Browsing by Subject "Mental health"

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CYFC Consortium Connections, Fall 2000, Vol 9, No 3
(Children, Youth & Family Consortium, 2000) Children, Youth & Family Consortium
CYFC Consortium Connections, Spring 2001, Vol 10, No 2
(Children, Youth & Family Consortium, 2001) Children, Youth & Family Consortium
CYFC Consortium Connections, Summer 2010
(Children, Youth & Family Consortium, 2010) Children, Youth & Family Consortium
CYFC Consortium Connections, Winter 2002, Vol 11, No 1
(Children, Youth & Family Consortium, 2002) Children, Youth & Family Consortium
Depression in your primary care doctors office: What are we doing to help you?
(2012-07-26) Lally, P.J.
The Digital Transformation of Mental Health
(2018-08) Bedor Hiland, Emma
The United States is experiencing a mental healthcare crisis. Alongside growing numbers of mental illness diagnoses we are also faced with the problems of practitioner scarcity, the geographic remoteness of populations in need of mental healthcare, and prohibitive costs for services that might otherwise be within reach. A potential solution to these problems, many technologists, healthcare workers, and others believe, is the integration of technology into the delivery of mental healthcare. This dissertation explores the emergence of a field that seeks to do just that, that I term the digital mental health industry, and which encompasses three areas: telemedicine, applications, and artificial intelligence. Despite the interest that the digital mental health industry attracts, as of yet there has been little study of it unto itself. This project provides not only an examination of the technologies it relies upon, but also its workers’ beliefs as well as the field’s broader social and medical effects. Methodologically this dissertation utilizes a combination of fieldwork, interviews, and textual analysis to tell the story of how the digital mental health industry came to be, how it is changing what it means to be mentally ill or healthy, and how technology mediates processes of self-care.
Early Educational Intervention and Midlife Psychological Wellbeing: A Longitudinal Investigation In A Low-Income, Urban Sample
(2020-06) Mondi-Rago, Christina
The present study is the first to examine the relations between participation in a public early childhood intervention (the Child-Parent Center (CPC) program) and psychological wellbeing into early mid-life. Data is drawn from the Chicago Longitudinal Study (CLS), which has followed a cohort of 1,539 individuals who grew up in urban poverty for over four decades. Approximately two-thirds of the original study cohort participated in the CPC program in early childhood; the rest comprise a demographically matched comparison group. In this study, participants’ psychological wellbeing is assessed in terms of rates of depressive symptoms, as well as aspects of positive psychological functioning. Processes mediating the relationship between ECE intervention and long-term psychological wellbeing are explored, as well as potential moderated mediation (e.g., whether the effects of CPC participation vary for different subgroups of children). Future directions for child development research, early childhood intervention, and public policy are discussed.
Effects of Mindfulness in Motion on Adults with Multiple Sclerosis
(2015) Gilbertson, Rachel M; Brice, Lynn; Munson, Bruce
Multiple Sclerosis (MS) is a neurological disorder that can negatively affect physical and cognitive abilities and mental health. Although there is no known cause or cure for MS, increased stress levels is thought to exacerbate symptoms. The purpose of this study was to examine the effect of an eight-week Mindfulness in Motion (MiM) program on adults with MS in areas of stress, anxiety, depression, fatigue and quality of life. Twenty-two adults with MS completed the program and assessments. After comparing pre and post responses of four self-reported questionnaires, significant improvements were seen in physical functioning, vitality, and mental health; specifically anxiety, depression, and positive affect; cognitive, psychosocial, and overall functioning in regard to fatigue, and mindfulness in areas of observation, acting with awareness, non-judgment, and non-reactivity. At the final session, participant feedback was collected via open ended question form and group dialog. Qualitative analysis found improvements in general health, better-quality sleep, increased awareness of body sensations and energy levels, overall improvement in emotional response, enhanced mindful awareness, improved quality of life, and enhanced resiliency through decreased stress. Because of the unknown nature of MS, uncertainty in disease progression, and multiple mental and physical symptoms associated with it, coping and stress reduction are key areas of future research of MS disease management. The positive results from this study support the need for more research to determine the extent to which mindfulness training can improve health outcomes for adults with MS.
