Search results for ‘Subject term:"mental health problems"’ Sort:
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Positive psychology in dual diagnosis: a preliminary investigation
- Authors:
- UJHELYI Katalin, CARSON Jerome, HOLLAND Mark
- Journal article citation:
- Advances in Dual Diagnosis, 9(4), 2016, pp.139-153.
- Publisher:
- Emerald
Purpose: Positive psychology is an area of rapid development in mainstream psychology, yet it has had little impact thus far in the field of dual diagnosis (DD). Effective treatment for clients with DD is limited, due to the lack of all-encompassing interventions that treat the two conditions simultaneously. The purpose of this paper is threefold: first, to discover the prevalence of DD among users of selected drug services in Manchester; second, to explore differences between DD clients and those with substance use in hope, resilience, and well-being; and third, to identify predictors of hope, resilience, and well-being in this population. Design/methodology/approach: The Snyder Hope Scale, the Connor-Davidson Resilience Scale, and the Short Warwick-Edinburgh Mental Well-being Scale were administered to 113 users of drug services through a convenience sampling method. Findings: Findings from this preliminary investigation indicated that the DD group were more vulnerable as they were less hopeful, less resilient, and had poorer well-being than their counterparts. Practical implications: This population of clients might benefit from specialized integrated treatment facilitating hope and resilience, which in turn would improve their well-being. Originality/value: The present study addresses a gap in the literature. Although the above positive psychological aspects have been looked at in relation to mental health, and in relation to addiction, the current research explores these positive dimensions with regard to the co-occurrence of substance abuse and mental illness. (Publisher abstract)
The lived experience of people with mental health and substance misuse problems: dimensions of belonging
- Authors:
- BLANK Alison, PRIOR Sarah, FINLAY Linda
- Journal article citation:
- British Journal of Occupational Therapy, 79(7), 2016, pp.434-441.
- Publisher:
- Sage
Introduction: People with co-occurring mental health and substance misuse problems are among the most excluded in society. A need to feel connected to others has been articulated in the occupational science literature although the concept of belonging itself has not been extensively explored within this paradigm. This paper reports findings from research that explored the meaning and experience of belonging for four people living with dual diagnosis in the United Kingdom. Method: Researchers employed an interpretative phenomenological approach to the study. Four semistructured interviews were carried out. The interviews were guided by questions around the meaning of belonging, barriers to belonging and how belonging and not belonging impacted on participants’ lives. Data analysis facilitated the identification of themes across individual accounts and enabled comparisons. Findings: Data analysis identified four themes – belonging in family, belonging in place, embodied understandings of belonging and barriers to belonging. Conclusion: The findings add further insights into the mutable nature of belonging. A link between sense of belonging and attachment theory has been proposed, along with a way to understand the changeable and dependent nature of belonging through ‘dimensions of belonging’. (Publisher abstract)
Prevalence and trajectories of psychiatric symptoms among sober living house residents
- Authors:
- POLCIN Doug, et al
- Journal article citation:
- Journal of Dual Diagnosis, 12(2), 2016, pp.175-184.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: Sober living houses are alcohol- and drug-free recovery residences that help individuals with substance use disorders maintain long-term abstinence. Given the prevalence of co-occurring mental disorders among individuals entering substance use treatment, it is likely that many such residents are also contending with psychiatric symptoms, and it is unclear how these symptoms may affect their sobriety. This study sought to describe the prevalence and trajectories of different types of symptoms among sober living house residents and examine how these symptoms affect substance use outcomes. Methods: Data for this study were collected as part of a larger study on outcomes among sober living house residents in Northern California. The current study examined data from 300 residents in two housing groups; residents were interviewed upon entry and re-interviewed at 6-, 12-, and 18-month follow-ups. Psychiatric symptoms were assessed using the Brief Symptom Inventory (BSI). General estimating equations tested changes in BSI global psychological distress and clinical symptom scales over time and examined the relationship between scale scores and substance use in longitudinal models controlling for demographics, length of stay, and psychiatric service utilisation. Results: The average age of residents was 38.5 years, and they were mostly male (80%) and Caucasian (65%). Retention rates were high, with 90% participating in at least one follow-up interview. Overall psychological distress, symptoms of depression, and phobic anxiety significantly improved over time. In all models examining the relationship between BSI scale scores and substance use, rates of abstinence and days of use among those who reported using substances also improved over time. Overall distress as well as higher scores on the somatization, depression, hostility, and phobic anxiety subscales were significantly associated with a decreased likelihood of abstinence. Symptoms of somatization were associated with an increase in the number of days substances were used among those who reported use. Conclusions: Psychological symptoms among sober living house residents improve over time, but they are risk factors for relapse, suggesting that additional support provided to residents with psychiatric symptoms could improve substance use outcomes. (Edited publisher abstract)
Integrating permanent supportive housing and co-occurring disorders treatment for individuals who are homeless
- Authors:
- SMELSON David A., et al
- Journal article citation:
- Journal of Dual Diagnosis, 12(2), 2016, pp.193-201.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objectives: This pilot study examined the feasibility and preliminary outcomes of systematically integrating permanent supportive housing and an evidence-based co-occurring disorders intervention called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking (MISSION). Methods: This single-group open pilot enrolled 107 people with co-occurring disorders experiencing chronic homelessness from two Massachusetts inner-city and rural areas. Enrolled subjects were interested in receiving permanent supportive housing along with 1 year of MISSION services. Data were collected through baseline and 6- and 12-month follow-up assessments. Results: Participants were mostly male (76.6%), Caucasian (52.3%), and unemployed (86.0%), with an average of 8.34 years of homelessness. Self-reported lifetime problems with anxiety (75.7%) and depression (76.6%) were common, as was use of alcohol (30.8%), cannabis (31.8%), and cocaine (15.9%). Almost all participants (95.3%) were placed into permanent housing, which took on average 42.6 days from enrollment. Among those placed, nearly 80% of the clients were able to retain housing through the end of the study. Overall retention was high, with 86.0% remaining in MISSION treatment until the end of the study. While there were no significant changes in rehospitalisation, service utilisation, or substance use, there were modest significant mental health symptom improvements from baseline to program completion. Conclusions: This pilot study suggests that co-occurring disorder interventions like MISSION are feasible to integrate with permanent supportive housing despite the somewhat differing philosophies, and preliminary data suggested substantial improvements in housing and modest improvements in mental health symptoms. While caution is warranted given the lack of a comparison group, these findings are consistent with other rigorous studies using MISSION among homeless individuals who did not receive permanent supportive housing. (Edited publisher abstract)
More than shelter: supported accommodation and mental health
- Author:
- BOARDMAN Jed
- Publisher:
- Centre for Mental Health
- Publication year:
- 2016
- Pagination:
- 36
- Place of publication:
- London
This report looks at evidence about the provision of supported housing for people with mental health problems in England, including those with multiple needs and substance misuse, and presents key themes for its future development. It highlights the significant links between housing and mental wellbeing, indicating that factors such as overcrowding, insufficient daylight and fear of crime all contribute to poorer mental health. The review identifies a wide range of types of housing support, including help for people to remain their own tenancies to specialist supported accommodation, hostels, crisis houses and the Housing First approach. Although the review identified limited evidence about what kinds of housing support are most effective and cost-effective, small-scale studies suggest that housing support can reduce the costs of hospital stays. When looking at the type of support people want, the literature found most people prefer help in their own homes to being in sheltered or transitional accommodation. The report calls for better provision of housing support and also argues that housing support should be funded jointly by local authorities and the NHS to ensure that services are delivered in partnership between health, housing and social care providers. (Edited publisher abstract)
Substance misuse in life and death in a 2-year cohort of suicides
- Authors:
- GALWAY Karen, et al
- Journal article citation:
- British Journal of Psychiatry, 208(3), 2016, pp.292-297.
- Publisher:
- Cambridge University Press
Background: Although substance misuse is a key risk factor in suicide, relatively little is known about the relationship between lifetime misuse and misuse at the time of suicide. Aims: To examine the relationship between substance misuse and subsequent suicide. Method: Linkage of coroners' reports to primary care records for 403 suicides occurring over 2 years. Results: With alcohol misuse, 67% of the cohort had previously sought help for alcohol problems and 39% were intoxicated at the time of suicide. Regarding misuse of other substances, 54% of the cohort was tested. Almost one in four (38%) tested positive, defined as an excess of drugs over the prescribed therapeutic dosage and/or detection of illicit substances. Those tested were more likely to be young and have a history of drug misuse. Conclusions: A deeper understanding of the relationship between substance misuse and suicide could contribute to prevention initiatives. Furthermore, standardised toxicology screening processes would avoid diminishing the importance of psychosocial factors involved in suicide as a ‘cause of death’. (Publisher abstract)
Dual diagnoses among detained female systematic offenders
- Authors:
- BLAAUW Eric, et al
- Journal article citation:
- Advances in Dual Diagnosis, 9(1), 2016, pp.7-13.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine the prevalence of psychopathology including substance use disorders in a sample of detained female systematic offenders. Design/methodology/approach: All case files of female systematic offenders who had been subjected to a special court order for systematic offenders in the period 2004-2014 were studied. A total of 81 fairly complete case files were selected for the study. These were all systematic offenders as they had been sentenced for at least 25 offences with an average of 102 offences over a period of 17.5 years. Findings: All except one woman were addicted to substances in the past year, with an average duration of addiction of 21 years. In addition, 53 per cent were diagnosed with another DSM Axis I disorder and 73 per cent were diagnosed with a personality disorder. Furthermore, 32-59 per cent were found to have intellectual dysfunctions. In total, 12 per cent had one type of the above disorders, 43 per cent two types, 31 per cent three types and 14 per cent all four types. The prevalence rates of these disorders were higher than those reported in other prison studies. Research limitations/implications: It is concluded that female systematic offenders can be characterised as problematic in many respects. Even in such a problematic group treatment can be provided. (Edited publisher abstract)
The impact of the crisis on homelessness in Spain: social intervention in a context of greater need and fewer resources
- Authors:
- MARQUEZ Gorka Moreno, URRAZA Xabier Aierdi
- Journal article citation:
- European Journal of Social Work, 19(1), 2016, pp.31-45.
