmful effects on adolescents' mental health, and the identification of more vulnerable groups can contribute to the development of effective strategies for prevention and treatment of ASB.

Knowledge and causal attributions for mental disorders in HIV-positive children and adolescents: results from rural and urban Uganda.

PubMed

Nalukenge, W; Martin, F; Seeley, J; Kinyanda, E

2018-05-02

Increasing availability of antiretroviral treatment (ART) has led HIV to be considered a chronic disease, shifting attention to focus on quality of life including mental wellbeing. We investigated knowledge and causal attributions for mental disorders in HIV-positive children and adolescents in rural and urban Uganda. This qualitative study was nested in an epidemiological mental health study among HIV-positive children and adolescents aged 5-17 years in rural and urban Uganda. In-depth interviews were conducted with caregivers of HIV-positive children (5-11 years) and adolescents (12-17 years) in HIV care. Interviews were audio recorded with permission from participants and written consent and assent sought before study procedures. Thirty eight participants (19 caregivers, 19 children/adolescents) were interviewed. Age range of caregivers was 28-69 years; majority were female (17). Caregivers had little knowledge on mental disorders ;only 3 related the vignette to a mental problem  and attributed it to: improper upbringing, violence, poverty and bereavement. Five adolescents identified vignettes as portraying mental disorders caused by: ill-health of parents, bereavement, child abuse, discrimination, HIV and poverty. Caregivers are not knowledgeable about behavioural and emotional challenges in HIV-positive children/adolescents. Mental health literacy programmes at HIV care clinics are essential to enhance treatment-seeking for mental health.

Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison.

PubMed

Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L

2006-01-01

Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p < .001) in the last year even though there were no differences in level of psychological distress by degree of rurality. Participants living in more rural areas also reported significantly fewer mental health visits in the previous month (p = .025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

Gender Differences in the Longitudinal Impact of Exposure to Violence on Mental Health in Urban Youth

ERIC Educational Resources Information Center

Zona, Kate; Milan, Stephanie

2011-01-01

There is evidence of gender differences in psychopathology during adolescence, but little research has investigated gender differences in trauma-related symptoms. Exposure to violence is a commonly experienced potentially traumatic event among urban adolescents, and the few studies examining gender differences in its mental health impact have…

Patterns of Place-Based Self-Regulation and Associated Mental Health of Urban Adolescents

ERIC Educational Resources Information Center

Mason, Michael J.; Korpela, Kalevi; Mennis, Jeremy; Coatsworth, J. Douglas; Valente, Thomas W.; Pomponio, Amber; Pate, Patricia A.

2010-01-01

Efforts to simultaneously address adolescent self-regulation, activity space (routine locations), and mental health represent a promising social ecological approach aimed at understanding the lives and development of urban youth. This type of examination of contextual influences on self-regulation is considered an important area of developmental…

Mental Health Characteristics of Elderly Black Urban Dwellers.

ERIC Educational Resources Information Center

Penn, Nolan E.

This study reports the initial results from a study designed to assess the perceived needs for mental health services and other types of services in a group of elderly black women who participated in an urban, federally subsidized luncheon program. The two hypotheses tested were: (l) that the majority of elderly persons participating in this…

'Nobody really gets it': a qualitative exploration of youth mental health in deprived urban areas.

PubMed

Schaffalitzky, Elisabeth; Leahy, Dorothy; Armstrong, Claire; Gavin, Blanaid; Latham, Linda; McNicholas, Fiona; Meagher, David; O'Connor, Ray; O'Toole, Thomas; Smyth, Bobby P; Cullen, Walter

2015-10-01

To examine the experience of developing and living with mental health and substance use disorders among young people living in urban-deprived areas in Ireland to inform primary care interventions. Semi-structured qualitative interviews with 20 young adults attending health and social care agencies in two deprived urban areas, and analysed using thematic analysis. Five themes were identified: experiencing symptoms, symptom progression, delay accessing help, loss of control/crisis point, and consequences of mental health and substance use disorders. As young people delayed help, symptoms disrupted normal life progression and they found themselves unable to engage in everyday activities, and living with reduced potential. Living in deprived areas influenced the development of problems: many had added stressors, less familial support and early exposure to violence, addiction and bereavement. Young people in urban-deprived areas are especially vulnerable to mental health and substance use disorders. Early identification in primary care appears necessary in halting symptom and illness progression, improving young people's chances of achieving their potential. © 2014 Wiley Publishing Asia Pty Ltd.

Objective community integration of mental health consumers living in supported housing and of others in the community.

PubMed

Yanos, Philip T; Stefancic, Ana; Tsemberis, Sam

2012-01-01

Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration.

Mental health in-reach in an urban UK remand prison.

PubMed

Forrester, Andrew; Singh, Jagmohan; Slade, Karen; Exworthy, Tim; Sen, Piyal

2014-01-01

Prison mental health in-reach teams (MHITs) have developed in England and Wales over the last decade. Services have been nationally reviewed, but detailed descriptions of their work have been scarce. The purpose of this paper is to describe the functions of one MHIT in a busy, ethnically diverse, male remand prison in London, UK. Clinical and demographic data were collected for prisoners referred to the MHIT using a retrospective design over an 18-week period in 2008/2009 (n=111). Foreign national prisoners and sentenced prisoners were significantly under-referred. Most referrals were already known to community mental health services, although around a quarter accessed services for the first time in prison. Around a third presented with self-harm/suicide risks. Substance misuse problems were common. Although the MHIT had evolved systems to promote service access, prisoner self-referrals were limited. Foreign national prisoners require enhanced investment to improve service access. MHITs identify people with mental disorders for the first time in prisons, but better screening arrangements are needed across systems. An evaluation of multiple MHIT models could inform a wider delivery template. Originality/value - One of the first ground-level evaluations of MHITs in England and Wales.

A national study of transitional hospital services in mental health.

PubMed Central

Dorwart, R A; Hoover, C W

1994-01-01

OBJECTIVES. Shifts in care for the seriously mentally ill from inpatient to community-based treatment have highlighted the importance of transitional care. Our objectives were to document the kinds and quantity of transitional services provided by psychiatric hospitals nationally and to assess the impact of hospital type (psychiatric vs general), ownership (public vs private), case mix, and revenue source on provision of these services. METHODS. A national sample of nonfederal inpatient mental health facilities (n = 915) was surveyed in 1988, and data were analyzed by using multiple regression. RESULTS. Half (46%) of the facilities surveyed provided patient follow-up of 1 week or less, and almost all (93%) conducted team review of discharge plans, but 74% provided no case management services. Hospital type was the most consistent predictor of transitional care, with psychiatric hospitals providing more of these services than general hospitals. Severity of illness, level of nonfederal funding, urbanicity, and teaching hospital affiliation were positively associated with provision of case management. CONCLUSIONS. Transitional care services for mentally ill patients leaving the hospital were found to be uneven and often inadequate. Reasons for broad variation in services are discussed. PMID:8059877

Tree Leaf Bacterial Community Structure and Diversity Differ along a Gradient of Urban Intensity

PubMed Central

Messier, Christian; Kembel, Steven W.

2017-01-01

ABSTRACT Tree leaf-associated microbiota have been studied in natural ecosystems but less so in urban settings, where anthropogenic pressures on trees could impact microbial communities and modify their interaction with their hosts. Additionally, trees act as vectors spreading bacterial cells in the air in urban environments due to the density of microbial cells on aerial plant surfaces. Characterizing tree leaf bacterial communities along an urban gradient is thus key to understand the impact of anthropogenic pressures on urban tree-bacterium interactions and on the overall urban microbiome. In this study, we aimed (i) to characterize phyllosphere bacterial communities of seven tree species in urban environments and (ii) to describe the changes in tree phyllosphere bacterial community structure and diversity along a gradient of increasing urban intensity and at two degrees of tree isolation. Our results indicate that, as anthropogenic pressures increase, urban leaf bacterial communities show a reduction in the abundance of the dominant class in the natural plant microbiome, the Alphaproteobacteria. Our work in the urban environment here reveals that the structures of leaf bacterial communities differ along the gradient of urban intensity. The diversity of phyllosphere microbial communities increases at higher urban intensity, also displaying a greater number and variety of associated indicator taxa than the low and medium urban gradient sites. In conclusion, we find that urban environments influence tree bacterial community composition, and our results suggest that feedback between human activity and plant microbiomes could shape urban microbiomes. IMPORTANCE In natural forests, tree leaf surfaces host diverse bacterial communities whose structure and composition are primarily driven by host species identity. Tree leaf bacterial diversity has also been shown to influence tree community productivity, a key function of terrestrial ecosystems. However, most urban microbiome studies have focused on the built environment, improving our understanding of indoor microbial communities but leaving much to be understood, especially in the nonbuilt microbiome. Here, we provide the first multiple-species comparison of tree phyllosphere bacterial structures and diversity along a gradient of urban intensity. We demonstrate that urban trees possess characteristic bacterial communities that differ from those seen with trees in nonurban environments, with microbial community structure on trees influenced by host species identity but also by the gradient of urban intensity and by the degree of isolation from other trees. Our results suggest that feedback between human activity and plant microbiomes could shape urban microbiomes. PMID:29238751

Tree Leaf Bacterial Community Structure and Diversity Differ along a Gradient of Urban Intensity.

PubMed

Laforest-Lapointe, Isabelle; Messier, Christian; Kembel, Steven W

2017-01-01

Tree leaf-associated microbiota have been studied in natural ecosystems but less so in urban settings, where anthropogenic pressures on trees could impact microbial communities and modify their interaction with their hosts. Additionally, trees act as vectors spreading bacterial cells in the air in urban environments due to the density of microbial cells on aerial plant surfaces. Characterizing tree leaf bacterial communities along an urban gradient is thus key to understand the impact of anthropogenic pressures on urban tree-bacterium interactions and on the overall urban microbiome. In this study, we aimed (i) to characterize phyllosphere bacterial communities of seven tree species in urban environments and (ii) to describe the changes in tree phyllosphere bacterial community structure and diversity along a gradient of increasing urban intensity and at two degrees of tree isolation. Our results indicate that, as anthropogenic pressures increase, urban leaf bacterial communities show a reduction in the abundance of the dominant class in the natural plant microbiome, the Alphaproteobacteria . Our work in the urban environment here reveals that the structures of leaf bacterial communities differ along the gradient of urban intensity. The diversity of phyllosphere microbial communities increases at higher urban intensity, also displaying a greater number and variety of associated indicator taxa than the low and medium urban gradient sites. In conclusion, we find that urban environments influence tree bacterial community composition, and our results suggest that feedback between human activity and plant microbiomes could shape urban microbiomes. IMPORTANCE In natural forests, tree leaf surfaces host diverse bacterial communities whose structure and composition are primarily driven by host species identity. Tree leaf bacterial diversity has also been shown to influence tree community productivity, a key function of terrestrial ecosystems. However, most urban microbiome studies have focused on the built environment, improving our understanding of indoor microbial communities but leaving much to be understood, especially in the nonbuilt microbiome. Here, we provide the first multiple-species comparison of tree phyllosphere bacterial structures and diversity along a gradient of urban intensity. We demonstrate that urban trees possess characteristic bacterial communities that differ from those seen with trees in nonurban environments, with microbial community structure on trees influenced by host species identity but also by the gradient of urban intensity and by the degree of isolation from other trees. Our results suggest that feedback between human activity and plant microbiomes could shape urban microbiomes.

Hearing loss and social support in urban and rural communities.

PubMed

Hay-McCutcheon, Marcia J; Hyams, Adriana; Yang, Xin; Parton, Jason

2018-04-19

Perceived social support and hearing handicap were assessed in adults with and without hearing loss who lived in different geographical regions of Alabama. The Hearing Handicap Inventory for Adults (HHIA) assessed emotional and social consequences of hearing loss. The Medical Outcomes Study (MOS) Social Support Survey and the Social Functioning, Role Emotional and Mental Health scales of the SF-36 were administered. Data were collected from 71 study participants with hearing loss and from 45 adults without hearing loss. Degree of hearing loss and outcomes from the HHIA did not differ between adults who lived in rural or urban settings. Tangible support was poorer for adults with hearing loss who lived in rural settings compared to those who lived in urban settings. For adults without hearing loss, residency was not associated with tangible support. For these adults, income was associated with other types of social support (i.e. informational support, affection, positive social interaction). Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.

A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India.

PubMed

Travasso, Sandra Mary; Rajaraman, Divya; Heymann, Sally Jody

2014-02-07

Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated with negative mental health amongst specific population groups in order to ensure greater impact.

A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India

PubMed Central

2014-01-01

Background Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Methods Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Results Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. Conclusion This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated with negative mental health amongst specific population groups in order to ensure greater impact. PMID:24502531

Highlighting the Way Forward: A Review of Community Mental Health Research and Practice Published in AJCP and JCP.

PubMed

Townley, Greg; Terry, Rachel

2018-03-01

Articles published in the two most prominent journals of community psychology in North America, the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP), provide a clear indicator of trends in community research and practice. An examination of community psychology's history and scholarship suggests that the field has reduced its emphasis on promoting mental health, well-being, and liberation of individuals with serious mental illnesses over the past several decades. To further investigate this claim, the current review presents an analysis of articles relevant to community mental health (N = 307) published in the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP) from 1973 to 2015. The review focuses on article characteristics (e.g., type of article and methods employed), author characteristics, topic areas, and theoretical frameworks. Results document a downward trend in published articles from the mid-1980s to mid-2000s, with a substantial increase in published work between 2006 and 2015. A majority of articles were empirical and employed quantitative methods. The most frequent topic area was community mental health centers and services (n = 49), but the past three decades demonstrate a clear shift away from mental health service provision to address pressing social issues that impact community mental health, particularly homelessness (n = 42) and community integration of adults with serious mental illnesses (n = 40). Findings reflect both the past and present state of community psychology and suggest promising directions for re-engaging with community mental health and fostering well-being, inclusion, and liberation of adults experiencing serious mental health challenges. © Society for Community Research and Action 2017.

US Religious Congregations' Programming to Support Veterans: A Mixed Methods Study.

PubMed

Derose, Kathryn Pitkin; Haas, Ann; Werber, Laura

2016-06-01

Religious congregations may be well equipped to address veterans' reintegration needs, but little is known about the prevalence and nature of such support. We conducted a mixed methods study using nationally representative congregational survey data and in-depth interviews with congregational leaders. Overall, 28% of congregations nationally reported having programming to support veterans and positive, independent predictors included: community context (county veteran presence, high-poverty census tract, rural compared to urban location); congregational resources (more adult attendees, having a paid employee that spent time on service programs); and external engagement (assessing community needs, collaboration, and social service participation). Qualitative interviews revealed a range of activities, including attending to spiritual issues, supporting mental, physical and social well-being, and addressing vocational, legal, financial, and material needs.

Effects of Social Development Intervention in Childhood Fifteen Years Later

PubMed Central

Hawkins, J. David; Kosterman, Rick; Catalano, Richard F.; Hill, Karl G.; Abbott, Robert D.

2008-01-01

Objective To examine long-term effects of a universal intervention in elementary schools in promoting positive functioning in school, work, and community, and preventing mental health problems, risky sexual behavior, substance misuse, and crime at ages 24 and 27. Design Nonrandomized controlled trial followed participants to age 27, 15 years after the intervention ended. Three intervention conditions were compared: a full intervention group, assigned to intervention in grades 1 through 6; a late intervention group, assigned to intervention in grades 5 and 6 only; and a no-treatment control group. Setting Fifteen public elementary schools serving diverse neighborhoods including high-crime neighborhoods of Seattle. Participants A gender-balanced and multiethnic sample of 598 participants at ages 24 and 27 (93% of original sample in these conditions). Interventions Teacher training in classroom instruction and management, child social and emotional skill development, and parent workshops. Outcome Measures Self-reports of functioning in school, work and community, mental health, sexual behavior, substance use, and crime, and court records. Results A significant multivariate intervention effect across all 16 primary outcome indices was found. Specific effects included significantly better educational and economic attainment, mental health, and sexual health by age 27 (all p < .05). Hypothesized effects on substance use and crime were not found at ages 24 or 27. Conclusions A universal intervention for urban elementary school children, focused on classroom management and instruction, children’s social competence, and parenting practices, positively affected educational and economic attainment, mental health, and sexual health 15 years following the intervention’s end. PMID:19047540

75 FR 27703 - National Urban and Community Forestry Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

... DEPARTMENT OF AGRICULTURE Forest Service National Urban and Community Forestry Advisory Council AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Urban and Community... discuss emerging issues in urban and community forestry, work on Council administrative items and hear...

The impact of intimate partner violence, substance use, and HIV on depressive symptoms among abused low-income urban women.

PubMed

Illangasekare, Samantha L; Burke, Jessica G; McDonnell, Karen A; Gielen, Andrea C

2013-09-01

Intimate partner violence (IPV), substance use, and HIV are often co-occuring health problems affecting low-income urban women, and have been described as connected epidemics making up a "syndemic." Research suggests that each issue separately is associated with depressive symptoms, but no studies have examined the combined effect of IPV, substance use and HIV on women's depression. Interviews were conducted with 96 women recruited from community health clinics serving low-income women in an urban U.S. city. All women were over 17, not pregnant, English-speaking, without private insurance and had experienced physical IPV in the past year. Women were primarily African American (82%) and 82% were receiving income assistance. Twenty seven percent were HIV-positive, and 27% had used heroin or cocaine in the past 6 months. Based on the Centers for Epidemiological Studies Depression Scale (CES-D ), 73% were depressed. Women who experienced severe IPV in the past 6 months were compared to women who experienced no IPV or psychological IPV only in the past 6 months; those who experienced severe IPV were 5.3 times more likely to be depressed, controlling for HIV status, drug use, age, and relationship status. Women who experienced severe IPV, were HIV-positive, and used drugs (7.3% of sample) were 7.98 times as likely to be depressed as women without these characteristics. These findings confirm that severe IPV is significantly associated with depression among urban abused women. Furthermore, this research suggests that the syndemic effect of IPV, substance use, and HIV could be even more detrimental to women's mental health. Health practitioners and researchers should be aware of the combined impact of the IPV, substance use, and HIV syndemic and consider how they can address the mental health needs of urban women.

24 CFR 597.403 - Revocation of designation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... Secretary may revoke the designation of an urban area as an Empowerment Zone or Enterprise Community if the... the designation of an urban area as an Empowerment Zone or Enterprise Community, the Secretary will...

24 CFR 597.403 - Revocation of designation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... Secretary may revoke the designation of an urban area as an Empowerment Zone or Enterprise Community if the... the designation of an urban area as an Empowerment Zone or Enterprise Community, the Secretary will...

24 CFR 597.403 - Revocation of designation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... Secretary may revoke the designation of an urban area as an Empowerment Zone or Enterprise Community if the... the designation of an urban area as an Empowerment Zone or Enterprise Community, the Secretary will...

77 FR 27179 - National Urban and Community Forestry Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-09

... DEPARTMENT OF AGRICULTURE Forest Service National Urban and Community Forestry Advisory Council AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Urban and Community... Staff to the National Urban and Community Forestry Advisory Council, 201 14th Street SW., Yates Building...

75 FR 57898 - National Urban and Community Forestry Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... DEPARTMENT OF AGRICULTURE Forest Service National Urban and Community Forestry Advisory Council AGENCY: Forest Service, USDA. ACTION: Notice; Announcement for the 2011 U.S. Forest Service Urban and Community Forestry Challenge Cost Share Grant Opportunity. SUMMARY: The National Urban and Community Foresty...

24 CFR 597.403 - Revocation of designation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... Secretary may revoke the designation of an urban area as an Empowerment Zone or Enterprise Community if the... the designation of an urban area as an Empowerment Zone or Enterprise Community, the Secretary will...

Objective Community Integration of Mental Health Consumers Living in Supported Housing and of Others in the Community

PubMed Central

Yanos, Philip T.; Stefancic, Ana; Tsemberis, Sam

2015-01-01

Objective Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Methods Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Results Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Conclusions Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration. PMID:22549530

Rural Health Care in Texas: The Facts--1982.

ERIC Educational Resources Information Center

Knudson, Yvonne, Comp.; And Others

Although there exists in the minds of urban Texans the myth that rural life is especially healthy, in fact the mental and physical health of rural Texans is markedly worse than that of urban Texans. If health is defined in terms of environmental, physical, mental, and social factors, it is inaccurate to say that rural residents are receiving…

Parental Nurturance and the Mental Health and Parenting of Urban African American Adolescent Mothers

ERIC Educational Resources Information Center

Lewin, Amy; Mitchell, Stephanie J.; Hodgkinson, Stacy; Burrell, Lori; Beers, Lee S. A.; Duggan, Anne K.

2011-01-01

This study examined the relationship between a teen mother's perceptions of nurturance from her mother and father and her mental health and parenting attitudes. One-hundred and thirty-eight urban, primarily African American adolescent mothers were interviewed. Multivariate results indicate that teen mothers who felt nurtured by their mothers had…

School-Based Mental Health and Behavioral Programs for Low-Income, Urban Youth: A Systematic and Meta-Analytic Review

ERIC Educational Resources Information Center

Farahmand, Farahnaz K.; Grant, Kathryn E.; Polo, Antonio J.; Duffy, Sophia N.; Dubois, David L.

2011-01-01

A systematic and meta-analytic review was conducted of the effectiveness of school-based mental health and behavioral programs for low-income, urban youth. Applying criteria from an earlier systematic review (Rones & Hoagwood, 2000) of such programs for all populations indicated substantially fewer effective programs for low-income, urban…

Mental illness stigma in the Israeli context: deliberations and suggestions.

PubMed

Tal, Amir; Roe, David; Corrigan, Patrick W

2007-11-01

In this paper we deliberate mental illness stigma in the Israeli context and suggest ways to reduce it, emphasizing the community's role in the rehabilitation of persons with mental illness. A literature review of Israeli and international literature of mental illness stigma. Community mental health, in addition to its traditional focus on developing community-based services, should focus also on community-based interventions such as the delivery of anti-stigma interventions. Providing individualized rehabilitation services in the community while addressing stigma-induced social barriers may create a better recovery ground for Israelis with mental illness.

Acculturative Stress of Chinese Rural-To-Urban Migrant Workers: A Qualitative Study.

PubMed

Zhong, Bao-Liang; Liu, Tie-Bang; Huang, Jian-Xing; Fung, Helene H; Chan, Sandra S M; Conwell, Yeates; Chiu, Helen F K

2016-01-01

Global literature has suggested a negative impact of acculturative stress on both physical and mental health among international migrants. In China, approximately 20 percent of its population is rural-to-urban migrant workers and there are significant cultural differences between rural and urban societies, but no data are available regarding the acculturative stress of Chinese migrant workers. This study aimed to explore the forms and contexts of acculturative stress among Chinese migrant workers. Qualitative data were collected from four focus group discussions with 17 Chinese rural-to-urban migrant workers and three individual interviews with three medical professionals who provided mental health services for factory-workers in Shenzhen, China. The data in the current study showed that rural-to-urban migrant workers in China had experienced various forms of acculturative stress including difficulties in adapting to the environment, work-related stress, family-related stress, financial hardship, and lack of sense of belonging to cities. Rural-to-urban migration in China is a challenging transition with significant acculturative stress and demands for major adjustments among migrant workers. The assessment and management of acculturative stress is a necessary first step in providing mental health services to migrant workers.

