Implementing Universal Adult Depression Screening In A Rural Maine Free Medical Clinic, Karen Hussion

Doctor of Nursing Practice Scholarly Projects

Abstract

BACKGROUND: Depression in adults is a leading cause of disability, morbidity and mortality worldwide with an estimated prevalence of 20% in the US population. Despite estimates that one out of every five Americans suffers from depression, less than 50% of adult primary care patients with depression are identified, and less than 5% of all adult primary care patients are screened. To increase early detection and management of depression, the United States Protective Service Task Force (USPSTF) recommends routine depression screening for adults older than 18 years in primary care settings.

LOCAL PROBLEM: This project site was a rural, free, …

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Police Versus Non-Police Response To 988 Crisis Calls, Miriam A. Maloney-Mattheisen Bsn, Rn, Latrina N. Blakemore Msn, Fnp-Bc, Janelle M. Scullark Msn, Fnp-C, Jacqueline Sharp Dnp, Pmhnp-Bc, Sharon Little Dnp, Fnp-Bc, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The 988 Suicide & Crisis Lifeline is a mental health-specific emergency line that became nationally available in July of 2022. This resource allows callers in crisis to connect with trained mental health professionals. Despite the initiation of this new dispatching service, there is still a significant shortage of trained mental health professionals to respond to these calls when they require emergency intervention. The present scoping review aims to determine whether non-police crisis responses correlate to improved outcomes when compared to police response as evidenced by reduced inpatient admissions, reduced arrests, and decreased presence of intrusive traumatic symptoms following intervention. …

Unlv Mental Health Initiatives: Unifying Through Innovation And Collaboration, The Lincy Institute, Unlv Practice, Behere Nv, Unlv Department Of Psychology

Lincy Institute Events

Nevada persistently ranks at or near the bottom in the country for overall access to mental health services despite the need (Mental Health America, 2015-2023). UNLV faculty are developing initiatives to change this unacceptable situation. The Lincy Institute, in partnership with UNLV PRACTICE, BeHERE Nevada, and researchers from the Department of Psychology, offered a community forum showcasing three mental health initiatives harnessing faculty collaboration and innovation to drive overdue changes in Nevada’s mental-health landscape. Following the presentations policymakers engaged in open discussion with UNLV presenters and the audience. The three main initiatives showcased in this forum …

M-Chat Implementation Strategies To Improve Autism Screening Rates In Pediatric Clinics In Metro Detroit, Karamoja Monchamp

Medical Student Research Symposium

The Modified Checklist for Autism in Toddlers (M-CHAT) is the most widely used autism screening tool. However, current practices for M-CHAT roll-outs and follow-ups are not wide-reaching, culturally sensitive, or consistent. This study aims to address the existing barriers to universal autism screenings and design a sustainable implementation strategy for a successful M-CHAT roll-out. We implemented strategies in five Henry Ford Health pediatric clinics, incorporating iPad-administered M-CHAT in waiting rooms, multilingual options, task shifting for referrals, forced choice mechanisms, and audit-and-feedback support. A Clinical Screening Dashboard tracked real-time M-CHAT data, including demographic information, collected from EPIC. Our goal is to …

General Cognitive Ability In High School, Attained Education, Occupational Complexity, And Dementia Risk, Jimi Huh, Thalida Em Arpawong, Tara L. Gruenewald, Gwenith G. Fisher, Carol A. Prescott, Jennifer J. Manly, Dominika Seblova, Ellen E. Walters, Margaret Gatz

Psychology Faculty Articles and Research

INTRODUCTION

We address the extent to which adolescent cognition predicts dementia risk in later life, mediated by educational attainment and occupational complexity.

METHODS

Using data from Project Talent Aging Study (PTAS), we fitted two structural equation models to test whether adolescent cognition predicts cognitive impairment (CI) and Ascertain Dementia 8 (AD8) status simultaneously (N_{Cognitive Assessment} = 2477) and AD8 alone (N_{Questionnaire} = 6491) 60 years later, mediated by education and occupational complexity. Co-twin control analysis examined 82 discordant pairs for CI/AD8.

RESULTS

Education partially mediated the effect of adolescent cognition on CI in the cognitive assessment aample and …

Infant Hedonic/Anhedonic Processing Index (Hapi-Infant): Assessing Infant Anhedonia And Its Prospective Association With Adolescent Depressive Symptoms, Jessica L. Irwin, Elysia Poggi Davis, Curt A. Sandman, Tallie Z. Baram, Hal S. Stern, Laura M. Glynn

Psychology Faculty Articles and Research

Background

Anhedonia, an impairment in the motivation for or experience of pleasure, is a well-established transdiagnostic harbinger and core symptom of mental illness. Given increasing recognition of early life origins of mental illness, we posit that anhedonia should, and could, be recognized earlier if appropriate tools were available. However, reliable diagnostic instruments prior to childhood do not currently exist.

