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This brief report describes results from an evaluation of NAMI Basics, a peer-delivered family education program for family caregivers of children and adolescents with mental illness. Over six classes, family members are given information (e.g. education about mental illness and treatments), skills training (e.g. family communication skills) and advocacy support. We report data from 36 caregivers who completed pre and posttest instruments measuring self-care, empowerment, and family problem-solving and communication skills. Results showed significant improvements in self-care, empowerment, and 'incendiary' family communication after participation in the program. Results suggest that NAMI Basics may improve both parental functioning and familial processes. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

Objectives Methodologically sound mixed methods research can improve our understanding of health services by providing a more comprehensive picture of health services than either method can alone. This study describes the frequency of mixed methods in published health services research and compares the presence of methodological components indicative of rigorous approaches across mixed methods, qualitative, and quantitative articles. Data Sources All empirical articles ( n = 1,651) published between 2003 and 2007 from four top-ranked health services journals. Study Design All mixed methods articles ( n = 47) and random samples of qualitative and quantitative articles were evaluated to identify reporting of key components indicating rigor for each method, based on accepted standards for evaluating the quality of research reports (e.g., use of p-values in quantitative reports, description of context in qualitative reports, and integration in mixed method reports). We used chi-square tests to evaluate differences between article types for each component. Principal Findings Mixed methods articles comprised 2.85 percent ( n = 47) of empirical articles, quantitative articles 90.98 percent ( n = 1,502), and qualitative articles 6.18 percent ( n = 102). There was a statistically significant difference (χ2(1) = 12.20, p = .0005, Cramer's V = 0.09, odds ratio = 1.49 [95% confidence interval = 1,27, 1.74]) in the proportion of quantitative methodological components present in mixed methods compared to quantitative papers (21.94 versus 47.07 percent, respectively) but no statistically significant difference (χ2(1) = 0.02, p = .89, Cramer's V = 0.01) in the proportion of qualitative methodological components in mixed methods compared to qualitative papers (21.34 versus 25.47 percent, respectively). Conclusion Few published health services research articles use mixed methods. The frequency of key methodological components is variable. Suggestions are provided to increase the transparency of mixed methods studies and the presence of key methodological components in published reports. [ABSTRACT FROM AUTHOR]

We conducted a review of empirically based prevention programs to identify prevalence and types of family support services within these programs. A total of 238 articles published between 1990 and 2011 that included a family support component were identified; 37 met criteria for inclusion. Following the Institute of Medicine's typology, prevention programs were categorized as universal, selective, or indicated; programs containing more than one prevention level were characterized as multi-level. Family support types included those led by a mental health professional, led by a peer, or team-led. Among the 37 prevention programs reviewed, 27% ( n = 10) were universal, 41% ( n = 15) were selective, 16% ( n = 6) were indicated, and 16% ( n = 6) were multi-level. The predominant model of family support was professionally led (95%, n = 35). Two ( n = 5%) provided team-led services. None were purely peer-led. In terms of content of family support services, all (100%, n = 37) provided instruction/skill build. Information and education was provided by 70% ( n = 26), followed by emotional support ( n = 11, 30%) and instrumental or concrete assistance ( n = 11, 30%). Only 14% ( n = 5) provided assistance with advocacy. The distribution of models and content of services in prevention studies differ from family support within treatment studies. As family support is likely to be an enduring component of the child and family mental health service continuum, comparative effectiveness studies are needed to inform future development. [ABSTRACT FROM AUTHOR]

This study explores utilization of treatment for HIV and barriers to care among 22 low-income adults of color who were hospitalized at an urban medical center in New York City. A semistructured interview assessing use of medical care and adherence to HIV medications, psychosocial stressors (e.g., social support, substance abuse, and mental health need), and logistical, perceptual, and environmental barriers to treatment was administered during the participants' hospital stay. Results showed that most of the sample had a regular source of outpatient care; however, very few were consistently connected to services. Further, the majority of respondents either skipped dosages or was not taking HIV medications all together. Untreated mental health and substance abuse difficulties, competing needs (e.g., housing, economic), unsafe living environments, negative views of treatment, and lack of social support were cited as contributing to treatment underuse. These findings suggest highly disadvantaged populations face innumerable obstacles to consistent receipt of needed care: implications and potential methods to intervene are discussed. [ABSTRACT FROM PUBLISHER]

