Recent attempts to integrate geographic information systems (GIS) and participatory techniques, have given rise to terminologies such as participatory GIS and community-integrated GIS. Although GIS was initially developed for physical geographic application, it can be used for the management and analysis of health and health care data. Geographic information systems, combined with participatory methodology, have facilitated the analysis of access to health facilities and disease risk in different populations. Little has been published about the usefulness of combining participatory methodologies and GIS technology in an effort to understand and inform community-based intervention studies, especially in the context of HIV. This article attempts to address this perceived gap in the literature. The authors describe the application of participatory research methods with GIS in the formative phase of a multisite community-based social mobilization trial, using voluntary counseling and testing and post-test support as the intervention.
With the rapid growth in the literature on social support and psychological disorder, a review of the area is in order. The present article describes current conceptualizations of social support, and presents a distillation of empirical evidence on the relationships among stress, social support, and psychological disorder. The structure of support links and the quality of the relationships they provide appear to be associated with a range of mental health issues. Methodological problems with current research are assessed, and suggestions for appropriate design and conceptualization are offered.
The recent (1980) immigration of 125,000 Cubans to the U.S. presented health workers with a situation bearing many of the characteristics of a disaster. Some of the organizational, clinical, and ecological issues which are inherent in providing mental health care in disaster situations are discussed. Ultimately, the development of an effective response to the situation depended on an understanding not only of the individuals involved, but also on an appreciation for the characteristics of the different phases of disaster situations.
A random sample of accredited graduate psychology departments and internship programs were surveyed to examine current efforts at integrating ethnic minority content into curricula and training. Additional information was sought on faculty development efforts and needs relative to integration of such content. Of the 121 department chair respondents, 80 affirmed inclusion of ethnic minority content in curricula. Integration was mainly found through provision of elective courses. Seventy internship directors responded, with 45 acknowledging ethnic minority content in their programs. However, only 36% of this content was found in "most of the program." Over 30% of both the departments and internship programs reported no efforts to integrate ethnic minority content into curricula or training. Faculty development efforts in both the academic and applied settings were also found to be minimal. However, the need existed to provide faculty with basic resource materials, guidelines, and approaches, as well as training in integrating ethnic minority content. Department chairs perceived summer institutes for faculty as a mechanism for fulfilling ethnic minority content requirements. Internship directors perceived continuing education programs as most advantageous. Issues regarding the implications of the apparent dearth of ethnic minority content in psychology are discussed.
This study was an archival study attempting to determine whether certain descriptive client characteristics are related to high levels of client absenteeism or client attrition. Subjects were 354 former outpatient clients from a community mental health center. Descriptive characteristics such as age income, and treatment latency were taken from information routinely collected for all clients. Correlations revealed no significant relationships between the descriptive client characteristics and either absenteeism or attrition.
An experimental comparison was made of the drug abuse treatment effectiveness of a halfway house and a community lodge program. Drug abusers, mainly heroin addicts, were randomly assigned to one of the two programs. After a three-month follow-up period, no significant differences between the two conditions were observed on four outcome variables: number of reinstitutionalizations, number of jailings, time spent in the program, and percentage of drug-free urines. The finding of no differences between the two approaches was interpreted as casting doubt on the argument for the need for highly structured programs for the treatment of chronic drug abusers. The factors that were found to be related to outcome generally supported the hypothesis that increased assimilation into the drug culture (as measured by longer time spent mainlining heroin, greater habit cost, illegal support of the habit, and more time spent in jail after beginning illegal drug use) leads to unfavorable treatment outcomes. No evidence was found that related treatment outcomes to social class, age, education, employment history, or marital status.
Community-based drug agencies were established as a means for confronting the drug abuse dilemma. However, due to the traditional guidelines that were followed in developing CBDA programs, the unique aspects of the problem were overlooked. This uniqueness relates to the ability of the drug culture to satisfy basic human needs. To be effective CBDA must be able to satisfy the same needs that clients previously met through participation in the drug culture. This article examines three areas of weakness which limit the effectiveness of CBDA: (1) fragment delivery of services; (2) perpetuation of minimal client involvement, commitment, and responsibility; and (3) motivational considerations of board members. The alternative family structure is described as an innovative CBDA approach that directly relates to the uniqueness of the drug abuse problem.
