Use of mental health services provides long term benefits to adolescent witness of violence in community

Violent victimization is known to negatively affect healthy progression of adolescents’ development.  Thus far, we know it is linked to multiple adverse health risk behaviors such juvenile delinquency, increased levels of violent behavior and weapon use, increased alcohol use and substance abuse, lowered self-esteem, social difficulties with peers, decrements in IQ, and poor academic performance.  There is ample evidence that such victimization experiences could also lead to various damaging psychological and mental health issues in the forms of post-traumatic stress disorder (PTSD), increased depression and anxiety symptoms, reduced expectation about future survival, and suicidal ideation or attempt.  These psychological effects may have life-long consequences.

How many adolescents in the U.S. are affected by violence in their communities? Using national data, we found high percentages of adolescents affected by community violence—ranging from about one-third for Asian Americans and whites to 54 percent for Hispanics and 59 percent for African Americans.

Will diverse violence victimization experience result in different responses among the victims?  In our study, we found that different types of community victimization experiences would have various impacts on individual’s mental health.  Compared to those who never experienced violence in their communities, adolescents who were both a witness and a victim will have the most severe depressive symptoms, followed by those only witnessing community violence, then, perhaps counter-intuitively, those who were only victims of violence.  The degree of negative impact remains consistent from adolescence through adulthood.

In addition to providing medical care for the physical injuries, what else can be done to assist adolescents affected by violence in their communities?  Mental health services such as psychotherapy have established evidence in successfully addressing psychological issues for individuals in need of help.  Nevertheless, will the victim seek and receive mental health services to address their psychological distress from victimization?  Will the difference in timing of accessing care make any difference?

In our study, we found a greater percentage of mental health service utilization among adolescents affected by community violence, both as witnesses and as victims during young age as compared to those who neither witnessed nor experienced victimization.  However, when they became young adults, only adolescent victims were more likely to use mental health service.  Fewer adolescent witnesses of violence used mental health services than non-witnesses when they became adults.

For adolescents who witnessed violence in their communities, with the help of mental health professionals, in time, the negative impact from violence (in the form of depression) was lessened thus mitigating effects into young adulthood.  Subsequently, we observed a reduction in the mental health service utilization rate among adolescent witnesses of violence when they became young adults.

Although adolescent victims of violence reported more depression than non-victims, those who experienced attacks but never saw others being hurt would not use mental health services during their youth.  Instead, we found these victimization experiences to be related to their seeking mental health treatment when they became adults.  Use of mental health services during this time did not lesson the negative psychological impact from being attacked during their youth. For adolescents who were both victimized and saw others being victimized, use of mental health services appeared to have a marginal effect in reducing the impact from victimization on their depression, both during adolescence and later.

Research has shown that most parents and mental health professionals are not aware of adolescent violent victimization experiences.  Our study finding suggests that screening adolescents who have been affected by violence in their communities and providing them with appropriate mental health treatments could be effective in supporting healthy development.

Wan-Yi Chen
Associate Professor, West Chester University
Graduate Social Work Department
West Chester, PA, USA

 

Publication

Longitudinal Trajectory of Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage.
Chen WY, Corvo K, Lee Y, Hahm HC
Community Ment Health J. 2016 Jun 10

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