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Godshall KC, Cross Hansel T, Brewer K. Exploring Teen Suicide Rates through the Lens of Macro Risk Factors. Soc Work Public Health 2024; 39:313-322. [PMID: 38415692 DOI: 10.1080/19371918.2024.2324145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
As the second leading cause of death in teenagers, suicide has been a consistent public health issue for the past decade. Our goal is to understand the relationship between increasing teen suicide rates by state policies. We explore links between macro-level risk factors and state suicide rates. Risk factors explored include state behavioral health spending, child access policies for firearms, insurance coverage, tax revenue from tobacco and alcohol, school spending per pupil, pupil support services funding, and teacher spending. This research shows a relationship between pupil support spending, any child access law, required legislation, and lower teen suicide rates. The results from this study can aid in the understanding of macro-level influences on teen suicide; empowering advocates, lawmakers, and researchers to develop informed interventions and policies. Increasing multi-level understanding around suicide can provide an opportunity to slow or stop suicide rates.
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Affiliation(s)
| | | | - Kathryne Brewer
- Social Work Department, University of New Hampshire, Durham, NH, USA
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Saltzman LY, Hansel TC. Psychological and social determinants of adaptation: the impact of finances, loneliness, information access and chronic stress on resilience activation. Front Psychol 2024; 15:1245765. [PMID: 38469213 PMCID: PMC10925763 DOI: 10.3389/fpsyg.2024.1245765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Abstract
Background Many people who face adversity, such as disasters, demonstrate resilience. However, less is known about reactions to large scale disasters with longer recovery periods. The concern is that protracted disasters may result in more chronic or accumulated stressors with an uncertain or unknown end point and can exhaust the natural coping methods and ability to rebound. Thus, understanding patterns of longer-term disaster recovery, inclusive of resilience, is needed. Further resilience is not individual specific rather social determinants, such as support networks and available resources, are contributing factors. Methods The purpose of this study is to improve understanding of mental health and resilience during increased stress, we aim to identify profiles of adaptation and psychological and social determinants that predict membership within predominant symptom groupings. We conducted an exploratory cross-section study (N = 334) with two phases of multivariate analysis. Latent profile models were estimated to identify groups based on depression, anxiety, and resilience scores. The second phase included a step-wise multinomial logistic regression to predict class membership. Results We identified four distinct groups: 33% of participants were categorized as anxious, 18% depressed, 9% comorbid, and 40% with above average levels of resilience. Psychosocial factors such as demographics, trauma history, information access, loneliness, and lack of financial resources predicted poorer mental health outcomes and lower resilience. Conclusion This study identified factors that contribute to overall wellbeing despite chronic stressors. Social determinants of adaptation, found in this study population, include loneliness, finances, and information access. The findings from this study support the need for both psychological and social adaption supports, inclusive of mental health treatment, to strengthen resilience activation.
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Affiliation(s)
| | - Tonya Cross Hansel
- School of Social Work, Tulane University, New Orleans, LA, United States
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Hansel TC, Saltzman LY, Melton PA. Work Environment and Health Care Workforce Well-Being: Mental Health and Burnout in Medically Underserved Communities Prone to Disaster. Am J Public Health 2024; 114:156-161. [PMID: 38354340 PMCID: PMC10916726 DOI: 10.2105/ajph.2023.307478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 02/16/2024]
Abstract
Health care workers (n = 71) completed an online survey or participated in one of five focus groups. Clinical cutoff scores revealed concerning levels of depression (16%), anxiety, and burnout (49%). Qualitative responses (n = 172) yielded two themes: work environment and well-being. Addressing burnout requires an ecological systems mindset, which accounts for complex stressors present in individual providers' lives (large-scale disasters and personal stressors), agency-level factors (scheduling and workload), and larger social and contextual administrative factors (allocating time for self-care through scheduling and billing codes). (Am J Public Health. 2024;114(S2):S156-S161. https://doi.org/10.2105/AJPH.2023.307478).
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Affiliation(s)
- Tonya Cross Hansel
- Tonya Cross Hansel, Leia Y. Saltzman, and Pamela A. Melton are with the School of Social Work, Tulane University, New Orleans, LA
| | - Leia Y Saltzman
- Tonya Cross Hansel, Leia Y. Saltzman, and Pamela A. Melton are with the School of Social Work, Tulane University, New Orleans, LA
| | - Pamela A Melton
- Tonya Cross Hansel, Leia Y. Saltzman, and Pamela A. Melton are with the School of Social Work, Tulane University, New Orleans, LA
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Abstract
INTRODUCTION The COVID-19 pandemic remains a significant mental health crisis. Although empirical research works to better understand the impact of COVID-19 on the mental health of the general population, some groups remain at greater risk for adverse mental health consequences. The purpose of this study is to better understand how COVID-19 experiences, food insecurities, and social support are associated with mental health and well-being for aging populations. METHODS Data collection began April 1, 2020 and continued through May 22, 2020. Study participants were recruited via website and media promotion and completed an anonymous survey. A sample of adults age 50 years and older (N = 136) were selected for the current analysis. Measures included scales of anxiety, depression, resilience, quality of life, COVID-19 experiences, interdependence, and insecurities. Three stepwise linear regression models were conducted using forward selection were estimated. RESULTS The first model found food insecurity, community closeness, and COVID-19 experiences predicted 23% of the variance in mental health. The second model found having enough money to meet needs, COVID-19 interdependence, and age predicted 20% of the variance in resilience. The final model found having enough money to meet needs, COVID-19 experiences, community closeness, and information access predicted 45% of the variance in quality of life. DISCUSSION Our discussion highlights the role of COVID-19 experiences, tangible resource losses, and community connection in mental health outcomes for aging populations during COVID-19. We suggest areas of future research and highlight the important role of technology in both scholarship and practice.
