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Causier C, Johns L, Radez J, Hassan H, Maughan D, Waite F. Experiences of Help-Seeking for Severe Mental Health Problems in Young Pakistani Women: A Preliminary Qualitative Study. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2024; 55:429-443. [PMID: 38766627 PMCID: PMC11101305 DOI: 10.1177/00220221241236944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Almost three quarters of mental illnesses start by the age of 25, yet youth (18-25-year-olds) are often underrepresented in U.K. services. This is particularly true for those of ethnic minorities. In this study, we aimed to understand how young Pakistani women and their parents make decisions to seek help for severe mental health problems, and the barriers and facilitators to accessing professional help. Young Pakistani women with experience of severe mental health problems and their parents were recruited from a community sample. Semi-structured interviews were conducted with six young people and two parents. Data were analyzed using reflexive thematic analysis. Pakistani culture and its interplay with British culture strongly influenced the decisions and ability of young Pakistani women and their parents to help-seek, largely through the role of stigma. Low mental health literacy, stigma, and a lack of culturally informed services were identified as the most common barriers to accessing care. These barriers fed into the internalized stigma these young women experienced which, through fear of damaged reputation and personal prejudices, posed further barriers to seeking help. Participants highlighted recommendations for both individual-level (e.g., increased education and awareness) and service-level (e.g., greater choice over care) change to facilitate accessibility of professional help. Young Pakistani women face multiple culturally related challenges to accessing care for severe mental health problems at both the individual- and service-level. Novel suggestions to address these challenges, such as including youth peer support workers in services, may facilitate more inclusive and accessible services.
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Affiliation(s)
- Chiara Causier
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Louise Johns
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Jerica Radez
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | - Hibah Hassan
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
| | | | - Felicity Waite
- University of Oxford, UK
- Oxford Health NHS Foundation Trust, UK
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Broersen M, Frieswijk N, van Vugt M, Vermulst AA, Creemers DHM, Kroon H. Examining Youth Flexible ACT Model Implementation in the Netherlands. Community Ment Health J 2024:10.1007/s10597-024-01260-z. [PMID: 38519800 DOI: 10.1007/s10597-024-01260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/20/2024] [Indexed: 03/25/2024]
Abstract
Model adherence is a key indicator of mental health care quality. This study investigates the degree of model adherence, as well as content and staging of care, among the first Youth Flexible Assertive Community Treatment (ACT) teams in the Netherlands. Model fidelity was assessed in sixteen teams with the Youth Flexile ACT model fidelity scale (2014 version). Mental health workers completed a 'content of care questionnaire' to map the interventions applied in the teams. Model fidelity scores revealed that twelve teams adhered to the Youth Flexible ACT standard with 'optimal implementation' (≥ 4.1 on a 5 point scale) and four teams with 'adequate implementation'. Most disciplines were well integrated within the teams; however, several items regarding the involvement of specific disciplines and the availability of treatment interventions (peer support worker, employment and education specialist and programs, family interventions, integrated dual disorder treatment) scored below the optimum. Frequency of contact during ACT and the use of Routine Outcome Monitoring instruments scored below the optimum as well. The 'content of care' data showed that most clients received an individual psychological intervention, and nearly half of the client sample received scaled-up / intensified ACT care. The findings indicate a predominantly successful translation of care from the theoretical Flexible ACT framework into practice, covering both ACT and non-ACT functions. Further room for improvement lies in the incorporation of specialized disciplines in the personal and social recovery domains, including the peer support worker and employment and education specialist, as well as in specific protocolled interventions.
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Affiliation(s)
- Marieke Broersen
- GGZ Oost Brabant, Oss, The Netherlands.
- Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | | | | | | | | | - Hans Kroon
- Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Trimbos Institute, Utrecht, The Netherlands
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3
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Klodnick VV, Sapiro B, Gold A, Pearlstein M, Crowe AN, Schneider A, Johnson RP, LaPelusa B, Holland H. Relational Complexity of the Near-Age Peer Support Provider Role in Youth and Young Adult Community Mental Health Settings. J Behav Health Serv Res 2024:10.1007/s11414-024-09877-4. [PMID: 38413546 DOI: 10.1007/s11414-024-09877-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 02/29/2024]
Abstract
Increasingly, US community mental health settings are integrating professional near-age youth peer support providers to improve youth service engagement and outcomes. Youth peer specialists (YPS) use their lived and living experiences with a mental health diagnosis to validate, empathize, and provide individualized support, while also improving their program's overall responsiveness to young people's needs. Although promising, these roles tend to lack clarity-responsibilities vary immensely, and turnover is high. Examining near-age youth peer on-the-job experiences is needed to design effective on-the-job supports. Using community-based participatory action research methods, young adults with lived experience worked in partnership with a PhD-level qualitative researcher to design, recruit, conduct, and analyze in-depth-interviews with current and former near-age youth peer providers. Ten young adult peer mentors in Massachusetts completed interviews that revealed near-age youth peer role relational complexity. Five relational aspects were identified requiring relational practice skills and self-awareness, including relationships with (1) self, (2) clients, (3) supervisors, (4) non-peer colleagues, and (5) other near-age peer providers. Near-age peers experience relationship-related struggles with non-peer identified colleagues who do not understand nor value the near-age peer role. Findings expand on current near-age peer practice and associated on-the-job challenges. Training, supervision, and professional development activities that target these five relational areas may improve YPS on-the-job wellbeing, decrease YPS turnover, and improve youth client outcomes.