Methods

We developed an assessment instrument for anhedonia/reward processing in infancy, the Infant Hedonic/Anhedonic Processing Index (HAPI-Infant). Exploratory factor and psychometric analyses were conducted using data from 6- and 12-month-old infants from two cohorts (N = 188, N = 212). …

Evidence Synthesis Methodology: Promoting Reproducible Methodology Through Modified Assignments, Laura Lipke, Neyda Gilman

Library Created Resources

Initially, systematic reviews in healthcare served to synthesize findings from clinical studies, aiding comprehensive access to the most effective treatments within evidence-based practice. Over time, their scope has broadened beyond treatment effectiveness, leading to a surge in publication. Consequently, many health science faculty now assign systematic reviews in classrooms without a full grasp of the standardized process, leaving students ill-equipped due to insufficient guidance and resources.

While mastering systematic review techniques is crucial for evidence-based practice, faculty can opt for modified assignments to foster a deeper understanding of the review process. These modified tasks, can be completed within a semester, …

The Image Of Schizophrenia In Spain's Healthcare System, Meghan Webb

CISLA Senior Integrative Projects

Schizophrenia affects thousands of people in Spain and is one of the most serious mental health disorders in existence. Despite its this characteristic, schizophrenia did not always get the proper attention it deserved within the country’s healthcare system. This was largely due to the influence that the Spanish government had, and continues to have, over the healthcare system, giving it the power to choose how the disorder was represented. Therefore, what does that mean for schizophrenia in Spain’s healthcare system today? This essay will explore the ways in which schizophrenia was represented in Spain’s healthcare system through an examination of …

Assessment Of Simultaneous Alcohol And Cannabis Use And Its Related Consequences And Cognitions In College Students: A Narrative Review, Jennifer L. Shipley, Abby L. Braitman

Psychology Faculty Publications

As rates of students using cannabis continue to rise, simultaneous use of alcohol and cannabis (such that their effects overlap; commonly referred to as simultaneous alcohol and marijuana [SAM] use) is prevalent among college students who use both substances. Although research focusing on SAM use and related cognitions and consequences continues to grow, there are no common established measures, as approaches vary across studies. This narrative review identifies current methods for assessing SAM use and measures of SAM-related consequences and cognitions (motives and expectancies) among college students, evaluates how they were developed, identifies gaps in the literature, and provides recommendations …

Mental Health Differences In Medical Students Based On Curriculum And Gender, Maxim Jestin, Shelly Sharma, Deval Jhaveri, Brittany Mitchell, Dean Micciche, Venkat Venkataraman, Kathryn Lambert

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: The prevalence of mental health struggles among students in medical school is widely reported; however, little is known about how it is impacted by the medical school curriculum. This study aimed to evaluate differences in anxiety, depression, and emotional exhaustion in medical students based on gender, class year, and curriculum.

METHODS: An anonymous online survey consisting of questions from established, validated questionnaires about demographics, anxiety, depression, emotional exhaustion, and personal health behaviors was sent to 817 medical students who attended Rowan-Virtua School of Osteopathic Medicine during the Spring of 2021. When applying to this school, each of these students …

Does Probiotic Supplementation Help Decrease Symptoms In Adults Previously Diagnosed With Major Depressive Disorder?, Alexa Hammock, Hayley Loiselle

Physician Assistant Capstones, 2020-current

Objective: To assess the effect of probiotic supplementation on clinical symptoms of major depressive disorder in adults. Design: Systematic literature review. Methods: Searches were performed on PubMed using the terms “adults with depression and probiotics”. The limits on PubMed were set to include randomized control trials, studies on adults, studies done within the last 10 years, studies done on patients that did not have depression, studies that did not use the Beck Depression Inventory, and studies that focused on other conditions. Results: Three studies were found that met search criteria: Reninghaus et al., Schaub et al., and Chahwan et al. …

Integrating Stakeholder Feedback Into The Design Of A Peer-Delivered Primary Care Wellness Program: A Rapid Qualitative Study, Emily M. Johnson, Kyle Possemato, Matthew Chinman, Gala True, Jacob Hedges, Brittany N. Hampton, E. Jennifer Edelman, Stephen A. Maisto

