Predictors of Post-Treatment Employment for Individuals with Substance Use Disorders Abstract This study examined the influence of gender, post-treatment issue severities, and treatment participation rate on the post-treatment employment status of consumers with substance use disorders. The study analyzed the archival data of 100 unemployed and underemployed participants from a substance abuse intensive outpatient program. We found significant differences in the characteristics of gender, severity of alcohol use, drug use, psychiatric issues, and treatment participation rate. Female gender and low treatment participation rates negatively predicted employment. This study increased understanding about the interplay of alcohol, drug, and psychiatric influences on post-treatment employment status.

Changing Rates of Mental Health Disorders Among Veterans Treated in the VHA During Troop Drawdown, 2007–2013 Abstract Nationally representative data on mental health disorder prevalence are critical to set informed mental health priorities and policies. Data indicating mental health diagnoses within our nation’s veteran population treated at the Veterans Health Administration (VHA) are available, but have yet to be examined for changing trends to inform both VHA and community care. We use VHA national program evaluation data from a time of increasing military enrollment (2007) to troop draw down (2013) to examine changes over time in the number of diagnoses in veterans receiving VHA services. The number of veterans in all diagnostic categories increased during our study period with the smallest increase in psychotic disorders (8%) and the largest in posttraumatic stress disorder (71%). Trends in behavioral health diagnoses among veterans have important implications for policy and clinician competencies within VHA and community providers as veteran mental health care needs change.

A Place to Call Home: Hearing the Perspectives of People Living with Homelessness and Mental Illness Through Service Evaluation Abstract There is an ongoing need to incorporate the perspectives of people in supported community housing to improve the provision of integrated mental health services. This study aimed to explore the satisfaction and experiences of people who have received supported housing and mental health services. We conducted a retrospective, mixed methods study using a data mining approach, analyzing consumer satisfaction survey responses collected on discharge from the service over a 7-year period. Responses from 178 consumers aged between 20 and 62 years were included. Quantitative results indicated that consumers rated the quality of services as relatively high. Analysis of qualitative responses identified seven themes describing people’s views on how they had benefitted from the service. Consumers reported benefits in terms of practical and emotional supports, responsiveness of the team to their needs, socialization and community integration, personal growth and recovery, and finding ‘my place’. Themes of learning and skills development were also important. These results suggest that practical support, together with emotional expressions of care and compassion are most valued by people who participated in this service. This research has implications for service evaluation and for future research, which may include focusing on the key role of connectedness, ‘my place’ and hope for recovery.

“Not Just One, It’s Both of Us”: Low-Income Mothers’ Perceptions of Structural Family Therapy Delivered in a Semi-rural Community Mental Health Center Abstract Qualitative methods were used to explore mothers’ perceptions of structural family therapy (SFT) delivered in a semi-rural community mental health clinic. In-depth, semi-structured interviews were conducted with sixteen mothers who received SFT after seeking services for their children. Thematic analysis suggests mothers found SFT acceptable and valuable. Mothers reported using SFT strategies to regain parental authority, which they believed improved their ability to manage their child’s needs and decreased their own stress. SFT also increased some mothers’ receptivity to individual treatment. Mothers identified their low dose of treatment and lack of father involvement as impediments to improvement, raising concerns about intervention sustainability.

Psychiatric Diagnoses and Medications for Hurricane Harvey Sheltered Evacuees Abstract To report on the diagnosis of and pharmacological services provided to 229 evacuees of Hurricane Harvey housed within a large convention center. Retrospective chart review of services rendered. Evacuees were primarily adults who presented with varied diagnoses, most commonly mood, anxiety and/or psychotic disorders. There was significant need for medications and psychosocial support to address preexisting conditions, as well as emerging problems (e.g., insomnia). Individuals presenting for pharmacological services following natural disasters may require medications to continue ongoing care, and/or treatment for insomnia. Therapists can provide direct intervention as well as identify those in need of further evaluation/intervention. Providers should be prepared with a fully stocked pharmacy, accessible but confidential location, and a pre-established method of record keeping.

Association Between Earthquake Exposures and Mental Health Outcomes in Phulpingdanda Village After the 2015 Nepal Earthquakes Abstract In 2015, two strong earthquakes, as well as continuous, high magnitude aftershocks, struck Nepal. Phulpingdanda village was greatly impacted due to its lack of infrastructure and environmental remoteness. Adults from sampled households were surveyed 1-year later to examine the association between earthquake exposures and indicators of depression, post-traumatic stress disorder (PTSD), and resilience. Results showed 33% of surveyed residents screened positive for depression, 9% screened positive for severe PTSD, and 46% displayed moderate to high resilience. Additionally, participants experienced resource loss (100%), damaged home and goods (99%), and exposure to the grotesque (82%). Traumatic earthquake experiences related to personal harm were associated with symptoms of depression and PTSD and resource loss was associated with depressive symptoms. Earthquake experiences associated with less damage to home and goods, but greater exposure to the grotesque were associated with increased resilience. This research adds to our knowledge of the relationship between traumatic exposures and indicators of psychological distress and resilience following a disaster.