Acculturative Stress of Chinese Rural-To-Urban Migrant Workers: A Qualitative Study

PubMed Central

Zhong, Bao-Liang; Liu, Tie-Bang; Huang, Jian-Xing; Fung, Helene H.; Chan, Sandra S. M.; Conwell, Yeates; Chiu, Helen F. K.

2016-01-01

Background Global literature has suggested a negative impact of acculturative stress on both physical and mental health among international migrants. In China, approximately 20 percent of its population is rural-to-urban migrant workers and there are significant cultural differences between rural and urban societies, but no data are available regarding the acculturative stress of Chinese migrant workers. This study aimed to explore the forms and contexts of acculturative stress among Chinese migrant workers. Methods Qualitative data were collected from four focus group discussions with 17 Chinese rural-to-urban migrant workers and three individual interviews with three medical professionals who provided mental health services for factory-workers in Shenzhen, China. Results The data in the current study showed that rural-to-urban migrant workers in China had experienced various forms of acculturative stress including difficulties in adapting to the environment, work-related stress, family-related stress, financial hardship, and lack of sense of belonging to cities. Conclusion Rural-to-urban migration in China is a challenging transition with significant acculturative stress and demands for major adjustments among migrant workers. The assessment and management of acculturative stress is a necessary first step in providing mental health services to migrant workers. PMID:27300005

Community Health Worker Employer Survey: Perspectives on CHW Workforce Development in the Midwest.

PubMed

Chaidez, Virginia; Palmer-Wackerly, Angela L; Trout, Kate E

2018-05-30

A statewide Community Health Worker Employer Survey was administered to various clinical, community, and faith-based organizations (n = 240) across a range of rural and urban settings in the Midwest. At least 80% of participants agreed or strongly agreed that items characterized as supervisory support were present in their work environment. Thirty-six percent of respondents currently employed CHWs, over half (51%) of survey respondents reported seeing the need to hire/work with more CHWs, and 44% saw the need for CHWs increasing in the future. Regarding CHW support, a majority of respondents indicated networking opportunities (63%), paid time for networking (80%), adequate time for supervision (75%), orientation training (78%), mandatory training (78%), ongoing training (79%), and paid time for training (82%). Open-ended responses to the question "In your organization, what needs could CHWs meet?" resulted in the largest number of respondents reporting mental health issues as a priority, followed by connecting people with services or resources, educating the public on preventive health, family support, and home care/visitations. Our findings suggest that respondents, who largely have supervisory or managerial roles, view workplace environments in Nebraska favorably, despite the fact that nearly two-thirds of respondents typically work well over 40 h per week. In addition, CHWs could help address mental and physical health needs in a variety of community and clinical settings through primary and secondary prevention activities, such as provision of health screenings, health and nutrition education, connecting people to resources and empowering community members through these activities and more.

Psychological Community Integration of Individuals With Serious Mental Illness.

PubMed

Pahwa, Rohini; Kriegel, Liat

2018-06-01

As different facets of community integration as well as psychological and social integration are important dimensions of recovery for individuals with serious mental illness (SMI). The primary aim of the study was to explore psychological integration for individuals with SMI into the mental health and mainstream (i.e., non-mental health) communities and its association with their social integration into both communities. The study used self-report and egocentric social network data from 60 individuals with SMI receiving community-based mental health services. The primary findings indicated that social integration connected to service providers was associated with psychological integration in both mental health and mainstream communities. Our data suggest that in addition to providing services, providers are doing something meaningful to impact their clients' lives well beyond mental health services. The study supports a bifurcated conceptualization of psychological integration and provides a more complex understanding of the community integration concept.

Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications, part I.

PubMed

Woersching, Joanna C; Snyder, Audrey E

2003-01-01

This is the first article in a series that evaluates the health concerns of people living in a Salvadoran rural community after major earthquakes. Part I reviews the background, methods, and results of post-earthquake conditions with regards to healthcare, access to healthcare, housing, food, water and sanitation. Part II reviews the implications of these results and recommendations for improvements within the community. Part III investigates the psychosocial and mental health consequences of the earthquakes and provides suggestions for improved mental health awareness, assessment, and intervention. El Salvador experienced 2 major earthquakes in January and February 2001. This study evaluates the effects of the earthquakes on the health practices in the rural town of San Sebastian. The research was conducted with use of a convenience sample survey of subjects affected by the earthquakes. The sample included 594 people within 100 households. The 32-question survey assessed post-earthquake conditions in the areas of health care and access to care, housing, food and water, and sanitation. Communicable diseases affected a number of family members. After the earthquakes, 38% of households reported new injuries, and 79% reported acute exacerbations of chronic illness. Rural inhabitants were 30% more likely to have an uninhabitable home than were urban inhabitants. Concerns included safe housing, water purification, and waste elimination. The findings indicate a need for greater public health awareness and community action to adapt living conditions after a disaster and prevent the spread of communicable disease.

Posttraumatic stress among young urban children exposed to family violence and other potentially traumatic events.

PubMed

Crusto, Cindy A; Whitson, Melissa L; Walling, Sherry M; Feinn, Richard; Friedman, Stacey R; Reynolds, Jesse; Amer, Mona; Kaufman, Joy S

2010-12-01

This study examines the relationship between the number of types of traumatic events experienced by children 3 to 6 years old, parenting stress, and children's posttraumatic stress (PTS). Parents and caregivers provided data for 154 urban children admitted into community-based mental health or developmental services. By parent and caregiver report, children experienced an average of 4.9 different types of potentially traumatic events. Nearly one quarter of the children evidenced clinically significant PTS. Posttraumatic stress was positively and significantly related to family violence and other family-related trauma exposure, nonfamily violence and trauma exposure, and parenting stress. Additionally, parenting stress partially mediated the relationship between family violence and trauma exposure and PTS. This study highlights the need for early violence and trauma exposure screening in help-seeking populations so that appropriate interventions are initiated. Copyright © 2010 International Society for Traumatic Stress Studies.

An analysis of the therapeutic elements in a black church service.

PubMed

Griffith, E E; Young, J L; Smith, D L

1984-05-01

Twenty members of an independent urban black church who frequently attended a midweek service were interviewed to determine the nature of their experiences during the service and to assess its psychological impact. The majority were relatively young, married, and from a Northern urban or Southern rural background. Their responses differed for each of four selected aspects of the service. Testimony was an ineffable and explicitly religious experience. Holy Ghost possession provided an emotionally ecstatic feeling that also produced a sense of relief. Dancing and speaking in tongues were intense individualistic experiences; speaking in tongues was a more explicitly religious phenomenon. The service as a whole imparted feelings of group closeness and strength. The authors note that participants' responses correspond to several curative factors associated with group psychotherapy and suggest that the black church service is a functional community mental health resource for its participants.

The effect of a community mental health training program for multidisciplinary staff.

PubMed

Yang, Bing Xiang; Stone, Teresa E; Davis, Scott A

2018-06-01

Primary health workers play a critical role in providing health education to people with mental disorders. In China community health workers working with people with mental health problems lack experience and training in this area. Additionally, coordination between hospital and community staff is not well established. The aim of this study was to provide an interdisciplinary community mental health training program and to evaluate the effect of the training on staff knowledge about mental health and confidence in their roles. A three-day community mental health training program was offered specifically for interdisciplinary mental health professionals. Using a one-group pre-test post-test design, participants completed a self-assessment of mental health concepts and program evaluation which included asking participants to rate their satisfaction using a five-point Likert scale and to respond to open-ended questions. Forty-eight participants including health professionals from colleges, hospital and community health centers were recruited. Only 8.7% of participants had ever received community mental health training. Post-test evaluation demonstrated improvements in knowledge, and most participants were very satisfied with the program. The findings indicate that this brief interdisciplinary training program had a positive effect in improving knowledge about community mental health concepts and confidence in dealing with people with mental health disorders for multidisciplinary staff working in primary health care areas. Copyright © 2017 Elsevier Inc. All rights reserved.

Urban Clan Mothers: Key Households in Cities

ERIC Educational Resources Information Center

Lobo, Susan

2003-01-01

Although each urban Indian community is distinctive, there are a number of common features or characteristics that are found in most urban Indian communities. The salient characteristics of the San Francisco Bay Area Indian community and many other urban Indian communities are that they are multitribal and therefore multicultural; dispersed…

"Black folk don't get no severe depression": Meanings and expressions of depression in a predominantly black urban neighborhood in Midwestern United States.

PubMed

Alang, Sirry M

2016-05-01

Discrepancies exist between how some Black populations perceive depression and how depression is conceptualized within research and clinical settings. Based on a 12-month ethnography of mental health in a predominantly Black disadvantaged urban neighborhood in Midwestern United States, the current study identifies meanings and common ways of expressing depression among African Americans. Depression was often considered a sign of weakness rather than a health problem that might need medical attention. Associated emotions like sadness and hopelessness were inconsistent with notions of strength. Common indicators of depression included classic symptoms such as hopelessness, loss of sleep, and feeling worthless. However, expressions of depression such as anger, agitation, violent behavior, and a frantic search for social interaction that are inconsistent with DSM-V criteria were also common. These findings have implications for the clinical assessment of depression and for the measurement of depression in community surveys. In addition, the context and meaning of symptoms play an important role in determining whether experiences are indicative of depression. This paper underscores that the provision of patient-centered mental health care requires a better understanding of the conceptualization of disorders within specific contexts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Geographic Access to Specialty Mental Health Care Across High- and Low-Income US Communities.

PubMed

Cummings, Janet R; Allen, Lindsay; Clennon, Julie; Ji, Xu; Druss, Benjamin G

2017-05-01

With the future of the Affordable Care Act and Medicaid program unclear, it is critical to examine the geographic availability of specialty mental health treatment resources that serve low-income populations across local communities. To examine the geographic availability of community-based specialty mental health treatment resources and how these resources are distributed by community socioeconomic status. Measures of the availability of specialty mental health treatment resources were derived using national data for 31 836 zip code tabulation areas from 2013 to 2015. Analyses examined the association between community socioeconomic status (assessed by median household income quartiles) and resource availability using logistic regressions. Models controlled for zip code tabulation area-level demographic characteristics and state indicators. Dichotomous indicators for whether a zip code tabulation area had any (1) outpatient mental health treatment facility (more than nine-tenths of which offer payment arrangements for low-income populations), (2) office-based practice of mental health specialist physician(s), (3) office-based practice of nonphysician mental health professionals (eg, therapists), and (4) mental health facility or office-based practice (ie, any community-based resource). Of the 31 836 zip code tabulation areas in the study, more than four-tenths (3382 of 7959 [42.5%]) of communities in the highest income quartile (mean income, $81 207) had any community-based mental health treatment resource vs 23.1% of communities (1841 of 7959) in the lowest income quartile (mean income, $30 534) (adjusted odds ratio, 1.74; 95% CI, 1.50-2.03). When examining the distribution of mental health professionals, 25.3% of the communities (2014 of 7959) in the highest income quartile had a mental health specialist physician practice vs 8.0% (637 of 7959) of those in the lowest income quartile (adjusted odds ratio, 3.04; 95% CI, 2.53-3.66). Similarly, 35.1% of the communities (2792 of 7959) in the highest income quartile had a nonphysician mental health professional practice vs 12.9% (1029 of 7959) of those in the lowest income quartile (adjusted odds ratio, 2.77; 95%, 2.35-3.26). In contrast, outpatient mental health treatment facilities were less likely to be located in the communities in the highest vs lowest income quartiles (12.9% [1025 of 7959] vs 16.5% [1317 of 7959]; adjusted odds ratio, 0.43; 95% CI, 0.37-0.51). More than seven-tenths of the lowest income communities with any resource (71.5% [1317 of 1841]) had an outpatient mental health treatment facility. Mental health treatment facilities are more likely to be located in poorer communities, whereas office-based practices of mental health professionals are more likely to be located in higher-income communities. These findings indicate that mental health treatment facilities constitute the backbone of the specialty mental health treatment infrastructure in low-income communities. Policies are needed to support and expand available resources for this critical infrastructure.

Collective Efficacy and the Contingent Consequences of Exposure to Life-Threatening Violence1

PubMed Central

Browning, Christopher R.; Gardner, Margo; Maimon, David; Brooks-Gunn, Jeanne

2014-01-01

Neighborhood research has increasingly emphasized the potential for contextual characteristics to moderate the effects of youths’ experiences on their outcomes. Drawing on collective efficacy theory, we examine the variable consequences of youths’ exposures to life threatening violence across neighborhoods. We argue that strong community normative orientations supporting the control of violence diminish the negative effect of exposure to severe violence on subsequent mental health among urban youth. We also consider the extent to which the consequences of exposure to violence vary by gender. Employing data from the Project on Human Development in Chicago Neighborhoods, we estimate a series of multivariate, multilevel linear models of internalizing and externalizing symptoms. Results indicate that, for girls, exposure to life threatening violence (witnessing someone being attacked with a weapon or shot) increases both internalizing and externalizing symptoms. However, this effect achieves statistical significance only for girls who reside in lower collective efficacy neighborhoods. For boys, our analyses offered weaker evidence of violence exposure effects on mental health. Implications for research on the social context of mental health are discussed. PMID:24842460

Examining Depression in Patients on Dialysis.

PubMed

Treadwell, Allison A

2017-01-01

This study measured the prevalence of depression in 39 patients on hemodialysis and peritoneal dialysis in two urban outpatient facilities in the southeastern United States. Additionally, it evaluated the number of patients who sought and scheduled a mental health evaluation after screening and education. The prevalence of mild to severely depressed individuals among participants in this study was 36%, affirming previous findings of depressive symptoms in the ESRD population. Results suggest that patients with ESRD are at a higher risk for depression than the general population. The effects of depression may exacerbate ESRD symptoms, affect treatment adherence, and increase hospitalizations and morbidity. It is likely that screening, diagnosing, and treating depression will be associated with improvement in quality and quantity of life. The practicality of using the screening procedure may improve the detection of depression in this population. However, only a fraction of identified patients in this study pursued further mental health evaluation within the 45-day period. Continued research is needed to identify barriers to seeking mental health consultation and treatment in this community. Copyright© by the American Nephrology Nurses Association.

Prevalence and factors associated with depressive symptoms in Malay women.

PubMed

Din, Meriam Omar; Noor, Noraini M

2009-12-01

Due to a dearth of research on depressive symptoms in Malaysia, particularly in Malay women, a community study was conducted to examine the prevalence and factors associated with current depressive symptoms in rural and urban Malay women with low socioeconomic status. Four hundred eighty-seven women (N rural = 242, N urban = 245) were interviewed. Information on socio-demographic variables, potential risk factors (family history of mental health problems, lifetime major depressive symptoms, and current life stressors), and current depressive symptoms (measured by the Centre for Epidemiologic Studies Depression Scale, CES-D) was collected. The prevalence of current depressive symptoms (CES-D scores > or = 16) reported was 34.5%, while the prevalence of lifetime major depressive symptoms was 27.5%. A significantly higher rate of current depressive symptoms was observed in urban women compared to rural women, chi(2) (1, N = 487) = 3.99, p < .05. However, no significant difference was found in the two groups of women in the prevalence of lifetime major depressive symptoms. The results of the multiple hierarchical regression analysis indicated that three potential factors (family history of mental health problems, lifetime major depressive symptoms, and current life stressors) were positively associated with current depressive symptoms, accounting for 17.8% of the variance, over and above the socio-demographic variables. The prevalence of depressive symptoms reported in the study was comparable to past studies. Among the factors associated with current depressive symptoms, the single most important was lifetime major depressive symptoms, followed by current life stressors, and family history of mental health problems. Among the socio-demographic variables used, perceived health status was the most important. The factors associated with depressive symptoms found in this study are consistent with past findings in the West, implying the universality of the phenomenon and common factors related to depressive symptoms in women.

How Can We Best Screen for Cognitive Impairment in Malaysia? A Pilot of the IDEA Cognitive Screen and Picture-Based Memory Impairment Scale and Comparison of Criterion Validity with the Mini Mental State Examination.

PubMed

Rosli, Roshaslina; Tan, Maw Pin; Gray, William K; Subramanian, Pathmawathi; Mohd Hairi, Noran Naqiah; Chin, Ai-Vyrn

2017-01-01

To pilot two new cognitive screening tools for use in an urban Malaysian population and to compare their criterion validity against a gold standard, the well-established Mini-Mental State Examination (MMSE). The IDEA cognitive screen, Picture-based Memory Impairment Scale (PMIS), and MMSE were administered to a convenience sample of elderly (≥ 65 years) from the community and outpatient clinics at an urban teaching hospital. Consensus diagnosis was performed by two geriatricians blinded to PMIS and IDEA cognitive screen scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria. The MMSE performance was used as a reference. The study enrolled 66 participants, with a median age of 78.5 years (interquartile range [IQR], 72.5-83.0) years and 11.0 median years of education (IQR, 9.0-13.0). Forty-three (65.2%) were female, and 32 (48.4%) were Chinese. The area under the receiver operating characteristic (AUROC) curve values were .962 (IDEA cognitive screen), .970 (PMIS), and .935 (MMSE). The optimal cutoff values for sensitivity and specificity were: IDEA cognitive screen: ≤ 11, 90.9% and 89.7%; PMIS: ≤ 6, 97.3% and 69.0%; and MMSE: ≤ 23, 84.6% and 76.0%. Although the sample size was small, multivariable logistic regression modelling suggested that all three screen scores did not appear to be educationally biased. The IDEA and PMIS tools are potentially valid screening tools for dementia in urban Malaysia, and perform at least as well as the MMSE. Further work on larger representative, cohorts is needed to further assess the psychometric properties. Study provides alternative screening tools for dementia for both non-specialists and specialists.

Trial of an electronic decision support system to facilitate shared decision making in community mental health.

PubMed

Woltmann, Emily M; Wilkniss, Sandra M; Teachout, Alexandra; McHugo, Gregory J; Drake, Robert E

2011-01-01

Involvement of community mental health consumers in mental health decision making has been consistently associated with improvements in health outcomes. Electronic decision support systems (EDSSs) that support both consumer and provider decision making may be a sustainable way to improve dyadic communication in a field with approximately 50% workforce turnover per year. This study examined the feasibility of such a system and investigated proximal outcomes of the system's performance. A cluster randomized design was used to evaluate an EDSS at three urban community mental health sites. Case managers (N=20) were randomly assigned to the EDSS-supported planning group or to the usual care planning group. Consumers (N=80) were assigned to the same group as their case managers. User satisfaction with the care planning process was assessed for consumers and case managers (possible scores range from 1 to 5, with higher summary scores indicating more satisfaction). Recall of the care plan was assessed for consumers. Linear regression with adjustment for grouping by worker was used to assess satisfaction scores. A Wilcoxon rank-sum test was used to examine knowledge of the care plan. Compared with case managers in the control group, those in the intervention group were significantly more satisfied with the care planning process (mean ± SD score=4.0 ± .5 versus 3.3 ± .5; adjusted p=.01). Compared with consumers in the control group, those in the intervention group had significantly greater recall of their care plans three days after the planning session (mean proportion of plan goals recalled=75% ± 28% versus 57% ± 32%; p=.02). There were no differences between the clients in the intervention and control groups regarding satisfaction. This study demonstrated that clients can build their own care plans and negotiate and revise them with their case managers using an EDSS.

An exploratory study of mental health and HIV risk behavior among drug-using rural women in jail

PubMed Central

Staton-Tindall, Michele; Harp, Kathi LH; Minieri, Alexandra; Oser, Carrie; Webster, J. Matthew; Havens, Jennifer; Leukefeld, Carl

2014-01-01

Objective Rural women, particularly those involved in the criminal justice system, are at risk for HIV due to the increasing prevalence of injection drug use, as well as limited services. Research on HIV risk correlates, including drug use and mental health, has primarily focused on urban women incarcerated in prisons. The purpose of this exploratory study is to examine dual HIV risk behavior by three different mental health problems (depression, anxiety, and PTSD) among drug-using women in rural jails. Methods This study involved random selection, screening, and face-to-face interviews with 136 women from rural jails in one Appalachian state. Analyses focused on the relationship between mental health and HIV risk among this sample of drug-using women. Findings Nearly 80% of women self-reported symptoms of depression, and more than 60% endorsed symptoms consistent with anxiety and PTSD symptoms. Mental health was significantly correlated with severity of certain types of drug use, as well as risky sexual activity. In addition, for women experiencing anxiety and PTSD, injection drug use moderated the relationship between mental health and risky sexual activity. Implications Based on these rates of drug use, mental health problems, and the emergence of injection drug use in rural Appalachia, the need to explore the relationships between these issues among vulnerable and understudied populations, such as rural women, is critical. Due to service limitations in rural communities, criminal justice venues such as jails provide opportune settings for screening, assessment, and intervention for drug use, mental health, and HIV education and prevention. PMID:25799305

An exploratory study of mental health and HIV risk behavior among drug-using rural women in jail.

PubMed

Staton-Tindall, Michele; Harp, Kathi L H; Minieri, Alexandra; Oser, Carrie; Webster, J Matthew; Havens, Jennifer; Leukefeld, Carl

2015-03-01

Rural women, particularly those in the criminal justice system, are at risk for HIV related to the increasing prevalence of injection drug use as well as limited services. Research on HIV risk correlates, including drug use and mental health, has primarily focused on urban women incarcerated in prisons. The purpose of this exploratory study is to examine dual HIV risk by 3 different mental health problems (depression, anxiety, and posttraumatic stress disorder [PTSD]) among drug-using women in rural jails. This study involved random selection, screening, and face-to-face interviews with 136 women in 1 Appalachian state. Analyses focused on the relationship between mental health and HIV risk. Nearly 80% of women self-reported symptoms of depression, and more than 60% endorsed symptoms consistent with anxiety and PTSD symptoms. Mental health significantly correlated with severity of certain types of drug use, as well as risky sexual activity. In addition, for women experiencing anxiety and PTSD, injection drug use moderated the relationship between mental health and risky sexual activity. Based on these rates of drug use, mental health problems, and the emergence of injection drug use in rural Appalachia, the need to explore the relationships between these issues among vulnerable and understudied populations, such as rural women, is critical. Because of service limitations in rural communities, criminal justice venues such as jails provide opportune settings for screening, assessment, and intervention for drug use, mental health, and HIV education and prevention. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Service contacts prior to death in people dying by suicide in the Scottish Highlands.