- Publisher:
- Taylor and Francis
The purpose of this article is to deepen the understanding of the impact of the social and economic crisis on homeless people in Spain. To this end we present the results of research carried out prior to the crisis and later updated in the midst of the economic recession, underscoring the main results obtained in both periods and tracing their evolution. The number of homeless people in Spain has risen as a result of the crisis. Moreover, while some characteristics of this group remain the same, others have changed. Hence, difficulties in access to the labour market and cuts in certain economic benefits are resulting in an increase in the duration of social inclusion processes. This results in a worsening of the personal situation of the homeless, especially in relation to mental illness and substance abuse. The immigrant population is the group most affected by these impacts. The situation clearly demonstrates the need to reflect on how to deal with the problem of homelessness in Spain, and to rethink the way professionals intervene, especially during periods of economic recession. (Publisher abstract)
Childhood sexual abuse and substance abuse: a gender paradox?
- Authors:
- TONMYR Lil, SHIELDS Margot
- Journal article citation:
- Child Abuse and Neglect, 63, 2016, pp.284-294.
- Publisher:
- Elsevier
The authors examine associations between childhood sexual abuse (CSA) and substance abuse, the role of mental health indicators as mediators in these associations and whether or not associations differ by gender. Data are from 14,063 respondents aged 18–76 years from the 2004–2005 Canadian Gender, Alcohol, and Culture: An International Study (GENACIS). Multiple logistic regression models were used to examine associations between CSA and substance abuse variables, controlling for socio-demographic factors. Odds were adjusted by indicators of mental health to assess if these variables mediated associations between CSA and substance abuse. Tests of interactions between sex and CSA were conducted to see if gender differences exist in associations. In 2004/2005, CSA was reported by 14% of women and 5% of men. CSA was associated with heavy drinking, hazardous drinking, and the use of marijuana, other illicit drugs, and off-label drugs. Associations were only very marginally attenuated when controlling for depression and self-perceived emotional/mental health. In all cases previously observed significant associations persisted. Evidence of gender differences in associations between CSA and substance abuse was negligible. Preventing CSA may also reduce substance abuse. (Edited publisher abstract)
The cost of late intervention: EIF analysis 2016
- Authors:
- CHOWDRY Haroon, FITZSIMONS Peter
- Publisher:
- Early Intervention Foundation
- Publication year:
- 2016
- Pagination:
- 21
- Place of publication:
- London
Updates the 2015 report from the Early Intervention Foundation on the financial cost of late intervention for children and young people in England and Wales. 'Late intervention' covers the cost of acute, statutory and essential services that are required when children and young people experience significant difficulties in life, many of which might have been prevented. The report analyses how the estimated cost of late intervention has changed since the 2015 report, looks at how the costs are spread across different public agencies and looks at how spending varies across England and Wales. The cost analysis included: crime and anti-social behaviour, school absence and exclusion, children’s social care, child injuries and mental health problems, substance misuse, and youth economic inactivity. It estimates that nearly £17 billion per year, equivalent to £287 per person, is spent by the state late intervention. Whilst the estimated cost of late intervention has not changed since the 2015 report, the analysis shows that its profile has changed. Costs due to domestic violence and abuse has risen to £5.2 billion, while the cost of criminal justice for children and young people is lower, driven by reductions in the youth justice system caseload and the number of recorded incidents of anti-social behaviour. The analysis also found the amount spent on late intervention varied significantly across England and Wales. Using spend per person in each local authority as a basis for comparison, an average cost £298 ranged from a low of £164 to a high of £531, with higher levels of late intervention spending more likely to found in areas with higher levels of deprivation. It concludes that in order to tackling injustice and increasing social mobility for children and families, investment in effective early intervention should be targeted in particular on service areas where spending on late intervention is high. The accompanying technical report sets out in detail the data sources and methods used. (Edited publisher abstract)