Mental and Social Health Commons^™

Misused And Misunderstood: Examining The Inappropriate Use Of Stimulant Medications, Connor Dains, Madilyn Paphanchith, Makayla Eversole, Chaehyeon Jin, Minhwan Yang, Joshua Honaker, Samantha Mccord, Kayla Petkus

Pharmacy and Wellness Review

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsivity. The American Academy of Pediatrics (AAP) endorses stimulant medications as the first-line treatment option. When combined with behavioral therapy, this pharmacologic class can improve focus, executive functioning, and the overall quality of life. While stimulant prescriptions can have a positive effect when used as directed, there is concern for the potential of provider overprescription and patient misuse related to these medications. Consequently, the Food and Drug Administration (FDA) revised the boxed warning and prescribing information for stimulant medications. Healthcare providers must educate …

Social Determinants Of Health Extraction From Clinical Notes Across Institutions Using Large Language Models, Vipina K Keloth, Salih Selek, Qingyu Chen, Christopher Gilman, Sunyang Fu, Yifang Dang, Xinghan Chen, Xinyue Hu, Yujia Zhou, Huan He, Jungwei W Fan, Karen Wang, Cynthia Brandt, Cui Tao, Hongfang Liu, Hua Xu

Faculty, Staff and Student Publications

Detailed social determinants of health (SDoH) is often buried within clinical text in EHRs. Most current NLP efforts for SDoH have limitations, investigating limited factors, deriving data from a single institution, using specific patient cohorts/note types, with reduced focus on generalizability. We aim to address these issues by creating cross-institutional corpora and developing and evaluating the generalizability of classification models, including large language models (LLMs), for detecting SDoH factors using data from four institutions. Clinical notes were annotated with 21 SDoH factors at two levels: level 1 (SDoH factors only) and level 2 (SDoH factors and associated values). Compared to …

Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) experience inequities in access to timely, accurate, and understandable information and communication technology (ICT), which increases risk for public health emergency (PHE)-related health disparities and impedes opportunities to achieve optimal health. This study assessed federal COVID-19 webpage accessibility levels and explored existing knowledge of and experience with filing accessibility complaints for federal ICT among adults with IDD. Through a mixed-methods approach, we evaluated compliance with accessibility standards for 18 federal agencies’ COVID-19 webpages (study 1) and interviewed 16 adults with IDD about experiences accessing federal webpages and filing accessibility complaints (study 2). We …

The Cost Of Accommodative Burdens: Prevalence & Impact On Deaf And Hard Of Hearing Individuals, Lorelei Becktel

Undergraduate University Honors Capstones

This exploratory qualitative study (n=8) investigated the mental health effects of lack of reciprocity in accommodation and the resulting accommodative burden on deaf and hard of hearing individuals. Lack of reciprocity occurs when the split of the burden for communication accommodations falls significantly more on the deaf or hard of hearing individual. The resulting accommodative burden occurs when deaf and hard of hearing individuals adapt to make communication easier for hearing people at a level that is uncomfortable, unwanted, and/or detrimental to their needs. Effects, determined by participant responses, were examined via semi-structured interviews and analyzed via thematic analysis. Relationships …

Assessing One-Year Health Impacts From Wildfires In Rural Communities: Roles For Extension In Promoting Wildfire Preparedness And Recovery, Marc T. Braverman, Sandi Cleveland Phibbs, Emily Jane Davis, Amanda Rau, Elijah Penner

Journal of Extension

Wildfires can produce health impacts that persist for years in affected communities. This article describes an Extension-led study of health impacts in rural Oregon communities one year after a destructive wildfire. Data collection included key informant interviews (n=36), an online survey (n=80), and three focus group interviews with survivors (n=23). Mental health, exposure to contaminants, physical stress, food insecurity, and other issues were frequently identified health concerns. Survivors’ difficulties in dealing with housing displacement significantly exacerbated health challenges. We describe potential roles for Extension in addressing wildfire risk and mitigating health impacts, including a description of the Oregon Fire Program.

Food Insecurity In Adolescent Athletes, Andrew Donaldson, Shannon Margherio, Jay Roberson, Kevin Latz

Research Days

Background: The prevalence of food insecurity among children in the United States is estimated at 21%. Food insecurity during childhood leads to worse school performance, more emotional and behavioral health concerns, and increased suicide attempts. Further, food insecurity has been noted to have multiple deleterious effects on the collegiate student athlete, including lower GPA, disordered eating, and substance use.

