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The author discusses Owens' paper from the point of view of a deterioration in mental health services in the US and in the UK with regard to the need in patients to establish trusting relationships as a pre-requisite to psychological stability and wellbeing. The advent of rapidly acting psychotropic drugs and a proliferation of short term psychological treatments, often addressed to very severe disturbance, sometimes with benefit to certain patients, are increasingly used to avoid fundamental needs for dependency. Owens discusses the serious fallout of this problem in the context of disturbed adolescents and bi-polar patients whose most basic developmental needs are too often not met, but the difficulty is widespread, this author suggests. The avoidance of close contact with patients who are disturbed is supported by cultural values that endorse technological and functional achievements above the need for human relatedness. [ABSTRACT FROM AUTHOR]

This paper discusses the impact of White supremacy, ableism, and U.S. policing on both the history and current state of psychology and sheds light on ways that psychologists can acknowledge and divest from carceral White supremacist practices in mental healthcare. Because of how oppression and intersectionality function within a White supremacist society, not all Black lives have been equally valued by non-Black Americans. Similarly, White supremacy and ableism have had lasting impacts on the public perception of disabled people. Connecting the historical origins of the U.S. policing system to the current practices of the U.S. police system, this paper argues that the police have always been about controlling "disorder." Similarly, psychology and the larger mental health field have a troubled history of controlling Black, Brown, and disabled bodies. Recommendations for ways therapists can unlearn therapy practices stemming from White supremacy cultural practices (e.g., carceral therapeutic practices and biased mental health care) are provided along with action items for mental health practitioners to maintain a commitment to undoing the harm from these historic and systemic issues. [ABSTRACT FROM AUTHOR]

Racial and ethnic minorities like Asians in the United States are significantly less likely to receive mental health treatment than Caucasians. Using 2012 Behavioral Risk Factor Surveillance System data, we examined the underutilization of mental health treatment in the US and find that being over 65 or 35–44, being unmarried, and being insured were positively associated with mental health treatment utilization, and as mentally unhealthy days increased, the utilization of treatment also increased. The paper offers a discussion on why there is this underutilization of mental health services amongst Asians and what steps can be taken to improve utilization. [ABSTRACT FROM AUTHOR]

In the wake of COVID-19, mental health providers and treatment programs are adapting rapidly to the challenges in engaging people and delivering treatment with limited guidance. This paper will explore the challenges associated with delivering treatment within coordinated specialty care (CSC) programs for people with first episode psychosis. Suggestions for treatment will take into consideration experiences with stress, changes to the pursuit of work and school, and increased time spent with families. Drawing on the experience of several CSC programs in the United States, Israel, and China, we describe the impact and modifications to the core treatment elements in CSC including medication, family interactions, supported employment and education, individual therapy, peer support and the way they are delivered. The paper includes recommendations based on experiences from CSC programs to help staff members, participants, and family members better identify, prepare, cope and respond to the unique new challenges and suggests modifications that can be made during various stages of the coronavirus pandemic. [ABSTRACT FROM AUTHOR]

This paper presents qualitative data collected from 996 licensed social workers in the United States who reported mental health and/or alcohol and other drug problems and indicated the types of services they used to address these issues. Outpatient therapy was the most commonly accessed modality to treat mental health issues. Regarding problems with alcohol and other drugs, self-help groups were the most frequently utilized intervention. Qualitative findings suggest that behavioral health service use has influenced respondents' work with clients, personal and professional development, and career trajectories. Barriers to service use, such as stigma and limited access to care, were also identified. Implications for social work education and professional practice are discussed. [ABSTRACT FROM AUTHOR]

Nearly half of children meeting criteria for a mental health disorder in the United States (U.S.) do not receive the treatment they need. Unfortunately, lack of access to and engagement in mental health services can be seen at even higher rates for historically marginalized groups, including low-income, racial, and ethnic minority youth. Lay Health Workers (LHWs) represent a valuable workforce that has been identified as a promising solution to address mental health disparities. LHWs are individuals without formal mental health training who oftentimes share lived experiences with the communities that they serve. A growing body of research has supported the mobilization of LHWs to address service disparities around the globe; however, challenges persist in how to scale-up and sustain LHW models of care, with specific barriers in the U.S. In this paper, we describe LHWs' different roles and involvement in the mental health field as well as the current state of the literature around LHW implementation. We integrate the RE-AIM Framework with a conceptual model of how LHWs address disparities to outline future directions in research and practice to enhance equity in the reach, effectiveness, adoption, implementation, and maintenance of LHW models of care and evidence-based practices for historically marginalized communities within the U.S. [ABSTRACT FROM AUTHOR]

