Carl Simela, Tolúwalàse Akanbi-Akinlolu, Malaika Okundi, Hannah Abdalla, Tom A. McAdams, Androulla Harris, Alex Augustine, Huong Le, Kadra Abdinasir, Ziada Ayorech, Yasmin I. Ahmadzadeh
Background
Experiences of racism are linked to negative physical and mental health outcomes among those exposed. According to quantitative research derived mainly from the United States, these negative outcomes can have cascading effects in families, when parents' experiences of racism indirectly impact offspring. New research is warranted for families in the United Kingdom, informed by a qualitative approach to canvassing community knowledge and perspectives, exploring how existing findings relate to lived experiences.
Method
We conducted four online focus groups with 14 parents of school-aged children and 14 adolescents who had experienced racism in the United Kingdom. Participants were asked what children know of parents' experiences of racism, and how these experiences can impact parent–child interactions, mental health and well-being. Focus group recordings were transcribed, data coded and analysed through iterative categorisation.
Results
Analyses drew four themes from participants' insights. Together, themes illuminated the pervasive nature of racism experienced by some families in the United Kingdom. Parent and child experiences of racism were connected and co-occurring, with indirect effects impacting mental health and well-being in both generations. These experiences were linked to both positive and negative changes in parenting behaviour and parent–child relationships, which could be moderated by intersecting identities such as the parent's generational status for immigration to the United Kingdom. Social cohesion, safe spaces and education programmes were highlighted for future intervention.
Conclusions
Findings corroborate existing literature, while further emphasising a broader bidirectional picture, requiring a family system and intersectional approach to understanding the mental health impact of racism in families. Avenues for future research are discussed to support development of equitable intervention and support strategies to prevent racism and support those affected.
{"title":"Intergenerational consequences of racism in the United Kingdom: a qualitative investigation into parents' exposure to racism and offspring mental health and well-being","authors":"Carl Simela, Tolúwalàse Akanbi-Akinlolu, Malaika Okundi, Hannah Abdalla, Tom A. McAdams, Androulla Harris, Alex Augustine, Huong Le, Kadra Abdinasir, Ziada Ayorech, Yasmin I. Ahmadzadeh","doi":"10.1111/camh.12695","DOIUrl":"10.1111/camh.12695","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Experiences of racism are linked to negative physical and mental health outcomes among those exposed. According to quantitative research derived mainly from the United States, these negative outcomes can have cascading effects in families, when parents' experiences of racism indirectly impact offspring. New research is warranted for families in the United Kingdom, informed by a qualitative approach to canvassing community knowledge and perspectives, exploring how existing findings relate to lived experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted four online focus groups with 14 parents of school-aged children and 14 adolescents who had experienced racism in the United Kingdom. Participants were asked what children know of parents' experiences of racism, and how these experiences can impact parent–child interactions, mental health and well-being. Focus group recordings were transcribed, data coded and analysed through iterative categorisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analyses drew four themes from participants' insights. Together, themes illuminated the pervasive nature of racism experienced by some families in the United Kingdom. Parent and child experiences of racism were connected and co-occurring, with indirect effects impacting mental health and well-being in both generations. These experiences were linked to both positive and negative changes in parenting behaviour and parent–child relationships, which could be moderated by intersecting identities such as the parent's generational status for immigration to the United Kingdom. Social cohesion, safe spaces and education programmes were highlighted for future intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings corroborate existing literature, while further emphasising a broader bidirectional picture, requiring a family system and intersectional approach to understanding the mental health impact of racism in families. Avenues for future research are discussed to support development of equitable intervention and support strategies to prevent racism and support those affected.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"181-191"},"PeriodicalIF":6.1,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Involuntary treatment has been reported to be traumatic, stigmatising and frightening, as well as sometimes lifesaving. However, there has been little research into the experiences of people who have been hospitalised involuntarily prior to the age of 18. A greater understanding of this may help us to make changes which could improve the experience of involuntary psychiatric treatment for children and young people. Lizzie Mitchell is an expert by experience who was admitted to a psychiatric hospital in England under the Mental Health Act (MHA) when she was 16 years old. Here, in discussion with Susan Walker, a child and adolescent psychiatrist, Lizzie reflects on her own experiences alongside wider reflections around the involuntary hospitalisation of young people, including the potential short and long-term impact on mental health, education, friendships, family and identity.
