Closing the rehabilitation utilization gap of New Zealand’s (Aotearoa) Māori people: Multiple case studies

Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency

A Prospective Examination of Service Use by Abused and Neglected Children Followed Up Into Adulthood

Royal Canadian Mounted Police (RCMP) officers experience an elevated risk for mental health disorders due to inherent work-related exposures to potentially psychologically traumatic events and occupational stressors. RCMP officers also report high levels of stigma and low levels of intentions to seek mental health services. In contrast, very little is known about the levels of mental health knowledge and stigma of RCMP cadets starting the Cadet Training Program (CTP). The current study was designed to: (1) obtain baseline levels of mental health knowledge, stigma against peers in the workplace, and service use intentions in RCMP cadets; (2) determine the relationship among mental health knowledge, stigma against peers in the workplace, and service use intentions among RCMP cadets; (3) examine differences across sociodemographic characteristics; and (4) compare cadets to a sample of previously surveyed serving RCMP. Participants were RCMP cadets (n = 772) starting the 26-week CTP. Cadets completed questionnaires assessing mental health knowledge, stigma against coworkers with mental health challenges, and mental health service use intentions. RCMP cadets reported statistically significantly lower levels of mental health knowledge (d = 0.233) and stigma (d = 0.127), and higher service use intentions (d = 0.148) than serving RCMP (all ps < 0.001). Female cadets reported statistically significantly higher scores on mental health knowledge and service use and lower scores on stigma compared to male cadets. Mental health knowledge and service use intentions were statistically significantly positively associated. For the total sample, stigma was inversely statistically significantly associated with mental health knowledge and service use intentions. The current results indicate that higher levels of mental health knowledge were associated with lower stigma and higher intention to use professional mental health services. Differences between cadets and serving RCMP highlight the need for regular ongoing training starting from the CTP, designed to reduce stigma and increase mental health knowledge. Differences between male and female cadets suggest differential barriers to help-seeking behaviors. The current results provide a baseline to monitor cadet mental health knowledge and service use intentions and stigma as they progress throughout their careers.

Objectives: Reports of racial discrimination against Asian Americans has surged during the Covid-19 pandemic. The goal of this paper is to provide an overview of Asian Americans' mental health status during Covid-19 and an assessment of the barriers and disparities within Asian Americans mental health service delivery. Methods: Four databases and the publisher The Lancet were chosen to search journal articles regarding Asian Americans' mental health status and service use. The increasing racial discrimination was examined as a critical parameter to assess Asian Americans' mental health status. The accessibility of mental health services and the responsiveness of Asian Americans appropriate needs were studied by gender, subgroups and other moderating factors. Results: A total of 49 studies met the review criteria. Asian Americans encountered increasing coronavirus-related discrimination and presented a deteriorated mental health state during Covid-19. A high rate of informal/non-professional mental health service use and an overall low rate of professional service use were found in Asian Americans. Inaccurate self-reporting and diagnosis, language barriers, financial difficulty, and the lack of health insurance and education are contributing factors of the unmet needs of Asian Americans when seeking mental health services. Conclusions: Possible reasons that explain Asian Americans mental health issues reside in socio-economic factors such as cultural differences, limited English proficiency, and low prevalence rates of health insurance and education. Evidence-based policies against racism, inter-ethnic connections, and cultural identity understanding are needed on national and community levels to address Asian hate crimes and discrimination. Virtual mental health services, culture-specific forms of intervention and treatment responses and appropriate education about Asian American mental health issues can help improve Asian Americans' mental health conditions.

The association of general medical illness and mental health service use among older adults from racial-ethnic minority groups is an important area of study given the disparities in mental health and general medical services and the low use of mental health services in this population. The purpose of this report is to describe the impact of comorbid general medical illness on mental health service use and expenditures among older adults and to evaluate disparities in mental health service use and expenditures in a racially-ethnically diverse sample of older adults with and without comorbid general medical illness. Data were obtained from the Medical Expenditure Panel Survey (years 2004-2011). The sample included 1,563 whites, 519 African Americans, and 642 Latinos (N=2,724) age ≥65 with probable mental illness. Two-part generalized linear models were used to estimate and compare mental health service use among adults with and without a comorbid general medical illness. Mental health service use was more likely for older adults with comorbid general medical illness than for those without it. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid general medical illness increased the likelihood of mental health service use by older whites and Latinos. However, the presence of comorbidity did not affect racial-ethnic disparities in mental health service use. This study highlighted the important role of comorbid general medical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial-ethnic minority groups.

