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Trost K, Ertl V, König J, Rosner R, Comtesse H. Climate change-related concerns in psychotherapy: therapists' experiences and views on addressing this topic in therapy. BMC Psychol 2024; 12:192. [PMID: 38589939 PMCID: PMC11003001 DOI: 10.1186/s40359-024-01677-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND While adverse impacts of climate change on physical health are well-known, research on its effects on mental health is still scarce. Thus, it is unclear whether potential impacts have already reached treatment practice. Our study aimed to quantify psychotherapists' experiences with patients reporting climate change-related concerns and their views on dealing with this topic in psychotherapy. METHODS In a nationwide online survey, responses were collected from 573 psychotherapists from Germany. Therapists reported on the presence of such patients, their socio-demographic characteristics, and climate change-related reactions. Psychotherapists' views on dealing with this topic in psychotherapy were also assessed. Descriptive statistics were used to analyse the responses. RESULTS About 72% (410/573) of psychotherapists indicated having had patients expressing concerns about climate change during treatment. Out of these therapists, 41% (166/410) stated that at least one patient sought treatment deliberately because of such concerns. Patients were mainly young adults with higher education. Most frequent primary diagnoses were depression, adjustment disorder, and generalized anxiety disorder. Psychotherapists having encountered such patients differed from those without such encounters in their views on potential functional impairment and the necessity to target the concerns in treatment. Although 79% (326/415) of all respondents felt adequately prepared by their current therapeutic skills, 50% (209/414) reported a lack of information on how to deal with such concerns in therapy. CONCLUSIONS Results indicate that psychotherapists are frequently confronted with climate change-related concerns and regard the mental health impact of climate change on their patients as meaningful to psychotherapeutic care. Regular care could be improved by a continuous refinement of the conceptualization and knowledge of the mental health influences of climate change. This would allow providing tailored methods of assessing and addressing climate change-related concerns in practice.
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Affiliation(s)
- Katharina Trost
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany.
| | - Verena Ertl
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Julia König
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Rita Rosner
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Hannah Comtesse
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
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Laboe AA, McGinnis CG, Fennig M, Zucker K, Wu E, Shah J, Levitan J, Firebaugh ML, Bardone-Cone AM, Pike KM, Taylor CB, Wilfley DE, Fitzsimmons-Craft EE. Development and usability testing of a cognitive-behavioral therapy-guided self-help mobile app and social media group for the post-acute treatment of anorexia nervosa. Eat Behav 2024; 53:101865. [PMID: 38461772 DOI: 10.1016/j.eatbeh.2024.101865] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/23/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Anorexia nervosa (AN) is often treated in the acute setting, but relapse after treatment is common. Cognitive-behavioral therapy (CBT) is useful in the post-acute period, but access to trained providers is limited. Social support is also critical during this period. This study utilized a user-centered design approach to develop and evaluate the usability of a CBT-based mobile app and social networking component for post-acute AN support. METHOD Participants (N = 19) were recently discharged from acute treatment for AN. Usability testing of the intervention was conducted over three cycles; assessments included the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), the Mobile Application Rating Scale (MARS), a social media questionnaire, and a semi-structured interview. RESULTS Interview feedback detailed aspects of the app that participants enjoyed and those needing improvement. Feedback converged on three themes: Logistical App Feedback, boosting recovery, and Real-World App/Social Media Use. USE and MARS scores were above average and SUS scores were "good" to "excellent" across cycles. CONCLUSION This study provides evidence of feasibility and acceptability of an app and social networking feature for post-acute care of AN. The intervention has potential for offering scalable support for individuals with AN in the high-risk period following discharge from acute care.
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Affiliation(s)
- Agatha A Laboe
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Claire G McGinnis
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Molly Fennig
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kianna Zucker
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Ellis Wu
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jillian Shah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Julie Levitan
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Anna M Bardone-Cone
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen M Pike
- Departments of Psychiatry, Epidemiology and Psychology, Columbia University, New York City, NY, USA
| | - C Barr Taylor
- Center for m2Health, Palo Alto University, Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Pirard P, Motreff Y, Stene LE, Rabet G, Vuillermoz C, Vandentorren S, Baubet T, Messiah A. Initiation of multiple-session psychological care in civilians exposed to the November 2015 Paris terrorist attacks. Arch Public Health 2023; 81:207. [PMID: 38031202 PMCID: PMC10685664 DOI: 10.1186/s13690-023-01206-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Terrorist attacks can induce post-traumatic stress disorder (PTSD) and depression, which require multiple-session psychological care (MSPC). This study aims at investigating MSPC initiation and associated factors. METHODS Data were collected from a web-based survey of civilians 8-12 months after their exposure to the November 2015 Paris terrorist attacks. Depression and partial and full PTSD were assessed using the Hospital Anxiety and Depression Scale and the PCL-5 checklist, respectively. Questionnaires collected data on socio-demographic variables, exposure to the attacks, psychological treatment history, social isolation, somatic problems, having received an outreach psychological support (OPS), consultations with a general practitioner, contact with an association for victims, MSPC initiation and, if not, reasons for not having initiated it. Logistic regressions were used to examine factors associated with MSPC initiation. RESULTS Among the 450 respondents, 154 reported having initiated a MSPC after the attacks. Of the 134 who provided the MSPC initiation date, 50% did so during the first month. Among the respondents with at least one of the considered psychological disorders, 53% declared not having initiated yet a MSPC. The primary three reasons for not having initiated a MSPC among people with PTSD were "did not feel the need", "it was not the right time to talk about it", and "not offered". For people with at least one psychological disorder, MSPC initiation was associated with the number of somatic problems, type of exposure (witness, threatened, indirectly exposed), prior psychological treatment, being a woman, being in a relationship, having consulted a psychiatrist or a psychologist, having received an OPS, and being in contact with association for victims. CONCLUSION The organization of adequate psychological care after a terror attack must take into account the need for healthcare that may emerge several months after the attack, and that witnesses seem less likely to receive MSPC than persons directly threatened despite their psychological disorder. Associations for victims and OPS seem to facilitate access to MSPC. Furthermore, our findings highlight the need to train physicians to screen for psychological disorders in persons exposed to terrorist attacks who present with somatic disorders.
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Affiliation(s)
- Philippe Pirard
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France.
- Team MOODS, Inserm-CESP, Université Paris-Saclay, UVSQ, 94807, Villejuif, France.
| | - Yvon Motreff
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, F75012, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Gabrielle Rabet
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France
| | - Cécile Vuillermoz
- Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, F75012, France
| | - Stéphanie Vandentorren
- Santé Publique France, French National Public Health Agency, Saint-Maurice, F-94415, France
- UMR 1219, Bordeaux Population Health Research Center, PHARes Team, University of Bordeaux, Bordeaux, France
| | - Thierry Baubet
- Université Sorbonne Paris Nord, UTRPP EA 4403, Villetaneuse, France
- AP-HP, Hôpital Avicenne, Bobigny, France
- Resources and Resilience National Centre (CN2R), LilleParis, France
| | - Antoine Messiah
- Team MOODS, Inserm-CESP, Université Paris-Saclay, UVSQ, 94807, Villejuif, France
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Lu W, Keyes KM. Major depression with co-occurring suicidal thoughts, plans, and attempts: An increasing mental health crisis in US adolescents, 2011-2020. Psychiatry Res 2023; 327:115352. [PMID: 37506585 DOI: 10.1016/j.psychres.2023.115352] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023]
Abstract
This study aimed to examine national trends and disparities in the prevalence and treatment of adolescent 12-month major depressive episode (MDE) with co-occurring suicidal thoughts, plans, and attempts. Publicly available data for adolescents aged 12-17 in the 2011-2020 National Survey on Drug Use and Health were analyzed. Bivariate and multivariable logistic regression analyses were conducted. In 2011, 4.6%, 2.1%, and 1.7% of adolescents had 12-month MDE with co-occurring suicidal thoughts, plans, and attempts, and the prevalence increased steadily to 9.8%, 5.3%, and 3.5% in 2019, respectively. In 2011, 45% of adolescents with MDE and suicidal thoughts received any mental health treatment, and the prevalence increased slightly to 46.6% in 2019. Meanwhile, the prevalence of treatment use among adolescents with MDE and suicidal plans remained stable at below 54%. Lastly, the prevalence of treatment use increased significantly from 53.6% in 2011 to 60.8% in 2019 among those with MDE and suicidal attempts. Continued high prevalence and low treatment use were observed in 2020. Disparities in treatment use were found in older adolescents, adolescents without insurance, Hispanics, and Asians. Concerted efforts are needed to prioritize evidence-based interventions, enhance outreach to high-risk groups, and expand service provisions to underserved adolescents.
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Affiliation(s)
- Wenhua Lu
- Department of Community Health and Social Medicine, School of Medicine, The City University of New York, New York, United States.
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
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Lin S(L. Inequities in Mental Health Care Facing Racialized Immigrant Older Adults With Mental Disorders Despite Universal Coverage: A Population-Based Study in Canada. J Gerontol B Psychol Sci Soc Sci 2023; 78:1555-1571. [PMID: 36842070 PMCID: PMC10461535 DOI: 10.1093/geronb/gbad036] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Indexed: 02/27/2023] Open
Abstract
OBJECTIVES Contemporary immigration scholarship has typically treated immigrants with diverse racial backgrounds as a monolithic population. Knowledge gaps remain in understanding how racial and nativity inequities in mental health care intersect and unfold in midlife and old age. This study aims to examine the joint impact of race, migration, and old age in shaping mental health treatment. METHODS Pooled data were obtained from the Canadian Community Health Survey (2015-2018) and restricted to respondents (aged ≥45 years) with mood or anxiety disorders (n = 9,099). Multivariable logistic regression was performed to estimate associations between race-migration nexus and past-year mental health consultations (MHC). Classification and regression tree (CART) analysis was applied to identify intersecting determinants of MHC. RESULTS Compared to Canadian-born Whites, racialized immigrants had greater mental health needs: poor/fair self-rated mental health (odds ratio [OR] = 2.23, 99% confidence interval [CI]: 1.67-2.99), perceived life stressful (OR = 1.49, 99% CI: 1.14-1.95), psychiatric comorbidity (OR = 1.42, 99% CI: 1.06-1.89), and unmet needs for care (OR = 2.02, 99% CI: 1.36-3.02); in sharp contrast, they were less likely to access mental health services across most indicators: overall past-year MHC (OR = 0.54, 99% CI: 0.41-0.71) and consultations with family doctors (OR = 0.67, 99% CI: 0.50-0.89), psychologists (OR = 0.54, 99% CI: 0.33-0.87), and social workers (OR = 0.37, 99% CI: 0.21-0.65), with the exception of psychiatrist visits (p = .324). The CART algorithm identifies three groups at risk of MHC service underuse: racialized immigrants aged ≥55 years, immigrants without high school diplomas, and linguistic minorities who were home renters. DISCUSSION To safeguard health care equity for medically underserved communities in Canada, multisectoral efforts need to guarantee culturally responsive mental health care, multilingual services, and affordable housing for racialized immigrant older adults with mental disorders.
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Affiliation(s)
- Shen (Lamson) Lin
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong Special Administrative Region, China
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Dunbar MS, Breslau J, Collins R, Beckman R, Engel CC. Heterogeneity in Unmet Treatment Need and Barriers to Accessing Mental Health Services Among U.S. Military Service Members with Serious Psychological Distress. Adm Policy Ment Health 2023:10.1007/s10488-023-01289-4. [PMID: 37596460 DOI: 10.1007/s10488-023-01289-4] [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] [Accepted: 07/30/2023] [Indexed: 08/20/2023]
Abstract
The goal of the current study is to examine heterogeneity in mental health treatment utilization, perceived unmet treatment need, and barriers to accessing care among U.S. military members with probable need for treatment. Using data from the 2018 Department of Defense Health Related Behavior Survey, we examined a subsample of 2,336 respondents with serious psychological distress (SPD; past-year K6 score ≥ 13) and defined four mutually exclusive groups based on past-year mental health treatment (treated, untreated) and self-perceived unmet treatment need (recognized, unrecognized). We used chi-square tests and adjusted regression models to compare groups on sociodemographic factors, impairment (K6 score; lost work days), and endorsement of treatment barriers. Approximately 43% of respondents with SPD reported past-year treatment and no unmet need (Needs Met). The remainder (57%) met criteria for unmet need: 18% endorsed treatment and recognized unmet need (Treated/Additional Need); 7% reported no treatment and recognized unmet need (Untreated/Recognized Need); and 32% reported no treatment and no unmet need (Untreated/Unrecognized Need). Compared to other groups, those with Untreated/Unrecognized Need tended to be younger (ages 18-24; p = 0.0002) and never married (p = 0.003). The Treated/Additional Need and Untreated/Recognized Need groups showed similar patterns of treatment barrier endorsement, whereas the Untreated/Unrecognized Need group endorsed nearly all barriers at lower rates. Different strategies may be needed to increase appropriate mental health service use among different subgroups of service members with unmet treatment need, particularly those who may not self-perceive need for treatment.
