Income and Self-Rated Mental Health: Diminished Returns for High Income Black Americans

A central paradox in the mental health literature is the tendency for black Americans to report similar or better mental health than white Americans despite experiencing greater stress exposure. However, black Americans’ higher levels of certain coping resources may explain this finding. Using data from the Nashville Stress and Health Study (n = 1,186), we examine whether black Americans have higher levels of self-esteem, social support, religious attendance, and divine control than white Americans and whether these resources, in turn, explain the black–white paradox in mental health. In adjusted models, the black–white paradox holds for depressive symptoms and any DSM-IV disorder. Findings indicate that black Americans have higher levels of self-esteem, family social support, and religiosity than white Americans. Causal mediation techniques reveal that self-esteem has the largest effect in explaining black–white differences in depressive symptoms, whereas divine control has the largest effect in explaining differences in disorder.

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Do police killings of unarmed persons really have spillover effects? Reanalyzing Bor et al. (2018)

10.31235/osf.io/ajz2q ◽

2020 ◽

Cited By ~ 2

Author(s):

Justin Nix ◽

M. James Lozada

Keyword(s):

Mental Health ◽

General Population ◽

Police Officers ◽

Black Americans ◽

Spillover Effects ◽

Black American ◽

Police Violence ◽

Crowdsourced Data

We reevaluate the claim from Bor et al. (2018: 302) that “police killings of unarmed black Americans have effects on mental health among black American adults in the general population.” The Mapping Police Violence data used by the authors includes 91 incidents involving black decedents who were either (1) not killed by police officers in the line of duty or (2) armed when killed. These incidents should have been removed or recoded prior to analysis. Correctly recoding these incidents decreased in magnitude all of the reported coefficients, and, more importantly, eliminated the reported statistically significant effect of exposure to police killings of unarmed black individuals on the mental health of black Americans in the general population. We caution researchers to vet carefully crowdsourced data that tracks police behaviors and warn against reducing these complex incidents to overly simplistic armed/unarmed dichotomies.

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Implementing Psychological Interventions Through Nonspecialist Providers and Telemedicine in High-Income Countries: Qualitative Study from a Multistakeholder Perspective

JMIR Mental Health ◽

10.2196/19271 ◽

2020 ◽

Vol 7 (8) ◽

pp. e19271

Author(s):

Daisy Radha Singla ◽

Sasha Lemberg-Pelly ◽

Andrea Lawson ◽

Nika Zahedi ◽

Tyla Thomas-Jacques ◽

...

Keyword(s):

Mental Health ◽

Lived Experience ◽

Mental Health Professionals ◽

Psychological Treatment ◽

Primary Objective ◽

Anxiety Symptoms ◽

High Income ◽

Barriers And Facilitators ◽

Psychological Treatments ◽

Stakeholder Groups

Background Task sharing has been used worldwide to improve access to mental health care, where nonspecialist providers—individuals with no formal training in mental health—have been trained to effectively treat perinatal depressive and anxiety symptoms. Little formative research has been conducted to examine relevant barriers and facilitators of nonspecialist providers and the use of telemedicine in treatment service delivery. Objective The primary objective of this study was to examine the main barriers and facilitators of nonspecialist provider–delivered psychological treatments for perinatal populations with common mental health disorders, such as depression and anxiety, from a multistakeholder perspective. Methods This study took place in Toronto, Canada. In total, 33 in-depth interviews were conducted with multiple stakeholder groups (women with lived experience and their significant others, as well as health and mental health professionals). Qualitative data were quantified to estimate commonly endorsed themes within and across stakeholder groups. Results Psychological treatments delivered by nonspecialist providers were considered acceptable by the vast majority of participants (30/33, 90%). Across all stakeholder groups, nurses (20/33, 61%) and midwives (14/33, 42%) were the most commonly endorsed cadre of nonspecialist providers. The majority of stakeholders (32/33, 97%) were amenable to nonspecialist providers delivering psychological treatment via telemedicine (27/33, 82%), although concerns were raised about the ability to establish a therapeutic alliance via telemedicine (16/33, 48%). Empathy was the most desired characteristic of a nonspecialist provider (61%). Patient and patient advocate stakeholders were more likely to emphasize stigma as an important barrier to accessing psychological treatments (7/12, 58%), compared to clinicians (2/9, 22%) and spouses (1/5, 20%). Clinician stakeholders were more likely to emphasize the importance of ensuring nonspecialist providers were trained to deliver psychological treatments (3/9, 33%), compared to other stakeholder groups. Conclusions These results can inform the design, implementation, and integration of nonspecialist-delivered interventions via telemedicine for women with perinatal depressive and anxiety symptoms in high-income country contexts.

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Perceived barriers to care for migrant children and young people with mental health problems and/or neurodevelopmental differences in high-income countries: a meta-ethnography

BMJ Open ◽

10.1136/bmjopen-2020-045923 ◽

2021 ◽

Vol 11 (9) ◽

pp. e045923

Author(s):

Vanessa Place ◽

Benjamin Nabb ◽

Ester Gubi ◽

Karima Assel ◽

Johan Åhlén ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Mental Health Problems ◽

