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Portland State University

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Articles 1 - 30 of 266

Full-Text Articles in Mental and Social Health

(Re)Claiming Homeplace: Dance As Embodied Resistance & Healing For Health & Spatial Justice, Preeya G. Kannan Jun 2026

(Re)Claiming Homeplace: Dance As Embodied Resistance & Healing For Health & Spatial Justice, Preeya G. Kannan

University Honors Theses

This thesis argues that dance functions as both an upstream public health intervention and a form of radical spatial resistance; creating healing, agency, and belonging among historically marginalized communities. Drawing on bell hooks' concept of homeplace, Jasbir Puar's assemblage theory, Nancy Krieger's eco-social theory, and Katherine McKittrick's Black geographies, I position the body as both an ecological and political landscape shaped by histories of colonialism, racial capitalism, displacement, and resilience.

Through this community-based participatory research study, Homeplace, I explore dance as a form of social prescription that centers liberation rather than pathology. Movement is often reduced in public health discourse …


Healthcare Access Challenges Among Asian Americans, Phyo Theingi Jun 2026

Healthcare Access Challenges Among Asian Americans, Phyo Theingi

University Honors Theses

Asian Americans are the fastest growing racial ethnic group in the U.S. According to the 2023 U.S. Census Bureau population estimate, Asian Americans account for 25.2 million (or 7.4%) of the nation's population. Asian Americans are not a monolith and represent a diversity of rich histories, cultures, languages and ethnicities. According to research conducted by the Pew Research Center, most Asian Americans face discrimination of some kind, including being treated as a foreigner in the U.S and being stereotyped as a model minority. They also experience health care access barriers. Research found that Asian Americans face barriers related to language …


The Gut Microbiome, The Gut-Brain Axis, And College Student Well-Being, Idi Mckay Jun 2026

The Gut Microbiome, The Gut-Brain Axis, And College Student Well-Being, Idi Mckay

University Honors Theses

This literature review examines how diet, stress, environmental exposure, and food accessibility may influence college students' mental health and academic performance through the gut microbiome and the Gut-Brain Axis (GBA). Current microbiome research often focuses on early childhood development, clinical disease populations, or older adults, while overlooking college-age students who experience significant social, environmental, and biological transitions. College students frequently face food insecurity, irregular eating patterns, chronic stress, inconsistent sleep schedules, and reduced access to nutrient-dense foods, all of which may influence microbial diversity and overall gut health.

This thesis explores how modern campus environments and lifestyle factors may contribute …


Social Determinants As A Predictor For Heart Disease Mortality: Oregon Regional Study, Jewel Jones Jun 2026

Social Determinants As A Predictor For Heart Disease Mortality: Oregon Regional Study, Jewel Jones

University Honors Theses

The study examined the association between selected social determinants of health and heart disease mortality across geographic regions in Oregon. Using a regional analysis design, county-level population and mortality data were grouped into nine geographic regions to evaluate patterns of cardiovascular disease burden across the state. Social determinant variables were obtained from publicly available U.S. Census Bureau datasets and included poverty, crowding among households, single-parent households, lack of broadband internet subscription, housing cost burden, high school diploma attainment, and unemployment.

Heart disease mortality counts per 100,000 population were derived from official birth and death certificate records. Statistical analyses were conducted …


Chatbot Therapy - Help Or Hindrance, Kadi Rae Smith Jan 2026

Chatbot Therapy - Help Or Hindrance, Kadi Rae Smith

Anthós

Introduction

Generative artificial intelligence (Gen-AI) chatbots are complex computer programs designed to mimic human conversations using programming that incorporates large language models (LLM) and natural language models (NLM) to simulate human interactions that are being rapidly integrated into everyday life across an increasing amount of online platforms. This article explores the applications and efficacy of chatbots for mental healthcare, from self-directed chatbot interactions to clinician-supervised implementation of chatbot-based therapeutic tools, weighing the benefits and limitations of this ever-expanding technology.