To assess rates of screening and testing of HIV and HCV among those with serious mental illness and co-occurring substance use disorders.
One hundred fifty-three people with serious mental illness and cooccurring substance use disorders completed measures and were screened for HIV and HCV.
Six percent were HIV positive and 25% were HCV positive. Almost a quarter reported a history of injection drug use and 86% reported a history of unprotected sexual encounters. Compared to those without a diagnosis of Hepatitis C, those diagnosed with Hepatitis C were significantly more likely to have a sexually transmitted infection, (p = 0.01), have a lifetime history of injection drug use, (p < 0.001), and a lifetime history of sniffing drugs, (p = 0.01).
Given the high levels of infection of HIV and HCV and high levels of transmission risk factors efforts to improve screening and provide risk reduction counseling are warranted.
This paper reports on referral sources and the disposition of 409 problem drinkers who were contacted over a two-year period for participation in a 17-week alcohol abuse treatment program. A longitudinal follow-up design was used with 103 persons to evaluate various learning-based techniques in moderating their drinking habits. Referrals were analyzed by source (75% were legal referrals), percentage completing the program (70%, 72%, and 69% for self, legal, and mental health referrals), and "success" at one year. Legal referrals reported a significantly smaller pretreatment alcohol intake than self and mental health referrals. However, the decrease in alcohol intake for legal and nonlegal referrals were almost identical. The stigma of alcoholism as a disease and the coercion associated with referral by legal agencies were considered to be factors in acceptance of treatment and in treatment outcome.
Using holistic-interactionistic theory, the simultaneous nature of risk and protection factors for both males and females (age 6-11 in Wave 1) is examined using Latent Profile Analysis (LPA). Risk/protection classes are estimated using multiple risk factor variables (e.g., physical child abuse) and multiple protective factors (e.g., extracurricular activities). These risk/protection classes were used to predict low academic performance. For both males and females, high risk, low protection individuals were significantly more likely to experience low academic performance than low risk, high protection cases. Gender differences emerged in a class for females that included the importance of parental/peer disapproval of anti-social behavior as a protective factor that was not present for males. Findings support elements of the holistic-interactionistic theory for human development and suggest the need to examine risk and protective factors in combination to account for their shared influences on developmental outcomes. Implications for youths underperforming academically are discussed.
Through a CBPR partnership, university and American Indian (AI) tribal members developed and tested Our Life intervention to promote mental health of AI youth and their families by addressing root causes of violence, trauma, and substance abuse. Based on premises that well-being is built on a foundation of traditional cultural beliefs and practices, and that it requires a process of healing and understanding, the 6-month intervention had four components: 1) recognizing/healing historical trauma; 2) reconnecting to traditional culture; 3) parenting/social skill-building; and 4) strengthening family relationships through equine-assisted activities. Feasibility, acceptability, appropriateness, and preliminary outcomes were examined in a mixed-method within-group design. Engagement and retention were challenging, suggesting that families faced numerous barriers to participation. Youth who completed the program experienced significant increases in cultural identity, self-esteem, positive coping strategies, quality of life, and social adjustment. Qualitative data supported these findings and suggested additional positive effects.
This study evaluated the effects of prompts and reinforcement on two aspects of hypertension control: a) attendance at a community-based blood pressure screening program and b) follow-up visits to a physician's office by persons identified through screening as at-risk clients. Baseline data showed a decreasing trend in attendance at the screening sessions and a 51% "no show" rate for physician follow-ups. Screening session attendance increased following intervention; however, attendance rates across weeks appeared to vary mainly as a function of the prompting schedule (monthly newsletter announcements ) rather than the availability of reinforcement. Finally, the intervention not only increased the percentage of at-risk clients who saw a physician, but also decreased the latency between the time of initial screening and the follow-up appointment.
An Accountability Questionnaire was administered to administrators, service providers, and board members of 50 community mental health centers. The results, using cluster analysis techniques, yielded an Accountability Scale of 22 items. Four clusters with satisfactory discriminative validity were extracted: (a) Importance of Program Evaluation; (b) Satisfaction with State Monitoring Procedures; (c) Traditional Clinical versus Community Psychology Concerns; (d) Agency Preservation versus External Accountability. Analyses of variance indicated that board members, staff, and administrators differed significantly in their scores on each cluster. The Accountability Scale is a potential tool for community mental health agencies in assessing intraorganizational attitudes concerning accountability and has implications for administrative planning and evaluation.
