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Mental health issues are a growing concern for individuals and the public. When patients do not attend their mental health appointments they place themselves at risk for poor health outcomes including worsening of symptoms, relapse, hospitalization, or danger to self and other behaviors. The breadth, background, and significance of this

Mental health issues are a growing concern for individuals and the public. When patients do not attend their mental health appointments they place themselves at risk for poor health outcomes including worsening of symptoms, relapse, hospitalization, or danger to self and other behaviors. The breadth, background, and significance of this issue were investigated to determine a clinically relevant PICOT question. These elements of the PICOT question were investigated and high-quality evidence was gathered, analyzed, and synthesized in order to develop recommendations for an evidence-based project to help with no-shows at a non-profit integrated healthcare organization that is experiencing a high incidence of no-shows. The Quality Health Outcomes Model and Ottawa Model of Research Use guide the implementation and monitoring of the project.

A chart review was completed in order to understand the impact of a novel automated reminder system on the no-show rate for all psychiatric appointments for 18 months. Additionally, demographic and appointment information was gathered to identify trends in the data and factors related to appointment status. The no-show rate significantly increased in 2019 with the new reminder system. No-shows occurred significantly more in males, tele-medicine appointments, and hospital discharge appointments. There were significant differences in no-show rates observed between reported races, with different providers, and at different practice locations. This gap analysis has provided insight into further projects and work to be completed in order to decrease no-shows, improve treatment compliance, produce better health outcomes, and increase revenue for this organization.

ContributorsHartman, Mykaila (Author) / McIntosh, Dr. Wayne (Thesis advisor)
Created2020-04-30
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Adolescents in the U.S. are experiencing a growing epidemic of maladaptive coping. The increasing occurrence of these behaviors make it likely that school personnel will continue to see an increase in adolescents presenting with maladaptive coping patterns, such as nonsuicidal self-injury and suicide, highlighting the urgency for continued research regarding

Adolescents in the U.S. are experiencing a growing epidemic of maladaptive coping. The increasing occurrence of these behaviors make it likely that school personnel will continue to see an increase in adolescents presenting with maladaptive coping patterns, such as nonsuicidal self-injury and suicide, highlighting the urgency for continued research regarding effective education. Nonsuicidal self-injury is highly correlated with suicidal behavior, and suicide is the second leading cause of death among ten to nineteen year olds in the US. Research points to the use of a specific type of Coping Skills Training known as Mental Health Literacy that reduces the chances that maladaptive coping will become the norm in adulthood.
ContributorsLandon, Rebecca J. (Author) / McIntosh, Wayne (Thesis advisor)
Created2019-04-15
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Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident attributed in part to disruptions and imbalances within the family system. Equine assisted learning is a complementary and alternative approach to family therapy which is being used increasingly to promote mental health in

Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident attributed in part to disruptions and imbalances within the family system. Equine assisted learning is a complementary and alternative approach to family therapy which is being used increasingly to promote mental health in both adults and children. This study sought to build and deliver an evidence-based, family-centered equine assisted learning program aimed at promoting family function, family satisfaction and child social-emotional competence, and to measure its acceptability and preliminary effect.

Method: Twenty families with children 10 years and older were recruited to participate in a 3-week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona. Sessions included groundwork activities with horses used to promote life skills using experiential learning theory. The study design included a mixed-method quasi-experimental one-group pretest posttest design using the following mental health instruments: Devereaux Student Strengths Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to measure child social-emotional competence, family function, and family satisfaction, respectively. Acceptability was determined using a Likert-type questionnaire with open-ended questions to gain a qualitative thematic perspective of the experience.

Results: Preliminary pretest and posttest comparisons were statistically significant for improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M = 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable magnitude of change over the three-week period. The intervention was highly accepted among both children and adults. Themes of proximity, self-discovery, and regard for others emerged during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month follow-up remain in-progress, a topic available for future discussion.

Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion of child social-emotional intelligence strengthened in part by the promotion of family function and family satisfaction. For mental health professionals, these results serve as a reminder of the alternatives that are available, as well as the importance of partnerships within the community. For therapeutic riding centers, these results help equine professionals validate their programs and gain a foothold within the scientific community. Additionally, they invite future riding centers to follow course in incorporating evidence into their programs and examining new directions for growth within the mental health community.
ContributorsSolarz, Allison (Author) / Chen, Angela (Thesis advisor)
Created2019-05-02