Mental and Social Health Commons^™

Experiences Seeking Meaningful Employment For Individuals With Substance Use Disorder In York County Maine, Tyler Egeland Ba, Mark Richards Bs Bs, Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

Two focus groups and one interview conducted in November 2021 collected information from a total of six respondents regarding theiremployment experiences in York County as individuals receiving treatment for substance use disorder. The guided discussion coveredtopics related to resources and services for finding employment opportunities, experiences obtaining meaningful employment, andpotential barriers and facilitators to maintaining employment. The interview and focus groups were facilitated and analyzed byexperienced researchers from the Catherine Cutler Institute at the University of Southern Maine. For more information, please contact Lindsey Smith at [email protected]

Nh Delivery System Reform Incentive Payment Program (Dsrip): Key Findings From The Summative Evaluation Report, Mary Lindsey Smith Phd, Deborah Thayer Mba, Katie Rosingana Ba, Rachel M. Gallo Mph, Catherine Mcguire Bs, Evelyn Ali Mph, Katharine Knight Mph, Chinonye Anumaka, Tyler Egeland Ba, Mark Richards Bs, Karen Pearson Mlis

Substance Use Research & Evaluation

Delivery System Reform Incentive Payment (DSRIP) programs are part of the broader Center for Medicare & Medicaid Services (CMS) Section 1115 Waiver programs and provide states with significant funding to support system transformation efforts. CMS approved New Hampshire’s five-year Building Capacity for Transformation Section 1115(a) Medicaid Demonstration Waiver in 2015. The overall goal of the DSRIP Demonstration is to improve the care for New Hampshire’s Medicaid Beneficiaries with behavioral health disorders by addressing workforce and infrastructure shortages, improving care transitions, and integrating physical and behavioral health. This condensed report highlights key findings from the NH DSRIP summative evaluation report. For …

Summative Evaluation Report By The Independent Evaluator For The New Hampshire Delivery System Reform Incentive Payment (Dsrip) Program, Mary Lindsey Smith Phd, Deborah Thayer Mba, Katie Rosingano Ba, Rachel M. Gallo Mph, Catherine Mcguire Bs, Evelyn Ali Mph, Katharine Knight Mph, Chinonye Anumaka Od, Mph, Tyler Egelund Ba, Mark Richards Bs, Karen Pearson Mlis, Ma

Substance Use Research & Evaluation

Delivery System Reform Incentive Payment (DSRIP) programs are part of the broader Center for Medicare & Medicaid Services (CMS) Section 1115 Waiver programs and provide states with significant funding to support system transformation efforts. CMS approved New Hampshire’s five-year Building Capacity for Transformation Section 1115(a) Medicaid Demonstration Waiver in 2015. The overall goal of the DSRIP Demonstration is to improve the care for New Hampshire’s Medicaid Beneficiaries with behavioral health disorders by addressing workforce and infrastructure shortages, improving care transitions, and integrating physical and behavioral health. This report is the final summative evaluation report on New Hampshire's DSRIP program. For …

Greater Portland Health Medication Assisted Treatment: Prescription Drug And Opioid Addiction Expansion Project: Biannual Summary, Mary Lindsey Smith Phd, Katharine Knight, Mark Richards Bs, Tyler Egeland Ba, Evelyn Ali Bs

Substance Use Research & Evaluation

Greater Portland Health (GPH) in collaboration with Preble Street Resource Center was awarded a Medication Assisted Treatment: Prescription Drug & Opioid Addiction (MOUD-PDOA) grant from SAMHSA. The GPH MOUD-PDOA project included a mixed-methods evaluation led by Catherine E. Cutler Institute’s Substance Use Research and Evaluation Team (SURE). The aims of the evaluation are to build knowledge, document lessons learned, and provide feedback to inform the implementation and refinement of the GPH MOUD-PDOA Program. This summary presentation is a biannual summary of the GPH MOUD-PDOA Project. For more information, please contact Lindsey Smith at [email protected]

Increased Risk Of Mental Illness Due To Epigenetic Alteration Of The Nr3c1 Gene After Early Life Adversity., Erin Mccue

