Mental Health Services Research Articles

Skills and knowledge therapists need to work with foster youth and families: According to key stakeholders in child welfare.

The current study relied on community-based participatory action research and qualitative methodology to explore the necessary skills and knowledge psychotherapists need to work effectively with foster youth and their families. In this study, the research team conducted interviews and focus groups with stakeholders (n = 48) in child welfare to learn how to support therapeutic relationships with foster youth clients. Using qualitative content analysis, the research team identified eight categories for needed knowledge and/or skills, such as collaboration with and inclusion of others in a client's system; flexibility and open-mindedness to individualize care follow the client's lead; and a solid understanding of trauma and attachment supported by therapist training and regular consultation specifically around foster care. These findings offer tangible suggestions for skills that psychotherapists can learn and practice in order to support beneficial mental health services for foster youth.

Use of Technology in the Delivery of College Mental Health Services: Opportunities and Challenges

ABSTRACT This article will examine the seismic impact that technology currently has and is likely to increasingly have on college mental health services, both direct and indirect. Numerous resources and suggestions are offered to assist college counseling center administrators and clinical staff make decisions aligned with best clinical, ethical, regulatory, and legal practice. The field is changing in truly profound ways and the future is highly uncertain.

Evaluating the effects of mental health e-learning on the knowledge, attitudes and practices of allied and healthcare professionals in Senegal

BackgroundDespite the widespread prevalence and substantial burden of mental disorders, they remain significantly underdiagnosed and undertreated. In low- and middle-income countries like Senegal, integrating mental health services into primary care represents the most feasible strategy to bridge the treatment gap. This study aimed to assess the effects of a mental health e-learning program on the knowledge, attitudes, and practices of allied and healthcare professionals in Senegal. MethodsAn e-learning platform including 12 interactive modules was used to train 322 allied and healthcare professionals. We evaluated changes in knowledge, attitudes, and practices, as well as in satisfaction with knowledge and in self-assessed ability to diagnose and manage patients, by comparing data collected before and after the e-learning modules. Qualitative feedback on the satisfaction with the various components of the program was also collected via a post-training survey. OutcomesKnowledge, attitudes and practices scores increased significantly for all modules. Additionally, scores related to satisfaction with knowledge and ability to diagnose and manage patients showed significant improvements (+77.0% and +75.0%, respectively), surpassing the gains observed in knowledge, attitudes, and practices scores (+19.2%, +11.1% and +15.0%, respectively). Mean scores regarding participants’ satisfaction with the various elements of the program ranged from 8.1 to 9.1, out of a maximum of 10. ConclusionAlthough only a limited number of participants completed all 12 modules, the mental health e-learning program showed positive results on the knowledge, attitudes, and practices of participants. It also increased their confidence and was perceived as a very positive experience by learners.

Meet and Greet Sessions: A Unique Virtual Opt-Out Approach to Support Trainee Well-Being.

Background Interventions to support graduate medical education (GME) trainee well-being at the institutional level continue to be an area for continuous improvement. Objective To assess participation, feasibility, and acceptability of a virtual, individual, brief, nonevaluative opt-out approach to accessing mental health support for residents and fellows. Methods From 2021 to 2023, all GME programs at one large institution were invited to participate. During orientation, incoming trainees from programs that had communicated interest were prescheduled for optional 20-minute, virtual "meet and greet" sessions with a counselor from the hospital's Employee Assistance Program. Nonformal feedback was gathered using an anonymous 6-question survey. Results Three hundred thirty-four residents and fellows from 12 of 74 (16%) participating GME programs were prescheduled for opt-out sessions over 3 academic years. Of the 334, 182 (54%) attended the sessions, 116 (35%) subsequently reached out to start counseling, and 108 (32%) responded to the survey. Each year, approximately 7 counselor hours were needed for the opt-out sessions per week over an 8-week period, which was feasible and added no extra cost. In the follow-up survey shared with all participants, 59 of 81 (73%) respondents reported that the sessions helped to reduce barriers to seeking mental health care. Conclusions During orientation, one-half of invited GME trainees participated in a virtual, individual, brief, nonevaluative meet and greet session with a counselor using an opt-out approach, and one-third subsequently requested counseling. Survey feedback was encouraging, and this approach can serve to help normalize culture surrounding accessing mental health services.

Attitudes toward psychedelics and psychedelic-assisted therapy among potential mental health service users and the general population in Australia.

