Matching Items (5)

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Improving the Care Transition to Outpatient Aftercare Services Following Addiction Treatment

Description

The chronic nature of substance use disorder requires continuity of care after residential treatment. Only a small proportion of patients, however, adhere to aftercare follow-up plans and the relapse rates

The chronic nature of substance use disorder requires continuity of care after residential treatment. Only a small proportion of patients, however, adhere to aftercare follow-up plans and the relapse rates remain between 40- 80% within a year post-discharge. Synthesis of evidence showed that facilitated referral (FR) significantly increased follow- up adherence and resulted to positive outcomes. The study aimed to examine the effectiveness of FR in improving access, follow-up adherence and engagement to aftercare services, and relapse rate after a month post- discharge.

After the Institutional Review Board approval, 30 participants were recruited in two residential treatment facilities. Questionnaires, the Assessment of Warning Signs of Relapse and Health leads surveys were utilized to collect data. Data were analyzed using descriptive statistics, McNemar, and Wilcoxon signed rank tests. Results showed that FR significantly increased access to many community aftercare services (p<.05). A significant reduction in relapse risk post-intervention was also noted (Z= -3.180, p= .001). Additionally, most participants discharged with scheduled appointments followed-up and had continued engagement with aftercare services. Eight participants maintained sobriety and 18 were lost to follow-up a month post-discharge, while four relapsed in the facility.

Overall, FR increased access to needed aftercare services and significantly decreased the relapse percentage risk post-discharge. FR is a promising intervention that can be implemented for practice. Future research is recommended to further examine the correlation with follow-up adherence and continuous engagement to aftercare services, and relapse rate at 30 days after discharge.

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Created

Date Created
  • 2018-04-29

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Uncharted territory: experiences of foster care youth navigating the mental health system as they age out of care

Description

Youth who turn 18 in the foster care system often face the difficulty of transitioning to adulthood without traditional emotional and financial supports. Early experiences of trauma impact their mental

Youth who turn 18 in the foster care system often face the difficulty of transitioning to adulthood without traditional emotional and financial supports. Early experiences of trauma impact their mental health and receipt of services both while in care as well as decisions whether to continue services after leaving care.

Using the behavior analytic model, this dissertation explores the challenging and supportive situations former foster youth experience with mental health services while transitioning to adulthood. Qualitative interviews and focus groups inform the development of a quantitative instrument in a mixed methods, sequential exploratory research design. The resulting instrument identifies the most intense and frequently encountered situations former foster youth experience, related to their mental health and transitions to adulthood.

Results indicate the most challenging situations foster youth experience during the transition are related to overwhelming expectations, receiving mixed messages from professionals, feelings of isolation, and a lack of voice and choice with regard to mental health services. Young adults in this study also emphasized the importance of responsive engagement, self-efficacy, and consistency in relationships both formally and informally.

This research provides important implications for social work practice, policy, and education. Acknowledging the voice of foster youth gives them a choice in services and allows for realistic transition planning. Developing problem-solving skills and a support network beyond foster care are necessary strategies of preparation to age out. Finally, practitioners should recognize the impact of trauma and other contextual factors when conducting assessment and treatment, to promote positive outcomes.

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Created

Date Created
  • 2015

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Coordinating care between behavioral health and primary care providers: examining agency challenges, capacity, and patient service utilization

Description

Health care in the United States has been undergoing significant changes since the 2010 passage of the Patient Protection and Affordable Care Act. One of the outcomes of this

Health care in the United States has been undergoing significant changes since the 2010 passage of the Patient Protection and Affordable Care Act. One of the outcomes of this policy was an attempt to bring physical health care and behavioral health care together in an effort to provide more coordinated care for patients. This change created an opportunity to improve the quality of care for patients, and as a result reduce high cost emergency service that could be prevented through better maintenance of chronic conditions. Three studies were conducted to examine challenges behavioral health agencies face in implementing two models of coordinated care (co-located and fully integrated), staff and organization capacity and needs, and patient service utilization by model of care coordination. The first study used site visits and interviews to capture the challenges faced by agencies. Results from this study indicated that behavioral health agencies faced a number of challenges in providing coordinated care including financial barriers, regulations, information sharing, inadequate technology, and provider training needs. The second study used a staff survey to assess agency and staff capacity and needs in providing coordinated care. The results from this study found differences in capacity based on model of coordination in multiple dimensions related to inter-agency coordination and communication, role clarity, and team cohesion. The third study examined patient service utilization for outpatient visits, inpatient visits, and emergency visits. The results indicated that patients receiving care from co-located agencies were more likely to have at least one encounter in each of the three service utilization categories compared to patients at fully integrated agencies. Overall, the three studies suggest that agencies that have or will implement models of coordinated care face significant barriers that may impact the sustainability or feasibility of such care. Given the findings on patient service utilization, it seems that coordinated care has great potential for patient level outcomes which makes addressing agency barriers even more critical.

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Created

Date Created
  • 2017

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A benefit cost analysis of the mental health outcomes of the family bereavement program

Description

The current study was a benefit cost analysis that examined mental and behavioral health and prescription drug service use data of 347 participants (212 youth and 135 caregivers) from a

The current study was a benefit cost analysis that examined mental and behavioral health and prescription drug service use data of 347 participants (212 youth and 135 caregivers) from a bereavement intervention, the Family Bereavement Program (FBP).The preliminary goals of the current study were to compare the FBP intervention and the Literature Control (LC) groups at the six year follow-up on: (a) number of participants using mental/behavioral health services and prescription drugs, (b) the frequency of use of mental/behavioral health services and prescription drugs, and (c) the costs of mental/behavioral health services and prescription drugs. The final, and primary goal, was to (d) calculate the benefits of the FBP by analyzing the monetary difference between the LC and FBP groups in terms of cost of services used and then by applying those benefits to the cost of the intervention. Data representing participating youths' and caregivers' mental health service use and prescription drug use at the sixth year post-intervention were collected, as were the costs of those services. Results indicated that fewer FBP participants used services and prescription drugs than the Literature Control (LC) participants, but FBP participants, particularly the youth, used some low intensity services more frequently whereas the LC youth used more intensive and costly services more frequently. Consequently, service costs were greater for participants in the LC group than for participants in the FBP group. The benefit cost ratio revealed that the FBP, as delivered, saved society between $.15 and $.27 in mental and behavioral health costs for every dollar spent on the intervention. Implications of these findings and directions for future research are discussed.

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Created

Date Created
  • 2011