History Of Service Use Research Articles

Public trust of social workers in Sweden: A repeated cross-sectional study

Summary Public trust towards social workers is essential for legitimacy and accessibility of the social services, as well as for help-seeking behaviour. However, research on public trust towards the social services is lacking. The aim of this study was to describe the extent to which Swedish citizens trust social workers who work within the social services, and to explore patterns in level of trust based on demographic factors and history of service use. The analysis draws on survey data from 2010, 2014, and 2018 (total n = 4975). Logistic regressions were conducted to assess associations between predictor variables and trust. Findings On average, 40 percent of the general public reported a high level of trust regardless of year. Approximately 20 percent reported a low level of trust. The results indicate a slight decrease in trust between 2010 and 2014 but not between 2014 and 2018. No gender or age differences were identified. Low income level, being related to a service user, and low level of education were all associated with low level of trust. Applications Our findings provide new insights regarding variations in levels of trust in the general population. Economically and educationally disadvantaged groups as well as those related to a service user are more likely to report low trust than their more advantaged counterparts. To strengthen legitimacy and accessibility, these groups should be prioritised in trust-enhancing efforts. Still, reports of high trust were predominant, indicating that social workers are generally perceived as trusted providers of social support.

Caregiver Perspectives on School Participation Among Students With Craniofacial Microsomia.

Importance: Knowledge of unmet school participation needs for students with craniofacial microsomia (CFM) can inform decisions regarding intervention support.Objective: To compare students with and without CFM on school participation (i.e., frequency, involvement, desire for participation to change) and caregivers’ perceptions of environmental support for participation in occupations.Design: Cross-sectional design using secondary analyses of a subset of data.Setting: Multisite cohort study.Participants: Caregivers of students with CFM (n = 120) and of students without CFM (n = 315), stratified by history of education- and health-related service use.Outcomes and Measures: School participation and environmental support, obtained with the Participation and Environment Measure–Children and Youth.Results: Significant group differences were found in frequency of school participation (effect size [ES] = −0.38, 95% confidence interval [−0.64, −0.12], p = .005), level of involvement (ES = −0.14, p = .029), and desired change (p = .001), with students with CFM exhibiting greater participation restriction than students without CFM and no history of service use. No statistically significant group differences were found in environmental support for participation in the school setting. Item-level findings showed statistically significant higher desire for participation to change in three of five school occupations (odds ratio = 1.77–2.39, p = .003–.045) for students with CFM compared with students without CFM and no history of service use.Conclusions and Relevance: The results suggest that students with CFM experience restriction in participation at school.What This Article Adds: Students with CFM may benefit from targeted school-based interventions to optimize their inclusion.

Veterans Crisis Line Callers With and Without Prior VHA Service Use

This study examines differences between Veterans with and without prior Veterans Health Administration service use who received a clinical referral from the Veterans’ Crisis Line. Differences between groups were identified using data taken from 13,444 calls and medical records. Approximately 91% of Veterans had a history of service use and 9% did not. Callers with prior service use were older, had more mental health disorders, made in-person contact more quickly, and used more outpatient mental healthcare. Those without prior service use were younger, had more mental health problems, and presented for care later. Callers with suicide-related diagnoses had high rates of service contact. These groups represent different subpopulations with unique healthcare needs and practices.

Child Mental Health Services and Psychotherapy Attitudes Among Asian Indian Parents: An Exploratory Study.

This exploratory study examined how parents' past personal use of psychotherapy related to perceived stigma and attitudes on intentions to use child mental health services among Asian Indian parents living in the United States. Participants were 89 Asian Indian parents recruited from 2009 to 2010 through a convenience sample. Descriptive analyses showed that Asian Indian parents reported similar attitudes as their American counterparts, but more stigma than European American and Latino parents. Using t-tests, results indicated that Asian Indian parents who previously used psychotherapy reported more positive attitudes than parents with no history of service use. Additionally, findings indicated that mothers reported more openness to seeking services than fathers. Finally, psychotherapy attitudes significantly predicted parents' intentions to seek services for their child in the future. Implications for research, practice, and policy are discussed.

Parent and family factors associated with service use by young people with mental health problems: a systematic review.

