Mental health of Sami Youth

Artikkel som omhandler samisk ungdoms mentale helse.Sami children and adolescents are the indigenous youngsters in Norway, mainly resided in the arctic part of the country. While disadvantaged living conditions, risk behavior and psychososial health problems has been shown for children and youth from many indigenous groups worldwide, the research among Sami youngsters is sparse. However, recent research show that compared to the Norwegian majority group, Sami children and adolescents have just as good mental health as their majority peers. They also show less risk taking behavior as substance and drug use, have less eating problems and have a stronger body satisfaction. However, the smoking rates are high as for their Norwegian counterparts. Intragroup studies show that Sami adolescents grown up in Sami dominated areas, have a strong bicultural identification, are practicing more Sami cultural behavior and have a better mental health compared to Sami peers in marginal Sami areas. Ethnocultural factors have only a slight impact on behavior problems among young Sami and particularly among boys in the marginal Sami areas

Concurrent adversities and deliberate self-harm among indigenous Sami and majority Norwegian adolescents: the Norwegian Arctic Adolescent Health Study

Source at: http://doi.org/10.21307/sjcapp-2017-011 , licensed CC BY-NC-ND 4.0.Background: Few studies have investigated proximal relationships between deliberate self-harm (DSH) and concurrent adversities. Objective: We aimed to investigate these relationships in a community population of 4881 indigenous Sami and majority Norwegian adolescents, 15 to 16 years old, and related to ethnicity and gender. Methods: Youth with and without self-reports of DSH last year were compared on 12 concurrent adversities, on scales measuring family and peer functioning, and on sociodemographic conditions. Results: DSH last year was reported by 22.3% of the adolescents, and by more girls (28.8%) than boys (15.9%). All 12 concurrent adversities were related strongly to DSH last year. Deliberate self-harmers reported twice as many concurrent adversities as non-DSHs, and a large effect size (Cohen’s d = 0.80) indicated a strong multiple additive relationship, but among DSHs no ethnic or gender differences were found. Multivariately, among Sami youth sexual abuse [odds ratio (OR), 8.4] was strongly related to DSH, whereas among majority Norwegians sexual abuse (OR, 3.9) and violence (OR, 4.5) were identified as the strongest predictors. Similarly, among boys violence from adults (OR, 8.8) was associated most strongly with DSH, whereas among girls sexual abuse (OR, 4.3) was the most robust predictor. DSHs reported more conflicts with parents, less family support and involvement, and more peer problems than non-DSHs, and DHS girls had more difficulties in these relationships than DHS boys. Only small ethnic differences were found. Conclusion: Adolescent DSHs reported twice as many concurrent adversities as non-DSHs, sexual abuse and violence were strongly related to DSH. Ethnic and gender differences in risk factors were found. Clinicians should inquire about traumatic experiences such as sexual and physical abuses, and should have a family, peer, and gender perspective in their work

Forekomsten av angst- og depresjonssymptomer hos samiske og ikke-samiske elever i videregående skole i Finnmark i 1994 og 2014

Kvernmo S, Bye RS. The prevalence of anxiety- and depression symptoms in Sami and non-Sami high school students in Finnmark county in 1994 and 2014. Nor J Epidemiol 2019; 28 (1-2): 15-25. ENGLISH SUMMARY As much as 15-20% of children and adolescents in Norway, aged 3-18 years, are suffering from anxiety, depressive or behavioral problems. Recent studies have shown an increase in the prevalence of emotional problems among adolescents during the last decades. The aim of this study is to examine the prevalence and the sociodemographic and psychosocial predictors of anxiety and depression symptoms in Indigenous Sami and non-Sami adolescents in 1994 to 2014. Data from 1655 high school students in the Young in North (Ung i Nord) study from 1994 was compared to data from 1856 high school students in Ungdata, conducted in 2014 in the same area. Similar and comparable measures were applied in the two studies with SCL-12 as the main measure. The results showed an increase in the prevalence of depression and anxiety symptoms from 1994 compared to 2014, but a decrease in behavioral problems. At both years females reported more problems. No significant ethnic differences occurred in rates of problems between indigenous Sami and non-Sami adolescents at any time point. Across gender and ethnic groups, self-esteem and the students' relationship to the school were the two strongest predictors. Conclusion: This study confirmed findings from other studies of an increase of rates of anxiety and depression symptoms in older adolescents over the last decades, but also in types of significant predictors. Our findings entail a future need for prevention and treatment offers to adolescents suffering from anxiety and depression problems

