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Psychological Services

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https://www.readbyqxmd.com/read/28541067/vocational-rehabilitation-for-veterans-with-felony-histories-and-mental-illness-12-month-outcomes
#1
James P LePage, Avery A Lewis, April M Crawford, Edward L Washington, Julie A Parish-Johnson, Daisha J Cipher, Ledjona D Bradshaw
Lack of employment is an important barrier to successful reintegration encountered by those released from prison with mental illnesses and/or substance use disorders. This study compares 3 different vocational reintegration modalities for a veteran population: (a) basic services; (b) self-study using the About Face Vocational Manual; and (c) the About Face Vocational Program, a standardized group program focused on the About Face Vocational Manual. One-hundred eleven veterans with a history of at least one felony conviction and a mental illness and/or substance use disorder were recruited from a large urban Veterans Affairs (VA) medical center...
May 25, 2017: Psychological Services
https://www.readbyqxmd.com/read/28517951/treatment-as-usual-therapy-targets-for-comorbid-youth-disproportionately-focus-on-externalizing-problems
#2
Matthew Milette-Winfree, Charles W Mueller
This study examined whether psychological treatment for youth with comorbid externalizing and internalizing disorders targets externalizing rather than internalizing pathology. Therapist-reported treatment targets for youth (N = 679) with (a) only internalizing diagnoses (n = 195); (b) only externalizing diagnoses (n = 314); (c) a primary internalizing diagnosis and at least 1 additional externalizing diagnosis (n = 75); and (d) a primary externalizing diagnosis and at least 1 additional internalizing diagnosis (n = 95) receiving treatment-as-usual in a public mental health system of care were examined...
May 18, 2017: Psychological Services
https://www.readbyqxmd.com/read/28517950/gender-differences-in-service-utilization-among-operations-enduring-freedom-iraqi-freedom-and-new-dawn-veterans-affairs-patients-with-severe-mental-illness-and-substance-use-disorders
#3
Janelle M Painter, Emily Brignone, Amanda K Gilmore, Keren Lehavot, Jamison Fargo, Ying Suo, Tracy Simpson, Marjorie E Carter, Rebecca K Blais, Adi V Gundlapalli
Severe mental illness (SMI) and substance use disorders (SUD) are among the more chronic and costly mental health conditions treated in the Department of Veterans Affairs (VA). Service use patterns of returning veterans with SMI and SUD have received little attention. We examined gender differences in the utilization of VA services among a national sample of Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) VA patients with SMI, SUD, and their comorbidity (SMI/SUD) in their first year of established VA care (N = 24,166)...
May 18, 2017: Psychological Services
https://www.readbyqxmd.com/read/28517949/cognitive-behavioral-treatments-for-criminogenic-thinking-barriers-and-facilitators-to-implementation-within-the-veterans-health-administration
#4
Daniel M Blonigen, Allison L Rodriguez, Luisa Manfredi, Andrea Nevedal, Joel Rosenthal, James F McGuire, David Smelson, Christine Timko
Cognitive-behavioral treatments for criminogenic thinking (i.e., antisocial cognitions, attitudes, and traits) are regarded as best practices for reducing criminal recidivism among justice-involved adults. However, the barriers and facilitators to implementation of these treatments within large health care systems such as the Veterans Health Administration (VHA) are largely unknown. To address this gap, we conducted qualitative interviews with 22 Specialists from the VHA's Veterans Justice Programs who had been trained in a cognitive-behavioral treatment for criminogenic thinking (i...
May 18, 2017: Psychological Services
https://www.readbyqxmd.com/read/28493731/pilot-data-of-a-brief-veteran-peer-intervention-and-its-relationship-to-mental-health-treatment-engagement
#5
Elizabeth M Goetter, Eric Bui, Travis P Weiner, Laura Lakin, Thomas Furlong, Naomi M Simon
Underutilization of mental health care is a significant problem among veterans. Offering peer support may improve mental health care engagement. This observational pilot study was conducted using an institutional review board-approved data repository to preliminarily evaluate the association and potential impact of a clinic-based veteran peer outreach strategy on treatment engagement and dropout. Veteran peer outreach coordinators (VPOCs) provided systematic contact (a) within 1 week after clinical evaluation and (b) 1 month after the patient's first treatment session to patients entering treatment at a specialty mental health clinic that provides military-informed mental health care to post-9/11 veterans and service members...
May 11, 2017: Psychological Services
https://www.readbyqxmd.com/read/28493730/behavioral-health-services-in-urban-american-indian-health-organizations-a-descriptive-portrait
#6
Andrew Pomerville, Joseph P Gone
The federal Indian Health Service (IHS) is the primary funding source for health services designated for American Indians (AIs; Gone & Trimble, 2012). Urban Indian health organizations (UIHOs), funded in part by IHS, are typically the only sites in large metropolitan settings offering treatments tailored to AI health needs. This is a first look at how mental health treatment is structured at UIHOs. UIHO staff at 17 of 34 UIHOs responded to our request to participate (50%), 14 employed behavioral health program directors who could complete the survey on behalf of their programs, and 11 of these submitted complete data regarding their current treatment practices and personal attitudes toward empirically supported treatments...
