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The case study discusses how the endemic nature of race and racism affects Black individuals’ level of trust in the medical system. The case begins with highlighting several past legacies of exploitation as well as contemporary experiences of discrimination in health care, which set the stage for medical distrust. It also presents disparities in several health outcomes. The case study then presents the experience of a Black family, who because of their lack of trust in the medical system was accused of, and reported to Child Welfare for medically neglecting their daughter. Inspired by CRT, the social worker in the case understood that Black and other marginalized families are often disproportionately targeted and face harsher judgments in child welfare cases. This informed her engagement with the family. Through this case, the author made the argument that without acknowledging systemic racism, biases are more likely to influence the classification of neglect, leading to interventions that do not address a family’s needs or mistakenly involves them with the child welfare system.
This conclusion reflects on the legacy of the Democrat Party in the aftermath of the 1960 coup. I argue that the removal of Turkey’s elected government by military officers did not mark the end of democratic politics in Turkey. Rather, it was part of a larger process of de-democratization in which Turkish leaders (first the Democrats, then the military and its allies) restricted the various institutions that enabled meaningful political contestation. Democracy was effectively rolled back during the 1950s because the achievements of Turkey’s “transition to democracy” were of a limited sort; they included independently verified elections, a narrow range of permitted political parties, and a relatively circumscribed press. If the DP failed to consistently defend and expand the institutions that bolster democracy, then perhaps its greatest legacy is the way in which it positioned Turkey in relation to other states. The DP presented the country as an essential part of the American order, willing to fight and, thus, deserving of significant financial support.
Self-harm and suicidal behaviours in children and young people are increasingly common. These behaviours sit on a broad continuum from relatively risk-free behaviours that may be used as coping mechanisms to life-threatening acts with suicidal intent. Self-harm is more likely in patients with co-morbid mental health conditions, but most young people who self-harm do not have a mental health diagnosis. Family adversity, educational stressors, physical health illnesses, bullying, and substance misuse may all increase the risk of self-harm. Young people may find internet support groups helpful as they may value the discretion of online support for a behaviour about which they may be embarrassed. However some internet sites teach young people more dangerous self-harming strategies and young people may be bullied or encouraged to complete suicide. Historical methods of risk stratification have poor predictive validity and it is instead recommended that clinicians engage collaboratively with young people in an individualised approach to risk assessment, developing a detailed risk formulation and safety plan. Young people who self-harm are 30 times more likely to die by suicide, and it appears that those from minority groups are at greater risk. Mild self-harm may only require a ‘listening ear’ from a trusted friend or adult, but more severe difficulties may need professional assistance from mental health services that should be trauma-informed and relational in approach, offering evidence-based interventions such as DBT-A or MBT-A. Crisis services should be responsive and flexible to young people’s needs so as to be able to engage them and de-escalate risks effectively.
The COVID-19 pandemic and associated lockdowns raised concerns about their impact on substance use among young people.
Objectives/Aims:
The aim of this study is to investigate the potential changes in alcohol and drug-related medical hospital admissions during the pandemic compared to pre and post pandemic years among individuals aged 15–24 in Ireland.
Methods:
Data from the Hospital Inpatient Enquiry (HIPE) database, covering emergency hospital admissions from 2017 to 2022, were analysed. Lockdown and control periods were identified, and admission rates for drug-related hospital admissions (DRHA) were calculated per population and per 100 all-cause admissions. The study also examined changes in alcohol-related hospital admissions (ARHA) and explored the contribution of different drug categories to DRHA during lockdowns.
Results:
We found that there was an increase in drug-related hospital admissions (DRHA) among individuals aged 15–24 years during the periods of hard lockdowns, comparing the three periods of hard lockdown from 2020 to 2021 with corresponding weeks in control years. The median rate of DRHA per million per week during the lockdowns was 23.8 (inter-quartile range [IQR] 19.0 – 29.9) while it was 18.2 (IQR 13.7–22.2) during the control weeks (p<0.001). DRHA accounted for a median 3.81% of admissions during lockdown weeks while they comprised 2.16% during the control weeks.
Conclusions:
Our findings suggest that an adverse effect of pandemic restrictions appears to be increased acute drug-related problems requiring medical management among youth aged 15–24 years.
Chapter 7 involves an analysis of the 2019 case brought to the UN committee on the rights of the child by 16 young people (Saachi et al. 2019). The case is assessed in terms of its legitimacy and effectiveness in promoting intergenerational justice discourses and its capacity to act as an indirect proxy representative for future generations. The chapter argues that while there are distinct limitations in the rights of the child complaints system (with an asymmetry in power between children and the states involved, with decisions being non-binding), the Saachi case, nevertheless, has the potential to have both a political and legal impact. It is one of the few avenues at the international level which allows young people increasingly impacted by climate change to have a voice. It can also allow young people to act as proxy representatives for future generations, while the Committee to date has been reticent to move in this direction. Finally, some elements of the decision are likely to be taken up in future climate litigation at the international and national levels.
