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Margarita Alegria - One of the best experts on this subject based on the ideXlab platform.
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reducing racial ethnic disparities in Mental Health Service use among emerging adults community level supply factors
Ethnicity & Health, 2020Co-Authors: Amanda Nemoyer, Mario Cruzgonzalez, Kiara Alvarez, Ronald C Kessler, Nancy A Sampson, Jennifer Greif Green, Margarita AlegriaAbstract:Objectives: Emerging adulthood-spanning 18-29 years of age-is associated with the highest risk for onset of certain behavioral Health disorders (e.g. major depression, bipolar disorder, psychosis, substance use disorders) and high prevalence of many behavioral Health disorders. Yet, rates of Mental Health Service use remain low in this age range. Racial/ethnic minorities are particularly impacted by individual, cultural/linguistic, and community-level barriers to Mental Health care. This study examined community-level factors associated with Mental Health Service use and investigated whether these associations varied by race/ethnicity. Design: This study analyzed individual- and county-level data for emerging adults in the United States (N=3,294) from the nationally representative Collaborative Psychiatric Epidemiological Surveys (CPES). Using the Andersen Model of Health Care Utilization, analyses examined predisposing, enabling, and need factors utilized in prior studies with adult samples as well as novel community characteristics hypothesized to impact Service use among emerging adults of diverse racial/ethnic backgrounds. Past-year use of both specialty and any Mental Health Services were assessed, controlling for individual- and community-level variables, and adjusting for presence of past-year Mental Health disorder, overall Health status, and functional impairment. Differences between racial/ethnic minority groups and Non-Latino Whites were tested through a multilevel model incorporating random intercepts logistic regression, with analysis focusing on the interaction between race/ethnicity and community-level supply variables. Results: For past-year use of specialty Mental Health Services, density of hospitals with child wellness programs was linked to Service use among Black emerging adults, whereas density of hospitals with linguistic/translation Services was linked to Service use among Latino emerging adults. Conclusions: This study expands on previous research in behavioral Health disparities to examine ways to improve behavioral Health Services for an emerging adult population with unmet Service needs and identifies specific community-level factors that can improve Mental Health for racial/ethnic minority emerging adults.
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does childhood Mental Health Service use predict subsequent Mental Health Service use during latino youth transition to young adulthood evidence from the boricua youth study
Social Psychiatry and Psychiatric Epidemiology, 2020Co-Authors: Jennifer Greif Green, Kiara Alvarez, Rachel Oblath, Gerrit Deyoung, Ye Wang, Hector R Bird, Glorisa Canino, Cristiane S Duarte, Margarita AlegriaAbstract:Studies document the substantial underutilization of Mental Health Services by US Latinos in young adulthood. Rates of Service use are higher in childhood, raising questions about whether Mental Health Service use during childhood may facilitate access to Services later in life. This article examines the extent to which utilization of Mental Health Services in childhood is predictive of utilization in young adulthood among US Latinos. Data come from the Boricua Youth Study, a longitudinal study of Puerto Rican youth at two sites (South Bronx, New York, and the standard metropolitan area of San Juan, Puerto Rico). Data were collected in three waves during childhood (ages 5–13; surveyed 1 year apart), with an approximately 11-year follow-up in young adulthood (ages 16–29). In childhood, parents reported on youth Mental Health Service use (Waves 1–3). In Wave 4, as youth transitioned to young adults (N = 2004), they reported on their past year Mental Health Service use. Whereas 30.2% of parents reported their child received Mental Health Services, only 3.5% of young adults reported Mental Health Service use in the past year. After controlling for young adult disorders and their severity, childhood disorders were associated with increased likelihood of Mental Health Service use in young adulthood. Childhood Mental Health Service use was also associated with young adult Service use; however, this association attenuated when controlling for childhood disorders. Findings suggest the importance of specifically considering childhood disorders in understanding mechanisms for improving access to Mental Health Services among Latino young adults.
