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This article is a reaction paper to the article in this journal issue entitled Human Service Cartels: The Soft Repression of the Mediocracy by David Stoesz. As such, it addresses two significant questions about the Stoesz article. One question is as follows: Are we really talking about a cartel? The other question is as follows: Isn't it the power elite that promotes societal control and repression? [ABSTRACT FROM AUTHOR]

This paper reports a study of the premedical student culture at a major university, based on fieldwork and interviews with 30 premedical students. The paper examines the role of stereotypes in the premedical culture; specifically, the common belief in "cut-throats" among premedical students. Cut-throats are described as excessively competitive, selfish, gradehungry students who cheat, steal books and lab reports, and sabotage lab experiments. Despite the widespread belief, our findings suggest cut-throats are a myth. We found more evidence for cooperative than cut-throat behavior. The myth emerges from the competitive and pressured situation of premedical students and the uncertainty of the medical school admission process, and is in part a manifestation of students' collective anxiety. More significantly, it provides cultural explanations for failure and success for premedical students. We discuss its connection to the general premedical stereotype and its relation to pre-medical education. [ABSTRACT FROM AUTHOR]

Asian Americans (AA) in the United States, and throughout the world, commonly hold a negative connotation or stigma regarding seeking mental health services. Unique cultural stigmas and beliefs of AA play an important role when examining why this population group is less likely to engage in therapy. This article explains why these cultural stigmas and beliefs contribute to the lack of mental health help seeking. Through examining these stigmas, perception of therapy, loss of face, and parental control among AA will allow therapists to have a better understanding when they are working with this population. Also, the consideration is given of how the increase of Anti-Asian racism due to the COVID-19 pandemic affects AA and the challenges it creates. This article includes a case example that provides information on how stigmas impact an AA family who have differing cultural values and expectations while experiencing discrimination from COVID-19. [ABSTRACT FROM AUTHOR]

This exploratory study examined the intersections of Middle Eastern and North African (MENA) American cultural identity and attitudes towards mental health and mental health services. Fifteen in-depth narrative interviews with participants of MENA descent in the United States were analyzed using qualitative thematic content analysis, revealing five primary themes within these data: denial, lack of awareness, stigma/shame, collective identity, and resistance. These results indicate cultural identity plays a unique and significant role in how this population understands and responds to mental health and substance use challenges, in a way that often creates barriers to social service provision and success. Implications and suggestions for how these findings might be used to develop more culturally competent and effective social work interventions for MENA communities are discussed. [ABSTRACT FROM AUTHOR]

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia.Conclusions: It is recommended that the Australian National Mental Health Plan 2003-2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Autistic adolescents and emerging adults experience high rates of mental health conditions—a risk factor for hospitalization. Using nationally representative data from the 2016 HCUP KID, we estimated the prevalence and costs of mental health–related hospitalizations for autistic adolescents and emerging adults in the United States. Hospital discharges for ages 10–20 years (n = 1,346,849) were analyzed using survey-adjusted logistic regression and general linear modeling. Mental health–related hospitalizations among autistic young people (n = 14,368) were mostly for neurodevelopmental, disruptive, depressive, and bipolar disorders. Mental health–related hospitalizations were almost 11 times more likely (OR = 10.98, 95% CI = 10.00–12.00) for autistic youth compared youth with complex and chronic conditions, and two times (OR = 2.03, 95% CI = 1.88–2.19) more likely compared to population controls. Predicted mean service delivery costs of mental health–related hospitalizations for autistic adolescents and emerging adults were US$7,401.23 per stay, resulting in US$106 million in estimated total service delivery costs in 2016. Mental health–related hospitalizations can indicate poor quality care, be traumatic, and increase suicide risk. Community mental health care for autistic young people is needed. Autistic young people are more likely to have mental health conditions, like depression and bipolar disorder, than people without autism. These mental health issues sometimes lead to hospitalizations, which can be expensive and traumatic. Because of this, we wanted to understand mental health–related hospitalizations among autistic young people aged 10–20. We found that the main mental health reasons for the hospitalization of autistic young people were neurodevelopmental, disruptive, depressive, and bipolar disorders. These hospitalizations cost an average of US$7401.23 per stay, for a total of US$106 million in service delivery costs in 2016. Mental health–related hospitalizations were compared between young people with autism, young people with complex and chronic conditions, and young people with no chronic conditions. Autistic young people were almost 11 times more likely to be hospitalized for mental health reasons than young people with complex and chronic conditions, and two times more likely than young people with no complex and chronic conditions. We believe the United States needs better community-based mental health care for young people with autism. [ABSTRACT FROM AUTHOR]

