scholarly journals Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Jennifer M Reingle Gonzalez ◽  
Michael S Businelle ◽  
Darla Kendzor ◽  
Michele Staton ◽  
Carol S North ◽  
...  

BACKGROUND There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid). Many barriers (eg, limited transportation, inability to schedule appointments, and limited knowledge of available services) prevent homeless adults who were recently released from incarceration from obtaining available case management, crisis management, substance abuse, and mental health services. OBJECTIVE The aim of the Link2Care study is to assess the effectiveness of a smartphone app for increasing case management and treatment service utilization, and in turn reduce homelessness and rearrest. The goals of this research are to (1) assess the impact of an innovative smartphone app that will prompt and directly link recently incarcerated homeless adults to community-based case management services and resources and (2) utilize in-person and smartphone-based assessments to identify key variables (eg, alcohol or drug use, social support, psychological distress, and quality of life) that predict continued homelessness and rearrest. METHODS Homeless adults (N=432) who enroll in a shelter-based Homeless Recovery Program after release from the Dallas County Jail will be randomly assigned to one of the three treatment groups: (1) usual case management, (2) usual case management plus smartphone, and (3) usual case management with a study-provided smartphone that is preloaded with an innovative case management app (smartphone-based case management). Those assigned to smartphone-based case management will receive smartphones that prompt (twice weekly) connections to shelter-based case managers. The app will also offer direct links to case managers (available during normal business hours) and crisis interventionists (available 24 hours a day, 7 days a week) with the touch of a button. RESULTS Recruitment began in the spring of 2018, and data collection will conclude in 2021. CONCLUSIONS This research represents an important step toward integrated service connection and health care service provision for one of the most underserved, high need, and understudied populations in the United States. CLINICALTRIAL ClinicalTrials.gov NCT03399500; https://clinicaltrials.gov/ct2/show/NCT03399500 (Archived by WebCite at http://www.webcitation.org/6zSJwdgUS) REGISTERED REPORT IDENTIFIER RR1-10.2196/9868

2004 ◽  
Vol 5 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Mary Vaughan Sarrazin ◽  
James A. Hall

Substance abuse can have a devastating effect on the social support networks of individuals. This article describes the impact of a comprehensive model of case management on substance abuse treatment clients’ perceptions of social support. Social support was defined using a well-documented typology identifying six provisions for social support. The Iowa Case Management Project (ICMP) for Rural Drug Abuse was a randomized clinical trial using a longitudinal design. Clients were recruited from the residential treatment program of one rural Midwestern substance abuse treatment agency and were randomly assigned to one of three experimental conditions that received case management according to a strengths-based model, or to a control group. Client perceptions of social support were measured up to 12 months after treatment initiation. Results indicated that case management positively impacted overall perceptions of social support subsequent to treatment admission, as well as perceptions of support in two of the six provisions of support. Reassurances of worth, which is the recognition of one’s competence, skills, and value by others, and attachment, which reflects close emotional bonds with others, were both significantly improved for clients who received case management. However, the effectiveness of case management in improving social support appears to be limited to clients who are married or have significant partners.


2020 ◽  
pp. bmjmilitary-2020-001622 ◽  
Author(s):  
Dominic Murphy ◽  
C Williamson ◽  
J Baumann ◽  
W Busuttil ◽  
N T Fear

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.


2021 ◽  
pp. 089198872199681
Author(s):  
Kerry Hanna ◽  
Clarissa Giebel ◽  
Hilary Tetlow ◽  
Kym Ward ◽  
Justine Shenton ◽  
...  

Background: To date, there appears to be no evidence on the longer-term impacts caused by COVID-19 and its related public health restrictions on some of the most vulnerable in our societies. The aim of this research was to explore the change in impact of COVID-19 public health measures on the mental wellbeing of people living with dementia (PLWD) and unpaid carers. Method: Semi-structured, follow-up telephone interviews were conducted with PLWD and unpaid carers between June and July 2020. Participants were asked about their experiences of accessing social support services during the pandemic, and the impact of restrictions on their daily lives. Results: 20 interviews were conducted and thematically analyzed, which produced 3 primary themes concerning emotional responses and impact to mental health and wellbeing during the course of the pandemic: 1) Impact on mental health during lockdown, 2) Changes to mental health following easing of public health, and 3) The long-term effect of public health measures. Conclusions: The findings from this research shed light on the longer-term psychological impacts of the UK Government’s public health measures on PLWD and their carers. The loss of social support services was key in impacting this cohort mentally and emotionally, displaying a need for better psychological support, for both carers and PLWD.