An Ethnographic Analysis of the Restrictions of Effective Mental Health Treatments in Moroccan Society: Where Do We Go From Here?
(2017) Trenberth, Tahnee
With its simultaneously omnipresent traditional and modern culture, Morocco possesses a unique binary demeanor. This is especially true when discussing the attitudes toward and perceptions of mental illnesses and those who suffer from them. It is important to understand the various components that influence perceptions, help-seeking behaviors, and overall attitudes toward perceived mental illness within Moroccan culture (Al-Krenawi, et al., 2009). Because there are a variety of ways in which patients conceptualize and articulate mental illnesses across cultures, it is necessary to consider factors such as cultural beliefs, societal legislative influences, local treatment availabilities, family involvement, awareness, stigmatization, and historical context to fully understand the challenges that arise concerning this complex issue. This is principally so in countries such as Morocco, where the conflicting ideals of traditional and Westernized psychiatric treatments often collide. The implementation of modern, westernized mental health treatments into a population that is already deeply embedded in traditional and religious healing methods has created an internal conflict surrounding the search for balance between the two practices (Stein, 2000). This can be problematic when attempting to treat cases, as practitioners’ misconceptions can lead to access barriers, misdiagnosis, or inappropriate treatment (Al-Krenawi, et al., 2009).
An Evaluation of the Effects of School Policies on Child and Adolescent Health and Health-Related Behavior
(2020-03) Berger, Aaron
School policies can potentially impact healthy youth development trajectories. This dissertation focused on evaluating two specific types of policies: 1) School district mandated start times for high schools, and 2) School food service policies that are mandated at the federal level. The first two manuscripts examine changes in health or health-related behaviors following a delay in high school start times. A cohort of students at five Minnesota high schools was followed over three years. All schools started at either 7:30am or 7:45am at the Baseline wave of data collection, when the students were in 9th grade. Beginning the year of 10th grade, and continuing through 11th grade, two of the schools delayed their start times by 50 and 65 minutes. In the first manuscript, I assessed if the delay in school start time that was implemented in two schools was associated with changes in adolescent depressed mood. Delaying school start time was not associated with changes in depressed mood score, high risk of depression, or incident high risk of depression, over two years of follow-up. The second manuscript assessed if school start time shifts affected physical activity levels, electronic screen time, or participation in organized sports or extracurricular activities. Later school start times were not associated with changes in any of these outcomes. The final manuscript evaluated whether a national school meal policy, the Healthy, Hunger-Free Kids Act of 2010 (HHFKA), affected children's dietary quality. I used a short dietary panel study to evaluate whether participation in school meals, or the dietary effects of school meals, changed during implementation of the HHFKA. I found that children reported the same percent of calories from school meals during HHFKA implementation, compared to the years before its passage. I found that the dietary benefits from school food increased substantially, compared to before HHFKA passage. Implementation of the HHFKA measurably improved average dietary quality of all US children. Understanding the effects of childhood programs and policies is important for setting children on a healthy life trajectory. The universal, compulsory nature of schools makes them a promising setting for a population approach to health promotion.
Examination of the Effectiveness of Mental Health First Aid Among the Public: A Meta-Analysis
(2018-06) Maslowski, Amy K
Mental health conditions are prevalent and can significantly impact a person's functioning; however, it can be challenging for an untrained individual to know when or how to provide assistance to a person experiencing a mental health concern. Mental Health First Aid (MHFA) was developed to provide people with training and guidelines to improve their mental health literacy, decrease stigma, and increase their confidence and willingness to offer aid to individuals experiencing a mental health disorder or crisis. Given recent initiatives to expand the implementation of MHFA programs and increased efforts to evaluate it with more rigorous designs, a comprehensive and systematic review of the evidence base is warranted. This study investigated and quantified, via meta-analytic methodology, MHFA outcomes (i.e., knowledge, attitude, behavior) for the training participant as well as both a quantitative and narrative review for the individual experiencing a mental health disorder or crisis. We conducted a comprehensive search for eligible studies that utilized either a control or comparison group. This resulted in 15 studies for inclusion in the meta-analysis. Small-to-moderate effect sizes were found for the primary outcomes for the trainees; however, preliminary evidence suggests effects for the recipients were more difficult to observe. Study quality had a significant moderating effect. Overall, MHFA appears to be an effective intervention for increasing knowledge about mental health, decreasing stigma and social distance, and increasing trainees' confidence in approaching and providing aid to an individual experiencing a mental health disorder or crisis. Considerably greater attention and effort in demonstrating effects on recipients is needed with future empirical investigations.