Indonesia’s population skews young, so political analysts are increasingly concerned with what the “youth vote” looks like, and what generational change will bring to Indonesia’s democracy. On the one hand, analysts have historically focused on the liberal political activism of more educated cohorts of young people, and especially those in urban areas. On the other, and most recently, young Indonesians overwhelmingly voted for Prabowo Subianto in the 2024 presidential elections, suggesting this cohort to be either unaware of, or unperturbed by, his authoritarian history. This paper examines how young Indonesians perceive their country’s democratic trajectory. We analyze two decades of nationally representative survey data, and examine the democratic preferences of Indonesian voters whose political socialization took place entirely in the post-authoritarian era (1998–). The results suggest both life-cycle and intriguing cohort effects: on average, Indonesians become more positive towards their democracy as they age; but we also find that Indonesia’s Gen Zs are more satisfied with democracy than other generational cohorts—despite a precipitous decline in the quality of Indonesian democracy over the past decade. We argue, therefore, that while all Indonesians show high levels of satisfaction with their weakening democracy, young Indonesians, more than other generations, can be understood as ‘complacent democrats.’
This chapter reviews recent anthropological studies of adolescence and youth. Some of the earliest research in psychological anthropology focused on this lifespan period. This early work insisted that social and cultural factors shaped the varieties of adolescent experiences both within and across societies, and that the social problems of youth were a political problem rather than an inevitable outcome of a universal life stage. Systematic research on adolescence and youth did not emerge until the 1970s, 1980s, and 1990s. These studies are organized into four themes: (1) adolescence as a liminal period; (2) adolescent vulnerabilities that result from social, political, and economic disruptions; (3) young people as instigators and innovators of social change; and (4) young people's social worlds as worthy research topics in themselves. The chapter calls for future research on young people that focuses on individual experiences within larger systems of power, such as the historical legacies of Western imperialism. Attending to these larger systems of power will provide greater awareness of how these systems shaped past research.
Household food insecurity (HFI) is a social determinant of health globally. Rates of HFI have risen in many high-income countries in recent years, particularly in households with children. The health outcomes associated with HFI for children and adolescents have not been systematically synthesised. This review was conducted to support advocacy efforts for meaningful policy action to reduce HFI in households with children.
Design:
A systematic search was conducted in Medline, Embase and PsycInfo databases. Primary studies measuring the association between physical or mental health outcomes and HFI were included. Studies were appraised and population, setting, measures and outcomes were extracted. Findings were grouped by related outcomes. Due to heterogeneity, findings were synthesised narratively. Rapid review methodology was used to accommodate resource constraints.
Setting:
High-income countries.
Participants:
Youth aged less than 18 years.
Results:
Thirty-six studies were included. Most were cross-sectional studies conducted in the USA. Outcomes included general health, early childhood, cardiometabolic, asthma, dental caries, mental health, sleep, diet and anaemia. Despite substantial heterogeneity in HFI measures and analysis, findings support associations between HFI and negative outcomes for general health status, asthma, dental caries and mental health. Findings for other outcomes were mixed.
Conclusions:
This review clarifies the effects of HFI on children and adolescents. Findings highlight trends for negative physical and mental health outcomes associated with HFI during youth, particularly related to mental health, oral health, asthma and general health status. Policy-level action should address rising rates of HFI and long-term effects on these vulnerable populations.
‘The Personified Will’ examines how the faculty of the will was depicted as a personified character in English Renaissance plays. The will was portrayed in a variety of benevolent and malevolent guises, yet the function of these characters has not yet been integrated into our appreciation of the era’s dramatic conventions. I argue that we may more fully appreciate the ways that dramatists queried the practical expression of individual liberty, identity, and civil harmony by attending to a historically disregarded set of Will characters (from Sebastian Westcott’s The Marriage of Wit and Science to William Shakespeare’s Twelfth Night). The performance of the personified will offers important, but hitherto overlooked, evidence of how playwrights attempted to scrutinize the nature of human freedom and social concord, and the extent to which personifications of the will were used to legitimize contemporary systems of status and authority. Exploring the actions of honourable and corrupt personifications of the will provides a way to elucidate the ethical predicaments associated with will’s performance, which the second chapter of this book examines in more detail.
Childhood irritability increases the risk of later suicidal behaviors, but the moderators of this association have not been identified. We investigated harsh parenting as a moderator in the association of childhood irritability with adolescent suicide attempt and self-harm, and possible sex differences in these associations.
