Psychotropic Medications and Children: Perceptions of Mental Health Professionals

This project explores mental health professionals\u27 perspectives on the prescription of psychotropic medications to children. It emphasizes the placement of biomedicine within its larger social, economic, and political context, and the influence these structures have on the way mental illness is conceptualized and treated in children. Eight semi-structured interviews were conducted in Denver, Colorado with psychiatrists, psychologists, social workers, and a pharmaceutical board member to capture multiple perspectives from different positionalities within the field. Participants discussed factors that they believe influence prescribing practices including: professional role changes, issues of access, limited evidence, cost, and institutional pressures to practice within a biomedical model of care. This thesis suggests that the supremacy of biomedicine has changed the conversation of mental health so drastically over the past forty years that psychological and social factors are no longer being legitimately considered as part of mental health care, to the detriment of children in need of services

The Time to Act Is Now: Addressing the Challenges of Being a Student, Staff, or Faculty Member at DU While Also Being a Parent to Young Children

The growing number of undergraduate and graduate students who are simultaneously raising children while attending school requires the attention of institutions that want to support their students through the completion of their intended program. Compared to traditional students, these students have greater time and financial restraints, lower graduation rates, and require accommodation, support, and resources to help them maintain their academic standing. This issue is not isolated to just students however. Staff and faculty at academic institutions are also balancing their family and work responsibilities. With an increase in the number of households where one or two adults work full time, more institutional employees are having to negotiate issues of childcare, parental leave, and the ways in which their family responsibilities are perceived by colleagues and employers. In 2017, it was found that many DU community members were struggling with issues of childcare, a child friendly environment at work, and institutional policies related to childcare at the University. These findings led to a study, conducted by the Applied Anthropology class of 2018, aimed at identifying solutions and recommendations for the aforementioned challenges. The study was exploratory and utilized mixed qualitative data collection and analysis methods. The class conducted interviews, surveys, and archival research and used thematic analysis techniques to identify overarching themes that informed the findings and suggestions of this project. Through this research three major needs were identified: clear communication of policies, accommodations for students, and on-site day care. Respondents from this and previous studies at DU identified that classroom policies, policies regarding parental leave, available childcare, and Fisher were being communicated either ineffectively or inaccurately. This has led to confusion, frustration, feelings of job insecurity, and unmet expectations regarding what resources and support DU actually offers parents. There is also a lack of policies in place for student parents, which makes creating schedules and fulfilling academic requirements more challenging for these nontraditional students. The most significant issue identified however was the lack of childcare at DU and the desire for an on-site daycare center. Respondents explained that Denver has a limited number of available, convenient, and affordable daycare options, that Fisher is not meeting their needs, and that they would like to see a facility designed specifically for DU students, staff, and faculty. In response to these challenges, this study suggests the assemblage and dissemination of accurate and clearly communicated childcare related policies, the creation of policies for student parents, and an on-site daycare facility for the DU community. Research and efforts to understand and alleviate these challenges have occurred at DU since the 1970s, and many of the identified needs and desired solutions have not changed over the past fifty years. However, because previous efforts have been powered by those in need of services, the momentum behind each effort has inevitably dissolved. A way to accomplish and sustain these suggestions and actively work towards making DU a more child and family friendly campus is by creating a permanent employee position at DU to handle these issues. This would help centralize information and policies, assist with their clear communication, and focus consistent and sustainable efforts towards helping DU students, staff, and faculty balance their work and family life

Perceptions About Work/Life Balance Among DU Community Members with Young Children