Objective: Disaggregated data on the mental health of Asian/Asian American people are needed to inform public health interventions related to reports of racism during the COVID-19 pandemic. We describe the prevalence of psychological distress and unmet mental health needs among Asian/Asian American adults during the COVID-19 pandemic across various sociodemographic subgroups. Methods: We used cross-sectional, weighted data from the US-based 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Study (unweighted n = 3508) to estimate prevalence rates of psychological distress and unmet mental health needs, overall and by nativity status. We conducted population-weighted multivariable logistic regression analyses to examine sociodemographic factors associated with these mental health outcomes. Results: About one-third (1419 of 3508) of Asian/Asian American adults (32.9%; 95% CI, 30.6%-35.2%) reported psychological distress; odds of psychological distress were increased among adults who were female, trans, and nonbinary; aged 18-44 years; US-born; Cambodian; multiracial; and low income. Of those reporting psychological distress (638 of 1419), 41.8% (95% CI, 37.8%-45.8%) reported unmet mental health needs; unmet mental health needs were highest among Asian/Asian American adults who were aged 18-24 years; Korean, Japanese, and Cambodian; US-born female; non–US-born young adults; and non–US-born with ≥bachelor's degree. Conclusions: The mental health of Asian/Asian American people is an important public health concern, with some groups more vulnerable and in need of services than others. Mental health resources need to be designed for vulnerable subgroups, and cultural and systemic barriers to mental health care need to be addressed. [ABSTRACT FROM AUTHOR]

The mental health burden associated with anti-immigrant rhetoric and ever-changing immigration policies is undeniable, though the psychological and emotional sequalae may remain invisible for years to come. Exclusionary immigration policies, as a form of structural racism, have also led to an epidemic of stress-related health within the Latinx community, particularly the Latinx immigrant community, across the United States. Recent examples of anti-Latinx and anti-immigrant rhetoric and policies include the 45th President's implementation of the Zero Tolerance policy, Migrant Protection Protocols, and Title 42. The recognition of previous and existing anti-immigrant policies, and the impact on Latinx immigrants, is critical in understanding the manifestation of psychological stress to prevent it from becoming chronic. For mental health providers, attention to existing policies that can be detrimental to the Latinx immigrant community is essential to understanding their mental health trajectory and applying frameworks that honor an individual's psychological stress to prevent pathologizing the immigrant experience and negative health outcomes. The objective of the present brief review is to shed light on recent research and offer recommendations for practice (eg, educating the Latinx community about the link between the immigrant experience and psychological stress) and policy (eg, drafting of legislation aimed at rescinding harmful immigration policies) regarding the relation between aggressive anti-immigration rhetoric and psychological stress among Latinx immigrants in the United States. [ABSTRACT FROM AUTHOR]

Among the many sites on the battleground of the United States in which racism and classism rage is the all-too-overlooked mental health industrial complex. Over the past four decades, the mental health industrial complex has used the biomedical explanation for mental suffering. This focus on diagnoses that result from problems of the brain and not from social factors has contributed to an exponential increase of consumed medications and total revenue earned from the mental health and addiction services provided in the United States. Moreover, this specific ontology of subjectivity—that humans are solely defined by their material brains—helps serve the interests of the dominant hegemony. It is the assertion of this article that today as persons are conditioned to understand mental illness as a result of a purely individual problem, they become unaware of the ways in which the structural problems of race and class contribute to their mental illness. As a therapist who works with marginalized populations, I have seen firsthand how the biomedical model can be used to reinforce the illnesses that it aims to treat. The following article will illustrate the complex dynamics of the mental health industrial complex by way of analyzing three case studies of Black, male patients who I treated while working at a mental health facility in the Northeastern United States. [ABSTRACT FROM AUTHOR]

