Mental and Social Health Commons^™

Experiences Of Shame, Exclusion, & Appropriation In Mindfulness-Based Wellness Culture, Charlotte Grace Starling

University Honors Theses

Yoga, meditation, and other mindfulness practices provide numerous benefits both physical and mental health to their practitioners. There is less research exploring the role mindfulness-based wellness programs and practices fit within the cultural environment of the United States and how the mindfulness movement influences wellness culture and practices. These practices and spaces have been accused of harming folks who don't fit the dominant social narrative of thin, white, upper-middle-class participants. This paper aims to explore how the United State’s commodification of mindfulness practices contributes to experiences of shame, exclusion, and appropriation in wellness culture. This is done by a literature …

Predictors Of Opioid And Alcohol Pharmacotherapy Initiation At Hospital Discharge Among Patients Seen By An Inpatient Addiction Consult Service, Honora Englander, Caroline King, Christina Nicolaidis, Devin Collins, Alisa Patten, Jessica Gregg, P. Todd Korthuis

School of Social Work Faculty Publications and Presentations

Background:

Medications for opioid use disorder (MOUD) and alcohol use disorder (MAUD) are effective and under-prescribed. Hospital-based addiction consult services can engage out-of-treatment adults in addictions care. Understanding which patients are most likely to initiate MOUD and MAUD can inform interventions and deepen understanding of hospitals’ role in addressing substance use disorders (SUD).

Objective:

Determine patient- and consult-service level characteristics associated with MOUD/MAUD initiation during hospitalization.

Methods:

We analyzed data from a study of the Improving Addiction Care Team (IMPACT), an interprofessional hospital-based addiction consult service at an academic medical center. Researchers collected patient surveys and clinical data from September …

The Experience Of Family Therapists Providing An In-Person Group Intervention, Responding To The Covid-19 Pandemic, And Attempting To Continue With A Comparable Intervention In A Virtual Setting, Miranda R. Gab

University Honors Theses

Group interventions are widely used in mental health and educational settings. Studies have shown that these groups can be conducted in either in-person or virtual settings with success, though there is limited research on the delivery of synchronous, online group interventions, particularly an in-person group intervention that abruptly transitioned to telehealth delivery due to the coronavirus. This observational research aims to tell the story of how two family therapists, who served as co-facilitators for an in-person parenting intervention, transitioned to deliver the same content virtually due to the restrictions of the COVID-19 pandemic. Drawing upon previous and present research in …

Predicting The Efficacy Of Psilocybin In Treating Mental Health And Addiction, Courtney Ledford

altREU Projects

Machine Learning is used to predict the efficacy of psilocybin in treating mental health and addiction by using a random forest algorithm. Psilocybin is a chemical compound found in fungi. Following ingestion, it is converted to psilocin which acts as a serotonin agonist, producing altered states of consciousness and hallucinations. Research suggests the use of psilocybin as a potential treatment for mental health disorders and addiction. An analysis of thirty-one experiments from the Altered States Database was inputted into the model. Past meta-analysis performed on this experimental data focuses on healthy participants rather than participants diagnosed with a mental illness. …

Individual And Community Supports That Impact Community Inclusion And Recovery For Individuals With Serious Mental Illnesses, Rachel Elizabeth Terry

Dissertations and Theses

The current dissertation presents two published manuscripts and discusses a third study that explored the role of social support in promoting community participation for individuals with serious mental illnesses. The first manuscript investigated sense of community as a potential mediating factor between community participation, psychological distress, and mental health functioning utilizing quantitative methods. The results indicated that sense of community acted as a partial mediator between community participation and psychological distress, as well as mental health functioning. The second manuscript is a literature review that explored the influence of social support on community integration for individuals with serious mental illnesses. …

De-Stigmatizing Mental Health Through First Person Narration In Young Adult Literature, Tatum E. Francis

University Honors Theses

This thesis project includes a written short story titled "Quiet Dissonance" that explicitly depicts anxiety and depression within the genre of Young Adult literature. The purpose of this story is to consciously de-stigmatize the mental health issues by depicting these mental disorders as authentically as possible with both research and my own real-life experience of being diagnosed with both anxiety and depression, rather than relying upon stereotypes and the influence of the media. This story is consciously written through the point of view of first person narration, allowing for further exploration into the interiority of the thoughts of the protagonist …

