Psychiatric and Mental Health Commons^™

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Enhancing Tardive Dyskinesia Screening In An Outpatient Psychiatry Training Clinic: A Quality Improvement Initiative, Ariel Davalos

Doctor of Nursing Practice Final Manuscripts

Background: Tardive Dyskinesia (TD) is a debilitating, often irreversible movement disorder caused by prolonged exposure to dopamine receptor-blocking agents, affecting 15-30% of patients on long-term antipsychotic therapy. Despite endorsement of the Abnormal Involuntary Movement Scale (AIMS) as the gold standard for TD screening, the condition remains significantly under-diagnosed. Purpose: This quality improvement project evaluated whether a 45-minute educational intervention could improve PMHNP trainees’ confidence and competence in TD recognition and AIMS administration. Methods: Guided by the Iowa Model of Evidence-Based Practice, the project used a pre-post survey design with a planned one-month follow-up across two clinical training sessions. Ten PMHNP …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Empowering Recovery: Implementing Ace Screenings To Enhance Care For Patients With Substance Use Disorders, Joshua Wolf

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project evaluated the impact of implementing adverse childhood experience (ACE) screenings for patients with substance use disorders (SUDs) in an outpatient community behavioral health clinic.

Background: ACEs are strongly associated with an increased risk of developing SUDs, chronic medical comorbidities, and negative treatment outcomes. Despite consistent evidence supporting the need for identification of ACEs and implementing trauma-informed care, standardized ACE screening is not routinely incorporated into outpatient SUD treatment, potentially limiting the identification of the need for education and referrals.

Methods: The ACE Questionnaire for Adults was implemented during routine psychiatric visits for patients diagnosed with …

Implementing A Mindfulness Mobile Application, Smiling Mind To Reduce Stress Experienced By Inpatient Psychiatric Nurses, Emma Jade Mowery, Justin D. Ruiz

Doctor of Nursing Practice Final Project Abstract

Purpose: To investigate the impact of implementing use of the Smiling Mind app (a free and easily accessed mobile application that teaches mindfulness skills) in inpatient psychiatric nurses. The aims: A 20% reduction in Perceived Stress and improved Workplace Satisfaction after 10 weeks.

Background: Workplace stressors experienced by psychiatric nurses include high patient acuity, emotional strain, environmental factors, and new policies. Unmanaged stress can harm nurse's well being and affect quality of care.

Methodology: Using a pre-post implementation design, 7 dayshift and 10 night-shift nurses used the Smiling Mind app for 10 weeks. Perceived stress (PSS-10) and workplace satisfaction (WPS) …

Silent Struggles: A Qualitative Study On Mental Health Stigma And Help- Seeking Among African Individuals In The U.S, Ololade Ekwere

Dissertations

Approximately one-third of African Americans and Caribbean Blacks who require mental health services seek and utilize them (Evans & Sheu, 2019). Research has shown that stigma surrounding mental health treatment contributes to lower rates of professional help-seeking among Black Americans (Pederson, 2023). Despite the growing diversity within the Black community, limited research exists on how stigma influences professional mental health help-seeking among Africans living in the United States.

The purpose of this qualitative descriptive study was to explore the effect of public stigma on the mental health help-seeking behaviors of Africans living in the United States. Demographic data were collected, …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Decreasing Wound Healing Times By Decreasing Stress Levels, Bayleigh S. Kraus, Colson Burnett, Kelsey Spann

Scholars Week

The relationship between stress levels and delayed wound healing needs to be further investigated, particularly in hospitalized and chronically ill patients. Research shows that psychological stress can impair immune function, reduce tissue regeneration, and prolong inflammation, all of which slow the healing process. It is important to explore how both acute and chronic stress affect different types of wounds, such as surgical incisions, pressure injuries, and diabetic ulcers. Additionally, identifying which stress-reduction interventions are most effective in improving healing outcomes is essential. Understanding these factors can help nurses implement targeted, evidence-based interventions to promote faster recovery.

Exploring The Relationship Between Behavioral Health Early Prediction Model And Patient Outcomes In The Emergency Department, Karen M. Richendollar, Kathie M. Zimbro

Knowledge and Creativity Expo

Problem: Emergency departments (EDs) are increasingly utilized for mental health (MH) care, often resulting in overcrowding and delayed access to specialized services. A significant proportion of MH patients are discharged without a psychiatric consult, raising concerns about safety and readmission rates. This trend places additional strain on already limited behavioral health resources and contributes to care delays for patients in acute crisis. Moreover, the lack of standardized discharge criteria for MH patients increases variability in care and may compromise patient outcomes. Purpose: This study evaluates the effectiveness of the Behavioral Health Early Discharge Prediction Model (BHEDPM) in identifying MH patients …

Effectiveness Of Dialectical-Behavioral Intervention On Emotional Regulation Difficulties, Distress Tolerance, And Social Functioning Among Patients With Bipolar Disorder: Randomized Controlled Trial, Nashwa Ibrahim

Nursing

Aim

To determine the effect of implementing dialectical behavior therapy (DBT) skills training groups on emotional regulation difficulties, distress tolerance, and social functioning among patients with bipolar disorder (BD).

