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Children are at risk of short- and long-term morbidity and mortality from COVID-19. We examine whether autistic children and children with mental health conditions have higher odds of underlying health conditions at high risk of severe disease from COVID-19. We use claims data from a national sample of Medicaid-enrolled children for the years 2008–2016. We examine (1) children with claims for autism and (2) a random sample of children covered by Medicaid, without autism claims but with mental health condition. The comparison group is a random sample of children without autism or any mental health condition. There were 888,487 autistic children, 423,397 with mental health conditions (but not autism or intellectual disability), and 932,625 children without autism or mental health condition. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had higher odds of having any underlying condition (odds ratio = 2.17; 99% confidence interval = 2.14–2.20), as did children with mental health conditions (odds ratio = 1.71; 99% confidence interval = 1.68–1.73), adjusting for basic demographic characteristics. Children with diagnoses of autism and mental health conditions may be at higher risk for severe COVID due to high-risk condition prevalence. Children are at risk of varying severity of illness and even death from COVID-19. We aim to determine whether autistic children or children with mental health conditions have more underlying health conditions that put people at risk of severe illness from COVID-19. We use data from a national sample of Medicaid-enrolled children for the years 2008–2016. These data include children across the 50 states and the District of Columbia. We compare the prevalence of underlying conditions among autistic children and children with mental health condition to that of other children in Medicaid. This study included 888,487 autistic children, 423,397 with any mental health condition (but not autism), and 932,625 children without any of these diagnoses. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had over twice the odds of having any underlying conditions, when accounting for age, race, sex, and other characteristics. Children with mental health conditions had 70% higher odds of having these underlying conditions. Mitigation measures in schools and other areas could minimize risk of short- and long-term impacts from COVID for autistic and all children. [ABSTRACT FROM AUTHOR]

This paper examines how multiple roles affect the mental health of the elderly in Japan and the United States, two countries with vastly different cultures. Hypotheses were drawn based on the cultural differences in role experiences, and these hypotheses are tested by analyzing nationally representative samples of the elderly in these countries. The results show that Americans are more likely to be involved in roles related to family, work, and community, while the Japanese are more likely to be involved in only those roles related to family and work. Multiple roles are also found to be less beneficialfor the mental health of Japanese elderly compared to American counterparts. National differences in the effects of individual roles and role configurations on mental health are also documented. Overall, the results show the importance of broad cultural contexts for understanding the relationship between roles and mental health. [ABSTRACT FROM AUTHOR]

Objectives: Research on the mental health and service needs of homeless seniors has been scant. This paper reviews the available literature and presents findings of a Toronto survey in an effort to describe the demographics of homeless seniors, their level of impairment, and their mental and physical health needs.Methods: We searched the Medline, AgeLine, and PsycINFO databases, using the following key words: elderly homeless, elderly hostel users, and urban geriatrics. To better describe the service needs of the elderly homeless, we obtained demographic data from the Community and Neighbourhood Services Department and distributed a survey questionnaire to 11 Toronto hostel directors. The questionnaire elicited data relating to reasons for shelter use, problem behaviours, and mental health needs of those over age 65 years.Results: Although seniors represent a small percentage of the homeless population, their numbers are growing. The available literature suggests a high prevalence of psychiatric disorders and cognitive impairment in this population, with a greater proportion of older women than men having severe mental illness. Further, our survey suggests that the service needs of elderly hostel users in Toronto differ from those of their younger counterparts.Conclusion: The homeless elderly are the most vulnerable of this impoverished population. Although more research is needed to define their mental and physical health needs and ways of meeting them, their characteristics appear to be unique. Geriatric psychiatrists could play a significant role in evaluating and treating this population more comprehensively. [ABSTRACT FROM AUTHOR]

