Amy N. Mendenhall

Predictors and moderators in the randomized trial of multifamily psychoeducational psychotherapy for childhood mood disorders.

This study investigated predictors and moderators of mood symptoms in the randomized controlled trial (RCT) of Multi-Family Psychoeducational Psychotherapy (MF-PEP) for childhood mood disorders. Based on predictors and moderators in RCTs of psychosocial interventions for adolescent mood disorders, we hypothesized that childrens greater functional impairment would predict worse outcome, whereas childrens stress/trauma history and parental expressed emotion and psychopathology would moderate outcome. Exploratory analyses examined other demographic, functioning, and diagnostic variables. Logistic regression and linear mixed effects modeling were used in this secondary analysis of the MF-PEP RCT of 165 children, ages 8 to 12, with mood disorders, a majority of whom were male (73%) and White, non-Hispanic (90%). Treatment nonresponse was significantly associated with higher baseline levels of global functioning (i.e., less impairment; Cohens d = 0.51) and lower levels of stress/trauma history (d = 0.56) in children and Cluster B personality disorder symptoms in parents (d = 0.49). Regarding moderators, children with moderately impaired functioning who received MF-PEP had significantly decreased mood symptoms (t = 2.10, d = 0.33) compared with waitlist control. MF-PEP had the strongest effect on severely impaired children (t = 3.03, d = 0.47). Comprehensive assessment of demographic, youth, parent, and familial variables should precede intervention. Treatment of mood disorders in high-functioning youth without stress/trauma histories and with parents with elevated Cluster B symptoms may require extra therapeutic effort, whereas severely impaired children may benefit most from MF-PEP.

Theory Meets Practice: The Localization of Wraparound Services for Youth with Serious Emotional Disturbance

This study identified statewide variation in implementation of wraparound for children on the severe emotional disturbance (SED) Waiver in Kansas. SED Waivers allow Community Mental Health Centers (CMHC) to offer an array of community-based services to high risk youth. Qualitative methods, including interviews, reviews of charts and billing records, and a survey, were employed. Stratified random sampling was used to select seven CMHCs, and random sampling was used to select individual cases for interviews. Although CMHCs shared similar wraparound philosophy and service initiation processes, each developed their own localized wraparound model within the confines of Medicaid eligibility and documentation rules. Eight models for wraparound team composition were identified. Findings demonstrate implementation of wraparound with fidelity to a central model is difficult on a large scale. The balance of standardized wraparound practices, localized innovations, and agency compliance with Medicaid is essential for optimizing children’s mental health services.

Adolescent Mental Health Case Management: Consumer Perspectives

This qualitative study describes case management practices and suggestions for mental health service delivery improvement from the perspective of parents and guardians of adolescent service recipients, as well as youth service recipients over the age of 18. Data were collected during a series of 10 personal semistructured interviews. Parent/guardian interview participants discussed case management and what they perceived as barriers to effective case management services, as well as those aspects found within quality services. Interview participants also discussed their ideas on how to improve mental health case management service at both the micro and macro level. Interview results indicate mental health case management is not meeting its full capacity as a service that can positively impact adolescent outcomes.

Experiences of graduates of the Mental Health First Aid-USA course

Mental health distress is common, yet many people lack mental health literacy and skills to help themselves and others. In this qualitative study, we used semi-structured interviews to ask graduates of Mental Health First Aid (MHFA-USA), a mental health promotion program designed to address such needs, about its impact. Interviewees described gaining knowledge, skills and confidence to help someone in distress, empathy for people with mental illness, and developing a sense of responsibility and permission to try to help when needed. They gave varied examples of using MHFA-USA skills with strangers, acquaintances, coworkers, clients and family members, and to help themselves, in a range of situations. We integrate these results into a tentative change process diagram, and speculate on its effects for people in distress and community norms regarding emotional and psychiatric distress. We then discuss the implications for MHFA-USA outcomes research.

Children’s Mental Health Providers’ Perceptions of Mental Health Literacy Among Parents and Caregivers

Mental health disorders are prevalent among children, yet many do not receive treatment. Parents and caregivers play a vital role in recognizing mental health disorders in children and accessing treatment. But a substantial number of parents lack essential knowledge of children’s mental health disorders, including risk factors, symptom recognition, and treatment options. Little focus has been given to parents in the children’s mental health literacy literature. The purpose of this article is to begin filling that gap by using a survey to describe the perceptions of child and family mental health providers’ perceptions regarding the amount, accuracy, and origin of mental health literacy in the parents of the children they treat. The impact of those perceptions on the work of providers is also explored. Eighty-seven mental health providers completed a survey to assess their perceptions of parent mental health literacy in the area of children’s mental health. Providers perceived parent mental health literacy as low, inaccurate, and inconsistent. In addition, providers indicated that parents rely on informal sources of support, such as friends and family for information about children’s mental health. Implications for social work researchers, practitioners, and the children and families they serve are discussed.

Adolescent mental health case management: Provider perspectives

ABSTRACT Due to the inconsistent definitions and varying models of implementation of adolescent mental health case management, the perceptions and experiences of the professionals providing services are invaluable to improving case management and mental health outcomes for adolescents. This qualitative article examines case management as a service for adolescents with mental illness within the context of one Midwestern state. The primary research question was: what are the current experiences of professionals providing case management services to adolescents with mental illness? Through collaboration with community mental health centers, researchers conducted five focus groups with adolescent mental health providers. Focus group participants discussed the challenges they currently experience while providing services to adolescents, and described current case management practices. Participants also provided suggestions for service delivery improvement. Researchers present focus group results and discuss the implications of the results at both a local and national level.