News & Announcements
Mental Health Care Scarce for Kids in Child-Welfare System
Posted: August 06, 2012
Young children who are the subject of investigations by child-welfare agencies because of allegations of maltreatment have a higher prevalence of mental health problems than their peers, and very few receive treatment for those problems. This is the focus of a new study titled Mental health problems in young children investigated by U.S. child welfare agencies published in the Journal of the American Academy of Child and Adolescent Psychiatry.
Sarah McCue Horwitz, Ph.D., a professor in the Department of Pediatrics and the Centers for Health Policy and Primary Care and Outcomes Research at Stanford University, and colleagues made that pronouncement after evaluating data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), a longitudinal study of 5,872 children from infancy to age 17.5 referred to child-welfare agencies for an investigation of potential maltreatment. The investigations were completed during the sampling period, February 2008 to April 2009.
For children aged 12 to 18 months who were part of the survey, caregivers were administered the Brief Infant-Toddler Social Emotional Assessment (BITSEA), a 42-item screening tool designed to identify children at risk for social-emotional problems and low social competence. For children aged 19 to 36 months, caregivers were administered the Child Behavior Checklist 1.5-5 (CBCL 1.5-5).
The results were disturbing: in all, the scores for 34.6 percent of children aged 12 to 18 months were high on the Problem Scale of the BITSEA, and 20.9 percent on the Competence Scale, while for 10 percent of those aged 19 to 36 months the scores were over the CBCL clinical cutoff, indicating the need for mental health services. Children of black ethnicity were less likely to have elevated scores on the BITSEA Problem Scale, and children who lived with a never-married caregiver were five times more likely to have elevated scores.
Competence problems were associated with prior child-welfare-system history, and elevated CBCL scores were associated with living with a depressed caregiver. But what the researchers found distressing was that few of the children with identified mental health problems—only 2.2 percent— received mental health services.
The Importance of Teen Substance Use Prevention in the LGBTQ Community
Posted: August 05, 2012
According to a report by the Centers for Disease Control and Prevention, gay, lesbian, and bisexual high school students are at higher risk for alcohol and drug abuse than heterosexual students. During Pride Month, David K. Mineta, Deputy Director of Demand Reduction for the Office of National Drug Control Policy, met with leaders and advocates from the LGBTQ community to talk about substance use and other important issues facing those who are “differently” oriented. He told them how proud he was to work for a President who has made more LGBTQ appointments than any before him and whose Administration is committed to securing equality for all citizens, regardless of race, creed, or sexual orientation.
They also talked about the importance of prevention – stopping substance use before it begins and identifying drug-related problems early. Alcohol and drugs can wreak havoc on even the most supportive and nurturing environments, so it is crucial for these young people, and indeed for all Americans, to remain vigilant against the threat.
The Obama Administration has made drug-use prevention one of their top priorities and has devoted substantial resources to supporting community-based coalitions around the country through the Drug Free Communities Support Program. These coalitions work to address local health and safety issues, including those faced by LGBTQ youth. Among the other powerful tools available for preventing substance abuse is ONDCP’s “Above the Influence” Campaign, which gives teens information and a national platform to talk about staying above the influence of drugs and alcohol.
Read more on the Reclaiming Futures website.
Circle of Life HIV/AIDS Prevention Intervention for American Indian and Alaska Native Youth
Posted: August 03, 2012
This article describes the objectives, theoretical bases, development process, and evaluation efforts to-date for the Circle of Life curricula, HIV/AIDS prevention interventions designed for American Indian and Alaska Native youth. The curricula are based on Indigenous models of learning and behavior encompassing concepts of Western theories of health behavior change. The curricula underwent extensive national and community review. Subsequent advances include the development of a computer-based version of the intervention.
A review of the interventions aimed at HIV prevention for youth reveals a growing list showing success in sexual risk reduction. While these reviews have provided useful guidance for many youth-serving programs, absent from these lists is an intervention designed specifically for American Indian/Alaska Native (AI/AN) youth. Several factors contribute to this absence, including the challenges of generating sufficient scientific evidence to meet the standards required by such lists, the gaps created by inconsistent funding and shifting programmatic priorities, and the rapid change in technology and opportunities to use approaches to learning appropriate for AI/AN youth. In this brief article, the authors present the case of two curricula developed specifically for AI/AN youth: “Circle of Life: HIV/AIDS Curriculum for K-6” and “Circle of Life: HIV/AIDS and STD Prevention Curriculum for Middle School.” They outline the challenges and successes of development, implementation, and dissemination of these AI/AN youth-focused interventions. This history, coupled with strategic partnerships and escalating HIV prevention need in AI/AN communities, has propelled the two Circle of Life (COL) curricula forward, positioning them as meaningful and appropriate options for youth sexual risk prevention. The article begins by describing the development of COL, including the objectives of the curricula and their theoretical bases. It then describes the evaluations of the COL curricula, recent developments with respect to COL, and the promise of upcoming research efforts.
