- Browse by Subject
Browsing by Subject "Mental Health"
Now showing 1 - 10 of 52
Results Per Page
Sort Options
Item Activation in Persons with Opioid Use Disorders in Intenstive Outpatient Treatment(2021-12) Keen, Alyson Yvonne; Lu, Yvonne; Draucker, Claire Burke; Oruche, Ukamaka; Mazurenko, OlenaPersons with opioid use disorder (OUD) often receive intensive outpatient treatment (IOT) but these programs are associated with low rates of completion and high rates of relapse. Enhancing patient activation - taking an active role in one’s healthcare - would likely improve outcomes for persons with OUD in IOT. The overarching purpose of this dissertation is to describe how persons with OUD experience IOT, especially regarding activation. The dissertation includes three components. The first is an integrative review of 29 studies of activation in persons with mental health disorders generally. Results revealed that activation was related to several heath and treatment-related factors and some interventions, most notably educational programs, increased activation. The second and third components were based on interviews with 14 persons who had been enrolled in an IOT program in academic health centers. The second component was a constructivist grounded theory study conducted to describe the process people undergo as they participate in an IOT program. Participants described a process of connecting and disconnecting that included eight stages: (1) connecting with drugs, (2) disconnecting from everyday life, (3) connecting with the IOT program, (4) connecting with others in the IOT program, (5) disconnecting from drugs, (6) reconnecting with others, (7) reconnecting with self, and (8) disconnecting from the IOT program. The third component was a qualitative descriptive study conducted to describe types of instances in which persons play an active role in their IOT (activation). Participants described six types of instances: (1) making and enacting one’s own treatment decisions, (2) actively engaging in treatment planning with staff, (3) choosing to actively engage in groups, (4) making a commitment to treatment, (5) taking responsibility for one’s own recovery, and (6) taking actions to avoid relapse. The results of this dissertation will inform the development of strategies to enhance activation among persons with OUD in IOT with the goal of improving engagement and program outcomes.Item Addressing mental health through therapeutic art for incarcerated mothers(2024-04-24) Briggeman, Hailey; Van Antwerp, Leah; Van Antwerp, Leah; Department of Occupational Therapy, School of Health and Human Sciences; None, NoneIncarcerated mothers have a high likelihood of experiencing trauma, mental health disorders, and substance use. Incarceration contributes to high levels of stress which affects both the mothers’ and their children’s mental wellbeing. This capstone project sought to improve incarcerated mothers’ mental wellness through a 7-week therapeutic art program focused on emotional regulation, coping skills, goal setting, self-esteem, and connectedness. Through targeting these performance skills, the goal was to improve overall mental well-being. The efficacy of this program was assessed through a pre- and post- survey taken from three staff members who work closely with the women. The results indicated changes in multiple categories, including significant changes in coping and overall connectedness. This project had an impact on multiple areas of mental health. For sustainability, a binder was created that had examples of art projects and activities to decrease stress even after the program ended. More studies should be conducted to determine the effects of therapeutic art for incarcerated women.Item ANSA: Becoming a Recovery Focused Tool(2014-11) Walton, Betty A.; Kim, Hea-WonItem Attacking the Drug Epidemic: Healthcare Delivery Perspective(2017) Oruche, Ukamaka M.Addiction is a chronic and recurring brain disease. Despite the associated symptoms and behaviors, prevention works, treatment is effective, and recovery is possible for everyone. Together we can attack current drug epidemic using a public health framework of integrated, comprehensive and multipronged approach appropriate to each person’s need.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 Bullying, Weapons Carrying, and Mental Health Outcomes Among U.S. High School Students(2019-05) Kriech, Amber C.; Hensel, Devon J.; Mintus, Kenzie L.; Seybold, Peter J.Using data from the 2007-2017 cycles of the national Youth Risk Behavior Survey (YRBS), this researcher aimed to understand how weapons carrying mediates the association between bullying and mental health outcomes. I dichotomized four bullying outcomes to create one new carried a weapon after bullied (CWB) (no/yes; e.g. did not carry a weapon post-bullying vs. did carry a weapon post-bullying) for each bullying type. Mental health outcomes included (all dichotomized, past 2 weeks, no/yes): felt sad or hopeless, seriously considered suicide, had a plan for suicide and attempted suicide. I used descriptive statistics and binary logistic regression adjusted for YRBS sampling methods and weighting (Stata 15.0). Initial results showed that weapons carrying has a complex relationship with mental health after bullying. One notable finding is that individuals who had been in a physical fight were the most likely to carry a weapon (N = 268), followed by those who had been threatened at school (N = 233). Additionally, more students who had been bullied at school (N = 185) carried a weapon than those who were victims of cyberbullying (N = 166). Another interesting result found that across all bullying types, males were 2 to 3 times more likely to carrying a weapon as a result of being bullied. In terms of mental health, being threatened at school was the most significant bullying type in relation to suicidal ideation.Item Closing the Gap between School & Community Partnerships, A Needs Assessment in Indianapolis, 2021(MCCY, 2021-01) Education Action Team, Early Intervention Planning CouncilOur children spend a significant amount of time in school – and success in school sets the foundation for successful careers and contribution to our communities. However, in recent decades, we have seen what the disinvestment to public education has done to individual schools and school systems. The past year, during the Covid-19 global pandemic, schools have faced even more challenges, navigating school closures, virtual learning, and hybrid models. Research clearly connects multiple external