California Veterans Receive Inadequate Treatment to Address their Mental Health Needs.

Data from the 2011 to 2013 California Health Interview Survey (CHIS) were pooled to estimate prevalence of mental health need (serious psychological distress and impairment in one or more life domains), minimally adequate treatment (having four or more visits with a health professional in the past 12 months and use of prescription medication for mental health problems in the past 12 months), and suicide ideation among veterans living in California. Numbers and percentages were weighted to the CA population using a large sample size (N=6,952), and for comparison purposes, veterans and nonveterans were standardized to the age and gender distribution of veterans in the sample. Although differences in mental health need were similar between veterans and nonveterans after adjustment, over three-quarters of veterans did not receive minimally adequate treatment needed to address their mental health needs. Suicide ideation was significantly higher among veterans than nonveterans. Male veterans at all ages were more vulnerable to thinking about suicide compared to their nonveteran counterparts.

The Mental Health Status of California Veterans.

Data from the California Health Interview Survey (CHIS) from 2011--2013 showed approximately 90,000 veterans had mental health needs and 200,000 reported serious thoughts of suicide during the 12 months prior to participating in CHIS. Although the proportion of veterans reporting mental health need or serious psychological distress was no higher than the general population, California veterans were more likely to report lifetime suicide ideation. This policy brief uses CHIS data to examine the mental health status, needs, and barriers to care among veterans in California. Veterans were more likely to receive mental health or substance use treatment than nonveterans, yet three of four veterans with mental health needs received either inadequate or no mental health care. Integrating mental and physical health services, increasing access to care, retaining veterans who seek mental health treatment, and reducing stigma are among the strategies that might improve the mental health of California's veterans.

Life stressors and psychological well-being. Does Access to Health Care Help the Older Lebanese?

Health care should protect against the detrimental effects of stress on psychological well-being by providing both direct and indirect benefits. Using a sample of 490 older Lebanese (age 60 and over), this study examines whether access to and utilization of medical care buffer the impact of specific stressors on depressive symptoms. Findings show that access to medical care is associated with depressive symptoms for those who experienced recent death, serious accident and health-related stressors and that limited access increases depression for those exposed to recent violent stressors. The saliency of health-related events may be associated with health care access which is imposed under distressing contexts, likely worsening psychological well-being.

Reach of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) interventions and nutrition and physical activity-related outcomes, California, 2011-2012.

INTRODUCTION: This study combined information on the interventions of the US Department of Agriculture's Supplemental Nutrition Assistance Program-Education with 5,927 interview responses from the California Health Interview Survey to investigate associations between levels of intervention reach in low-income census tracts in California and self-reported physical activity and consumption of fruits and vegetables, fast food, and sugar-sweetened beverages. METHODS: We determined 4 levels of intervention reach (low reach, moderate reach, high reach, and no intervention) across 1,273 program-eligible census tracts from data on actual and eligible number of intervention participants. The locations of California Health Interview Survey respondents were geocoded and linked with program data. Regression analyses included measures for sex, age, race/ethnicity, and education. RESULTS: Adults and children from high-reach census tracts reported eating more fruits and vegetables than adults and children from no-intervention census tracts. Adults from census tracts with low, moderate, or high levels of reach reported eating fast food less often than adults from no-intervention census tracts. Teenagers from low-reach census tracts reported more physical activity than teenagers in no-intervention census tracts. CONCLUSION: The greatest concentration of Supplemental Nutrition Assistance Program-Education interventions was associated with adults and children eating more fruits and vegetables and adults eating fast food less frequently. These findings demonstrate the potential impact of such interventions as implemented by numerous organizations with diverse populations; these interventions can play an important role in addressing the obesity epidemic in the United States. Limitations of this study include the absence of measures of exposure to the intervention at the individual level and low statistical power for the teenager sample.

Three out of four children with mental health needs in California do not receive treatment despite having health care coverage.

More than 300,000 California children ages 4 to 11 have mental health needs, yet only one-fourth of them received mental health care in 2007 and 2009. Health insurance coverage and a usual source of care typically facilitate mental health service use; however, this is not the case for children with mental health needs. This policy brief identifies children at risk for mental health needs and highlights some barriers to their receiving mental health services. Childhood is a vital time for the promotion of positive mental health among children, as well as for supporting at-risk families in order to avert the early onset of some disorders and help reduce the severity of others. To reduce the potential burden and lifelong difficulties of untreated mental health needs, it is critical that mental health problems in young children be identified and addressed early.

More than half a million California adults seriously thought about suicide in the past year.

In 2009, nearly 2.4 million adults in California reported having seriously thought about suicide during their lifetimes. Among these adults, more than half a million had thought seriously about suicide sometime during the past year. Members of sexual minorities were almost three times as likely as all adults in California to have had suicidal thoughts during the past year. This policy brief, based on data from the 2009 California Health Interview Survey (CHIS), presents a comprehensive overview of risk factors associated with suicidal thoughts among adults ages 18 and older and highlights differences in suicidal ideation among demographic groups and geographic regions in California.

The link between intimate partner violence, substance abuse and mental health in California.

This policy brief presents findings on the linkages between intimate partner violence (IPV), emotional health and substance use among adults ages 18-65 in California. Among the 3.5 million Californians who have ever been victimized by IPV as adults, over half a million report serious psychological distress (SPD) in the past year. Almost half of all adult IPV victims indicate that their partner was under the influence of alcohol or other drugs during the most recent incident. Two-fifths of adult IPV victims report past-year binge drinking and 7% report daily or weekly binge drinking. One in three IPV victims expressed a need for mental health, alcohol or other drug (AOD) services and almost one-fourth used mental health or AOD services during the past year. These disturbing findings can aid strategies to identify, intervene with and assist IPV victims who experience emotional and/or substance use problems.

The health status and unique health challenges of rural older adults in California.

Despite living in the countryside where open space is plentiful and there is often significant agricultural production, rural older adults have higher rates of overweight/obesity, physical inactivity and food insecurity than older adults living in suburban areas. All three conditions are risk factors for heart disease, diabetes and repeated falls. This policy brief examines the health of rural elders and, by contrast, their urban counterparts, and finds that both groups are more likely to be unhealthy than suburban older adults. Yet rural elders, because of their geographical isolation and lack of proximity to health care providers, experience unique environmental and other risk factors that require context-specific solutions to these health issues. In both policies and programs that impact health, policymakers need to take into account the distinctive environmental and social context of older adults living in California's countryside.

Mental health status and use of mental health services by California adults.

In 2005, nearly one in five adults in California, about 4.9 million people, said they needed help for a mental or emotional health problem. Approximately one in 25, or over one million Californians, reported symptoms associated with serious psychological distress (SPD). Of those adults with either perceived need or SPD, only one in three reported visiting a mental health professional for treatment. This policy brief, based on data from the 2005 California Health Interview Survey (CHIS 2005), presents the first comprehensive overview of mental health status and service use in California, and highlights differences by age, gender, race/ethnicity, income and insurance status. It also demonstrates the critical need for continued efforts to expand mental health services and threats to such services caused by the ongoing state budget crisis.