Digital media use, depressive symptoms and support for violent radicalization among young Canadians: a latent profile analysis

BACKGROUND

Despite the prominent role that digital media play in the lives and mental health of young people as well as in violent radicalization (VR) processes, empirical research aimed to investigate the association between Internet use, depressive symptoms and support for VR among young people is scant. We adopt a person-centered approach to investigate patterns of digital media use and their association with depressive symptoms and support for VR.

METHODS

A sample of 2,324 Canadian young people (Mage = 30.10; SDage = 5.44 ; 59% women) responded to an online questionnaire. We used latent profile analysis to identify patterns of digital media use and linear regression to estimate the associations between class membership, depressive symptoms and support for VR.

RESULTS

We identified four classes of individuals with regards to digital media use, named Average Internet Use/Institutional trust, Average internet use/Undifferentiated Trust, Limited Internet Use/Low Trust and Online Relational and Political Engagement/Social Media Trust. Linear regression indicated that individuals in the Online Relational and Political Engagement/Social Media Trust and Average Internet Use/Institutional trust profiles reported the highest and lowest scores of both depression and support for VR, respectively.

CONCLUSIONS

It is essential to tailor prevention and intervention efforts to mitigate risks of VR to the specific needs and experiences of different groups in society, within a socio-ecological perspective. Prevention should consider both strengths and risks of digital media use and simulteaneously target both online and offline experiences and networks, with a focus on the sociopolitical and relational/emotional components of Internet use.

Preference for online social interactions and support for violent radicalization among college and university students

Young people are at increased risk of supporting violent radicalization (VR), and VR processes are increasingly happening online. Despite the important role that online socialization plays in the lives of digital natives as well as in VR processes, empirical research aimed to investigate the association between online socialization and support for VR among young people is scant. This article examines the association between preference for online social interactions and support for VR among students and investigates whether this association is moderated by social support and collective self-esteem and mediated by depressive symptoms. A total of 5,598 Canadian college and university students (M_age = 22.75, SD_age = 7.45) responded to an online survey. We implemented multivariable mixed-effects regression models, stratified and mediation analyses. Greater preference for online social interactions was associated with stronger support for VR. Preference for online social interactions was a risk factor for VR, particularly at low levels of public self-esteem and social support as well as at high levels of importance attributed to one's group identity. Depressive symptoms partially mediated this association. Programs aimed to foster and value multiple identities and increase social support in educational settings are urgently needed to address the possible negative consequences of the online space on young people's mental health and support for violence. Prevention programs should address the provision of psychosocial support to students reporting depressive symptoms and help them build and maintain a supportive social network, as well as enhance inclusion at the societal level and across educational institutions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mental health among older Bhutanese with a refugee life experience: A mixed-methods latent class analysis study

There are disparities in the mental health of refugee populations compared to individuals who have not experienced forced migration. It is important to identify individuals with a refugee life experience who are most in need of mental health care and prioritize their engagement in services. The objectives of this convergent mixed-methods study are to quantitatively identify the association between exposure to pre- and postresettlement traumas and stressors and mental health among older adults with a refugee life experience, qualitatively identify typologies of narratives of forced migration, and integrate findings to provide a more comprehensive understanding of the relationship between trauma and symptoms of posttraumatic stress disorder (PTSD). Study participants were Bhutanese with a refugee life experience living in a metropolitan area in New England (United States). We used quantitative surveys to identify exposures to traumas and symptoms of PTSD. We used latent class analysis to identify subgroups of trauma exposure and association with symptoms of PTSD. A subset of individuals participated in qualitative interviews. Narrative thematic analysis was used to explore typologies of life history narratives. Quantitatively, we identified four classes of patterns of trauma exposure throughout the refugee life trajectory. These classes were associated with current symptoms of PTSD. Qualitatively, we identified four narrative types that indicate participants interpreted and made sense of their life trajectories in a variety of ways. Integration of findings indicate that caution is needed in identifying individuals in need of mental health services and the best approach for interventions that promote psychosocial well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Violent Radicalization, Mental Health, and Gender Identity: Considerations for Future Research

ABSTRACT

This study examines the association between gender identity, mental health, social adversity, and sympathy for violent radicalization (VR). Data were collected through an online survey in Canada. A total of 6003 eligible participants who were residents of Montreal, Toronto, Calgary, or Edmonton and aged from 18 to 35 years were included. We used Fisher exact test to assess gender differences in gender-based discrimination and we used analysis of variance tests to assess differences in scores on bullying, mental health, and sympathy for VR. We used linear regression to assess the relationship between mental health, social adversities, and sympathy for VR. Individuals who self-identified as trans and gender diverse had greater sympathy for VR than females did, experienced online victimization more frequently, and reported higher levels of psychological distress than both male and female participants. Our findings indicate that more research is needed on the association between social adversity and support for VR among this vulnerable population.