Thinking Matters Symposium

Early life adversity (ELA), such as malnutrition, abuse, and economic disparity, is an issue commonly seen in adolescents, a group already facing increased risk for stress-related disorders. This review of current literature reveals that gestational stress exposure, as well as variations in maternal care during postnatal development, cause latent effects on the epigenome, specifically impacting the glucocorticoid receptors (GRs) encoded by the NR3C1 gene. GRs bind to glucocorticoids to regulate the body’s neuroendocrine stress response. However, in those with a history of ELA, the number of GRs is reduced, generating dysregulation within the hypothalamic-pituitary-adrenal (HPA) axis. Rodent studies are utilized …

A Path For Evidenced-Based Evaluation: The Case For Restorative Justice, Raúl D. Gierbolini-Rivera, Atc,Cscs

Thinking Matters Symposium

No abstract provided.

House: Homeless Opioid User Service Engagement Program. Year 1 Report, Mary Lindsey Smith Phd, Katharine Knight Mph, Evelyn Ali Bs, Thomas Chalmers Mclaughlin Msw, Phd, Katie Rosingana Ba, Tyler Egeland Ba, Mark Richards Bs, Karen Pearson Mlis, Ma

Substance Use Research & Evaluation

Homelessness and lack of stable housing is often a barrier to achieving stability for individuals who are experiencing homelessness (IWAEH) with an OUD. In order to meet the complex needs of IWAEH with OUD, the Department of Health and Human Services funded a pilot program in 2021, the Homeless Opioid Users Service Engagement (HOUSE) Program; clinicians at Greater Portland Health provide clients with low-barrier Medication Assisted Treatment (MAT), while staff at Preble Street provide casework support and rapid housing assistance to individuals who have been identified as being at high risk of overdose, are experiencing homelessness, and are diagnosed with …

R.A.C.E. To Recovery Year 1 Evaluation Summary Report, Katie Rosingana Ba, Evelyn Ali Bs, Tyler Egeland Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

Through a collaborative effort led by the Healthy Community Coalition, the multi-sector Rural Addiction Care Expansion (R.A.C.E.) to Recovery initiative consortium is utilizing evidence-based, community-wide response to impact and reduce the effects of the opioid epidemic in the Western Maine Public Health District/ Greater Franklin County. To assess and evaluate the implementation, successes, and challenges of the RACE to Recovery project, the Cutler Institute is collecting and analyzing data for both process and outcomes of the initiative.

In the first year of the initiative, the Cutler evaluation team utilized both primary and secondary data to assess RACE to Recovery program …

Support For Me Needs Assessment Summary., Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Karen Pearson Mlis, Ma, Mark Richards Bs, Katharine Knight Mph, Tyler Egeland Ba, Olivia Dooley Mpa

Substance Use Research & Evaluation

Maine Department of Health and Human Services contracted with the Catherine Cutler Institute at the University of Southern Maine to conduct a baseline needs assessment. The overall goal was to better understand the current capacity to address substance use in Maine; find barriers to receiving and utilizing SUD treatment and recovery services; and identify any gaps in SUD-related services in the state. The Cutler team conducted interviews, surveys, community listening sessions and focus groups with healthcare key informants (leadership from health systems, residential care, recovery housing, behavioral health agencies), providers (medical, behavioral health, first responders, residential treatment, law enforcement, opioid …

Time To Ask Program At Greater Portland Health [Infographic], Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The goals of the Time to Ask education and quality improvement program of the Lunder Dineen include increasing the capacity of interprofessional care teams in discussing alcohol use with the patients through the screening, brief intervention, and referral (SBIRT) process, and expanding providers' use of screening and monitoring unhealthy alcohol use of their patients.

This evaluation infographic visualizes the impact of Greater Portland Health's use of this program.

For more information about Time to Ask, visit https://lunderdineen.org/program/alcohol-use-time-to-ask/

For more information about the evaluation, please contact M. Lindsey Smith, PhD, [email protected]

Support For Me: Substance Use Disorder Prevalence And Treatment Capacity Assessment, Rachel T. Gallo Mph, Katharine Knight Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity.

