Health Services Research Commons^™

A Pilot Study Of Deaf Trauma Survivors’ Experiences: Early Traumas Unique To Being Deaf In A Hearing World, Melissa L. Anderson, Kelly S. Wolf Craig, Wyatte C. Hall, Douglas M. Ziedonis

Melissa L. Anderson

Conducting semi-structured American Sign Language interviews with 17 Deaf trauma survivors, this pilot study explored Deaf individuals’ trauma experiences and whether these experiences generally align with trauma in the hearing population. Most commonly reported traumas were physical assault, sudden unexpected deaths, and “other” very stressful events. Although some “other” events overlap with traumas in the general population, many are unique to Deaf people (e.g., corporal punishment at oral/aural school if caught using sign language, utter lack of communication with hearing parents). These findings suggest that Deaf individuals may experience developmental traumas distinct to being raised in a hearing world. Such …

Sex Offending And Serious Mental Illness: Directions For Policy And Research, Andrew Harris, William Fisher, Bonita Veysey, Laura Ragusa, Arthur Lurigio

Arthur J. Lurigio

Over the past decade, two rapidly evolving areas of criminal justice practice have garnered increasing attention from policy makers, practitioners, and researchers: the management and treatment of justice involved individuals with serious and persistent mental illness, and the challenges of managing the perceived societal risk presented by sex offenders. Yet, whereas each of these issues has independently attracted significant attention, the nexus between them has remained largely unexamined. Matters of concern include the manner in which individuals with serious mental illness may be disproportionately affected by the expanding range of restrictions placed on those with sexual offense histories, the demands …

Building The Foundation For The Family Options Project, Joanne Nicholson, Kathleen Biebel, Valerie Williams, Karen Albert

Joanne Nicholson

This article describes how the long-standing partnership between Employment Options, Inc., a psychosocial rehabilitation agency in Marlborough, MA, and the University of Massachusetts Medical School's (UMMS) Center for Mental Health Services Research led to the development of the Family Options program.

Mothers With Mental Health Disorders: Mental Health Promotion In The Context Of Parenting, Joanne Nicholson, Elizabeth Aaker, Michael Agar, Karen Albert, Steven Banks, Kathleen Biebel, Bernice Gershenson, Antonia Seligowski, Valerie Williams, Brenda Warren, Sierra Williams, Katherine Woolsey

Joanne Nicholson

Parenting is a meaningful role for the majority of American women, including those with mental health disorders. Success in this role, particularly for women with mental health disorders, would seem to be intimately related to mental health promotion, the recovery process, and successful functioning in other major life domains (e.g., employment, community living, and personal health and well-being). The achievement of maximum social participation for women with mental health disorders may hinge on addressing the challenges they face as parents. Presented at Margins to Mainstream: World Congress on Mental Health Promotion and Prevention. Melbourne, Victoria, Australia, September 2008.

Exploring The Concept Of “Young Carer” In Families Living With Parental Mental Illness, Antonia Seligowski, Peter Mcnamee, Karen Albert, Valerie Williams, Joanne Nicholson

Joanne Nicholson

Background Information: The concept of “young carers” has been framed in the literature as children providing care and assuming household responsibilities when parents have physical and/or mental disabilities (Aldridge & Becker, 2003). In the United Kingdom, young carers have been studied extensively, leading to increased access to services and supports (Dearden & Becker, 2004). Our goal is to explore the concept of young carers in the U.S.

Aims: 1) To describe the care giving and household responsibilities of children and youth living with parents with mental illnesses, how often they are performed, and the feelings of children and youth about …

Programs For Families With Parental Mental Illness: Results Of A Us National Survey, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Lawrence Stier

Joanne Nicholson

Citation: Nicholson, J., Hinden, B., Biebel, K., Henry, A., & Stier, L. (2004). Programs for families with parental mental illness. Visions: British Columbia Mental Health and Addictions Journal, 2(2), 27-29. Available at: http://www.heretohelp.bc.ca/publications/visions/parenting. Summary: Survey of programs in the U.S. for parents with mental illness.

A Multi-Disciplinary, Whole-Of-Family Approach To Supporting Parents With Mental Illness, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership. Citation: Nicholson, J. (2010, November). A multi-disciplinary, whole-of-family approach to supporting parents with mental illness. Presented as a plenary at the Developing Strength and Resilience in Children conference of Voksne for Barn, Oslo, Norway.