Military sexual trauma (MST) is highly prevalent among women veterans. Research among MST survivors has focused on individuals receiving care in specific settings, such as mental health services. There is a dearth of knowledge regarding MST prevalence and associations in other settings commonly accessed by women veterans, including reproductive healthcare settings. We examined MST prevalence (overall, by MST type and extent of underreporting) and associations with suicidal ideation and suicide attempts, among women veterans accessing Veterans Health Administration (VHA) reproductive health care. Our sample included 352 post-9/11 women veterans who used VHA reproductive health care in Fiscal Year (FY) 2018 and participated in a cross-sectional survey. Approximately 68.7% screened positive for MST, including 44.9% who reported experiencing military sexual assault. Notably, 30.8% reported MST on the survey, but had a negative MST screen for their most recent MST screen in their VHA medical record. Both military sexual harassment and assault were associated with increased prevalence of experiencing suicidal ideation following military service; however, a significant association among military sexual harassment, pastmonth suicidal ideation, and post-military suicide attempts was not detected. Military sexual assault was uniquely associated with past-month suicidal ideation and post-military suicide attempts. As MST and underreporting are highly prevalent among women veterans using VHA reproductive health care, rescreening for MST within this population is essential. A trauma-informed approach is recommended irrespective of prior MST screening results and may facilitate suicide prevention in this population. Addressing barriers to MST disclosure and preventing MST and its sequelae remain critical. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular disease (CVD) is the leading cause of death for males, females, and people of most racial and ethnic groups in the United States. In addition to known epidemiological and behavioral risk factors, recent evidence suggests that circumstantial or behavioral factors may also be associated with CVD. This study evaluates the contribution of cardiovascular disease (CVD) risk factors, community vulnerabilities, and individual health behaviors to individual physical and mental wellness among Black and White, male, and female Medicare beneficiaries. Methods: This study utilized data from the Behavioral Risk Factor Surveillance System, county-level CVD risk factor prevalence, and selected items from the Social Vulnerability Index. Results: Correlations were found between unhealthy days reported by males and area social vulnerabilities and health behaviors. Prevalence of disease was correlated with mentally unhealthy days for White males. Among White females, health behaviors, disease prevalence, and social vulnerability measures were associated with unhealthy days. Among Black females, disease prevalence was highly correlated with mentally unhealthy days. Discussion: While individual-level health behaviors are highly associated with perceived physical and mental health, the self-reported health of Black respondents is also heavily correlated with local area vulnerabilities, including community poverty, group housing, and crowding. [ABSTRACT FROM AUTHOR]

Summary: Social workers' eating disorder mental health literacy (ED-MHL) is essential to the detection, assessment, and treatment of eating disorders (EDs) and disordered eating (DE) in clinical practice. This study explored social workers' ED-MHL, particularly the assessment practices of EDs on intake forms, and within the first two therapy sessions. Participants in this national survey were N = 316 outpatient masters-level social workers in the United States. Participants completed an online survey measuring ED assessment practices in clinical practice. Findings: Results showed that 42.4% (n = 133) of respondents did not routinely assess for EDs/DE on clinical intake forms, and 53.2% (n = 165) did not assess within the first two therapy sessions. However, those with recent training related to EDs were more likely to assess. Participants reported low to moderate perceived comfort levels with the assessment of EDs, and training and education were identified as needed resources. Social workers reported deficits in their own assessment practices of EDs. Barriers included: lack of training about EDs/DE; uncertainty about process questions to ask; and perceptions that EDs/DE are rarely the client's primary presenting problem. Applications: Difficulties with detection and screening practices appeared contingent on gaps in existing education and training related to EDs/DE. These findings suggest that future research may serve to increase social workers' ED-MHL, as underscored by the noteworthy finding that 86.1% (n = 229) of the sample reported that they would make proactive changes in their clinical practice, as a direct result of participating in this study. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice. Methods: This three-year exploratory mixed methods study included transformational assistance from 9 interprofessional coaches, one assigned to each of 9 interprofessional primary care teams that included family medicine, internal medicine, pediatrics, nursing, pharmacy and behavioral health. Coaches interacted with teams during 2 in-person training sessions, an in-person site visit, and then as requested by their teams. Surveys administered at 1 year and end study assessed the coaching relationship and process. Results: The majority of participants (82% at end of Year 1 and 76.6% at end study) agreed or strongly agreed that their coach developed a positive working relationship with their team. Participants indicated coaches helped them: (1) develop as teams, (2) stay on task, and (3) respond to local context issues, with between 54.3% and 69.2% agreeing or strongly agreeing that their coaches were helpful in these areas. Cronbach's alpha for the 15 coaching survey items was 0.965. Challenges included aligning the coach's expertise with the team's needs. Conclusions: While team coaching was well received by interprofessional teams of primary care professionals undertaking educational and clinical redesign, the 3 primary care disciplines have much to learn from each other regarding how to improve inter- and intra-professional collaborative practice among clinicians and staff as well as with interprofessional learners rotating through their outpatient clinics. [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 data from a 2005 national survey of working adults in the United States, we examine the effects of the gender composition of the superordinate-subordinate role-set on mental and physical health measures. Subordinates' and superordinates' genders are important determinants. Men who work in gender-mixed superordinate contexts (i.e., with one male and one female superior) report lower levels of distress and physical symptoms than men who work with one male superior. Women who work with one male superior report less distress and fewer physical symptoms compared to women who work with one female superior or in gender-mixed superordinate contexts. With a few exceptions, these observations generally hold net of occupation, job sector, and an array of work-related conditions. We discuss the implications of these findings in light of predictions derived from the similarity-attraction and role congruity theories. We also outline ways that theoretical development in relational demography can be refined by a more specific focus on the demographic characteristics--especially gender--of the superordinate-subordinate role-set. [ABSTRACT FROM AUTHOR]

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