{"title":"Debate: The experience of involuntary psychiatric hospitalisation for children and young people","authors":"Lizzie Mitchell, Susan Walker","doi":"10.1111/camh.12696","DOIUrl":"10.1111/camh.12696","url":null,"abstract":"<p>Involuntary treatment has been reported to be traumatic, stigmatising and frightening, as well as sometimes lifesaving. However, there has been little research into the experiences of people who have been hospitalised involuntarily prior to the age of 18. A greater understanding of this may help us to make changes which could improve the experience of involuntary psychiatric treatment for children and young people. Lizzie Mitchell is an expert by experience who was admitted to a psychiatric hospital in England under the Mental Health Act (MHA) when she was 16 years old. Here, in discussion with Susan Walker, a child and adolescent psychiatrist, Lizzie reflects on her own experiences alongside wider reflections around the involuntary hospitalisation of young people, including the potential short and long-term impact on mental health, education, friendships, family and identity.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"211-213"},"PeriodicalIF":6.1,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tong Xie, Wanyue Jiang, Xiaoyan Liu, Jianping Wang
Background
Social, emotional, and behavioral difficulties (SEBDs) tend to develop during adolescence. Their presence and especially co-occurrence induce numerous disrupting consequences, including suicidality. A recently developed network analysis is suitable to investigate the symptom-level structure of comorbid psychopathology. Rather than pairwise comorbidity networks, the current study investigated a comprehensive network of SEBDs at the symptom level and explored the differential relationships between symptoms of SEBDs and suicidality.
Methods
Recruited from four public schools in China, a sample of adolescents (N = 6974, mean age = 15.84, 50.1% boys) were assessed with the Strengths and Difficulties Questionnaire (SDQ) and one suicidality-related item. The cross-sectional network structure of the SEBD symptoms was investigated. The differential associations between individual symptoms of SEBDs and suicidality were also explored with a relative importance analysis.
Results
The results showed that constantly fidgeting, worry a lot, unhappy, down-hearted, tearful, and easily scared emerged as the most central symptoms in the network of SEBDs. Worry a lot, constantly fidgeting, lose my temper, and being bullied served as bridge symptoms, connecting various domains of SEBDs. In addition, the centrality of symptoms was positively associated with the variance shared with suicidality, with worry a lot and unhappy, down-hearted, and tearful explaining a large portion of the variance of suicidality.
Conclusions
Taken together, the results were indicative of close connections among emotional, hyperactivity-inattention, peer, and conduct aspects of adolescent mental health difficulties, as well as the central role of emotional difficulties in the SEBDs network.
{"title":"Network structure of adolescent social, emotional, and behavioral difficulties and their differential relationships with suicidality","authors":"Tong Xie, Wanyue Jiang, Xiaoyan Liu, Jianping Wang","doi":"10.1111/camh.12693","DOIUrl":"10.1111/camh.12693","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Social, emotional, and behavioral difficulties (SEBDs) tend to develop during adolescence. Their presence and especially co-occurrence induce numerous disrupting consequences, including suicidality. A recently developed network analysis is suitable to investigate the symptom-level structure of comorbid psychopathology. Rather than pairwise comorbidity networks, the current study investigated a comprehensive network of SEBDs at the symptom level and explored the differential relationships between symptoms of SEBDs and suicidality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Recruited from four public schools in China, a sample of adolescents (<i>N</i> = 6974, mean age = 15.84, 50.1% boys) were assessed with the Strengths and Difficulties Questionnaire (SDQ) and one suicidality-related item. The cross-sectional network structure of the SEBD symptoms was investigated. The differential associations between individual symptoms of SEBDs and suicidality were also explored with a relative importance analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed that constantly fidgeting, worry a lot, unhappy, down-hearted, tearful, and easily scared emerged as the most central symptoms in the network of SEBDs. Worry a lot, constantly fidgeting, lose my temper, and being bullied served as bridge symptoms, connecting various domains of SEBDs. In addition, the centrality of symptoms was positively associated with the variance shared with suicidality, with worry a lot and unhappy, down-hearted, and tearful explaining a large portion of the variance of suicidality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Taken together, the results were indicative of close connections among emotional, hyperactivity-inattention, peer, and conduct aspects of adolescent mental health difficulties, as well as the central role of emotional difficulties in the SEBDs network.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 3","pages":"281-291"},"PeriodicalIF":6.8,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heidi M. Renner, Bosco Rowland, Delyse Hutchinson, John W. Toumbourou
Background
Completing high school enables access to educational and employment opportunities associated with better physical and mental health and improved quality of life. Identifying modifiable factors that promote optimal educational trajectories for youth experiencing disadvantage is an important research focus. Social inclusion has been theorised to play a role in promoting better educational outcomes for this priority population, however limited research has examined this relationship.