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Affiliation(s)
- Michael S Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA.
| | - Joshua Breslau
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA
| | - Rebecca Collins
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - Robin Beckman
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | - Charles C Engel
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA
- Health Services Research & Development Center for Innovation, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA
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Swinkels LTA, Hoeve M, Ter Harmsel JF, Schoonmade LJ, Dekker JJM, Popma A, van der Pol TM. The effectiveness of social network interventions for psychiatric patients: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102321. [PMID: 37499318 DOI: 10.1016/j.cpr.2023.102321] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
Strengthening social networks is an important goal in mental health treatment. This study aimed to determine the effectiveness of social network interventions for psychiatric patients. A systematic review and meta-analysis was conducted comparing these interventions with control groups on social and mental health-related outcomes in psychiatric patients. PubMed, EMBASE.com, PsycInfo, Scopus, and IBSS were searched for studies until December 21, 2022. Three-level random effects models were used to obtain Cohen's d mean estimates on composite outcomes of social network and secondary mental health outcomes. Heterogeneity was examined with potential moderators. Thirty-three studies were included. Small-to-moderate effects of social network interventions were detected on positive social network (d = 0.115, p = 0.022) and support (d = 0.159; p = 0.007), general functioning (d = 0.127, p = 0.046), mental health treatment adherence (d = 0.332, p = 0.003), days substance use (d = 0.097, p = 0.004), and abstinence (d = 0.254, p = 0.004). Estimates of psychiatric functioning were higher in samples with more females. The quality of evidence was moderate-to-low. This evidence suggests that social network interventions can improve positive social networks, general functioning, mental health treatment adherence, and substance use in psychiatric patients receiving usual care. PROSPERO ID: CRD42019131959.
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Affiliation(s)
- L T A Swinkels
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - M Hoeve
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, Netherlands
| | - J F Ter Harmsel
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - L J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - J J M Dekker
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - T M van der Pol
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
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Hayes BB. Annual use and perceived need for mental health and substance treatment among people in remission from substance use disorders in the United States. Drug Alcohol Depend 2023; 249:110820. [PMID: 37329728 DOI: 10.1016/j.drugalcdep.2023.110820] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/31/2023] [Accepted: 06/03/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Receiving specialty substance treatment or general mental health treatment during remission from substance use disorders (SUD) may reduce odds of SUD recurrence, but little is known about prevalence of treatment or perceptions of treatment need among remitted people in the United States. SAMPLE Participants in the National Survey on Drug Use and Health, years 2018-2020, were considered remitted if they ever had an SUD (i.e., self-reported history of "problems with alcohol or drugs", or lifetime history of treatment for SUD) but did not meet DSM-IV criteria for substance abuse or dependence during the prior year (n = 9,295). ANALYSES Annual prevalence was estimated for any SUD treatment (e.g., mutual-help groups), any mental health (MH) treatment (e.g., private therapy), self-reported perceived need for SUD treatment, and self-reported unmet need for MH treatment. Generalized linear models examined effects of socio-demographics, mental illness, past-year substance use, and self-identified recovery status on outcomes. FINDINGS MH treatment was more common than SUD treatment (27.2% [25.6%, 28.8%] v. 7.8% [7.0%, 8.6%], respectively). Unmet need for mental health treatment was reported by 9.8% [8.8%, 10.9%], but only 0.9% [0.6%, 1.2%] perceived need for substance treatment. Age, sex, marital status, education, health insurance, mental illness, and prior year alcohol use were among the factors associated with variation in outcomes. CONCLUSION Most people who maintained clinical remission from substance use disorders in the U.S. during the prior year did so without treatment. Remitted people report substantial unmet need for mental health treatment, but not specialized substance use treatment.
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Affiliation(s)
- Bridget B Hayes
- Department of Psychology, Cornell University, United States; Substance Abuse and Mental Health Services Administration, United States.
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Hall SV, Zivin K, Piatt GA, Weaver A, Tilea A, Zhang X, Moyer CA. Factors associated with mental health treatment among Michigan medicaid enrollees with perinatal mood and anxiety disorders, 2012-2015. Gen Hosp Psychiatry 2023; 83:164-171. [PMID: 37210824 DOI: 10.1016/j.genhosppsych.2023.05.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Perinatal mood and anxiety disorders (PMADs) represent the most prevalent pregnancy-related comorbidity and a leading cause of maternal mortality. Effective treatments exist, but remain underutilized. We sought to identify factors associated with receipt of prenatal and postpartum mental health treatment. METHODS This observational, cross-sectional analysis used self-reported survey data from the Michigan Pregnancy Risk Assessment Monitoring System linked to Michigan Medicaid administrative claims for births from 2012 to 2015. We used survey-weighted multinomial logistic regression to predict prescription medication and psychotherapy utilization among respondents with PMADs. RESULTS Only 28.0% of respondents with prenatal PMAD and 17.9% of respondents with postpartum PMAD received both prescription medication and psychotherapy. During pregnancy, Black respondents were 0.33 (95%CI: 0.13-0.85, p = 0.022) times less likely to receive both treatments while more comorbidities were associated with receipt of both treatments (adjRR = 1.31, 95%CI: 1.02-1.70, p = 0.036). In the first three months postpartum, respondents with four or more stressors were 6.52 times more likely to receive both treatments (95%CI: 1.62-26.24, p = 0.008) and those satisfied with prenatal care were 16.25 times more likely to receive both treatments (95%CI: 3.35-78.85, p = 0.001). DISCUSSION Race, comorbidities, and stress are critical factors in PMAD treatment. Satisfaction with perinatal healthcare may facilitate access to care.
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Affiliation(s)
- Stephanie V Hall
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA; University of Michigan, Department of Learning Health Sciences, Ann Arbor, MI, USA.
| | - Kara Zivin
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA; University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI, USA
| | - Gretchen A Piatt
- University of Michigan, Department of Learning Health Sciences, Ann Arbor, MI, USA
| | - Addie Weaver
- University of Michigan, School of Social Work, Ann Arbor, MI, USA
| | - Anca Tilea
- University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI, USA
| | - Xiaosong Zhang
- University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI, USA
| | - Cheryl A Moyer
- University of Michigan, Department of Learning Health Sciences, Ann Arbor, MI, USA; University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, MI, USA
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Abstract
OBJECTIVE Although U.S. mental health treatment rates increased in the 2000s, gaps in treatment among racial-ethnic groups grew. Little is known, however, about national trends after 2012, when treatment access increased overall. This study assessed trends in racial-ethnic disparities in past-year treatment rates among people with a major depressive episode, serious psychological distress, or serious mental illness. METHODS National Survey on Drug Use and Health (2005-2019) data of adults with a past-year major depressive episode (N=49,791) or serious psychological distress (N=89,233) and of adults with past-year serious mental illness (N=24,944; 2008-2019) were analyzed. Linear risk regressions were used to model trends in past-year use of mental health treatment and included an interaction term between survey year and race-ethnicity. RESULTS Treatment use prevalence (2005-2019) among marginalized individuals with a major depressive episode remained lower than that among White people. The magnitude of the disparity in treatment use between White and Hispanic people with major depressive episode decreased slightly (percentage-point difference=-25.1% to -14.9%), whereas the disparity in treatment use between White people and American Indian/Alaska Native people with serious mental illness increased significantly (percentage-point difference=23.4% to -12.2%), from 2005 to 2019. The magnitude of the disparities for other marginalized racial-ethnic groups did not meaningfully change. CONCLUSIONS Racial-ethnic disparities in past-year mental health treatment use have persisted. Efforts to reduce disparities should consider structural barriers that hinder treatment use among marginalized groups.
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Affiliation(s)
- Navdep Kaur
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City
| | - Precious Esie
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City
| | - Megan C Finsaas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City
| | - Pia M Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City
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Moghimi E, Stephenson C, Gutierrez G, Jagayat J, Layzell G, Patel C, McCart A, Gibney C, Langstaff C, Ayonrinde O, Khalid-Khan S, Milev R, Snelgrove-Clarke E, Soares C, Omrani M, Alavi N. Mental health challenges, treatment experiences, and care needs of post-secondary students: a cross-sectional mixed-methods study. BMC Public Health 2023; 23:655. [PMID: 37020282 PMCID: PMC10076091 DOI: 10.1186/s12889-023-15452-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/15/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Post-secondary students frequently experience high rates of mental health challenges. However, they present meagre rates of treatment-seeking behaviours. This elevated prevalence of mental health problems, particularly after the COVID-19 pandemic, can lead to distress, poor academic performance, and lower job prospects following the completion of education. To address the needs of this population, it is important to understand students' perceptions of mental health and the barriers preventing or limiting their access to care. METHODS A broad-scoping online survey was publicly distributed to post-secondary students, collecting demographic, sociocultural, economic, and educational information while assessing various components of mental health. RESULTS In total, 448 students across post-secondary institutions in Ontario, Canada, responded to the survey. Over a third (n = 170; 38.6%) of respondents reported a formal mental health diagnosis. Depression and generalized anxiety disorder were the most commonly reported diagnoses. Most respondents felt that post-secondary students did not have good mental health (n = 253; 60.5%) and had inadequate coping strategies (n = 261; 62.4%). The most frequently reported barriers to care were financial (n = 214; 50.5%), long wait times (n = 202; 47.6%), insufficient resources (n = 165; 38.9%), time constraints (n = 148; 34.9%), stigma (n = 133; 31.4%), cultural barriers (n = 108; 25.5%), and past negative experiences with mental health care (n = 86; 20.3%). The majority of students felt their post-secondary institution needed to increase awareness (n = 231; 56.5%) and mental health resources (n = 306; 73.2%). Most viewed in-person therapy and online care with a therapist as more helpful than self-guided online care. However, there was uncertainty about the helpfulness and accessibility of different forms of treatment, including online interventions. The qualitative findings highlighted the need for personal strategies, mental health education and awareness, and institutional support and services. CONCLUSIONS Various barriers to care, perceived lack of resources, and low knowledge of available interventions may contribute to compromised mental health in post-secondary students. The survey findings indicate that upstream approaches such as integrating mental health education for students may address the varying needs of this critical population. Therapist-involved online mental health interventions may be a promising solution to address accessibility issues.
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Affiliation(s)
- Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Canada
| | - Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Gina Layzell
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Amber McCart
- Student Wellness Services, Queen's University, Kingston, ON, Canada
| | - Cynthia Gibney
- Student Wellness Services, Queen's University, Kingston, ON, Canada
| | - Caryn Langstaff
- Wellness, Accessibility & Student Success, St. Lawrence College, Kingston, ON, Canada
| | - Oyedeji Ayonrinde
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Sarosh Khalid-Khan
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Roumen Milev
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Claudio Soares
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
- OPTT Inc, Toronto, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada.
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
- OPTT Inc, Toronto, ON, Canada.
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12
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González-García C, Vassiliadis E, Moreno-Manso JM, Alcántara M, del Valle JF, Bravo A. Changes in Mental Health of Children and Young People in Residential Care: Outcomes and Associated Factors. Interv Psicosoc 2023; 32:11-19. [PMID: 37361630 PMCID: PMC10268551 DOI: 10.5093/pi2022a16] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/29/2022] [Accepted: 10/03/2022] [Indexed: 06/28/2023]
Abstract
Several studies have evidenced that children in out-of-home care (OOHC), including foster family care and residential care, reveal high levels of mental health disorders (ranging from 40% to 88%). This study examines the outcomes in mental health reported by key residential workers in a group of children and youth (N = 492) between 8-17 years old who were in residential child care (RCC) in Spain. The research also aims to explore the relationship between mental health outcomes and the provision of mental health services (i.e., receiving any mental health treatment) as well as the influence of child, family, and placement factors. The design of this study includes two measures: a baseline (T1) and a follow-up two years later (T2). The results indicated that 29.9% of young people enjoyed sustained mental health; 26% meaningful improvement in their mental health; 23.5% meaningful deterioration; and the remaining 20.5% showed no meaningful change. One of the main findings was that receiving mental health treatment had a significant impact on mental health outcomes. It is crucial to establish protocols and systematic detection tools to assess mental health and ensure detection and referral to proper treatment.
