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Franco Z, Ruffalo L, Curry B, Gollin-Graves M, Ahamed SI, Winstead O, Hooyer K, Pazdera M, Rein L, Lizarraga Mazaba J, Hossain MF, Stoffel V, Flower M, Madiraju P, Melka S, Berte K, Whittle J. Impact of veteran-led peer mentorship on posttraumatic stress disorder. J Trauma Stress 2024; 37:617-630. [PMID: 38635149 DOI: 10.1002/jts.23038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/05/2024] [Accepted: 03/23/2024] [Indexed: 04/19/2024]
Abstract
Peer mentorship shows promise as a strategy to support veteran mental health. A community-academic partnership involving a veteran-led nonprofit organization and institutions of higher education evaluated a collaboratively developed peer mentor intervention. We assessed posttraumatic stress disorder (PTSD), postdeployment experiences, social functioning, and psychological strengths at baseline, midpoint, and 12-week discharge using the PTSD Checklist for DSM-5 (PCL-5), Deployment Risk and Resilience Inventory-2, Social Adaptation Self-evaluation Scale, and Values in Action Survey. Brief weekly check-in surveys reinforced mentor contact and assessed retention. The sample included 307 veterans who were served by 17 veteran peer mentors. Mixed-effects linear models found a modest effect for PTSD symptom change, with a mean PCL-5 score reduction of 4.04 points, 95% CI [-6.44, -1.64], d = 0.44. More symptomatic veterans showed a larger effect, with average reductions of 9.03 points, 95% CI [-12.11, -5.95], d = 0.77. There were no significant findings for other outcome variables. Compared to younger veterans, those aged 32-57 years were less likely to drop out by 6 weeks, aORs = 0.32-0.26. Week-by-week hazard of drop-out was lower with mentors ≥ 35 years old, aHR = 0.62, 95% CI [0.37, 1.05]. Unadjusted survival differed by mentor military branch, p = .028, but the small mentor sample reduced interpretability. Like many community research efforts, this study lacked a control group, limiting the inferences that can be drawn. Continued study of veteran peer mentorship is important as this modality is often viewed as more tolerable than therapy.
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Affiliation(s)
- Zeno Franco
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Leslie Ruffalo
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Bob Curry
- Great Lakes Dryhootch, Milwaukee, Wisconsin, USA
| | | | - Sheikh Iqbal Ahamed
- Department of Computer Science, Marquette University, Milwaukee, Wisconsin, USA
| | | | - Katinka Hooyer
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Myah Pazdera
- Office of Community Engagement, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lisa Rein
- Institute for Health & Equity, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jose Lizarraga Mazaba
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Md Fitrat Hossain
- Department of Computer Science, Marquette University, Milwaukee, Wisconsin, USA
| | - Virginia Stoffel
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Mark Flower
- Mental Health America of Wisconsin, Milwaukee, Wisconsin, USA
| | - Praveen Madiraju
- Department of Computer Science, Marquette University, Milwaukee, Wisconsin, USA
| | - Stephen Melka
- Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA
| | - Karen Berte
- Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA
| | - Jeffrey Whittle
- Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA
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Hoover GG, Teer A, Lento R, Ward P, Zakarian RJ, Tinney W, Sanders W, Echevarria K, Bonvie J, Dunford K, Covitz J, Tanev KS. Innovative outpatient treatment for veterans and service members and their family members. Front Psychiatry 2024; 15:1377433. [PMID: 39114738 PMCID: PMC11303280 DOI: 10.3389/fpsyt.2024.1377433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
In 2009, Massachusetts General Hospital and the Red Sox Foundation launched Home Base, a nonprofit dedicated to providing care to veterans, service members, and their loved ones who struggle with the invisible wounds of war free of charge. Significant needs exist for mental health services in each of these populations, and a need for innovative approaches to address shortcomings in existing treatment models. Three inventive components of our programming are highlighted herein: a Veteran Outreach Team, which helps to engage patients in care, programming, and services specifically for family members, and an intensive outpatient substance use treatment program. More than 4,000 patients, 3,031 veterans and service members, and 1,025 family members have engaged in treatment at Home Base. Patients were asked to complete post-treatment self-measures, including a satisfaction questionnaire via an electronic data collection system. The vast majority of individuals who engaged in our treatment model were satisfied with the care they received (>92%) and would refer their peers to the Home Base program (>75%). Data from 78 individuals who completed the dual diagnosis services demonstrated large effect sizes in reductions in alcohol use and comorbid mental health symptoms. These data suggest that novel components to the standard outpatient mental health model might provide substantive benefits for the patients served. While internal data is prone to a lack of generalizability, these additional offerings help ameliorate patients' expressed shortcomings with existing models; present literature that describes the benefits that these additions provide is also reviewed. The lessons learned and limitations are discussed.