Method
This study used three waves of data from the state-representative Australian arm of the International Youth Development Study (IYDS) (youngest cohort, N = 733; 54% female, 95% Australian born) to examine the extent to which vulnerability in primary school (Grade 5; Mage = 10.97, SD = 0.38) and social inclusion in mid-adolescence (Year 10; Mage = 15.50, SD = 0.53), were associated with school completion in young adulthood (post-secondary; Mage = 19.02, SD = 0.43).
Results
Regression models identified an interaction between social inclusion and vulnerability (OR = 1.37, 95% CI [1.06, 1.77], p = .016), indicating that the association between vulnerability and school completion varied as a student's level of social inclusion increased. Higher social inclusion was beneficial for youth with lower levels of vulnerability but did not appear to influence school completion for the most vulnerable students.
Conclusions
For many young people, promoting social inclusion may support engagement in education and play a protective role. However, further research is needed to better understand the role of social inclusion for highly vulnerable youth, particularly the mechanisms via which social inclusion may have differential effects on school completion.
{"title":"The role of adolescent social inclusion in educational attainment among vulnerable youth","authors":"Heidi M. Renner, Bosco Rowland, Delyse Hutchinson, John W. Toumbourou","doi":"10.1111/camh.12709","DOIUrl":"10.1111/camh.12709","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Completing high school enables access to educational and employment opportunities associated with better physical and mental health and improved quality of life. Identifying modifiable factors that promote optimal educational trajectories for youth experiencing disadvantage is an important research focus. Social inclusion has been theorised to play a role in promoting better educational outcomes for this priority population, however limited research has examined this relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study used three waves of data from the state-representative Australian arm of the International Youth Development Study (IYDS) (youngest cohort, <i>N</i> = 733; 54% female, 95% Australian born) to examine the extent to which vulnerability in primary school (Grade 5; <i>M</i><sub>age</sub> = 10.97, <i>SD</i> = 0.38) and social inclusion in mid-adolescence (Year 10; <i>M</i><sub>age</sub> = 15.50, <i>SD</i> = 0.53), were associated with school completion in young adulthood (post-secondary; <i>M</i><sub>age</sub> = 19.02, <i>SD</i> = 0.43).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regression models identified an interaction between social inclusion and vulnerability (OR = 1.37, 95% CI [1.06, 1.77], <i>p</i> = .016), indicating that the association between vulnerability and school completion varied as a student's level of social inclusion increased. Higher social inclusion was beneficial for youth with lower levels of vulnerability but did not appear to influence school completion for the most vulnerable students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For many young people, promoting social inclusion may support engagement in education and play a protective role. However, further research is needed to better understand the role of social inclusion for highly vulnerable youth, particularly the mechanisms via which social inclusion may have differential effects on school completion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"161-169"},"PeriodicalIF":6.1,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12709","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Pearce, Paul Henery, S. Vittal Katikireddi, Ruth Dundas, Alastair H. Leyland, Dasha Nicholls, Russell M. Viner, Lynda Fenton, Steven Hope
Background
Children from disadvantaged backgrounds are at greater risk of attention-deficit hyperactivity disorder (ADHD)-related symptoms, being diagnosed with ADHD, and being prescribed ADHD medications. We aimed to examine how inequalities manifest across the ‘patient journey’, from perceptions of impacts of ADHD symptoms on daily life, to the propensity to seek and receive a diagnosis and treatment.
Methods
We investigated four ‘stages’: (1) symptoms, (2) caregiver perception of impact, (3) diagnosis and (4) medication, in two data sets: UK Millennium Cohort Study (MCS, analytic n ~ 9,000), with relevant (parent-reported) information on all four stages (until 14 years); and a population-wide ‘administrative cohort’, which includes symptoms (child health checks) and prescriptions (dispensing records), born in Scotland, 2010–2012 (analytic n ~ 100,000), until ~6 years. We described inequalities according to maternal occupational status, with percentages and relative indices of inequality (RII).
Results
The prevalence of ADHD symptoms and medication receipt was considerably higher in the least compared to the most advantaged children in the administrative cohort (RIIs of 5.9 [5.5–6.4] and 8.1 [4.2–15.6]) and the MCS (3.08 [2.68–3.55], 3.75 [2.21–6.36]). MCS analyses highlighted complexities between these two stages, however, those from least advantaged backgrounds, with ADHD symptoms, were the least likely to perceive impacts on daily life (15.7% vs. average 19.5%) and to progress from diagnosis to medication (44.1% vs. average 72.5%).