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Affiliation(s)
| | | | - Juan M. Moreno-Manso
- Universidad de ExtremaduraBadajozSpainUniversidad de Extremadura, Badajoz, Spain;
| | - Mavi Alcántara
- University of MurciaMurciaSpainUniversity of Murcia, Spain
| | | | - Amaia Bravo
- University of OviedoOviedoSpainUniversity of Oviedo, Spain
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13
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Larsen AR, Cummings JR, von Esenwein SA, Druss BG. Trends in Alcohol Use Disorder Treatment Utilization and Setting From 2008 to 2017. Psychiatr Serv 2022; 73:991-998. [PMID: 35193376 DOI: 10.1176/appi.ps.202000323] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Little is known about recent trends in treatment for alcohol use disorder. The authors used national data to examine treatment trends among individuals with alcohol use disorder. METHODS A sample of nonelderly adults (ages 18-64 years, N=36,707) with alcohol use disorder was identified from the National Survey on Drug Use and Health. Multinomial logistic regression analysis was conducted to examine trends in treatment for alcohol use disorder in 2008-2010, 2011-2013, and 2014-2017 in any medical setting (hospitals, rehabilitation centers, mental health centers, emergency departments, and private doctors' offices), self-help groups only (no medical setting), and no setting (i.e., no treatment). Additional analyses investigated trends in mental health treatment. Regression models adjusted for predisposing, enabling, and need-related characteristics. RESULTS Among those with an alcohol use disorder, the percentage who received any treatment was significantly lower in 2011-2013 (5.6%) than in 2008-2010 (6.9%) (p<0.05). In adjusted analyses, the probability of receiving no treatment increased by 1.5 percentage points in 2014-2017 (95% CI=0.5-2.5) compared with the 2008-2010 baseline. Significant declines were observed in the receipt of any treatment in a medical setting (marginal effect [ME]=-1.0%, 95% CI=-2.0 to -0.0) and self-help treatment only (ME=-0.5%, 95% CI=-0.8 to -0.1) in 2014-2017 compared with the baseline period. The probability of receiving any mental health treatment did not change during the study period. CONCLUSIONS Among persons with an alcohol use disorder, treatment declined from 2008 to 2017. Future studies should examine the mechanisms that may be responsible for this decline.
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Affiliation(s)
- Aidan R Larsen
- Mathematica Policy Research, Washington, D.C. (Larsen); Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Cummings, Druss); Center for Public Partnerships and Research, University of Kansas, Lawrence (von Esenwein)
| | - Janet R Cummings
- Mathematica Policy Research, Washington, D.C. (Larsen); Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Cummings, Druss); Center for Public Partnerships and Research, University of Kansas, Lawrence (von Esenwein)
| | - Silke A von Esenwein
- Mathematica Policy Research, Washington, D.C. (Larsen); Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Cummings, Druss); Center for Public Partnerships and Research, University of Kansas, Lawrence (von Esenwein)
| | - Benjamin G Druss
- Mathematica Policy Research, Washington, D.C. (Larsen); Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Cummings, Druss); Center for Public Partnerships and Research, University of Kansas, Lawrence (von Esenwein)
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14
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Pazderka H, Reeson M, Polzin W, Jin J, Hnatko G, Wei Y, Agyapong VIO, Greenshaw AJ, Ohinmaa A, Silverstone PH. Five year cost savings of a multimodal treatment program for child sexual abuse (CSA): a social return on investment study. BMC Health Serv Res 2022; 22:892. [PMID: 35810283 PMCID: PMC9270795 DOI: 10.1186/s12913-022-08267-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Specialized mental health services for the treatment of Child Sexual Abuse (CSA) are generally expensive and labour intensive. They require a trauma-informed approach that may involve multiple services and therapeutic modalities, provided over the course of several months. That said, given the broad-ranging, long term negative sequelae of CSA, an evaluation of the cost-benefit analysis of treatment is clearly justified. METHODS We performed a Social Return on Investment (SROI) analysis of data gathered as part of the treatment program at the Be Brave Ranch in Edmonton, Canada to determine the value-for-money of the services provided. We endeavoured to take a conservative, medium-term (5 year) perspective; this is in contrast to short term (1-2 year) effects, which may rapidly dissipate, or long term (15-20 year) effects, which are likely diffuse and difficult to measure. As such, our analysis was based on an average annual intake of 100 children/adolescents (60:40 split) and their families, followed over a five-year timeframe. Financial proxies were assigned to benefits not easily monetized, and six potential domains of cost savings were identified. RESULTS Our analyses suggest that each dollar spent in treatment results in an average cost savings of $11.60 (sensitivity analysis suggests range of 9.20-12.80). The largest value-for-money was identified as the domain of crisis prevention, via the avoidance of rare but costly events associated with the long term impacts of CSA. Somewhat surprisingly, savings related to the area of criminal justice were minimal, compared to other social domains analysed. Implications are discussed. CONCLUSIONS Our results support the cost effectiveness of the investment associated with specialized, evidence-based early interventions for CSA. These approaches alleviate severe, negative outcomes associated with CSA, resulting in both economic savings and social benefits. These findings rest upon a number of assumptions, and generalizability of these results is therefore limited to similar programs located in comparable areas. However, the SROI ratio achieved in this analysis, in excess of $11:1, supports the idea that, while costly, these services more than pay for themselves over time.
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Affiliation(s)
- Hannah Pazderka
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada.,Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, Canada
| | - Matthew Reeson
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Wanda Polzin
- Be Brave Ranch, Centre for Treatment of Child Sexual Abuse, Edmonton, Canada
| | - Jonathan Jin
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Gary Hnatko
- CASA Child, Adolescent and Family Mental Health, Edmonton, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Peter H Silverstone
- Department of Psychiatry, University of Alberta, 1E7.17 Mackenzie Centre, 8114 -112 Street, Edmonton, Alberta, T6G 2B7, Canada.
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15
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Lipson SK, Zhou S, Abelson S, Heinze J, Jirsa M, Morigney J, Patterson A, Singh M, Eisenberg D. Trends in college student mental health and help-seeking by race/ethnicity: Findings from the national healthy minds study, 2013-2021. J Affect Disord 2022; 306:138-147. [PMID: 35307411 PMCID: PMC8995361 DOI: 10.1016/j.jad.2022.03.038] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND A considerable gap in knowledge exists around mental health trends in diverse racial and ethnic adolescent and young adult populations. The purpose of this study is to examine annual trends for mental health and help-seeking by race/ethnicity in a national sample of college students. METHODS Survey data come from >350,000 students at 373 campuses that participated in the Healthy Minds Study between 2013 and 2021. Analyses are descriptive in nature focusing on year-by-year prevalence and help-seeking rates for each racial/ethnic group. RESULTS In 2020-2021, >60% of students met criteria for one or more mental health problems, a nearly 50% increase from 2013. Mental health worsened among all groups over the study period. American Indian/Alaskan Native students experienced the largest increases in depression, anxiety, suicidal ideation, and meeting criteria for one or more mental health problem. Students of color had the lowest rates of mental health service utilization. The highest annual rate of past-year treatment for Asian, Black, and Latinx students was at or below the lowest rate for White students. Although Arab American students experienced a 22% increase in prevalence, there was an 18% decrease in treatment. LIMITATIONS Response rates raise the potential of nonresponse bias. Sample weights adjust along known characteristics, but there may be differences on unobserved characteristics. CONCLUSIONS Findings have important implications for campus mental health programming and underscore the urgency of reducing mental health inequalities in college student populations through the identification and implementation of best practices both in clinical settings and through system-level change.
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Affiliation(s)
- Sarah Ketchen Lipson
- Boston University School of Public Health, Department of Health Law Policy and Management, 715 Albany Street, Room 264W, Boston, MA 02118, USA.
| | - Sasha Zhou
- Wayne State University, College of Liberal Arts and Sciences, Department of Public Health, 2155 Old Main 4841 Cass Avenue, Detroit, MI 48201, USA
| | - Sara Abelson
- Hope Center for College, Community, and Justice, Lewis Katz School of Medicine, Temple University, 3500 N. Broad St., Philadelphia, PA 19140, USA
| | - Justin Heinze
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Matthew Jirsa
- University of Michigan School of Public Health, Department of Health Management and Policy, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Jasmine Morigney
- Eastern Michigan University Psychology Department, 341 Science Complex, Ypsilanti, MI 48197, USA
| | - Akilah Patterson
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Meghna Singh
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Daniel Eisenberg
- University of California Los Angeles Fielding School of Public Health, Department of Health Policy of Management, 650 Charles E. Young Dr. South, 16-035, Center for Health Sciences Los Angeles, CA, USA
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16
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Gearing RE, Brewer KB, Leung P, Cheung M, Chen W, Carr LC, Bjugstad A, He X. Mental health help-seeking in China. J Ment Health 2022:1-8. [PMID: 35532046 DOI: 10.1080/09638237.2022.2069703] [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: 03/23/2021] [Revised: 01/21/2022] [Accepted: 02/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND In China, mental health disorders are considered the leading causes of disability, yet treatment-seeking behaviors among individuals with mental health problems are deficient. AIMS This study sought to examine attitudes and participant characteristics associated with help-seeking among adults residing in China's Shanghai metropolitan area. METHODS This study employed a convenience cross-sectional sampling strategy and recruited 500 participants in public places in Shanghai. The survey administered in Mandarin was comprised of two sections: a series of demographic questions and standardized instruments measuring stigma and help-seeking attitudes. RESULTS Findings indicate that beliefs about seeking professional help for mental health are influenced by knowing someone with a mental health problem. In addition, men who were older, had a child, and were married endorsed more openness to help-seeking for mental health needs, underscoring the importance of life experience as an essential variable when considering attitudes toward help-seeking. CONCLUSIONS Findings support future research identifying the mechanisms by which these life experiences impact individuals' help-seeking attitudes.
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Affiliation(s)
- Robin Edward Gearing
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Kathryne B Brewer
- University of New Hampshire Institute for Policy and Social Science Research, Durham, NH, USA
| | - Patrick Leung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Monit Cheung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Wanzhen Chen
- East China University of Science and Technology, Shanghai, China
| | - L Christian Carr
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Arlene Bjugstad
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Xuesong He
- East China University of Science and Technology, Shanghai, China
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17
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Abstract
Sexual minorities (individuals with a lesbian, gay, bisexual, queer, or other non-heterosexual identity) are at elevated risk of developing common mental health disorders relative to heterosexual people, yet have less favourable mental health service experiences and poorer treatment outcomes. We investigated the experiences of sexual minority service users accessing mental health services for common mental health problems (e.g. depression or anxiety) in the UK. We recruited 26 sexual minority adults with experiences of being referred to Improving Access to Psychological Therapies (IAPT) or primary care counselling services. Semi-structured interviews explored participants' experiences of service use and views on service development. Interviews were analysed using thematic analysis. Barriers to effective relationships with practitioners included service users' fears surrounding disclosure, and practitioners' lack of understanding and/or neglect of discussions around sexuality. Regarding service development, participants highlighted the value of seeing practitioners with shared identities and experiences, visible signs of inclusivity, sexual minority training, tailored supports, and technological adjuncts. Our findings offer insights into possible contributory factors to treatment inequalities, and highlight potential methods for improving service provision for sexual minorities.
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Affiliation(s)
- Daniel D A Morris
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vanessa Fernandes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katharine A Rimes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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18
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Alto ME, Bantelman E, Manly JT, Hathaway A, Knight S, Frounfelker RL, Petrenko C. The Development of a Mental Health Program for Unaccompanied Minors in the United States. Int J Adv Couns 2022; 44:164-196. [PMID: 37727220 PMCID: PMC10508890 DOI: 10.1007/s10447-021-09442-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 10/20/2022]
Abstract
The unique needs of unaccompanied children (UC) and unaccompanied refugee minors (URM) often make it challenging for them to engage in traditional mental health services. This paper describes the development and implementation of a mental health program for UC and URM using a collaborative approach with key stakeholders. In the Exploration phase, we conducted an assessment of youths' mental health needs, barriers to, and recommendations for care through discussions with community partners. Next, we describe the Preparation phase in which we designed the program around three major domains: 1) training and consultation, 2) cross-sector collaboration, and 3) direct services. Discussion of the Implementation phase includes a description of youth served and program materials. Finally, the Sustainment phase focuses on recommendations for best practice informed by successes and challenges of program implementation. Findings have implications for future mental health programming for UC/URM.
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Affiliation(s)
- Michelle E. Alto
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | | | - Jody Todd Manly
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Alisa Hathaway
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Stevie Knight
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
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19
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Abstract
Mental health treatment of juvenile offenders and undocumented immigrant youth in detention provides a unique opportunity for treatment providers. Although the work may be challenging, the clinical needs and opportunities for early and meaningful interventions are significant. One of the best clinical experiences a psychiatrist can have is working with extremely high-risk youth to help them find safer and better developmental pathways. Few settings can offer such an opportunity to leverage clinical skills to improve the lives and futures of children and adolescents as are afforded to those professionals lucky enough to work in juvenile justice settings.
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Affiliation(s)
- Kevin Whitley
- Southwood Psychiatric Hospital, 2575 Boyce Plaza Road, Pittsburgh, PA 15241, USA
| | - Camille Tastenhoye
- Department of Psychiatry, University of Pittsburgh School of Medicine, UPMC Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Amanda Downey
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA 94118, USA
| | - John S Rozel
- University of Pittsburgh, resolve Crisis Services of UPMC Western Psychiatric Hospital, 333 N Braddock Avenue, Pittsburgh, PA 15208, USA.