Methodology/Taxonomy

A literature review was conducted primarily using Web of Science, accessed through Portland State University, and Google Scholar, with specifications …


Just-In-Time Adaptive Intervention To Improve Hiv Prevention And Substance Use In Youth Experiencing Homelessness (My-Ride): Protocol Fora Randomized Controlled Trial, Diane Santa Maria, Nikhil Padhye, Michael Businelle, Natasha Slesnick, Stefani Ricondo, Marguerita Lightfoot Oct 2025

Just-In-Time Adaptive Intervention To Improve Hiv Prevention And Substance Use In Youth Experiencing Homelessness (My-Ride): Protocol Fora Randomized Controlled Trial, Diane Santa Maria, Nikhil Padhye, Michael Businelle, Natasha Slesnick, Stefani Ricondo, Marguerita Lightfoot

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Youth who are experiencing homelessness face a higher risk of HIV infection compared to their housed peers, and suicide and overdose remain the leading causes of death among homeless youth. Just-in-Time Adaptive Interventions (JITAIs) are gaining momentum for HIV prevention and substance use research. Yet, most interventions for homeless youth have not addressed modifiable real-time factors. Objective: This paper describes the development and implementation of a randomized attention-controlled trial to assess the efficacy of motivating youth to reduce infections, disconnections, and emotional dysregulation (MY-RIDE), a JITAI to improve HIV prevention and substance use in homeless youth. Methods: This study …


The Role Of Neuroscience In Mental Health Management Within The Adhd Population, Kadi Rae Smith Jun 2025

The Role Of Neuroscience In Mental Health Management Within The Adhd Population, Kadi Rae Smith

University Honors Theses

Neuroscience-based educational interventions play a role in the management of Attention Deficit Hyperactive Disorder (ADHD), including the regulation of ADHD-correlated depression and anxiety. Existing research shows that elevated rates of depression correspond to anxiety within the ADHD community; approximately 8.83% of the global population. Social ostracization and isolation are established contributors to depression and anxiety which are commonly comorbid with ADHD. The need exists for further investigation of the beneficial impact that an accurate, biological understanding of how the brain works has on the mental health of the ADHD population, and by extension their families, education systems, and medical industries. …


Revising And Consolidating The Dsm-5 And Icd-11 Post-Traumatic Stress Disorders Into A Dimensional Spectrum-Based Disorder: A Literature Review, Samuel Milton Shatsky Jun 2025

Revising And Consolidating The Dsm-5 And Icd-11 Post-Traumatic Stress Disorders Into A Dimensional Spectrum-Based Disorder: A Literature Review, Samuel Milton Shatsky

University Honors Theses

This thesis investigates the clinical, cultural, and theoretical implications of replacing the current DSM-5 and ICD-11 categorical diagnoses of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) with a unified dimensional framework: trauma spectrum disorder (TSD). The proposed TSD model addresses ongoing concerns around diagnostic inflation, treatment misalignment, and clinical confusion stemming from binary trauma categorizations. This thesis explores whether adopting a dimensional diagnostic model to replace DSM-5 and ICD-11's current PTSD and CPTSD designations could lead to improved treatment outcomes and diagnostic clarity.

Methodology consisted of an extensive literature review of the field's current research. Using the …


Evaluation Of Social Worker Knowledge Of Human Trafficking At The Oregon State Hospital: A Qualitative And Quantitative Analysis Of Education, Training, And Victim Identification, Jamie Sue Pryde Jun 2025

Evaluation Of Social Worker Knowledge Of Human Trafficking At The Oregon State Hospital: A Qualitative And Quantitative Analysis Of Education, Training, And Victim Identification, Jamie Sue Pryde

Dissertations and Theses

The prevalence of human trafficking continues to increase worldwide, and the implementation of human trafficking education and victim identification within institutions is slow to catch up. The Oregon State Hospital is a psychiatric in-patient hospital that currently does not provide human trafficking education or a screening tool for staff and does not know how to provide treatment to trafficked victims. Interviews were conducted with employed social workers at the Oregon State Hospital to obtain a baseline understanding of their previous education, training, and knowledge of human trafficking to aid in the creation of a trafficking screening tool. Results indicate participants …


The Impact Of Nicu Death On Bereaved Mothers, Jennie Terranova Jun 2025

The Impact Of Nicu Death On Bereaved Mothers, Jennie Terranova

University Honors Theses

Infant loss in the United States occurs 5.6 per 1,000 live births. This paper examines risk factors that contribute to neonatal death. Prematurity is a risk factor for NICU admission. A portion of premature babies receiving care in the NICU will die. The stressful nature of the NICU has been studied widely in journals. The impact of NICU death on hospital staff and bereaved parents has been studied less. Mortality studies suggest that bereaved mothers are at a high risk of dying within the first 5 years after their child has died. Despite the frequency of maternal death post-child loss, …