Collective case formulation in situations of violent radicalization: A critical perspective in training

Case formulation is used in clinical training to weave together theoretical perspectives and support a shared plan of action. Although a cornerstone of clinical practice, critical social theorists have highlighted the risks of depoliticizing political struggles and of reifying and fixing subjects when using psychopathology and case formulation to address situations of injustice. In the field of violent radicalization, this risk is increased by the extreme affects evoked by terror in practitioners and in societies. This article explores the challenges of training clinicians in the field of violent radicalization. It does so by analyzing a Community of Practice (CoP) that was developed to support practitioners involved in this domain of practice in Quebec, Canada. Four focus groups with CoP participants and participant observation of nine CoP meetings were conducted. Thematic and narrative analyses were used to explore the training potential of the CoP and to identify the discursive processes and group dynamics associated with this modality. Results indicate that the diversity of professional perspectives and social positionalities in the group plays a central role in helping participants become aware of their biases and in developing more complex understandings of cases and of their social embedding. Results also suggest that the collective holding of risk is key to preserve practitioners' investment in patients involved with violent radicalization. The sensitive issue of partnership between health and social services and security agencies is also addressed. Results suggest that CoPs with strong leadership allow for experiential training to enhance clinical and critical thinking.

Past trauma, resettlement stress, and mental health of older Bhutanese with a refugee life experience

OBJECTIVES

Older displaced persons often receive limited attention from aid organizations, policy-makers and service providers in countries of resettlement. The objective of this study is to identify the relationship between experiencing traumatic events and stressors prior to resettlement, current resettlement stressors, social support, and mental health of older Bhutanese with a refugee life experience.

METHOD

Study participants were 190 older Bhutanese with a refugee life experience living in a metropolitan area in New England (US) and Ontario (Canada). We used structural equation modeling to determine the association between traumatic and stressful events in Bhutan and Nepal, current resettlement stressors, and symptoms of anxiety and depression, as measured by the GAD-7 and PHQ-9. We assessed the role of social support as an effect modifier in the relationship between these variables.

RESULTS

Surviving torture was associated with anxiety (p=.006), and experiencing threats to physical wellbeing in Nepal was associated with both anxiety (p=.003) and depression (p=.002). The relationship between physical threats in Nepal and current mental health were partially mediated by resettlement stressors. Social support moderated the relationship between trauma, stress, and mental health.

CONCLUSION

Both past traumas and current resettlement stressors contribute to the current psychosocial functioning of older Bhutanese with a refugee life experience. Based on our findings, social support is critical in promoting mental health in this population.

The Development of a Mental Health Program for Unaccompanied Minors in the United States

The unique needs of unaccompanied children (UC) and unaccompanied refugee minors (URM) often make it challenging for them to engage in traditional mental health services. This paper describes the development and implementation of a mental health program for UC and URM using a collaborative approach with key stakeholders. In the Exploration phase, we conducted an assessment of youths' mental health needs, barriers to, and recommendations for care through discussions with community partners. Next, we describe the Preparation phase in which we designed the program around three major domains: 1) training and consultation, 2) cross-sector collaboration, and 3) direct services. Discussion of the Implementation phase includes a description of youth served and program materials. Finally, the Sustainment phase focuses on recommendations for best practice informed by successes and challenges of program implementation. Findings have implications for future mental health programming for UC/URM.

