Formal Help Research Articles

Rabbinical response to domestic violence: A qualitative study

ABSTRACTClergy, including Rabbis, though not specifically trained to provide domestic violence (DV) counseling, are often now considered formal helpers because of the active role they have taken in addressing DV issues among congregants. Participants were presented with two vignettes about couples engaged in conflict and asked to describe how they would respond to each. The Rabbis in this sample, while willing and desiring to help, also talked much about their discomfort with providing advice, as they did not feel qualified to help or to provide advice. Implications for social work practitioners and educators will be discussed.

Influence of Intimate Partner Violence Severity on the Help-Seeking Strategies of Female Victims and the Influence of Social Reactions to Violence Disclosure on the Process of Leaving a Violent Relationship

This article uses data from the 2015 Spanish Survey on Violence Against Women, a nationally representative survey of 10,171 women aged 16 or above, to analyze the relationship between the severity of intimate partner violence and formal and informal help-seeking strategies, the link between the severity of abuse and the reasons for not seeking formal help, and the influence of social reactions to violence disclosure on the process of leaving a violent relationship. The results show that in Spain, many abused women disclose violence and seek help. However, the severity of the violence strongly determines their help-seeking strategies, especially the search for formal help. Women who experienced less severe incidents tended to minimize their importance and did not seek formal help. For informal help, the differences were smaller, and a high proportion of women talked about the abuse with someone within their social environment, regardless of the severity of the suffered violence. A supportive reaction to violence disclosure had a strong and positive influence on the process of leaving the abusive relationship. The implications of these findings for the design of public policies, education, and awareness-raising campaigns are discussed.

A population-based study of help seeking and self-medication among trauma-exposed individuals.

Epidemiologic studies of trauma highlight the imbalance between prevalence of psychiatric diagnoses and help seeking. We investigated prevalence and correlates of help seeking and self-medication in Norwegian adults with trauma history with a focus on common posttrauma outcomes of posttraumatic stress disorder (PTSD) and substance use disorders (alcohol or drug). Participants reporting at least 1 PTSD symptom (n = 307) were asked if they consulted with a doctor/another professional (help seeking) or used drugs/alcohol (self-medication) for trauma-related problems. PTSD, alcohol abuse or dependence (AUD), and drug use or dependence (DUD) were assessed via structured diagnostic interviews. Help seeking and self-medication were endorsed by 37.4% and 10.4% of the sample, respectively. As compared to the full sample, help seeking was endorsed at a greater rate in individuals with PTSD (χ2 = 8.59, p = .005) and at a lower rate in those with AUD (χ2 = 7.34, p < .004). Self-medication was more likely to be endorsed by individuals with PTSD than without PTSD (χ2 = 25.68, p < .001). In regression analyses, PTSD was associated with increased likelihood of self-medication (odds ratio [OR] = 4.56) and help seeking (OR = 2.29), while AUD was associated with decreased likelihood of help-seeking (OR = .29). When self-medication was included as a predictor, PTSD was no longer associated with help seeking, although AUD remained inversely associated. PTSD and AUDs have a nuanced relationship with formal help seeking as well as the use of substances to cope. Trauma-exposed individuals are likely engaging in adaptive and maladaptive coping strategies, the latter of which may be compounding distress. (PsycINFO Database Record

Identifying barriers to mental health help-seeking among young adults in the UK: a cross-sectional survey.

Despite the high prevalence and burden of mental health problems among young people, studies have suggested that they infrequently seek professional help. Understanding the barriers to help-seeking is an important step towards facilitating early access to mental health services and improving psychological wellbeing. To investigate why young adults may choose not to seek any support for an emotional or mental health difficulty. A cross-sectional online survey of young adults aged 18-25 from the general UK population. The survey consisted of an anonymous questionnaire that measured psychological distress, help-seeking preferences, and barriers to accessing help, which included the Barriers to Access to Care Evaluation (BACE) scale and an open-ended question to explore reasons for not seeking help in the past. Qualitative feedback was analysed using thematic analysis. Overall, 35% of participants (n = 45) who reported having an emotional or mental health difficulty did not seek any formal or informal help. The thematic analysis revealed that stigmatising beliefs, difficulty identifying or expressing concerns, a preference for self-reliance, and difficulty accessing help were prominent barrier themes among responders. Young adults experiencing psychological distress may struggle to access help from others. Stigma and negative perceptions surrounding mental health and help-seeking may explain why young people are reluctant to approach others for help. Improving public awareness of the services and resources that are available, as well as screening for psychological distress in primary care services, may be necessary to improve mental wellbeing among young adults.

