Mental Health Division Research Articles

The North Carolina Division of Mental Health’s Strategic Plan for Limiting Substance Use Overdose Deaths

The North Carolina Division of Mental Health, Developmental Disabilities, and Substance Use Services has implemented a strategic plan for limiting substance use overdose deaths, including increasing primary prevention and increasing public awareness of and access to evidence-based treatment options.

30 years of youth system of care lessons learned – a qualitative study of Hawaiʻi’s partnership with the Substance Abuse and Mental Health Services Administration

BackgroundThe Hawaiʻi State Department of Health, Child and Adolescent Mental Health Division (CAMHD) has maintained a longstanding partnership with Substance Abuse and Mental Health Services Administration (SAMHSA) to enhance capacity and quality of community-based mental health services. The current study explored CAMHD’s history of SAMHSA system of care (SOC) awards and identified common themes, lessons learned, and recommendations for future funding.MethodsEmploying a two-phase qualitative approach, the study first conducted content analysis on seven final project reports, identifying themes and lessons learned based on SOC values and principles. Subsequently, interviews were conducted with 11 system leaders in grant projects and SOC award projects within the state. All data from project reports and interview transcripts were independently coded and analyzed using rapid qualitative analysis techniques.ResultsContent validation and interview coding unveiled two content themes, interagency collaboration and youth and family voice, as areas that required long-term and consistent efforts across multiple projects. In addition, two general process themes, connection and continuity, emerged as essential approaches to system improvement work. The first emphasizes the importance of fostering connections in family, community, and culture, as well as within workforce members and child-serving agencies. The second highlights the importance of nurturing continuity throughout the system, from interagency collaboration to individual treatment.ConclusionsThe study provides deeper understanding of system of care evaluations, offering guidance to enhance and innovate youth mental health systems. The findings suggest that aligning state policies with federal guidelines and implementing longer funding mechanisms may alleviate administrative burdens.

Digitally interconnected tertiary old age mental healthcare services and primary healthcare services for seniors in remote areas in Greece: An exportable model?

AbstractBackgroundEven though communities in remote areas across the globe age, old age mental healthcare services are mainly tertiary‐ or secondary hospital‐ based and subsequently not easily accessible by seniors with mental disorders living in such communities.MethodsThe INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) network embodies a model of digitally interconnected tertiary old age mental healthcare services and primary healthcare services for seniors in remote areas in Greece. It is coordinated by the Division of Old age mental health of the 1st Department of Psychiatry of the National and Kapodistrian University of Athens. INTRINSIC network is built around five pillars: The digital platform, bridging healthcare professionals, service users and communities; The old age mental health risk factor surveillance system, enabling the generation of a map of mental health problems of older adults living in each remote community and the initiation of the adequate treatment; the Modified Problem Adaptation Therapy (M‐PATH) intervention; Hearing and vision assessment and support of service users; and an advocacy body consisting of service users, their care partners and families and active members of the local communities. The initial, six‐month phase of INTRINSIC is funded by the Greek Ministry of Health.Results298 seniors living in remote areas of four different Nomenclature of Territorial Units for Statistics 2 (NUTS2) regions have been enrolled in INTRINSIC. They are on average 71.8 years old and 30.5% of them are males. Approximately 18% and 26% of INSTRINSIC service users suffer from depressive and anxiety symptoms, respectively; 62.3% complained about cognitive decline. Of note, only in 8% of service users the diagnosis of dementia had been established prior their enrolment, while 33.2% were treated with antidepressants.ConclusionBased on amplification of existing resources through the cooperation of tertiary‐ and primary healthcare professionals who share a vision of change, the INTRINSIC model offers a pragmatic opportunity to provide high quality old age healthcare services to seniors living in remote communities. The still ongoing collection and analyses of service users’ data may provide a solid foundation for INTRINSIC feasibility and sustainability

Improving the mental health care process in response to Covid-19 pandemic: The case of a penitentiary mental health division.

Covid-19 outbreak led all organizations to reorganize their processes to prevent infection and contagion risk. All healthcare facilities, included penitentiary mental health services, had to redesign their processes to safely deliver care services. In this paper, the case of a Penitentiary Mental Health Division located in southern Italy is presented. Soft System Methodology and Business process management principles and techniques are adopted to analyse and redesign the detainees' mental health care process. The process, characterized by direct, close and prolonged contact with patients, exposes detainees and healthcare staff to a high Covid-19 infection risk. Through document analysis, interviews with the actors involved in the process and direct observation, the process's inefficiencies and criticalities are identified. The process is redesigned to make it compliant with Covid-19 prevention provisions and national penitentiary regulations and address the other criticalities. The proposed methodological approach-which innovatively combines Soft System Methodology and Business Process Management-constitutes a human-centered process-based redesign approach that can be used both in healthcare and other organizational settings.

Trishul division of mental health: Conveying all sadness or stress of life is NOT a mental illness to people, the public, professionals, and policymakers.