School-based mental health services are a promising context for evidence-based interventions to promote early socio-emotional development, yet implementation presents significant challenges. This paper describes the rationale, content and format of a school-based intervention, Starting Strong in Kindergarten (Starting Strong). Starting Strong is a 10 week, indicated prevention programme aimed at promoting positive student–teacher relationships and behavioural adjustment during the transition to kindergarten. This parent- and teacher-focused indicated prevention programme targets children with or at risk for disruptive behaviour problems. The paper describes feasibility results of a pilot study of Starting Strong’s parent programme. Twenty-five families participated; rates of enrolment, attendance, retention, session engagement, homework completion, treatment fidelity and participant satisfaction suggest promising feasibility. School-based efforts targeting the transition to kindergarten may be helpful in improving behavioural and relational adjustment, especially for children who begin school with behavioural or relational risk. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been stressful for many, increasing levels of anxiety, depression and other mental health concerns worldwide. With the spread of the virus, many youth found themselves physically isolated from their peers and confined to their homes, and medical and mental health services previously provided in person had to adapt by providing virtual sessions. The transition to virtual care created many new challenges for clinicians and patients, including some specific to transgender youth and their families. Pre-pandemic, transgender youth comprised a marginalized and vulnerable population, with elevated risk for adverse mental health outcomes. However, community support, strong group identification and family affirmation can serve as important mitigating factors. In this paper, we will discuss unique challenges encountered in working with the parents and caregivers of transgender youth during virtual visits that have the potential to interfere with development of a therapeutic alliance and the movement toward increased family acceptance. We will provide clinical case examples and propose methods through which to address difficulties and improve care. [ABSTRACT FROM AUTHOR]

For people experiencing chronic homelessness, supportive housing with intensive social, health, and behavioral health services reduces the likelihood of re-entering homelessness and the public costs of associated acute medical care, shelter use, and incarceration. Due to a limited supply of supportive housing, it must be allocated to those most in need. This paper examines findings from a unique, region-wide method for prioritizing individuals for supportive housing based on utilization of high-cost public services and vulnerability if left on the street. A sample of 196 individuals were prioritized for housing based on this method, while a comparison group of 102 were housed not using the method. Results showed that those housed under the prioritization method achieved greater reductions in utilization of high-cost public services, but were also less likely to have positive dispositions when exiting the housing programs, suggesting the need for a greater intensity of supports and/or multiple “doses” of supportive housing before stability can be expected. The method described in the paper can provide a starting point for developing regional, comprehensive systems of coordinated, prioritized entry into supportive housing, such as those now required by US Department of Housing and Urban Development. [ABSTRACT FROM PUBLISHER]

Mental health recovery is emerging as a central philosophy in every institution providing mental health services across the world. However, in order to implement effective and efficient programs and policies that focus on recovery, it is important to understand how recovery happens. This understanding involves more than outcomes monitoring; it requires that the indicators be used in a way that will increase our understanding and do not lead us in unexpected directions. Therefore, it is important that mental health stakeholders recognize the impact that outcomes monitoring can have on programs and be aware of their unwanted influence. In this paper we describe the measurement tools, methodological techniques (quantitative and qualitative), and outcome reporting systems currently used at the Mental Health Center of Denver in the United States, that are helping us to investigate critical research questions about what drives recovery. The article concludes by discussing how we are using the information we have gathered to develop programs and policies that help people recover, as well as use resources more efficiently. [ABSTRACT FROM AUTHOR]

The United States spends more money on mental health services than any other country, yet access to effective psychological services remains strikingly low. The need-to-access gap is especially wide among children and adolescents, with up to 80% of youths with mental health needs going without services, and the remainder often receiving insufficient or untested care. Single-session interventions (SSIs) may offer a promising path toward improving accessibility, cost-effectiveness, and completion rates for youth mental health services. SSIs are structured programs that intentionally involve only one visit or encounter with a clinic, provider, or program; they may serve as stand-alone or adjunctive clinical services. A growing body of evidence supports the capacity of SSIs to reduce and prevent youth psychopathology of multiple types. Here, we provide a working definition of SSIs for use in future research and practice; summarize the literature to date on SSIs for child and adolescent mental health; and propose recommendations for the future design, evaluation, and implementation of SSIs across a variety of settings and contexts. We hope that this paper will serve as an actionable research agenda for gauging the full potential of SSIs as a force for youth mental health. [ABSTRACT FROM AUTHOR]

The opioid epidemic is a national emergency in the United States. To meet the needs of individuals diagnosed with Opioid Use Disorder (OUD) office-based opioid treatment programs (OBOT) are quickly expanding. However, social workers roles in OBOT programs are not clearly described. This paper will emphasize three roles social workers may fulfill in OBOT programs to combat the opioid crisis. [ABSTRACT FROM AUTHOR]

Objective: This paper examines common barriers to IPS supported employment implementation from the perspective of various stakeholders for IPS. Stakeholders describe the strategies used within their state to minimize or eliminate those problems. Methods: Six stakeholders reported barriers they encountered while implementing IPS and strategies they found helpful in overcoming those issues. The stakeholders included two senior planners from state mental health, one senior planner from state vocational rehabilitation, a mental health agency executive director, a client advocate, and a family member advocate. Barriers examined in this paper include program fee schedules that promote the use of traditional vocational assessments, difficulties funding IPS services, practitioner attitudes that conflict with IPS principles, client and family fears regarding loss of disability benefits or increased symptoms related to a return to work, and difficulties related to effective program implementation and sustainability. Conclusions: Although many service delivery systems have barriers to IPS implementation, these can be managed or eliminated through leadership from stakeholders such as state mental health and vocational rehabilitation senior planners, client and family advocates, and agency directors. [ABSTRACT FROM AUTHOR]

