When money and mental health problems pile up: The reciprocal relationship between income and psychological distress.

Background: Longitudinal studies suggest that socioeconomic status (SES) and mental health have a bidirectional relationship such that SES declines lead to a deterioration of mental health (social causation), while worsening mental health leads to SES declines (social drift). However, the dynamic relationship between income and psychological distress has not been sufficiently studied. Methods: We use cross-lagged panel models with unit fixed effects (FE-CLPM) and data from a five-wave representative panel (n = 3103) of working-age (18-64) New York City adults. Yearly measures include individual earnings, family income (income-to-needs), and psychological distress. We also examine effects by age, gender, education, and racial/ethnic identification. Results: We find significant bidirectional effects between earnings and distress. Increases in past-year individual earnings decrease past-month psychological distress (social causation effect [SCE], standardized ß= -0.07) and increases in psychological distress reduce next-year individual earnings (social drift effect [SDE], ß= -0.03). Family income and distress only have a unidirectional relationship from past-year family income to distress (SCE, ß= -.03). Strongest evidence of bidirectional effects between earnings and distress is for prime working-age individuals (SCE, ß= -0.1; SDE, ß= -0.03), those with less than bachelor's degrees (SCE, ß= -0.08; SDE, ß= -0.05), and Hispanics (SCE, ß= -0.06; SDE, ß= -0.08). We also find evidence of reciprocal effects between family income and distress for women (SCE, ß= -0.03; SDE, ß= -0.05), and Hispanics (SDE, ß= -0.04; SDE, ß= -0.08). Conclusions: Individual earnings, which are labor market indicators, may be stronger social determinants of mental health than family income. However, important differences in social causation and social drift effects exist across groups by age, education, gender, and racial/ethnic identities. Future research should examine the types of policies that may buffer the mental health impact of negative income shocks and the declines in income associated with worsening mental health, especially among the most vulnerable.

No Evidence The Child Tax Credit Expansion Had An Effect On The Well-Being And Mental Health Of Parents.

In 1997 the US established the Child Tax Credit (CTC), which offers payments to parents of dependent children to help defray child-rearing costs. In 2021 a temporary expansion to the CTC increased the size of payments, extended payments to families with low or no earnings, and distributed payments monthly instead of annually. Quasi-experimental evidence from the US and experimental evidence from low- and middle-income countries shows that moderate-to-large cash transfers improve subjective well-being and mental health. We estimated the CTC's expansion's effects on the subjective well-being and mental health of adult recipients, using data from the Understanding America Study, a nationally representative survey with more than 7,000 respondents and more than 2,700 unique respondents with children. We found no evidence that the CTC expansion had a significant short-term impact on measures of life satisfaction, anxiety, and depression symptomology among adult recipients. We speculate that the null effects may be due to the expansion's temporary nature.

Financial Hardship, Hope, and Life Satisfaction Among Un/Underemployed Individuals With Psychiatric Diagnoses: A Mediation Analysis.

Background: Individuals with psychiatric diagnoses who are unemployed or underemployed are likely to disproportionately experience financial hardship and, in turn, lower life satisfaction (LS). Understanding the mechanisms though which financial hardship affects LS is essential to inform effective economic empowerment interventions for this population. Aim: To examine if subjective financial hardship (SFH) mediates the relationship between objective financial hardship (OFH) and LS, and whether hope, and its agency and pathways components, further mediate the effect of SFH on LS among individuals with psychiatric diagnoses seeking employment. Methods: We conducted structured interviews with participants (N = 215) of two peer-run employment programs using indicators of OFH and SFH and standardized scales for hope (overall hope, hope agency, and hope pathways) and LS. Three structural equation models were employed to test measurement models for OFH and SFH, and mediational relationships. Covariates included gender, age, psychiatric diagnosis, race/ethnicity, education, income, employment status, SSI/SSDI receipt, and site. Results: Confirmatory factor analysis (CFA) for items measuring OFH and SFH supported two separate hypothesized factors. OFH had a strong and significant total effect on SFH [standardized beta (B) = 0.68] and LS (B = 0.49), and a weak-to-moderate effect on hope (B = -0.31). SFH alone mediated up to 94% of the effect of OFH on LS (indirect effect B = -0.46, p < 0.01). The effect of SFH on LS through hope was small (indirect effect B = -0.09, p < 0.05), primarily through hope agency (indirect effect B = -0.13, p < 0.01) and not hope pathways. Black and Hispanic ethno-racial identification seemed to buffer the effect of financial hardship on hope and LS. Individuals identifying as Black reported significantly higher overall hope (B = 0.41-0.47) and higher LS (B = 0.29-0.46), net of the effect of OFH and SFH. Conclusion: SFH is a strong mediator of the relationship between OFH and LS in our study of unemployed and underemployed individuals with psychiatric diagnoses. Hope, and particularly its agency component, further mediate a modest but significant proportion of the association between SFH and LS. Economic empowerment interventions for this population should address objective and subjective financial stressors, foster a sense of agency, and consider the diverse effects of financial hardship across ethno-racial groups.

