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This article reviews the literature on interventions and services for depression and suicide prevention among adolescents, with the goals of placing this science within the context of current changing health care environments and highlighting innovative models for improving health and mental health. We examine the: challenges and opportunities offered by new initiatives and legislation designed to transform the U.S. health and mental healthcare systems; summarize knowledge regarding the treatment of depression and suicidality/self-harm in adolescents; and describe innovative models for partnering with health systems and communities. This review demonstrates that treatment models and service delivery strategies are currently available for increasing evidence-based care, particularly for depression, and concludes with recommendations for future research and quality improvement initiatives aimed at inspiring additional efforts to put science to work, bridge science and community practice, and develop strategies for partnering with communities to improve care, mental health, and well-being among adolescents.

Background: Numerous observational studies demonstrate associations between social context and depressive symptoms, yet few intervention trials exist in this arena. Aims: This review examines intervention trials that explore the impact of contextual change on depressive symptoms. Methods: Electronic literature databases of PubMed and PsycINFO, bibliographies of retrieved articles and the publicly available internet were searched for English-language articles published between 1997 and 2008. Peer-reviewed studies were eligible for inclusion if they reported contextual interventions and depressive symptoms measures in adult populations without other significant underlying medical or psychological illness. In total, 2,128 studies met search term criteria. Of these, 13 studies meeting inclusion criteria were classified by type of intervention. Qualitative synthesis was used to interpret the mental health impact of contextual interventions. Results: The interventions focused on employment, housing, poverty, parenting and violence. Eight of these studies reported a decrease in depressive symptoms and/or psychological distress in intervention groups. Interventions varied in focus, length of follow-up and measures of depressive symptoms. Conclusions: Contextual interventions for the prevention and treatment of depressive symptoms and psychological distress can be effective, though very limited data exist in this field. Policy implications include a greater emphasis on improving context to decrease depression and other mental disorders.

Purpose: The 2016 U.S. election significantly changed the political landscape for sexual and gender minority (SGM) individuals. The current study assessed the consequences of the election and transition to a new overtly discriminatory administration on the health-related quality of life of SGM adults compared with their cisgender and heterosexual counterparts. Methods: The study used repeated cross-sectional data from the 17 states that administered the sexual orientation and gender identity module in the 2015 and 2018 Behavioral Risk Factor Surveillance System surveys. The sample included 268,851 adult respondents: 12,006 SGM adults (5.35%) and 256,845 cisgender and heterosexual adults (94.65%). Outcomes were frequent (≥14 days in the last month) physical distress, mental distress, limited activity, and/or fair/poor general health. Difference-in-differences estimates were calculated from logistic regression models, controlling for sociodemographic, health care coverage, and chronic medical condition confounders. Results: Compared with the cisgender and heterosexual population, frequent mental distress among SGM adults increased by 5% points, corresponding to a relative increase of 32.5% (p < 0.001) from 2015. Rates of frequent physical distress, limited activity, and fair/poor general health were not significantly altered between the two populations. Gender minority adults were most negatively affected with a relative increase in frequent mental distress of 117.5% (p < 0.001). Conclusions: The 2016 U.S. election and administration changeover were associated with a substantial increase in the proportion of SGM adults reporting frequent mental distress. These data provide empirical evidence as to the psychological effects of an abrupt political realignment on SGM mental health.

Foundations -- Theoretical and empirical underpinnings of adoption-specific therapy -- Overview of adoption-specific therapy -- The adapt curriculum -- Module 1. trust, positive coping strategies, and behavior management -- Module 2. developmental understanding of adoption experience -- Module 3. loss and grief issues in adoption -- Module 4. attachment/joining with adoptive family -- Module 5. search for identity/self-esteem/transracial adoption -- Module 6. adoption and the outside world -- Module 7. trauma treatment (optional: may be inserted as needed any time after module 1) -- Termination session -- References

<p><strong>Objective: </strong>Limited data exist on approaches to improve depression services for men in under-resourced communities. This article explores this issue using a sub-analysis of male participants in Community Partners in Care (CPIC). <strong></strong></p><p><strong>Design: </strong>Community partnered, cluster, randomized trial. </p><p><strong>Setting: </strong>Hollywood-Metropolitan and South Los Angeles, California. </p><p><strong>Participants: </strong>423 adult male clients with modified depression (PHQ-8 score≥10). </p><p><strong>Interventions: </strong>Depression collaborative care implementation using community engagement and planning (CEP) across programs compared with the more-traditional individual program, technical assistance (Resources for Services, RS). </p><p><strong>Main Outcomes Measured: </strong>Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), mental wellness, services utilization and settings. </p><p><strong>Results: </strong>At screening, levels of probable depression were moderate to high (17.5%- 47.1%) among men across services sectors. Intervention effects on primary outcomes (PHQ-8 score and MHRQL) did not differ. Men in CEP compared with RS had improved mental wellness (OR 1.85, 95% CI 1.00–3.42) and reduced hospitalizations (OR .40, 95% CI .16–.98), with fewer mental health specialty medication visits (IRR 0.33, 95% CI .15–.69), and a trend toward greater faith-based depression visits (IRR 2.89, 95% CI .99–8.45). </p><p><strong>Conclusions: </strong>Exploratory sub-analyses suggest that high rates of mainly minority men in under-resourced communities have high prevalence of depression. A multisector coalition approach may hold promise for improving community-prioritized outcomes, such as mental wellness and reduced hospitalizations for men, meriting further development of this approach for future research and program design.</p><p><em>Ethn Dis. </em>2017;27(3):223-232; doi:10.18865/ed.27.3.223 </p>

Objective: Community Partners in Care, a community-partnered, cluster-randomized trial with depressed clients from 95 Los Angeles health and community programs, examined the added value of a community coalition approach (Community Engage­ment and Planning [CEP]) versus individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care in underserved communi­ties. This exploratory subanalysis examines 6- and 12-month outcomes among CPIC participants aged >50 years.Design: Community-partnered, cluster-randomized trial conducted between April 2010 and March 2012.Setting: Hollywood-Metropolitan (HM) and South Los Angeles (SLA) Service Planning Areas (SPAs), Los Angeles, CaliforniaParticipants: 394 participants aged >50 years with depressive symptoms (8-item Patient Health Questionnaire score ≥ 10).Intervention: A community-partnered multi-sector coalition approach (Com­munity Engagement and Planning [CEP]) vs individual program technical assistance (Resources for Services [RS]) to implement depression collaborative care.Main Outcome Measures: Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), commu­nity-prioritized outcomes including mental wellness, homelessness risk and physical activity, and services utilization.Results: At 6 months, CEP was more ef­fective than RS at improving MHRQL and mental wellness among participants aged >50 years; no differences were found in the effects of CEP vs RS on other outcomes. No significant outcome differences between CEP and RS were found at 12 months.Conclusions: A multisector community coalition approach may offer additional benefits over individual program tech­nical assistance to improve outcomes among depressed adults aged >50 years living in underserved communi­ties. Ethn Dis.2018;28(Suppl 2):339-348; doi:10.18865/ed.28.S2.339.