Professional Mental Health Treatment Research Articles

"Something very taboo": a qualitative exploration of beliefs, barriers, and recommendations for improving mental health care and access for Hispanic adults in the Paso del Norte U.S.-Mexico border region.

Hispanic adults with mental health conditions in the United States experience disproportionate access to and utilization of professional mental health treatment. This is believed to be in part due to systemic barriers and challenges, difficulty accessing care, cultural factors, and stigma. Studies to date have failed to examine these specific factors within the unique context of the Paso del Norte U.S.-Mexico border region. For this study, 25 Hispanic adults identifying primarily of Mexican descent participated in four focus groups exploring these topics. Three groups were facilitated in Spanish and one group in both English and Spanish. Focus groups followed a semi-structured format eliciting perspectives on mental health and mental illness, help-seeking, barriers and facilitators of help-seeking and treatment access, and recommendations for mental health agencies and providers. Qualitative data analysis yielded the following themes: understanding of mental health and help-seeking; barriers to accessing care; mental health treatment facilitators; and recommendations for agencies, providers, and researchers. Findings from this study support the need for innovative mental health engagement strategies to reduce stigma, increase understanding of mental health, foster support systems, reduce individual and systemic barriers to seeking and accessing care, and to continue to engage communities in mental health outreach and research.

Mental health treatment use among cannabis users aged 50+: Associations with cannabis use characteristics

BackgroundThis study examined associations of mental health treatment use and perceived treatment need with cannabis use characteristics (medical vs. nonmedical use, initiation age, use frequency, and cannabis use disorder) among past-year cannabis users aged 50+. MethodsData came from the 2015–2019 National Survey of Drug Use and Health (N = 44,007). After comparing past-year cannabis users with nonusers and nonmedical users with medical users on sociodemographic and health-related factors, the research questions were examined with logistic regression models. ResultsIn addition to mental disorders, medical use, compared to nonmedical use, was associated with higher odds of psychotherapeutic prescription medication use (AOR = 1.47, 95 % CI = 1.07–2.01) and any mental health treatment (prescription medication, outpatient care and/or inpatient care) (AOR = 1.51, 95 % CI = 1.13−2.03). Compared to 1−29 days of use, nonmedical users who used on 100−199 days (AOR = 0.60, 95 % CI = 0.40−0.89) and medical users who used on 200−365 days users (AOR = 0.48, 95 % CI = 0.26−0.87) had lower odds of treatment receipt. Factors associated with increased odds of receiving treatment included discussion with a healthcare professional about drug use, higher education, and having health insurance. Other illicit drug use, chronic illnesses, and female gender were associated with higher odds of perceived treatment need, while having health insurance was associated with lower odds. ConclusionsSome older adults may use medical cannabis as an adjunct to professional mental health treatment while others may use it as a substitute. Affordability and accessibility gaps followed by cultural and personal sense of stigma and self-sufficiency beliefs appear to be barriers to receiving professional care.

Depression, anxiety, and stress among students, faculty, and staff

Objectives: To identify and compare the prevalence of depression, anxiety, and stress among and between students and faculty/staff; and to determine and contrast the coping mechanisms utilized and barriers to mental health care perceived within and between these two populations. Participants: A total of 448 students and faculty/staff from a Midwestern university. Methods: An electronic survey including the 21 question Depression, Anxiety, and Stress Scale and an exploration of individual coping mechanisms and perceived barriers to mental health care. Results: Approximately one-third of the campus community experience symptoms consistent with severe or extremely severe depression (28.3% faculty/staff, 31% students), anxiety (38.6% faculty/staff, 41.8% students), and/or stress (31.1% faculty/staff, 33.9% students). There were significant differences between faculty/staff and students in regard to mental health coping mechanisms utilized and perceived barriers to professional mental health treatment. Conclusion: Mental health problems are common in both faculty/staff and student populations.

