Mental Health Organizations Research Articles

Adapting Peer Researcher Facilitated Strategies to Recruit People Receiving Mental Health Services to a Tobacco Treatment Trial.

IntroductionOne of the most challenging aspects of conducting intervention trials among people who experience severe mental illness (SMI) and who smoke tobacco, is recruitment. In our parent “QuitLink” randomized controlled trial (RCT), slower than expected peer researcher facilitated recruitment, along with the impact of COVID-19 pandemic restrictions, necessitated an adaptive recruitment response. The objectives of the present study were to: (i) describe adaptive peer researcher facilitated recruitment strategies; (ii) explore the effectiveness of these strategies; (iii) investigate whether recruitment strategies reached different subgroups of participants; and (iv) examine the costs and resources required for implementing these strategies. Finally, we offer experience-based lessons in a Peer Researcher Commentary.MethodsPeople were included in the RCT if they smoked at least 10 cigarettes a day and were accessing mental health support from the project's two partnering mental health organizations in Victoria, Australia. The majority of people accessing these services will have been diagnosed with SMI. Recruitment occurred over 2 years. We began with peer facilitated recruitment strategies delivered face-to-face, then replaced this with direct mail postcards followed by telephone contact. In the final 4 months of the study, we began online recruitment, broadening it to people who smoked and were accessing support or treatment (including from general practitioners) for mental health and/or alcohol or other drug problems, anywhere in the state of Victoria. Differences between recruitment strategies on key participant variables were assessed. We calculated the average cost per enrolee of the different recruitment approaches.ResultsOnly 109 people were recruited from a target of 382: 29 via face-to-face (March 2019 to April 2020), 66 from postcards (May 2020 to November 2020), and 14 from online (November to December 2020 and January to March 2021) strategies. Reflecting our initial focus on recruiting from supported independent living accommodation facilities, participants recruited face-to-face were significantly more likely to be living in partially or fully supported independent living (n = 29, <0.001), but the samples were otherwise similar. After the initial investment in training and equipping peer researchers, the average cost of recruitment was AU$1,182 per participant—~US$850. Face-to-face recruitment was the most expensive approach and postcard recruitment the least (AU$1,648 and AU$928 per participant).DiscussionPeer researcher facilitated recruitment into a tobacco treatment trial was difficult and expensive. Widely dispersed services and COVID-19 restrictions necessitated non-face-to-face recruitment strategies, such as direct mail postcards, which improved recruitment and may be worthy of further research.Clinical Trial Registration:The trial is registered with ANZCTR (www.anzctr.org.au): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines. The trial sponsor was the University of Newcastle, NSW, Australia.

Mental health field responds to tragic Buffalo shootings

Mental health advocacy groups and organizations have released statements denouncing the horrific shooting of 10 people in a Buffalo supermarket last weekend, encouraging the public to get help, if needed, for mental health struggles from a trained mental health counselor. The groups also urged the need to commit to eliminating racism and discrimination.

Perceptions of causal attribution and attitudes to genetic testing among people with schizophrenia and their first-degree relatives

Rapid advances in the genetics of psychiatric disorders mean that diagnostic and predictive genetic testing for schizophrenia risk may one day be a reality. This study examined how causal attributions for schizophrenia contribute to interest in a hypothetical genetic test. People with schizophrenia and first-degree relatives of people with schizophrenia were recruited through a schizophrenia research bank and mental health organisation. Semi-structured telephone interviews were conducted with 13 individuals with schizophrenia and 8 first-degree relatives. Transcripts were subjected to a qualitative analysis using the thematic analysis framework. Five themes were developed: (i) “It is like a cocktail”, with most participants aware that both genetic and environmental factors contributed to causation, and many mentioning the positive impact of genetic causal explanations; (ii) “Knowledge is power” (i.e., in favour of genetic testing); (iii) Genetic testing provides opportunities for early intervention and avoiding triggers, with participants citing a wide range of perceived benefits of genetic testing but few risks; (iv) Views on reproductive genetic testing for schizophrenia risk with a few participants viewing it as “playing God” but not necessarily being against it; and (v) “It snowballs”, whereby participants’ understanding of genetics was sophisticated with most believing that multiple rather than single genes contributed to schizophrenia. In conclusion, many individuals had a sound understanding of the role of genetic testing if it were to become available, with evidence of insight into the role of multiple genes and the contribution of other risk factors that may interact with any inherited genetic risk.

