Behavioral Health Professionals Research Articles

School Nurses' Perceived Role and Capacity to Support School Behavioral Health Programs in DC Public and Public Charter Schools.

School nurses (SNs) practicing in DC public and public charter schools were surveyed to assess their perceived role and self-reported preparation to provide behavioral health prevention, early identification, and treatment services in schools. A total of 154 SNs completed a questionnaire about their role in the delivery of behavioral health services and supports. SNs reported they are primarily involved in the identification and referral of students to other school behavioral health professionals. Respondents also reported a lack of training in behavioral health and a desire for more information on related programs and services. This study offers recommendations for educating future SNs and highlights how the DC School Health Services Program utilized study findings to build capacity for SNs employed in practice. This study can help tailor educational opportunities for SNs to maximize their role in school behavioral healthcare process flows and ultimately improve outcomes for students and families.

Attitudes and behaviours of mental health professionals in the care of transgender people: A qualitative study.

INTRODUCTION: Transgender people face against significant barriers in accessing mental health services due to, among other reasons, discrimination and a lack of expertise among professionals. To explore the beliefs and attitudes of professionals in the mental health network of the region of Murcia towards transgender people, focusing on aspects such as knowledge, perceptions, and prejudices about gender identity. We carried out a qualitative study involving 14 participants, conducting semi-structured interviews based on prior knowledge of the topic. We asked the professionals about their experiences and challenges in their clinical interaction with transgender users and followed an inductive-deductive process to analyse the data. Two main themes were identified from the interviews, which were sub-categorised into different sub-themes: (a) beliefs about transgender people: underlying factors and origins of gender diversity, health needs, and stereotypes about the demand for health care; (b) attitudes and behaviours of professionals towards transgender people: pathologization and attitudes towards decision-making. Our findings suggest that mental health professionals tend to oversimplify the factors underlying gender diversity and hold certain stereotypical beliefs about these users that oversimplify the complexity of their experiences.

Use of standardized decision support instruments to inform child welfare decision-making: lessons from an implementation study

Research has demonstrated children in out-of-home care have experienced trauma and a significant proportion are in need of behavioral health services (e.g. Casaneuva et al., NSCAW II baseline report: Child well-being, US Department of Health and Human Services, Washington, DC, 2011). Accessing services requires interagency coordination between child welfare and behavioral health professionals; however, challenges to coordination and collaboration may result in lack of service utilization for many youth (Hanson et al. 2016). Utilizing a mixed methodological approach, this paper describes the results of a study conducted five years after full state-wide implementation of processes designed to promote the use of evidence-based practices to inform decision-making for youth dually served by the child welfare and behavioral health systems. Outcomes from the study were used to develop strategies to address programmatic concerns and reinforce implementation supports. Study findings may aid organizations seeking to reinforce data-informed practices and employ strategies for addressing barriers at the worker and agency level.

The relationship between mental health literacy and professional psychological help-seeking behavior among Chinese college students: mediating roles of perceived social support and psychological help-seeking stigma

The relationship between mental health literacy and professional psychological help-seeking behavior among Chinese college students: mediating roles of perceived social support and psychological help-seeking stigma

Supporting Implementation Through Online Learning Communities: Lessons Learned From a National Training and Technical Assistance Network.

Recent implementation science frameworks highlight the role of training and technical assistance (TTA) in building workforce capacity to implement evidence-based practices (EBPs). However, evaluation of TTA is limited. We describe three case examples that highlight TTA by three regional centers in the national Mental Health Technology Transfer Center (MHTTC) network. Each MHTTC formed Learning Communities (LCs) to facilitate connections among behavioral health professionals with the goals of sharing implementation strategies, discussing best-practices, and developing problem solving techniques. Data on outcomes were collected through a combination of self-report surveys and qualitative interviews. LC participants reported strong connectedness, gains in knowledge and skills, improvements in implementation capacity, and intentions to advocate for organizational and systems-level change. Furthermore, across the case examples, we identified LC characteristics that are associated with participant perceptions of outcomes, including tailoring LC content to workforce needs, providing culturally relevant information, engaging leaders, forming connections among participants and trainers, and challenging participants' current workplace practices. These findings are interpreted through the lens of the Interactive Systems Framework, which focuses on how TTA, such as LCs, can facilitate connections between the theoretical and empirical foundations of interventions and the practices of implementing interventions in real-world settings to advance workforce capacity.

Graduate and Health Professional Student Knowledge, Attitudes, Beliefs, and Behavior Related to Human Papillomavirus and Human Papillomavirus Vaccination: A Scoping Review of the Literature.