Religiosity and Attitudes Toward Treatment for Mental Health in the Black Church

To investigate the relationship between dimensions of religiosity and attitudes toward the professional treatment of mental health among African American church attendees. In 2018, surveys were administered to African American attendees of four churches in northeastern Pennsylvania and central New Jersey (n = 435). The independent variables assessed were three dimensions of religiosity: subjective (perceptions and attitudes), organizational (public displays), and non-organizational (private practices). The Multidimensional Measure of Religious Involvement for African Americans scale assessed each dimension of religiosity. The dependent variable was measured through the 20-item scale, Attitudes Toward Mental Health Treatment Scale. We conducted multivariate linear regression with robust standard errors to adjust for clustering effects by church. Covariates adjusted for in the analysis were age, sex, denomination, education, marital status, depressive symptoms, location, and support. Most participants were aged 50 and older (79.3%). They resided in urban (9.89%), rural (2.3%), or suburban (87.8%) settings. Participants who reported high subjective religiosity endorsed less positive attitudes toward professional mental health treatment in comparison with participants reporting low subjective religiosity (β = − 1.36, 95% confidence interval [− 2.35, − 0.39], p < 0.05). No association was found between organizational or non-organizational religiosity in relation to attitudes toward professional mental health service use. Our findings suggest that greater subjective religiosity may be related to lower engagement in and utilization of professional mental health services among African Americans in the northeastern United States.

Adolescents’ Disclosure of Mental Illness to Parents: Preferences and Barriers

ABSTRACT Adolescents with a diagnosable mental health disorder must often first disclose their mental health problems to a parent in order to obtain professional mental health treatment. The decision to disclose private, personal health information is the result of successful progression through disclosure decision-making processes fraught with barriers that can discourage disclosure; therefore, the current study explored adolescents’ perceptions of factors that facilitate or discourage disclosure of mental health information to parents. Thematic analysis of a series of focus groups with adolescents with and without a mental health disorder discovered several themes that describe factors adolescents consider in the disclosure decision-making process. Several identified themes are consistent with past research related to health-related disclosure decisions, but some themes suggest that the mental health disclosure decision-making processes of adolescents may be different than the decision-making processes of adults in other health contexts. Results of the study have implications for interventions associated with adolescents’ and parents’ mental health literacy, mental health stigma and communication about mental health issues.

Men with Depression and Inpatient Mental Health Treatment: Professionals' Perspectives on Treatment Needs and Aims

To meet mental health needs in men with depression, gender sensitive services are needed and recommended. Therefore, mental health professionals' views on care needs among men with depression that should be met by gender-sensitive services were assessed and consequences for inpatient treatment are considered. Semi-structured interviews were conducted with 33 mental health professionals focusing on men's specific needs in depression treatment against the background of male gender role expectations. Qualitative Content Analysis was performed using MAXqda-Software. Men with depression benefit from individual talk with staff and structured activity during treatment. Men-only groups are assessed as enabling critical reflection of aspects of masculinity. Physical activities and handicraft enable men to examine their performance level. Services focusing on men's specific needs are assessed as helpful but largely inexistent. Expectations of social gender roles and their implications for mental health treatment should be considered in both mental health professional training and mental health treatment.

A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: a randomized controlled trial

BackgroundAsylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which, critically, are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and limited mainly to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety.Methods/designThis trial is the first evaluation of a short-term, transdiagnostic treatment protocol for treatment-seeking Afghan refugees which addresses mental health problems and PMLDs while using an adapted version of the Problem Management Plus (PM+) protocol. Here, we will investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor-blind, two-group trial among refugees who are on a waiting list for professional mental health treatment. Furthermore, we will investigate participants’ subjective experiences with the intervention manual via in-depth interviews. One hundred twenty people will be assessed and randomly allocated to either the intervention arm or a treatment-as-usual arm. Clinical psychologists will conduct the treatment, and the sessions will take place with a Dari interpreter. The protocol consists of six 90-min sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints are the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12).DiscussionThis trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees.Trial registrationGerman Clinical Trials Register (DRKS) registration number: DRKS00016538. Universal Trial Number: U1111-1226-3285. Registered on January 7, 2019. https://www.drks.de/drks_web/setLocale_EN.do