The relationship between internalizing and externalizing symptoms and cultural resilience factors in Indigenous Sami youth from Arctic Norway

The accepted manuscript version of this article is part of Margrethe Bals' doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2934Objectives. To examine whether enculturation factors, like cultural activities, ethnic pride and native language competence, are related to decreased internalizing and externalizing symptoms in Indigenous Sami youth from Arctic Norway. The impact of self-efficacy on the relationship between enculturation factors and mental health problems was also examined. Study design. Population-based, cross-sectional questionnaire study. Methods. The Norwegian Arctic Adolescent Health Study was conducted among 10th graders in junior high schools in north Norway during 2003–2005. The study sample consisted of 450 Indigenous Sami youth, aged 15–16 years. Internalizing symptoms were measured with the Hopkins Symptom Check List- 10 (HSCL-10), while externalizing symptoms were measured by two subscales of the Strengths and Difficulties Questionnaire (SDQ). Results. For boys, self-efficacy and participation in cultural activities were associated with decreased internalizing symptoms. Additionally, self-efficacy interacted with Sami language competence and cultural activities: when self-efficacy increased, these enculturation factors were related to symptom reduction. For girls, self-efficacy had an independent effect on internalizing symptoms and also strengthened the relationship between participation in cultural activities and reduced externalizing symptoms. Sami language competence was related to the reduction of both internalizing and externalizing symptoms in girls. Conclusions. In the present study, several enculturation factors as well as self-efficacy were identified as potential protective factors against mental health problems. In order to develop theoretical models that explain the mechanisms between cultural resilience and mental health, there is a need for both qualitative studies and longitudinal studies

Predictors of rate of change for children and youth with emotional disorders: a naturalistic observational study

Published version. Source at http://dx.doi.org/10.1186/s13034-016-0098-3 Background: To examine demographic and clinical characteristics as potential predictors of change for children and youth with emotional disorders treated at two child and adolescent mental health outpatient services (CAMHS) in Norway. Methods: The study was of naturalistic observational type with “treatment as usual” (TAU). The sample consisted of 84 children and youth with emotional disorders. The Health of the Nation Outcome Scale (HONOSCA), and the Children’s Global Assessment Scale (CGAS) were administered at intake (T0), during the assessment (T1) and approximately six months after assessment (T2). Change was analysed by means of the linear mixed models procedure. Results: For the HONOSCA total score, youths with a diagnosis of depression had statistically higher symptom severity levels at baseline and significantly lower change rates as compared to youths with an anxiety disorder. Conclusions: The current study adds to the limited knowledge of predictors of rate of change for children and adolescents with emotional disorders treated within CAMHS. Our results point to a special need to improve clinical care for depressed children and adolescents. Important limitations comprising the external validity of the study concern missing data, a small study sample, and lack of information regarding the content and extent of the service provided

Teacher reports of emotional and behavioral problems in Nepali schoolchildren: to what extent do they agree with parent reports?