Conclusions
Despite large inequalities in ADHD symptoms and medication, parents from the least advantaged backgrounds were less likely to report impacts of ADHD symptoms on daily life, and their children were less likely to have received medication postdiagnosis, highlighting how patient journeys differed according to socioeconomic circumstances.
{"title":"Childhood attention-deficit hyperactivity disorder: socioeconomic inequalities in symptoms, impact, diagnosis and medication","authors":"Anna Pearce, Paul Henery, S. Vittal Katikireddi, Ruth Dundas, Alastair H. Leyland, Dasha Nicholls, Russell M. Viner, Lynda Fenton, Steven Hope","doi":"10.1111/camh.12707","DOIUrl":"10.1111/camh.12707","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Children from disadvantaged backgrounds are at greater risk of attention-deficit hyperactivity disorder (ADHD)-related symptoms, being diagnosed with ADHD, and being prescribed ADHD medications. We aimed to examine how inequalities manifest across the ‘patient journey’, from perceptions of impacts of ADHD symptoms on daily life, to the propensity to seek and receive a diagnosis and treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated four ‘stages’: (1) symptoms, (2) caregiver perception of impact, (3) diagnosis and (4) medication, in two data sets: UK Millennium Cohort Study (MCS, analytic <i>n</i> ~ 9,000), with relevant (parent-reported) information on all four stages (until 14 years); and a population-wide ‘administrative cohort’, which includes symptoms (child health checks) and prescriptions (dispensing records), born in Scotland, 2010–2012 (analytic <i>n</i> ~ 100,000), until ~6 years. We described inequalities according to maternal occupational status, with percentages and relative indices of inequality (RII).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of ADHD symptoms and medication receipt was considerably higher in the least compared to the most advantaged children in the administrative cohort (RIIs of 5.9 [5.5–6.4] and 8.1 [4.2–15.6]) and the MCS (3.08 [2.68–3.55], 3.75 [2.21–6.36]). MCS analyses highlighted complexities between these two stages, however, those from least advantaged backgrounds, with ADHD symptoms, were the least likely to perceive impacts on daily life (15.7% vs. average 19.5%) and to progress from diagnosis to medication (44.1% vs. average 72.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite large inequalities in ADHD symptoms and medication, parents from the least advantaged backgrounds were less likely to report impacts of ADHD symptoms on daily life, and their children were less likely to have received medication postdiagnosis, highlighting how patient journeys differed according to socioeconomic circumstances.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"126-135"},"PeriodicalIF":6.1,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12707","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>There is growing evidence for the value of music in helping those experiencing hardship to flourish and its role in the promotion of resilience (Gerber et al., <span>2014</span>; Viola et al., <span>2023</span>). Conversely, social inequality itself deprives lower-income communities of the multiple benefits associated with active music participation (Francisco Reyes, <span>2019</span>; Hughes, <span>2023</span>). In this paper, we will consider the significant adversity in the life of the composer Gustav Mahler and the protective role of his music. Mahler's music is inextricably bound up with his life, his beliefs and feelings. Mahler's attribution of meaning to his music acted as a sustaining and cathartic agent, enabling him to express, process, resolve and transform the suffering and loss faced from a very young age into sublime songs and symphonies.</p><p>With limited space, we can only touch the surface of the ideas and complex music under discussion. But, as we will show below, Mahler is an excellent example to illustrate the healing and transformative power of music: through the subjects of his compositions, and through the act of creation itself. A great composer, like Mahler, demonstrates this process more clearly, but it is relevant to everyone, regardless of their talent or expertise.</p><p>As an adult, Mahler had many losses and was afflicted by terrible grief: the death of his closest brother Ernst at the age of 13; his sister Leopoldine at the age of 26; and the suicide of his brother Otto at the age of 22. Mahler himself had serious health problems, sometimes life-threatening, throughout his life. However, perhaps most tragic of all, was the loss of his elder daughter Maria at the age of 4, in the summer of 1907.</p><p>This last event, along with the discovery of his own serious heart condition that same summer hung heavily over the remaining 4 years of the composer's life, and the last two symphonies, and what is arguably Mahler's masterpiece, <i>Das Lied von der Erde</i> (<i>The Song of the Earth</i>) are permeated by thoughts and images of death. He had a turbulent relationship with his wife Alma, which included her infidelity, and his last, unfinished Tenth Symphony, is as much about Mahler's reaction to and sublimation of the traumatic discovery of her affair with the architect Walter Gropius in 1910, as it is about death. This last work is a vital piece of evidence in understanding Mahler, the relationship of art to life, and the statements made at the start of this article.</p><p>The manuscript, in its unfinished state, preserves written comments, outbursts and messages which clearly relate the events of that summer to the music being composed, and the fact that the sketch was almost certainly composed during a narrow window of less than 8 weeks or so between July and September 1910, means we can relate the music to events in Mahler's life quite closely. The written exclamations, for example ‘Erbarmen!’ (‘Have mercy!’), ‘