Perceptions of depression among Hispanics with Pentecostal beliefs

ABSTRACTPrevious research has shown that Hispanics in the US and Christians, specifically Pentecostals, may hold beliefs about psychological disorders that affect help-seeking. In this study, Hispanic Pentecostal Christians (N = 142) completed a questionnaire that examined religious belief, acculturation, depression beliefs and depression symptoms. Results showed Hispanic Pentecostals were more likely to view depression as caused by social-relational factors than biological or spiritual factors, and were more likely to endorse spiritual treatments instead of professional mental health treatments. Mainstream acculturation was significantly associated with a stronger belief in genetics as a possible depression cause, but not with a preference for professional mental health treatment. Heritage acculturation was positively associated with religious belief, and there was no significant association of acculturation with depression. Possible recommendations include outreach to pastors, education of professional mental health staff regarding cultural and religious beliefs, and designing treatments that integrate religion and spirituality for this population.

Gender differences in Korean adolescents who died by suicide based on teacher reports

BackgroundWe investigated the characteristics of adolescents who committed suicide in South Korea, and how these characteristics differed by gender.MethodData from middle and high school students who committed suicide between 2014 and 2016 were analyzed. We evaluated differences in suicide method and place, personal characteristics, and school life characteristics by gender using the Chi square test and t test.ResultsJumping from a high place was the most common suicide method for both male and female students. A significantly greater proportion of female adolescents had experienced depressive symptoms, previous self-injury, previous suicide attempts, and had problems with school attendance and peers. Additionally, they were more likely to be classified as high risk according to a school-based mental health screening test and to utilize professional mental health treatment services.ConclusionOur results demonstrate that adolescents who committed suicide exhibited gender differences in personal characteristics and school life. These characteristics might aid in the development of adolescent suicide policies and intervention programs.

An examination of PTSD symptoms and their effects on suicidal ideation and behavior in non-treatment seeking veterans

This study sought to examine the effect of general PTSD symptoms as well as specific PTSD symptom clusters on suicidal ideation and suicidal attempts. We first compared a correlated factors solution consistent with the DSM-5 symptom clusters for PTSD with a bifactor solution comprising a General PTSD factor and orthogonal specific factors. Using the best fitting model (i.e., bifactor solution), we then investigated the effect of specific PTSD symptom clusters on severity of suicidal ideation and suicide attempts above and beyond the effect of general PTSD symptoms. A sample of 773 veterans who have never sought professional mental health treatment were screened for suicidal ideation within the past two weeks. One month after the baseline measurement, the participants completed a follow-up assessment, again by telephone. A bi-factor solution was used to account for a general PTSD factor as well as the specific DSM-5 PTSD symptom clusters. After controlling for baseline suicidal ideation and behavior, it appeared that the Anxious Arousal factor was predictive of changes in the magnitude of severity of suicidal ideation and the General PTSD factor was predictive of the onset of new suicidal behavior at the one-month follow-up. Additionally, the Re-experiencing factor of PTSD also significantly predicted new suicidal behavior at the one-month follow-up. These results suggest that it may beneficial for clinicians, who are assessing individuals with PTSD for suicidality, to be aware of the frequency, duration, and content of their clients’ repetitive, intrusive thoughts as these thoughts may increase their capability to inflict non-lethal or lethal forms of self-injury.

Individuals with currently untreated mental illness: causal beliefs and readiness to seek help.