PubMed

Stark, Cameron R; Vaughan, Susan; Huc, Sara; O'Neill, Noelle

2012-01-01

Many people who die by suicide have been in contact with health services prior to their death. This study examined service contacts in people in urban and rural areas of the Scottish Highlands. Highland residents dying by suicide or undetermined intent in 2001-2004 were identified using routine death records. Health service databases were searched to identify general hospital, mental health and general practice notes. 177 residents died in the time period (136 males). At least one type of record was identified on 175 people, including general practice records (167 people, 94.4%), psychiatric hospital records (n=87, 49.2%) and general hospital records (n=142, 80.2%). Of these, 52.5% had been in contact with at least one health service in the month before their death, including 18.6% with mental health services, and 46.4% with general practice. In total, 68.9% had a previous diagnosis of mental illness, 52.5% of substance misuse problems, and 40.1% of self-harm. The commonest mental illness diagnosis was depression (n=97, 54.8%). There was no difference in rates of GP contact in rural and urban areas. Of those dying in urban areas, 32% had been in contact with mental health services in the previous month, compared with 21% in Accessible Rural/Accessible Small Towns, and 11% in Remote Rural/Remote Small Towns (p<0.01). People in rural areas were less likely to have had contact with mental health services in the year before their death (p<0.01), and to have had lower recorded lifetime rates of mental health service contact (p<0.001), deliberate self-harm (p<0.005) and mental illness (p<0.001). Overall service contact rates prior to death by suicide were very similar to the results of a previous meta-analysis. Rates of contact with specialist mental health services were significantly lower in rural than urban areas, and this finding increased with greater rurality.

Psychiatric disorders and urbanization in Germany

PubMed Central

Dekker, Jack; Peen, Jaap; Koelen, Jurrijn; Smit, Filip; Schoevers, Robert

2008-01-01

Background Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in a nationwide German population study, controlling for other known risk factors such as gender, social class, marital status and the interaction variables of these factors with urbanization. Methods The Munich Composite International Diagnostic Interview (M-CIDI) was used to assess the prevalence of mental disorders (DSM-IV) in a representative sample of the German population (N = 4181, age: 18–65). The sample contains five levels of urbanization based on residence location. The epidemiological study was commissioned by the German Ministry of Research, Education and Science (BMBF) and approved by the relevant Institutional Review Board and ethics committee. Written informed consent was obtained for both surveys (core survey and Mental Health Supplement). Subjects did not get any financial compensation for their study participation. Results Higher levels of urbanization were linked to higher 12-month prevalence rates for almost all major psychiatric disorders (with the exception of substance abuse and psychotic disorders). The weighted prevalence percentages were highest in the most urbanized category. Alongside urbanization, female gender, lower social class and being unmarried were generally found to be associated with higher levels of psychopathology. The impact of urbanization on mental health was about equal (for almost all major psychiatric disorders) in young people and elderly people, men and women, and in married and single people. Only people from a low social class in the most urbanized settings had more somatoform disorders, and unmarried people in the most urbanized settings had more anxiety disorders. Conclusion Psychiatric disorders are more prevalent among the inhabitants of more urbanized areas. probably because of environmental stressors. PMID:18201380

The DUDES Club

PubMed Central

Gross, Paul A.; Efimoff, Iloradanon; Patrick, Lyana; Josewski, Viviane; Hau, Keith; Lambert, Sandy; Smye, Victoria

2016-01-01

Abstract Problem addressed In Canada, there are few health promotion programs for men, particularly programs focused on indigenous and other men marginalized by social and structural inequities. Objective of program To build solidarity and brotherhood among vulnerable men; to promote health through education, dialogue, and health screening clinics; and to help men regain a sense of pride and fulfilment in their lives. Program description The DUDES Club was established in 2010 as a community-based health promotion program for indigenous men in the Downtown Eastside neighbourhood of Vancouver, BC. Between August 2014 and May 2015, 150 men completed an evaluation survey developed using a logic model approach. Responses were analyzed based on the 4 dimensions of the indigenous medicine wheel (mental, physical, emotional, and spiritual). Evaluation results demonstrated high participant satisfaction and positive outcomes across all 4 dimensions of health and well-being: 90.6% of respondents indicated that the DUDES Club program improved their quality of life. Participants who attended meetings more often experienced greater physical, mental, and social benefits (P < .05). Conclusion Findings indicate that this innovative model is effective in promoting the well-being of mainly indigenous men through culturally safe services in an urban community.

Provider, veteran, and family perspectives on family education in Veterans Affairs community-based outpatient facilities.

PubMed

Sherman, Michelle D; Fischer, Ellen P

2012-02-01

The Veterans Affairs (VA) healthcare system is dedicated to providing high-quality mental health services to all veterans, including the nearly 40% of enrolled veterans living in rural areas. Family education programs regarding mental illness and posttraumatic stress disorder, mandated for delivery in all VA medical centers and some community-based outpatient clinics (CBOCs), have been developed and provided primarily in large, urban medical centers. This qualitative investigation involved interviews with CBOC providers and veterans and families who live in rural areas and/or seek care in CBOCs to ascertain their perceptions of the benefits, feasibility, structural and cultural barriers, and logistical preferences regarding family education. The perspectives and concerns that emerged in these interviews were combined with expert knowledge to identify the resources and considerations a VAMC would want to address when translating and implementing similar programming into CBOCs. Although institutional, logistic, and attitudinal challenges were described, all three stakeholder groups endorsed the need for family education, did not see the barriers as insurmountable, and provided creative solutions. Administrators and CBOC clinicians may benefit by anticipating and problem solving around the key issues raised when developing family programming.

Influence of Urban Residence on Use of Psychotropic Medications in Pennsylvania, USA: Cross-sectional Comparison of Older Adults Attending Senior Centers

PubMed Central

Edelstein, Offer; Pater, Karen; Sharma, Ravi; Albert, Steven M.

2014-01-01

Background Differences in medication use by geographic region may indicate differences in access to specialist medical care, especially in the case of prescriptions for psychotropic medications. We assessed the effect of more or less urbanized residence on likelihood of psychotropic medication use in a large cohort of older adults in Pennsylvania, USA. Methods Community-dwelling older adults were recruited from senior centers across PA. Participant residences were geocoded and categorized according to U.S. Department of Agriculture Rural-Urban Continuum Codes. We used the codes to identify respondents who live in relatively urban counties with 250,000 or more residents (n=1360) or less urban counties with fewer than 250,000 residents (n=401). Participants reported prescription medications in a clinical interview. Psychotropic medications were categorized by class. Logistic regression models were estimated to assess the independent effect of residence on likelihood of psychotropic medication use. Results Geographic region was significantly associated with use of psychotropic medications. Psychotropic medication use was higher in less urban areas (19.7%) relative to more urban areas (14.2%), p =.007. In adjusted models, degree of urban residence was a significant correlate in models that adjusted for sociodemographic features and medical status (odds ratio, 1.62; 95% confidence interval 1.13–2.31, p < .01). Use of psychotropic medications on the Beers list also increased with less urban residence (13.0% vs. 8.3%, p = .005). Conclusions Older adults living in less urbanized areas are more likely to be prescribed psychotropic drugs. This difference may indicate a health disparity based on access to geriatric specialists or mental health care. PMID:24357135

Influence of urban residence on use of psychotropic medications in Pennsylvania, USA: cross-sectional comparison of older adults attending senior centers.

PubMed

Edelstein, Offer; Pater, Karen; Sharma, Ravi; Albert, Steven M

2014-02-01

Differences in medication use by geographic region may indicate differences in access to specialist medical care, especially in the case of prescriptions for psychotropic medications. We assessed the effect of more or less urbanized residence on likelihood of psychotropic medication use in a large cohort of older adults in Pennsylvania, USA. Community-dwelling older adults were recruited from senior centers across Pennsylvania. Participant residences were geocoded and categorized according to US Department of Agriculture Rural-Urban Continuum Codes. We used the codes to identify respondents who live in relatively urban counties with 250,000 or more residents (n = 1,360) or less urban counties with fewer than 250,000 residents (n = 401). Participants reported prescription medications in a clinical interview. Psychotropic medications were categorized by class. Logistic regression models were estimated to assess the independent effect of residence on likelihood of psychotropic medication use. Geographic region was significantly associated with use of psychotropic medications. Psychotropic medication use was higher in less urban areas (19.7%) relative to more urban areas (14.2%), p = 0.007. In adjusted models, degree of urban residence was a significant correlate in models that adjusted for sociodemographic features and medical status (odds ratio 1.62; 95% confidence interval 1.13-2.31, p < 0.01). Use of psychotropic medications on the Beers list also increased with less urban residence (13.0 vs. 8.3%, p = 0.005). Older adults living in less urbanized areas are more likely to be prescribed psychotropic drugs. This difference may indicate a health disparity based on access to geriatric specialists or mental health care.

Understanding the Behavioral Determinants of Mental Health Service Use by Urban, Under-Resourced Black Youth: Adolescent and Caregiver Perspectives

PubMed Central

Chambers, Kerri; Pohle, Cara; Beall, Peggy; Lucksted, Alicia

2012-01-01

Black adolescents with mental health problems are less likely than non-Black adolescents with mental health problems to receive treatment, primarily for non-financial reasons including negative perceptions of services and providers, and self-stigma associated with experiencing mental health problems. To better understand these obstacles, 16 adolescents and 11 caregivers, recruited from two K-8th grade elementary-middle schools, participated in four focus groups guided by the unified theory of behavior to explore mental health help-seeking behaviors and perceptions of mental health services. In the focus groups, caregivers acknowledged more positive attitudes about seeking mental health services than adolescents, but both expected the experience of actually doing so to be negative. Adolescents and caregivers also acknowledged social norms that inhibit their mental health help-seeking. Therefore, we conclude that interventions targeting expectancies and social norms might increase the connection of urban, under-resourced Black adolescents and their families to mental health services, and be particularly important given the long-term consequences of untreated mental health problems for this group. PMID:23355768

Understanding the Behavioral Determinants of Mental Health Service Use by Urban, Under-Resourced Black Youth: Adolescent and Caregiver Perspectives.

PubMed

Lindsey, Michael A; Chambers, Kerri; Pohle, Cara; Beall, Peggy; Lucksted, Alicia

2013-01-01

Black adolescents with mental health problems are less likely than non-Black adolescents with mental health problems to receive treatment, primarily for non-financial reasons including negative perceptions of services and providers, and self-stigma associated with experiencing mental health problems. To better understand these obstacles, 16 adolescents and 11 caregivers, recruited from two K-8th grade elementary-middle schools, participated in four focus groups guided by the unified theory of behavior to explore mental health help-seeking behaviors and perceptions of mental health services. In the focus groups, caregivers acknowledged more positive attitudes about seeking mental health services than adolescents, but both expected the experience of actually doing so to be negative. Adolescents and caregivers also acknowledged social norms that inhibit their mental health help-seeking. Therefore, we conclude that interventions targeting expectancies and social norms might increase the connection of urban, under-resourced Black adolescents and their families to mental health services, and be particularly important given the long-term consequences of untreated mental health problems for this group.

A gender-informed model to train community health workers in maternal mental health.

PubMed

Smith, Megan V; Kruse-Austin, Anna

2015-08-01

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers. Copyright © 2014. Published by Elsevier Ltd.

Comparing the mental health of rural-to-urban migrant children and their counterparts in china: Protocol for a systematic review and meta-analysis.

PubMed

Zhang, Jun-Hua; Yan, Li-Xia; Yuan, Yang

2018-04-01

In recent years, the issue of migrant children with peasant parents working in cities has attracted widespread attention in recent years because of the sheer number and the benefits bundled in China's household. The focus has gradually extended from early education opportunities to all aspects of physical and mental development, especially the social adaptation and mental health of migrant children. The negative impact of environment changes on migrant children' mental health is very worrying for parents and the society. Some studies have found that immigrant children's mental health is significantly lower than their peers, but there are also studies that hold the opposite view. Thus, the mental health status of migrant children is still a controversial issue, which may have a certain relationship with the potential differences in the specific problems of mental health, regions, comparison objects, and researchers. The objective of this protocol is to investigate whether mental health and subdimensions differ between rural-to-urban migrant children and their counterparts living in China and examine study characteristics that might result in differences among studies. We will search PubMed, Embase, OVID, ERIC, Web of Science, and Chinese databases including CNKI, Chongqing VIP, and Wan Fang data from start to April 2018. Cross-sectional studies with a comparison of migrant children and their counterparts will be included. The primary outcome will be the mean and standard deviation of mental health and its sub-dimensions. Standardized mean difference is used as the main effect value. Subgroup analyses will be carried out by the location of studies and school type of. Sensitivity analyses will be conducted to assess the robustness of the findings. Analyses will be performed with RevMan and Stata software. This systematic review and meta-analysis will compare the mental health status of rural-to-urban migrant children and their counterparts living in China. The results of this systematic and meta-analysis will be helpful to get a more reliable understanding of the mental health of rural-to-urban migrant children and the reasons for the controversy on this issue.

Community mental health nursing: keeping pace with care delivery?

PubMed

Henderson, Julie; Willis, Eileen; Walter, Bonnie; Toffoli, Luisa

2008-06-01

The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.

Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

PubMed

Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

2015-09-01

The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

Community forensic psychiatry: restoring some sanity to forensic psychiatric rehabilitation.

PubMed

Skipworth, J; Humberstone, V

2002-01-01

To review clinical and legal paradigms of community forensic mental health care, with specific focus on New Zealand, and to develop a clinically based set of guiding principles for service development in this area. The general principles of rehabilitating mentally disordered offenders, and assertive community care programmes were reviewed and applied to the law and policy in a New Zealand forensic mental health setting. There is a need to develop comprehensive community treatment programmes for mentally disordered offenders. The limited available research supports assertive community treatment models, with specialist forensic input. Ten clinically based principles of care provision important to forensic mental health assertive community treatment were developed. Deinstitutionalization in forensic psychiatry lags behind the rest of psychiatry, but can only occur with well-supported systems in place to assess and manage risk in the community setting. The development of community-based forensic rehabilitation services in conjunction with general mental health is indicated.

COPE: A Pilot Study with Urban-Dwelling Minority Sixth-Grade Youth to Improve Physical Activity and Mental Health Outcomes

ERIC Educational Resources Information Center

Hoying, Jacqueline; Melnyk, Bernadette Mazurek

2016-01-01

Approximately one in three preadolescents (34%) is obese/overweight and one in four (25%) experience a mental health issue. Urban youth suffer from higher rates of these problems, and at earlier ages than their peers. This study's purpose was to determine feasibility/acceptability and preliminary effects of the COPE (Creating Opportunities for…

Child Community Mental Health Services in Asia Pacific and Singapore’s REACH Model

PubMed Central

Lim, Choon Guan; Loh, Hannah; Renjan, Vidhya; Tan, Jason; Fung, Daniel

2017-01-01

In recent decades, there have been concerted efforts to improve mental health services for youths alongside the challenges of rising healthcare costs and increasing demand for mental health needs. One important phenomenon is the shift from traditional clinic-based care to community-based mental health services to improve accessibility to services and provide patient-centred care. In this article, we discuss the child and adolescent community mental health efforts within the Asia-Pacific region. We also discuss Singapore’s community and school-based mental health service, known as the Response, Early Intervention and Assessment in Community Mental Health (REACH). This article discusses how REACH has evolved over the years in response to the changing needs of youths in Singapore. Finally, we discuss the current challenges and future directions for youth mental health care. PMID:28984830

Deinstitutionalization: Its Impact on Community Mental Health Centers and the Seriously Mentally Ill

ERIC Educational Resources Information Center

Kliewer, Stephen P.; McNally Melissa; Trippany, Robyn L.

2009-01-01

Deinstitutionalization has had a significant impact on the mental health system, including the client, the agency, and the counselor. For clients with serious mental illness, learning to live in a community setting poses challenges that are often difficult to overcome. Community mental health agencies must respond to these specific needs, thus…

Quercus rubra-associated ectomycorrhizal fungal communities of disturbed urban sites and mature forests.

PubMed

Karpati, Amy S; Handel, Steven N; Dighton, John; Horton, Thomas R

2011-08-01

The presence and quality of the belowground mycorrhizal fungal community could greatly influence plant community structure and host species response. This study tests whether mycorrhizal fungal communities in areas highly impacted by anthropogenic disturbance and urbanization are less species rich or exhibit lower host root colonization rates when compared to those of less disturbed systems. Using a soil bioassay, we sampled the ectomycorrhizal fungal (EMF) communities associating with Quercus rubra (northern red oak) seedlings in soil collected from seven sites: two mature forest reference sites and five urban sites of varying levels of disturbance. Morphological and polymerase chain reaction-restriction fragment length polymorphism analyses of fungi colonizing root tips revealed that colonization rates and fungal species richness were significantly lower on root systems of seedlings grown in disturbed site soils. Analysis of similarity showed that EMF community composition was not significantly different among several urban site soils but did differ significantly between mature forest sites and all but one urban site. We identified a suite of fungal species that occurred across several urban sites. Lack of a diverse community of belowground mutualists could be a constraint on urban plant community development, especially of late-successional woodlands. Analysis of urban EMF communities can add to our understanding of urban plant community structure and should be addressed during ecological assessment before pragmatic decisions to restore habitats are framed.

The Role of MDMA (Ecstasy) in Coping with Negative Life Situations Among Urban Young Adults

PubMed Central

Moonzwe, Lwendo S.; Schensul, Jean J.; Kostick, Kristin M.

2011-01-01

This article examines the role of Ecstasy (MDMA or 3, 4-methylenedioxymethamphetamine) as a drug used for self-medication and coping with both short- and long-term negative life situations. We show that urban youth who do not have a specific diagnosed mental illness are more likely than those who have been diagnosed and have received treatment to use Ecstasy to cope with both situational stress and lifetime trauma. Diagnosed and treated youth sometimes self-medicate with other drugs, but do not choose Ecstasy for mediation of their psychological stress. We discuss the implications of self-medication with Ecstasy for mental health services to urban youth experiencing mental health disparities, and for the continued testing and prescription of MDMA for therapeutic use in controlled clinical settings. PMID:22111403

Feasibility trial of a scalable psychological intervention for women affected by urban adversity and gender-based violence in Nairobi.

PubMed

Dawson, Katie S; Schafer, Alison; Anjuri, Dorothy; Ndogoni, Lincoln; Musyoki, Caroline; Sijbrandij, Marit; van Ommeren, Mark; Bryant, Richard A

2016-11-18

Living in conditions of chronic adversity renders many women more vulnerable to experiencing gender-based violence (GBV). In addition to GBV's physical and social consequences, the psychological effects can be pervasive. Access to evidence-based psychological interventions that seek to support the mental health of women affected by such adversity is rare in low- and middle-income countries. The current study evaluates a brief evidence-informed psychological intervention developed by the World Health Organization for adults impacted by adversity (Problem Management Plus; PM+). A feasibility randomised control trial (RCT) was conducted to inform a fully powered trial. Community health workers delivered the intervention to 70 women residing in three peri-urban settings in Nairobi, Kenya. Women, among whom 80% were survivors of GBV (N = 56), were randomised to receive five sessions of either PM+ (n = 35) by community health workers or enhanced treatment as usual (ETAU; n = 35). PM+ was not associated with any adverse events. Although the study was not powered to identify effects and accordingly did not identify effects on the primary outcome measure of general psychological distress, women survivors of adversity, including GBV, who received PM+ displayed greater reductions in posttraumatic stress disorder symptoms following treatment than those receiving ETAU. This feasibility study suggests that PM+ delivered by lay health workers is an acceptable and safe intervention to reach women experiencing common mental disorders and be inclusive for those affected by GBV and can be studied in a RCT in this setting. The study sets the stage for a fully powered, definitive controlled trial to assess this potentially effective intervention. ACTRN12614001291673 , 10/12/2014, retrospectively registered during the recruitment phase.

Therapist and client predictors of use of therapy techniques within the context of implementation efforts in a large public mental health system

PubMed Central

Wolk, Courtney Benjamin; Marcus, Steven C.; Weersing, V. Robin; Hawley, Kristin M.; Evans, Arthur; Hurford, Matthew; Beidas, Rinad

2016-01-01

Objective Many youth receiving community mental health treatment do not receive evidence-based interventions. Research suggests that community mental health therapists use a broad range of therapeutic techniques at low intensities. The present study examined the relationship between therapist- and client-level predictors on community-based therapists’ report of cognitive, behavioral, psychodynamic, and family techniques within the context of implementation efforts. Methods One hundred thirty therapists from 23 organizations in an urban publicly funded behavioral health system implementing evidence-based practices participated. Therapist-level predictors included age, gender, clinical experience, licensure status, and participation in evidence-based practice initiatives. Child-level predictors included therapist-reported child primary disorder (i.e., externalizing, internalizing, or other) and child age. Therapists completed the Therapist Procedures Checklist- Family Revised, a self-report measure of therapeutic techniques used. Results Unlicensed therapists were more likely to report use of both psychodynamic and behavioral techniques. Therapists who did not participate in an evidence-based practice initiative were less likely to report use of cognitive techniques. Those with externalizing clients were more likely to report use of behavioral and family techniques. Therapists with the youngest clients (aged 3-7) were most likely to report use of behavioral techniques and less likely to report use of cognitive and psychodynamic techniques. Conclusions Results suggest that both therapist and client factors predict self-reported use of therapy techniques. Participating in an evidence-based practice initiative increased report of cognitive techniques. Therapists reported using more behavioral and family techniques for youth with externalizing disorders and fewer cognitive and psychodynamic techniques with young clients. PMID:26876658

Culture as a mediator of gene-environment interaction: Cultural consonance, childhood adversity, a 2A serotonin receptor polymorphism, and depression in urban Brazil.

PubMed

Dressler, William W; Balieiro, Mauro C; Ferreira de Araújo, Luiza; Silva, Wilson A; Ernesto Dos Santos, José

2016-07-01

Research on gene-environment interaction was facilitated by breakthroughs in molecular biology in the late 20th century, especially in the study of mental health. There is a reliable interaction between candidate genes for depression and childhood adversity in relation to mental health outcomes. The aim of this paper is to explore the role of culture in this process in an urban community in Brazil. The specific cultural factor examined is cultural consonance, or the degree to which individuals are able to successfully incorporate salient cultural models into their own beliefs and behaviors. It was hypothesized that cultural consonance in family life would mediate the interaction of genotype and childhood adversity. In a study of 402 adult Brazilians from diverse socioeconomic backgrounds, conducted from 2011 to 2014, the interaction of reported childhood adversity and a polymorphism in the 2A serotonin receptor was associated with higher depressive symptoms. Further analysis showed that the gene-environment interaction was mediated by cultural consonance in family life, and that these effects were more pronounced in lower social class neighborhoods. The findings reinforce the role of the serotonergic system in the regulation of stress response and learning and memory, and how these processes in turn interact with environmental events and circumstances. Furthermore, these results suggest that gene-environment interaction models should incorporate a wider range of environmental experience and more complex pathways to better understand how genes and the environment combine to influence mental health outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Working atmosphere, job satisfaction and individual characteristics of community mental health professionals in integrated care.

