Exploring Parent & Youth Concepts of Teen Mental Illness in High-Poverty Settings

描述（由申请人提供）：本探索性质的研究询问：高贫困城市环境中的青少年及其父母如何概念化、认识和应对青少年心理健康问题？心理健康问题不仅会给家庭带来情感上的损失，还会干扰青少年的正常发展，阻碍学业成功和建立健康的人际关系。然而，多达三分之二有精神健康问题的青少年，包括患有精神疾病的青少年，得不到精神卫生服务系统的充分服务。对于经济上处于不利地位的年轻人来说尤其如此，他们中的许多人居住在我们国家的内城。在纽约市为低收入家庭服务的学校开展的十多年研究的基础上，本研究将采用理论和经验相结合的定性方法，创建一个丰富的青少年和家长关于青少年心理健康问题和治疗的“主流”概念数据库。核心数据收集将包括对100对父母-青少年的半结构化开放式访谈。通过开放式调查获得的叙述将进一步了解家庭如何思考和理解社区中的青少年心理健康问题。检查父母和青少年的叙述也将有助于确定哪些地方存在障碍，包括对精神卫生服务的负面看法和经历，这些障碍阻碍了获得适当治疗的途径。此外，访谈将使用假想的小插曲作为共同的刺激，以引出关于青少年心理健康、精神症状和疾病以及治疗的规范、态度和信念。将进行最初的一组焦点小组，以获得社区对访谈协议的投入，并将进行最后一组焦点小组，以审查主要调查结果及其解释。具体目标是：1。引出青少年和家长对青少年心理健康问题的概念，问题的警告信号，以及对精神疾病及其治疗的信念和态度；2. 识别与青少年和家长用于解决青少年心理健康问题的自助实践和求助策略相关的规范性信念、态度和行为；3. 综合研究结果，以(a)完善青少年问题寻求帮助的概念模型，以指导未来的研究；(b)有助于制定了解emic的战略，以改善高度贫困环境中的青少年心理健康和心理健康教育、外展和服务。长期目标是为与文化相关的教育、外联和服务提供信息，以支持家庭并改善可能患有精神健康问题的青少年的功能和生活机会。研究结果有可能使人们更全面地了解为什么处于经济困难环境中的青少年得不到充分的服务，以及可以采取哪些措施来弥补持续存在的差距。

DESCRIPTION (provided by applicant): This exploratory qualitative study asks: How do youth and their parents in high-poverty urban environments conceptualize, recognize and respond to teen mental health problems? Mental health problems not only take an emotional toll on families, but also can interfere with normal adolescent development, impeding academic success and the establishment of healthy relationships. Yet as many as two-thirds of adolescents experiencing mental health problems, including those with psychiatric disorders, are underserved by the mental health service system. This is especially the case for economically disadvantaged youth, many of whom reside in our nation's inner cities. Building on over a decade of research conducted with New York City schools serving low-income families, this study will use a theoretically and empirically informed qualitative approach to create a rich database of youths' and parents' "emic" concepts of teen mental health problems and treatment. Core data collection will consist of semi-structured open-ended interviews with 100 parent-youth dyads. Narratives obtained through open-ended inquiry will further understanding of how families think about and make sense of adolescent mental health problems in their community. Examining parents' and youths' narratives will also help identify where there are barriers, including negative perceptions of and experiences with mental health services, that derail pathways to appropriate treatment. In addition, interviews will use hypothetical vignettes as a common stimulus to elicit norms, attitudes, and beliefs about teen mental health, psychiatric symptoms and illness, and treatment. An initial set of focus groups will conducted to obtain community input on the interview protocol and a final set of focus groups will be conducted to review key findings and their interpretation. The specific aims are to: 1. Elicit youth and parent emic conceptualizations of adolescent mental health problems, warning signs of problems, and beliefs and attitudes about mental illness and its treatment; 2. Identify normative beliefs, attitudes, and behaviors related to self-help practices and help-seeking strategies used by adolescents and parents to address teen mental health problems; 3. Synthesize findings to (a) refine a conceptual model of help seeking for teen problems that can guide future research and (b) contribute to the development of emic-informed strategies for improving teen mental health and mental health education, outreach, and services in high-poverty settings. The long-term goal is to inform culturally-relevant education, outreach and services that support families and improve the functioning and life chances of adolescents who may be experiencing mental health problems. Findings have the potential to provide a fuller understanding of why adolescents in challenging economically disadvantaged settings are underserved and what steps can be taken to remedy ongoing disparities.