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Affiliation(s)
- Maya Martin
- School of Social Work, Tulane University, New Orleans, LA, USA
| | - Leia Y Saltzman
- School of Social Work, Tulane University, New Orleans, LA, USA
| | - Veronica Henry
- School of Social Work, Tulane University, New Orleans, LA, USA
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Weiss A, Steadman S, Mercier HD, Hansel TC, Chaudhry S, Clark I. Pathways to Care: How Help-Seeking Behaviors Relate to Duration of Untreated Psychosis and Treatment Engagement. Psychiatr Q 2022; 93:473-482. [PMID: 34669120 DOI: 10.1007/s11126-021-09960-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 01/20/2023]
Abstract
While much research has focused on the relationship between duration of untreated psychosis (DUP) and clinical outcomes in the first episode psychosis (FEP) patient population, little is known about the individual help-seeking episodes (HSE) that patients undergo before receiving appropriate care. The purpose of this project is to better understand how early referral to FEP-specific care and support system differences affect patients' DUP and engagement with treatment. Data from 50 patients was analyzed at the Early Psychosis Intervention Clinic of New Orleans (EPIC-NOLA) using a modified version of the Pathways to Care Assessments and data captured during clinical care. Patients with their first HSE leading to a referral to EPIC-NOLA (M = 13.3, SD = 11.17) had shorter DUP compared to patients referred after two or more HSEs (M = 29.7, SD = 36. 7), t (38.6) = 2.31, p = .026, 95%CI = 2.0-30.7. One chi-square test revealed a significantly greater proportion of patients referred after one HSE stayed in treatment for 12 months or more. Cluster analysis and independent t-test analyses revealed that patients with hospital pathways (M = 35.00, SD = 39.36) had significantly longer DUP compared to those with self, other and hospital (M = 15.21, SD = 19.07) care pathways. This study supports existing literature that suggest early FEP treatment leads to shortened DUP and longer treatment engagement. Additionally, patients with support systems (people or services) assisting them with help-seeking reach EPIC-NOLA faster, have shorter DUP, and have better treatment engagement.
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Affiliation(s)
- Ashley Weiss
- Department of Psychiatry and Behavioral Services, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Spencer Steadman
- Department of Psychiatry and Behavioral Services, Tulane University School of Medicine, New Orleans, LA, USA
| | - Hannah D Mercier
- Department of Psychiatry and Behavioral Services, Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Serena Chaudhry
- Department of Psychiatry and Behavioral Services, Tulane University School of Medicine, New Orleans, LA, USA
| | - Isabel Clark
- Department of Psychiatry and Behavioral Services, Tulane University School of Medicine, New Orleans, LA, USA
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Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psychol Trauma 2020; 12:S55-S57. [PMID: 32551762 DOI: 10.1037/tra0000703] [Citation(s) in RCA: 277] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Social support plays a key role in well-being, yet one of the major preventative efforts for reducing the spread of COVID-19 involves social distancing. During times of crisis, social support is emphasized as a coping mechanism. This requires many people to change their typical ways of connectedness and assumes that people have existing healthy relationships or access to technology. The purpose of this article was to explore the potential impact of COVID-19 on loneliness and well-being. Social support is an important consideration for understanding the impact of COVID-19 Psychological First Aid and Skills for Psychological Recovery, which are tools used to inform response methods to help people connect during isolation and are interventions that could be adapted to COVID-specific needs for what may be a prolonged isolation and postisolation. Given the many unknowns of COVID-19, studies are needed to understand the larger behavioral health impact to ensure resources are available, current, and evidence informed. Future studies are also needed to understand how access to technology may help buffer loneliness and isolation and thus improve the social outcomes of the current pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Osofsky JD, Drell MJ, Osofsky HJ, Hansel TC, Williams A. Infant Mental Health Training for Child and Adolescent Psychiatry: A Comprehensive Model. Acad Psychiatry 2017; 41:592-595. [PMID: 27561276 DOI: 10.1007/s40596-016-0609-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 08/15/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Joy D Osofsky
- Louisiana State University Health Sciences Center, New Orleans, LA, USA.