Integrative Body–Mind–Spirit (I-BMS) Practices for Schizophrenia: An Outcome Literature Review on Randomized Controlled Trials Abstract Prior reviews show that certain complementary and alternative practices are promising for patients with schizophrenia. The aim of this study is to review the outcome literature on intervention studies using integrative body–mind–spirit (I-BMS) practices on schizophrenia. This is an outcome literature review of randomized controlled trials (RCTs) on I-BMS practices from 2004 to 2016. The review used a modified Delphi List to assess methodological rigor and the California Evidence-Based Clearinghouse Scientific Rating Scale to evaluate the level of research support for each identified I-BMS practice. This review identified 13 RCTs of I-BMS practices, including mindfulness interventions (5), yoga (3), tai-chi (2), and relaxation (3). I-BMS practices were effective with medium to large effect sizes for alleviating symptoms, decreasing anxiety and stress, improving insight and mindfulness, subjective well-being and social/occupational functioning, as well as decreasing the frequency and duration of re-hospitalization. This review expands the knowledge base of treatment effectiveness pertaining to patients with schizophrenia.

Psychiatric Risk Assessment from the Clinician’s Perspective: Lessons for the Future Abstract Accurate prediction of risk-states in Serious Mental Illnesses (SMIs) is critical for reducing their massive societal burden. Risk-state assessments are notably inaccurate. Recent innovations, including widely available and inexpensive mobile technologies for ambulatory “biobehavioral” data, can reshape risk assessment. To help understand and accelerate clinician involvement, we surveyed 90 multi-disciplinary clinicians serving SMI populations in various settings to evaluate how risk assessment is conducted and can improve. Clinicians reported considerable variability in conducting risk assessment, and few clinicians explicated their procedures beyond tying it to broader mental status examinations or interviews. Very few clinicians endorsed using currently-available standardized risk measures, and most reported low confidence in their utility. Clinicians also reported spending approximately half the time conducting individual risk assessments than optimally needed. When asked about improvement, virtually no clinicians acknowledged biobehavioral, objective technologies, or ambulatory recording. Overall, clinicians seemed unaware of meaningful ways to improve risk assessment.

Effect of a Mindfulness-Based Intervention Program on Comprehensive Mental Health Problems of Chinese Undergraduates Abstract How best to support mental health of young people is an important public health challenge. More empirical researches are need to examine the relationship between mindfulness-based interventions and mental health in China. The present study reports results from a quasi-experiment following a one-group repeated-measures design which investigated the impact of a standard 8-week mindfulness-based cognitive therapy (MBCT) program in 81 Chinese undergraduates (14 males, 67 females, age 20.35 ± 1.35 years). Data was collected using the Symptom Check List 90 (SCL90) at baseline, week 3, week 6 and week 8 in order to examine the trajectory of mental health changes during the MBCT training. The repeated measures analysis of variance showed that the decrease was significant in the scores of somatization (F = 13.432, P < 0.01), obsessive–compulsive symptoms (F = 43.954, P < 0.01), interpersonal sensitivity (F = 36.196, P < 0.01), depression (F = 25.914, P < 0.01), anxiety (F = 26.547, P < 0.01), hostility (F = 19.707, P < 0.01), phobic anxiety (F = 21.145, P < 0.01), paranoid ideation (F = 19.857, P < 0.01) and psychoticism (F = 32.833, P < 0.01). The findings from the present study show that a standard MBCT program may have positive impact on reduction in mental health problems in Chinese undergraduates. Further controlled studies with randomized designs are needed to investigate these promising results in more depth.

Preliminary Report on a Spiritually-Based PTSD Intervention for Military Veterans Abstract Military veterans can experience spiritual/religious struggles such as weakening of beliefs, loss of meaning, increased guilt, difficulty forgiving, and moral challenges as a result of military trauma. While mainstream treatments (e.g., exposure therapy) have been shown to be effective for many, they often fail to address these issues adequately. This paper describes an 8-session spiritually-based group intervention designed to treat trauma-related spiritual wounds among military veterans. A program evaluation conducted with 24 veterans revealed significant reductions in PTSD symptoms, spiritual injury, and negative religious coping from pretest to posttest. The findings support the need for additional PTSD treatment approaches.