{"title":"Narrative Matters: Gustav Mahler – music as a source of meaning and healing in the face of adversity and inequality","authors":"David Bentley, Glòria Durà-Vilà","doi":"10.1111/camh.12710","DOIUrl":"10.1111/camh.12710","url":null,"abstract":"<p>There is growing evidence for the value of music in helping those experiencing hardship to flourish and its role in the promotion of resilience (Gerber et al., <span>2014</span>; Viola et al., <span>2023</span>). Conversely, social inequality itself deprives lower-income communities of the multiple benefits associated with active music participation (Francisco Reyes, <span>2019</span>; Hughes, <span>2023</span>). In this paper, we will consider the significant adversity in the life of the composer Gustav Mahler and the protective role of his music. Mahler's music is inextricably bound up with his life, his beliefs and feelings. Mahler's attribution of meaning to his music acted as a sustaining and cathartic agent, enabling him to express, process, resolve and transform the suffering and loss faced from a very young age into sublime songs and symphonies.</p><p>With limited space, we can only touch the surface of the ideas and complex music under discussion. But, as we will show below, Mahler is an excellent example to illustrate the healing and transformative power of music: through the subjects of his compositions, and through the act of creation itself. A great composer, like Mahler, demonstrates this process more clearly, but it is relevant to everyone, regardless of their talent or expertise.</p><p>As an adult, Mahler had many losses and was afflicted by terrible grief: the death of his closest brother Ernst at the age of 13; his sister Leopoldine at the age of 26; and the suicide of his brother Otto at the age of 22. Mahler himself had serious health problems, sometimes life-threatening, throughout his life. However, perhaps most tragic of all, was the loss of his elder daughter Maria at the age of 4, in the summer of 1907.</p><p>This last event, along with the discovery of his own serious heart condition that same summer hung heavily over the remaining 4 years of the composer's life, and the last two symphonies, and what is arguably Mahler's masterpiece, <i>Das Lied von der Erde</i> (<i>The Song of the Earth</i>) are permeated by thoughts and images of death. He had a turbulent relationship with his wife Alma, which included her infidelity, and his last, unfinished Tenth Symphony, is as much about Mahler's reaction to and sublimation of the traumatic discovery of her affair with the architect Walter Gropius in 1910, as it is about death. This last work is a vital piece of evidence in understanding Mahler, the relationship of art to life, and the statements made at the start of this article.</p><p>The manuscript, in its unfinished state, preserves written comments, outbursts and messages which clearly relate the events of that summer to the music being composed, and the fact that the sketch was almost certainly composed during a narrow window of less than 8 weeks or so between July and September 1910, means we can relate the music to events in Mahler's life quite closely. The written exclamations, for example ‘Erbarmen!’ (‘Have mercy!’), ‘","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"214-216"},"PeriodicalIF":6.1,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12710","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Help-seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help-seeking from a life-course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help-seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms.
Methods
We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14–15 years. Based on previous literature and life-course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0–1 year, 4–5 years and 12–13 years). Outcomes at 14–15 years were help-seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit-binomial links were used.
Results
There were varying and common patterns of influencing factors across the three population groups and sources of help-seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help-seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help-seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support.
Conclusion
Both intrinsic and extrinsic barriers exist for adolescents' mental health help-seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help-seeking among adolescents.