The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act …

Support For Me: Provider Focus Group Summary, Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Tyler Egeland Ba, Karen Pearson Mlis, Ma, Mark Richards Bs

Substance Use Research & Evaluation

This summary highlights feedback from focus groups with providers across Maine who currently address the needs of persons with substance use disorder (SUD). These providers represent individuals working in the following organizations: Health Systems, Behavioral Health Agencies, Residential Treatment, Community Recovery Programs, Opioid Treatment Programs (OTP), Emergency Medical Services (EMS), First Responders (EMT, fire, police), and law enforcement (e.g., Sheriff’s Office, Corrections). This summary report is designed to provide feedback to the Office of MaineCare Services to help inform their strategic planning process to increase statewide capacity for SUD treatment and recovery service capacity to better meet the needs of …

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Support For Me Assessment Of Substance Use Treatment And Recovery Services Current Infrastructure And Future Needs: Summary Of Feedback From The Support For Me Community Focus Groups (Condensed), Katie Rosingana Ba, Mary Lindsey Smith Phd, Evelyn Ali Bs, Karen Pearson Mlos, Ma, Tyler Egeland Ba, Mark Richards Bs

Substance Use Research & Evaluation

In 2019, Maine’s Department of Health & Human Services received a $2.1 million grant from the Centers for Medicare and Medicaid Services (CMS) SUPPORT Act, establishing the SUPPORT for ME initiative within the Office of MaineCare Services. The primary goal of this planning grant is to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services for Medicaid beneficiaries. In collaboration with Maine DHHS, the Cutler Institute conducted a series of virtual focus groups in Maine as part of a needs assessment for the SUPPORT for ME initative. These focus groups were conducted regionally by Public …

Support For Me Assessment Of Substance Use Treatment And Recovery Services Current Infrastructure And Future Needs: Findings From The Support For Me Youth Survey (Condensed), Evelyn Ali Bs, Katie Rosingana Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

In 2019, Maine’s Department of Health & Human Services received a $2.1 million grant from the Centers for Medicare and Medicaid Services (CMS) SUPPORT Act, establishing the SUPPORT for ME initiative within the Office of MaineCare Services. The primary goal of this planning grant is to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services for Medicaid beneficiaries. In collaboration with Maine DHHS, the Cutler Institute conducted a survey for youth and young adults in Maine as part of a needs assessment for the SUPPORT for ME initative. The data collection goals of the survey …

Support For Me: Key Stakeholder Interview Summary, Katie Rosingana Ba, Mary Lindsey Smith Phd, Karen Pearson Mlis, Ma, Evelyn Ali Bs, Tyler Egeland Ba, Mark Richards Bs

Substance Use Research & Evaluation

This summary feedback report is organized to inform the Office of MaineCare Services goal of addressing barriers and finding new and/or improved ways to increase capacity in Maine for people who seek treatment and recovery services for substance use disorder. Interview protocols were designed to assess critical domains of interest for the state, which include: current and potential provider capacity, access to care & service delivery provider willingness, and financial/ administrative policies.

Key Highlights from the stakeholder interviews indicated that:

• While there have been improvements in the integration of care for persons with behavioral health (BH) diagnoses, this integration has …

Educator Wellbeing During Covid-19: Caregivers Vs. Non-Caregivers, Elizabeth Larsen, Judy Gagnon, Yana Davis, Nicole Hudson

Thinking Matters Symposium

The phenomenon of the COVID-19 pandemic has dramatically changed the format of public education, putting stress on the educational system and its teachers. This research study aims to understand the impact of COVID-19 on the role of teachers in Maine, specifically focusing on the added responsibility that parents may experience while simultaneously meeting professional obligations. Researchers posed the question: “What is the relationship between caregiving responsibilities and emotional wellbeing of teachers during the COVID-19 pandemic among public school teachers in Maine?” Participants from K-12 public schools around the state were recruited through direct contact or via building administrators who distributed …

Clinicians Use Of Mindfulness-Based Practices During The Covid-19 Pandemic, Leah Ridley, Samuel J. Giese, Shelby Cogan, Chelsea Hughes

Thinking Matters Symposium

Alternative mental health treatments like mindfulness hold a great deal of promise, but limited research exists on their success and application with the adolescent population. This study investigates the primary research question, “What are the experiences of clinicians providing mindfulness-based treatment to school-aged children in Maine during the COVID-19 pandemic?” This explanatory mixed methods study involves a quantitative survey of clinicians, and will be followed by a virtual focus group to further unpack the value of mindfulness-based practices when working with school-aged children. Survey data will be analyzed using descriptive statistics and qualitative content analysis; focus group data will be …

