Use Of Professional Help Research Articles

A RANDOMIZED CONTROLLED TRIAL OF SELF-HELP GUIDED BY LAY PROVIDERS FOR GENERALIZED ANXIETY DISORDER IN OLDER ADULTS

Abstract Low use of professional help for anxiety disorders in older adults may be due in part to limited access to mental health services. Self-help guided by lay providers (LPs) could help improve access to treatment. This study evaluated the efficacy and long-term outcomes of self-help guided by LPs for generalized anxiety disorder (GAD) in older adults. Participants (≥ 60 years) with threshold or subthreshold GAD were randomly assigned to an intervention group (n = 75) or a wait-list control group (n = 75). Intervention group participants used a manual presenting readings and exercises based on principles of cognitive-behavioral therapy and received weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the intervention group had decreased significantly on various measures while the wait-list group remained stable: Generalized Anxiety Disorder 7-item (GAD-7): -4.8 vs -.03; Penn State Worry Questionnaire (PSWQ): -11.7 vs .07; Geriatric Anxiety Inventory (GAI): -5.3 vs -.07. Probability of having a diagnosis of threshold GAD decreased significantly more in the intervention group (79% to 16% vs 74% to 53%). Intervention group scores on the GAD-7, the PSWQ, and the GAI as well as probability of having a diagnosis of threshold GAD remained stable at 6- and 12-month follow-ups. Results provide evidence of the efficacy of self-help guided by LPs for GAD in older adults as well as of the maintenance of improvement following this treatment.

Mental Health Care Access and Individual Help-Seeking During the Covid-19 Pandemic.

The UJA Covid-19 Jewish Impact Study constitutes a random sample of 4403 adults in Jewish households in the New York area. Collected between February and May 2021, the data include symptoms of depression and anxiety and the use of professional help. Via respondents’ zip code tabulation areas (ZCTAs), these data are linked to contextual measures of mental health care access from two data sources: the SAMHSA Locator on specialty community treatment clinics, and the Zip Code Business Patterns database on solo and small group practices. Both treatment facilities and office practices are added to multilevel logistic regression models as density rates (per 10,000 people) and as binary indicators of presence. While we find no meaningful relationship between the general presence of mental health care services and help-seeking behavior, the ZCTA-level density of office practices is significantly associated with service utilization among the socially isolated, foreign-born and Hispanics or non-white respondents.

The use of professional help and predictors of unmet needs for dealing with mental health to legal problems among victims of violence, accidents, theft and threat, and nonvictims in the general population.

AimsVictims of violence, accidents, theft, and serious threat (hereafter abbreviated as victims) are more than nonvictims at risk for problems in different domains, varying from mental health to legal problems. However, the extent to which victims with these problems compared to nonvictims with similar problems receive problem-related professional or formal help is unclear. It is unknown if predictors of unmet needs differ between victims and nonvictims. Aim of the present study is to fill this gap of knowledge.MethodsData was extracted from surveys of the VICTIMS-study (2018, 2019 and 2020), conducted with the Dutch population-based longitudinal LISS panel. Each survey assessed 1.) experiences with physical violence, accidents, theft, and serious threat and other traumatic or stressful events in the past 12 months and 2.) various problems and use of professional help, e.g. do receive help, do not need help, could use help but do not use it, cannot find or afford help for these problems. Multivariate logistic regression analyses were performed to assess differences in problems, in the use of problem-related professional help, and in predictors of unmet needs between victims (N = 1,756) and nonvictims (N = 5,000).ResultsVictims more often had assessed problems than nonvictims. Victims compared to nonvictims with similar problems had 1.5 to 2 times more often unmet needs: they could not find or afford professional help for their mental, physical, partner/family, financial and legal problems. In addition, victims less often received help for legal and administrative problems. Most predictors of unmet needs, e.g. could use help but do not use it, cannot find or afford help, were not significant and hardly differed between both groups.ConclusionsThe findings that victims compared to nonvictims more often have various problems and more often cannot find or afford problem-related professional help, suggest that there is room for improvement for victims services.