In this paper, we propose an interdisciplinary framework to study perceptions of child sexual abuse and help-seeking among South Asians living in the United States. We integrate research on social marginality, intersectionality, and cultural psychology to understand how marginalized social experience accentuates South Asian immigrants' desire to construct a positive self-identity. Using model minority ideology as an example of such a construction, we highlight its role in silencing the topic of child sexual abuse within this immigrant community as well as its impact on attitudes towards professional mental health services. We contend that our framework, the idealized cultural identities model on help-seeking and child sexual abuse, provides a unique analytical model for clinicians and researchers to understand how South Asian Americans process, experience, and react to child sexual abuse. [ABSTRACT FROM AUTHOR]

This paper explores historical and recent trends in the delivery of residential adolescent substance abuse treatment, looking specifically at the impact of managed care on the service delivery system. Three historical eras are conceptualized by the authors: (1) an era prior to managed care in which services were provided on a fee for service basis by health insurance companies and lengths of stay were relatively longer; (2) an era of managed care in which services were funded through managed care organizations and lengths of stay were significantly reduced; and (3) the current era in which residential services are provided through self-pay and through other service systems. Awareness of these changes is important for all practitioners who provide services to adolescents and demonstrate the need to advocates for residential substance abuse services for all adolescents. [ABSTRACT FROM AUTHOR]

One of the current debates in the literature on aging inmates asks, what is the most efficient housing/health care model for this "special needs" population? State and federal correctional systems place elderly inmates either in specialized segregated housing units away from the general inmate population, consolidate elderly inmates in housing units within the prison, or provide a combination of both models. In general, proponents of the segregated housing model argue that aging inmates will receive specialized medical services in geriatric units. However, proponents of consolidated housing model argue that aging inmates will have the benefit of both geriatric and non-geriatric health services. This paper examines the association between the type of housing management model for aging inmates and the availability of non-geriatric physical and mental health services. Data for the analysis come from the 2000 Bureau of Justice Statistics Census of State and Federal Adult Correctional Facilities. The results suggest that institutions offering consolidated geriatric care provide more mental health services and that these effects are independent of the characteristics of prison facility. [ABSTRACT FROM AUTHOR]

The article focuses on the funding announcements made by the National Institutes of Health (NIH) and other health organizations in the U.S. The announcements include the receipt dates for grants which took effect in January 2007 and applicable to both paper and electronic processes for the 10th year anniversary celebration of PubMed, a service of the county's National Library of Medicine and the study "Structural Interventions, Alcohol Use and Risk of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). The primary purpose of the announcements are to develop or solicit funding opportunities and application resources from various institutions offer efficient exploration for mental illness treatment.

Improving the conditions under which incarcerated populations give ‘informed consent’ is a desirable goal given prisoners' lack of autonomy; part of the Institutional Review Board's (IRB) procedures is the inclusion of representative voices from the prisoner population as a mechanism to reduce harms. The most recent review of the ethics of research on pnsoners by the Institute of Medicine recommends an expanded role for prisoner involvement, outlining a collaborative research approach involving prisoners as active participants in all aspects of the research, including design, planning and implementation, not just at the IRB stage. In this paper, we briefly outline the existing state of IRB protections for prisoners selected for research, and focus on the effectiveness of prisoner representatives in this process. We suggest that there are weaknesses within the existing system such that representation may provide little more than ideological legitimation for the process. Moreover, we argue that while the Institute of Medicine's recommendations mark a major improvement in protection vis-à-vis prisoner representation, it does not go far enough in articulating the process whereby the voices of prisoners, their advocates or their representatives are included in the different stages of the process. In short, we question whether ‘being heard’ is enough. We suggest that research needs to be conducted to more extensively map the scope of this issue and to raise some critical questions in order to improve the effectiveness of the ethical considerations for research on prisoners, as well as the RB process and any post-IRB oversight, in protecting this vulnerable population. [ABSTRACT FROM AUTHOR]

This paper reviews the experience of evaluating a cultural competence workshop series for social workers practicing in a mental health care setting. The study used a pretest-posttest nonequivalent comparison group design, and evaluation was based on both quantitative and qualitative data collections. Between subjects analyses suggested that there were no differences between the intervention and comparison group after the intervention was completed, hut within-subjects analyses revealed that the intervention group had made superior gains in their scores on the Awareness subscale of the Multicultural Counseling Inventory. Qualitative data contributed additional information about important individual and group processes that affected the experience of training and contributed to self-reported outcomes from training. The study suggests that evaluating process and outcomes of training at both the individual and group levels may be particularly important to understanding how cultural competence develops for social work practitioners in interdisciplinary settings. [ABSTRACT FROM AUTHOR]

This paper examines mental health service use among publicly insured white and African-American pregnant and postpartum women who live in a metropolitan area. The study examines the extent to which ethnicity, physical health problems, and behavioral health risk factors are associated with the probability of service use during the prenatal-postpartum period. It also analyzes the patterns of service utilization for those women who used mental health services. Medicaid claims and eligibility data, County Reporting System claims and admissions data, and Pennsylvania State Vital Birth Records were integrated using a unique algorithm. Logistic regression was employed to estimate the probability of mental health service use among 3,841 low-income women residing in Philadelphia who were continuously enrolled in Medicaid for 9 months preceding delivery and 6 months postpartum. Analyses were also conducted on the intensity and location of service use, as well as psychiatric diagnosis, during pregnancy and the postpartum period. About 10% of the women used mental health services during the study period. Women were more likely to use services if they were Caucasian, had a number of chronic diseases, had a number of pregnancy complications, and smoked. Among users, the same proportion (ca. 6%) used services during pregnancy and postpartum, with the average number of outpatient visits slightly higher during pregnancy than during the postpartum period. Most outpatient services (86%) were delivered in the specialty sector. Most women who used mental health services (84%) were diagnosed with minor psychiatric disorders including minor depression and anxiety disorders. Women who used services during the postpartum only were more likely to be diagnosed with major depression, whereas women who used services throughout the perinatal period were more likely to be diagnosed with severe mental disorders. Health providers can use information generated in this study to identify women who are likely to have a need for mental health services. [ABSTRACT FROM AUTHOR]