Hypothesis: Food insecurity is prevalent in the adolescent athlete population and exists across demographics.

Methods: Voluntary surveys were distributed to parents at all sports medicine clinics at our institution. Demographic data was collected including athlete age, race, school and school district, …

Evaluating Scheduling Tool To Improve Behavioral Health Counseling Scheduling Rates On Same Day Of Referral, Edward Delesky, Md, Oluwatoni Okuboyejo, Md, Elizabeth Franko, Md, Nwamaka Amobi, Md, Ronak Ahir, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Studies suggest 1 in 5 adults in the US suffer from mental illness, with up to 46% of Philadelphia residents reporting poor mental health.
• Care integration beginning with primary care physician evaluation and management is becoming more common.
• Behavioral health counseling (BHC), provided by a primary physician and trained psychologist, is vital in management of mental health conditions.
• Studies suggest same-day scheduling of follow up appointments improves treatment adherence.
• Goal: improve BHC scheduling rates on same-day of initial referral across two practice teams

Viral Hepatitis And Hiv Screening Amongst Inpatients With Substance Use Disorder: An Initial Pdsa Cycle Analysis, Christine Papastamelos, Md, Elizabeth Novick, Md, Carolyn Kramer, Md, John Zurlo, Md, Nikhil Seval, Md, Mollie Tucker, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• ~67,000 individuals in Philadelphia county are estimated to be living with substance use disorder (SUD).¹
• Persons who inject drugs (PWID) are at disproportionately higher risk of acquiring HIV and viral hepatitis compared to the general public.² 
• A 3-month retrospective chart review (11/6/23-1/22/24) of 160 inpatient SUD encounters with an Infectious Disease (ID) consult showed that 35%-42% of HIV and hepatitis C screening opportunities were missed.

Recommendations For Telesupervision: Promoting Ethical, Legal, And Effective University And Clinical Supervision Using Technology, Madeleine M. Stevens, Yegan Pillay, Edisa Music, Elena Shahen

Journal of Counselor Preparation and Supervision

The expansion of the use of technology in counseling has implicated counseling professionals in considering how to legally and ethically incorporate it into all facets of practice, including university and clinical supervision settings. In this article, we provide scholarship-backed recommendations for doing so as well as provide suggestions for incorporating psychodynamic and cognitive-behavioral (CBT) supervision models into telesupervision.

Exploring Race In Addiction Treatment And The Need For An Anti-Racist Approach, Jackie D. Dell, Mei Tang

Journal of Counselor Preparation and Supervision

Extensive literature documents that Black people, Indigenous people, and People of Color (BIPOC) have been historically and systematically discriminated in addiction and substance use disorder treatment and services. This systemic oppression is the result of the creation and intersection of multiple systems that are rooted in White supremacy, which continue to fail to recognize racism as a critical factor in health disparities. The complexities of the structural factors that contribute to these racial health disparities, and opportunities to better address these disparities were reviewed to discuss their impact on BIPOC clients and the necessity for anti-racist approaches to addressing addiction …

Applying Supervision To Animal Assisted Therapy: Using The Integrative Development Model, Rachel W. Rachlinski, Kelli A. Mcfarland

Journal of Counselor Preparation and Supervision

A study conducted by Hartwig and Smelser (2018) reported 91.7% of clinicians being aware of animal assisted therapy (AAT) who agree it is a legitimate treatment model. However, 57% of respondents expressed interest in receiving AAT training. Although published standards and competencies published by ACA and IAHAIO indicate the requirement for clinical supervision when implementing AAT, research does not address supervision protocols for AAT. This manuscript suggests a protocol for supervising the implementation of AAT. The consequence of untrained supervisors is the potential harm to the well-being of the client as well as the clinician and the animal. As such, …

Culturally-Affirming Service-Learning For Counselors-In-Training: Child-Parent Relationship Therapy Training With Spanish-Speaking Families, Karen M. Roller, Szu-Yu Chen, Katrina Volante

Journal of Counselor Preparation and Supervision

The Spanish-speaking community is the largest underserved language group in the United States. To advance social justice advocacy and multicultural humility for this language group, the field of counselor education needs to create pedagogical scaffolding for non-Spanish-speaking counselors-in-training to work with interpreters to support Spanish-speaking families, while also enhancing language-concordant training for Spanish-English bilingual counselors-in-training. We utilized a critical race research design to explore six counselors-in-training’s experience participating in service-learning through online facilitation of Child-Parent Relationship Therapy with Spanish-speaking families. Interpretative phenomenological analysis of qualitative data yielded four major themes: (a) collaboration, (b) improved awareness, (c) growth and strength, and …

