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The impact of stigma and discrimination against persons with mental illness is well documented. Less well researched are the interpersonal and intrapersonal mechanisms that mediate how acts of discrimination impact persons with mental illness, specifically social support. Past research has focused on the buffering, or moderating impact of perceived social support. We hypothesize that perceived social support is a psychological process, changed by interactions with the outside world, including stressful interactions. In this study, we explore perceived social support as a mediator between the impact of experienced discrimination and mental health. We also test the moderating hypotheses as a way to determine if past research on the role of perceived social support is a better model than the mediating model. We used data from a subset of the Canadian Community Health Survey-Mental Health. We tested the mediating role of perceived social support using the bootstrapped estimate of the 95% confidence interval of the indirect effect. We also tested the buffering hypothesis of perceived social support, using the product of the impact of decimation measure and perceived social support measure. The results suggest that perceived social support does mediate the relationship between the impact of experienced discrimination and mental health. The buffering hypothesis did not hold. Results suggest a new way to model the relationship of perceived social support, stigma, and mental health. Further, the results provide insights into the importance of intervening at the point of discrimination.

This paper explores the biopsychosocial and spiritual needs of adolescents and young adults (AYA) with life-threatening or terminal illnesses. AYA are situated between childhood and adulthood (ages 15-25) and have distinct biopsychosocial and spiritual needs unique to their developmental stage. Having a life-threatening or terminal illness directly challenges normal AYA developmental tasks and identity formation. AYA experience more troubling physical symptoms during the dying process compared to other age groups, which leads to significant psychological distress and an increased need for pharmacological treatments. In general, AYA desire to be fully informed and involved in the health care decision-making process, leading to ethical dilemmas when the AYA is a minor and their wishes differ from the wishes of their legal guardian(s). Social workers are especially well-equipped to serve this population due to aligning professional standards and ability to advocate for holistic care within interdisciplinary teams. Additional research is needed to tailor holistic interventions to meet the needs of this population.

One-third or more of persons presenting to Emergency Rooms (ER)/ Accident and Emergency departments in psychiatric emergencies report experiencing suicidal ideations. A critical task for hospital-based practitioners is to assess the lethality of the situation to determine whether the person should be hospitalized. Practitioners often employ standardized assessment instruments to assist in determining the suicidal risk factors, yet such measures often fail to recognize or consider the following: 1) the relative importance of the therapeutic process in creating meaningful therapeutic change; 2) the quality of the therapeutic encounter in the ER; and 3) follow-through with the community referral process.Findings: This article proposes the use of the actual ER encounter between client and practitioner to work with suicidal risk factors that are amenable to immediate therapeutic change. Using a therapy approach that can positively impact a client's level of hopelessness and allow for the assessment of suicide risk can work to ensure that an appropriate hospitalization disposition is reached.Application: This article details how the use of solution-focused therapy provides one avenue for assessing suicide risk and how the therapeutic intervention, which has not been subjected to the scrutiny of empirical research, can serve as an opportunity for increasing hope.