A Comparison of Participants in Two Community-Based Programs: Assisted Outpatient Treatment and a Mental Health Court.
Assisted Outpatient Treatment; mental health courts; Outpatient commitment
OBJECTIVE: Mental health courts and assisted outpatient treatment (AOT) are tools to help people with serious mental illness engage in treatment and avoid or reduce institutionalization. As both programs become increasingly prevalent, questions remain about whether people with severe mental illness who receive AOT have the same characteristics, histories, and service needs as those who participate in mental health courts. If there are differences, each program may require assessments and interventions tailored to the specific characteristics and needs of participants. METHODS: This study examined administrative criminal justice and mental health services data for 261 people with serious mental illness who participated in AOT, a mental health court, or both over seven years. RESULTS: Three percent of the sample participated in both programs. Compared with participants in mental health court, participants in AOT were older, less likely to have an alcohol use disorder, and more likely to have a schizophrenia spectrum disorder than a bipolar disorder. The participants' histories of crisis mental health service utilization, hospitalization, and incarceration prior to program entry varied significantly by program. CONCLUSIONS: The findings suggest that there are differences among individuals with serious mental illness who are served by AOT and mental health court programs. AOT participants had greater engagement with mental health services, and a significant portion of AOT participants also had a prior criminal history that placed them at risk of future justice involvement. Program administrators need to recognize and address the clinical and criminogenic needs that place individuals at risk of becoming hospitalized and incarcerated.
Bonfine Natalie; Ritter Christian; Teller Jennifer L S; Munetz Mark R
Psychiatric services (Washington, D.C.)
2018
2018-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/appi.ps.201700341" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.201700341</a>
A mock morbidity and mortality conference: Does it change providers' behavior?
Welton RS; Ashai A; Virgo L; Nahhas RW
Academic Psychiatry
2021
2021-04-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1007/s40596-021-01449-4" target="_blank" rel="noreferrer noopener">10.1007/s40596-021-01449-4</a>
A systematic review of ketamine for the treatment of depression among older adults.
older adults; major depressive disorder; bipolar depression; ketamine; treatment-resistant depression
Objective: To review the currently available data on the use of ketamine in the treatment of depression among older adults from randomized controlled studies.; Design: Randomized controlled trials.; Setting: Variable.; Participants: 60 years and older with depression.; Intervention: Ketamine.; Measurements: Change in Montgomery-Asberg Depression Rating Scale (MADRS) scores.; Results: Two studies met the inclusion criteria. The first study showed a significant reduction in depression symptoms with use of repeated subcutaneous ketamine administration among older adults with depression. The second study failed to achieve significance on its primary outcome measure but did show a decrease in MADRS scores with intranasal ketamine along with a higher response and remission rates in esketamine group compared with the placebo group. The adverse effects from ketamine generally lasted only a few hours and abated spontaneously. No cognitive adverse effects were noted in either trial from the use of ketamine.; Conclusions: The current evidence for use of ketamine among older adults with depression indicates some benefits with one positive and one negative trial. Although one of the trials did not achieve significance on the primary outcome measure, it still showed benefit of ketamine in reducing depressive symptoms. Ketamine was well tolerated in both studies with adverse effects being mild and transient.
Gupta A; Dhar R; Patadia P; Funaro M; Bhattacharya G; Farheen SA; Tampi RR
International Psychogeriatrics
2020
2020-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1017/S1041610220000903" target="_blank" rel="noreferrer noopener">10.1017/S1041610220000903</a>
A Test of the Career Construction Theory Model of Adaptation in Adult Workers With Chiari Malformation
abilities scale; adaptability; Career Adapt-Abilities Scale-Short Form; career adaptability; career construction theory; Chiari malformation; job; life; mediation; need satisfaction; personality; psychometric properties; self-regulation; students
October 2019 Update
The present study examined the career construction theory (CCT) model of adaptation using a sample of working adults diagnosed with Chiari malformation. Specifically, we tested a mediation model in which adaptivity (i.e., proactivity, openness, and conscientiousness) fosters adaptability, which conditions adapting (i.e., competence need satisfaction at work), which leads to adaptation (i.e., work well-being and subjective well-being). Results of structural equation modeling supported all of the hypothesized direct and indirect relations between CCT constructs, thus providing strong support for the applicability of the model of adaptation among workers with Chiari malformation. Prior to testing the model of adaptation, we examined and found support for the hypothesized hierarchical structure of the Career Adapt-Abilities Scale-Short Form, a recently developed operationalization of career adaptability.
Tokar David M; Savickas Mark L; Kaut Kevin P
Journal of Career Assessment
2019
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1069072719867733" target="_blank" rel="noreferrer noopener">10.1177/1069072719867733</a>
Adapting cognitive behavioral therapy for psychosis for case managers: increasing access to services in a community mental health agency.
*Community Mental Health Services; *Diffusion of Innovation; *Health Services Accessibility; Adult; Case Management; Case Managers; Cognitive Behavioral Therapy/education/*methods; Cognitive Therapy – Methods; Collaboration; Community Mental Health Services – United States; Cooperative Behavior; Evidence-Based; Evidence-Based Practice/education/methods; Female; Human; Humans; Inservice Training; Interinstitutional Relations; Male; Pilot Studies; Professional Practice; Program Implementation – Methods; Psychotic Disorders/*therapy; Questionnaires; Scales; Schizophrenia – Rehabilitation; Schizophrenia/*therapy; Staff Development; Thematic Analysis; Treatment Outcome; United Kingdom; United States
OBJECTIVE: The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) using a dissemination framework, to describe the process of implementing the practice at a community mental health agency. METHOD: The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. RESULTS: Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.
Montesano Vicki L; Sivec Harry J; Munetz Mark R; Pelton Jeremy R; Turkington Douglas
Psychiatric rehabilitation journal
2014
2014-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1037/prj0000037" target="_blank" rel="noreferrer noopener">10.1037/prj0000037</a>
Age moderates the relationship between source of social support and mental health in racial minority lesbian, gay, and bisexual youth
Depression; sexuality; social support; trauma; youth
We examined the relationship between source of social support and mental health (and the moderating impact of age) in 64 low socioeconomic status, racial minority lesbian, gay, and bisexual adolescents/young adults. Social support from family ( β = -.302, p = .03; β = -.364, p = .008), but not friends or significant others, was independently related to posttraumatic stress disorder and depression symptoms, respectively. Family social support was associated with lower posttraumatic stress disorder and depression symptoms in participants aged 16-19 years, while friend social support was associated with lower symptoms for participants aged over 20 years. Friend social support was also associated with lower posttraumatic stress disorder symptoms in participants aged 16-17 years. Interventions should target age-appropriate sources of social support.
Wise Anna E; Smith Brian C; Armelie Aaron P; Boarts Jessica M; Delahanty Douglas L
Journal of Health Psychology
2019
2019-06
<a href="http://doi.org/10.1177/1359105316686667" target="_blank" rel="noreferrer noopener">10.1177/1359105316686667</a>
An examination of pain, disability, and the psychological correlates of Chiari Malformation pre- and post-surgical correction
Chiari malformation; Decompression surgery; Disability; Pain; Psychological symptoms
BACKGROUND: 50% of patients with Chiari Malformation (CM) report a history of depression; however, rates of other psychological symptoms are unknown. Further, it is unclear whether surgical correction impacts pain, disability, and psychological symptoms. OBJECTIVE: /Hypothesis: We examined rates of symptoms in a nationwide sample of CM patients who had (n = 639) and had not (n = 551) undergone surgical correction. We hypothesized lower symptom severity in the latter group. METHODS: Participants completed assessments and submitted pre-surgical MRI scans online (n = 286). Informed by the Fear-Avoidance Model of pain, we controlled for psychological symptoms when assessing pain/disability, and pain/disability when assessing psychological symptoms. RESULTS: Overall, high rates of depression (44% moderate-severe) and anxiety (60% moderate-severe) were reported. Groups (surgery vs. no-surgery) did not differ in the proportion of patients meeting cutoff scores for current disability; however, the no-surgery group was more likely to meet cutoffs for anxiety (χ2 = 11.26, p < .05), stress (χ2 = 14.63, p < .01) and health anxiety (χ2 = 4.63, p < .05). The surgery group reported lower levels of continuous affective pain F(1, 1065) = 10.28, p < .001), anxiety F(1,1026) = 4.96, p < .05) and stress F(1, 978) = 5.67, p < .05) although effect sizes were small (η2s ranging from 0.010 to 0.006, Cohen's D ranging from 0.17 to 0.25). CONCLUSION: CM patients experience high rates of psychological symptomatology regardless of surgical status, suggesting that all CM patients may benefit from evidence-based interventions to address anxiety and depression.
Garcia Monica A; Allen Philip A; Li Xuan; Houston James R; Loth Francis; Labuda Rick; Delahanty Douglas L
Disability and Health Journal
2019
2019-05
<a href="http://doi.org/10.1016/j.dhjo.2019.05.004" target="_blank" rel="noreferrer noopener">10.1016/j.dhjo.2019.05.004</a>
An examination of premature mortality among decedents with serious mental illness and those in the general population.
*Mortality; *Severity of Illness Index; 80 and over; 80 and Over; Aged; Cause of Death – Trends; Cause of Death/trends; Death Certificates; Female; Human; Humans; Male; Mental Disorders – Mortality; Mental Disorders/*mortality; Middle Age; Middle Aged; Mortality; Ohio; Ohio/epidemiology; Population Surveillance; Retrospective Design; Retrospective Studies; Severity of Illness Indices
OBJECTIVES: The primary aim of this retrospective study of death records was to determine whether there were significant differences in years of potential life lost (YPLL) between decedents with serious and persistent mental illness at a community mental health center (N=647) and decedents in the general population (N=15,517) after the analysis adjusted for sociodemographic factors and cause of death. METHODS: Clinical case management files from a community mental health center were matched to state death records from 1998 to 2004 to identify decedents being treated for a serious and persistent mental illness. Differences in leading causes of death and YPLL were calculated with descriptive and multivariate methods. RESULTS: Mean+/-SD YPLL for the decedents with serious and persistent mental illness was 14.5+/-10.6, compared with 10.3+/-6.7 for the general population. Heart disease was the leading cause of death for both groups. Mean differences in YPLL after adjustment for gender, race, marital status, and education ranged from 1.7 years for chronic lower respiratory disease to 13.1 years for accidents and were significant for every leading cause of death. Differences in cause of death did not explain the difference in YPLL. Suicide, cancer, accidents, liver disease, and septicemia were differentially associated with YPLL for persons with serious and persistent mental illness. CONCLUSIONS: Suicide, cancer, accidents, liver disease, and septicemia increased premature mortality among persons with serious and persistent mental illness. Along with ongoing suicide prevention programs, efforts to integrate primary and psychiatric care should focus on these preventable causes of early death.
Piatt Elizabeth E; Munetz Mark R; Ritter Christian
Psychiatric services (Washington, D.C.)
2010
2010-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/ps.2010.61.7.663" target="_blank" rel="noreferrer noopener">10.1176/ps.2010.61.7.663</a>
An integrative ideology to guide community-based multidisciplinary care of severely mentally ill patients.
Combined Modality Therapy; Community Mental Health Services/*organization & administration; Comprehensive Health Care/*organization & administration; Health Care/organization & administration; Humans; Interprofessional Relations; Mental Disorders/psychology/*rehabilitation; Patient Care Team/*organization & administration; Quality Assurance; United States
Most practitioners working in community support settings understand the need to provide a comprehensive array of well-coordinated services to individuals with severe mental disabilities. However, a lack of consensus about the conceptual basis of mental health care, especially between advocates of psychosocial rehabilitation and psychiatric practitioners who favor a more medically oriented approach, has hindered efforts to optimize the effectiveness of the multidisciplinary teams found in most community support programs. The authors articulate 18 basic assumptions that have been helpful in their clinical practice in building an integrative ideology among professionals with disparate training and orientations. The assumptions attempt to balance the reality of psychiatric disorders with a fundamental interest in maintaining the autonomy and dignity of people with severe mental disorders.
Munetz M R; Birnbaum A; Wyzik P F
Hospital & community psychiatry
1993
1993-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/ps.44.6.551" target="_blank" rel="noreferrer noopener">10.1176/ps.44.6.551</a>
AOT and Long-Term Use of Antipsychotics-3.
*Antipsychotic Agents; Antipsychotic Agents; Humans
Munetz Mark R; Fuller Doris A
Psychiatric services (Washington, D.C.)
2016
2016-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/appi.ps.670704" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.670704</a>
Association Between Hospitalization and Delivery of Assisted Outpatient Treatment With and Without Assertive Community Treatment
Assertive community treatment; Outpatient commitment
OBJECTIVE: This study examined hospitalizations for individuals receiving assisted outpatient treatment (AOT), some of whom also received assertive community treatment (ACT). We examined whether participation in AOT, as well as in AOT paired with ACT services, was associated with reduced hospitalizations. METHODS: Data were collected for 74 people who were receiving AOT for at least 6 months. Comparisons were made between those receiving AOT with ACT and those receiving AOT without ACT. Changes were examined in number and days of hospitalization before, during, and after AOT on an annualized basis. RESULTS: AOT was associated with reduced hospitalizations and hospital days during and after the court order. Participating in AOT without ACT was associated with fewer hospitalizations during and after AOT and fewer days hospitalized after the court order ended. CONCLUSIONS: Individuals whose needs can be met with less intensive services while under an AOT order may not require ACT.
Munetz Mark R; Ritter Christian; Teller Jennifer L S; Bonfine Natalie
Psychiatric Services (Washington, D.C.)
2019
2019-06
<a href="http://doi.org/10.1176/appi.ps.201800375" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.201800375</a>
Behavioral Health Provider Attitudes and Beliefs about Sexuality and Intimacy: Findings from a Mixed Method Design.
Behavioral health provider attitudes and beliefs; Recovery; Sexuality and intimacy communication
Recovery-oriented services overlook a crucial health domain for persons with severe mental illnesses (SMI): sexuality and intimacy. Though this aspect of social recovery correlates with improved life quality and treatment outcomes, behavioral health (BH) providers avoid such topics. The study's purpose was to obtain an updated snapshot of their attitudes and beliefs about sexuality and intimacy communication. Utilizing a community advisory board, we adapted the Sexual Attitudes and Beliefs Survey (SABS) and distributed it via survey link to a national listserv. We used independent samples t-tests to examine differences on SABS mean scores by gender, age group, educational attainment, and previous training on sexuality and intimacy. We asked open-ended questions and coded responses using content analysis. Participants with more education and previous exposure to training on sexuality and intimacy were more likely to hold open views on communication. Findings offer directions for addressing this neglected aspect of recovery.
Tennille J; Bohrman C; Barrenger S; Compton E; Meduna E; Klein L
Community Mental Health Journal
2021
2021-06-03
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journalArticle
<a href="http://doi.org/10.1007/s10597-021-00838-1" target="_blank" rel="noreferrer noopener">10.1007/s10597-021-00838-1</a>
Black Robe/White Coat: Mental Health Providers Must Reclaim the Role of Caring Clinician.
Public policy issues; Community psychiatry
Munetz Mark R
Psychiatric services (Washington, D.C.)
2020
2020-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1176/appi.ps.201900366" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.201900366</a>
Characteristics Associated with Depression and Suicidal Thoughts Among Medical Residents: Results from the DEPRESS-Ohio Study
depression; Licensure; No terms assigned; Residents; Treatment; Wellness
OBJECTIVE: This study describes the characteristics that are associated with depression in residents and also examines resident perception of available mental health support. METHODS: Residents and their program directors from each of 10 specialties across all academic training institutions in Ohio were electronically surveyed over a 2-month period. Generalized logistic regression was used to test for association between risk factors and depression and, among depressed residents, with suicidal thoughts. RESULTS: Using the PHQ-9, 19% of residents met criteria for at least moderate depression and 31.1% of depressed residents had suicidal thoughts. Over 70% of depressed residents were not receiving treatment, including 70% of depressed residents with suicidal thoughts. Residents who were unaware of wellness programming or did not believe their program director would be supportive of a depressed resident were significantly more likely to be depressed. Residents who believed depression treatment would negatively impact medical licensure were significantly more likely to be depressed. Male program directors and those in their position for fewer than 5 years were significantly more likely to have depressed residents in their program. CONCLUSIONS: A substantial proportion of depressed residents have suicidal thoughts, and most are not receiving treatment. Depressed residents may perceive the availability of support from their program director differently than their non-depressed colleagues, and may perceive greater risk to medical licensure if they seek treatment.
Levy Alan B; Nahhas Ramzi W; Sampang Suzanne; Jacobs Karen; Weston Christina; Cerny-Suelzer Cathleen; Riese Amy; Munetz Mark R; Shaw Janet
Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2019
2019-07
<a href="http://doi.org/10.1007/s40596-019-01089-9" target="_blank" rel="noreferrer noopener">10.1007/s40596-019-01089-9</a>
Childhood Adversity, Proximal Stressors and PTSD Among People with Severe Mental Illness: An Exploratory Study.
Childhood adversity; PTSD; Serious mental illness; Stress; Trauma
The purpose of this exploratory study is to: (1) assess prevalence of childhood adversities and posttraumatic stress disorder (PTSD); (2) assess their association, and; (3) explore whether proximal sources of stress affect this relationship and/or have an association with PTSD among people with severe and persistent psychological disorders. Using data from 141 respondents, we assess the extent to which individuals in this population experienced 17 PTSD symptoms, various correlates to probable PTSD, and the most relevant of these factors in a multivariate logistic regression. Overall, 27% of the participants met study criteria for probable PTSD and each symptom was reported by at least 18% of the sample. Multivariate logistic regression models indicated that interpersonal conflict and being a victim of a crime were significantly related to probable PTSD. We discuss these findings in relation to treatment and course of disease for people suffering from severe and persistent mental illness experiencing a traumatic event.
Adams Richard E; Bonfine Natalie; Ritter Christian
Community mental health journal
2020
2020-03-13
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1007/s10597-020-00607-6" target="_blank" rel="noreferrer noopener">10.1007/s10597-020-00607-6</a>
Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy.
*Case Managers; *CBT-p; *Cognitive behavioral techniques for psychosis; *Cognitive behavioral therapy for psychosis; *Community Mental Health Services; *Continuum of care; *Schizophrenia; Adult; Case Management; Case-Control Studies; Cognitive Behavioral Therapy/*methods; Cognitive Therapy – Methods; Community Mental Health Services; Comparative Studies; Continuity of Patient Care; Evidence-Based; Exploratory Research; Female; Human; Humans; Male; Middle Aged; Outcome Assessment; Professional Practice; Program Implementation – Methods; Psychotic Disorders – Therapy; Psychotic Disorders/*therapy; Schizophrenia; Surveys and Questionnaires
This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.
Sivec Harry J; Montesano Vicki L; Skubby David; Knepp Kristen A; Munetz Mark R
Community mental health journal
2017
2017-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10597-015-9930-0" target="_blank" rel="noreferrer noopener">10.1007/s10597-015-9930-0</a>
Crime, Vulnerability, and AOT.
*Crime; *Mental Health Services; Humans; Outpatients; Research
Munetz Mark R; Aultman Julie M
Psychiatric services (Washington, D.C.)
2017
2017-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/appi.ps.68202" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.68202</a>
Crisis Intervention Team (CIT) programs in rural communities: a focus group study.
Cooperative Behavior; Criminal Law/organization & administration; Crisis Intervention; Crisis Intervention/*organization & administration; Descriptive Statistics; Focus Groups; Human; Humans; Interprofessional Relations; Mental Health Personnel; Mental Health Services/*organization & administration; Models; National Alliance for the Mentally Ill; Organizational; Police; Program Development; Program Evaluation; Psychiatric Emergencies; Qualitative Research; Rural Health; Rural Health Services/*organization & administration
The Crisis Intervention Teams model (CIT) was originally developed as an urban model for police officers responding to calls about persons experiencing a mental illness crisis. Literature suggests that there is reason to believe that there may be unique challenges to adapting this model in rural settings. This study attempts to better understand these unique challenges. Thematic analysis of focus group interviews revealed that there were both external and internal barriers to developing CIT in their respective communities. Some of these barriers were a consequence of working in small communities and working within small police departments. Participants actively overcame these barriers through the realization that CIT was needed in their community, through collaborative efforts across disciplines, and through the involvement of mental health advocacy groups. These results indicate that CIT can be successfully implemented in rural communities.
Skubby David; Bonfine Natalie; Novisky Meghan; Munetz Mark R; Ritter Christian
Community mental health journal
2013
2013-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10597-012-9517-y" target="_blank" rel="noreferrer noopener">10.1007/s10597-012-9517-y</a>
Crisis intervention team officer dispatch, assessment, and disposition: Interactions with individuals with severe mental illness.
*Coercion; *Mental Disorders; *Police; *Severity of Illness Index; 80 and over; Adolescent; Adult; Aged; Crisis Intervention/*organization & administration; Female; Humans; Male; Middle Aged; Occupational Exposure; Young Adult
The Crisis Intervention Team (CIT) model is a specialized police response program for people in a mental illness crisis. We analyzed 2174 CIT officers' reports from one community, which were completed during a five year period. These officers' reports described interactions with people presumed to be in a mental illness crisis. We used hierarchical logistic and multinomial regression analyses to compare transport to treatment to either transport to jail or no transport by how the calls were dispatched. The results revealed that both dispatch codes and officers' on-scene assessments influenced transport decisions. Specifically, calls dispatched as suspected suicide were more likely to be transported to treatment than calls dispatched as mental disturbance. Furthermore, calls dispatched as calls for assistance, disturbance, suspicious person, assault, suspicion of a crime, and to meet a citizen were all less likely than mental disturbance calls to result in transportation to treatment. Officer assessments of the use of substances, being off medications, signs and symptoms of mental or physical illness, and violence to self or others were associated with the likelihood of being transported to treatment. These results build on previous work that demonstrated differences in transport decisions between CIT trained and non-CIT trained officers.
Ritter Christian; Teller Jennifer L S; Marcussen Kristen; Munetz Mark R; Teasdale Brent
International journal of law and psychiatry
2011
2011-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ijlp.2010.11.005" target="_blank" rel="noreferrer noopener">10.1016/j.ijlp.2010.11.005</a>
Delirium Precipitated by Polycythaemia.
delirium, polycytemia
Delirium is a common and serious problem among acutely unwell persons. Although linked to higher rates of mortality, institutionalization and dementia, it remains under diagnosed. Careful consideration of its phenomenology is warranted to improve detection and therefore mitigate some of its clinical impact. The publication of the fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM- 5) provides an opportunity to examine the constructs underlying delirium as a clinical entity [1]. We are reporting a case of delirium in a 20 years old female that was precipitated by a secondary polycythaemia caused by a congenital cardiac left to right shunt resulting in a pulmonary hypertension. Our med pub mesh literature search did not yield a previously reported similar case.
Adel S. Zaraa, MD
Journal of Psychology & Clinical Psychiatry
2016
Zaraa A, Miquel MAR, Ahmad M
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.15406/jpcpy.2016.06.00369" target="_blank" rel="noreferrer noopener">10.15406/jpcpy.2016.06.00369</a>
Different Strokes: How to Spot and Treat Poststroke Depression.
DISEASE complications; DISEASE management; PSYCHOLOGICAL stress; CONTINUING education units; STROKE; STROKE diagnosis; STROKE patients; STROKE prevention; STROKE treatment
The article discusses tips on how to diagnose and treat poststroke depression. Other topics include the prevalence of stroke in the U.S. and around the world, the adverse effects of stroke like mild, moderate, and severe disability, the possible neuropsychiatric syndromes following a stroke like poststroke bipolar disorder, depression, and anxiety, as well as the pathogenesis of poststroke depression (PSD).