To conduct a systematic review of parent and family factors associated with service use for young people with mental health problems, to inform early intervention efforts aimed at increasing service use by young people. A systematic search of academic databases was performed. Articles were included in the review if they had: a sample of young people aged between 5 and 18 years; service use as the outcome measure; one or more parental or family variables as a predictor; and a comparison group of non-service using young people with mental health problems. In order to focus on factors additional to need, the mental health symptoms of the young person also had to be controlled for. Stouffer's method of combining P-values was used to draw conclusions as to whether or not associations between variables were reliable. Twenty-eight articles were identified investigating 15 parental or family factors, 7 of which were found to be associated with service use for a young person with mental health needs: parental burden, parent problem perception, parent perception of need, parent psychopathology, single-parent household, change in family structure and being from the dominant ethnic group for the United States specifically. Factors not found to be related to service use were: family history of service use, parent-child relationship quality, family functioning, number of children, parent education level, parent employment status, household income and non-urban location of residence. A number of family-related factors were identified that can inform effective interventions aimed at early intervention for mental health problems. Areas requiring further research were also identified.

Lifetime and 12-month use of psychiatric services among U.S. Army National Guard soldiers in Ohio.

The individual and economic burden of psychiatric illnesses is substantial. Although treatment of psychiatric disorders mitigates the burden of illness, over half of military personnel with disorders do not receive mental health care. However, there is a paucity of research examining the relationship between psychiatric disorder categories and treatment-seeking behavior in representative military populations. This study aimed to document, by psychiatric disorder category, the annualized rate of Guard members who obtained psychiatric services and the factors associated with service utilization. Face-to-face clinical assessments were conducted between 2008 and 2012 to assess lifetime and current psychiatric disorders and recent psychiatric service use among 528 Ohio Army National Guard soldiers. An annualized rate of 31% of persons per year accessed psychiatric services between 2010 and 2012. Persons with substance use disorders had the lowest annualized rate of service use, and these were the only disorders not predictive of accessing services. Current mood disorder, current anxiety disorder, and lifetime history of service use were the strongest predictors of recent service use. There were no socioeconomic or other group predictors of psychiatric service use. About half of the soldiers who could benefit from mental health services used them, yet soldiers with substance use disorders were predominantly going untreated. There were no differences in treatment utilization by group characteristics, suggesting no systematic barriers to care for particular groups. Efforts to encourage broader adoption of treatment seeking, particularly among persons with substance use disorders, are necessary to mitigate psychiatric health burden in this population.

Screening for psychopathology in child welfare: the Strengths and Difficulties Questionnaire (SDQ) compared with the Achenbach System of Empirically Based Assessment (ASEBA)

Whilst children in child welfare suffer more psychopathology than their community peers, only a small percentage of them actually receive mental health care. Previous literature suggested that all children entering child welfare should be screened. This study evaluated whether the Strengths and Difficulties Questionnaire (SDQ) could be used for this purpose. The extended version of the SDQ and the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire were administered to parents and caregivers of 292 children in child welfare. Children older than 11 years also completed the SDQ self-report and the Youth Self Report (YSR). Furthermore, the child's history of service use was recorded and informants were asked if the actual care was sufficient. Inter-informant correlations for the scores from the SDQ and ASEBA were high and comparable or favoured the use of the SDQ (for parents and caregivers). Internal consistency was satisfactory to good. For all informants, high correlations were found between SDQ and ASEBA. Despite high scores on the SDQ, only 29% of the children had received mental health care. Service use was only correlated with the parent SDQ and the CBCL and TRF. Additional help, as requested by 21% of the parents and 37% of the caregivers, correlated moderately with the SDQ and ASEBA scores. Compared to the total difficulties score, the impact supplement is a better predictor of service use and the informant's request for additional help. This study illustrates that the Dutch version of the SDQ, similar to the English and German versions, has equal validity as the Dutch ASEBA for screening children. Caution is warranted when the SDQ is the only source of information for referrals to specialized care.

Design of Anonymous Attribute Authentication Mechanism

Privacy remains an issue for IT services. Users are concemed that their history of service use may be traceable since each user is assigned a single identifier as a means of authentication. In this paper, we propose a perfectly anonymous attribute authentication scheme that is both unidentifiable and untraceable. Then, we present the evaluation results of a prototype system using a PC and mobile phone with the scheme. The proposed scheme employs a self-blindable certificate that a user can change randomly; thus the certificate is modified for each authentication, and the authentication scheme is unidentifiable and untraceable. Furthermore, our scheme can revoke self-blindable certificates without leaks of confidential private information and check the revocation status without online access.

