Connie Lee, Gina Marandola, Ashok Malla and Srividya Iyer
The purpose of this paper is to present a series of cases of international students being treated in a specialized early intervention service for first-episode psychosis (FEP)…
Abstract
Purpose
The purpose of this paper is to present a series of cases of international students being treated in a specialized early intervention service for first-episode psychosis (FEP), describing the particular challenges that arise in this process, and to provide recommendations addressing these challenges.
Design/methodology/approach
Two researchers independently reviewed the charts of seven international students and discussed them with their treating clinicians. Recurring themes were identified through an iterative process of discussion and consensus.
Findings
Four themes were identified which demonstrated specific challenges faced by international students being treated for FEP: difficulty maintaining student visa status, limited social and family support, financial and health insurance issues, and service disengagement.
Originality/value
The study suggests that international students with FEP may present with numerous and unique challenges, thereby requiring special attention in their treatment. Although these are preliminary findings based on a small case series, the findings can inform recommendations for mental health services in cities with a sizeable international student population and guide future research on this topic.
Details
Keywords
Matthew E. Archibald, Rachel N. Head, Jordan Yakoby and Pamela Behrman
This study examines chronic illness, disability and social inequality within an exposure-vulnerabilities theoretical framework.
Abstract
Purpose
This study examines chronic illness, disability and social inequality within an exposure-vulnerabilities theoretical framework.
Methodology/Approach
Using the National Survey of Drug Use and Health (NSDUH), a preeminent source of national behavioral health estimates of chronic medical illness, stress and disability, for selected sample years 2005–2014, we construct and analyze two foundational hypotheses underlying the exposure-vulnerabilities model: (1) greater exposure to stressors (i.e., chronic medical illness) among racial/ethnic minority populations yields higher levels of serious psychological distress, which in turn increases the likelihood of medical disability; (2) greater vulnerability among minority populations to stressors such as chronic medical illness exacerbates the impact of these conditions on mental health as well as the impact of mental health on medical disability.
Findings
Results of our analyses provided mixed support for the vulnerability (moderator) hypothesis, but not for the exposure (mediation) hypothesis. In the exposure models, while Blacks were more likely than Whites to have a long-term disability, the pathway to disability through chronic illness and serious psychological distress did not emerge. Rather, Whites were more likely than Blacks and Latinx to have a chronic illness and to have experienced severe psychological distress (both of which themselves were related to disability). In the vulnerability models, both Blacks and Latinx with chronic medical illness were more likely than Whites to experience serious psychological distress, although Whites with serious psychological distress were more likely than these groups to have a long-term disability.
Research Limitations
Several possibilities for understanding the failure to uncover an exposure dynamic in the model turn on the potential intersectional effects of age and gender, as well as several other covariates that seem to confound the linkages in the model (e.g., issues of stigma, social support, education).
Originality/Value
This study (1) extends the racial/ethnic disparities in exposure-vulnerability framework by including factors measuring chronic medical illness and disability which: (2) explicitly test exposure and vulnerability hypotheses in minority populations; (3) develop and test the causal linkages in the hypothesized processes, based on innovations in general structural equation models, and lastly; (4) use national population estimates of these conditions which are rarely, if ever, investigated in this kind of causal framework.