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Background: In contrast to their white counterparts, Latino Americans are less likely to utilize mental health services., Aims: Guided by the Behavioral Model of Health Service Utilization, this study examined factors affecting use of mental health services and dropouts from mental health services among Latino Americans with mental health issues., Methods: This is a secondary analysis utilizing data from the National Latino and Asian American Study. Seven hundred 88 Latinos with mental health issues were included in this study. Logistic regression analyses were conducted., Results: Being older, having health insurance, having self-perceived need for mental health services, having mental health service need perceived by others and a greater number of probable psychiatric disorders were associated with the use of mental health services among Latinos with mental health issues. Among 194 Latino mental health service users, being younger, not having health insurance, and having a lower level of family support were associated with dropouts from mental health services., Conclusions: The findings suggest that education is needed to help Latino Americans recognize the need for mental health services. In addition, policies are needed to address financial difficulties in accessing mental health services.

Objective: This study examines the role of mattering to others as an intrapersonal construct that may mediate the relationship between social support and 2 separate criterion variables: recovery and internalized stigma associated with living with a serious mental health condition. Adults living with serious mental health disorders, such as schizophrenia, face numerous social challenges that may leave them feeling isolated, stigmatized, and that they do not matter to others, thus thwarting the potential for recovery. Theorists and researchers conceptualize the sense of mattering to others as the perception that 1 is valued, recognized by others along with the feelings that others are concerned about our well-being., Method: Clubhouse members (N = 119) completed 1-hr, in-depth personal interviews assessing perceived social support, experiences of mental health recovery, and stigma associated with living with a mental health condition as well as a sense of mattering to others., Results: Mediation analyses revealed the significant effects of mattering to others as explaining the relationship between social support and recovery as well as the relationship between social support and internalized stigma., Conclusions and Implications for Practice: The findings illuminate our understanding as to how social support interventions can enhance recovery and reduce stigma associated with living with a psychiatric condition by attention to perceptions of whether one is valued and recognized by others. Mattering to others among consumers of social and health care interventions can serve to engage individuals who may withdraw from supports or internalize negative self-stereotypes based on internalized stigma. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Background: Although researchers have demonstrated the benefits of psychosocial Clubhouse participation on a number of clinical and psychosocial outcomes, few studies have investigated the consumer's participation from the perspectives of others., Aim: This study aimed to investigate family members' perspectives of how Clubhouse programming has affected consumers' recovery., Method: Twenty-four relatives of Clubhouse members were interviewed using a semi-structured protocol. Relatives were nominated by their Clubhouse members as their family member who provided them with the most social support. All interviews were transcribed and underwent content analysis yielding multilevel coding., Results: Four main dimensions emerged from family interviews about how Clubhouses affected their relatives. These dimensions aligned with areas of clinical recovery and personal growth. Family members observed and noted changes in: (1) positive affective changes, (2) improved goal directed and challenging behaviors, (3) positive attitude changes and (4) greater social interactions., Conclusion: As one of the first studies to document the perspectives of the relatives of Clubhouse members, this exploratory study indicates that family members recognize positive changes in their Clubhouse family members and these changes align with areas of functional recovery. Implications for practice and future studies are discussed.

Objective: Loneliness can impede subjective experiences of recovery. This study examines the relationship between clubhouse participation and loneliness using standardized instruments while controlling for age, gender, living status, and social network characteristics., Method: A random sample of 126 members from one clubhouse was recruited for this cross-sectional investigation. A hierarchical multiple regression analysis was performed to examine the association between participation and loneliness., Results: A greater number of clubhouse visits, greater perceived availability of social support and higher levels of overall satisfaction with social network relationships were significantly related to a lower level of loneliness after controlling for covariates., Conclusions and Implications for Practice: Service providers may want to pay more attention to those members experiencing loneliness and help them connect with others. Future studies using longitudinal analyses are needed to further assess the causal relationship between clubhouse participation and loneliness. Multiple aspects of participation should be examined.