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Affiliation(s)
- Vanessa V Klodnick
- Texas Institute for Excellence in Mental Health, The University of Texas at Austin, Austin, TX, USA.
- Research & Innovation, Youth & Young Adult Services, Thresholds, Chicago, IL, USA.
| | - Beth Sapiro
- Department of Social Work and Child Advocacy, Montclair State University, Montclair, NJ, USA
| | - Alisa Gold
- Massachusetts Department of Mental Health, Boston, MA, USA
| | - Mei Pearlstein
- Massachusetts Department of Mental Health, Boston, MA, USA
- Transitions to Adulthood Center for Research, Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Autumn N Crowe
- Research & Innovation, Youth & Young Adult Services, Thresholds, Chicago, IL, USA
| | - Ava Schneider
- Research & Innovation, Youth & Young Adult Services, Thresholds, Chicago, IL, USA
- School of Social Work, Loyola University of Chicago, Chicago, IL, USA
| | - Rebecca P Johnson
- Research & Innovation, Youth & Young Adult Services, Thresholds, Chicago, IL, USA
- Texas Institute for Excellence in Mental Health, The University of Texas at Austin, Austin, TX, USA
| | - Brianne LaPelusa
- Research & Innovation, Youth & Young Adult Services, Thresholds, Chicago, IL, USA
- Texas Institute for Excellence in Mental Health, The University of Texas at Austin, Austin, TX, USA
| | - Heidi Holland
- Massachusetts Department of Mental Health, Boston, MA, USA
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Murphy R, Huggard L, Fitzgerald A, Hennessy E, Booth A. A systematic scoping review of peer support interventions in integrated primary youth mental health care. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:154-180. [PMID: 37740958 DOI: 10.1002/jcop.23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/29/2023] [Accepted: 09/11/2023] [Indexed: 09/25/2023]
Abstract
Peer support, defined as the social and emotional support offered and received by individuals with a shared experience of mental health difficulties, is gaining popularity in youth mental health settings. This systematic scoping review aimed to collate and synthesise the evidence on key aspects of peer support interventions within integrated youth services and educational settings. Specifically, it synthesised evidence on the (1) assessed mental health outcomes in peer support interventions, (2) key characteristics and associated roles of peer support workers (PSWs) and (3) barriers and facilitators to implementation. A search of peer reviewed articles from January 2005 to June 2022 across five electronic databases (PsychINFO, Pubmed, Scopus, ERIC and CINAHL) was conducted. A total of 15 studies retrieved in the search met the inclusion criteria and were included in the review. This review supports previous research indicating that peer support has potential for improving recovery related outcomes. While a variety of interventions and PSW roles were reported, studies could be strengthened by providing more in-depth information on intervention content. Examples of barriers to implementation included staff concerns around confidentiality of peer support relationships as well as PSWs' confidence in their roles. Facilitators included positive support from staff members and role clarity.
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Affiliation(s)
- Rachel Murphy
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Leigh Huggard
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Amanda Fitzgerald
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Eilis Hennessy
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
| | - Ailbhe Booth
- School of Psychology, University College Dublin (UCD), Dublin, Ireland
- Department of Research & Evaluation, Jigsaw-The National Centre for Youth Mental Health, Dublin, Ireland
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Bansema CH, Vermeiren RRJM, Nijland L, de Soet R, Roeleveld J, van Ewijk H, Nooteboom LA. Towards identifying the characteristics of youth with severe and enduring mental health problems in practice: a qualitative study. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02325-2. [PMID: 38147108 DOI: 10.1007/s00787-023-02325-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/28/2023] [Indexed: 12/27/2023]
Abstract
A group of youth with severe and enduring mental health problems (SEMHP) falls between the cracks of the child-and-adolescent psychiatry (CAP) system. An insufficient understanding of these youth's mental health problems results in a failure to accurately identify and provide support to these youth. To gain a deeper understanding, the aim of this study is to explore characteristics of youth with SEMHP in clinical practice based on the experiences of youth and clinicians in CAP. This qualitative study consisted of 20 semi-structured interviews with 10 youth with lived experience and 10 specialized clinicians in CAP. Both a thematic and content analysis was conducted to identify, assess, and report themes associated with youth with SEMHP. Themes were individual characteristics such as trauma, masking, self-destructive behavior, interpersonal distrust as well as environmental and systematic characteristics including parental stressors, social isolation and societal stressors, which go beyond the existing classifications. These characteristics profoundly impact youth's daily functioning across various life domains, creating an interactive process, ultimately leading to elusive mental health problems and overwhelming feelings of hopelessness. The authors recommend proper assessment of characteristics in all life domains affected and their perpetuating effect on SEMHP during diagnostics in CAP. Engaging in a dialogue with youth themselves is crucial due to the nature of youth's characteristics, which frequently transcend traditional classifications and may not be immediately discernible. It also requires an integrated care approach, entailing collaborations between educational institutions and mental healthcare providers, and attention to potential indicators of deficits in the healthcare system and society.
