The Role of Mental Health Courts in Mitigating Family Violence.

Mental health courts are one potential means to mitigate violence against family members by people with mental illness. This study identified the rate at which cases of family violence come before a mental health court and the success of defendants charged with assaulting family members. In a sample of 1,456 defendants eligible to participate in a mental health court, descriptive statistics were used to report rates of admission of defendants charged with assaulting family members and their characteristics; a static group design was used to compare post-program rearrests among defendants who assaulted family members who successfully completed the program, who did not complete the program, and who did not participate despite being eligible; and logistic regression was used to determine the effect of participation on rearrest when controlling for demographic and clinical factors. The study found that family violence occurred in 24.7% of admitted cases. Most eligible defendants who assaulted family members (75.8%) participated in the court program, and among those who did, 72.2% successfully completed the program. Defendants who assaulted family members and had a positive program termination had a much lower rate of rearrest post-program completion compared with those who did not complete the program or did not participate despite being eligible, a finding that held when controlling for other factors. This study suggests that mental health courts can be an effective option for mitigating family violence committed by people with mental illness.

Suicidal Ideation and Suicide Attempts among Women Seeking Treatment for Substance Use and Trauma Symptoms.

Substance use disorders and posttraumatic stress disorder have been associated with suicide. Through secondary analysis of the screening data from the Women and Trauma Study conducted by the National Institute on Drug Abuse Clinical Trials Network, the present study examined rates and correlates of suicidal ideation and suicide attempts among women who sought treatment for substance use and trauma at seven outpatient substance use programs. The sample included women between the ages of 18 and 65 years (M = 39.2; SD = 9.3) and was 44 percent white, 33 percent African American, 8 percent Latina, and 15 percent other races or ethnicities. Logistic regression was used to examine factors associated with a lifetime history of recurrent suicidal ideation and a serious suicide attempt. Findings highlight the need for social workers to address elevated risk levels for suicidal thoughts and behaviors when working with women with histories of substance use and trauma.

Bio-psycho-social-spiritual needs of adolescents and young adults with life-threatening illnesses: Implications for social work practice.

This paper explores the biopsychosocial and spiritual needs of adolescents and young adults (AYA) with life-threatening or terminal illnesses. AYA are situated between childhood and adulthood (ages 15-25) and have distinct biopsychosocial and spiritual needs unique to their developmental stage. Having a life-threatening or terminal illness directly challenges normal AYA developmental tasks and identity formation. AYA experience more troubling physical symptoms during the dying process compared to other age groups, which leads to significant psychological distress and an increased need for pharmacological treatments. In general, AYA desire to be fully informed and involved in the health care decision-making process, leading to ethical dilemmas when the AYA is a minor and their wishes differ from the wishes of their legal guardian(s). Social workers are especially well-equipped to serve this population due to aligning professional standards and ability to advocate for holistic care within interdisciplinary teams. Additional research is needed to tailor holistic interventions to meet the needs of this population.

Case managers' perceptions of consumer work readiness and association with pursuit of employment.

OBJECTIVE The purpose of this study was to determine whether case managers' perceptions of consumers' work readiness-in the areas of the individual consumer's hygiene, social skills, medication adherence, psychiatric symptoms, and substance use-influence pursuit of employment. METHODS A cross-sectional survey study design was used to assess the role of staff perceptions in consumers' pursuit of employment. A hierarchical generalized linear model with a logit link function was used to analyze data from 1,556 consumers nested within data for 113 case manager caseloads. RESULTS Case managers' perception of work readiness was significantly associated with pursuit of employment. CONCLUSIONS The clients of case managers with less stringent criteria for pursuing employment were more likely to take positive steps toward employment.

Peer employees' and clinicians' perceptions of public mental illness stigma and discrimination.

OBJECTIVE: Stigma and discrimination against people with mental illnesses are serious problems that can lead to many negative effects. This study examined providers' awareness of consumers' daily lived experience of discrimination. METHOD: We surveyed 51 peer employees and 52 licensed clinicians to learn how they viewed the extent of public stigma and discrimination. RESULTS: Clinicians, women, and those who had observed a friend with a mental illness treated unfairly perceived significantly higher levels of public discrimination than did their counterparts (adjusted R² = .399, p < .001). Men's perceptions of public discrimination were more strongly affected by personal contact. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Mental health providers are uniquely situated to help consumers deal with the effects of discrimination and should incorporate this issue into their clinical practice. Further research should examine the reasons for differences in perception and how these differences relate to provider behavior and consumer outcomes.

Measuring social support among kinship caregivers: validity and reliability of the Family Support Scale.

The scope of research about kinship care has expanded. One area of interest is the impact social support has on kinship caregivers (Kelley, Whitley, & Campos, 2011). The Family Support Scale (FSS) has been used to measure social support among kinship caregivers (Kelley et al., 2011; Leder et al., 2007); however, there has been no rigorous examination of the psychometric properties of the FSS when administered to kinship caregivers. This study used a sample of 255 kinship caregivers to conduct a principal component analysis and developed a four-component structure for the FSS. The results suggest that the four-component structure identifies four sub-scales that have adequate face validity and internal consistency validity with this population.

Battling in the trenches: case managers' ability to combat the effects of mental illness stigma on consumers' perceived quality of life.

Intervention effectiveness research requires that investigators include "real world" variables in the design of studies to develop an understanding of how interventions perform in the "real world." Two areas that have been neglected in effectiveness research on mental health case management are mental illness self-stigma and the effects of different case managers. Self-stigma is a reality for many consumers that negatively impacts their lives. Case managers, themselves, are a potential source of autocorrelation and likely provide services differently. This study explores the relationship between self-stigma and quality of life for consumers receiving services from different case managers. Cross-sectional data were collected from 160 consumers of an urban case management agency. Self-stigma was negatively associated with quality of life. Case managers did not account for a significant amount of variance in quality of life scores. However, the interaction between case manager and self-stigma was significant. Some case managers were able to mitigate the negative effects of self-stigma on quality of life. Future effectiveness research in community mental health case management needs to account for the effects of self-stigma, case managers, and the interaction between the two in the research design.