Background: Teacher reports of child emotional and behavioral problems (EBPs) are sparse in many low- and middle-income countries, especially when compared to reports from parents. Cross-informant information is pivotal to clinicians when dealing with mentally ill children. In this study from Nepal, we examined teacher reports of child EBPs, the agreement between teacher and parent reports, and how this agreement varied by type of EBP and child gender. Methods: This cross-sectional, observational study included 3808 schoolchildren aged 6–18 years from 16 districts of Nepal. Teacher and parent reports of EBPs were measured by the Nepali versions of the Teacher Report Form (TRF) and the Child Behavior Checklist (CBCL), respectively. Linear mixed model analysis was used for group comparisons and intraclass correlations. Agreement between TRF and CBCL scale scores were analyzed using Pearson’s correlation coeffcient. Results: The prevalence of EBPs according to teacher reports was 15.4%, whereas the previous parent reported prevalence was 19.1%. Also, the mean TRF score was significantly lower than mean CBCL score for the 90 common items. Mean TRF scores for Total Problems, Externalizing Problems, and Internalizing Problems were 26.9 (standard deviation, SD 24.5), 6.1 (SD 7.2), and 7.9 (SD 7.3), respectively. Consistent with parent reports, mean TRF scores for Total Problems and Externalizing Problems were higher among boys than girls, whereas no significant gender differences were found for Internalizing Problems. Teacher-parent agreement was moderate (r=.38), and slightly higher for Externalizing Problems than for Internalizing Problems (r=.37 versus r=.34). Moderate to low correlations were found for all syndrome scales, with coeffcients ranging from r=.26 (Social Problems) to r=.37 (Attention Problems). The effect of child gender on the teacher-parent agreement was significant for Internalizing Problems only, with a higher agreement for girls than for boys. Conclusion: Nepali teachers reported fewer child EBPs than parents. Teacher-parent agreement was moderate and varied by type of EBP and child gender. Our fndings underscore the importance of obtaining information on child EBPs from both parents and teachers when evaluating and treating children in low- and middle-income countries like Nepal

Parents’ perspectives on preparing for parenthood: a qualitative study on Greenland’s universal parenting programme MANU 0–1 year

Background The transition to parenthood has received increasing attention in research, partly due to evidence pointing out the crucial developmental period of a child’s first thousand days. Parenting programmes aim to prepare and support families in their transition and distress. For a programme to be implemented successfully it is important to consider parents’ needs and resources. Bringing parents’ perspectives and experiences to the forefront of the implementation of the Greenlandic parenting programme MANU 0–1 Year (MANU) is important for determining if the programme can meet its aim of contributing to thriving families. This study aims to investigate how parents’ notions and experiences of parenthood are reflected and challenged in MANU. Method Data were collected in three of Greenland’s five municipalities. Qualitative interviews were held with 38 mothers and 12 fathers either individually or as couples: a total of 40 interviews. Additionally, a Sharing Circle with three fathers was held. Interviews were in Greenlandic or Danish. A thematic, inductive analysis was applied. Results In their transition to parenthood, participants experienced a reprioritisation of their life and changes in their network. It is important to parents that their child experiences security and care, and participants describe this in contrast to their own childhood. Community is the most important value in child-rearing. Conversations and advice from family members and friends are mentioned as a means to prepare for birth and parenthood. Additionally, conversations with midwives and MANU sessions were also used for preparation. Parents appreciated learning from and listening to other parents in MANU sessions. However, accessing MANU depends on the individual parent’s interest and ability to attend sessions. Conclusions Parents’ notions and experiences of parenthood are addressed in the programme, but the use of MANU depends on the parents’ attendance and how it is organised and locally offered. The study suggests that MANU has the possibility to create a space for parents to reflect and prepare. However, for MANU to be universal as intended and to reach both mother and father the facilitation of sessions could be revisited

Self-rated health among Greenlandic Inuit and Norwegian Sami adolescents: associated risk and protective correlates