Addressing Intimate Partner Violence With Latina Women: A Call for Research

Latina women, especially those who are immigrants, have an increased vulnerability to intimate partner violence, yet they also have a low rate of using formal services (i.e. health care and legal services). Existing research focused on Latina women’s help seeking for intimate partner violence has identified multiple factors, such as the presence of children, cultural values, and type of victimization, that influence women’s formal help seeking. Immigrant Latina women in particular commonly report many barriers to formal services; however, heterogeneity and nuanced patterns of help seeking exist across Latina survivors. While research has focused mainly on understanding factors that are barriers to help seeking by Latina women, there is an overwhelming dearth of research about interventions and factors that facilitate effective help-seeking experiences for Latina IPV survivors. In an effort to improve Latina IPV survivors’ access to services, we examine the gaps in research across dimensions of access to care (i.e. availability, affordability, accessibility, accommodation, and acceptability of services). Research within each of these facets of access to services for Latina survivors is lacking. This brief commentary illustrates the sparse data to inform evidence based interventions for Latina IPV survivors and is a call for research in order to determine best practices and to move the knowledge base from the vast descriptive base to evidence-based, culturally appropriate and acceptable interventions.

Improving care for victims: a study protocol of the evaluation of a centre for sexual and family violence

IntroductionWorldwide, sexual and family violence are highly prevalent problems. Victims of sexual and family violence often do not seek formal help in the acute phase. When they do seek help,...

Interfacing informal and formal help systems: Historical pathways to the Meitheal model

AbstractMeitheal is a national practice model which aims to ensure that the needs and strengths of children and their families are effectively identified, understood and responded to in a timely manner. The aim of this article is to consider some of the notable learning from the historical background and context in the development of children and family services. The discussion draws together four interrelated themes: the interaction between the voluntary and statutory systems, the interface of family and child oriented services, balancing formal and informal responses to child welfare, and early intervention and prevention services. The complexity of this endeavour is emphasised through identifying the core considerations required at the levels of Bronfenbrenner’s ecological model. The article concludes with a commentary on how the future of child welfare in Ireland may be influenced through this attempt at a reorientation of children and family services towards early intervention, prevention, partnership and participation.

Using an emergency response infrastructure to help women who experience gender-based violence in Gujarat, India.

ProblemMany women who experience gender-based violence may never seek any formal help because they do not feel safe or confident that they will receive help if they try.ApproachA public–private-academic partnership in Gujarat, India, established a toll-free telephone helpline – called 181 Abhayam – for women experiencing gender-based violence. The partnership used existing emergency response service infrastructure to link women to phone counselling, nongovernmental organizations (NGOs) and government programmes.Local settingIn India, the lifetime prevalence of gender-based violence is 37.2%, but less than 1% of women will ever seek help beyond their family or friends. Before implementation of the helpline, there were no toll-free helplines or centralized coordinating systems for government programmes, NGOs and emergency response services.Relevant changesIn February 2014, the helpline was launched across Gujarat. In the first 10 months, the helpline assisted 9767 individuals, of which 8654 identified themselves as women. Of all calls, 79% (7694) required an intervention by phone or in person on the day they called and 43% (4190) of calls were by or for women experiencing violence.Lessons learntDespite previous data that showed women experiencing gender-based violence rarely sought help from formal sources, women in Gujarat did use the helpline for concerns across the spectrum of gender-based violence. However, for evaluating the impact of the helpline, the operational definitions of concern categories need to be further clarified. The initial triage system for incoming calls was advantageous for handling high call volumes, but may have contributed to dropped calls.