School of Medicine Faculty Publications

Background: Individuals seen in Primary Care with behavioral health concerns who decline behavioral health treatment may benefit from the support of peers (consumers in recovery from behavioral health concerns employed to support other consumers). Whole Health STEPS is a new intervention for Veterans in Primary Care with behavioral health concerns which combines essential elements of peers’ role and the Whole Health model using a stepped-care design. We incorporated stakeholder feedback in the Whole Health STEPS design to improve fit with Veterans, peers, and primary care settings. Methods: We conducted semi-structured qualitative interviews with VA staff using questions derived from the …

High Acceptability, Convenience And Reduced Carbon Emissions Of Tele-Neurology Outpatient Services At A Regional Referral Centre In Kenya, Fazal Yakub, Jasmit Shah, Dilraj Sokhi

Internal Medicine, East Africa

Background: There is severe shortage of neurologists in sub-Saharan Africa. Tele-neurology consultations (TNC) can bridge this service gap, but there is very little published evidence on TNC in our setting, which we addressed through our study.

Methods: We prospectively enrolled patients at our neurology outpatients from October 2020 to October 2021. We administered a post-TNC questionnaire which captured satisfaction/acceptability using Likert scales. A sub-group of participants who also did in-person consultations (IPC) were additionally administered post-IPC questionnaires. Statistical comparisons were made using the paired student t-test, and descriptive data expressed as median (inter-quartile range).

Results: From 219 enrolled patients, 66.7% …

Effects Of Sex And Estrous Cycle On Intravenous Oxycodone Self-Administration And The Reinstatement Of Oxycodone-Seeking Behavior In Rats, Nicole M. Hinds, Ireneusz D. Wojtas, Corinne A. Gallagher, Claire M. Corbett, Daniel F. Manvich

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The increasing misuse of both prescription and illicit opioids has culminated in a national healthcare crisis in the United States. Oxycodone is among the most widely prescribed and misused opioid pain relievers and has been associated with a high risk for transition to compulsive opioid use. Here, we sought to examine potential sex differences and estrous cycle-dependent effects on the reinforcing efficacy of oxycodone, as well as on stress-induced or cue-induced oxycodone-seeking behavior, using intravenous (IV) oxycodone self-administration and reinstatement procedures. In experiment 1, adult male and female Long-Evans rats were trained to self-administer 0.03 mg/kg/inf oxycodone according to a …

Rural Mental Health Care During A Global Health Pandemic: Addressing And Supporting The Rapid Transition To Tele-Mental Health, Shawnda Schroeder, Holly Roberts, Thomasine Heitkamp, Brandy Clarke, Heather J. Gotham, Erika Franta

Indigenous Health Faculty Publications

The adoption of tele-mental health by mental health professionals has been slow, especially in rural areas. Prior to 2020, less than half of mental health agencies offered tele-mental health for patients. In response to the global health pandemic in March of 2020, mental health therapists across the U.S. were challenged to make the rapid shift to tele-mental health to provide patient care. Given the lack of adoption of tele-mental health previously, immediate training in tele-mental health was needed. This article describes collaborative efforts between two mental health technology transfer centers and one addiction technology transfer center in rural regions of …

Tf-Cbt Training Augmented With A Self-Care Focus: Understanding Facilitators And Barriers To Treatment Implementation., Julie P. Harrison, Esther Deblinger, Elisabeth Pollio, Beth Cooper, Robert A Steer

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Clinicians working with youth exposed to trauma may be at increased risk for experiencing elevated levels of stress and symptoms of secondary traumatic stress, which can negatively impact clinician wellbeing and ultimately contribute to reduced access to quality care for clients. An innovative Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training incorporating self-care practices (i.e., Practice What You Preach; PWYP) was developed to help facilitate the implementation of TF-CBT and to enhance clinicians' coping and decrease stress. The primary purpose of this study was to determine whether the PWYP-augmented training met three Objectives: (1) increase clinicians' feelings of TF-CBT competency; (2) improve …

Mental Health And Psychological Well-Being Of Kenyan Adolescents From Nairobi And The Coast Regions In The Context Of Covid-19, Gideon Mbithi, Adam Mabrouk, Ahmed Sarki, Rachel Odhiambo, Mary Namuguzi, Judith Dzombo, Joseph Atukwatse, Margaret Kabue, Paul Mwangi, Amina Abubakar

