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Mental Health Training: Pathway to Early Mental Health Intervention

Description

There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of

There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of youth who experience a major depressive disorder. Teachers and non-teaching staff are well placed in the community to identify youth undergoing emotional distress and facilitate early interventions, yet do not receive adequate training in mental health.

A project was undertaken to determine if a mental health training intervention affected the community youth mentors knowledge, attitude and self-efficacy towards helping youth with mental health issues. Three instruments with good validity and reliability namely Mental Health Literacy Scale (MHLS), Attitudes to Severe Mental Illness (ASMI) scale, and Gatekeeper Behavior Scale were used in pre intervention, immediately post intervention and two weeks post intervention questionnaires. The Wilcoxon Signed Ranks test indicated changes in the pre and post intervention scores as significant in knowledge, and attitude between pre intervention and immediately post intervention time periods. Cohen’s effect size value suggested large, medium, small, and minimum clinical significance in the variables over period of time.

Mental health literacy narrows the gap between symptom onset and intervention. Numerous mental health trainings are currently available worldwide. Schools and after school clubs in collaboration with hospital mental health and other community agencies are better equipped to bridge the gap. School staff report better confidence in addressing mental health and behavioral health issues among youth when equipped with additional resources within the school in the form of psychologists, social workers, and counselors.

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Date Created
2020-05-03

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Screening for Posttraumatic Stress Disorder in Behavioral Health

Description

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA services, leaving over 50% seeking treatment from civilian providers. Given the high prevalence of Posttraumatic Stress Disorder (PTSD) in the military population, it is imperative to implement a valid and reliable screening tool at primary care facilities to ensure timely and accurate diagnosis and treatment.

Method: This project aimed to provide an evidence-based education for intake nurses to understand prevalence of PTSD and to use a screening tool Primary Care PTSD for DSM-5 (PC-PTSD-5) in a non-VA behavioral health facility.

Setting: The project site was a civilian behavioral health facility located in West Phoenix Metropolitan area. The behavioral health facility serves mental health and substance abuse needs. Project implementation focused on the intake department.

Measures: Sociodemographic data, PTSD diagnosis criteria, prevalence and PC-PTDSD-5 screening tool knowledge collected from pre and posttest evaluation. Patients’ charts for those admitted 6-week before and 6-week after the education to calculate numbers of screening tools completed by nurses at intake assessment.

Data analysis: Descriptive statistics was used to describe the sample and key measures; the Wilcoxon Signed Rank Test was used to examine differences between pre-test and post-test scores. Cohen’s effect size was used to estimate clinical significance.

Results: A total of 23 intake nurses (87.0% female, 65.2% 20-39 years old, 52.2% Caucasian, 95.6% reported having 0-10 years of experience, 56.5% completed Associate’s degree) received the education. For PTSD-related knowledge, the pre-test score (Mdn = 6.00) was significantly lower than the post-test score (Mdn = 10.00; Z= -4.23, p < .001), suggesting an increase of PTSD knowledge among nurses after the education. Regarding the diagnosis, the percentage of patients who were diagnosed with PTSD increased from (0.02% to 20% after the education).

Discussion: An evidence-based education aimed at enhancing intake nurses’ knowledge, confidence and skills implementing a brief and no-cost PTSD screening tool showed positive results, including an increase of PTSD diagnosis. The implementation of this screening tool in a civilian primary mental health care facility was feasible and helped patients connect to PTSD treatment in a timely fashion. Continued use of paper version of screening tool will be maintained at facility as an intermediary solution until final approval through parent company is received to implement into electronic medical records.

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Date Created
2020-05-06

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Mental Health Application in Anxiety

Description

Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being

Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being through self-management of symptoms.

Methods: A project was undertaken at an outpatient behavioral setting in urban Arizona to determine the use and effectiveness of a mental health app called insight timer to reduce anxiety symptoms. Adult clients with anxiety symptoms were provided with the insight timer app to use over a period of eight weeks. Anxiety was evaluated with the GAD-7 scale initially and after the eight weeks of app use. Usability and the quality of the app were assessed with an app rating scale at the end of the eight weeks.

Results: Findings of the Wilcoxon Signed Ranks test indicated changes in pre and posttest assessment scores as significant (p = .028), which is a significant reduction in anxiety among seven clients who completed the 8-week intervention. the mean TI score was 15.57 (SD = 4.9), and the mean T2 score was 7.71 (SD = 5.7). Besides, Cohen's effect size value (d = 1.465) suggested large clinical significance for GAD7 in pre and posttest.

Discussion: Evidence suggests that the use of an evidence-based app can effectively reduce anxiety symptoms and improve the quality of life. The use of mental health apps like insight timer could reduce health care costs associated with unnecessary hospital admissions as well as re-hospitalizations. The routine use of apps such as the insight timer may also be beneficial to all the clients who have anxiety symptoms in outpatient as well as inpatient settings.

