Desire to Quit Smoking in an Outpatient Population of Persons with Serious Mental Illness.

National survey data indicates that about 32% of adults with any mental illness smoke, compared with 23% of adults without a psychiatric disorder. Smoking rates are higher in clinical populations, where up to 53% of persons with serious mental illnesses (schizophrenia and bipolar disorder) are estimated to smoke. Despite higher rates of smoking among persons with mental illnesses, motivation to quit in this population is similar to that of the general population of smokers. Nevertheless, smoking cessation rates in the USA have been significantly lower among persons with mental illnesses than among persons without a mental illness. Advising patients to quit is among the most basic approaches to smoking cessation used by health care professionals, and there is evidence that the likelihood of cessation increases with even minimal advising. Indeed, advising is the second of five smoking cessation activities recommended in the US Department of Health and Human Services clinical guideline, Treating Tobacco Use and Dependence, which promotes physician intervention activities in steps known as the five A's (ask, advise, assess, assist, and arrange). A randomized, state-wide survey was used to estimate the smoking prevalence among psychiatric outpatients served in Ohio's publicly funded behavioral health care system. A follow-up survey explored a self-selected sample's exposure to cessation advising by health care practitioners and the relationship between that advising and subjects' desire to quit.

Employment services and substance abuse treatment.

This qualitative study of over 800 participants focused on the employment experiences of consumers of substance abuse treatment programs to provide a better understanding of what employment services are offered and what needs treatment agencies have in the area of employment services, examining barriers and facilitators from both the consumer and provider perspectives. Data were collected via a mixed research methodology of focus groups and surveys from July 2015 through June 2016 in a large Midwestern U.S. state. Employment is a challenge for persons with substance use disorders. Only a quarter of this study's large sample of substance abuse treatment consumers reported being cur-rently employed; and of those consumers who reported no current employment, greater than half reported that their current unemployment was due to their substance use. Persons receiving substance abuse treatment face many challenges in obtaining and maintaining employment. Treatment providers identified several barriers to implementation of employment services. They named an array of resources as needed, including increased funding for supportive employment programs and staff appropriate to the delivery of employment services. Some providers believed employment services to fall outside of their scope of practice. Data generated through this study may inform policy to invest resources in employment services within substance abuse treatment settings.

Attrition in drug court research: Examining participant characteristics and recommendations for follow-up.

Drug court research is often challenged by study attrition. In this study, researchers attempted to predict study completion using variables traditionally associated with treatment attrition. Findings showed that participants who reported a need for additional help to resolve legal problems and who reported accessing outpatient treatments were more likely to complete the study at the three-month follow-up. The study also demonstrated a relationship between trauma-related symptoms and study attrition. Although sample size was a limitation with these pilot data, researchers are urged to examine attrition and increase efforts to engage drug court enrollees in research studies, especially those with trauma-related symptoms.