Institute for Human Development

Background Despite the high burden of mental health problems during adolescence and its associated nega- tive consequences, it has remained neglected especially in sub-Saharan Africa. The 2019 novel Coronavirus disease (COVID-19) pandemic has placed additional stress on adolescent mental health. However, there are few studies docu- menting the burden of mental health problems and even fewer mental health services in the region. In relation to the limited body of knowledge, the present study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 …

A Research Review Of Antidepressants For The Treatment Of Major Depressive Disorder, Connor Grady

Senior Honors Theses

The prevalence of major depressive disorder (MDD) in the U.S. has been significantly on the rise between 2015 and 2020, with adolescents and young adults (ages 18-34) contributing the most to this increase (Goodwin et al., 2022). The trend represents a disturbing downturn in the mental health of U.S. adults and warrants close attention and consideration. As the case number of MDD has continuously risen in the recent past, medical practitioners have been searching for more effective solutions. The techniques for combating the symptoms and curing the disease have varied, but one option consistently respected throughout the literature has been …

Case Series: Continued Remission Of Ptsd Symptoms After Discontinuation Of Prazosin, Christie Richardson, Jonathan Yuh, Jing Su, Martin Forsberg

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Post-traumatic stress disorder is a debilitating chronic illness that affects 6 out of 100 adults after a severe trauma. The alpha-adrenergic antagonist prazosin, which is prescribed off-label for flashbacks and nightmares due to trauma, is often continued indefinitely due to reports of symptoms returning upon discontinuation. There is no standard guidance for a trial of discontinuation of prazosin due to intolerance or side effects. In this case series, three patients are started on prazosin leading to remission of trauma-related symptoms, and symptoms continue to remit after treatment for an average of about 2 years followed by discontinuation of the medication. …

The Global Anxiety Crisis In Teenagers And A Proposed School-Based Preventative Intervention Plan Focusing On Building Resilience In Children, Lia Darling

Independent Study Project (ISP) Collection

The impacts of the COVID-19 pandemic and climate change have significantly influenced teenagers, creating a global anxiety crisis. This paper discusses why and how the pandemic and climate crisis increased anxiety in teenagers and the ways that prevent anxiety disorders like building resilience in children. While there is much literature on the negative effects on mental well-being, few propose solutions. This paper discusses the urgent need for preventative interventions to decrease the risk of developing an anxiety disorder along with proposing a framework for a school-based intervention focusing on building resilience skills in children. The paper used a mix method …

Psychology University Students’ Mental Health Status During Covid-19 Pandemic In Karachi, Pakistan, Aisha Noorullah, Mubarak Mansoor, Ayesha Zahid

Department of Psychiatry

Purpose: The COVID-19 pandemic has brought challenges in various domains of life but for low and middle-income country university students very demanding situations have emerged. University students’ psychological well-being has always been an area of concern worldwide and higher rates of anxiety and depression have been extensively reported among this cohort.
Objective: To determine the frequency of depressive symptoms, anxiety symptoms, and quality of sleep and the association of sleep quality and personality traits with anxiety and depressive symptoms among university students in Karachi, Pakistan in the context of the pandemic COVID-19.
Method: This web-based cross-sectional study was conducted among …

Psychopathology Or Possession: How Ghanaian Pentecostal And Charismatic Christians Understand Mental Illnesses And How Perceived Understandings Vary Depending On If They Are Current Students Or Not, Jamila L. Taffe

Independent Study Project (ISP) Collection

This research investigates the perceptions held by Ghanaian Chrsitians from Pentecostal/Charismatic churches about mental illnesses. The data collected was done through a qualitative method of acquiring information. Interviews were conducted alongside intensive research of existing scholarship that addressed religion and mental health within Ghanaian culture. A total of 5 in depth interviews were carried out with participants ranging from the ages of 20-35. Three participants were current university students at the University of Ghana while the other two were non-students but held degrees. The objective was to make comparisons between the student and non-student groups about their knowledge about mental …

Childhood-Onset Attention-Deficit/Hyperactivity Disorder Exacerbates Opioid Use Disorder Consequences: Mediation By Impulsive Phenotypes, Liam R. Browning, Ciara Cannoy, Tabitha E. H. Moses, Leslie H. Lundahl Phd, David M. Ledgerwood Phd, Mark K. Greenwald Phd

Medical Student Research Symposium

Background: Attention deficit hyperactivity disorder (ADHD) is highly prevalent and associated with opioid use disorder (OUD). Yet, little is known about the mechanisms by which ADHD (which is a heterogeneous construct/diagnosis) might alter the trajectory of OUD outcomes.

Aim: This cross-sectional study examines relationships between childhood ADHD (inferred as predating substance use) and the extent to which the effects of ADHD on lifetime heroin-use consequences are mediated by foreshortened time perspective and drug-use impulsivity.

Methods: Individuals who report heroin use (N=214) were screened using the Assessment of Hyperactivity and Attention (AHA), Impulsive Relapse Questionnaire (IRQ), Stanford Time Perception Inventory (STPI), …

Is Biological Death Final? Recomputing The Drake-S Equation For Postmortem Survival Of Consciousness, Adam J. Rock, James Houran, Patrizio E. Tressoldi, Brian Laythe

International Journal of Transpersonal Studies Advance Publication Archive

This participatory team science project extended Laythe and Houran’s (2022) prior application of a famous probabilistic argument known as the ‘Drake equation’ to the question of postmortem survival. Specifically, we evaluated effect sizes from peer-reviewed, empirical studies to determine the maximum average percentage effect that ostensibly supports (i.e., "anomalous effects") or refutes (i.e., "known confounds") the survival hypothesis. But unlike the earlier application, this research included a study-specific estimate of the hypothesized variable of ‘living agent psi’ via a new meta-analysis of empirical studies (N = 17) with exceptional subjects vs participants from the general population. Our updated analysis found …

The Often‑Circuitous Path To Affirming Mental Health Care For Transgender And Gender‑Diverse Adults, Natalie Holt, Debra Hope, Richard Mocarski, Nathan Woodruff

Trans Collaborations Academic Papers

Purpose of Review We describe recent research regarding access to affirming mental health services for transgender and gender-diverse (TGD) adults and explore new resources available for therapists to inform evidence-based practice with TGD clients.

Recent Findings Barriers and facilitators at all socioecological levels impact TGD adults’ mental health help-seeking. TGD adults often interface with mental health providers while accessing gender-affirming medical care, though new standards of care are likely to alter this typically common path to mental health services. Efforts to improve therapist education, such as therapy manuals, are increasingly available and a necessary step to increase the number of …

Pmh Connect, English (Greyscale For Printing), Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Criterion Validity Of Protective Behavioral Strategies For Alcohol Consumption Among College Students, Abby L. Braitman, Amy Stamates, Melissa Colangelo, Sarah J. Ehlke, Jordan Ortman, Kristin E. Heron, Kate B. Carey

Psychology Faculty Publications

Background: Protective behavioral strategies (PBS), or behaviors used to reduce harm associated with alcohol use, are often associated with lower levels of alcohol consumption, lower engagement in high-risk drinking behaviors, and fewer alcohol-related consequences. Although the majority of studies have found significant associations between higher PBS use and lower consumption or consequences, some studies have found nonsignificant or even positive associations. One explanatory hypothesis is that the mixed findings are due to differential content in PBS measures. Objectives: The current study examined the criterion validity of two widely-used PBS measures, the PBSS and the SQ. In a multi-institution online …

Mindfulness Traps And The Entanglement Of Self: An Inquiry Into The Regime Of Mind, Richard Dixey, Ronald E. Purser

International Journal of Transpersonal Studies Advance Publication Archive

Mindfulness meditation can provide salutary therapeutic benefits, as well as lead advanced practitioners to states of calm and equanimity. In this paper, we argue that such forms of meditation may subtly entrap practitioners in circular, self-reflexive feedback loops. Because these meditation traps fail to clearly discern the operations of mind, they offer a temporary oasis of peace within an unaltered dualistic realm of mind that leaves the root delusion of self-identity intact. Drawing upon Tarthang Tulku’s seminal book Revelations of Mind, we present what he refers to as the “regime of mind,” the processes of cognition, identification and re-cognition in …

Changes In Mental Health As A Predictor Of Cannabis Coping Motives And Consequences: Examining The Impact Of Covid-19 Among College Students, Rebecca Dunaief, Adrian Jorge Bravo, James Henson

Psychology Faculty Publications

Objective: Cannabis use is common among college students and many students use cannabis to cope with negative affect. The COVID-19 pandemic was a particularly stressful time for college students. Subsequently, the present study compared college students who reported increases in anxiety/depression symptoms since COVID-19 stay at home orders to those who reported no change in anxiety/depression symptoms on cannabis coping motives, use frequency, and negative consequences. Specifically, we examined whether self-reported changes (i.e., group that indicated increases) in poor mental health during COVID-19 were associated with problematic cannabis use via higher cannabis coping motives. Method: College students (analytic n = …