| | - Martin J Drell
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Howard J Osofsky
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Osofsky HJ, Speier A, Hansel TC, Wells JH, Kaliebe KE, Savage NJ. Collaborative Health Care and Emerging Trends in a Community-Based Psychiatry Residency Model. Acad Psychiatry 2016; 40:747-754. [PMID: 27160893 DOI: 10.1007/s40596-016-0566-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/21/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This paper provides a report of an academic department of psychiatry's journey into the change process associated with addressing the new requirements in health-care delivery, the emphasis on person-centered treatment models, and the implications for residency training programs. Louisiana State University Health Sciences Center Department of Psychiatry's experience is based on responding to real-world shifts in which academic departments can play a leadership role. METHODS Importantly, methods are based on person-centered collaboration being central to a successful change process and include a description of the training, with data supporting implementation of the model. RESULTS The model demonstrates increased access to care and improved behavioral health symptoms. It indicates that with proper training and supervision, psychiatry residents can be an agent of change. CONCLUSION This brief review of our experience offers to other departments of psychiatry examples of collaborative strategies substantially informed by the needs and preferences of both persons accessing services and local communities.
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Affiliation(s)
- Howard J Osofsky
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Anthony Speier
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Tonya Cross Hansel
- Louisiana State University Health Sciences Center, New Orleans, LA, USA.
| | - John H Wells
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | | | - Nicole J Savage
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Abstract
Environment as a contextual factor plays an important role in southeastern Louisiana, as this area represents a major economic hub for the United States port, petroleum, and fishing industries. The location also exposes the population to both natural and technological disasters, including Hurricane Katrina and the Gulf oil spill. This study explored associations among hurricane loss, oil spill disruption, and environmental quality of life on mental and physical health on over 1,000 residents (N = 1,225) using structural equation modeling techniques. Results showed that oil spill distress was associated with increased symptoms of mental and physical health; Hurricane Katrina loss; and decreased environmental quality of life. Findings also indicate that mental health symptoms explain the association among oil spill distress and physical health symptoms-specifically, those that overlap with somatic complaints. These findings provide important support of the need for mental health assessment and service availability for disaster recovery.
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Osofsky J, Kronenberg M, Bocknek E, Cross Hansel T. Longitudinal Impact of Attachment-Related Risk and Exposure to Trauma Among Young Children After Hurricane Katrina. Child Youth Care Forum 2015. [DOI: 10.1007/s10566-015-9300-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hansel TC, Osofsky HJ, Steinberg AM, Brymer MJ, Landis R, Riise KS, Gilkey S, Osofsky JD, Speier A. Louisiana Spirit Specialized Crisis Counseling: Counselor perceptions of training and services. Psychological Trauma: Theory, Research, Practice, and Policy 2011. [DOI: 10.1037/a0024644] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hansel TC, Osofsky HJ, Osofsky JD, Costa RN, Kronenberg ME, Selby ML. Attention to process and clinical outcomes of implementing a rural school-based trauma treatment program. J Trauma Stress 2010; 23:708-15. [PMID: 21171131 DOI: 10.1002/jts.20595] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Louisiana Rural Trauma Services Center was established to provide, improve, and enhance urgently needed assessment, treatment, crisis management, and consultation services for children and adolescents exposed to traumatic events in three rural southeastern Louisiana parishes. The purpose of this study is to describe the process of implementing the rural school-based trauma treatment program and to evaluate its effectiveness in 115 students. Through attention to process including the three-tiered approach of relationship building, trauma training, and trauma services, the school-based trauma treatment program proved effective in reducing trauma symptoms. This study is important to support the widespread implementation of school-based mental health services.
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Affiliation(s)
- Tonya Cross Hansel
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
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Kronenberg ME, Hansel TC, Brennan AM, Osofsky HJ, Osofsky JD, Lawrason B. Children of Katrina: Lessons Learned About Postdisaster Symptoms and Recovery Patterns. Child Dev 2010; 81:1241-59. [DOI: 10.1111/j.1467-8624.2010.01465.x] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Osofsky HJ, Osofsky JD, Kronenberg M, Brennan A, Hansel TC. Posttraumatic stress symptoms in children after Hurricane Katrina: predicting the need for mental health services. Am J Orthopsychiatry 2009; 79:212-20. [PMID: 19485638 DOI: 10.1037/a0016179] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The purpose of this study was to examine factors related to the development of posttraumatic stress symptoms in children and adolescents after Hurricane Katrina. It was hypothesized that a positive correlation would exist between trauma exposure variables and symptoms indicating need for mental health services experienced 2 years after Hurricane Katrina. Specifically, the authors hypothesized that experiences associated with natural disaster including personal loss, separation from family and/or community, and lack of community support as well as previous loss or trauma would be related to increased symptomatology in both children and adolescents. This study included 7,258 children and adolescents from heavily affected Louisiana parishes. Measures included the Hurricane Assessment and Referral Tool for Children and Adolescents developed by the National Child Traumatic Stress Network (NCTSN, 2005). Results were generally supportive of our hypotheses, and specific exposure and demographic variables were found to be strongly related to posttraumatic stress symptoms in children and adolescents.
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Affiliation(s)
- Howard J Osofsky
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA 70130, USA.
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