Many people with mental illness do not seek professional help. Beliefs about the causes of their current health problem seem relevant for initiating treatment. Our aim was to find out to what extent the perceived causes of current untreated mental health problems determine whether a person considers herself/himself as having a mental illness, perceives need for professional help and plans to seek help in the near future. In a cross-sectional study, we examined 207 untreated persons with a depressive syndrome, all fulfilling criteria for a current mental illness as confirmed with a structured diagnostic interview (Mini International Neuropsychiatric Interview). The sample was recruited in the community using adverts, flyers and social media. We elicited causal explanations for the present problem, depression literacy, self-identification as having a mental illness, perceived need for professional help, help-seeking intentions, severity of depressive symptoms (Patient Health Questionnaire - Depression), and whether respondents had previously sought mental healthcare. Most participants fulfilled diagnostic criteria for a mood disorder (n = 181, 87.4%) and/or neurotic, stress-related and somatoform disorders (n = 120, 58.0%) according to the ICD-10. N = 94 (45.4%) participants had never received mental health treatment previously. Exploratory factor analysis of a list of 25 different causal explanations resulted in five factors: biomedical causes, person-related causes, childhood trauma, current stress and unhealthy behaviour. Attributing the present problem to biomedical causes, person-related causes, childhood trauma and stress were all associated with stronger self-identification as having a mental illness. In persons who had never received mental health treatment previously, attribution to biomedical causes was related to greater perceived need and stronger help-seeking intentions. In those with treatment experience, lower attribution to person-related causes and stress were related to greater perceived need for professional help. While several causal explanations are associated with self-identification as having a mental illness, only biomedical attributions seem to be related to increase perceived need and help-seeking intentions, especially in individuals with no treatment experiences. Longitudinal studies investigating causal beliefs and help-seeking are needed to find out how causal attributions guide help-seeking behaviour. From this study it seems possible that portraying professional mental health treatment as not being restricted to biomedical problems would contribute to closing the treatment gap for mental disorders.

Perceptions of Harm and Reasons for Misuse of Prescription Opioid Drugs and Reasons for Not Seeking Treatment for Physical or Emotional Pain Among a Sample of College Students

ABSTRACTBackground: Since the early 1990s, the United States has seen a significant increase in the prevalence of prescription opioid misuse. Despite benefits prescription opioids provide, misuse can be fatal. Objectives: The current study was designed to investigate the prevalence of prescription opioid misuse, perceived harm of misuse, and reasons for misuse for physical or emotional pain instead of seeking professional medical or mental health treatment. Methods: Survey data were collected in the fall of 2013 via an online survey to a random sample of 668 students from a public Midwestern university. Results: Lifetime prevalence of prescription opioid misuse was 9.5%. Misusers of prescription opioid drugs generally reported lower ratings of perceived harm as compared to individuals not reporting misuse of prescription opioid drugs. Primary reasons for misuse of prescription opioid drugs was to relieve pain (33.9%), “to feel good/get high” (23.2%) and experimentation (21.4%). Lifetime misuse of a prescription opioid drug for physical or emotional pain was reported by 8.1% and 2.2% of respondents, respectively. Primary reasons for misuse for physical pain included because pain was temporary, immediate relief was needed, and no health insurance/financial resources. Primary reasons for misuse for emotional pain included not wanting others to find out, embarrassment and fear. Conclusions/Importance: Reasons for misuse of prescription opioid drugs vary by type of prescription opioid drug. Reasons for not seeking treatment that ultimately lead to misuse, vary by type of pain being treated and may be important considerations in the effort to stem the misuse of prescription opioid drugs among college students.

Utilization of Professional Mental Health Services Related to Population-Level Screening for Anxiety, Depression, and Post-traumatic Stress Disorder Among Public High School Students.

This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast Texas affiliated with the Dating it Safe study. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders, and the Primary Care Posttraumatic Stress Disorder screen. Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16%. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents.

Assessment and Comparison of Culturally Based Explanations for Mental Disorder Among Singaporean Chinese Youth

Background: Culture is important to how populations understand the cause of mental disorder, a variable that has implications for treatment-seeking behaviour. Asian populations underutilize professional mental health treatment partly because of their endorsement of supernatural causation models to explain mental disorders, beliefs that stem from their religious backgrounds. Aims: This study sought to understand the dimensions of explanatory models used by three groups of Singaporean Chinese youth (n = 842) — Christian, Chinese religionist, no religion — and examined their responses to an instrument that combined explanations from psychological and organic perspectives on mental disorder with approaches from Asian and Western religious traditions. Results: Factor analysis revealed five factors. Two were psychological corresponding to the humanistic and cognitive-behavioural perspectives respectively. Another two, which were supernatural in nature, dealt with karmaic beliefs popular among Asian religionists and more classical religious explanations common in monotheistic religions. The remaining factor was deemed a physiological model although it incorporated an item that made it consistent with an Asian organic model. Conclusion: While groups differed in their endorsement of supernatural explanations, psychological perspectives had the strongest endorsement among this population. Regression analysis showed that individuals who endorsed supernatural explanations more strongly tended to have no exposure to psychology courses and heightened religiosity.

