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Journal: The American journal of orthopsychiatry


Paid sick leave is increasingly identified as a social justice issue having important implications for health and wellness; however, little is known about its relationship to mental health. Data from the 2015 cross section of the National Health Interview Survey (NHIS; 2015) were used to examine the relationship between paid sick leave and psychological distress during the last 30 days among N = 17,897 working United States adults. The 6-item Kessler Psychological Distress Scale (K6), a valid and reliable instrument for assessing psychological distress in population based samples, was used to measure the outcome variable of interest. The K6 score was computed from 6 questions and was regressed on paid sick leave status, after controlling for variables known to be related to psychological distress. Results indicated that workers who lack paid sick leave benefits report a statistically significant higher level of psychological distress, and are 1.45 times more likely to report their distress symptoms interfere a lot with their life or activities compared with workers with paid sick leave. This research adds to a body of work analyzing institutional structures and social determinants of health. Findings support the potential value of paid sick leave as an intervention to promote behavioral health. (PsycINFO Database Record

Concepts: Psychology, Statistics, Sociology, Population health, Social justice


This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia-a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants' perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. Participants stressed that poor treatment quality-not merely access-limited their engagement in treatment and at times reinforced their depression. While women acknowledged the stigma of depression, they indicated that their resistance to seek help for their depression was influenced by the expectation of women’s self-reliance in the rural setting and the gendered taboo against negative thinking. Ambivalence and stigma led women to try to cope independently, resulting in further isolation. This study’s findings reiterate the need for improved quality and increased availability of depression treatment in rural areas. In addition, culturally appropriate depression interventions must acknowledge rural cultural values of self-reliance and barriers to obtaining social support that lead many women to endure depression in isolation. (PsycINFO Database Record

Concepts: Psychology, Mental health, Sociology, Symptoms, Illness, Culture, Mind, Rural


The objective of this article is to analyze the relationship between suffering from stressful life events (SLE) and subsequent suicidal behavior among women in a homeless situation, examining the differences in the number and characteristics of SLE experienced by attempters and nonattempters. The study was carried out based on the data obtained from a sample of women living homeless in Madrid (Spain; n = 138). The information was gathered using a structured interview. The results show that 46% of these women living homeless in Madrid had attempted suicide, and 32% of them had done so for the first time when they were homeless. We observed a high level of SLE among the women in a homeless situation, with a substantial increase in the number and severity of the stressors suffered by the interviewees who had attempted suicide, both during their childhood and adolescence and in their later lives. (PsycINFO Database Record © 2018 APA, all rights reserved).


This article tests a hypothesized model of overall happiness among homeless people in Spain. The research was conducted based on a representative sample of homeless people in Madrid (n = 235), all adults, who had spent the night before the interview in a shelter for homeless people, on the street or in other places not initially designed for sleeping, or who were in supervised accommodation for homeless people at the time of the interview. Information was gathered using a structured interview. The results obtained show that around half of the homeless people in Madrid said that they were happy. A positive meta-stereotype and a better perceived general health were associated with a higher overall happiness, while feelings of loneliness were associated with a lower overall happiness. Happiness also showed a significant effect on future expectations. Disabilities and handicaps had a significant effect on perceived general health, which was in turn associated with overall happiness among homeless people. (PsycINFO Database Record

Concepts: Homelessness, Unemployment


Religious freedom restoration acts (RFRAs) in the United States potentially facilitate discrimination against lesbian, gay, and bisexual individuals (i.e., sexual minorities). In the current investigation, we explored whether a population health metric among sexual minority adults changed over time based on the presence, absence, or introduction of a state RFRA. Data are from 21 of the United States that gathered sexual orientation data from population-based samples of noninstitutionalized adults in the 2015 Behavioral Risk Factor Surveillance System (CDC, 2015, 2016). The analytic sample included 4,911 sexual minority individuals. Time was measured in 4 3-month quarters (i.e., Q1, Q2, Q3, Q4). For each state, the prevalence of sexual minority adults reporting ≥14 unhealthy days/30 days was calculated. Only Indiana (the only state in the sample that passed an RFRA in 2015) exhibited significant increasing proportions over time of sexual minority adults reporting ≥14 unhealthy days (Q1 = 24.5%, Q2 = 34.8%, Q3 = 41.2%, Q4 = 59.5%; β = 0.50, SE = 0.23, p = .037). Post hoc analyses revealed that unhealthy days did not increase for heterosexual adults in Indiana. Indiana’s RFRA could have contributed to the increasing prevalence of unhealthy days among sexual minority adults in that state during 2015. Public health surveillance tools are needed to expedite analyses of the impact of laws on minority population health. (PsycINFO Database Record