Meaning in Life, Future Orientation and Support for Violent Radicalization Among Canadian College Students During the COVID-19 Pandemic

The COVID-19 pandemic has increased levels of uncertainty and social polarization in our societies, compromising young people's capacity to envision a positive future and maintain a meaningful sense of purpose in life. Within a positive youth development framework, the present study investigates the associations of a positive future orientation, presence of and search for meaning in life, and support for violent radicalization (VR) in a diverse sample of Canadian college students. In addition, we investigate the moderating role of future orientation in the association between presence of and search for a meaning in life and support for VR. A total of 3,100 college students in Québec (Canada) (69% female; M _age = 18.57, SD _age = 1.76) completed an online survey during the second wave of the COVID-19 pandemic. Results from linear mixed-effects models indicate that a positive future orientation and a higher presence of a meaning in life were negatively and independently associated with support for VR. Search for meaning in life was not associated with support for VR. The magnitude of the negative association between presence of a meaning in life and support for VR was greater among students with a more positive future orientation. Schools and colleges are in a privileged position to implement preventive interventions to support a positive future orientation and the presence of a meaning in life among young people during these challenging and uncertain times and reduce the risk of violence related to extreme ideologies in our rapidly changing society.

Latent class analysis of COVID-19 experiences, social distancing, and mental health

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes (p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, β = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes (p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Transnational evaluation of the Sympathy for Violent Radicalization Scale: Measuring population attitudes toward violent radicalization in two countries

Countering violent radicalization is a priority in many countries, prompting research that assesses attitudes and beliefs about violent radicalization in the general population. The majority of violent radicalization assessments have been developed among specific populations, with limited investigation into the generalizability and cross-cultural applicability of measurement tools. A transcultural investigation raises questions about the implicit assumptions and norms that inform instrument development. This research examined the psychometric properties of the Sympathy for Violent Radicalization Scale (SyfoR), a measure developed for use with Pakistani and Bangladeshi immigrant groups in the UK, in two convenience samples of youth and young adults in North America and Western Europe. We investigated the factor structure, reliability, and construct validity of adapted versions of the SyfoR among convenience samples of youth and young adults living in Belgium (N = 2014) and in Quebec, Canada (N = 1364) via online surveys administered to students engaged in secondary and post-secondary education. Results indicate that, in both samples, a reduced, 8-item version of the SyfoR has a 3-factor structure with good model fit statistics using confirmatory factor analysis and good internal consistency reliability. More studies are needed to assess the appropriateness of the SyfoR for use in diverse contexts and among diverse populations. The potential usefulness and harmfulness of measures of violent radicalization should balance the benefits of obtaining local data with the risks associated with pathologizing social dissent.

Discrimination and Sympathy for Violent Radicalization Among College Students in Quebec (Canada): The Protective Role of Intrinsic and Extrinsic Religiosity

ABSTRACT

The present study examines the moderating role of total, intrinsic, and extrinsic religiosity in the relation between perceived discrimination and sympathy for violent radicalization (VR) among college students in Quebec, Canada. A total of 931 students responded to an online questionnaire and were included in this study. Linear mixed-effects models were conducted to account for the clustered nature of the data, and moderation was assessed via interaction analysis using cross-product terms in the models. Findings indicated that both intrinsic and extrinsic religiosity had a protective role in the link between perceived discrimination and sympathy for VR and buffered the effects of sadness in response to discrimination on sympathy for VR, but not the effects of anger in response to discrimination. These results provide evidence of the protective role of religiosity in Canada, a social context characterized by an increase in religious discrimination, but which also supports religious diversity.

Canadian Health Personnel Attitudes Toward Refugee Claimants' Entitlement to Health Care

Health care personnel attitudes toward refugee claimant entitlement to health care are influenced by multilevel factors including institutional and societal culture. Although individual attitudes may be modified through training, macro- and meso-issues require system-level interventions. This paper analyzes the role of individual-, institutional-, and city-level factors in shaping attitudes toward refugee claimants' access to health care among Canadian health care personnel. A total of 4207 health care personnel in 16 institutions located in Montreal and Toronto completed an online survey on attitudes regarding health care access for refugee claimants. We used multilevel logistic regression analysis to identify individual-, institutional-, and city-level predictors of endorsing access to care. Participants who had prior contact with refugee claimants had greater odds of endorsing access to care than those who did not (OR 1.13; 95% CI 1.05, 1.21). Attitudes varied with occupation: social workers had the highest probability of endorsing equal access to health care (.83; 95% CI .77, .89) followed by physicians (.77; 95% CI .71, .82). An estimated 7.97% of the individual variation in endorsement of equal access to health care was attributable to differences between institutions, but this association was no longer statistically significant after adjusting for city residence. Results indicate that the contexts in which health care professionals live and work are important when understanding opinions on access to health care for vulnerable populations. They suggest that institutional interventions promoting a collective mission to care for vulnerable populations may improve access to health care for precarious status migrants.