Centering Children In Co-Parenting, Kristen L. Wiidanen

University Honors Theses

Comprehensive systems theory identifies several associated risk factors and consequences of separation but, research suggests that legal divorce itself has few direct effects on children. While there is diversity in children’s responses to separation, generally associated risk factors are behavioral disruptions, emotional upheaval, anger, resentment, anxiety, guilt and depression. Parents abilities to cope with their divorce are critical to the child’s adjustment and, if parents are able to control their feelings toward their ex-spouse, cooperate in parenting, negotiate differences, and settle their quarrels in privacy, their children will show fewer social and emotional problems. It is expected that the curriculum …

Understanding Individual And Family Experiences Associated With Dup: Lessons From The Early Assessment And Support Alliance (Easa) Program In Oregon, Usa, Ryan P. Melton, Shannon Blajeski, Diana Glasser

Regional Research Institute for Human Services

Research shows that a longer duration of untreated psychosis (DUP) is associated with worse psychiatric outcomes, with average length of DUP of 73 weeks in the U.S. The aim was to examine the DUP period for first episode psychosis in Oregon, with a focus on the processes between the first positive symptoms and first treatment. To investigate DUP, researchers used methods consistent with grounded theory to collect data from 9 participants and their families about the process between onset of psychotic symptoms and entrance into treatment. Results suggest that recognition of symptoms was the primary driver of help-seeking in this …

A Systematic Literature Review Of Video-Based Interventions To Improve Integrated Competitive Employment Skills Among Youth And Adults With Autism Spectrum Disorder, Vidya D. Munandar, Mary E. Morningstar, Sarah R. Carlson

Special Education Faculty Publications and Presentations

BACKGROUND:

People with Autism Spectrum Disorder (ASD) have lower employment rates than their peers without disabilities or other disabilities. Clear evidence exists regarding video-based interventions (VBIs) for improving task performance and social communication skills for students with ASD. However, such interventions have rarely been applied in integrated employment settings.

OBJECTIVE:

This systematic literature review aims to examine the utilization and efficacy of video-based interventions in improving the skills required to secure and maintain a job for youth and adults with ASD.

METHODS:

A systematic literature review was conducted on peer-reviewed articles on VBIs and ASD from electronic databases (n.d. –2019), …

‘Presumptively Initiating Vaccines And Optimizing Talk With Motivational Interviewing’ (Pivot With Mi) Trial: A Protocol For A Luster Randomised Controlled Trial Of A Clinician Vaccine Communication Intervention, Douglas J. Opel, Jeffrey D. Robinson, Heather Spielvogle, Christine Spina, Kathleen Garrett, Amanda F. Dempsey, Cathryn Perreira, Miriam Dickinson, Chuan Zhou, Barbara Pahud, Multiple Additional Authors

Communication Faculty Publications and Presentations

Introduction A key contributor to under immunisation is parental refusal or delay of vaccines due to vaccine concerns. Many clinicians lack confidence in communicating with vaccine-hesitant parents (VHP) and perceive that their discussions will do little to change parents’ minds. Improving clinician communication with VHPs is critical to increasing childhood vaccine uptake.

Methods and analysis We describe the protocol for a cluster randomised controlled trial to test the impact of a novel, multifaceted clinician vaccine communication strategy on child immunisation status. The trial will be conducted in 24 primary care practices in two US states (Washington and Colorado). The strategy …

Annual Wellness Visits And Influenza Vaccinations Among Older Adults In The Us, Terese Sara Hoj Jørgensen, Heather G. Allore, Miriam R. Elman, Corey L. Nagel, Mengran Zhang, Sheila Markwardt, Ana R. Quiñones

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives

Investigate whether combinations of sociodemographic factors, chronic conditions, and other health indicators pose barriers for older adults to access Annual Wellness Visits (AWVs) and influenza vaccinations.

Methods

Data on 4999 individuals aged ≥65 years from the 2012 wave of the Health and Retirement Study linked with Medicare claims were analyzed. Conditional Inference Tree (CIT) and Random Forest (CIRF) analyses identified the most important predictors of AWVs and influenza vaccinations. Multivariable logistic regression (MLR) was used to quantify the associations.