There are calls across America for police to re-imagine themselves as ‘guardians’ rather than ‘warriors’ in the performance of their innumerable duties. The contentious history of police attitudes and practices surrounding encounters with people affected by mental illnesses can be understood through the lens of this wider push towards guardianship. At least as far back as the de-institutionalisation of mental health care and the profound lack of community-based resources to fill service deficits, the role of police as mental health interventionists has been controversial and complex. This paper reviews the first wave of reform efforts designed to re-shape police sensibilities and practices in the handling of mental health-related encounters. We argue that such efforts, centred on specialised training and cooperative agreements with the health care sector, have advanced a guardian mindset through improved knowledge and attitudes about mental health vulnerabilities and needs. Building on the progress made, we suggest there are critical opportunities for a new wave of efforts that can further advance the guardianship agenda. We highlight three such opportunities: (1) enhancing experiences of procedural justice during mental health-related encounters; (2) building the evidence base through integrated data sets; and (3) balancing a ‘case-based’ focus with a ‘place-based’ focus. [ABSTRACT FROM PUBLISHER]

With the passage of the Patient Protection and Affordable Care Act (PPACA) and ongoing health care reform efforts, this is a critical time for the social work profession. The approaches and values embedded in health care reform are congruent with social work. One strategy is to improve care for people with co-morbid and chronic illnesses by integrating primary care and behavioral health services. This paper defines integrated health and how the PPACA promotes integrated health care through system redesign and payment reform. We consider how social workers can prepare for health care reform and discuss the implications of these changes for the future of the profession. [ABSTRACT FROM AUTHOR]

ABSTRACT: Attention deficit/hyperactivity disorder (ADHD) is both a common and controversial psychiatric diagnosis. The controversy surrounds its origins, empirical validity, and potential over-diagnoses across child and adolescent populations. This paper summarizes the debate and presents the historical development of this mental health disorder across the Diagnostic and Statistical Manual of Mental Disorders lifetime (first DSM to DSM-5). The analysis of the ADHD empirical development finds at best intermittent validity attained, raising concerns and implications for clinical mental health practice. [ABSTRACT FROM AUTHOR]

Prior work on Muslims' mental health help-seeking factors has emphasised their rejection attitudes, religious and cultural beliefs, and familiarity with mental health. However, no research has examined differences in these factors across different Muslim ethnic groups, and particularly among Muslim women. A sample of 1214 Muslim women living in the USA completed online questionnaires. Data was stratified based on history of mental health visits to control for previous service utilisation. MANOVAs assessed ethnic group differences in beliefs, familiarity, and rejection attitudes toward professional mental healthcare. Results revealed significant differences between ethnic groups in all three factors; these differences depended on the women's history of service utilisation. Findings suggest that barriers to accessing professional mental healthcare differ among Muslim ethnic groups. Results are discussed in light of clinical implications and other contributing factors to the underutilisation of professional mental healthcare among ethnically diverse American Muslim women. [ABSTRACT FROM AUTHOR]

Undertreatment of mental illness is associated with greater acute care and costs and worse mental and physical outcomes. Structural barriers may contribute to worse care. National Health Interview Survey data for 2011–2017 were used to examine associations of psychological distress and nine structural barriers with four health services, guided by the Andersen Behavioral Model of Health Services Utilization. Per the Kessler-6 Scale, United States adults 18–64 years of age (sample size = 172,209, estimated annual population = 189.4 million) were categorized as: no or low psychological distress (NLPD: 79.2%), moderate (MPD: 17.1%), and serious (SPD: 3.7%). Those with MPD and SPD had higher likelihoods of any mental health visit (Adjusted Odds Ratio: 3.53; 8.36, respectively), hospitalization (AOR: 1.16; 1.55), emergency room/department visit (AOR: 1.62; 2.23), and lower likelihood of office visits (AOR: 0.42; 0.64) in the past 12 months compared to NLPD (all p < 0.001). Psychological distress was the largest contributor of explained variation for mental health visits (67%), hospitalization (37%), and ER/ED usage (47%). Adults with SPD and MPD faced structural barriers at higher proportions. For example, reports of "had trouble finding general doctor" were: NLPD (2.2%), MPD (6.0%), and SPD (11.8%). Eight structural barriers were positively associated with ER/ED use and five barriers negatively associated with office visits. Barriers significantly associated with all four outcomes were: "Told health care coverage not accepted" and "Delayed care, couldn't get appointment soon." Innovative policy solutions coupled with comparable innovations in care delivery for complex patient populations could ensure equitable access to health services for individuals with psychological distress. [ABSTRACT FROM AUTHOR]