2021 ◽  
Vol 7 ◽  
pp. 237796082110242
Author(s):  
Anna E. Schierberl Scherr ◽  
Brian J. Ayotte ◽  
Marni B. Kellogg

Introduction Staff and equipment shortages and an easily transmissible virus make working in the COVID-19 pandemic demanding physically and psychologically. Nurses on the frontlines are particularly vulnerable to the adversity of working under these conditions, particularly with regard to mental health. Thus, understanding risk and protective factors for this vulnerable and essential group is critical for identifying potential targets of interventions. We had two aims for the current study: (a) to examine work functioning and symptoms of depression, anxiety, and posttraumatic stress (PTSD) among nurses who did and did not care for patients with COVID-19; and (b) to determine if resilience and social support moderate these relationships. Methods For three weeks in July 2020, nurses across the United States were invited to participate in an online survey collecting data on demographics, resilience, social support, and screening measures of depression, PTSD, anxiety, and distracted practice. Data were analyzed using descriptive statistics and hierarchical regression for each outcome measure. Conclusions Our findings support a growing body of research reporting that nurses are experiencing mental health sequelae during the COVID-19 pandemic, especially those providing direct care to patients with the virus. We found that compared to nurses who did not care for patients with COVID-19, those who did reported increased symptoms of PTSD, depression, and anxiety. A novel contribution is our finding that nurses providing direct COVID-19 care also experienced increased levels of distracted practice, a behavioral measure of distraction linking to a potential impact on patient care. We also found that resilience and social support acted as moderators of some of these relationships. Fostering resilience and social support may help buffer the effects of providing care to patients with COVID-19 and could potentially decrease nurse vulnerability to developing psychological symptoms and impairment on the job.


2002 ◽  
Vol 181 (1) ◽  
pp. 17-21 ◽  
Author(s):  
S. J. Ziguras ◽  
G. W. Stuart ◽  
A. C. Jackson

BackgroundEvidence on the impact of case management is contradictory.AimsTo discuss two different systematic reviews (one conducted by the authors and one conducted through the Cochrane collaboration) that came to contradictory conclusions about the impact of case management in mental health services.MethodWe summarised the findings of the two reviews with respect to case management effectiveness, examined key methodological differences between the two approaches and discuss the impact of these on the validity of the results.ResultsThe differences in conclusions between the two reviews result from the differences in inclusion criteria, namely non-randomised trials, data from unpublished scales and data from variables with skewed distributions. The theoretical and empirical effects of these are discussed.ConclusionsSystematic reviewers may face a trade-off between the application of strict criteria for the inclusion of studies and the amount of data available for analysis and hence statistical power. The available research suggests that case management is generally effective.


Author(s):  
Naila Yaqoob ◽  
Sadaf Ahsan

Objective: The present study investigated the impact of perceived social-support and parental-bonding in predicting suicidal intent among self-harm patients.Methods: Cross-sectional research design was used in current study. Study was conducted at Foundation University, Rawalpindi from February, 2019 to September, 2019. A purposive sample of 50 self-harm patients was collected from different mental health departments of hospitals of Rawalpindi, Jhelum and Peshawar. Participants were administered Multidimensional Scale of Perceived Social Support (MSPSS), Parental-Bonding Instrument (PBI) and Beck Suicide Intention Scale (BSIS). Data was analyzed through SPSS using correlation, t test and regression. Differences on the basis of demographic variable were also studied.Results: The main results of the study specified that social support and parental bonding’ factor ‘care’ had significant negative correlation with suicide intent. Moreover, it negatively predicted suicide intent. Whereas, parental boding’ factor ‘overprotectiveness’ had significant positive correlation with suicide intent and significantly positively predicted suicide intent. Conclusion: The outcomes of present study emphasized that social-support and parental bonding both can play substantial roles in saving lives. Researchers and mental health experts will be able to start examine about the factors that distinguish deliberate self-harm from attempted suicide as well as the characteristics common to both conducts. Continuous...


