Training Needs of Peer and Non-Peer Transition Service Providers: Results of a National Survey.

Participatory action research processes guided a national online survey of service providers working with transition age youth with mental health challenges. The survey investigated transition service providers' ratings of the importance of competencies and skills, self-assessed need for training in these competencies and skills, their preferred training modalities, and obstacles to engaging in training. The 254 participants identified trauma-informed care, understanding youth culture, promoting natural supports, and using culturally responsive practices as most important training needs. Age, years in current job, years in transition work, and race/ethnicity predicted training needs regarding some competencies and skills. Peer providers expressed preferences for young adult-led training. Qualitative responses highlighted training needs for supporting specific underserved populations: youth from communities of color, LGBTQ youth, and those with co-occurring disorders. Results may guide future training initiatives for peer support and non-peer support providers and workforce development initiatives designed to improve behavioral health services for young people.

Meeting the Transition Needs of Urban American Indian/Alaska Native Youth through Culturally Based Services.

This article reports findings from three qualitative studies exploring supports for positive transitions of American Indian/Alaska Native (AI/AN) youth to adulthood. Community-based participatory methods were employed through a research partnership involving a culturally based community agency, the Native American Youth and Family Center (NAYA), the National Indian Child Welfare Association, and Portland State University. Studies utilized a Relational Worldview (RWV) framework, where well-being is understood as a balance among the domains of mind, body, spirit, and context. Collectively, findings demonstrate that NAYA employs culturally grounded interventions to overcome the traumatic histories and current oppressive conditions affecting low-income urban AI/AN youth with mental health challenges and to support their well-being and transition to adulthood. In addition, addressing the mental health and well-being of AI/AN youth in culturally appropriate ways involves consideration of all RWV domains. Recommendations for behavioral health practice are to connect AI/AN youth to culturally specific services whenever possible, utilize cultural consultants, and implement holistic and positive approaches to mental health.

Community integration of transition-age individuals: views of young with mental health disorders.

This qualitative study examines the perceptions of young adults with mental health disorders of community integration. Fifty-nine young men and women participated in 12 focus groups whose aim was to gain understanding of what community integration means to them. Focus group questions also explored barriers and supports for their community integration, as well as their goals for the future and advice to others facing similar challenges. Themes that emerged were reported within the multiple domains that participants used to describe their experiences of community integration (or the lack thereof). This study highlights the desires of these young people to achieve goals in education and employment and to have friendships. Participants identified a pervasive lack of understanding of mental health and prevalent stigmatizing attitudes as resulting in challenges to their community integration. Implications of the study discuss roles for behavioral health services in encouraging empowerment, choices, and connections so that young people with mental health disorders may achieve their preferred levels of community integration.

Studying family participation in system-of-care evaluations: using qualitative methods to examine a national mandate in local contexts.

With the rapid pace of policy and practice changes in children's mental health, there is a need for research to examine, describe, and disseminate information about the translation of policy directives into practice innovations at the local level. National policy mandates for children's mental health have placed expectations on local communities to involve families as partners in the development, implementation, and evaluation of systems of care with little guidance about how to implement program requirements locally. Consequently, there is a gap in the knowledge base regarding how innovations are actually implemented in local community contexts. This article reports on a qualitative study to gain understanding of family participation in evaluations of systems of care from the perspectives of evaluators and family members working together. Findings provided rich examples of the experiences and perceptions of evaluators and family members working on evaluation teams, the challenges they encountered, and effective strategies to meet those challenges.

Preserving family bonds: examining parent perspectives in the light of practice standards for out-of-home treatment.

Family participation is a core system of care value that is supported by previous research in medical, child welfare, and mental health settings. However, many parents with children receiving out-of-home mental health treatment experience restrictions on contact. This cross-sectional study examines the experiences of families (N = 102) regarding parent-child contact in relation to examples of national accreditation standards. Results of the national survey found that most respondents (79.4%) reported restrictions on contact, including limits based on behavioral contingencies (65.7%) and point and level systems (52.5%).

Family caregivers' perceptions of barriers to and supports of participation in their children's out-of-home treatment.

OBJECTIVE: Although the importance of family caregivers' involvement in their children's mental health treatment is increasingly recognized, factors that influence caregivers' participation are not clearly understood. This study examined the views of family caregivers whose children received out-of-home treatment to determine the amount and types of family caregivers' participation in their children's treatment, the caregivers' perceptions of barriers and supports to participation, and the relationship of barriers and supports to caregivers' participation and satisfaction with care. METHODS: As part of a national survey, a subsample of 102 family caregivers from 31 states whose children were in a residential treatment center, psychiatric unit, or group home answered a questionnaire that included questions about their participation in their children's treatment and about barriers and supports to their participation. RESULTS: Family caregivers identified as barriers concrete factors such as cost of transportation and distance from service providers as well as more intangible factors such as lack of communication between staff members of different programs and negative attitudes of staff members. CONCLUSIONS: Programs seeking to create a more supportive environment for family caregivers' involvement in out-of-home care will need to seek out family members' perceptions of their experience with their children's treatment and their views about factors that would help increase their participation.