Results

Two-year uptake was 22.8% for AWVs and 65.9% for influenza vaccinations. For AWVs, geographical region and wealth emerged as …

Gut Carriage Of Antimicrobial Resistance Genes In Women Exposed To Small-Scale Poultry Farms In Rural Uganda: A Feasibility Study, Ana A. Weil, Meti D. Debela, Daniel M. Muyanja, Bernard Kakuhikire, Charles Baguma, David Bangsberg, Alexander C. Tsai, Peggy S. Lai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Antibiotic use for livestock is presumed to be a contributor to the acquisition of antimicrobial resistance (AMR) genes in humans, yet studies do not capture AMR data before and after livestock introduction.

Methods: We performed a feasibility study by recruiting a subset of women in a delayed-start randomized controlled trial of small-scale chicken farming to examine the prevalence of clinically-relevant AMR genes. Stool samples were obtained at baseline and one year post-randomization from five intervention women who received chickens at the start of the study, six control women who did not receive chickens until the end of the study, …

Strong Men, Strong Communities: Design Of A Randomized Controlled Trial Of A Diabetes Prevention Intervention For American Indian And Alaska Native Men, Ka‘Imi Sinclair, Cara Carty, Kelly L. Gonzales, Cassandra Nikolaus, Lucas Gillespie, Dedra Buchwald

OHSU-PSU School of Public Health Faculty Publications and Presentations

Type 2 diabetes is a serious global epidemic that disproportionately affects disadvantaged populations. American Indians and Alaska Natives (AIs/ANs) have the highest rates of diabetes in the nation with a prevalence of 14.7% in 2018, more than twice that of non-Hispanic Whites. AI/AN men have the highest prevalence of diagnosed type 2 diabetes (14.5%) compared to non-Hispanic Black (11.4%), non-Hispanic Asian (10.0%), and non-Hispanic White (8.6%) men. Several landmark clinical trials have shown that lifestyle interventions can effectively prevent or delay the onset of diabetes among those at risk, including in AIs/ANs. Despite positive outcomes for AIs/ANs in these studies, …

There’S More To The Story: Both Individual And Collective Policy Narratives Can Increase Support For Community-Level Action, Chris Skurka, Jeff Niederdeppe, Liana Winett

OHSU-PSU School of Public Health Faculty Publications and Presentations

Narratives can convey the need or community-level action to address social problems. Yet narratives often tell stories about specific individuals rather than the broader collectives these problems affect. Some theorists argue that individualizing collective problems inhibits audiences from recognizing upstream causes and solutions. This study tested how narrative individualization (whether a story focuses on an individual case or a larger collective) might produce trade-offs when mobilizing support for community-level policies to address childhood obesity. We also investigated whether narratives using language congruent with political partisans’ morals (equity or loyalty) might minimize polarized responses to such narratives. A large, Web-based experiment …

The Politics Of Caregiving: Taking Stock Of State-Level Policies To Support Family Caregivers, Walter D. Dawson, Lauren Bangerter, Micheal Splaine

Institute on Aging Publications

The U.S. population is aging rapidly. The changing demographics offer several benefits and opportunities at local, national, and global levels (Kluge, Zagheni, Loichinger, & Vogt, 2014). Yet, living to an advanced age remains a significant risk factor for the need of care and support during one’s lifetime. Half of all adults 65 years of age and older will reach a point where they require a high level of support due to either physical or cognitive challenges (Tumlinson, Juring, & Alkema, 2016). At the same time, the number of older adults living with chronic disease (e.g., diabetes, …

To Disclose Or Not To Disclose? Self-Disclosure Of Mental Health In The Workplace, Samantha Margaret Reynolds

Dissertations and Theses

When making the decision to disclose a mental illness, individuals may be met with a number of factors that impact disclosure. This study examines the relationship between self-stigma, psychological safety, social support and self-disclosure of mental illness in the workplace. The present study surveyed 756 participants and found a positive relationship between stigma and self-disclosure as well as a positive relationship between social support and self-disclosure. For work outcomes, there was a negative relationship between both job satisfaction and productivity in relation to self-disclosure. This study potentiates the antecedents and consequences of self-disclosure of mental illness and how it impacts …

Forests And Mental Health In South Africa: Panel Data Evidence, Dambala Gelo

Forest Collaborative Research

Slides from a presentation that examines the linkages between the green environment (urban forests, green open urban space) and mental health in South Africa. The author used representative panel data from the National Income Dynamics Survey, including the Center for Epidemiological Studies Short Depression Scale, to uncover these links.