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school Mental Health resources and adolescent Mental Health Service use
Journal of the American Academy of Child and Adolescent Psychiatry, 2013Co-Authors: Jennifer Greif Green, Margarita Alegria, Katie A Mclaughlin, Jane E Costello, Michael J Gruber, Kimberly Hoagwood, Philip J Leaf, Serene S OlinAbstract:Objective Although schools are identified as critical for detecting youth Mental disorders, little is known about whether the number of Mental Health providers and types of resources that they offer influence student Mental Health Service use. Such information could inform the development and allocation of appropriate school-based resources to increase Service use. This article examines associations of school resources with past-year Mental Health Service use among students with 12-month DSM-IV Mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent Mental Health that included 4,445 adolescent–parent pairs in 227 schools in which principals and Mental Health coordinators completed surveys about school resources and policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported Mental Health Service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school Mental Health resources and individual-level Service use. Results Nearly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year Mental Health Services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with Mental Health Service use for adolescents with mild/moderate Mental and behavior disorders. The ratio of students to Mental Health providers was not associated with overall Service use, but was associated with sector of Service use. Conclusions School Mental Health resources, particularly those related to early identification, may facilitate Mental Health Service use and may influence sector of Service use for youths with DSM disorders.
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correlates of past year Mental Health Service use among latinos results from the national latino and asian american study
American Journal of Public Health, 2007Co-Authors: Margarita Alegria, Norah Mulvaneyday, Meghan Woo, Maria Torres, Shan Gao, Vanessa M OddoAbstract:Objectives. We examined correlates and rates of past-year Mental Health Service use in a national sample of Latinos residing in the United States.Methods. We used data from the National Latino and Asian American Study, a national epidemiological household survey of Latinos.Results. Cultural factors such as nativity, language, age at migration, years of residence in the United States, and generational status were associated with whether or not Latinos had used Mental Health Services. However, when the analysis was stratified according to past-year psychiatric diagnoses, these associations held only among those who did not fulfill criteria for any of the psychiatric disorders assessed. Rates of Mental Health Service use among those who did not fulfill diagnostic criteria were higher among Puerto Ricans and US-born Latinos than among non–Puerto Ricans and foreign-born Latinos.Conclusions. Rates of Mental Health Service use among Latinos appear to have increased substantially over the past decade relative to ...
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depressive and disruptive disorders and Mental Health Service utilization in children and adolescents
Journal of the American Academy of Child and Adolescent Psychiatry, 1999Co-Authors: Christina W Hoven, Margarita Alegria, Hector R Bird, Robert E Moore, Patricia Cohen, Mina K Dulcan, Sherryl H Goodman, Sarah Mccue Horwitz, Judith Lichtman, William E NarrowAbstract:ABSTRACT Objective To examine the relationship of depressive and disruptive disorders with patterns of Mental Health Services utilization in a community sample of children and adolescents. Method Data were from the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The sample consisted of 1,285 child (ages 9–17 years) and parent/guardian pairs. Data included child psychopathology (assessed by the Diagnostic Interview Schedule for Children), Impairment, child need and use of Mental Health Services, and family socioeconomic status. Results After adjusting for potential confounding factors, disruptive disorder was significantly associated with children's use of Mental Health Services, but depressive disorder was not. For school-based Services, no difference was found between the 2 types of disorders. Parents perceived greater need for Mental Health Services for children with disruptive disorders than for those with depression. Conversely, depression was more related to children's perception of Mental Health Service need than was disruptive disorder. Conclusions The findings highlight the need for more effective ways to identify and refer depressed children to Mental Health professionals, the importance of improving school-based Services to meet children's needs, and the necessity to better educate parents and teachers regarding the identification of psychiatric disorders, especially depression. J. Am. Acad. Chlid Adolesc. Psychiatry , 1999, 38(9):1081–1090.
Robert A Rosenheck - One of the best experts on this subject based on the ideXlab platform.