Longitudinal trajectories of suicidal ideation and attempts in adolescents with psychiatric disorders in Chile: study protocol.

INTRODUCTION: Adolescent suicide is a worldwide public health problem, being the second and the third leading cause of death in the 15-29 and the 15-19 age groups, respectively. Among adolescents, it is estimated that for every suicide, there are 100-200 suicide attempts. Although 79% of suicides in the world occur in low/middle-income countries, most of scientific evidence comes from high-income and low-risk countries. In recent years, adolescent suicide rates have steadily increased in Chile. Deaths caused by self-harm increased by 220% in the population aged 10-19 years between 2000 and 2015. The Maule Region is one of the regions of Chile with the highest levels of suicide among those aged 15 and 19 years old. The objective of this study is to evaluate the trajectories of ideation and suicidal attempts in adolescents with psychiatric disorders treated within the public health system of the Maule Region, Chile, based on different clinical, psychological and neuropsychological factors. METHOD: A prospective naturalistic study of a clinical sample of adolescents under psychiatric treatment in the Maule Region, Chile. Adolescents will be evaluated using a thorough protocol that includes suicide-related clinical variables. The study seeks to establish patterns of change in the trajectories of ideation and suicide attempts among adolescents. ETHICS AND DISSEMINATION: Ethical approval was granted by the Scientific Ethics Committee of the Universidad Católica del Maule in Chile. This protocol was registered in ClinicalTrials.gov. The results of this study will be disseminated to health centres through executive reports and feedback sessions. In addition, the most relevant findings will be presented in scientific articles, conferences and seminars open to the community. TRIAL REGISTRATION NUMBER: NCT04635163.

Interpreters in Transcultural Psychiatry.

A myriad of cultural and language-related factors can affect the communication between clinicians, interpreters, and patients. Misunderstandings can lead to diagnostic errors; inadequate treatment; disengagement; and, thereby, poor clinical outcomes. A qualified interpreter can decrease the risk of miscommunication. The integration of an interpreter in the clinical encounter can shape the course of treatment and patient experience. Therefore, developing clinicians' awareness about and skills to address contextual challenges in using interpreters in transcultural psychiatry is of great importance. Clinicians who are trained to work effectively with interpreters can improve clinical outcomes for individuals with limited language proficiency. This is illustrated through a clinical case example.

An Online Training Module on the Cultural Formulation Interview: The Case of New York State.

Professional organizations and government guidelines recommend cultural competence training for providers, but the lack of a standardized cultural assessment has hindered research. Studies with the DSM-5 Cultural Formulation Interview (CFI) suggest that active learning during training improves perceptions of the CFI's usefulness as a cultural competence tool. This column reports demographic characteristics and evaluation scores among 423 providers who completed an online CFI training module developed through the New York State Office of Mental Health. Both the module, which uses the principle of active learning, and the CFI were associated with strong favorability ratings.

Peer-supported economic empowerment: A financial wellness intervention framework for people with psychiatric disabilities.

OBJECTIVE: People with psychiatric disabilities experience substantial economic exclusion, which hinders their ability to achieve recovery and wellness. The purpose of this article is to describe a framework for a peer-supported economic empowerment intervention grounded in empirical literature and designed to enhance financial wellness. METHOD: The authors followed a 3-step process, including (a) an environmental scan of scientific literature, (b) a critical review of relevant conceptual frameworks, and (c) the design of an intervention logic framework based on (a) and (b), the programmatic experience of the authors, and input from peer providers. RESULTS: We identified 6 peer provider functions to support individuals with psychiatric disabilities to overcome economic inclusion barriers, achieve financial wellness goals, and lessen the psychosocial impact of poverty and dependency. These include (a) engaging individuals in culturally meaningful conversations about life dreams and financial goals, (b) inspiring individuals to reframe self-defeating narratives by sharing personal stories, (c) facilitating a financial wellness action plan, (d) coaching to develop essential financial skills, (e) supporting navigation and utilization of financial and asset-building services, and (f) fostering mutual emotional and social support to achieve financial wellness goals. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Financial wellness requires capabilities that depend on gaining access to financial and asset-building supports, and not merely developing financial skills. The proposed framework outlines new roles and competencies for peer providers to help individuals build essential financial capabilities, and address social determinants of mental health and disability. Research is currently underway to pilot-test and refine peer-supported economic empowerment strategies. (PsycINFO Database Record