The Intersecting Association Of Speaking A Non-Dominant Language And Lower Healthcare Access On Self-Reported Depression Among U.S. Adults: A Cross Sectional Study Using Nhanes Data (2015-March 2020), Vincenzo J. Cornacchione, Corey Linver Apr 2025

The Intersecting Association Of Speaking A Non-Dominant Language And Lower Healthcare Access On Self-Reported Depression Among U.S. Adults: A Cross Sectional Study Using Nhanes Data (2015-March 2020), Vincenzo J. Cornacchione, Corey Linver

OHSU-PSU School of Public Health Annual Conference

Objective: This analytic study examined the joint and independent associations between language preferences and healthcare access on moderate to severe depression among non-institutionalized adults living in the U.S., using data from the 2015 to March 2020 National Health and Nutrition Examination Survey (NHANES).

Methods: In this cross-sectional study design, we analyzed a nationally representative data set comprised of 11,051 participants. Multivariable logistic regression models were used to estimate the joint and independent associations between our dual exposures and moderate to severe depression, adjusting for key demographic variables based on our theoretical framework. We created categorical measures of preferred language (speaking …


It's Going To Be Okay: Experiences And Perceptions Of People Who Seek Reassurance At Work, Liana Bernard Dec 2024

It's Going To Be Okay: Experiences And Perceptions Of People Who Seek Reassurance At Work, Liana Bernard

Dissertations and Theses

This study examined the experiences and perceptions of people who seek reassurance at work using a mixed methods (focus groups and experimental) approach. Reassurance-seeking is an attempt to elicit supportive communication from another person to help one reduce experienced anxiety. First, using focus groups with 32 participants, this study found that people seeking reassurance at work develop complex cognitive structures to reduce the prospective negative impacts of reassurance-seeking behaviors, particularly for those with marginalized identities. Then, in a 3x2 between-person experimental design in which employee gender and reassurance-seeking were manipulated, participants read a transcript of an interaction between an employee …


Neuroscience-Based Harm Reduction Education For College Students In Portland, Or, Catriona Swallow Aug 2024

Neuroscience-Based Harm Reduction Education For College Students In Portland, Or, Catriona Swallow

University Honors Theses

Harm reduction (HR) is a movement focused on reducing the harms of the opioid overdose crisis through education, advocacy, and community engagement. A key component of HR is naloxone, a medication which reverses opioid overdoses when administered. Due to increased fentanyl contamination, opioid overdose deaths have been on the rise among adolescents in the U.S and HR practices are crucially important at this point in time. In recent years, alternative curricula of HR education have included a neuroscience-based approach to the topic of substance use. While both traditional and alternative programs have had success increasing substance use literacy among adolescents, …


What Are The Psychosocial Effects Of Service Dogs On Handlers With Disabilities, Kylie Kline Jul 2024

What Are The Psychosocial Effects Of Service Dogs On Handlers With Disabilities, Kylie Kline

University Honors Theses

This study looks to explore the psychosocial effects that service dogs have on handlers with disabilities. A cross-sectional survey designed to gather information about this directly from service dog handlers was administered to a sample of 20 participants. Then, a qualitative analysis was conducted on data from the survey using an inductive coding scheme that identified themes in the data as key terms and ideas emerged.

Results revealed many nuances surrounding service dogs' effects on handlers' psychosocial health. Notable results include: 20 of 20 participants (100%) reporting their service dogs have had positive impacts on their quality of life; 19 …


Flattening Morrison's Beloved: The Limits Of Psychoanalysis In Literary Criticism, A Literature Review, Isaac Vanhook Jun 2024

Flattening Morrison's Beloved: The Limits Of Psychoanalysis In Literary Criticism, A Literature Review, Isaac Vanhook

University Honors Theses

Toni Morrison's Beloved was first published in 1987 and has amassed a wide range of scholarship throughout the years; with some literary scholars using psychoanalysis to suggest a reading of Beloved. Because of the volume of scholarship and Beloved's plot--dealing with a mother who represses the memory of killing her daughter, Beloved--I found it to be perfect for the scope of this project. This literature review focuses on the sometimes reductive qualities of psychoanalyzing Beloved (such as the Freudian universal psychoanalytic subject, and the 'drawbacks' of object relations theory), while also discussing some revelatory qualities via the same …


