Black Adolescent Experiences with COVID-19 and Mental Health Services Utilization.

BACKGROUND: COVID-19 is disproportionately impacting communities of color. Black adolescents are among the most vulnerable to COVID-19, have high mental health service needs, and have low mental health services utilization. During this time of great physical threat due to COVID-19, it is equally important to understand and support the mental health of Black adolescents. METHOD: This study collected open-ended survey item responses from adolescents (12-17 years old) that identified as Black, living in a city in the Southeastern United States (n = 33). Grounded theory was used to analyze the data, revealing details of the lived experience of these Black adolescents during the COVID-19 pandemic. RESULTS: Black adolescents reported that COVID-19 has been both positive and negative for them. Family is of utmost importance to them, as are their peers, whom they do not get to interact with due to changes in the operation of schools. Despite experiencing stress, adaptive responses to COVID-19 are reported. Black adolescents continue to cite issues with mental health services and providers. Financial issues were a common theme for these youth, blocking access to services and causing issues in the home environment. CONCLUSIONS: Mental health service providers must address the service access and quality issues repeatedly reported by Black adolescents. Direct action must be taken to facilitate an increase in Black adolescents mental health services utilization and satisfaction. Changes are needed at the individual and macro levels to alter the experience of one of our most vulnerable groups.

Correlates of Incarceration of Fathers, Socioeconomic Influences, and Mental Illness.

The United States leads globally in incarceration. Incarceration can disrupt families in both immediate and long-term ways, including finances and mental illness. We examined the relationship between father incarceration during adolescence and the development of mental illness in adulthood as well as the relationship of household assets and debts in relation to the mental illness outcomes. Wave IV data of the National Longitudinal Study of Adolescent to Adult Health were used with a final analytic sample of 2129 participants. Data were analyzed using MANOVA in Stata 13.1. The findings indicated that biological father incarceration correlates with more adolescent mental illness. Enhanced model residuals were also significant for father incarceration, household assets, and household debts. Incarceration of biological fathers correlates with poorer mental health outcomes. Household assets and debts correlate with changes in adolescent outcomes as well, giving us more target areas for intervention development and testing. Clinically, assessing for adolescent experiences with father incarceration may be useful in supporting improved mental health over the life course. Policy work should give more attention to promotion of health and well-being of adolescents via reduction of the negative experience of fathers serving and/or having served time in prison. More discussion on family-level assets and debts is warranted to promote health and well-being for adolescents and adults.

A Review of Treatments for Young Black Males Experiencing Depression.

The objective was to qualitatively examine the treatment effects of depression interventions on young, Black males (YBM) across treatment providers and settings via a review. Randomized controlled trials (RCTs) seeking to ameliorate depressive symptomology in Black males ages 12-29 were eligible for inclusion. After review of 627 abstracts and 212 full-text articles, 12 studies were selected. These RCTs were organized into five categories based on the intervention method. We isolated only one study that targeted YBM exclusively. Additionally, only two treatment effect sizes for YBM were available from the data. While remaining RCTs did involve Black youth, disaggregated data based on race and gender were not reported. Overall, the lack of research specific to YBM prevented any strong conclusions about the treatment effects on depression for this population. Small sample size along with poor representation of YBM were trends in the selected studies that also posed an issue. Therefore, our review produced qualitative findings but failed to isolate any true effect size for YBM being treated for depression. Until more conclusive evidence exists, alternative strategies may need to be employed in order to find appropriate interventions for depressed YBM seeking mental health treatment.

What Works for Adolescent Black Males at Risk of Suicide: A Review.

We reviewed the controlled studies that report outcome findings for Black adolescent males 24 years of age and younger at risk of suicide. Our review identified 48 articles published from 2000 to 2015, 33 that met our initial criteria for full-text articles review, resulting in 6 that met all inclusion criteria. We sought to understand what works for Black males experiencing suicide ideation or engaging in suicidal behaviors (e.g., attempts). We identified crossover effects for multisystemic therapy for reducing the risk for suicide ideation and attempts. Attachment-based family therapy was salient for use as a component of clinical practice for Black males being treated for suicide ideation. While remaining randomized control trials did involve Black youth, dis-aggregated data based on ethnicity and gender were not reported. Overall, the located studies are too few to provide unequivocal guidance for practice.

Black Males, Trauma, and Mental Health Service Use: A Systematic Review.

OBJECTIVE: To systematically review the evidence of and synthesize results from relevant studies that have examined barriers and facilitators to professional mental health service use for Black male trauma survivors ages 18 and older. METHODS: A thorough search of selected databases that included EBSCO, ProQuest, and Web of Science Core Collection and careful consideration of inclusion and exclusion criteria yielded a final six studies for detailed review. RESULTS: Black male trauma survivors were significantly less likely to be utilizing mental health services than other sex-ethnic groups. High levels of daily crises, a lack of knowledge of steps to obtain services, and service eligibility issues were significant individual barriers to mental health service use for Black males, whereas social support, occupational disability, and PTSD symptoms severity were significant facilitators for mental health service use. CONCLUSION: Exposure to trauma, whether through witnessing or direct victimization, is often a daily reality for many Black males. Findings from this review suggest that 56-74% of Black males exposed to traumatic events may have an unmet need for mental health services. Future research examining the relationship between trauma and mental health service use for Black men and factors that moderate and/or mediate this relationship is warranted.

"Down in the Sewers": Perceptions of Depression and Depression Care Among African American Men.

Depression is one of the most common, costly, and debilitating psychiatric disorders in the United States. One of the most persistent mental health disparities is the underutilization of treatment services among African American men with depression. Little is known about appropriateness or acceptability of depression care among African American men. The purpose of this study was to examine perceptions of depression and determine barriers to depression treatment among African American men. A series of four focus groups were conducted with 26 African American men. The average age of the sample was 41 years and most participants reported that they had completed high school. Nearly half of the participants reported that they are currently unemployed and most had never been married. The most common descriptions of depression in this study were defining depression as feeling down, stressed, and isolated. A small group of participants expressed disbelief of depression. The majority of participants recognized the need to identify depression and were supportive of depression treatment. Nonetheless, most men in this sample had never sought treatment for depression and discussed a number of barriers to depression care including norms of masculinity, mistrust of the health care system, and affordability of treatment. Men also voiced their desire to discuss stress in nonjudgmental support groups. Research findings highlight the need to increase the awareness of symptoms some African American men display and the need to provide appropriate depression treatment options to African American men.

Treating Mental Illness Among Diabetic Black Male Adolescents: A Review.

OBJECTIVE: To examine randomized controlled trials (RCTs) for treatment evidence for Black male adolescents suffering from comorbid mental illness and diabetes mellitus. METHOD: A review of the studies published in English-language journals was conducted. RESULTS: We found no RCT focused on Black males with diabetes mellitus Type 2 (DMT2). However, we found RCT inclusive of Black male adolescents with diabetes mellitus Type 1 (DMT1). Multisystemic therapy appears to be the best supported overall treatment for DMT1 management and psychosocial functioning followed by an enhanced form of behavioral family systems therapy for diabetics. Metformin was the only treatment in this review noted for use within DMT2. Metformin and a nursing-based telephone case management intervention realized utility as secondary services. CONCLUSIONS: There are gaps present for what effectively treats comorbid mental illness and DMT2 in Black male adolescents. For comorbid mental illness and DMT1, there are gaps in additional efficacious treatments, effectiveness across conditions, and effect duration beyond 24 months.