Efforts to transform the mental health service delivery system to a more consumer-driven and recovery-orientated approach has its roots in a somewhat radical anti-psychiatry and civil-rights movement dating back to the 1970s. This grass-roots effort gained momentum and credibility with Harding's landmark study published in 1988 followed by the work of Anthony et al. from Boston University in beginning to define the term 'recovery'. In 1998 the Office of the US Surgeon General issued its first report on mental health, and this critical view of the shortcomings of the existing service system set the stage for the 2003 President's New Freedom Commission and its recommendations for recovery-orientated systems transformation. The recovery movement has evolved from a more radical view in the early days, to participatory involvement in systems, to returning to alternative models of care that are more independent. Now as more peer specialists work in systems, there is an increased emphasis on non-medical alternatives and the cycle continues. Regardless, recovery, self-determination, choice, etc. are always at the centre. This paper notes the interesting cycles of recovery-orientation and how they spin around the values/tenets of the movement's early roots. [ABSTRACT FROM AUTHOR]

As the United States has engaged in record levels of incarceration, there has been a concomitant rise in the number of persons incarcerated afflicted with severe mental illness (SMI) including schizophrenia, bipolar disorder, and major depression. Legislation aimed at diverting SMI persons away from incarceration and toward treatment has been recently developed. This paper reviews the Mentally Ill Offender Treatment and Crime Reduction Act of 2004 (MIOTCRA), and the potential of outpatient commitment laws to work in tandem with the experimental mental health courts program the MIOTCRA of 2004 helped to create. [ABSTRACT FROM AUTHOR]

Compulsory and noncompulsory treatments in the United States have changed over the past 50 years in response to a series of events occurring politically, clinically, economically, and ethically. This paper examines the key aspects of this development and identifies both differences and similarities between these different approaches for difficult-to-engage clients. Attention is given to the integral but controversial role of coercion. As part of the ongoing continuum of development, I propose that the language and definition around coercion be refined to identify better the important proactive components that occur across the treatment spectrum. [ABSTRACT FROM AUTHOR]

Violence is an important public health issue. Because of a substantial variability in the intensity and frequency of violence worldwide a socio-cultural perspective is required for the better understanding of violent behaviours. This paper describes the current status of youth violence in Japan and the USA to elucidate critical points for mental health intervention. Although the profiles of youth violence in these two countries are quite different, violent behaviours in youths, including murder, are becoming more serious problems for both countries. From the experience in the USA a dual perspective, clinical and social/community, is proposed to understand youth violence. To prevent and treat youth violence, effective mental health service systems are needed and should be community-based and easily accessible for children and adolescents and their families as considered in the 'systems of care' philosophy. [ABSTRACT FROM AUTHOR]

Given the complexity of the health care system and the prevalence of acute and chronic mental illnesses, multi-system interventions from an interdisciplinary team of health care providers are necessary to address the needs of individuals in psychiatric and mental health treatment venues. Despite claims that interdisciplinary practice is the norm, in reality it is difficult to accomplish (Martin-Rodriguez, Beaulieu, D'Amour, & Ferrada-Videla, 2005). Students must be taught the principles and elements of this way of providing care in order to succeed. This paper describes strategies for educating undergraduate nursing students to engage in interdisciplinary collaborative practice. Two case studies are used to illustrate how teaching collaborative skills can be integrated into a psychiatric undergraduate nursing course. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent or persistent thoughts, impulses, or images that are experienced as intrusive or distressing (obsessions), and repetitive behaviors or mental acts (compulsions) often performed in response to an obsession. Recent epidemiological studies have found lifetime prevalence of pediatric OCD to be approximately 1-4% in the USA. OCD begins before the age of 18 years for as many as 80% of cases and follows a chronic, unremitting course. Due to the distressing, time-consuming, and debilitating nature of OCD, impairments in academic, social, and family functioning are often substantial. Despite the relatively high prevalence rate of OCD, dissemination about effective assessment and treatment has lagged. Increasing the awareness of OCD symptoms and its treatment among nurses and other health professionals will enhance identification of children presenting with unrecognized or untreated symptoms of OCD and will stimulate appropriate referrals for treatment to improve children's psychological functioning and overall quality of life. This paper reviews the nature, etiology, assessment, and treatment of OCD, highlighting clinical implications for nurses involved in mental health care. [ABSTRACT FROM AUTHOR]

Comprehensive community systems of care are essential for successful transformation of mental health services in the US. This document outlines core principles that can guide development of such systems and proposes key actions steps to initiate the process. Declaration of interest: This paper was produced while Ms. Hutchings and I were employees of the U.S. Government. Therefore, it is in the public domain and cannot be copyrighted. Rights are transferred to the extent possible. [ABSTRACT FROM AUTHOR]

Emphasis has been placed on understanding the mental health disparities that exist within minority populations in the United States. Disparities are of particular importance when examining access to services. This paper reports findings from a NINR-funded qualitative study that examined the barriers to mental health care service use in an African American low-income population. Barriers were identified at three levels -- Individual, Environmental, and Institutional. Fourteen barrier categories were identified within those levels with three categories common to the majority of participants. The identified categories provide insight into the process of seeking services within this population and provide direction for future investigation. [ABSTRACT FROM AUTHOR]