PubMed

Goetz, Katja; Kleine-Budde, Katja; Bramesfeld, Anke; Stegbauer, Constance

2018-03-01

Working requirements of community mental healthcare professionals in integrated care are complex. There is a lack of research concerning the relation of job satisfaction, working atmosphere and individual characteristics. For the current study, a survey evaluating job satisfaction and working atmosphere of mental healthcare professionals in integrated care was performed. About 321 community mental healthcare professionals were included in the survey; the response rate was 59.5%. The professional background of community mental healthcare professionals included nursing, social work and psychology. Community mental healthcare professionals reported the highest satisfaction with colleagues and the lowest satisfaction with income. Moreover, it could be shown that more responsibility, more recognition and more variety in job tasks lead to an increase of overall job satisfaction. Healthcare for mentally ill patients in the community setting is complex and requires well-structured care with appropriate responsibilities within the team. A co-operative relationship among colleagues as well as clearly defined responsibilities seem to be the key for the job satisfaction of community mental healthcare professionals in integrated care. © 2017 John Wiley & Sons Ltd.

From Community to Meta-Community Mental Health Care.

PubMed

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-04-20

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care.

From Community to Meta-Community Mental Health Care

PubMed Central

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-01-01

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care. PMID:29677100

Treatment of Individuals with Borderline Personality Disorder Using Dialectical Behavior Therapy in a Community Mental Health Setting: Clinical Application and a Preliminary Investigation

ERIC Educational Resources Information Center

Ben-Porath, Denise D.; Peterson, Gregory A.; Smee, Jacqueline

2004-01-01

This article describes an effort to implement and examine dialectical behavior therapy's (DBT) effectiveness in a community mental health setting. Modifications made to address unique aspects of community mental health settings are described. Barriers encountered in implementation of DBT treatment in community mental health settings, such as staff…

Housing index, urbanisation level and lifetime prevalence of depressive and anxiety disorders: a cross-sectional analysis of the Colombian national mental health survey.

PubMed

de Vries, Esther; Rincon, Carlos Javier; Tamayo Martínez, Nathalie; Rodriguez, Nelcy; Tiemeier, Henning; Mackenbach, Johan P; Gómez-Restrepo, Carlos; Guarnizo-Herreño, Carol C

2018-06-07

To study socioeconomic inequalities in mental health in rural and urban Colombia, a country with a history of internal conflict and large socioeconomic inequalities. Recent survey data are available to study this understudied topic in a middle-income country. Using data from 9656 respondents from the 2015 Colombian Mental Health survey, we investigated the association between lifetime prevalence of depressive and anxiety disorders and quality of dwellings and access to public services housing score (HS). We calculated the relative index of inequality (RII) and slope index of inequality (SII) for HS in urban and rural areas, adjusting for potential confounders and mediating factors. The lifetime prevalence of anxiety and depression (combined) was 9.6% in urban versus 6.9% in rural areas (p<0.001). HS was not associated with prevalence of anxiety and depression in urban settings, whereas a higher HS (poorer housing quality) was associated with fewer mental disorders in rural areas in both univariate and multivariate models (multivariate RII urban 0.96 (95% CI 0.51 to 1.81); RII rural 0.11 (95% CI 0.04 to 0.32)). In rural areas, the prevalence of mental health problems was 12% points lower in persons living in the poorest quality dwellings than in those living in high-quality dwellings (SII -0.12 (95% CI -0.18 to -0.06)). Interestingly, within rural areas, persons living in 'populated centres' (small towns, villages) had a higher lifetime prevalence of any mental health disorder (9.8% (95% CI 6.9 to 13.6)) compared with those living in more isolated, dispersed areas (6.0% (95% CI 4.6 to 7.7)). In rural Colombia, those living in the poorest houses and in dispersed areas had a lower prevalence of mental health problems. Further understanding of this phenomenon of a seemingly inverse association of prevalence of mental disorders with poverty and/or urbanisation in rural areas is needed. Particularly, considering the progressive urbanisation process in Colombia, it is important to monitor mental health in populations migrating to the cities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nation's Nationalities and People's Region, Ethiopia.

PubMed

Bedaso, Asres; Yeneabat, Tebikew; Yohannis, Zegeye; Bedasso, Kufa; Feyera, Fetuma

2016-01-01

Mental illnesses worldwide are accompanied by another pandemic, that of stigma and discrimination. Public understanding about mental illnesses and attitudes towards people with mental illness play a paramount role in the prevention and treatment of mental illness and the rehabilitation of people with mental illness. To assess community attitude and associated factors towards people with mental illness. Community based cross-sectional study was conducted from April 28 to May 28, 2014. Quantitative data were collected through interview from 435 adults selected using simple random sampling. Data were collected using community attitude towards mentally ill (CAMI) tool to assess community attitude towards people with mental illness and associated factors. Multiple linear regression analysis was performed to identify predictors of community attitude towards people with mental illness and the level of significance association was determined by beta with 95% confidence interval and P less than 0.05. The highest mean score was on social restrictiveness subscale (31.55±5.62). Farmers had more socially restrictive view (β = 0.291, CI [0.09, 0.49]) and have less humanistic view towards mentally ill (β = 0.193, CI [-0.36, -0.03]). Having mental health information had significantly less socially restrictive (β = -0.59, CI [-1.13, -0.05]) and less authoritarian (β = -0.10, CI [-1.11, -0.06]) view towards mentally ill but respondents who are at university or college level reported to be more socially restrictive (β = 0.298, CI [0.059, 0.54]). Respondents whose age is above 48 years old had significantly less view of community mental health ideology (β = -0.59, CI [-1.09, -0.08]). Residents of Worabe town were highly socially restrictive but less authoritarian. There was high level of negative attitude towards people with mental illness along all the subscales with relative variation indicating a need to develop strategies to change negative attitude attached to mental illness in Worabe town at community level.

[Mental Health Promotion Among the Chronic Disabled Population in the Community].

PubMed

Huang, Hui-Chuan; Wang, Li-Hua; Chang, Hsiu-Ju

2015-08-01

Societal ageing and the rising prevalence of chronic disease are important causes that underlie the growth in the number of disabled individuals. The disease-induced psychological distress experienced by this population not only decreases quality of life but also increases demand for healthcare. The healthcare policy for the disabled population currently focuses on community healthcare. Therefore, developing appropriate programs to promote mental health among the disabled population in community settings is a critical issue. The present paper reviews current mental health promotion initiatives that target the disabled population in the community and addresses mental healthcare issues that are prevalent among the chronically disabled; strategies of mental health promotion that use music therapy, reminiscence therapy, and horticultural therapy; and the roles and responsibilities of community professionals in mental healthcare. We offer these perspectives as a reference to promote mental health and to establish holistic community healthcare for chronically disabled individuals.

Climate Change in Urban Communities | Urban ...

EPA Pesticide Factsheets

2017-04-10

Climate Change in Urban Communities is a PowerPoint presentation designed to inform urban residents about the impact of climate change, why it's a problem for their communities, and how individual actions can help make a difference as well as save people money.

Does conurbation affect the risk of poor mental health? A population based record linkage study.

PubMed

Maguire, A; O'Reilly, D

2015-07-01

To determine if urban residence is associated with an increased risk of anxiety/depression independent of psychosocial stressors, concentrated disadvantage or selective migration between urban and rural areas, this population wide record-linkage study utilised data on receipt of prescription medication linked to area level indicators of conurbation and disadvantage. An urban/rural gradient in anxiolytic and antidepressant use was evident that was independent of variation in population composition. This gradient was most pronounced amongst disadvantaged areas. Migration into increasingly urban areas increased the likelihood of medication. These results suggest increasing conurbation is deleterious to mental health, especially amongst residents of deprived areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

COPE: A Pilot Study With Urban-Dwelling Minority Sixth-Grade Youth to Improve Physical Activity and Mental Health Outcomes.

PubMed

Hoying, Jacqueline; Melnyk, Bernadette Mazurek

2016-10-01

Approximately one in three preadolescents (34%) is obese/overweight and one in four (25%) experience a mental health issue. Urban youth suffer from higher rates of these problems, and at earlier ages than their peers. This study's purpose was to determine feasibility/acceptability and preliminary effects of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotion, Exercise, and Nutrition) intervention on physical activity (PA) and mental health outcomes of 11- to 13-year-olds. A one group pre- and posttest design was used in a Midwest urban middle school. Preadolescents (n = 31) who received COPE reported significant decreases in anxiety and increases in healthy lifestyle beliefs and PA. Further, preadolescents at baseline with elevated anxiety, depression, suicide risk, and below average self-concept who received COPE reported significant increases in self-concept and decreases in anxiety, depression, and suicidal ideation. The COPE program is a promising intervention that can improve physical and mental health outcomes. © The Author(s) 2016.

[A Long Way Home: The Current State of Care Provided by Family Caregivers and Public Health Nurses to Persons With Mental Illness in the Community].

PubMed

Huang, Yu-Chu; Wang, Yu-Hui

2015-08-01

According to Taiwan's Health and Welfare Ministry statistics, Taiwan had a total of 122,538 people who were officially registered as mentally disabled at the end of December 2013. Worldwide, schizophrenia ranks as the sixth most burdensome disease in terms of total expenditures. The present paper uses the two actual care stories of the families of mental illness patients and compares and contrasts these with the community mental illness care models used in other countries. The hospital-based psychiatric and community-based mental illness care that is practiced in Taiwan presents dilemmas and has long focused on "disease-orientated care" rather than holistic care. The gap between institutional and community mental rehabilitation services in Taiwan are examined. We recommend that policy makers create an open space for mental illness family caregivers and public health nurses to engage in dialogue in order to effectively integrate the care resources available to community mental illness patients and to break down the care barriers that currently separate community mental illness patients, family caregivers, and public health nurses.

Community beliefs about causes and risks for mental disorders: a mental health literacy survey in a rural area of Maharashtra, India.

PubMed

Kermode, Michelle; Bowen, Kathryn; Arole, Shoba; Joag, Kaustubh; Jorm, Anthony F

2010-11-01

Explanations for mental disorders in India can be influenced by biomedicine, systems of traditional medicine and supernatural beliefs. Community beliefs about causes of mental distress influence help-seeking behaviours. This study aimed to assess local knowledge and understanding of causes and risks for mental disorders in a rural area of Maharashtra, and to assess the prevalence of possible common mental disorders. A cross-sectional mental health literacy survey was undertaken in late 2007. A questionnaire was administered to 240 systematically sampled community members and 60 village health workers (VHWs). Participants were presented with two vignettes describing people experiencing symptoms of mental disorders (depression, psychosis); they were asked about the causes of the problems and the vulnerabilities of community sub-groups. Additionally, the General Health Questionnaire (GHQ12) was administered to assess prevalence of possible common mental disorders. The most commonly acknowledged causes of the problems were a range of socioeconomic factors. Supernatural and biological explanations were not widely endorsed. Women, the unemployed and the poor were judged as more likely to develop mental disorders, while both young and older people were perceived to be less vulnerable. Results of the GHQ12 indicated that 27% had a possible common mental disorder and that the elderly were at increased risk, contrary to community perceptions. Enhancing mental health literacy of both VHWs and community members using approaches that are sensitive to local conceptualizations of mental health and illness will contribute to improved treatment and care for people with mental disorders. Further investigation of mental health among the elderly in this community is indicated.

It Hurts to Be Lonely! Loneliness and Positive Mental Wellbeing in Australian Rural and Urban Adolescents

ERIC Educational Resources Information Center

Houghton, Stephen; Hattie, John; Carroll, Annemaree; Wood, Lisa; Baffour, Bernard

2016-01-01

This study examined associations between loneliness, a construct associated with serious adverse mental health outcomes, and positive mental wellbeing. Validated measures of loneliness (represented by friendship-related loneliness, isolation, positive attitude to solitude, and negative attitude to solitude) and positive mental wellbeing were…

Impact of Housing and Community Conditions on Multidimensional Health among Middle- and Low-Income Groups in Hong Kong.

PubMed

Wang, Jionghua; Huang, Bo; Zhang, Ting; Wong, Hung; Huang, Yifan

2018-05-31

With decades of urbanization, housing and community problems (e.g., poor ventilation and lack of open public spaces) have become important social determinants of health that require increasing attention worldwide. Knowledge regarding the link between health and these problems can provide crucial evidence for building healthy communities. However, this link has heretofore not been identified in Hong Kong, and few studies have compared the health impact of housing and community conditions across different income groups. To overcome this gap, we hypothesize that the health impact of housing and community problems may vary across income groups and across health dimensions. We tested these hypotheses using cross-sectional survey data from Hong Kong. Several health outcomes, e.g., chronic diseases and the SF-12 v. 2 mental component summary scores, were correlated with a few types of housing and community problems, while other outcomes, such as the DASS-21⁻Stress scores, were sensitive to a broader range of problems. The middle- and low-income group was more severely affected by poor built environments. These results can be used to identify significant problems in the local built environment, especially amongst the middle- and low-income group.

Psychiatric care in the Middle East: a "mental health supermarket" in the town of Lod.

PubMed

Shaked, Ginette; Renert, Noa; Mahuda, Israela; Strous, Rael D

2004-01-01

It is often in times of political tension and hostilities that community mental health care is neglected. We describe a novel and creative community mental health program where a combination of professional mental health workers and an innovative mental health system network combine to provide a remarkably successful and tension free mental health care arrangement in an area of high political and intergroup hostility. The system, termed the "mental health supermarket," encompasses multi-component rehabilitation, hospital liaison and interagency collaborative care. The framework succeeds in settling fears and insecurities between various communities as well as catering to a fragmented and lower income community, while introducing an element of self-determination in personal mental health care.

Perceptions of the community on the pricing of community mental health services.

PubMed

Ogden, J R; Ogden, D T

1992-01-01

In the past few years there has been a decrease in governmental support of Community Mental Health centers. Because of this, there has been some concern, on the part of Community Mental Health professionals, as to the overall impact of this decreased governmental support. Research has been conducted that speculates on how best to handle this mini-crisis. One article suggests moving to an overall marketing approach to help combat this dollar support decline (Day and Ford 1988). Others provide methods for surveying Community Mental Health users (Ludke, Curry & Saywell 1983). William Winston (1988) suggests an overall psychographic segmentation approach to developing market targets. There has also been research detailing promotional methods for expanded marketing coverage (Moldenhauer 1988), however little has been written defining the pricing impact on Community Mental Health services. This study addresses the perceptions of Community Mental Health Center users toward the price variable of the marketing mix.

When They Call, Will They Come? A Contextually Responsive Approach for Engaging Multistressed Families in an Urban Child Mental Health Center: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Stern, Susan B.; Walsh, Margaret; Mercado, Micaela; Levene, Kathryn; Pepler, Debra J.; Carr, Ashley; Heppell, Allison; Lowe, Erin

2015-01-01

Objective: This study examines the effect of an ecological and contextually responsive approach, during initial intake call, on engagement for multistressed families seeking child mental health services in an urban setting. Methods: Using a randomized design, parents were allocated to phone Intake As Usual (IAU) or Enhanced Engagement Phone Intake…

24 CFR 597.1 - Applicability and scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... procedures applicable to urban Empowerment Zones and Enterprise Communities, authorized under subchapter U of... Empowerment Zones, Enterprise Communities and Rural Development Investment Areas. (b) This part contains...

24 CFR 597.1 - Applicability and scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... procedures applicable to urban Empowerment Zones and Enterprise Communities, authorized under subchapter U of... Empowerment Zones, Enterprise Communities and Rural Development Investment Areas. (b) This part contains...

24 CFR 597.1 - Applicability and scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... procedures applicable to urban Empowerment Zones and Enterprise Communities, authorized under subchapter U of... Empowerment Zones, Enterprise Communities and Rural Development Investment Areas. (b) This part contains...

24 CFR 597.1 - Applicability and scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... procedures applicable to urban Empowerment Zones and Enterprise Communities, authorized under subchapter U of... Empowerment Zones, Enterprise Communities and Rural Development Investment Areas. (b) This part contains...

24 CFR 597.1 - Applicability and scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... procedures applicable to urban Empowerment Zones and Enterprise Communities, authorized under subchapter U of... Empowerment Zones, Enterprise Communities and Rural Development Investment Areas. (b) This part contains...

24 CFR 597.500 - Indian Reservations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE DESIGNATIONS Special Rules § 597.500 Indian Reservations. No urban Empowerment Zone or Enterprise Community may...

Mental wellbeing amongst younger and older migrant workers in comparison to their urban counterparts in Guangzhou city, China: a cross-sectional study.

PubMed

Li, Jie; Chang, Shu-Sen; Yip, Paul S F; Li, Juan; Jordan, Lucy P; Tang, Yunge; Hao, Yuantao; Huang, Xingmei; Yang, Ning; Chen, Chaoqi; Zeng, Qiaomei

2014-12-16

There has been a dramatic increase in internal migrant workers in China over recent decades, and there is a recent concern of poor mental health particularly amongst younger or "new generation" migrants who were born in 1980 or later. A cross-sectional study was conducted in Guangzhou city between May and July in 2012. Mental wellbeing was measured using the World Health Organization Five-item Well-Being Index Scale and the 36 Item Short Form Health Survey mental health scale. Linear and logistic regression models were used to investigate the differences between migrant workers and their urban counterparts and between younger and older migrants. Migrant workers (n = 914) showed a small but significant advantage in mental wellbeing compared to their urban counterparts (n = 814). There was some evidence for age modification effect (p for interaction = 0.055-0.095); better mental wellbeing in migrants than urbanites were mainly seen in the older compared to the younger group, and the difference attenuated somewhat after controlling for income satisfaction. Older migrants showed better mental health than younger migrants. Factors that were independently associated with poor mental health in migrants included being male, longer working hours, and income dissatisfaction, whilst older age, factory job, high income, and increased use of social support resources were associated with reduced risk. Efforts to promote mental health amongst migrant workers may be usefully targeted on younger migrants and include measures aimed to improve working conditions, strengthen the social support network, and address age-specific needs.

Advancing Community–Based Research with Urban American Indian Populations: Multidisciplinary Perspectives

PubMed Central

Hartmann, William E.; Wendt, Dennis C.; Saftner, Melissa A.; Marcus, John; Momper, Sandra L.

2014-01-01

The U.S. has witnessed significant growth among urban AI populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations. PMID:24659391

Eco-evolutionary dynamics in urbanized landscapes: evolution, species sorting and the change in zooplankton body size along urbanization gradients.

PubMed

Brans, Kristien I; Govaert, Lynn; Engelen, Jessie M T; Gianuca, Andros T; Souffreau, Caroline; De Meester, Luc

2017-01-19

Urbanization causes both changes in community composition and evolutionary responses, but most studies focus on these responses in isolation. We performed an integrated analysis assessing the relative contribution of intra- and interspecific trait turnover to the observed change in zooplankton community body size in 83 cladoceran communities along urbanization gradients quantified at seven spatial scales (50-3200 m radii). We also performed a quantitative genetic analysis on 12 Daphnia magna populations along the same urbanization gradient. Body size in zooplankton communities generally declined with increasing urbanization, but the opposite was observed for communities dominated by large species. The contribution of intraspecific trait variation to community body size turnover with urbanization strongly varied with the spatial scale considered, and was highest for communities dominated by large cladoceran species and at intermediate spatial scales. Genotypic size at maturity was smaller for urban than for rural D. magna populations and for animals cultured at 24°C compared with 20°C. While local genetic adaptation likely contributed to the persistence of D. magna in the urban heat islands, buffering for the phenotypic shift to larger body sizes with increasing urbanization, community body size turnover was mainly driven by non-genetic intraspecific trait change.This article is part of the themed issue 'Human influences on evolution, and the ecological and societal consequences'. © 2016 The Author(s).

Eco-evolutionary dynamics in urbanized landscapes: evolution, species sorting and the change in zooplankton body size along urbanization gradients

PubMed Central

Souffreau, Caroline

2017-01-01

Urbanization causes both changes in community composition and evolutionary responses, but most studies focus on these responses in isolation. We performed an integrated analysis assessing the relative contribution of intra- and interspecific trait turnover to the observed change in zooplankton community body size in 83 cladoceran communities along urbanization gradients quantified at seven spatial scales (50–3200 m radii). We also performed a quantitative genetic analysis on 12 Daphnia magna populations along the same urbanization gradient. Body size in zooplankton communities generally declined with increasing urbanization, but the opposite was observed for communities dominated by large species. The contribution of intraspecific trait variation to community body size turnover with urbanization strongly varied with the spatial scale considered, and was highest for communities dominated by large cladoceran species and at intermediate spatial scales. Genotypic size at maturity was smaller for urban than for rural D. magna populations and for animals cultured at 24°C compared with 20°C. While local genetic adaptation likely contributed to the persistence of D. magna in the urban heat islands, buffering for the phenotypic shift to larger body sizes with increasing urbanization, community body size turnover was mainly driven by non-genetic intraspecific trait change. This article is part of the themed issue ‘Human influences on evolution, and the ecological and societal consequences’. PMID:27920375

[Community inclusion as a human right and medical necessity for individuals with serious mental illnesses].

PubMed

Salzer, Mark S

2017-09-01

Community inclusion refers to equal opportunities for people to participate in the community and willingness to welcome and active community attitude. The opportunity to participate in the community is both a medical necessity and a rights issue. This concept provides a novel theoretical framework for the advancement of mental health policies, programs, and global practices that enable the development of the well-being and health of people with mental disorders. Eleven fundamentals for promoting community inclusion of individuals with serious mental illnesses that are supported by key conceptual, theoretical, and research evidence. These fundamentals reflect beliefs and schemas that need to be present to truly prioritize and facilitate inclusion, intervention strategies and achieve the most impactful objectives that were expected. The greater inclusion, greater community participation, which includes work, education, religion and spiritual participation, and other domains associated with having a life that makes sense, all of which generates physical, cognitive and mental benefts for anyone, disregarding the presence or absence of a mental disorder. The concept of community inclusion offers a transformative next step in the delivery of mental health services that clearly articulates community participation in meaningful areas as the target for promoting full health and wellness.