Many adolescents entering substance abuse treatment do not stay for the full course of prescribed treatment. There have been few explorations into what facilitates the ongoing participation of adolescents while in treatment. This paper describes adolescent, parent, and treatment staff perceptions of the barriers and facilitators to retention and participation. Interviews were conducted with 87 adolescents, parents, and staff from three residential substance abuse treatment agencies in two states. Data were coded thematically and organized into themes by respondent type. Respondents reported barriers related to treatment population, program design, and communication and relationships, and reported facilitators related only to communication and relationships. Staff reported far more barriers than facilitators in comparison to either adolescents or parents. Findings suggest that parents and staff underestimate their contributions to the treatment process and practitioners might benefit from rethinking how to communicate the value of these stakeholders. [ABSTRACT FROM AUTHOR]

Many adolescents with substance abuse problems do not obtain treatment, and there has been no systematic exploration of perceived barriers to starting care from multiple stakeholders. This article describes adolescent, parent, and treatment staff perceptions of barriers and facilitators to treatment. We interviewed 87 adolescents, their parents, and agency staff from three residential substance abuse treatment agencies in two states to explore barriers and facilitators to care in seeking, finding, and initiating substance abuse treatment. Youth, parent, and staff reports of barriers to treatment ( n == 128) far outnumbered facilitators to treatment ( n == 6). Staff perceived primarily family barriers to seeking treatment (e.g., denial, stigma); parents stated challenges finding treatment (e.g., lack of knowledge), and all three groups reported barriers to initiating treatment (e.g., lack of motivation). Findings suggest structural and perceptual barriers to adolescent services vary by respondent and by the reference point on the help-seeking continuum. [ABSTRACT FROM AUTHOR]

A comprehensive review of structured family support programs in children’s mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met criteria for inclusion. Programs were categorized by whether they were delivered by peer family members, clinicians, or teams. Five salient components of family support were identified: (a) informational, (b) instructional, (c) emotional, (d) instrumental, and (e) advocacy. Clinician-led programs were heavily represented ( n = 33, 66%), followed by family-led ( n = 11, 22%), and team-delivered ( n = 6, 12%) programs. Key differences between programs delivered by clinicians or by peer family members were found in the degree of emphasis, research methodology, and outcomes. However, the content of the components was similar across all three program types. There are both important differences in emphasis across typologies of family support provided by clinicians, family members, or teams as well as important similarities in content. Family-delivered support may be an important adjunct to existing services for parents, although the research base remains thin. A research agenda to promote more rigorous evaluations of these services especially those delivered by peer family members is critical. [ABSTRACT FROM AUTHOR]

A comprehensive review of structured family support programs in children's mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met criteria for inclusion. Programs were categorized by whether they were delivered by peer family members, clinicians, or teams. Five salient components of family support were identified: (a) informational, (b) instructional, (c) emotional, (d) instrumental, and (e) advocacy. Clinician-led programs were heavily represented (n = 33, 66%), followed by family-led (n = 11, 22%), and team-delivered (n = 6, 12%) programs. Key differences between programs delivered by clinicians or by peer family members were found in the degree of emphasis, research methodology, and outcomes. However, the content of the components was similar across all three program types. There are both important differences in emphasis across typologies of family support provided by clinicians, family members, or teams as well as important similarities in content. Family-delivered support may be an important adjunct to existing services for parents, although the research base remains thin. A research agenda to promote more rigorous evaluations of these services especially those delivered by peer family members is critical. [ABSTRACT FROM AUTHOR]

