Identifying Young People's Guidance Needs through Telephone Counseling

ABSTRACT This study examined the needs that young people in Guadalajara, in the state of Jalisco, Mexico, expressed in phone calls to a research unit of the Mexican Social Security Institute. Three hundred forty-five calls, from individuals 11 to 24 years old who phoned from June 1995 to November 1998, were analyzed. Two hundred ninety-four of the callers were female and 51 were male. Greater percentages of females than males called to ask about sexuality and family problems. Males more than females asked about reproductive health (particularly pregnancy) and mental health. There were significant differences by gender and age, differences that were not detected in health service statistics. The findings have implications for decision makers and health and education service providers. They point to the need for programs that will reinforce young people's good health practices and help them avoid risky behaviors. Young people (ages 10 to 24 years old) represent 33.5% of the total population in the state of Jalisco, Mexico (INEGI, 1996). However, few have the opportunity to receive professional counseling or other assistance for their social, psychological, and developmental problems because of a lack of specialized health services for this age group. Available services tend to deal with, and keep records on, accidents and violence, contagious and parasitic diseases, respiratory diseases, tumors, and pregnancy, delivery, and puerperium-related complications (Reyes et al., 1994). The demands for care that are reported are primarily visits to the doctor because of respiratory and digestive sicknesses and accidents (Rasmussen & Hidalgo, 1998). Thus, statistical data, which no doubt point to public health problems, do not necessarily reflect young people's need for information and help with socioaffective issues. Research indicates that when young people are faced with problems and specific needs, they prefer services that can ensure confidentiality, anonymity, quality, and accessibility (Nuno et al., 1998)--conditions recommended by the Society for Adolescent Medicine (1992). Phone services have the ability to meet these requirements. Phone services date back to the end of the 1950s in the United States, when crisis care began, mainly for suicide prevention. Since then, phone services have evolved and increased (see Slaikeu & Leff, 1988), with the addition of crisis situation interventions (Boehm & Campbell, 1995; Jianlin, 1995), sexually transmitted disease (STD) counseling (Neumann, 1996), and treatment support programs (Leed-Kelly et al., 1996). The reasons why young people use phone counseling services have been found to vary by age and gender, and to range from calls "just to talk" to calls about suicide. Nevertheless, researchers have reported that peer relationships, family relationships, and sex are the most common topics, followed by self-esteem issues and substance abuse problems (Boehm, Schondel, Marlowe, & Rose, 1995; Boehm, Schondel, Ivoska, Marlowe, & Manke-Mitchell, 1998; Neumann, 1996; Holmberg, 1997). There have been telephone counseling services in Mexico since 1987. In 1994, a phone service began in Mexico City for adolescents called De Joven a Joven (From One Young Person to Another). It was found that 41% of the callers were between the ages of 15 and 17, 66% were female, 76% were junior high and senior high school students, and 19% were employed. Among the most common issues were peer relationships, going steady, and family relationships, as well as aspects of sex and reproductive health (CONAPO, 1998). The purpose of the present study was to examine the phone counseling needs of young people in Guadalajara, Mexico. METHOD Since 1994, the Epidemiological and Adolescent Health Services Research Unit (Unidad de Investigacion Epidemiologica y en Servicios de Salud del Adolescente; UIESSA) of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social; IMSS) in Guadalajara has collaborated with a local newspaper to answer adolescents' questions. …