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20
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Choi NG, DiNitto DM. Alcohol use disorder and treatment receipt among individuals aged 50 years and older: Other substance use and psychiatric correlates. J Subst Abuse Treat 2021; 131:108445. [PMID: 34098300 DOI: 10.1016/j.jsat.2021.108445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/21/2021] [Accepted: 04/26/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Alcohol use disorder (AUD) is increasing among U.S. individuals aged 50+. We examined associations of past-year AUD with other substance use and any mental illness (AMI) and associations of past-year AUD treatment receipt with other substance use, AMI, and mental health treatment receipt among those with AUD. METHODS Data came from the 2015-2018 National Survey on Drug Use and Health (N = 35,229). We used multivariable logistic regression analysis to examine the research questions. RESULTS In the 50+ age group, 58.7% of women and 66.9% of men reported past-year alcohol use and 2.0% of women and 4.9% of men had AUD. Those with any alcohol use problem (binge drinking, heavy drinking, or AUD) had higher odds of other substance use or use disorders; however, AMI was associated with higher odds of AUD only (AOR = 2.54, 95% CI = 2.15-3.00, AOR = 2.63, 95% CI = 1.98-3.50, and AOR = 3.13, 95% CI = 2.19-4.48, respectively, for mild, moderate, and serious mental illness). Only 7.9% of those with AUD received any alcohol treatment. AMI and mental health treatment were associated with higher odds of alcohol treatment receipt (AOR = 5.18, 95% CI = 2.13-12.55, AOR = 4.14, 95% CI = 1.51-11.30, and AOR = 2.91, 95% CI = 1.41-6.00, respectively, for moderate mental illness, serious mental illness, and mental health treatment receipt). CONCLUSION The findings show that fewer than one in 10 older adults with AUD received any alcohol treatment and suggest that individuals need education on alcohol harms and assistance in accessing alcohol treatment. Combined mental health and alcohol treatment at a single location may improve access and use.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, United States of America.
| | - Diana M DiNitto
- Steve Hicks School of Social Work, University of Texas at Austin, United States of America
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21
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Salameh T, Hall L, Crawford T, Hall M. Perceived barriers to mental health and substance use treatment among US childbearing-aged women: NSDUH 2008-2014. Women Health 2021; 61:1007-1015. [PMID: 34802393 DOI: 10.1080/03630242.2021.2003501] [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] [Indexed: 10/19/2022]
Abstract
This study compared and contrasted perceived barriers to mental health and substance use treatment among pregnant and non-pregnant women from 2008-2010 to 2011-2014. A trend study was conducted using secondary data from the National Survey on Drug Use and Health 2008-2014 from a propensity score-matched sample of pregnant (n = 5,520) and nonpregnant women (n = 11,040) aged 18 to 44 years. The most frequently perceived barriers to mental health treatment among all women ranked similarly in 2008-2010 compared to 2011-2014: cost (45.2% vs. 50.6%), opposition to treatment (41.9% vs. 41.4%), and stigma (28.2% vs. 24.7%). The rank order of barriers to substance use treatment in 2008-2010 among all women was cost (38.7%), stigma (18.2%), and time/transportation limitations (17%), whereas in 2011-2014, stigma ranked first (35.5%), followed by cost (25.9%) and time/transportation limitations (22.2%). In 2011-2014, the women were significantly more likely than women in 2008-2010 to report not knowing where to go (8.2% vs. .9%, p = .003) and a lack of substance use treatment programs (17.7% vs. 3.0%, p = .014). Perceived barriers to mental health treatment did not change overtime; however, there was a decrease in reported availability of substance use treatment programs between 2008-2010 and 2011-2014.
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Affiliation(s)
- Taghreed Salameh
- Department of Women's Health, Koc University School of Nursing, İstanbul, Turkey
| | - Lynne Hall
- University of Louisville School of Nursing, Louisville, Kentucky, USA
| | - Timothy Crawford
- Wright State University Department of Population and Public Health Sciences, Kettering, Ohio, USA
| | - Martin Hall
- University of Louisville Kent School of Social Work, Louisville, Kentucky, USA
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22
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Kaushik A, Papachristou E, Telesia L, Dima D, Fewings S, Kostaki E, Gaete J, Ploubidis GB, Kyriakopoulos M. Experience of stigmatization in children receiving inpatient and outpatient mental health treatment: a longitudinal study. Eur Child Adolesc Psychiatry 2021; 32:675-683. [PMID: 34751811 PMCID: PMC10115721 DOI: 10.1007/s00787-021-01904-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
Mental health-related stigma is poorly understood, and minimal research has focused on the experience of stigma from children's perspectives. We sought to investigate whether children treated as inpatients and outpatients had different experiences of stigma over time and whether stigma is linked to global functioning cross-sectionally and longitudinally. Children, aged 8-12 years, receiving treatment within a national specialist mental health inpatient unit were matched for age, gender and diagnosis with children receiving outpatient treatment (N = 64). Validated measures of stigma, global functioning and symptom severity were collected at the start of treatment and upon discharge from the ward for inpatients, and a similar timeframe for their individually matched outpatients. Latent change score models and partial correlation coefficients were employed to test our hypotheses. No differences in most aspects of stigma between children treated as inpatients and outpatients were observed, except for personal rejection at baseline and self-stigma at follow-up favouring outpatients. A reduction in stigma was observed in societal devaluation, personal rejection and secrecy for inpatients, and self-stigma and secrecy for outpatients between the two assessments. Societal devaluation declined at a higher rate among inpatients compared to outpatients, albeit reductions in stigma were comparable for all remaining measures. No association was found between the change in stigma and change in global functioning. Future research may offer further insights into the development and maintenance of stigma and identify key targets for anti-stigma interventions to reduce its long-term impact.
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Affiliation(s)
- Anya Kaushik
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK
| | - Efstathios Papachristou
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
| | - Laurence Telesia
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (PO66), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Danai Dima
- Department of Psychology, School of Arts and Social Sciences, City, University of London, London, UK.,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sandra Fewings
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK
| | - Evgenia Kostaki
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK.,Learning Disability Specialist Health Services, Hertfordshire Partnership University NHS Foundation Trust, Braintree, Essex, UK
| | - Jorge Gaete
- Faculty of Education, Universidad de los Andes, Santiago, Chile.,Millennium Nucleus To Improve the Mental Health of Adolescents and Youths, Santiago, Chile
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
| | - Marinos Kyriakopoulos
- National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK. .,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (PO66), King's College London, De Crespigny Park, London, SE5 8AF, UK. .,First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.
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23
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Coley RL, Baum CF. Trends in mental health symptoms, service use, and unmet need for services among US adults through the first 8 months of the COVID-19 pandemic. Transl Behav Med 2021; 12:273-283. [PMID: 34662427 DOI: 10.1093/tbm/ibab133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The COVID-19 pandemic has led to rising morbidity, mortality, and social and economic disruption, likely impairing mental health. The purpose of this study was to track trends in mental health symptoms, use of services, and unmet need for services among US adults, and to delineate variation across demographic strata. Data were drawn from the 2020 US Household Pulse Survey from repeated cross-sectional online surveys collected between April 23 and November 23, 2020 from 1,302,455 US adults, weighted to represent the US population. Survey respondents self-reported their symptoms of anxiety and depression, use of medication and counseling services, and unmet need for services. Reports of probable anxiety and depression rose significantly through the study period, to prevalence rates of 37% and 29%, respectively, by November, 2020, rates more than four times higher than early 2019 US norms. Use of prescription medication, counseling services, and unmet need for mental health services also rose significantly. Prevalence rates of probable mental health disorders were highest among young, less educated, single parent, female, Black and multi-racial respondents, with some vacillation in such disparities over cohorts. Young, female, and moderately educated respondents also reported higher unmet needs for services. Disparities in estimates of mental health disorders and mental health treatment indicate a striking disequilibrium between the potential need for and the use of mental health services during the COVID-19 pandemic. Rising mental health challenges are being borne largely by young, less advantaged people of color and women, with the potential for expanded interruptions to optimal functioning and societal recovery from COVID-19.
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Affiliation(s)
- Rebekah Levine Coley
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, MA, USA
| | - Christopher F Baum
- Department of Economics and School of Social Work, Boston College, Chestnut Hill, MA, USA
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24
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Xiao Y, Lindsey MA. Racial/Ethnic, Sex, Sexual Orientation, and Socioeconomic Disparities in Suicidal Trajectories and Mental Health Treatment Among Adolescents Transitioning to Young Adulthood in the USA: A Population-Based Cohort Study. Adm Policy Ment Health 2021; 48:742-756. [PMID: 33629220 PMCID: PMC7904031 DOI: 10.1007/s10488-021-01122-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2021] [Indexed: 12/19/2022]
Abstract
Suicide is the second leading cause of death for people aged 10-34 years old. Limited research has documented extant heterogeneities in suicide across the life course and among diverse sociodemographic groups. There is also limited research on the influences of mental health utilization on suicidal trajectories across the life course. This study aims to: (1) identify racial/ethnic, sex, sexual orientation, socioeconomic status, and intersectional differences in suicidal trajectories among adolescents transitioning to adulthood; and (2) examine influences of mental health service utilization on disparities in suicidal trajectories. The study included 9421 respondents (Mage = 14.99 [SD = 1.61]) from Waves I-IV National Longitudinal Study of Adolescent to Adult Health (1994-2008). Latent class growth analyses were used to identify trajectories of suicidal ideation and suicide attempts. Multivariate multinomial logistic regression was used to examine the influences of mental health treatment and sociodemographic characteristics on suicidal trajectories. Three suicidal ideation (low-stable, high-decreasing, moderate-decreasing-increasing) and two suicide attempt (low-stable, moderate-decreasing) trajectories were identified. Compared with the low-stable trajectories, the risks of being in high-decreasing suicidal ideation trajectories were higher among females (AOR = 1.45, 95% CI 1.01-2.13) and sexual minorities (AOR = 1.82, 95% CI 1.21-2.74). Sexual minorities (AOR = 2.63, 95% CI 1.69-4.08) and low-SES adolescents (AOR = 1.79, 95% CI 1.08-2.98) were more likely to be in the moderate-decreasing suicide attempt group. Mental health service utilization predicted engagement in high-risk suicidal trajectories. Sociodemographic disparities in suicidal trajectories initiate early and persist over time. Individuals in high-risk trajectories received mental health treatment during adolescence. Suicide prevention should target vulnerable subpopulations and mental health service utilization in the early stage.
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Affiliation(s)
- Yunyu Xiao
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
- School of Social Work, Indiana University Bloomington, Bloomington, IN, 47401, USA.
| | - Michael A Lindsey
- McSilver Institute for Poverty Policy and Research, New York, NY, 10003, USA
- Silver School of Social Work, New York University, New York, NY, 10003, USA
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25
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Dickson KS, Lind T, Jobin A, Kinnear M, Lok H, Brookman-Frazee L. A Systematic Review of Mental Health Interventions for ASD: Characterizing Interventions, Intervention Adaptations, and Implementation Outcomes. Adm Policy Ment Health 2021; 48:857-883. [PMID: 33884535 PMCID: PMC8411365 DOI: 10.1007/s10488-021-01133-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
Youth with autism spectrum disorder (ASD) have high rates of co-occurring mental health needs that necessitate mental health interventions. Given the unique clinical characteristics of youth with ASD, there have been significant efforts to adapt and test mental health interventions for this population. Yet, characterization of the nature and types of interventions adaptations is limited, especially across the wide range of interventions tested for youth with ASD with a focus on implementation factors. Additionally, understanding how these interventions may be implemented in community services is limited. The aims of this systematic review are to characterize the (1) types of interventions tested for co-occurring mental health conditions for youth with ASD; (2) adaptations to mental health interventions for use with youth with ASD; and (3) implementation strategies, outcomes, and determinants of mental health interventions to inform their translation to community service settings. Eighty-three articles testing interventions targeting mental health symptoms in youth with ASD that included implementation factors in analyses were reviewed. The Stirman et al. (2013; 2019) FRAME adaptation, Powell et al. (2012;2015) implementation strategies, and Proctor et al. (2011) implementation outcomes taxonomies were applied to characterize the nature and types of adaptations for use with youth with ASD and types of implementation strategies, outcomes, and determinants used, when available, respectively. Of the interventions examined, the majority (64.1%) were originally designed to target youth mental health concerns and were then adapted to be used with ASD. The most common adaptations included those to the intervention content, particularly adding elements with tailoring or refining aspects of the intervention while maintaining core functions. Half of the articles described at least one implementation strategy used during intervention testing. Fidelity and acceptability were the most frequently examined implementation outcomes, with some examination of appropriateness and feasibility. Nineteen percent of articles described implementation determinants (i.e. barriers/facilitators) of these implementation outcomes. The common adaptations for ASD provide direction for future intervention development and for training community therapists. Further examination, specification, and reporting of implementation strategies and outcomes within ongoing efforts to adapt and interventions to meet the co-occurring mental health needs of youth ASD are needed to facilitate their translation to community settings. Areas for future research as well as clinical implications are discussed.
