The mental health benefits of work: do they apply to welfare mothers with a drinking problem?

Socio-Demographic and Coping Correlates and Predictors of Depressive Symptoms Among Low-Income and Ethnic Minority Mothers At-Risk

This study identified coping and sociodemographic correlates and predictors of depressive symptoms in mothers at risk for clinical depression. A descriptive, cross-sectional design was employed. A convenience sample of 88 low-income or ethnic-minority mothers aged 21 to 45 completed a depression scale, demographic data sheet, and responded to an open-ended question. Content analysis, descriptive, and inferential statistics was used for data analysis. Exactly 42.5% of mothers reported high depressive symptoms (>16). Lower income levels (r = .342, p = .01) and head-of-household status (r = .220, p = .04) were significantly associated with higher depressive symptoms. Those who used social support coping had lower depressive symptoms than those who did not (t = 2.50, p = .014). Those using emotion-focused coping only had higher depressive symptoms than those using a mix of coping strategies (t = 2.60, p = .011). Healthcare providers can employ vigilant depression screening and encourage utilization of a mix of problem and emotion-focused coping strategies to reduce depressive symptoms and prevent clinical depression.

The knowledge, attitudes and perceptions of physiotherapists in KwaZulu-Natal, South Africa, towards mental health

Background

Physiotherapists are trained to manage patients with physical needs, but because of limited training at an undergraduate level in mental health, patients may not receive holistic care. This lack of knowledge often can deny people living with a mental illness (PLWMI) the potential benefits of physiotherapy treatment and exercise.

Objectives

Our study conducted in the KwaZulu-Natal province of South Africa aimed to determine the knowledge, attitudes and perceptions of physiotherapists working in the Department of Health (DoH) in KwaZulu-Natal, South Africa, towards mental health, and to determine whether their undergraduate training prepared them to manage PLWMI.

Methods

A mixed-method design was employed. The Attitudes to Psychiatry (ATP-30) questionnaire was distributed to 153 physiotherapists in KwaZulu-Natal. Focus groups were conducted to ascertain whether their undergraduate training prepared them adequately to manage PLWMI.

Results

A total of 124 physiotherapists completed the questionnaires. The mean ATP-30 scores was 103.70 (SD = 11.71). Females had slightly higher ATP-30 scores than males. Physiotherapists indicated in the focus groups that they received limited training about mental health at an undergraduate level.

Conclusion

Physiotherapists working in the KwaZulu-Natal public sector have a positive attitude towards mental health and managing PLWMI. Participants expressed the need for the inclusion of theoretical and practical knowledge about mental health in the undergraduate curriculum and postgraduate courses related to this topic.

Clinical implications

The outcomes of this study show the importance of the inclusion of mental health in the undergraduate physiotherapy programme. Exposure to the theoretical and practical knowledge of mental health during the undergraduate physiotherapy programme will assist qualified physiotherapists better manage PLWMI. Future studies should be conducted in the other provinces and in the private practice setting in South Africa, so as to compare the results.

Perceived neighborhood safety, recovery capital, and successful outcomes among mothers 10 years after substance abuse treatment

This study examines perceived neighborhood characteristics associated with successful outcome among mothers 10 years after being treated for substance use disorders. Data were obtained from 713 mothers first studied at admission to drug treatment in California in 2000-2002 and followed up in 2009-2011. At follow-up, 53.6% of mothers had a successful outcome (i.e., no use of illicit drugs and not involved with the criminal justice system). Perceived neighborhood safety almost doubled the odds of success. Perceived neighborhood safety interacted with social involvement, decreasing the odds of success among mothers who reported more versus less neighborhood social involvement. Perceived neighborhood climate is associated with long-term outcomes among mothers with substance use disorders independent of individual-level characteristics, underscoring the need for further efforts to understand its interaction with recovery capital in ways that promote and impede health.

Reconsidering the effects of poverty and social support on health: a 5-year longitudinal test of the stress-buffering hypothesis

Prior research in the general population has found that social support can buffer the adverse effects of stressors on health. However, both stressors and social support may be qualitatively different for those living in urban poverty. We examined the effects of social support and poverty-specific stressors on self-rated health. We used data from the Welfare Client Longitudinal Survey (WCLS), a 5-year longitudinal study of 718 public aid recipients. We measured received social support and "net social support," defined as the difference between support received and that given to others. We used restricted cubic splines to model the stress-buffering effects of social support on self-rated health as a function of stressful life events and neighborhood disorder. Increased exposure to stressors was associated with poorer self-rated health. Evidence of stress buffering was confined to those with the heaviest exposure to stressors, and its effects decreased across increasing levels of social support. Analyses using net social support had generally more modest effects than those using received social support. Social support does not buffer the effects of stressors on health uniformly for individuals living in conditions of urban poverty. Researchers and policymakers should be cautious in overestimating the beneficial effects that social support may have on health for marginalized populations.

