Community Mental Health Journal最新文献

While some international qualitative research has interviewed people with serious mental illnesses (SMI) about their experiences in the initial months of the COVID-19 pandemic, few US studies have explored their experiences and perspectives as the pandemic has continued. Drawing from disability studies perspectives, this qualitative study conducted in 2022 explored the experiences of people with SMI seeking services at community mental health centers during the COVID-19 pandemic. Fifteen clients who identified as living with an SMI and were clients during March 2020 were interviewed. Using narrative analysis, we identified an overarching tenor of client experiences: feeling left behind by institutions and society. This feeling of being left behind was conceptualized as three themes. As the literature around the COVID-19 pandemic grows and we attempt to integrate it into community mental health policy and practice, it is essential to include the experiences and perspectives of clients with lived experience of SMI.

Mental health concerns among juvenile-justice-involved youth (JJIY) continue to be a major health crisis in the United States (US). While scholarship has explored mental health concerns among JJIY, and the link to negative life outcomes, there are gaps in the existing research, particularly in effective interventions and models aimed at addressing both the mental health concerns and criminogenic risk contributing to recidivism and other negative life outcomes of this population. In this paper, we present Justice-Based Interdisciplinary Collective Care (JBICC), an innovative framework to address both the mental health needs and delinquent behavior of youth offenders. The model bridges community partners, with the purpose of informing future interventions, implementations, and research in this area. Increased justice-based interdisciplinary collective collaboration between the juvenile justice system and community programs/organizations would be a major benefit to youth offenders and their families. We also focus on the need for cultural responsiveness to be interwoven throughout all aspects of treatment. JBICC offers an opportunity to expanded services outside traditional settings and methods to ensure that youth offenders and their families receive validating and culturally responsive access to services.

Suicide is a significant public health problem, yet barriers to treatment remain. To address barriers and meet needs, Congress designated a new 988 dialing code to increase utilization of the National Suicide Prevention Lifeline. As a result, call volume increased, and demand for community-based crisis services is expected. To examine the availability of community-based crisis care, we analyzed information collected from 2020 to 2022 Crisis Intercept Mapping (CIM) technical assistance workshops conducted with communities across the country. We found that training and implementation of suicide risk screening, safety planning, lethal means safety, and follow-up were limited and inconsistent among communities in our study. Collaboration was variable, impacting the ability of communities to support care transitions. Participants described multiple barriers to the routine implementation of evidence-based care and identified potential solutions for addressing them. Findings suggest a need for relationship building and targeted education and training to meet future demand for crisis care.

In the United States, a disproportionately high number of incarcerated individuals suffer from serious mental illnesses, substance use disorders, chronic medical conditions, infectious diseases, and traumatic brain injuries. Correctional facilities are often ill-equipped to address the incarcerated community's physical and mental health needs. Current laws and policies remain outdated and do not adequately address the complex health issues faced by incarcerated individuals, particularly the aging and terminally ill patients in correctional settings. We present a case of a male with schizophrenia whose ongoing psychiatric symptoms impaired his decisional capacity, leading to him to refuse medical treatment for an initially treatable medical condition, ultimately resulting in his death due to the lack of a surrogate decision-maker. This case underscores the urgent need for policy revisions to assign medical decision-making authority for individuals in custody and highlights potential interventions to bridge existing gaps in care for this population.

The significant rise in the prevalence of mental health disorders among school children and adolescents in Lebanon and conflict zones necessitate immediate interventions. Despite this elevated prevalence, such communities currently lack effective programs which clearly identify the concepts of mental health promotion and prevention among school children. Addressing this gap, our paper aims to propose a contextual model and framework for educators, researchers and policy-makers. The proposed model includes 3-levels comprising set of actions and interventions. Interventions adopted at each level should be fine-tuned to produce a caring and supportive learning environment that effectively incorporates the three essential domains of student's mental health: promoting mental health protective factors, notably social and emotional learning (SEL) and resilience, as well as preventing mental health disorders (MHD). Interventions set at each level are elaborated in the framework and linked to the corresponding segments present in the school environment to include teachers, family, community, media, and policymakers. The framework also extends these interventions to encompass the core competencies of SEL, resilience, as well as the prevention of the most prevalent mental health disorders in conflict zones.