The Impacts Of Social Media Sites Such As Instagram And Facebook On Emerging Adult’S Perceptions Of Self-Esteem And Body Satisfaction, Wynne Cushing, Samantha Shandorf, Courtney Piccirillo, Abby Frazier

Thinking Matters Symposium

This study investigated the impacts of social media use, specifically Facebook and Instagram, on emerging adults’ perceptions of self-esteem and body satisfaction. Limited research exists regarding the influence of demographic variables, such as gender, race, and geographic location, on the relationship between social media use and negative outcome variables. The researchers utilized a cross-sectional survey design with a target population of University of Southern Maine students. Researchers hypothesize that emerging adults who spend more time on Facebook and Instagram are more likely to have lower self-esteem and body satisfaction than emerging adults who spend little to no time on Facebook …

Opioid Use And Harm Reduction, Elise Bourassa, David Lee, Jason Rogers, Christian Silverthorne

Thinking Matters Symposium

Calls for various harm reduction approaches to the opioid epidemic are increasing in activist communities (Chapkis, 2020; Kennedy-Hendricks et al., 2019; Sederer & Marino, 2018). Given that harm reduction approaches, if implemented, will be provided by people in various helping professions, the current study investigates the relationship between choice of human service-focused college major and level of support for harm reduction interventions for people who use opioid drugs. A quantitative survey that aims to measure knowledge and perceptions of harm reduction strategies has been disseminated to students in social work, counseling, public health and nursing departments at the University of …

Impact Of Group Prenatal Care On Health Outcomes For Women Of Color In The United States: A Systematic Literature Review, Morgan Brockington, Emily Bauer, Julie Kameisha

Thinking Matters Symposium

Women of color in the United States experience disproportionately higher rates of adverse pregnancy-related outcomes, both in the prenatal and postpartum period. Group prenatal care (GPC) has been gaining popularity in recent years and has demonstrated improved health outcomes. The aim of this systematic literature review was to examine and summarize the impact of group prenatal care on health outcomes for women of color in the United States. Using a systematic approach and PRISMA guidelines, two electronic databases—CINAHL and PubMed—were used to search the literature. Quantitative research studies that were published in peer-reviewed journals between 2010 and 2020, written in …

Support For Me Key Takeaways Of The Care Integration Assessment, Rachel M. Gallo Mph, Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Karen Pearson Mlis, Ma, Mark Richards Bs, Tyler Egeland Ba, Olivia Dooley Mpa

Substance Use Research & Evaluation

In 2019, Maine’s Department of Health & Human Services received a $2.1 million grant from the Centers for Medicare and Medicaid Services (CMS) SUPPORT Act, establishing the SUPPORT for ME initiative within the Office of MaineCare Services. The primary goal of this planning grant is to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services for Medicaid beneficiaries. One key component of this project is an assessment to collect information from Maine organizations to help MaineCare better understand levels of care integrations within organizations and across several dimensions of care (“Care Integration Assessment”). This condensed …

Support For Me Results From The Care Integration Assessment, Rachel M. Gallo Mph, Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Karen Pearson Mlis, Ma, Mark Richards Bs, Tyler Egeland Ba, Olivia Dooley Mpa

Substance Use Research & Evaluation

In 2019, Maine’s Department of Health & Human Services received a $2.1 million grant from the Centers for Medicare and Medicaid Services (CMS) SUPPORT Act, establishing the SUPPORT for ME initiative within the Office of MaineCare Services. The primary goal of this planning grant is to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services for Medicaid beneficiaries. One key component of this project is an assessment to collect information from Maine organizations to help MaineCare better understand levels of care integrations within organizations and across several dimensions of care (“Care Integration Assessment”). This report …

Opioid-Related Visits To Rural Emergency Departments, Erika C. Ziller Phd, Jean A. Talbot Phd, Deborah Thayer Mba, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Increased rates of acute opioid poisoning and related emergency department (ED) visits in the United States have occurred at the same time as rural EDs face a number of resource constraints. Researchers at the Maine Rural Health Research Center conducted this study to gain insight about rural ED visits for acute opioid poisoning and how they compare with urban ED visits. The authors used data from the 2006 and 2013 Nationwide Emergency Department Sample to examine rural and urban opioid-related visits (ORVs) to EDs, including rate change over time, and the outcomes of these ED visits (treatment and release, inpatient …