The relationship between social support and anxiety among caregivers of children in HIV-endemic South Africa

PubMed Central

Casale, Marisa; Wild, Lauren; Cluver, Lucie; Kuo, Caroline

2013-01-01

Caring for children can be a source of joy and fulfilment, but also a source of stress, especially for caregivers living with illness and/or coping with difficult socio-economic conditions. Risks for poor caregiver mental health are especially salient in many parts of southern Africa affected by a generalised HIV epidemic, high rates of physical illness, difficult livelihood conditions and an increasing number of orphaned and vulnerable children in need of care. Given limited availability and low uptake of formal mental health services in South Africa, the potential protective role of informal community or ‘social’ resources for caregiver populations requires greater attention. To our knowledge, this is the first study to quantitatively assess the relationship between social support and symptomatic anxiety among caregivers of children living in HIV-endemic southern African communities. The data are from household survey interviews with 2477 adult primary caregivers of children aged 10-17 years living in two (urban and rural) resource-deprived HIV-endemic South African communities. Hierarchical logistic regression analysis with interaction terms was conducted to assess whether HIV and other illness were significant stressors for caregiver anxiety, whether social support had main or stress-buffering protective effects on anxiety, and whether gender moderated the association between social support and anxiety. Our findings showed significant main effects of social support on caregiver anxiety, but no evidence of stress-buffering effects of support or of gender moderating the support-anxiety relationship. This suggests that social support is a general mental health resource for both male and female caregivers of children in these HIV-endemic communities, regardless of whether they are facing specific stressors related to HIV or other illness. Our results highlight the importance of paying greater attention to the social environment when designing and implementing caregiver health interventions, and indicate that social support could be a valuable component of such interventions. PMID:24003858

The relationship between social support and anxiety among caregivers of children in HIV-endemic South Africa.

PubMed

Casale, Marisa; Wild, Lauren; Cluver, Lucie; Kuo, Caroline

2014-01-01

Caring for children can be a source of joy and fulfilment, but also a source of stress, especially for caregivers living with illness and/or coping with difficult socio-economic conditions. Risks for poor caregiver mental health are especially salient in many parts of southern Africa affected by a generalised HIV-epidemic, high rates of physical illness, difficult livelihood conditions and an increasing number of orphaned and vulnerable children in need of care. Given limited availability and low uptake of formal mental health services in South Africa, the potential protective role of informal community or "social" resources for caregiver populations requires greater attention. To our knowledge, this is the first study to quantitatively assess the relationship between social support and symptomatic anxiety among caregivers of children living in HIV-endemic southern African communities. The data are from household survey interviews with 2477 adult primary caregivers of children aged 10-17 years living in two (urban and rural) resource-deprived HIV-endemic South African communities. Hierarchical logistic regression analysis with interaction terms was conducted to assess whether HIV and other illness were significant stressors for caregiver anxiety, whether social support had main or stress-buffering protective effects on anxiety and whether gender moderated the association between social support and anxiety. Our findings showed significant main effects of social support on caregiver anxiety, but no evidence of stress-buffering effects of support or of gender moderating the support-anxiety relationship. This suggests that social support is a general mental health resource for both male and female caregivers of children in these HIV-endemic communities, regardless of whether they are facing specific stressors related to HIV or other illness. Our results highlight the importance of paying greater attention to the social environment when designing and implementing caregiver health interventions, and indicate that social support could be a valuable component of such interventions.

Addressing Mental Health Needs: Perspectives from African Americans Living in the Rural South

PubMed Central

Haynes, Tiffany F.; Cheney, Ann; Sullivan, Greer; Bryant, Keneshia; Curran, Geoffrey; Olson, Mary; Cottoms, Naomi; Reaves, Christina

2017-01-01

OBJECTIVE Rural African Americans are disproportionately impacted by social stressors that place them at risk of developing psychiatric disorders. This study aims to understand mental health from the perspective of rural African American residents and other stakeholders in order to devise culturally acceptable treatment approaches. METHODS Seven focus groups (N=50) were conducted with four stakeholder groups. A semi-structured interview guide was used to elicit perspectives of mental health, mental health treatment, and ways to improve mental health within rural African American communities. Inductive analysis was used to identify emergent themes and develop a conceptual model grounded in the textual data. RESULTS Stressful living environments (e.g. impoverished communities) and broader community held beliefs (e.g. religious beliefs and mental health stigma) impacted not only perceptions of mental health but also contributed to barriers that impede mental health seeking. Participants also identified community level strategies that can be utilized to improve emotional wellness in rural African American communities. CONCLUSION Rural African Americans experience several barriers that impede treatment use. Strategies that include conceptualizing mental illness as a normal reaction to stressful living environments, the use of community-based mental health services, and providing mental health education to the general public may improve use of services in this population. PMID:28142389

Emergent Approaches to Mental Health Problems. The Century Psychology Series.

ERIC Educational Resources Information Center

Cowen, Emory L., Ed.; And Others

Innovative approaches to mental health problems are described. Conceptualizations about the following areas are outlined: psychiatry, the universe, and the community; theoretical malaise and community mental health; the relation of conceptual models to manpower needs; and mental health manpower and institutional change. Community programs and new…

24 CFR 597.2 - Objective and purpose.

Code of Federal Regulations, 2012 CFR

2012-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... establishment of Empowerment Zones and Enterprise Communities in urban areas, to stimulate the creation of new...

24 CFR 597.2 - Objective and purpose.

Code of Federal Regulations, 2013 CFR

2013-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... establishment of Empowerment Zones and Enterprise Communities in urban areas, to stimulate the creation of new...

24 CFR 597.2 - Objective and purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... establishment of Empowerment Zones and Enterprise Communities in urban areas, to stimulate the creation of new...

School as Community, Community as School: Examining Principal Leadership for Urban School Reform and Community Development

ERIC Educational Resources Information Center

Green, Terrance L.

2018-01-01

For decades, reform has been a persistent issue in urban schools. Research suggests that urban school reforms that are connected to equitable community development efforts are more sustainable, and that principals play a pivot role in leading such efforts. Yet, limited research has explored how urban school principals connect school reform with…

Mental-Health Conditions, Barriers to Care, and Productivity Loss Among Officers in An Urban Police Department

PubMed Central

Fox, Justin; Desai, Mayur M.; Britten, Karissa; Lucas, Georgina; Luneau, Renee; Rosenthal, Marjorie S.

2014-01-01

Background Police officers are frequently exposed to situations that can negatively impact their mental health. Methods We conducted this study of an urban police department to determine 1) the prevalence of post-traumatic stress disorder (PTSD), depression, and alcohol abuse; 2) patterns of and barriers to mental-health services utilization; and 3) the impact these conditions have on productivity loss. Results Among 150 officers, PTSD (24%), depression (9%), and alcohol abuse (19%) were common. Only 46.7% had ever sought mental-health services; the most commonly cited barriers to accessing services were concerns regarding confidentiality and the potential “negative career impact.” Officers with mental-health conditions had higher productivity loss (5.9% vs 3.4%, P <0.001) at an annual cost of $ 4,489 per officer. Conclusion Mental-health conditions among police officers are common, and costly, yet most officers had never accessed mental-health services; many due to modifiable risk factors. PMID:23155671

24 CFR 570.403 - New Communities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true New Communities. 570.403 Section 570.403 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN...

24 CFR 570.403 - New Communities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false New Communities. 570.403 Section 570.403 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN...

Proximity to Urban Parks and Mental Health

PubMed Central

Sturm, Roland; Cohen, Deborah

2014-01-01

Background Urban parks have received attention in recent years as a possible environmental factor that could encourage physical activity, prevent obesity, and reduce the incidence of chronic conditions. Despite long hypothesized benefits of parks for mental health, few park studies incorporate mental health measures. Aims of the Study To test the association between proximity to urban parks and psychological distress. Methods Cross-sectional analysis of individual health survey responses. Data were collected for a study of capital improvements of neighborhood parks in Los Angeles. A survey was fielded on a sample of residential addresses, stratified by distance from the park (within 400m, 800m, 1.6 km, and 3.2km; N=1070). We used multiple regression to estimate the relationship between the psychological distress as measured by the MHI-5 (outcome variable) and distance to parks (main explanatory variable), controlling for observed individual characteristics. Results Mental health is significantly related to residential distance from parks, with the highest MHI-5 scores among residents within short walking distance from the park (400m) and decreasing significantly over the next distances. The number of visits and physical activity minutes are significantly and independently related to distance, although controlling for them does not reduce the association between distance and mental health. Discussion and Limitations This paper provides a new data point for an arguably very old question, but for which empirical data are sparse for the US. A nearby urban park is associated with the same mental health benefits as decreasing local unemployment rates by 2 percentage points, suggesting at least the potential of environmental interventions to improve mental health. The analysis is cross-sectional, making it impossible to control for important confounders, including residential selection. Implications for Health Policy Mental health policy has traditionally focused on individual-centered interventions. Just as health policy for preventable chronic illnesses has shifted attention to modifiable environmental determinants, population mental health may benefit substantially from environmental interventions. Implications for Future Research Policy evaluations should incorporate mental health measures when assessing neighborhood improvement programs and physical environments. Many recent and ongoing studies have excluded mental health measure in the belief that they are too burdensome for respondents or irrelevant. If a causal relationship is confirmed, then ameliorating neighborhood conditions and physical environments could represent a scalable way to improve mental health issues for large populations. PMID:24864118

Toward a new architecture for global mental health.

PubMed

Kirmayer, Laurence J; Pedersen, Duncan

2014-12-01

Current efforts in global mental health (GMH) aim to address the inequities in mental health between low-income and high-income countries, as well as vulnerable populations within wealthy nations (e.g., indigenous peoples, refugees, urban poor). The main strategies promoted by the World Health Organization (WHO) and other allies have been focused on developing, implementing, and evaluating evidence-based practices that can be scaled up through task-shifting and other methods to improve access to services or interventions and reduce the global treatment gap for mental disorders. Recent debates on global mental health have raised questions about the goals and consequences of current approaches. Some of these critiques emphasize the difficulties and potential dangers of applying Western categories, concepts, and interventions given the ways that culture shapes illness experience. The concern is that in the urgency to address disparities in global health, interventions that are not locally relevant and culturally consonant will be exported with negative effects including inappropriate diagnoses and interventions, increased stigma, and poor health outcomes. More fundamentally, exclusive attention to mental disorders identified by psychiatric nosologies may shift attention from social structural determinants of health that are among the root causes of global health disparities. This paper addresses these critiques and suggests how the GMH movement can respond through appropriate modes of community-based practice and ongoing research, while continuing to work for greater equity and social justice in access to effective, socially relevant, culturally safe and appropriate mental health care on a global scale. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Children living with a mentally ill parent: the role of public health nurses.

PubMed

Mahoney, Laurie

2010-08-01

Public Health Nurses work with children under 18 years in schools and the community. Increasingly children are living with a parent suffering from a mental illness. Consequently Public Health Nurses are encountering more mental illness as part of their practice. The research reported in this article aimed to identify the Public Health Nurse's role with regard to children in these circumstances. A qualitative research design was used with eight Public Health Nurses working in rural and urban settings. Participants engaged in a focus group from which data were gathered and analysed thematically using axial coding. To evaluate the identified themes six of the participants went on to take part in a further focus group. The three key themes identified were Advocacy, Assessment, and Relational Knowing and Clinical Practice. It emerged that the role of Public Health Nurses working with such families involved advocating for the child, using a range of assessment skills to gather relevant information and make referrals, with all informed by expert knowledge and clinical experience. Findings indicate the need for more acknowledgement of the frequency with which Public Health Nurses are encountering problems associated with mental illness; and hence the need for provision of appropriate education and support that will enable them to effectively advocate for children's safety and wellbeing.

77 FR 24457 - National Urban and Community Forestry Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... the U.S. Forest Service's Urban and Community Forestry Web site: www.fs.fed.us/ucf/. DATES: Nomination... DEPARTMENT OF AGRICULTURE Forest Service National Urban and Community Forestry Advisory Council AGENCY: Forest Service, USDA. ACTION: 2012 Notice call for nominations. SUMMARY: The National Urban and...

76 FR 85 - National Urban and Community Forestry Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

... DEPARTMENT OF AGRICULTURE Forest Service National Urban and Community Forestry Advisory Council AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Urban and Community..., recommendations for the Secretary of Agriculture, develop the 2011 plan of work, hear from some of the Urban and...

77 FR 13262 - National Urban and Community Forestry Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

... DEPARTMENT OF AGRICULTURE Forest Service National Urban and Community Forestry Advisory Council AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The National Urban and Community..., recommendations for the Secretary of Agriculture, the 2012 plan of work, and hear public input related to urban...

"Something good can grow here": chicago urban agriculture food projects.

PubMed

Hatchett, Lena; Brown, Loretta; Hopkins, Joan; Larsen, Kelly; Fournier, Eliza

2015-01-01

Food security is a challenge facing many African-American low-income communities nationally. Community and university partners have established urban agriculture programs to improve access to high quality affordable fruits and vegetables by growing, distributing, and selling food in urban neighborhoods. While the challenge of food security is within communities of color, few studies have described these urban agriculture programs and documented their impact on the crew members who work in the programs and live in the low-income communities. More information is needed on the program impact for crew and community health promotion. Using a survey and focus group discussion from the crew and staff we describe the program and activities of four Chicago Urban Agriculture programs. We summarized the impact these programs have on crew members' perception of urban agriculture, health habits, community engagement, and community health promotion in low-income African-American neighborhoods.

Stories of Renewal: Community Building and the Future of Urban America.

ERIC Educational Resources Information Center

Walsh, Joan

Community building is an approach to urban poverty that rejects a programmatic approach in favor of efforts that catalyze personal relationships and social networks to improve community life. Community building analyzes urban poverty as a web of interwoven problems that can lock families out of opportunity permanently. Community building…

Roles of Urban Indigenous Community Members in Collaborative Field-Based Teacher Preparation

ERIC Educational Resources Information Center

Lees, Anna

2016-01-01

This qualitative case study explored a community-university partnership for teacher preparation with an urban Indigenous community organization. The study examined the roles of Indigenous community partners as co-teacher educators working to better prepare teachers for the needs of urban Indigenous children and communities. The author collected…

Mental Health Services in a Rural Area: The Integrated Relationship between State Hospital and Community Mental Health Centers. Notes from the Field.

ERIC Educational Resources Information Center

Bittle, Ronald G.

1988-01-01

Describes "linkage agreement" system between Illinois community mental health centers and Anna Mental Health and Developmental Center serving 28 rural counties. Agreements specify responsibilities of community centers and hospital staff regarding referrals, client treatment, and discharge. Describes improvements over previous…

Factors that influence Asian communities' access to mental health care.

PubMed

Wynaden, Dianne; Chapman, Rose; Orb, Angelica; McGowan, Sunita; Zeeman, Zenith; Yeak, SiewHo

2005-06-01

This paper presents the findings of a qualitative study to identify factors that influence Asian communities' access to mental health care and how mental health care is delivered to them. Semistructured interviews were completed with Asian community members/leaders and health-care professionals. Content analysis identified major themes. Participants also completed a demographic data sheet. The research aimed to provide health professionals with an increased understanding of the values and beliefs held by people from Asian communities regarding the cause and treatment of mental illness. Data analysis identified six main themes that influenced Asian communities' access to mental health care and how mental health care is delivered to them. They were: shame and stigma; causes of mental illness; family reputation; hiding up; seeking help; and lack of collaboration. The findings highlighted that people from Asian communities are unwilling to access help from mainstream services because of their beliefs, and that stigma and shame are key factors that influence this reluctance. The findings also highlight that the mental health needs of refugee women are significant, and that they comprise a vulnerable group within Australian society.

Stigmatization of people with mental illness among inhabitants of a rural community in northern Nigeria.

PubMed

Audu, Ishaq A; Idris, Suleiman H; Olisah, Victor O; Sheikh, Taiwo L

2013-02-01

Despite the fact that mental illness is a common problem in society, people's perception of the mentally ill and community attitude towards them is still rather poor, making their rehabilitation and reintegration into society an uphill task. To examine the stigmatization of people with mental illness within a rural community and identify the socio-demographic variables involved. A cross-sectional descriptive study using a multi-stage random sampling technique to obtain data through an interviewer-administered questionnaire to 325 adult inhabitants of a rural community in Nigeria. The results showed widespread ignorance about causation, mode of transmission and remedies available for mental illness, with only 0.9% of respondents attributing mental illness to brain disease. The others attributed it to spiritual attack, punishment for evil doing and illicit psychoactive substance use, among other things. Negative views about the mentally ill were also widely expressed resulting in discriminatory practices. Stigmatization of people with mental illness is still rampant in our community. There is a need for adequate public education about the causes and mode of transmission of mental illness and the treatment options available in the community.

24 CFR 574.340 - Additional standards for community residences.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Additional standards for community residences. 574.340 Section 574.340 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

Cultural Psychiatry: A Spotlight on the Experience of Clinical Social Workers' Encounter with Jewish Ultra-Orthodox Mental Health Clients.

PubMed

Freund, Anat; Band-Winterstein, Tova

2017-07-01

Community is a complex issue, especially in two particular populations overlap: Haredi society, which embraces cultural codes common to closed communities, and the mental health population characterized by its own unique needs. The present study explores the encounter experience of social workers with the cultural perceptions of mental health clients in the Haredi community in light of Community Cultural Psychiatry. A qualitative-phenomenological approach was adopted. In-depth semi-structured interviews were conducted with 27 social workers, mental health professionals, who are in contact with ultra-Orthodox Jewish clients. Three major themes emerged from the data analysis: (1) Exclusion vs. grace and compassion. (2) Mental health: A professional or cultural arena? (3) Mental health help-seeking changing processes. This study shows that the attitude in the Haredi community toward mental health therapy undergoes a process of change. It is important to strengthen this process, together with preserving existing community informal structures of help.

[Human rights violations among people with mental illness; rural vs. urban comparison].

PubMed

Poreddi, Vijayalakshmi; Ramachandra; Nagarajaiah; Konduru, Reddemma; Badamath, Suresh

2013-01-01

Human rights violations are commonly reported against people with mental illness and have remained a major research issue in recent times. The present study was aimed to compare psychiatric patients' perceptions of human rights needs between rural and urban settings. A descriptive study design was carried out among 100 recovered psychiatric patients based on the Clinical Global Impression-Improvement Scale (CGI-I scale), at a tertiary care center. Participants were selected through a random sampling method. Data was collected through face to face interviews, using a structured questionnaire. Data was analyzed and interpreted using descriptive and inferential statistics. The present study highlighted the significant differences in meeting their basic human rights needs in a physical needs dimension i.e. availability of hot water for bathing (c2=8.305, p<0.40) and provision of clean clothes to wear (c2=8.229, p<0.42) were rated higher in rural participants than participants from those in an urban setting. Similarly, in the ethical needs dimension, merely 13% of the rural participants reported that they never/rarely experienced sexual advances by family members (c2=9.949, p> .019). Our findings revealed that human rights violations among mentally ill are evident across rural and urban environments. Thus, there is an urgent need to change the attitude of the general population towards people with mental illness through awareness campaign. In addition, educating the public about the human rights of mentally ill is also essential.

Mental Health Condition of the Only-Child: A Study of Urban and Rural High School Students in China

ERIC Educational Resources Information Center

Liu, Chenying; Munakata, Tsunetsugu; Onuoha, Francis N.

2005-01-01

The mental health of the only-child continues to generate interest in research literature. The present study examines the issue in China, where the one-child phenomenon is highest due to deliberate government policy. Subjects are 299 and 333 students in two high-rank high schools in urban Harebin and rural Qing an Xian, respectively (mean age =…

Commentary: The failure of social inclusion: an alternative approach through community development.

PubMed

Mandiberg, James M

2012-01-01

Mental health services have not resulted in broad-based inclusion of people with psychiatric disabilities. Rather, many maintain their community lives only through the support of formal mental health services, which is financially unsustainable given current fiscal realities. Fundamental assumptions about sources of support for everyday life need to be reassessed. The economic and social development of the mental health recovery community provides an alternative approach to helping people maintain successful community lives and shifts some of the supports from mental health providers to business infrastructure within the mental health recovery identity community. Some projects that have utilized this approach, such as business incubators and work integration social enterprises, are described, and community development that builds on concepts of recovery is discussed.

Decentralizing provision of mental health care in Sri Lanka.

PubMed

Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee

2017-04-01

In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.

THE COMMUNITY COLLEGE IN MENTAL HEALTH TRAINING, REPORT OF A CONFERENCE TO EXPLORE THE ROLE OF THE COMMUNITY COLLEGE IN TRAINING MENTAL HEALTH WORKERS (ATLANTA, APRIL, 1966).

ERIC Educational Resources Information Center

PENNINGROTH, PAUL W.

A CONFERENCE SPONSORED BY THE SOUTHERN REGIONAL EDUCATION BOARD AND THE NATIONAL INSTITUTE OF MENTAL HEALTH WAS HELD IN APRIL 1966, TO (1) PROVIDE OPPORTUNITY FOR COMMUNITY COLLEGE AND MENTAL HEALTH LEADERS TO CONSIDER SIGNIFICANT ISSUES IN THE TRAINING OF MENTAL HEALTH WORKERS, (2) PROVIDE INFORMATION ABOUT DEVELOPMENTS AND CURRENT PROGRAMS IN…

Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nation’s Nationalities and People’s Region, Ethiopia

PubMed Central

Bedasso, Kufa; Feyera, Fetuma

2016-01-01

Background Mental illnesses worldwide are accompanied by another pandemic, that of stigma and discrimination. Public understanding about mental illnesses and attitudes towards people with mental illness play a paramount role in the prevention and treatment of mental illness and the rehabilitation of people with mental illness. Objective To assess community attitude and associated factors towards people with mental illness. Methods Community based cross-sectional study was conducted from April 28 to May 28, 2014. Quantitative data were collected through interview from 435 adults selected using simple random sampling. Data were collected using community attitude towards mentally ill (CAMI) tool to assess community attitude towards people with mental illness and associated factors. Multiple linear regression analysis was performed to identify predictors of community attitude towards people with mental illness and the level of significance association was determined by beta with 95% confidence interval and P less than 0.05. Results The highest mean score was on social restrictiveness subscale (31.55±5.62). Farmers had more socially restrictive view (β = 0.291, CI [0.09, 0.49]) and have less humanistic view towards mentally ill (β = 0.193, CI [-0.36, -0.03]). Having mental health information had significantly less socially restrictive (β = -0.59, CI [-1.13, -0.05]) and less authoritarian (β = -0.10, CI [-1.11, -0.06]) view towards mentally ill but respondents who are at university or college level reported to be more socially restrictive (β = 0.298, CI [0.059, 0.54]). Respondents whose age is above 48 years old had significantly less view of community mental health ideology (β = -0.59, CI [-1.09, -0.08]). Conclusion and Recommendation Residents of Worabe town were highly socially restrictive but less authoritarian. There was high level of negative attitude towards people with mental illness along all the subscales with relative variation indicating a need to develop strategies to change negative attitude attached to mental illness in Worabe town at community level. PMID:26930591

The Concentration of Severely Disturbed CMI in a Core Urban Area.

ERIC Educational Resources Information Center

Shern, David; Dilts, Stephen L.

