IU Indianapolis ScholarWorks :: Browsing by Subject "Mental health services"

Browsing by Subject "Mental health services"

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Adolescents’ Perceptions of Functional Seizure Self-Management Strategies, Facilitators, and Barriers in the School Environment
(Slack, 2023) Tanner, Andrea L.; von Gaudecker, Jane R.; Buelow, Janice M.; Oruche, Ukamaka M.; Miller, Wendy R.; School of Nursing
Adolescents with functional (psychogenic nonepileptic) seizures encounter many struggles within the school environment, including stress, bullying, stigmatization, and accusations of faking seizure events. Mental health nurses and school personnel are poised to support school-based self-management; unfortunately, to date, no evidence exists to detail effective school-based self-management strategies for adolescents with functional seizures. Therefore, in the current qualitative study, we examined adolescents' functional seizure self-management, perceived effectiveness, and facilitators and barriers using semi-structured interviews analyzed using content analysis. We interviewed 10 adolescent females aged 12 to 19 years. Themes of proactive (prior to seizure warning symptoms) and reactive (after seizure warning symptoms) self-management, involving protection, perseverance, and progress monitoring, emerged. Adolescents perceived proactive strategies as primarily effective, whereas reactive strategies were less effective. Adolescents identified school nurses and personnel, family, and peers as facilitators and barriers to self-management. Mental health nurses are positioned to provide care, co-create plans, and advocate for adolescents with functional seizures in collaboration with school nurses and personnel.
Barriers to and Facilitators of Mental Health Treatment Engagement among Latina Adolescents
(SpringerLink, 2020-05) McCord Stafford, Allison; Burke Draucker, Claire; School of Nursing
Latina adolescents are more likely to experience depressive symptoms and less likely to receive mental health treatment than White peers. The purpose of this study is to describe barriers to and facilitators of engagement in depression treatment among Latina adolescents. Twenty-five Latina young women (mean age=16.7 years) with a history of depressive symptoms during adolescence participated in this qualitative descriptive study. Participants were recruited from clinical and community settings and were interviewed about their experiences with depression treatment. Using qualitative content analysis, we identified barriers to and facilitators of engagement in treatment for depression. Barriers included beliefs about depression and its treatments, negative experiences with treatment, and logistical problems. Facilitators included positive treatment outcomes, meaningful connection with a therapist, and family support of depression treatment. Mental health providers should minimize barriers and maximize facilitators to promote mental health treatment use and engagement among Latina adolescents with depressive symptoms.
Behavioral Health Care Needs, Detention-Based Care, and Criminal Recidivism at Community Reentry From Juvenile Detention: A Multisite Survival Curve Analysis
(American Public Health Association, 2015-07) Aalsma, Matthew C.; White, Laura M.; Lau, Katherine S. L.; Perkins, Anthony; Monahan, Patrick; Grisso, Thomas; Pediatrics, School of Medicine
OBJECTIVES: We examined the provision of behavioral health services to youths detained in Indiana between 2008 and 2012 and the impact of services on recidivism. METHOD: We obtained information about behavioral health needs, behavioral health treatment received, and recidivism within 12 months after release for 8363 adolescents (aged 12-18 years; 79.4% male). We conducted survival analyses to determine whether behavioral health services significantly affected time to recidivating. RESULTS: Approximately 19.1% of youths had positive mental health screens, and 25.3% of all youths recidivated within 12 months after release. Of youths with positive screens, 29.2% saw a mental health clinician, 16.1% received behavioral health services during detention, and 30.0% received referrals for postdetention services. Survival analyses showed that being male, Black, and younger, and having higher scores on the substance use or irritability subscales of the screen predicted shorter time to recidivism. Receiving a behavior precaution, behavioral health services in detention, or an assessment in the community also predicted shorter time to recidivating. CONCLUSIONS: Findings support previous research showing that behavioral health problems are related to recidivism and that Black males are disproportionately rearrested after detention.
