I can still hear my baby crying: The ambiguous loss of American Indian/Alaska Native birthmothers.

This study captures the experiences of American Indian/Alaska Native birthmothers who lost a child to adoption and the impact of said loss on their health and wellbeing. Few studies examine the loss experiences of American Indian/Alaska Native birthmothers despite their increased probability to lose a child to foster care and adoption. American Indian/Alaska Native birthmothers are distinct from birthmothers of other races in their experiences of intergenerational and historical child loss, having disproportionately lost their children to systematic practices of child removal via boarding schools, the adoption era, and child welfare. Interview data from 8 American Indian/Alaska Native birthmothers were analyzed using inductive thematic analysis. Five themes emerged including: (1) the social context of losing a child to adoption for American Indian/Alaska Native birthmothers, (2) the ambiguous loss of a child to adoption, (3) grief reactions to the loss, (4) the impact of the loss on birthmother health and wellbeing, and (5) creating resiliency. Findings suggest that American Indian/Alaska Native birthmothers experience ambiguous loss, as well as elevated mental health problems and substance abuse following the loss of a child to adoption.

A scoping review of mental health prevention and intervention initiatives for infants and preschoolers at risk for socio-emotional difficulties.

BACKGROUND: Infant mental health has emerged as a unique area of practice and research distinguished from child and youth sub-specialties by its advocacy for a relational practice framework with an emphasis on parents/caregivers being integral to assessment, treatment, and prevention initiatives. A diverse array of initiatives offered across a broad spectrum of delivery methods is available to clinicians. However, to date, a large-scale mapping of the research evidence regarding these interventions has yet to be completed to help inform clinician's decisions regarding the best approaches for their clients. To address this knowledge gap, this study aimed to report on the landscape of research pertaining to mental health interventions for infants and preschoolers (0-5 years), and their families at risk for socio-emotional difficulties and negative developmental outcomes. METHOD: A scoping review methodology was used to conduct a large-scale mapping of the intervention research pertaining to infants and preschoolers (0-5) at risk for socio-emotional difficulties. We searched MEDLINE, PsycINFO, EMBASE, Web of Science, The Cochrane Library, CINAHL, LILACS, ProQuest Nursing & Allied Health Source, World Cat, and ClinicalTrials.gov , from inception to December 31, 2012. We extracted information regarding publication date, geographical location, study design, level of risk, population, key intervention mechanism, and outcome measures. RESULTS: We identified 533 potential studies from 1233 title and abstracts after the first round of screening. Full text article review in the second round of screening resulted in a total of 162 included articles for the final analysis. Results indicated that over 50% of interventions evaluated were randomized controlled trials conducted in Westernized countries. Most studies could be subdivided by level of risk within a preventative public health framework including universal, selected, indicated, and direct treatment for children formally diagnosed with a mental disorder. Risk factors experienced by children and their families were heterogeneously defined and numerous outcome measures across included studies. The results of this study are limited to the last search date of 2012. CONCLUSIONS: Key intervention mechanisms spanned a range of approaches including parenting groups, dyadic, in-home, cognitive-behavioral therapy, and day care-based interventions. The findings are discussed in terms of implications for broad trends and gaps in research and policy for this population.