Knowledge, Attitudes and Practices towards Malaria in Mbonge and Kumba Sub-divisions in Cameroon

Aims: To assess knowledge, attitudes and practices regarding transmission, prevention and treatment of malaria in four rural settings and one urban neighborhood. Study Design: Cross-sectional descriptive survey carried out in Cameroon. Place and Duration of Study: This study took place in rural Mbonge division (Pete, Marumba-1, Marumba-2, and Bai Manya) and one neighbourhood in a urban town (Kumba), South West region of Cameroon between May and July 2015. Methodology: 227 participants (118 males and 109 females) took part in this study. Information was collected with a pre-tested questionnaire with mostly closed-ended questions and a few open-ended questions. Questions focused on socio-demographic parameters, knowledge attitudes and practices with respect to malaria. Data was analysed using SPSS Statistics version 22 (SPSS Inc. IBM). p values <0.05 were considered significant. Results: 118(52%) males and 109(48.0%) females were part of this study. Malaria was listed as the most common disease in all the settings without exception. In the rural settings, respondents related transmission of malaria to mosquito as follows: 53.3% in Pete, 70.7% in Marumba-2, 53.3% in Marumba-1, 65% in Bai Manya. In the urban setting, Kumba, 85.4% of respondents said malaria was caused by a mosquito bite. Other factors listed as ways in which malaria was transmitted include: using the same cup, dirtiness, dirty water, through drugs, bad environment, wind, sun and red fly. Mosquito nets were predominantly used for malaria prevention. These were obtained mostly as government donations. Respondents sought formal help mostly after 48 hours from onset of symptoms. Self-medication was commonly practiced irrespective of setting. Conclusion: This study has shown that participants in Mbonge sub-division and Buea-road Kumba have gaps in knowledge about malaria transmission, prevention and treatment. There is a need for tailored health-education intervention building on formal and local knowledge to reduce the imposed burden of malaria.

Welfare state and individual expectations of economic support: A comparison of Norway and Spain

This research investigates individual expectations of economic support from different sources: partner, family, friends and formal help. Using data from the International Social Survey Programme (ISSP) the study compares Norway, as representative of the Scandinavian model, and Spain, as representative of the Mediterranean model. The findings confirm that family plays a more important role as a source of economic support in Spain while formal help is far more important in Norway. Moreover, gender and life course have a significant impact on expectations of economic support in both countries, although the differences do not go in the same direction. Women expect more financial support from their partners than men do in Norway, while Spanish women tend to rely more on support from their families. Regarding life course, although expectations of economic support from the family are higher for young and older people in both countries, the life-cycle effect is stronger in Spain.

Suicide and the Internet: Changes in the accessibility of suicide-related information between 2007 and 2014

BackgroundFollowing the ongoing concerns about cyber-suicide, we investigate changes between 2007 and 2014 in material likely to be accessed by suicidal individuals searching for methods of suicide. Methods12 search terms relating to suicide methods were applied to four search engines and the top ten hits from each were categorised and analysed for content. The frequency of each category of site across all searches, using particular search terms and engines, was counted. ResultsKey changes: growth of blogs and discussion forums (from 3% of hits, 2007 to 18.5% of hits, 2014); increase in hits linking to general information sites – especially factual sites that detail and evaluate suicide methods (from 9%, 2007 to 21.7%, 2014). Hits for dedicated suicide sites increased (from 19% to 23%), while formal help sites were less visible (from 13% to 6.5%). Overall, 54% of hits contained information about new high-lethality methods. LimitationsWe did not search for help sites so cannot assess the balance of suicide promoting versus preventing sites available online. Social media was beyond the scope of this study. ConclusionsWorking with ISPs and search engines would help optimise support sites. Better site moderation and implementation of suicide reporting guidelines should be encouraged.

Mental Health Literacy in Emerging Adults in a University Setting: Distinctions Between Symptom Awareness and Appraisal

Despite the high prevalence of mental health concerns in university populations, students are unlikely to seek formal help. The current study examined help-seeking behaviors among emerging adults in a university setting using a mental health literacy framework. Responses from 122 university undergraduates were examined. Students ranged in age from 17 to 25 years ( M = 20.67 years, SD = 2.03 years). Quantitative data were collected to determine students’ knowledge and use of campus services and to compare students’ awareness and appraisal of common mental health symptoms. Narrative data were collected to identify the key symptoms that are appraised to be “early warning signs” versus “early action signs,” and to identify barriers and facilitators to help-seeking. Mental health symptoms were more likely to be assessed as warning signs than signs warranting action. Lack of knowledge and stigma were barriers to help-seeking, while urging from family and friends, increased knowledge, and confidentiality were identified as facilitators to help-seeking. Emerging adults in a university setting tend to make distinctions between warning and action signs. Although demonstrating good awareness of the signs of declining mental health, students may respond reactively rather than proactively to symptoms.

