Emergency departments (EDs) across the country have been forced to accommodate an ever-expanding population of mental health patients. This study surveyed physicians and social workers in order to determine the most commonly treated mental illnesses in the ED, common frustrations in the care of mental health patients, limitations in the provision of treatment, and possible changes and improvements to the treatment system for the future. Attitudes toward the deinstitutionalization movement of the 1960s also were assessed, as this movement is hypothesized to have contributed to the current strain on EDs with respect to treating mental health issues. In this thesis, the deinstirutionalization movement and possible implications for mental health treatment in EDs are reviewed' In addition, questionnaires were administered to a sample of 6 ED doctors and 2 ED social workers-. Survey responses suggest that more resources, including availability of ED staff psychiatrists and dedicated facilities for mental health patients' would offer improvements to the current system. With careful evaluation of the ability of the ED to meet the needs of mental health patients, alternative resources for more effective and successful treatment strategies may be developed that offer a compromise between institutionalization and the revolving door of the ED.

Previous studies have established a link between parenting style (e.g. authoritarian, authoritative, permissive) and depression in children and adolescents. Parenting factors are also implicated in the development of emotion regulation. There is a gap in the literature, however, concerning perceptions of parenting in relation to adult depression. The current study examined the effect of parenting on reported adult depressive symptoms. Of interest was the role of emotion regulation strategies in this relationship. Participants were recruited through Amazon Mechanical Turk, and the sample consisted of 302 adults (125 males, 177 females) ranging in age from 18 to 65. Measures of how participants were parented by their mothers and fathers, emotion regulation strategies most frequently utilized, and current depressive symptoms were collected using an online survey. The emotion regulation strategy, positive reappraisal, was found to moderate the relation between maternal authoritative parenting and depression. Permissive parenting was also significantly predictive of depression, but catastrophizing fully mediated only the relation between maternal permissive parenting and depressive symptoms. Authoritarian parenting was unrelated to depression and emotion regulation in this study. The findings of this study indicate that the effects of how an individual was parented may persist into adulthood. Implications of these findings and future directions for further research are discussed.

Approximately one-third of Iraq and Afghanistan veterans develop mental health problems, yet only 35-40% of those with mental disorders are seeking mental healthcare (Hoge, et al., 2004; Vogt, 2011). Military spouses may be an important resource for facilitating treatment seeking (Warner, et al., 2008), especially if service member mental health issues are impacting the marriage. Military spouses might be hesitant to encourage service member help-seeking, however, due to perceived threat of adverse military career consequences. For this study, 62 military wives completed an online survey. As part of the survey, participants were randomly assigned to one of four vignettes containing a description of a hypothetical military husband with mental health symptoms. Each vignette presented different combinations of marital conflict (high versus low) and service member concerns about adverse career consequences (high versus low). Wives rated on a five-point scale how likely they were to encourage the hypothetical military husband to seek help. It was hypothesized that spouses would be more willing to encourage help-seeking when concerns about adverse military career consequences were low and marital distress was high. No main effects or interaction effect were found for marriage and career. Perceived stigma about seeking mental health treatment in the military, psychological identification as a military spouse, and experience and familiarity with military mental healthcare policies failed to moderate the relationship between marital conflict, career concerns, and encouragement of help-seeking. Correlational analyses revealed that (1) greater experience with military mental healthcare (first- or secondhand), and (2) greater perceptions of stigma regarding seeking mental healthcare in the military each were associated with decreased perceptions of military supportiveness of mental healthcare. Therefore, although the experimental manipulation in this study did not lead to differences in military spouses' encouragement of a hypothetical military service member to seek mental health services, other findings based on participants' actual experiences suggest that experiences with military mental healthcare may generate or reinforce negative perceptions of military mental healthcare. Altering actual experiences with military mental healthcare, in addition to perceptions of stigma, may be a useful area of intervention for military service members and spouses.

Parents are the primary source for socializing children's attitudes and behaviors about adaptive concepts such as how to stay safe and reduce risk. Parent-child discussions about potential health risks have the ability to evoke anxiety in both mothers and children. This study examined the impact of observed anxiety on non-clinically anxious families, and the differences observed between anxious or non- anxious families. Sixty-one mothers engaged in naturalistic conversation with their children (aged 9-11) about their potential exposure to an anxiety-provoking situation, an Avian influenza pandemic. Conversations were video recorded and observational data were collected to examine mother and child behaviors; questionnaire data from both mothers and children supplemented this observational data. Results indicated that anxious children were more engaged in these discussions than less anxious children, and anxious mothers were less engaged than non-anxious mothers. The content of the parent-child conversations varied between non-anxious and anxious dyads; mothers were more likely to remind their children that the situation was "pretend" if they recognized that their child became anxious, and mothers that emphasized the severity of the hypothetical situation had children who self-reported higher levels of anxiety. Underlying parental beliefs about how children develop also varied among mothers; mothers of anxious children were more likely to believe that their children learn because of cognitive development that occurs through their own interactions within their environment, while there was a trend for mothers of non-anxious children to hold stronger beliefs that children learn through modeling and the direct teaching of behaviors. Results indicate that dysfunctional behaviors previously observed in clinically anxious families may be apparent within non-clinically anxious families when anxiety levels increase, and the bi-directional influence of mother-child anxious behavior is explored. This study builds on our understanding of parent-child interactions, parent socialization behaviors, and the importance of minimizing anxiousness during parent-child threat discussions evoking child anxiety.