{"title":"Factors that impact mental health help-seeking in Australian adolescents: a life-course and socioecological perspective","authors":"Shuaijun Guo, Sharon Goldfeld, Lisa Mundy","doi":"10.1111/camh.12694","DOIUrl":"10.1111/camh.12694","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Help-seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help-seeking from a life-course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help-seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14–15 years. Based on previous literature and life-course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0–1 year, 4–5 years and 12–13 years). Outcomes at 14–15 years were help-seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit-binomial links were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were varying and common patterns of influencing factors across the three population groups and sources of help-seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help-seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help-seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both intrinsic and extrinsic barriers exist for adolescents' mental health help-seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help-seeking among adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"170-180"},"PeriodicalIF":6.1,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This is a perspective from an Independent Advocate in England, United Kingdom on the importance of equality in the involuntary treatment of children and young people (CYP). The article highlights the need for safeguards when CYP require detention as part of their mental health care. The paper raises concern that CYP and their families who are less empowered to advocate for optimal care plans may be at risk of less satisfactory outcomes from mental health detention. It notes that CYP in the care system may be particularly vulnerable to such outcomes due to their lower levels empowerment. To mitigate this risk, services need to be proactive in reducing inequity arising from differential levels of empowerment among service users. This could be achieved by adopting strong participation and coproduction activities and ensuring access to Advocacy services for all CYP.
{"title":"Debate: Involuntary treatment and detention are a necessary part of mental health care for children and young people – a perspective from an Independent Advocate in England, United Kingdom","authors":"Sam Young","doi":"10.1111/camh.12711","DOIUrl":"10.1111/camh.12711","url":null,"abstract":"<p>This is a perspective from an Independent Advocate in England, United Kingdom on the importance of equality in the involuntary treatment of children and young people (CYP). The article highlights the need for safeguards when CYP require detention as part of their mental health care. The paper raises concern that CYP and their families who are less empowered to advocate for optimal care plans may be at risk of less satisfactory outcomes from mental health detention. It notes that CYP in the care system may be particularly vulnerable to such outcomes due to their lower levels empowerment. To mitigate this risk, services need to be proactive in reducing inequity arising from differential levels of empowerment among service users. This could be achieved by adopting strong participation and coproduction activities and ensuring access to Advocacy services for all CYP.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"209-210"},"PeriodicalIF":6.1,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mental health care is underpinned by human rights. However, certain mental health presentations can be associated with increased risk to self or others. Thus, appropriate and effective care plan to mitigate the risk may include a temporary restriction of the person's human rights. Legal frameworks are required to ensure appropriate safeguards for the affected person, and clarity about boundaries of necessity and proportionality for clinicians. The restriction needs to be proportionate, for the shortest possible period, done in a humane manner, and in a safe environment. Effective early mental interventions can reduce need for human right restrictions by preventing acute escalations in risk-related behaviours. While these principles apply across all regions, we discuss the particular circumstances in low and middle-income countries.
{"title":"Debate: Involuntary treatment and detention are a necessary part of mental health care – a perspective from low and middle-income countries","authors":"Cornelius Ani, Jibril Abdulmalik","doi":"10.1111/camh.12701","DOIUrl":"10.1111/camh.12701","url":null,"abstract":"<p>Mental health care is underpinned by human rights. However, certain mental health presentations can be associated with increased risk to self or others. Thus, appropriate and effective care plan to mitigate the risk may include a temporary restriction of the person's human rights. Legal frameworks are required to ensure appropriate safeguards for the affected person, and clarity about boundaries of necessity and proportionality for clinicians. The restriction needs to be proportionate, for the shortest possible period, done in a humane manner, and in a safe environment. Effective early mental interventions can reduce need for human right restrictions by preventing acute escalations in risk-related behaviours. While these principles apply across all regions, we discuss the particular circumstances in low and middle-income countries.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"203-205"},"PeriodicalIF":6.1,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
People of all ages are subject to involuntary psychiatric detention and treatment worldwide but there is current discussion about whether this complies with modern human rights law. The use of involuntary psychiatric hospitalisation among children and young people has largely eschewed research and policy interest to date. In this debate section, we hear from people with experience of child mental health services in the UK, USA and low- and middle-income countries about their views on the use of involuntary treatment in young people.
{"title":"Debate: Involuntary treatment and detention are a necessary part of mental health care for children and young people","authors":"Susan Walker","doi":"10.1111/camh.12703","DOIUrl":"10.1111/camh.12703","url":null,"abstract":"<p>People of all ages are subject to involuntary psychiatric detention and treatment worldwide but there is current discussion about whether this complies with modern human rights law. The use of involuntary psychiatric hospitalisation among children and young people has largely eschewed research and policy interest to date. In this debate section, we hear from people with experience of child mental health services in the UK, USA and low- and middle-income countries about their views on the use of involuntary treatment in young people.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"29 2","pages":"200-202"},"PeriodicalIF":6.1,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/camh.12703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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