Qualitative Evaluation of a High School Mental Health Program

Expanded school mental health (ESMH) programs offer a comprehensive range of mental health services (evaluation, therapy, case management) to youth in special and regular education. Research is needed to document that these programs are in fact providing quality care to youth and leading to enhanced outcomes. In this exploratory study, focus groups were conducted with high school students receiving mental health services and students not receiving services, therapists, parents, administrators, and health care staff to gauge the quality and effectiveness of an ESMH program. It was difficult to schedule parents for group sessions; thus, interviews also were conducted with this group. Focus groups and interviews were effective methods for understanding strengths, areas for improvement, and outcomes for our ESMH program. Participants reported that therapy served as a protective factor, enhancing physical and mental health and reducing risk for teenagers. Ideas for improving clinical practice were developed from study results.     

Detection of sequence variation in the HVII region of the human mitochondrial genome in 689 individuals using immobilized sequence-specific oligonucleotide probes

We have developed a rapid, immobilized probe-based assay for the detection of sequence variation in the hypervariable segment II (HVII) of the mitochondrial DNA (mtDNA) control region. Using a panel of 17 sequence-specific oligonucleotide (SSO) probes immobilized on nylon membrane strips, we typed 689 individuals from four population groups. The genetic diversity value for each population was calculated from the frequency data, and the frequencies of distinct "mitotypes" in each group were determined. We performed DNA sequence analysis of 129 samples to characterize the sequences associated with "blanks" (absence of probe signals) and weak probe signals. Out of 689 samples, we observed five heteroplasmic samples (excluding the variable C-stretch beginning at position 303) using the immobilized SSO probe panel. The SSO probe strips were used for the analysis of shed hairs and bloodstains from several criminal cases in Sweden, one of which is described here. We conclude that this mtDNA typing system is useful for human identification and significantly decreases casework turnaround time.     

Life Constraints and Psychological Well-Being of Domestic Violence Shelter Graduates

Psychosocial adjustment and life constraints of 81 domestic violence shelter graduates were examined via field interviews in the community, assessing womens current life status, satisfaction with core life domains, and violence experience, pre- and post-shelter. Psychometric scales for depression and trauma symptoms were also administered. Participants had received extensive services in either an emergency or a transitional living shelter. Although fairly satisfied across life domains, many had serious post-shelter financial hardships. Most importantly, they reported remarkably little post-shelter violence exposure, either within or outside of romantic relationships. Despite now living independently, 43% and 75% reported clinical levels of depression and trauma symptoms, respectively. In hierarchical stepwise regressions, depression was related to womens childhood sexual abuse, dissatisfaction with housing and their own parenting, and experience of financial difficulties conjoined with public assistance. Trauma symptoms were associated with childhood sexual abuse and post-shelter financial difficulties. The impaired psychosocial functioning and life difficulties of these predominantly successful domestic violence survivors highlights the need for specialized shelter intervention and continuity of care in the community.     

The biology of trauma: implications for treatment

During the past 20 years, the development of brain imaging techniques and new biochemical approaches has led to increased understanding of the biological effects of psychological trauma. New hypotheses have been generated about brain development and the roots of antisocial behavior. We now understand that psychological trauma disrupts homeostasis and can cause both short and long-term effects on many organs and systems of the body. Our expanding knowledge of the effects of trauma on the body has inspired new approaches to treating trauma survivors. Biologically informed therapy addresses the physiological effects of trauma, as well as cognitive distortions and maladaptive behaviors. The authors suggest that the most effective therapeutic innovation during the past 20 years for treating trauma survivors has been Eye Movement Desensitization and Reprocessing (EMDR), a therapeutic approach that focuses on resolving trauma using a combination of top-down (cognitive) and bottom-up (affect/body) processing.     

Contextualizing community violence and its effects: an ecological model of parent-child interdependent coping

This article presents an integrated conceptual framework that contextualizes exposure to community violence and the interpersonal and interdependent processes of parent and child response to community violence. This model posits that parental distress, including post-traumatic stress disorder (PTSD) and depression, is a significant mediator of child distress symptomatology and behavior problems. The model advances understanding of the impact of community violence in the lives of parents and children through various mechanisms, including social capital. This article underscores the need for a fundamental shift in the study of community violence, in the delivery of mental health services, and in prevention efforts from focusing on the individual child to concentrating on the parent, family, and community-level factors and processes. This article highlights important areas to address in future research, including investigation and specification of the mechanisms and processes by which neighborhoods affect and influence human development outcomes.     

Design of an algorithm to identify persons with mental illness in a police administrative database

North American police maintain a database to track events and information related to their involvement with the public that contain a series of electronic caution/dependency flags attached to an individual's name for internal communication. To identify persons with mental illness in a police administrative database, an algorithm was developed that was composed of (a) caution/dependency flags, (b) addresses, and (c) key search words indicative of mental illness. Based on the level of confidence of the algorithm, persons with mental illness (PMI) were then assigned to one of three categories: Definite, Probable and Possible PMI. Results for 2000 include the sociodemographic characteristics of PMI and non-PMI in the database. The mean number of contacts, types of interactions, re-involvement with a year, charges and dispositions are described. The algorithm provides a cheap, quick method to identify PMI for North American police. It enables police to monitor the effectiveness of pre-arrest diversion programs and allows researchers to analyze questions of criminalization and mental illness.     

Empire, Region, World: the International Context of Australian Foreign Policy since 1939

What have been the most important factors in international relations for Australian foreign‐policymakers over the last sixty years? Five broad themes stand out: the end of empire; Cold War dependency; the changing nature of security; economic development; and race and national identity. Cumulatively, and often in intertwined ways, these themes have amounted to little short of a revolution in Australia's place in the world since the Second World War. The challenges facing Australians have, as a result, been considerable. The international context in which Liberals have made foreign policy has been reshaping Australia as it has been reshaping the external environment.     

Competency Restoration: An Examination of the Differences Between Defendants Predicted Restorable and Not Restorable to Competency

According to the U.S. Supreme Court's decision in Jackson v. Indiana (1972), examiners must determine if a defendant has substantial probability of regaining competency through treatment in the foreseeable future. Previous research has indicated that, given the low base rate of defendants unable to be restored to competency, examiners are relatively poor at predicting which defendants will regain competency. Determining the characteristics of not restorable incompetent defendants and restorable incompetent defendants is a necessary first step toward improving examiners' ability to predict a defendant's likelihood of regaining competency. This study examined the competency evaluation reports of 468 defendants evaluated for competency to stand trial. Incompetent defendants significantly differed from competent defendants with regard to age, employment status, ethnicity, criminal charges, and psychiatric diagnosis. Few significant differences existed between defendants predicted restorable and those predicted not restorable by mental health examiners—the differences that did exist were related mainly to nonpsychiatric variables.     

Youth homicide: a review of the literature and a blueprint for action

This article first synthesizes the literature on clinical and empirical findings related to youth homicide. Thereafter, it reviews the literature with respect to the treatment of juvenile homicide offenders. Although a large body of literature exists, many questions regarding etiology, associated risk factors, intervention strategies, and long-term outcomes remain unanswered. The article concludes with recommendations to guide future research efforts with the aim of increasing understanding of etiological factors associated with juvenile homicide and designing effective intervention strategies. Greater advances in knowledge will follow with the implementation of enhanced methodological designs that examine juvenile homicide across four distinct time frames: the years preceding the homicide, the time period immediately following the homicide, the incarcerative or treatment period, and the post-release period.