“Characteristics of Effective Mental Health Consultation in Early Childhood Settings: Multilevel Analysis of a National Survey.” By Beth Green, NPC Research, and others. IN: Topics in Early Childhood Special Education, vol. 26, no.3 (2006) pp. 142-152.

[“ In response to a) an increasing need to support children with emotional and behavioral challenges in childcare settings and b) the high rates of expulsion among preschool children, mental health consultation in early childhood settings is becoming an increasingly popular intervention strategy. At the same time, there is little agreement or empirical evidence to help early childhood program managers and other professionals make decisions about the most important characteristics and services that mental health consultants should provide. The current study presents findings from a nationally representative survey of 74 Head Start programs and 655 Head Start directors, staff members, and mental health consultants to use in addressing this gap. Using Hierarchical Linear Modeling (HLM), the authors present results suggesting that the single most important characteristic of mental health consultants is their ability to build positive collaborative relationships with program staff members. The frequency of consultant activities was important, primarily because consultants who provided more frequent services were reported to have more positive relationships with staff members. These results were significant even after controlling for program-level characteristics, such as program size, budget for mental health services, and ratio of consultant hours to number of children."]

[Request #S70404]

"School-Based Prevention and Intervention Programs for Children with Emotional Disturbance." By Linda A. Reddy and Laura Richardson, Fairleigh Dickinson University. IN: Education and Treatment of Children, vol. 29, no. 2 (May 2006) pp. 379-404.

["Children and adolescents with emotional disturbance (ED) exhibit chronic and diverse academic, emotional, behavioral and/or medical difficulties that pose significant challenges for their education and treatment in schools....Given this information, two U.S. Presidential Commissions (U. S. Surgeon General Report, 2000; President's Freedom Commission on Mental Health, 2003) have called for the transformation of the mental health system emphasizing the early identification and intervention programs for children at risk for and with ED in school and public health settings. In this manuscript, three school-based prevention and intervention programs for children at risk for and with ED are presented as examples of exemplary programs.”

Based on the three programs, recommendations were developed which included the following concepts: “(a) comprehensive outcome assessment approaches that include multiple domains (i.e., academic, behavior, and social competencies); (b) psychometrically sound and clinically sensitive outcome assessment instruments; (c) the assessment of quantifiable behavioral goals; (d) empirically supported academic and behavioral interventions; (e) well-defined treatment components; (f) intensive skill-based parent and teacher training; (g) home and school contingency management plans; and, (h) interventions tailored to the developmental level of the child. Additionally, it was recommended that culturally appropriate interventions that target functional behaviors and competencies in children, parents, and/or teachers be developed."]

[Request #S70405]

"Defining 'Mental Illness' in Mental Health Policy." By Howard H. Goldman, University of Maryland School of Medicine and Gerald N. Grob, Rutgers University. IN: Health Affairs, vol. 25, no. 3 (May/June 2006) pp. 737-749.

[“Mental health policy is shaped fundamentally by the definition of mental illness associated with the policy. Changing policies reflect changing definitions. At various times, the definition may be narrow or broad with respect to the scope of conditions covered by a specific policy. The priority accorded to impairment severity is the most crucial and enduring policy issue related to the definition of mental illness and the scope of the definition. This paper explores the role of definitions in framing mental health policy, using examples from the history of policy making over the past half century.”]

[Request #S70411]

"Enhancing No Child Left Behind-School Mental Health Connections." By Brian P. Daly and others. IN: The Journal of School Health, vol. 76, no. 9 (November 2006) pp. 446-451.

[“The No Child Left Behind Act of 2001 was signed into law by President George W. Bush in January 2002 and is regarded as the most significant federal education policy initiative in a generation. The primary focus of the No Child Left Behind Act is on promoting educational success for all children; however, the legislation also contains opportunities to advance school-based mental. Unfortunately, the complexities of the provisions of the No Child Left Behind Act have made it difficult for educators, stakeholders, and mental health professionals to understand the legal and practical interface between No Child Left Behind and the school mental health movement. Therefore, the goals of this article are to 1) raise awareness about the challenges educators and school mental health professionals face as a result of the implementation of No Child Left Behind and 2) provide ideas and recommendations to advance the interface between No Child Left Behind and school mental health, which will support key provisions of the act and the growth of the field.”]