Biophilic Design Strategies In Healthcare: Using Nature To Promote Wellness In Small-Scale Mental And Behavioral Health Facilities, Skyler Peckham Jun 2024

Biophilic Design Strategies In Healthcare: Using Nature To Promote Wellness In Small-Scale Mental And Behavioral Health Facilities, Skyler Peckham

University Honors Theses

Designing spaces that promote the health and well-being of the general public has been a highly debated topic for several centuries within the disciplines of architecture, urban planning, and other similar fields. As more research has been done throughout the years, the notion of utilizing nature to promote wellness has become a prominent design strategy. Through the examination of a wide range of scholarship regarding the benefits that nature has for human health and connecting this research to the biophilic evidence-based design strategies of healthcare facilities, I aim to highlight what design aspects truly promote wellness for patients in small-scale …


Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel Jun 2024

Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel

University Honors Theses

Substance Use Disorder (SUD) and stress are often predictive of one another, bidirectionally causal, and mutually intensifying. This thesis describes the bi-directional connection between physiological stress-modulating systems and Substance Use Disorder, and explores some emerging biofeedback stress-reduction gaming technology as a potential adjunct to recovery treatments. Improving autonomic balance, often described by Heart Rate Variability, has been shown to be beneficial for physical and psychological recovery, as well as improving self-control. For this reason, regular biofeedback for stress relief could be helpful in augmenting SUD treatment and preventing relapse. This exploration found that presenting it through a gaming lens may …


Engaging Antiracist And Decolonial Praxis To Advance Equity In Oregon Public Health Surveillance Practices, Ryan J. Petteway, Daniel López-Cevallos, Mira Mohsini, Andres Lopez, Roberta S. Hunte, Tim Holbert, Kusuma Madamala Jun 2024

Engaging Antiracist And Decolonial Praxis To Advance Equity In Oregon Public Health Surveillance Practices, Ryan J. Petteway, Daniel López-Cevallos, Mira Mohsini, Andres Lopez, Roberta S. Hunte, Tim Holbert, Kusuma Madamala

OHSU-PSU School of Public Health Faculty Publications and Presentations

Public health surveillance and data systems in the US remain an unnamed facet of structural racism. What gets measured, which data get collected and analyzed, and how and by whom are not matters of happenstance. Rather, surveillance and data systems are productions and reproductions of political priority, epistemic privilege, and racialized state power. This has consequences for how communities of color are represented or misrepresented, viewed, and valued and for what is prioritized and viewed as legitimate cause for action. Surveillance and data systems accordingly must be understood as both an instrument of structural racism and an opportunity to dismantle …


Mindspace: A Multi-Media Art Exhibition On C-Ptsd Awareness, Emma Wallace May 2024

Mindspace: A Multi-Media Art Exhibition On C-Ptsd Awareness, Emma Wallace

Student Research Symposium

"Mindspace" is an autobiographical art exhibition aimed at raising awareness about Complex Post-Traumatic Stress Disorder (C-PTSD) through a multi-sensory experience. The exhibition combines sculpture, lights, sound, and video projection to immerse viewers in the intricate emotional landscape of C-PTSD. Through a series of sculptural installations and carefully curated lighting and audio, visitors are invited to explore the internal world of an artist affected by C-PTSD and learn how it differs from PTSD and other types of mental health issues.

“Mindspace" incorporates specially composed soundscapes that offer an intimate look into the artist’s thoughts and memories, which range from spoken word …


Gut Feelings: A Literature Review On The Gut-Brain Axis And Its Potential Influence On Mood, Grace Johnson Mar 2024

Gut Feelings: A Literature Review On The Gut-Brain Axis And Its Potential Influence On Mood, Grace Johnson

University Honors Theses

In recent decades, research on the gut-brain axis has evolved due to an increasing interest in the connection between gut health and mental health. The gut-brain axis presents a new frontier of health for both medical professionals and psychologists as there is expanding evidence illustrating the comorbidity of gut disorders and mood disorders. Due to the complex nature of studying the gut-brain axis and the myriad of influences on mood disorders such as depression, research has yet to find significant results definitively tying the two together. Nonetheless, the current body of literature on the topic provides a promising outlook on …