Using Telepsychiatry for the Treatment of Depression in Underserved Hispanics
Posted: August 02, 2012
St. Elizabeth’s Health Center (St. Elizabeth’s) located in Tucson, Arizona, offers an array of medical, dental, counseling, and social services to its patient population. St. Elizabeth’s serves a highly underinsured and uninsured primarily Spanish speaking population. One respondent indicated at least 60% of the patient population identifies as Hispanic and approximately 97% of patients are uninsured or underinsured. The clinic also treats some undocumented immigrants who seek care.
Hispanics, the single largest and fastest growing minority group in the United Sates, face significant disparities in health and health care access. Research shows inadequate care for major depression among Hispanics. In April 2008, the University of Arizona College of Medicine, Department of Psychiatry (University of Arizona), in partnership with St. Elizabeth’s, received funding from the Robert Wood Johnson Foundation (RWJF) to conduct a project examining the acceptability and effectiveness of telepsychiatry depression treatment for low-income Hispanic adults provided by a psychiatrist through internet videoconferencing using a webcam. Prior to RWJF funding, the University of Arizona partnered with St. Elizabeth’s to conduct a telepyschiatry pilot project to determine the feasibility of using commercially available webcams to provide mental health services to patients in their primary care medical home.
As part of the RWJF project, which replicated the pilot on a larger scale, University of Arizona and St. Elizabeth’s staff screened approximately 160 patients into a study based on a diagnosis of major depressive disorder and other criteria. Researchers randomly assigned patients to one of two groups: an experimental group receiving the psychiatric webcam intervention, and the control group receiving “treatment as usual” care from their primary care provider and additional behavioral health services from a counselor if determined necessary. Researchers measured several depression outcome variables from physician and patient-rated perspectives, including quality of life, mental and physical functional abilities, and satisfaction with treatment, and assessed how acceptability and clinical response are impacted by levels of acculturation, severity of illness, age, and gender.
Read the full report (pdf).
Black Teens in Public Housing Twice As Likely to Smoke
Posted: August 01, 2012
Black teens living in public housing communities are more than twice as likely to smoke as their peers in other U.S. communities, researchers have found. The findings, published in the August issue of Addictive Behaviors, suggest that early interventions are needed to prevent young people in these communities from lighting up. The study is titled Understanding tobacco use among urban African American adolescents living in public housing communities: A test of problem behavior theory.
"Compared to their same-aged peers, youth living in public housing were more likely to use tobacco and have positive attitudes about using tobacco," researcher Mansoo Yu, an assistant professor of social work and public health in the MU College of Human Environmental Sciences, said in a University of Missouri news release. "As previous research suggests, early use of tobacco increases individuals' chances of using more serious drugs later. In addition, early drug use is related to other serious problems, such as delinquent behaviors, and family and social problems," Yu added.
In conducting the study, Yu and colleagues from the University of Illinois at Chicago, Boston College and the University of South Carolina asked 518 black teenagers living in public housing in three large U.S. cities about their attitudes on tobacco use, symptoms of depression and delinquent behaviors. The study authors found that these teens were 2.3 times more likely to use tobacco than other black teens. The investigators pointed out that teens living in public housing may be more afraid, have poorer social relationships and more psychological strain, which could contribute to the higher rates of smoking.
"Smoking cessation programs for young African-Americans living in public housing communities should focus on reversing their positive attitudes toward tobacco use," Yu said in the news release. "In addition, programs should help address the youths' depressive symptoms and keep them from getting involved in delinquent behaviors." The researchers added that smoking prevention programs in public housing communities should target young children. "Early interventions are critical for these individuals since the likelihood of being exposed to risky behaviors dramatically increases as the children age," explained Yu. "In public housing communities, adolescents may have easier access to drugs and social activities where drugs are used."