Emergency Department-Initiated Interventions for Illicit Drug Overdose: An Integrative Review of Best Practices.

More than 20 million people in the United States have a substance use disorder (SUD), increasing their risk for overdose (OD). Patients arriving to emergency departments (EDs) with OD typically require lifesaving interventions, but inconsistencies exist regarding further intervention and discharge instructions. The purpose of the current integrative review was to determine best care practices for patients presenting to EDs with an illicit drug OD. A literature search included the databases PubMed, EBSCO Host, ProQuest Health and Medicine, and Google Scholar. Thirty-five articles outlined interventions for SUD/OD initiated in EDs; most for opioid OD. Best practice intervention components included psychiatric evaluations, SUD screening tools, buprenorphine initiation, naloxone distribution and training, OD prevention education, referrals to medication-assisted treatment, and harm reduction strategies. Barriers to implementation included legislation, insurance/costs, community resource availability, staffing, training, and potential stigma. With myriad approaches, nurses with SUD care experience can advocate for instituting best practices for patients in the ED and upon discharge. [Journal of Psychosocial Nursing and Mental Health Services, 61(6), 18-24.].

Losing to Gain: The Effects of a Healthy Lifestyle Intervention on the Physical and Psychosocial Well-being of Clients in a Community-based Mental Health Setting.

Individuals with severe and persistent mental illness (SPMI) encounter both poorer physical health and psychosocial well-being in comparison to the general population. Obesity, hypertension, heart disease, and diabetes can result from the symptoms of mental illness, the side effects from psychotropic medications, as well as disparities associated with being mentally ill. Mental health nurses are in a prime position to implement healthy lifestyle interventions (HLIs). This study tested a HLI (physical exercise and nutrition) and examined the effects on physical and psychosocial outcomes in clients obtaining mental health services at a community-based facility. Key findings included a decrease in anxiety and depressive symptoms at 3 months and consistent improvement in self-efficacy for exercise in the intervention group. Bridges and barriers to achieving optimal results in physical and psychosocial well-being were identified. Findings from this study offer insight into designing and executing more effective HLIs with individuals who have SPMI.

Correction to: Losing to Gain: The Effects of a Healthy Lifestyle Intervention on the Physical and Psychosocial Well-being of Clients in a Community-based Mental Health Setting.

The original version of this article unfortunately contained an error in author group. The second author Tamatha Arms was inadvertently missed to include in the author group.

Eating disorders and spirituality in college students.

Associations were examined between eating disorder symptoms and spiritual well-being in a convenience sample of college students. Undergraduate nursing students at a university in a Mid-Atlantic coastal beach community were recruited for the study. A total of 115 students completed the Spiritual Well-Being Scale (SWBS); the Sick, Control, One Stone, Fat, Food (SCOFF) screening questionnaire; and the Eating Attitudes Test (EAT-26). Approximately one quarter of students had positive screens for an eating disorder, and 40% admitted to binging/purging. SWBS scores reflected low life satisfaction and a lack of clarity and purpose among students. A significant association was found between EAT-26 scores and SWBS Existential Well-Being (EWB) sub-scale scores (p = 0.014). SCOFF scores were significantly associated with SWBS EWB scores (p = 0.001). Symptoms of eating disorders were pervasive. Future research that assesses the impact of spiritual factors on eating disorders may help health care providers better understand the unique contributions to the development of eating disorders. [Journal of Psychosocial Nursing and Mental Health Services, 53(1), 30-37.].

Parental opioid use disorder: Examining their children's experiences, needs, and road to resilience.