Background: In the past fifty years, families in the USA have changed in configuration, size and dynamics. The percentage of families that do not conform to the traditional family unit (married mother and father with children) has increased as there are more single-parent families, LGBTQ families and interracial families. The proportion of unmarried or divorced families has also increased, as it has the number of married and unmarried couples that opt to not have children and, additionally, more couples are opting for adoption and foster parenting (Pew Research Center 2010). Furthermore, the percentage of households where all the adults work has increased, which impacts the amount and quality of time available for family activities and household chores (Bianchi, Robinson and Milkie 2006). These and other trends have led to the identification of “work-family balance” as an important challenge of our times, one that families have been facing for decades and that institutions are only starting to pay attention to (Hochschild 2013). Although there are many aspects of family life that are challenging to balance with workplace demands, childcare has been specifically identified as one that needs attention (Desilver 2014). Methods: Study goal: To describe the perceptions that some DU community members with children have about work-family balance with attention to challenges, difficulties and institutional responses. Study design: Descriptive, cross-sectional, qualitative study. Population and sample: We recruited 63 University of Denver students (13), staff (14) and faculty (36) who are responsible of parenting at least one child under 10 years of age. We used purposive sampling. which consists in actively finding individuals who meet the criteria. Data collection: Semi structured interviews (January 23-February 8, 2017), in person, audio recorded and transcribed within one week. Participants’ autonomy, confidentiality and anonymity were protected throughout the process. Data analysis: Thematic analysis, which consists in the systematic identification of themes in the interview transcripts, followed by their conceptual organization and hierarchization. Research team: sixty-six undergraduate students taking Cultural Anthropology (ANTH 2010) in winter 2017, four graduate teaching assistants and one course instructor. Findings: Student participants portrayed work/life balance as set of interconnected situations and relations that go from the deeply personal to the interpersonal, communal and institutional. Aiming at capturing such complexity, we organized our findings in four themes: work/life balance, family dynamics, personal challenges and support. Participants told us about their struggles when negotiating work and life responsibilities which often lead to feelings of guilt, which are mediated by their colleagues’ reactions, schedule flexibility, their job situation and the presence or absence of maternity leave. Family dynamics reflected a tension between a narrative of independence and one of dependence in raising children, highlighting the importance of social networks, both of which are also affected by immigration status and intra-household negotiations particularly, Perceptions about work/life balance among DU community members with young children Cultural Anthropology (ANTH 2010) winter 2017 4 with their partners. Personal challenges relate primarily with time management and establishing clear boundaries between work and family, which related to managing emails, organization and scheduling of activities, maintaining a financial balance, and solving transportation needs, all of which were mediated the ability parents have of controlling a flexible work schedule, an ability greatly diminished among students. Support parents need related to child care goes from the one that happens in interpersonal interactions with neighbors, friends, relatives and colleagues, to the institutionalized forms of support, where participants expressed their frustration for the insufficiency of accessible options in Denver, the lack of options at DU, and the inaccessibility of DU’s Fisher Early Learning Center. Conclusions and recommendations: Participant’s ability to control their schedules together with their financial and social capital seem to shape important differences in the ability that parents have for balancing work and life. Students, single parents and recent immigrants seem to have a combination of elements that add to the challenges. At the interpersonal level, simple acts of kindness, sympathy and empathy in the everyday interactions seem to make an important difference to parents. The perception that many of the student participants expressed about the academy not being comfortable with children, families or parents could be addressed by making it normal to talk about all these aspects of life. At the institutional level, efforts could be made at reaching out to parents, especially students and single parents, to offer them guidance and support that is already in place at DU, such as counselling and wellbeing resources, as well as orientation related to institutional policies. Policies related to maternity and paternity leave should be refined to ensure that they do not negatively affect those they are supposed to support. Convenient, affordable and sustainable on-campus child care options should be seriously considered given that they would enhance the possibilities for parents to participate in activities at DU. Events should be organized where members of the DU community have the opportunity to share not as students, staff or faculty, but as members of families

Sources of Clinician Burnout in Providing Care for Underserved Patients in a Safety-Net Healthcare System.

BACKGROUND: Burnout among clinicians is common and can undermine quality of care, patient outcomes, and workforce preservation, but sources of burnout or protective factors unique to clinicians working in safety-net settings are less well understood. Understanding these clinician experiences may inform interventions to reduce burnout. OBJECTIVE: To describe clinician perspectives on sources of burnout in a safety-net healthcare system. DESIGN: Semi-structured interviews were conducted with clinicians from multiple disciplines who provided care at a safety-net healthcare system from October 2018 to January 2019. Transcripts were analyzed using thematic analysis. PARTICIPANTS: Forty clinicians (25 female and 15 male; mean [SD] age, 41 [9.1]) participated, including physicians, social workers, advanced practice providers, nurses, psychologists, physical and occupational therapists, and other healthcare professionals. MAIN OUTCOMES AND MEASURES: Themes and subthemes that reflected clinician experiences, burnout, and workload expectations. KEY RESULTS: Five themes emerged: limited resources (entrenched social injustices, brokenness of the US healthcare system, precarious discharge options, and revolving door readmissions), barriers to building trust with patients (chasm of communication, addressing fear and mistrust, and being exposed to threats), administrative requirements (criticism hampering meaningful care, assuming extra workloads, bureaucratic burden), compassion fatigue (confronting traumatic situations, persistent worry about patient safety and welfare, witnessing mistreatment and stigmatization, overextending and overinvesting, withdrawing and shutting down, blaming self and career crisis), and advocacy as a counterbalance to burnout (solidarity when helping underserved communities, fervent advocacy, and patient gratitude). CONCLUSIONS: Among clinicians who provide care in a safety-net healthcare system, sources of burnout included limited resources, barriers to building trust with patients, administrative requirements, and compassion fatigue, but clinicians remained driven by their desire to advocate for patients. Policy-level interventions which increase funding to safety-net healthcare systems to bolster existing resources and staffing, create peer-support and wellness programs, and support advocacy efforts may mitigate burnout