Developing and Initially Validating the Youth Mental Health Literacy Scale for Ages 11-14.

Despite rising rates of youth mental health disorders and suicides, most youth lack access to accurate, non-stigmatized mental health information. Instead, many describe people with mental illness as violent and incompetent. Mental health literacy aligns with resilience theory. It assumes that youth that have accurate mental health information will have less stigmatized views of mental illness and will be more likely to seek help earlier should mental health symptoms arise. Accurate, non-stigmatized mental health information is especially needed for Children of a Parent or other Family Member that has a mental illness (COPFMI) since they are more likely to acquire a mental illness than children who do not have a family member with a mental illness. COPFMI youth are in need of the same mental health information as general population youth but they can also benefit from knowing how to deal with a family member's mental health disorder. Based on many foundation studies and key stakeholder input from parents, educators, mental health providers, child welfare providers, and especially youth, an emerging Youth Mental Health Literacy (YMHL) scale was developed and validated for measuring the mental health literacy levels of youth ages 11-14. The scale provides a full scale score of youth mental health literacy. It has subscales of knowledge of mental illness and recovery; stigma, help seeking for self/others; coping with stress; and dealing with family mental health challenges. The validation study indicated support for a unidimensional structure for each of the refined subscales. The subscales showed suitable reliability as evaluated by several measures of internal consistency. While the scale needs further study with larger samples of youth, it is hoped that the scale can yield mental health literacy outcome data that can help mental health literacy programs to build evidence-based programs that may, in turn, help prevent, delay, or ameliorate mental health disorders among youth.

Mental health literacy websites for children of parents with a mental illness.

OBJECTIVE: This review of online mental health resources was conducted to evaluate and document the availability of mental health resources pertinent to the needs of children of parents with a mental illness (COPMI). This review identified available websites and analyzed the appropriateness of content and readability. METHODS: We conducted an extensive 6-month review of websites with available mental health literacy content that may be found by COPMI searching for information. Web content was evaluated and described with qualitative thematic analysis techniques. Web content was also evaluated for reading levels using the Flesch-Kincaid readability analysis tool. RESULTS: The researchers described 7 descriptive themes, 10 content areas, and described what information was available across websites and where gaps existed. They also concluded the average reading level of the websites was 9.7, which was substantially higher than current web development recommendations. CONCLUSIONS: Websites can be a valuable tool for COPMI without access to direct services. To improve current web resources, developers should strive to offer content specific to the identified needs of COPMI. Additionally, web content should be developed at a level that is accessible to teens and parents.

Mental Health Literacy of Youth That Have a Family Member With a Mental Illness: Outcomes From a New Program and Scale.

A program evaluation examined mental health literacy levels and coping outcomes for youth (ages 10-16), before and at the end of their participation in a manualized, school-based mental health literacy program called Youth Education and Support (YES). Most of the youth reportedly had a parent or other family member with a mental health disorder such as depression, anxiety, and/or substance abuse. The mental health literacy levels of program participants from pre to post were evaluated with the developing Knowledge of Mental Illness and Recovery (K-MIR) scale. This scale was validated using item-response theory, demonstrating good psychometric properties. Youth answered two coping questions about their use of positive coping during the program and coping skills compared from pre to post intervention. Findings revealed that youth levels of mental health literacy increased significantly from pre to post program participation. Over 90% of the youth reported an improved use of positive coping strategies from pre to post intervention. The program appeared to deliver enhanced levels of literacy and coping for this sample of youth. The scale appeared to be appropriate to measure youth mental health literacy. Recommendations for practice, policy, and research are offered.

Mental Health Literacy Content for Children of Parents with a Mental Illness: Thematic Analysis of a Literature Review.

Millions of children have a parent with a mental illness (COPMI). These children are at higher risk of acquiring behavioural, developmental and emotional difficulties. Most children, including COPMI, have low levels of mental health literacy (MHL), meaning they do not have accurate, non-stigmatized information. There is limited knowledge about what kind of MHL content should be delivered to children. The aim of this exploratory study is to identify the knowledge content needed for general population children and COPMI to increase their MHL. A second aim is to explore content for emerging children's MHL scales. Researchers created and analyzed a literature review database. Thematic analysis yielded five main mental health knowledge themes for children: (1) attaining an overview of mental illness and recovery; (2) reducing mental health stigma; (3) building developmental resiliencies; (4) increasing help-seeking capacities; and (5) identifying risk factors for mental illness. COPMI appeared to need the same kind of MHL knowledge content, but with extra family-contextual content such as dealing with stigma experiences, managing stress, and communicating about parental mental illness. There is a need for MHL programs, validated scales, and research on what works for prevention and early intervention with COPMI children.