1987-01-01

Conducted two needs assessment studies of chronically mentally ill (CMI). Examined differential concentration of CMI persons in areas of Colorado, finding a disproportionate concentration on CMI persons in core urban area of Denver. Comparison of core urban clients to national sample revealed that Denver's core urban CMI population was severely…

Roles of community helpers in using the Medicare Part D benefit

PubMed Central

Hensley, Melissa A.

2013-01-01

Objectives To examine the experiences of low-income Part D beneficiaries with mental illness and their use of community helpers to access prescription medicines. Methods Individual semi-structured interviews were conducted with 26 Medicare beneficiaries with mental illness in community settings. The transcripts were analyzed for content related to community help-seeking and attitudes toward family and professional helpers. Results Medicare Part D beneficiaries with mental illness used the assistance of community helpers extensively. Pharmacists, nurses, community mental health case managers, and family members assisted beneficiaries with understanding their benefit plans and interpreting paperwork from plans and government agencies. Community helpers also assisted with tasks related to medication adherence. Mental health consumers appreciated the help that they received from family members and professionals. Conclusion This group of Medicare beneficiaries would have experienced difficulty in using their benefits and obtaining their medication without considerable help from professionals and family members in the community. PMID:21317520

Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature.

PubMed

Hattingh, H Laetitia; Scahill, Shane; Fowler, Jane L; Wheeler, Amanda J

2016-12-01

Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers. This narrative review explored the potential role of community pharmacy in mental health services. Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and "lay" search engines such as GoogleScholar were also searched. Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified. International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services.

Experienced HIV-Related Stigma in Health Care and Community Settings: Mediated Associations With Psychosocial and Health Outcomes.

PubMed

Kay, Emma S; Rice, Whitney S; Crockett, Kaylee B; Atkins, Ghislaine C; Batey, David Scott; Turan, Bulent

2018-03-01

There are multiple dimensions of HIV-related stigma that can compromise the mental and physical health of people living with HIV. We focused on the dimension of experienced stigma, defined as exposure to acts of discrimination, devaluation, and prejudice, and investigated its relationship with HIV health and psychosocial outcomes. We examined associations between experienced stigma in the community and health care settings and psychosocial and health outcomes for people living with HIV (N = 203) receiving care at an urban HIV clinic in the Southeastern United States. We also investigated whether those effects are unique to experienced stigma or are mediated by other dimensions of HIV-related stigma. Experienced stigma was associated with suboptimal clinical outcomes such as viral nonsuppression, as well as poor affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, and blame coping) and interpersonal outcomes such as social support and physician trust. Furthermore, serial mediation models suggested significant indirect effects of experienced stigma through internalized stigma and anticipated stigma from various theoretically expected sources of stigma (eg, community members, friends and family, and health care workers), with varying effects depending on the source. These findings suggest nuanced mechanisms for the effects of experienced HIV-related stigma, especially in health care settings, and may be used to inform stigma-reduction interventions. Interventions designed to address experienced stigma in health care settings might be more tailored to specific outcomes, such as depression and physician trust, than interventions designed to address experienced stigma in the community.

Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

PubMed

Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida

2017-01-01

New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.

Housing index, urbanisation level and lifetime prevalence of depressive and anxiety disorders: a cross-sectional analysis of the Colombian national mental health survey

PubMed Central

Rincon, Carlos Javier; Tamayo Martínez, Nathalie; Rodriguez, Nelcy; Tiemeier, Henning; Mackenbach, Johan P; Gómez-Restrepo, Carlos; Guarnizo-Herreño, Carol C

2018-01-01

Objectives To study socioeconomic inequalities in mental health in rural and urban Colombia, a country with a history of internal conflict and large socioeconomic inequalities. Recent survey data are available to study this understudied topic in a middle-income country. Methods Using data from 9656 respondents from the 2015 Colombian Mental Health survey, we investigated the association between lifetime prevalence of depressive and anxiety disorders and quality of dwellings and access to public services housing score (HS). We calculated the relative index of inequality (RII) and slope index of inequality (SII) for HS in urban and rural areas, adjusting for potential confounders and mediating factors. Outcomes The lifetime prevalence of anxiety and depression (combined) was 9.6% in urban versus 6.9% in rural areas (p<0.001). HS was not associated with prevalence of anxiety and depression in urban settings, whereas a higher HS (poorer housing quality) was associated with fewer mental disorders in rural areas in both univariate and multivariate models (multivariate RIIurban0.96 (95% CI 0.51 to 1.81); RIIrural0.11 (95% CI 0.04 to 0.32)). In rural areas, the prevalence of mental health problems was 12% points lower in persons living in the poorest quality dwellings than in those living in high-quality dwellings (SII −0.12 (95% CI −0.18 to −0.06)). Interestingly, within rural areas, persons living in ‘populated centres’ (small towns, villages) had a higher lifetime prevalence of any mental health disorder (9.8% (95% CI 6.9 to 13.6)) compared with those living in more isolated, dispersed areas (6.0% (95% CI 4.6 to 7.7)). Interpretation In rural Colombia, those living in the poorest houses and in dispersed areas had a lower prevalence of mental health problems. Further understanding of this phenomenon of a seemingly inverse association of prevalence of mental disorders with poverty and/or urbanisation in rural areas is needed. Particularly, considering the progressive urbanisation process in Colombia, it is important to monitor mental health in populations migrating to the cities. PMID:29880561

'SMS' for mental health—feasibility and acceptability of using text messages for mental health promotion among young women from urban low income settings in India.

PubMed

Chandra, Prabha S; Sowmya, H R; Mehrotra, Seema; Duggal, Mona

2014-10-01

The current study assesses the acceptability and feasibility of mobile text messages for promoting positive mental health and as a helpline among young women in urban slums of Bangalore. Forty girls in the age range of 16-18 years from urban slums received messages every day for a month. They could call or message back or give a 'missed call' to the same number whenever they had emotional problems or felt like talking to a counselor. The received responses in the form of return texts, missed calls and return phone calls were recorded. Feedback about the feasibility and acceptability of the mobile messages was collected after a month. 25 out of 40 (62.5%) participants called back, asking for mental health services and to say they felt good about the messages. 23 of 40 (57.5%) messaged back regarding their feelings. 62% reported that they felt supported with the mental health messages. Male family members of nearly half of the participants called back to check the authenticity of the source. Most women did not face any problems because of the messages. This pilot qualitative study indicates that mobile text messages are a feasible and culturally acceptable method for mental health promotion and prevention among young women from urban slums in India. Issues such as consent from the woman and family, ensuring confidentiality and providing authentic and reliable support services, need to be taken into account before attempting to scale up such a service, particularly in vulnerable groups. Copyright © 2014 Elsevier B.V. All rights reserved.

Talking about Mental Illness: A Guide for Developing an Awareness Program for Youth. Community Guide.

ERIC Educational Resources Information Center

2001

This guide contains all of the information, support and tools that community members need to implement "Talking About Mental Illness" in their community--an awareness program proven to be effective in bringing about positive change in young people's knowledge about mental illness, and in reducing stigma that surrounds mental illness. The…

[Development of the community mental health system and activities of the community mental health team in Kawasaki City].

PubMed

Ito, Masato

2012-01-01

Since the 1960s, Kawasaki City has been leading the nation in its efforts regarding community mental health practices. Public institutions such as the Psychiatric Rehabilitation Center in the central area of the city and the Mental Health and Welfare Center in the southern area have mainly developed the psychiatric rehabilitation system. However, since 2000, new mental health needs have emerged, as the target of mental health and welfare services has been diversified to include people with developmental disorders, higher brain dysfunction, or social withdrawal, in addition to those with schizophrenia. Therefore, Kawasaki City's plan for community-based rehabilitation was drawn up, which makes professional support available for individuals with physical, intellectual, and mental disabilities. As the plan was being implemented, in 2008, the Northern Community Rehabilitation Center was established by both the public and private sectors in partnership. After the community mental health teams were assigned to both southern and northern areas of the city, the community partnership has been developed not only for individual support but also for other objectives that required the partnership. Takeshima pointed out that the local community should be inclusive of the psychiatric care in the final stage of community mental health care in Japan. Because of the major policies regarding people with disabilities, the final stage has been reached in the northern area of Kawasaki City. This also leads to improvement in measures for major issues in psychiatry, such as suicide prevention and intervention in psychiatric disease at an early stage.

Preparation of Mental Health Clinicians to Work with Children with Co-Occurring Autism Spectrum Disorders and Mental Health Needs

ERIC Educational Resources Information Center

Williams, Marian E.; Haranin, Emily C.

2016-01-01

Up to 70% of children with autism spectrum disorders (ASD) have a co-occurring mental health disorder; however, many clinicians feel unprepared to serve children with complex co-occurring conditions. This study surveyed 64 mental health clinicians working in 21 publically-funded mental health agencies in a large urban setting to explore their…

Positioning Community Art Practices in Urban Cracks

ERIC Educational Resources Information Center

Verschelden, Griet; Van Eeghem, Elly; Steel, Riet; De Visscher, Sven; Dekeyrel, Carlos

2012-01-01

This article addresses the position of community art practices and the role of practitioners in urban cracks. Community art practices raise possibilities for a reconceptualisation of the concept of community and an extension of the concept of art in public space. Urban cracks are conceptualised as spatial, temporal and relational manifestations of…

Criterion 8: Urban and community forests

Treesearch

Stephen R. Shifley; Francisco X. Aguilar; Nianfu Song; Susan I. Stewart; David J. Nowak; Dale D. Gormanson; W. Keith Moser; Sherri Wormstead; Eric J. Greenfield

2012-01-01

Urban and community forests are the trees and forests found in cities, towns, villages, and communities. This category of forest includes both forested stands and trees along streets, in residential lots, and parks. These trees within cities and communities provide many ecosystem services and values to both urban and rural populations.

Characterizing Urban Household Waste Generation and Metabolism Considering Community Stratification in a Rapid Urbanizing Area of China.

PubMed

Xiao, Lishan; Lin, Tao; Chen, Shaohua; Zhang, Guoqin; Ye, Zhilong; Yu, Zhaowu

2015-01-01

The relationship between social stratification and municipal solid waste generation remains uncertain under current rapid urbanization. Based on a multi-object spatial sampling technique, we selected 191 households in a rapidly urbanizing area of Xiamen, China. The selected communities were classified into three types: work-unit, transitional, and commercial communities in the context of housing policy reform in China. Field survey data were used to characterize household waste generation patterns considering community stratification. Our results revealed a disparity in waste generation profiles among different households. The three community types differed with respect to family income, living area, religious affiliation, and homeowner occupation. Income, family structure, and lifestyle caused significant differences in waste generation among work-unit, transitional, and commercial communities, respectively. Urban waste generation patterns are expected to evolve due to accelerating urbanization and associated community transition. A multi-scale integrated analysis of societal and ecosystem metabolism approach was applied to waste metabolism linking it to particular socioeconomic conditions that influence material flows and their evolution. Waste metabolism, both pace and density, was highest for family structure driven patterns, followed by lifestyle and income driven. The results will guide community-specific management policies in rapidly urbanizing areas.

Exploring How African American Males from an Urban Community Navigate the Interracial and Intra-Racial Dimensions of Their Experiences at an Urban Jesuit High School

ERIC Educational Resources Information Center

Simmons, Robert W., III

2012-01-01

African American males from urban communities have been attending Jesuit high schools in urban spaces for many years, yet little to no literature exists that explores their experiences while attending these elite private schools. This qualitative study of 10 African American males from an urban community attending a similarly positioned Jesuit…

Setting Up a Mental Health Clinic in the Heart of Rural Africa.

PubMed

Enow, Humphrey; Thalitaya, Madhusudan Deepak; Mbatia, Wallace; Kirpekar, Sheetal

2015-09-01

The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO 1948). In Africa, mental health issues often come last on the list of priorities for policy-makers & people's attitudes towards mental illness are strongly influenced by traditional beliefs in supernatural causes/remedies. The massive burden attributed to mental illness in these communities, poses a huge moral, cultural/economic challenge and requires a concerted and integrated approach involving policy makers, mental health Practitioners, the general public, service users and their families and other stake holders to reverse the trend. Improving community awareness of mental illness. Change the negative perception of mental illness by the community. Providing a screening/referral pathway for mental illnesses. Providing supervision of patient care. Promote community participation on issues regarding mental health with a view to challenge existing traditional attitudes and beliefs, reduce stigma and promote health seeking behaviour.

Individual- and community-level determinants of Inuit youth mental wellness.

PubMed

Gray, Andrew Paul; Richer, Faisca; Harper, Sam

2016-10-20

Following the onset of intensive colonial intervention and rapid social change in the lives of Inuit people, youth in Nunavik have experienced high rates of mental health problems and suicide. Inuit people describe a broad range of contextual influences on mental wellness based on lived experience, but most epidemiological studies have focused on individual risk factors and pathologies. This study aimed to assess the influence of multiple determinants of mental wellness among Inuit youth in Nunavik, including culturally meaningful activities, housing and community social characteristics. Mental wellness was measured in the form of two primary outcomes: self-esteem and suicidal ideation. Using cross-sectional data from the 2004 Nunavik Inuit Health Survey and multilevel regression modelling, we estimated associations between these two outcomes and various independent individual- and community-level explanatory factors among Inuit youth. All variables were selected to reflect Inuit perspectives on determinants of mental wellness. The study design and interpretation of results were validated with Inuit community representatives. Pride in Inuit identity, traditional activities, community-level social support and community-level socio-economic status were found to be protective. Barriers to participating in traditional activities, household crowding and high community rates of violence were risk factors. These findings support Inuit perspectives, expand the scope of epidemiological analysis of Inuit mental wellness and reinforce the need for locally informed, community-wide approaches to mental wellness promotion for Inuit youth.

Community mental health care in India.

PubMed

Padmavati, R

2005-04-01

Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.

To explore the efficacy of community rehabilitation for facilitating daily function among patients with mental illness.

PubMed

Cheng, Jui-Fen; Chen, Chung-Ying; Lin, Mei-Chu; Huang, Xuan-Yi

2018-04-17

To explore the efficacy of community rehabilitation for facilitating daily function among patients with mental illness. A quasi-experimental design was used. Two hundred and sixty-four participants completed a daily living function scale questionnaire and provided disease-related information. Community rehabilitation was shown to be efficient in helping to stabilize mental illness and enhance daily function. Daily function had a significant and positive correlation with disease stability. Community rehabilitation for patients with mental illness can effectively stabilize and prevent disability among those with mental illness. © 2018 Wiley Periodicals, Inc.

Community Determinants of Latinos’ Use of Mental Health Services

PubMed Central

Aguilera, Adrian; Regeser López, Steven

2014-01-01

Objective This study examined the role of community in understanding Latino adults’ (18–64 years of age) use of community mental health services. Methods Service utilization data from the Los Angeles County Department of Mental Health were analyzed from 2003 in two service provider areas. Demographic data, including foreign-born status, language, education, and income for the Latino population, were obtained from the 2000 U.S. Census. The study sample consisted of 4,133 consumers of mental health services in 413 census tracts from an established immigrant community and 4,156 consumers of mental health services in 204 census tracts from a recent immigrant community. Negative binomial regression analyses were conducted to examine associations between locales, community characteristics, and use of services. Results Community of residence and foreign-born status were significantly associated with Latinos’ service use. Latinos from the established immigrant community were more likely to use services than Latinos from the recent immigrant community. Across both communities, census tracts with a higher percentage of foreign-born noncitizen residents showed lower service use. Within the established immigrant community, as income levels increased there was little change in utilization. In contrast, in the recent immigrant community, as income levels increased utilization rates increased as well (β=.001, p<.001). Conclusions The findings point out the importance of locale and community determinants in understanding Latinos’ use of public mental health services. PMID:18378840

Practitioners' Perceptions of Culturally Responsive School-Based Mental Health Services for Low-Income African American Girls

ERIC Educational Resources Information Center

Harper, Erin; Kruger, Ann Cale; Hamilton, Chela; Meyers, Joel; Truscott, Stephen D.; Varjas, Kris

2016-01-01

School-based mental health practitioners are positioned to address low-income urban African American girls' mental health needs through culturally responsive services. Despite the importance of culturally reflective practice, it is understudied. We asked school-based mental health practitioners (N = 7) to reflect on barriers and facilitators to…

The impact of a community mental health initiative on outcomes for offenders with a serious mental disorder.

PubMed

Stewart, Lynn A; Farrell-MacDonald, Shanna; Feeley, Stacey

2017-10-01

The Community Mental Health Initiative (CMHI) is mandated to assist offenders with serious mental disorders in their transition from institutions to the community, but this incorporates different styles of service. An important unanswered question is whether these are equivalent. Our aim was to compare outcomes for different intervention styles within the CMHI, a programme for serious offenders in prison who also have at least one major mental disorder. Our specific research questions were as follows: do outcomes differ according to whether offenders with mental health difficulties receive (1) clinical discharge planning only; (2) community mental health services only; (3) the combined services or (4) none, although meeting criteria for any CMHI service? Survival analyses, controlling for variables with a significant effect on recidivism or return to prison, were used to test for differences in recidivism or return to prison rates between the intervention and no-intervention groups during a fixed follow-up period. Men receiving only community mental health services had a significantly lower risk of returning to custody and of recidivism than men receiving discharge planning alone or no community mental health service at all, even after controlling for potential confounders including age, number of previous imprisonments and number of previous community failures. The advantages were apparent within 3-6 months and sustained for up to 4 years. Provision of specialised community mental health services for higher-risk male offenders with a mental disorder may reduce recidivism in the short and longer term - within 3 months and up to 4 years respectively. Statistical modelling also pointed to the need to include treatment for substance abuse and assistance in identifying stable accommodation and brokerage of community services among the interventions and services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The impact of caregivers on the effectiveness of an early community mental health detection and intervention programme in Hong Kong.

PubMed

Pan, Jia-Yan; Ng, Yat-Nam Petrus; Young, Kim-Wan Daniel

2016-12-01

The prevalence rate of mental illness in Chinese communities is high, but Chinese clients tend to underutilize mental health services. Caregivers may play an important role in mental health early detection and intervention, but few studies have investigated their roles in community mental health services. This study compared the effectiveness of an early detection and intervention programme, the Community Mental Health Intervention Project, for two groups in the context of Hong Kong - clients with and without caregivers. A comparison group pre-post-test design was adopted. A total of 170 service users joined this study, including 100 with caregivers and 70 without caregivers. Both groups showed a significant decrease in psychiatric symptoms and increase in community living skills; the group without caregivers indicated a greater reduction in psychiatric symptoms. Different social work intervention components had different predictive effects on these changes. The Community Mental Health Intervention Project is an effective early detection and intervention programme in working with Hong Kong Chinese people who are suspected of having mental health problems, especially for those without caregivers. © 2014 Wiley Publishing Asia Pty Ltd.

"We Felt They Took the Heart out of the Community": Examining a Community-Based Response to Urban School Closure

ERIC Educational Resources Information Center

Green, Terrance L.

2017-01-01

Massive school closures are occurring in urban school districts across the United States. Research suggests that school closures are the outcome of racialized neoliberal policies and decades of disinvestment that have left many urban districts with fiscal deficits and declining student enrollments. However, some urban communities have successfully…

Community perceptions of mental distress in a post-conflict setting: a qualitative study in Burundi.

PubMed

Familiar, Itziar; Sharma, Sonali; Ndayisaba, Herman; Munyentwari, Norbert; Sibomana, Seleus; Bass, Judith K

2013-01-01

There is scant documentation of the mental health characteristics of low-income communities recovering from armed conflict. To prepare for quantitative health surveys and health service planning in Burundi, we implemented a qualitative study to explore concepts related to mental distress and coping among adults. Mental distress was defined as problems related to feelings, thinking, behaviour and physical stress. Using free listing and key informant interviews with a range of community members, we triangulated data to identify salient issues. Thirty-eight free list respondents and 23 key informants were interviewed in 5 rural communities in Burundi using 2 interview guides from the WHO Toolkit for Mental Health Assessment in Humanitarian Settings. Based on these interviews, we identified four locally defined idioms/terms relating to mental distress: ihahamuka (anxiety spectrum illnesses), ukutiyemera (a mix of depression and anxiety-like syndrome), akabonge (depression/grief-like syndrome) and kwamana ubwoba burengeje (anxiety-like syndrome). Mental distress terms were perceived as important problems impacting community development. Affected individuals sought help from several sources within the community, including community leaders and traditional healers. We discuss how local expressions of distress can be used to tailor health research and service integration from the bottom up.

[Prevalence and diagnosis of depression in Mexico].

PubMed

Belló, Mariana; Puentes-Rosas, Esteban; Medina-Mora, María Elena; Lozano, Rafael

2005-01-01

To present the prevalence of depressive episodes, as well as the percentage of the population with medical diagnosis. The definition of depression was based on a schedule with DSM IV diagnostic criteria. Using data from the 2002-2003 National Assessment Performance Survey, the prevalence of depression was estimated at the national level, by sex, age, education, size of residence community, and state. The percentage of individuals with medically diagnosed depression and the percentage of those under treatment were also estimated. The national prevalence of depression was 4.5%: 5.8% in women and 2.5% in men. The prevalence of depression increased with age and decreased with higher education. Among males, the prevalence was higher in rural than urban communities. A large percentage of affected individuals have no medical diagnosis. Depression is a frequent disease in adults.A higher prevalence is associated with social vulnerability. The low percentage of diagnosis represents a challenge for mental health service planning and provision.

Taxonomic and functional trait diversity of wild bees in different urban settings.

PubMed

Normandin, Étienne; Vereecken, Nicolas J; Buddle, Christopher M; Fournier, Valérie

2017-01-01

Urbanization is one of the major anthropogenic processes contributing to local habitat loss and extirpation of numerous species, including wild bees, the most widespread pollinators. Little is known about the mechanisms through which urbanization impacts wild bee communities, or the types of urban green spaces that best promote their conservation in cities. The main objective of this study was to describe and compare wild bee community diversity, structure, and dynamics in two Canadian cities, Montreal and Quebec City. A second objective was to compare functional trait diversity among three habitat types (cemeteries, community gardens and urban parks) within each city. Bees were collected using pan traps and netting on the same 46 sites, multiple times, over the active season in 2012 and 2013. A total of 32,237 specimens were identified, representing 200 species and 6 families, including two new continental records, Hylaeus communis Nylander (1852) and Anthidium florentinum (Fabricius, 1775). Despite high community evenness, we found significant abundance of diverse species, including exotic ones. Spatio-temporal analysis showed higher stability in the most urbanized city (Montreal) but low nestedness of species assemblages among the three urban habitats in both cities. Our study demonstrates that cities are home to diverse communities of wild bees, but in turn affect bee community structure and dynamics. We also found that community gardens harbour high levels of functional trait diversity. Urban agriculture therefore contributes substantially to the provision of functionally diverse bee communities and possibly to urban pollination services.