Does alcohol consumption exacerbate the mental health consequences of interpersonal violence?

Although studies show that interpersonal violence is associated with poorer mental health, few studies specify the conditions under which victimization can be more or less detrimental to psychological well-being. Building on previous research, the authors test whether the association between interpersonal violence and psychological distress is moderated by alcohol consumption. Our analysis of longitudinal data from the Welfare, Children, and Families project suggests that interpersonal violence is more strongly associated with psychological distress in the context of more frequent intoxication. Programs designed to treat the combination of victimization and heavy alcohol consumption may make unique contributions to the well-being of women.

Mortality among substance-using mothers in California: a 10-year prospective study

AIMS

To examine mortality rates and causes of death among a cohort of substance-using mothers and to identify risk factors that predict mortality.

DESIGN, SETTING, PARTICIPANTS

This is a prospective study of a cohort of 4447 substance-using mothers (pregnant or parenting) who were enrolled during 2000-02 in 40 drug abuse treatment programs across California.

METHODS

All mothers were assessed at baseline using the Addiction Severity Index. Mortality data were obtained from the National Death Index and causes of death were coded using ICD-10. Standardized mortality ratios (SMR) were calculated relative to women in the general population adjusted for age. Proportional hazard (Cox) regression was used to identify risk factors predicting death.

RESULTS

At the end of 2010, 194 deaths were confirmed, corresponding to a crude mortality rate of 4.47 per 1000 person-years and SMR of 8.4 (95% confidence interval: 7.2-9.6). Drug overdose (28.8%), cardiovascular disease (10%), and alcohol or drug disorders (8.9%) were the leading causes of death. Baseline factors associated with higher mortality included older age, being white (relative to African American or Hispanic), heroin, alcohol, cocaine or marijuana (relative to methamphetamine) as the primary drug problem, drug injection and greater severity of employment, medical/health and psychiatric problems.

CONCLUSIONS

Substance-using mothers have 8.4 times the mortality than that observed among US women of similar age. Greater severity of employment, medical/health and psychiatric problems contributed to the elevated mortality.

Employment Trajectories: Exploring Gender Differences and Impacts of Drug Use

This study investigated the impact of drug use on employment over 20 years among men and women, utilizing data on 7,661 participants in the National Longitudinal Survey of Youth. Growth mixture modeling was applied, and five distinct employment trajectory groups were identified for both men and women. The identified patterns were largely similar for men and women except that a U-shape employment trajectory was uniquely identified for women. Early-initiation drug users, users of "hard" drugs, and frequent drug users were more likely to demonstrate consistently low levels of employment, and the negative relationship between drug use and employment was more apparent among men than women. Also, positive associations between employment and marriage became more salient for men over time, as did negative associations between employment and childrearing among women. Processes are dynamic and complex, suggesting that throughout the life course, protective factors that reduce the risk of employment problems emerge and change, as do critical periods for maximizing the impact of drug prevention and intervention efforts.

The mental health benefits of work: do they apply to poor single mothers?

BACKGROUND

The relationship between employment and improved mental health is well documented. However, no research has examined whether this relationship applies to poor single mothers. Given recent changes in the labor market where poor women are disproportionately employed in unstable jobs, the competing demands of work and childcare may operate to prevent poor women from reaping the mental health benefits of employment. Understanding these connections has become more salient not just for mental health epidemiology but for policies targeting employment and poverty.

METHODS

This study draws on four waves of data from the Welfare Client Longitudinal Study. Generalized estimating equations are utilized to assess the role of current employment and employment continuity on the depression status of poor single mothers over time. Through a comparison of results drawn from a dichotomous categorization of current employment with results drawn from measures of employment continuity, this study is also able to assess whether it is employment per se or the characteristics of employment that matter.

RESULTS

Overall, the results from this study suggest that current employment improves the mental health of many poor single mothers. However, the circumstances most likely to improve their mental health are full-time or stable, longer term employment.

CONCLUSIONS

The results from this study are of concern given that the lack of employment continuity is a growing trend in the U.S. labor market and poor women are disproportionately employed in these types of unstable jobs. These findings, thus, have wide-reaching implications for welfare policy as they provide an important and timely perspective in our understanding of the impact of the changing face of employment on poor women.