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Affiliation(s)
- Kelsey S Dickson
- San Diego State University, San Diego, USA.
- Child and Adolescent Services Research Center, San Diego, CA, USA.
| | - Teresa Lind
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California, San Diego, USA
| | - Allison Jobin
- University of California, San Diego, USA
- California State University, San Marcos, USA
| | | | - Ho Lok
- San Diego State University, San Diego, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California, San Diego, USA
- Rady Children's Hospital-San Diego, San Diego, USA
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26
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Eads R, Lee MY, Liu C, Yates N. The Power of Perception: Lived Experiences with Diagnostic Labeling in Mental Health Recovery without Ongoing Medication Use. Psychiatr Q 2021; 92:889-904. [PMID: 33236231 DOI: 10.1007/s11126-020-09866-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
The recovery movement in mental health emphasizes holistic and individualized treatment through many pathways to recovery, though the majority of mental health treatment and existing literature emphasize pharmacotherapy and medication adherence for major mental health conditions. The reimbursement system and research literature are oriented around formal diagnostic categories based in a biomedical perspective of mental health problems, but diagnostic labels also carry stigma and influence how clients perceive themselves and their mental health problems. To investigate the influence of labeling and perception in alternate pathways to recovery, this qualitative study explores the lived experience of diagnostic labeling and self-perception among persons in sustained recovery without ongoing medication use. The study used a grounded theory approach to analyze data from in-depth interviews with 19 participants. Participants had previously received diagnoses of schizophrenia, bipolar disorder, and/or major depression, met criteria for functional recovery, and were no longer taking psychotropic medications for 12 months. The participants identified positive perceptions-externalization of the problem and hope for an external "cure"-and negative perceptions-stigma and powerlessness-following a diagnostic label. Notably, the theme of powerlessness related to the initially positive themes as the diagnosis placed the problem outside their control and some participants experienced treatments as unhelpful. Participants succeeded in overcoming powerlessness by finding internalized solutions and redefining their mental health experience as transformative. Rather than pressing clients to accept their diagnosis or "illness," mental health providers can support multiple pathways to recovery by emphasizing empowerment and personal meaning-making in the recovery process.
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27
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Schleider JL, Mullarkey MC, Chacko A. Harnessing Wise Interventions to Advance the Potency and Reach of Youth Mental Health Services. Clin Child Fam Psychol Rev 2020; 23:70-101. [PMID: 31440858 DOI: 10.1007/s10567-019-00301-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite progress in research on evidence-based treatments (EBTs) for youth psychopathology, many youths with mental health needs do not receive services, and EBTs are not always effective for those who access them. Wise interventions (WIs) may help address needs for more disseminable, potent youth mental health interventions. WIs are single-component, social-psychological interventions designed to foster adaptive meaning-making. They have improved health-related and interpersonal youth outcomes, yet their potential to reduce youth psychopathology has not been systematically explored. Accordingly, we conducted a systematic, descriptive review characterizing WIs' potential to reduce youth mental health problems. Across 25 RCTs (N = 9219 youths, ages 11-19) testing 13 intervention types, 7 WIs qualified as "Well-Established," "Probably Efficacious," or "Possibly Efficacious" for reducing one or more types of youth psychopathology, relative to controls. Among these, 5 WIs significantly reduced youth depressive symptoms; 3, general psychological distress; and 1 each, eating problems, anxiety, and substance use. Three of these 7 WIs were self-administered by youths, and four by trained interventionists; collectively, they were 30-168 min in length and targeted clinic-referred and non-referred samples in clinical, school, and laboratory settings. Overall, certain WIs show promise in reducing mild-to-severe youth psychopathology. Given their brevity and low cost relative to traditional (i.e., therapist-delivered, 12- to 16-week, clinic-based) EBTs, WIs may represent beneficial additions to the youth mental healthcare ecosystem. Priorities for future research are proposed, including testing WIs for parents, younger children, and externalizing problems; as EBT adjuncts; and in schools and primary care clinics to increase access to brief, effective supports.
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28
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Choi NG, DiNitto DM, Phillips KT. Mental health treatment use among cannabis users aged 50+: Associations with cannabis use characteristics. Drug Alcohol Depend 2021; 223:108705. [PMID: 33862322 DOI: 10.1016/j.drugalcdep.2021.108705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/27/2021] [Accepted: 02/28/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study examined associations of mental health treatment use and perceived treatment need with cannabis use characteristics (medical vs. nonmedical use, initiation age, use frequency, and cannabis use disorder) among past-year cannabis users aged 50+. METHODS Data came from the 2015-2019 National Survey of Drug Use and Health (N = 44,007). After comparing past-year cannabis users with nonusers and nonmedical users with medical users on sociodemographic and health-related factors, the research questions were examined with logistic regression models. RESULTS In addition to mental disorders, medical use, compared to nonmedical use, was associated with higher odds of psychotherapeutic prescription medication use (AOR = 1.47, 95 % CI = 1.07-2.01) and any mental health treatment (prescription medication, outpatient care and/or inpatient care) (AOR = 1.51, 95 % CI = 1.13-2.03). Compared to 1-29 days of use, nonmedical users who used on 100-199 days (AOR = 0.60, 95 % CI = 0.40-0.89) and medical users who used on 200-365 days users (AOR = 0.48, 95 % CI = 0.26-0.87) had lower odds of treatment receipt. Factors associated with increased odds of receiving treatment included discussion with a healthcare professional about drug use, higher education, and having health insurance. Other illicit drug use, chronic illnesses, and female gender were associated with higher odds of perceived treatment need, while having health insurance was associated with lower odds. CONCLUSIONS Some older adults may use medical cannabis as an adjunct to professional mental health treatment while others may use it as a substitute. Affordability and accessibility gaps followed by cultural and personal sense of stigma and self-sufficiency beliefs appear to be barriers to receiving professional care.
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Affiliation(s)
- Namkee G Choi
- The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, 78702, United States.
| | - Diana M DiNitto
- The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, 78702, United States
| | - Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente, Honolulu, HI, 96817, United States
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29
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Kitsantas P, Aljoudi SM, Adams AR, Booth EJ. Prevalence and correlates of suicidal behaviors during pregnancy: evidence from the National Survey on Drug Use and Health. Arch Womens Ment Health 2021; 24:473-81. [PMID: 33222035 DOI: 10.1007/s00737-020-01089-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/03/2020] [Indexed: 10/22/2022]
Abstract
Suicidal behaviors during pregnancy are prevalent and have the potential to adversely affect a woman's health and her developing infant. The purpose of this study was to examine prevalence and correlates of suicidal behaviors in a national sample of pregnant women. Using data from the 2009-2018 National Survey on Drug Use and Health, a sample of 7479 pregnant women was analyzed. Multiple logistic regression was used to examine associations between sample characteristics and suicidal behaviors overall and by pregnancy trimester. In this sample, 3.4% of women exhibited suicidal behaviors such as ideation, planning, and attempt. Suicidal behaviors were more prevalent at 4.4% among women in the first trimester compared to the second/third trimesters (2.9%). Of those exhibiting suicidal behavior, 63.0% were ideators, 18.9% planned suicide, and 18.1% attempted suicide. Logistic regression analyses revealed that all racial/ethnic groups of women in the third trimester were less likely to be suicidal relative to black non-Hispanic women. Alcohol abuse (OR 3.70, 95% CI 1.97, 6.81) and major depressive episode (OR 4.91, 95% CI 3.10, 7.84) in the past year significantly increased the odds of suicidality for all pregnant women. Perceived unmet need for treatment increased the likelihood (OR 5.64, 95% CI 3.55, 8.97) of suicidal behavior regardless of trimester. These findings underscore the importance of screening for suicidal behaviors in the first trimester, especially among those with existing mood disorders and substance abuse. Racial/ethnic differences should be considered in targeted interventions for suicide prevention.
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30
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Coley RL, Baum CF. Trends in mental health symptoms, service use, and unmet need for services among U.S. adults through the first 9 months of the COVID-19 pandemic. Transl Behav Med 2021; 11:1947-1956. [PMID: 33823047 PMCID: PMC8139151 DOI: 10.1093/tbm/ibab030] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has led to rising morbidity, mortality, and social and economic disruption, likely impairing mental health. The purpose of this study was to track trends in mental health symptoms, use of services, and unmet need for services among U.S. adults and to delineate variation across demographic strata. Data were drawn from the 2020 U.S. Household Pulse Survey from repeated cross-sectional online surveys collected between April 23 and November 23, 2020 from 1,483,378 US adults, weighted to represent the U.S. population. Survey respondents self-reported their symptoms of anxiety and depression, use of medication, counseling services, and unmet need for services. Reports of probable anxiety and depression rose significantly through the study period, to prevalence rates of 50% and 44%, respectively, by November 2020, rates six times higher than early 2019 U.S. norms. Use of prescription medication, counseling services, and unmet need for mental health services also rose significantly. Prevalence rates of probable mental health disorders were highest among young, less educated, single, female, Black and Hispanic respondents, with age and education disparities growing over cohorts. Young, female, and moderately educated respondents also reported higher unmet needs for services. Disparities in estimates of mental health disorders and mental health treatment indicate a striking disequilibrium between the potential need for and the use of mental health services during the COVID-19 pandemic. Rising mental health challenges are being borne largely by young, less advantaged people of color and women, with the potential for expanded interruptions to optimal functioning and societal recovery from COVID-19.
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Affiliation(s)
- Rebekah Levine Coley
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, MA, USA
| | - Christopher F Baum
- Department of Economics and School of Social Work, Boston College, Chestnut Hill, MA, USA
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31
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Lee MY, Eads R, Yates N, Liu C. Lived Experiences of a Sustained Mental Health Recovery Process Without Ongoing Medication Use. Community Ment Health J 2021; 57:540-551. [PMID: 32696208 DOI: 10.1007/s10597-020-00680-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Received: 08/28/2019] [Accepted: 07/04/2020] [Indexed: 11/26/2022]
Abstract
Serious mental health conditions have historically been considered lifelong conditions, with substantial literature supporting pharmaceutical approaches to remission. More recently, the recovery movement has emphasized lasting recovery, which can occur through a variety of pathways. With the traditional focus on medication, less is known about the recovery process of persons who achieve sustained recovery without ongoing medication use. This qualitative study used a grounded theory approach to explore the recovery process of 19 participants with diagnoses of schizophrenia, bipolar disorder, or major depression who were in recovery and not taking medications for at least twelve months. Participants identified internal recovery processes (cognitive changes, emotional processes, and spirituality/faith) leading to a perspective change about self and symptoms. Participants also identified external recovery processes including both support received and productive ways of giving back. The study findings highlight the importance of self-efficacy, emotion management, and social giving in mental health recovery.
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Affiliation(s)
- Mo Yee Lee
- College of Social Work, Ohio State University, 1947 College Road, Columbus, OH, 614-292-9910, USA.
| | - Ray Eads
- College of Social Work, Ohio State University, 1947 College Road, Columbus, OH, 614-292-9910, USA
| | - Nancy Yates
- College of Social Work, Ohio State University, 1947 College Road, Columbus, OH, 614-292-9910, USA
| | - Chang Liu
- College of Social Work, Ohio State University, 1947 College Road, Columbus, OH, 614-292-9910, USA
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32
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Ratcliff CG, Massarweh NN, Sansgiry S, Dindo L, Cully JA. Impact of Psychiatric Diagnoses and Treatment on Postoperative Outcomes Among Patients Undergoing Surgery for Colorectal Cancer. Psychiatr Serv 2021; 72:391-398. [PMID: 33557593 DOI: 10.1176/appi.ps.201900559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Psychiatric diagnoses may be a risk factor for poor colorectal cancer (CRC) surgery outcomes. The authors investigated the risk of psychiatric diagnoses and benefit of mental health treatment for surgery outcomes among CRC patients. METHODS This retrospective cohort study of patients undergoing CRC surgery in the 2000-2014 period identified documentation of psychiatric diagnosis and mental health treatment (no treatment, medication only, psychotherapy only, or both medication and psychotherapy) 30 days before surgery. Associations between psychiatric diagnoses, mental health treatment, and postoperative outcomes (postoperative complications, length of stay [LOS], and 90-day readmission rate) were evaluated with multivariable generalized estimating equations. RESULTS Among 58,961 patients undergoing CRC surgery, 9,029 (15.3%) had psychiatric diagnoses, 4,601 (51.0%) of whom received preoperative mental health treatment (90.0% psychiatric medication, 6.7% psychotherapy, and 3.0% medication and psychotherapy). Patients with psychiatric diagnoses had an increased risk for postoperative complications (odds ratio [OR]=1.09, 95% confidence interval [CI]=1.03-1.15) and 90-day readmission (OR=1.11, 95% CI=1.06-1.17) compared with patients without psychiatric diagnoses. Patients with psychiatric diagnoses who received no mental health treatment or only medication had a 7%-17% increased risk for postoperative complications and 90-day readmission compared with patients without psychiatric diagnoses. Patients who received medication only also had a 4% increase in LOS relative to patients without psychiatric diagnoses. Patients with psychiatric diagnoses receiving only psychotherapy and patients without psychiatric diagnoses had similar postoperative outcomes. CONCLUSIONS Preoperative psychiatric diagnoses were associated with worse postoperative outcomes. Surgical quality-improvement efforts should focus on identifying patients with preoperative psychiatric diagnoses and addressing these conditions presurgery.
