Psychiatric and Mental Health Commons^™

“Invisible Populations”: A Policy Brief Approach To Address Housing Data Needs In Vulnerable Communities, Kristin E. Moser

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Dependent adult children with severe mental illness (ASMI) living with aging parents have been an increasing population over decades due to lack of supportive housing and services in the community. ASMI living with aging parents is a high-risk group for housing instability and future homelessness. Local Problem: A limited amount of literature and data exist to determine the size and needs of the population of ASMI living with aging parents. A collaboration with University of San Francisco (USF) and non-profit, Solutions for Supportive Homes (S4SH) of San Mateo County (SMC) formed to disseminate information and quantify the “invisible …

Universal Adolescent Depression Screening And Implications For Identification Of Adolescent Depression And Mental Health Referrals, Cherry Cooper, Juan Zhou Powell

Doctor of Nursing Practice Projects: College of Nursing

Background: Throughout the United States, mental health concerns have been steadily increasing, which has created a significant impact for caregivers, overburdened healthcare facilities, and patients. In fact, a large number of those experiencing mental health issues are unidentified and thus more likely to experience mental health crises, suicidal ideation, or suicide attempts. Rural adolescents are significantly more vulnerable than their urban counterparts related to disparities in both mental health services and preventative screening. Coordination with a critical access hospital (CAH) emergency department revealed that there was no universal adolescent depression screening in place, and patients were potentially going undiagnosed and …

Program Evaluation Of The Behavioral Interventions Monitoring Assessment System-2 For High School Students In Rural Nebraska, Laura Burnett, Lakin Braman

Doctor of Nursing Practice Projects: College of Nursing

Behavioral and mental health issues among adolescents in rural areas often go unrecognized due to limited access to screening and intervention. This study evaluated the efficacy of the BIMAS- 2 tool in identifying at-risk high school students in a rural Nebraska high school. Methods: A retrospective cohort program evaluation was conducted over two years with 263 students in grades 9-12. The BIMAS-2 assessment was administered electronically each semester, followed by in-person mental health interviews. Descriptive statistics and Pearson chi-square tests assessed the tool’s sensitivity, specificity, and predictive value. Results: The BIMAS-2 demonstrated high sensitivity (100%) and specificity (96.15%), with a …

Psychoeducational Training For Community Health Workers To Improve Confidence In Providing Mental Health Services To Migrants, Nimota M. Akintoye

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

There is a higher prevalence of mental health illnesses among migrants. This minority group is faced with challenges in accessing healthcare due to poverty, stigmatization, and fear of discrimination. Research has shown that community health workers (CHWs) bridge the gap between the health and social service sectors and the patients by improving patient access to care and healthcare outcomes. A translational project was implemented to evaluate how psychoeducational training improved the CHWs’ confidence and knowledge level in providing mental health support to the patients and community members. Sister Calista Roy’s Adaptation Model was used to guide the study by incorporating …

Healthcare Provider Comfort Surrounding Adverse Childhood Events (Aces), Cameo Culcasi

Doctoral Projects

Adverse Childhood Experiences (ACEs) are strongly linked to long-term health outcomes, yet discussions around ACEs in clinical settings remain inconsistent. This study investigates the comfort levels of healthcare providers in addressing ACEs with their patients, identifying barriers and facilitators to such conversations. Using a Quasi-experimental, single group, pretest-post test experimental design, we surveyed a diverse group of physicians, nurse practitioners, and physician assistants working in a primary care setting, providing ACE training, and an opportunity for learning reflection. Preliminary results indicate that while most providers acknowledge the importance of discussing ACEs, many report discomfort due to time constraints, lack of …

Addressing Gaps In The Continuum Of Care: A Quality Improvement Project Focused On Adolescent Youth With Depression Symptoms At A School-Based Health Clinic, Leah Nigon

Theses and Graduate Projects

This Doctor of Nursing Practice (DNP) quality improvement project aimed to address gaps in the continuum of care for adolescents experiencing depression symptoms at a school-based health clinic (SBHC) within an alternative learning community school (ALCS) in southeast Minnesota. Adolescent depression rates are on the rise and are only exacerbated by systemic barriers and social determinants of health, requiring improved mental health care access. Guided by Madeleine Leininger’s Culture Care Theory, the project focused on improving follow-up care for students with elevated depression scores on the Patient Health Questionnaire-9 (PHQ-9-M). A tracking system was developed, and the SBHC nurse contacted …

Implementing Lean Methodology To Decrease Wait Times In A Psychiatric Emergency Department, Kristina S. Baxter

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project aimed to implement Lean strategies to optimize the intake process in a psychiatric emergency department, thereby reducing patient wait times, minimizing left-without-being-seen (LWBS) occurrences, and improving access to timely psychiatric care.