Predictors of help-seeking for gambling disorder from the transtheoretical model perspective

Few gamblers seek treatment despite the severe negative impacts prolonged gambling can have. Research surrounding the predictors of help-seeking for problem gambling is often retrospective in design and inconsistent in findings. This study prospectively investigated whether transtheoretical model (TTM) constructs (readiness to change, ratings of temptations and self-efficacy, decisional balance and processes of change) have utility in predicting help-seeking among disordered gamblers. Community-recruited disordered gamblers (N = 136; 47.06% female; mean age = 44.5 years, SD = 12.8; 80.1% Caucasian) completed three assessments of TTM constructs, help-seeking behaviour, gambling problem severity, and other potential predictors of help-seeking. Informal help-seeking was common (6-month = 71.1%; 12-month = 79.6%); however, formal help-seeking was relatively infrequent (6-month = 22.7%; 12-month = 35.1%). Logistic regression demonstrated that gambling problem severity and the social liberation process of change (i.e. endorsing public awareness of gambling problems or non-gambling role models) consistently predicted formal help-seeking. Helping relationships and counter-conditioning (i.e. engaging in other activities as a replacement for gambling) processes of change uniquely predicted informal help-seeking at 12 months. Individuals most likely to seek formal help have greater problem severity and greater readiness to address problems. Seeking informal help is less predictable but more common.

Not ageing in place: Negotiating meanings of residency in age-related housing

PurposeThis article explores the experience of residing in age-related housing. The focus is on the negotiations around the multiple meanings assigned to place of residency among older people — in a situation where the official policy objectives of growing old in one's own home are not achieved. Design and methodsNarrative analysis is employed to study the experiences of older people aged 75 or older living in special types of housing due to actual or anticipated difficulties associated with age. The interviews are part of a larger body of data gathered in MOVAGE Moving in Old Age: Transitions in Housing and Care research project. FindingsThe storyworld was structured by the romantic canonical narrative associated with the policy of ‘ageing in place’; growing old at home is idealised and moving is constructed as a disruption. This breach was resolved through explaining deviance from canonical expectations by causes constructed as legitimate, through encountering trouble by constructing oneself as a non-typical resident, and through creating counter stories of natural transitions and choices. As a result, despite the commonly negative meanings associated with the residency in age-related housing, positive storylines respecting values embedded in the canonical narratives of home and endurance were achieved. ImplicationsA living environment that is experienced as suitable, and that has adequate formal help available, supports and enables wellbeing and independence. This is true within age-related housing as well as in other forms. Thus, even though the important meaning of a long-term home should continue to be acknowledged, various other kinds of forms of housing should be made available in order to enhance older people's sense of security and feeling that they are autonomous, independent agents in their everyday life in accordance with their subjective life experiences.

Relationship between individual characteristics, neighbourhood contexts and help-seeking intentions for mental illness

ObjectiveEncouraging help-seeking for mental illness is essential for prevention of suicide. This study examined the relationship between individual characteristics, neighbourhood contexts and help-seeking intentions for mental illness for the purpose...

Quitting Attempts and Utilisation of Smoking Cessation Aids among Smokers in Germany: Results from the 2012 Epidemiological Survey of Substance Abuse