Understanding the processes of acculturation in ethnic minority populations is one of the central tasks of crosscultural research. Addressing challenges of theory, methods, and application in acculturation research requires ongoing advancements in methods and theoretical and model development. The current study was designed to explain a person-centered approach to investigating acculturation and biculturalism and to illustrate this method with a sample of 315 Hispanic youth. Pattern analyses of the Hispanicism and Americanism scores from the Bicultural Involvement Scale yielded four distinct acculturation types, including one characterized by moderate scores on both scales. Relations between acculturation types and indicators of individual, family, and peer adaptation were tested. Results indicated that bicultural youth tended to show the most adaptive pattern of functioning across multiple sociocultural domains. Assimilated youth did not show as strongly negative a pattern as has been reported elsewhere. Implications and benefits of a person-centered approach are discussed.
Several acculturation theories note the importance of surrounding context, but few studies describe neighborhood influences on immigrant adaptation. The purpose of this study was to examine relationships among neighborhood immigrant concentration, acculturation, and alienation for 151 women aged 44-80 from the former Soviet Union who lived in the US fewer than 13 years. Participants resided in 65 census tracts in the Chicago area with varying concentrations of Russian-speaking and diverse immigrants. Results from self-report questionnaires suggest that the effect of acculturation on alienation varies depending on neighborhood characteristics. The study also demonstrates the complexity of individual and contextual influences on immigrant adoption. Understanding these relationships is important for developing community-based and neighborhood-level interventions to enhance the mental health of immigrants.
This article presents the findings of a survey completed by 1351 predominantly Mexican American middle school students residing in a large urban center in the U.S. Southwest. The study explores possible associations between drug use attitudes and behaviors and gender (biological sex), gender identity, ethnicity, and acculturation status. Based on the concepts of "machismo" and "marianismo" that have been used to describe Mexican populations, four dimensions of gender identity were measured: aggressive masculinity, assertive masculinity, affective femininity, and submissive femininity. In explaining a variety of indicators of drug use behaviors and anti-drug norms, gender alone had limited explanatory power, while gender identity-often regardless of gender-was a better predictor. Aggressive masculinity was generally associated with higher risk of drug use, while the other three gender identity measures had selected protective effects. However, the impact of gender identity was strongly mediated by acculturation. Less acculturated Mexican American students reported lower aggressive masculinity scores than non-Latinos. Less acculturated Mexican American girls reported both the lowest aggressive masculinity scores and the highest submissive femininity scores. More acculturated Mexican American students, along with the less acculturated Mexican American boys, did not appear to be following a polarized approach to gender identity (machismo and marianismo) as was expected. The findings suggest that some aspects of culturally prescribed gender roles can have a protective effect against drug use behaviors and attitudes, possibly for both girls and boys.
Children living with perinatal HIV illness (PHIV+) disproportionately reside in disadvantaged neighborhoods and contend with persistent mental health challenges. This study examined the influences of disadvantaged residential neighborhood on anxiety and depression, and potential resources that buffer against internalizing problems when youths were exposed to neighborhood stressors. Multilevel analysis of 196 PHIV+ and 129 perinatally HIV-exposed but uninfected youth (PHIV-) in New York City found that higher exposure to neighborhood disorder was associated with higher levels of depression and anxiety for PHIV+ and PHIV- youths. Stressful events unrelated to residential neighborhoods significantly mediated the relationship between neighborhood disorder and anxiety and depression. Social problem solving and religiosity did not moderate the relationship between neighborhood disorder and internalizing problems. Our findings highlighted that interventions that attenuate the negative effects of stressful life events were equally critical in addressing the broader impact of disadvantaged neighborhoods on the mental health of youth affected by HIV.
This study examined a highly successful, well-documented, national program to prevent teenage pregnancy and school failure-the Teen Outreach program-to address a fundamental question: How well can a developmentally focused, broadly targeted prevention program address the needs of those students within the program who are at the highest risk of problematic behavior. The hypothesis that the developmental focus of a broadly targeted intervention would lead it to have greater program efficacy among those young people who began the program at greatest risk was examined with multisite data collected on more than 3,300 Teen Outreach and comparison group students. Results confirmed prior findings regarding the overall efficacy of the Teen Outreach program, and indicated that the program appeared most effective for those students at greatest initial risk of the problem behaviors being targeted. Implications for the targeting of the Teen Outreach program specifically and of similar primary prevention programs more generally are discussed.