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Hinton M, Metcalf O, Varker T, Roebuck G, McGaw V, Watson L, Fredrickson J, Johnson L, Forbes D, Phelps A, Kartal D, Dell L, Bryant R, McFarlane AC, Hopwood M, O'Donnell M. A Qualitative Study of the Expectations, Experiences, and Perceptions That Underpin Decisions Regarding PTSD Treatment in Help-seeking Veterans. Mil Med 2023; 188:e2234-e2241. [PMID: 36433752 DOI: 10.1093/milmed/usac374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/06/2022] [Accepted: 11/14/2022] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION A range of evidence-based treatments are available for PTSD. However, many veterans with PTSD do not engage in these treatments. Concurrently, various novel PTSD treatments with little or no evidence based are increasingly popular among veterans. This qualitative study explored the expectations, experiences, and perceptions of help-seeking veterans with PTSD to improve understanding of how these veterans make treatment decisions. MATERIALS AND METHODS Fifteen treatment-seeking veterans with PTSD participated in the study. Participants took part in semi-structured interviews. Data were analyzed using interpretative phenomenological analysis. RESULTS A number of themes and subthemes emerged from the data, providing a detailed account of the factors that influenced participants' treatment decisions. Most participants were in an acute crisis when they made the initial decision to seek treatment for their PTSD. In choosing a specific treatment, they tended to follow recommendations made by other veterans or health professionals or orders or directions from their superiors, health providers, or employers. Few participants actively considered the scientific evidence supporting different treatments. Participants had a strong preference for treatment provided by or involving other veterans. They reported finding PTSD treatments helpful, although some were not convinced of the value of evidence-based treatments specifically. Many participants reported negative experiences with treatment providers. CONCLUSIONS These findings will inform strategies to improve engagement of veterans in evidence-based PTSD treatments and advance progress toward veteran-centered care.
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Affiliation(s)
- Mark Hinton
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Olivia Metcalf
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Tracey Varker
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Greg Roebuck
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Violette McGaw
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Loretta Watson
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Julia Fredrickson
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Lucinda Johnson
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - David Forbes
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Andrea Phelps
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Dzenana Kartal
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Lisa Dell
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Kensington, NSW 2052, Australia
| | - Alexander C McFarlane
- Adelaide Medical School, University of Adelaide, Adelaide Health and Medical Sciences building, Adelaide, SA 5000, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne, Parkville, VIC 3010, Australia
| | - Meaghan O'Donnell
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia
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Carson LM, Marsh SM, Brown MM, Elkins KL, Tiesman HM. An analysis of suicides among first responders ─ Findings from the National Violent Death Reporting System, 2015-2017. JOURNAL OF SAFETY RESEARCH 2023; 85:361-370. [PMID: 37330885 PMCID: PMC11284622 DOI: 10.1016/j.jsr.2023.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/06/2022] [Accepted: 04/18/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION First responders, including law enforcement officers (LEOs), firefighters, emergency medical services (EMS) clinicians, and public safety telecommunicators, face unique occupational stressors and may be at elevated risk for suicide. This study characterized suicides among first responders and identifies potential opportunities for additional data collection. METHODS Using suicides identified from the three most recent years of National Violent Death Reporting System data with industry and occupation codes from the NIOSH Industry and Occupation Computerized Coding System (2015-2017), decedents were categorized as first responders or non-first responders based on usual occupation. Chi-square tests were used to evaluate differences in sociodemographic and suicide circumstances between first and non-first responders. RESULTS First responder decedents made up 1% of all suicides. Over half of first responders (58%) were LEOs, 21% were firefighters, 18% were EMS clinicians, and 2% were public safety telecommunicators. Compared to non-first responder decedents, more first responders served in the military (23% vs. 11%) and used a firearm as the method of injury (69% vs. 44%). Among first responder decedents for whom circumstances were known, intimate partner problems, job problems, and physical health problems were most frequent. Some common risk factors for suicide (history of suicidal thoughts, previous suicide attempt, alcohol/substance abuse problem) were significantly lower among first responders. Selected sociodemographics and characteristics were compared across first responder occupations. Compared to firefighters and EMS clinicians, LEO decedents had slightly lower percentages of depressed mood, mental health problems, history of suicidal thoughts, and history of suicide attempts. CONCLUSIONS While this analysis provides a small glimpse into some of these stressors, more detailed research may help inform future suicide prevention efforts and interventions. PRACTICAL APPLICATION Understanding stressors and their relation to suicide and suicidal behaviors can facilitate suicide prevention among this critical workforce.