COVID-19 Experiences and Social Distancing: Insights From the Theory of Planned Behavior

Purpose:

The objective of this study is to identify the relationship between COVID-19 experiences, perceived COVID-19 behavioral control, social norms and attitudes, and future intention to follow social distancing guidelines.

Design:

This is a cross-sectional study.

Setting:

Participants responded to an on-line survey in June 2020.

Subjects:

The study included 3,183 residents within Quebec, Canada aged 18 and over.

Measures:

Measures include perceived COVID-19 related discrimination, fear of COVID-19 infection, prior exposure to COVID-19, and prior social distancing behavior. Participants self-reported attitudes, perceived behavioral control, and perceived norms related to social distancing. Finally, we measured social distancing behavioral intention.

Analysis:

We evaluated a theory of planned behavior (TPB) measurement model of social distancing using confirmatory factor analysis (CFA). The association between COVID-19 perceived discrimination, fear of infection, previous social distancing behavior, exposure to COVID-19, TPB constructs and behavioral intentions to social distance were estimated using SEM path analysis.

Results:

TPB constructs were positively associated with intention to follow social distancing guidelines. Fear of COVID-19 infection and prior social distancing behavior were positively associated with behavioral intentions. In contrast, perceived discrimination was negatively associated with the outcome. Associations between fear of COVID-19, perceived COVID-19 discrimination and behavioral intentions were partially mediated by constructs of TPB.

Conclusions:

COVID-19 prevention efforts designed to emphasize positive attitudes, perceived control, and social norms around social distancing should carefully balance campaigns that heighten fear of infection along with anti- discrimination messaging.

Classifying childhood war trauma exposure: latent profile analyses of Sierra Leone's former child soldiers

BACKGROUND

Former child soldiers are at elevated risk for mental health problems (e.g., traumatic stress, emotion dysregulation, and internalizing and externalizing problems). To examine which groups of former child soldiers are more likely to have difficulties with emotion regulation, interpersonal relationships, and mental health postconflict, we explored patterns of war trauma exposure and their effects on subsequent mental health problems among former child soldiers in Sierra Leone.

METHODS

Participants were 415 (23.86% female) Sierra Leonean former child soldiers participating in a 15-year, four-wave longitudinal study. At T1 (2002), 282 former child soldiers (aged 10-17) were recruited. T2 (2004) included 186 participants from T1 and an additional cohort of self-reintegrated former child soldiers (NT2 = 132). T3 (2008) and T4 (2016/2017) participants were youth enrolled in previous waves (NT3 = 315; NT4 = 364). Latent profile analysis (LPA) was used to classify participants based on the first-time reports of eight forms of war exposure (separation and loss of assets, parental loss, loss of loved ones, witnessing violence, victimization, perpetrating violence, noncombat activities, and deprivation). ANOVA examined whether patterns of war exposure were associated with sociodemographic characteristics and mental health outcomes between T1 and T4.

RESULTS

LPA identified two profiles: higher exposure versus lower exposure, using cumulative scores of eight forms of war-related trauma exposure. The 'higher war exposure' group comprised 226 (54.5%) former child soldiers and the 'lower war exposure' group included 189 (45.5%). Significantly higher levels of violence-related and combat experiences characterized the group exposed to more traumatic events. The 'higher war exposure' group reported more PTSD symptoms at T2, more hyperarousal symptoms across all waves, and more difficulties in emotion regulation at T4.

CONCLUSIONS

Former child soldiers exposed to higher levels of war-related traumatic events and loss should be prioritized for mental health services immediately postconflict and as they transition into adulthood.

A Latent Class Analysis of Attitudes Towards Asylum Seeker Access to Health Care

In the past decade there has been an increase in focus on the concept of deservingness and how it plays out in debates around health care for migrant populations with precarious legal status. This study uses latent class analysis to identify subtypes of attitudes regarding asylum seeker access to health care and endorsement of support for asylum seeker access to care among 4066 employees of health care institutions in Montreal and Toronto, Canada. Authors identified four classes of attitudes towards asylum seeker access to care named 'Favorable,' 'Opposed,' 'Ambivalent/Reactive,' and 'Unconcerned/Status quo'. The odds of endorsing access to health care depended on the individual's class membership of asylum seeker attitude. Although there are segments of the population that overwhelmingly endorse, or reject, asylum seeker access to care, there are important variants in opinions and beliefs. Interventions are needed to engage professionals more ambivalent or opposed to asylum seeker access to care.