This study explores the perceptions of specialty mental health caseload probation officers and their use of discretion in day-to-day supervision of individuals with mental illness in one large jurisdiction in the United States. Scholars have examined overall effectiveness of specialty probation programs, probation officers' roles as street-level bureaucrats, and the impact of the mental health caseload probation officer and probationer relationship on successful completion. Less attention, however, has been placed on examining how the officers supervising these specialty caseloads perceive their roles as mental health probation officers and how they use discretion in their caseload management. The current study examines the narratives of 24 specialty mental health caseload probation officers and supervisors to understand how discretion is used on a problem-solving caseload and how discretionary decision-making may impact probationer outcomes. [ABSTRACT FROM AUTHOR]

Immigration—both the experience of migrating and events after migration—can affect the mental health and well-being of immigrants and their communities. However, evidence suggests that immigrants in the United States do not access mental health services to the same extent as nonimmigrants. In particular, immigrant adolescents and young adults may have unique stressors related to their developmental stage, experiences in school and with peer groups, and shifting roles within family systems. This scoping review summarizes findings from published research studies and practitioner-focused gray literature about the mental health needs of immigrant communities in the United States. The review finds that specific mental health needs vary across factors like age, racial/ethnic group, immigration status, and place of residency. Findings also indicate that structural factors like immigration-related laws affect both access to mental health services and stressors in the overall environment for immigrants and their families. This review also explores models of community-level initiatives that utilize strengths-based approaches to promoting mental health and well-being among immigrant communities. Findings highlight the need for a better understanding of the mental health needs and current barriers to care among diverse immigrant populations, as immigration continues to play a major role in U.S. public policy and discourse. The COVID-19 pandemic taking place as this article goes to press in 2020 also raises questions regarding health equity and access for marginalized populations, including immigrants and their communities, and so these findings also indicate the need for further interdisciplinary research to assess intersections among the pandemic's many impacts, including those related to mental health and well-being. [ABSTRACT FROM AUTHOR]

Despite limited program evaluations of Medicaid accountable care organizations (ACOs), no studies have examined if cost-saving goals negatively affect quality of life and health care experiences of low-income enrollees. The Hennepin Health ACO uses an integrated care model to address the physical, behavioral, and social needs of Medicaid expansion enrollees. As part of a larger evaluation, we conducted semistructured interviews with 35 primary care using Hennepin Health members enrolled for 2 or more years. Using fuzzy set qualitative comparative analysis, we assessed enrollee complexity and use of the care model and improvements in quality of life. We found improved quality of life was consistently associated with strong bonds to primary care, consistent mental health care, and support from extended care team members. Comprehensive, integrated care models within ACOs may improve quality of life for low-income Medicaid enrollees through coordinated primary and mental health care. [ABSTRACT FROM AUTHOR]

Using a lens of structuration theory, this study highlights the ways that specific structures within the current community-based model of mental health care might enable and constrain individuals and families living with mental illness. Through a case study of a volunteer mental illness advocacy group, the authors employed a duality analysis on a variety of data collected from the case (i.e., interviews, organizational documents, and community health care data). Findings indicate that while group members encountered structural barriers to their organizational mission, they also used communicative agency creatively and collectively to (re)create structures within the current community-based model of mental health care. Member agency is examined in relation to perceived structural influence. Theoretical and practical applications of the findings are discussed. [ABSTRACT FROM AUTHOR]