Family members are important to the well-being of their relatives with substance use disorders or co-occurring substance use and mental disorders. Many caregivers experience high levels of burden, negatively impacting their capacity to provide support to their ill family member. The Andersen health care utilization model (Andersen & Newman, 1973, 2005) was used to identify the impact of predisposing, enabling and need factors hypothesized to predict caregivers' likelihood of asking for help and support with their caregiving role. The sample include 82 women recruited from outpatient or inpatient substance abuse treatment centers and 82 family caregivers nominated by these women. Findings showed that almost half of caregivers were unlikely to ask for help. Multiple regression analysis found that two need variables were statistically signficant predictors of caregivers' likelihood to ask for help. Caregivers who had higher subject burden (worry) and caregivers who provided more assistance with daily living were more likely to ask for help. It is suggested that case managers assess the amount of worried family caregivers' experience because their worries may provide the motivation to ask for help or to participate in help when it is offered to them.

There is significant documentation in the literature of barriers that may prevent research results from being utilized by agencies to inform and impact practice and policy. Such barriers pertain to several factors as follows: (a) those related to the nature of the research enterprise itself (b) those related to differences between the producers and consumers of research, and (c) barriers arising from the differences in organizational contexts of researchers and case management and supported employment agency staff. This article discusses a collaborative relationship between university researchers and agency practitioners in the context of a research project studying the implementation of supported employment, an evidence-based practice. As a case example, it provides an exemplar of the problems and issues of conducting mental health research with community-based agencies and offers strategies and case examples that address these issues.

Clinical trials demonstrate that Supported Employment is effective in assisting persons with severe mental illness in obtaining competitive employment. However, little is known about the factors related to consumers' decisions to pursue employment, especially for consumers with co-occurring substance and mental disorders. This study examines the demographic, socioeconomic and illness characteristics of consumers referred for Supported Employment services. Consumers were drawn from Integrated Dual Diagnosis Treatment programs in four community mental health agencies. Study participants included 113 consumers referred for Supported Employment services and 78 randomly selected non-referred consumers as the comparison group. Results suggest that consumers who have past work experience are more likely to be referred to Supported Employment, while consumers who perceive themselves as disabled or who are diagnosed as substance dependent are less likely to be referred to Supported Employment. Implications for agency practice and future research are discussed.

Predictors of psychiatric hospitalization, predisposing, enabling and need, of adults with co-occurring mental and substance disorders were compared to predictors for adults with a mental illness only. Research participants were 1613 users of crisis intervention services. Findings using Cox regression show that dually-diagnosed individuals were more likely to be hospitalized. Enabling and need factors were important predictors for both groups. Disruptive behavior was a predictor for dually-diagnosed clients but not for clients with mental illness only. Findings suggest that outpatient mental health services are less well equipped to address a psychiatric crisis when it was accompanied by substance use issues.

Objective: Few low-income and minority caregivers of persons with serious mental illness participate in support groups. This study examined the facilitators and barriers to participation in support groups for families of persons with serious mental illness among lower socioeconomic African-American and Caucasian family caregivers. Three hypotheses were tested in a multivariate model which included need, enabling and predisposing variables utilizing a revised version of the Andersen model. Support group membership was hypothesized to be predicted by a higher perceived cost-benefit ratio (benefits minus costs) of group participation, fewer numbers of access barriers and higher levels of service use., Methods: A non-experimental cross-sectional design was used. Subjects were 145 lower socioeconomic status African-American and Caucasian family caregivers, 65 of whom were current support group members and 80 of whom had never participated in support groups., Results: Findings confirmed that support group members reported a more favorable cost-benefit ratio and fewer access barriers than did non-support group members, controlling for other variables. Level of non-support group service use was not significantly different for support and non-support group members., Conclusions: Non-members' assessments of support group participation may be based on inaccurate perceptions and/or incomplete knowledge. Educational campaigns, sponsored by support groups and mental health authorities focusing on both perceptions about support groups as well as structural impediments to participation, such as access barriers, should be undertaken.