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study

Predictors of Likelihood and Intensity of Past-Year Mental Health Service Use in an Active Canadian Military Sample

It is known that youth engaged in the juvenile justice system show high rates of psychiatric disorders. However, little is known about the course of those disorders over time, or about mental health service use on the part of children and families during justice system involvement. Boys and girls recruited from their first contact with juvenile court (n=75), at a mean age of 13.6 years, completed three waves of interviews, each consisting of a structured clinical interview and questionnaires regarding service use, family functioning, parental burden, parental psychopathology. High rates of psychiatric disorders were evident. Three quarters (n = 56) met criteria for a mood, anxiety or behavioral disorder by parent or child report. Despite the high prevalence of mental health concerns, relatively few youth (approximately 20%) were involved in mental health services in follow-up waves. The presence of ODD and higher levels of family communication problems were associated with involvement in mental health services. Although parents experienced burden associated with their child's mental health problems, burden was not a strong correlate of help-seeking. Mental health problems declined from the point of initial involvement with juvenile justice; only ODD symptoms showed stability over time. Low rates of engagement in mental health services are found for juveniles subsequent to their first contact with juvenile justice. ODD and family communication problems most influenced service engagement, while burden due to mental health problems did not. The results provide potential targets for efforts to enhance parental motivation towards service engagement.

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

The current study examined reports of stigma toward mental health services, depressive symptoms, flourishing, and mental health service use among a sample of 8,285 college students across the United States who completed the Healthy Minds Study. The study aimed to: (a) identify profiles of public and personal stigma against mental health service utilization, and (b) examine the demographic predictors of stigma group membership and mental health service utilization. Latent profile analyses revealed 3 distinct groups based on public and self-stigma (i.e., "High Self, High Public Stigma," "Average Self, High Public Stigma," and "Low Self, Low Public Stigma"). Subsequent analyses examined demographic characteristics and mental health across the 3 groups. Results indicated significant differences in age, gender, race/ethnicity, mental health, and mental health service use across the 3 groups. Results further showed that students with high perceived need for mental health services, identifying as male or Asian, and belonging to the "High Self, High Public Stigma" group had lower likelihood of seeking mental health services in the past year. Implications for future research and clinical practice are discussed. (PsycINFO Database Record

Mental health service use among American Red Cross disaster workers responding to the September 11, 2001 U.S. terrorist attacks

There is limited empirical evidence on the extent to which perceived public stigma prevents individuals from using mental health services, despite substantial recent policy interest in this issue. This study investigated associations between perceived public stigma and mental health care seeking. This study used cross-sectional survey data from a representative sample of undergraduate and graduate students (N=2,782) at one university. A five-item scale was used to assess perceived public stigma toward mental health service use. Perceived need for help in the past 12 months and current presence of depressive and anxiety disorders were also assessed. Perceived stigma was higher among males, older students, Asian and Pacific Islanders, international students, students with lower socioeconomic status backgrounds, and students with current mental health problems. Perceived stigma was also higher among those without any family members or friends who had used mental health services and among those who believed that therapy or medication is not very helpful. Perceived stigma was negatively associated with the likelihood of perceiving a need for mental health services, but only among younger students. Among those with probable depressive or anxiety disorders, there was no evidence that perceived stigma was associated with service use. These results suggest that, at least in this population, perceived stigma may not be as important a barrier to mental health care as the mental health policy discourse currently assumes.

Opportunities in mental health services research.

PurposeStudies have shown positive housing retention and quality of life outcomes in moving on initiatives (MOIs). However, less is known about how movers’ health service use changes post-move. This paper aims to explore physical and mental health service use over time for participants in New York City’s MOI program.Design/methodology/approachThis paper uses data collected at baseline, 12-months post move and 24-months post move to explore patterns in mental and physical health service use and their association with mental and physical health status for participants (N = 41). Health status was measured with the Medical Outcomes Study Short Form Survey Instrument.FindingsThree mental health service use patterns emerged: service use at all time points, inconsistent service use across time points and no service use at any time point. Significant group differences in mental health were found at baseline and 12 months. Two physical health service use patterns emerged: service use at all three time points and inconsistent service use across time points. Significant group differences were found in mental health at 12 and 24 months.Originality/valueThis study showed that physical and mental health service use varied slightly over time for participants, with the majority of service use being for outpatient/non-acute care. The findings also point to possible relationships between service use and mental health status. Positive and negative implications of these findings are framed within the broader context of PSH and MOI goals.

Rapid economic growth and social change in China in recent years have been accompanied by increased rates of mental health problems among the country's adolescents. This study examined rates of mental health service use and associated factors among Chinese adolescents. A survey of 1,891 high school students in grades ten through 12 from three high schools in Shantou, China, was conducted in 2009. Measures of mental health status, service need (perceived and objective), mental health service use, and informal help seeking were obtained. Twenty-five percent of the adolescents reported a perceived need for the services of a mental health professional. Only 5% of the sample had used school-based mental health services and only 4% had used non-school-based services. Three factors emerged as independently associated with adolescent use of both school-based and non-school-based services: perceiving a need for mental health services, having turned to a teacher for help, and having turned to a relative other than one's parents for help. Male gender, being a 12th grader, and being an only child were independently associated with use of school-based services only, whereas a suicide attempt and having turned to one's parents for help were independently associated with use of non-school-based services. Findings indicate a high level of unmet need for mental health services among Chinese adolescents and highlight the need to improve the mental health knowledge of parents, teachers, and other significant individuals in adolescents' lives to facilitate adolescents' access to the mental health services that they need.