Search results for ‘Subject term:"mental health problems"’ Sort:
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Permanent supportive housing: assessing the evidence
- Authors:
- ROG Debra J., et al
- Journal article citation:
- Psychiatric Services, 65(3), 2014, pp.287-294.
- Publisher:
- American Psychiatric Association
Objectives: Permanent supportive housing provides safe, stable housing for people with mental and substance use disorders who are homeless or disabled. This article describes permanent supportive housing and reviews research. Methods: Authors reviewed individual studies and literature reviews 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. The authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results: The level of evidence for permanent supportive housing was graded as moderate. Substantial literature, including seven randomized controlled trials, demonstrated that components of the model reduced homelessness, increased housing tenure, and decreased emergency room visits and hospitalization. Consumers consistently rated this model more positively than other housing models. Methodological flaws limited the ability to draw firm conclusions. Results were stronger for studies that compared permanent supportive housing with treatment as usual or no housing rather than with other models. Conclusions: The moderate level of evidence indicates that permanent supportive housing is promising, but research is needed to clarify the model and determine the most effective elements for various subpopulations. Policy makers should consider including permanent supportive housing as a covered service for individuals with mental and substance use disorders. An evaluation component is needed to continue building its evidence base. (Publisher abstract)
Dual diagnosis discourse in Victoria Australia: the responsiveness of mental health services
- Authors:
- ROBERTS Bridget M., MAYBERY Darryl
- Journal article citation:
- Journal of Dual Diagnosis, 10(3), 2014, pp.139-144.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In recent decades, psychiatric services have been challenged to be more responsive to patients’ coexisting problems, in particular those concerning substance use. In Australia this has been referred to as a “No Wrong Door” approach. This qualitative study involved a review of the research literatures, analysis of policy documents, and interviews with 19 key informants in a case study of the State of Victoria, Australia. Informants were from a range of professional backgrounds, including medical, nursing, social work, and a variety of experience in the relevant service sectors. The analysis resulted in two broad themes surrounding the implications of dual diagnosis discourse for the mental health sector. The first involves progress regarding the concept of No Wrong Door with subthemes including interprofessional cultural conflicts, intersectoral professional status issues, terminology, problem definition, perspectives on serious mental illness, the role of the client, and pharmacological treatment. The second overarching theme focuses upon informants’ thoughts on future directions for the sector and highlights divided opinion on the implications of dual diagnosis discourse for the mental health service and social care systems. While the perspectives on system change and multiple issues such as resource concerns and cultural clashes are presented here, the informants in this study also gave clear guidance for the future of dual diagnosis work in the mental health sector (e.g., focusing on orienting services toward consumer strengths and recovery), along with recommendations for future research. This paper contributes to the small body of qualitative research on the history and course of efforts to develop appropriate practice in mental health services with regard to patients who have substance use problems and other mental health disorders. (Edited publisher abstract)
Hope and recovery: a scoping review
- Authors:
- SAELOR Knut Tore, et al
- Journal article citation:
- Advances in Dual Diagnosis, 7(2), 2014, pp.63-72.
- Publisher:
- Emerald
Purpose: Hope is regarded as central to recovery processes. The phenomenon along with its implications for research and practice has, however, gained limited attention within the fields of mental health and substance use. The purpose of this paper is to explore how hope, and what may inspire it, is described within the literature by persons experiencing co-occurring mental health and substance use problems. Design/methodology/approach: The method chosen when conducting this literature review was a scoping study. This allows for a broad approach, aiming to examine research activity and identifying potential gaps within existing literature. Searches were conducted in EMBASE Ovid, PsychINFO Ovid, MEDLINE Ovid, CINAHL Ebsco, SveMed+ and Brithish Nursing Index. Findings: The authors included five articles and one book. None of these presented first-hand experiences of hope and there appears to be a gap in the literature. All included material underlined the importance of the phenomenon to those experiencing co-occurring mental health and substance use problems. Originality/value: Hope seems as important to people experiencing co-occurring problems as to anyone else. There appears to be a need for further research on how persons experiencing co-occurring problems perceive hope and what may inspire it. Hope and what people hope for take many forms and can arise unexpectedly. Practitioners need to take in account the diversity of the phenomenon and find ways of inspiring hope in collaboration with those in need of support.
Trauma, gender, and mental health symptoms in individuals with substance use disorders
- Authors:
- KEYSER-MARCUS Lori, et al
- Journal article citation:
- Journal of Interpersonal Violence, 30(1), 2014, pp.3-24.
- Publisher:
- Sage
The relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender were examined in a sample of individuals participating in outpatient substance abuse treatment. Study participants (N = 625) from six psychosocial counselling and five methadone maintenance programmes were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) in the United States. Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index–Lite [ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma. (Edited publisher abstract)
Gender differences in psychotic disorders with concurrent substance use
- Authors:
- CATON Carol L. M., et al
- Journal article citation:
- Journal of Dual Diagnosis, 10(4), 2014, pp.177-186.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: The authors conducted a comparative analysis of gender differences in patients with primary psychotic disorders with concurrent substance use and in those with substance-induced psychoses. Methods: A total of 385 individuals admitted to psychiatric emergency departments with early-onset psychosis and recent substance use were interviewed at baseline and at six-month intervals for two years. Using a standardised research diagnostic assessment instrument, the authors classified patients at baseline into primary and substance-induced psychosis groups and analysed the effects of gender on demographic, family, and clinical characteristics at baseline, the interaction of gender and diagnosis, and gender main effects on illness course, adjustment, and service use over the two-year follow-up period. Results: Women had better premorbid adjustment, less misattribution of symptoms, and a later age at onset of regular drug use compared to men. Women, however, showed greater depression and histories of abuse compared to men. Men had greater arrest histories. No interactions between gender and diagnosis were significant. Both genders in the primary and substance-induced psychosis groups showed clinical and functional improvement over the follow-up period despite the overall minimal use of mental health and substance abuse treatment services. Conclusions: Women and men with psychosis and substance use differ on several dimensions. The findings suggest the need for gender-specific treatment programming across both diagnostic groups. (Edited publisher abstract)
The 10 most important debates surrounding dual diagnosis
- Author:
- HAMILTON Ian
- Journal article citation:
- Advances in Dual Diagnosis, 7(3), 2014, pp.118-128.