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Affiliation(s)
- C H Bansema
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands.
| | - R R J M Vermeiren
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
- Youz, Parnassia Group, The Hague, The Netherlands
| | - L Nijland
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - R de Soet
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - J Roeleveld
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - H van Ewijk
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - L A Nooteboom
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
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de Beer CRM, van Domburgh L, Vermeiren RRJM, de Vreugd M, Nooteboom LA. Improving Collaboration Between Youth Peer Support Workers and Non-peer Colleagues in Child and Adolescent Mental Health Services. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:824-833. [PMID: 37335401 PMCID: PMC10359199 DOI: 10.1007/s10488-023-01283-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 06/21/2023]
Abstract
The involvement of youth peer workers (YPSWs) in child and adolescent mental health services (CAMHS) stimulates hope, destigmatization, and more culturally and developmentally appropriate support. Nevertheless, the collaboration between YPSWs and non-peer colleagues remains challenging, as it requires services to embed a new type of expert into practice. To stimulate the involvement of YPSWs in practice, this study reports on 27 semi-structured interviews with YPSWs and non-peer colleagues to provide insight into the barriers and facilitators in the collaboration process. The study took place in the Netherlands. A total of 10 interviews with YPSWs, and 17 interviews with non-peer colleagues in different healthcare occupations in CAMHS were conducted. Overall, the participants perceived relatively more barriers compared to facilitators in the collaboration process. Barriers to operate efficiently with YPSWs in multidisciplinary teams included: condescending attitudes and professional stigma towards YPSWs; concerns for YPSW boundaries; bureaucratic and clinical language usage by non-peer colleagues; conflicts due to different sets of expertise; and, lack of role clarity and guidelines for YPSWs. To improve the partnership between YPSWs and non-peer colleagues, participants described the importance of supervision and monitoring of YPSW activities. Moreover, participants also stressed the need for clear guidelines, and introduction and evaluation sessions to facilitate the collaboration process. While YPSWs seem to be an asset to CAMHS, there are a number of barriers to overcome. To overcome these barriers, organizational commitment, supervision (especially from peer colleagues), flexibility by non-peer colleagues, training non-peer staff to support YPSWs, and consistent evaluation of the implementation of YPSWs in services is recommended.
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Affiliation(s)
- Carolijn R M de Beer
- LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands.
| | - Lieke van Domburgh
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Amsterdam, The Netherlands
- iHUB, Rotterdam, The Netherlands
| | - Robert R J M Vermeiren
- LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - Martin de Vreugd
- LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - Laura A Nooteboom
- LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
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Jordan G, Mutschler C, Kidd SA, Rowe M, Iyer SN. Making the case for citizenship-oriented mental healthcare for youth in Canada. JOURNAL OF PUBLIC MENTAL HEALTH 2023. [DOI: 10.1108/jpmh-06-2022-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Purpose
Varying stakeholders have highlighted how recovery-oriented mental health services such as youth mental health services have traditionally focused on supporting individual resources to promote recovery (e.g., agency) to the exclusion of addressing structural issues that influence recovery (e.g. poverty). One response to this criticism has been work helping people with mental health problems recover a sense of citizenship and sense of belonging in their communities. Work on citizenship has yet to influence youth mental healthcare in Canada’s provinces and territories. This paper aims to highlight ways that youth mental healthcare can better help youth recover a sense of citizenship.
Design/methodology/approach
The arguments described in this paper were established through discussion and consensus among authors based on clinical experience in youth mental health and an understanding of Canada’s healthcare policy landscape, including current best practices as well as guidelines for recovery-oriented care by the Mental Health Commission of Canada.
Findings
Here, this study proposes several recommendations that can help young with mental health problems recover their sense of citizenship at the social, systems and service levels. These include addressing the social determinants of health; developing a citizenship-based system of care; addressing identity-related disparities; employing youth community health workers within services; adapting and delivering citizenship-based interventions; and connecting youth in care to civic-oriented organizations.
Originality/value
This paper provides the first discussion of how the concept of citizenship can be applied to youth mental health in Canada in multiple ways. The authors hope that this work provides momentum for adopting policies and practices that can help youth in Canada recover a sense of citizenship following a mental health crisis.
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