Consistent evidence documents the negative impacts of family separation on refugee mental health and concerns for the welfare of distant family members and desire to reunite with family members as priorities for refugees postmigration. Less is known about refugees' emic perspectives on their experiences of family separation. Using mixed methods data from a community-based mental health intervention study, we found that family separation was a major source of distress for refugees and that it was experienced in a range of ways: as fear for family still in harm’s way, as a feeling of helplessness, as cultural disruption, as the greatest source of distress since resettlement, and contributing to mixed emotions around resettlement. In addition to these qualitative findings, we used quantitative data to test the relative contribution of family separation to refugees' depression/anxiety symptoms, posttraumatic stress disorder (PTSD) symptoms, and psychological quality of life. Separation from a family member was significantly related to all 3 measures of mental health, and it explained significant additional variance in all 3 measures even after accounting for participants' overall level of trauma exposure. Relative to 26 other types of trauma exposure, family separation was 1 of only 2 traumatic experiences that explained additional variance in all 3 measures of mental health. Given the current global refugee crisis and the need for policies to address this large and growing issue, this research highlights the importance of considering the ways in which family separation impacts refugee mental health and policies and practices that could help ameliorate this ongoing stressor. (PsycINFO Database Record

Concepts: Psychology, Psychological trauma, Complex post-traumatic stress disorder, Cognitive behavioral therapy, Posttraumatic stress disorder, Prolonged exposure therapy, Quantitative research, Vietnam War


Research can be used to develop empirically informed policy solutions to our most pressing public problems. However, research is all too often left out of the public policymaking conversation. Researchers can change this, by learning how to engage and collaborate with policymakers. In this article, we present and adapt a conceptual framework from the field of community psychology-Kelly’s (1971) “Qualities for a Community Psychologist”-to provide insight into training graduate students for policy engagement. (PsycINFO Database Record © 2019 APA, all rights reserved).


Mental health needs have been recognized as a priority area by the World Health Organization (WHO), and a Comprehensive Mental Health Action Plan (2013) was proposed to address the needs of millions of people around the world. Concerns have been raised about the degree to which current global efforts are appropriate and sufficient for promoting mental health (MH), reducing the risk for common MH disorders, and addressing the needs of individuals experiencing mental illness. This commentary expands on the presentation of the Global Alliance for Behavioral Health and Social Justice’s Task Force on Global Mental Health at the 16th Biennial Conference of the Society for Community Research and Action, held in Ottawa, Ontario, Canada June 21-24, 2017, “Building Capacity to Address Mental Illness and Emotional Distress in Low-Resource Settings and Among Refugee Populations.” Utilizing a socioecological framework, this commentary offers a call to action in addressing global mental health by emphasizing the need for greater investments in wellness promotion, prevention, treatment, and recovery. Importantly, such efforts need to value local knowledge and culture, harness natural existing resources and assets, and ensure equitable distribution of key resources for MH. (PsycINFO Database Record © 2019 APA, all rights reserved).


Literature regarding the field of early childhood policy planning and implementation has focused mainly on activities at global, regional, and national levels. However, during the last decade, important roles have emerged in policy planning for community-municipal and provincial decision makers, specialists, parents, and children. To achieve strong policy ownership at provincial and community levels, their representatives must participate actively in assessing the policy environment; child and family needs; human, organizational, and financial resources; and gaps and quality improvement in local services. Communities and provinces can help ensure early childhood services will address the needs of children in difficult situations and those with developmental delays, disabilities, and behavioral and mental health needs, leading ultimately to greater program equity. Studies have shown that when participatory policy-planning processes include community and provincial stakeholders alongside national decision makers, policy instruments have a greater likelihood of being implemented effectively. Furthermore, participatory processes often lead to the expansion and improvement of early childhood programs and the development of new initiatives to meet evolving needs. The establishment of multisectoral early childhood committees at the community level helps support the successful implementation of early childhood policies. Recommendations are offered regarding further research and activities for the improvement of community and provincial participation in early childhood policy planning. (PsycINFO Database Record © 2019 APA, all rights reserved).


The current study investigates the role of race and county characteristics in substantiation and out-of-home placement decisions in the United States. Using multilevel models, we analyzed data from counties in the United States available through the National Child Abuse and Neglect Data Systems and Adoption and Foster Care Analysis and Reporting System to investigate the interactions between children’s race and the context in which they live. Our sample consisted exclusively of children whose cases had been investigated; therefore, we were able to focus on the role played by race and county characteristics in substantiation and out-of-home placement decisions made by Child Protective Services, net of the heightened risk factors (or potential biases) that lead to disparate rates of reporting. Adjusting for state and county of investigation, Black, American Indian/Alaskan Native, and multiracial children were more likely than White (non-Hispanic) children to be substantiated or placed out of home, whereas Asian children were less likely to be substantiated or placed out of home. Notably, differences across groups are far smaller in magnitude when demographic and geographic differences are taken into account. Higher county-level poverty, percentages of Black residents, and juvenile arrest rates were associated with lower odds of substantiation and out-of-home placement among investigated children, whereas an elevated percentage of single-headed households was associated with higher odds of both outcomes. We also found that living in a rural county was associated with greater odds of substantiation but lower odds of out-of-home placement. Important differences by race were found for these associations. (PsycINFO Database Record © 2019 APA, all rights reserved).