The Family Networks Implementation Study, Susan Maciolek, Joanne Nicholson, Nicole Dube, Jodi Adams, Bernice Gershenson

Joanne Nicholson

Family Networks is a comprehensive system transformation initiative to redesign and integrate traditional categorical services across Massachusetts into local systems of care for children, youth, and families served by the child welfare system. The Family Networks Implementation Study, a partnership between the Massachusetts Department of Social Services and the University of Massachusetts Medical School, is a two-year study of the process of implementing local systems of care that began in January 2007, and will continue through December 2008. Presented at the 21th Annual Research Conference. A System of Care for Children’s Mental Health: Expanding the Research Base. Tampa, Florida, February …

Mental Illness: Understanding The Impact On Families And How To Help, Joanne Nicholson

Joanne Nicholson

Abstract: Family is the context where mental health recovery takes place. Mental health services need to take a whole-of-family approach when working with people with a mental illness. Supporting people with a mental illness in their family roles actually improved the mental health outcomes of people participating in their programs. Citation: Nicholson, J. (2010, May). Mental illness: Understanding the impact on families and how to help. Presented as the 12th Annual Bruce Woodcock Memorial Lecture, Mental Illness Fellowship Victoria, Melbourne, Victoria, Australia.

Family Members With Overlapping Mental Health Needs Require The Transformation Of Systems And Services, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Valerie Williams, Bernice Gershenson, Judith Katz-Leavy

Joanne Nicholson

Women and men with a lifetime prevalence of psychiatric disorder are at least as likely to be parents as are adults without psychiatric disorder. The majority of adults in all diagnostic categories are parents, including those meeting criteria for affective and anxiety disorders, PTSD, and non-affective psychosis. Children with Serious Emotional Disturbance (SED) receiving services in Systems of Care (SOCs) programs may have multiple family risk factors. Family-centered, strengths-based practices require a paradigm shift in the way administrators and providers view and intervene with children and adults. Presented at The Santa Fe Summit on Behavioral Health, the American College of …

Using Organizational Data To Create The Essential Context For System Transformation In Child Welfare, William Deveney, Joanne Nicholson

Joanne Nicholson

The Massachusetts Department of Social Services (MA/DSS) has 29 area offices organized in 6 regions; 74,651 consumers (39,913 are children < 18 years of age); 10,863 children and youth in placement; and 3,400 employees (FY2005; 2nd quarter).

A comprehensive system transformation initiative is underway, to shift from the traditional “adversarial” child protective model, and translate the core values of “child-driven,” “family-centered,” “community-focused,” “strength-based,” “committed to diversity/ cultural competence,” and committed to continuous learning” into an active child welfare agenda. The “learning organization” is the guiding framework.

Continuous Quality Improvement (CQI) is an interactive, iterative, participatory process that reflects change in organizational values, and catalyzes and guides improvements in policy and practice. Data drive CQI, obtained as framed …

Creating Opportunities For Success: Working With Trauma Survivors In The Shelter Setting, Joanne Nicholson, Linda Weinreb, Tina Runyan, Kathleen Biebel

Joanne Nicholson

Summary: Training workshop with the following objectives: Increase knowledge, awareness, & understanding of trauma & its impact; Provide information about skills & strategies; Suggest self care strategies. Citation: Nicholson, J., Weinreb, L., Runyan, T., & Biebel, K. (2010, November). Creating opportunities for success: Working with trauma survivors in the shelter setting. Presented at a training workshop for the Central Massachusetts Housing Alliance, Worcester, MA.

The Massachusetts Family Networks Implementation Study, Susan Maciolek, Joanne Nicholson, Jodi Adams, Bernice Gershenson, Katherine Woolsey, Brenda Warren

Joanne Nicholson

Family Networks is a comprehensive systems transformation initiative to redesign and integrate traditional categorical services across the Commonwealth into local systems of care for children, youth, and families served by the child welfare system. The Family Networks Implementation Study, a partnership between the Massachusetts Department of Social Services (MA/DSS) and the University of Massachusetts Medical School, is a two-year study of the process of implementing local systems of care that began in January 2007, and will continue through December 2008. Findings from the Family Networks Implementation Study will inform MA/DSS strategic planning, system refinements, and the Family Networks outcomes evaluation. …

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …

Supporting Parents: Multi-Needs And The Need For Multi-Institutions’ Coordination Of Supports, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership.

Citation: Nicholson, J. (2010, May). Supporting parents: multi-needs and the need for multi-institutions coordination of supports. Presented as a keynote at the Conference on Ondersteuning Ouders met Psychiasche Problemen,The Hague, The Netherlands.