Art Therapy And Dialectical Behavioral Therapy: A Workbook, Jasmine S. Griswold

University Honors Theses

Looking into the ways in which we treat anxiety and depression in both clinical and casual settings it seemed apparent that there are similar tools being utilized to alleviate the effects, but there didn’t seem to be a cohesion of these tools. With Dialectical Behavioral Therapy (DBT) a mindfulness based approach to therapy and the use of art as a tool to create dialogue in Art Therapy (AT) it seemed appropriate to combine the modalities to create a workbook that could be used on one's own or in conjunction with a therapist.

Attrition And Psychotherapy, Jesse Barrington Homan

Dissertations and Theses

Attrition in psychotherapy, also known as dropout, is a problem that affects clients who terminate, their families, therapists, mental health systems, and the overall community. Research on attrition is vast. However, the majority of this research has been done post hoc, relied on quantitative methods, and looked primarily at client demographic variables as the predictors of attrition. This has resulted in inconsistent findings, offers little to no useful information about attrition, and appears to blame clients for failed therapy. There has been little research on attrition from the perspective of clients who terminate. This study was designed to answer the …

Urbanicity As A Moderator Of The Relationship Between Stigma And Well-Being Outcomes For Individuals With Serious Mental Illnesses, Emily Leickly

Dissertations and Theses

During the deinstitutionalization movement in the 1960s, community mental health centers and supportive and affordable housing for people with serious mental illnesses (SMI) was concentrated in economically disadvantaged urban centers. Today, these urban centers are becoming increasingly gentrified and unaffordable for people with SMI. Affordability is no longer synonymous with urban living, and supportive housing for people with SMI is increasingly found in non-urban areas. Given this shift, it is important to understand the potential impacts of non-urban living on people with SMI. Non-urban environments provide potential benefits for the general population, including reduced traffic and increased proximity to the …

Development And Validation Of The Workplace Mental Illness Stigma Scale (W-Miss), Nicholas Anthony Smith

Dissertations and Theses

Although 1 in 5 Americans will experience a mental illness at some point, each year people with mental illnesses continue to face high levels of stigmatization and discrimination at work. Recognizing this, many organizational researchers and practitioners have sought to improve workplaces for employees with mental illness through a variety of organizational interventions. Unfortunately, few interventions are thoroughly evaluated. One barrier to evaluating such interventions is the lack of a theoretically meaningful measure of workplace mental illness stigma. In this dissertation, I proposed to develop and evaluate such a measure (the W-MISS) based on Jones, Farina, Hastorf, Markus, Miller, and …

Impactful Care: Addressing Social Determinants Of Health Across Health Systems, Nicole Lisa Friedman

Dissertations and Theses

There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual's ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.

The goal of this applied research project is …

Depiction And Function Of Madness In Elizabethan And Jacobean Literature, Yeiji Seo

Young Historians Conference

Since the ancient times of Israel, Greece, and Rome, people with mental illnesses have been regarded as different from others in society. This paper aims to analyze the motives of authors of medical and dramatic texts of Elizabethan and Jacobean literature in regards to mental illness by specifically observing William Shakespeare’s King Lear and Robert Burton’s The Anatomy of Melancholy. This paper also considers the views of other scholars of the field to compose a complete insight on Shakespeare and Burton’s goals in depicting mental illness and finally advocates further research and understanding to positively contribute towards disability reform today.

Using “Remote” Training And Coaching To Increase Providers’ Skills For Working Effectively With Older Youth And Young Adults With Serious Mental Health Conditions, Janet S. Walker, Caitlin Baird

School of Social Work Faculty Publications and Presentations

Since about the turn of the century, a growing awareness of the poor outcomes resulting from “as usual” community mental health care has led to increasing efforts to implement programs and interventions with empirical evidence of effectiveness. However, these efforts have encountered numerous barriers, in particular the high cost of implementation, which has severely limited uptake and sustainment of empiricallysupported programs and interventions. Typically, the largest contributor to cost is the training and coaching required to ensure provider competence and fidelity to the intervention or program model. This paper describes a social innovation that aims to provide high-quality training and …

Take Control: A Proposed Mental Health Treatment Program To Be Implemented In Youth Correctional Facilities Around Oregon Based On The Evidence-Based Target Program, Zoey S. Rochefort

