Daphne C. Watkins

Increased demand for mental health services on college campuses: Perspectives from administrators

This study examined changes in the demand and role of student mental health services as reported by administrators from college counseling and mental health centers (CCMHCs). Ten CCMHC administrators from US institutions engaged in semi-structured interviews. Four themes characterized the changes in demand and role of student mental health services: 1) an increase in the severity of mental health concerns and demand for services; 2) overall psychosocial differences in today’s college student population; 3) changes in the roles of counseling centers; and 4) institutional challenges and the response to those challenges. Administrators’ responses provided an enriched understanding of the current mental health needs of college students, the potential psychosocial and societal causes of these needs, and the importance of dynamic and flexible responses by counseling centers and institutions more broadly as the mental health profile of students continues to evolve.

A Meta-Study of Black Male Mental Health and Well-Being

Aggregating and interpreting available qualitative data is a necessary next step to understanding the mental health needs and experiences of Black men. This study describes the findings from a meta-synthesis of qualitative research on Black men’s mental health and well-being using Paterson, Thorne, Canam, and Jillings’s qualitative meta-study approach. Though previous studies have reported various forms of racism as salient concerns for Black men’s mental health and well-being, findings from this meta-study revealed seven themes that present an initial step toward advancing the knowledge pertaining to how Black men perceive and express their mental health and well-being. For instance, male gender socialization and economic status were found to play as large a role in Black men’s mental health and well-being as racism. Additional theoretical perspectives are proposed, and implications for clinical practice and research are discussed.

Discrimination, Mastery, and Depressive Symptoms among African American Men.

Purpose: This study examines the influence of discrimination and mastery on depressive symptoms for African American men at young (18—34), middle (35—54), and late (55+) adulthood. Method: Analyses are based on responses from 1,271 African American men from the National Survey of American Life (NSAL). Results: Discrimination was significantly related to depressive symptoms for men ages 35 to 54 and mastery was found to be protective against depressive symptoms for all men. Compared to African American men in the young and late adult groups, discrimination remained a statistically significant predictor of depressive symptoms for men in the middle group once mastery was included. Implications: Findings demonstrate the distinct differences in the influence of discrimination on depressive symptoms among adult African American males and the need for future research that explores the correlates of mental health across age groups. Implications for social work research and practice with African American men are discussed.

Measuring masculinity in research on men of color: findings and future directions.

The purpose of this study was to examine the association between masculinity and the health of US men of color aged 18 years and older. We identified 22 population-based studies that included a measure of masculinity and a measure of health behavior, mental health, or physical health. The associations between masculinity and health were complex and varied by construct and health outcome, though they generally were significant in the hypothesized directions. Future research should explore the centrality of masculinity versus other identities and characteristics, how the relationship between masculinity and health varies by health outcome, and the identification of the conceptions and aspects of masculinity that are most relevant to and associated with specific health behaviors and health outcomes.

Correlates of Psychological Distress and Major Depressive Disorder among African American Men.

This study examines the demographic correlates of depressive symptoms, serious psychological distress (SPD), and major depressive disorder (MDD; 12-month and lifetime prevalence) among a national sample of African American men. Analysis of the National Survey of American Life (NSAL) data set provides first-time substantiation of important demographic differences in depressive symptoms (measured by the Center for Epidemiological Studies Depression scale [CES-D]), SPD (measured by the K6), and 12-month and lifetime MDD among African American men. Findings illuminate the heterogeneity within the African American male population. Findings also demonstrate the need for additional research focusing on within-group differences and a comprehensive research and mental health promotion agenda that recognizes the importance of improving access to education and employment and promoting healthy coping behaviors, while acknowledging the larger social context in which African American men live.

Depression Over the Adult Life Course for African American Men: Toward a Framework for Research and Practice

Rarely are within-group differences among African American men explored in the context of mental health and well-being. Though current conceptual and empirical studies on depression among African American men exists, these studies do not offer a framework that considers how this disorder manifests over the adult life course for African American men. The purpose of this article is to examine the use of an adult life course perspective in understanding the complexity of depression for African American men. The proposed framework underscores six social determinants of depression (socioeconomic status, stressors, racial and masculine identity, kinship and social support, self-esteem and mastery, and access to quality health care) to initiate dialogue about the risk and protective factors that initiate, prolong, and exacerbate depression for African American men. The framework presented here is meant to stimulate discussion about the social determinants that influence depression for African American men to and through adulthood. Implications for the utility and applicability of the framework for researchers and health professionals who work with African American men are discussed.