Parenting With A Mental Illness. A Radio Interview For Abc Radio National, Australia Public Radio (Audio File), Joanne Nicholson

Joanne Nicholson

Interview (mp3 audio file, 9.8 MB) by Dr. Joanne Nicholson with Richard Aedy, host and producer, “Parenting with a Mental Illness” on Life Matters, ABC Radio National, Australia public radio, May 25, 2010. Nicholson says that keeping families intact benefits both the family as a whole, and the ill parent's recovery. She argues too many health professionals make treatment plans without considering the family context. Citation: Nicholson, J. Interview with Richard Aedy, host and producer, “Parenting with a Mental Illness” on Life Matters, ABC Radio National, Australia public radio. May 25, 2010. Available from: http://www.abc.net.au/rn/lifematters/stories/2010/2906312.htm.

Helping Families— Shifting The Emphasis, Joanne Nicholson

Joanne Nicholson

Abstract: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness and carers. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders. Citation: Nicholson, J. (2010, May). Helping families – Shifting the emphasis. Presented as a keynote address at the Annual Corporate Breakfast with the Lord Mayor, Mental Illness Fellowship Victoria, Melbourne, Victoria, Australia.

Supporting Parents With Mental Health Needs In Systems Of Care, Barbara Friesen, Judith Katz-Leavy, Joanne Nicholson

Joanne Nicholson

Summary: Community-based systems of care (SOCs) must address both the needs of parents with mental illness and the needs of their children. Learning more about the challenges faced by SOCs in this area, and the strategies they implement to overcome them, provides insights with implications for the broader field. This project was intended to learn more about efforts to assess parents’ mental health needs, effectively engage and support them, and improve system coordination and access to services to inform service delivery and system reform, especially for those involved in both child welfare and mental health. This report presents information gathered …

Supporting Parents With Psychiatric Disabilities And Promoting Recovery: An International Challenge, Peter Van Der Ende, Joanne Nicholson

Joanne Nicholson

Introduction: Parenting is a significant life role for adults with psychiatric disabilities. Not only is success in this role a normal life goal for many, but functioning as well as possible as parents would seem to be intimately related to the recovery process and successful functioning in other major life domains. Research on the prevalence and needs of parents with psychiatric disabilities in two countries, the U.S. and The Netherlands, provides the framework for developing and testing interventions. Essential program components include supports for parents in meeting their children’s needs as well as managing their own. Research Question: What are …

Implementation Challenges In Wrapping Interventions Around Families Living With Parental Mental Illness, Joanne Nicholson, Beth Hinden, Joan Mikula, Kathleen Biebel, Valerie Williams, Katherine Woolsey, Elizabeth Aaker

Joanne Nicholson

Citation: Hinden,B., Mikula, J., Nicholson, J., Bieble, K., Williams, V., Woolsey, K., & Aaker, E. (2008). Implementation Challenges in Wrapping Interventions Around Families with Parental Mental Illness. In C. Newman, C. Liberton, K. Kutash, and R/ Friedman (Eds.), Proceedings of the 20th Annual Research Conference, A System of Care for Children’s Mental Health: Expanding the Research Base. Tampa, FL: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children’s Mental Health.

Summary: Parental mental illness challenges service providers in adult mental health, child welfare and children’s mental health systems of care. This presentation describes the development …

Brief Report: Need For Autonomy And Other Perceived Barriers Relating To Adolescents’ Intentions To Seek Professional Mental Health Care., Coralie J. Wilson, Frank P. Deane

Coralie J Wilson

The current study examined the relationship between belief-based barriers to seeking professional mental health care and help-seeking intentions in a sample of 1037 adolescents. From early adolescence to adulthood, for males and females, the need for autonomy was a strong barrier to seeking professional mental health care. Help-seeking fears were weaker in the older age groups. Having lower perceived need for autonomy and believing that prior mental health care was helpful was significantly associated with higher intentions to seek future professional mental health care. Implications for prevention and overcoming barriers to seeking mental health care are suggested.

Predicting Adolescents’ Future Intentions To Seek Help For Mental Health Problems., Coralie J. Wilson

Coralie J Wilson

This study examined whether high school students’ current symptoms of general psychological distress, self-rated social problem-solving skills, and recent help-seeking experiences predict their future intentions to seek help for a mental health problem. At Time 1, 98 high school students, aged 12-17 years, completed the study self-report survey that included measures of psychological distress, social problem-solving skill, and recent help-seeking behaviour. At Time 2, three weeks later, the same students completed measures of help-seeking intentions. Students with more severe levels of distress symptoms at Time 1 had lower intentions to seek help for a mental health problem at Time 2. …

Early Access And Help Seeking: Practice Implications And New Initiatives., Coralie J. Wilson

