Browsing by Subject "Behavioral Health"

Now showing 1 - 10 of 11
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    CANS and ANSA Outcome Reports Reference Guide, version 3
    (2024) Walton, Betty; Moynihan, Stephanie; Hong, Stephanie; Kwon, Hyejean
    Although behavioral health disorders are common, the quality of care has not kept pace with the quality of physical health care. Measuring behavioral health care quality has slowly evolved. Suggested quality of care initiatives include a routine process (fidelity) and outcome feedback, which has been linked to improved symptoms, quality of life, and lower readmission rates. Regularly discussing and measuring personal change is recommended. To support data-informed decisions based on personal change and to improve service quality, outcome management reports based on the Child and Adolescent Needs and Strengths (CANS) and Adult Needs and Strengths Assessment (ANSA) data were developed in DARMHA, the Indiana Division of Mental Health and Addiction's data collection and reporting platform. This reference guide describes each individual or aggregate report and provides tips to access and utilize the information.
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    Collaborate, Review Data and Change; Repeat
    (2022-09-27) Walton, Betty; Wendy, Harrold
    Context. The ANSA and TCOM framework, in conjunction with related information, can support data-informed policy planning and funding initiatives. One state’s collaborative data-informed recovery strategies provide an example. The concept of recovery from mental health and substance use disorders evolved from a deficit focus to include functional and personal recovery. Through a collaborative process SAMHSA, the federal behavior health authority, developed recovery’s working definition: “a process of change through which individuals improve their health and wellness, live a self- directed life, and strive to reach their full potential” in four dimensions (Health - overcoming or managing one’s diseases or symptoms, Home – a stable and safe place to live, Purpose - meaningful daily activities, and Community - relationships and social networks that provide support, friendship, love, and hope. Recently, SAMHSA acknowledged that the 2012 framework needs to evolve and issued a Recovery Challenge to community-based organizations to highlight innovative recovery strategies and practices. The challenge requires active, meaningful involvement of individuals with lived experience. Recovery and TCOM frameworks were cross walked to support training and to inform the state’s recovery support strategies. One strategy was to create a Recovery Support Workgroup (RSW) comprised of a dozen state agencies and community stakeholders. More than 51% of RSW members have lived experience with mental health and/or substance use. This group makes data-informed recommendations to state’s Mental Health and Addiction Planning and Advisory Council. Following a statewide 2019 gap analysis, which identified recovery support needs, the RSW created subgroups to address five recovery support needs: Personal support networks, Peer support services, Hobbies and interests, Prevention and wellness, and Safe and affordable housing. Data Collection Methodology. Multiple data sources informed the subgroups’ efforts: a consumer satisfaction survey, social determinants of health survey a Lived Experience Survey distributed through recovery groups, Medicaid claims diagnoses, recovery data collected at recovery organizations, and ANSA data. All data were associated with recovery dimensions: Health, Home, Community and Purpose. For ANSA data, the process required collaboration among the state’s data management, recovery support services, and the IU CANS/ANSA technical assistance teams. Enhancing ANSA Outcome Management Reports. Outcome Management reports, available to the state team, providers, and the IU CANS/ANSA team, were modified to inform the RSW subgroups by formatting reports by recovery dimensions and additional concerns. Building on existing reports (Resolved Actionable Needs, and item level metrics (Actionable, Continuing, Clinical Progress, Newly Identified, and Worsening), three new recovery focused reports were developed. Sharing and using the data. This collaborative, data-informed recovery initiative has received national attention. A variety of strategies to disseminate and to use the results for planning and managing change will be discussed: What has worked? What has been challenging? What has not work? What are the implications for quality improvement, program evaluation, and research?
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    Divergent Caregiver and Youth Perspectives Regarding Behavioral Health Needs and Psychosocial Functioning: An Exploratory Study
    (2019-11-05) Karikari, Isaac; Walton, Betty A.; Bishop, Christine
    Background. To promote effectiveness in behavioral health treatment, the system of care framework and wraparound model accentuate inclusion of family and youth as important stakeholders, not just as consumers. This has challenged conventional practices; and youth and caregivers' perspectives have become integral to treatment planning and service delivery. This study explored caregivers and youth's perspectives of behavioral health needs and psychosocial functioning. Methods. This exploratory study utilized data collected in a Midwestern, suburban county as part of the national Child and Family Study of youth with complex behavioral health needs enrolled in the Child Mental Health Wraparound initiative. The sample consisted of 25 caregiver-youth pairs. Assessment measures included the Pediatric Symptom Checklist (PSC) and the Columbia Impairment Scale (CIS). Independent t-tests were used to examine differences in caregiver and youth perspectives. Results. Significant differences were identified in caregivers and youth's perspectives of youth's behavioral health on the PSC, but no significant differences between caregivers and youth on the CIS measure. Responses showed that compared to youth, caregivers perceived a higher level of functional impairment in interpersonal relationships, academic, and community functioning. Further, caregivers' views of severity of functional impairment varied based on the caregiver type. Conclusion. Divergent perspectives regarding youth's behavioral health needs and functioning between caregivers and youth have implications for behavioral health treatment planning and service delivery. Additional research is needed on collaborative assessments and implications of different views for practice and outcomes.