Taxonomic and functional trait diversity of wild bees in different urban settings

PubMed Central

Buddle, Christopher M.; Fournier, Valérie

2017-01-01

Urbanization is one of the major anthropogenic processes contributing to local habitat loss and extirpation of numerous species, including wild bees, the most widespread pollinators. Little is known about the mechanisms through which urbanization impacts wild bee communities, or the types of urban green spaces that best promote their conservation in cities. The main objective of this study was to describe and compare wild bee community diversity, structure, and dynamics in two Canadian cities, Montreal and Quebec City. A second objective was to compare functional trait diversity among three habitat types (cemeteries, community gardens and urban parks) within each city. Bees were collected using pan traps and netting on the same 46 sites, multiple times, over the active season in 2012 and 2013. A total of 32,237 specimens were identified, representing 200 species and 6 families, including two new continental records, Hylaeus communis Nylander (1852) and Anthidium florentinum (Fabricius, 1775). Despite high community evenness, we found significant abundance of diverse species, including exotic ones. Spatio-temporal analysis showed higher stability in the most urbanized city (Montreal) but low nestedness of species assemblages among the three urban habitats in both cities. Our study demonstrates that cities are home to diverse communities of wild bees, but in turn affect bee community structure and dynamics. We also found that community gardens harbour high levels of functional trait diversity. Urban agriculture therefore contributes substantially to the provision of functionally diverse bee communities and possibly to urban pollination services. PMID:28286711

[The challenge of inclusion in mental health: an analysis of a community center and its work with social bonds].

PubMed

Ardila-Gómez, Sara; Hartfiel, María Isabel; Fernández, Marina A; Ares Lavalle, Guadalupe; Borelli, Mariana; Stolkiner, Alicia

2016-01-01

Social inclusion is a key component of transformations in mental health care, because it takes into account the benefits of community life for both those with mental illness and the other members of the community. In order to understand the scope of inclusion within mental health, 45 participants of a community center linked to a psychiatric hospital discharge program which explicitly seeks to provide social inclusion were interviewed. The possible changes in social relationships between users and other community members based in their sustained daily interactions in the community center were explored. Results suggest that the building of social bonds, as part of informal support networks, is one of the benefits of attending the community center. Positive changes in ideas regarding people with "mental illness" were also observed, although these ideas seemed to be more connected to the notion of integration than to social inclusion.

Examining the psychological sense of community for individuals with serious mental illness residing in supported housing environments.

PubMed

Townley, Greg; Kloos, Bret

2011-08-01

The psychological sense of community is an important aspect of community life; yet, it remains largely unexamined among individuals with serious mental illness (SMI). Sense of community represents the strength of bonding among community members; and this social phenomenon likely impacts the process by which individuals with SMI integrate into community life. The current study examined sense of community (SOC) for individuals with SMI by assessing the relationships between neighborhood experiences, unique factors related to SMI (e.g., mental illness diagnosis), and sense of community in the neighborhood. Participants were 402 residents of supported housing programs who used mental health services in South Carolina. Hierarchical linear regression was utilized to determine which components of community life helped to explain variability in sense of community. In total, 214 participants reported that it is very important for them to feel a sense of community in their neighborhoods. Neighbor relations, neighborhood safety, neighborhood satisfaction, neighborhood tolerance for mental illness, and housing site type emerged as significant explanatory variables of sense of community. These findings have implications for interventions aimed at enhancing SOC and community integration for individuals with SMI.

Refugees' admission to mental health institutions in Norway: Is there an ethnic density effect?

PubMed

Finnvold, Jon Erik; Ugreninov, Elisabeth

2018-07-01

Some recent European research claims that immigrants settle in urban areas with low scores on level-of-living conditions and a high prevalence of health-risk factors, and that these settlement patterns adversely affect their health. Other studies question the association between immigrant segregation and area deprivation on one hand, and negative health outcomes on the other hand, and identify possible beneficial effects of segregation, specifically the ethnic density effect. This paper aims to explore the possible ethnic density effect among refugees, a sub-population that often appears relatively vulnerable compared with immigrants in general. The data comprise 30 871 individuals, aged 20-69, with an (post-1989) officially registered refugee status from six major countries, including Vietnam, Somalia, Iran, Iraq, Sri Lanka and Bosnia. Two outcomes are analysed, covering the 2008-2011 period - the probability of being admitted at least once to a mental health institution and the number of bed days during that period. The results show that all immigrant clusters have relatively high concentrations of negative level-of-living conditions. Despite this finding, refugees living in clusters tend to have less use of mental healthcare services. The results suggest that for most refugee groups, living in clusters has positive health outcomes. Many countries use settlement policies to direct the inflow of refugees away from immigrant-dense areas. Norway's settlement policy is no exception, aiming at a geographic dispersal of refugees to avoid the emergence of socially segregated urban ethnic communities. This paper discusses the relevance of such a policy for refugees' overall integration and level-of-living conditions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Voting pattern of mental patients in a community state hospital.

PubMed

Klein, M M; Grossman, S A

1967-06-01

The voting pattern of mental patients in a community-based state hospital was studied. Patients were polled on the New York City mayoralty race. A comparison to the vote of the general population revealed that the hospital sample vote resembled most closely the election results of the hospital district. The results highlight the advantage of community-centered mental health facilities, which undertake the treatment and rehabilitation of mental patients under conditions that maintain ties with family and community.

Israeli culture and the emergence of community mental health practices: the case of the West Jerusalem Mental Health Center.

PubMed

Reinharz, S; Mester, R

1978-01-01

The action assumptions which characterize and differentiate cultures affect the creation and functioning of their institutions. Using this analytic framework, the development of a community mental health center in Israel reflects a culture which contains both pioneering and bureaucratic action assumptions. The effects of these assumptions on staff interventions in community problems are traced. Finally, various dimensions of the emerging definition of community mental health practice in Israel are discussed and their problematic features identified.

Urban and Community Forestry Achievements in 1998

Treesearch

Daniel Liptzin; Robert Neville

1999-01-01

The vision for urban and community forestry in the Northeastern Area has remained essentially constant since 1990, "...to achieve community sustainability and an enhanced quality of life through stewardship of urban and community forests and related natural resources." Implied in this statement is full participation by all those who affect or are affected by...

[Community self-help houses as a form of community social support].

PubMed

Dabrowski, S; Brodniak, W; Gierlacki, J; Welbel, S

1998-01-01

Two forms of community-based social support were introduced by the Polish Mental Health Act--community specialist social help services and community self-help houses--for seriously mentally ill and severely mentally retarded persons. According to the art. 8 community social support should be organized by social help agencies in consultation with psychiatric facilities. Data obtained from the Ministry of Labour and Social Policy indicated that from 21th of January 1995 (when the Mental Health Act was put in force) until 30th of June 1997 social help agencies and non-governmental organizations sponsored by social help agencies have set up 134 community self-help houses with 4103 places. In the middle of last year nearly 3500 persons were using these houses. Most of the houses were located in the following districts: Gdańsk (20), Gorzów (16), Płock (12), Warszawa (8 for 164 persons). Vast majority of them served as day rehabilitation houses, while only a few provided sheltered housing as well. Tentative evaluation of functioning of these houses shows that: operational definition of community self-help house given in the target network of nursing homes and community self-help houses should be modified to include statutory purposes of community social support provided in art.8, selection of the persons using community self-help houses should follow the legal requirement of the Mental Health Act (art. 8), separated rehabilitation programs for mentally ill (psychotic) and mentally retarded persons need to be provided, participation of psychiatric facilities in the organization of the community self-help houses should be increased, functioning of the community self-help houses ought to be supervised by specialists, staff of the community self-help houses need to be systematically trained.

Exploring Asian American attitudes regarding mental health treatment in primary care: A qualitative study.

PubMed

Hails, Katherine; Madu, Andrea; Kim, Daniel Ju Hyung; Hahm, Hyeouk Chris; Cook, Benjamin; Chen, Justin; Chang, Trina; Yeung, Albert; Trinh, Nhi-Ha

2018-05-01

In this exploratory study, we examined attitudes regarding mental health treatment among 10 Asian American patients in an urban primary care setting to better understand contextual barriers to care. Ten semi-structured telephone interviews were conducted with Asian Americans recruited from primary care practices in an urban medical center. The study's qualitative data suggest that focusing on specific cultural concerns is essential for increasing mental health access for Asian Americans. Although few participants initially expressed interest in a culturally focused mental health program themselves, when phrased as being part of their primary care practice, 8 expressed interest. Furthermore, most felt that the program could help family or friends. Many participants preferred to seek care initially from social systems and alternative and complementary medicine before seeking psychiatric care. Because Asian Americans face notable barriers to seeking mental health treatment, addressing cultural concerns by providing culturally sensitive care could help make mental health treatment more acceptable, particularly among less acculturated individuals. To our knowledge, this is the first qualitative study exploring barriers to Asian Americans accessing integrated mental health services in primary care.

Exposure to manganese: health effects on the general population, a pilot study in central Mexico.

PubMed

Santos-Burgoa, C; Rios, C; Mercado, L A; Arechiga-Serrano, R; Cano-Valle, F; Eden-Wynter, R A; Texcalac-Sangrador, J L; Villa-Barragan, J P; Rodriguez-Agudelo, Y; Montes, S

2001-02-01

To support a risk assessment of manganese exposure in two communities living within a manganese mining district a cross-sectional study was performed on a sample of the adult population of long-term residents. One community was exposed to a point source from an ore primary refining plant. Manganese is an essential mineral for human life. It is also the fourth in importance for industrial metal making. Data were collected on socioeconomic living conditions, emission sources, environmental media concentrations (air, water, soil, dust, food), respiratory symptomatology, and a neuropsychological examination (Mini-Mental Screening test, the Hooper Visual Organization test, the Ardila-Ostroski, and others). We examined 73 subjects (52 women), most of low socioeconomic status. Environmental air concentrations were 2 to 3 times higher than those in other urban concentrations. Manganese blood concentrations ranged from 7.5 to 88 microg/L, with a median concentration of 15, the upper quartile starting at 20 microg/L; the upper 10% was above 25 microg/L. Lead and manganese were highly correlated; there was an inverse relation to hemoglobin. Reduced levels of plasma lipid peroxidation were associated with blood manganese. Using multivariate logistic regression, we identified B-Mn as increasing the risk of deficient cognitive performance 12 times (Mini-Mental score of less than 17). Copyright 2001 Academic Press.

Violence Exposure and Psychopathology in Latino Youth: The Moderating Role of Active and Avoidant Coping.

PubMed

Gudiño, Omar G; Stiles, Allison A; Diaz, Kathleen I

2018-06-01

Despite high rates of exposure to community violence among Latino youth in urban communities, there is considerable variability in individual outcomes. This study examined (a) associations between coping and indices of Latino culture, (b) main effects of active/avoidant coping on psychopathology, and (c) whether coping moderates the impact of violence exposure on mental health in Latino youth. Participants included 168 Latino youth (56% female; ages 11-14) that took part in a short-term longitudinal study. Results indicate that youth acculturation was positively associated with active coping, but enculturation level and immigrant status were not associated with coping. Structural equation models suggested that active coping was negatively associated with internalizing problems (p = .046) while avoidant coping was positively associated with internalizing problems (p = .013) and posttraumatic stress symptoms (p = .024). Moderation analyses revealed that violence exposure was more strongly associated with internalizing problems as reliance on avoidance coping increased. However, at high levels of violence exposure, a greater reliance on active coping was related to increased posttraumatic stress problems. Findings suggest that consideration of the specific stressor, level of stress exposure, and mental health problem-type may be crucial in determining the effectiveness of a coping strategy. Implications for future research and intervention are discussed.

Communicating: How? A Manual for Mental Health Educators.

ERIC Educational Resources Information Center

National Inst. of Mental Health (DHEW), Rockville, MD.

The Alternatives Project, a 60-week, mass media, mental health education project, had as its goals community education and increased public awareness of mental health facilities in the community. Sponsored by the River Region Mental Health/Mental Retardation Board in Louisville, Kentucky, the program made use of creatively produced, coordinated…

Becoming an Independent Community Mental Health Center: Perils of the Process

PubMed Central

Adams, Milton S.

1978-01-01

Over the past 12 years, since the inception of the Community Mental Health Center (CMHC) movement, there has been increasing concern that local communities have more input; in fact, that they actually have the opportunity to operate the mental health programs that they deem necessary for their communities.1 Under the Amendments to the Community Mental Health Act (P.L.94-63) 1975, CMHCs were given such options as independence or governance. The whole process of governance presents numerous problems as well as opportunities. An overview of the vicissitudes of this process is presented in this paper. PMID:702582

Disaster mental health preparedness in the community: A systematic review study

PubMed Central

Roudini, Juliet; Khankeh, Hamid Reza; Witruk, Evelin

2017-01-01

The objective of this study was to perform a systematic review of articles that cover aspects of disaster mental health preparedness. This assessment was done by a thorough review and summary of the available studies which provided a considerable background and amplified the gaps in knowledge about community mental health preparedness. By this systematic review, we tried to identify available concept of community mental health preparedness and related tools that communities and individuals will need to prepare for natural disasters. We found there is a lack of mental health preparedness in the majority of countries; valid and reliable tools and context-bound programs should be developed based on the experiences and perceptions of the community. PMID:28680695

Key Elements of a Successful Multi-System Collaboration for School-Based Mental Health: In-Depth Interviews with District and Agency Administrators

ERIC Educational Resources Information Center

Powers, Joelle D.; Edwards, Jeffrey D.; Blackman, Kate F.; Wegmann, Kate M.

2013-01-01

The alarming number of youth with unmet mental health needs in the US is a significant social problem. The pilot school-based mental health project described here established an innovative multi-system partnership between an urban school district, a public mental health agency, and a local university to better meet the mental health needs of youth…

Reorganization of mental health services: from institutional to community-based models of care.

PubMed

Saraceno, B; Gater, R; Rahman, A; Saeed, K; Eaton, J; Ivbijaro, G; Kidd, M; Dowrick, C; Servili, C; Funk, M K; Underhill, C

2015-09-28

Mental health services in the Eastern Mediterranean Region are predominantly centralized and institutionalized, relying on scarce specialist manpower. This creates a major treatment gap for patients with common and disabling mental disorders and places an unnecessary burden on the individual, their family and society. Six steps for reorganization of mental health services in the Region can be outlined: (1) integrate delivery of interventions for priority mental disorders into primary health care and existing priority programmes; (2) systematically strengthen the capacity of non-specialized health personnel for providing mental health care; (3) scale up community-based services (community outreach teams for defined catchment, supported residential facilities, supported employment and family support); (4) establish mental health services in general hospitals for outpatient and acute inpatient care; (5) progressively reduce the number of long-stay beds in mental hospitals through restricting new admissions; and (6) provide transitional/bridge funding over a period of time to scale up community-based services and downsize mental institutions in parallel.

Social exclusion and people with intellectual disabilities: a rural-urban comparison.

PubMed

Nicholson, L; Cooper, S-A

2013-04-01

Research suggests that social exclusion is a problem both for people with intellectual disabilities (ID) and for people living in rural areas. This may give rise to a double disadvantage for people with ID living in rural areas. Conversely, aspects of rural life such as community spirit and social support may protect against social exclusion in this population. This study was designed to compare a number of measures of social exclusion in adults with ID living in rural and urban areas, with the aim of identifying whether a double disadvantage exists. Adults with ID were recruited from a rural and an urban area in Scotland. Participants participated in a face-to-face interview and their medical notes were accessed. Social exclusion was investigated using a number of measures comprising: daytime opportunities and physical access to community facilities (using part of the British Institute of Learning Disabilities questionnaire), recent contact with others and the quality of personal relationships (using a modified Interview Measure of Social Relationships questionnaire) and area deprivation by postcode (using the Scottish Index of Multiple Deprivation). The data were analysed using a series of binary logistic regression models that adjusted for variables including age, gender, level of ID, mental illhealth and common physical co-morbidities. A representative sample of adults with ID from rural (n = 39) and urban (n = 633) areas participated. Participants from rural areas were significantly more likely to have any regular daytime opportunity [odds ratio (OR) = 10.8, 95% CI = 2.3-51.5] including employment (OR = 22.1, 95% CI = 5.7-85.5) and attending resource centres (OR = 6.7, 95% CI = 2.6-17.2) than were participants from urban areas. They were also more likely to have been on holiday (OR = 17.8, 95% CI = 4.9-60.1); however, were less likely to use community facilities on a regular basis. Participants from urban and rural areas had a similar number of contacts with other people in a wide range of situations, but the quality of relationships may have been less close in rural areas. Finally, participants lived in significantly less deprived areas when in rural compared with urban areas (Mann-Whitney U = 7826, Z = -3.675, P ≤ 0.001). These results suggest that adults with ID living in rural areas have better opportunities and live in less deprived areas than adults with ID living in urban areas. However, they may not hold such positive or close relationships, and this may be important when considering the subjective experience of social exclusion. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

Exploring the role of ethnic media and the community readiness to combat stigma attached to mental illness among Vietnamese immigrants: the pilot project Tam An (Inner Peace in Vietnamese).

PubMed

Han, Meekyung; Cao, Lien; Anton, Karen

2015-01-01

Vietnamese Americans are at high risk for developing mental health disorders due to multiple risk factors such as trauma and acculturative stress. However, the utilization of mental health services has been low. The pilot project Tam An was implemented to raise mental health awareness by engaging community resources in the Vietnamese population. Informed by the Community Readiness Model and through local ethnic media sources, messages to destigmatize mental health and promote the willingness to initiate mental health treatment were presented. Using an exploratory perspective, findings from focus group data suggest that the project improved the community's stage of readiness.

Neighborhood environment walkability and health-related quality of life among older adults in Hong Kong.

PubMed

Zhao, Yanan; Chung, Pak-Kwong

2017-11-01

This study examined the associations between walkability related environmental attributes (WREA) and health-related quality of life (HRQoL) among older adults in Hong Kong. A cross-sectional study was conducted among 340 participants (women = 233; mean age = 74.4 years) living in urban communities. Independent variables included residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure for walking, aesthetics, traffic hazards, crime, access to parking, lack of cul-de-sacs, hilliness, and physical barriers. Physical and mental dimensions of HRQoL were the dependent variables. Results revealed significant associations between WREA and HRQoL and demonstrated that aesthetics and physical barriers were significant determinants of physical health after adjusting age and sex, and crime and physical barriers were significant determinants of mental health after adjusting sex. This study provided empirical evidence that environmental walkability was associated with HRQoL among older adults in Hong Kong. Copyright © 2017 Elsevier B.V. All rights reserved.

"It's like pay or don't have it and now I'm doing without": the voice of transitional uninsured former foster youth.

PubMed

Kruszka, Bonnie J; Lindell, Deborah; Killion, Cheryl; Criss, Sam

2012-02-01

Twenty-four thousand American youth lose Medicaid entitlements after discharge from foster care annually. The circumstance of being uninsured is a formidable barrier to health care that leaves the youth vulnerable to unmet health care needs. Given that foster youth often develop physical and/or mental health problems as a result of abuse or neglect, continuous access to health care is especially important. This descriptive phenomenology study explores the lived experience of transitional uninsured former foster youth. Nine uninsured former foster youth were recruited from a nonprofit community organization in an urban county and interviewed using semistructured interviews. Four themes identified from the analysis were (a) "Surviving the real world": emancipation without essential documentation; (b) "It's not always going to be fine": managing mental and physical health without health care insurance; (c) "Roadblocks": barriers to securing health care insurance; and (d) "Just not knowing": Medicaid eligible albeit without health care insurance.

Conceptualizing community: the experience of mental health consumers.

PubMed

Wong, Yin-Ling Irene; Sands, Roberta G; Solomon, Phyllis L

2010-05-01

In this article we describe a focus group study of the perspectives of diverse groups of mental health consumers on the concept of community. We identify the core domains that constitute the notion of community, and commonalities and differences in the perception of community along the lines of ethnicity and sexual orientation/gender identity. Seven focus groups were conducted with a total of 62 participants. Transcripts were analyzed using the grounded theory approach.Two domains-togetherness and community acceptance-emerged as common to four types of communities that were most frequently mentioned in the focus group discussion. Our findings show that identities other than those associated with mental illness and the role of service user are critical to the understanding of the psychological sense of community among persons with psychiatric disabilities. We suggest that mental health providers empower consumers to expand their "personal communities" beyond that of mental health clients using their diverse identities, and design interventions for addressing the stigma emanating from identities that are discriminated against by the wider society.

Making A Difference: What Communities Can Do To Prevent Mental Handicap and Promote Lives of Quality. Volume IV: Respected and Responsible Citizens.

ERIC Educational Resources Information Center

Kappel, Bruce

The fourth of five volumes on the means by which Canadian communities can reduce the incidence of mental retardation, minimize existing impairment, and improve the quality of life of the mentally retarded, this booklet focuses on the prevention of mental handicap in adults and ways to accommodate and encourage community participation by the…

Revitalizing sociology: urban life and mental illness between history and the present.

PubMed

Fitzgerald, Des; Rose, Nikolas; Singh, Ilina

2016-03-01

This paper proposes a re-thinking of the relationship between sociology and the biological sciences. Tracing lines of connection between the history of sociology and the contemporary landscape of biology, the paper argues for a reconfiguration of this relationship beyond popular rhetorics of 'biologization' or 'medicalization'. At the heart of the paper is a claim that, today, there are some potent new frames for re-imagining the traffic between sociological and biological research - even for 'revitalizing' the sociological enterprise as such. The paper threads this argument through one empirical case: the relationship between urban life and mental illness. In its first section, it shows how this relationship enlivened both early psychiatric epidemiology, and some forms of the new discipline of sociology; it then traces the historical division of these sciences, as the sociological investment in psychiatric questions waned, and 'the social' become marginalized within an increasingly 'biological' psychiatry. In its third section, however, the paper shows how this relationship has lately been revivified, but now by a nuanced epigenetic and neurobiological attention to the links between mental health and urban life. What role can sociology play here? In its final section, the paper shows how this older sociology, with its lively interest in the psychiatric and neurobiological vicissitudes of urban social life, can be our guide in helping to identify intersections between sociological and biological attention. With a new century now underway, the paper concludes by suggesting that the relationship between urban life and mental illness may prove a core testing-ground for a 'revitalized' sociology. © London School of Economics and Political Science 2016.

Hmong mental health needs assessment: a community-based partnership in a small mid-Western community.

