Medicine and Health Sciences Commons^™

Interprofessional Team Collaboration To Study Integrated Behavioral Health Services In Primary Care, Priya Srivastava, Sindhura Nemani, Danielle Schweitzer, Anne C. Jones

Rowan-Virtua Research Day

• In Rowan Family Medicine (Sewell, NJ), an interprofessional team of medical and clinical psychology professionals and trainees collaborate to investigate the integration of behavioral health in patients’ primary care visits.

• We screen patients for PTSD symptoms using the DSM CAPS-5 during their primary care visits

• The PTSD Coach app is then encouraged to use 3x a day

• By making mental health care more accessible to patients, we strive to help meet the increased demand and alleviate the strain our healthcare system is currently experiencing.

• The team composed of Medicine and Clinical Psychology allows students to gain invaluable experience in interdisciplinary …

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Developing Healthy Routines In Adults With Serious Mental Illness Living In Supportive Housing: A Caregiver Guidebook, Mckenna Kuhlman, Angela Blackwell, Lacey Spark

Spring 2024 Virtual OTD Capstone Symposium

Serious mental illness (SMI) are mental, emotional, or behavioral disorders that result in serious functional impairment limiting daily participation in activities. (National Institute of Mental Health [NIMH], n.d.-a). Adults living with serious mental illness (SMI) often experience unhealthy or maladaptive routines and often lack the support to build these routines. Supportive housing provides a stable home for adults with SMI to build healthy routines while receiving specialized treatments. In supportive housing organizations, there is a need for caregiver resources to support the individual's healthy routine obtainment. This capstone project developed a five-step caregiver guidebook to help adults with SMI build …

Behavioral Health Integration And Outcomes That Matter To Patients: A Longitudinal Mixed-Methods Observational Study, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The study team hypothesized that patients would have a better experience over time in clinics that had greater degrees of behavioral health integration.

Psychotropics Prescription In Primary Care, Ruthzaine Lopez Bolano

Research Colloquium

Background: The study aimed to measure the prevalence of psychotropic prescriptions in primary care at four UTRGV clinical sites. Based on the results, this paper serves to inform and educate primary care providers of their current practices and treatment options when diagnosing mental health disorders and prescribing psychotropics.

Methods: This study used EMR data from January to March 2021 in four primary care clinics affiliated with the UT Health RGV system. Primary care patients from January to March 2021 and who were diagnosed with mood disorders (including Depression, Anxiety, and Bipolar Disorder) were included in this quality improvement study.

Results: …

A Literature Review Of The Psychosocial Impacts On Livestock Producers And Veterinary Responders Involved With Depopulation During And After An Animal Health Emergency, Beth Galles

Capstone Experience

A vital aspect of an animal health emergency in the United States is removing and disposing of diseased and healthy animals through depopulation. It is frequently required to prevent the spread of diseases that affect human health or economic stability. Production animals are eventually slaughtered, but this does not negate the human-animal bond felt between these animals and their caretakers. There is increasing recognition that participation in depopulation may be a traumatic event requiring care for the individuals involved, including livestock producers and veterinarians. Despite this, limited resources are available for these individuals when an animal health emergency occurs. This …

Behavioral Health Grants Overview 2022, Parkview Health

Health Services and Informatics Research

2022 List of Externally and Internally Funded Research for our Behavioral Health Outreach Initiatives.

Our Mission: To strengthen awareness around mental health, support needs in our community, reduce stigma, and encourage people to connect with care.

African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks

Walden Dissertations and Doctoral Studies

Few studies have studied how community-based services (CBS) work to mitigate the strong Black woman image (SBWI) coping mechanism for Black women to improve their mental health. The purpose of this generic, qualitative study was to understand the experiences of 10 African American women, ages 18 and older, who identified with the SBWI and had received CBS to address their stress-related coping strategies. Transactional theory of coping with stress and the SBWI approach was used as the framework to help explain how stress in terms of the SBWI impacted the response of the African American women within their environment. Data …

African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks

Walden Dissertations and Doctoral Studies

Few studies have studied how community-based services (CBS) work to mitigate the strong Black woman image (SBWI) coping mechanism for Black women to improve their mental health. The purpose of this generic, qualitative study was to understand the experiences of 10 African American women, ages 18 and older, who identified with the SBWI and had received CBS to address their stress-related coping strategies. Transactional theory of coping with stress and the SBWI approach was used as the framework to help explain how stress in terms of the SBWI impacted the response of the African American women within their environment. Data …