Method
Data were from 9,480 children from the Millennium Cohort Study. We averaged parent ratings of child irritability and harsh parenting at ages 3, 5, and 7 years (range 1–3). Suicide attempt and self-harm were self-reported at age 17. Logistic regression models were used to estimate associations of irritability with suicide attempt and self-harm, adjusting for confounding factors. Interaction analyses were used to test the moderating role of harsh parenting and sex in these associations.
Results
Children with greater irritability scores were at increased risk to attempt suicide (OR=1.72, 95% CI=1.42–2.08). Interaction analyses suggested that this risk in males was elevated regardless of harsh parenting. However, high levels of harsh parenting interacted with irritability in increasing the risk of suicide attempt in females. Children with high irritability were also more at risk of self-harm (OR = 1.16, 95% CI = 1.03–1.31) but this association was not moderated by harsh parenting in either sex.
Conclusion
Parental behaviors may play an important role in the pathway to suicide attempt of children with irritability, especially for females, who may have a heightened sensitivity to interpersonal stressors. Parenting interventions may be helpful in suicide prevention among females with irritability.
While the links between extreme weather events and mental health have received growing attention, little is known about how climate change impacts adolescent mental health in low- and middle-income climate-affected settings. To address this gap, we conducted a multi-method qualitative study exploring how young adolescents (YAs) aged 10–14 years experience climate-related stressors across six regions in Kenya. Guided by the resource insecurity framework, we thematically analyzed Elder focus groups, YA walk-along interviews and YA participatory mapping workshops. Our findings revealed that food, water and sanitation insecurity contribute to psychological distress, including symptoms of depression and suicidality, and heighten concerns of community violence (e.g., assault, fighting). Water insecurity, particularly the time and distance required for collection, disrupted school attendance, while resource borrowing generated feelings of shame. Food insecurity and larger contexts of poverty were associated with substance use as a coping mechanism, which in turn contributed to school dropout, crime and gang involvement. Poverty also led some youth to run away from home. These findings highlight the urgent need for climate-informed mental health interventions that address co-occurring resource insecurities. To advance adolescent mental health and well-being in climate-affected settings, policy responses must be targeted and multilevel, engaging families, communities and institutions.
Refugee youth are at high risk for trauma-related disorders – outcomes not only the result of pre-migration trauma, but consequences of diverse post-migration stressors. This study identified individual, parental, and environmental factors – some potentially modifiable – associated with trajectories of psychological risk and resilience in 291 Syrian and Iraqi refugee youth during resettlement in the U.S. Data was collected at arrival and at two follow-up visits up to 7 years post-arrival. Linear mixed modeling assessed predictors of posttraumatic stress disorder (PTSD), anxiety, and depression trajectories. Victimization trauma (i.e., assault) and lower maternal subjective social status predicted more severe PTSD (p = .046, f2 = .07; p < .001, f2 = .23) and anxiety (p = .008, f2 = .05; p = .002, f2 = .11) trajectories in youth. Paternal unemployment predicted less stable PTSD (p = .009, f2 = .13) and anxiety (p < .001, f2 = .10) trajectories. More severe depression trajectories were associated with female sex (p = .045, f2 = .06) and death threat traumas (p = .014, f2 = .07). Findings identified predictors of long-term risk and resilience for refugee youth, as well as potentially modifiable ecological risk factors. Victimization and death threat trauma exposure could be salient in identifying youth at high risk for trauma-related symptoms early in resettlement. Indicators of financial security were also associated with symptoms, suggesting environmental intervention targets.
This article analyses the agony column ‘Voi e il cinema’, launched in November 1938 in Cine illustrato, one of the most popular film magazines of the time. ‘Voi e il cinema’ invited readers to share their acting aspirations, but also to send in photographs of themselves that might contain the defining feature of a diva: photogenicity. The magazine was flooded with images of ‘ordinary young Italian women’ that created an intermediate visual grammar. Focusing on both the photographs and the editors’ responses, the article reveals how shared consumption practices redefined the relationship between public and private space. It also highlights the distance of the readers’ self-representations from Fascist models and sheds light on the role of American star culture in creating the ‘modern’ subject. Although they were not politically opposed to Fascist models, the photographs reveal a strong desire for social change and the perception of such change, particularly in relation to traditional female roles.
Chapter 5 continues to explore the connections and disconnections between the transitional justice project and non-recurrence of conflict in Bosnia and Herzegovina (BiH). It proposes that education can make or break meaningful assurances of conflict non-recurrence. The chapter demonstrates how ethnically segregated history teaching in BiH plays a key role in the maintenance of a post-conflict status quo which has frozen certain anxieties around the uncertain future of peace in the country. Further, the chapter posits that the global project of transitional justice, while not responsible for the burgeoning ethnonationalism, has actively made bad situations worse with its short-sighted security priorities and general misunderstanding of security as lived experience. In particular, the chapter focuses on how and why the International Criminal Tribunal for the former Yugoslavia undertook a role of an educator of the BiH youth and public and how the advocates of the transitional justice project have ignored the complexity of the prevention needs of the BiH society.