Trishul division of mental health: Conveying all sadness or stress of life is NOT a mental illness to people, the public, professionals, and policymakers.

Editorial introductions.

Editorial introductions.

Retailers’ perspectives on the prevention of underage tobacco and electronic nicotine delivery system sales

Background: Tobacco retailers have an important role to play in reducing access to tobacco among youth, but in the USA, their role has become more complicated because of recent developments in policies and industry, such as the Indiana Tobacco-21 law and the rising popularity of electronic nicotine delivery systems (ENDS) products. This study aimed to explore Indiana retailers’ knowledge, attitudes, and skills related to the prevention of underage sales of tobacco and ENDS products and identify retailers’ needs for further education and training. Methods: The study involved a secondary analysis of anonymous cross-sectional data from the 2020 Indiana Tobacco Compliance Survey conducted by the Indiana Division of Mental Health and Addiction (DMHA). Managers and owners of retail stores who sold tobacco or ENDS products (i.e., large corporate-owned stores and smaller venues such as tobacco shops, vapour shops, and convenience stores) were eligible for inclusion. Records of retailers’ tobacco certificates were utilised for random sampling. Subgroup comparisons were conducted using chi-square tests. Results: The survey sample ( n = 102) included participants from all 10 DMHA planning regions in Indiana and all types of tobacco retail stores. Many retailers did not know about or understand the negative impacts of ENDS products on young people or existing regulations to minimise these impacts and the Indiana State Tobacco-21 law. Retailers in larger stores had a greater objective knowledge and reported more frequent prevention programme utilisation than smaller stores (e.g., by means of ‘We Card’). Conclusions: Underage tobacco sale prevention procedures varied significantly, but resources such as ‘We Card’ and ‘This is Our Watch’ were more popular than alternatives. Retailers reported a need for more convenient education and training options on how to check photo identification and refuse sales to minors.

“Social issue”, sexual division of labor and mental health in the pandemic

Resumo: O presente trabalho analisa as repercussões do acirramento da “questão social” e da divisão sexual do trabalho na saúde mental das mulheres no contexto de pandemia (Covid-19) no município de Aracati-CE. A pesquisa, com abordagem qualitativa-quantitativa, ancorou-se na teoria social crítica de Marx e foi processada em três etapas: a etapa exploratória, a pesquisa bibliográfica e a pesquisa de campo. Esta última, realizada com doze mulheres usuárias do Caps II de Aracati através de entrevista semiestruturada, com suporte do uso de dados indiretos e diretos. Conclui-se que houve a ampliação da produção do sofrimento mental em virtude da agudização da “questão social” e da intensificação da divisão sexual do trabalho no contexto da pandemia.

Editorial introductions.

Editorial introductions.

Division of Labour and Parental Mental Health and Relationship Well-Being during COVID-19 Pandemic-Mandated Homeschooling.

While the COVID-19 pandemic has impacted the way parents partition tasks between one another, it is not clear how these division of labour arrangements affect well-being. Pre-pandemic research offers two hypotheses: economic theory argues optimal outcomes result from partners specialising in different tasks, whereas psychological theory argues for a more equitable division of labour. The question of which approach optimizes well-being is more pressing in recent times, with COVID-19 school closures leaving many couples with the burden of homeschooling. It is unknown whether specialisation or equity confer more benefits for mandated homeschoolers, relative to non-homeschoolers or voluntary homeschoolers. Couples (n = 962) with children in grades 1-5 completed measures of workload division and parental well-being. A linear mixed modelling in the total sample revealed that specialisation, but not equity, promoted increased parental emotional and relationship well-being. These relations were moderated by schooling status: voluntary homeschoolers' well-being benefitted from specialisation, whereas mandated homeschoolers' well-being did not benefit from either strategy; non-homeschoolers well-being benefitted from both strategies. Across the mixed-gender couples, mothers' and fathers' well-being both benefitted from specialisation; equity was only beneficial for mothers' well-being. Overall, couples might be advised to adopt highly equitable and specialised arrangements to promote both parents' well-being.

988 in North Carolina sees 22% increase compared with old number

North Carolina has seen a 22% increase in calls to its mental health hotline year‐to‐year, according to data released by the North Carolina Department of Health and Human Services, WRAL News reported Nov. 7. On July 16, 2022, North Carolina launched its 988 mental health hotline. The 988 number replaced a longer 1‐800 number tied to the national Suicide Prevention Lifeline. Renee Rader, an assistant director for policy and programs for the North Carolina's Division of Mental Health, Developmental Disabilities and Substance Abuse Services, said the state increased staffing to account for the new number launch. “Obviously, the biggest thing is the pandemic that just happened,” North Carolina State student Emma Scardina said, WRAL News reported. “That definitely isolated a lot of students and broke down the community that they had.” According to state leaders, people ages 20‐24 are the most likely to take their own lives. In August 2022, the new 988 hotline received an average of 160 calls a day with nearly 2,000 first‐time callers. Counselors contacted police 10 times. In 33 situations, dispatchers sent a mobile crisis unit. “It's raising more alarms for us,” said Rader. “We are putting more efforts into suicide prevention.”