Mental health consumer parents' recommendations for designing psychoeducation interventions for their minor children.

OBJECTIVE: This research explores consumer parents' recommendations for developing psychoeducation programs for their minor children. METHOD: Data were drawn from a purposive sample of 3 focus groups of parent consumers of a community mental health agency. The research question was: "What do consumer parents recommend for developing psychoeducation programs for their minor children?" RESULTS: Parents recommended content foci of mental illness, recovery, heritability, stigma, and coping. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The next step is youth psychoeducation intervention development and evaluation. Parents, youth, and professionals should be included in the program planning.

Early outcomes of a pilot psychoeducation group intervention for children of a parent with a psychiatric illness.

OBJECTIVE: This study reports early findings of a still-developing Youth Education and Support (YES) pilot intervention of multifamily group psychoeducation for youth with a parent with a psychiatric illness. METHODS: Hypotheses predicted YES participants would increase pre-to-post: 1) Knowledge of psychiatric illness and recovery, and 2) Coping. A purposive sample of 17 youth, ages 10-16, participated in six lively, activity-focused, two-hour sessions within four groups facilitated by the PI and professionals employed within two public mental health agencies. Data revealed a significant increase in pre-to-post youth-reported knowledge (p= less than .001) and no significant change in overall coping. At post-intervention, youth reported significantly increased use of the coping skills of avoiding problems and relaxing, as indicated within these coping subscales. CONCLUSIONS: Study limitations merit interpretation caution. They are useful for future research, including development and testing of youth psychoeducation programs with longer interventions, more emphases on coping, parent-inclusion, and larger samples using randomized, experimental designs. Suggestions for research, practice, and policy are provided.

How are the experiences and needs of families of individuals with mental illness reflected in medical education guidelines?

OBJECTIVE: This descriptive study explored the extent that medical education curriculum guidelines contained content about the experiences and needs of family members of people with serious mental illness. METHODS: Key family-focused-literature themes about the experiences and needs of families of individuals with mental illness were drawn from a review of over 6,000 sources in the mental health practice literature that were identified within a systematic search and thematic development process. The study identified the extent and nature of family-focused key literature themes as reflected in medical education curriculum guidelines for psychiatry and primary care practice specialties of family practice, internal medicine, and pediatrics. An iterative process was used to retrieve and analyze text data drawn from the curriculum guidelines of national accrediting organizations for undergraduate, graduate, and continuing medical education. RESULTS: The key family-focused themes, as drawn from the mental health practice research literature, were: mental illness stigma; family caregiver burden; information exchange and referral; family stress, coping, and adaptation; family support; crisis response; and family psychoeducation. Two of these seven themes appeared in medical education curriculum guidelines: information exchange and caregiver burden. The most frequently appearing family-focused key literature theme was information exchange. Psychiatry and undergraduate medical education reflected the most family content. CONCLUSION: It appears that medical education curriculum guidelines have insufficient content about families of people with mental illness. The educational experiences of psychiatrists and primary care physicians may not adequately prepare them for working with family members of their patients. It is recommended that medical education curriculum guidelines incorporate information about family stigma; family/caregiver burden; information exchange; family stress, coping, and adaptation; family support; crisis response; and multiple family group psychoeducation.

Good days and bad days: the experiences of children of a parent with a psychiatric disability.

Twenty-two children, ages 5 to 17, described their experiences living within a family that included a parent with a psychiatric disability who was involved in community mental health agency services. The children's descriptions of parents' "good days" and "bad days" were captured in a secondary data analysis of a study that included face-to-face children's interviews. Children also discussed their perceptions of psychiatric disabilities and rehabilitation. Children reported more attention from parents on "good days." They expressed concerns about multiple family stressors and bias associated with psychiatric disability. They had little information about psychiatric disabilities and/or rehabilitation. Children recommended "Get help earlier."

Community mental health professionals' theoretical assumptions about families: responses to a practice simulation vignette.

Seventy-three community mental health professionals read a practice simulation vignette about a man with increased schizophrenia symptoms who appears at a community mental health agency accompanied by his parents. Professionals reported their levels of agreement that the parent/s may play a role in the man's schizophrenia symptoms and/or mental health treatment, i.e., serving as treatment resources; expecting consultation from professionals; serving as partners and allies; expressing negative emotions; expressing double bind communication; engaging in hostile behavior per the schizophrenogenic mother; having marriage conflicts; and also having a psychiatric disability. Professionals reported their level of agreement that the parents may be experiencing responses to their son's schizophrenia such as coping; grieving; adjusting to a biological illness; dealing with caregiving responsibilities/burdens; and remaining strong, resilient people. Findings revealed that this sample of mental health professionals most strongly agreed that families are coping, grieving, and positive treatment resources.