Authors:Emily Velazquez Trask; Kya Barounis; Brandon L. Carlisle; Ann F. Garland; Gregory A. Aarons Pages: 821 - 830 Abstract: Therapeutic homework is a fundamental skill-building component of the majority of evidence-based therapies and is associated with better treatment outcomes. However, it is rarely utilized in public mental health settings. To determine barriers to homework use and identify predictors of clinicians’ assignment of homework, an online survey was administered to 267 clinicians in a large diverse public mental health system. Clinicians who were younger, licensed, whose supervisors asked about homework and whose clients completed their homework more frequently were predictors of greater homework utilization. The survey results are discussed and a novel idea to increase the use of homework is introduced. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0867-9 Issue No:Vol. 45, No. 6 (2018)
Authors:Meghan Romanelli; Wenhua Lu; Michael A. Lindsey Pages: 831 - 849 Abstract: This study examined how experiences of service denial and discrimination in three health care settings—doctors’ offices, emergency rooms, and mental health clinics—might contribute to attempted suicide among transgender adults. Mechanisms of this relationship were examined, including treatment receipt and the use of substances to cope with mistreatment. Perceived emotional social support was also tested as a potential protective factor against the deleterious effects of service denial and discrimination on treatment receipt, substance use, and attempted suicide. The analysis included 4190 respondents from the National Transgender Discrimination Survey. Structural equation modeling was employed to test hypothesized relationships. Being denied a greater number of services and discriminated against in more settings were associated with lower levels of treatment receipt. Service denial was also correlated with increased rates of coping-motivated substance use and elevated rates of attempted suicide. Treatment receipt mediated the relationships between service denial/discrimination and substance use. Substance use mediated the relationship between treatment receipt and attempted suicide. Higher levels of support were protective to treatment receipt when denied services in one setting, but no longer retained protective effects when denied in two or three settings. Results have critical implications for service access and delivery and policies that protect transgender help-seekers in the health care system. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0868-8 Issue No:Vol. 45, No. 6 (2018)
Authors:Vanessa Panaite; Racine Brown; Michelle Henry; Amanda Garcia; Gail Powell-Cope; Rodney D. Vanderploeg; Heather G. Belanger Pages: 850 - 875 Abstract: Population-based post-deployment screening programs within the Departments of Defense and Veterans Affairs have been implemented to assess for mental health conditions and traumatic brain injury. The purpose of this paper is to systematically review the literature on post-deployment screening within this context and evaluate evidence compared to commonly accepted screening implementation criteria. Findings reflected highly variable psychometric properties of the various screens, variable treatment referral rates following screening, low to moderate treatment initiation rates following screening, and no information on treatment completion or long-term outcomes following screening. In sum, the evidence supporting population based post-deployment screening is inconclusive. Implications are discussed. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0869-7 Issue No:Vol. 45, No. 6 (2018)
Authors:Alex R. Dopp; Cindy M. Schaeffer; Cynthia Cupit Swenson; Jennifer S. Powell Pages: 876 - 887 Abstract: This study evaluated the economics of Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) by applying the Washington State Institute for Public Policy (WSIPP) cost-benefit model to data from a randomized effectiveness trial with 86 families (Swenson et al. in JFP 24:497–507, 2010b). The net benefit of MST-CAN, versus enhanced outpatient treatment, was $26,655 per family at 16 months post-baseline. Stated differently, every dollar spent on MST-CAN recovered $3.31 in savings to participants, taxpayers, and society at large. Policymakers and public service agencies should consider these findings when making investments into interventions for high-need families involved with child protective services. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0870-1 Issue No:Vol. 45, No. 6 (2018)
Authors:Alene Kennedy-Hendricks; Gail L. Daumit; Seema Choksy; Sarah Linden; Emma E. McGinty Pages: 888 - 899 Abstract: Despite the proliferation of initiatives to integrate services for people with serious mental illness (SMI), measures of distinct dimensions of integration, such as spatial arrangement and care team expertise, are lacking. Such measures are needed to support organizations’ assessment of progress toward integrated service delivery. We developed measures characterizing integration of behavioral, somatic, and social services to operationalize the integrated care dimensions conceived by the Agency for Healthcare Research and Quality. In a survey fielded to 46 Maryland Medicaid health homes (response rate: 96%) serving adults with SMI during 2015–2016, we found that these measures provided a useful description of variation across dimensions of integration. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0871-0 Issue No:Vol. 45, No. 6 (2018)
Authors:Fateme Dehghani-Arani; Mohammad Ali Besharat; Victoria A. Fitton; Asghar Aghamohammadi Pages: 900 - 910 Abstract: Studies have shown significant relationship between health conditions and attachment. This study aimed to examine an attachment-based intervention model named mother–child-disease triangle (MCDT) on health indices in children with chronic disease and their mothers. This randomized trial study included 22 volunteer children aged 12–18 years undergoing medical treatment for a chronic disease and their mothers. After evaluation by 28-form General Health Questionnaire (GHQ-28), inventory of parent and peer attachment (IPPA), 28-form Child Health Questionnaire (CHQ-28) and Illness Perception Questionnaire (IPQ), the mother–child dyads were paired on the basis of IPPA scores. These pairs were then randomly assigned to an experimental or control group. The experimental group received ten 90-min sessions of MCDT over a 7-week period. Meanwhile, the control group received ten simple conversational sessions as a dummy intervention. In accordance with this study’s pre-test/post-test design, both groups were evaluated once again after completing their respective treatment. Multivariate analysis of covariance (MANCOVA) showed members of the experimental group to have significantly stronger attachment and better physiological and psychosocial health than those in the control group. These findings suggest that attachment-based interventions can be used to improve the effectiveness of treatment among children with chronic disease and their mothers. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0873-y Issue No:Vol. 45, No. 6 (2018)
Authors:Shereen Hussein Pages: 911 - 923 Abstract: Social workers (SWs) provide emotional and practical support to vulnerable service users who are likely to suffer from emotional trauma and mental health conditions. Stress and burnout levels are reported to be high among SWs, however, little is known about their relationships with different characteristics. The current article utilises unique and large dataset (n = 3786) on SWs working in adults and children’s services to examine factors associated with burnout. Employing job-demand/resources model and structural equations modelling, we highlight the varying significant impact of work-engagement, administrative support and work experience as moderating factors to burnout across adult and children service specialism in this sample. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0872-z Issue No:Vol. 45, No. 6 (2018)
Authors:Priscilla Novak; Andrew C. Anderson; Jie Chen Pages: 924 - 932 Abstract: The Affordable Care Act (ACA) aims to expand health insurance coverage and minimize financial barriers to receiving health care services for individuals. However, little is known about how the ACA has impacted individuals with mental health conditions. This study finds that the implementation of the ACA is associated with an increase in rate of health insurance coverage among nonelderly adults with serious psychological distress (SPD) and a reduction in delaying and forgoing necessary care. The ACA also reduced the odds of an individual with SPD not being able to afford mental health care. Mental health care access among racial and ethnic minority populations and people with low income has improved during 2014–2016, but gaps remain. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0875-9 Issue No:Vol. 45, No. 6 (2018)
Authors:Kalyani Gopalan; Marcela Horvitz Lennon; Bradley D. Stein; Frank Ghinassi; Nicholas Castle; Joyce Chang; Julie Donohue Pages: 933 - 943 Abstract: People with mental illnesses (MI) receive suboptimal care for medical comorbidities and their high risk for readmission may be addressed by adequate medication management and follow-up care. We examined the association between MI, medication changes, and post-discharge outpatient visits with 30-day readmission in 40,048 Medicare beneficiaries hospitalized for acute myocardial infarction, heart failure or pneumonia. Beneficiaries with MI were more likely to be readmitted than those without MI (14 vs. 11%). Probability of readmission was 13 and 12% when medications were dropped or added, respectively, versus 11% when no change was made. Probability of readmission also increased with outpatient visits. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0874-x Issue No:Vol. 45, No. 6 (2018)
Authors:Karen T. G. Schwartz; Amanda A. Bowling; John F. Dickerson; Frances L. Lynch; David A. Brent; Giovanna Porta; Satish Iyengar; V. Robin Weersing Pages: 944 - 957 Abstract: The current study evaluated the interrater reliability of the Child and Adolescent Services Assessment (CASA), a widely used structured interview measuring pediatric mental health service use. Interviews (N = 72) were randomly selected from a pediatric effectiveness trial, and audio was coded by an independent rater. Regressions were employed to identify predictors of rater disagreement. Interrater reliability was high for items (> 94%) and summary metrics (ICC > .79) across service sectors. Predictors of disagreement varied by domain; significant predictors indexed higher clinical severity or social disadvantage. Results support the CASA as a reliable and robust assessment of pediatric service use, but administrators should be alert when assessing vulnerable populations. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0876-8 Issue No:Vol. 45, No. 6 (2018)
Authors:Lauren M. Haack; Jocelyn Meza; Yuanyuan Jiang; Eva Jimenez Araujo; Linda Pfiffner Pages: 958 - 977 Abstract: ADHD problem recognition serves as the first step of help seeking for ethnic minority families, such as Latinos, who underutilize ADHD services. The current mixed-method study explores underlying factors influencing recognition of ADHD problems in a sample of 159 school-aged youth. Parent-teacher informant discrepancy results suggest that parent ethnicity, problem domain, and child age influence ADHD problem recognition. Emerging themes from semi-structured qualitative interviews/focus groups conducted with eighteen Spanish-speaking Latino parents receiving school-based services for attention and behavior concerns support a range of recognized ADHD problems, beliefs about causes, and reactions to ADHD identification. Findings provide recommendations for reducing disparities in ADHD problem recognition and subsequent help seeking. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0877-7 Issue No:Vol. 45, No. 6 (2018)
Authors:Lauren M. Haack; Jocelyn Meza; Yuanyuan Jiang; Eva A. Araujo; Linda Pfiffner Pages: 978 - 978 Abstract: The original version of this article unfortunately contained a mistake. The co-author, Dr. Araujo’s name and the affiliation for Dr. Pfiffner was incorrect in the original version of the article. The correct information is given below. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0888-4 Issue No:Vol. 45, No. 6 (2018)
Authors:Brooke Lifland; Davene R. Wright; Rita Mangione-Smith; Arti D. Desai Pages: 979 - 987 Abstract: Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions. Understanding which care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0878-6 Issue No:Vol. 45, No. 6 (2018)
Authors:Anne-Katharina Schiefele; Wolfgang Lutz; Michael Barkham; Julian Rubel; Jan Böhnke; Jaime Delgadillo; Mark Kopta; Dietmar Schulte; David Saxon; Stevan L. Nielsen; Michael J. Lambert Pages: 988 - 988 Abstract: The original version of this article unfortunately contained a mistake. In Results section, under the heading the “Application”, CI difference values were incorrect in one of the sentences. The corrected sentence is given below. PubDate: 2018-11-01 DOI: 10.1007/s10488-018-0891-9 Issue No:Vol. 45, No. 6 (2018)
Authors:David H. Sommerfeld; Gregory A. Aarons; Jeanean B. Naqvi; Jason Holden; Dimitri Perivoliotis; Kim T. Mueser; Eric Granholm Abstract: This study examined stakeholder perceptions of the “fit” between cognitive-behavioral social skills training (CBSST) and assertive community treatment (ACT) when implementing CBSST into existing community-based ACT teams. Focus group feedback was collected from a diverse set of stakeholders (i.e., clients, providers, supervisors, agency administrators, public sector representatives, and intervention developers). Results identified perceived client and provider benefits for integrating CBSST into ACT while highlighting the importance of purposeful adaptations, training, and implementation tools to facilitate structural and values fit between CBSST and ACT. Study findings will inform future endeavors to implement CBSST and other relevant EBPs into ACT. Trial Registry: ClinicalTrials.gov #NCT02254733. PubDate: 2018-11-08 DOI: 10.1007/s10488-018-0904-8
Authors:Winnie W. S. Mak; Randolph C. H. Chan; Sania S. W. Yau Abstract: Recovery-oriented transformation of mental health service systems not only necessitates changes in mental health policies and practices, it also requires an adoption of recovery-oriented mindset, which includes knowledge and attitudes, among service providers. It is also important that service users are informed about the changes and can fully participate in the process. The present study developed and evaluated the efficacy of a recovery psychoeducation program in enhancing recovery-oriented knowledge and attitudes among mental health service providers and users in Hong Kong. In study 1, 111 service providers were randomly assigned to 2-day psychoeducation group or control group. Results showed that participants in psychoeducation group had significantly better recovery knowledge and more positive attitudes towards recovery after the intervention than the control counterparts. The effect of the recovery psychoeducation program on recovery attitudes was fully mediated by the improvement in recovery knowledge. In study 2, 93 people with mental illness were randomized into 2-week psychoeducation group or control group. Participants in the psychoeducation group had a significant improvement in the level of recovery-oriented knowledge immediately after the workshops, but the effect could not be sustained at follow-up. To transform into a recovery-oriented service system, having an effective program to orient service providers and users to recovery is essential. This study provided initial support to the use of a brief psychoeducational program for recovery-oriented knowledge enhancement. Given the short-term efficacy and feasibility of the interventions, service leaders and managers in different clinical and social service settings should consider implementing the programs as part of staff and users’ service orientation to build a recovery-supporting workforce and empower their service users early in the recovery process. PubDate: 2018-11-07 DOI: 10.1007/s10488-018-0905-7
Authors:Allyson L. Dir; Lisa Saldana; Jason E. Chapman; Matthew C. Aalsma Abstract: Despite high rates of mental health problems among juvenile justice-involved youth, mental health stigma among juvenile probation officers (JPOs) is under-studied. This cross-sectional study examined effects of job burnout and workplace participatory atmosphere on mental health stigma among JPOs across Indiana (n = 226). Participatory atmosphere moderated the relationship between JPO burnout-related cynicism and mental health stigma (interaction β = − 0.14, p = .04); burnout was related to greater mental health stigma at low levels of participatory atmosphere. Findings suggest participatory atmosphere mitigates effects of burnout on mental health stigma among JPOs. Organizational-level interventions might help to reduce mental health stigma and combat negative effects from burnout among JPOs. PubDate: 2018-11-03 DOI: 10.1007/s10488-018-0902-x
Authors:Jessica F. Saunders; Asia A. Eaton; Stacy L. Frazier Abstract: This qualitative study draws on a photo-elicitation method (“PhotoVoice”) and semi-structured interviews to examine the key areas stakeholders (30 young women between the ages of 18 and 35 in eating disorder recovery) identify as meaningful venues of policy-based change. Photography and the accompanying narratives capturing personally-meaningful social, cultural, and systemic influences on recovery were shared with the research team. Photographs and interviews were examined for policy implications using thematic analysis, and six areas of improvement emerged: media, healthcare practice and access, health insurance reform, education, objectification of the female body, and mental health stigma. Implications for reform are discussed. PubDate: 2018-10-26 DOI: 10.1007/s10488-018-0903-9
Authors:Christopher J. Miller; Jennifer L. Sullivan; Bo Kim; A. Rani Elwy; Karen L. Drummond; Samantha Connolly; Rachel P. Riendeau; Mark S. Bauer Abstract: The Collaborative Care Model (CCM) is an evidence-based approach for structuring care for chronic health conditions. Attempts to implement CCM-based care in a given setting depend, however, on the extent to which care in that setting is already aligned with the specific elements of CCM-based care. We therefore interviewed staff from ten outpatient mental health teams in the US Department of Veterans Affairs to determine whether care delivery was consistent or inconsistent with CCM-based care in those settings. We discuss implications of our findings for future attempts to implement CCM-based outpatient mental health care. PubDate: 2018-10-23 DOI: 10.1007/s10488-018-0901-y
Authors:Edwin S. Wong; Matthew L. Maciejewski; Paul L. Hebert; John C. Fortney; Chuan-Fen Liu Abstract: Older veterans can obtain care from the Veterans Affairs Health System (VA), Medicare or both. We examined whether their use of mental health care was impacted by capacity effects stemming from younger, uninsured veterans’ enrolling in VA to satisfy the individual mandate within Massachusetts Health Reform (MHR). Using administrative data, we applied a difference-in-difference approach to compare pre-post changes in mental health use following MHR implementation. Findings indicated MHR was associated with increases in use through Medicare and the probability of dual VA-Medicare use. These results provide support for the possibility that limited capacity led to care seeking outside VA. PubDate: 2018-10-20 DOI: 10.1007/s10488-018-0900-z
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