Perspectives on Psychotropic Medication Treatment Among Young Adults Formerly Served in Public Systems of Care: A Thematic and Narrative Analysis

This study examines the perspectives of psychotropic medications held by young adults with mood disorder diagnoses. This article presents an analysis of qualitative interviews with 52 young adults who had been involved with public systems of care during adolescence and had used psychiatric medications. A concatenated analytic approach was used. First, we used a thematic analysis across cases, then a narrative analysis within selected cases. Two main themes emerged from the thematic analysis that captured aspects of the experience of taking medication. First, young adults described the effects of the medications and how they thought the medications were working. They described the impact on their moods, thinking, bodies, and functioning, and the ways in which these effects related to their lives. Second, the process of taking medications emerged as an important aspect of the medication treatment experience, including the trial-and-error nature of treatment and interactions with psychiatrists. The narrative analysis within cases identified that some youth created a medication narrative composed of three elements: why medications were needed, what medications do, and participants’ outlook on future medication use. These narratives are helpful in understanding prior patterns of service use and are instructive in framing young people’s future intentions to use medications. Findings support the importance of eliciting the perspectives of young adults about their treatment and ensuring that services are designed and delivered in developmentally appropriate ways tailored to this group

Foster youth and psychotropic treatment: Where next?

Foster care children are prescribed psychotropic medications at rates significantly higher than same-aged peers. Concerns about the safety of psychoactive chemicals on developing bodies and potential misuses with foster care populations have led to varied and complex responses by the media, lawmakers, and researchers. First, we look at how foster youth are prescribed psychoactive substances, including polypharmacy (sometimes called concomitant prescription), and at the mounting and major responses by federal and state governments. Second, we consider a recent parameter published by the American Academy of Child and Adolescent Psychiatry. Third, we consider how foster care settings, what we call open systems, complicate parameter implementation, creating potential gaps among researcher, prescriber, foster caregivers, and youth medication explanatory models of treatment experience. And finally, to address gaps among researcher, prescriber, and patient explanatory models, we propose the use of arbitrage, a conceptual framework and process for the integration of competing and sometimes incommensurable explanatory models, knowledge and practice claims.Foster care Psychotropic medication Treatment parameter illness behavior Explanatory models Practice arbitrage

Stigma experience among adolescents taking psychiatric medication

This study investigated the experience of stigma among adolescents taking psychiatric medication for the treatment of a diagnosed mental illness. Although medications are intended to improve functioning and reduce mental disorder symptoms, little research has examined the potential stigma associated with taking them. This study recruited forty adolescents, ages 12-17, who met DSM-IV criteria for a mental health disorder and who were taking a psychiatric medication at the time of the study. Data were collected using a semi-structured interview instrument and were thematically analyzed using Link, Cullen, Struening, Shrout, and Dohrenwend's (1989) modified model of labeling theory. Results indicate that many adolescents did experience stigma. In particular, 90% of the sample endorsed at least one of Link et al.'s (1989) constructs of secrecy, shame, and limiting social interaction; four endorsed no stigma themes. Additional themes emerged indicating that the perceptions of adolescents' family members and school environments can accentuate their experience of stigma or serve as a protective barrier against it. The thematic findings of secrecy and shame were used to construct hypothetical models for how adolescents limited their social interaction.Mental illness stigma Adolescent mental health Adolescence Qualitative research Psychotropic treatment

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members\u27 supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women\u27s social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using 3 coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery

Strengthening the Social Response to the Human Impacts of Environmental Change

The United States and other contemporary societies face unprecedented environmental challenges as a result of climate change and escalating urbanization, ranging from acute hazards (e.g., natural disasters) to chronic, slow-onset stressors (e.g., prolonged drought, rising urban pollution levels, intransigent urban spatial inequities). These challenges threaten human health and well-being; destabilize assets, coping capacities, and response infrastructures; and substantially increase the number of socially, economically, and psychologically vulnerable individuals and communities. They disproportionately affect populations of lower economic privilege or social status, disrupting employment and income, escalating food insecurity, and degrading the ecologically vulnerable, inadequately resourced locations where poor and marginalized groups often live. Environmental inequities are also social inequities, with significant social justice implications. Social work is positioned to play a key role in developing and implementing innovative strategies to anticipate, mitigate, and respond to the social and human dimensions of environmental challenges. Core areas for social work leadership include (1) local, national, and international disaster preparedness and response; (2) assistance to dislocated populations; (3) collaborative capacity building to mobilize and strengthen place-based, community-level resilience, assets, and action; and (4) advocacy to elevate public and policy attention to the social and human dimensions of environmental change