“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 …

Group Therapy For Young Adults With Intellectual Disabilities And Anxiety, Rayah Secrist

Educational Specialist, 2020-current

The purpose of this Ed.S. project is to propose a therapy group for individuals with intellectual disabilities who are struggling with anxiety. This paper will explore the literature on social and emotional barriers, mental health access inequality, and evidence-based practices in therapy for young adults with intellectual disabilities. Drawing on the research, this paper aims to provide clinicians with a guide for leading effective therapy groups tailored to this specific demographic.

Burnout And Self-Efficacy: Exploring The Rewards And Challenges Faced By Crisis Counselors Working In Emergency Department Settings, Ellen Dotas

Dissertations, 2020-current

This dissertation explores burnout and self-efficacy in counselors who work with clients in crisis in emergency department settings. Mental health and emergency departments are two areas that tend to report higher levels of burnout than are reported in other occupational fields. While much research has been done on the topics of burnout and self-efficacy, limited information is available about counselors who work in these crisis roles. This dissertation follows a three-manuscript format and includes a conceptual, qualitative, and quantitative manuscript. The conceptual manuscript explores the nature of the crisis assessment itself, focusing on the area of risk assessment. The qualitative …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …

Functional Brain Connectivity Of The Salience Network In Alcohol Use And Anxiety Disorders, Dhruv M Patel, Guillermo F Poblete, Alexandra Castellanos, Ramiro Salas

Staff and Researcher Publications

The interplay between alcohol use disorder (AUD) and anxiety disorders (ANX) is well-documented, yet the underlying neurobiological mechanisms remain elusive. This study aims to elucidate these mechanisms by examining the resting-state functional connectivity (RSFC) within the salience network and to the amygdala, both implicated in alcohol and anxiety disorders. We analyzed data from 264 inpatient participants culled from a wider group of 518 inpatients at The Menninger Clinic in Houston, TX, categorized into four groups (n = 66 each) based on DSM-IV diagnoses: AUD without ANX (AUD), ANX without AUD (ANX), concurrent AUD and ANX (BOTH), and neither (NEITHER). Our …

Mental Health And Law: How Can Attorneys Improve Their Wellbeing?, Matthew P. Ruble

Honors Program Theses and Research Projects

Mental health is a concern for attorneys that affects elements such as well-being and performance. Poor mental health results in various risky behaviors such as substance abuse, depression, stress, vicarious trauma symptoms, and other issues. The legal profession requires tremendous commitment to the discipline’s work, and poor mental health prevents attorneys from achieving this outcome. Much research about the nature of mental health and law focuses on data prior to or during COVID-19. Literature is analyzed to provide a framework about the current knowledge of mental health in the legal profession. The literature discusses research studies about depression, secondary trauma, …

Strengthening Community Health Through Dementia Listening Sessions, Raven Albertson

Utah Conference on Community Engagement

"This session explores innovative strategies for strengthening community health through dementia listening sessions and engagement, equipping community partners with the knowledge to make informed decisions regarding dementia care and support. Participants will gain insights into effective partnership-building, impactful dementia education delivery, and strategies for fostering meaningful community involvement through community listening sessions and collaboration. Through a live listening session workshop, attendees will participate in interactive discussions, inform efforts in Utah communities, and acquire practical tools to drive sustainable, community-led improvements in dementia care and support."

Effect Of Social Determinants Of Health On Clinic Visit Attendance In Patients With Hemophilia, Shailly Gaur Md, Brian Lee Phd, Mph, James Anderst Md, Msci, Katie Foote Lscsw, Lcsw, Osw-C, Andrea Bradley-Ewing Mpa, Ma, Shannon Carpenter Md

Research Days

Background

Social determinants of health (SDOH) create barriers to seeking care regularly, especially for patients with chronic disease. Patients with moderate-severe hemophilia A and B (factor 8 and 9 deficiencies respectively) have a life-long higher risk of bleeding and require chronic therapies. Specialized care is offered through hemophilia treatment centers (HTCs); however, these can be difficult to access for some individuals. Previous SDOH research in this patient population has been limited; therefore, it can be difficult to identify the barriers to care that exist. There is a need to examine SDOH more thoroughly to create patient-directed interventions to improve access …