Socio-cultural correlates of self-reported experiences of discrimination related to COVID-19 in a culturally diverse sample of Canadian adults

Minorities and marginalized groups have increasingly become the target of discriminatory actions related to the COVID-19 pandemic. Detailed information about the manifestation of COVID-related discrimination is required to develop preventive actions that are not stigmatizing for such groups. The present study investigates experiences of perceived discrimination related to COVID-19 and its socio-cultural correlates in a culturally diverse sample of adults in Quebec (Canada). An online survey was completed by 3273 Quebec residents (49 % 18-39 years old; 57 % female; 49 % White). We used multivariate binomial logistic regression models to assess prevalence of COVID-related discrimination and to investigate socio-cultural correlates of reasons and contexts of discrimination. COVID-related discrimination was reported by 16.58 % of participants. Non-white participants, health-care workers and younger participants were more likely to experience discrimination than White, unemployed and older participants, respectively. Discrimination was reported primarily in association with participants' ethno-cultural group, age, occupation and physical health and in the context of public spaces. Participants of East-Asian descent and essential workers were more likely to report discrimination because of their ethnicity and occupation, respectively. Although young people experienced discrimination across more contexts, older participants were primarily discriminated in the context of grocery stores and because of their age. Our findings indicate that health communication actions informed by a social pedagogy approach should target public beliefs related to the association of COVID-19 with ethnicity, age and occupation, to minimize pandemic-related discrimination. Visible minorities, health-care workers and seniors should be protected and supported, especially in public spaces.

Traditional Medicine and Help-Seeking Behaviors for Health Problems Among Somali Bantu Refugees Resettled in the United States

Somali refugees have resettled in the United States in large numbers. The focus of this study was specifically on the Somali Bantu refugees, an ethnic minority group from Somalia. The goal of this study was to understand the following: (a) jinn (invisible beings or forces in Islamic theology) and related health problems resulting from jinn possession affecting Somali Bantu refugees, (b) types of traditional healing practices integrated into help-seeking behavior, and (c) pathways of care utilized to address health problems. In total, 20 participant interviews were conducted with Somali Bantu refugees resettled in the United States. Overall, participants described types of jinn and associated health problems. In addition, participants identified different pathways of care, including formal and informal health care. Participants accessed these pathways both concurrently and sequentially. Somali Bantu utilize complex and varied health care services based on their understanding of the causes of health problems and experiences with care providers.

Ethno-cultural disparities in mental health during the COVID-19 pandemic: a cross-sectional study on the impact of exposure to the virus and COVID-19-related discrimination and stigma on mental health across ethno-cultural groups in Quebec (Canada)

BACKGROUND

Although social and structural inequalities associated with COVID-19 have been documented since the start of the pandemic, few studies have explored the association between pandemic-specific risk factors and the mental health of minority populations.

AIMS

We investigated the association of exposure to the virus, COVID-19-related discrimination and stigma with mental health during the COVID-19 pandemic, in a culturally diverse sample of adults in Quebec (Canada).

METHOD

A total of 3273 residents of the province of Quebec (49% aged 18-39 years, 57% women, 51% belonging to a minority ethno-cultural group) completed an online survey. We used linear and ordinal logistic regression to identify the relationship between COVID-19 experiences and mental health, and the moderating role of ethno-cultural identity.

RESULTS

Mental health varied significantly based on socioeconomic status and ethno-cultural group, with those with lower incomes and Arab participants reporting higher psychological distress. Exposure to the virus, COVID-19-related discrimination, and stigma were associated with poorer mental health. Associations with mental health varied across ethno-cultural groups, with exposed and discriminated Black participants reporting higher mental distress.

CONCLUSIONS

Findings indicate sociocultural inequalities in mental health related to COVID-19 in the Canadian context. COVID-19-related risk factors, including exposure, discrimination and stigma, jeopardise mental health. This burden is most noteworthy for the Black community. There is an urgent need for public health authorities and health professionals to advocate against the discrimination of racialised minorities, and ensure that mental health services are accessible and culturally sensitive during and in the aftermath of the pandemic.