Disparities in substance use treatment retention: An exploration of reasons for discharge from publicly funded treatment

Although Delaware is the seventh smallest state in the country (including Washington, D.C.) in terms of population size, it has the second highest drug overdose death rate. The Delaware Division of Substance Abuse and Mental Health has increased attention in identifying disparities in treatment outcomes. We explored reasons for discharge from publicly-funded treatment in Delaware with special attention to populations at risk for health inequities, with a focus on covariates of treatment non-completion. Using secondary data collected from publicly-funded treatment providers, we analyzed data from individuals that were admitted to substance use treatment between 2015 and 2019 and had been discharged in 2019. We did this by using logistic and multinomial regression, focusing on non-completion treatment outcomes such as failure to meet requirements, loss of contact, and treatment refusal. Clients who were Black or African American, compared to white clients, were more likely to be lost contact with, administratively discharged, or marked as failing to meet treatment requirements than having a completed treatment discharge. Women were 30% less likely than men to have “failed to meet treatment requirements” compared to completing treatment. Further investigation is needed into these patterns. While treatment quality cannot be assessed using this data, the results point to a need for closer study of disparities in treatment related to race, ethnicity, gender, employment, criminal justice involvement, and type of drug used. Treatment providers should be made aware of culturally informed care, as well as client-created goals, in order to reduce disparities in exit from treatment.

Judges, Psychiatrists Trained to Share Education About MH in Justice System

Judges, Psychiatrists Trained to Share Education About MH in Justice System

Rutgers Grad Students RIOT for Opioid Education

Rutgers Grad Students RIOT for Opioid Education

Editorial introductions.

Editorial introductions.

Experiences and attitudes of mental health care staff to the reporting of violence in the workplace in the Republic of Ireland

IntroductionThe WHO and the Violence Prevention Alliance define violence as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.” The types of violence examined in this study include physical, sexual, verbal and racial as the most commonly reported manifestations of violence in the workplace.ObjectivesTo obtain the most recent statistics on violent acts perpetrated against mental health care workers in the Republic of Ireland. To capture the experiences and attitudes of staff to the reporting of this violence.MethodsThe State Claims Agency (SCA) were contacted to obtain the most up to date figures on violence against mental health care workers. An electronic survey based on the WHO’s validated questionnaire on violence was then disseminated to all acute psychiatric units nationally.ResultsThere were 6,690 episodes of violence against staff in the Mental Health Division in 2018 and 2019. The survey found, 92.4% of respondents reported verbal abuse, 30.3% recorded physical assault, 15.2% had suffered sexual violence in a 24 month period. 20.3% of study participants took no action. Of those who did, 70% felt that the incident had not been investigated properly. More than half of respondents felt that there were no consequences to the aggressor.ConclusionsFurther work is needed in the prevention of workplace violence as well as improvements in reporting and investigating of incidents when they do occur.DisclosureNo significant relationships.

Apprenticeship seen as innovation to expand mental health workforce

A group of state officials in Missouri contends that a component of the workforce that has been used successfully in other fields could have important applicability to human services during a severe labor shortage. Although the innovative Missouri Talent Pathways apprenticeship program will be implemented in the state Department of Mental Health's Division of Developmental Disabilities, officials are confident that the program can be replicated in mental health, aging and a host of other human‐service sectors.

Public Mental Health services in the European region during the COVID-19 pandemic

The European Public Health Association (EUPHA), in conjunction with the Mental Health Foundation UK, conducted a purposely designed online survey of public and mental health professionals from across Europe, exploring public mental health responses to the pandemic in different regions, nations and localities. Participants were recruited from EUPHAs mental health division and through snowballing. Four broad areas were explored, namely; (1) perceived changes in available mental health supports during the pandemic; (2) whether or not a public mental health response plan had been developed; (3) if any demographic groups or priority areas had been given particularly consideration in this response and (4) how the response had been developed (i.e. whether intersectoral approaches had been adopted and the perceived degree to which service users and carers had been included in its development). Forty-four survey responses from twenty different European nations were collected and grouped according to whether respondents were practising in countries with low, medium or high COVID-19 incidence rates. The majority of responses were from public health professionals with over 20 years of experience. Results indicated wide variations in policy responses to the crisis and in the way mental health services have adapted to date. However, in the majority of countries surveyed, while an increase in online mental health supports during the pandemic was reported, no change in long term funding for mental health supports was observed. In addition, in the majority of countries, several vulnerable groups were rarely given specific attention in policy responses, namely low-income families, people with long-term health conditions or disabilities and ethnic minorities. In this workshop we will discuss the findings from this survey and explore what insights might be learned from experiences across Europe to date.

Hospital SUD Programs, Psychiatric Hospitals Lag in Electronic Health Record Use

Hospital SUD Programs, Psychiatric Hospitals Lag in Electronic Health Record Use

Editorial introductions.

Editorial introductions.