Capacity Of Rural Counties To Address An Hiv Or Hepatitis C Outbreak, Jennifer Lenardson Mhs, Jaclyn Janis Rn, Mph, Amanda Burgess Mppm, Karen Pearson Mlis, Ma, Martha Elbaum Mpa

Population Health

HIV and hepatitis C (HCV) are major public health concerns in the United States and are a focus of significant federal health policy attention. Rural counties may be potentially vulnerable to an HIV or HCV outbreak among persons who inject drugs due to greater prevalence of high-risk injection practices as well as limited public health capacity to prevent, prepare for, and respond to an HIV or HCV outbreak. This study identified states potentially at risk for an HIV or HCV outbreak and used data from the 2016 Association of State and Territorial Health Officials (ASTHO) Profile Survey, 2016 National Association …

Downeast Maine Mat Expansion Project: Year 3 Final Data Summary, Mary Lindsey Smith Phd, Evelyn Ali Bs, Katharine Knight Mph, Tyler Egeland Ba

Substance Use Research & Evaluation

This report summarizes the collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network, and Downeast Substance Use Response Coalition, to combat opioid use disorder (OUD) in Downeast Maine through multiple evidence-based strategies.

Project goals included the reduction of barriers to accessing medication-assisted treatment (MAT) and the enhancement of MAT services by improving provider capacity through training and implementation of best practice treatment.

For more information, please contact M. Lindsey Smith, PhD, [email protected]

Downeast Maine Mat Expansion Project: Year 2 Data Summary, Mary Lindsey Smith Phd, Evelyn Ali Bs, Tyler Egeland Ba

Substance Use Research & Evaluation

This report summarizes the Year 2 activities of the Healthy Acadia Downeast Maine MAT Expansion Project. Through a collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network and Downeast Substance Use Response Coalition, the project utilized multiple evidence-based strategies to combat opioid use disorder (OUD) in Downeast Maine.

FMI: M. Lindsey Smith, PhD, [email protected]

Substance Use Among Rural And Urban Youth And Young Adults, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Erika C. Ziller Phd

Mental Health / Substance Use Disorders

Rural youth and young adults have historically had higher use rates of alcohol and other substances than their urban counterparts. Recent research suggests that rates of youth and young adult alcohol and other substance use have declined over the past two decades, but we have limited knowledge of whether and how current rural and urban substance use patterns may differ. As national substance use rates decline, it is important to re-assess differences in use among rural versus urban youth and young adults. This study uses data from the National Survey of Drug Use and Health (NSDUH) to examine rural-urban differences …

Interim Evaluation Report By The Independent Evaluator For The New Hampshire Delivery System Reform Incentive Payment (Dsrip) Program, Mary Lindsey Smith Phd, Deborah Thayer, Katie Rosingana Ba, Catherine Mcguire, Rachel M. Gallo Mph, Evelyn Ali, Olivia Dooley Mpa, Carolyn Gray Mph, Tom Merrill Ma, Karen Pearson Mlis, Ma,, Mark Richards Bs

Substance Use Research & Evaluation

Delivery System Reform Incentive Payment (DSRIP) programs are part of the broader Center for Medicare & Medicaid Services (CMS) Section 1115 Waiver programs and provide states with significant funding to support system transformation efforts. CMS approved New Hampshire’s five-year Building Capacity for Transformation Section 1115(a) Medicaid Demonstration Waiver in 2015. The overall goal of the DSRIP Demonstration is to improve the care for New Hampshire’s Medicaid Beneficiaries with behavioral health disorders by addressing workforce and infrastructure shortages, improving care transitions, and integrating physical and behavioral health.

Provision Of Mental Health Services By Critical Access Hospital-Based Rural Health Clinics, John A. Gale Ms, Zachariah T. Croll Mph, Nathan First Lcsw, Msw, Ma, Sara Kahn-Troster Mph

Rural Health Clinics

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural …