Browsing by Author "Holloway, Evan D."
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Item Barriers and facilitators to treatment participation by adolescents in a community mental health clinic(2013-05-17) Oruche, Ukamaka M.; Downs, Sarah M.; Holloway, Evan D.; Burke Draucker, Claire; Aalsma, Matthew C.An estimated 40–60% of children in mental health treatment drop out before completing their treatment plans, resulting in increased risk for ongoing clinical symptoms and functional impairment, lower satisfaction with treatment, and other poor outcomes. Research has focused predominately on child, caregiver, and family factors that affect treatment participation in this population and relatively less on organizational factors. Findings are limited by focus on children between 3 and 14 years of age and included only caregivers’ and/or therapists’ perspectives. The purpose of this descriptive qualitative study was to identify organizational factors that influenced participation in treatment, with special attention to factors that contributed to dropout in adolescents. The sample included 12 adolescent–caregiver dyads drawn from two groups in a large public mental health provider database. Analysis of focus group interview data revealed several perceived facilitators and barriers to adolescent participation in treatment and provided several practical suggestions for improving treatment participation. Implications of the findings for psychiatric mental health nurses and other clinicians who provide services to families of adolescents with mental health concerns are discussed.Item Connection to mental health care upon community reentry for detained youth: a qualitative study(Springer Nature, 2014-02-05) Aalsma, Matthew C.; Brown, James R.; Holloway, Evan D.; Ott, Mary A.; Pediatrics, School of MedicineBackground: Although detained youth evidence increased rates of mental illness, relatively few adolescents utilize mental health care upon release from detention. Thus, the goal of this study is to understand the process of mental health care engagement upon community reentry for mentally-ill detained youth. Methods: Qualitative interviews were conducted with 19 youth and caregiver dyads (39 participants) recruited from four Midwest counties affiliated with a state-wide mental health screening project. Previously detained youth (ages 11-17), who had elevated scores on a validated mental health screening measure, and a caregiver were interviewed 30 days post release. A critical realist perspective was used to identify themes on the detention and reentry experiences that impacted youth mental health care acquisition. Results: Youth perceived detention as a crisis event and having detention-based mental health care increased their motivation to seek mental health care at reentry. Caregivers described receiving very little information regarding their child during detention and felt "out of the loop," which resulted in mental health care utilization difficulty. Upon community reentry, long wait periods between detention release and initial contact with court or probation officers were associated with decreased motivation for youth to seek care. However, systemic coordination between the family, court and mental health system facilitated mental health care connection. Conclusions: Utilizing mental health care services can be a daunting process, particularly for youth upon community reentry from detention. The current study illustrates that individual, family-specific and systemic issues interact to facilitate or impair mental health care utilization. As such, in order to aid youth in accessing mental health care at detention release, systemic coordination efforts are necessary. The systematic coordination among caregivers, youth, and individuals within the justice system are needed to reduce barriers given that utilization of mental health care is a complex process.Item How Previously Detained Youths Perceive “Mental Health” and “Counseling”(Elsevier, 2019-07) Brown, James R.; Holloway, Evan D.; Maurer, Erica; Bruno, David G.; Ashirifi, Gifty D.; Aalsma, Matthew C.; Pediatrics, School of MedicineThis study explored previously detained youths' perceptions of the term “mental health” and related stigma. The study also examined how the youth see and compare “mental health” to “counseling” services. Qualitative interviews were conducted with an ethnically diverse, purposeful sample of 19 youth aged 11–17 who scored high on the Massachusetts Youth Screening Instrument (MAYSI-2) for mental health disorders. Our findings suggest that participants often found it difficult to disclose that they were receiving mental health services to non-primary friends. Overall, there were negative and inaccurate perceptions of mental health. Furthermore, this terminology was not easily understood and was associated with mental health stigma. Given this negative association with “mental health,” our results suggest that this term could represent, in and of itself, a significant barrier to accessing treatment that requires further investigation. These findings should prompt researchers, policy makers, and mental health professionals to evaluate alternative names or descriptions of mental health services to reduce both internal and external stigma.Item Job-Related Burnout among Juvenile Probation Officers: Implications for Mental Health Stigma and Competency(APA, 2015-08) White, Laura M.; Aalsma, Matthew C.; Holloway, Evan D.; Adams, Erin L.; Salyers, Michelle P.; Department of Psychology, School of ScienceThe high demands and responsibilities of probation work, particularly with juvenile clients, may lead to burnout, which can negatively impact