Snus cessation patterns - a long-term follow-up of snus users in Sweden

BackgroundSeveral studies have investigated the role of snus as an aid to become smoke-free, but few have focused on who use snus, how they perceive snus use, why and how they quit, and their perception of being non-snus users. The purpose of this paper is to describe snus cessation patterns.MethodsRespondents are part of a 7-year follow-up of former smokers in Sweden. Initially, 1400 respondents were contacted regarding participation and 705 answered a web-based survey (response rate 50%). Out of them, 118 had used snus. The analyses include percentage distributions, as well as factor analyses of inventories, and configural frequency analysis in order to examine configurations of snus-related patterns.ResultsOver 80% found snus of great importance to succeed with smoking cessation and half of them continued to use snus on a long term. Those who experienced both physical and psychological effects of switching to snus were the ones who continued and vice versa; those who did not experience such effects quit using snus. None made use of professional help but had their own strategies (60%), and most respondents who quit obtained psychological benefits (68%).ConclusionsThe distinction between the concepts smoke-free, tobacco-free, and nicotine-free contributes to nuances in the debate on snus as harm reduction. Continued snus use does not mean that snus is not an effective aid to become smoke-free. Snus cessation is mostly mentioned in relation to advices on how to succeed, but the cessation process has rarely been described; therefore, this study expands the knowledge on this quite neglected topic and contributes to a more nuanced picture of snus cessation.

"Everything changes"-Everyday Life with dementia from the caregivers' perspective

Most people with dementia live in private homes and are supported by their relatives. Current figures estimate that the number of people with dementia will continue to increase over the next years. In comparison to other groups of people that care for their relatives, those taking care of people with dementia face asubstantially higher burden due to changes that are typically associated with dementia. Relatively little is known on how relatives of people with dementia manage their support arrangements, which strategies they follow and which structures are perceived as helpful or obstructive in their daily routine. The aim of this study was to provide insights into the structure of support arrangements from the perspective of the main caregiver. The results show in which areas of life the main caregivers experience the greatest cuts and which strategies they use to overcome these problems. In this context 14 in-depth interviews were carried out with relatives who were the main caregivers of people with dementia. The interviews were evaluated in aresearch group using the techniques of grounded theory. All aspects of life were affected by the decision to take care of people with dementia. To what extent the caregivers are affected by these decisions subjectively differs from individual to individual. All interviewees reported that the biggest challenge was to find abalance between taking care of others and self-care; however, such a balance does not always succeed for the caregivers' health and sustainability of support arrangements but nevertheless is of enormous importance. At the same time there is evidence of the circumstances under which caregivers make use of professional help and thus contribute to the sustainability of the support arrangements. The findings show that unsustainable support arrangements cannot only be seen as alack of adaptability on the part of the caregivers to the progression of dementia. The realization of sustainable arrangements is multidimensional and multicausal.

Father's and mother's beliefs about children's anxiety.

Previous research has focused on parenting styles and parental behaviors associated with children's anxiety. Parental beliefs about their child's anxiety have scarcely been studied, in spite of their probable influence in parents seeking help. The present study intended to fil that gap, by exploring what parents think about their children's anxiety and whether these cognitions are related or not to their use of professional help. In-depth semistructured interviews were conducted with 48 parents (50% fathers) of children (9-12years old) with anxiety problems. Theoretical thematic analysis was performed on the transcripts. Three dimensions were derived from the analysis, concerning (a) the causes of child's anxiety, (b) the impact of anxiety in the child's functioning, and (c) the evolution of anxiety. Most parents perceived the child's anxiety as a permanent condition, attributing it to external and parental factors and considering that the anxiety problems have a negative impact on the child's well-being. Plus, parents who had previously sought professional help for the child's emotional problems tended to believe that anxiety could improve with child's or parents' efforts and with professional guidance, contrarily to those who had not. Implications for research and clinical practice are discussed. The present study highlighted important parental beliefs about their children's anxiety that might influence their attitudes and decisions (e.g., seek for professional help). Other parental cognitions should be investigated in order to understand parenting in the context of childhood anxiety.