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use of the internet and an online personal Health record system by us veterans comparison of veterans affairs Mental Health Service users and other veterans nationally
Journal of the American Medical Informatics Association, 2012Co-Authors: Jack Tsai, Robert A RosenheckAbstract:Objective The Department of Veterans Affairs (VA) operates one of the largest nationwide Healthcare systems and is increasing use of internet technology, including development of an online personal Health record system called My Health e Vet. This study examined internet use among veterans in general and particularly use of online Health information among VA patients and specifically Mental Health Service users. Methods A nationally representative sample of 7215 veterans from the 2010 National Survey of Veterans was used. Logistic regression was employed to examine background characteristics associated with internet use and My Health e Vet. Results 71% of veterans reported using the internet and about a fifth reported using My Health e Vet. Veterans who were younger, more educated, white, married, and had higher incomes were more likely to use the internet. There was no association between background characteristics and use of My Health e Vet. Mental Health Service users were no less likely to use the internet or My Health e Vet than other veterans. Discussion Most veterans are willing to access VA information online, although many VA Service users do not use My Health e Vet, suggesting more education and research is needed to reduce barriers to its use. Conclusion Although adoption of My Health e Vet has been slow, the majority of veterans, including Mental Health Service users, use the internet and indicate a willingness to receive and interact with Health information online.
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Mental Health Service delivery and suicide risk the role of individual patient and facility factors
American Journal of Psychiatry, 2005Co-Authors: Rani A Desai, David J Dausey, Robert A RosenheckAbstract:OBJECTIVE: This study explores suicide rates as a quality measure and identifies risk factors for suicide among psychiatric inpatients. METHOD: Data from a prospective mortality study of psychiatric inpatients from 128 U.S. Department of Veterans Affairs hospitals throughout the United States were utilized to examine the relationship of death by suicide to patient-level sociodemographic, clinical, and Mental Health Service delivery characteristics, as well as to facility-level measures of Service delivery. Data were collected on all patients discharged with a diagnosis of schizophrenia, major depression, posttraumatic stress disorder, or bipolar disorder (N=121,933) between 1994 and 1998. RESULTS: There were 481 suicides in the study sample. Several variables were associated with higher risk for suicide risk, including length of stay less than 14 days, poorer continuity of care, and lack of readmission within 6 months. These variables were significant even after adjustment for state suicide rates, the pro...
Murray B. Stein - One of the best experts on this subject based on the ideXlab platform.
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Mental Health Service utilization in the U.S. Army.
Psychiatric services (Washington D.C.), 2013Co-Authors: Jodi B. A. Mckibben, Ronald C Kessler, Carol S. Fullerton, Christine L. Gray, Murray B. Stein, Robert J. UrsanoAbstract:ObjectiveU.S. Army personnel experience significant burden from Mental disorders, particularly during times of war and with multiple deployments. This study identified the rates and predictors of Mental Health Service use by Army soldiers and examined the association of daily functioning with the various types of Mental Health Service use.MethodsThis study used the U.S. Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel, which sampled 10,400 Army soldiers, representing 508,088 soldiers. Mental Health Service utilization over a 12-month period included receiving counseling or therapy from a general medical doctor, receiving counseling or therapy from a Mental Health professional, and being prescribed medications for depression, anxiety, or sleep. Current functioning was assessed with the Health-Related Quality of Life–4 instrument.ResultsOf the active U.S. Army, 21% had used Mental Health Services in the previous 12 months, and 48% of them had used two or more ser...
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perceived barriers to Mental Health Service utilization in the united states ontario and the netherlands
Psychiatric Services, 2007Co-Authors: Jitender Sareen, Amit Jagdeo, Brian J Cox, Ian Clara, Margreet Ten Have, Sc Shaylee B Belik, Ron De Graaf, Murray B. SteinAbstract:Objective: Although rates of Mental Health Service utilization differ dramatically across countries, little information is available about differences in self-reported barriers to Mental Health Service utilization. Perceived barriers were examined in three locations with differing Health care systems. Methods: Data came from three methodologically similar population-based surveys of adults conducted in the 1990s in Ontario, Canada (N=6,261), the United States (N=5,384), and the Netherlands (N=6,031) that assessed DSM-III-R nonpsychotic Mental disorders with the Composite International Diagnostic Interview. Respondents who reported a need for professional help were asked to indicate reasons for not seeking care. Multiple logistic regression analyses were used to determine the sociodemographic, Mental disorder, and location-specific correlates of each perceived barrier. Results: The pattern of reported barriers to Mental Health Service utilization was similar across locations: attitudinal barriers (thoughts that the problem would get better on its own) were more prevalent than structural barriers (inability to get an appointment). Fear of stigmatization was not commonly endorsed. With adjustment for sociodemographic factors and type of Mental disorder, low-income respondents were significantly more likely to report a financial barrier in the United States than in either Ontario or the Netherlands. Conclusions: Across locations, attitudinal barriers were more likely to be endorsed than structural barriers to Service utilization. The most striking reported cross-national difference was structural, with many more U.S. respondents (especially those with low incomes) reporting financial barriers than respondents in either Ontario or the Netherlands. (Psychiatric Services 58:357–364, 2007)
Jennifer Greif Green - One of the best experts on this subject based on the ideXlab platform.