Despite rapid advances in psychedelic sciences and the increasing number of countries legalizing psychedelics for the treatment of mental illnesses, the attitudes, knowledge and readiness of both mental health consumers and the general population remain largely unknown. A cross-sectional survey was conducted among Australians, targeting individuals with mental illness as potential mental health service users. A sub-sample of individuals free of mental illness was also surveyed to assess attitudes in the general population. Participants completed the Attitudes on Psychedelics Questionnaire, the Basic Knowledge of Psychedelics Test and a questionnaire by Corrigan et al. to capture attitudes toward psychedelic therapy by mental health service users. Of the 502 respondents, 64.5% self-identified as having a mental illness. A significant proportion favored legalizing psychedelics for medical use (43%) and were open to their use (52.4%), yet fewer viewed their effects positively (24%) or considered them safe (33%). Most participants reported to be psychedelic naive (61%). Participants with mental illness had significantly more experience with psychedelics than participant free of mental illness (44.1% vs 29.7%). Experience, perceived knowledge and actual knowledge significantly predicted attitudes toward legalization, effects, risks and openness to psychedelics. While a large proportion of Australians are in favor of legalizing psychedelics for medical purposes, concerns about safety remain. People with self-identified mental illness, those with previous recreational psychedelic experience and those with greater knowledge of psychedelics were more likely to have positive attitudes toward psychedelics and psychedelic-assisted therapy.

What happens after the funding ends?: A qualitative sustainability investigation of emergency department-based peer support programs implemented as part of Indiana's opioid state targeted response initiative

Introduction: In 2017, funding disseminated through the US Substance Abuse and Mental Health Services Administration's Opioid State Targeted Response (STR) program accelerated the expansion of peer recovery support services across several states to engage emergency department patients presenting with opioid use disorder. While there is some literature on the initial implementation of these programs, little is known about their sustainability after the STR funding's end. Identifying what happened to these programs is a key component of understanding their ultimate impact and can inform future activities to develop, fund, or sustain similar efforts. Methods: We collected qualitative data from six organizations that participated in Indiana's STR-funded Recovery Coaching and Peer Support Initiative (RCPSI). The semi-structured interview guide was designed to gather data related to eight domains of sustainability (i.e., environmental support, funding stability, partnerships, organizational capacity, program evaluation, program adaptation, program evaluation, communications, and strategic planning). The analysts followed a deductive-inductive analysis approach, using the eight domains as an a priori coding structure and developing higher-level inductive themes. Results: A total of ten individuals (roles included 4 Program Supervisors, 2 Nurse Administrators, a Psychiatric Social Worker, a Mobile Treatment Manager, a Grant Coordinator, and a Vice President of Planning) participated in six interviews. Two programs did not sustain services, primarily because they lacked a sufficient volume of eligible patients to justify services. Factors identified as supporting sustainability in the other four programs included (1) identification of alternate funding sources, (2) evolving internal support for ED-based opioid use disorder treatment, and (3) investment in internal and external relationships. Furthermore, these themes operated across multiple sustainability domains. Conclusions: The findings illustrate a dynamic interplay between program context and multiple theorized sustainability domains that impacted the viability of RCPSI programs after the end of STR funding. Results indicate a need for a better understanding of the factors influencing the sustainability of programs supported by federal funding to mitigate the opioid crisis, and such findings will likely apply to a broader range of grant-supported programs.

State-level variation in the prevalence of child psychopathology symptoms in the US: Results from the ABCD study

ObjectiveTo estimate the prevalence of clinically meaningful youth mood, anxiety, behavioral, and attention symptoms across US states. MethodData are drawn from the Adolescent Brain Cognitive Development (ABCD) study baseline wave, which included 11,876 children ages 9-10. Statistical weighting strategies generated projected state-specific prevalence estimates for the 17 states where ABCD collected data based on state socio-demographics. Twenty dimensions of mental health were assessed with the Child Behavior Checklist using recommended cut-scores to assess clinical and sub-threshold symptoms. ResultsPsychopathology symptom prevalence varied by state and outcome. Projected prevalence of internalizing problems ranged from 11.0% [95% CI: 9.8%, 12.2%; Oklahoma] to 7.9% [95% CI: 6.9%, 9.0%; Maryland] across states. Projected prevalence of externalizing problems ranged from 6.9% [95% CI: 6.1%, 7.8%; South Carolina] to 4.5% [95% CI: 3.7%, 5.4%; California]. Regions with high symptoms included sections of the South (e.g., Oklahoma, South Carolina) and Vermont. Conduct problems had the most variability across states (i.e., greatest state-level prevalence 91% higher than the lowest). Attention problems had the least variability across states (greatest state-level prevalence 26% higher than the lowest). ConclusionsClinically meaningful psychopathology symptoms are common in children across the US, with substantial state-level variability in prevalence. Understanding variability in the prevalence of psychopathology symptoms across the US can help to inform resource allocation to increase the availability of youth mental health services.