A survey was used to compare the attitudes of twelve Phoenix area mental health agencies regarding community control and participation in social action. A modified Likert scale provided attitude choices for survey items. The researcher computed mean scores for the twelve agencies for survey items. Each agency's attitudes are compared to the attitudes of the other eleven agencies considered as a group. No agency differed significantly from the other eleven on community control. One agency significantly differed from the other eleven regarding participation in social action.
Translational research (Pentz, Jasuja, Rohrbach, Sussman, & Bardo, 2006; Woolf, 2008) is concerned with moving advances in prevention science into everyday practice in communities, yet there are few models for ensuring this transfer of knowledge. Communities That Care (CTC) provides a planned, structured, and data-driven system that trains community prevention coalitions to select evidence-based programs and replicate them with strong implementation fidelity. In this article, the authors describe the implementation of the CTC prevention system over a 5-year period in 12 communities participating in the Community Youth Development Study.
The results indicated that the intervention communities enacted, on average, 90% of the core components of the CTC system, and achieved high rates of implementation fidelity when replicating a variety of school, afterschool, and parent training programs. These results held over time; communities successfully launched their prevention coalitions and programs and maintained the quality of their prevention services over 5 years. These results indicate that the CTC system can be used to foster translational research.
Consumer feedback about services can be used to reward staff, stimulate improved performance, and make the service organization more responsive to consumer needs. Carefully collected consumer feedback can be used in a process of organizational planned change involving a cycle of problem perception and documentation, followed by the choice, implementation, and evaluation of solutions to these problems. Presently, consumer feedback is often poorly collected or inadequately utilized. Through preparation of concrete items related to manipulable aspects of service delivery, use of precoded response categories for items, and use of computers for data analysis, high quality consumer feedback can be obtained and used to pinpoint service delivery problems, evaluate solutions to problems, and evaluate the impact of other service changes and innovations.
The paper describes the development of scales to assess the perceived social-environmental quality of work and family settings. The use of these scales in comparing and contrasting work and family settings and in examining their role as contexts for adaptation and growth is illustrated. Some tentative conclusions about social-environmental influences on individual and family adaptation are drawn and practical applications for planning ecologically oriented interventions are discussed.
Striking racial disparities in infant mortality exist in the United States, with rates of infant death among African Americans (AA) nearly twice the national average. Community-based participatory research (CBPR) approaches have been successful in fostering collaborative relationships between communities and researchers focused on developing effective and sustainable interventions and programs targeting needs of the community. The current paper details use of the Perinatal Period of Risk (PPOR) model as a method to engage communities by identifying factors influencing racial disparities in infant mortality and examining changes in those factors over a ten year period.
What variables are highly correlated with successful community adjustment? A group of ex-patients who left a halfway house to return to the community were interviewed around their active involvement and perceived support from the staff members of the halfway house, while living on their own or with their families. There was a highly positive relationship between continuing contact with the halfway house and the level of adjustment in the community. The implications for understanding the nature, continuity, and purpose of social supports for this group are discussed.
Administrators and middle managers from six CMHCs in Tennessee and Alabama were interviewed during site visits for the purpose of determining the main issues in mental health management. A step-by-step conceptual methodology was followed to process the field notes and interview responses. The views of a senior-level management professor specializing in mental health management and a senior-level professor in community psychology were used to further interpret and refine the results of this investigation. Although many diverse issues surfaced, an integrating theme emerged in the form of a need for management to motivate and inspire CMHC staff to a sense of mission.
The relationships between childhood exposure to violence and adolescent conduct problems were investigated in a sample of 88 primiparous adolescent mothers and their children. Regression analyses revealed that witnessing violence and victimization prior to age 10 predicted delinquency and violent behaviors, even after controlling for prenatal maternal and early childhood externalizing problems. Social competency and depression during middle childhood moderated the relationship between victimization and violent behaviors for girls, but not boys: Lower levels of social competency and depression served as risk factors for delinquency among teenage girls who experienced victimization during childhood. These findings have important implications for youth violence prevention programs.