May 11, 2017: Psychological Services
https://www.readbyqxmd.com/read/28481613/perceptions-of-masculinity-and-fatherhood-among-men-experiencing-homelessness
#7
Alexander Rice, Ji Youn Cindy Kim, Christopher Nguyen, William Ming Liu, Kevin Fall, Patrick Galligan
This study explored the perceptions of fatherhood held by 11 men living in a homeless shelter. Using consensual qualitative research methodology (CQR; Hill, 2012), we investigated perceptions of masculinity and fatherhood among fathers experiencing homelessness. Participants described (a) their perceptions of masculinity and fatherhood and changes resulting from homelessness, (b) physical and psychological challenges of being a father experiencing homelessness, and (c) expectations of homeless fathers. The fathers generally expressed feelings of low self-esteem related to their perceived difficulty fulfilling the role of providers for their family; however, they also adapted their view of fatherhood to include roles suited to their situation, such as that of guide, teacher, and role model...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481612/examining-the-bidirectional-association-between-veteran-homelessness-and-incarceration-within-the-context-of-permanent-supportive-housing
#8
Meagan Cusack, Ann Elizabeth Montgomery
Homelessness and incarceration share a bidirectional association: individuals experiencing homelessness are more likely to be incarcerated and former inmates are more likely to become homeless. Permanent supportive housing (PSH) programs have demonstrated positive outcomes for participants with criminal histories, yet participants continue to exit to jail or prison and experience subsequent homelessness. Using data on Veterans participating in a PSH program at 4 locations between 2011 and 2014 (N = 1,060), logistic regression was used to examine the risk factors for exiting PSH because of incarceration and returning to homelessness...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481611/intimate-partner-violence-unhealthy-alcohol-use-and-housing-instability-among-women-veterans-in-the-veterans-health-administration
#9
Melissa E Dichter, Clara Wagner, Sonya Borrero, Lauren Broyles, Ann Elizabeth Montgomery
Women U.S. military veterans face particularly high rates of homelessness, which may be associated with psychosocial experiences including unhealthy alcohol use and experience of intimate partner violence (IPV). In this study, we examined clinical social health screening data to assess the association between housing instability and (a) experience of past-year IPV victimization, and (b) unhealthy alcohol use among 554 women receiving primary care from the Veterans Health Administration. Approximately 12% of patients screened reported housing instability...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481610/exploring-the-potential-of-technology-based-mental-health-services-for-homeless-youth-a-qualitative-study
#10
Elizabeth C Adkins, Alyson K Zalta, Randy A Boley, Angela Glover, Niranjan S Karnik, Stephen M Schueller
Homelessness has serious consequences for youth that heighten the need for mental health services; however, these individuals face significant barriers to access. New models of intervention delivery are required to improve the dissemination of mental health interventions that tailor these services to the unique challenges faced by homeless youth. The purpose of this study was to better understand homeless youths' use of technology, mental health experiences and needs, and willingness to engage with technology-supported mental health interventions to help guide the development of future youth-facing technology-supported interventions...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481609/pathways-into-homelessness-among-post-9-11-era-veterans
#11
Stephen Metraux, Meagan Cusack, Thomas H Byrne, Nora Hunt-Johnson, Gala True
Despite the scale of veteran homelessness and government-community initiatives to end homelessness among veterans, few studies have featured individual veteran accounts of experiencing homelessness. Here we track veterans' trajectories from military service to homelessness through qualitative, semistructured interviews with 17 post-9/11-era veterans. Our objective was to examine how veterans become homeless-including the role of military and postmilitary experiences-and how they negotiate and attempt to resolve episodes of homelessness...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481608/risk-factors-for-diabetic-retinopathy-among-homeless-veterans
#12
John A Davis, Irena Tsui, Lillian Gelberg, Sonya Gabrielian, Martin L Lee, Evelyn T Chang
Homeless patients have high rates of visual impairment and lower rates of glycemic control than housed patients. Although diabetic retinopathy (DR) is the most common cause of new visual impairment and legal blindness in the developed world, little is known about differential risk factors for and rates of DR in homeless versus housed populations. This study aimed to compare the rates of DR between homeless and housed patients with diabetes at the Greater Los Angeles Veterans Affairs Health care System (GLA) and identify clinical and psychosocial predictors of DR rates...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481607/engagement-in-steps-of-advance-health-care-planning-by-homeless-veterans
#13
Patricia M Dubbert, Kimberly K Garner, Shelly Lensing, J Glen White, Dennis H Sullivan