Bill would reauthorize MD, SUD programs, strengthen parity

Strengthening existing mental health and substance use disorder (SUD) parity laws, improving community mental health services and authorizing a significant increase in the Mental Health Services Block Grant (MHBG), are among the provisions present in the legislation to reauthorize key programs that are set to expire in September and are endorsed by more than 30 health, addiction and mental health organizations.

Broad coalition calls for increasing addiction workforce

The Coalition to Stop Opioid Overdose (CSOO), a group pulled together by the American Society of Addiction Medicine and including many mental health organizations such as the American Psychiatric Association, the National Council for Mental Wellbeing, the Behavioral Health Association of Providers and the Kennedy Forum, has sent a letter to Congress calling for strengthening the addiction service workforce via fiscal year 2023 (FY23) appropriations. For the specific bills in question, see the accompanying chart.

Combining rules and dialogue: exploring stakeholder perspectives on preventing sexual boundary violations in mental health and disability care organizations

BackgroundSexual boundary violations (SBV) in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.MethodsWe carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data.ResultsWe found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: (1) setting rules and regulations, (2) engaging in dialogue about sexuality, and (3) addressing systemic and organizational dimensions.ConclusionOur findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations.

A literature review of the factors influencing the development of paternal symptoms of depression during the perinatal period

Background/Aims Depression during pregnancy and following the birth of a child is now also recognised as a paternal issue. However, the evidence has received little attention compared to maternal depression. The aim of this article was to systematically review the available evidence examining factors that influence the development of depressive symptoms in men during the perinatal period. Methods A systematic search of six electronic databases (CINAHL, MEDLINE, PsycINFO, Internurse, Intermid and Maternity and Infant Care) from the period 2010–19 was undertaken. A total of 20 studies were identified using the inclusion and exclusion criteria. Findings were synthesised using thematic analysis. Results A total of five synthesised risk factors were identified as pregnancy and infant, individual, social and relationship, psychological and demographic. Conclusions Expectant fathers are vulnerable to the development of depressive symptoms during the transition to parenthood. Mental health organisations should deliver services to support fathers during the perinatal period.

Implementation of peer support in mental health services: A systematic review of the literature.

Peer support within mental health services has a growing evidence base and aligns with current policies of recovery-oriented care. Despite these advantages, widespread implementation of peer support remains limited, likely due to various methodological and implementation issues. Researchers have noted the importance of utilizing an implementation framework to understand best practices for implementation. Therefore, the purpose of the current study was to synthesize the existing literature on the implementation of peer support interventions and identify barriers and facilitators using an implementation framework. The Consolidated Framework for Implementation Research (CFIR) was used to organize the literature obtained in the systematic search and synthesize best practices for implementation. The systematic search identified 19 published articles that were coded for relevant information including implementation barriers and facilitators. The review highlighted a number of important elements for implementation within the CFIR domains, including clear role definition, a flexible organizational culture, and education for peer and nonpeer staff. Implementation barriers included an organizational culture without a recovery focus, allied practitioners' beliefs about peer support, and an unclear peer role. The results of this review provide a summary of best practices for the implementation of peer support in mental health services that can be used by researchers and service providers in future implementation. These practices should continue to be tested and reworked as the climate of recovery-oriented services within mental health organizations evolves. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Songwriting, professional studio recording, and a CD release party: Interviews with two adults with mental health conditions

Through attaining a small university grant, I was able to fund a studio recording project of original compositions written in music therapy sessions at a local mental health organization and then provide members with a CD release party to showcase their work. I was interested in exploring the members’ experiences of songwriting, recording in a professional studio, and having a CD release party. I therefore conducted individual semi-structured interviews with two adult members who participated in the project and used an inductive approach to thematic analysis to analyze data. The participating music therapist verified the seven themes resultant of data analyses: Commitment to songwriting despite challenges; Valued collaborating with a professional musician and qualified music therapist; Anticipated future songwriting; Desire to deliver an inspirational message through songwriting; Songwriting benefits included pride, mood, self-expression, and accomplishment; Enjoyed the novel studio recording experience; and Positive experience at the CD release party. Emerging themes indicated that songwriting and recording were challenging yet rewarding experiences that the members took seriously. Implications for clinical practice, limitations, and suggestions for future research are provided.