Barriers To Care ◽

Health Problems ◽

High Income ◽

Migrant Children ◽

Perceived Barriers ◽

Qualitative Evidence Synthesis ◽

Children And Young People

ObjectivesTo develop conceptual understanding of perceived barriers to seeking care for migrant children and young people (aged 0–25 years) with mental health problems and/or neurodevelopmental differences in high-income countries.DesignQualitative evidence synthesis using meta-ethnography methodology. We searched four electronic databases (Medline, PsycINFO, Global Health and Web of Science) from inception to July 2019 for qualitative studies exploring barriers to care (as perceived by migrant communities and service providers) for migrant children and young people in high-income countries with neurodevelopmental differences and/or mental health problems. The quality of included studies was explored systematically using a quality assessment tool.ResultsWe screened 753 unique citations and 101 full texts, and 30 studies met our inclusion criteria. We developed 16 themes representing perceived barriers to care on the supply and demand side of the care-seeking process. Barriers included: stigma; fear and mistrust of services; lack of information on mental health and service providers lacking cultural responsiveness. Themes were incorporated into Levesque et al’s conceptual framework of patient-centred access to healthcare, creating a version of the framework specific to migrant children and young people’s mental health and neurodevelopmental differences.ConclusionsThis is the first qualitative evidence synthesis on barriers to care for mental health problems and/or neurodevelopmental differences in migrant children and young people in high-income countries. We present an adapted conceptual framework that will help professionals and policy-makers to visualise the complex nature of barriers to care, and assist in improving practice and designing interventions to overcome them. Similar barriers were identified across study participants and migrant populations. While many barriers were also similar to those for children and young people in general populations, migrant families faced further, specific barriers to care. Interventions targeting multiple barriers may be required to ensure migrant families reach care.

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Psychological and psychosocial interventions for refugee children resettled in high-income countries

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000695 ◽

2017 ◽

Vol 27 (2) ◽

pp. 117-123 ◽

Cited By ~ 19

Author(s):

M. Fazel

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Psychosocial Interventions ◽

High Income ◽

Refugee Children ◽

Post Traumatic Stress ◽

General Mental Health ◽

Large Numbers ◽

Post Traumatic ◽

Science Methodology

Large numbers of refugee children are arriving in high-income countries. The evidence to date suggests that they have mental health needs that are higher than for the general population and that these are exacerbated by the numbers of traumatic events they have experienced and the post-migration stressors they continue to be exposed to. The importance of a thorough and thoughtful assessment is discussed. Treatments of note are described for post-traumatic stress disorder, family functioning, general mental health problems and school environments. Future opportunities to operationalise outcome measures, develop multimodal interventions and utilise implementation science methodology are considered.

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How Argentina is training their mental health residents to face its Silver Tsunami?

International Psychogeriatrics ◽

10.1017/s1041610218000182 ◽

2018 ◽

Vol 30 (10) ◽

pp. 1573-1574

Author(s):

Sergio A. Strejilevich ◽

Florencia Vallejos ◽

Julian Bustin

Keyword(s):

Mental Health ◽

Human Resources ◽

Health Systems ◽

Population Ageing ◽

High Income ◽

World Population ◽

Demographic Changes ◽

Middle Income ◽

Middle Income Countries ◽

Essential Step

In low- and middle-income countries, there is an increase in the percentage of aging population similar to or greater than that of high-income countries (World Population Ageing 1950–2050, UN, 2001). The emerging health and economical challenges due to these demographic changes will have to be addressed by their health systems. In this context, an adequate training of available human resources in geriatric psychiatry/psychogeriatrics (GP/PG) should be an essential step to meet those challenges.

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High-skilled migration and mental health

Oxford Textbook of Migrant Psychiatry ◽

10.1093/med/9780198833741.003.0029 ◽

2021 ◽

pp. 259-262

Author(s):

Antonio Ventriglio ◽

Susham Gupta ◽

Cameron Watson

Keyword(s):

Mental Health ◽

High Income ◽

Skilled Migration ◽

Pull Factors ◽

Push Factors ◽

Middle Income ◽

Middle Income Countries ◽

Migrant Labour ◽

Permanent Migration ◽

University Degree

High-skilled migrants are more likely to migrate for professional or educational reasons. There is a difference between the high-skilled migrants and labour in that the former may well be responding to pull factors, whereas the latter may be responding to push factors related to migration. These migrants are also more likely to belong to permanent migration category. High-skilled migrants are those with a university degree or extensive/equivalent experience in a chosen field. They are largely likely to migrate from low- to middle-income countries to high-income countries. The immigration rates show that these migrants are likely to be self-selected; have skills that are in demand and globally transferable. In the post-migration phase they may experience mental ill health, especially if they do not feel valued; feel overqualified for the jobs they are doing; and if they experience a discrepancy between aspirations and achievement. Their clinical needs may well differ from those of migrant labour.

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International perspectives on inpatient mental health care

Oxford Textbook of Inpatient Psychiatry ◽

10.1093/med/9780198794257.003.0003 ◽

2019 ◽

pp. 23-32

Author(s):

Andrew Molodynski

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Inpatient Care ◽

Systems Approach ◽

Income Group ◽

High Income ◽

Economic Factors ◽

High Income Group ◽

International Perspectives

Inpatient care varies enormously, both between countries and regions and within them. These variations are most stark when based on economic factors, but stigma, prevailing societal attitudes, and the role of the family also play a significant part in the amount and quality of mental health care overall. This chapter begins by outlining global economic factors and their impact on provision. It then focuses on the concept of a whole systems approach, looking briefly at the evidence base for different components of services generally seen in high-income group countries. Alternative suggestions to ‘high-income group’ models are discussed as the evidence internationally emanates almost exclusively from a small number of wealthy westernized countries. The chapter ends with a section looking at several internationally important themes in inpatient care and outlining examples of differences between countries in challenges and in solutions to what is one of the longest standing issues in mental health care: how to provide humane, effective inpatient care to those who need it (and not to those who do not).

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