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Affiliation(s)
- Leslie M Carson
- National Highway Traffic Safety Administration, Office of Impaired Driving and Occupant Protection, Impaired Driving Division, Washington, DC, USA
| | - Suzanne M Marsh
- National Institute for Occupational Safety and Health, Division of Safety Research, Surveillance and Field Investigations Branch, Morgantown, WV, USA.
| | - Margaret M Brown
- National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| | - Katherine L Elkins
- National Highway Traffic Safety Administration, Office of Emergency Medical Services, EMS and National 911 Programs, Washington, DC, USA
| | - Hope M Tiesman
- National Institute for Occupational Safety and Health, Division of Safety Research, Analysis and Field Evaluations Branch, Morgantown, WV, USA
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Murray SJ, Cancio LC. The Phenomenon of Community Reintegration for Veterans with Burn Injury: Supportive Communities and Future-Oriented Thinking. J Burn Care Res 2023; 44:555-562. [PMID: 31808802 DOI: 10.1093/jbcr/irz198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Indexed: 11/14/2022]
Abstract
Combat missions in the Middle East have resulted in approximately 52,000 U.S. veterans who have been wounded in action, with 10% of whom suffered burn injuries. More than 90% of the wounded survived, but many were unable to return to military service. The purpose of this study was to investigate the factors that impacted reintegration of veterans with combat burn injuries. Using a mixed-methods approach and analysis, we asked veterans with combat burns "What was your experience reintegrating into the civilian community?" Additionally, we administered the Community Reintegration of Injured Service Members (CRIS) tool to measure the current level of reintegration. Six veterans with combat burn injury identified two major themes: supportive communities and future-oriented thinking. Supportive communities are defined as communities that are veteran-specific, provide long-term burn/injury care, are financially beneficial, and support hobbies, education, and work opportunities. Future-oriented thinking is defined as thinking in which a veteran experiences a turning point in recovery, has a desire to serve others, develops new meaning in life, and experiences posttraumatic growth. In both themes, peer support was a key component. Community reintegration was enhanced by future-oriented thinking and a supportive community, both of which can be buoyed by peer support. These findings are similar to other studies noting the importance of peer support for veterans. Studies of civilians burn survivors describe similar reintegration issues. These two factors may also be applicable to those survivors. Further qualitative inquiry into peer support in the burn community at large may reveal more actionable evidence which could enable burn survivors to meet the long-term goal of community reintegration.