Psilocybin With Acceptance And Commitment Therapy (Act) For The Treatment Of Social Anxiety Disorder (Sad), Aspen E. Allred Mar 2024

Psilocybin With Acceptance And Commitment Therapy (Act) For The Treatment Of Social Anxiety Disorder (Sad), Aspen E. Allred

University Honors Theses

Social Anxiety Disorder (SAD) is a debilitating mental health condition characterized by an overwhelming fear and anxiety of social rejection that can lead to chronic patterns of social behavioral avoidance. Despite the existence of traditional efficacious treatments, a significant number of individuals either do not respond to treatment or experience a recurrence of symptoms over extended periods, spanning 10-12 years. Acceptance and Commitment Therapy (ACT), a form of acceptance-based behavioral therapy considered part of the "third wave" of cognitive behavioral therapies, has shown promising results in early studies, comparable to those of Cognitive Behavioral Therapy (CBT) that is considered the …


Salvation And Sweet Rolls: An Examination Of Mormon Diet Books, Rachel Noorda Jan 2024

Salvation And Sweet Rolls: An Examination Of Mormon Diet Books, Rachel Noorda

English Faculty Publications and Presentations

Religious diet books highlight the overlap between religious and diet cultures. This article examines the intersection of Mormonism, diet culture, and fatphobia through an analysis of Mormon diet books published between 1990 and 2015. The study explores how Mormon diet books leverage the Word of Wisdom (the LDS health code) to promote weight loss and reinforce religious obedience. By framing dietary compliance as a spiritual mandate, these texts link physical health and body size to moral and spiritual worthiness. This conflation of body and spirit, rooted in Mormon theology, amplifies fatphobia by promoting thinness as a sign of obedience and …


Unmasking And Addressing Burnout In The Mental Health Profession, Sara Edwards Dec 2023

Unmasking And Addressing Burnout In The Mental Health Profession, Sara Edwards

University Honors Theses

Burnout poses a significant challenge among mental health workers, impacting both the well-being of practitioners and the outcomes for their patients. The key inquiries guiding this literature review are: what factors contribute to burnout, and what interventions are essential for treating and preventing burnout in mental health professionals? The findings reveal that factors such as level of experience, lack of quality supervision, vicarious trauma, working conditions, and personal beliefs significantly contribute to burnout. Effective prevention and treatment measures for mental health workers vulnerable to burnout encompass self-monitoring, participation in support groups, additional training, and organizational interventions. These insights could serve …


Motivation To Collaborate: A Qualitative Exploration Of The Perspectives Of Service Providers On An Alternative First Response Program, Desiree' J. Duboise Nov 2023

Motivation To Collaborate: A Qualitative Exploration Of The Perspectives Of Service Providers On An Alternative First Response Program, Desiree' J. Duboise

Dissertations and Theses

Alternative first response programs have existed in the United States for decades, and the formation of these programs has increased across the country in light of public calls for non-police responses to emergency. Portland Street Response (PSR) is an alternative first response program located in Portland, Oregon. The program assists individuals experiencing mental health crises by providing unarmed response in non-violent situations that ordinarily would be responded to by armed police officers. In order for such programs to thrive, collaboration with other organizations is crucial. Service-providing organizations are uniquely prepared to collaborate with a program such as PSR due to …


Understanding Veteran Perceptions About Mental Health And Its Treatment, Quinn Turner Stoddard Jul 2023

Understanding Veteran Perceptions About Mental Health And Its Treatment, Quinn Turner Stoddard

Dissertations and Theses

Mental health illnesses are a growing issue for a large part of the country, and veterans in particular are vulnerable to the numerous negative effects they pose. Despite the high number of people that may benefit from treatment, a variety of issues with trust, stigma, and attitudes may act as barriers to care utilization. In response, this study investigated the perceptions that veterans within the Pacific Northwest hold in regards to mental health treatment as well as their intentions to seek it out should they require it. Using the integrated model of behavioral prediction (IMBP), data was gathered about veterans’ …


Who Puts The "Support" In Supportive Housing? The Impact Of Housing Staff On Resident's Well-Being, And The Potential Moderating Role Of Self-Determination, Kenna Estell Dickard Jul 2023