OHSU-PSU School of Public Health Annual Conference

70% of youth in state and local juvenile justice systems exhibit symptoms of one or more mental health disorders and are not receiving adequate treatment. Currently, in Oregon, there is no mental health-screening requirement for youth admitted into detention centers or correctional facilities. Though this doesn’t mean kids never get diagnosed, it does mean there is a large delay in time before treatment begins where they could be receiving care. The Take Control program is working to mitigate wasted time and improve mental health treatment for youth inmates through a seven-step treatment program that provides youth with steps and strategies …

Hospital-Based Services For Opioid Use Disorder: A Study Of Supply-Side Attributes, Kelsey Caroline Priest

Dissertations and Theses

The United States (U.S.) is in the midst of an opioid overdose epidemic. In the U.S., overdose deaths related to opioid exposure are the leading cause of accidental death, yet life-saving treatments, such as methadone or buprenorphine (opioid agonist therapy [OAT]), are underused. OAT underused is due, in part, to complex regulatory and health services delivery environments. Public health officials and policymakers have focused on expanding OAT access in the community (e.g. office-based buprenorphine treatment, and opioid treatment programs); however, an often-overlooked component of the treatment pathway is the acute care delivery setting, in particular hospitals.

Opioid use disorder (OUD)-related …

“Little Tablets Of Gold”: An Examination Of The Psychological And Social Dimensions Of Prep Among Lgbtq Communities, Christina J. Sun, Kirsten M. Anderson, Kim Toevs, Dayna Morrison, Caitlin Wells, Christina Nicolaidis

OHSU-PSU School of Public Health Faculty Publications and Presentations

There are significant psychological, social, and cultural dimensions to the HIV epidemic in the United States, especially among lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. Biomedical HIV treatment has been shown to impact these dimensions. However, there is little understanding of the real-world psychosocial and sociocultural effects of the latest biomedical HIV prevention strategy, HIV pre-exposure prophylaxis (PrEP). This study explored the psychosocial and sociocultural dimensions of PrEP use among LGBTQ adults. We interviewed 23 LGBTQ adults who were current or former users of PrEP. Results included that PrEP users’ experiences were shaped by multiple forms of stigma. Participants …

Internet Addiction, Smartphone Addiction, And Hikikomori Trait In Japanese Young Adult: Social Isolation And Social Network, Masaru Tateno, Alan R. Teo, Wataru Ukai, Junichiro Kanazawa, Ryoko Katsuki, Hiroaki Kubo, Takahiro A. Kato

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: As the number of internet users increases, problems related to internet overuse are becoming more and more serious. Adolescents and youth may be particularly attracted to and preoccupied with various online activities. In this study, we investigated the relationship of internet addiction, smartphone addiction, and the risk of hikikomori, severe social withdrawal, in Japanese young adult.

Methods: The subjects were 478 college/university students in Japan. They were requested to complete the study questionnaire, which consisted of questions about demographics, internet use, the Internet Addiction Test (IAT), the Smartphone Addiction Scale (SAS)–Short Version (SV), the 25-item Hikikomori Questionnaire …

Impacts Of An Opioid Overdose Prevention Intervention Delivered Subsequent To Acute Care, Caleb J. Banta-Green, Phillip O. Coffin, Joseph O. Merrill, Jeanne M. Sears, Chris Dunn, Norbert D. Yanez, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons.

Methods Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting …

Portrayals Of Mental Illness, Treatment, And Relapse And Their Effects On The Stigma Of Mental Illness: Population-Based, Randomized Survey Experiment In Rural Uganda, Justin D. Rasmussen, Bernard Kakuhikire, C. Baguma, Scholastic Ashaba, Christine E. Cooper-Vince, Jessica M. Perkins, David Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Mental illness stigma is a fundamental barrier to improving mental health worldwide, but little is known about how to durably reduce it. Understanding of mental illness as a treatable medical condition may influence stigmatizing beliefs, but available evidence to inform this hypothesis has been derived solely from high-income countries. We embedded a randomized survey experiment within a whole-population cohort study in rural southwestern Uganda to assess the extent to which portrayals of mental illness treatment effectiveness influence personal beliefs and perceived norms about mental illness and about persons with mental illness.

Methods and findings

Study participants were randomly assigned …