Showing items related by title, author, creator and subject.

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  The System of Care Mental Health Service Experience: Differences in Perceptions between African American and Caucasian Youth and its Impact on Service Use and the Relationship between Receipt of Services and Emotional and Behavioral Symptoms

  Williams, Crystal; Harrington, Donna (2012)

  Racial disparities in adolescent mental health services remain an unrelenting public health problem. The purpose of this study was to understand the differential system of care service utilization patterns and associated symptoms among African American and Caucasian adolescents with serious emotional disturbances (N = 655; M age = 13.7, 60% Caucasian, 63% male). The primary objectives were to: (1) explore differences in perceptions of mental health service experiences at 6-months by race; (2) examine race as a moderator between perceptions of service experiences and receipt of services between 6 and 12 months; and (3) explore mental health symptoms at 12 months as a function of race. Mental health symptoms for a subsample of youth (N = 548) with elevated symptoms were also examined. A secondary data analysis using data from the Comprehensive Community Mental Health Services for Children and Their Families Program (CMHI) and generalized estimating equation (GEE) analyses indicated that (1) African American and Caucasian adolescents did not differ in their overall perceptions of their service experience, (2) race did not moderate perceptions and receipt of services, and (3) race moderated the relationship between receipt of family therapy and externalizing symptoms. The results also showed that use of individual therapy was predicted by race (Caucasian) and greater emotional/behavioral symptoms at baseline, while group therapy was predicated by gender (male) and greater functional impairment at baseline. Adolescents' perceived social support from adults (not peers) predicted fewer internalizing symptoms, and Caucasian adolescents experienced fewer externalizing symptoms. The examination of mental health symptoms for the subsample revealed that race did not moderate receipt of services and symptoms. Instead, perceived social support from adults (not peers) predicted fewer internalizing symptoms, and clinician-client racial match predicted fewer externalizing symptoms. The findings suggest that African American and Caucasian adolescents share similar perceptions of their service experience, yet disparities in service use and symptomatology persist. Further, youth with perceived social support and a clinician-client racial match experience fewer mental health symptoms. Practitioners should assess adolescent's perceived social support upon receipt of treatment, discuss clinician preferences, and explore opportunities to engage African American families in family therapy.
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  Behavioral Health among Foreign-Born and U.S.-Born Emerging Adults: Barriers to Seeking Services, College Enrollment Status, and Service Utilization

  Bessaha, Melissa; Cornelius, Llewellyn Joseph, 1959-; Unick, George Jay (2016)

  Behavioral health problems are a leading cause of disability and a major public health issue in the United States. Compared to other adult age groups, emerging adults aged 18 to 29 experience more behavioral health problems. Although transitioning to adulthood may provide growth opportunities, it can also be a time of increased vulnerability and risk as emerging adults often face challenges in emotional, educational, and professional transitions. The United States has also seen rapid growth in the foreign-born emerging adult population as well as growing health disparities among immigrant and minority groups; however, prior research investigating behavioral health service use of emerging adults has largely been limited to homogeneous samples of college students. Using the Behavioral Model for Vulnerable Populations, this study explored factors associated with patterns of behavioral health service use across a diverse national sample of emerging adults by nativity status (foreign-born, U.S.-born) and college enrollment status (college student, non- student). A subsample of 6,696 emerging adults from the 2012 Agency for Healthcare Research and Quality Medical Expansion Panel Study was used for this study. Multiple hierarchical binomial logistic regression analyses were performed to determine which factors predicted patterns of behavioral health service use among emerging adult groups. Employed (foreign-born) and Black (all groups except foreign-born) emerging adults were less likely to use services compared to unemployed and White emerging adults, respectively. Preference for English language (non-college students), shorter duration in the United States (college students), and having insurance (all groups except foreign-born) was associated with service use. Those with middle and high income backgrounds (college students) were less likely to use services compared to poor students. Having higher perceived mental health status (all groups except college students) and higher general mental health status (all groups) predicted less service use. Although certain factors were consistently predictive of service use among emerging adult groups, there were differences that necessitate further research. Findings clearly portray the need for greater awareness and consideration of factors related to service use on healthcare policy and higher education program initiatives especially as they relate to promoting health equity and successful transition to adulthood.
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  2013/2014 Employee Service Recognition & Community Service Awards Program

  University of Maryland, Baltimore (Produced by the Office of Communications and Public Affairs, 2014)