[Request #S70412]

"The Patient as a Policy Factor: A Historical Case Study of the Consumer/Survivor Movement in Mental Health." By Nancy Tomes, Stony Brook University. IN: Health Affairs, vol. 25, no. 3 (May/June 2006) pp. 720-729.

[“This paper analyzes the history of the modern consumer/survivor movement and its impact on the policy-making climate in the mental health field. The growing attentiveness to consumers” perspectives is presented largely as a consequence, no cause, of radical restructurings of the mental health system. Consumers’ perspectives have entered policy discourse in the wake of policy failures and have flourished in a climate of perpetual crisis and tight budgets. Precisely because it has been such a contested arena for so long, the mental health field has produced innovative responses to demands for patient empowerment.”]

[Request #S70414]

"School Connectedness is an Underemphasized Parameter in Adolescent Mental Health: Results of a Community Prediction Study." By Ian M. Shochet, Queensland University of Technology and others. IN: Journal of Clinical Child & Adolescent Psychology, vol. 35, no. 2 (June 2006) pp. 170-179.

[“This study is concerned with the limited prospective research on the relation between school connectedness (i.e., the extent to which students feel accepted, valued, respected, and included in the school ) and mental health symptoms in adolescents. A sample of 2,022 students (999 boys and 1,023 girls) ages 12 to 14 years was measured at 2 time points (12 months apart) on school connectedness and mental health symptoms (general functioning, depression, and anxiety symptoms). The study shows that school connectedness correlated extensively with concurrent mental health symptoms at both time points (between 38% and 55% co-variation with depression, 26% to 46% with general functioning, and 9% and 16% for anxiety symptoms).

Using hierarchical linear modeling, school connectedness also predicted depressive symptoms 1 year later for both boys and girls, anxiety symptoms for girls, and general functioning for boys, even after controlling for prior symptoms. The reverse, however, was not true. Prior mental health symptoms did not predict school connectedness 1 year later when controlling for prior school connectedness. Results suggest a stronger than previously reported association with school connectedness and adolescent depressive symptoms in particular and a predictive link from school connectedness to future mental health problems.”]

[Request #S70415]

"Stigma: Barrier to Mental Health Care among Ethnic Minorities." By Faye A. Gary, Case Western Reserve University. IN: Issues in Mental Health Nursing, vol. 26 (2005) pp. 979-999.

[“This paper explicates the stigma of mental as it is experienced by four ethnic minority groups in the United States. Concerns about prejudice and discrimination among individuals who suffer burdens related to mental illness are delineated. It is proposed that ethnic minority groups, who already confront prejudice and discrimination because of their group affiliation, suffer double stigma when faced with the burdens of mental illness. The potency of the stigma of mental illness is one reason why some ethnic minority group members who would benefit from mental health services elect not to seek or adequately participate in treatment. The combination of stigma and membership in an ethnic minority group can impede treatment and well-being, creating preventable and treatable mortalities and morbidities.

The article offers some recommendations both as to research and to policy makers. In the research area, the author recommends that “research about stigma should be a major focus for mental health professionals. The author further recommends that the research should address cogent issues such as public stigma, self-stigma, family stigmatizing, help-seeking and delaying behaviors, quality indicators for mental health care among ethnic minority groups, and others.”

In the area of health policy makers, the author recommends that they must support research that informs health professionals about the social determinants of health, including mortality and morbidity. In this regard, it is suggested that the use of race and or ethnicity as 'proxies' for socioeconomic status, environmental and situational life experiences that are known to disproportionately impact minority groups should not be continued.”]

[Request #S70416]

"Stigma of Mental Illness Among American Indian and Alaska Native Nations: Historical and Contemporary Perspectives." By Donna Grandbois, North Dakota State University. IN: Issues in Mental Health Nursing, vol. 26, no. 10 (December 2005) pp. 1001-1024.