Closing the Gap: Increasing Community Mental Health Services in Rural Indiana
(Springer Nature, 2021) Schultz, Kristi; Farmer, Sara; Harrell, Sam; Hostetter, Carol; Medicine, School of Medicine
Due to the significant need for mental health services in rural Martin County, IN and lack of providers, this study examined the current strengths of the community as well as the barriers preventing mental health service delivery. The goal of the study was to propose community-specific solutions to overcoming the barriers. Using a strengths-based approach (Saleeby in The strengths perspective in social work practice, Longman, White Plains, NY, 1992), the authors first sought to understand Martin County residents’ current experiences with mental health services. Second, the authors sought to understand Martin County residents’ opinions about church/mental health partnerships. As a result of this analysis, the authors comprised a list of feasible and sustainable recommendations for Martin County and similar rural areas that incorporate the strengths in the community, address their identified challenges, and thus created a model for mental health service provision that can be replicated in other rural communities with similar strengths as well as similar challenges.
Engagement With Mental Health Services Among Survivors of Firearm Injury
(American Medical Association, 2023-10-02) Magee, Lauren A.; Ortiz, Damaris; Adams, Zachary W.; Marriott, Brigid R.; Beverly, Anthony W.; Beverly, Beatrice; Aalsma, Matthew C.; Wiehe, Sarah E.; Ranney, Megan L.; School of Public and Environmental Affairs
Importance: Despite the prevalence of posttraumatic stress symptoms after firearm injury, little is known about how firearm injury survivors connect with mental health services. Objective: To determine facilitators and barriers to mental health care engagement among firearm injury survivors. Design, setting, and participants: A qualitative study of 1-on-1, semistructured interviews conducted within a community setting in Indianapolis, Indiana, between June 2021 and January 2022. Participants were recruited via community partners and snowball sampling. Participants who survived an intentional firearm injury, were shot within Indianapolis, were aged 13 years or older, and were English speaking were eligible. Participants were asked to discuss their lives after firearm injury, the emotional consequences of their injury, and their utilization patterns of mental health services. Data were analyzed from August 2022 to June 2023. Main outcomes and measures: Survivors' lived experience after firearm injury, sources of emotional support, mental health utilization, and their desired engagement with mental health care after firearm injury. Results: A total of 18 participants (17 were Black [94%], 16 were male [89%], and 14 were aged between 13 and 24 years [77%]) who survived a firearm injury were interviewed. Survivors described family members, friends, and informal networks as their main source of emotional support. Barriers to mental health care utilization were perceived as a lack of benefit to services, distrust in practitioners, and fear of stigma. Credible messengers served as facilitators to mental health care. Survivors also described the emotional impact their shooting had on their families, particularly mothers, partners, and children. Conclusions and relevance: In this study of survivors of firearm injury, findings illustrated the consequences of stigma and fear when seeking mental health care, inadequate trusted resources, and the need for awareness of and access to mental health resources for family members and communities most impacted by firearm injury. Future studies should evaluate whether community capacity building, digital health delivery, and trauma-informed public health campaigns could overcome these barriers to mitigate the emotional trauma of firearm injuries to reduce health disparities and prevent future firearm violence.
