Physician Assistant Student Attitudes About People With Serious Mental Illness.

PURPOSE: This study explored the attitudes of physician assistant (PA) students toward the future care of individuals with serious mental illness (SMI). Physician assistant student education offers a unique opportunity to confront and reduce bias toward individuals with SMI. However, no previous literature has documented PA student attitudes toward SMI. METHODS: Preclinical students (n = 7) from a single PA program were invited to participate in 2 focus groups exploring attitudes toward the future care of patients with SMI. The focus groups lasted approximately 60 minutes and were conducted by non-PA faculty using a question guide. RESULTS: Four themes emerged from interviews: perceptions about the population, knowledge of mental health conditions, approach to care, and program curriculum input. CONCLUSION: Several themes aligned with the participant's level of training. Participants demonstrated didactic knowledge yet lacked clinical exposure to provide context. Future studies should focus on developing interactive learning techniques to prepare students for patients with SMI.

Dental pre-doctoral student perceptions about serious mental illness: Concerns and role clarification.

PURPOSE/OBJECTIVES: Little is understood about dental student perspectives providing care to people with serious mental illness (SMI), a population with significant oral health disparities. This study explored student perceptions, questions and beliefs about people with SMI using the Social Ecological Model as a framework to better understand perspectives and identify potential educational needs in dental medicine curricula for providing care to this population. METHODS: Survey data was collected in spring of 2021 from predoctoral dental students (n = 126) enrolled in a required course at a mid-Atlantic university. Ninety-nine percent of the students completed the survey. The IRB approved qualitative study examined student responses to a six question survey using content analysis. An iterative coding process was used and included reflexivity memos, data dictionaries and consensus building among the four coding researchers to identify recurring concepts and ultimately identify themes. RESULTS: Four primary themes were identified: Concerns and Stereotypes; Uncertainties; Professional Role and Responsibilities; and Learning Preferences. Participants expressed fear and discomfort in working with people with SMI. They also noted multiple questions about providing clinical care, referrals and the interaction of oral health and mental health. Lastly, they offered ideas about educational strategies to improve learning on the topic. CONCLUSION(S): Pre-doctoral dental students have concerns about providing care to people with SMI and limited understanding of dental professional role and responsibilities about care for this vulnerable population. Predoctoral dental curriculum should be expanded to address professional roles when working with this population to improve student competency and comfort, and ultimately improve care to people with SMI.

Evaluating Educational and Employment Services for Young People With Psychiatric Conditions: A Systematic Review.

OBJECTIVE: The authors conducted a systematic review of studies evaluating vocational interventions for young people with psychiatric conditions to determine the extent to which services were adapted for young people and whether services promoted gains in postsecondary education and employment. METHODS: Five databases (PubMed, PsycINFO, Web of Science, Academic Search Premier, and ERIC) were searched. Sources eligible for inclusion were controlled studies published between 2000 and mid-2020 that evaluated a vocational intervention and examined postsecondary educational or employment outcomes for youths or young adults (ages 14-35 years) with psychiatric conditions. RESULTS: Ten studies met the inclusion criteria. Several of the studies evaluated services that were adapted for young people, including through the incorporation of educational supports. The most consistent finding was that services based on the individual placement and support (IPS) model improved employment outcomes more effectively than did comparison approaches and treatment as usual. Fewer studies assessed educational outcomes, and they yielded mixed results; however, recent findings from a controlled trial indicate that an enhanced IPS intervention that included well-specified supported education and skills training led to significantly superior outcomes in both education and employment. CONCLUSIONS: These results provide support for the efficacy of IPS-based services to improve employment outcomes among young people with psychiatric conditions and suggest that adapting IPS to include comprehensive educational supports and skills training may be important for efforts to improve postsecondary educational outcomes. Additional well-controlled intervention studies that examine educational and longer-term outcomes should further inform the development and delivery of vocational services for this population.

Physical therapy students' perceptions for working with persons with mental illness in the USA.