Empowering Autistic Youth and Adults to Advocate for Mental Health and Social Connection Goals as they Transition to Adulthood

Transition to adulthood is difficult for autistic teens. Speech-language pathologists (SLPs) can bridge the communication gap that often occurs between autistic youth, their health care providers, and their community. Autistic youth and adults, health care providers, and families were engaged in research discussions to better understand their transition needs from pediatric to primary care. Using qualitative analysis, themes were identified that specifically related to the social connection and mental health needs of autistic youth. Six primary themes emerged, including: (1) helping autistic individuals to feel heard; (2) having providers with more training in autism; (3) having accessible means for communication with new providers; (4) accessing mental health services with autism-informed counseling; (5) educating and empowering autistic youth to advocate for their needs; and (6) facilitating community engagement. Results highlight the importance of neurodiversity-affirming practices for autistic youth and adults. Communication goes both ways and when breakdowns occur, there are usually misunderstandings by both communication partners. As part of an interdisciplinary team, SLPs can facilitate mutual understanding between autistic youth and their non-autistic providers.

Policy and practice innovations in school-based mental health services

The child mental health crisis resulted in US legislative expansions of funding eligibility and access to clinical interventions in schools. In tandem with the movement to decentralize mental healthcare, we argue that schools are well-positioned to adopt place-based health care models. We describe this framework while summarizing the evidence of four priorities outlined in policy documents that promote equitable mental health access. We identify examples of federal and foundation grants aligned with implementation science, robust services, care eligibility, and workforce development. Our theory-informed discussion provides an overview of research and opportunities for school-based interventions promoting child mental health.

Beyond Physical Injury: Routine Screening for Acute Stress Disorder and Posttraumatic Stress Disorder in Pediatric Trauma Patients – A Longitudinal Cohort Pilot Study

IntroductionEarly identification of children at risk for PTSD is critical for improving mental health outcomes after traumatic injury. Currently, there is no standard PTSD screen for pediatric trauma patients and limited data on long-term quality of life for those who screen positive. MethodsIn 2022, we piloted a comprehensive routine screening program for ASD and PTSD at our Level I PTC. All admitted trauma patients ≥8 years old were eligible for screening. Inpatients were administered the ASC3. Those who screened positive were referred for follow-up and repeat mental health evaluation. PTSD screening (CTSQ, CPSS) and quality-of-life screening (PedsQL™) surveys were administered to eligible discharged trauma patients at 1-month post-injury. Children who screened positive on the CTSQ or CPSS were referred for behavioral health services. Results205 children were screened for ASD using the ASC3. 49/205 children (23.9 %) had a positive screen (score ≥3). 56 children completed PTSD screening at 1-month post-discharge. 14/54 children (25.9 %) screened positive on CTSQ, and 8/50 children (16 %) screened positive on CPSS. There was a significant positive correlation between CTSQ and CPSS scores (r 0.76, ∗P<0.0001). When stratified by screening results, patients who screened positive on CTSQ and CPSS were found to have the most significant correlations with poor School and Emotional Functioning on their quality-of-life inventory. ConclusionEarly screening for ASD may be predictive of later development of PTSD in children. Screening using previously validated tools (ASC3, CTSQ, CPSS) were effective in identifying children with negative emotional functioning lasting beyond the acute phase of physical recovery following injury. CTSQ and CPSS both performed well for screening at one-month post-discharge. Early identification can facilitate timely referral to mental health services to potentially minimize long-term socioemotional impact of PTSD.

Improving Access to Mental Health Care through a Stepped Care Approach: Preliminary Results from a University Students’ Sample