Aim: This study presents current data on smoking cessation and usage of smoking cessation aids among smokers in a representative sample of German smokers. Data of 2012 will be compared with data of the year 2000. Methods: The sample of the 2012 Epidemiological Survey of Substance Abuse (ESA) was randomly drawn from population registers and consisted of 9 084 individuals aged 18-64 years. A mixed-mode design including questionnaires, telephone and Internet interviews was applied. The response rate was 53,6%. Number of smoking cessation attempts and usage of smoking cessation aids were assessed among actual and former smokers. Results: Of the 4 261 persons who had smoked in their lifetime 54,1% are actual and 45,9% former smokers. Among actual smokers 64,5% have tried to quit smoking at least once; 24,3% within the last 12 months. Quit attempts were mostly undertaken without formal help (53,7%). Users of smoking cessation aids report that they used social support (22,6%), self-help material (13,3%), nicotine replacement products (11,3%) and E-cigarettes (8,4%). Conclusions: Compared to the year 2000 the number of former smokers has increased. While the number of smoking cessation attempts among smokers is unchanged, more smokers use smoking cessation aids. Using E-cigarettes for smoking cessation is becoming more important.

EDUCACIÓN PARENTAL Y COMPETENCIAS PARENTALES PARA PREVENIR EL ABANDONO ESCOLAR TEMPRANO

INTRODUCTION. The programme “Living the adolescence in the family”, adapted for families whose children are at risk of Early School Leaving (ESL), shows its effectiveness in promoting parental competences. In the same way, one of the necessary educational answers for reducing ESL is to work with these families. METHOD. The programme was implemented in 48 High schools in the Canary Islands, with 60 teachers working on the programme and a total of 654 mothers, of which 438 belonged to the intervention group and 216 to control group. The children of these families were also assessed, specifically 538 students, of which 372 were children of the mothers involved in the programme and 166 belonged to the control group. Two questionnaires were used: a questionnaire on the perception of parental competences. Maternal version and the Questionnaire of personal competences of the minor (teacher’s version). These questionnaires were applied simultaneously to both groups, at the beginning and at the end of the programme. RESULTS. The mothers of the intervention group significantly improved their competences in personal development, resilience and those competences related to seeking formal help. In the same way, comparing the results to those of the control group, the mothers involved in the programme have a significantly higher level in all parental competences, with the exception of the competence related to the seeking informal help. Concerning the children of the participating mothers, they improved their competences related to personal development , resilience and cognitive skills. Comparing these with the control group, they had significantly higher levels in all the assessed personal competences. DISCUSSION. Group parental education with experiential methodology is a very effective psychoeducational resource to achieve significant changes in parental competences.

