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Journal article Full text available online for free

Supported employment: assessing the evidence

Authors:
MARSHALL Tina, et al
Journal article citation:
Psychiatric Services, 65(1), 2014, pp.16-23.
Publisher:
American Psychiatric Association

Objective: Supported employment is a direct service with multiple components designed to help adults with mental disorders or co-occurring mental and substance use disorders choose, acquire, and maintain competitive employment. This article describes supported employment and assesses the evidence base for this service. Methods: Authors reviewed meta-analyses, research reviews, and individual studies from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. Authors chose from three levels of evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence for service effectiveness. Results: The level of research evidence for supported employment was graded as high, based on 12 systematic reviews and 17 randomized controlled trials of the individual placement and support model. Supported employment consistently demonstrated positive outcomes for individuals with mental disorders, including higher rates of competitive employment, fewer days to the first competitive job, more hours and weeks worked, and higher wages. There was also strong evidence supporting the effectiveness of individual elements of the model. Conclusions: Substantial evidence demonstrates the effectiveness of supported employment. Policy makers should consider including it as a covered service. Future research is needed for subgroups such as young adults, older adults, people with primary substance use disorders, and those from various cultural, racial, and ethnic backgrounds. (Publisher abstract)

Journal article

Facilitators and barriers in dual recovery: a literature review of first-person perspectives

Authors:
NESS Ottar, BORG Marit, DAVIDSON Larry
Journal article citation:
Advances in Dual Diagnosis, 7(3), 2014, pp.107-117.
Publisher:
Emerald

Purpose: The co-occurrence of mental health and substance use problems is prevalent, and has been problematic both in terms of its complexity for the person and of the challenges it poses to health care practitioners. Recovery in co-occurring mental health and substance use problems is viewed as with multiple challenges embedded in it. As most of the existing literature on recovery tends to treat recovery in mental health and substance use problems separately, it is critical to assess the nature of our current understanding of what has been described as “complex” or “dual” recovery. The purpose of this paper is to identify and discuss what persons with co-occurring mental health and substance use problems describe as facilitators and barriers in their recovery process as revealed in the literature. Design/methodology/approach: The method used for this study was a small-scale review of the literature gleaned from a wider general view. Searches were conducted in CINAHL, Psych info, Medline, Embase, SweMed+, and NORART. Findings: Three overarching themes were identified as facilitators of dual recovery: first, meaningful everyday life; second, focus on strengths and future orientation; and third, re-establishing a social life and supportive relationships. Two overarching themes were identified as barriers to dual recovery: first, lack of tailored help and second, complex systems and uncoordinated services. Originality/value: The recovery literature mostly focuses on recovery in mental health and substance use problems separately, with less attention being paid in the first-person literature to what helps and what hinders dual recovery. (Publisher abstract)

Journal article

Substance use and mental health disorders: why do some people suffer from both?

Authors:
REEDY Amanda R., KOBAYASHI Rie
Journal article citation:
Social Work in Mental Health, 10(6), 2012, pp.496-517.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Co-occurring substance use disorders (SUD) and mental health disorders (MHD) are prevalent in the United States, affecting between 7 and 10 million adults. Social workers frequently practice in mental health and substance use disorder treatment settings where they are likely to encounter clients who have co-occurring disorders. Therefore, social workers should be familiar with the various etiological models of co-occurring disorders and the strengths and weaknesses of these models, in order to effectively assess and assist clients with co-occurring disorders. The purpose of this article is to describe and critique 4 different models of the etiology of co-occurring disorders: MHD leads to SUD - the self-medication model; SUD leads to MHD model; common factor model; and the combination model. The theory that social workers are most familiar with is the self-medication model, but this may not best explain the client's experience. While there is not definitive support for any of the models, each one seems to have its place in helping researchers and practitioners better understand co-occurring disorders. Implications for practice, policy, and research are discussed.

Journal article

Patterns and predictors of changes in substance use in individuals with schizophrenia and affective disorders

Authors:
BENNETT Melanie E., et al
Journal article citation:
Journal of Dual Diagnosis, 8(1), January 2012, pp.2-12.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Involving 240 participants recruited from outpatient mental health treatment centres who were assessed 5 times over 12 months, this US study looked at cocaine use in individuals with schizophrenia and affective disorders. It examined patterns of cocaine use over time, baseline predictors of continued cocaine use over one year, and predictors of transitions into and out of drug use and treatment. The article describes the participants, the measures used, data analysis and study results. Overall, the researchers found that rates and intensity of cocaine use did not change over the year, but a number of baseline variables were found to predict a decreased likelihood of cocaine use and transitions into and out of outpatient substance abuse treatment. They discuss the study results and report that the findings illustrate how drug use may show a cyclical pattern for those with serious mental illness, in which more severe use is followed by decreased use over time.