Over the past two decades, the number of children with parents in prison has increased substantially. Using structural equation modeling with prospective longitudinal data gathered as part of the ongoing Linking the Interests of Families and Teachers (LIFT) trial, the study tests a theoretical model which examines the direct and indirect relationships of four specific domains (parental incarceration, social advantage, parent mental and physical health, effective parenting) as they relate to youth antisocial behavior in the 5th, 8th, and 10th grades. Across all three grades, the relationship between parental incarceration and youth antisocial behaviors was mediated through a complex set of both direct and indirect pathways involving social advantage, parent health, and effective parenting. The total amount of variation explained by the models for youth externalizing ranged from .60 (in 5th grade) to .21 (in 10th grade). The total effects in all the refined models were small.
School suspension is associated with school drop-out, crime, delinquency, and alcohol and other drug use for the suspended student. Important research questions are how academic and related factors are relevant to the school suspension process and the generality of the process in different sites. State representative samples of Grade 7 students (N = 1,945) in Washington State, United States and Victoria, Australia were followed from 2002 to 2004. In both states, Grade 7 school suspension was associated with higher rates of nonviolent antisocial behavior and suspension 24 months later, before Grade 8 factors were entered into the model. Relevant factors were Grade 8 low school grades and association with antisocial peers, as well as Grade 8 antisocial behavior in Washington State only. The implications of these findings for the ways in which suspension is used in schools are outlined.
The association between community-aggregated levels of peer and individual risk and protective factors and prevalence of adolescent substance use was examined in repeated cross-sectional data among youth in 41 communities ranging in population from 1,578 to 106,221. The association between community levels of these peer and individual risk and protective factors in 2000 and substance use 2 years later was examined by using within-cohort analyses (e.g., sixth grade in 2000 predicting eighth grade in 2002) and cross-cohort analyses (e.g., sixth grade in 2000 predicting sixth grade in 2002). In both within- and across-cohort analyses, community-aggregated levels of peer and individual risk and protective factors predicted the prevalence of adolescent substance use 2 years later, suggesting that focusing on elevated peer and individual risk factors and depressed peer and individual protective factors at the community level to guide the selection of preventive interventions may be a viable strategy for community efforts to prevent adolescent substance use community wide.
The purpose of this study was to assess the combined effects of ethnic identification and perceived parental monitoring on the substance use of a sample of 162 male and 192 female Mexican heritage seventh grade adolescents. Parental monitoring predicted lower risk for substance use. An interaction of ethnic identification by parental monitoring was observed with parental monitoring exhibiting stronger effects in decreasing use of alcohol use among boys who scored low on ethnic identification. For girls, decreased substance use was predicted by stronger parental monitoring coupled with high ethnic identification. Results are discussed in terms of how the youth's ethnic identification is a distinct process from acculturation, and how ethnic identification may operate as an added protective factor in conjunction with parental monitoring, as protective factors against adolescent substance abuse.
This article describes the structure, philosophy, and goals of a high expectations halfway house program for adolescents. The Transitional Treatment Center (TTC) is a residential treatment program for emotionally disturbed adolescents making the transition from institutionalization to independent community life. Topics covered are specification of the TTC program objectives, methods for monitoring residents' progress towards resocialization and plans for future programming.
Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), we identified a significant inverse association between the variety of youth organizations available at the neighborhood level and adolescents' exposure to community violence. We examined two non-competing explanations for this finding. First, at the individual level, we tested the hypothesis that access to a greater variety of neighborhood youth organizations predicts adolescents' participation in organized community-based activities, which, in turn, protects against community violence exposure. Second, at the neighborhood level, we tested the hypothesis that lower violent crime rates explain the inverse relation between neighborhood youth organization variety and community violence exposure. Our findings supported the latter of these two mechanisms.
Few studies have examined the effects of household change on adolescent development. We study household composition change and its effect on development, as measured by both internalizing symptoms and externalizing behaviors, in a sample of urban African American adolescents. Household change was defined based on the movement in or out of the household of one of the two most important adults adolescents named. We found 25% of adolescents reported changes in their household composition over the four years of high school. Youth who experienced change reported more internalizing symptoms and externalizing behavior than youth who did not experience change. Those reporting important people leaving their household had the greatest negative outcomes.