PubMed

Collier, Ann Futterman; Munger, Martha; Moua, Yong Kay

2012-03-01

The overall goal of this assessment was to verify the mental health needs of Hmong living in a mid-west community in order clarify the format, content, and feasibility of providing mental health services for Hmong in the future. Using a Community-Based Participatory Research (CBPR) model, we held four focus groups with 36 men, women, adolescents and professionals, all of Hmong descent, as well as interviewed 28 individual medical, mental health, education, and social service providers in the Eau Claire community. Our Hmong sample was frequently unclear about what "mental" health meant, indicating a low level of mental health literacy. Results confirmed that there are significant mental health needs in this refugee and immigrant population. Participants described problems consistent with depression, post-traumatic stress disorder (PTSD), anxiety disorders, somatoform disorders, and severe social stress and acculturation difficulties in every generation. Elder people and male adolescents were described as the most disaffected and in need of immediate services. It will be critical to address mental health literacy before designing future interventions. Treatment suggestions were provided with the intention of removing barriers and incorporating culturally sensitive methodologies, while continuing to work closely with our local mental health providers and Hmong leadership.

Community mental health care worldwide: current status and further developments

PubMed Central

Thornicroft, Graham; Deb, Tanya; Henderson, Claire

2016-01-01

This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness. PMID:27717265

Assessment of self-care and medication adherence in individuals with mental health conditions.

PubMed

Bible, Lisa J; Casper, Kristin A; Seifert, Jennifer L; Porter, Kyle A

This descriptive study explored whether patients with mental health conditions engage in personal medicine (self-care activities) as part of their treatment regimen. Personal medicine is patient-identified and -initiated activities of self-care that can improve mental health through various means, including physical activity, social engagement, and spiritual connectedness. The purpose of this study was to explore patient engagement in personal medicine within an underserved population and to evaluate the impact self-care might have on self-reported medication use and adherence and patient perception of mental health control. Cross-sectional study design with a face-to-face verbally administered survey assessing medication adherence, engagement in self-care activities, perception of self-care, and mental health control. The study site was a nonprofit charitable pharmacy in an urban setting. The pharmacy provides medications and pharmacy services at no charge, including disease state education, point-of-care testing, and medication therapy management. Study participants included those who fill medications for mental health conditions and who are age 18 years and older. Main outcomes included engagement in self-care and self-reported medication adherence. Additional measures included stratification of dimensions of self-care, perception of mental health control, and patient knowledge of community resources. Overall, 81.7% of participants engaged in activities of self-care, with 98.3% recognizing self-care as important to improving and maintaining their mental health. Greater self-reported adherence rates and mental health control were seen with patients who participate in self-care. Participants who identify and engage in personal medicine recognize its value and are willing to incorporate it into their treatment regimen. As accessible and trusted health care providers, pharmacists can encourage patients to identify and use personal medicine to aid in the improvement of their mental health condition. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Functional Limitations, Depression, and Cash Assistance are Associated with Food Insecurity among Older Urban Adults in Mexico City.

PubMed

Vilar-Compte, Mireya; Martínez-Martínez, Oscar; Orta-Alemán, Dania; Perez-Escamilla, Rafael

2016-01-01

To examine factors associated with food insecurity among urban older adults (65 years and older). Three hundred and fifty two older adults attending community centers in a neighborhood of Mexico City were surveyed for food insecurity, functional impairments, health and mental health status, cash-transfer assistance, socio-demographic characteristics, social isolation, and the built food environment. Having at least primary education and receiving cash-transfers were significantly associated with a lower probability of being moderately-severely food insecure (OR=0.478 and 0.597, respectively). The probability of moderate-severe food insecurity was significantly higher among elderly at risk of depression (OR=2.843), those with at least one activity of daily living impaired (OR=2.177) and those with at least one instrumental activity of daily living impaired (OR=1.785). Higher educational attainment and cash-transfers may have a positive influence on reducing food insecurity. Depression and functional limitations may increase the likelihood of food insecurity among older adults.

Review of the Literature: A Rural-Urban Comparison of Social Networks of Older Adults Living With HIV.

PubMed

Gannon, Brittany N; Stacciarini, Jeanne-Marie R

2016-01-01

Globally, aging populations and older persons living with HIV (OPLWH) are emerging socioeconomic and health care concerns. Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwelling OPLWH. The purpose of this integrative literature review was to compare emerging themes in the social network components of rural versus urban-dwelling OPLWH and network benefits and barriers. Overarching themes include: limited and/or fragile networks, social inclusion versus social isolation, social capital, and health outcomes. Results demonstrate an overall lack of rural-focused research on OPLWH and a universal lack of informal and formal networks due to isolation, lack of health care services, and omnipresent HIV stigma. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Community perspectives on barriers and strategies for promoting locally grown produce from an urban agriculture farm.

PubMed

Hu, Alice; Acosta, Angela; McDaniel, Abigail; Gittelsohn, Joel

2013-01-01

Although much is understood about barriers to healthy food consumption in low-income, urban communities, knowledge regarding the crucial next step of building feasible, community-supported approaches to address those barriers remains limited. This qualitative study used in-depth interviews (n = 20), focus groups (n = 2), and participant observations (n = 3) to identify strategies to promote locally grown produce from an urban food security project, Produce From the Park (PFP), an urban farm. Informants included community organization representatives and residents from low-income neighborhoods in a mid-Atlantic city. Informants identified structural and cultural barriers to purchasing healthy food, including price, location, food culture, and lack of interest. Participants proposed a number of strategies, such as distribution through mobile food carts and farm stands, marketing new foods through taste tests and cooking demonstrations, and youth mentorship. Informants also described their perceptions of the local urban farm and suggested ways to increase community buy-in. Strategies mentioned were inexpensive and incorporated cultural norms and local assets. These community perspectives can provide insights for those promoting healthy eating in urban African American communities through urban food security projects.

The Mental Health Status of Single-Parent Community College Students in California.

PubMed

Shenoy, Divya P; Lee, Christine; Trieu, Sang Leng

2016-01-01

Single-parenting students face unique challenges that may adversely affect their mental health, which have not been explored in community college settings. The authors conducted secondary analysis of Spring 2013 data from the American College Health Association-National College Health Assessment to examine difficulties facing single-parent community college students and the association between single parenting and negative mental health (depression, self-injury, suicide attempt). Participants were 6,832 California community college students, of whom 309 were single parents. Demographic and mental health data were characterized using univariate descriptive analyses. Bivariate analyses determined whether single parents differed from other students regarding negative mental health or traumatic/difficult events. Finances, family, and relationship difficulties disproportionally affected single parents, who reported nearly twice as many suicide attempts as their counterparts (5.3% vs. 2.7%; p < .0001). Single-parenting students face a higher prevalence of mental health stressors than other community college students.

A prison mental health in-reach model informed by assertive community treatment principles: evaluation of its impact on planning during the pre-release period, community mental health service engagement and reoffending.

PubMed

McKenna, Brian; Skipworth, Jeremy; Tapsell, Rees; Madell, Dominic; Pillai, Krishna; Simpson, Alexander; Cavney, James; Rouse, Paul

2015-12-01

It is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk. To evaluate the impact of implementing an assertive community treatment informed prison in-reach model of care (PMOC) on post-release engagement with community mental health services and on reoffending rates. One hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation. The assertive prison model of care was associated with more pre-release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post-release community mental health service engagements after implementation of this model (Z = -2.388, p = 0.02). There was a trend towards reduction in reoffending rates after release from some of the prisons (Z =1.82, p = 0.07). Assertive community treatment applied to prisoners with mental health problems was superior to 'treatment as usual', but more work is needed to ensure that agencies will engage prisoners in pre-release care. The fact that the model showed some benefits in the absence of any increase in resources suggests that it may be the model per se that is effective. Copyright © 2014 John Wiley & Sons, Ltd.

Urban-development-induced Changes in the Diversity and Composition of the Soil Bacterial Community in Beijing.

PubMed

Yan, Bing; Li, Junsheng; Xiao, Nengwen; Qi, Yue; Fu, Gang; Liu, Gaohui; Qiao, Mengping

2016-12-09

Numerous studies have implicated urbanization as a major cause of loss of biodiversity. Most of them have focused on plants and animals, even though soil microorganisms make up a large proportion of that biodiversity. However, it is unclear how the soil bacterial community is affected by urban development. Here, paired-end Illumina sequencing of the 16 S rRNA gene at V4 region was performed to study the soil microbial community across Beijing's built-up area. Proteobacteria, Acidobacteria, Bacteroidetes, Actinobacteria, Gemmatimonadetes, Verrucomicrobia, Planctomycetes, and Chloroflexi were the dominant phyla in all samples, but the relative abundance of these phyla differed significantly across these concentric zones. The diversity and composition of the soil bacterial community were found to be closely correlated with soil pH. Variance partitioning analysis suggested that urban ring roads contributed 5.95% of the bacterial community variation, and soil environmental factors explained 17.65% of the variation. The results of the current work indicate that urban development can alter the composition and diversity of the soil microbial community, and showed pH to be a key factor in the shaping of the composition of the soil bacterial community. Urban development did have a strong impact on the bacterial community of urban soil in Beijing.

Characterizing Urban Household Waste Generation and Metabolism Considering Community Stratification in a Rapid Urbanizing Area of China

PubMed Central

Xiao, Lishan; Lin, Tao; Chen, Shaohua; Zhang, Guoqin; Ye, Zhilong; Yu, Zhaowu

2015-01-01

The relationship between social stratification and municipal solid waste generation remains uncertain under current rapid urbanization. Based on a multi-object spatial sampling technique, we selected 191 households in a rapidly urbanizing area of Xiamen, China. The selected communities were classified into three types: work-unit, transitional, and commercial communities in the context of housing policy reform in China. Field survey data were used to characterize household waste generation patterns considering community stratification. Our results revealed a disparity in waste generation profiles among different households. The three community types differed with respect to family income, living area, religious affiliation, and homeowner occupation. Income, family structure, and lifestyle caused significant differences in waste generation among work-unit, transitional, and commercial communities, respectively. Urban waste generation patterns are expected to evolve due to accelerating urbanization and associated community transition. A multi-scale integrated analysis of societal and ecosystem metabolism approach was applied to waste metabolism linking it to particular socioeconomic conditions that influence material flows and their evolution. Waste metabolism, both pace and density, was highest for family structure driven patterns, followed by lifestyle and income driven. The results will guide community-specific management policies in rapidly urbanizing areas. PMID:26690056

Urban-development-induced Changes in the Diversity and Composition of the Soil Bacterial Community in Beijing

NASA Astrophysics Data System (ADS)

Yan, Bing; Li, Junsheng; Xiao, Nengwen; Qi, Yue; Fu, Gang; Liu, Gaohui; Qiao, Mengping

2016-12-01

Numerous studies have implicated urbanization as a major cause of loss of biodiversity. Most of them have focused on plants and animals, even though soil microorganisms make up a large proportion of that biodiversity. However, it is unclear how the soil bacterial community is affected by urban development. Here, paired-end Illumina sequencing of the 16 S rRNA gene at V4 region was performed to study the soil microbial community across Beijing’s built-up area. Proteobacteria, Acidobacteria, Bacteroidetes, Actinobacteria, Gemmatimonadetes, Verrucomicrobia, Planctomycetes, and Chloroflexi were the dominant phyla in all samples, but the relative abundance of these phyla differed significantly across these concentric zones. The diversity and composition of the soil bacterial community were found to be closely correlated with soil pH. Variance partitioning analysis suggested that urban ring roads contributed 5.95% of the bacterial community variation, and soil environmental factors explained 17.65% of the variation. The results of the current work indicate that urban development can alter the composition and diversity of the soil microbial community, and showed pH to be a key factor in the shaping of the composition of the soil bacterial community. Urban development did have a strong impact on the bacterial community of urban soil in Beijing.

Intimate partner violence and mental health effects: a population-based study among married women in Karachi, Pakistan.

PubMed

Ali, Tazeen S; Mogren, Ingrid; Krantz, Gunilla

2013-03-01

Intimate partner violence (IPV) is recognized all over the world for its association with mental health problems in women. In Pakistan, such violence occurs commonly, but detailed information on mental health effects is scarce. The purpose of this study is to focused on married couples in urban Karachi to investigate mental health effects associated with physical, sexual and psychological violence perpetrated by husbands towards wives. Disclosure rates and health care-seeking behaviour were also investigated. This cross-sectional study involved 759 women between the ages of 25 and 60 years, selected using a multi-stage random sampling technique. The women were interviewed by trained community midwives using a structured questionnaire. In the total population of women, mental symptoms were prevalent. Women subjected to any form of violence reported, however, considerably poorer mental health than unexposed women. A statistically significant difference for almost all of the studied health parameters persisted even after controlling for socio-demographic factors. The strongest associations were found for suicidal thoughts and physical violence (OR 4.41; 3.18-6.12), sexual abuse (OR 4.39; 3.17-6.07) and psychological abuse (OR 5.17; 3.28-8.15). The interviews revealed that only 27% of the women subjected to violence had disclosed this to anyone, in most cases to their parents. The findings in this study highlight that the violence women have to face contributes to the development of multiple forms of psychological stress and serious mental health problems. Women's restrictive life circumstances seriously hamper women's empowerment. Reliable health surveillance system and health care services are needed to serve abused women. Policy initiatives focused on IPV and gender inequality in Pakistan should be initiated.

Comparing Mental Health of US Children of Immigrants and Non-Immigrants in 4 Racial/Ethnic Groups

ERIC Educational Resources Information Center

Kim, JaHun; Nicodimos, Semret; Kushner, Siri E.; Rhew, Isaac C.; McCauley, Elizabeth; Vander Stoep, Ann

2018-01-01

Background: To compare the mental health status of children of immigrant (COI) and non-immigrant (NI) parents and to determine whether differences in mental health status between COI and NI vary across 4 racial/ethnic groups. Methods: We conducted universal mental health screening of 2374 sixth graders in an urban public school district. To…

Living Arrangements and Social Support: Effects on the Well-Being of Mothers with Mental Illness

ERIC Educational Resources Information Center

Mowbray, Carol T.; Bybee, Deborah; Hollingsworth, Leslie; Goodkind, Sara; Oyserman, Daphna

2005-01-01

This article examines the effects of living arrangements on the well-being of mothers with a serious mental illness. Analyses of data from a National Institute of Mental Health-funded study of an urban, primarily African American sample of 379 mothers with mental illness revealed few differences in parenting or social functioning between mothers…

Using the K6 to Assess the Mental Health of Jailed Women

ERIC Educational Resources Information Center

Kubiak, Sheryl Pimlott; Beeble, Marisa L.; Bybee, Deborah

2009-01-01

Despite high prevalence rates, many jails lack validated measures or consistent processes for detecting mental illness. In this study, we examined the utility of the K6, an internationally used brief mental health screening measure within an urban jail. The K6 and several other mental health measures were administered to 515 jailed women. The K6…

Nineteenth-century urbanization as sacred process: insights from German Strasbourg.

PubMed

Steinhoff, Anthony J

2011-01-01

This article examines a crucial site for modernity’s encounter with religion during the long nineteenth century, albeit one largely ignored both by religious and urban historians: the modern big city. Drawing on evidence from Strasbourg, which joined the ranks of Germany’s big cities soon after the Franco-Prussian War, it points out first, that urbanization had a significant urban dimension. It altered the absolute and relative size of the city’s faith communities, affected the confessional composition of urban neighborhoods, and prompted faith communities to mark additional parts of the urban landscape as sacred. Second, while urban growth—both demographic and physical—frequently challenged traditional understandings of religious community, it also facilitated the construction of new understandings of piety and community, especially via voluntary organizations and the religious media. Thereby, urbanization emerged as a key force behind sacralization in city and countryside as the nineteenth century ended and the twentieth began.

Identifying environmental health priorities in underserved populations: a study of rural versus urban communities

PubMed Central

Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.

2013-01-01

Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study, understand and effectively address environmental issues, and are particularly relevant to developing effective community-based strategies in vulnerable populations. PMID:24239281

Transforming Out-of-School Challenges into Opportunities: Community Schools Reform in the Urban Midwest

ERIC Educational Resources Information Center

Green, Terrance L.; Gooden, Mark A.

2014-01-01

For more than three decades, community schools have aimed to improve education and neighborhood outcomes in low-income, urban communities of color. In this article, we position community schools as a place-based reform strategy that pushes back on top-down accountability systems. While most research on urban school reform focuses on improving…

'Our community is the worst': the influence of cultural beliefs on stigma, relationships with family and help-seeking in three ethnic communities in London.

PubMed

Shefer, Guy; Rose, Diana; Nellums, Laura; Thornicroft, Graham; Henderson, Claire; Evans-Lacko, Sara

2013-09-01

Existing knowledge about the cultural beliefs of black and minority ethnic (BME) communities in the UK regarding stigma and mental illness is limited. Data were collected in 10 focus groups, five with service users and five with laypersons, from BME communities in London. Thematic analysis identified that cultural beliefs regarding mental illness reflect four different voices present within the BME communities. The study revealed that cultural beliefs influencing both relationships with family and, consequently, help-seeking for individuals with mental illness must be considered in the development of anti-stigma interventions and when engaging communities around mental health.

Marketing and Community Mental Health Centers.

ERIC Educational Resources Information Center

Ferniany, Isaac W.; Garove, William E.

1983-01-01

Suggests that a marketing approach can be applied to community mental health centers. Marketing is a management orientation of providing services for, not to, patients in a systematic manner, which can help mental health centers improve services, strengthen community image, achieve financial independence and aid in staff recruitment. (Author)

Ectomycorrhizal Fungal Communities in Urban Parks Are Similar to Those in Natural Forests but Shaped by Vegetation and Park Age

PubMed Central

Liu, Xinxin; Kotze, D. Johan; Jumpponen, Ari; Francini, Gaia; Setälä, Heikki

2017-01-01

ABSTRACT Ectomycorrhizal (ECM) fungi are important mutualists for the growth and health of most boreal trees. Forest age and its host species composition can impact the composition of ECM fungal communities. Although plentiful empirical data exist for forested environments, the effects of established vegetation and its successional trajectories on ECM fungi in urban greenspaces remain poorly understood. We analyzed ECM fungi in 5 control forests and 41 urban parks of two plant functional groups (conifer and broadleaf trees) and in three age categories (10, ∼50, and >100 years old) in southern Finland. Our results show that although ECM fungal richness was marginally greater in forests than in urban parks, urban parks still hosted rich and diverse ECM fungal communities. ECM fungal community composition differed between the two habitats but was driven by taxon rank order reordering, as key ECM fungal taxa remained largely the same. In parks, the ECM communities differed between conifer and broadleaf trees. The successional trajectories of ECM fungi, as inferred in relation to the time since park construction, differed among the conifers and broadleaf trees: the ECM fungal communities changed over time under the conifers, whereas communities under broadleaf trees provided no evidence for such age-related effects. Our data show that plant-ECM fungus interactions in urban parks, in spite of being constructed environments, are surprisingly similar in richness to those in natural forests. This suggests that the presence of host trees, rather than soil characteristics or even disturbance regime of the system, determine ECM fungal community structure and diversity. IMPORTANCE In urban environments, soil and trees improve environmental quality and provide essential ecosystem services. ECM fungi enhance plant growth and performance, increasing plant nutrient acquisition and protecting plants against toxic compounds. Recent evidence indicates that soil-inhabiting fungal communities, including ECM and saprotrophic fungi, in urban parks are affected by plant functional type and park age. However, ECM fungal diversity and its responses to urban stress, plant functional type, or park age remain unknown. The significance of our study is in identifying, in greater detail, the responses of ECM fungi in the rhizospheres of conifer and broadleaf trees in urban parks. This will greatly enhance our knowledge of ECM fungal communities under urban stresses, and the findings can be utilized by urban planners to improve urban ecosystem services. PMID:28970220

Community Mental Health Model for Campus Mental Health Services.

ERIC Educational Resources Information Center

Banning, James H.

University and college mental health services have historically modeled themselves after a traditional clinic model. Few delivery systems have been influenced by the community mental health model. The major reason for this lack of influence appears to be the "in loco parentis" stance of colleges and universities. A campus mental health service…

Art and mental health in Samoa.

PubMed

Ryan, Brigid; Goding, Margaret; Fenner, Patricia; Percival, Steven; Percival, Wendy; Latai, Leua; Petaia, Lisi; Pulotu-Endemann, Fuimaono Karl; Parkin, Ian; Tuitama, George; Ng, Chee

2015-12-01

To pilot an art and mental health project with Samoan and Australian stakeholders. The aim of this project was to provide a voice through the medium of art for people experiencing mental illness, and to improve the public understanding in Samoa of mental illness and trauma. Over 12 months, a series of innovative workshops were held with Samoan and Australian stakeholders, followed by an art exhibition. These workshops developed strategies to support the promotion and understanding of mental health in Samoa. Key stakeholders from both art making and mental health services were engaged in activities to explore the possibility of collaboration in the Apia community. The project was able to identify the existing resources and community support for the arts and mental health projects, to design a series of activities aimed to promote and maintain health in the community, and to pilot these programs with five key organizations. This project demonstrates the potential for art and mental health projects to contribute to both improving mental health and to lowering the personal and social costs of mental ill health for communities in Samoa. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Urban Environmental Program in New England | US EPA

EPA Pesticide Factsheets

2017-04-10

The Urban Environmental Program's mission is to improve the environment and enhance the quality of life for urban residents throughout New England by building community capacity to assess and resolve environmental problems, achieving measurable and sustainable improvements in urban communities, and restoring and revitalizing neighborhoods for urban residents.

Microbial diversity in the floral nectar of Linaria vulgaris along an urbanization gradient.

PubMed

Bartlewicz, Jacek; Lievens, Bart; Honnay, Olivier; Jacquemyn, Hans

2016-03-30

Microbes are common inhabitants of floral nectar and are capable of influencing plant-pollinator interactions. All studies so far investigated microbial communities in floral nectar in plant populations that were located in natural environments, but nothing is known about these communities in nectar of plants inhabiting urban environments. However, at least some microbes are vectored into floral nectar by pollinators, and because urbanization can have a profound impact on pollinator communities and plant-pollinator interactions, it can be expected that it affects nectar microbes as well. To test this hypothesis, we related microbial diversity in floral nectar to the degree of urbanization in the late-flowering plant Linaria vulgaris. Floral nectar was collected from twenty populations along an urbanization gradient and culturable bacteria and yeasts were isolated and identified by partially sequencing the genes coding for small and large ribosome subunits, respectively. A total of seven yeast and 13 bacterial operational taxonomic units (OTUs) were found at 3 and 1% sequence dissimilarity cut-offs, respectively. In agreement with previous studies, Metschnikowia reukaufii and M. gruessi were the main yeast constituents of nectar yeast communities, whereas Acinetobacter nectaris and Rosenbergiella epipactidis were the most frequently found bacterial species. Microbial incidence was high and did not change along the investigated urbanization gradient. However, microbial communities showed a nested subset structure, indicating that species-poor communities were a subset of species-rich communities. The level of urbanization was putatively identified as an important driver of nestedness, suggesting that environmental changes related to urbanization may impact microbial communities in floral nectar of plants growing in urban environments.

Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

PubMed Central

Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

2008-01-01

Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:18687596