Social groups and identities significantly influence mental health outcomes, yet their impact in resource-poor communities remains understudied. We explored the role of social group memberships and identities in shaping mental health experiences in two urban poor communities in Ghana. Data from 77 participants were analyzed thematically, revealing widespread engagement in social groups that provide access to both material and symbolic resources. However, these groups also serve as sources of tension and contribute to the stigmatization and marginalization of vulnerable members. Those affected include individuals with severe mental disorders, men experiencing depression, young men involved in substance abuse, family caregivers, migrant and tenant households, and otherwise healthy individuals with recurring psychosocial challenges. The groups exacerbate mental health challenges and restrict access to care among marginalized populations. The findings underscore the need for targeted interventions aimed at enhancing mental health support and reducing stigma in resource-poor settings.

The purpose of this program evaluation was to examine preliminary outcomes associated with a novel stepdown program for clients of early intervention in psychosis services ("Step Up") that featured occupational therapy (OT) as a critical treatment component. Clients participated in Step Up for at least 6 months and were administered pre-post assessments of clinician-rated performance of daily living activities and self-perceived performance and satisfaction with daily occupational functioning. Paired samples Wilcoxon tests were used to compare outcomes across the two time points. Data from 23 participants of Step Up were analyzed. Clinician-rated performance of daily living (especially in the areas of money and time management and leisure engagement) and client-rated performance and satisfaction with daily occupational functioning improved significantly over time. Results demonstrate the promise of programs such as Step Up that capitalize on OT and promote functional outcomes during the transition from early intervention.

Peer recovery coaches utilize their lived experiences to support overdose survivors, a role gaining prominence across communities. A convergent mixed methods design, informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, was used to evaluate the Recovery Opioid Overdose Team Plus (ROOT +), through an iterative evaluation using web-based surveys and qualitative interviews. Reach: Over 27 months, ROOT + responded to 83% of suspected overdose referrals (n = 607) and engaged with 41% of survivors (n = 217) and 7% of survivors' family/friends (n = 38). Effectiveness: Among those initially engaged with ROOT +, 36% of survivors remained engaged, entered treatment, or were in recovery at 90 days post-overdose (n = 77). Adoption: First responders completed 77% of ROOT + referrals (n = 468). Implementation: Barriers included lack of awareness of ROOT + , working phones, and access to treatment from community partner interviews (n = 15). Maintenance: Adaptations to ROOT + were made to facilitate implementation. Peer-led teams are promising models to engage with overdose survivors.

South Asians (SAs) underutilize mental health services compared to many racial and ethnic groups in the United States (US), yet there is limited research on the experiences of SAs living with severe mental illness (SMI). This study examined psychiatric healthcare experiences of SA patients with SMI diagnoses (e.g., severe depression, bipolar disorder, schizophrenia) in New York City. Data collection included semi-structured interviews with 36 participants (21 patients, 11 family members, 4 clinicians). Data was managed in NVivo. Two pairs of SA researchers conducted thematic analysis. Limited mental health knowledge led to delayed care for SAs due to a low perceived need for help. Ease of access, linguistic resources, patient-provider relationships, and family involvement influenced psychiatric healthcare experiences. Prescribed medications, self-motivation, communication, and religious practices were factors aiding symptom management and recovery. Findings highlight the need for improving psychiatric healthcare access and culturally-salient mental health education for SA communities.

Traditional medical models have given way to recovery-oriented approaches over the years in the management of individuals with serious mental illnesses. However, very little is known about such recovery-based models in the Indian context. This qualitative study used a phenomenological approach to explore the experiences and meanings of recovery among individuals with serious mental illness in southern India. Purposive sampling with maximum variation was used to recruit participants. In-depth interviews were conducted with ten participants, using a semi-structured interview guide. Thematic analysis resulted in three themes: "The illness journey," "Life minus illness = Recovery," and "It takes a village to recover,". Illness and recovery seemed to be two sides of the same coin with the context playing an influential role in the perceptions of recovery. The term "recovery" seemed to be a misnomer giving the impression that one is expected to return to an illness free state.