The impact of a student's suicide: Teachers’ perspectives

BackgroundThe impact of suicide of adolescents is devastating, yet little is known about the distressing impact for teachers. The aim of this study therefore is to explore the impact student suicide on teachers’ personal and professional lives. MethodsA cross-sectional anonymous online survey of primary and secondary school teachers was conducted in Australia. The Impact of Event Scale – Revised, questions about personal and professional impact, help seeking, perceived needs and experiences after student's suicide were included in the analysis. ResultsIn total, 229 teachers commenced the questionnaire, with 138 (60.3%) completing the full questionnaire. Questions about exposure to students’ suicide were completed by 145 teachers (63.3%). In total, 35.9% (n=52) were exposed to at least the suicide of one student (two or more: 54.8%). The most recent suicide of a student had (some or great) impact on the personal life of 76% of teachers and on the professional life of 85.7%. Impact on personal life was significantly higher for female teachers. The most frequent source for help seeking was family or partner (65.3%); use of professional help was also reported, with the school counsellor being the most frequent (30.6%). Following the most recent suicide of a student, 27.1% of teachers exposed to suicide felt that they needed more support. LimitationsThe potential for selection bias through the use of an online survey, and the relatively small sample. ConclusionThe study showed high levels of distress among teachers after exposure to a student's suicide and greater need for help than that obtained.

Smoking cessation and gender differences – results from a Swedish sample

Aim Previous research has concluded that prevalence of smoking, reasons to quit and strategies to become smoke-free vary markedly by gender. Yet we lack a more comprehensive understanding of the process leading to a quit attempt and a positive long-term outcome, and of the gender-specific mechanisms behind successful cessation. My aim is therefore to investigate reasons of smoking and motives, mechanisms and factors of smoking cessation, with special regard to gender differences. Data/Method Between October 2009 and May 2010, respondents were recruited through the Swedish Monitor project. Each month 1 500 individuals from a representative sample in the Swedish population (n=12 000) were interviewed on the telephone. In a screening process, previous daily smokers who had been smoke-free for at last 12 months were asked to answer a postal survey (n=1 683) concerning their process to a smoke-free life. The analyses consist of both descriptive statistics and factor analyses. Results The results indicate that women's smoking filled an important role in life and that the cessation process was quite complex. Women often met harsh consequences from smoking, quitting for the sake of others. They tended to plan their cessation in advance and made more often use of professional help and nicotine replacement therapy (NRT) than men. Men tended to experience their smoking as quite unproblematic and typically quit for more self-oriented reasons. They seldom planned their cessation in advance, but many made use of snuff or snus, and about half were still using it. More than men, women perceived physical problems in not smoking, but also more social and personal benefits. Conclusions Gender differences were found in reasons to smoke, reasons to quit and strategies to quit smoking. Because the smoking cessation process is gendered, strategies and policy decisions should be gender sensitive, taking into account an array of specific needs.

Seeking Help for Postpartum Depression in the Israeli Jewish Orthodox Community: Factors Associated with Use of Professional and Informal Help

Postpartum depression (PPD) has potentially devastating personal and familial consequences. However, very few women receive treatment, either professional or informal. Use patterns and factors associated with both professional and informal help for PPD have not yet been investigated. This study examined factors associated with use of professional and informal help for PPD in an Israeli sample that included women from secular, traditional, orthodox, and ultra-orthodox Jewish religious groups. One to two days postpartum, 1,059 women were recruited from a large hospital in Jerusalem, Israel, and completed an initial survey; 805 women (76%) participated at the 6-week follow-up; 94 women (12%) screened positive for PPD symptoms at the 6-week follow-up and were referred for help; and 88 women completed the 6-month postpartum follow-up interview. Of the women referred for help, 69% used some sort of help, with 24% using professional help and 45% using informal help. Confidence in mental health professionals and higher levels of PPD symptomatology were associated with use of professional help. Recognition of personal need for professional psychological help was negatively associated with use of informal help. Findings from this study highlight the importance of routine screening for PPD and culturally sensitive referrals using informal sources of help.

The ZInEP Epidemiology Survey: background, design and methods.

