Natural and manmade crises impact community-level behavioral health, including mental health and substance use. This article shares findings from a larger project about community behavioral health, relevant to the ongoing water crisis in Flint, Michigan, using data from a larger study, involving monthly surveys of a panel of key informants from Genesee County. The data come from open-response questions and are analyzed as qualitative data using grounded theory techniques. Although respondents were not asked about the water issues in Flint, participants commented that the water situation was increasing stress, anxiety, and depression among the city’s population. Participants thought these mental health issues would affect the entire community but would be worse among low-income, African American populations in the city. Mental health consequences were related not only to the water contamination but to distrust of public officials who are expected and have the authority to resolve the issues. The mental health effects of this public health crisis are significant and have received inadequate attention in the literature. Public health response to situations similar to the water issues in Flint should include sustained attention mental health.

Community climate is the degree of support for GLBT people within a specific locale. In this paper we describe the elements of community climate, theorize how it is produced, and argue that this approach provides an important elaboration of Meyer's (2003) minority stress model. Furthermore, we present a new methodology for assessing community climate that could be used by any researcher with a geographically diverse data set that includes location identifiers such as ZIP code. In closing we discuss the theoretical, empirical, and practical contributions that could be made by GLBT family scholars who utilize this new technique for measuring community climate.

No abstract

Research on the complex relationships of variables contributing to farmer suicide is limited. The purpose of the study was to examine factors associated with suicide risk through the use of standardized instruments measuring psychological (depression, anxiety), social (social support), and contextual factors. A questionnaire was completed by 600 farmers in the Midwestern United States. A multiple linear regression model was used to analyze associations with suicide risk (SBQ-R), including depression (PHQ-9), anxiety (GAD-7), Brief COPE subscales (BC), social support (MSPSS), and select demographic and farming characteristics. The only variable that emerged as having a significant relationship with the natural log-transformed suicide risk score was coping through self-blame. While suicidality is often considered the outcome of mental illness, our findings do not suggest that suicide risk among farmers is related to mental illness, and a further examination of self-blame as a coping strategy is warranted.

While the story of the Flint water crisis has frequently been told, even sympathetic analyses have largely worked to make invisible the significant actions of Flint residents to protect and advocate for their community. Leaving the voices of these stakeholders out of narratives about the crisis has served to deepen distrust in the community. Our project responds to these silences through a community-driven research study aimed explicitly at elevating the frame of Flint residents in and around the Flint water crisis. This paper describes the coming together of the research team, the overall project design for each of the three research efforts, and lessons learned. The three sub-projects include: (1) a qualitative analysis of community sentiment provided during 17 recorded legislative, media, and community events, (2) an analysis of trust in the Flint community through nine focus groups across demographic groups (African American, Hispanic, seniors, and youth) of residents in Flint, and (3) an analysis of the role of the faith-based community in response to public health crises through two focus groups with faith based leaders from Flint involved with response efforts to the water crisis. Our study offers insight for understanding trust in crisis, which could be valuable to other communities and researchers seeking to address similar situations. The project offers community science as a model for considering community engagement in research as part of the process of resilience.

No abstract

Farmers and ranchers (agricultural producers) have higher psychological distress and suicide rates than the general population. Poorer mental health status and outcomes among producers are often attributed to the continuously challenging economic, social, and climate-related changes to agriculture as an occupation and industry. This article describes the development of a training program for agribusiness professionals from the U.S. Department of Agriculture Farm Service Agency (N = 500) who work with producers, as they regularly interact with producers and thus are in a position to readily offer helpful mental health resources. The goal of the program was for agribusiness professionals to build skills and confidence to identify and respond to distressed producers. The educational program was offered primarily online and included a 1-day in-person training to practice skills to communicate with distressed producers and refer them to appropriate mental health resources. Evaluation of the program demonstrated participants experienced gains in knowledge and skills related to identifying and helping distressed producers.

Clinical–community linkages enhance health care delivery and enable physician–patient partnerships to achieve better health. The Michigan State University (MSU) Model of Health Extension includes a strategy for forming these linkages by focusing on increasing primary care patient referrals and enrollment in health programs. This article shares the results of a survey of Michigan internal medicine and family medicine physicians ( n = 323) to better understand attitudes toward and familiarity with community-based education (CBE) programs and to assess the logistical requirements to make CBE referrals efficient and sustainable. Survey results showed that at most, 55% of respondents were aware of at least one CBE program implemented by Cooperative Extension. Of those who were aware, over 85% agreed that the programs have positive benefits for patients. Thirty-five percent reported at least one referral barrier, and familiarity with the CBE programs was a significant predictor for reporting all referral barriers. The results suggest that increasing physicians’ familiarity of CBE health programs is a key first step in identifying ideal strategies to overcome referral barriers. Data from this study may help determine scalable state level models for increasing awareness of chronic disease prevention and other CBE programs in efforts to improve the health of the nation.