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    Exploring Disparities in Behavioral Health Service Use in the Early Stages of the Covid-19 Pandemic
    (2024-09) Walton, Betty; Hong, Saahoon; Kwon, Hyejean; Kim, Hea-Won; Moynihan, Stephanie
    This research brief highlights the findings and takeaways from a published study comparing behavioral health service use by adults during the early COVID-19 pandemic and the previous year. From 2019 to 2020, admissions increased by 46%. Although individuals with co-occurring mental health and substance use disorders experienced the most complex challenges, the greatest increase in accessing treatment was by people with mental health concerns. More women accessed services than men. Service use increased for Multiracial and Hispanic adults, decreased for African American and White people, and remained stable for American Indians. Different service access patterns and complexity may have been related to pandemic and existing factors.
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    Interventions for Family Members of Adolescents With Disruptive Behavior Disorders
    (Wiley, 2014-08) Oruche, Ukamaka M.; Burke Draucker, Claire; Alkhattab, Halima; Knopf, Amy; Mazurcyk, Jill; IU School of Nursing
    Problem - The family members of adolescents diagnosed with disruptive behavior disorders (DBDs) experience profound stress and burden. Despite the need for empirically supported interventions that address the challenges faced by these family members, few such interventions are available. Methods - In this qualitative descriptive study, we conducted in-depth interviews with 15 families of adolescents diagnosed with DBD. We asked the family members to identify what types of mental health services they needed and to describe the “ideal” program that would best address their concerns. Findings - Family members identified several intervention modalities that would fit their needs, including multifamily groups, family therapy, individual therapy, and community-based hotlines. They indicated that programs should address the following topics: family communication, conflict resolution, education about DBD, and strategies to improve interactions with child service agencies. Conclusions - Clinicians should recognize that all family members may need support to manage the stressors associated with caring for or living with adolescents with DBD. When working with families, clinicians should provide information about the etiology and management of DBD, help navigate interactions with child service agencies, and employ strategies to improve family communication and functioning.
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    Managing Recovery with Adults Involved in Behavioral Health and Criminal Justice Systems
    (2022-09-21) Hong, Saahoon; Walton, Betty
    Young adults with mental health needs experience increased criminal behaviors, peaking at 16-25 years. In addition, the lack of support for young adults' behavioral health needs increases the likelihood of further involvement in the justice system. This study aimed to predict dual behavioral health and justice system involvement for adults participating in publicly funded treatment and support services needs. Policy implications were also discussed.
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    Predicting the Behavioral Health Needs of Asian Americans in Public Mental Health Treatment: A Classification Tree Approach
    (2024-09) Walton, Betty; Hong, Saahoon; Kwon, Hyejean; Kim, Hea-Won; Moynihan, Stephanie
    As experiencing pandemic related hardships (social isolation, financial distress, and health anxiety) and racial discrimination worsened Asian American’s mental health, a study examined unique behavioral health characteristics of Asian Americans compared to White and Black Americans in behavioral health treatment. Assessment data was analyzed using descriptive and chi-squared automatic interaction detection (CHAID), a machine learning approach, to detect additional differences among groups. Asian Americans had distinct patterns of behavioral health needs compared to White and African Americans. Key takeaways inform culturally responsive practice.
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    The Intersectionality of Factors Predictng Co-occurring Disorders: A Decision Tree Model
    (2024-09) Walton, Betty; Hong, Saahoon; Kwon, Hyejean; Kim, Hea-Won; Moynihan, Stephanie
    Individuals with co-occurring psychiatric and substance use disorders (COD) face challenges accessing care, accurate diagnoses, and effective treatment. To better understand factors other than substance use, which differentiates COD from psychiatric disorders PD, a study examined the combined effects of age, gender identity, race/ethnicity, pandemic, behavioral health needs, useful strengths, and COD. Involvement in recovery, active participation in treatment and managing one’s health, was the strongest predictor of having COD. This research brief highlights finding and key takeaways with implication for creating accessible, effective services, building life functioning skills, identifying risky behavior, and person-centered recovery planning.
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    Transforming Indiana’s Behavioral Health System for Children and Their Families
    (2006-08) Walton, Betty A.
    State (Boggs, 2005) and federal (New Freedom Commission on Mental Health, 2003; SAMSHA, 2005) policy calls for the transformation of mental health care to achieve the promise of recovery so that individuals are able to live, work, learn, and participate fully in their community. Access to effective treatments and support services are necessary to realize this promise (NFCMH, 2003). Transformation is by definition more than reform; it “represents the bold vision to change the very form and function of the mental health service delivery system to better meet the needs of individuals and families it was designed to serve .... it will be a complex process that proceeds in a non-linear fashion and that requires collaboration, innovation, sustained commitment, and a willingness to learn from mistakes” (SAMHSA, section 5, 2005). Why is transformation needed? What does transformation mean for the behavioral health system for children, youth and their families in Indiana?