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.

Developing the evidence base for families living with parental psychiatric disabilities: crossing the bridge while we're building it.

For this special issue, the latest research findings on the topic of families living with parental psychiatric disabilities were solicited and compiled, to inform policymakers and practitioners with the best research available, while informing researchers about new developments in the field. The creative efforts of practitioners on the ground who strategically cobble together service responses for parents and families, as well as the extraordinary efforts of parents, adult children, young carers, and advocates who continue to bring attention to family issues in psychiatric rehabilitation, are applauded. These things are happening as we build the evidence base. That is, we are "crossing the bridge" to evidence-based practice while we are "building it." This is not without its challenges, in policy, practice, or research. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Children's beliefs about causes of childhood depression and ADHD: a study of stigmatization.

OBJECTIVE: Children's causal attributions about childhood mental health problems were examined in a national sample for prevalence; relative stigmatization; variation by age, race and ethnicity, and gender; and self-report of a diagnosis of depression or attention-deficit hyperactivity disorder (ADHD). METHODS: A national sample of 1,091 children were randomly assigned to read vignettes about a peer with depression, ADHD, or asthma and respond to an online survey. Causal attributions and social distance were assessed, and correlations were examined. Logistic regression models for each causal item tested main effects and interaction terms for conditions, demographic characteristics, and self-reported diagnosis. RESULTS: The beliefs that parenting, substance abuse, and low effort caused the condition were all strongly intercorrelated and were moderately correlated with social distance. The depression condition was the strongest predictor of endorsement of the most stigmatizing causal beliefs. Stigmatizing causal beliefs were evident for ADHD, but with more modest effects. Children who reported a diagnosis were more likely to endorse parenting and substance abuse as causes (attenuated for ADHD). Modest to moderate effects were found for variation in causal beliefs across ethnic groups. CONCLUSIONS: This study demonstrated a consistent presence of stigmatization in children's beliefs about the causes of childhood mental health problems. Low effort, parenting, and substance abuse together tapped a moralistic and blaming view of mental health problems. The results reinforce the need to address stigmatization of mental disorders and the relative stigmatization of different causal beliefs. The findings of variation by ethnicity and diagnosis can inform and target antistigmatization efforts.

Children's stigmatization of childhood depression and ADHD: magnitude and demographic variation in a national sample.

OBJECTIVE: To estimate the magnitude of stigmatizing attitudes toward peers with depression or attention-deficit/hyperactivity disorder (ADHD) in a national sample of children ages 8 to 18 and to examine variation in level of stigma by school location, region of the United States, grade level, race/ethnicity, or sex. METHOD: Surveys were administered to 1,318 children and adolescents. Respondents were randomly assigned to depression, ADHD, or asthma conditions and were presented with a vignette about a peer with one of the conditions. Participants responded to items assessing positive and negative attributions, social distance, and family attitudes. Mean differences were tested for statistical significance and effect sizes were computed. RESULTS: Respondents were more likely to make negative attributions about peers with ADHD and depression versus asthma, particularly regarding the likelihood of antisocial behavior and violence (Cohen d range 0.78-1.35, large effect sizes). Moderate effect sizes were found for preferences for social distance from peers with ADHD(d = 0.37) and depression (d = 0.45). Effects were found for perceptions of negative family attitudes toward both mental health conditions, with depression (d = 0.78) seen as even more stigmatized than ADHD (d = 0.47). The level of stigmatization was relatively constant across demographic variables, with the exception of greater stigmatization evident in Asian/Pacific Islander youths. CONCLUSIONS: Across most items, both depression and ADHD were more stigmatized than asthma, with depression more stigmatized than ADHD. The perception of likelihood of violence and antisocial behavior was particularly high for both ADHD and depression, greatly exceeding the real-world association for depression.

Recovery and resilience in children's mental health: views from the field.

This article explores the questions, "What does recovery mean in the context of children's mental health?" "How do recovery and resilience fit with the system of care values that underpin current transformation efforts in the children's mental health field?" And, "What implications flow from the answers to these questions?" The author details a process designed to gather the perspectives of family members, service providers, administrators, researchers, and advocates, summarizes the results of these discussions, and concludes with recommendations for next steps.

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.

Voices of African American families: perspectives on residential treatment.

This article examines families' perceptions about involvement in residential treatment from the viewpoints of African American and non-African American family members. Focus group interviews found that all family members shared some common positive and negative experiences. However, unique issues remained for African American caregivers. The costs to children of being separated from their families and communities, fears regarding the use of medications, cultural dissimilarities of staff and clients, staff stereotyping, and a commitment to advocating for children other than their own were themes frequently expressed by African American family members. Implications for social services professionals serving African American families are highlighted.