This paper describes the process by which child mental health researchers partnered with paraprofessionals called peer family advisors to create a stress-reducing intervention for caregivers of children and adolescents with mental health challenges. The issues that arose as the team strove to develop an intervention that was both relevant to the issues that these caregivers grapple with, as well as palatable and feasible for peers to deliver, are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the impact of parental mental health and types of racial socialization. The sample consisted of 169 African-American parents and their children (ages 9-11) who participated in a federally funded research project. "Knowledge about the African American Research Experience" (KAARE). Bivariate analyses revealed significant positive relationships between parent mental health status and two forms of racial socialization: spiritual/religious coping, and racial awareness teaching, while multivariate analyses supported the positive association between parental mental health and spiritual/religious coping. These results suggest that parental characteristics may influence the use of specific types of racial socialization to assist youth in coping with discriminatory societal messages. [ABSTRACT FROM AUTHOR]

The articles in this special issue are a significant contribution to the literature pertaining to racial socialization, which is defined as messages parents communicate about race and culture, how African Americans are perceived societally, and how to cope with discrimination due to their skin color. More specifically, these articles examine the relationship between racial socialization and parental mental health status, child socio-behavioral functioning, and the utilization of menial health and prevention services for both parent and child. Overall, the results of these articles indicate that various racial socialization practices do indeed influence key variables such as the child's behavioral functioning and decision-making, parental mental health status, and the receipt of prevention and mental health services, applications of these findings suggest that racial socialization beliefs and practices may in fact influence the health and functioning of African American youth and families. [ABSTRACT FROM AUTHOR]

Objective: To examine how parental endorsement of racial socialization parenting practices relates to child mental health service use among an urban sample of African American families. Methods: A crosssectional sample of urban African American parents (n = 96) provided ratings of their beliefs concerning various dimensions of racial socialization constructs, i.e., spiritual or religious coping (SRC), extended family caring (EFC), cultural pride reinforcement (CPR), and assessed regarding their use of child mental health services. Results: At the multivariate level, the use of child mental health services was significantly positively associated with moderate levels of endorsement of SRC and EFC. Inversely, scores in the moderate range of CPR were associated with a reduced likelihood of child mental health service use. Conclusion: Parental endorsement racial socialization parenting practices appear to play a salient role in child mental health service use among an urban African American families. Further research with larger and more representative samples should be pursued. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine symptoms of posttraumatic stress disorder (PTSD) in a community sample of low-income pregnant women who met the DSM-IV diagnostic criteria for the disorder. Method: Pregnant women (N=948) were screened for trauma, PTSD, depression, and co-occurring illicit substance use. PTSD symptoms were compared in traumatized pregnant women and a sample of nonpregnant traumatized women from the National Comorbidity Survey. Results: Suicidal thoughts and a high degree of psychiatric comorbidity were common in pregnant women with PTSD. Pregnant women were selectively and significantly less likely to endorse reexperiencing symptoms of PTSD (29.5%, N= 82), compared to nonpregnant women (79.4%, N=464). Conclusions: PTSD in pregnancy was associated with comorbidity, poor health behaviors, and lower recall of memory-related PTSD symptoms. Further prospective study is needed. [ABSTRACT FROM AUTHOR]

The article focuses on the recognition of depression among gynecologic patients. Included among the symptoms of major depressive disorder (MDD) are decrease or increase in appetite and fatigue. Decreased sexual interest and anger are some of MDD manifestation among women. A multidisciplinary approach is significant to depressed women with chronic pelvic pain. INSET: Take-home messages.

Assesses rates of detection and treatment of depression, panic disorder and post-traumatic stress disorder among pregnant women receiving prenatal care at public-sector obstetric clinics in New Haven, Connecticut. Comparison of detection rates for the different types of mental disorder; Prevalence of depression among pregnant women.

The article concludes various exploratory studies conducted on a variety of issues related to racial socialization. The exploratory studies presented in the issue suggested that parental racial socialization processes are relevant in determining the outcomes of mental health services and in the decision making capacity of youth. Each emphasized the significance of ethnicity to the outcome of mental health services and behavior modification efforts. They also revealed the link between parental racial socialization and the utilization of child mental health services.