Background

The project was conducted in a hospital-based psychiatric emergency department in Southeast Texas, serving adults and children six years and older.

Methodology

Lean methodology and PDSA cycles were employed to refine the intake process and eliminate inefficiencies. Key interventions included patient transport by technicians to minimize delays, using tele-clinicians for assessments to reduce staff burden, and restructuring nursing assessments to prioritize telehealth consultations …

Gad-7 Screening In Middle School Students: Evaluating The Effectiveness On Referral Rate Scoping Review, Bailey Hall, Cara Dennis, Kayla Drennen-Ferguson, Pamela B. Taylor, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

The prevalence of anxiety disorders among adolescents, mainly middle school-aged students, highlights the critical need for practical screening tools to support early detection and intervention. The Generalized Anxiety Disorder-7 (GAD-7) scale is widely utilized in various settings, but its efficacy in this specific population remains underexplored. This scoping review examines the use of the GAD-7 in middle school-aged students, evaluating its reliability, validity, and impact on referral rates to mental health services. The review also considers factors influencing anxiety and identifies gaps in current research.

Methods

Ten articles, published in peer-reviewed journals within the past decade and involving human …

The Effect Of Maternal Anxiety On Breastfeeding Exclusivity And Duration, Zoe E. Treat

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: The postpartum period, especially during the first year, presents a heightened risk for maternal anxiety. Research suggests a potential negative relationship between maternal anxiety and breastfeeding duration, though there is currently a gap in the existing literature regarding how maternal mental health impacts breastfeeding outcomes.

Purpose: This study seeks to investigate the influence of postpartum anxiety on both the duration and exclusivity of breastfeeding, crucial knowledge required to support and implement targeted interventions. We expected that maternal anxiety would predict shorter exclusive and total breastfeeding durations.

Methodology: To explore the relationship between postpartum anxiety and breastfeeding behaviors, we distributed …

To Heal A Mind: A Comparison Of Functional And Conventional Treatments In Major Depressive Disorder, Gillian Chambers

Senior Honors Theses

Incidence of major depressive disorder is increasing year over year, with little able to be done to halt the spread of the condition. However, there are many treatment possibilities considered unconventional by the healthcare system. This thesis examines the respective benefits and risks, in comparison to one another, between conventional pharmacological treatment and functional, holistic treatment of depression. This was done via integrative review of available clinical literature, synthesizing evidence on both conventional and functional treatments for depression, as dictated by Whittemore and Knafl (2005). Exploratory search methods revealed 758 records fulfilling inclusion criteria, which were screened and narrowed down …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

The Role Of Self Esteem Upon The Recovery Of Eating Disordered Patients, Samanta Flores Velazquez

Undergraduate Honors Theses

Eating disorders such as anorexia-nervosa, bulimia-nervosa, and binge-eating disorders are detrimental to overall health and well-being. The demands of beauty ideals and attitudes impact young adults negatively as they attempt to meet societal beauty standards. The need for approval, fitting in with the community, and confidence drive the behaviors of people in negative ways. In recent years, the modernization of social media has contributed to dieting cultures, the thin ideal, harmful weight-loss practices, and the cycle to use the body as a means to control or repent. External factors affect the risk of eating disorders which contribute to the challenge …

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

Enhancing Schizophrenia Treatment Outcomes: Integrating Cbt With Medication Therapy To Reduce Hospital Readmission, Kamauri Fleming Msn, Rn, Grace Adeniji-Ilesanmi Fnp-Bc, Zillah Anagho Tah Fnp-C, Alex Cook Msn, Rn, Margaret Harvey Phd, Acnp-Bc, Chfn, Sharon Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn, Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Schizophrenia is a chronic mental illness that disrupts cognition, emotion, and social functioning, imposing significant personal and societal burdens. While antipsychotic medications are effective in alleviating psychotic symptoms, they are often associated with side effects, poor adherence, and relapse risk. Cognitive behavioral therapy (CBT) has shown promise as an adjunct to medication, addressing persistent symptoms and improving outcomes. This scoping review examines the integration of CBT with medication therapy to reduce hospital readmissions and improve quality of life for adult patients hospitalized with schizophrenia.