Experiencing co-occurring mental health and substance misuse disorders: the voices of rural older adults
(2013-02) McKinley, Kathryn J.
This exploratory qualitative study investigated the perspectives of rural older adults who experience co-occurring mental health and substance misuse disorders. These disorders co-occur frequently and have serious consequences. Risk and protective factors have been identified for older adults with co-occurring disorders. A treatment model addressing the specific needs of rural older adults with co-occurring disorders has not been developed. The literature does not reflect the views of rural older adults about their experiences with these disorders, treatment, or recovery. Critical theory was employed to examine the inattention to co-occurring disorders in rural older adults. Resilience theory facilitated understanding participants’ strength in coping with these disorders. Grounded theory was used to develop theory throughout the exploration and analysis of rural older adults’ perceptions of their experiences. Data consisted of in-depth qualitative interviews collected from older adults living in rural Iowa who identified as having co-occurring disorders. Interviews with 23 older adults ages 55 to 90 living in rural Iowa explored their perceptions of experience with co-occurring disorders; the responses of family, providers, and community; treatment and recovery; and policy issues. The analysis reveals that older adults experience multiple individual, community, and structural service risks to develop co-occurring disorders. Individual resilience, supportive relationships, and treatment lead to recovery. The treatment model developed from the analysis focuses on principles of treatment; prevention that provides information for individuals, family, community, and providers; and integrated treatment that includes older adult role models, responds to the needs of older adults, and is accessible to those living in rural communities. The study concludes that in spite of risks and lack of appropriate prevention and treatment, rural older adults with co-occurring disorders exhibit resilience that can be supported through culturally relevant prevention and treatment. Barriers and risks need to be addressed at individual, community, and service structure levels. Stigma about `co-occurring disorders, age, and rural communities contributes to the absence of appropriate services. Implications for social work education and practice, policy, and research are noted.
From Deinstitutionalization to Today: The History of the Modern Mental Health Crisis
(2016) Moret, Katie; Stuart, Lee
Treatment for those with mental health conditions has been influenced by many factors and changes in the field. One such change which shifted mental health treatment drastically was the deinstitutionalization movement in the United States during the 1950s. This movement advocated for the closing of state mental hospitals in favor of community-based resources to help those with mental illnesses. While hospitals were seen as restricting, community resources were seen as more conducive to recovery. This was a well-intentioned but failed initiative which led to negative outcomes for the area of mental health treatment throughout the country. This paper outlines the history of deinstitutionalization in the U.S. and its repercussions, and examines how this movement has led to the mental health crisis seen across the country. The state of mental health in St. Louis County, Minnesota is the focus, and the various services available and future improvements to be made are described.
In the system for too long: former foster youth and the structural ambivalence towards mental health
(2014-08) Baiocchi, Arturo
A growing research literature documents that young people who "age out" of foster care (after turning 18 or in some states 21) frequently encounter challenging obstacles during their transition into adulthood, and in particular are susceptible to poor mental health and substance abuse problems throughout their early twenties. Drawing from an 8-month longitudinal study of 26 young people transitioning out of care, the dissertation reports on the conflicted relationship that some former foster youth have with service providers, mental health programs and ideas of seeking help more generally, during their transition out of care. The dissertation argues that many former foster youth endorse conventional health beliefs about the efficacy of mental health treatments, but are nonetheless ambivalent about re-integrating themselves with what they perceive as an inconsistent and untrustworthy system of social services and public supports. This sense of what I describe as "structural ambivalence " reflects the inconsistent and contradictory forms of support that many foster youth received while wards of the state, and underpins many of their decisions as young adults to avoid and resist prolonged engagement with social services. Structural ambivalence has implications for meso-level theories of health seeking behavior, and in particular recent frameworks that emphasize the role that social networks and culture play in shaping the dynamic engagement that young consumers have with mental health treatments. This conceptual framework also highlights the contradictory logics of welfare and public health institutions more broadly in the US, and the troubling situation that former foster youth find themselves in while navigating these public systems during their uncertain transition to adulthood.