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Affiliation(s)
- Chelsea G Ratcliff
- Department of Psychology, Sam Houston State University, Huntsville, Texas (Ratcliff); Department of Psychiatry and Behavioral Sciences (Ratcliff, Cully), Department of Surgery (Massarweh), and Department of Medicine (Sansgiry, Dindo), Baylor College of Medicine, Houston; Health Policy, Quality, and Informatics Program (Massarweh), Methodology and Analytics Core (Sansgiry), and Behavioral Health Program (Dindo, Cully), U.S. Department of Veterans Affairs (VA) Health Services Research VA Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston; VA South Central Mental Illness Research, Education, and Clinical Center (MIRECC), Houston (Ratcliff, Massarweh, Sansgiry, Dindo, Cully)
| | - Nader N Massarweh
- Department of Psychology, Sam Houston State University, Huntsville, Texas (Ratcliff); Department of Psychiatry and Behavioral Sciences (Ratcliff, Cully), Department of Surgery (Massarweh), and Department of Medicine (Sansgiry, Dindo), Baylor College of Medicine, Houston; Health Policy, Quality, and Informatics Program (Massarweh), Methodology and Analytics Core (Sansgiry), and Behavioral Health Program (Dindo, Cully), U.S. Department of Veterans Affairs (VA) Health Services Research VA Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston; VA South Central Mental Illness Research, Education, and Clinical Center (MIRECC), Houston (Ratcliff, Massarweh, Sansgiry, Dindo, Cully)
| | - Shubhada Sansgiry
- Department of Psychology, Sam Houston State University, Huntsville, Texas (Ratcliff); Department of Psychiatry and Behavioral Sciences (Ratcliff, Cully), Department of Surgery (Massarweh), and Department of Medicine (Sansgiry, Dindo), Baylor College of Medicine, Houston; Health Policy, Quality, and Informatics Program (Massarweh), Methodology and Analytics Core (Sansgiry), and Behavioral Health Program (Dindo, Cully), U.S. Department of Veterans Affairs (VA) Health Services Research VA Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston; VA South Central Mental Illness Research, Education, and Clinical Center (MIRECC), Houston (Ratcliff, Massarweh, Sansgiry, Dindo, Cully)
| | - Lilian Dindo
- Department of Psychology, Sam Houston State University, Huntsville, Texas (Ratcliff); Department of Psychiatry and Behavioral Sciences (Ratcliff, Cully), Department of Surgery (Massarweh), and Department of Medicine (Sansgiry, Dindo), Baylor College of Medicine, Houston; Health Policy, Quality, and Informatics Program (Massarweh), Methodology and Analytics Core (Sansgiry), and Behavioral Health Program (Dindo, Cully), U.S. Department of Veterans Affairs (VA) Health Services Research VA Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston; VA South Central Mental Illness Research, Education, and Clinical Center (MIRECC), Houston (Ratcliff, Massarweh, Sansgiry, Dindo, Cully)
| | - Jeffrey A Cully
- Department of Psychology, Sam Houston State University, Huntsville, Texas (Ratcliff); Department of Psychiatry and Behavioral Sciences (Ratcliff, Cully), Department of Surgery (Massarweh), and Department of Medicine (Sansgiry, Dindo), Baylor College of Medicine, Houston; Health Policy, Quality, and Informatics Program (Massarweh), Methodology and Analytics Core (Sansgiry), and Behavioral Health Program (Dindo, Cully), U.S. Department of Veterans Affairs (VA) Health Services Research VA Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston; VA South Central Mental Illness Research, Education, and Clinical Center (MIRECC), Houston (Ratcliff, Massarweh, Sansgiry, Dindo, Cully)
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Collopy CM, Cosh SM, Tully PJ. Screening and referral is not enough: a qualitative exploration of barriers to access and uptake of mental health services in patients with cardiovascular diseases. BMC Health Serv Res 2021; 21:49. [PMID: 33419443 PMCID: PMC7796597 DOI: 10.1186/s12913-020-06030-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/18/2020] [Indexed: 01/06/2023] Open
Abstract
Background Cardiovascular diseases (CVD) are commonly comorbid with mental health disorders, portending poorer cardiac prognosis. Despite the high prevalence of depression and anxiety, and guidelines recommending routine depression screening and referral, uptake of mental healthcare in CVD populations remains low. Reasons for the underutilisation of mental health and psychological services for this population remain largely unknown. Methods Thirteen CVD patients with clinically significant psychological symptoms (depression, anxiety and/or stress) participated in one-on-one in-depth semi-structured interviews. Data were analysed using inductive thematic analysis. Results Barriers to uptake included the timing of referral and screening, with patients reporting a need for longer term follow-up. A lack of information provision and understanding around mental health and services, especially following cardiac-events were further barriers. A reluctance to report mental health or engage in services was also identified, with patients indicating a preference for informal peer support networks. A range of practical barriers such as mobility, transport and cost were also reported. Conclusions Longer term follow-up and routine mental health assessment may be beneficial to facilitate use of mental health services. Upskilling of practitioners around mental health may be a further avenue to promote information provision and enhance service use. Further focus on enhancing informal peer support may be a valuable initial approach for the CVD population. The implications for improving services and enhancing service use are discussed.
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Affiliation(s)
- C M Collopy
- School of Psychology, University of New England, Armidale, NSW, 2351, Australia
| | - S M Cosh
- School of Psychology, University of New England, Armidale, NSW, 2351, Australia.
| | - P J Tully
- Freemasons Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, SA, Australia
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Hai AH, Lee CS, Oh S, Vaughn MG, Piñeros-Leaño M, Delva J, Salas-Wright CP. Trends and correlates of Internet support group participation for mental health problems in the United States, 2004-2018. J Psychiatr Res 2021; 132:136-143. [PMID: 33091688 PMCID: PMC7566800 DOI: 10.1016/j.jpsychires.2020.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE This study sought to examine the trends in Internet support group (ISG) participation among U.S. adults and to investigate the sociodemographic and behavioral health profiles of ISG participants. METHODS Data was derived from the National Survey on Drug Use and Health (2004-2018, n = 625,883). Logistic regression was used to examine significance of trend year and correlates of ISG participation. Latent class analysis was conducted to identify subtypes of ISG participants. RESULTS The proportion of U.S. adults participating in ISG increased significantly from 2.29% (2004-2007) to 3.55% (2016-2018). ISG participants were less likely to be male, 35 or older, be part of an ethnic/racial minority group, or have household incomes between $20,000 and $49,999. Black/African American participants and those classified as "other" race showed the largest percent increases, while Hispanics showed no change. ISG participants were more likely to have experienced a depressive episode and to have used cannabis. Three subtypes of ISG participants were identified, including the Lower Behavioral Health Risk group (62%), the Elevated Behavioral Health Risk group (24%), and the Depression, Cigarettes, and Cannabis group (14%). CONCLUSION Overall, we found an increasing trend in seeking mental health care through ISG among US adults since the early 2000s. While disparities among some disadvantaged groups such as Blacks/African Americans and individuals with lower household income were diminishing, continuing efforts to engage men, older adults, and Hispanics in ISG are needed. This investigation also identified distinct subtypes of ISG participants and provides important implications for future research on ISG.
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Affiliation(s)
- Audrey Hang Hai
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, Boston, MA, 02215, USA.
| | - Christina S. Lee
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, Boston, MA, 02215, USA
| | - Sehun Oh
- College of Social Work, The Ohio State University, Columbus, OH, 43210, United States
| | - Michael G. Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, United States,Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | | | - Jorge Delva
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, Boston, MA, 02215, USA
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Hwang YIJ, Albalawi O, Adily A, Hudson M, Wand H, Kariminia A, O'Driscoll C, Allnutt S, Grant L, Sara G, Ogloff J, Greenberg DM, Butler T. Disengagement from mental health treatment and re-offending in those with psychosis: a multi-state model of linked data. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1639-1648. [PMID: 32390094 DOI: 10.1007/s00127-020-01873-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/02/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Individuals with psychosis are over-represented in the criminal justice system and, as a group, are at elevated risk of re-offending. Recent studies have observed an association between increased contacts with mental health services and reduced re-offending, as well as reduced risk of re-offending in those who are ordered to mental health treatment rather than punitive sanctions. In furthering this work, this study examines the effect of disengagement from mental health treatment on probability of re-offence in offenders with psychosis over time. METHODS Data linkage was conducted with judicial, health and mortality datasets from New South Wales, Australia (2001-2015). The study population included 4960 offenders with psychosis who received non-custodial sentences and engaged with community-based mental health treatment. Risk factors for leaving treatment and/or reconviction were examined using multivariate cox regression. Further, a multi-state model was used to observe the probabilities associated with individuals moving between three states: conviction, disengagement from mental health treatment and subsequent re-conviction. RESULTS A threefold increase was observed in the risk of re-offending for those who disengaged from treatment compared to those who did not (aHR = 2.76, 95% CI 1.65-4.62, p < 0.001). The median time until re-offence was 195 days, with the majority (67%) being convicted within one year of leaving treatment. A higher risk of leaving treatment was found for those born outside of Australia, with substance-related psychosis, and a history of violent offence. CONCLUSIONS The findings argue for an emphasis on continued engagement with mental health services following release for offenders with psychosis and identify subgroups within this population for whom concentrated efforts regarding treatment retention should be targeted.
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Affiliation(s)
- Ye In Jane Hwang
- Kirby Institute, University of New South Wales, Sydney, Australia.
| | - Olayan Albalawi
- Kirby Institute, University of New South Wales, Sydney, Australia.,Department of Statistics, Science Faculty, Tabuk University, Tabuk, Saudi Arabia
| | - Armita Adily
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Malcolm Hudson
- Department of Mathematics and Statistics, Macquarie University, Sydney, Australia
| | - Handan Wand
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Azar Kariminia
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Stephen Allnutt
- Community and Forensic Mental Health Services, New South Wales, Australia
| | - Luke Grant
- Corrective Services New South Wales, Haymarket, Australia
| | - Grant Sara
- Northern Clinical School, University of Sydney, Sydney, Australia
| | - James Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Australia
| | - David Mace Greenberg
- Justice Health and Forensic Mental Health Network New South Wales, Matraville, Australia
| | - Tony Butler
- Kirby Institute, University of New South Wales, Sydney, Australia
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Neathery M, Taylor EJ, He Z. Perceived barriers to providing spiritual care among psychiatric mental health nurses. Arch Psychiatr Nurs 2020; 34:572-579. [PMID: 33280682 DOI: 10.1016/j.apnu.2020.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 09/26/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although nurses typically view spiritual care as important, it is provided infrequently. OBJECTIVES This research investigated psychiatric mental health nurses' perceived barriers to providing spiritual care, and how these barriers were associated with frequency of spiritual care and demographic factors. METHODS This cross-sectional correlational study of 159 psychiatric mental health nurses used questionnaires to measure frequency of spiritual care and barriers to spiritual care. RESULTS The most frequent barriers to providing spiritual care were lack of education and fear of exacerbating psychiatric symptoms. Psychiatric mental health nurses provided spiritual care infrequently. CONCLUSIONS Nurses need education about providing spiritual care to those with psychiatric mental health needs.
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Affiliation(s)
- Melissa Neathery
- Baylor University Louise Herrington School of Nursing, 333 N. Washington Ave, Dallas, TX 75246, USA.
| | | | - Zhaomin He
- University of Texas at Tyler, 3900 University Blvd, Tyler, TX 75799, USA.
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37
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Pinedo M, Villatoro AP. The role of perceived treatment need in explaining racial/ethnic disparities in the use of substance abuse treatment services. J Subst Abuse Treat 2020; 118:108105. [PMID: 32839050 DOI: 10.1016/j.jsat.2020.108105] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 03/27/2020] [Revised: 07/30/2020] [Accepted: 08/07/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The current study examined the role of perceived treatment need in explaining racial/ethnic disparities in treatment utilization for a substance use disorder (SUD). METHODS We pooled data from the National Survey on Drug Use and Health survey for years 2014-2017. The analytic sample included adult white, Black, and Latino participants with a past-year SUD (n = 16,393). Multivariable logistic regressions examined racial/ethnic disparities in perceived treatment need-the perception of needing mental health and/or SUD treatment services within the past 12 months-and utilization of past-year substance use, mental health, and any treatment. RESULTS Latinos with SUD were less likely to perceive a need for treatment than whites. Black and Latino participants, relative to white participants, had lower odds of past-year treatment utilization, regardless of treatment type. In models stratified by perceived treatment need, racial/ethnic differences in the use of past-year SUD treatment and any treatment service were only significant among persons without a perceived need for treatment. We found no disparities in use of mental health treatment. CONCLUSIONS Adults with SUD have low perceived treatment need overall but especially among Latinos. Furthermore, Black and Latino disparities in SUD treatment use may be driven in part by lower perceived need for treatment. Interventions that promote better perceived need and delivery models that strengthen the integration of SUD treatment in mental health services may help to reduce these disparities.