Methods A systematic search of databases, including PubMed, PsycINFO, Embase, and Cochrane Library, was conducted …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino, Laura Gray, R. David Phillippi

DNP Projects

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact of a financial transparency intervention on reducing payment responsibility for HDHP patients in …

Supporting Maternal Mental Health In The Postpartum Period With The Use Of Home Resource Kit, Nicole Craig

Theses and Graduate Projects

Postpartum mental health disorders, including postpartum depression and anxiety, can affect a significant proportion of new mothers for centuries. This paper explores the development, implementation, and evaluation of an at-home mental health resource kit designed to support maternal mental health while navigating the stresses of new motherhood. Utilizing Jean Watson's Theory of Human Caring as a theoretical framework, the study assesses the effectiveness of integrative therapies such as aromatherapy, mindful meditation, and educational resources in managing postpartum stress. Data collected through pre- and post-surveys and roundtable discussions provide insights into the benefits and limitations of these interventions. The findings indicate …

Evaluating The Efficacy Of Predischarge Referrals In Preventing Emergency Mental Health Hospital Readmissions: A Scoping Review, Pretia Carpenter Bsn, Rn, Stephanie Mays Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Background

Emergency mental health hospital readmissions present significant challenges to healthcare systems, often resulting in increased costs, prolonged hospital stays, and poor patient outcomes. Continuity of care through predischarge referrals to outpatient mental health services, psychosocial support, and community resources has been proposed as a strategy to reduce readmissions. However, the effectiveness of these interventions remains inconsistent across different populations and settings.

Objective

This scoping review aims to evaluate the effectiveness of predischarge referrals in reducing 30-day emergency mental health hospital readmissions, identify key components of successful programs, and assess the influence of demographic factors on readmission rates.

Methods

A …

An Exploration Of The Experiences Of Perinatal Depression And Anxiety Among Pregnant And Parenting Adolescents In The Tampa Bay Area Of Florida, Olajumoke Adetoun Ojeleye

USF Tampa Graduate Theses and Dissertations

Perinatal depression (PND) and perinatal anxiety (PNA) are increasing among pregnant and parenting adolescents (PPAs), with PNA often underrecognized. This leads to significant socioeconomic costs and adverse maternal consequences if untreated. Hence, this dissertation explores the experiences of PND and PNA among PPAs, focusing on their knowledge gaps, perception, mental health needs, care preferences, and access to PMH care. The research employs a qualitative design (free-listing and in-depth interviews) to gather participant insights. Key findings reveal that many PPAs possess limited knowledge about PNA when compared to PND. Lack of support from partners, family, and peers emerged as the topmost …

How To Help New Nurses Deal With Anxiety And Stress, Jared Modzelewski Bsn, Rn

Posters

Background

New graduate nurses need to reduce their stress and anxiety to improve patient outcomes. Every nurse has some anxiety and stress, but new graduate nurses have been talking about it more. This change is necessary because improvement in mental health for nurses can improve their wellbeing and the overall quality of care they provide their patients.

Psychological Impact Of Ulcerative Colitis On Pregnancy And Postpartum Period, Stephanie C. Carver

Nursing | Senior Theses

Background

Ulcerative colitis (UC) poses significant challenges during pregnancy, affecting both physical and mental health. While the physiological effects of UC during pregnancy are well documented, less is known about its impact on maternal mental health. This study aims to investigate the psychological effects of UC on pregnant women, focusing on stress levels, postpartum depression (PPD) incidence, and the role of multidisciplinary care in improving mental health outcomes.

Objective

The primary objective of this research proposal is to evaluate the psychological impact of UC during pregnancy and determine whether disease activity increases the risk of PPD and stress. A secondary …

Improving Maternal Mental Health: The Role Of Specialized Support For Queer Women With Postpartum Depression, Dan-Tam Pham

Nursing | Senior Theses

Queer women face disproportionately high rates of postpartum depression compared to heterosexual and cisgender individuals. Studies showed that queer women face heightened mental health challenges, including higher rates of depression and anxiety due to factors like discrimination, limited support systems, and negative healthcare experiences. There is a need for culturally competent, LGBTQ+-affirming interventions to improve maternal mental health outcomes; despite the health disparities faced by this population, research on specialized postpartum interventions is limited, revealing gaps in effective mental health care for queer mothers. The key search terms for the articles used in the study included: postpartum depression, queer women, …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

The Impact Of Structured Weekend Group Therapy On Restraints, Seclusion And Length Of Stay On Inpatient Psychiatric Units, Victoria Grau

West Chester University Doctoral Projects

Group therapy is an essential part of inpatient psychiatric treatment, with documented positive effects including better medication compliance, lower readmission rate, and improved self- esteem. Patients who are admitted for an inpatient psychiatric stay have a small window of time in which behavioral health staff can work with them. Group therapy can help patients develop a plan for these issues and provide a foundation for successful discharge and symptom management. The project site is a mid-size teaching hospital in an urban community with higher rates of mental health diagnoses than the national average. Group therapy was conducted initially Monday – …