The term dual diagnosis is frequently used by mental health professionals to refer to people who have mental illness complicated by substance abuse. A less commonly recognized population are those individuals who have the dual diagnosis of mental retardation and mental illness. In this paper the author discusses (1) the mental health needs of persons with mental retardation and (2) the current state of services for them. There is a significant lack of appropriately trained professionals to help address the needs of this population. Traditionally, nurses have primarily been identified as providers of physical care. Advanced practice psychiatric nurses, however, are an underutilized group of professionals who have the capacity to assume a leadership role in clinical care, service coordination, and advocacy for individuals and families affected by mental illness and mental retardation. [ABSTRACT FROM AUTHOR]

The field of forensic psychiatric nursing is a relatively recent addition to the specialty of psychiatric nursing. This paper provides an overview of forensic psychiatric care of adolescent patients. It describes the juvenile justice system, identifies various theoretical models useful for understanding youthful offenders, and explores risk and protective factors. Psychiatric comorbidities and treatment considerations also are presented. [ABSTRACT FROM AUTHOR]

Cultural competence and cultural humility are hallmarks of social work practice. Cultural competence focuses on the clients' lived experiences. Cultural humility centers the lived experiences of the clinician and the client. However, few resources are available to illustrate how to apply cultural competence and cultural humility separately. Even fewer opportunities are available to apply both. We illustrate how to employ both, cultural competence and cultural humility in practice with Black women with depression. When used together, cultural competence and cultural humility appears to be more valuable than when used individually. Based on research information presented, implications for practice are discussed. [ABSTRACT FROM AUTHOR]

This study provides the first nationally representative estimates of parent-reported barriers to mental health services for children with mental health conditions in the United States. It identifies individual, family, and environmental characteristics associated with the most common barriers to mental health care for children with common mental health disorders reporting the need for mental health services. Cost barriers, inconvenient service times, and lack of service availability or transportation barriers were the most reported barriers to mental health services. Children with more severe conditions reported these barriers at significantly higher rates than children with less severe conditions. [ABSTRACT FROM AUTHOR]

Background: Substance use (SU) is associated with physical injury and mental health disorders in older persons, but recent research has scarcely examined SU in U.S. Vietnam-era veterans who are mostly in or near their eighth decade of life. Objectives: We compared the prevalence of self-reported lifetime and current SU and modeled current usage patterns in a nationally representative sample of veterans versus a matched nonveteran cohort. Methods: Cross-sectional, self-reported survey data were analyzed from the 2016–2017 Vietnam Era Health Retrospective Observational Study (VE-HEROeS) (n = 18,866 veterans, n = 4,530 nonveterans). We assessed lifetime and current alcohol and drug use disorders; lifetime and current use of cannabis, opioids, stimulants, sedatives, "other drugs" (psychedelics, prescription or over-the-counter drugs not prescribed/used as intended); and current SU patterns (alcohol-use-only, drug-use-only, dual-SU, no SU). Weighted descriptive, bivariable, and multivariable statistics were calculated. Covariates in multinomial modeling included sociodemographic characteristics, lifetime cigarette smoking, depression, potentially traumatic events (PTEs), and current pain (SF-8TM). Results: Prevalence of lifetime opioid and sedative use (p ≤.01), drug and alcohol use disorders (p <.001), and current "other drug" use (p <.001) were higher in veterans versus nonveterans. Current use of alcohol and cannabis was high in both cohorts. In veterans, very severe/severe pain, depression, and PTEs were highly associated with drug-use-only (p <.001) and dual-SU (p <.01), but these associations were fewer for nonveterans. Conclusion: This research confirmed existing concerns over substance misuse in older individuals. Vietnam-era veterans may be at particular risk due to service-related experiences and later-life tribulations. Era veterans' unique perceptions toward healthcare assistance for SU may need greater provider focus to maximize self-efficacy and treatment. [ABSTRACT FROM AUTHOR]

The meaning and experience of masculinity differs across people and groups, and previous research has demonstrated that such differences are reflected in mental health outcomes. For gay Black men situated at the intersection of identifying as both a sexual minority and a racial minority, navigating the norms and expectations associated with masculinity often presents many challenges. This phenomenological study explored how 17 gay Black men ranging in age from 26 to 67 years, who live in a major city in the southeastern region of the United States, define, understand, and experience masculinity, as well as their perceptions about its connection to their mental health and well-being. Participant narratives reflected a strong consensus that masculinity is a social construction that is associated with a range of both limiting and liberating characteristics and experiences, and that has strong implications for mental health. Increased awareness and understanding of the relevance of a masculine identity to the mental health and well-being of gay Black men can help provide more appropriate and more compassionate mental health programs and services that are likely to promote service utilization among members of this community. [ABSTRACT FROM AUTHOR]

Although women in jail are the fastest-growing correctional population in the United States and research suggests that gender, race, and ethnicity predict the experiences of incarcerated people, scant research has addressed the experiences of women in jail. The current study analyzed bivariate statistics (Pearson's chi-squares and independent-samples t tests) in two studies to highlight differences in mental health needs, jail-based processes, and mental health jail interventions (MHJIs) between Women of Color (WoC) and White Women (WW). Findings show important differences exist among WW and WoC. For example, we found WW were more likely than WoC to receive past mental health treatment and to be currently taking medications for a mental health diagnosis. Additionally, compared to WW, WoC are more likely to participate in MHJI programs in metropolitan counties and received more mental health services in the pre-period. Interventions designed to reduce recidivism should be designed with these differences in mind. [ABSTRACT FROM AUTHOR]