Human papillomavirus (HPV) is a common sexually transmitted infection. Despite a safe and effective vaccine, uptake continues to be suboptimal. Recently, focus has moved to college campuses in an effort to increase vaccination rates. Little is known about the extent of efforts to reach graduate students on college campuses in the United States and the vaccination rates within this subpopulation. This scoping review assessed the literature on knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination among graduate and post-baccalaureate professional students in the United States. This review also aims to identify areas for further research to improve institutions' abilities to create health programming to increase HPV awareness and HPV vaccination coverage on their campuses. Publications focusing on knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination in post-baccalaureate students were included. The systematic review of PubMed, CINAHL, and Embase identified 2562 articles, and 56 articles met all inclusion criteria and were included in this scoping review. A majority of the reviewed studies investigated some combination of knowledge, attitudes, behaviors, and beliefs about HPV and the HPV vaccine in students in professional programs such as medicine. Study design approaches were primarily cross-sectional, utilizing web-based survey distribution methods. HPV vaccination status and HPV screening behaviors were primarily measured through participant self-report. There is limited research investigating post-baccalaureate student knowledge, attitudes, beliefs, and behaviors about HPV and HPV vaccination. There is a need for researchers to further investigate the needs of graduate students to create informative and effective HPV programming.

Understanding delays in chronic limb-threatening ischaemia care: Application of the theoretical domains framework to identify factors affecting primary care clinicians' referral behaviours.

Patients in the community with suspected Chronic limb-threatening ischaemia (CLTI) should be urgently referred to vascular services for investigation and management. The Theoretical Domains Framework (TDF) allows identification of influences on health professional behaviour in order to inform future interventions. Here, the TDF is used to explore primary care clinicians' behaviours with regards to recognition and referral of CLTI. Semi-structured interviews were conducted with 20 podiatrists, nurses and general practitioners in primary care. Directed content analysis was performed according to the framework method. Utterances were coded to TDF domains, and belief statements were defined by grouping similar utterances. Relevance of domains was confirmed according to belief frequency, presence of conflicting beliefs and the content of the beliefs indicating relevance. Nine TDF domains were identified as relevant to primary care clinicians: Knowledge, Environmental context and resources, Memory, Decision and attention processes, Beliefs about capabilities, Skills, Emotions, Reinforcement and Behavioural regulation. Relationships across domains were identified, including how primary care clinician confidence and working in a highly pressurized environment can affect behaviour. We have identified key barriers and enablers to timely recognition and referral behaviour. These beliefs identify targets for theory-driven behaviour change interventions to reduce delays in CLTI pathways.

Implementing Measurement-Based Care in a Youth Partial Hospital Setting: Leveraging Feedback for Sustainability.

This paper describes the successful implementation of Measurement-Based Care (MBC) within a Partial Hospitalization Program (PHP) for children and adolescents. Measurement-based care (MBC), the practice of using patient-reported measures routinely to inform decision-making, is associated with improved clinical outcomes for behavioral health patients (Jong et al., Clinical Psychology Review 85, 2021; Fortney & Sladek, 2015). MBC holds great promise in partial hospital programs (PHP) to improve outcomes, yet implementation strategies are as complex as the setting itself. This paper provides a case study example of MBC implementation in a PHP for youth. Over the course of 18months, an interdisciplinary staff of approximately 20 behavioral health professionals provided partial hospitalization level of care to 633 (39% in-person, 61% telehealth) youth from ages 5 to 18years old. MBC in this setting incorporated daily patient self-report and weekly caregiver-reported measurements. This descriptive reconstruction, which includes examples of the data that were used during the implementation project, illustrates specific barriers and facilitators in a successful implementation in the local PHP setting. Implementation strategies to address workflow integration, leadership and supervision, and coaching are described, including evolution of these strategies over the course of implementation. Practical considerations for implementing MBC in youth PHP settings are discussed. Finally, the authors explore the potential relationships between the data-driven MBC model of decision making and the development of resilient organizations.

