Mental Disorders and Help Seeking in a Rural Impoverished Population

Fox, Justin P.; Blank, Michael B.; Berman, Jessica; Rovnyak, Virginia

doi:10.2190/y4ka-8xyc-kqwh-duxn

Cited by 48 publications

(39 citation statements)

References 21 publications

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“…1, a set of background contextual factors have been identified and are hypothesized to be stable (e.g., relatively fixed) over time and to moderate study outcomes. These factors include the following: the county's level of poverty, whether they operate services primarily within rural or urban settings, the county's history of consumer involvement and advocacy, and the county's previous history of cross-agency collaboration on children's mental health issues (Fox et al 1999). …”

Section: Conceptual Model Underlying the Study Designmentioning

confidence: 99%

Engaging and Recruiting Counties in an Experiment on Implementing Evidence-based Practice in California

Chamberlain

Brown

Saldana

et al. 2008

Adm Policy Ment Health

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There is a growing consensus that implementation of evidence-based intervention and treatment models holds promise to improve the quality of services in child public service systems such as mental health, juvenile justice, and child welfare. Recent policy initiatives to integrate such researchbased services into public service systems have created pressure to expand knowledge about implementation methods. Experimental strategies are needed to test multi-level models of implementation in real world contexts. In this article, the initial phase of a randomized trial that tests two methods of implementing Multidimensional Treatment Foster Care (an evidence-based intervention that crosses child public service systems) in 40 non-early adopting California counties is described. Results are presented that support the feasibility of using a randomized design to rigorously test contrasting implementation models and engaging system leaders to participate in the trial. Keywords Implementation; Randomized design; Community development team; Multidimensional treatment foster careA number of rigorous randomized trials have shown that theoretically based, developmentally and culturally sensitive interventions can produce positive outcomes for children and adolescents with mental health and behavioral problems (e.g., Olds et al. 2003;Henggeler et al. 1998). As the number and variety of well-validated interventions increases, the pressure also has increased from a broad range of stakeholders (e.g., scientific and practice institutes, state legislatures, public interest legal challenges) to incorporate evidence-based practices (EBP) into publicly funded child welfare, mental health, and juvenile justice systems (NIMH 2001(NIMH , 2004. Despite the increasing availability and demand for well-validated interventions, it is estimated that 90% of public systems do not deliver treatments or services that are evidence-

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Section: Conceptual Model Underlying the Study Designmentioning

confidence: 99%

Engaging and Recruiting Counties in an Experiment on Implementing Evidence-based Practice in California

Chamberlain

Brown

Saldana

et al. 2008

Adm Policy Ment Health

View full text Add to dashboard Cite

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“…All persons screening positive do not require treatment (Regier et al 1998). Conversely, many people who screen positive for mental health conditions, even when informed that they may have a serious problem, do not seek treatment because they see no need for it (Fox et al 1999). These two considerations suggest that the population studied, persons screening positive for depression, may include individuals who do not actually need care.…”

Section: Limitationsmentioning

confidence: 99%

Race and Ethnicity Differences in Reporting of Depressive Symptoms

Probst

Laditka

Moore

et al. 2007

Adm Policy Ment Health

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Our study explored race and ethnicity differences in reporting of symptoms to physicians and other practitioners among respondents to the 1999 National Health Interview Survey who screened positive for depression. Respondents were asked if they had told a doctor or another practitioner (nurse, social worker, psychologist, clergy, other) about their problems. Whites and Hispanics were significantly more likely to communicate with a physician or other practitioner than were African Americans, even with personal characteristics held constant. Practitioners should actively elicit descriptions of feelings and mood, especially with African Americans, and be prepared to treat or refer patients appropriately.

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“…11,12 Further, rural residents may receive little encouragement from primary social-support networks to seek treatment in the specialty mental health service sector. 13 The relationship between rurality and psychotherapy utilization has not been examined in the VA health care system. Evidence of rural-urban disparities in access to psychotherapy services is necessary to justify the VA investment in strategies to improve access for rural veterans.…”

mentioning

confidence: 99%

Use of Psychotherapy by Rural and Urban Veterans

Cully

Jameson

Phillips

et al. 2010

The Journal of Rural Health

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Purpose: To examine whether differences exist between rural and urban veterans in terms of initiation of psychotherapy, delay in time from diagnosis to treatment, and dose of psychotherapy sessions. Methods: Using a longitudinal cohort of veterans obtained from national Veterans Affairs databases (October 2003 through September 2004), we extracted veterans with a new diagnosis of depression, anxiety, or posttraumatic stress disorder (PTSD) (n = 410,923). Veterans were classified as rural (categories 6-9; n = 65,044) or urban (category 1; n = 149,747), using the US Department of Agriculture Rural-Urban Continuum Codes. Psychotherapy encounters were identified using Current Procedural Terminology codes for the 12 months following patients' initial diagnosis. Findings: Newly diagnosed rural veterans were significantly less likely (P < .0001) to receive psychotherapy (both individual and group). Urban veterans were roughly twice as likely as rural veterans to receive 4 or more (9.46% vs 5.08%) and 8 or more (5.59% vs 2.35%) psychotherapy sessions (P < .001). Conclusions: Rural veterans are significantly less likely to receive psychotherapy services, and the dose of the psychotherapy services provided for rural veterans is limited relative to their urban counterparts. Focused efforts are needed to increase access to psychotherapy services provided to rural veterans with depression, anxiety, and PTSD.

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Mental Disorders and Help Seeking in a Rural Impoverished Population

Cited by 48 publications

References 21 publications

Engaging and Recruiting Counties in an Experiment on Implementing Evidence-based Practice in California

Engaging and Recruiting Counties in an Experiment on Implementing Evidence-based Practice in California

Race and Ethnicity Differences in Reporting of Depressive Symptoms

Use of Psychotherapy by Rural and Urban Veterans

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