“Among American Indian and Alaska Native (AIAN) people, the concept of mental illness has different meanings and is interpreted in various ways. This paper describes the realities of mental health care that confront AIAN people. Stigma is associated with mental illness, which can be a barrier for those individuals who are in need of mental health services. Within the context of the AIAN historical and contemporary experiences, the paper details domains that negatively influence the lives of AIAN people. Included are the failure of the U.S. government to fulfill its treaty agreements with AIAN people; the disparities in income and education, and the pervasiveness of poverty; and access to care issues. These domains help to set the stage for health disparities that frequently catapult AIAN people to early morbidity and mortality. Importantly, many of these conditions are preventable. The paper concludes with recommendations for a more diverse workforce that will include AIAN mental health professionals who are available to provide culturally competent care to AIAN people in a variety of settings."]

[Request #S70417]

"The Self-Stigma of Mental Illness: Implications for Self-Esteem and Self-Efficacy." By Patrick W. Corrigan, Center for Psychiatric Rehabilitation, Evanston Northwestern Healthcare. IN: Journal of Social & Clinical Psychology, vol. 25, no. 8 (October 2006) pp.875-884.

[“Self stigma is distinguished from perceived stigma (stereotype awareness) and presents as a three-level model: stereotype agreement, self-concurrence, and self-esteem decrement. The relationships between elements of this model and self-esteem, self efficacy, and depression are examined in this study. In Study 1, 54 people with psychiatric disabilities completed a draft version of the Self-Stigma of Mental Illness Scale (SSMIS) to determine internal consistency and test-retest reliability of composite scales. In Study 2, 60 people with psychiatric disabilities completed the revised SSMIS plus instruments that represent self-esteem, self-efficacy, and depression. Stereotype awareness was found to not be significantly associated with measures of self-esteem and self efficacy. These associations remained significant after partialing out concurrent depression. Implications for better understanding self-stigma are discussed.”]

[Request #S70418]

“Does Availability of Mental Health Resources Prevent Recurrent Suicidal Behavior? An Ecological Analysis.” By Sara L. Cooper, University of Colorado Health Services Center, and others. IN: Suicide and Life Threatening Behavior, vol. 36, no. 4 (August 2006) 9 p.

[“Almost 30,000 people commit suicide annually, making it the eleventh leading cause of death in the United States (National Center for Injury Prevention and Control, 2004). Colorado has consistently had one of the highest suicide rates in the country (National Center for Injury Prevention and Control, 2004). This study examines whether availability of mental health resources in the county of residence in Colorado is associated with subsequent suicidal behavior after a previous suicide attempt. Among 10,922 individuals who attempted suicide in Colorado between 1998 and 2002, residence in a county that offered a minimum safety-net of mental health services significantly reduced the risk of suicidal behavior for a least 1 year after the index attempt. Safety-net services included mental health treatment, crisis treatment, and case management. These results suggest one strategy for prevention of suicidal behavior that could inform state-level health policy development and resource allocation.”]

[Request #S70420]

“Feasibility of Screening Adolescents for Suicide Risk in 'Real-World” High School Settings.'" By: Denise Hallfors, Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina, and others. IN: American Journal of Public Health, vol. 96, no.2 (February 2006) pp. 282-287.

{“ The authors evaluated the feasibility of a population-based approach to preventing adolescent suicide. A total of 1323 students in 10 high schools completed the Suicide Risk Screen (SRS) and the screening results, student follow-up, staff feedback and school responses were then assessed. The results indicated that 29% of the participants were rated as at risk of suicide. As a result of this percentage, school staffs chose to discontinue the screening after 2 semesters, In further analyses (of the study), about half of the students (initially identified as high risk) were deemed at high risk on the basis of high levels of depression, suicide ideation, or suicidal behavior. Priority rankings evidenced good construct validity on correlates such as drug use, hopelessness, and perceived family support.