This article introduces the design, sampling, field procedures and instruments used in the ZInEP Epidemiology Survey. This survey is one of six ZInEP projects (Zürcher Impulsprogramm zur nachhaltigen Entwicklung der Psychiatrie, i.e. the "Zurich Program for Sustainable Development of Mental Health Services"). It parallels the longitudinal Zurich Study with a sample comparable in age and gender, and with similar methodology, including identical instruments. Thus, it is aimed at assessing the change of prevalence rates of common mental disorders and the use of professional help and psychiatric sevices. Moreover, the current survey widens the spectrum of topics by including sociopsychiatric questionnaires on stigma, stress related biological measures such as load and cortisol levels, electroencephalographic (EEG) and near-infrared spectroscopy (NIRS) examinations with various paradigms, and sociophysiological tests. The structure of the ZInEP Epidemiology Survey entails four subprojects: a short telephone screening using the SCL-27 (n of nearly 10,000), a comprehensive face-to-face interview based on the SPIKE (Structured Psychopathological Interview and Rating of the Social Consequences for Epidemiology: the main instrument of the Zurich Study) with a stratified sample (n = 1500), tests in the Center for Neurophysiology and Sociophysiology (n = 227), and a prospective study with up to three follow-up interviews and further measures (n = 157). In sum, the four subprojects of the ZInEP Epidemiology Survey deliver a large interdisciplinary database.

How ubiquitous are physical and psychological complaints in young and middle adulthood?

To investigate continuity and change of self-reported physical and psychological complaints in young adults over a period of 20 years. The Zurich Study--a long-term panel survey in psychiatric epidemiology--is based on a stratified sample of 591 subjects born in 1958 (women) and 1959 (men). The sample strata combine SCL-90-R high-scorers and low-scorers in a 2:1 ratio. Up to now, the Zurich Study has included six interviews between 1979 and 1999, i.e. 20 years of life in young adults. We analysed the longitudinal frequency data of a variety of physical and psychological complaints, as well as information about subjective suffering and use of professional help. The analyses utilised on the McNemar's test, the Q-test and Markov chain models. Sleep disorders, depression, menstruation, backache, headache, stomach and bowel complaints yielded cumulative prevalence rates of 80% or higher. Physical and psychological complaints systematically differ with respect to the change patterns between 1979 and 1999. Moreover, strong differences were found in view of subjective suffering and use of professional help. Even though many self-reported physical and psychological complaints are very common in young adulthood, the underlying dynamics and the implications largely differ. It seems to be crucial whether respondents use somatic glasses or psychological lenses.

Factors associated with posttraumatic stress among peacekeeping soldiers

This study aimed to investigate positive and negative consequences of peacekeeping operations, help-seeking behaviour among peacekeepers, PTSD prevalence rates and factors associated with PTSD symptoms. A sample of 3,481 peacekeeping soldiers who participated in various peacekeeping operations was investigated on average 6 years following their deployment. The prevalence of PTSD was 5.6% overall, with 8.0% among peacekeepers of the former Yugoslavia and 3.7% among peacekeepers who went to Cambodia. Twelve percent received professional help during deployment. The majority reported positive consequences of the deployment as well (e.g., a broadening of their horizon [82%], increased self-confidence [52%]). The following variables were significantly associated with current PTSD symptoms: lower level of education, being single, more traumatic situations during deployment, feeling more powerless and threatened, the idea that the mission had become meaningless, having had no control over the situation, and the use of professional help during deployment.

Suicide and mental health in rural, remote and metropolitan areas in Australia.

To compare the prevalence of mental health disorders and the use of professional help by area of residence, age and sex; and to determine whether the differences parallel differences in suicide rates. Retrospective cross-sectional analysis of Australian national mortality data (1997-2000) and the National Survey of Mental Health and Wellbeing (1997), using broad area-of-residence classifications based on the Rural, Remote and Metropolitan Area (RRMA) index. (a) Suicide rates; (b) prevalence of depression, anxiety and substance-use disorders; and (c) use of health professionals for mental health problems - by age, sex and area of residence. Higher suicide rates were evident for men, particularly young men in rural (40.4 per 100 000; z, 3.2) and remote (51.7 per 100 000; z, 7.2) populations compared with metropolitan (31.8 per 100 000) populations. Although the proportion of young men reporting mental health disorders did not differ significantly between rural (23.5%; z, -0.5) and remote (18.8%; z, -1.6) areas compared with metropolitan (25.6%) areas, young men with a mental health disorder from non-metropolitan areas were significantly less likely than those from metropolitan areas to seek professional help for a mental health disorder (11.4% v 25.2%; z, -2.2). There is a need to investigate why young men in non-metropolitan areas, the population with the greatest suicide risk, do and do not engage with mental health services.