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reducing racial ethnic disparities in Mental Health Service use among emerging adults community level supply factors
Ethnicity & Health, 2020Co-Authors: Amanda Nemoyer, Mario Cruzgonzalez, Kiara Alvarez, Ronald C Kessler, Nancy A Sampson, Jennifer Greif Green, Margarita AlegriaAbstract:Objectives: Emerging adulthood-spanning 18-29 years of age-is associated with the highest risk for onset of certain behavioral Health disorders (e.g. major depression, bipolar disorder, psychosis, substance use disorders) and high prevalence of many behavioral Health disorders. Yet, rates of Mental Health Service use remain low in this age range. Racial/ethnic minorities are particularly impacted by individual, cultural/linguistic, and community-level barriers to Mental Health care. This study examined community-level factors associated with Mental Health Service use and investigated whether these associations varied by race/ethnicity. Design: This study analyzed individual- and county-level data for emerging adults in the United States (N=3,294) from the nationally representative Collaborative Psychiatric Epidemiological Surveys (CPES). Using the Andersen Model of Health Care Utilization, analyses examined predisposing, enabling, and need factors utilized in prior studies with adult samples as well as novel community characteristics hypothesized to impact Service use among emerging adults of diverse racial/ethnic backgrounds. Past-year use of both specialty and any Mental Health Services were assessed, controlling for individual- and community-level variables, and adjusting for presence of past-year Mental Health disorder, overall Health status, and functional impairment. Differences between racial/ethnic minority groups and Non-Latino Whites were tested through a multilevel model incorporating random intercepts logistic regression, with analysis focusing on the interaction between race/ethnicity and community-level supply variables. Results: For past-year use of specialty Mental Health Services, density of hospitals with child wellness programs was linked to Service use among Black emerging adults, whereas density of hospitals with linguistic/translation Services was linked to Service use among Latino emerging adults. Conclusions: This study expands on previous research in behavioral Health disparities to examine ways to improve behavioral Health Services for an emerging adult population with unmet Service needs and identifies specific community-level factors that can improve Mental Health for racial/ethnic minority emerging adults.
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does childhood Mental Health Service use predict subsequent Mental Health Service use during latino youth transition to young adulthood evidence from the boricua youth study
Social Psychiatry and Psychiatric Epidemiology, 2020Co-Authors: Jennifer Greif Green, Kiara Alvarez, Rachel Oblath, Gerrit Deyoung, Ye Wang, Hector R Bird, Glorisa Canino, Cristiane S Duarte, Margarita AlegriaAbstract:Studies document the substantial underutilization of Mental Health Services by US Latinos in young adulthood. Rates of Service use are higher in childhood, raising questions about whether Mental Health Service use during childhood may facilitate access to Services later in life. This article examines the extent to which utilization of Mental Health Services in childhood is predictive of utilization in young adulthood among US Latinos. Data come from the Boricua Youth Study, a longitudinal study of Puerto Rican youth at two sites (South Bronx, New York, and the standard metropolitan area of San Juan, Puerto Rico). Data were collected in three waves during childhood (ages 5–13; surveyed 1 year apart), with an approximately 11-year follow-up in young adulthood (ages 16–29). In childhood, parents reported on youth Mental Health Service use (Waves 1–3). In Wave 4, as youth transitioned to young adults (N = 2004), they reported on their past year Mental Health Service use. Whereas 30.2% of parents reported their child received Mental Health Services, only 3.5% of young adults reported Mental Health Service use in the past year. After controlling for young adult disorders and their severity, childhood disorders were associated with increased likelihood of Mental Health Service use in young adulthood. Childhood Mental Health Service use was also associated with young adult Service use; however, this association attenuated when controlling for childhood disorders. Findings suggest the importance of specifically considering childhood disorders in understanding mechanisms for improving access to Mental Health Services among Latino young adults.
