Adolescent Psychiatry - Volume 10, Issue 2, 2020

Background: Adolescence is defined by key transitional elements which are considered within a cross-cultural context. The importance of building mental health capacity for adolescents in low- and middle-income countries (LMICs) as well as high-income countries (HICs) is reviewed. Objectives: To review the developmental period of adolescence, global needs for mental health promotion, the needs of LMICs while emphasizing building adolescent mental health capacity, and the importance of efforts to promote mental health literacy. Methods: Mental health literacy (MHL) is presented as a strategy that can increase public awareness regarding mental health issues among adolescents. Increased awareness through an MHL framework is discussed as a way to build adolescent mental health capacity; with this work ideally occurring through global communities of practice (COP), dialogue, collaboration, and mutual support that aim to build innovation in systems of mental health promotion. Results: The authors review structural components in research, practice, and policy that seek to build global adolescent mental health capacity, nested within COPs involving HICs and LMICs working together to advance mental health promotion for children, adolescents, and young people. Conclusion: The article concludes with a discussion of how the three structural components (i.e., research, practice, and policy) can address gaps in the provision of global mental health services for adolescents to meet adolescent mental health needs in LMICs and HICs. A multi-sectoral approach emphasizing a global COP is presented as a way to scale up capacity and maximize outcomes.

Background: Historical and conceptual issues related to community psychiatry as an innovative approach to clinical assistance across the world, precede a more or less detailed examination of its presence, role and current accomplishments in Latin America, particularly related to child and adolescent subpopulations. Information about transition processes from the traditional hospital-centered model to the community-based approach, applicable mental health policies, levels of implementation and quality of the available reports in different countries, are duly evaluated. Objectives: Within an understanding of the broader Latin American context, the paper describes the situation in Perú, a country considered representative of the Low and Middle Income (LMIC) group in the subcontinent. Methods: The situation in Perú is presented with particular emphasis on a recently established community-based mental health centers program across its territory. Results: This description includes consideration of variables such as personal, family and identity empowerment, a focus on integrated care, and clinical outcomes and community relations. The development of community mental health centers across Perú is described. Conclusion: Adolescents represent the unique future of socio-culturally diverse Latin American countries, and must be the target population of well-conceived, cohesive community mental health policies and programs. The importance of political will to promote community health centers that provide adolescents access to services is critical.

Background: Autobiographical narrative (i.e., the process through writing or storytelling where one recalls life experiences and their impact on identity) has been found to effectively help adolescents cope with a range of medical and psychological issues. Objective: The current study addressed the overall preliminary research question: How does implementing an autobiographical narrative approach promote resilience, psychological well- being, and ethnic identity among adolescents? A secondary study aim was to explore how central the memories evoked by each workshop were to participant identity. The study’s third goal was to promote life skill development and self-awareness through participation in the autobiographical narrative intervention. Methods: The intervention incorporated a community-based participatory research (CBPR) framework in its partnership with a community centre in Northern England. The intervention consisted of an 8-week autobiographical program with youth participants from working and lower middle-class backgrounds. Socioeconomic status was operationalized by self-report on a demographic data sheet completed by participants. Results: Analyses indicated that participants viewed the events discussed in the 8-week program as being more central to their lives after their participation. Maladaptive coping appeared to decrease after participation in the intervention. Conclusion: Results suggest interventions that incorporate an autobiographical narrative approach within a CBPR framework may promote positive outcomes among adolescents with limited economic resources.

Background: Partnerships with families in education settings should emphasize their roles as active and engaged co-equal partners. However, common practices in schools are to involve families at school-based events and share information with them about their child’s education in a manner that does not promote two-way interactions. Objectives: The objectives of this paper are to describe relevant background on familyschool connections; approaches to promote academic performance and mental and behavioral health; and a framework to organize family partnerships that support all youth across a continuum of support intensity. Methods: A review based on the relevant family-school partnership and systems change literature was conducted. The review focused on prevention, tiered approaches that provide a continuum of support to students, and partnership-centered family engagement. Results: Research supports family-school partnerships in a tiered prevention framework. A theory of change was developed to depict the impact of family partnerships on proximal and distal outcomes. Conclusions: Implications suggest a need for partnership-centered approaches to school reform in state and federal policy to support investments in school and district initiatives. Initiatives should embed culturally sensitive practices so that all children can thrive. Future directions for investigating effective approaches for family partnerships are described.

Background: Bias-motivated victimization is common among school-age youth and is associated with negative academic and emotional consequences. Few studies have looked at the incidence of various forms of bias-motivated victimization for first- and second- generation immigrant-origin students even though these students represent an especially vulnerable population for experiencing bias. Objective: The present study investigated whether immigrant-origin students reported higher incidences of bias-motivated victimization relative to their nonimmigrant-origin peers. For students who experienced bias-motivated victimization, we examined the impact of these experiences on levels of distress and examined perceived social and community support between immigrant-origin and nonimmigrant-origin students. Methods: Participants completed the Youth Bias Victimization Questionnaire (YBVQ), a questionnaire designed to capture information about how often youth experience different types of bias-motivated victimization. Results: Approximately 60% of youth in the full sample reported experiencing one or more types of bias victimization in their lifetime and this rate was generally equivalent across immigrant- origin and nonimmigrant-origin participants. For those students who reported at least one lifetime event of bias victimization, immigrant-origin youth were more likely than nonimmigrant-origin youth to experience victimization related to peers’ perceptions of their country of origin or immigrant status. There were no significant differences in reported levels of distress or perceived social and community support between immigrant-origin and nonimmigrant-origin youth, regardless of whether they experienced bias-motivated victimization during their lifetime. Conclusion: Clinicians working in school settings should be aware of the high incidence of students who experience bias-motivated victimization and when indicated provide targeted intervention services to those negatively impacted by these experiences.

Background: International data indicates that up to 20% of the world’s children and adolescents have at least one mental health disorder. In the United States, nearly 50% of teenagers meet DSM criteria for a psychiatric disorder, and over 25% suffer from a “severe disorder.” Mental health and substance use disorders remain two of the greatest contributors to the global disease burden. Typically, mental health professionals are not trained for prevention; however, over the past 50 years, the field of psychiatry has identified many practices that prevent and limit the severity of psychiatric disorders. Objectives: In this overview, we first address the great degree of cognitive, emotional, and behavioral suffering that children and adolescents face world-wide. We then describe how a health promotion/disease prevention model differs from typical mental health care. Finally, we describe a series of interventions at the individual, community, and societal levels that can be utilized to prevent and lessen the burden of mental illness. Conclusion: Given our enhanced understanding of the prevalence of mental illness, the degree to which it interferes with healthy functioning, and the enormous global burden it causes, now is the time to engage psychiatrists and psychologists in health promotion and disease prevention. The field of psychiatry should begin to focus on designing and implementing mental health promotion and disease prevention programs, akin to those described here, to combat the onset, development, and progression of mental illness.