2019 ◽  
Author(s):  
Teal Bohrer ◽  
Cass Dykeman

Rates of death by suicide continue to increase across the United States. Mental health clinicians often have contact with individuals expressing suicidal ideation, but research suggests clinicians may not be appropriately prepared to assess a client’s suicide risk. Numerous models and theories explain and assess suicidal ideation. In 2009, Thomas Joiner and his colleagues proposed the interpersonal-psychological theory of suicide (IPT), which focused on three main factors strongly supported by research over the preceding decade. The present study utilized a nonconcurrent, multiple-baseline, multiple-probe design as well as a one-group pretest–posttest design to examine the impact of an IPT-based training model. Participants were preservice mental health clinicians currently enrolled in Master’s degree programs. Participants completed assessments on IPT knowledge and suicide-assessment self-efficacy, and results from this study indicated a significant increase in knowledge after completion of the training, as well as a slight decrease in self-efficacy. This study suggests that suicide-assessment training, even when done remotely, can increase suicide-assessment knowledge. Future research should explore preservice mental health clinicians’ self-efficacy as well as those factors influencing the confidence these professionals feel in their assessments of risk.


2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Reka Sundaram-Stukel ◽  
Ousmane Diallo ◽  
Benjamin Wiseman ◽  
Richard E. Miller

ObjectiveIn this paper we used hospital charges to assess costs incurred dueto prescription drug/opioid hospitalizationsIntroductionThere is a resurgence in the need to evaluate the economic burdenof prescription drug hospitalizations in the United States. We used theWisconsin 2014 Hospital Discharge data to examine opioid relatedhospitalization incidence and costs. Fentanyl, a powerful syntheticopioid, is frequently being used for as an intraoperative agent inanesthesia, and post-operative recovery in hospitals. According to a2013 study, synthetic Fentanyl is 40 times more potent than heroinand other prescription opioids; the strength of Fentanyl leads tosubstantial hospitalizations risks. Since, 1990 it has been availablewith a prescription in various forms such as transdermal patches orlollipops for treatment of serious chronic pain, most often prescribedfor late stage cancer patients. There have been reported fatal overdosesassociated with misuse of prescription fentanyl. In Wisconsin numberof total opioid related deaths increased by 51% from 2010 to 2014with the number of deaths involving prescription opioids specificallyincreased by 23% and number of deaths involving heroin increasedby 192%. We hypothesized that opioids prescription drugs, as a proxyof Fentanyl use, result in excessive health care costs.MethodsOpioid hospitalizations was defined as any mention of the ICD9codes (304,305) in any diagnostic field or the mention of (:E935.09) onthe first listed E-code. Our analysis used the Heckman 2-stage model,a method often used by Economists in absence of randomized controltrials. In presence of unobserved choice, for example opioid relatedhospitalizations, there usually is a correlation between error in anunderlying function (fentanyl prescription) and an estimated function(hospital charges) that introduces a selection bias. Heckman treats thiscorrelation between errors as an omitted variable bias. Therefore, weestimate a Heckman two step model using hospitalization: where theselection function is the probability of being hospitalized for syntheticopioid via logistic regression. Finally, we estimate the hospitalcharges realized if the patient was given opioids.ResultsMale patients are significantly more likely to be hospitalized foropioids than are female patients; while white patients are significantlymore likely to be admitted for opioid usage than other racialgroups. We also find that comorbid factors, such as mental health,significantly impact hospital charges associated with opioid use. Wefind that persons with private health insurance are associated withhigher rates of opioid use.ConclusionsUsing a Heckman two step approach we show that comorbidconditions such as mental health, Hepatitis C, injuries, etc significantlyaffect hospital charges associated with hospitalization. We usethese findings to explore the impact of the 2013 rule mandatingdoctors share opioid prescription information on the incidence ofopioid related death and hospital charges associated with opioidprescriptions. This work is policy relevant because alternatives toopioid prescription such as meditation, pain management therapiesmay be relevant.


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