Barriers and enablers to a healthy lifestyle in people with infertility: a mixed-methods systematic review

While there is a recognised role of optimising lifestyle behaviours such as diet and physical activity in the management of infertility, the best practice for lifestyle management of infertility remains unknown, and factors influencing the lifestyle behaviours of people with infertility are not well understood. The aim of this systematic review is to evaluate the barriers and enablers to a healthy lifestyle in people with infertility, from the perspectives of people with infertility and health professionals, in order to inform optimal behavioural change strategies for lifestyle management of infertility. Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL Plus were searched from inception to 12th September 2022. Eligible studies were qualitative, quantitative or mixed-methods primary studies which explored barriers and/or enablers to lifestyle for infertility management, from the perspectives of people with infertility and/or health professionals. Two independent reviewers performed quality assessment, using the Centre for Evidence-Based Management Critical Appraisal of a Survey Tool (quantitative and mixed-methods studies) and the Critical Appraisal Skills Programme Qualitative Checklist (qualitative and mixed-methods studies). Data were analysed by inductive thematic analysis with themes mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) model(1) and Theoretical Domains Framework (TDF)(2). Relevant behaviour change techniques (BCTs)(3) to target the identified enablers and barriers were suggested. After screening 10703 citations and 82 full-texts, 22 studies were included (12 quantitative, 7 mixed-methods and 3 qualitative) with 18 studies including women with infertility (n = 2442), 10 including men with infertility (n = 1372) and 6 including health professionals (n = 261). From the perspectives of people with infertility, themes related to capability (e.g. strategies for behaviour change), opportunity (e.g. limited time, resources and money) and motivation (e.g. interplay between lifestyle and emotional state); themes mapped to 8 TDF domains. From the perspectives of health professionals, themes related to capability (e.g. identification of patients appropriate for lifestyle intervention), opportunity (e.g. mode of delivery) and motivation (e.g. professional responsibility); themes mapped to 6 TDF domains. 34 BCTs were identified across the suggested interventions. This systematic review found that several interacting factors influence lifestyle in people with infertility as well as health professional behaviour with regards to provision of lifestyle interventions for infertility. These factors can be targeted for optimisation of interventions. In light of the limited number of qualitative studies, there is a need for more qualitative research to gain deeper insights into the perspectives of people with infertility and health professionals for further exploration of the complex and interacting factors which shape lifestyle during the fertility journey.

Evaluation and comparison of aging education for undergraduates across multiple fields of study

ABSTRACT The college years represent a key opportunity for broadening the future gerontology workforce by introducing students to the aging content that may influence their career decisions, yet this content is often limited to students with behavioral health and health professions majors. The present study sought to determine the degree to which a Midwestern university’s general education course on aging could increase learning, interest, knowledge, and ability to use knowledge for undergraduates across multiple fields of study. Participants included 560 undergraduate students, 48% of which were health professions majors, 28% behavioral health majors, and 23% majors in other fields. While all groups reported significant increases in learning, knowledge, and interest in aging studies, ANOVA found significant differences by students’ field of study in reported ability to apply course knowledge in their career or organization. As demand increases for workers versed in the needs of the older adult population, it will be important for educators to incorporate career connections into aging studies coursework and make abundantly clear how students in all fields of study are necessary for the future gerontological workforce.

THE ROLE OF PSYCHOLOGICAL CAPITAL IN THE EFFECT OF EMOTIONAL LABOR ON BURNOUT

In this study, it was aimed to understand the emotional labor behaviors of health professionals working in dialysis units and to determine the relationship between emotional labor and burnout. Research on burnout shows that health professionals have high levels of burnout. Working conditions have become even more difficult, especially during the pandemic period. There are few studies on healthcare professionals working in dialysis units. This is a cross-sectional survey involving 215 healthcare professionals working in dialysis units. The sample of the study consisted of physicians, nurses and dialysis technicians working in dialysis units in different provinces of Turkey. In the research findings, it was determined that health professionals working in the dialysis unit had low levels of surface acting, moderate levels of deep acting, and high levels of natural feelings, burnout levels were low in all sub-dimensions and high level of psychological capital. A statistically significant relationship was found between emotional labor, burnout and psychological capital. This research shows that health workers with strong psychological capital can perform better emotional labor regulation and experience less burnout.

Outcomes of an Interprofessional Opioid Training Program for Graduate Students in Nursing and Social Work

ABSTRACT Social workers and other behavioral health professionals trained to provide prevention, treatment, and recovery services for opioid use disorders (OUD) remain urgently needed in the U.S. particularly in states with widespread health professional shortage areas. To help mitigate this workforce gap, faculty in social work and nursing at a public university in Alabama developed and piloted an innovative HRSA-funded interprofessional traineeship to prepare graduate-level nursing and social work students to assess and treat opioid use disorders (OUD). The yearlong traineeship included specialized coursework on evidenced-based practice in addictions, interprofessional telemedicine and simulation training, and multi-semester field practica in outpatient treatment settings. Impact of the pilot training was evaluated using a pre-experimental one group design. Baseline and post-training surveys assessed knowledge, attitudes, and skills related to OUD and interprofessional practice and perceived program impact. Significant increases were observed for trainees’ self-reported knowledge, attitudes, and skills. Moreover, at graduation students reported that the traineeship had improved their abilities to interact with underserved populations, collaborate interprofessionally, and understand ethical issues in SUD treatment as well as enhancing their professional competence, clinical problem-solving, and health workforce skills. Findings suggest that the interprofessional training program may prepare social work and nursing graduate students to effectively serve clients with OUD and help to address a critical workforce gap in medically underserved communities.