A 1-Day Training Course to Disseminate the BREF Psychoeducational Program to Caregivers and Promote Network Establishment between Psychiatry Departments and Family Associations

ObjectiveAlthough international guidelines state that psychoeducation to caregivers should be provided systematically, it remains insufficiently available in psychiatry. This study reports the development and evaluation of an original training course aimed to provide participants with the knowledge and skills to implement “BREF,” a psychoeducational program for caregivers.MethodsThe BREF program training course, a free, 1-day course incorporating peer role-play was developed. In addition to psychiatrists, nurses, and psychologists, caregivers were involved as preceptors. Participants were mental health professionals and volunteer caregivers. Participants to the first 28 sessions of the course (n=467) completed a post-course questionnaire (n=341) and a cross-sectional questionnaire (n=56). Quantitative data on satisfaction, learning, and behavior changes following the course were collected equating to levels 1, 2, and 3 of Kirkpatrick’s model.ResultsAfter the course, high levels of satisfaction and commitment were observed with 100% of responders recommending the course and 81% intending to implement the BREF program. Confidence mean score to implement BREF was 7.9/10 (±1.4) with no significant effect of course session. At cross-sectional evaluation, 73% of responders reported improvements in skills related to providing psychoeducation to caregivers, 64% stated that the BREF program was implemented/under implementation, and 66% stated that their department had connected with a family association.ConclusionsTraining course sessions alone can increase psychoeducational programs for caregivers and network establishment. The BREF program training course demonstrates a high level of participant satisfaction and is a promising method to disseminate psychoeducation to caregivers, thus addressing a major shortage in mental health organization.

The role of self-efficacy and self-esteem in mediating positive associations between functional social support and psychological wellbeing in people with a mental health diagnosis

Background Previous research has observed positive associations between perceived quality of social support and mental well-being. Having access to functional social support that provides sources of care, compassion and helpful information have shown to be beneficial for mental health. However, there is a need to identify the psychological processes through which functional social support can elicit therapeutic outcomes on mental well-being. Aims The present cross-sectional study aimed to examine the extent to which self-efficacy and self-esteem mediated the association between functional social support and mental well-being. Method Seventy-three people with a mental health diagnosis, who attended group-based activities as facilitated by a third sector community mental health organisation, took part in the present study. Participants were required to complete measures that assessed perceived quality of functional social support, self-efficacy, self-esteem, and subjective mental well-being. Results A multiple mediation analysis revealed that self-efficacy and self-esteem fully mediated the positive association between perceived functional social support and mental well-being. Conclusions The implications of these results are that social interventions, which aim to facilitate the delivery of functional social support, could enhance mental well-being via their positive effects on self-efficacy and self-esteem.

Partnership brings about services for military veterans at no cost

A partnership with a nonprofit that is devoted to serving military veterans is allowing a southwest Florida mental health organization to establish a more formalized approach to assist this population, at no cost to recipients.

Assessing Virtual Mental Health Access for Refugees during the COVID-19 Pandemic Using the Levesque Client-Centered Framework: What Have We Learned and How Will We Plan for the Future?