The Rural Inpatient Behavioral Health Delivery System’S Challenges To Access, Catherine L. Williams

Walden Dissertations and Doctoral Studies

Readmissions occurring in rural areas are an operational problem for administrators of state-owned facilities. The number of state-owned psychiatric beds have decreased by more than 96% nationwide. Georgia has 954 state-owned psychiatric beds (9.3 beds per 100,000 people) and ranks 48th in the United States. This is important as health administrators must ensure quality care for patients. The purpose of this study was to understand the relationship between readmission rate, discharge disposition, and rural access for patients who were admitted to an inpatient state-owned behavioral health center with a diagnosis indicating the patient is seriously mentally ill. The theoretical framework …

Fall Prevention Among Older Adult Behavioral Health Patients, Jodie Shipley

Dissertations

Abstract

Problem: Inpatient falls are a major patient safety issue. Behavioral health units experience higher rates of falls among elderly patients with between 13.1 to 25 falls per 1,000 occupied bed days (OBD). The risk of falls for the aged population is increased on a psychiatric unit due to a myriad of issues including psychotropic medications, over-activity on the unit, and confusion (Wong & Pang, 2019).

Methods: This QI project is an observational descriptive pilot intervention evaluation of a redesigned fall prevention program with the aim to reduce falls on a midsized suburban Midwestern inpatient geriatric behavior health …

Implementing Adverse Childhood Experience Screening In An Intensive Outpatient Mental Health Program, Bryan Amaro

Doctor of Nursing Practice Final Manuscripts

Adverse Childhood Experiences (ACES) are linked to damaging events which happen to people when we are young (0-18). ACEs are connected to a phenomenon known as the toxic stress response which can later become the root etiology for many mental health, substance abuse and chronic medical health complications our society faces. ACEs affect all populations and do not discriminate across socioeconomic, racial, ethnic, gender, or geographic lines. Roughly two thirds of Americans have experienced at least one ACE. This project seeks to perform ACE screening at an Intensive Outpatient behavioral health center by screening for ACEs upon all admissions into …

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

A Behavioral Health Organizational Perspective On Eliminating Restrictive Interventions, Malisa Santana Shuler

Walden Dissertations and Doctoral Studies

To manage difficult behaviors and ensure the safety of clients and staff, behavioral health organizations have often relied on restrictive interventions such as seclusion and restraint. Although organizational leaders are increasingly seeking alternatives, there is very little literature or organizational practice knowledge addressing this issue. The purpose of this qualitative study was to explore, from an organizational leader’s perspective, sustainable best practices after the leaders of a behavioral health organization in the Southeastern region of the United States adopted a statewide initiative to reduce and eliminate restrictive intervention by transitioning to a no seclusion policy. The Baldrige Excellence Framework was …

Association Between Health Literacy Levels And Behavioral Health Hospitalizations And Emergency Department Utilization In The United States, Rebecca Lynn Hoen

Legacy Theses & Dissertations (2009 - 2024)

Behavioral health disorders are common in the United States (US) and are associated with potentially preventable high-cost health care utilization, such as inpatient hospitalization and emergency department utilization. Health literacy (HL) may be an important modifiable contributing factor to this preventable utilization, as limited health literacy is common in the US and has been linked to increased risk of hospitalization and emergency department utilization. However, few published studies have examined the association between health literacy and behavioral health disorders, and no studies have examined either the association between health literacy and utilization or the potential effects HL interventions might have …

Phq 9 Utilization In Maine Health, Steven Gerrish, Kerri Barton, Neil Korsen

Costas T. Lambrew Research Retreat 2021

The PHQ is a brief patient survey for diagnosing depression and monitoring response to treatment.

Mitigating Suicide Risk Post-Discharge From Inpatient Crisis Stabilization: Safety Planning Intervention, Leighia M. Mcghee

Dissertations

Abstract

Purpose: The purpose of this program evaluation is to evaluate the effectiveness of a newly implemented safety planning intervention (SPI) tool, comparing patient outcomes relating to suicide attempt rates, emergency department (ED) encounter rates, and inpatient rehospitalizations rates pre and post its integration to care in a suburban behavioral health hospital.