The authors concluded that a simpler, more specific screening instrument than the SRS would identify approximately 11% of urban high school youths for assessment, offering high school officials an important opportunity to identify young people at the greatest levels of need and to target scarce health resources. Our experience from this study show that lack of feasibility testing greatly contributes to the gap between science and practice.”]

[Request #S70421]

“Suicidality, School Dropout, and Reading Problems among Adolescents.” By Stefanie Sergent Daniel, Wake Forest University School of Medicine and others. IN: Journal of Learning Disabilities, vol. 39, no. 6 (November/December 2006) pp. 507-514.

[“The purpose of this study was to examine the risk of suicidal ideation and suicide attempts and school dropout among youth with poor reading in comparison with typical reading (n=188), recruited from public schools at the age of 15. In a prospective naturalistic study, youth and parents participated in repeated research assessments to obtain information about suicide ideation and attempts, psychiatric and socio-demographic variables and school dropout. Youth with poor reading ability were more likely to experience suicidal ideation or attempts and more likely to drop out of school than youth with typical reading, even after controlling for socio-demographic and psychiatric variables. Suicidality and school dropout were strongly associated with each other. The authors recommend that prevention events should focus on better understanding the relationship between these outcomes, as well as on the developmental paths leading up to these behaviors among youth with reading difficulties.”]

[Request #S70423]

“U.S. Suicide Rates by Age Group, 1970-2002: An Examination of Recent Trends.” By R.E. McKeown, University of South Carolina Arnold School of Public Health and others. IN: American Journal of Public Health, vol. 96, no. 10 (October 2006) pp. 1744-51.

[“US suicide rates have declined in recent years, reversing earlier trends. This study examined suicide rates among 4 age groups from 1970 to 2002 and the factors that may have contributed to the decline. The authors paid particular attention to newer anti-depressants because of recent concerns and controversy about a possible association with suicidal behaviors. It is their opinion that these trends warrant more extensive analysis of suicide rates among specific subgroups, including consideration of additional variables that may influence rates differentially. The relative contributions of depression diagnosis and treatment, post suicide attempt care, and other contextual factors (e.g., overall economic conditions and increase in a healthy life expectancy) also deserve attention. If the decline is associated with contextual factors, clarifying these associations will better inform public policy decisions and contribute to more effective interventions for preventing suicide.”

Further, the authors state that 'the implications of decreasing rather than increasing suicide rates are significant. If the conventional wisdom is that suicide rates are increasing held, attention would be redirected from current strategies that are considered to be failing. However, the authors’ evidence indicates that rates have been declining significantly, especially if seen through a 10-year, or even a 5-year window. Because of this more recent trend, their opinion is that attention should be focused on identifying the component(s) in the current approach to depression diagnosis and treatment, suicide prevention and post suicide attempt care most responsible for this decline. Furthermore, if the decline is associated with some of the contextual factors that have been described, especially those affected by public policy, clarifying the association between the decline and related factors will better inform health care discussion and public policy debate.”]

[Request #S70424]

"Bringing Evidence-Based Child Mental Health Services to the Schools: General Issues and Specific Populations." By Carrie Masia-Warner and others. IN: Education & Treatment of Children. vol. 29 no. 2 (May 2006) pp. 165-172.

["This article discusses general issues regarding the introduction of evidence-based child mental health services to the schools in the U.S. According to epidemiological research, there is a high prevalence of psychiatric disorders among children and adolescents across the nation. Unfortunately, there is a significant gap between the many youth who are in need of treatment and those who actually receive mental health services. Schools present a crucial avenue for ameliorating this problem, and thus, have been designated as a key setting by the Surgeon General's office for the identification and delivery of mental health care in this population."

"The authors argue that one critical direction for school-based mental health is to determine the transportability and efficacy of evidence-based programs in school settings. A complementary approach for intervention development in schools, outlined in the National Institute of Mental Health (NIMH) Blueprint for Change Report, proposes a closer link between science and real-world clinical practice at the initial stages of program development so that the final context for service delivery is considered in the design, development, refinement, and implementation of the intervention."]

[Request #S70725]