Journal article

Adolescent co-occurring disorders treatment: clinicians' attitudes, values, and knowledge

Authors:
DENBY Ramona W., BRINSON Jesse A., AYALA Jessica
Journal article citation:
Child and Youth Services, 32(1), January 2011, pp.56-74.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

In the United States, over 1 million young people are in contact with the youth justice system. Eighty per cent of these are estimated to have some form of mental health disorder. To effectively intervene, youth justice workers must be able to detect such disorders, along with substance misuse. This study investigated 294 community-based clinicians’ attitudes, experiences, values, and knowledge relating to issues of co-occurring disorders, within the youth justice system. Findings indicated that clinicians self-rate their clinical values and attitudes at or above the expected level of competency, but they acknowledged that their skill and knowledge levels were not adequate. Comparison measures reveal that employment setting conditions, geographic region, hours worked per week, and strongly held convictions about the importance of integrated mental health and substance use disorders service delivery distinguish clinicians’ co-occurring disorders knowledge levels. Implications for practice are discussed.

Journal article

Research on the effectiveness of the modified therapeutic community for persons with co-occurring substance use and mental disorders

Authors:
SACKS Stanley, SACKS JoAnn Y.
Journal article citation:
Therapeutic Communities: the International Journal of Therapeutic Communities, 31(2), Summer 2010, pp.176-211.
Publisher:
Association of Therapeutic Communities

This article highlights the development of the modified therapeutic community (MTC) as an approach to the treatment of co-occurring disorders. Four research studies are presented, each of which investigated the effectiveness of the MTC. Nine hundred and two subjects had mental disorders co-occurring with substance use disorders, and all four studies were undertaken by the same investigative team. Better outcomes were observed for the MTC group in every study, but the measures and domains in which differences were detected varied from study to study. Analysis showed significant improvements in outcomes for the MTC group in five of six outcome domains – substance use, mental health, crime, employment and housing. However, no significant differences were detected in HIV-risk. The paper concludes with brief summaries of preliminary findings from two current studies. In ending, the paper presents a discussion of staff training, aftercare services, and future directions for research related to the MTC.

Journal article

Update in smoking and mental illness: a primary care perspective

Author:
LASSER Karen E.
Journal article citation:
Journal of Dual Diagnosis, 5(2), April 2009, pp.191-196.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

The 1991-92 National Comorbidity Survey (NCS) found that 41% of people with a mental illness in the previous month were current smokers, that people with mental illness were twice as likely to smoke as those without, and that heavy smoking was rare in people without mental illness. People with a current mental illness smoked 44% of all cigarettes in the USA, and the paper briefly explores explanations of why smoking rates, and thus smoking-related death rates, are so high in this population. Data from the NCS indicate that those with mental illness are able to stop smoking, though the rates are lower than in the general population, and the author argues that they should be included in clinical trials of smoking cessation medications.

Journal

Advances in Dual Diagnosis

Publisher:
Emerald

This practice-based Journal offers access to and information about dual diagnosis in the UK. It provides practical information to help improve services for people with dual diagnosis. The title is peer-reviewed. Articles from this journal are indexed and abstracted selectively on Social Care Online.

Journal article

Dual diagnosis capability: moving from concept to implementation

Authors:
MINKOFF Kenneth, CLINE Christine A.
Journal article citation:
Journal of Dual Diagnosis, 2(2), 2006, pp.121-134.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Dual diagnosis capability (DDC) refers to the notion that every agency/program providing behavioural health services must have a core capacity to provide services to individuals and families with co-occuring  mental health and substance misuse issues who are already using services. This American article describes the history and characteristics of dual diagnosis capability (DDC). It then presents an illustration of usual starting paces for the implementation of DDC within agencies/programs engaged in the developmental process. It concludes with consideration of future challenges as DDC becomes better defined and organised through the system of care. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal

Journal of Dual Diagnosis

Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

The Journal of Dual Diagnosis examines the latest research in the co-occurrence of mental health disorders and substance abuse disorders. The journal is useful for clinicians, research neuroscientists, mental health services researchers, and health service administrators, as well those in training. Its coverage includes high quality, original scientific papers, brief research reports, clinical case reports, and review articles important to the clinical and therapeutic aspects of dual diagnosis. This journal title is indexed and abstracted selectively on Social Care Online.

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