Who Puts The "Support" In Supportive Housing? The Impact Of Housing Staff On Resident's Well-Being, And The Potential Moderating Role Of Self-Determination, Kenna Estell Dickard

Dissertations and Theses

The provision of residential and community-based services for individuals with serious mental illness (SMI) has become increasingly important following the deinstitutionalization movement. Much of the existing research on supportive housing focuses on housing outcomes rather than exploring how the program helps its residents thrive in the broader community. This study draws upon data collected from 176 people with SMI residing in 16 supportive housing locations in Portland, Oregon. Analyses employed an ecological approach, exploring how housing staff support relates to residents' well-being at three levels of analysis: loneliness (interpersonal level), residential satisfaction (housing and neighborhood level), and sense of community …


Reconceptualizing The Interaction Between Adhd Symptoms And Environmental Context, Oliver G. Mcfadden Jun 2023

Reconceptualizing The Interaction Between Adhd Symptoms And Environmental Context, Oliver G. Mcfadden

University Honors Theses

Difficult questions regarding etiology, prevalence, and individual treatment allude to the heterogenous and complex neurocognitive profile ADHD. Current understandings do not point to there being any yet-undiscovered, succinct set of features for the condition that will answer these questions. ADHD in fact has a heterogeneous etiology and neurocognitive profile, suffers from both overdiagnosis and underdiagnosis, and a variety of styles of treatment are conceivable to address this. Sociocultural factors have crucially guided the direction of ADHD pathology and medicalization and are woven into institutional environments. These extant problems have eluded ADHD research, and the debate over the construction and validity …


Community Paramedicine In Central Oregon: A Promising Model To Reduce Non-Urgent Emergency Department Utilization Among Medically Complexmedicaid Beneficiaries, Jessica Currier, Neal Wallace, Keshia Bigler, Maggie O’Connor, Paige E. Farris, Jackilen Shannon Jun 2023

Community Paramedicine In Central Oregon: A Promising Model To Reduce Non-Urgent Emergency Department Utilization Among Medically Complexmedicaid Beneficiaries, Jessica Currier, Neal Wallace, Keshia Bigler, Maggie O’Connor, Paige E. Farris, Jackilen Shannon

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Community paramedicine has emerged as a promising model to redirect persons with nonmedically emergent conditions to more appropriate and less expensive community-based health care settings. Outreach through community paramedicine to patients with a history of high hospital emergency department (ED) use and chronic health conditions has been found to reduce ED use. This study examined the effect of community paramedicine implemented in 2 rural counties in reducing nonemergent ED use among a sample of Medicaid beneficiaries with complex medical conditions and a history of high ED utilization.

Methods

A cluster randomized trial approach with a stepped wedge design was …


A Literature Review On Understanding, Solidifying, And Expanding The Role Of Art Therapy In Death And Dying, Deborah D. Clark May 2023

A Literature Review On Understanding, Solidifying, And Expanding The Role Of Art Therapy In Death And Dying, Deborah D. Clark

University Honors Theses

The purpose of this literature review is to weave together an understanding of what research exists around art therapy in death and dying, what the role of art therapy is in end-of-life care and education, and determine what gaps exist for further study. When it comes to the topic of death and dying, most of us would agree that end-of-life care is extremely important, though this agreement often falls apart regarding what that care looks like, and how we do (or don't) talk and learn about death and dying. This review argues for an integrated holistic model of care concerning …


Experiences Of People With Serious Mental Illness Seeking Services At Community Mental Health Centers During The Covid-19 Pandemic, Emily Leickly May 2023

Experiences Of People With Serious Mental Illness Seeking Services At Community Mental Health Centers During The Covid-19 Pandemic, Emily Leickly

Dissertations and Theses

Community mental health centers (CMHCs) have been underfunded and overburdened since Reagan-era disinvestment and the United States' move toward neoliberalism. Rates of mental illness have been rising consistently, particularly in Oregon, as CMHCs face continuing financial pressures and staff retention issues. This was before the COVID-19 pandemic. Today, we are still trying to understand the ongoing pandemic's impact on people with serious mental illnesses (SMI). Most of the studies in this area thus far are quantitative, and first-hand accounts of the pandemic from people with SMI are largely absent. Additionally, research in this area fails to draw on critical alternative …