Enhancing Patient-Centered Suicide Prevention: A Quality Improvement Project Addressing Educational Gaps In Staff Caring For Veterans, Shayla Craigue

Master's Theses and Capstones

Veterans are at significantly higher risk for suicidal ideation (SI) than the general population and often encounter barriers to care such as stigma, trauma, and distrust in healthcare systems. This quality improvement project, conducted at a Veterans Affairs (VA) Urgent Care Clinic, aimed to enhance trauma-informed care by addressing educational gaps among clinical staff. Using the Plan-Do-Study-Act (PDSA) model, the intervention included a pre-intervention survey to assess baseline knowledge, a targeted educational poster informed by survey findings, and a post-intervention survey to measure changes in staff confidence, resource awareness, and understanding of the role of the mental health response team, …

Psychological Interventions In The Work Environment And Reducing Burnout In Critical Care Nurses, Amelia Bloom, Isabella Tisevich

Williams Honors College, Honors Research Projects

Burnout is an increasing issue in the nursing field, particularly for critical care nurses. The purpose of this systematic review is to discover how the work environment impacts burnout of critical care nurses, and how different psychological interventions instituted by the workplace impact their burnout levels. The PICO question is: In critical care nurses, do work environments that provide psychological interventions compared to work environments that do not provide psychological interventions document outcomes of less burnout? The articles used within this systematic review were found using the databases Academic Search Complete and PubMed. Articles were selected based on the inclusion …

Navigating Sexual And Gender Diversity: A Quality Improvement Project To Increase Provider Cultural Competencies For Sexual And Gender Minorities In Mental Health Outpatient Facilities, Shermeen Chandani

Doctor of Nursing Practice Final Project Abstract

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The …

To Be Soft Again: A Phenomenological Study Of Uncertainty And Resilience In Childbearing During The Covid-19 Pandemic, Marcianna Nosek

Nursing and Health Professions Faculty Research and Publications

Background:

During the COVID-19 pandemic, uncertainty was exacerbated in experiences of pregnancy and childbirth as people navigated through uncharted territory. Building resilience may be one effective way to cope. However, for those who carry a heavier burden in upholding others, a societal expectation of “toughness” and the ability to endure may lead to an appearance of resilience, while on the inside, well-being may be compromised.

Objectives:

This study is part of a larger phenomenological study that explored the broad research question: What is the lived experience of childbearing during the COVID-19 pandemic? Specific themes of uncertainty and resilience are reported …

Nurses’ Empathy, Burnout, And Contentment With Life In Turkey, Sevinç Mersin, Özlem İbrahimoğlu, Merve Tuncer, Ali Arslanoğlu

Makara Journal of Health Research

Background: Empathy has various consequences for nurses. Therefore, its effects on nurses should be identified. Thus, this study aimed to determine the relationships between empathy, burnout, and level of contentment with life in nurses and the characteristics that affect them.

Methods: This descriptive–correlational study was conducted on 653 nurses in Turkey between November and December 2021. Data were collected using an information form, the Basic Empathy Scale, Burnout Measure Short Scale, and Contentment with Life Assessment Scale.

Results: A positive, weak, and significant relationship was noted between the mean Basic Empathy Scale and Burnout Measure Scale scores. …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

DNP Qualifying Manuscripts

Introduction: Suicide among adolescents and youth is such a serious issue that immediate, appropriate interventions are needed to reduce rates of suicide ideation and suicide mortality. The increasing rate of suicide among this population profoundly affects families, friends, and the community. Identifying and implementing appropriate interventions in schools could identify individuals who are suffering from mental illness and support suicide prevention.

Aim: The purpose of this integrative literature review was to examine the literature on suicide prevention interventions for young adolescents and teenagers aged 12-17 years old and identify the best, evidence-based practices for the school setting. The aim …

Promoting Confidence And Evidence-Based Practices For Attention-Deficit/Hyperactivity Disorder Among Integrated Primary Care Providers: A Qualitive Improvement Education Initiative, Omar Samateh, Margaret Emerson, Kayla Meisinger, Taylor Wilson, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Primary Care Providers (PCPs) are seeing growing number of patients presenting for adult attention-deficit/hyperactivity disorder (ADHD) evaluations as a result of social media influences highlighting ADHD. Yet, PCPs report lacking confidence and education with adult ADHD. The purpose of this quality improvement study was to develop educational materials to promote confidence, competence, and adherence to ADHD evidence-based recommendations among integrated care PCPs. Methods: A literature review and retrospective chart review of 19 patients were used to create 1) Baseline ADHD Provider Education (PE) tool, 2) Standardized ADHD Diagnosis (SAD) referral process, 3) ADHD Assessment, Treatment, and Monitoring …