Public Health Commons^™

A Pilot Study Of Deaf Trauma Survivors’ Experiences: Early Traumas Unique To Being Deaf In A Hearing World, Melissa L. Anderson, Kelly S. Wolf Craig, Wyatte C. Hall, Douglas M. Ziedonis

Melissa L. Anderson

Conducting semi-structured American Sign Language interviews with 17 Deaf trauma survivors, this pilot study explored Deaf individuals’ trauma experiences and whether these experiences generally align with trauma in the hearing population. Most commonly reported traumas were physical assault, sudden unexpected deaths, and “other” very stressful events. Although some “other” events overlap with traumas in the general population, many are unique to Deaf people (e.g., corporal punishment at oral/aural school if caught using sign language, utter lack of communication with hearing parents). These findings suggest that Deaf individuals may experience developmental traumas distinct to being raised in a hearing world. Such …

Sex Offending And Serious Mental Illness: Directions For Policy And Research, Andrew Harris, William Fisher, Bonita Veysey, Laura Ragusa, Arthur Lurigio

Arthur J. Lurigio

Over the past decade, two rapidly evolving areas of criminal justice practice have garnered increasing attention from policy makers, practitioners, and researchers: the management and treatment of justice involved individuals with serious and persistent mental illness, and the challenges of managing the perceived societal risk presented by sex offenders. Yet, whereas each of these issues has independently attracted significant attention, the nexus between them has remained largely unexamined. Matters of concern include the manner in which individuals with serious mental illness may be disproportionately affected by the expanding range of restrictions placed on those with sexual offense histories, the demands …

United States Acculturation And Cancer Patients’ End-Of-Life Care, Alexi Wright, Heather Stieglitz, Yankel Kupersztoch, M. Elizabeth Paulk, Yookyung Kim, Ingrid Katz, Francisco Munoz, Rachel Jimenez, Jan Mutchler, Lorna Rivera, Anthony Back, Holly Prigerson

Lorna Rivera

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients’ end-of-life treatment preferences and medical care.

Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19- item scale developed to assess the degree of ‘‘Americanization’’ in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers’ USAS scores predicted patients’ …

Everyday Life In Southeast Asia, Kathleen Adams

Kathleen M. Adams

This lively survey of the peoples, cultures, and societies of Southeast Asia introduces a region of tremendous geographic, linguistic, historical, and religious diversity. Encompassing both mainland and island countries, these engaging essays describe personhood and identity, family and household organization, nation-states, religion, popular culture and the arts, the legacies of war and recovery, globalization, and the environment. Throughout, the focus is on the daily lives and experiences of ordinary people. Most of the essays are original to this volume, while a few are widely taught classics.

The Impact Of Hiv-Related Stigma On Older And Younger Adults Living With Hiv Disease: Does Age Matter?, Charles A. Emlet, David J. Brennan, Sarah Brennenstuhl, Sergio Rueda, Trevor A. Hart, Sean B. Rourke

Charles Emlet

Care-Seeking Patterns And Outcomes Of Hospitalized Pneumonia Patients Who Are Socioeconomically Disadvantaged, Jay Shen, Johnathan Perlin, Yi-Hua Xu, Thomas Wan

Thomas T.H. Wan

No abstract provided.

Chick Clique: Persuasive Technology To Motivate Teenage Girls To Exercise, Tammy Toscos, Anne Faber, Shunying An, Mona Gandhi

Tammy R Toscos

We are developing a preventative health cell phone application that helps motivate teenage girls to exercise by exploiting their social desire to stay connected with their peers. We targeted girls because they are more likely to become less active throughout adolescence and are more likely to use dangerous techniques for losing weight. The intent of Chick Clique is to provide information at opportune times in order to modify the behaviors of girls and ultimately lead to improved health habits. Our study investigated how collecting, sharing and comparing personal fitness information impacts activity level and health awareness.

“What’S Your Number?” A Survey Of How Parents And Teens Cope With Diabetes In The Context Of Technology Support., Tammy Toscos, Kay Connelly, Yvonne Rogers

Tammy R Toscos

Teenagers make many transitions during adolescence toward adult lifestyles and responsibilities. Teens with Type 1 Diabetes (T1D) have the additional burden of assuming responsibility for disease management. The findings reported in this paper represent the perspective of parents and adolescents who are coping with T1D - uncovering various tensions that interfere with the effective use of technology to manage the disease. Predominant themes from a set of semi-structured interviews are used to construct implications for the design of new technology intended to support families coping with T1D.