BACKGROUND: Physical therapists provide important services for improving health and function for the general population; however, physical therapy (PT) is infrequently accessed by persons with a primary diagnosis of severe mental illness (SMI). This study examined the attitudes of PT students before and during their participation in a service-learning (SL) program for people with SMI. MATERIALS AND METHODS: A cross-sectional institutional review board approved qualitative study collected 1-h semi-structured qualitative interviews from seven graduates of a doctor of PT program. Participants were from a New Jersey University program in the USA who participated in an SMI SL experience. Participants were asked about participant attitudes toward people with SMI and their observations during a SL experience using an interview guide. All interviews were digitally recorded, transcribed, and coded using interpretive phenomenological analysis by a team of researchers. This type of qualitative analysis aims to explore participants understanding of their experience without pre-conceived theoretical direction. Recordings, transcripts, and field notes were reviewed for recurring ideas that were summarized into codes. Through independent coding, reflexivity memos, and consensus meetings, data were further analyzed to identify themes. Investigator triangulation addressed differences and aided consensus development. RESULTS: Before the SL experience, the students reported negative perceptions about people with SMI and feelings of uncertainty and unpreparedness to work with this population. According to student reports, SL supported their personal and professional development and allowed them to see that PT services are beneficial for people with SMI. CONCLUSIONS: The results of this study indicate that PT students have negative attitudes of people with SMI and feel unprepared to work with this population. The results also support SL as an effective strategy for helping students in their preparation for working with people with SMI.

Challenges Experienced by Behavioral Health Organizations in New York Resulting from COVID-19: A Qualitative Analysis.

This paper presents a qualitative content analysis of survey data collected from behavioral health care providers from throughout New York regarding the challenges faced as a result of COVID-19. Survey responses from 295 agency and program administrators and staff, representing 238 organizations, were analyzed. Ten themes were identified: business operations, service provision, telehealth, safety, client concerns, staff concerns, supplies, technology, illness/grief/loss, and communication. These themes represent concerns that arose from the rapid transition to widespread use of telehealth, limited technology accessibility for both staff and clients, reduced revenue and billing changes, impact of COVID-19 infection itself and subsequent deaths of clients and staff, and necessary modifications for organizational communication both internally and externally. The implications of these challenges and the need for further research to identify how to best address them are discussed.

Service learning experiences of doctor of physical therapy students with a severe mental illness population.

INTRODUCTION: Physical therapists provide important services to improve physical health for the general population; however, physical therapy interventions are less utilized with underserved populations such as those with severe mental illness (SMI). The quality of services for these populations is impacted in part by negative provider attitudes and lack of preparation to work with the SMI population. This study examined the impact of structured educational field experience on the physical therapist's attitudes and knowledge about working with the SMI population. This will inform future educational practices to best prepare students to provide quality of healthcare to the population. MATERIALS AND METHODS: Seven graduates of a doctor of physical therapy (DPT) program from a Mid-Atlantic University in the United States who participated in an SMI service-learning (SL) experience completed a semi-structured qualitative interview in 2016. Questions about how the experience impacted their current work were asked. Interviews were digitally recorded, transcribed, and examined using interpretive phenomenological analysis. Coding and investigator triangulation were conducted. All interviews reached thematic saturation. RESULTS: The graduated DPT students reported attitudinal changes toward people with SMI through qualitative interviews. They reported an improvement in their skills, greater competence to work with the SMI population, and an increased focus in the use of person-centered services. CONCLUSIONS: The results of this study suggest that DPT students gain an understanding of both the SMI population and themselves during SL. Using SL as part of the DPT educational curriculum can offer students and the opportunity to build confidence in working with the SMI population. SL can also improve their skills and attitudes toward the population, key areas that are identified as barriers to receiving quality physical healthcare among the SMI population.

Evaluation of a cognitive remediation intervention for college students with psychiatric conditions.

OBJECTIVE: Given the poor educational outcomes associated with psychiatric conditions, we developed Focused Academic Strength Training (FAST), a 12-week strategy-focused cognitive remediation intervention designed to improve academic functioning among college students with psychiatric conditions. Here we report initial results from a randomized controlled trial of FAST. METHOD: Seventy-two college students with mood, anxiety, and/or psychotic disorders were randomized to receive FAST or services as usual and were assessed at baseline and 4 months (posttreatment). RESULTS: Repeated-measures analyses of variance indicated FAST-associated improvements in self-reported cognitive strategy use (p < .001), self-efficacy (p = .001), and academic difficulties (p = .025). There were no significant treatment-related improvements in neuropsychological performance. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: FAST may lead to an increase in self-efficacy and cognitive strategy use, as well as a reduction in academic difficulties among students with psychiatric conditions. Future analyses with follow-up data through 12 months will address the potential of FAST to improve academic functioning among this population. (PsycINFO Database Record