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Objective: Two-hundred thirty-nine grandparents who were raising their grandchildren were surveyed regarding their attitudes toward mental health and mental health care as well as their use of mental health services, each twice over a one-year time frame. Methods: Mental health attitudes were assessed utilizing self-report scales assessing openness to seeking help, biases regarding mental health and mental health professionals, and breadth regarding beliefs about the origins of mental/emotional distress. Results: Findings suggested that grandparent caregivers were generally positive regarding their willingness to seek mental health care, biases regarding mental health professionals, and beliefs about the origins of emotional distress. Factors that predicted mental health attitudes reflected grandparent personal characteristics, aspects of caregiving, and sample demographics. There was a relationship between attitudes toward mental health and the use of mental health-related services, and having sought help was associated with mental health attitudes and emotional distress at both occasions of measurement and over the one-year timeframe. Some modest evidence was found for the role of openness to seeking help in partially mediating relationships between emotional/caregiving-related distress and mental health care use. Conclusion: These findings are important in understanding not only grandparent caregivers' attitudes toward mental health, but also can serve as a basis for enhancing their use of mental health care services.

The Family Empowerment Scale (FES) was developed specifically to assess empowerment in families with emotional disorders. Its relevance to custodial grandfamilies is reflected in the difficulties in grandchildren's social, emotional, and behavioral functioning, wherein such difficulties may be explained via either reactions to changes in their family structure or in their responses to the newly formed family unit. Utilizing 27 items derived from the 34-item version of the FES, which had represented differential levels of empowerment (family, service system, community) as indexed by one's attitudes, knowledge, and behavior, we explored the factor structure, internal consistency, construct, and convergent validity of the FES with grandparent caregivers. Three-hundred forty-three ( M age = 58.45, SD = 8.22, n Caucasian = 152, n African American = 149, n Hispanic = 38) custodial grandmothers caring for grandchildren between ages 4 and 12 years completed the 27 FES items and various measures of their psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. Factor analysis revealed three factors that differed slightly from the originally proposed FES subscales: Parental Self-Efficacy/Self-Confidence, Service Activism, and Service Knowledge. Each of the factors was internally consistent, and derived factor scores were moderately interrelated, speaking to the question of convergent validity. The construct validity of these three factors was evidenced by meaningful patterns of statistically significant correlations with grandmothers' psychological well-being, grandchild psychological difficulties, emotional support, and parenting practices. These factor scores were independent of grandmother age, health, and education. These findings suggest the newly identified FES factors to be valuable in understanding empowerment among grandmother caregivers.

African American grandmothers who parent their grandchildren often experience burden and altered health related to these responsibilities. However, little is known about how such burden reliably predicts physical and mental health, needs for information about services, needs for service and service use. Recruited from churches and community centers, 93 African American grandmothers who provided care for their grandchildren participated in this study. Hierarchical multiple regression was used to ascertain relationships between variables. Findings suggested that burden predicted needs for information about services, needs for service, service use, and physical health, but not mental health. In order to better understand grandmother caregivers' well-being and orientation to services, the present study suggests that the role of burden be centralized as a predictor of many parameters pertinent to grandparents raising their grandchildren., (Copyright © 2012 Mosby, Inc. All rights reserved.)

In order to explore the generalizability of perceptions of the losses experienced by grandparents raising their grandchildren, 610 traditional/non-custodial grandparents, who had no custodial responsibility for their grandchildren, read a randomly assigned scenario depicting a grandmother and her grandchild, wherein scenarios varied in terms of grandchild gender, the presence or absence of grandchild problems, and the reason for role assumption. They then completed the Perceptions of Loss (PLS) scale, where higher scores indexed greater awareness of loss. Results suggested that perceptions of loss varied by grandchild gender (favoring females), grandchild problem (favoring those with problems), and the reason for role assumption (favoring parental abandonment and parental drug abuse). Moreover, PLS scores were influenced by the interaction between grandchild gender and reason for role assumption, where the impact of role assumption was greater for female grandchildren than for male grandchildren. These findings in part parallel those obtained from young adults, and generally suggest that others in varying degrees are sensitive to the losses grandparents raising their grandchild experience. Such findings have implications regarding the extent to which grandparent caregivers' grief is disenfranchised, as well as impacting custodial grandparents' feelings of loneliness and isolation from age peers brought about by the necessity to raise their grandchildren.

This study compared three groups of grandparents, attempting to disentangle grandparental role demands from child-specific problems as sources of role-specific and grandchild-relationship distress. Those grandparents raising grandchildren reported to demonstrate neurological, physical, emotional, or behavioral problems exhibited the most personal distress, the least role satisfaction and role meaning, and the most deteriorated grandparent-grandchild relationships. Custodial grandparents raising grandchildren reported to have few difficulties also differed in the ways listed above from those grandparents not raising their grandchildren and from those raising grandchildren displaying problems. For men, but not women, more positive grandparent meaning was associated with raising a grandchild. Significantly, custodial grandparents were more likely to be raising boys, suggesting that boys may be either more difficult for grandparents to raise or that boys react more negatively to the adverse circumstances under which grandparents assume care.