There has been growing concern about the quality of health services, including mental health services, within the world’s and prisons. The purpose of the current qualitative interpretive meta-synthesis (QIMS) is to examine the prison environment and how it influences the mental health services delivered to prisoners. It is the hope of these authors that with this QIMS, knowledge improvements and modifications to current policies and practices can begin to take shape. A total of five studies published between 2003 and 2013 were utilized for this QIMS. Participants in all five studies included males and females incarcerated in England, Wales, and the United States. Three overarching themes were identified after analysis: difficulties with accessing services, difficulties with primary staff, and isolation. In each overarching theme, sub-themes are reviewed in detail. These three broad categories are discussed in relation to the person-in-environment system, demonstrating its application in an incarcerated setting. [ABSTRACT FROM AUTHOR]

This study explores how US veterans who suffer from mental health problems navigate between two primary statuses: national hero and mental patient. The analysis reveals a more nuanced understanding than previous research, which has focused on a simple negative association between positive veteran identity and stigma. Qualitative evidence collected in a work-therapy program for veterans demonstrates that the status of mental patient became salient in peer-group activities, where it engendered a sense of solidarity and mutual empathy, and in interactions outside the mental health care facility, where it involved a sense of stigma. The status of being a national hero emerged in interactions with casual visitors from whom material contributions were sought, but did not reinforce a sense of positive veteran identity because veterans were aware of its instrumental nature. When leaving the program, a strong sense of stigma emerged despite the possibility of embracing the veteran identity. [ABSTRACT FROM PUBLISHER]

In the past decade, the push for evidence-based programs has taken on unprecedented prominence in the fields of substance abuse and correctional treatment as a key determinant for intervention funding. The National Registry of Evidence-based Programs and Practices (NREPP), managed and funded by the Substance Abuse and Mental Health Services Administration, was established in 1997 to aid community agencies in adopting intervention models for their particular clientele. Although well intentioned, the NREPP has also created opportunities that invite conflicts of interests and promulgate programs with questionable efficacy. After an exhaustive review of the literature that purports to have provided the “empirical evidence” for the NREPP registered programs, the authors found numerous irregularities in the studies with findings often based on small sample sizes. A more troubling finding is that much of the supporting literature is produced by the program developers themselves. There is a general lack of independent verification of the claimed treatment effects. If the NREPP is to fulfill its intended function, a tighter vetting process is needed for programs to be registered so that community agencies and treatment practitioners can consult with confidence. [ABSTRACT FROM AUTHOR]

Although most research and policy in the mental health and criminal justice arenas have operated independently of one another, there is a growing consensus suggesting the need for an integration of these two disparate, yet complementary systems. Furthermore, in light of the adverse mental health consequences that often accompany victimization experiences, it is apparent that these two systems should develop and foster overlapping services for crime victims. The research reviewed herein provides an examination of issues such as these, identifies some of the barriers that stand in the way of a successful integration of the two systems, and attempts to provide some guidance and direction for future integrated mental health and criminal justice system approaches. An outline of research gaps and directions for future study are offered for the integration of criminal justice and mental health systems, as such collaborations are likely to alleviate some of the deleterious mental health outcomes evident among crime victims and at the same time reduce the occurrence of repeat victimization. [ABSTRACT FROM PUBLISHER]

The article examines a programme for U.S. psychiatry, wherein the profession would dedicate itself to the reconstitution of mentally-fit and socially-productive citizens, developed by William Alanson White at Saint Elizabeths Hospital in Washington, D.C. It is noted that racist assumptions that lies within the programme led physicians to expect little more than common labour from their black patients, that prevented them from comprehending the impact of substandard and racially-segregated care.