Qualitative research: the importance of conducting research that doesn't "count".

or health education and promotion specialists who want to contribute to evidence-based research and practice, using quantitative methods is impor-tant. However, when quantitative methods are used alone, or used to acquire more depth about a topic, they are not sufficient. To get the complete picture, it is important to understand and be able to conduct qualita-tive research—research that traditionally does not include numbers and statistical figures, or “count” data.The purpose of this tool is to provide an overview of what health education and promotion specialists need to know—mainly, what qualitative health research is and how to conduct it. Competence in qualitative research is particularly important because much of what we do is grounded in the social and behavioral sciences—areas that benefit greatly from qualitative research insight. As we work to change not only life-styles but also systems, built environments, and policies, the “deeper data” that we can tap into using qualitative methods become increasingly valuable.Competent health education and promotion specialists must be knowledgeable about both quantitative and qual-itative research approaches. While the debate continues about the relative value of each approach, the best option may be to understand both methods well, know the most appropriate conditions for using each method, and con-sider integrating them as a gold standard for rigorous health education and promotion research and practice.The impetus for writing this tool stems from my teach-ing and mentoring experiences used to empower and educate health and social service professionals about the importance of using qualitative research to accomplish their project goals. This tool also presents information on how to initiate and follow through on rigorous health research that may include qualitative or mixed methods.

The Effects of Race, Ethnicity, and Mood/Anxiety Disorders on the Chronic Physical Health Conditions of Men From a National Sample

Racial/ethnic differences in health are evident among men. Previous work suggests associations between mental and physical health but few studies have examined how mood/anxiety disorders and chronic physical health conditions covary by age, race, and ethnicity among men. Using data from 1,277 African American, 629 Caribbean Black, and 371 non-Hispanic White men from the National Survey of American Life, we examined associations between race/ethnicity and experiencing one or more chronic physical health conditions in logistic regression models stratified by age and 12-month mood/anxiety disorder status. Among men <45 years without mood/anxiety disorders, Caribbean Blacks had lower odds of chronic physical health conditions than Whites. Among men aged 45+ years with mood/anxiety disorders, African Americans had greater odds of chronic physical health conditions than Whites. Future studies should explore the underlying causes of such variation and how studying mental and chronic physical health problems together may help identify mechanisms that underlie racial disparities in life expectancy among men.

Coping Styles, Well-Being, and Self-Care Behaviors Among African Americans With Type 2 Diabetes

PURPOSE The purpose of this study was to describe how coping styles among African Americans with type 2 diabetes relate to diabetes appraisals, self-care behaviors, and health-related quality of life or well-being. METHODS This cross-sectional analysis of baseline measures from 185 African Americans with type 2 diabetes enrolled in a church-based randomized controlled trial uses the theoretical framework of the transactional model of stress and coping to describe bivariate and multivariate associations among coping styles, psychosocial factors, self-care behaviors, and well-being, as measured by validated questionnaires. RESULTS Among participants who were on average 59 years of age with 9 years of diagnosed diabetes, passive and emotive styles of coping were used most frequently, with older and less educated participants using more often passive forms of coping. Emotive styles of coping were significantly associated with greater perceived stress, problem areas in diabetes, and negative appraisals of diabetes control. Both passive and active styles of coping were associated with better diabetes self-efficacy and competence in bivariate analysis. In multivariate analysis, significant proportions of the variance in dietary behaviors and mental well-being outcomes (general and diabetes specific) were explained, with coping styles among the independent predictors. A positive role for church involvement in the psychological adaptation to living with diabetes was also observed. CONCLUSIONS In this sample of older African Americans with diabetes, coping styles were important factors in diabetes appraisals, self-care behaviors, and psychological outcomes. These findings suggest potential benefits in emphasizing cognitive and behavioral strategies to promote healthy coping outcomes in persons living with diabetes.

Race and Ethnic Group Differences in Comorbid Major Depressive Disorder, Generalized Anxiety Disorder, and Chronic Medical Conditions.

This study tested whether race and ethnic group differences exist for lifetime major depressive disorder and/or general anxiety disorder with one or more chronic medical conditions. Data from the National Survey of American Life, which included 3570 African American, 1438 Caribbean Black, and 891 non-Hispanic White adults were analyzed. Outcomes included at least one and multiple chronic medical conditions, from a list of 14 medical conditions (e.g., arthritis, cancer, diabetes, kidney disease, stroke, heart disease, etc.). Logistic regressions were fitted to data to determine how the association between major depressive disorder, general anxiety disorder, and one or more chronic medical conditions vary across race and ethnicity. Lifetime major depressive disorder (but not lifetime general anxiety disorder) was associated with at least one chronic medical condition among African Americans and Caribbean Blacks, but not non-Hispanic Whites. Lifetime major depressive disorder was similarly associated with multiple chronic medical conditions among African Americans, Caribbean Blacks, and non-Hispanic Whites. For Caribbean Blacks, stronger associations were found between major depressive disorder and general anxiety disorder with one or more chronic medical conditions compared to African Americans and non-Hispanic Whites. Findings suggest that race and ethnicity may shape the links between comorbid psychiatric disorders and chronic medical conditions. Mental health screening of individuals with chronic medical conditions in primary health-care settings may benefit from tailoring based on race and ethnicity. More research is needed to understand why associations between physical and mental health vary among race and ethnic groups.