Using Behavior Change Theory To Understand And Guide Technological Interventions., Tammy Toscos, Kay Connelly

Tammy R Toscos

No abstract provided.

Using Data To Promote Healthy Behavior In Children., Tammy Toscos

Tammy R Toscos

Childhood offers a number of opportunities for parents to shape the health related attitudes and behaviors of their children. The proposed research described in this paper aims to better understand the ways in which a child’s personal health data can be leveraged to educate and provide a transition to healthy adult behaviors. The target population for this project is children with Type 1 Diabetes and their parents but many of the design issues may be relevant to the management of other chronic diseases as well as general health in childhood.

"…Is It Normal To Be This Sore?": Using An Online Forum To Investigate Barriers To Physical Activity., Tammy Toscos, Sunny Consolvo, David Mcdonald

Tammy R Toscos

The importance of regular physical activity to overall health has been well established, yet U.S. adults are leading increasingly sedentary lives. Research suggests that lowering perceived barriers to physical activity is a critical part of interventions that encourage physical activity. In this paper, we describe the top five barriers—two of which have not been reported as principle barriers in the literature—that emerged from our systematic qualitative coding of an online forum used to support a three month healthy lifestyle intervention. Based on our analysis, we identify design considerations for technologies that encourage and support physical activity. Understanding the needs of …

A Double-Blind, Randomized, Placebo Controlled Trial Of Ramelteon For The Treatment Of Insomnia And Mood Stability In Patients With Euthymic Bipolar Disorder, Edward Norris

Edward R Norris MD, FAPA, FAPM

The study was a single-site, double-blind, randomized, placebo-controlled, parallel group study to evaluate the efficacy of adjunctive ramelteon in the treatment of insomnia and mood stability in patients with euthymic bipolar disorder for up to 24 weeks of maintenance treatment. Participants with euthymic bipolar disorder and sleep disturbances were randomized to receive adjunctive ramelteon or placebo in addition to their reular psychiatric medications for up to 24 weeks or until they experienced a relapse (defined as a depressed or manic event).

Reducing Treatment Delay For Early Intervention: Evaluation Of A Community Based Crisis Helpline, Amresh Srivastava

Amresh Srivastava

Background A limited number of studies have assessed the pathways to care of patients experiencing psychosis for the first time. Helpline/clinic programs may offer patients who are still functional but have potential for crisis an alternative that is free from judgment. Methods In this study we report on patient calling a round-the-clock crisis helpline for suicide prevention supported by psychiatric facilities in Mumbai, India. Chi-square and test of mean differences were used to compare outcomes between first-episode patients and those with a previous history. Results Within five years, the helpline received 15,169 calls. Of those callers, 2341 (15.4%) experienced suicidal …

Building The Foundation For The Family Options Project, Joanne Nicholson, Kathleen Biebel, Valerie Williams, Karen Albert

Joanne Nicholson

This article describes how the long-standing partnership between Employment Options, Inc., a psychosocial rehabilitation agency in Marlborough, MA, and the University of Massachusetts Medical School's (UMMS) Center for Mental Health Services Research led to the development of the Family Options program.

Mothers With Mental Health Disorders: Mental Health Promotion In The Context Of Parenting, Joanne Nicholson, Elizabeth Aaker, Michael Agar, Karen Albert, Steven Banks, Kathleen Biebel, Bernice Gershenson, Antonia Seligowski, Valerie Williams, Brenda Warren, Sierra Williams, Katherine Woolsey

Joanne Nicholson

Parenting is a meaningful role for the majority of American women, including those with mental health disorders. Success in this role, particularly for women with mental health disorders, would seem to be intimately related to mental health promotion, the recovery process, and successful functioning in other major life domains (e.g., employment, community living, and personal health and well-being). The achievement of maximum social participation for women with mental health disorders may hinge on addressing the challenges they face as parents. Presented at Margins to Mainstream: World Congress on Mental Health Promotion and Prevention. Melbourne, Victoria, Australia, September 2008.

