Social isolation and mental health: Evidence from adults with serious mental illness.

OBJECTIVE: In the United States, loneliness is increasingly becoming a public health crisis. Individuals with serious mental illness (SMI) report loneliness at rates much higher than the general population. In this secondary data analysis, we examine how subjective and objective social isolation influence perceptions of mental health and well-being. METHOD: Using a cross-sectional design, we conducted a multivariate hierarchical regression analysis to determine the unique influence both subjective and objective isolation had on perceptions of mental health and well-being in adults with SMI. RESULTS: Rates of reported loneliness in those with SMI was consistent with the literature. Increased perceptions of loneliness were found to be a significant predictor of decreased self-report mental health rating and increased frequency of bothersome symptoms. Increased perceptions of social support were also a significant predictor in increased self-report mental health rating and frequency of bothersome symptoms. CONCLUSION AND IMPLICATIONS FOR PRACTICE: For social workers and providers of services to individuals with SMI, it is important to understand the prevalence of loneliness in the population. It is also critical to provide those with SMI social support and inclusion interventions that aim to increase perceptions of mental well-being. Additionally, the distinction between subjective and objective social isolation provides evaluators of social support interventions a more accurate definition from which to measure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient Service Utilization Among Individuals with Co-occurring Disorders: A Comparison of Two Models of Care Coordination.

Healthcare systems have increasingly adopted integrated care models with demonstrated effectiveness. However, few studies examine integrated care for individuals with co-morbid mental illness and medical conditions. This quasi-experimental study compared service use for two integrated care models for patients with co-occurring conditions. We used hierarchical negative binomial and logistic regressions with random effects to test the relationship between integration and service use. Patients treated at co-located agencies had significantly higher odds of inpatient hospitalization compared to those in fully integrated settings. Additionally, some comorbidities had significantly different levels of service use. Patients at co-located agencies had more outpatient and emergency visits, but was not statistically significant. Our findings provide evidence that the model of care may impact service use for patients experiencing co-occurring conditions, however, variations in service use for specific co-morbid conditions highlight the need to examine the specific needs and characteristics of this population.

Testing a Screening, Brief Intervention, and Referral to Treatment (SBIRT) interdisciplinary training program model for higher education systems.

INTRODUCTION: An estimated 21 million Americans meet the criteria for a substance use disorder (SUD), whereas 24% of the population engages in risky alcohol use leading to tremendous health and economic impacts (Substance Abuse and Mental Health Services Administration, 2017). Opioid misuse is a national public health emergency, with an estimated 46,802 opioid-related deaths occurring in 2018 (National Center for Health Statistics, 2020). Despite the high prevalence of risky substance use and SUDs, preservice education related to screening for and treating SUDs in health and behavioral health professions is inadequate (Dimoff, Sayette, & Norcross, 2017; Russett & Williams, 2015; Savage et al., 2014; Tabak et al., 2012). A critical need exists for an interdisciplinary, implementation science-informed approach for developing academic training programs in the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model within higher education systems. METHOD: We delineate a training model implemented within 5 health and behavioral health disciplines (nursing, social work, clinical psychology, counseling psychology, and integrated behavioral health), informed by prominent implementation scientists (Proctor et al., 2011; Rogers, 2003). RESULTS: Faculty surveys (n = 33), interviews (n = 24), and syllabi and training records reviews indicated the Brief Intervention, and Referral to Treatment model was infused into course content by 89.47% of trained faculty and sustained in 90.47% of course syllabi at project close. CONCLUSION: The model demonstrated successful uptake and sustainability in higher education systems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Staff and Organizational Capacity in the Implementation of Coordinated Care: an Examination of 10 Behavioral Health Agencies in Rural Communities.

Providing primary care services in behavioral health settings has become more common and necessary given the needs of individuals with serious mental illness (SMI). In this exploratory study, we developed a survey to assess agency and professional staff and practitioner capacity for coordinated care. The survey provides a feedback mechanism for agencies to target staff and organizational needs related to building capacity to provide coordinated care. Logistic regressions compared differences in 24 dimensions of coordinated care specifically comparing capacity based on professional role (behavioral health and medical), model of coordination (co-located and fully integrated), and time of model adoption (early and late adopters). Findings indicated that all three were significant predictors of capacity in multiple dimensions suggesting the need for training and planning around inter-professional and inter-agency coordination.

Critical Issues in Leadership Development for Peer Support Specialists.

This paper is a qualitative analysis of perspectives on leadership development among working peer support specialists and highlights the challenges, needs and efficacy these individuals experience in their work settings. Six participants engaged in a 2 h semi-structured focus group. Participants were guided through a series of nine questions regarding their transition to leadership, professional communication and relationships. Seven themes emerged: managing dual relationships; having difficult conversations; push and pull of leadership; taking responsibility for others; taking responsibility for self-care; addressing stigma in the workplace, and, spirituality/a calling to help. These professionals integrate their personal experiences of recovery into their direct care and leadership approaches in the workplace. This blending of recovery concepts and supervision approaches reflect some of the powerful elements that peer recovery specialists are uniquely qualified to lead in the healthcare workforce. These findings provide important implications for leadership development among this growing segment of the healthcare workforce.