Methods: A descriptive cohort design utilizing a retrospective chart review was completed over six months, three months pre, and three months post implementation of the SPI program. A convenience sample of inpatient charts was reviewed to assess the rate of suicide attempts, ED encounters frequencies, and hospitalization rates …

School Of Nursing News, Georgia Southern University

School of Nursing News (2013-2023)

• Alumna Serving Behavioral Health Needs of Communities

Strategic Planning At Nationwide Children’S Hospital, Stella Choe

Masters Theses/Capstone Projects

The strategic planning department at Nationwide Children’s Hospital works to plan and make decisions regarding the wellbeing of patients with behavioral health disorders. This project involved an 8-hour workday everyday Friday and on site involvement in the strategic planning department at Nationwide Children’s Hospital. During this process, I was able to support providers specifically in the Youth Crisis Stabilization Unit (YCSU), Nursing Staff in BHP, President & Vice President of Behavioral Health.

Veterans' Perceptions Of Behavioral Health Services For Posttraumatic Stress, Larence Kirby

Walden Dissertations and Doctoral Studies

Behavioral health services exist for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans diagnosed with posttraumatic stress disorder (PTSD); yet, untreated diagnoses may lead to the risk of compromised behavioral health. The purpose of this hermeneutic phenomenological study was to understand the lived experiences of OEF/OIF veterans regarding their decision to seek and retain behavioral health services for addressing PTSD. The research focus and questions were employed through the theoretical concepts of Heidegger’s hermeneutic phenomenological theory, Heider’s attribution theory, and Beck’s cognitive behavioral theory. In-person interviews were conducted to collect data from 8 OEF/OIF veterans who had encounters with behavioral …

Implementation Of A Psychiatric Admission Acuity Tool In The Pediatric Behavioral Health Unit, Tyler T. Wansley

Doctoral Projects

Staffing, patient ratios, and acuity are not new concepts in health care. While these are popular concepts in medical units, inpatient psychiatric facilities are lacking the tools to correctly quantify patient acuity. An even considerably larger gap exists in the literature regarding the quantification of acuity in pediatric behavioral health units.

A needs assessment was conducted to determine if an existing psychiatric acuity tool would prove useful after implementation in a pediatric behavioral health unit. A need for such a tool was found which led to the purpose of this doctoral project, which was to measure nurse satisfaction with the …

Understanding The Implementation Of Integrated Care For People Living With Hiv, Vickie A. Lynn

USF Tampa Graduate Theses and Dissertations

Introduction: The integration of physical and behavioral health services is an innovative method of delivering health care services for persons dual or triply diagnosed with HIV, mental health and/or substance use disorders. Reducing the fragmented delivery of health services by integrating services into one setting is essential to providing holistic patient-centered care and address the complex health needs of this population. Although research shows integrated care improves health outcomes, little is known about the implementation of integrated care in real-world settings because the perspectives and experiences of those delivering and receiving integrated health and social services are underrepresented in the …

Risky Business: Millennials’ Protection Motivation Factors For Norovirus Outbreaks On College Campuses, Dylan Conrad Martinez

Graduate Theses and Dissertations

The risk and severity of hNoV transmission is obscurely recognized to foodservice millennial customers. Most commonly associated with cruise ships, consumers are not aware of its full potential to strike at other locations, especially college campuses. For the foodservice industry and the university community, it is imperative that a proactive method for increasing millennials’ motivation to practice mitigation methods emerges to reduce future hNoV outbreaks on college campuses. Research has shown that students can play a major role in the spread of hNoV on college campuses. Therefore, the purpose of these studies is to examine motivations for health protective behaviors …

Microclinic International Social Network Behavioral Health Intervention In Mongolia, Kalli A. Beasley

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Diabetes is a chronic communicable disease that is projected by 2030 to be the seventh leading cause of death worldwide. In Mongolia diabetes and cardiovascular disease are the number one reason for disability-adjusted life years and trends of diabetes is starting to be observed in the poorer populations. Diabetes in countries like Mongolia are extremely costly to treat using insulin, costing $200 USD per month while the average annual income sits only at $1,466.85 USD. Mongolia has a total population of 2,959,000 and half of its population resides in the capital city of Ulaanbaatar. 60% of residents in capital live …