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Affiliation(s)
- M Pinedo
- Department of Kinesiology & Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., Stop D3700, Austin, TX 78712-1415, United States of America.
| | - A P Villatoro
- Latino Research Institute, The University of Texas at Austin, 210 W. 24th Street, Stop F9200, Austin, TX 78712, United States of America
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Abstract
This paper analyzes the impact of mental health treatment on suicide attempts. While prior work demonstrates the effectiveness of mental health treatment at reducing suicide risk, few studies examine nationally representative populations or use broad measures of access to mental health services. A methodological problem can arise in studies of mental health treatment and suicidal behavior because a suicide attempt can result in the use of more mental health services. Using nationally representative survey data combined with national estimates of provider availability, this paper employs a methodological correction to address that potential problem of reverse causation. This paper uses measures of the density of health care providers in an area as statistical instruments for use of mental health treatment in an analysis of the impact of mental health treatment on suicide attempts. This study finds that mental health treatment significantly reduces suicide attempts.
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Affiliation(s)
- Chandler McClellan
- Agency for Healthcare Research and Quality, 07N180A, 5600 Fishers Lane, Rockville, MD, 20852, USA.
| | - Mir M Ali
- Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, D.C., USA
| | - Ryan Mutter
- Congressional Budget Office, Washington, D.C., USA
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Start AR, Amiya RM, Dixon AC, Britt TW, Toblin RL, Adler AB. LINKS Training and Unit Support for Mental Health: a Group-randomized Effectiveness Trial. Prev Sci 2020; 21:784-794. [PMID: 32242289 DOI: 10.1007/s11121-020-01106-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The LINKS curriculum, adapted from Britt et al. (2018a), was designed to improve unit climate, knowledge, and attitudes about mental health treatment seeking in military personnel. The present study extends this research by examining implementation options, comparing the effectiveness of LINKS to an active control condition with training delivered by non-experts and comparing modules that varied in training length. Eight Army platoons were randomly assigned to one of four conditions: (1) 1-h Active Control, (2) 2-h Active Control, (3) 1-h LINKS, or (4) 2-h LINKS. Two platoons were assigned to each condition. Surveys were administered at pre-training (T1), post-training (T2), and 3 months later (T3). Eighty-four participants completed all study phases. Regardless of training content, participants receiving the 2-h modules reported greater training acceptability than those receiving the 1-h modules. At T3, participants in the LINKS conditions reported more mental health knowledge than participants in the Active Control conditions. Sustained effects were also observed on a number of treatment barriers and facilitators, with the LINKS conditions generally leading to better outcomes. At T3, 2-h LINKS condition participants reported receiving more mental health treatment relative to the other conditions. Findings suggest that LINKS can be effectively delivered by non-expert trainers, is a viable intervention for targeting mental health treatment-seeking, and is optimally packaged in a 2-h module. The training might benefit from additional leadership training efforts.
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Affiliation(s)
- Amanda R Start
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD, 20910, USA
| | - Rachel M Amiya
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD, 20910, USA
| | - Alexis C Dixon
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD, 20910, USA
| | - Thomas W Britt
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD, 20910, USA.,Department of Psychology, Clemson University, Clemson, SC, USA
| | - Robin L Toblin
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD, 20910, USA
| | - Amy B Adler
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD, 20910, USA.
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40
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Pinedo M. Help seeking behaviors of Latinos with substance use disorders who perceive a need for treatment: Substance abuse versus mental health treatment services. J Subst Abuse Treat 2020; 109:41-45. [PMID: 31856949 PMCID: PMC6927404 DOI: 10.1016/j.jsat.2019.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/06/2019] [Accepted: 11/13/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Perceiving a need for substance abuse treatment is a strong predictor of substance abuse treatment utilization among those with substance use disorders (SUD). Studies have found that when persons with SUD perceive a need for treatment, they are more likely to use mental health treatment rather than substance abuse treatment. Substance abuse treatment utilization is low among Latinos, relative to other racial/ethnic groups. It is unknown if Latinos with SUD who perceive a need for treatment are more likely to use mental health or substance abuse treatment. METHODS Data were pooled from the National Survey on Drug Use and Health survey years 2014, 2015, 2016, and 2017. Analyses were limited to adult Latino participants who met DSM-IV criteria for a past-year substance use disorder (n = 1889). Multinomial logistic regression analyses examined the role of perceived treatment need on the past-year use of (1) no treatment, (2) substance abuse treatment only, and (3) mental health treatment only. Important covariates included socio-demographics, problem severity, currently being on parole or probation, and poor mental health status. RESULTS Only 5% of Latinos with SUD reported perceiving a need for treatment. Treatment utilization was also low: 83% reported not using any treatment in the past-year. In multinomial logistic regressions, compared to not using any treatment, Latinos with SUD who perceived a need for substance abuse treatment were more likely to report using mental health treatment only. Perceiving a need for treatment and using substance abuse treatment services only was not statistically different from not using any treatment. CONCLUSIONS Findings underscore the need for better integration of substance abuse and mental health treatment services to address the health needs of Latinos.
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Affiliation(s)
- Miguel Pinedo
- Department of Kinesiology & Health Education, College of Education, University of Texas, Austin, 2109 San Jacinto Blvd., Stop D3700, Austin, TX 78712, USA.
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Sanmartin MX, Ali MM, Chen J, Dwyer DS. Prescription opioid misuse, sources of opioids and reasons for opioid misuse among reproductive aged parenting women with major depressive episode. Addict Behav 2019; 98:106057. [PMID: 31376658 DOI: 10.1016/j.addbeh.2019.106057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/21/2019] [Accepted: 07/15/2019] [Indexed: 01/27/2023]
Abstract
The impact of the opioid epidemic has been particularly hard on reproductive-aged parenting women. Yet, very little is known about opioid use, opioid misuse and opioid use disorder among parenting women with major depressive episode (MDE). Information on sources of opioids intended for misuse and reasons for opioid misuse among this population is also lacking. Using the 2015-2016 National Survey on Drug Use and Health, the study estimates a multinomial logistic regression model to investigate the association between MDE and opioid misuse as well as use disorder among reproductive-aged parenting women (n = 7750). Among reproductive-aged parenting women with prescription opioid use in the past 12 months, having had a MDE was associated with a higher relative risk of misusing prescription pain relievers without use disorder (RRR = 1.38, p < .001) and having a use disorder (RRR = 1.99, p < .001), relative to using prescription opioid without misuse or use disorder. However, utilization of mental health treatment mitigated the risk for opioid misuse and use disorder. A significant proportion of parenting women regardless of their MDE status identified family or friends and physicians as their main source of opioids. Relief from physical pain and help with feelings or emotions were the two primary motivations for opioid misuse among this population. These findings underscore the importance of maternal depression and mental health treatment in undertaking policy initiatives directed at the opioid crisis and highlights the role of medical providers, family and friends in targeted interventions aimed at this population.
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Affiliation(s)
- Maria X Sanmartin
- Department of Health Professions, Hofstra University, 220 Hofstra University, Hempstead, NY 11549-2200, USA.
| | - Mir M Ali
- Office of the Assistant Secretary for Planning & Evaluation, US Department of Health & Human Services, USA
| | - Jie Chen
- Department of Health Services Administration, University of Maryland, USA
| | - Debra S Dwyer
- College of Arts and Sciences, Stony Brook University, USA
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Yang JC, Roman-Urrestarazu A, McKee M, Brayne C. Demographic, socioeconomic, and health correlates of unmet need for mental health treatment in the United States, 2002-16: evidence from the national surveys on drug use and health. Int J Equity Health 2019; 18:122. [PMID: 31382979 PMCID: PMC6683484 DOI: 10.1186/s12939-019-1026-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/28/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Unmet need for mental health services remains high in the United States and is disproportionately concentrated in some groups. The scale and nature of these disparities have not been fully elucidated and bear further scrutiny. As such, in this study, we examine the demographic, socioeconomic, and health correlates of unmet need for mental health treatment as well as the reasons for unmet need. METHODS We draw upon the National Survey for Drug Use and Health (NSDUH) from 2002 to 16 for adults aged 18 and over in the United States (n = 579,017). Using multivariable logistic regression, we simultaneously model the demographic, socioeconomic, and health correlates of unmet need for mental health treatment from 2002 to 16. We also analyse the reasons for unmet need expressed by these populations, reasons which include cost, perceived stigma, minimisation of symptoms, low perceived effectiveness of treatment, and structural barriers. RESULTS Major characteristics associated with increased odds of unmet need include past year substance abuse or dependence (other than hallucinogens and sedatives), fair, poor, or very poor health, being female, and an educational attainment of college or higher. With respect to reasons for unmet need, cost was most often cited, followed by perceived stigma, structural barriers, and minimisation. Characteristics associated with increased odds of indicating cost as a reason for unmet need include: being uninsured or aged 26-35. Minimisation and low perceived effectiveness are mentioned by high-income persons as reasons for unmet need. College-educated persons and women had higher odds of citing structural barriers as a reason for unmet need. CONCLUSIONS The correlates and causes of unmet need highlight the intersectionality of individual health needs with implications on addressing inequities in mental health policy and practice.
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Affiliation(s)
- Justin C Yang
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
| | - Andres Roman-Urrestarazu
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Carol Brayne
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
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Ali MM, Teich J, Lynch S, Mutter R. Utilization of Mental Health Services by Preschool-Aged Children with Private Insurance Coverage. Adm Policy Ment Health 2019; 45:731-740. [PMID: 29476292 DOI: 10.1007/s10488-018-0858-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is increasing recognition that some preschool-aged children suffer from mental health conditions, but little is known about the treatment they receive. Using the 2014 MarketScan Commercial Claims and Encounters database (N = 1,987,759) the study finds that only a small proportion of preschool-aged children receive any behavioral interventions, including psychotherapy, in conjunction with having a filled psychiatric prescription. Nearly all of the preschool-aged children who had psychotropic prescriptions filled had no other claims for treatment, and among those children who had prescriptions for psychotropic medication filled, the vast majority did not have a mental health diagnosis on a claim.
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Affiliation(s)
- Mir M Ali
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20852, USA.
| | - Judith Teich
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20852, USA
| | - Sean Lynch
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20852, USA
| | - Ryan Mutter
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20852, USA
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44
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Ali MM, Lackey S, Mutter R, McKeon R. The Relationship Between Perceived Unmet Mental Health Care Needs and Suicidal Ideation and Attempt. Adm Policy Ment Health 2019; 45:709-715. [PMID: 29476291 DOI: 10.1007/s10488-018-0856-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study utilizes data from the National Survey of Drug Use and Health (NSDUH) to analyze the relationship between perceived unmet mental health care needs and suicidal ideation and attempt. Estimates from multivariable logistic regression models suggest that individuals who report perceived unmet mental health care needs have higher probability of experiencing suicidal ideation and attempt. Perceived unmet mental health care need has an important association with suicidal ideation and attempt, and efforts aimed at improving access to care are needed to address this issue.
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Affiliation(s)
- Mir M Ali
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20852, USA.
| | - Sara Lackey
- School of Public Policy, University of Maryland College Park, College Park, USA
| | - Ryan Mutter
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD, 20852, USA
| | - Richard McKeon
- Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, USA
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Ackland PE, Greer N, Sayer NA, Spoont MR, Taylor BC, MacDonald R, McKenzie L, Rosebush C, Wilt TJ. Effectiveness and harms of mental health treatments in service members and veterans with deployment-related mild traumatic brain injury. J Affect Disord 2019; 252:493-501. [PMID: 31028994 DOI: 10.1016/j.jad.2019.04.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 03/08/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Co-morbidity of psychiatric conditions with traumatic brain injury (TBI) is common among service members and Veterans from recent deployments. Practice guidelines for mild TBI (mTBI) recommend management of co-occurring psychiatric conditions with existing treatments, but it is unclear whether the effectiveness of treatments for psychiatric conditions is impacted by mTBI. We conducted a systematic literature review to examine the effectiveness and harms of pharmacological and non-pharmacological treatments for posttraumatic stress disorder, depressive disorders, substance use disorders, suicidal ideation or attempts, and anxiety disorders in the presence of co-morbid deployment-related mTBI. METHODS We searched bibliographic databases for peer-reviewed, English language studies published from 2000 to October 2017. Two reviewers independently completed abstract triage and full text review. RESULTS We identified 7 studies (5 pre-post and 2 secondary analysis). Six assessed psychotherapy and one reported on hyperbaric oxygen therapy (HBO2). Studies comparing outcomes by TBI history found that a history of TBI does not affect treatment outcomes. Harms were reported only for HBO2 and were mild. No study examined the effectiveness of treatments for substance use disorders or suicidal ideation, or the effectiveness of pharmacological interventions for the psychiatric conditions of interest in service members and Veterans with mTBI. LIMITATIONS Studies lacked usual care or wait-list control groups and no randomized trials were found, making the strength of evidence insufficient. CONCLUSIONS Evidence is insufficient to fully assess the impact of TBI on the effectiveness of treatments for psychiatric conditions. Higher quality evidence with definitive guidance for providers treating this population is needed.