Recent estimates indicate that 10% to 25% of women in the United States report clinically significant depressive symptoms and that Black women are less likely to obtain care for depression and to receive appropriate treatment when they do seek care. Current mental and social health services necessitate a search for strength-based treatment models that affirm the psychosocial and cultural reality of Black women at risk of depression. The emergent psychosocial competence practice model in mental health represents an innovative paradigm with potential relevance and applicability to preventing depression among Black women. This study evaluates the effectiveness of a culturally relevant group intervention with low-income Black women aimed at reducing depression symptoms and enhancing psychosocial competence, including stress reduction, locus of control, and active coping. Directions for the development of future culturally relevant practice interventions with this population are discussed. [ABSTRACT FROM AUTHOR]

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Several recent national reports have noted that there is a 20-year gap between knowledge generated from our best clinical research and the utilization of that knowledge in our health and mental health care sectors. One solution to this dilemma has been the emergence of translational science. Translational science has become a top priority of the National Institute of Mental Health. The goal of translational science in mental health is to speed the use of findings from our best science into usual-care settings and to build partnerships between research and practice constituencies. The purpose of this article is to define translational science for social work, to provide a framework for translational research, and to outline an agenda of activity that will allow social work to become a significant driver in the translational research agenda in mental health services. [ABSTRACT FROM AUTHOR]

This article explores the nature of expanded school mental health (ESMH) services in Baltimore City, which at the time of the study were incorporated into 40% of the city's public schools. A provider survey was distributed to ESMH clinicians to gather information on the characteristics of service providers and recipients, types of services being provided, and their proposed outcomes. Provider reports indicated an impressive service capacity, augmentation of traditional school-based services, and the continual need for increased mental health service hours in their buildings. In addition, the most frequently voiced benefits of the ESMH programs were increased mental health awareness and improved school climate. Implications of the findings for future programming development and research are discussed. [ABSTRACT FROM AUTHOR]

The present study reports comparative male-female vulnerability to several stressed life circumstances that have been implicated in the development of depression. My analysis, which draws on data from a 1978 survey of 1,026 adults in central Wisconsin who were administered the Psychiatric Evaluation Research Instrument (PERI) Depression Scale, is based on a structural modeling approach that controls for the confounding of dysphoric mood and other forms of distress with a depressive syndrome. Findings show that women are more likely than men to suffer hardships associated with the absence of a spouse, social isolation, financial difficulties, and chronic health problems. However, none of these hardships has a significantly greater impact on depressive syndrome levels for women than for men. [ABSTRACT FROM AUTHOR]

The article presents several research on the role of classroom interactions and teachers influence in combating mental illness of children in the U.S. The report of the Joint Commission on Mental Illness and Health contained recommendations in combating mental illness which include balanced portfolio of mental health services and research, suggestion for increasing government spending for all levels of mental health services, encourage towards health and helping professions. Ralph Rabinovitch, director of Hawthorne Center, indicated that schools must offer psychological guide through organize and challenging programs of academic studies and routines for emotionally handicapped children.

A sample survey using personal interviews was conducted in the Reno, Nevada, area to assess public conceptions of suicide and suicidal actions, attitudes toward the notion of suicide, attitudes toward people personally known to have committed or attempted suicide, and various degrees of familiarity with suicidal behaviors. Suicidal behavior by others was personally familiar to 74 percent of the respondents, and the general conceptions of suicide included shame and social disgrace, but not blame, to the family. Suicide generally was seen as something that happens to a person, rather than something he intentionally brings about. Public health implications of the data are discussed. [ABSTRACT FROM AUTHOR]

In a study of 1,045 state mental hospital patients released on leave of absence during the calendar year of 1956 to the Oakland California Bureau of Social Work, a large amount of evaluative information was collected on post-hospital adjustment. Data from case records, administrative files, and hospital records were reviewed. They clearly demonstrated that most ex-patients did not possess a sufficient number of social resources to allow them to adapt to the world outside the state hospital. On the basis of these findings, one can easily understand why seven out of ten of these patients returned to the hospital. [ABSTRACT FROM AUTHOR]

The author reflects on the value of community mental health centers in the U.S. The author emphasizes on the center's responsiveness as the main concept of community mental health programs with the belief that the public should play an important part in the process of determining the nature of mental health services. The author suggests that mental health is a system of care rather than a collection of discrete facilities.

Focuses on the problems of providing school mental health services to children in the U.S. Impact of mental health services on children; Details on the pattern of mental health and education; Benefits of developing a school mental health service.