Introduction: Recently, university counseling services have been faced with an increasing number of students seeking psychological support. However, human resources and time constraints limit the services to respond adequately. Recently, national guidelines for Mental Health Services in Higher Education recommended the stepped care approach to increase efficiency. The present study aimed to explore the implementation of a stepped care model in a Portuguese public university, analyzing students’ sociodemographic and clinical characteristics, and presenting the flow of the stepped care approach and the students’ waiting periods in each step. Methods: An observational study was conducted in the University of Coimbra’s health services between May 2019 and June 2021. Descriptive statistics were performed to describe the sociodemographic and clinical characteristics of the sample, the flow of the stepped care approach, and students’ waiting periods. Results: We enrolled 295 students in the present study. The findings of this study revealed that over 40% had a clinical diagnosis of anxiety or depressive disorders. In terms of students’ flow within the stepped care model, 82% of students sought psychological help through self-referral. Concerning the implementation of the stepped care model, results have shown that most students wait less than a month to access each step. Discussion/Conclusions: Although preliminary, our results suggest that the stepped care model might be a useful service organization, mainly in a community in which accessibility to services and speed of response are particularly important. Most students being self-referred highlight the importance of direct contact between the university community and the health services. Additionally, anxiety and mood disorders were the most prevalent diagnoses in our sample, which also points to the relevance of a stepped care approach, since other studies have highlighted its advantages for this kind of clinical population.

Mental health services utilization by rurality: Evidence from the National Institutes of Health All of Us Research Program.

Mental health services utilization by rurality: Evidence from the National Institutes of Health All of Us Research Program.

The Counseling Center Field’s Relationship with the Mental Health Marketplace

ABSTRACT One of the most significant changes to college mental health is the growing use of telehealth vendors to provide, extend, or augment mental health services provided by college and university counseling centers. In a time of sharply increased demand for services, new investments in the mental health marketplace, and the perception that mental health is a “crisis,” the relationships between counseling centers and mental health vendors are increasingly important. This paper provides an overview of these new relationships, briefly reviews relevant history and context, and explores the relationship dynamics shaping this space. In addition, this paper reviews common fears and worries faced by counseling centers when considering vendors, addresses some of the confusion surround vendor/service types, and offers a set of suggestions for the inevitable future relationship in the development of guiding principle and standards.

The Impact of Loneliness and Social Relationship Dissatisfaction on Clinical and Functional Outcomes in Dutch Mental Health Service Users

The relationship between reduced social connectedness and mental health outcomes is increasingly acknowledged. Yet, relatively little is known about how two crucial subjective aspects of social disconnectedness - loneliness and social relationship dissatisfaction (SRD) - are related to clinical and functional recovery. This cohort study aimed to investigate the association of loneliness and SRD with various mental health outcomes among 15,512 outpatients from a Dutch mental health service. Demographics and data on loneliness, SRD, symptomatic distress, suicidal ideation, and role functioning, as well as treatment duration, and mortality, were collected. The study analyzed the association between these factors overall and by diagnostic group, gender, and age, using cross-sectional and longitudinal regression, while controlling for relevant covariates. Findings revealed significant, independent, associations between loneliness, SRD, symptomatic distress, and role functioning across different diagnostic groups. Particularly strong associations were noted in bipolar and psychosis-related disorders. Gender did not significantly influence the strength of associations. In older patients, lower levels of loneliness and SRD were observed, but the impact on clinical and functional outcomes was consistent across ages. Higher loneliness and SRD were associated with longer treatment durations, regardless of age, gender or diagnosis. This study indicates the wide-reaching effects of perceived social disconnectedness on recovery and emphasizes interventions targeting loneliness and SRD to enhance outcomes.

Identifying complex emotional and relational needs of service users in Later Life CMHTs within the Greater Manchester Mental Health NHS Foundation Trust

The Community Mental Health Transformation Agenda places a focus on supporting adults and older adults with severe and enduring mental health difficulties, including care for older adults with complex emotional and relational needs (CERN). Current research has paid little attention to CERN in later life. Studies suggest that older adults with CERN present differently to younger adults. This means services may not be identifying and meeting the needs of these individuals. The aim of this scoping exercise was to understand the prevalence of CERN in older adult community mental health services in Greater Manchester. Data was collected on 347 service users under the Care Programme Approach with later life community mental health teams in Greater Manchester. Data was gathered from the Trust electronic record system and interviews with care co-ordinators. Findings revealed that services users had high levels of complex need, including high levels of service use and high levels of risk, especially for self-neglect. Findings aligned with scoping exercises conducted in other Trusts and provided a better understanding of the needs of this population.

The development of a mental health service for East and Southeast Asian communities in the United Kingdom: A critical reflection.

The development of a mental health service for East and Southeast Asian communities in the United Kingdom: A critical reflection.

