RESUMEN
Background. Poverty disproportionally affects persons with disabilities, elderly individuals and racialized groups. Leisure, play and rest are not prioritized in either services for or research with people living in poverty. Purpose. This study aims to examine the facilitators and barriers to participation in meaningful leisure activities for adults living in poverty. Method. We used community-based participatory research and art-based elicitation strategies with 39 service users at a food security organization. Findings. Individuals experiencing poverty value and engage in a variety of free and affordable leisure activities, but they are not afforded the necessary leisure opportunities, accommodations and supports as the general population. We co-created a map of local leisure resources to foster collective capacity in leisure planning, and to support organizations working with this population. Implications. Occupational therapists can work alongside members of underserved communities to uncover and address the systemic and local contextual barriers to engagement in leisure activities.
Asunto(s)
Terapia Ocupacional , Adulto , Anciano , Participación de la Comunidad , Investigación Participativa Basada en la Comunidad , Humanos , Actividades Recreativas , PobrezaRESUMEN
CONTEXT: Children exposed to a traumatic event may be at higher risk for developing mental disorders. The prevalence of child psychopathology, however, has not been assessed in a population-based sample exposed to different levels of mass trauma or across a range of disorders. OBJECTIVE: To determine prevalence and correlates of probable mental disorders among New York City, NY, public school students 6 months following the September 11, 2001, World Trade Center attack. DESIGN: Survey. SETTING: New York City public schools. PARTICIPANTS: A citywide, random, representative sample of 8236 students in grades 4 through 12, including oversampling in closest proximity to the World Trade Center site (ground zero) and other high-risk areas. MAIN OUTCOME MEASURE: Children were screened for probable mental disorders with the Diagnostic Interview Schedule for Children Predictive Scales. RESULTS: One or more of 6 probable anxiety/depressive disorders were identified in 28.6% of all children. The most prevalent were probable agoraphobia (14.8%), probable separation anxiety (12.3%), and probable posttraumatic stress disorder (10.6%). Higher levels of exposure correspond to higher prevalence for all probable anxiety/depressive disorders. Girls and children in grades 4 and 5 were the most affected. In logistic regression analyses, child's exposure (adjusted odds ratio, 1.62), exposure of a child's family member (adjusted odds ratio, 1.80), and the child's prior trauma (adjusted odds ratio, 2.01) were related to increased likelihood of probable anxiety/depressive disorders. Results were adjusted for different types of exposure, sociodemographic characteristics, and child mental health service use. CONCLUSIONS: A high proportion of New York City public school children had a probable mental disorder 6 months after September 11, 2001. The data suggest that there is a relationship between level of exposure to trauma and likelihood of child anxiety/depressive disorders in the community. The results support the need to apply wide-area epidemiological approaches to mental health assessment after any large-scale disaster.
Asunto(s)
Acontecimientos que Cambian la Vida , Trastornos Mentales/epidemiología , Instituciones Académicas/estadística & datos numéricos , Ataques Terroristas del 11 de Septiembre/psicología , Estudiantes/estadística & datos numéricos , Adolescente , Agorafobia/diagnóstico , Agorafobia/epidemiología , Ansiedad de Separación/diagnóstico , Ansiedad de Separación/epidemiología , Niño , Planificación en Desastres/normas , Femenino , Estudios de Seguimiento , Encuestas Epidemiológicas , Humanos , Masculino , Tamizaje Masivo/estadística & datos numéricos , Trastornos Mentales/diagnóstico , Ciudad de Nueva York/epidemiología , Prevalencia , Escalas de Valoración Psiquiátrica , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiología , Estudiantes/psicologíaRESUMEN
PROBLEM: After the Soviet Union dissolved in 1989, it became apparent that there was little recognition of the problems of child abuse and neglect, professionally, legally, or societally. There were no effective systems or laws in place to deal with these problems. METHOD: Beginning in 1995 the Children's Mental Health Alliance, in conjunction with the Open Society Institute began conducting trainings in Eastern Europe [Journal of the American Academy of Child Adolescent Psychiatry 39 (2000) 660]. Originally 18 countries from the Baltics to the Balkans participated. A program was elaborated which would proceed in several stages: (1) training mental health professionals to deal with child abuse and neglect (CAN); (2) teaching multidisciplinary team work and fostering the development of multidisciplinary NGOs focused on CAN; (3) promoting the self-sufficiency of these NGO's which would then facilitate social and legal reform and increase public awareness of the problem. Specific methods included multi-national trainings, assignment of mentors to the developing teams who maintained weekly contact with the teams and made yearly site visits to their countries, and overseeing project grants from OSI. RESULTS: NGO's had been established and registered in 11 countries, many establishing a network of programs within their countries. By 2000, over 3800 mental health professional had been trained, either directly by the program or by the trainees of the program. By the end of 2000, over 17,000 other professionals (lawyers, police, judges, educators, other physicians, etc.) had been trained by the network. CONCLUSION: While more work needs to be in this region, the teams in 11 countries have made solid starts.