During the COVID-19 pandemic, mental health services rapidly transitioned to virtual care. Although such services can improve access for underserved populations, they may also present unique challenges, especially for refugee newcomers. This study examined the multidimensional nature of access to virtual mental health (VMH) care for refugee newcomers during the COVID-19 pandemic, using Levesque et al.’s Client-Centered Framework for Assessing Access to Health Care. One hundred and eight structured and semi structured interviews were conducted in four Canadian provinces (8 community leaders, 37 newcomer clients, 63 mental health or service providers or managers). Deductive qualitative analysis, based on the Client-Centered Framework, identified several overarching themes: challenges due to the cost and complexity of using technology; comfort for VMH outside clinical settings; sustainability post-COVID-19; and communication and the therapeutic alliance. Mental health organizations, community organizations, and service providers can improve access to (virtual) mental health care for refugee newcomers by addressing cultural and structural barriers, tailoring services, and offering choice and flexibility to newcomers.

To Utility and Beyond! Specifying and Advancing the Utility of Measurement-Based Care for Youth

ABSTRACT Mental health organizations that serve youth are under pressure to adopt measurement-based care (MBC), defined as the continuous collection of client-report data used to support clinical decision-making as part of standard care. However, few frameworks exist to help leadership ascertain how to select an MBC approach for a clinical setting. This paper seeks to define how an MBC approach can display clinical utility to provide such a framework. Broadly, we define clinical utility as evidence that an MBC approach assists stakeholders in fulfilling clinical goals related to care quality (i.e., improve client-clinician alliance and clinical outcomes) at the client (i.e., youth and caregiver), clinician, supervisor, and administrator levels. More specifically, our definition of clinical utility is divided into two categories relevant to the usability and usefulness of an MBC approach for a specific setting: (a) implementability (i.e., evidence indicating ease of use in a clinical setting) and (b) usefulness in aiding clinical activities (i.e., evidence indicating the potential to improve communication and make clinical activities related to care quality easier or more effective). These categories provide valuable information about how easy an MBC approach is to use and the potential benefits that the MBC data will confer. To detail how we arrived at this definition, we review prior definitions of clinical utility, discuss how previous definitions inform our definition of clinical utility for MBC, and provide examples of how the concept of clinical utility can be applied to MBC. We finish with a discussion of future research directions.

Avoidance/emotion-focused coping mediates the relationship between distress tolerance and problematic Internet use in a representative sample of adolescents in Taiwan: One-year follow-up.

Based on the theoretical frameworks of the Theory of Triadic Influence (TTI), this longitudinal study was designed to examine the mediating role of avoidance/emotion-focused coping in the relationship between distress tolerance and problematic Internet use (PIU) in a large representative sample of senior high school students in Taiwan. Through a 1-year follow-up design, 2170 participants were recruited from high schools throughout Taiwan using both stratified and cluster sampling in time 1 (T1), and 1832 students were followed-up 1 year later (T2). Structure equation modeling and bootstrap analyses results showed that after controlling for PIU measured at T1, PIU (T2) was significantly predicted by distress tolerance (T1) and fully mediated through avoidance/emotion-focused coping (T2). The results not only support the TTI framework, but can also serve as a reference to help educational agencies and mental health organizations create policies and design programs that will help in the prevention of PIU among adolescents. The mediating role of avoidance/emotion-focused coping in the relationship between distress tolerance and PIU was discussed.

Factors Influencing Soldiers’ Smartphone Use during the COVID-19 Pandemic: Focusing on COVID-19 Stress and Social Support

Background: This study aimed to investigate the influence of COVID-19 stress on the level of smartphone use among soldiers. In addition, it explores the potential moderating effect of social support as a protective factor.Methods: We collected responses from 205 soldiers serving in one military division in Chungcheongbuk-do using cross-sectional online and offline surveys. The data were analyzed with descriptive statistics, Pearson correlations, and hierarchical regression analysis using the SPSS 27.0 program.Results: Controlling for covariates, COVID-19 stress and social support were significant factors influencing the level of smartphone use. The analysis did not identify a moderating effect of social support on the relationship between pandemic stress and smartphone use.Conclusions: Our study results could help military and mental health organizations intervene in problematic smartphone use by creating programs for soldiers at high risk for COVID-19 stress.

Adolescent self-harm: Parents' experiences of supporting their child and help-seeking.