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Affiliation(s)
- Sarah J Murray
- US Army Institute of Surgical Research Burn Center, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315
| | - Leopoldo C Cancio
- US Army Institute of Surgical Research Burn Center, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315
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Åkerblom KB, Ness O. Peer Workers in Co-production and Co-creation in Mental Health and Substance Use Services: A Scoping Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:296-316. [PMID: 36396756 PMCID: PMC9931804 DOI: 10.1007/s10488-022-01242-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
People with lived experience of mental health challenges are extensively employed as peer workers within mental health and substance use services worldwide. Research shows that peer workers benefit individuals using such services and can have essential roles in developing recovery-oriented services. However, understanding how peer workers' contributions, by their role, functions, and input can be better used remains a critical challenge. Research on public sector innovation has focused on relevant actors collaborating to tackle complex demands. Co-production and co-creation are concepts used to describe this collaboration. Co-production refers to the collaboration between providers and users at the point of service delivery, whereas co-creation refers to collaboration starting in the early service cycle phases (e.g., in commissioning or design), including solution implementation. We overviewed research literature describing peer workers' involvement in mental health and substance use services. The research question is as follows: How are peer workers involved in co-production and co-creation in mental health and substance use services, and what are the described outcomes? A literature search was performed in 10 different databases, and 13,178 articles were screened, of which 172 research articles describing peer workers' roles or activities were included. The findings show that peer workers are involved in co-production and function as providers of pre-determined services or, most often, as providers of peer support. However, they are rarely engaged as partners in co-creation. We conclude that the identified peer worker roles have different potential to generate input and affect service delivery and development.
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Affiliation(s)
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
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Ha J, Kim Y. Surviving Child Abuse in People With Mental Illness: A Grounded Theory Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2828-2849. [PMID: 35574841 DOI: 10.1177/08862605221102486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this qualitative study was to examine the process of surviving child abuse in people with a mental illness in order to develop an explanatory theory. The study utilized the grounded theory approach. Seventeen community-dwelling adults with a mental illness who had experienced child abuse were interviewed. For the in-depth interview, the lifeline interview method was used. Data were collected from July 14, 2019, to February 28, 2020. The constant comparative method was used for analysis, to identify similarities and differences between different statements, and similar phenomena or theories were compared and analyzed continuously. The central phenomena were "losing oneself" and "in a precarious state." Participants used "expressing," "standing on one's own feet," and "avoiding" as coping strategies. Observed outcomes were "making life work for them" and "living with others." The core category was "losing myself, embracing myself as someone in a precarious state, and being reborn as the master of my life." Positive religious coping, having a supportive network, and emotional or physical distance from difficult situations played a major role in surviving participants' experiences of child abuse and being victimized because of their mental illness. Our findings provide a theoretical basis for understanding people with mental illness who have survived child abuse, and suggest that opportunities for sharing their stories, facilitating self-reliance, and avoiding the causes of their difficulties all play a role in their healing process. Based on this study, it is expected that clinical experts and policy developers will be able to formulate evidence-based interventions and policies.
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Affiliation(s)
- Jeongmin Ha
- College of Nursing, 34940Dong-A University, Busan, Korea
| | - Yoonjung Kim
- Faculty of Red Cross College of Nursing, 26729Chung-Ang University, Seoul, Korea
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Geraci JC, Finley EP, Edwards ER, Frankfurt S, Kurz AS, Kamdar N, Vanneman ME, Lopoo LM, Patnaik H, Yoon J, Armstrong N, Greene AL, Cantor G, Wrobleski J, Young E, Goldsmith M, Seim RW, Goodman M. Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness-implementation trial. Implement Sci 2022; 17:43. [PMID: 35804354 PMCID: PMC9264302 DOI: 10.1186/s13012-022-01212-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The USA is undergoing a suicide epidemic for its youngest Veterans (18-to-34-years-old) as their suicide rate has almost doubled since 2001. Veterans are at the highest risk during their first-year post-discharge, thus creating a "deadly gap." In response, the nation has developed strategies that emphasize a preventive, universal, and public health approach and embrace the value of community interventions. The three-step theory of suicide suggests that community interventions that reduce reintegration difficulties and promote connectedness for Veterans as they transition to civilian life have the greatest likelihood of reducing suicide. Recent research shows that the effectiveness of community interventions can be enhanced when augmented by volunteer and certified sponsors (1-on-1) who actively engage with Veterans, as part of the Veteran Sponsorship Initiative (VSI). METHOD/DESIGN The purpose of this randomized hybrid type 2 effectiveness-implementation trial is to evaluate the implementation of the VSI in six cities in Texas in collaboration with the US Departments of Defense, Labor and Veterans Affairs, Texas government, and local stakeholders. Texas is an optimal location for this large-scale implementation as it has the second largest population of these young Veterans and is home to the largest US military installation, Fort Hood. The first aim is to determine the effectiveness of the VSI, as evidenced by measures of reintegration difficulties, health/psychological distress, VA healthcare utilization, connectedness, and suicidal risk. The second aim is to determine the feasibility and potential utility of a stakeholder-engaged plan for implementing the VSI in Texas with the intent of future expansion in more states. The evaluators will use a stepped wedge design with a sequential roll-out to participating cities over time. Participants (n=630) will be enrolled on military installations six months prior to discharge. Implementation efforts will draw upon a bundled implementation strategy that includes strategies such as ongoing training, implementation facilitation, and audit and feedback. Formative and summative evaluations will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and will include interviews with participants and periodic reflections with key stakeholders to longitudinally identify barriers and facilitators to implementation. DISCUSSION This evaluation will have important implications for the national implementation of community interventions that address the epidemic of Veteran suicide. Aligned with the Evidence Act, it is the first large-scale implementation of an evidence-based practice that conducts a thorough assessment of TSMVs during the "deadly gap." TRIAL REGISTRATION ClinicalTrials.gov ID number: NCT05224440 . Registered on 04 February 2022.