Childhood anxiety in rural and urban areas: Presentation, impact and help seeking

The current study investigated relationships between anxiety symptoms and residential location on problem recognition, service use and resultant impact. Clinically significant differences between rural and urban residents were not found on mental health symptoms, problem recognition or history of service use. Parent and family interference was found to be strongly linked to a child's anxiety level in both regions, with a child's negative experiences and direct interference on the child's life being attributed a smaller role. The impact of anxiety in rural areas was found to be higher than that experienced by similarly anxious children from urban areas. Finally patterns of service use were found to vary with a greater reliance on medical and school services in rural areas, and specialist and allied health services in urban areas. The findings together provide support for the development of specialised services for rural communities, and have implications for targeted education of parents to improve the number of children receiving appropriate help.

Impact of Permanent Supportive Housing on the Use of Acute Care Health Services by Homeless Adults

This analysis examined the impact of permanent supportive housing on the use of acute care public health services by homeless people with mental illness, substance use disorder, and other disabilities. The sample consisted of 236 single adults who entered supportive housing at two San Francisco sites, Canon Kip Community House and the Lyric Hotel, between October 10, 1994, and June 30, 1998. Eighty percent had a diagnosis of dual psychiatric and substance use disorders. Administrative data from the city's public health system were used to construct a retrospective, longitudinal history of service use. Analyses compared service use during the two years before entry into supportive housing with service use during the two years after entry. Eighty-one percent of residents remained in permanent supportive housing for at least one year. Housing placement significantly reduced the percentage of residents with an emergency department visit (53 to 37 percent), the average number of visits per person (1.94 to .86), and the total number of emergency department visits (56 percent decrease, from 457 to 202) for the sample as a whole. For hospitalizations, permanent supportive housing placement significantly reduced the likelihood of being hospitalized (19 to 11 percent) and the mean number of admissions per person (.34 to .19 admissions per resident). Providing permanent supportive housing to homeless people with psychiatric and substance use disorders reduced their use of costly hospital emergency department and inpatient services, which are publicly provided.

Characteristics of women engaged in treatment for trauma and co‐occurring disorders: Findings from a national multisite study

AbstractUsing data from a common cross‐site protocol administered at study enrollment, in this article we examine key characteristics of 2,729 participants in the Women, Co‐Occurring Disorders and Violence Study (WCDVS), including demographics, physical health, mental health, substance abuse, trauma experiences, parenting status, and past history of service use. These data are important because they represent the first federal initiative that addresses the significant lack of appropriate services for women with co‐occurring substance use and mental health disorders who have experienced trauma. Study findings reveal a very vulnerable population with extensive histories of abuse and substantial physical and mental health service needs. Data suggest a pressing need for increased availability of physical and mental health services capable of serving the complex needs of women with co‐occurring disorders and histories of interpersonal violence (physical and/or sexual abuse). Equally important are funding strategies to support needed services. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 429–443, 2005.

Racial Distribution of Dual-Diagnosis Clients in Public Sector Mental Health and Drug Treatment Settings

This study examined the racial distribution of dual-diagnosis clients in public sector residential mental health and drug treatment settings. In a sample of 179 dual-diagnosis clients, there was a significantly larger proportion of blacks in the drug treatment cohort than the mental health cohort. There were black-white differences in the types of substance use disorders found, but not in the types of mental health disorders. Diagnostic and drug use pattern differences did not account for the differential racial distribution in the two settings. However, the racial distribution was explained by the recent history of service use in the two treatment sectors. In the 2 years after study entry, blacks were less likely than whites to receive mental health treatment and whites were less likely than blacks to receive drug treatment. The implications of these findings regarding the appropriate treatment for dual-diagnosis blacks and whites in the public sector are discussed.

Parental Identification of Depression and Mental Health Service Use Among Depressed Adolescents

To examine a proposed pathway to service use among depressed adolescents, this study assessed the effects of (1) parental perceptions of family burden due to adolescents'depression, (2) adolescent-parent communication, (3) parents' depressive symptomatology, and (4) comorbid substance use disorders on parental identification of adolescent depression and use of mental health services. A two-stage screening process was used to recruit 44 depressed adolescents and their parents from pediatrics clinics between 1997 and 1999. Measures included structured diagnostic interviews with adolescents, the Child and Adolescent Services Assessment, the Child and Adolescent Functional Assessment Scale, the Beck Depression Inventory (for parents), and the Communication subscale of the Inventory of Parent and Peer Attachment. When history of service use was controlled, two predictors--parental perceptions of family burden and presence of a substance use disorder in the adolescent--were most strongly related to parental depression-identification. The data support the role of parental identification of depression as a mediator between the parent/adolescent characteristics and reports of mental health service use. Enhancing parents' abilities to identify and understand signs of depression may facilitate service use among depressed adolescents.