how probation officers work with clients, particularly individuals with behavioral health concerns. Yet, research examining burnout and related outcomes among juvenile probation officers (JPOs) is limited. We surveyed 246 JPOs in a Midwestern state to identify the prevalence, predictors, and potential outcomes of burnout. JPOs reported moderate levels of burnout; about 30% of the sample scored in the high range for emotional exhaustion and cynicism. Contrary to study hypotheses, there were no group-level differences in burnout scores across gender, race/ethnicity, age, or education. In regression models, burnout was predicted by being White (vs. minority), serving in an urban (vs. rural) county, dissatisfaction with department guidelines, job dissatisfaction, viewing job role as more treatment-oriented along the enforcement−treatment continuum, and turnover intention. JPOs with burnout were more likely to endorse mental health stigma and lack of mental health competency to address juvenile clients with behavioral health concerns. Findings suggest burnout prevention and intervention programs should be considered for JPOs to increase job satisfaction, limit job turnover, reduce burnout, and possibly increase effective practices for managing juvenile clients with behavioral health needs.Item Motivating compliance: Juvenile probation officer strategies and skills(Taylor & Francis, 2017) Schwartz, Katherine; Alexander, Andrew O.; Lau, Katherine S. L.; Holloway, Evan D.; Aalsma, Matthew C.; Department of Pediatrics, School of MedicineJuvenile probation officers aim to improve youth compliance with probation conditions, but questions remain about how officers motivate youth. The study’s purpose was to determine which officer-reported probation strategies (client-centered vs. confrontational) were associated with their use of evidence-based motivational interviewing skills. Officers (N = 221) from 18 Indiana counties demonstrated motivational interviewing skills by responding to scenarios depicting issues common to youth probationers. Results of a hierarchical multiple regression analysis indicated that, while officer endorsement of client-centered strategies was not associated with differential use of motivational interviewing skills, officers endorsing confrontational strategies were less likely to demonstrate motivational interviewing skills.Item Participants’ Perspectives of a Worksite Wellness Program Using an Outcome-Based Contingency Approach(Indiana University School of Social Work, 2017-12) Bruno, David Gerard; Brown, James R.; Holloway, Evan D.; School of Social WorkWorksite wellness programs in the U.S. are increasingly common. Social workers in healthcare and administration should familiarize themselves with the various wellness programs and the impact they have on workers and organizations. This study examined a worksite wellness outcome-based contingency approach (WWOCA). This approach bases individual employee health insurance discounts on each participant achieving biometric goals. A mixed-method explanatory approach was used. Quantitative health measures of participants (n = 397) and six focus group discussions (n = 45) were conducted using a convenience sample. Results indicate that over half of the participants met their work-based health goals (i.e., body measurements at the average or excellent rankings) with increases from 56% in year one to 87% in year two and 90% by year three. However, focus group participants expressed a high sense of failure in relation to health goal attainment, frustration with loss of the financial incentive, and stress and anxiety linked to negative feedback about their body measurements. These results suggest that many participants’ self-worth was negatively impacted when participants had difficulty conforming to worksite wellness standards. Social workers in healthcare and administration will need to advocate for worksite wellness programs that promote human dignity and avoid discriminating based on employee health status.Item Racial Heterogeneity and Mental Illness: A Study on Detained Youth Across Multiple Counties(APA, 2015-09) Lau, Katherine S. L.; Aalsma, Matthew C.; Holloway, Evan D.; Wiehe, Sarah E.; Vachon, David D.; Department of Pediatrics, IU School of MedicineA majority of detained adolescents experience mental health and substance use problems. Limited research has examined the interaction between the race/ethnicity of an individual youth and county-level racial heterogeneity on adolescent mental health outcomes. Participants were identified through a statewide mental health screening project that took place in detention centers across 11 different counties in a Midwestern state during January 1, 2008, to May 10, 2010. A total of 23,831 detained youth (ages 11–18 years), identified as non-Hispanic White (46.6%), Black (43.5%), or Hispanic (9.8%), completed a mental health screener that assessed problems in alcohol/drug use, depression-anxiety, anger-irritability, trauma, somatic complaints, and suicide ideation. Census data were gathered to determine the racial heterogeneity of each county and other county-level variables. Hierarchical linear regression analyses were used to test the independent and interactive effects of youth race/ethnicity and county-level variables (including racial heterogeneity of the county) on adolescent mental health. Independent of other community characteristics, as county-level racial heterogeneity increased, mental health problems among detained youth decreased. In future research on the development and persistence of mental health problems in detained youth, both community and individual-level factors should be considered.