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Mental Health Service use among high school students exposed to interpersonal violence
Journal of School Health, 2014Co-Authors: Jennifer Greif Green, Renee M Johnson, Erin C Dunn, Michael A Lindsey, Ziming Xuan, Alan M ZaslavskyAbstract:BACKGROUND: Violence-exposed youth rarely receive Mental Health Services, even though exposure increases risk for academic and psychosocial problems. This study examines the association between violence exposure and Mental Health Service contact. The 4 forms of violence exposure were peer, family, sexual, and witnessing. METHODS: Data are from 1534 Boston public high school students who participated in a 2008 self-report survey of violence exposure and its correlates. Multivariate logistic regressions estimated associations between each form of violence with Service contact, then examined whether associations persisted when controlling for suicidality and self-injurious behaviors. RESULTS: In unadjusted models, violence-exposed students more often reported Service contact than their peers. However, in multivariate models, only exposure to family (odds ratio [OR] = 1.69, 95% confidence interval [CI] = 1.23-2.31) and sexual violence (OR = 2.34, 95% CI = 1.29-4.20) were associated with Service contact. Associations attenuated when controlling for suicidality and self-injurious behaviors, indicating they were largely explained by self-harm. Sexual violence alone remained associated with Mental Health Service contact in fully adjusted models, but only for girls (OR=3.32, 95% CI=1.30-8.45), suggesting sex-specific pathways. CONCLUSIONS: Associations between adolescent violence exposure and Mental Health Service contact vary by forms of exposure. Outreach to a broader set of exposed youth may reduce the impact of violence and its consequences for vulnerable students. Language: en
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school Mental Health resources and adolescent Mental Health Service use
Journal of the American Academy of Child and Adolescent Psychiatry, 2013Co-Authors: Jennifer Greif Green, Margarita Alegria, Katie A Mclaughlin, Jane E Costello, Michael J Gruber, Kimberly Hoagwood, Philip J Leaf, Serene S OlinAbstract:Objective Although schools are identified as critical for detecting youth Mental disorders, little is known about whether the number of Mental Health providers and types of resources that they offer influence student Mental Health Service use. Such information could inform the development and allocation of appropriate school-based resources to increase Service use. This article examines associations of school resources with past-year Mental Health Service use among students with 12-month DSM-IV Mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent Mental Health that included 4,445 adolescent–parent pairs in 227 schools in which principals and Mental Health coordinators completed surveys about school resources and policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported Mental Health Service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school Mental Health resources and individual-level Service use. Results Nearly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year Mental Health Services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with Mental Health Service use for adolescents with mild/moderate Mental and behavior disorders. The ratio of students to Mental Health providers was not associated with overall Service use, but was associated with sector of Service use. Conclusions School Mental Health resources, particularly those related to early identification, may facilitate Mental Health Service use and may influence sector of Service use for youths with DSM disorders.
Amelia Seraphia Derr - One of the best experts on this subject based on the ideXlab platform.
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Mental Health Service use among immigrants in the united states a systematic review
Psychiatric Services, 2016Co-Authors: Amelia Seraphia DerrAbstract:Objective:Immigrants face stressors unique to the experience of migration that may exacerbate or cause Mental Health problems but access care at rates far below the general population, leaving them at risk of untreated Mental Health conditions. This review synthesizes current findings on Mental Health Service utilization among immigrants to inform future research efforts addressing disparities in access to care.Methods:A systematic literature search of seven databases yielded 62 articles that met inclusion criteria: peer-reviewed reports of empirical studies based in the United States with an explicit focus on immigrant Mental Health Service use. Each article was evaluated, and information was extracted by using a structured abstracting form.Results:Studies have shown that immigrants from Asia, Latin America, and Africa use Mental Health Services at lower rates than nonimmigrants, despite an equal or greater need. Lower usage has been found to be more pronounced among men, the uninsured, and the undocumen...