ARRIVE Together: A Qualitative Process Evaluation of the New Jersey State Police Co-responding Pilot Program

Law enforcement personnel are often first to respond to calls involving behavioral health emergencies. However, encounters with law enforcement are more dangerous and lethal for people with behavioral health conditions. Co-responding models, wherein law enforcement and behavioral health professionals respond to calls together, are among the top programs developed to improve responding to behavioral health crises. The current study describes a qualitative process evaluation of a co-responding pilot program in New Jersey: “Alternative Responses to Reduce Instances of Violence & Escalation” (ARRIVE Together). The evaluation centered on the experience of the co-responding team as to their perceptions of specific deployments and of the program implementation overall. Semi-structured interviews were conducted following 10 consecutive encounters (three interviews per encounter; February-March 2022). Transcripts were transcribed and thematically analyzed by two trained researchers independently. Once thematically analyzed, researchers determined a consensus and developed a SWOT analysis report. Thematic analysis produced six major themes: communication, staffing, training, resources, community outreach, and deployments with minors. Overall, participants were enthusiastic about the program, but they shared numerous observations about ways in which the program could be improved. Sample size, the brief follow-up window, and lack of generalizability to other contexts were among the most limiting factors. Further research should include an effectiveness evaluation and extend to urban and suburban communities and communities of color. Future research should also explore after-response affects including accessibility to follow-up care. The current study gives insight into piloting a co-responding model for approaching behavioral health crisis calls.

Occupational Therapy: A Potential Solution to the Behavioral Health Workforce Shortage.

Occupational therapy practitioners (OTPs) are clinically prepared to treat patients with behavioral health conditions. Yet, many state and national policies defining qualified behavioral health providers do not include occupational therapy. In this Open Forum, the authors argue that OTPs should be considered qualified to work as behavioral health professionals, especially given the severe behavioral health workforce shortage in the United States. The authors summarize policy barriers preventing OTPs from working on behavioral health teams and the evidence to support their presence. They also propose a policy and advocacy agenda to include and recognize OTPs as members of the behavioral health workforce.

Development of an accelerated curriculum for clinical psychology doctoral students in substance use disorders and integrated care.

Recently, a significant increase in the population with Substance Use Disorders (SUD) and Opioid Use Disorders (OUD) has been documented. This scenario is a complex one that adversely impacts disadvantaged populations and health systems in Puerto Rico. Similarly, limited access to adequate health services for the population with SUD/OUD has been studied. In addition, there is a need for trained behavioral health professionals with the right competencies to offer evidence-based services to people with SUD/OUD. This scenario points out the need for clinical psychology doctoral programs with specialized curriculum in SUD/OUD and integrated care at a reasonable time that allows for expanding the base of competent professionals in these services. OBJECTIVE: This work aims to discuss the results of developing and validating a curriculum for evidence-based behavioral health clinical training in SUD/OUD and integrated care in one (1) year. METHOD: A specialized SUD/OUD and integrated care curriculum were developed to achieve the objective. The curriculum developed was evaluated by a panel of experts. The recommendations were integrated into the final version of the curriculum. RESULTS: The curriculum revised in its final version contains thirty-three (33) training distributed in the following areas of focus: 1) SUD; 2) OUD; 3) Primary Care; 4) Integrated Care; 5) Tele-Psychology. The thematic areas of the training are distributed in three levels of complexity: basic, intermediate, and advanced. DISCUSSION: The accelerated curriculum for clinical training in SUD/OUD and integrated care developed offers a crucial opportunity to train professionals at the doctoral level with the necessary competencies to work with people affected by SUD and OUD. In addition, it offers a unique opportunity to integrate theory and practice in one (1) year, increasing the base of trained professionals. This program is a crucial opportunity to continue strengthening access to specialized and integrated services for SUD and OUD and close the disparity gaps that impact the population affected by SUD and OUD.