Exploring The Concept Of “Young Carer” In Families Living With Parental Mental Illness, Antonia Seligowski, Peter Mcnamee, Karen Albert, Valerie Williams, Joanne Nicholson

Joanne Nicholson

Background Information: The concept of “young carers” has been framed in the literature as children providing care and assuming household responsibilities when parents have physical and/or mental disabilities (Aldridge & Becker, 2003). In the United Kingdom, young carers have been studied extensively, leading to increased access to services and supports (Dearden & Becker, 2004). Our goal is to explore the concept of young carers in the U.S.

Aims: 1) To describe the care giving and household responsibilities of children and youth living with parents with mental illnesses, how often they are performed, and the feelings of children and youth about …

Programs For Families With Parental Mental Illness: Results Of A Us National Survey, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Lawrence Stier

Joanne Nicholson

Citation: Nicholson, J., Hinden, B., Biebel, K., Henry, A., & Stier, L. (2004). Programs for families with parental mental illness. Visions: British Columbia Mental Health and Addictions Journal, 2(2), 27-29. Available at: http://www.heretohelp.bc.ca/publications/visions/parenting. Summary: Survey of programs in the U.S. for parents with mental illness.

A Multi-Disciplinary, Whole-Of-Family Approach To Supporting Parents With Mental Illness, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership. Citation: Nicholson, J. (2010, November). A multi-disciplinary, whole-of-family approach to supporting parents with mental illness. Presented as a plenary at the Developing Strength and Resilience in Children conference of Voksne for Barn, Oslo, Norway.

The Family Networks Implementation Study, Susan Maciolek, Joanne Nicholson, Nicole Dube, Jodi Adams, Bernice Gershenson

Joanne Nicholson

Family Networks is a comprehensive system transformation initiative to redesign and integrate traditional categorical services across Massachusetts into local systems of care for children, youth, and families served by the child welfare system. The Family Networks Implementation Study, a partnership between the Massachusetts Department of Social Services and the University of Massachusetts Medical School, is a two-year study of the process of implementing local systems of care that began in January 2007, and will continue through December 2008. Presented at the 21th Annual Research Conference. A System of Care for Children’s Mental Health: Expanding the Research Base. Tampa, Florida, February …

Mental Illness: Understanding The Impact On Families And How To Help, Joanne Nicholson

Joanne Nicholson

Abstract: Family is the context where mental health recovery takes place. Mental health services need to take a whole-of-family approach when working with people with a mental illness. Supporting people with a mental illness in their family roles actually improved the mental health outcomes of people participating in their programs. Citation: Nicholson, J. (2010, May). Mental illness: Understanding the impact on families and how to help. Presented as the 12th Annual Bruce Woodcock Memorial Lecture, Mental Illness Fellowship Victoria, Melbourne, Victoria, Australia.

The Responsiveness Of State Mental Health Authorities To Parents With Mental Illness, Kathleen Biebel, Joanne Nicholson, Valerie Williams, Beth Hinden

Joanne Nicholson

The majority of adults with serious mental illness living in the community are parents, many of whom may be receiving services from State Mental Health Authorities (SMHA). Innovative intervention approaches are available to improve outcomes for these parents and their children. Analyses of SMHA and state-level data, as well as qualitative interviews of administrators, service providers, and consumers, underscore the importance of organizational structure and philosophy, an advocacy presence, and available funding to SMHA efforts on behalf of parents and their families.

Family Members With Overlapping Mental Health Needs Require The Transformation Of Systems And Services, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Valerie Williams, Bernice Gershenson, Judith Katz-Leavy

Joanne Nicholson

Women and men with a lifetime prevalence of psychiatric disorder are at least as likely to be parents as are adults without psychiatric disorder. The majority of adults in all diagnostic categories are parents, including those meeting criteria for affective and anxiety disorders, PTSD, and non-affective psychosis. Children with Serious Emotional Disturbance (SED) receiving services in Systems of Care (SOCs) programs may have multiple family risk factors. Family-centered, strengths-based practices require a paradigm shift in the way administrators and providers view and intervene with children and adults. Presented at The Santa Fe Summit on Behavioral Health, the American College of …

Using Organizational Data To Create The Essential Context For System Transformation In Child Welfare, William Deveney, Joanne Nicholson

Joanne Nicholson

The Massachusetts Department of Social Services (MA/DSS) has 29 area offices organized in 6 regions; 74,651 consumers (39,913 are children < 18 years of age); 10,863 children and youth in placement; and 3,400 employees (FY2005; 2nd quarter).

