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 …

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 …

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 …

Lawyers, Trauma, And Professional Well-Being: How The Legal Community Takes Back Its Mental Health, Brenda D. Gibson

Arkansas Law Review

Accompanying a notable shift in the legal academy to being more attentive to our students’ mental health, there must be an equal (or even greater) shift to focusing on trauma, mental health, and well-being in the broader profession. Significantly, trauma and its effects are compounded when combined with the challenges faced by underrepresented populations within the profession. To date, these challenges have been greeted by an ad hoc, piecemeal reaction to stress and trauma,10 which only inhibits wellness in the profession. Part I explores the current literature in both the humanities and the legal profession, beginning with a brief discussion …

Eos Wellness Center: Rethinking Inpatient Mental Health Facility Design, Emily Simms

Bachelor of Architecture Theses - 5th Year

The design of mental health facilities significantly impacts patient outcomes, especially for individuals with depression. Environmental factors such as lighting, thermal comfort, and access to nature influence mental health. This research explores how architectural design can reduce self-harm incidents and enhance recovery outcomes for patients with depression. The project hypothesizes that synchronizing light patterns and thermal comfort with patients’ circadian rhythms will reduce self-harm incidents and improve recovery. The problem established in the research is that disruptions to circadian rhythms increase the risk of depression, PTSD, and anxiety by 30% (Burns et al., 2022). Suicide is also the second leading …

An Educational Intervention: Knowledge Acquisition Of Perimenopausal Mental Health Symptoms And Treatment Options For Women Aged 35 Years Plus, Allison M. Hopps

Doctor of Nursing Practice Scholarly Projects

Perimenopause is a span of four to six years preceding menopause when estrogen levels decline. Up to 40% of women experience depression during the perimenopause transition. Hormone replacement therapy (HRT) can be an effective treatment for depressive symptoms during perimenopause, but many healthcare practitioners prescribe antidepressants instead of HRT for the management of mood-related symptoms. Perimenopausal depression is associated with the progression of chronic conditions such as cardiovascular disease, diabetes, and dyslipidemia. The general population, including women and healthcare providers, lacks the education and awareness surrounding perimenopause symptoms and treatment. This project educated women between ages 35 to 55 on …

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 …

One Can Only Dream, Sophia V. Yacca

Theses and Dissertations

One Can Only Dream is an interactive installation in which players are invited to navigate a liminal, dream-like game, engage with a branching series of questions, and introspect upon the relationships between unconscious expression, conscious self-perception, and the inherent difficulty of depicting, sharing, and understanding subconscious thought.

Rooted in both my personal experience with a rare neurophysiological condition and in my desire to create, this project examines dreams not only as a medical and cultural phenomenon, but also as a means to form identity, reflect trauma, and inspire creativity. Drawing from modern interactive storytelling and my lived experiences, this work …

Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

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 Impact Of Quality Of Life And Recovery Capital On Inhibitory Control In Patients On Medication For Opioid Use Disorder, Caroline K. Jeffries

All Theses

The opioid crisis persists as a global health challenge, necessitating a comprehensive understanding of the complex interplay between psychological factors and neurocognitive responses among individuals with opioid use disorder (OUD). Two such psychological factors include recovery capital, an individual's internal and external resources to supporting recovery, and quality of life. Past work suggests that positive levels of recovery capital and quality of life may enhance individuals’ ability to regulate emotions and manage cravings. However, it is unclear how these variables are affected when buprenorphine is taken. This study investigates the influence of recovery capital and quality of life on inhibitory …

Cobenfy(Xanomeline/Trospium) Vs. Clozapine For Treatment-Resistant Schizophrenia, Harmann Singh, Akash M. Patel, Abdullah Noory, Kush C. Patel, Simran Gandhi

Rowan-Virtua Research Day

Background: Treatment-resistant schizophrenia (TRS) poses significant therapeutic challenges. Although clozapine remains the gold-standard pharmacologic treatment for TRS, its clinical utility is hampered by severe side effects and intensive monitoring requirements. KarXT (Cobenfy), a combination of xanomeline and trospium chloride, represents a novel antipsychotic approach by targeting muscarinic M1/M4 receptors instead of dopamine D2 pathways.

Hypothesis: KarXT offers comparable efficacy to clozapine with a more favorable safety and tolerability profile, making it a viable alternative for patients with TRS.

Methods: A systematic review was conducted to identify studies from 2015–2025 evaluating KarXT in schizophrenia. Sources included PubMed, ClinicalTrials.gov, FDA databases, ICER …

Is The Vaping Epidemic Linked To Neurologic Changes And Mental Health Diagnoses Amongst Us Adolescents?, Tracy Lin, Victoria Shwe

Rowan-Virtua Research Day

Vaping has significantly increased among U.S. adolescents, driven by the rise of e-cigarettes and flavored pods. Nicotine exposure during brain development is linked to changes in the limbic-dopaminergic system, white matter integrity, and increased risk of emotional and behavioral dysregulation. Higher rates of depression, anxiety, and suicidality are reported among adolescent users, with greater symptom severity seen in those with high vaping dependence. Though studies show correlation rather than causation, findings suggest vaping may contribute to rising mental health diagnoses. Addressing vaping’s neurological and psychological impact is critical to guiding prevention efforts, regulatory policies, and support for at-risk youth.

Is Acupuncture At The Auricular Shenmen Point Effective In Treating Anxiety?, Nicole Vaiani, Alexander King, Venkateswar Venkataraman

Rowan-Virtua Research Day

Anxiety disorders are the most prevalent mental health condition in the United States and are often managed with pharmacological interventions, which can lead to adverse side effects. As a result, alternative therapies such as acupuncture are gaining attention. This study investigates the effectiveness of auricular acupuncture, specifically targeting the Shenmen point, in reducing symptoms of anxiety. We analyzed ten randomized controlled trials that included quantitative outcome measures. The results suggest that auricular acupuncture at the Shenmen point is an effective and well-tolerated adjunctive treatment for anxiety. While further research with larger sample sizes and extended follow-up periods is warranted, these …

The Role Of Ect In Ocd: A 10-Year Review (2014-2024), Mariana Sales, Tainiz Polanco, Amy Nguyen

Rowan-Virtua Research Day

Background: Obsessive-compulsive disorder (OCD) affects up to 2.5% of the population with significant impacts on everyday functioning and relationships. First-line treatment includes selective serotonin reuptake inhibitors (SSRI) and cognitive behavioral therapy; however, studies have found that up to 40-60% of patients do not respond to SSRIs. ECT is an alternative approach that has demonstrated limited efficacy in OCD.

Objective: The current review aims to summarize the results of published work between 2014-2024 to assess the efficacy of ECT in the treatment of OCD.

Methods: A literature review was conducted using eight studies from 2014-2024 to assess the effectiveness of ECT …

Autoimmune Encephalitis Presenting As Pseudodementia (Case Report), Renita Ng, Christie Richardson

Rowan-Virtua Research Day

Patients with autoimmune encephalitis frequently present with psychiatric symptoms including psychosis, behavioral changes, and affective disorders. Because of this, misdiagnosis of a primary psychiatric disorder in a case of autoimmune encephalitis is not uncommon. We present a case of autoimmune encephalitis in a 72 year old who was initially thought to have psuedodementia or catatonia due to variable collateral who later on LP was found to have markers and responded to steroid treatment. This case highlights the importance of maintaining a broad differential with patients who present with psychiatric alterations and to consider other causes of behavioral change.