Quality of Care and Quality of Life from the Perspective of Patients and Parents

Although easily used the concept of quality is rather complex, ambiguous, and difficult to measure. Consequently, this applies to the concepts of ‘quality of care’ and ‘quality of life’, being constructs which as such are difficult to determine and to measure. Although it is supposed that the first contributes to the second, they are often considered as ‘opponents’ rather than ‘friends’. ‘Quality of care’ refers to the process as well as to the results of care related to specific goals for a specific type of care as judged by the groups involved. Daily functioning and the appraisal of someone's health or well-being are integral parts of the ‘quality of life'. An often neglected standpoint concerning quality of care is that of the group of patients, their parents or partners which contributes to the opposing characteristics of both concepts. In case of a chronic condition, they will make use of professional help and care for a long period of time, affecting their quality of life. Therefore, insight into their standpoint concerning the quality of the care delivered to them is urgently needed. In this article both concepts and their possible relationship will be discussed and illustrated with some examples derived from a research among adult patients with epilepsy, all members of the Dutch Patient Organization and from two researches among parents of a child with epilepsy. From these studies it appears that a) the quality of care provided is often judged as unsatisfactory, that b) the quality of care as experienced by parents may help them in handling their child with epilepsy, and finally, that c) it influences the behaviour of the child via parental child rearing practices. It may be concluded that in this sense, the quality of care provided is not always as optimal as it should be and that it affects the quality of life of parents and child.

Where do you turn for help? A community survey of the use of professionals, reading materials, and group programs for three problems in living

This paper reports the results of a community survey on the use of professional help, reading materials, and group programs for three common problems in living: coping with stress and anxiety, dealing with problems in child-rearing, and coping with problems with alcohol or drugs. Respondents were 581 residents of a city in the Canadian midwest. Reading material was the most commonly used source of help for child-rearing and stress and anxiety problems, followed by professional help and group programs. The three sources of help were used with approximately equal frequency for alcohol and drug problems. The results suggest that the self-help reading materials and group programs have a high degree of public acceptance and that the optimal utilization of these services should be studied in more depth.

Seeking professional help for personal problems: black Americans' use of health and mental health services.

This article explored the use of health and mental health services for serious personal problems in a national sample of adult black Americans. The results indicated low usage of the mental health sector in response to problems. Only 9% of the respondents who sought professional help contacted a community mental health center, psychiatrist or psychologist. Mental health usage was low even among respondents who felt their problem brought them to the point of a nervous breakdown and among respondents who conceptualized their distress in "emotional" terms. The traditional health care sector (doctors, hospitals) and ministers were used more often by blacks in distress. When the use of professional help only is considered, there appeared to be a large pocket of unmet need in the black community. When the use of informal help is taken into consideration, however, the percentage of respondents who did not receive help was considerably lower. The implications of these findings for professional service delivery are discussed.

Social Class and the Use of Professional Help for Personal Problems: 1957 and 1976

By comparing national survey data collected in 1957 and 1976, this paper assesses the stability of relationships between social class and the use of professional help for personal problems, examining the influence of education and income on: (a) problem definition, (b) the decision to seek help, and (c) the choice of a particular help source. In spite of a general increase in readiness for self-referral from 1957 to 1976 for the population as a whole, social class differences in defining a problem as relevant for professional help and in adopting a self-help position with regard to potential problems (both reported in 1957) generally persist in 1976. Among those who have identified a personal problem as relevant for help, however, social class differences in the actual use of help, apparent in 1957, have largely disappeared. Despite a marked increase in the use of mental health professionals in all socioeconomic strata, education and income differences in the use of psychiatrists and psychologists found in 1957 also generally persist in 1976, although the gap between highand low-income groups appears to be narrowing. Although perceived psychological distress is found to play a major role in seeking help, differences in professional help-seeking by socioeconomic status are largely independent of reported symptom levels. These patterns of persistence and change are interpreted as reflecting differential changes in the influence of motivational versus facilitating factors, respectively.