There is growing evidence to support developing new typologies for homeless adolescents. Current typologies focus on the risks associated with being homeless, with less consideration of the positive attributes of homeless adolescents. The authors examined both risk and protective factors in a sample of newly homeless adolescents. Using cluster analysis techniques, they identified three distinct clusters of newly homeless adolescents: those who are protected and doing relatively well while out of home with more protective than risk factors, those who are at-risk, and those who are risky with more risk than protective factors. Over half (51.9%) of these newly homeless adolescents were in the protected cluster. This typology has implications for the design and implementation of services and interventions for newly homeless adolescents to reconnect them with stable housing situations.
This study compares problem behaviors across a range of adolescent Asian Pacific Islander (API) subgroups using the Add Health data, and controlling for parental education or immigrant status. The study finds that Filipino, "other" API, and multiethnic API American youth are at higher risk for poorer outcomes than Chinese, Korean, and Vietnamese American counterparts. Many of these differences remained after adjusting for parental education. Controlling for immigrant status explained only some of the subgroup differences. The results suggest several shortcomings to the "model minority" stereotype that is often applied to API American youth. Research and practice should not overlook the higher risk for problem behaviors among certain API American subgroups. The findings highlight the need for more resources for API Americans, especially for the API subgroups facing higher risks.
The present study examined racial differences in the relationship between exposure to community violence and public and private religiosity in predicting externalizing problems among at-risk emerging adults. Participants were 178 African American and 163 European American emerging adults at risk for exposure to community violence. Exposure to community violence related to more externalizing problems. Greater public religious affiliation buffered the relationship between community violence and substance abuse, for both African American and European emerging adults. In addition, more privately religious African American emerging adults engaged in less deviant behavior when exposed to higher levels of community violence. European Americans were not protected by private religiosity.
This study examines the relationship between neighboring behavior and depressive symptoms across 3 years in a prospective study of 273 community-dwelling, Hispanic older adults in Miami, Florida. The analyses extend the literature by testing for a bidirectional or reciprocal relationship between neighboring behavior and depressive symptoms over time and examining the relationship between these variables in Hispanic older adults, a group at risk of developing depressive symptoms. Structural Equation Modeling with a cross-lagged panel design showed that depressive symptoms were unrelated to subsequent neighboring behavior. However, neighboring behavior was related to subsequent depressive symptoms at every time point, such that higher levels of neighboring behavior were related to lower levels of depressive symptoms. Findings suggest that neighboring behavior may be a protective factor against depressive symptoms in community-dwelling Hispanic older adults.
This article describes and evaluates the treatment effectiveness of a behaviorally oriented intermediate day-care clinic for adults with psychiatric disturbances. The goals of the program included reducing the number of psychiatric hospital admissions and readmissions, providing a community-based controlled environment to assist patients in the modification of specific problem behavior, improving interpersonal relations with "significant others" in the natural environment, teaching patients how to use community resources, and preparing them for employment and/or continued outpatient treatment. The program was structured so that patients advance through a series of four achievement levels for a variety of extrinsic and intrinsic reinforcers. While in the program, patients were introduced to available community resources, and were gradually phased into follow-up services. Results showed that 79% of all patients thus far treated partially, if not completely, advanced through the levels. There was also a high probability that a patient would advance from any given level. Outside-clinic behavior showed sustained improvement, with the authors concluding that the day-care clinic offered promise for the future.
Police traditionally have brought persons they define to be in need of psychiatric intervention to state hospitals. However, as large state facilities decline, community mental health centers must be prepared to receive these individuals. The present study defines the client population that police bring to a large, urban community mental health center. In addition, a two-year follow-up compares the dispositions of those persons brought by police to the community mental health center with the outcomes for patients treated at a state facility. Treatment benefits inherent in such a community-based program are discussed.
The impact of patients' and family therapists' own family values on judgments about a help-seeking family was investigated via a clinical analogue. Fifty family-oriented clinicians were classified as either traditional or nontraditional in their beliefs about the family. Clinical judgments were rendered of a hypothetical family in which the parents' verbalizations were suggestive of either traditional or nontraditional family values. Little diagnostic value-bias was detected, thereby failing to establish the operation of political bias in the family treatment setting.