factors and academic success. With a global pandemic layered onto limited funding and capacity, schools continue to struggle to provide the supports students and their families need to address the challenges and struggles reflected in the classroom. In 2018, the Education Action Team of Marion County’s Early Intervention Planning Council launched an assessment to identify the issues impeding student success from the perspective of school personnel. Additionally, we sought to identify barriers to building stronger partnerships with community resources. Marion County, Indiana is resource rich but systems poor – our community lacks a cohesive network of community services for schools to tap into, thus teachers and staff navigate a fragmented system. Through an online survey, three community conversations, and key informant interviews, we were able to identify key findings that can inform strategic actions moving forward to strengthen the ability of schools to meet student needs – whether they develop within the classroom or not. Our findings show some of the top issues impacting student success are challenges that all exist outside of the school building: • Social and Emotional Health • Trauma and Violence • Mental Health • Chronic Absenteeism • Social Media and Internet School staff are often left trying to address the symptoms of these complex, adaptive challenges, yet they do not have the capacity to fully tackle the root causes nor should they be expected to do so alone. This emphasizes the need to build strong partnerships with community resources, in addition to building the capacity of school personnel to carry out effective solutions inside the classroom. Moreover, schools realize that family engagement is a proactive strategy to support students and building trust with families is paramount. Stronger school-community partnerships and networks will more effectively work towards the systems change necessary to support learning. The recommendations put forth in this report work across multiple levels to provide holistic solutions to the complex problems discussed in our findings from the assessment. Schools and community organizations can join us in taking the necessary steps to building supportive community networks around our schools and advocating for the investment needed to create safe, healthy learning environments for our children.Item Co-occurring Substance Use and Mental Health Needs: Enhancing the Adult Needs and Strengths Assessment (ANSA) to Manage Services(2019-10-04) Walton, Betty A.; Kim, Hea-WonSubstance use disorders (SUD) are common, affecting one in 25 adolescents (ages 12 -17), one in seven young adults (ages 18 to 25), and one in 16 adults (ages 26 and older) during 2017. 1 While 16.7% of adults without SUD experienced mental health (MH) disorders, 45.6% of adults with SUD experienced co-occurring MH disorders.1 Related research found much higher rates of adults with MH or SUD disorders (50-75%) have co-occurring disorders. 2, 3, 4, 5 Co-occurring MH and SUD make treatment more difficult, increase use of health resources, and interfere with individuals’ life functioning.2, 3, 4 In response to the opioid crisis, SUD treatment funding and services are expanding. Effective treatment requires identification of co-occurring disorders (COD). The goal of this study was to examine how well practitioners assess and identify COD in practice.Item Community Transition: Addressing Factors that Lead to Readmission in Inpatient Psychiatric Units(2021-05-07) Chim, Chhattrah; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Button, JoPsychiatric readmission is a common problem for individuals with psychiatric illness worldwide. Approximately one in seven individuals hospitalized for psychiatric illness are readmitted within 30 days of discharge. 30-day readmission is a common outcome measure to indicate quality of patient care. Frequent readmission for patients decreases their quality of life, disrupts their recovery, and fosters dependence on psychiatric services. The purpose of this doctoral capstone experience is to develop a clinically useful screening tool used to identify at-risk patients for readmission to improve transition into the community. In doing so, effective patient-centered interventions focused on individualized needs can be provided to possibly decrease the risk of readmission. The screening tool was developed using retrospective clinical data collected from electronic medical records of all patients readmitted to SEMHRC within 30 days of discharge in 2020. The screening tool examines 5 domains which include previous admissions, risk of harm to self and others, individual factors, community barriers, and engagement in treatment. In 2020, Sandra Eskenazi Mental Health Recovery Center discharged 1,119 patients. Of those patients discharged, 10.3% readmitted within 30 days at least one or more times. A bivariate analysis was done using the developed screening tool on 19 patients that were first time users of the psychiatric unit comparing their hospital index admission to following hospital readmissions. These patients averaged a score of seven on the screening tool for risk of readmission. Individuals with 3+ readmissions within 30 days of prior hospitalization had an average score of 12.7 upon assessment. The study showed that the higher score on the screening tool increased the probability of readmission. The study shows the use of a screening tool to assess patients' risk of readmission on a psychiatric unit has the potential to improve delivery of mental health services.Item Core domains of shared decision-making during psychiatric visits: scientific and preference-based discussions(Springer, 2015-01) Fukui, Sadaaki; Matthias, Marianne S.; Salyers, Michelle P.; Department of Psychology, School of ScienceShared decision-making (SDM) is imperative to person-centered care, yet little is known about what aspects of SDM are targeted during psychiatric visits. This secondary data analysis (191 psychiatric visits with 11 providers, coded with a validated SDM coding system) revealed two factors (scientific and preference-based discussions) underlying SDM communication. Preference-based discussion occurred less. Both provider and consumer initiation of SDM elements and decision complexity were associated with greater discussions in both factors, but were more strongly associated with scientific discussion. Longer visit length correlated with only scientific discussion. Providers' understanding of core domains could facilitate engaging consumers in SDM.