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Kelly E, Pasquarella FJ, Davis L, Hunt A, Lee S, Fairhurst S, Giambone L, Murch L, Thorning H, Brekke JS. Managing substance use for clients with serious mental illnesses: Knowledge, attitude, and training challenges among outpatient behavioral health providers in California, Ohio, and New York. J Subst Abuse Treat 2021; 131:108547. [PMID: 34244012 DOI: 10.1016/j.jsat.2021.108547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/16/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Individuals with serious mental illness have high rates of substance use. The most commonly used substances among this population are alcohol and cannabis, and whether clinical providers delivering mental health services feel adequately prepared to address substance use is unclear. While information about the effects of alcohol are well established, the effects of cannabis are less well known and staff may feel less confident in their abilities to assess its use and may rely on more informal sources to learn about it. METHODS Mental health agencies in three states (California, Ohio, and New York) surveyed their staff (n =717) to explore their knowledge, training, and expertise in assessment of substance use generally as well as cannabis and alcohol specifically. RESULTS Overall, providers felt more prepared to address their clients' alcohol use than cannabis use. In between-state comparisons, California providers felt significantly less well prepared to assess, discuss, and refer their clients to treatment compared to Ohio and New York providers. Using a series of multi-categorical mediation models, we confirmed that deficits in training for these specific substances largely accounted for between-state differences in assessment, capacity, and treatment. CONCLUSIONS Substance use training to address the service needs of individuals with co-occurring disorders is insufficient and a significant need exists for systemic changes to workforce training of community mental health providers.
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Affiliation(s)
- Erin Kelly
- Department of Family and Community Medicine, Thomas Jefferson University, United States of America.
| | - Fred J Pasquarella
- Culver City Mental Health Services, Sepulveda Blvd, Los Angeles, CA, United States of America.
| | - Lisa Davis
- Center for Health Services and Society, University of California, Los Angeles, 10920 Wilshire Blvd # 300, Los Angeles, CA 90024, United States of America.
| | - Andrew Hunt
- Department of Psychiatry, Case Western University Hospitals, 10524 Euclid Ave, Cleveland, OH 44106, United States of America.
| | - Sae Lee
- Culver City Mental Health Services, Sepulveda Blvd, Los Angeles, CA, United States of America.
| | - Scott Fairhurst
- Pacific Clinics, 800 South Santa Anita Blvd, Arcadia, CA, United States of America.
| | - Leslie Giambone
- Mental Health America Los Angeles, East 7th Street, Long Beach, CA 90804, United States of America.
| | - Lezlie Murch
- Exodus Recovery, Incorporated, 9808 Venice Boulevard, Los Angeles 90232, United States of America.
| | - Helle Thorning
- Columbia University, Department of Psychiatry, New York, NY, United States of America.
| | - John S Brekke
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Montgomery Ross Fisher Building, Los Angeles, CA 90089, United States of America.
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An Instrument to Measure Mental Health Professionals' Beliefs and Attitudes towards Service Users' Rights. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020244. [PMID: 30654510 PMCID: PMC6352182 DOI: 10.3390/ijerph16020244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 11/16/2022]
Abstract
We aimed at developing and validating a scale on the beliefs and attitudes of mental health professionals towards services users' rights in order to provide a valid evaluation instrument for training activities with heterogeneous mental health professional groups. Items were extracted from a review of previous instruments, as well as from several focus groups which have been conducted with different mental health stakeholders, including mental health service users. The preliminary scale consisted of 44 items and was administered to 480 mental health professionals. After eliminating non-discriminant and low weighting items, a final scale of 25 items was obtained. Exploratory and confirmatory factor analyses produced a four-factor solution consisting of the following four dimensions; system criticism/justifying beliefs, freedom/coercion, empowerment/paternalism, and tolerance/discrimination. The scale shows high concordance with our theoretical model as well as adequate parameters of explained variance, model fit, and internal reliability. Additional work is required to assess the cultural equivalence and psychometrics of this tool in other settings and populations, including health students.
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