The adherence of a community mental health center staff to community mental health ideology was measured by the Baker-Schulberg CMHI Scale. The results were essentially the same as those of the previously published studies, indicating that the CMHI Scale stably measures differences between professional groups, and is useful for research purposes. CMHI Scale scores were found to be significantly related to the socioeconomic backgrounds of the families of origin of therapists as well as to their professional affiliation.
Drawing upon a sample of 1,599 adults caring for children in HIV-endemic Umlazi Township in South Africa, this cross-sectional survey investigated whether perceived social support varied among caregivers of AIDS-orphaned children (n=359) as compared to caregivers of children orphaned by other causes (n=171) and caregivers of non-orphaned children (n=1,069). Results of multivariate linear regressions indicate that caregivers of AIDS-orphaned children reported significantly lower levels of social support compared to caregivers of other-orphaned children and non-orphaned children independent of socio-demographic covariates. Caregivers of other-orphaned and non-orphaned children reported similar levels of social support. In terms of sources of support, all caregivers were more likely to draw support from family and significant others rather than friends. These findings indicate a need to develop interventions that can increase levels of social support for caregivers of AIDS-orphaned children, particularly networks that include friends and significant others.
This study examined demographic predictors of attitudes regarding religious coping (i.e., prayer during stressful times and look to God for support, strength and guidance) within a national sample of African American, Caribbean Blacks and non-Hispanic Whites (National Survey of American Life). The findings demonstrate significant Black-White differences in attitudes regarding religious coping with higher endorsements of religious coping among African Americans and Black Caribbeans (Caribbean Blacks). Comparisons of African Americans and Black Caribbeans revealed both similar and divergent patterns of demographic effects. For both African Americans and Black Caribbeans, women were more likely to utilize religious coping than men and married respondents were more likely than never married respondents to report utilizing prayer when dealing with a stressful situation. Further, for both groups, higher levels of education were associated with lower endorsements of the importance of prayer in dealing with stressful situations. Among African Americans only, Southerners were more likely than respondents who resided in other regions to endorse religious coping. Among Black Caribbeans, those who emigrated from Haiti were more likely than Jamaicans to utilize religious coping when dealing with a stressful episode.
Men who have sex with men (MSM) experience greater mental health problems as compared with heterosexual populations. Informal social support plays a critical role in emotional well-being. The primary goal of this article is to examine the relationship between depressive symptoms and received social support from family, friends, and sex partners within the social network from a sample of 188 African American MSM in Baltimore, Maryland. We found that receiving emotional support from a family member or a sex partner was associated with reduced odds of having depressive symptoms. Receiving financial support from a family member or a friend was associated with increased odds of having depressive symptoms. The results suggest the importance of emotional support provided by family and sex partner in mental health and the potential value of training African American MSM in skills to enhance the quality of the relationships.
Mentally retarded individuals, their families, and professionals in the service delivery system in the African-American community were interviewed concerning the use of services for the mentally retarded. It was found that African-Americans underutilized available services. Reasons for this included aspects of the service delivery system and features of African-American Culture. Recommendations were made for increasing the use of services.
With increasing numbers of individuals being returned to the community from mental institutions, diverse community mental health center based „aftercare” programs have emerged to potentially meet the needs of these individuals. The degree to which aftercare programs are effectively preventing reinstitutionalization remains as a major unanswered question. In the present evaluation, an attempt was made to analyze the effects on recidivism of beginning formal aftercare programs in three Tennessee counties. A „multiple baseline type analysis” indicated that no clear reductions in recidivism rates occurred as a result of the aftercare programs. However, a more in-depth analysis in one of the target counties indicated that recidivism rates were substantially lower for individuals who contacted the aftercare program than those who did not contact the program. Thus, while the results do not suggest overall reductions in recidivism rates, it is possible that the aftercare programs are not contacting a large enough proportion of the releases to result in significant overall reductions.
Ratings of the importance of the goals of a pilot community mental health center (CMHC)-state psychiatric hospital cooperative program aimed at providing screening and aftercare were obtained from 214 mental health professionals. Respondents were employed at state hospitals, at CMHCs that were participating in the program, and at CMHCs that were not participating in the pilot cooperative program. Ratings of importance were found to differ across goals, between mental health workers of state hospitals and CMHCs, between participating and nonparticipating CMHCs, between professions, and as a function of distance between CMHCs and state hospitals. Implications of the findings for the evaluation of the success of a cooperative screening-aftercare pilot program are discussed.