A comprehensive system transformation initiative is underway, to shift from the traditional “adversarial” child protective model, and translate the core values of “child-driven,” “family-centered,” “community-focused,” “strength-based,” “committed to diversity/ cultural competence,” and committed to continuous learning” into an active child welfare agenda. The “learning organization” is the guiding framework.

Continuous Quality Improvement (CQI) is an interactive, iterative, participatory process that reflects change in organizational values, and catalyzes and guides improvements in policy and practice. Data drive CQI, obtained as framed …

Creating Opportunities For Success: Working With Trauma Survivors In The Shelter Setting, Joanne Nicholson, Linda Weinreb, Tina Runyan, Kathleen Biebel

Joanne Nicholson

Summary: Training workshop with the following objectives: Increase knowledge, awareness, & understanding of trauma & its impact; Provide information about skills & strategies; Suggest self care strategies. Citation: Nicholson, J., Weinreb, L., Runyan, T., & Biebel, K. (2010, November). Creating opportunities for success: Working with trauma survivors in the shelter setting. Presented at a training workshop for the Central Massachusetts Housing Alliance, Worcester, MA.

The Massachusetts Family Networks Implementation Study, Susan Maciolek, Joanne Nicholson, Jodi Adams, Bernice Gershenson, Katherine Woolsey, Brenda Warren

Joanne Nicholson

Family Networks is a comprehensive systems transformation initiative to redesign and integrate traditional categorical services across the Commonwealth into local systems of care for children, youth, and families served by the child welfare system. The Family Networks Implementation Study, a partnership between the Massachusetts Department of Social Services (MA/DSS) and the University of Massachusetts Medical School, is a two-year study of the process of implementing local systems of care that began in January 2007, and will continue through December 2008. Findings from the Family Networks Implementation Study will inform MA/DSS strategic planning, system refinements, and the Family Networks outcomes evaluation. …

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …

Supporting Parents: Multi-Needs And The Need For Multi-Institutions’ Coordination Of Supports, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership.

Citation: Nicholson, J. (2010, May). Supporting parents: multi-needs and the need for multi-institutions coordination of supports. Presented as a keynote at the Conference on Ondersteuning Ouders met Psychiasche Problemen,The Hague, The Netherlands.

Parenting With A Mental Illness. A Radio Interview For Abc Radio National, Australia Public Radio (Audio File), Joanne Nicholson

Joanne Nicholson

Interview (mp3 audio file, 9.8 MB) by Dr. Joanne Nicholson with Richard Aedy, host and producer, “Parenting with a Mental Illness” on Life Matters, ABC Radio National, Australia public radio, May 25, 2010. Nicholson says that keeping families intact benefits both the family as a whole, and the ill parent's recovery. She argues too many health professionals make treatment plans without considering the family context. Citation: Nicholson, J. Interview with Richard Aedy, host and producer, “Parenting with a Mental Illness” on Life Matters, ABC Radio National, Australia public radio. May 25, 2010. Available from: http://www.abc.net.au/rn/lifematters/stories/2010/2906312.htm.

Helping Families— Shifting The Emphasis, Joanne Nicholson

Joanne Nicholson

Abstract: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness and carers. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders. Citation: Nicholson, J. (2010, May). Helping families – Shifting the emphasis. Presented as a keynote address at the Annual Corporate Breakfast with the Lord Mayor, Mental Illness Fellowship Victoria, Melbourne, Victoria, Australia.

Supporting Parents With Mental Health Needs In Systems Of Care, Barbara Friesen, Judith Katz-Leavy, Joanne Nicholson

Joanne Nicholson

Summary: Community-based systems of care (SOCs) must address both the needs of parents with mental illness and the needs of their children. Learning more about the challenges faced by SOCs in this area, and the strategies they implement to overcome them, provides insights with implications for the broader field. This project was intended to learn more about efforts to assess parents’ mental health needs, effectively engage and support them, and improve system coordination and access to services to inform service delivery and system reform, especially for those involved in both child welfare and mental health. This report presents information gathered …