Methods

A randomized controlled trial was conducted with 120 patients diagnosed with BD who were attending follow-up at the outpatient clinic. Participants were randomly assigned to either the experimental group, which received 16 group psychoeducation sessions held twice weekly, or the control group, which received standard outpatient care. Analysis of variance (ANOVA) with repeated measures was applied to compare normally distributed quantitative variables across more than two time points or stages, …

Treatment For Women With Mental Health Disorders Associated With Reproductive Health: An Opportunity For Interprofessional Collaboration, Ellen Modlin Phd, Otr/L, Bcp, Caps, Deana Goldin Phd, Dnp, Arnp, Fnp-Bc, Pmhnp-Bc

Journal of Interprofessional Practice and Collaboration

Abstract

Purpose: This article proposes an opportunity for interprofessional collaboration between mental health practitioners (MHPs) and occupational therapy practitioners (OTPs) for the treatment of women experiencing mental health disorders (MHDs) associated with reproductive health (RH) changes throughout the lifespan. This collaborative approach have the potential to optimize women’s health care and mitigate the risk of fragmented care, as these conditions are highly complex.

Method: Peer- reviewed literature from mental health and occupational therapy (OT) research was reviewed and summarized. The search focused on the barriers and potential opportunities for collaboration between MHPs and OTPs in women affected with MHDs associated …

Atypical Antipsychotic-Induced Weight Gain Preventive Bundle: A Quality Improvement Project, Jocelyn Urbano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may …

Precision In Practice: Subject Matter Expert Integration To Support Excellence In Population-Specific Documentation, Sara Pump, Mary Hawes, Lauren Spain, Virginia Kasenic, Meagan Talent, Alivia Stewart, Carrin Shaw, Chad Gautreaux, Dori Cousin, Ponesea Allen, Jonathan Rowe

2026

This poster describes a quality improvement initiative that integrated psychiatric resource nurses as subject matter experts (SMEs) into clinical documentation workflows to improve documentation compliance for high-risk behavioral health patients. The intervention resulted in substantial improvements in charting accuracy and compliance, including an increase in emergency department documentation compliance from 28% to 95% over seven months, while enhancing staff education, collaboration, and patient safety.

Magnifying Mental Health In The Perinatal Population: A Systematic Review, Kasey E. Arnold, Alyssa M. Maki

Williams Honors College, Honors Research Projects

Pregnant individuals often experience significant anxiety, which can negatively affect both pregnancy and fetal outcomes. This systematic review evaluates the effectiveness of pharmacologic versus non-pharmacologic anxiety-relieving interventions, primarily focusing on the labor period. The PICOT question is: In perinatal patients, do non-pharmacologic anxiety-relieving measures, compared to pharmacologic anxiety-relieving measures, have a greater impact on ease of delivery and overall mental health during pregnancy and the perinatal period? PRISMA (2020) guidelines were used with inclusion criteria of human subjects, English language, and published within the last six years. Databases included PubMed, CINAHL, and Cochrane Library. Twenty-three studies were analyzed to examine …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

Mental Health And Art Adherence In A Multisite International Study: The Mediating Roles Of Social Support And Substance Use In People With Hiv, Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Sheila Shaibu

School of Nursing & Midwifery, East Africa

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from N = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental …

Moving Toward Healthy Ageing: The Role Of Physical Activity In Cognitive Function And Self-Esteem Among Older Adults In Türkiye, Canan Birimoglu Okuyan, Müjde Kerkez

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: A cross-sectional study was conducted with 251 older adults. Data were collected using the International Physical Activity Questionnaire, the Standardized Mini-Mental State Examination, and the Rosenberg Self-Esteem Scale. Spearman’s correlation and chi-square tests were employed for statistical analysis.

Results: Physical activity levels were positively correlated with both cognitive function (r = 0.546, p < 0.001) and self-esteem (r = 0.168, p < 0.05). No significant association was observed between cognitive function and self-esteem. Physical inactivity, cognitive decline, and low self-esteem were more prevalent among women, participants with lower educational attainment, those with chronic diseases, and individuals engaged in polypharmacy.

Conclusions: The findings emphasize the importance of integrating physical activity promotion into national healthy ageing policies, particularly in Mediterranean contexts such …

Integrating Sbirt Training Into The Family Nurse Practitioner Curriculum: A Pilot Dnp Project, Fiji Simmons

Doctor of Nursing Practice (DNP) Projects

Background: Substance Use Disorder (SUD) and Alcohol Use Disorder (AUD) are major public health concerns, particularly in underserved populations. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is evidence-based models that promote early detection and care. Integrating SBIRT into Family Nurse Practitioner (FNP) curricula prepares future providers to address substance use in primary care. Local Problem: Despite the effectiveness of SBIRT, its use in primary care remains inconsistent. Barriers, including limited training, low confidence, and unfamiliarity with referral resources, hinder implementation. Structured education and protocols are needed to support provider readiness. Methods: SBIRT was integrated into the FNP curriculum of …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Evaluation Of A Behavioral Response Team To Decrease Use Of Violent Restraint, Katherine Skrade

Dissertations

Abstract Introduction: The purpose of this Quality Improvement project was to evaluate the implementation of the Behavioral Assessment and Response Team (BART) and evaluate its effect on occurrence and duration of violent restraints on non-psychiatric floors in a pediatric hospital. This QI project also aimed to correlate the use of the Broset Violence Checklist (BVC) to the utilization of the BART as a means of predicting patient escalation, as well as to assess the effect of booster education on the BVC and BART on bedside staff confidence in utilization of these resources.

Methods: Data was collected across three time periods: …

Implementing Behavioral Management And Social Skills Training For Pediatric Patients With Adhd And Their Caregivers, Meagan A. Conwell

Dissertations

Problem: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 11.4% of children in the United States. Patients diagnosed with ADHD struggle with focus, hyperactivity, and impulsivity, resulting in executive and emotional dysfunction, poor social skills and quality of relationships, and poor school performance.

The American Academy of Pediatrics guidelines recommend that school-age children diagnosed with ADHD should receive both medication management and behavioral management training (BMT) for the best treatment outcomes. Research over the last decade has found that combining social skills training (SST) with BMT results in even better outcomes for these patients. Less than half of pediatric …

Implementation Of A Zen Room And Mindfulness Techniques To Decrease Perceived Burnout, Danika Scott

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a Zen room and mindfulness techniques, aiming to improve job satisfaction by 65% and reduce perceived burnout by 10% among behavioral health staff. The project was conducted at a substance abuse center in Deer Park, TX.

Background: Behavioral health staff face high levels of emotional exhaustion and job-related stress, leading to increased burnout.

Methodology: The Plan-Do-Study-Act model guided the QI methodology using a sample of 23 behavioral health staff. Interventions included an equipped Zen space and wellness resources. Data collection utilized the Maslach Burnout Inventory and a …

Improving Medication Nonadherence In Clients With Attention Deficit Hyperactivity Disorder Using Medication Reminder Applications, Christian Durand

All Doctor of Nursing Practice (DNP) Scholarly Projects

At an outpatient clinic in Southern California, a 77% medication adherence rate was observed in August 2024 among clients with ADHD. Medication nonadherence in ADHD clients may result in difficulty reaching therapeutic levels, leading to adverse outcomes, such as family disruptions, substance addiction, injuries, criminal occurrences, and even suicide. The project aims to reduce the number of ADHD clients who are noncompliant with their medications and surpass the national benchmark of 80% medication adherence. Evidence has suggested that MRAs may improve medication nonadherence among ADHD clients. Current research has supported the use of MRAs for various chronic diseases including diabetes …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

Cultivating Workplace Wellness: An Evaluation Of Gratitude Card Interventions Among University Faculty, Jeffrey Druck, Patrick Ockerse, Jamal Jones

Journal of Wellness

Introduction: There has been a growing interest in understanding the role of gratitude in promoting well-being. Gratitude, defined as a feeling of thankfulness and appreciation in response to receiving a benefit from someone else, has been shown to improve mood, increase social support, and decrease symptoms of depression and anxiety. This research paper explores an innovative intervention using gratitude cards for faculty members and measures the emotional impact of this intervention.

Methods: The study involved 32 clinical physicians from the Department of Emergency Medicine at the University of Utah. Participants were invited to write a gratitude card to …

From Fee For Service To Outcome Based Care: A Policy Proposal To Reduce Provider Burnout In Assertive Community Treatment, Amanda M. Thompson

Doctor of Nursing Practice Final Manuscripts

Purpose: This project examines the impact of the fee-for-service (FFS) reimbursement models on provider burnout within Assertive Community Treatment (ACT) programs and proposes a hybrid reimbursement framework that integrates case-rate and outcome-based payment structures. The goal is to enhance care quality, improve provider retention and optimize patient outcomes by addressing financial and administrative inefficiencies inherent in the current model.

Background: Mental illness affects over 59 million U.S. adults with serious mental illness (SMI) presenting significant challenges in healthcare delivery. ACT is an evidence-based, multidisciplinary approach designed to provide intensive, community-based psychiatric care to individuals with serious mental illness (SMI). However, …