Tampi RR; George E
Psychiatric Times
2021
2021-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
Disease Burden Among Individuals with Severe Mental Illness in a Community Setting.
*Cost of Illness; Adult; Assisted Living; Chronic Disease/*epidemiology; Chronic pain; Chronic Pain; Co-morbid illness; Comorbidity; Female; Headache; Health status; Health Status; Human; Humans; Male; Mental Disorders; Mental Disorders/complications/*epidemiology; Middle Aged; Prevalence; Self Report; Severe mental illness; Young Adult
This study examines the prevalence of comorbid physical health conditions within a community sample of individuals with severe mental illness (SMI), compares them to a matched national sample without SMI, and identifies which comorbidities create the greatest disease burden for those with SMI. Self-reported health status, co-morbid medical conditions and perceived disease burden were collected from 203 adults with SMI. Prevalence of chronic health conditions was compared to a propensity-matched sample without SMI from the National Comorbidity Survey-Replication (NCS-R). Compared to NCS-R sample without SMI, our sample with SMI had a higher prevalence of seven out of nine categories of chronic health conditions. Chronic pain and headaches, as well as the number of chronic conditions, were associated with increased disease burden for individuals with SMI. Further investigation of possible interventions, including effective pain management, is needed to improve the health status of this population.
Baughman Kristin R; Bonfine Natalie; Dugan Sara E; Adams Richard; Gallagher Mary; Olds R Scott; Piatt Elizabeth; Ritter Christian
Community mental health journal
2016
2016-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10597-015-9973-2" target="_blank" rel="noreferrer noopener">10.1007/s10597-015-9973-2</a>
Do Attitudes Matter? Evaluating the Influence of Training in CBT-p-Informed Strategies on Attitudes About Working with People Who Experience Psychosis.
alliance; Attitudes; beliefs; CBT-p informed skills; Cognitive behavioral therapy for psychosis; cognitive-behavioral therapy; dangerousness; illness; mental-health professionals; outcomes; perceptions; Recovery; schizophrenia; schizophrenia; staff attitudes; Stigma
Attitudes of mental health providers are an important consideration in training and delivering evidence-based practices. Treatment approaches for individuals who experience schizophrenia consistently endorse the importance of a recovery perspective. At the same time, a review of the literature suggests that the attitudes of many providers and many policies of community health care settings serving individuals who experience schizophrenia, may not align with the recovery perspective. This brief report provides a summary of the program evaluation outcomes of a wide range of mental health providers who participated in a 2-day intensive training to learn strategies informed by Cognitive Behavioral Therapy for Psychosis (CBT-p). This intensive training emphasizes engagement strategies and person-centered approaches inherent in the recovery perspective. Consistent with the aims of the training, participants' attitudes about working with people who experience psychosis appeared to be positively influenced by training.
Sivec Harry J; Kreider Valerie A L; Buzzelli Christopher; Hrouda Debra R; Hricovec Megan M
Community mental health journal
2020
2020-03-28
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1007/s10597-020-00611-w" target="_blank" rel="noreferrer noopener">10.1007/s10597-020-00611-w</a>
Evaluation of dextromethorphan with select antidepressant therapy for the treatment of depression in the acute care psychiatric setting.
depression; NMDA; fluoxetine; bupropion; CYP2D6 inhibitor; dextromethorphan; paroxetine
Introduction: Dextromethorphan (DXM), an N-methyl-D-aspartate receptor antagonist, may have ketamine-like antidepressant effects. Dextromethorphan is extensively metabolized via cytochrome P450 (CYP) 2D6, and its half-life in extensive metabolizers is 2 to 4 hours. The purpose of this study was to evaluate the effects of DXM in combination with a moderate-to-strong CYP2D6 inhibitor antidepressant on depression in an acute care psychiatric setting. Methods: This was a single-center, retrospective chart review of adult patients with a depressive disorder diagnosis. Patients who received select antidepressant therapy with or without scheduled DXM were included. The primary outcome was the difference in time to improvement of depressive symptoms, which was an average composite of physician documentation, nurse documentation, and first time to 24 hours without as-needed anxiolytics or antipsychotics. The study group consisted of patients who received DXM with select antidepressant therapy, whereas the control group included those who received only select antidepressant therapy. Results: A total of 40 patients were included. The median time to clinical improvement was 3.00 days and 2.83 days for the study group and control group, respectively (P = .986). The incidence of perceptual disturbances and delusions was higher in the study group as compared with the control group (55% and 35% vs 30% and 25%, respectively). Discussion: Dextromethorphan was not associated with a rapid antidepressant effect. The commonly used dose of 30 mg daily may have been too low to have an effect; additionally, the most frequently utilized select antidepressant, bupropion, has moderately less CYP2D6 inhibition than fluoxetine and paroxetine.
Nofziger Jill L; Paxos Chris; Emshoff Jessica; Mullen Chanda
The mental health clinician
2019
2019-03
<a href="http://doi.org/10.9740/mhc.2019.03.076" target="_blank" rel="noreferrer noopener">10.9740/mhc.2019.03.076</a>
Exploring the Networking of Academic Health Science Leaders: How and Why Do They Do It?
PURPOSE: Networking is essential to leadership effectiveness in the business context. Yet little is known about leadership networking within the academic health science context. If we are going to train academic leaders, we must first understand the relational, network-based activities of their work. The purpose of this study was to explore how academic health science leaders engage in networking activities in the academic health science context. METHOD: A constructivist grounded theory approach guided our study. The authors interviewed 24 academic health science leaders who were enrolled in the New and Evolving Academic Leadership program at the University of Toronto and used social network mapping as an elicitation method. Interviews, which were conducted between September 2014 and June 2015, explored participants' networks and networking activities. Constant comparative analysis was used to analyze the interviews, with attention paid to identifying key networking activities. RESULTS: Academic health science leaders were found to engage in 4 types of networking activities: role bound, project based, goal/vision informed, and opportunity driven. These 4 types were influenced by participants' conception of their role and their perceived leadership work context, which in turn influenced their sense of agency. CONCLUSIONS: The networking activities identified in this study of academic health science leaders resonate with effective networking activities found in other fields. The findings highlight that these activities can be facilitated by focusing on leaders' perceptions about role and work context. Leadership development should thus attend to these perceptions to encourage effective networking skills.