A repeated cross-sectional study of sympathy for violent radicalization in Canadian college students

The upsurge in violent radicalization is associated with a global increase in social inequalities and conflicts related to different markers of identity. To date, literature on the factors associated with legitimizing violence toward others is cross-sectional and does not provide information on the possible change of this phenomenon over time. Such information is necessary to design primary prevention programs that are adapted to and address a rapidly evolving social context. We use a repeated cross-sectional study design to explore the association between sociodemographic characteristics and scores on the Sympathy for Violent Radicalization Scale (SVR) in Quebec (Canada) college students at 2 times points. Results from an online survey completed by students of 6 colleges in 2015 (n = 854) and 2017 (n = 702) indicate that although overall scores on the SVR scale remained stable, there were changes in the association between age, identity, and the outcome at the two time points. Specifically, scores on the SVR were significantly higher among younger students in 2017 than in 2015. In addition, in 2017 we observed a relationship between collective identity and SVR that was not present in 2015. These results align with other recent studies in Canada and the U.S. documenting the emergence of new forms of youth politicized bullying associated with race, ethnicity, and religion. A close monitoring of the phenomenon is warranted to both better understand the impact of populist policies on the increase in hate incidents and crimes and develop programs to address these forms of violence from a public health perspective. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mental Health of Refugee Children and Youth: Epidemiology, Interventions, and Future Directions

The number of refugee youth worldwide receives international attention and is a top priority in both academic and political agendas. This article adopts a critical eye in summarizing current epidemiological knowledge of refugee youth mental health as well as interventions aimed to prevent or reduce mental health problems among children and adolescents in both high- and low-to-middle-income countries. We highlight current challenges and limitations of extant literature and present potential opportunities and recommendations in refugee child psychiatric epidemiology and mental health services research for moving forward. In light of the mounting xenophobic sentiments we are presently witnessing across societies, we argue that, as a first step, all epidemiological and intervention research should advocate for social justice to guarantee the safety of and respect for the basic human rights of all refugee populations during their journey and resettlement. A constructive dialogue between scholars and policy makers is warranted.

Stronger together: Community resilience and Somali Bantu refugees

OBJECTIVES

Refugee populations are at risk of adverse mental health outcomes. It is important to identify refugee strengths at the community level that can be leveraged to overcome barriers to well-being. In pursuit of this goal, this study focuses on identifying what promotes community resilience among Somali Bantu refugees in the United States.

METHOD

Researchers used snowball-sampling strategies in a large New England city to recruit 81 Somali Bantu youth and adults to participate in 14 focus groups conducted between 2011 and 2013. Researchers used principles of thematic content analysis to analyze data specific to the construct of community resilience.

RESULTS

Authors identified 2 main components of Somali Bantu community resilience: independence and cultural preservation. There were 2 themes related to promoting community resilience among Somali Bantu: commitment to community, and religion and spirituality.

CONCLUSIONS

We discuss the importance of identifying culturally informed components of community resilience that can be used to develop services for refugee populations. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Mental health needs and services for migrants: an overview for primary care providers

BACKGROUND

The objective of this article is to present an overview of the burden, spectrum of diseases and risk factors for mental illness among subgroups of migrants, namely, immigrants, refugees and individuals with precarious legal status. This expert review summarises some of the implications for primary care services in migrant receiving countries in the global North.

METHODS

A broad literature review was conducted on the epidemiology of mental health disorders in migrants and the available evidence on mental health services for this population focusing on key issues for primary care practitioners in high-income countries.

RESULTS

Although most migrants are resilient, migration is associated with an over-representation of mental disorder in specific subpopulations. There is a general consensus that stress-related disorders are more prevalent among refugee populations of all ages compared to the general population. Relative to refugees, migrants with precarious legal status may be at even higher risk of depression and anxiety disorders. Persistence and severity of psychiatric disorders among migrant populations can be attributed to a combination of factors including severity of trauma exposures during the migration process. Exposure to stressors after resettlement, such as poverty and limited social support, also impacts mental illness. Services for migrants are affected by restricted accessibility and should address cultural and linguistic barriers to and issues in the larger social environment that impact psychosocial functioning.

CONCLUSION

There is substantial burden of mental illness among some migrant populations. Primary care providers seeking to assist individuals need to be cognizant of language barriers to and challenges of working with interpreters as well as sensitive to cultural and social contexts within the diagnosis and service delivery process. In addition, best practices in screening migrants and providing intervention services for mental disorders need to be sensitive to where individuals and families are in the resettlement trajectory.

Qualitative Assessment of Smoke-Free Policy Implementation in Low-Income Housing: Enhancing Resident Compliance

PURPOSE

As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance.

DESIGN

Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations.

SETTING

Four low-income housing properties in Massachusetts, 12 months postpolicy adoption.

PARTICIPANTS

Individual interviews (n = 17) with property staff (managers, resident service coordinators, maintenance, security, and administrators) and focus groups with resident smokers (n = 28) and nonsmokers (n = 47).

MEASURES

Informed by the social-ecological model: intrapersonal, interpersonal, organizational, and community factors relating to compliance were assessed.

ANALYSIS

Utilized MAXQDA in a theory-driven immersion/crystallization analytic process with cycles of raw data examination and pattern identification until no new themes emerged.

RESULTS

Self-reported secondhand smoke exposure (SHSe) was reduced but not eliminated. Challenges included relying on ambivalent maintenance staff and residents to report violations, staff serving as both enforcers and smoking cessation counsellors, and inability to enforce on nights and weekends. Erroneous knowledge of the policy, perception that SHSe is not harmful to neighbors, as well as believing that smokers were losing their autonomy and being unfairly singled out when other resident violations were being unaddressed, hindered policy acceptance among resident smokers. The greatest challenge to compliance was the lack of allowable outdoor smoking areas that may have reduced the burden of the policy on smokers.

CONCLUSION

Smoke-free policy implementation to support compliance could be enhanced with information about SHSe for smokers and nonsmokers, cessation support from external community partners, discussion forums for maintenance staff, resident inclusion in decision-making, and framing the policy as part of a broader wellness initiative.

A Controlled Trial of Supported Employment for People With Severe Mental Illness and Justice Involvement

OBJECTIVE

Employment is a key to participation in community life for people with severe mental illness, especially those who have been involved in the criminal justice system. Although the Individual Placement and Support (IPS) model of supported employment has been established as an evidence-based practice for helping people with severe mental illness attain competitive employment, little is known about whether IPS is effective for people with severe mental illness who have a history of arrest or incarceration. This study examined this question.

METHODS

A randomized controlled trial examined competitive employment outcomes for 85 participants with severe mental illness and justice involvement who were assigned to IPS or to a comparison group that offered a job club approach with peer support.

RESULTS

At one-year follow-up, a greater proportion of participants in the IPS group than in the comparison group had obtained competitive employment (31% versus 7%; p<.01). The IPS and comparison groups did not differ significantly during follow-up in rates of hospitalization (51% versus 40%) or justice involvement-either arrests (24% versus 19%) or incarceration (2% for both groups).

CONCLUSIONS

Although IPS was shown to be an effective model for helping justice-involved clients with severe mental illness achieve employment, the outcomes were modest compared with those in prior IPS studies. The IPS model provided a useful framework for employment services for this population, but augmentations may be needed.

Competencies of more and less successful employment specialists

The competencies of individual employment specialists influence rates of competitive employment among consumers and programs. Identifying competencies can lead to the development of more effective specialists and improve employment outcomes for consumers enrolled in employment services in community mental health care settings. The purpose of this study was to examine how more successful employment specialists performed supported employment duties in comparison to less successful employment specialists. Ethnographic researchers observed more and less successful employment specialists performing job duties related to the five phases of supported employment. Using grounded theory, they identified factors that differentiated the two groups. More successful employment specialists worked efficiently, developed egalitarian relationships with consumers, and collaborated well with other partners. Less successful employment specialists understood the model but lacked these behavioral skills. Service providers should screen and train employment specialists for efficiency, flexibility, and interpersonal skills.

Partnering with mental health providers: a guide for services researchers

BACKGROUND

There is a 20-year delay between the development of effective interventions for individuals with severe mental illness and widespread adoption in public mental health care settings. Academic-provider collaborations can shorten this gap, but establishing and maintaining partnerships entail significant challenges.

AIMS

This paper identifies potential barriers to academic-provider research collaborations and provides guidelines to overcome these obstacles.

METHOD

Authors from an academic institution and community mental health organization outline the components of their long-standing partnership, and discuss the lessons learned that were instrumental in establishing the collaborative model. Results Realistic resource allocation and training, a thorough understanding of the service model and consumer characteristics, systemic and bidirectional communication and concrete plans for post-project continuation are necessary at all project phases.

CONCLUSIONS

A shared decision-making framework is essential for effective academic institution and community mental health agency collaborations and can facilitate long-term sustainability of novel interventions.