Maternal Mental health and substance use:An examination of their role in pregnancy health behaviors and birth outcomes.
(2010-12) Gyllstrom, Marilyn Elizabeth
Objective: To characterize maternal mental health from a surveillance perspective and to specifically focus on maternal mental health and its potential relationship with prenatal substance use by: describing the co-occurrence of maternal mood and prenatal substance use; exploring the independent and interactive associations of maternal mood and prenatal substance use with infant health outcomes; and examining the relationship between maternal mood, stressful life events and prenatal tobacco cessation and maternal mood, stressful life events, postpartum depression and postpartum tobacco relapse. A qualitative study of methamphetamine use during pregnancy was designed to describe the experiences of pregnant women who had used methamphetamine immediately prior to or during pregnancy, with a specific focus on their mental health history. Methods: Surveillance data from the Minnesota Pregnancy Risk Assessment Monitoring System (PRAMS), an on-going written/telephone survey of women who recently delivered live births in Minnesota linked to birth certificate data, comprised the dataset used to examine substance use, maternal mental health and infant health outcomes, as well as the tobacco cessation/relapse analyses. It is considered representative of Minnesota's recent mothers and infants. The Maternal Methamphetamine Study evolved from a community-based, participatory research model. Primary data collection and analysis focused on a small sample of women located in urban and rural settings in Minnesota. Qualitative methods were used to describe a population of women in out-patient therapy for methamphetamine use through county-based treatment programs. Data collection tools were designed in collaboration with researchers from the Minnesota Department of Health (MDH), Children's Hospitals and Clinics and Hennepin County Medical Center (HCMC). Qualitative data were obtained through in-person or telephone interviews and quantitative data through self-administered, written questionnaires. The University of Minnesota Institutional Review Board (IRB) reviewed both studies. The PRAMS questionnaire has been previously reviewed and approved by the Centers for Disease Control and Prevention (CDC) and MDH IRBs. The secondary analyses of PRAMS data qualified for IRB exemption, as it uses existing data and does not contain personal identifiers. The methamphetamine project was approved by the University of Minnesota IRB. Conclusions: Low maternal mood co-occurred with substance use during pregnancy, which has profound implications for the health of women and their infants. Low maternal mood during pregnancy and tobacco use were interactively associated with a two-fold higher risk of low birthweight births. Women who reported low mood during pregnancy and who abstained from alcohol use during the third trimester of pregnancy were twice as likely to have a preterm delivery compared to women who reported higher mood levels. Low mood levels and stress were associated with decreased likelihood of tobacco cessation during pregnancy. Women with a history of methamphetamine addiction reported personal and familial histories of psychological problems. In addition, methamphetamine was described as a remedy for low energy, low self-esteem, depression and anxiety. Women stated they could accomplish more while on methamphetamine and it helped them cope with the demands of daily life. Thus, mental health problems and substance use co-occurred, which may have potential adverse consequences for pregnant women. More study of this complex relationship, and the resulting effects on women and their children, is important for long-term maternal and child health. Limitations: The two data sources define depressive symptoms differently, with different data collection methods. Thus, comparability between the study populations is difficult. This further reflects the lack of a gold standard measure for prenatal depression and depressive symptoms and the difficulty of measuring such symptoms during pregnancy. The question related to maternal mood during pregnancy from PRAMS is not considered a standard screening question and requires caution when interpreting results. Additionally, the women participating in the methamphetamine study are a select group of women who were identified through drug treatment programs. Public Health Implications: This proposal suggests that mental health may be important over the course of a pregnancy and during the postpartum. The innovative nature of this project relates to its exploration of maternal mental health and substance use concurrently, and their potential joint contributions to adverse maternal and infant health outcomes. In addition, it is one of the first studies to describe pregnant women in recovery from methamphetamine addiction. The results from these manuscripts provide information for local, state and federal public health agencies for program development and research allocation, and could influence their confidence in surveillance data designed to track maternal mental health.
Mental health and health care utilization among transition age youth
(2015-11) Rowan, Kathleen
Many individuals experience mental health problems during the transition from adolescence to adulthood. For most persons, this experience is a temporary departure from otherwise good mental health. However, persistent mental health problems during young adulthood have serious implications for the life course, as such problems can interfere with educational, employment and social opportunities. There has been little research that examines the persistence of mental health problems during young adulthood, and limited research using multiple dimensions of mental health (rather than one specific condition). And further, little is known about the extent to which young adults with mental health problems use mental health care and other medical care. This study used nationally representative household survey data spanning a two-year period and latent class models to identify transition age youth (age 18 to 27) with persistent mental health problems, to identify their patterns of mental health and other medical care use, and to examine the socio-demographic and physical health correlates of poor mental health and health care use. Results indicated that about twelve percent of young adults have persistent mental health problems. But about half of these young adults rated their mental health as good, and this group was less likely to be in poverty, had fewer physical health problems, and used less health care overall compared to those with persistent problems and poor self-rated mental health (severe persistent problems). Two in five young adults with severe persistent mental health problems did not receive mental health care during the study period; however, nearly ninety percent of these young adults received other medical care, suggesting stronger integration of mental and physical health care is needed. Among young adults with persistent severe problems, those who were uninsured, poor, and Black or Hispanic were substantially less likely to use mental health care, compared to their insured, wealthier, and White counterparts. Removing barriers to mental health care could reduce disparities in well-being between social groups during the transition to adulthood, and potentially in life course outcomes.
Perceived need for mental health care, mental health service utilization, and satisfaction with care in elderly people.
(2008-06) Nelson, Melissa Marie
Background. Elderly people experience symptoms, diagnosis, and treatment of mental illnesses differently than younger people, and only half of elderly people with a probable mental illness use mental health care services. Nevertheless, most mental health care research has focused on younger people. This study examined relationships among attitudes toward care, quality of social support, severity of mental illness, presence of physical comorbidities or alcohol abuse problems, sociodemographics, possession of supplemental insurance, perceived need for care, rates of utilization, and satisfaction with mental health care for elderly people. Methods. Data were used from the Collaborative Psychiatric Epidemiology Surveys (CPES), a nationally representative, cross-sectional study of community-dwelling people's mental illnesses and mental health care utilization patterns. Logistic and linear regression models were used to study perceived need, utilization, and satisfaction with care. Results. Perceived need for mental health care increased with severity of depression and anxiety, history of chronic physical conditions, and pressure to seek care. Among respondents who met diagnostic criteria for depression or anxiety, the number of mental illness symptoms experienced was still related to perceived need for care. The odds of using formal mental health care increased with severity of depression or anxiety and with history of chronic physical illnesses. When utilization was measured among respondents who perceived a need for care, however, most measures of mental illness severity and history of chronic physical illness were no longer significant. There was little variation in the satisfaction measure, and multivariate models of satisfaction were unstable. Conclusion. Many elderly people who meet diagnostic criteria for depression and/or anxiety disorders do not use mental health services or even perceive a need for these services. Additionally, physical and mental health are associated with perceived need, but other factors are responsible for determining utilization among those with perceived need. Further studies that include more detailed measures of psychosocial factors and satisfaction with mental health care are necessary to understand what factors lead elderly people to perceive a need for mental health care and what factors influence those who perceive a need for care to actually seek treatment and adhere to it.
The role of certified athletic trainers in the recognition and referral of mental health issues in intercollegiate student-athletes.