Among people living with HIV, trauma is associated with increased viral loads and obstructed access to HIV care. Trauma-Informed Care (TIC), a SAMHSA Evidence Based Practice, responds to the impact of trauma for service users by focusing on all aspects of service delivery systems and structures. TIC could be potentially lifesaving in regions where HIV rates continue to rise, like the U.S. South. Thus, the purpose of this study is to (1) understand the extent to which HIV service organizations in the U.S. South provide mental health and substance use services and referrals; (2) the extent to which they employ trauma informed care and (3) the barriers of employing trauma informed care. Analyzing quantitative data of 207 organizations, we found that less than a third of organizations provided a trauma informed intervention. Only 44% of organizations had participated in TIC training but 84% expressed interest in TIC training. Organizations who completed TIC training were 10 times more likely than those who did not to report that they implemented at least one trauma informed care strategies. Barriers to TIC implementation included lack of training, capacity, and resources. Building the capacity of organizations to implement TIC will be a key to ending the HIV epidemic. [ABSTRACT FROM AUTHOR]

Background: In 2007, Cochran, Peavy, and Robohm conducted a study of treatment programs that indicated that they provided specialized services for gay and lesbian clients; however, phone calls to these agencies revealed that over 90% of these agencies actually did not provide services that were discernibly different from the agencies' general services. Objectives: Given the progress and development since 2007 regarding awareness of SGM (sexual and gender minority) rights and an increased understanding of the impact of health disparities on SGM individuals, the current study aimed to gain a renewed understanding of the state of SGM-specific substance treatment using a similar methodology. Results: agencies reporting that they provide SGMTitle specific services since 2007, fewer than 1 in 5 agencies who indicated offering SGM-specific treatment on the National Survey of Substance Abuse Treatment Services (N-SSAT S) survey actually provided such services (17.4%) in 2021. Conclusions/Importance: The current study reinforces the already observed need for specialized substance treatment services for the SGM population. Despite having hundreds more SGM-specific substance treatment services in existence today compared to 2007, our findings point to a strong need to address the discrepancies between self-reported and existing availabilities of SGM-specific services in substance treatment. Actions that can potentially close this gap might be two-fold: standardizing the definition of and criteria for SGM-specific services and increasing funding and resources that could expand the availability of such services, particularly in rural regions. [ABSTRACT FROM AUTHOR]

Over 5800 licensed social workers in 13 U.S. states responded to questions in an online survey regarding their use of mental health and substance use disorder (SUD) services during different periods of their lives. As many as 69% of respondents reported ever having accessed mental health treatment, with only 6% having utilized SUD treatment. Among participants reporting a history of mental health problems, 89% utilized mental health treatment. However, only 35% of respondents who indicated a history of substance use problems reported using SUD services, with a much larger proportion of this cohort (84%) reporting use of mental health services. [ABSTRACT FROM AUTHOR]

Practice-based evidence research was used to document the use of spiritual interventions in three mental health treatment settings among eight therapists and 128 clients. Materials included measures of client distress, along with measures of counselor's therapeutic process use and orientations toward the delivery of spiritual interventions. Analyses revealed the most common theoretical approaches and spiritual interventions in our settings. Differences emerged in cross-site comparisons of therapeutic processes, as well as in spiritual intervention use with clients of different genders. This study contributes insight into what is being done in real-world settings to address spirituality into psychotherapeutic interventions. [ABSTRACT FROM AUTHOR]

Mechanical Turk (MTurk) is a popular data collection tool that is increasingly used to study parents and children. We examined the quality of data obtained via MTurk, the representativeness of parents on MTurk, and whether the wording of MTurk recruitment materials is related to sample characteristics. Participants were 650 parents with children aged 4 to 17 recruited for two separate studies (64.6% female, 83.8% Caucasian, mean age = 37.6 years). The Mental Health Survey (N = 322) recruitment materials described a study about mental health and the Health Survey (N = 328) materials only referenced health; both surveys restricted participation to parents in the United States (U.S.). Parents completed measures about demographics, mental health service seeking history, and parent and youth psychopathology. Participants provided reliable responses on study measures, with low rates of missing data. Participants were more female, less racially/ethnically diverse, and more educated than the U.S. population, and also had more children per household. Over 40% of parents and 30% of children had previously received mental health services and many scored in the clinical range on measures of psychopathology. Contrary to hypotheses, mental health help seeking was higher in the Health Survey than the Mental Health survey. MTurk is a feasible method for child and adolescent clinical psychology research, although participants may not be fully demographically representative of the general population and could possibly be better considered an at-risk or clinical sample than a community sample. [ABSTRACT FROM AUTHOR]

Families that include a current or former member of the US Armed Services face unique challenges. These challenges center on three facets of military family life known to contribute to negative child mental health outcomes; mobility, family separation and parent health. The purpose of this study is to use the 2017–2018 National Survey of Children's Health to understand children's mental health outcomes in military and nonmilitary families. Parents of 39,465 United States children between the ages of 2 and 17 were surveyed about their child's mental health and use of mental health services in the past 12 months. The association between mobility, family separation, parent health and child mental health are tested through two logistic regression analyses. Results indicate that current military families have a lower likelihood of reporting mental health problems in their children compared to nonmilitary and former military families. The potential reasons for the protective effect of military family status on child mental health problems may be related to the social networks available to active duty military families. [ABSTRACT FROM AUTHOR]