Coralie J Wilson

Seeking appropriate help for early signs and symptoms of psychological distress can reduce the long-term impact of many mental disorders. This article describes practice implications and new initiatives for promoting early access and help-seeking among young people. Relevant help-seeking research is reviewed, and prominent help-seeking barriers are discussed. Prominent barriers for young people include: incomplete mental health and emotional literacy, beliefs about having little need for help versus having a need for autonomy, and the process of help-negation for different symptoms of psychological distress. To improve early access to appropriate help and mental health services, barriers that can be reduced, …

Differences In Discharge Medication After Acute Myocardial Infarction In Patients With Hmo And Fee-For-Service Medical Insurance, Danny Mccormick, Jerry Gurwitz, Judith Savageau, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVE: To assess the impact of fee-for-service (FFS) versus HMO medical insurance coverage on receipt of aspirin, beta-blockers, and calcium channel blockers at the time of hospital discharge following an acute myocardial infarction. DESIGN: Prospective, population-based study. SETTING: All 16 community and tertiary care hospitals in the metropolitan area of Worcester, Massachusetts. PATIENTS: The study population consisted of patients under 65 years of age hospitalized with a validated acute myocardial infarction in all hospitals in the Worcester (Massachusetts) Standard Metropolitan Statistical Area (1990 census estimate, 437,000) during 1986, 1988, 1990, 1991, and 1993. MEASUREMENTS AND MAIN RESULTS: After adjustment for …

Should ‘Risk Syndrome Of Psychosis’ Be Included In Dsm V As A Diagnosis? A Road Towards Preventive Psychiatry”, Amresh Srivastava

Amresh Srivastava

Psychiatric diagnosis has acquired a position of a quasi-legal document for mental health services and agencies working with mental health. Its utility has gone far beyond ‘clinical diagnosis for treatment’.

The concept of risk syndrome for schizophrenia has been thoroughly researched in last ten years or so. Significant advancement has been made in phenomenology, diagnostic criteria, classification, & neurobiology. The research of prodromal or at-risk or Ultra high-risk psychosis has significantly contributed to the body of knowledge of aetio-pathogenesis of schizophrenia.

The science of risk syndrome has apparently matured and its proponents are ready for its inclusion in DSM V …

Outcome, Early Intervention & Dup: The Matrix Of Research In Early Psychosis, Amresh Srivastava, Megan Johnston

Amresh Srivastava

There has been little investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning neither have the possible confounds of DUP been widely investigated or controlled. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention. Shorter duration of untreated psychosis was associated with greater response to antipsychotic treatment, as measured by severity of global psychopathology, positive symptoms, negative symptoms, and functional outcomes. At the time of treatment initiation, duration of initially untreated psychosis was associated …

Integrating Social & Clinical Parameters In Outcome Measures Of Schizophrenia: Clinician’S Perspective., Amresh Srivastava, Nilesh Shah, Yves Bureau

Amresh Srivastava

Schizophrenia is a complex neurobehavioral disorder for which there are many promising new treatments. There is, however, a discrepancy in outcome measure reports when they are obtained from patients, relatives, caregivers, or professionals, thus making it difficult to determine the level of recovery. The reason for this lack of agreement may be due to the limitations of the measurement tools themselves, which are not comprehensive and may be measuring different aspects of outcome. Alternatively, it could be that the conceptual understanding of outcome and recovery require development. Unfortunately for one of the above reasons or both, patients assessed as “recovered” …

Help-Negation And Suicidal Ideation: The Role Of Depression, Anxiety And Hopelessness., Coralie J. Wilson

Coralie J Wilson

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study is part of a larger multi-cite research program developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from friends, family and professional mental health sources in a sample of 302 Australian university students. Participants were 77.5% female and aged from 18-25 years old, with 85.4% aged 21 years or younger. Higher levels of suicidal ideation were related to lower help-seeking …

Correspondence: Help-Negation, Coralie Wilson

Coralie J Wilson

It is positive that preliminary findings from the 2007 National Survey of Mental Health and Wellbeing suggest that more Australians than in 1997 are seeking help for common mental disorders. However, the 2007 Survey also suggests that two in three Australians who had common forms of mental disorder and 41% of those with serious thoughts of suicide during the last year did not seek or engage in professional help for their condition [1]. Even more concerning are the preliminary results suggesting that 86% of those who didn’t seek help for their common mental disorders thought they didn’t need any type …

Clinical Skills In Psychiatric Assessment: An Educational Module, Amresh Srivastava

Amresh Srivastava

No abstract provided.