Mental Health Utilization Among Transgender Veterans
(American Medical Association, 2025-01-02) Lee, Joy L.; Hirsh, Adam; Radhakrishnan, Archana; Jasuja, Guneet K.; Taylor, Stanley; Dickinson, Stephanie; Mineo, Jocelyn; Carnahan, Jennifer; Weiner, Michael; Psychology, School of Science
Importance: Compared with cisgender (CG) individuals, transgender and gender-diverse (TGD) individuals experience substantial social and economic disparities that can result in adverse mental health consequences. It is critical to understand potential barriers to care and to address the causes of the disparities in the future. Objective: To characterize mental health care utilization among TGD veterans with depression. Design, setting, and participants: This cohort study used electronic health record data from the US Department of Veterans Affairs (VA) to create a 1:3 age group-matched and VA facility-matched nationwide cohort of TGD and CG veterans with documentation of depression during 2018 to 2020. Data analysis was performed from January to November 2023. Exposure: TGD identity was ascertained by diagnosis of a gender identity disorder. Main outcomes and measures: The primary outcome was mental health care utilization, including counts of outpatient (in specialty care and primary care settings), telehealth, emergency department, and inpatient visits in this cohort. Descriptive statistics were used to characterize counts of mental health utilization, and statistically significant differences between TGD and CG veterans were tested using χ2 and Fisher exact tests. Wilcoxon rank-sum tests were used to test for differences in utilization between the 2 groups. Adjusted logistic regression, controlling for age group, administrative sex, race, Charlson Comorbidity Index, and number of mental health medications (eg, antidepressant, antipsychotic, and anxiolytic medications), was also used to compare utilization between TGD and CG veterans. Results: Among 10 564 veterans with depression (mean [SD] age, 46.4 [15.2] years; 8050 male [76.2%]), 2643 TGD veterans were matched with 7921 CG veterans. TGD veterans had 6 more specialty mental health visits per year than CG veterans (mean [SD], 13.93 [20.08] vs 8.46 [14.96] visits a year; median [range], 7.14 [0.00-246.30] vs 3.76 [0.00-202.38] visits per year). In adjusted models, compared with CG veterans, TGD veterans were 2.6 times more likely to have an outpatient mental-health visit (odds ratio, 2.60; 95% CI, 2.16-3.15). Conclusions and relevance: In this cohort study of veterans with depression, TGD veterans had significantly higher utilization of mental health services compared with CG veterans, even after adjusting for several relevant health factors. Different health system resources may be required to meet the needs of this population. Further studies are needed to understand the determinants of these disparities and subsequently how to address them.
The processes of disease management in African American adolescents with depression
(2016-05-05) Al-Khattab, Halima Abdur-Rahman; Draucker, Claire Burke; Oruche, Ukamaka; Perkins, Danielle; Pescosolido, Bernice
Depression in African American (AA) adolescents is a prevalent mental health problem, can result in serious concurrent and long-term effects, and is associated with health disparities due to underutilization of mental health services. Initiatives to reduce disparities among depressed AA adolescents require a greater understanding of the experience of depression from their own point of view. The purpose of this dissertation was to generate a comprehensive theoretical framework that describes how AA adolescents experience depression throughout adolescence. The information gained about how AA adolescents understand and manage depressive symptoms, and in some cases seek and use mental health services will contribute to initiatives to reduce behavioral health disparities. This dissertation project was composed of two components. The first component was an integrative review of studies that explored associations between adolescent coping responses and depression. The integrative review summarized and integrated research from the past ten years that examined coping techniques of depressed adolescents. It revealed that the use of active coping strategies plays an important role in recovery from depression. The second component was a grounded theory study which included a sample of 22 community-based AA young adults (ages 18-21) and 5 clinic-based AA adolescents (ages 13-17). During semi-structured interviews, participants described their experiences with depression as adolescents. In addition, a timeline was constructed that included major events related to the unfolding of depression, including treatment seeking, which occurred during adolescence. Data generated from the grounded theory study were analyzed and resulted in two qualitatively derived products. The first is a typology titled Being With Others that depicts interaction patterns of depressed AA adolescents with people in their lives. The five categories in the typology are keeping others at bay, striking out at others, seeking help from others, joining in with others, and having others reach out. The second product is a theoretical framework titled Weathering through the Storm that describes how depression in AA adolescents unfolds over time. The five phases of the framework are labeled enduring stormy weather, braving the storm alone, struggling with the storm, finding shelter in the storm, and moving out of the storm.