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Affiliation(s)
- Princess E Ackland
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Department of Medicine, University of Minnesota, Minneapolis, MN.
| | - Nancy Greer
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Minneapolis VA Evidence-based Synthesis Program Center, Minneapolis VA Health Care System, One Veterans Drive (111-O), Minneapolis, MN 55417, USA
| | - Nina A Sayer
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Department of Medicine, University of Minnesota, Minneapolis, MN; Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Michele R Spoont
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Department of Medicine, University of Minnesota, Minneapolis, MN; National Center for PTSD, Honolulu, HI
| | - Brent C Taylor
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Department of Medicine, University of Minnesota, Minneapolis, MN; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Roderick MacDonald
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Minneapolis VA Evidence-based Synthesis Program Center, Minneapolis VA Health Care System, One Veterans Drive (111-O), Minneapolis, MN 55417, USA
| | - Lauren McKenzie
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Minneapolis VA Evidence-based Synthesis Program Center, Minneapolis VA Health Care System, One Veterans Drive (111-O), Minneapolis, MN 55417, USA
| | - Christina Rosebush
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Minneapolis VA Evidence-based Synthesis Program Center, Minneapolis VA Health Care System, One Veterans Drive (111-O), Minneapolis, MN 55417, USA
| | - Timothy J Wilt
- Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, One Veterans Drive (152), Minneapolis, MN 55417, USA; Department of Medicine, University of Minnesota, Minneapolis, MN; Minneapolis VA Evidence-based Synthesis Program Center, Minneapolis VA Health Care System, One Veterans Drive (111-O), Minneapolis, MN 55417, USA
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Salameh TN, Hall LA, Crawford TN, Staten RR, Hall MT. Racial/ethnic differences in mental health treatment among a national sample of pregnant women with mental health and/or substance use disorders in the United States. J Psychosom Res 2019; 121:74-80. [PMID: 30928211 DOI: 10.1016/j.jpsychores.2019.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/13/2019] [Accepted: 03/15/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine racial/ethnic differences in the receipt of mental health treatment among pregnant women with mental health (i.e., depression and serious psychological distress) and/or substance use disorders. METHOD Secondary analysis of data from the National Survey on Drug Use and Health was conducted. The sample consisted of 1232 pregnant women with mental health/substance use disorders. RESULTS Black/African American (Adjusted Odds Ratio [AOR]: 0.36, 95% Confidence Interval [CI]: 0.17-0.75), other non-Hispanic (AOR: 0.24, 95% CI: 0.11-0.52), and Hispanic (AOR: 0.42, 95% CI: 0.22-0.81) pregnant women had significantly lower odds of mental health treatment receipt compared to Whites, even when controlling for age, education, marital status, number of children, employment status, income, health insurance, county urbanicity, self-rated health status, type of mental health condition, and time. There were no racial/ethnic differences by mental health and/or substance use disorders. Among pregnant women who perceived unmet mental health treatment need (N = 299), a greater proportion of White compared to Non-White pregnant women perceived cost as an obstacle to access treatment (62.1% vs. 35.6%, p = .001); however, the two groups did not differ in other perceived barriers to mental health treatment (i.e., opposition to treatment, stigma, time/transportation limitation, and not knowing where to go). CONCLUSIONS Strategies are needed to increase access to mental health treatment among racial/ethnic minority women who are pregnant and have mental health/substance use disorders. Further studies are required to understand racial/ethnic differences in the perceived barriers to mental health treatment.
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Bryson WC, Cotton BP, Barry LC, Bruce ML, Piel J, Thielke SM, Williams BA. Mental health treatment among older adults with mental illness on parole or probation. Health Justice 2019; 7:4. [PMID: 30923982 PMCID: PMC6717990 DOI: 10.1186/s40352-019-0084-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/11/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND The number of older adults on parole and probation is growing at an unprecedented rate, yet little is known about the mental health needs and treatment utilization patterns among this group. The objective of this study is to compare the prevalence of serious or moderate mental illness (SMMI), and the proportion of those with SMMI who receive mental health treatment, among community-dwelling older adults on correctional supervision (parole or probation) vs. not on correctional supervision. METHODS Design: Cross-sectional analysis of data from the 2008-2014 National Surveys for Drug Use and Health (NSDUH). SETTING Population-based national survey data. PARTICIPANTS Older adults (age ≥ 50) who participated in the NSDUH between 2008 and 2014 (n = 44,624). Participants were categorized according to whether they were on parole or probation during the 12 months prior to survey completion (n = 379) vs. not (n = 44,245). MEASUREMENTS Probable SMMI was defined using a validated measure in the NSDUH. Mental health treatment included any outpatient mental health services or prescriptions over the 12 months prior to survey completion. We compared the prevalence of SMMI, and the proportion of those with SMMI who received any treatment, by correctional status. RESULTS Overall, 7% (N = 3266) of participants had SMMI; the prevalence was disproportionately higher among those on parole or probation (21% vs. 7%, p < 0.001). Sixty-two percent of those with SMMI received any mental health treatment, including 81% of those on parole or probation and 61% of those who were not (p < 0.001). This result remained statistically significant after logistic regression accounted for differences in sociodemographics and health. CONCLUSIONS SMMI is disproportionally prevalent among older adults on parole or probation, and community correctional supervision programs may be facilitating linkages to needed community-based mental health treatment.
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Affiliation(s)
- William C. Bryson
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Multnomah Pavilion, Room 2316, Portland, OR 97239-3098 USA
| | - Brandi P. Cotton
- University of Rhode Island, College of Nursing, Kingston, RI USA
| | - Lisa C. Barry
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT USA
| | - Martha L. Bruce
- Geisel School of Medicine, Dartmouth University, Hanover, NH USA
| | - Jennifer Piel
- University of Washington Medical Center, Seattle, WA USA
- Puget Sound Veterans Affairs Medical Center, Seattle, WA USA
| | - Stephen M. Thielke
- University of Washington Medical Center, Seattle, WA USA
- Puget Sound Veterans Affairs Medical Center, Seattle, WA USA
| | - Brie A. Williams
- Division of Geriatrics, University of California San Francisco, San Francisco, CA USA
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48
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Novak P, Feder KA, Ali MM, Chen J. Behavioral health treatment utilization among individuals with co-occurring opioid use disorder and mental illness: Evidence from a national survey. J Subst Abuse Treat 2019; 98:47-52. [PMID: 30665603 PMCID: PMC6350939 DOI: 10.1016/j.jsat.2018.12.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Past research shows that among individuals with substance use disorders, the presence of a co-occurring mental illness can influence the initiation, course, and success of behavioral health treatment, but little research has examined people with opioid use disorder (OUD) specifically. METHODS Using the 2008-2014 National Survey on Drug Use and Health, this study examines the utilization of substance use disorder and mental health treatment among individuals with OUD and different degrees of mental illness severity. The study also examined types of treatment, perceived unmet need for treatment, and barriers to care. RESULTS 47% of individuals with OUD and co-occurring mild/moderate mental illness did not receive any behavioral health treatment, and 21% of those with co-occurring serious mental illnesses did not receive any behavioral health treatment. Among those with OUD and co-occurring mild/moderate mental illness, 16% reported receiving both substance use disorder and mental health treatment; among those with co-occurring serious mental illness the rate was 32%. The most common form of treatment was prescription medication for mental health, and this was true regardless of whether or not the individual had any mental illness. More than 50% of the study population reported financial difficulties as a barrier to treatment. CONCLUSION A high proportion of individuals with OUD and co-occurring mental illness are not receiving needed care. However, nearly one in five of those with OUD but no diagnosed mental illness is receiving prescription medication for mental illness. These findings suggest that there is a need to better facilitate access to and coordinate behavioral health care across settings for individuals with OUD.
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Affiliation(s)
- Priscilla Novak
- University of Maryland, College Park, School of Public Health, Department of Health Services Administration, 4200 Valley Drive #2242, College Park, MD 20847, United States of America.
| | - Kenneth A Feder
- Johns Hopkins University, Bloomberg School of Public Health, United States of America
| | - Mir M Ali
- Office of the Assistant Secretary for Planning & Evaluation, US Department of Health & Human Services, United States of America
| | - Jie Chen
- University of Maryland, College Park, School of Public Health, United States of America
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Tomczyk S, Muehlan H, Freitag S, Stolzenburg S, Schomerus G, Schmidt S. Is knowledge "half the battle"? The role of depression literacy in help-seeking among a non-clinical sample of adults with currently untreated mental health problems. J Affect Disord 2018; 238:289-296. [PMID: 29902732 DOI: 10.1016/j.jad.2018.05.059] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/27/2018] [Accepted: 05/28/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUNDS The concept of mental health literacy suggests that higher literacy increases the likelihood of seeking treatment. However, previous studies mostly use vignettes, and do not investigate actual help-seeking behaviour. METHODS We assessed depression literacy and type of mental illness in a convenience sample of 207 adults with currently untreated mental health problems from the general population. Our analysis sample comprised 152 adults (Mage = 52.12; 73.0% female) with a depressive disorder. Help-seeking behaviour was measured 3 and 6 months after the initial assessment. We conducted multiple logistic regression models to test whether depression literacy predicted help-seeking from mental health professionals, general practitioner, family and friends, or counselling, controlling for sociodemographic data, and depression severity. RESULTS Depression literacy was lower in men and older participants, and higher in participants with prior treatment experience. Depression literacy was negatively linked to informal help-seeking (aOR = 0.33 [0.13; 0.84]) when included as a dichotomous predictor (i.e., 'high' versus 'low' literacy). LIMITATIONS Our sample was small, thus we did not differentiate between types of depressive disorders in our analysis. CONCLUSION We could not corroborate most postulated associations between depression literacy and help-seeking, except for the negative association with informal help. Our findings underline differences between previous vignette-based and community-based investigations of the help-seeking process for mental health problems. To explore underlying mechanisms, future research should investigate the role of intermediary variables and processes in the association between depression literacy and help-seeking, such as self-efficacy and symptom attribution, which might be more clinically relevant in help-seeking for depressive symptoms.
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Affiliation(s)
- S Tomczyk
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany.
| | - H Muehlan
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - S Freitag
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - S Stolzenburg
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - G Schomerus
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - S Schmidt
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
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50
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Smith NB, Tsai J, Pietrzak RH, Cook JM, Hoff R, Harpaz-Rotem I. Differential predictive value of PTSD symptom clusters for mental health care among Iraq and Afghanistan veterans following PTSD diagnosis. Psychiatry Res 2017. [PMID: 28622572 DOI: 10.1016/j.psychres.2017.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Veterans from the recent conflicts in Iraq and Afghanistan are being diagnosed with posttraumatic stress disorder (PTSD) at high rates. This study examined characteristics associated with mental health service utilization, specifically psychotherapy, through the Department of Veterans Affairs (VA), in a large cohort of Iraq and Afghanistan veterans newly diagnosed with PTSD. METHOD This study utilized national VA administrative data from Iraq and Afghanistan veterans following an initial diagnosis of PTSD and completed a self-report measure of PTSD symptoms between Fiscal Years 2008-2012 (N=52,456; 91.7% male; 59.7% Caucasian; mean age 30.6, SD=8.3). Regression analyses examined the relation between PTSD symptom cluster severity and treatment-related variables. RESULTS Accounting for demographic/clinical variables, PTSD symptom clusters were related to psychotherapy initiation (re-experiencing, OR=1.23; numbing, OR=1.15), combination treatment (medication and psychotherapy; re-experiencing, OR=1.13; avoidance, OR=1.07; dysphoric arousal, OR=1.06), number of psychotherapy visits (re-experiencing, IRR= 1.08; numbing, IRR=1.09), and adequate dose of therapy (e.g., 8 visits/14 weeks; re-experiencing: OR= 1.07). CONCLUSIONS When considering treatment approaches for trauma-exposed veterans, it is important to map the severity of unique PTSD symptoms clusters; this may have implications on the selection of treatment that best fits the veterans' needs and preferences (e.g., exposure therapy versus cognitive processing therapy).
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Affiliation(s)
- Noelle B Smith
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA.
| | - Jack Tsai
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; VA New England Mental Illness Research, Education, and Clinical Center, West Haven, CT, USA
| | - Robert H Pietrzak
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Joan M Cook
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Rani Hoff
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; VA Northeast Program Evaluation Center, West Haven, CT, USA
| | - Ilan Harpaz-Rotem
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; VA Northeast Program Evaluation Center, West Haven, CT, USA.
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