Mental ill-health has a major impact on young people, with pain often co-occurring. We estimated the prevalence and impact of pain in young people with mental ill-health.
Methods
Longitudinal data (baseline and three-month follow-up) of 1,107 Australian young people (aged 12–25 years) attending one of five youth mental health services. Multi-level linear mixed models estimated associations between pain characteristics (frequency, intensity, and limitations) and outcomes with false discovery rate (FDR) adjustment. Pain characteristics were baseline-centered to estimate if the baseline score (between-participant effect) and/or change from baseline (within-participant effect) was associated with outcomes.
Results
At baseline, 16% reported serious pain more than 3 days, 51% reported at least moderate pain, and 25% reported pain-related activity limitations in the last week. Between participants, higher serious pain frequency was associated with greater anxiety symptoms (β[95%CI]: 0.90 [0.45, 1.35], FDR-p=0.001), higher pain intensity was associated with greater symptoms of depression (1.50 [0.71, 2.28], FDR-p=0.001), anxiety (1.22 [0.56, 1.89], FDR-p=0.002), and suicidal ideation (3.47 [0.98, 5.96], FDR-p=0.020), and higher pain limitations were associated with greater depressive symptoms (1.13 [0.63, 1.63], FDR-p<0.001). Within participants, increases in pain intensity were associated with increases in tobacco use risk (1.09 [0.48, 1.70], FDR-p=0.002), and increases in pain limitations were associated with increases in depressive symptoms (0.99 [0.54, 1.43], FDR-p<0.001) and decreases in social and occupational functioning (−1.08 [−1.78, −0.38], FDR-p=0.009).
Conclusions
One-in-two young people seeking support for mental ill-health report pain. Youth mental health services should consider integrating pain management.
The global prevalence of mental health disorders among youths aged 15 to 24 is a significant public health concern. This systematic review aimed to explore global strategies for promoting mental well-being and addressing mental health challenges within this demographic, as defined by the World Health Organization. A comprehensive search of electronic scientific databases was conducted on November 1, 2023, yielding 43 studies with a total of 29,581 participants published between 2008 and 2023 that examined mental health interventions targeting youth. This review identified heterogeneity across multiple dimensions including modes and modalities of intervention delivery, conceptualisations of mental health, measurement tools and implementation settings. Digital/ technology-based interventions were prevalent in high-income countries, whereas physical interventions were more commonly employed across all income groups, especially where technological infrastructure was limited. Cognitive-behavioural therapy, psychoeducation and mindfulness-based interventions dominated the intervention modalities, likely due to their structured formats, scalability and broad applicability across a range of settings and mental health conditions. However, limited evidence of cultural adaptation in the reviewed interventions highlights the need for more inclusive and context-sensitive approaches. Schools were the most frequent delivery setting; however, reliance on educational platforms risks excluding out-of-school and marginalised youth. Conceptually, the reviewed interventions reflected both disorder-specific (diagnostic) and transdiagnostic understandings of mental health, affirming a spectrum-based view that integrates symptom reduction with well-being enhancement. This dual lens supports emerging frameworks such as the Hierarchical Taxonomy of Psychopathology (HiTOP). Measurement heterogeneity mirrored conceptual diversity, with both standardised and context-specific tools used to assess outcomes. This diversity highlighted the urgent need for culturally relevant, flexible and multi-modal interventions that span diverse settings and conceptualisations to equitably support youth mental health worldwide.
Besides his teachers and mentors, Pierre Boulez was surrounded by a circle of friends at the turn of the 1950s with whom he shared artistic and political interests and whom he often met in the more personal context of his social life. His interest in contemporary painting and interdisciplinary relations connected him with the painter Bernard Saby who, like Boulez, had pursued mathematical studies. Armand Gatti and Pierre Joffroy (pseudonym of Maurice Weil) were engaged journalists and writers, marked by the terror of the German occupation and the political turmoil of the post-war period. From this circle of friends emerged significant stimulations and influences in the transition from the composerʼs youthful works to the first phase of maturity
Roger was a 60-year-old man living with both HIV and schizophrenia who was admitted to the hospital for treatment of a chronic obstructive pulmonary disease exacerbation. He was referred to the psychiatry consultation-liaison team due to persistent psychotic symptoms that had not responded to multiple antipsychotic trials. Roger’s psychiatric history revealed a diagnosis of schizophrenia in early adulthood, marked by hallucinations and delusions of grandeur. Over the next 4 decades, he cycled through jails, prisons, shelters, and periods of homelessness. Though intermittently connected with outpatient care, his illness remained poorly controlled.