Inaugural Editorial

Mothers’ Perceptions of Help-Seeking for Depression in Head Start: A Thematic, Discourse Analysis by Language Group Abstract Maternal depression poses a threat to the well-being of poor minority mothers and their young children, but significant disparities remain in the access and utilization of treatment among this population in the United States. Providing group treatment in early childhood education settings like Head Start may be an effective way to address this public health concern. However, intervention developers would benefit from understanding potential barriers and facilitators to engagement with this population, particularly those related to cultural and linguistic differences. Focus groups were conducted to explore perceptions of help-seeking for depression among English and Spanish-speaking Head Start mothers as part of a larger effectiveness study. Thematic and discourse analysis strategies were used to examine similarities and differences across English and Spanish language groups. Results revealed similar and divergent concerns about broader environmental stressors and striking differences in the processes of group formation. Findings demonstrate the importance of addressing structural factors, developing flexible interventions, and tailoring interventions for both English-speaking and Spanish-speaking groups.

The Effectiveness of Two Potential Mass Media Interventions on Stigma: Video-Recorded Social Contact and Audio/Visual Simulations Abstract Two approaches that may be particularly well suited for mass media (large scale) stigma interventions are video-recorded social contact and simulations, but research is rather limited. The purpose of this study was to evaluate two potential mass media interventions on different facets of stigma. Participants (N = 244) completed stigma measures prior to, immediately following, and 1 week following the random assignment of: (1) video-recorded social contact, (2) an audio/visual simulation, or (3) no intervention. The video-recorded social contact led to decreases on preference for social distance and negative emotions across 1 week, but only a temporary decrease on perceptions of dangerousness. In contrast, no significant changes in stigma were noted following the simulation. In sum, video-recorded social contact appears promising and offers many advantages for mass media implementation including low cost, minimal resources, and ease of dissemination. In contrast, further evaluation of audio/visual simulations is warranted before implementation.

Defining Employment Specialist Competencies: Results of a Participatory Research Study Abstract The preponderance of research conducted on supported employment has focused on the structure of interventions with little empirical investigation into the contribution of employment specialists to work outcomes. Using a participatory approach, we identified competencies essential to the role of the employment specialists, operationalized and refined those competencies using the perspectives of experts, service recipients, and employment specialists themselves. We conducted an online survey with 34 candidate items and n = 142 respondents. Results suggested good psychometric properties, stability and coherence of the Vocational Practices and Relationship Scale. A total of n = 23 final items tapping the working alliance coalesced into a strong factor, as did strategies for promoting vocational recovery, suggesting that the scale warrants wide-scale testing for predictive validity. We consider these constructs and competencies to be a potential blueprint for training employment specialists, not only in technical skills and strategies, but also to increase the hope for vocational recovery among those they serve.

Editor’s Comments: 2019

With Small Power, Comes Great Responsibility: Lessons Learned from an Evaluation of Veteran and Military Mental Health Public Awareness Campaigns Abstract This study was conducted to determine the feasibility of conducting a cost–benefit evaluation of federally-funded media campaigns encouraging mental health help-seeking among United States military personnel and veterans. To calculate the necessary sample size for the evaluation, we obtained campaign costs, and determined the number of treatment seekers needed for the campaign to break even with its cost and the associated population change that an evaluation would need to detect. The sample size needed for an evaluation with 80% power was greater than the total population of U.S. military personnel and veterans. Given that the necessary sample size exceeds the population to be sampled, an appropriately powered outcome evaluation is not feasible. Other programs that would be cost effective with extremely small effect sizes should not be subject to underpowered and thus inaccurate empirical outcome evaluation.

Sandra Steingard (ed.): Two Views of Critical Psychiatry: Controversies and Clinical Implications

Attitudes of Community-Leading Occupational Groups Towards Mental Illnesses: The Sample of a City in Western Turkey Abstract This descriptive study aims to determine attitudes of community-leading occupational groups towards mental illnesses. The sample of this descriptive study consisted of a total of 1100 participants from clergymen, headmen, teachers, policemen and primary healthcare professionals working in Düzce, Turkey. Data were collected using the Personal Information Form and the Beliefs Toward Mental Illness Scale-BTMIS. Occupational groups were determined to have moderate beliefs about mental diseases according to their BTMIS scale total scores. The occupational groups that had most negative beliefs toward mental illnesses were headmen, police officers, teachers, healthcare professionals and clergymen, respectively. Data were evaluated using descriptive statistics of mean, standard deviation, minimum, maximum, and percentage. Community-leading occupational groups should be actively involved in anti-stigma activities to change quickly and effectively community attitudes towards mental illnesses.

Self-Esteem and HIV Infection in Morocco: Associated Factors Among People Living with HIV—Results from a Community-Based Study Abstract People living with HIV (PLHIV) face specific issues regarding mental quality of life (QoL), in particular self-esteem. The objective of this study was to measure self-esteem and to identify associated factors among PLHIV in Morocco. A 125-item questionnaire was administered to 300 PLHIV. The dependent variable was adapted from Rosenberg’s self-esteem scale (range 0–4). A weighted multiple linear regression was performed. The mean level of self-esteem was 2.4 ± 1.0. The factors independently associated with self-esteem were: feeling of loneliness (p = 0.001), perceived seriousness of infection (p = 0.006), thinking serostatus disclosure was a mistake (p = 0.007), thinking HIV infection will last for life (p = 0.008), sexual orientation (p = 0.050), satisfaction with sexual life (p = 0.019) and perceived treatment efficacy (p = 0.009). These results underline the need for evidence-based interventions (e.g. anti-discrimination measures, interventions to prevent social isolation of PLHIV, support in the serostatus disclosure process), in order to improve the social environment and eventually improve their self-esteem and QoL.

Integrated Care: Should It Count as Community Psychiatry Training for Psychiatry Residents? Abstract Psychiatry residents are required to be exposed to community psychiatry. Historically, this occurred in public hospitals or assertive community treatment (ACT) teams. A new model of psychiatric care delivery, integrated care, has become prevalent. While integrated care shares some features with traditional community psychiatry rotations, no research exists to demonstrate if integrated care rotations can accomplish the aims of traditional rotations. This pilot study compared learning outcomes in ACT team rotations versus integrated care rotations. Pre- and post-rotation surveys were disseminated to third-year psychiatry residents (N = 8) who were randomized to complete a rotation with an ACT team or an integrated care team. By rotation end, many in both settings changed how conservative they were in treatment philosophies, but this did not result in a difference between groups. Residents in both groups were satisfied with their rotations. Training in integrated care may be a reasonable alternative to traditional community psychiatry rotations.