- Publisher:
- Emerald
This paper reflects on the progress made to date in advancing knowledge and understanding of the relationship between substance use and mental health. The author draws on the available literature, identifying key contributions from a variety of fields which have helped to shape the understanding of the issues in relation to dual diagnosis. The ten key themes are identified: the definition of the term dual diagnosis; prevelence and incidence; assessment; cognitive functioning; the reasons behind the relationship between substance misuse and mental health; contrasting perspectives; integrated care; identity and stigma; staff attitudes; and philosophy of treatment. (Edited publisher abstract)
Helping children with the Steps to Cope intervention
- Authors:
- TEMPLETON Lorna, SIPLER Ed
- Journal article citation:
- Drugs and Alcohol Today, 14(3), 2014, pp.126-136.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to summarise the findings from two projects in Northern Ireland which investigated the feasibility of adapting an existing adult intervention, the 5-Step Method, for children affected by parental substance misuse and/or parental mental illness. The structured brief psychosocial intervention is called Steps to Cope and can be delivered as an individual or group intervention. Design/methodology/approach: The two projects recruited and trained 57 practitioners from across Northern Ireland, 20 of whom went on to use the Steps to Cope intervention with a total of 43 children. Findings: It appears possible to adapt the intervention for children; to train practitioners, some of whom are able to use the intervention with one or more children; and for the intervention to benefit children in line with the five steps of the intervention targeting areas such as health, feelings, information, coping, support, and resilience. However, there are organisational and practical barriers to delivery which need to be overcome for the intervention to be more widely implemented. Originality/value: Steps to Cope is a unique intervention for this population and the findings discussed here suggest that the model has potential in an area where support for children in their own right is lacking. (Publisher abstract)
Substance use and mental health severity among LGBTQ individuals attending Minnesota model-based residential treatment
- Authors:
- KLEIN Audrey A., ROSS Buster L.
- Journal article citation:
- Journal of Gay and Lesbian Social Services, 26(3), 2014, pp.303-317.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This administrative data analysis examined substance use and mental health severity among a sample of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) individuals receiving residential treatment for an alcohol or drug use disorder. LGBTQ were statistically compared to heterosexual patients on a number of variables, including frequency and amount of pretreatment alcohol use, frequency of pretreatment illicit drug use, co-occurring Axis I mental health diagnoses, and past history of physical or sexual abuse. LGBTQ patients exhibited significantly greater severity on nearly all variables, suggesting a strong relationship between clinical severity and being a sexual minority. This study also found a relationship between patient gender and the pattern of differences between LGBTQ and heterosexual patients. These results replicate and extend those of studies examining LGBTQ in the general population and suggest opportunities for development of alcohol/drug treatment approaches that address the unique needs of LGBTQ. (Publisher abstract)
Psychosocial groupwork for older adults having substance use and mental health issues: the participants speak
- Authors:
- WHITE-CAMPBELL Marilyn, LUKETIC Lea, MacDONALD Stephanie
- Journal article citation:
- Groupwork, 24(1), 2014, pp.60-80.
- Publisher:
- Whiting and Birch
Community Outreach Programs in Addictions (COPA) is a Canadian organisation that assists older adults who live with substance misuse and mental health issues. COPA College, a psycho educational mutual aide support group consists of weekly group sessions. The programme uses a Solution Focussed approach which provides support to socially disadvantaged older adults with substance and mental health issues through a group format. This article sets out to evaluate participant reactions and determine if participants decrease substance use following completion of the group. One-on-one semi-structured interviews with ten participants were conducted. Participants were asked to rate the importance of different aspects of the programme and discuss alcohol intake following involvement in the group. Aspects of the programme rated highly by all the participants included learning new information, the breadth of topics discussed and the harm reduction approach taken by the programme. Finally, the general atmosphere of the group was considered very important, especially being comfortable in the group and combining humour with learning, and an opportunity for reflective, sharing peer support. (Edited publisher abstract)
Multidimensional family therapy in theory and in practice
- Author:
- DANZER Graham S.
- Journal article citation:
- Child and Youth Services, 35(1), 2014, pp.16-34.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reviews the family therapy case of an adolescent substance abuser through the lens of multidimensional family therapy (MDFT). Initially, the adolescent presented with suicidal ideation, depression, academic difficulties, and behaviour problems. The family experienced chronically high levels of conflict, which related to the mother's depression, the father's harsh discipline, and the adolescent's sister's frequent suicidal threats and outbursts. Family therapeutic interventions helped to decrease family conflict and improve the adolescent's grades and behaviour. In particular, conjoint work with the parents had a stabilizing effect on the family system. As predicted by MDFT, this stabilising effect was shown to place the adolescent on a healthier developmental trajectory. Limitations of the case and implications for future research are also presented. (Edited publisher abstract)