Self-harm in children and adolescents is a growing public health issue. Parents are forefront in identifying, responding to and supporting their child to seek help. A sequential mixed-method study which included an online survey (N = 37) and a semi-structured interview (n = 10) was conducted to understand parents' experiences of supporting and accessing help for their child. Parents (M = 45.70years, SD = 6.18) with a child who has engaged in self-harm behaviours (M = 16.89years, SD = 3.91) participated. Parents sought help from a range of services and perceived psychiatrists, private psychologists and friends as the most helpful and school psychologists, paediatricians, Emergency Department (ED) and the national youth mental health organisation as the least helpful. Two themes were interpreted from the qualitative data: (1) An emotional journey into the dark unknown, and (2) The promise of psychological help. A series of recommendations for other parents in similar situations, as well as health professionals were made. Parents want health professionals to provide appropriate referrals, work collaboratively with families, meaningfully connect with and validate parents, provide practical and psychological support for families and establish parent support groups. There remains a need for widely available evidence-informed resources, information and support for parents.

The development of nurse prescribing in mental health services: Outcomes from five national surveys 2004-2019.

AimThis study aimed to explore data from national surveys of nurse prescribing in England's National Health Service mental health services.BackgroundNurse prescribing is increasing worldwide. Reports describing long‐term developments after implementation are rare.MethodsFive surveys were distributed to all mental health organisations between 2004 and 2019.ResultsResponse rates increased from 54% (n = 45/83) in 2004 to 79% (n = 42/53) in 2019. The estimated proportion of mental health nurses who were prescribers increased to 4.3% by 2019. Distribution between clinical practice areas did not change significantly over time, with the largest numbers in community mental health teams. The proportion of nurse prescribers actively prescribing increased from 76.4% in 2014 to 87.8% in 2019. Independent prescribing became the predominant approach, with supplementary prescribing rarely used as the sole model within organisations. The scale of implementation varied markedly between organisations.ConclusionsAlthough nurse prescribing in mental health services has grown over time, growth has slowed and is variable at local level.Implications for Nursing ManagementOrganisations considering the introduction or growth of nurse prescribing should note the evidenced preference for an independent prescribing model to date and consider how to avoid unwarranted variation in nurse prescriber role distribution.

South Carolina MH advocates ask lawmakers to prioritize suicide prevention initiatives

Mental health advocates in South Carolina are calling on lawmakers to prioritize suicide prevention and mental health initiatives in the state, ABC Columbia reported March 15. According to the Centers for Disease Control and Prevention, suicide is the tenth‐leading cause of death in South Carolina and in the United States. On March 15, advocates with the American Foundation for Suicide Prevention, along with other mental health organizations and speakers, came together at the State House to share their personal stories of suicide and hope, and push for state funding for their call center. It comes as the National Suicide Prevention Lifeline transitions into a new three‐digit number to make it easier for those in need to get help. The new National Suicide Prevention Lifeline number is 988 and is set to go into effect in July.

Lived Experience as a Protective Factor for Mental Health Workers.

When clients do not seem to be improving, mental health workers have more negative job attitudes, experience higher levels of client-related burnout, and are more interested in leaving the field. Nonetheless, it is unclear whether all mental health workers are equally susceptible to burnout caused by feelings that their clients are not improving. Specifically, people with lived experience of mental illness are intimately familiar with their own recovery challenges and thus may be less susceptible to this source of burnout. To test this possibility, mental health providers (N=179) from a nongovernmental community mental health organization in Australia completed a survey assessing their perceptions of client improvement from treatment, their feelings of client-related burnout, and a range of organizational outcomes (job satisfaction, job engagement, workplace well-being, and intentions to resign). Moderated mediation analyses revealed that although mental health providers who felt that their clients were not improving experienced client-related burnout, lived experience served as a buffer. Staff with lived experience were less susceptible to burnout associated with perceptions that their clients were not improving from treatment. Mental health providers with lived experience also reported more positive job attitudes compared with providers without lived experience. Given the high rates of burnout in the mental health profession, future research should examine why lived experience appears to buffer staff from burnout when they believe that their clients are not improving. This knowledge could aid in the development of interventions to boost resilience, engagement, and longevity in the field.