(2010-12) LaRue, Mary Jean
Currently, limited statistics are available regarding the incidence, recognition and treatment of psychiatric conditions in college student-athletes (Glick & Horsfall, 2001). A University of Minnesota study (Mattern & Ware, 2007) indicated that 25.1% of college students had been diagnosed with a mental health condition in their lifetime; therefore, it is probable that student-athletes are experiencing these conditions at similar rates. Certified athletic trainers may be in the best position to notice when student-athletes are experiencing psychological problems (Ray & Wiese-Bjornstal, 1999). The purpose of this study was to interview 18 certified athletic trainers regarding their role in the recognition and referral of mental health issues in intercollegiate student-athletes. Semi-structured interviews in an interpretivist phenomenology were conducted. Questions were posed regarding the recognition and referral of mental health issues in student-athletes and the educational and experiential backgrounds that prepared certified athletic trainers to recognize, intervene and refer mental health issues in student-athletes. The recognition and referral process was impacted by both positive and negative aspects which either improved or hindered recognition and referral. Positive factors were concepts such as performance declines, the advantage of personal experiences, knowledge of comorbid conditions, convenience of Division I resources, cost and convenience of campus counseling centers, confidentiality and coaches' influence. Negative factors which hindered recognition and referral were lack of confidence in recognition and referral, detrimental coaches' influence, Division III resources, campus counseling location, confidentiality and emotional impact. Certified athletic trainers interviewed saw a variety of mental health issues in their student-athletes ranging from anxiety and depression to substance abuse and disordered eating. Referrals were made to many different medical professionals ranging from team physicians and neuropsychologists to emergency room physicians. Certified athletic trainers felt their educational background did very little to prepare them to recognize and refer mental health issues in their student-athletes, however practical experiences assisted them in gaining this knowledge. Curricular and practical implications such as implementation of additional coursework into existing athletic training curricula and incorporation of mental health protocols into athletic training room policies was also reviewed.
Yoga as a psychological intervention: conceptualizations and practice integration of professional psychologist-yoga teachers
(2014-09) Roth, Anna Laurie
Yoga is being increasingly utilized as a mental health intervention in the United States (Kinser, Goehler, & Taylor, 2012; Bennett, Weintraub, & Khalsa, 2008; Khalsa, 2004). However, little research has been done examining yoga through a psychological lens and no prior research has attempted to articulate an initial psychological conceptualization of yoga. In the present study, 14 individuals dually trained as Psychologists (PhD or PsyD) and Registered Yoga Teachers participated in semi-structured telephone interviews to aid in the examination of two primary research questions: (1) How do individuals dually trained as psychologists and yoga teachers conceptualize yoga as a mental health intervention? (2) In what ways do psychologists trained as yoga teachers integrate their dual training into their current professional psychology practice? Interviews were analyzed by a research team of three researchers and two study auditors who employed a modified version of the Consensual Qualitative Research methodology (CQR; Hill et al., 1997; 2005; 2012). Five domains and 15 categories were revealed from the data to address the research questions. The derived domains were Provider Context, Conceptualization Content, Conceptualization Process, Clinical Implications, and Practice Integration. The study found four explicit yoga components to be essential for psychological benefit (in order of prevalence): breath, mindfulness/meditation, relationship with self, and connection with body. Further, three implicit essential components were classified as increased distress tolerance, openness to yoga, and using "mat as metaphor" for life. Disorders identified as benefiting most from a yoga intervention included anxiety-based disorders (including trauma), and eating, substance abuse, and mood disorders. Cautions were expressed related to Axis II and psychosis. The study also found that participants incorporate yoga in some combination of the following: individual therapy breath work, mindfulness and yoga philosophy, group therapy with a yoga component, and workshops. The ideal integration of yoga in traditional mental health was identified as a combination of yoga with traditional therapeutic modalities, a systemic shift toward a more holistic healing paradigm generally, and opportunities to practice in a holistic community of integrative multidisciplinary providers in one community setting. Major study findings, study strengths and limitations, and implications are discussed.

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