Self-Help and Community Mental Health Agency Outcomes: A Recovery-Focused Randomized Controlled Trial

Self-Help and Community Mental Health Agency Outcomes: A Recovery-Focused Randomized Controlled Trial

Racial Differences in Attitudes Toward Professional Mental Health Treatment: The Mediating Effect of Stigma

Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.

Assessment and Comparison of Culturally Based Explanations for Mental Disorder Among Singaporean Chinese Youth

Culture is important to how populations understand the cause of mental disorder, a variable that has implications for treatment-seeking behaviour. Asian populations underutilize professional mental health treatment partly because of their endorsement of supernatural causation models to explain mental disorders, beliefs that stem from their religious backgrounds. This study sought to understand the dimensions of explanatory models used by three groups of Singaporean Chinese youth (n = 842)--Christian, Chinese religionist, no religion--and examined their responses to an instrument that combined explanations from psychological and organic perspectives on mental disorder with approaches from Asian and Western religious traditions. Factor analysis revealed five factors. Two were psychological corresponding to the humanistic and cognitive-behavioural perspectives respectively. Another two, which were supernatural in nature, dealt with karmaic beliefs popular among Asian religionists and more classical religious explanations common in monotheistic religions. The remaining factor was deemed a physiological model although it incorporated an item that made it consistent with an Asian organic model. While groups differed in their endorsement of supernatural explanations, psychological perspectives had the strongest endorsement among this population. Regression analysis showed that individuals who endorsed supernatural explanations more strongly tended to have no exposure to psychology courses and heightened religiosity.

Service Utilization Differences for Axis I Psychiatric and Substance Use Disorders Between White and Black Adults

Service Utilization Differences for Axis I Psychiatric and Substance Use Disorders Between White and Black Adults

Pragmatic Help Seeking: How Sexual and Gender Minority Groups Access Mental Health Care in a Rural State

This qualitative study examined how lesbian, gay, bisexual, and transgender (LGBT) people in rural areas of the poor and multiethnic state of New Mexico access secular (professional and lay) and sacred (indigenous and Christian) mental health care resources. In-depth, semistructured interviews were used to document the help-seeking processes of 38 rural LGBT people. Obtaining assistance was complicated by the ideal of self-reliance and the view of mental illness as a sign of weakness. Financial considerations and a lack of and community-based LGBT social networks also exerted substantial influence on help seeking. Many LGBT people would strategically remain silent about their sexuality or gender status and rely on their family ties to access the range of secular and sacred resources that are most commonly available in medically underserved rural communities. Although persons from sexual and gender minority groups often experience positive outcomes as a result of help seeking, some LGBT people remain vulnerable to anti-LGBT sentiments that persist within secular and sacred sectors of rural health care systems.

Do films about mentally disturbed characters promote ineffective coping in vulnerable youth?

Suicidal youth tend to doubt the effectiveness of professional mental health treatment. This study examined whether exposure to films about suicidal and mentally disturbed persons supports this lack of belief. Exposure to three popular films featuring suicides or the mentally ill was compared to films that featured a heroic suicide unrelated to mental illness as well as to films with violent and comedic content in a nationally representative survey of youth ages 14–22 ( N = 9 0 0 ). Exposure to films about mental disturbance among “vulnerable” respondents who had experienced recent depressive and suicidal symptoms (24% of sample) was compared to those without these symptoms. Increasing exposure to films with mentally disturbed characters was related to belief in the treatment inefficacy of mental disorders. The findings suggest that exposure to fictional depictions of characters failing to get help for mental disorders may have long-term effects on depressed and suicidal youth.