Objectives. Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami. Design. Cross-sectional data were collected from ‘‘Well-being among Youth in Greenland’’ (WBYG) and ‘‘The Norwegian Arctic Adolescent Health Study’’ (NAAHS), conducted during 2003 2005 and comprising 10th and 11th graders, 378 Inuit and 350 Sami. Methods. SRH was assessed by one single item, using a 4-point and 5-point scale for NAAHS and WBYG, respectively. Logistic regressions were performed separately for each indigenous group using a dichotomous measure with ‘‘very good’’ (NAAHS) and ‘‘very good/good’’ (WBYG) as reference categories. We simultaneously controlled for various socio-demographics, risk correlates (drinking, smoking, violence and suicidal behaviour) and protective correlates (physical activity, well-being in school, number of close friends and adolescent parent relationship). Results. A majority of both Inuit (62%) and Sami (89%) youth reported ‘‘good’’ or ‘‘very good’’ SRH. The proportion of ‘‘poor/fair/not so good’’ SRH was three times higher among Inuit than Sami (38% vs. 11%, p50.001). Significantly more Inuit females than males reported ‘‘poor/fair’’SRH(44% vs. 29%, p50.05),while no gender differences occurred among Sami (12% vs. 9%, p50.08). In both indigenous groups, suicidal thoughts (risk) and physical activity (protective) were associated with poor and good SRH, respectively. Conclusions. In accordance with other studies of indigenous adolescents, suicidal thoughts were strongly associated with poorer SRH among Sami and Inuit. The Inuit Sami differences in SRH could partly be due to higher ‘‘risk’’ and lower ‘‘protective’’ correlates among Inuit than Sami. The positive impact of physical activity on SRH needs to be targeted in future intervention programs

IQ as a moderator of outcome in severity of children's mental health status after treatment in outpatient clinics

Psychotherapy is an effective treatment for mental health disorders, but even with the most efficacious treatment, many patients do not experience improvement. Moderator analysis can identify the conditions under which treatment is effective or whether there are factors that can attenuate the effects of treatment. In this study, linear mixed model analysis was used to examine whether the Full Scale IQ (FSIQ), Performance IQ (PIQ) and Verbal IQ (VIQ) on the Wechsler Intelligence Scale for Children – Third Edition, moderated outcomes in general functioning and symptom load. A total of 132 patients treated at three outpatient child and adolescent mental health services (CAMHS) were assessed at three different time points. The Children’s Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were used to measure the severity of impairments in general functioning and symptom load. IQ was assessed at the start of treatment. Moderator analysis revealed that the FSIQ × time interaction predicted changes in CGAS scores (p < .01), and that the PIQ × time interaction predicted changes in HoNOSCA scores (p < .05). The slopes and intercepts in HoNOSCA scores covaried negatively and significantly (p < .05). The same pattern was not detected for the CGAS scores (p = .08). FISQ and PIQ moderated change in general functioning and symptom load, respectively. This implies that patients with higher IQ scores had a steeper improvement slope than those with lower scores. The patients with the highest initial symptom loads showed the greatest improvement, this pattern was not found in the improvement of general functioning

Health service use in indigenous Sami and non-indigenous youth in North Norway: A population based survey

<p>Abstract</p> <p>Background</p> <p>This is the first population based study exploring health service use and ethno-cultural factors in indigenous Sami and non-Sami youth in North Norway. The first aim of the present study was to compare the frequency of health service use between Sami adolescents and their non-indigenous peers. The second aim was to explore the relationships between health service use and ethno-cultural factors, such as ethnic context, Sami self-identification, perceived discrimination and Sami language competence. Finally, we wanted to explore the relationship between use of health services and emotional and behavioural problems.</p> <p>Method</p> <p>The Norwegian Arctic Adolescent Health Study was conducted among 10th graders (15-16 years old) in junior high schools in North Norway. The sample consisted of 4,449 adolescents, of whom 450 (10.1%) were indigenous Sami and 3,999 (89.9%) were non-Sami.</p> <p>Results</p> <p>Sami and non-Sami youth used all health services with equal frequency. However, several ethno-cultural factors were found to influence health service use. Sami youth in more assimilated ethnic contexts used general practitioners more than non-Sami youth. Youth with Sami self-identification had a higher probability of using the school health service compared with other youth. Ethnic barriers to health service use were also identified. Sami speaking youth with a high degree of perceived discrimination had lower probability of using school health services than non-Sami speaking youth. Sami youth with conduct problems were less likely than non-Sami to use psychologist/psychiatrist. The present study demonstrated a relationship between health need and actual health service use.</p> <p>Conclusion</p> <p>Culture-specific factors influenced the help-seeking process in indigenous youth; some factors acted as barriers against health service use and other factors increased the probability of health service use.</p