Qualitative study of factors affecting engagement with a hospital-based violence intervention programme in Indianapolis, Indiana
(BMJ, 2024) Ortiz, Damaris; Magee, Lauren A.; Adams, Zachary W.; Marriott, Brigid R.; Moore, Reilin J.; Brooks, Blakney Q.; Boustani, Malaz; Simons, Clark J.; Psychiatry, School of Medicine
Background: There are few qualitative studies of firearm injury survivors and hospital-based violence intervention programme (HVIP) participants. The original study aimed to identify facilitators and barriers to survivors’ utilisation of mental health services. This secondary analysis aimed to identify factors that may impact engagement with an HVIP. Study design: This study was a subanalysis of an original qualitative study that used a community-based participatory research approach to conduct semistructured interviews with English-speaking, intentional firearm injury survivors aged 13 and older within Indianapolis, Indiana between 2021 and 2022. Participants were recruited by a community organisation through a snowball sampling method. Interviews were analysed using manual thematic analysis. Themes were analysed and discussed in relation to HVIPs. Results: A total of 18 interviews were completed. The majority of participants identified as black (17/18, 94.4%). Nearly all (75%) participants were between the ages of 13 and 24 years of age at the time of their shooting. During content analysis, five themes were identified: (1) delayed readiness to change, (2) desire for independence, (3) lack of trust, (4) persistent emotional and physical effects of trauma and (5) unawareness of HVIP resources. Conclusions: This qualitative analysis of firearm injury survivor experiences provided insights for improved engagement with HVIPs. Continued pursuit of survivors for several years after their injury, improved dissemination of resources, establishing trust, and addressing persistent physical and psychological symptoms while respecting participants’ desire for independence may lead to increased engagement of firearm injury survivors with HVIPs.
The Development of a Comprehensive Mental Health Service for Medical Trainees
(Wolters Kluwer, 2022) Hasan, Samia; Pozdol, Stacie L.; Nichelson, Brian K.; Cunningham, Stephanie J.; Lasek, Dana G.; Dankoski, Mary E.; Psychiatry, School of Medicine
Mental distress in medical learners and its consequent harmful effects on personal and professional functioning, a well-documented concern, draws attention to the need for solutions. The authors review the development of a comprehensive mental health service within a large and complex academic medical education system, created with special attention to offering equitable, accessible, and responsive care to all trainees. From the inception of the service in January 2017, the authors placed particular emphasis on eliminating obstacles to learners' willingness and ability to access care, including concerns related to cost, session limits, privacy, and flexibility with modality of service delivery. Development of outreach initiatives included psychoeducational programming, consultation services, and cultivation of liaison relationships with faculty and staff. Significant utilization of clinical services occurred in the first year of the program and increased further over the course of 4 academic years (2017-2021); with a 2.2 times increase in trainees served and a 2.4 times increase in visits annually. In the 2020-2021 academic year, 821 medical learners received services (for a total 5,656 visits); 30% of all medical students and 25% of house staff and fellows sought treatment in that year. In 2021, 38% of graduating medical school students and 27% of graduating residents and fellows had used mental health services at some point in their training. Extensive use of services combined with very high patient satisfaction ratings by medical learners within this system demonstrate the perceived value of these services and willingness to pursue mental health care when offered a resource that is cognizant of, and responsive to, their unique needs. The authors reflect on potential factors promoting utilization of services-institutional financial support, outreach efforts, and design of services to increase accessibility and reduce barriers to seeking treatment-and propose future areas for investigation.
The Impact of COVID-19 on Postpartum Depression and the Responsibility of the Healthcare System
(Springer Nature, 2022-08-09) DiGregory, Sydney; Githere, Nancy; Crites, Kundai; Rouse, Caroline; Shanks, Anthony L.; Obstetrics and Gynecology, School of Medicine
Peripartum depression is a common complication of pregnancy with the potential for dangerous consequences to maternal and infant health if left untreated. The disorder was previously classified as a global public health issue due to the high prevalence of the disorder and the mismatch between available treatment options and successful completion of those options. The coronavirus disease 2019 (COVID-19) pandemic increased the incidence of mental health disorders globally, with an even greater effect on peripartum mothers. A preliminary study on fetal implications suggests the resulting increased maternal stress and depressive mood symptoms correlates to worsened fetal brain development. The pandemic highlighted existing barriers to the treatment of peripartum mood disorders. The drastic increase in the use of telemedicine as a modality of treatment in response to the public health crisis has the potential to address some of these barriers. Future global disasters are inevitable with peripartum mothers highly susceptible to worsened mental health outcomes. We are thus highlighting the responsibility of clinicians, professional organizations, and policymakers to support, identify, and facilitate the treatment of postpartum depression for this vulnerable population to prevent short-term and long-term repercussions.

Browsing by Subject "Mental health services"

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