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Date Created
2020-05-06

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Health & Wealthness Podcast

Description

Health and Wealthness is a podcast where your hosts, Emily Weigel and Hanaa Khan discuss pressing and trending topics about health and wealth that everyone should know about. Our first four episodes focus on the opioid crisis. Both the science

Health and Wealthness is a podcast where your hosts, Emily Weigel and Hanaa Khan discuss pressing and trending topics about health and wealth that everyone should know about. Our first four episodes focus on the opioid crisis. Both the science and healthcare sides. We then go on to talk about burnout and mental health in a conversational episode.

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Date Created
2021-05

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Bullying, loneliness, and future responses to stress

Description

Bully victimization has been associated with blunted cardiovascular responses to stress as well as elevated responses to stress. The difference between these altered physiological responses to stress is largely unknown. This study explored several possible moderators to the relationship between

Bully victimization has been associated with blunted cardiovascular responses to stress as well as elevated responses to stress. The difference between these altered physiological responses to stress is largely unknown. This study explored several possible moderators to the relationship between chronic stress and future cardiac output (an indicator of increased stress) in response to future stressors. These moderators include the difference between social and physical stressors and individual levels of loneliness. Participants were administered measures of loneliness and victimization history, and led to anticipate either a "social" (recorded speech) or "non-social" (pain tolerance test ) stressor, neither of which occurred. EKG and impedance cardiography were measured throughout the session. When anticipating both stressors, loneliness and victimization were associated with increased CO. A regression revealed a three-way interaction, with change in cardiac output depending on victimization history, loneliness, and condition in the physical stressor condition. Loneliness magnified the CO output levels of non-bullied individuals when facing a physical stressor. These results suggest that non- bullied participants high in loneliness are more stressed out when facing stressors, particularly stressors that are physically threatening in nature.

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Agent

Created

Date Created
2013

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The effect of stress on self-reported academic performance measures among Hispanic undergraduate students at Arizona State University

Description

Research on the impact of stress on the academic performance of Hispanic undergraduate students is limited, leaving institutions of higher education without needed information about how to better support this growing population of students. The purpose of this study was

Research on the impact of stress on the academic performance of Hispanic undergraduate students is limited, leaving institutions of higher education without needed information about how to better support this growing population of students. The purpose of this study was to identify stressors that have a negative impact on academic performance of Hispanic undergraduate students. Themes were derived from focus groups and interviews regarding stress, stressors and related academic performance impacts of Hispanic undergraduate students attending a large multi-campus urban university and incorporated into a survey addressing common stressors, their impact on academic performance, stress impact on other areas of life, stress management ability, and demographic characteristics. The survey was administered to a random sample of Hispanic undergraduate students using an online format (n = 169). Descriptive statistics were used to examine frequencies. Stressors were placed into themes and tested for reliability of fit using Cronbach's Alpha. Pearson's Chi-Square and Cramer's V were used to measure association. Significance was set at ¡Ü .05. Overall stress of respondents resulted in serious performance effects among 32.5% of respondents and moderate performance effects among 43.8% of respondents. Stress impeded academic performance at least weekly among 36.1% of respondents. Stressors resulting in the most serious stress and academic performance effects included family, time factors, finances, and academics. Moderate stress and academic performance effects were evident in stressors related to mental health, technology, commuting, personal concerns, physical health and legal problems. The majority of respondents indicated doing a fair (n = 84, 49.7%) or good (n = 52, 30.8%) job managing stress. The remaining 20.0% (n = 33) of respondents did a poor job managing stress. Students with lower grade-point averages managed stress poorly compared to students with higher grade-point averages, X2 (6, N = 163) = 15.222, p = .019, Cramer's V = .019. These findings provide evidence that stressors related to family, time factors, finances, and academics, and overall stress have considerable negative effects on the academic performance of Hispanic undergraduate students. Institutions of higher education can improve academic outcomes among this student population by addressing and reducing the impact of common stressors affecting these students.

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Created

Date Created
2012

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On the brink: experiences of women with mental illness on probation

Description

This dissertation explores the lives of women who are on the Severely Mentally Ill (SMI) caseload at Maricopa County Adult Probation in Arizona (The Phoenix metro region). The project focuses on three primary issues: (1) what are the pathways to

This dissertation explores the lives of women who are on the Severely Mentally Ill (SMI) caseload at Maricopa County Adult Probation in Arizona (The Phoenix metro region). The project focuses on three primary issues: (1) what are the pathways to the criminal justice and mental health systems for women on the SMI caseload (2) how does discretion and expansive formal social control (both benevolent and coercive) impact the lives of these women on the SMI caseload and (3) what are the gendered aspects to successful completion of SMI probation. To answer these questions a mixed-methods research design was employed. First, in-depth semi-structured interviews were completed with 65 women on the SMI caseload. Second, these interviews were supplemented with a case file review of each participant, and field observations (encompassing roughly 100 hours) were conducted at the Maricopa County Mental Health Court. Third, analysis also included 5.5 years of quantitative intake data from the SMI caseload, exploring demographic information and risk and assessment needs scores. The biographies of the women on the SMI caseload revealed similar histories of victimization, substance abuse, and relationship difficulty that previous pathways research has noted. Additionally, mental health problems directly impacted the path to the criminal justice system for some women on the SMI caseload. Results also showed many aspects of expanded social control for women on the SMI caseload. This expanded control appeared to be gendered at times and often created double binds for women. Finally, quantitative analysis showed that some predictive factors of SMI probation completion were gendered. Policy implications and summaries of findings are discussed.