Effects Of Patient Protection And Affordable Care Act On Behavioral Health Access, Godwin Oshegbo

Walden Dissertations and Doctoral Studies

About 50% of adults in the United States suffer from at least 1 mental health challenge in their lifetime. Annually, mental health and substance use disorders cost the United States about $800 billion, leaving individuals with unaffordable cost of care and the nation with diminished productivity and revenue. With the Essential Health Benefits and Medicaid expansion under the Patient Protection and Affordable Care Act (PPACA), healthcare resources were created to address gaps in behavioral healthcare. There is a need to understand how the healthcare law has influenced the availability of behavioral health services and access to needed care. This study …

Using Online Behavioral Health Modules To Expand Care In Rural New York State, Matthew Sommers

Family Medicine Clerkship Student Projects

There are substantial barriers to receiving behavioral health in rural areas such as Upstate New York. Online modules are an evidence-supported option that could exist within a primary care focused stepped-care model, expand access, and increase efficiency of existing resources.

Adverse Childhood Experiences In Rural And Urban Contexts, Jean A. Talbot Phd, Donald Szlosek Mph, Erika C. Ziller Phd

Mental Health / Substance Use Disorders

Recent research shows that rural children are more likely than urban children to experience certain kinds of adversity. Researchers at the Maine Rural Health Research Center looked at how adverse childhood experiences (ACEs) have affected rural and urban adults. Using data from the Behavioral Risk Factor Surveillance System Assessment, this study found that, while the prevalence of ACEs was comparable in rural and urban adults, over half of rural adults surveyed reported having ACE exposure.Among those with any ACE history, about one quarter experienced four or more ACEs. Policy implications and strategies are highlighted in this brief.

Key Findings:

• Past …

Disaster Behavioral Health First Aid Specialist Training For Responders, Center For Leadership In Public Health Practice

Preparedness and Emergency Response Learning Center

Essential awareness, knowledge, and skills to promote behavioral health and wellness through individual and team approaches for preventing, mitigating, and managing disaster worker stress and for developing disaster stress resistance and resilience to the negative effects of critical incident stress exposure.

Transforming Care Of The Behavioral Health Patient In An Emergency Department Setting, Theresa J. Kubiel

Walden Dissertations and Doctoral Studies

Behavioral and mental health issues contribute to the needs of many patients presenting to emergency departments, and yet these needs often go unrecognized. Patient processing procedures in emergency departments may not include mechanisms to consistently identify and triage patients whose care is complicated by behavioral illness. The purpose of this project was to plan a program to improve early identification and management of behavioral health patients presenting to the emergency department. The objective of this project was to develop a rapid mental health screening tool and policies guiding use of the tool in the emergency department. A multi-disciplinary team of …

Behavioral Health Medical Interpreters: Cluster Analysis Of Vicarious Traumatization And Posttraumatic Growth, Pauline N. Stahlbrodt

Walden Dissertations and Doctoral Studies

Medical interpreter services will be essential for developing and implementing culturally relevant interventions and treatment for limited English proficiency (LEP) populations. This study sought to identify the possible risks or protective factors that may be associated with vicarious traumatization (VT) or vicarious posttraumatic growth among medical interpreters in behavioral health settings. A 2-step cluster analysis was conducted yielding 2 distinct groupings of medical interpreters (Subtype 1, n = 73; Subtype 2, n = 101). The most important predictor determining the 2 subtypes was whether the participant had a personal history of trauma. In addition, there were significant differences between the …

Conception To Implementation: Quality Improvement In Behavioral Health Home Organizations, Elizabeth A. Miller

Muskie School Capstones and Dissertations

This capstone project developed quality improvement tools to be used by community mental health agencies participating in the Maine Behavioral Health Homes Initiative. Providing technical assistance, analysis of feedback, and developing recommendations were the foundation of this project with a central tenet to enhance the existing Quality Improvement Project Template created by MaineCare, Maine’s Medicaid Office. These recommendations suggest the Quality Improvement Project Template may be improved by providing an additional fillable quality improvement process outline, providing a list of example projects and focus areas for quality improvement projects, and providing tools to assist in implementation of quality improvement projects. …