PROBLEM: Over 8 million children in the United States live with a parent with substance use disorder (SUD), inclusive of opioid use disorder (OUD). This is an adverse childhood experience (ACE), that often leads to poor outcomes such as developing SUD or mental illness. Interventions and research have focused more on the parent and not their children. Without emphasis on child's experiences, their needs, and building interventions toward developing resilience, the intergenerational cycle of SUD/OUD will persist. METHODS: Nine children (ages 12-17) in custody of Social Services, who experienced a parent with OUD, participated in this pilot study. The intervention was SAMHSA's Children's Program Kit: Supportive Education for Children of Addicted Parents. Thematic analysis of verbal responses/behaviors, observations, field notes, and any retained materials (i.e., handouts) was conducted over eight sessions. FINDINGS: Findings included three themes regarding participant's experiences: Meaning of a Parent; Others Involved; and Witnessing the Cycle. Two sub-themes also emerged: Ways to Cope and Support from Various Sources. CONCLUSIONS: Results support mental health nurses as forerunners in building, implementing, and evaluating child-focused interventions for children of parents with OUD. Interventions should focus on the needs of the children and use a strength-based approach to promote their resilience.

The experiences of youth serving as caregivers for mentally ill parents: a background review of the literature.

Young caregivers of mentally ill parents are a vulnerable population. These vulnerabilities include risks for developmental issues, poor socialization, and poor school performance. The purpose of this background review of the literature is to explore the experiences of young caregivers of mentally ill parents and detect the gaps in the literature. The guiding research questions were: What is the experience of young caregivers of mentally ill parents? and What is the experience for those who witness or must assist their parent during a crisis? The majority of research has been conducted outside the United States, primarily in the United Kingdom, and studies have focused mostly on young caregivers of parents with physical rather than mental illness. No studies focused on young caregivers who witnessed or assisted their mentally ill parent in crisis. Information gained through this review will add to the body of knowledge for child mental health and build a case for additional research.

Promoting resilience for children of parents with opioid use disorder: A pilot study of a directed intervention.

PROBLEM: Having a parent with Opioid Use Disorder (OUD) is a childhood adverse experience (ACE), magnified by other accompanying ACEs. Outcomes for these children tend to include developing mental illness and/or Substance Use Disorders themselves. Few studies address these children's experiences and needs. Without child-focused interventions to foster their resilience, generational ramifications of the OUD crisis will persist. METHODS: Nine children (ages 12-17), in Department of Social Services' custody, participated in this pilot study. The intervention delivered was Substance Abuse and Mental Health Administration's Children's Program Kit (CPK): Supportive Education for Children of Addicted Parents. Measures included OUD knowledge pre/posttests and the Behavioral and Emotional Rating Scale (BERS-2). FINDINGS: Findings from paired-samples t tests showed a significant increase in youth OUD knowledge from pre to posttest. Affective strength on the parent version (foster parent or social worker's perception of participant) and overall strength index on the youth's version BERS-2 increased significantly from pre to posttest. Career strength, a separate strength index, showed significant increased scores on both youth and parent BERS-2 versions pre to posttest. CONCLUSIONS: Results support Psychiatric Mental Health nurses to lead development and implementation of interventions, such as the CPK, with a strength-based approach to promote the knowledge and resilience of these children.

Applying ambiguous loss theory to children of parents with an opioid use disorder.

PROBLEM: Opioid use disorder (OUD) has reached epidemic proportions in the United States. Children of parents with OUD are an unrepresented population, who often suffer consequences from their parent's substance abuse disorder. Such children may incur numerous psychosocial and physical losses. Without intervention, they are more likely to be diagnosed with a mental illness and/or substance use disorder (SUD). METHODS: This paper examines the experiences of children of parents with OUD using Boss's theory of ambiguous loss (AL) as a lens. FINDINGS: Children growing up with a parent who has an OUD experience AL through that parent's physical absence and psychological presence (e.g., the parent is out opioid-seeking or in rehab or jail) and psychological absence but physical presence (e.g., the parent is high or in withdrawal, or is preoccupied with obtaining opioids). Evidence supports the fact that OUDs affect parenting, produce changes in the parent-child relationship, and often impact child development. Interventions that are child-focused are lacking. CONCLUSIONS: The application of AL theory to this problem can enhance health professionals' understanding and need for developmentally specific interventions to care for this population. Interventions should focus on diminishing stigma and promoting psychosocial wellness and resiliency for children of parents with an OUD.