Significant barriers exist to the implementation of evidence-based practices into routine mental health and substance abuse settings. This paper discusses the role and function of technical assistance centers to help support the implementation process using, as a guide, the experience of the Ohio Substance Abuse and Mental Illness Coordinating Center (SAMI CCOE) in helping mental health and substance abuse agencies to implement Integrated Dual Disorders Treatment (IDDT), an evidence-based practice for adults with co-occurring substance and mental disorders A description of the SAMI CCOE is presented followed by discussion of an implementation framework, using stages of organizational change, to help understand and guide the process of implementing evidence-based practices. The paper concludes with a discussion of lessons learned in helping organizations to implement integrated treatment for adults with co-occurring disorders. (Contains 1 figure.)

This study utilized a stress-process model to examine the impact of having a female family member with substance use or co-occurring substance use and mental disorders on family caregivers' depressive symptomatology. Participants were 82 women receiving substance abuse treatment and the family member providing the most social support for each woman. Greater caregiver depressive symptomatology was predicted by greater care recipient emotional problems, less care recipient social support, and poor caregiver health. Implications of findings for treatment and future research are discussed. (Contains 2 tables.)

This cross-sectional study utilized a stress-process model to examine the impact of caregivers' (N = 82) perceptions of their relationship quality with a female family member (i.e., care-recipient) with substance-use or co-occurring substance and mental disorders on caregivers' perceived burden. Regression findings indicate that relationship quality impacts both subjective and objective burden. Higher levels of emotional support given to the care recipient by the caregiver predicted lower levels of caregiver displeasure; whereas higher levels of undermining of the care recipient by the caregiver predicted higher levels of caregiver stigma. Higher levels of emotional support received by the caregiver from the care recipient were associated with lower levels of caregiver displeasure and lower objective burden; higher levels of undermining of the caregiver by the care recipient predicted higher objective burden. Implications for practice and service delivery are presented. (Contains 1 figure and 3 tables.)

This article describes one school's effort to establish a social work research development center in the area of coexisting drug and mental disorders (dual disorders), within the context of the social work profession's efforts to compete more effectively for federal research grants. This center was funded as part of a successful application in response to the National Institute on Drug Abuse's announcement of support for a Social Work Research Development Program stressing the development of social work research in drug abuse intervention and services research. The center builds on the school's previous research and training experiences in the area of co-occurring drug and mental disorders. The center's purpose, structure, and institutional impact are described, with particular attention to the challenges faced in both its formation and its operation and the lessons learned that could generalize to other similar efforts.

The Ohio Supported Employment Coordinating Center of Excellence is a joint project of the Mandel School of Applied Social Sciences and the Department of Psychiatry at Case Western Reserve University. The center is focused on helping to implement and evaluate evidence-based employment services provided to individuals with a severe mental illness. The staffing and funding of the center is described, as are the current research projects, future directions, and the implementation lessons learned. This article is the latest in a series of reports of social work research centers published in "Research on Social Work Practice".

There are significant knowledge gaps concerning the experiences of families of persons with co-occurring substance and mental disorders and the impact of families on treatment of individuals with these disorders. This paper presents a conceptual framework for examining family involvement of adults in treatment for co-occurring substance and mental disorders. An overview of the characteristics, problems, and needs of these individuals and their family members is presented. The extant literature pertaining to our conceptual framework is reviewed with focus on predictors of family involvement with clients, predictors of family member involvement in clients' treatment, and consequences of family involvement for client treatment outcomes. Gaps in the research literature and implications for future research and practice are discussed.

Used concept mapping, along with other analytical techniques, to examine and address barriers to African-American families' involvement in the treatment of family members with mental illness. Focus groups recommended a variety of strategies for improving caregiver supports and for increasing the involvement of caregivers in the treatment process. (RJM)