Applying social and cultural capital frameworks: understanding employment perspectives of transition age youth with serious mental health conditions

Vulnerable transition age youth, such as those in foster care and with serious mental health conditions, are at increased risk for lower rates of employment. Social capital is empirically linked to employment in the general population, yet little is known about the role of social capital in employment for at-risk transition age youth. Focus groups were conducted with young people with serious mental health conditions and their vocational specialists. Discussions reveal that both social and cultural capital influence employment processes. Those with employment experience value the motivation to work provided through others compared to those with no employment experience. Consistently employed describe strong working relationships with vocational specialists and possession of self-awareness, professionalism, and work-place knowledge as critical for employment success, while inconsistently employed describe worries about controlling emotions or behaviors on the job. Building social and cultural capital are explored as potential service provider goals.

Enrollment in supported employment services for clients with a co-occurring disorder

OBJECTIVE

People with serious mental illnesses and co-occurring substance use disorders are often excluded from vocational services, despite the lack of evidence that having a substance use disorder prevents them from being able to work. This study explored enrollment in supported employment services among clients with and without co-occurring substance use disorders.

METHODS

With data from electronic medical records from a psychiatric rehabilitation agency, relationships between co-occurring substance use disorders and supported employment were examined among 1,748 clients with serious mental illnesses who were consecutively admitted to the agency over a two-year period.

RESULTS

Despite a similar interest in employment, clients with a co-occurring substance use disorder were 52% less likely than those without to enroll in a supported employment program. Those who were enrolled had similar competitive employment rates (25% for those with co-occurring disorders and 28% for those without).

CONCLUSIONS

People with co-occurring substance disorders have reduced rates of enrollment in supported employment services.

The Thresholds-Dartmouth partnership and research on shared decision making

Thresholds Rehabilitation Centers is one of the largest providers of psychiatric rehabilitation services in the United States, and the Dartmouth Psychiatric Research Center is a highly regarded team of rehabilitation researchers. This column describes efforts to build upon the long-standing collaborative relationship between Thresholds (community partner) and Dartmouth (academic partner) to implement and study shared decision making in a community mental health care setting that serves an ethnoracially diverse population. Shared decision making encompasses a client-centered approach in which client and practitioner are equal partners. This joint project incorporates modern information technology, decision science, cultural competence, stakeholder collaboration, outcomes research, and training. The partnership itself provides an exemplar of shared decision making.

The Thresholds-Dartmouth partnership and research on shared decision making

Thresholds Rehabilitation Centers is one of the largest providers of psychiatric rehabilitation services in the United States, and the Dartmouth Psychiatric Research Center is a highly regarded team of rehabilitation researchers. This column describes efforts to build upon the long-standing collaborative relationship between Thresholds (community partner) and Dartmouth (academic partner) to implement and study shared decision making in a community mental health care setting that serves an ethnoracially diverse population. Shared decision making encompasses a client-centered approach in which client and practitioner are equal partners. This joint project incorporates modern information technology, decision science, cultural competence, stakeholder collaboration, outcomes research, and training. The partnership itself provides an exemplar of shared decision making.

SPATTER! SPATTER! SPATTER! Workers' health and the spray machine debate

A conflict between industrialization and worker health developed in the painting industry during the early 1900s with the introduction of the spray machine. This technological innovation allowed the application of paint at greater speed and lower cost than hand painting and increased the rate at which painters were exposed to lead and other toxins contained in paint. From roughly 1919 to 1931, the painters' trade union clashed with employers, paint manufacturers, and legislatures over the impact of the spray machine on the health of workers and the need to enact legislation to regulate its use. While painters made gains on local, state, and national levels during the 1920s to prevent the use of the spray machine, their efforts ultimately failed.

SPLATTER! SPLATTER! SPLATTER! Workers’ Health and the Spray Machine Debate

A conflict between industrialization and worker health developed in the painting industry during the early 1900s with the introduction of the spray machine. This technological innovation allowed the application of paint at greater speed and lower cost than hand painting and increased the rate at which painters were exposed to lead and other toxins contained in paint.

From roughly 1919 to 1931, the painters’ trade union clashed with employers, paint manufacturers, and legislatures over the impact of the spray machine on the health of workers and the need to enact legislation to regulate its use. While painters made gains on local, state, and national levels during the 1920s to prevent the use of the spray machine, their efforts ultimately failed.