Lieff Susan J; Baker Lindsay; Poost-Foroosh Laya; Castellani Brian; Hafferty Fred W; Ng Stella L
Academic medicine : journal of the Association of American Medical Colleges
2020
2020-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/ACM.0000000000003177" target="_blank" rel="noreferrer noopener">10.1097/ACM.0000000000003177</a>
Exploring the relationship between criminogenic risk assessment and mental health court program completion.
*Needs Assessment; *Risk Assessment; Clinical services; Comparative Studies; Criminal Law/*legislation & jurisprudence; Criminals/*legislation & jurisprudence/*psychology; Criminogenic risk assessment; Criminology – Legislation and Jurisprudence; Evaluation Research; Goals; Goals and Objectives; Human; Humans; Judicial Role; Jurisprudence; Mental Disorders – Therapy; Mental Disorders/*therapy; Mental health court; Mental Health Services; Mentally Ill Persons/*legislation & jurisprudence/*psychology; Multicenter Studies; Needs Assessment; Ohio; Psychiatric Patients – Legislation and Jurisprudence; Psychiatric Patients – Psychosocial Factors; Public Offenders – Legislation and Jurisprudence; Public Offenders – Psychosocial Factors; Risk Assessment; Scales; Validation Studies
The two primary goals of mental health courts are to engage individuals with severe mental illness in the criminal justice system with clinical mental health services and to prevent future involvement with the criminal justice system. An important factor in helping to achieve both goals is to identify participants' level of clinical needs and criminogenic risk/needs. This study seeks to better understand how criminogenic risk affects outcomes in a mental health court. Specifically, we explore if high criminogenic risk is associated with failure to complete mental health court. Our subjects are participants of a municipal mental health court (MHC) who completed the Level of Services Inventory-Revised (LSI-R) upon entry to the program (N=146). We used binary logistic regression to determine the association between termination from the program with the total
Bonfine Natalie; Ritter Christian; Munetz Mark R
International journal of law and psychiatry
2016
2016-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ijlp.2016.02.002" target="_blank" rel="noreferrer noopener">10.1016/j.ijlp.2016.02.002</a>
Fred Frese: A Tribute to a Quintessential Prosumer.
Geller Jeffrey L; Munetz Mark R
Psychiatric services (Washington, D.C.)
2019
2019-03
<a href="http://doi.org/10.1176/appi.ps.70302" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.70302</a>
From Boundary Spanning to Deep Partnerships.
*Cooperative Behavior; *Criminal Behavior; *Interdisciplinary Communication; *Interprofessional Relations; Humans; Mental Disorders/*complications; Substance-Related Disorders/*complications
Munetz Mark R; Bonfine Natalie
Psychiatric services (Washington, D.C.)
2015
2015-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/appi.ps.660902" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.660902</a>
Getting ready for recovery: reconciling mandatory treatment with the recovery vision.
*Commitment of Mentally Ill; *Convalescence; Community Participation; Decision Making; Humans; Mental Health Services/*organization & administration; Psychotic Disorders/*therapy
Considering treatment of serious mental illnesses, it might appear that the recovery model would be incompatible with any form of mandatory treatment. The authors suggest that this is not so. With individuals whose psychotic illness substantially impairs decision making, mandatory treatment may offer the best hope of getting well enough for recovery to be possible. It is essential, however, that any program involving involuntary community treatment involves recovering individuals who have themselves experienced a serious mental illness. The authors propose the use of a consumer-run guardianship program and a capacity review panel as two possible ways to achieve such participation.
Munetz M R; Frese F J 3rd
Psychiatric rehabilitation journal
2001
1905-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1037/h0095052" target="_blank" rel="noreferrer noopener">10.1037/h0095052</a>
Improving our understanding of the relationship between emotional abuse and substance use disorders: the mediating roles of negative urgency and posttraumatic stress disorder
detoxification; emotional abuse; negative urgency; PTSD; Substance use
Background: Emotional abuse is associated with an increased risk for substance use disorders (SUDs) as well as with negative urgency and posttraumatic stress disorder (PTSD) following a subsequent trauma. Both negative urgency and PTSD are key contributors to the relationship between emotional abuse and SUDs when examined separately. A comprehensive model including both factors can inform models of PTSD-SUD comorbidity. Furthermore, the comparison of these mechanistic roles in emotional versus other types of abuse can shed light on the specificity of these effects. Objectives: The present study tested whether negative urgency and PTSD symptom severity serially mediated the relationship between emotional abuse and substance use across two separate samples. Method: Participants were recruited from a detoxification center and completed a battery of surveys examining abuse history, PTSD symptom severity, and impulsivity measures including negative urgency and substance use history during the last 3 months. The samples consisted of predominantly (59% and 62%) males with an average age of 35 (age range: 18-65). The majority of participants (90% and 93%) were Caucasian. Results: Study 1 (N = 368) and Study 2 (N = 274) both found that negative urgency and PTSD symptom severity serially mediated the relationship between emotional abuse and substance use. When comparing indirect effects, both contributed equally. Conclusion: These findings suggest that negative urgency and PTSD symptom severity together account more for the link between emotional abuse and SUDs than either alone and argue for the inclusion of negative urgency in models of PTSD-SUD comorbidity.
Junglen Angela; Hruska Bryce; Jensen Tammy; Boros Alec; Delahanty Douglas L
Substance Use & Misuse
2019
1905-07
<a href="http://doi.org/10.1080/10826084.2019.1594905" target="_blank" rel="noreferrer noopener">10.1080/10826084.2019.1594905</a>
Improving Patient Experience by Teaching Empathic Touch and Eye Gaze: A Randomized Controlled Trial of Medical Students
empathy; patient perception; empathic touch; eye gaze; standardized patient encounter
Background: Empathy is critical for optimal patient experience with health-care providers. Verbal empathy is routinely taught to medical students, but nonverbal empathy, including touch, less so. Our objective was to determine whether instruction encouraging empathic touch and eye gaze at exit can impact behaviors and change patient-perceived empathy. Materials: A randomized, controlled, double-blinded trial of 34 first-year medical students was conducted during standardized patient (SP) interviews. A video either encouraging empathic touch and eye gaze at exit or demonstrating proper hand hygiene (control) was shown. Encounter videos were analyzed for touch and eye gaze at exit. The Jefferson Scale of Patient Perceptions of Physician Empathy was used to measure correlations. Intervention students were surveyed regarding patient touch. Results: Of this, 23.5% of intervention students touched the SP versus zero controls; 88.2% of intervention students demonstrated eye gaze at exit. Eye gaze at exit positively impacted patient-perceived empathy (correlation = 0.48, P > .001). Survey responses revealed specific barriers to touch. Conclusion: Medical students may increase perceived empathy using eye gaze at exit. Instruction on empathic touch and sustained eye gaze at exit at the medical school level may be useful in promoting empathic nonverbal communication. Medical educators should consider providing specific instructions on how to appropriately touch patients during history-taking. This is one of the few studies to explore touch with patients and the first ever to report the positive correlation of a health provider's sustained eye gaze at exit with the patient's perceived empathy. Further studies are needed to explore barriers to empathic touch.
Lecat P;Dhawan N;Hartung PJ;Gerzina H;Larson R;Konen-Butler C
Journal Of Patient Experience
2020
2020-12
journalArticle
<a href="http://doi.org/10.1177/2374373520916323" target="_blank" rel="noreferrer noopener">10.1177/2374373520916323</a>
Informed consent: A policy prescription for communicating benefit and risk in state medical marijuana programs
Drug-Related Side Effects and Adverse Reactions; Cannabis; Information Dissemination; Marijuana Use; Medical Marijuana; Policy Making
In creating medical marijuana laws, state governments signal to the public that marijuana can safely and effectively treat a wide range of diseases. In many cases, these state approvals overestimate the benefits of marijuana and understate the risks. After a comprehensive review of the medical literature, the National Academies of Sciences, Engineering, and Medicine identified six medical benefits from marijuana that were supported with at least a moderate level of medical evidence and 14 potential health hazards. In contrast, the average state medical marijuana program lists 18 medical benefits, and 24 state medical marijuana program websites say nothing about possible risks. Medication approval processes through the federal government traditionally require independent analysis of data from well-designed clinical trials that measure the effectiveness and capture the risks of adverse effects from specific doses of the medicine. These considerations are generally missing from state approvals of medical marijuana. The power to declare something to be a legitimate medicine comes with the responsibility to provide information that people need to use the medicine wisely. The authors recommend that states that declare marijuana to be a medicine should inform the public about the quality of medical evidence behind each approved use and publicize all scientifically credible risks.
Messamore E;Dugan SE
Psychiatric Services
2020
2020-09-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1176/appi.ps.202000140" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.202000140</a>
Informed consent: A policy prescription for communicating benefit and risk in state medical marijuana programs.
Information Dissemination; Policy Making; Medical Marijuana; Drug-Related Side Effects and Adverse Reactions; Cannabis; Marijuana Use
In creating medical marijuana laws, state governments signal to the public that marijuana can safely and effectively treat a wide range of diseases. In many cases, these state approvals overestimate the benefits of marijuana and understate the risks. After a comprehensive review of the medical literature, the National Academies of Sciences, Engineering, and Medicine identified six medical benefits from marijuana that were supported with at least a moderate level of medical evidence and 14 potential health hazards. In contrast, the average state medical marijuana program lists 18 medical benefits, and 24 state medical marijuana program websites say nothing about possible risks. Medication approval processes through the federal government traditionally require independent analysis of data from well-designed clinical trials that measure the effectiveness and capture the risks of adverse effects from specific doses of the medicine. These considerations are generally missing from state approvals of medical marijuana. The power to declare something to be a legitimate medicine comes with the responsibility to provide information that people need to use the medicine wisely. The authors recommend that states that declare marijuana to be a medicine should inform the public about the quality of medical evidence behind each approved use and publicize all scientifically credible risks.
Messamore E; Dugan SE
Psychiatric Services
2020
2020-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1176/appi.ps.202000140" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.202000140</a>
International models of psychiatric emergency care: The state of Qatar
A variety of cultural, legal, and ethnic influences have led to an increase in mental health-related emergency department (ED) visits in Qatar. Patients who experience psychiatric emergencies often require resources not available at the general hospital, and require transfer to an appropriate psychiatric facility such as the emergency department of Hamad General Hospital (HGH), the only hospital that provides psychiatric services in the country. In May of 2014, Hamad General Hospital established the psychiatric emergency service (PES) as an innovative and pioneering psychiatric liaison service based in the ED of HGH. This chapter describes this model of psychiatric emergency services that successfully reduced response time, boarding time, and disposition when compared to previous years.
Zaraa AS
Models of Emergency Psychiatric Services That Work
2020
1905-7
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
bookSection
<a href="http://doi.org/" target="_blank" rel="noreferrer noopener"></a>
Interventions That Target Criminogenic Needs for Justice-Involved Persons With Serious Mental Illnesses: A Targeted Service Delivery Approach.
*Criminals; *Health Services Needs and Demand; Adult; criminogenic needs; Health Services Needs and Demand; Humans; Mental Disorders – Therapy; Mental Disorders/*therapy; Mental Health Services – Administration; Mental Health Services/*organization & administration; mental illness; Middle Age; Middle Aged; Public Offenders; recidivism; Young Adult
This research describes the development of a targeted service delivery approach that tailors the delivery of interventions that target criminogenic needs to the specific learning and treatment needs of justice-involved people with serious mental illnesses (SMIs). This targeted service delivery approach includes five service delivery strategies: repetition and summarizing, amplification, active coaching, low-demand practice, and maximizing participation. Examples of how to apply each strategy in session are provided, as well as recommendations on when to use each strategy during the delivery of interventions that target criminogenic needs. This targeted service delivery approach makes an important contribution to the development of interventions for justice-involved people with SMI by increasing the chances that people with SMI can participate fully in and benefit from these interventions that target criminogenic needs. These developments come at a critical time in the field as the next generation of services for justice-involved people with SMI are being developed.
Wilson Amy Blank; Farkas Kathleen; Bonfine Natalie; Duda-Banwar Janelle
International journal of offender therapy and comparative criminology
2018
2018-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0306624X17695588" target="_blank" rel="noreferrer noopener">10.1177/0306624X17695588</a>
Interventions That Target Criminogenic Needs for Justice-Involved Persons With Serious Mental Illnesses: A Targeted Service Delivery Approach.
Humans; criminogenic needs; mental illness; recidivism; Community Mental Health Services/*organization & administration; Mental Disorders/psychology/*therapy; Criminal Law; Criminals/*psychology/statistics & numerical data; Health Services Needs and Demand/*statistics & numerical data; Mentally Ill Persons/*psychology/statistics & numerical data
This research describes the development of a targeted service delivery approach that tailors the delivery of interventions that target criminogenic needs to the specific learning and treatment needs of justice-involved people with serious mental illnesses (SMI). This targeted service delivery approach includes five service delivery strategies: repetition and summarizing, amplification, coaching, low-demand practice, and maximizing participation. Examples of how to apply each strategy in session are provided, as well as recommendations on when to use each strategy during the delivery of interventions that target criminogenic needs. This targeted service delivery approach makes an important contribution to the development of interventions for justice-involved people with SMI by increasing the chances that people with SMI can participate fully in and benefit from these interventions that target criminogenic needs. These developments come at a critical time in the field as the next generation of services for justice-involved people with SMI are being developed.
Wilson Amy Blank; Farkas Kathleen; Bonfine Natalie; Duda-Banwar Janelle
International journal of offender therapy and comparative criminology
2018
2018-10
<a href="http://doi.org/10.1177/0306624X18759242" target="_blank" rel="noreferrer noopener">10.1177/0306624X18759242</a>
Learning From the Past and Creating the Future: American Association for Geriatric Psychiatry (AAGP) and Geriatric Mental Healthcare in the United States
October 2019 Update
Tampi Rajesh R
The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry
2019
2019-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jagp.2019.08.004" target="_blank" rel="noreferrer noopener">10.1016/j.jagp.2019.08.004</a>
Meeting the Needs of Justice-Involved People With Serious Mental Illness Within Community Behavioral Health Systems
Community mental health services; Jails and prisons/mental health services
The overrepresentation of people with serious mental illness in the criminal justice system is a complex problem. A long-standing explanation for this phenomenon, the criminalization hypothesis, posits that policy changes that shifted the care of people with serious mental illness from psychiatric hospitals to an underfunded community treatment setting resulted in their overrepresentation within the criminal justice system. This framework has driven the development of interventions to connect people with serious mental illness to needed mental health and substance use treatment, a critical component for people in need. However, the criminalization hypothesis is a limited explanation of the overrepresentation of people with serious mental illness in the criminal justice system because it downplays the social and economic forces that have contributed to justice system involvement in general and minimizes the complex clinical, criminogenic, substance use, and social services needs of people with serious mental illness. A new approach is needed that focuses on addressing the multiple factors that contribute to justice involvement for this population. Although the authors' proposed approach may be viewed as aspirational, they suggest that an integrated community-based behavioral health system-i.e., intercept 0-serve as the focal point for coordinating and integrating services for justice-involved people with serious mental illness.
Bonfine Natalie; Wilson Amy Blank; Munetz Mark R
Psychiatric Services (Washington, D.C.)
2019
2019-12-04
Journal Article
<a href="http://doi.org/10.1176/appi.ps.201900453" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.201900453</a>
PMID: 31795858
Mental Health and Service Impacts During COVID-19 for Individuals with Serious Mental Illnesses Recently Released from Prison and Jail.
COVID-19; Prison and jail reentry; Serious mental illnesses; Services
Individuals recently released from jail or prison with serious mental illnesses may be vulnerable to the coronavirus pandemic. This study aims to understand how they experienced the pandemic during initial stay-at-home orders in New York City. Structured surveys and in-depth semi-structured interviews examined the impact of the pandemic on participants. Survey responses are presented as percentages. Thematic analysis was used to code and analyze in-depth interviews. All participants (N = 5) knew about the coronavirus pandemic, and most took steps to minimize risk. Participants experienced changes to their services, including suspensions of some supportive services. They also reported an increase in psychiatric symptoms but utilized a variety of coping mechanisms in response. Community reintegration was essentially on hold as supportive services were suspended. Comprehensive reentry services may need to be adapted during the pandemic to address the multiple needs of individuals and to facilitate community reintegration.
Barrenger SL; Bond L
The Journal Of Behavioral Health Services & Research
2021
2021-05-13
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1007/s11414-021-09759-z" target="_blank" rel="noreferrer noopener">10.1007/s11414-021-09759-z</a>
Mental Illness as a Stigmatized Identity
appraisals; discrepancy; disorders; identity; internalized stigma; mental illness; modified labeling theory; people; reflected; self-esteem; Sociology; stigma
In this study, we examine the relationships among reflected appraisals, self-views, and well-being for individuals diagnosed with severe and persistent mental illness. We also test a perceptual control model of identity to determine whether discrepancies between stigmatized reflected appraisals and stigmatized self-views are associated with self-evaluation (self-esteem and self-efficacy) and psychological distress (depressive symptoms). We find that stigmatized self-views are significantly associated with lower self-esteem and self-efficacy and higher levels of depressive symptoms. Stigmatized reflected appraisals are also associated with lower self-efficacy and higher depressive symptoms but are not associated with self-esteem. As predicted, discrepancies between reflected appraisals and self-views are associated with lower levels of self-efficacy and higher levels of depressive symptoms; however, we do not find a relationship between identity discrepancy and self-esteem. We discuss the implications of our findings for identity and stigma research.
Marcussen K; Gallagher M; Ritter C
Society and Mental Health
2019
2019-07
<a href="http://doi.org/10.1177/2156869318810326" target="_blank" rel="noreferrer noopener">10.1177/2156869318810326</a>