Communicating health care preferences in advance, so that wishes can be honored if the person becomes unable to participate in decision-making, is especially important for vulnerable populations such as homeless veterans. Hospitals are required to inform patients of their rights to document their preferences, but completion rates for advance directives are low. Conceptualizing advance health care planning as a series of health behavior steps emphasizing communication is recommended for improving engagement in advance health care planning...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481606/characteristics-and-service-utilization-of-homeless-veterans-entering-va-substance-use-treatment
#14
Koriann B Cox, Carol A Malte, Andrew J Saxon
This article compares characteristics and health care utilization patterns of homeless veterans entering substance use disorder (SUD) treatment. Baseline self-report and medical record data were collected from 181 homeless veterans participating in a randomized trial of SUD/housing case management. Veterans, categorized as newly (n = 45), episodically (n = 61), or chronically homeless (n = 75), were compared on clinical characteristics and health care utilization in the year prior to baseline. Between-groups differences were seen in stimulant use, bipolar, and depressive disorders...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481605/one-year-incidence-and-predictors-of-homelessness-among-300-000-u-s-veterans-seen-in-specialty-mental-health-care
#15
Jack Tsai, Rani A Hoff, Ilan Harpaz-Rotem
The Department of Veterans Affairs (VA) is committed to preventing and ending homelessness among U.S. veterans, but there have been few estimates of the incidence of veteran homelessness and prospective studies to identify predictors of homelessness. This study examines the 1-year incidence of homelessness among veterans seen in VA specialty mental health clinics and identified sociodemographic and clinical predictors of homelessness. Using a retrospective cohort study design, data were extracted from the VA medical records of 306,351 veterans referred to anxiety and posttraumatic stress disorder clinics across 130 VA facilities from 2008-2012 and followed for 1 year after referral...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481604/cost-of-health-care-utilization-among-homeless-frequent-emergency-department-users
#16
Matthew S Mitchell, Casey L K León, Thomas H Byrne, Wen-Chieh Lin, Monica Bharel
Research demonstrates that homelessness is associated with frequent use of emergency department (ED) services, yet prior studies have not adequately examined the relationship between frequent ED use and utilization of non-ED health care services among those experiencing homelessness. There has also been little effort to assess heterogeneity among homeless individuals who make frequent use of ED services. To address these gaps, the present study used Medicaid claims data from 2010 to estimate the association between the number of ED visits and non-ED health care costs for a cohort of 6,338 Boston Health Care for the Homeless Program patients, and to identify distinct subgroups of persons in this cohort who made frequent use of ED services based on their clinical and demographic characteristics...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481603/comprehensive-services-delivery-and-emergency-department-use-among-chronically-homeless-adults
#17
David T Moore, Robert A Rosenheck
Homeless adults use emergency department (ED) services more frequently than other adults, but the relationships between homelessness, health status, outpatient service use, and ED utilization are poorly understood. Data from the Collaborative Initiative to Help End Chronic Homelessness (CICH) were used to compare ED use among chronically homeless adults receiving comprehensive housing, case management, mental health, addiction, and primary care services through CICH at 5 U.S. sites (n = 274) and ED use among comparison group clients receiving generally available community services (n = 116) at the same sites...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481602/a-national-evaluation-of-homeless-and-nonhomeless-veterans-experiences-with-primary-care
#18
Audrey L Jones, Leslie R M Hausmann, Gretchen L Haas, Maria K Mor, John P Cashy, James H Schaefer, Adam J Gordon
Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481601/no-wrong-door-can-clinical-care-facilitate-veteran-engagement-in-housing-services
#19
Erin E Johnson, Matthew Borgia, Jennifer Rose, Thomas P O'Toole
It is well established that providing stable housing to homeless persons improves health outcomes. It is less clear whether engagement in clinical care facilitates housing outcomes. We present a post hoc analysis of a prospective, community-based randomized controlled trial of homeless veterans not actively receiving or assigned to a primary care. Study subjects were interviewed at baseline, 1 month and 6 months and survey results were supplemented/verified by review of all notes in their VA electronic medical record for 6 months postenrollment...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481600/-they-re-homeless-in-a-home-retaining-homeless-experienced-consumers-in-supported-housing
#20
Sonya Gabrielian, Alison B Hamilton, Adrian Alexandrino, Gerhard Hellemann, Alexander S Young
Permanent, community-based housing with supportive services ("supported housing") has numerous favorable outcomes for homeless-experienced consumers. Little is known, however, about consumers who attain but subsequently lose their supported housing. Using mixed methods, we compared persons who retained their supported housing for at least 1 year ("stayers") with those who lost their supported housing within 1 year of move-in ("exiters"). Among persons housed through the VA Supported Housing (VASH) program at the VA Greater Los Angeles between 2011 and 2012, we queried VA homeless registry data to identify stayers (n = 1,558) and exiters (n = 85)...
May 2017: Psychological Services
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