İşe Yabancılaşma ile Sanal Kaytarma Arasındaki İlişki: Sağlık Çalışanlarına Yönelik Bir Araştırma

This study was conducted to determine the relationship between work alienation and cyberloafing among healthcare professionals. Besides, it is aimed to reveal the differences between both concepts according to sociodemographic variables. In the current research, a questionnaire form consisting of a cyberloafing scale, a work alienation scale, and sociodemographic characteristics were used as data collection tools. The questionnaire consists of 51 questions and 5 dimensions. The population of the research consists of 4042 people working at a public hospital, a hospital of health science university, and a private hospital. A total of 602 questionnaires were evaluated in these institutions. Based on the findings, there was a relationship between work alienation and cyberloafing behaviors of health professionals and some sociodemographic variables. In addition, there was a low-level positive and significant relationship between work alienation and cyberloafing levels of healthcare professionals. As a result of the correlation analysis in the study, a low-level positive and significant relationship was found between work alienation and cyberloafing. In addition, significant differences were found between work alienation, cyberloafing, and sociodemographic variables.

Homelessness and Mental Illness: Using Participatory Action Research to Inform Mental Health Counseling

Homelessness and mental illness frequently occur together. Individuals who have a mental illness and are homeless may experience a range of challenges and are often underserved by behavioral health professionals. This study used Participatory Action Research to form a working group (n=6), which met at a homeless shelter located in a small city in the United States (U.S) mid-Atlantic region, to generate insights and responses to the challenges they had encountered. The authors posed several research questions in the context of lived experiences of individuals who experience homelessness and mental illness. The researchers used Interpretive Phenomenological Analysis to interpret the data in light of these questions. We generated four key themes: the trauma of homelessness and mental illness, the power of personal connection, personal agency, and achievement, and meaning through action. For mental health counselors, suggestions include incorporating a trauma-informed framework, minimal turnover in counselor coverage, and a client-centered approach.

Book Review: Risk management in the behavioral health professions: A practical guide to preventing malpractice and licensing-board complaints

Book Review: Risk management in the behavioral health professions: A practical guide to preventing malpractice and licensing-board complaints

Ethical issues in the operating room: A scoping review.

For the patients receiving care in the operating room, it emphasizes that the ethical behavior and attitude of health professionals should be aligned with patients' basic human rights. Surgical ethics may provide an ethical alternative in a specific operating room context. However, it is unclear how actively research is being conducted in this regard. This study determines the direction of future research by identifying ethical issues experienced in the operating room. This scoping review is based on the methodological framework suggested by Arksey and O'Malley in 2005. PubMed, CINAHL, EMBASE, WOS, Cochrane, KISS, and KMbase databases were searched from January 2012 to May 2022. Two researchers independently screened the searched articles by reviewing the titles, abstracts, and full texts. Consequently, 19 studies were selected. Five categories were identified: Professional ethics, Organizational ethics, Patients' rights, Patient safety, and Allocating resources. The derived categories covered all the same content as the International Council of Nurses' (ICN) code of ethics, with the exception of one element, that is, global health. This study highlights ethical issues in the operating theatre and emphasizes the need for individual and organizational strategies aligned with the ICN code of ethics. Future research should cover a wider range of issues, employ diverse perspectives and methodologies, and enhance ethical practices to improve understanding and ethical practices in the field.

From Two Dimensions to Multidimensions: A Mechanistic Model to Support Deliberate CPD Development, Coordination, and Evaluation.

The effectiveness of continuing professional development as an intervention to improve health professional behavior and patient health is variable and contentious. To clarify the causal relationships underlying program outcomes and facilitate a necessary shift from outcomes-only-based approaches to outcome-based and theory-based approaches in program development and evaluation, we developed a model of mechanisms mapped to relevant outcomes. Mechanisms identified in a prior realist synthesis of opioid agonist therapy continuing professional development programs were iteratively tested and refined using purposive and opportunistic sampling and realist approaches against two systematic reviews of programs in analgesic prescribing and palliative care. Further testing involved practical application within programs in sustainable health care and pain management. Ninety reports on 75 programs and practical application to multiple additional programs informed the final model consisting of five distinct mechanisms: motivation transformation, expert influence, confidence development, self-efficacy facilitation, and community of practice expansion. The mechanisms and related analysis emphasize that continuing professional development is heterogeneous, complex, and context dependent. Shifting toward outcome-based and theory-based approaches facilitates further conceptual shifts at intraprogram and interprogram and interintervention levels toward more deliberate program development and evaluation, increased program complementarity and subsequent collaboration. It clarifies opportunities for intercalation of continuing professional development with other intervention sciences. The model presents a resource for practitioners, researchers, and policymakers to advance continuing professional development planning, coordination, and evaluation.