Health of the Pandemic Dementia Paid Staff and Unpaid Caregiver Workforce in Congregate Care and Community Settings

ObjectivesThe objective of this study was to assess the impact of the pandemic on the health, well-being, and access to services of paid staff and unpaid caregivers of persons living with dementia. DesignQuestionnaires were developed to capture the experiences of paid staff and unpaid caregivers throughout the pandemic, leveraging a pre-existing clinical trial collaborative. SettingCommunity and long-term care locations in Miami, Florida, Boston, Massachusetts, and the greater Baltimore, Maryland, and D.C. areas. ParticipantsPaid staff from Miami Jewish and Benchmark who worked with patients with dementia during the first two years of the pandemic. Unpaid caregivers who lived within the catchment area of the study sites and provided care for community-based persons with dementia. MeasurementsMeasures included the Coronavirus Impact Scale, the Herth Hope Index, NPI-Q, the Modified Caregiver Strain Index, PHQ-8, items about workplace changes, caregiving relationship, and changes to caregiver support. ResultsPaid staff were statistically more likely to have been exposed to, tested for, hospitalized, or seriously ill with COVID-19 and indicated moderate to severe impacts to medical and mental health services compared to unpaid caregivers. Unpaid caregivers exhibited significantly higher rates of depressive symptom severity and overall lower scores on the Herth Hope Scale compared to paid staff. ConclusionsOur findings suggest that the pandemic had significant impacts on the mental health and general well-being of unpaid caregivers. While notable that paid staff suffered from increased exposure and decreased access to services, policies supporting both workforces should respond to the unique outcomes that each faced, post-pandemic.

Perceived control moderates the internalized stigma model of seeking mental health services in distressed older adults.

Older adults are especially unlikely to seek mental health services, and internalized stigma is a key reason why. However, little research has investigated which older adults are particularly likely to have stigma influence help-seeking. To address this, we tested whether perceived control (PC) moderates an internalized stigma model in which public stigma is internalized as self-stigma, which negatively predicts help-seeking attitudes and help-seeking intentions. We employed moderated mediation analysis of cross-sectional, secondary data from 348 psychologically distressed Canadian adults aged 65 years and older. Participants completed an online survey that included measures of public stigma of help-seeking, self-stigma of help-seeking, help-seeking attitudes, conditional help-seeking intentions, psychological distress, and PC. PC emerged as a moderator of the internalized stigma model. Those lower in PC were more likely to have public stigma negatively predict help-seeking intentions through the serial mediation of (a) self-stigma and (b) help-seeking attitudes. Further, those lower in PC were more likely to have public stigma internalized as self-stigma and more likely to have negative help-seeking attitudes predict lower help-seeking intentions. Finally, those lower in PC also had lower help-seeking intentions in the face of low levels of self-stigma. These results contribute to a nuanced understanding of which older adults are unlikely to seek help. Identifying PC as a moderator of the internalized stigma model suggests that interventions that enhance PC should protect against public stigma's internalization and improve help-seeking behaviors for older adults who need such help. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differences In SMHAT-1 Scores Among Collegiate Athletes After Utilization Of University-sponsored Mental Health Services

Differences In SMHAT-1 Scores Among Collegiate Athletes After Utilization Of University-sponsored Mental Health Services

The trajectories and associations of sleep disturbance symptoms with suicidal ideation in adolescents: A three-wave longitudinal study

BackgroundThis study aimed to investigate the developmental trajectories of sleep disturbance symptoms and examine whether specific trajectory memberships of sleep disturbance symptoms could prospectively predict suicidal ideation (SI) among a large sample of Chinese adolescents over one year. MethodsA three-wave longitudinal study was conducted from April 2021 to June 2022, with a sample of 19,095 adolescents from Shenzhen in Guangdong Province, China (51.2% males; mean age = 12.4 ± 1.6 years at baseline). Socio-demographics (at baseline), SI, sleep disturbance symptoms (at each assessment), depressive symptoms (at the last follow-up), and negative life events (at two follow-ups) were assessed. Data were analyzed employing Growth Mixture Modeling and binary logistic regressions. ResultsThe Growth Mixture Modeling identified four trajectories of sleep disturbance symptoms over one year: resistant group (76.2%), delayed-dysfunction group (8.8%), recovery group (7.4%), and chronic-dysfunction group (7.6%). Binary logistic regression analysis revealed that adolescents in the group of delayed-dysfunction (OR = 2.86, 95% CI = 2.51-3.27) and chronic-dysfunction (OR = 2.14, 95% CI = 1.84-2.47) exhibited higher risks of developing SI compared to those in the resistant group, even after controlling for socio-demographics, negative life events, depressive symptoms, and baseline SI. ConclusionsThese findings underscore the importance of identifying individuals at higher risks of sleep disturbance and providing personalized and effective mental health services to reduce the incidence of SI.