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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.

This study examines whether risk factors associated with child externalizing behavior symptoms differ between two similar low-income, urban communities, using baseline parent data of 154 African American youth (ages 9-15) participating in the Collaborative HIV-Prevention and Adolescent Mental Health Project (CHAMP) family program. Separate multiple regression analyses of each city sample indicated that greater child externalizing symptoms were associated with increasing parenting hassles for New York families (n = 46), but greater parent mental health symptoms for participants in Chicago (n = 108). Understanding such distinctions between communities is an important first step toward tailoring services to unique community needs. (Contains 1 figure and 5 tables.)

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 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]

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]

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]

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]

This study examined the sustainability of a learning collaborative to improve service use among nine outpatient mental health agencies in the New York City area. Questionnaires were sent to collaborative participants to determine whether key practices and interventions were sustained one year later, and whether aspects of the staff, leadership, agency, and new practices facilitated or hindered their sustainability. All the agencies continued at least one of the new interventions to varying degrees. Agency openness, interventions that were aligned with agency mission, and dedicated leadership were the most frequently cited facilitators to sustainability. In contrast, staff and agency factors (such as not seeing a need for change) and inadequate resources were the most commonly noted obstacles to adoption. Learning collaboratives appear to be successful for effecting enduring change in agency practice, although various staff-, leadership-, agency-, and practice-related factors can either hinder or facilitate their sustainability. [ABSTRACT FROM AUTHOR]

This study examined the impact of a nine-month learning collaborative that was adapted from the Breakthrough Series Collaborative Model to improve mental health service use among urban youth and families who sought care at twelve participating mental health agencies between October 2004 and June 2005. A secondary analysis was conducted of data pertaining to: (a) initial show rates for first intake appointments for all new evaluations of children and adolescents and (b) attendance at any scheduled clinic appointment subsequent to the first kept intake appointment. During the course of the collaborative, an average increase of 14 percent in the rate of attendance at child mental health intake appointments (the equivalent of 448 more children attending) was evidenced. More modest gains in rates of ongoing involvement were noted. Collaborative learning environments can be useful for enhancing initial and continued attendance in mental health care for youth and their families, as well as being an effective method for disseminating engagement practices across agencies. [ABSTRACT FROM AUTHOR]

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.

This study is an exploration of engagement in outpatient medical care, medication utilization, and barriers to treatment utilization among 24 predominantly low-income, ethnic minority adults who were admitted to an urban hospital for HIV-related illnesses. A semi-structured interview was administered during the sample's hospital stay to explore patterns of service use and identify barriers to care. The majority of the sample was connected to an outpatient provider and satisfied with the care they received; however, most missed treatment appointments and skipped medication dosages. Health and treatment-related barriers, competing demands, and co-occurring mental health symptoms and illicit substance use were identified as barriers to care. Multiple obstacles indigenous to the individual, their treatment, and the environment prevented consistent treatment use among an economically disadvantaged ethnic minority sample: Implications and future directions in engaging vulnerable populations into health care for HIV are discussed.