Individuals with mental illness are at risk of developing co-occurring substance use disorders (SUDs). We assessed whether unmet need for mental health treatment in the past year was a risk factor for past-month use of marijuana, cocaine, methamphetamine, and misuse of prescription opioids in this population. Data from adults diagnosed with mental illness who were not diagnosed with SUD were examined from the 2015–2018 National Survey on Drug Use and Health (N = 33,104). An estimated 20.8% (95% CI: 20.1–21.5) of adults in the US with mental illness have experienced unmet need in the past year. Those reporting marijuana use (29.7% vs. 19.5%, p <.001) and/or prescription opioid misuse (35.7% vs. 20.5%, p <.001) were more likely to report unmet need than those not reporting use. In multivariable models, unmet need remained a risk factor for marijuana use (aOR = 1.37, 95% CI: 1.24–1.54) and prescription opioid misuse (aOR = 1.65, 95% CI: 1.29–2.13). Unmet need was not a risk factor for cocaine or methamphetamine use. Cost as a barrier to treatment was a risk factor for marijuana use (aOR = 1.37, 95% CI: 1.19–1.58) and prescription opioid misuse (aOR = 1.95, 95% CI: 1.43–2.64). Policies aimed at improving mental healthcare access may be effective in reducing substance use in this population. [ABSTRACT FROM AUTHOR]

Objectives: Emerging adulthood—spanning 18–29 years of age—is associated with the highest risk for onset of certain behavioral health disorders (e.g. major depression, bipolar disorder, psychosis, substance use disorders) and high prevalence of many behavioral health disorders. Yet, rates of mental health service use remain low in this age range. Racial/ethnic minorities are particularly impacted by individual, cultural/linguistic, and community-level barriers to mental health care. This study examined community-level factors associated with mental health service use and investigated whether these associations varied by race/ethnicity. Design: This study analyzed individual- and county-level data for emerging adults in the United States (N=3,294) from the nationally representative Collaborative Psychiatric Epidemiological Surveys (CPES). Using the Andersen Model of Health Care Utilization, analyses examined predisposing, enabling, and need factors utilized in prior studies with adult samples as well as novel community characteristics hypothesized to impact service use among emerging adults of diverse racial/ethnic backgrounds. Past-year use of both specialty and any mental health services were assessed, controlling for individual- and community-level variables, and adjusting for presence of past-year mental health disorder, overall health status, and functional impairment. Differences between racial/ethnic minority groups and Non-Latino Whites were tested through a multilevel model incorporating random intercepts logistic regression, with analysis focusing on the interaction between race/ethnicity and community-level supply variables. Results: For past-year use of specialty mental health services, density of hospitals with child wellness programs was linked to service use among Black emerging adults, whereas density of hospitals with linguistic/translation services was linked to service use among Latino emerging adults. Conclusions: This study expands on previous research in behavioral health disparities to examine ways to improve behavioral health services for an emerging adult population with unmet service needs and identifies specific community-level factors that can improve mental health for racial/ethnic minority emerging adults. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the mental well-being of audiologists in the midst of the COVID-19 pandemic. A cross-sectional online survey was conducted during the COVID-19 pandemic, between 23 June and 13 August 2020. A self-report survey included screening measures for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3). 239 audiologists from around the world. The prevalence of psychological distress was 12.1% (subscales for anxiety 16.3% and depression 10.4%), and loneliness 32.2%. Depression and loneliness were higher in those participants self-reporting perceived job insecurity, with psychological distress (anxiety and depression) higher in those from South Africa. Accessibility to Employee Assistance Programs (EAPs) appears to be a protective factor. Well-being interventions, such as EAPS, are needed to support audiologists during challenging times like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Limited attention has focused on midlife health. Yet, this is a time of great change, including onset of chronic conditions and changes in mental health. To examine unmet healthcare needs among midlife adults (50–64 years) in the US with severe psychological distress (SPD) and/or multiple chronic conditions (MCC). Nationally representative data for midlife adults (50–64 years) from NHIS 2014–2018 were examined (n = 39,329). Multimorbidity status: no MCC/SPD, MCC alone, SPD alone, or both. We used logistic regression to estimate adjusted odds ratios (AOR) of delayed or foregone care by multimorbidity status. Nearly 40% of midlife adults had MCC, SPD, or SPD/MCC. SPD with or without MCC had higher prevalence of social disadvantage, fair/poor health, activity limitations, and delayed/foregone healthcare. Compared to those with neither, adults with SPD/MCC were more likely to delay care due to limited office hours (AOR = 4.2, 95% CI 3.1–5.5) and had nearly three to four times higher odds of delays for all other reasons. Those with SPD/MCC had higher odds of needing but not getting mental healthcare (AOR = 6.4, 95% CI 4.5–9.1), prescriptions (AOR = 4.8, 95% CI 3.9–5.9), or follow-up care (AOR = 5.0, 95% CI 3.7–6.6), and three to four times higher odds of all other types of foregone care. Midlife adults with SPD/MCC have substantial unmet healthcare needs. Midlife is a critical time to manage both chronic conditions and mental illness. Coordinated efforts by policymakers and healthcare systems are crucial to address complex healthcare needs of this population at a critical stage of the life-course. [ABSTRACT FROM AUTHOR]