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Created

Date Created
2013

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Measuring mindfulness-related constructs and the role of meditation in the association between mindfulness-related constructs and mental health among U.S. adults

Description

Mindfulness is a concept derived from the Buddhist discourses of the Satipattana. Interventions that draw on mindfulness have been shown to reduce psychologically distressing symptoms in clinical settings. It has become widely used as a therapeutic technique in counseling, so

Mindfulness is a concept derived from the Buddhist discourses of the Satipattana. Interventions that draw on mindfulness have been shown to reduce psychologically distressing symptoms in clinical settings. It has become widely used as a therapeutic technique in counseling, so it is important to develop an instrument measuring mindfulness-related constructs. This study presents a new instrument measuring the importance of mindfulness-related constructs. Results from an exploratory factor analysis revealed a clear two-factor structure, with the factors named "Present Moment Awareness", and "Compassion and Ethical Behavior." These items were positively correlated with each other and, as expected, negatively correlated with depression. Finally, hours of meditation moderated this association such that the association was stronger among participants who reported higher levels of meditation practice.

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Date Created
2014

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A constructivist grounded theory exploration of wellbeing in female adult sexual assault victims/survivors

Description

The purpose of this constructivist grounded theory study was to explore the perceptions of adult female sexual assault victims/survivors about their wellbeing: their definitions and descriptions of wellbeing; the impact of the assault on wellbeing; and barriers and facilitators to

The purpose of this constructivist grounded theory study was to explore the perceptions of adult female sexual assault victims/survivors about their wellbeing: their definitions and descriptions of wellbeing; the impact of the assault on wellbeing; and barriers and facilitators to achieving wellbeing following assault. Feminist theory provided the sensitizing concepts for this research. Data were collected via semistructured interviews with 22 adult women who had experienced at least one episode of sexual assault at or above the age of 18. Data analysis included first, second, and third level coding techniques, memo writing, and data displays. Participants experienced negative effects to their overall wellbeing as well as to the wellbeing domains of physical, mental, career/economic/financial, relational, and spiritual. The findings of this study support wellbeing as a core category encompassing the five domains listed above, also described in the literature. The participants also confirmed and expounded in depth on the dynamic, interactive, and overlapping nature of each of the domains of wellbeing and their ability to enhance, maintain, or worsen health status and overall wellbeing. In addition, a new construct emerged that cut across all domains, that of safety, and the overarching significance of culture was recognized. Additional research should continue to explore wellbeing in diverse populations of sexual assault victims/survivors. Additional research should also explore the significance and function of safety in sexual assault victims/survivors. Formal and informal supporters of sexual assault victims/survivors should be aware of the complex ways that sexual assault affects women. In addition, they should be aware of helpful resources for sexual assault victims/survivors.

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Date Created
2015

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Breaking down the barriers of stigma: understanding and fostering help-seeking behaviors in medical students

Description

Many medical students are reluctant to seek help during the course of their four years of medical school. When they do finally ask for help, some are already burned out or in a crisis. One of the main reasons students

Many medical students are reluctant to seek help during the course of their four years of medical school. When they do finally ask for help, some are already burned out or in a crisis. One of the main reasons students are apprehensive about seeking help is stigma. This mixed methods action research study was conducted to explore whether a help-seeking, anti-stigma campaign improved help-seeking behaviors. The innovation was an anti-stigma campaign consisting of three components: (a) video vignettes of upper class students normalizing help-seeking, (b) a Friends and Family of Medical Students session to educate those closest to the student about medical school, and (c) an anonymous, online mental health screening tool. Data from the General Help-Seeking Questionnaire, individual interviews, and institutional data from the medical school provided information about the effects of the campaign and determined factors influencing help-seeking. Using these strategies, I hoped to normalize help-seeking and break down the barriers of stigma. Major findings included: Students were more likely to seek help from personal resources (close family and friends); Students may be more proactive with personal resources, but need prompting for college or formal resources; Students’ beliefs and attitudes were influenced by those closest to them and; First year students were more likely to seek help than their second year classmates. In addition, data inspired future research ideas and programming regarding the topic of help-seeking in medical school.

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Date Created
2016