Living alone in Alzheimer's Disease – the influence of functional impairment

Background: A large number of individuals with Alzheimer’s disease (AD) live alone and receive little or no help from family members, which implies an additional pressure on the increasing societal costs of dementia care. Their adult children, if any, might have very limited ability to assist by providing informal help because of social structural changes, such as full-time work for most women and sometimes a place of residence located far away from the parents’ home. About half of the informal help received has been reported to consist of surveillance, diversion from repetitive or dangerous activities, and management of behavioral disturbances. Lack of help in monitoring these expressions of AD might lead to safety issues for individuals who live alone. Moreover, difficulties in detecting increasing impairments in their cognitive and functional abilities could affect negatively the opportunities of solitary-living individuals to receive necessary formal help. Living alone with dementia is also a strong factor for nursing home placement. This study aimed to describe the cognitive and functional abilities of solitary-living AD patients, as well as the potential predictors of usage of community-based home help services (HHS). Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, open, nonrandomized, multicenter study that was undertaken the investigation of the long-term effectiveness of cholinesterase inhibitor (ChEI) treatment from various perspectives, such as cognition, activities of daily living (ADL), and usage of community-based services. Among the 1,258 outpatients with a clinical diagnosis of probable or possible AD in the SATS, 1,021 had mild-to-moderate AD (Mini-Mental State Examination (MMSE) score, 10–26) at the start of ChEI therapy (baseline). Three hundred fifty-five (35%) of these individuals were living alone at the baseline, with or without HHS, and were included in the current study. Patients were assessed regarding cognitive ability (MMSE), functional capacity (Instrumental Activities of Daily Living (IADL) scale and Physical Self-Maintenance Scale (PSMS)), and the amount of HHS (hours/week), at baseline and every 6 months for a total period of 3 years. Binary logistic regression was used to determine the individuals’ characteristics that affected the use of HHS at baseline. The following potential predictors were investigated: gender, APOE 4 carrier status, years of education, illness duration, age, number of medications, and cognitive and functional abilities at baseline. Results: At the start of ChEI therapy, 267 (75%) of the solitary-living patients were in the mild stage of AD (MMSE score, 20–26). HHS was used by 85 (32%) of the mild and 48 (55%) of the moderate (MMSE, 10–19) AD patients (P < 0.001). The mean hours of HHS used per week was 5.7 (95% confidence interval (CI), 5.0–6.5); no difference in this parameter was detected among the disease stages. The IADL capacity was already markedly impaired at baseline: 50–65% of the individuals were dependent on assistance to perform these activities (IADL score, 2–5). Regarding basic ADL, most patients were able to manage themselves independently, with the exception of physical ambulation (almost 60% of individuals needed some assistance; PSMS score, 2–5). A significant difference in mean IADL score at the start of ChEI treatment was observed between the mild and moderate AD patients: 14.6 points (95% CI, 13.9–15.2) vs 19.2 points (95% CI, 18.1–20.3; P < 0.001). The corresponding PSMS scores were 7.5 points (95% CI, 7.2–7.7) vs 8.9 points (95% CI, 8.2–9.6; P < 0.001). No difference in age or number of medications at baseline was found among the disease stages. In a logistic regression model, the variables IADL score (OR, 1.27; 95% CI, 1.17–1.38; P < 0.001) and number of medications at baseline (OR, 1.19; 95% CI, 1.07–1.33; P = 0.002) correctly classified 80.2% of the patients with AD regarding whether they used HHS at the start of ChEI therapy. After 3 years of ChEI treatment, 89 AD patients (25%) were still living alone in their own home. Of those, 65 individuals used a mean of 9.5 hours (95% CI, 7.8–11.3) of HHS per week. The cognitive ability of the solitary-living patients varied appreciably, but 80–90% could not carry out IADL tasks independently. In addition, more than 50% of the individuals needed assistance in performing the basic ADL items of grooming and physical ambulation. Conclusions: A substantial number of AD patients, predominantly females, with severe cognitive and functional impairments live alone, which might lead to safety risks for these vulnerable individuals. The amount of HHS used did not reflect disease severity. Functional, but not cognitive, ability predicted the need for home help, suggesting that HHS meets the needs related to cognitive deterioration to a lesser extent. Increased knowledge about how community-based services can better accommodate the care needs of recipients with cognitive impairment is essential. (Less)

Technology-Based Interventions and Reducing the Burdens of Mental Illness: Perspectives and Comments on the Special Series

This series illustrates excellent advances in the use of technology to deliver psychological treatments. My comments place technology-based treatments in the context of current evidence-based psychotherapies and focus on the extent to which technology can expand the reach of psychosocial interventions. I discuss criteria for the development of novel treatment methods so that our interventions can reach individuals who could profit from psychological services but who currently receive no formal help. Technology-based methods of delivery have excellent benefits and as they continue to be evaluated it would be valuable not only to collect the usual outcome data for individual clients but also to examine system-level outcomes to see whether our interventions in fact reach more of the underserved who are in need of psychological services.

Encouraging Help Across Projects

Companies struggle with timely project execution despite employing sophisticated management methods. Although help across projects is critical for time performance, it has not been explicitly incorporated into project management (PM) systems. We model a PM system, based on an innovative real-life practice, that both incorporates and shapes project managers’ helping behavior. A help process is at the core of this system, in which project managers may ask for and provide help while top management facilitates such exchanges. We find that companies should take a nuanced approach when designing help exchange and time-based incentives in tandem. A company that faces high project rewards after delays and highly effective help can benefit from inducing help because doing so enables the pursuit of projects it might abandon if delayed or even at the outset. The formal help process delivers value by creating and exploiting interdependencies between projects. These interdependencies allow project prioritization by inducing different effort levels in otherwise identical projects. A help process also allows the company to “tune” the timing of efforts by front-loading or back-loading project work. The benefits of a help system accrue through cost efficiencies, increased probability of success under help, and intertemporal incentive effects that encourage early efforts. However, because the help process creates the opportunity for free riding, a help system is not always recommended and a no-help system may perform better, especially when there are low project rewards after delay and low opportunity costs for project work. This paper was accepted by Serguei Netessine, operations management.