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Affiliation(s)
- Joseph C Geraci
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA. .,Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA. .,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Erin P Finley
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, New York, USA
| | - Emily R Edwards
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheila Frankfurt
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Central Texas Veterans Healthcare System, Temple, TX, USA
| | - A Solomon Kurz
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA
| | - Nipa Kamdar
- Center for Innovations in Quality, Effectiveness and Safety, VA, VA, Houston, USA
| | - Megan E Vanneman
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Leonard M Lopoo
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - Hannah Patnaik
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - Jean Yoon
- VA Health Economics Resource Center, VA Palo Alto Healthcare System, Livermore, CA, USA.,Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, CA, USA
| | - Nicholas Armstrong
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Ashley L Greene
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gilly Cantor
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Joseph Wrobleski
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA
| | - Erin Young
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA.,Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Matthew Goldsmith
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA
| | - Richard W Seim
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA
| | - Marianne Goodman
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Laban-Sharman A, Majumdar A. Self-Care practices for anxiety during the COVID-19 pandemic in the UK in adults. Ment Health (Lond) 2021. [DOI: 10.32437/mhgcj.v4i1.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction. The National Health Service cannot chronically sustain the overwhelming demands being placed on it due to financial cuts, staff numbers and presence of Covid-19. As a result, anxiety levels are on the rise thus increasing the need for effective self-care behaviors.Purpose: The purpose of this study was to comprehend and acknowledge the profound influence Covid-19 has had on anxiety levels and explore what behaviors people engage in to manage their perceived stress levels themselves.Methodology: This study was an exploratory mixed-methods design consisting of 110 self-referred adults aged 18-65 with anxiety completed an online survey guided by the “Harvard Anxiety and Depression Scale”. Data collected from the free-text questions were analyzed using the thematic analyses method to evoke the most relevant themes and generate an evidence-based narrative.Results and Discussion: Self-care behaviors used for anxiety self-management pre and during lockdown were walks, virtual family/social peer support, cooking and aerobic exercise. Additionally, it was apparent that a lack of ongoing family/social support was a key predictor for the proclivity of anxiety-inducing thoughts to be experienced. Interestingly, individuals who continually engaged in activity experienced positive mood states irrespective of the current lockdown environment.Conclusion: This study adds to novel literature on the current anxiety levels of adults living in the UK under the Covid-19 pandemic and what self-care behaviors people implement to self-manage their anxiety levels. This study stresses the significance of ongoing peer support as a self-care behavior that can act as a positive meditator for healthy cognitive processes to ensue. Therefore, future self-care programs advocating this strategy may, if not prevent, slow down the rising cases of anxiety and ill mental health due to the uncertain environment of Covid-19
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Mikolas C, Pike A, Jones C, Smith-MacDonald L, Lee M, Winfield H, Griffiths J, Perry R, Olson DM, Heber A, Olson J, Sevigny PR, Brémault-Philips S. Resilient Parents… Resilient Communities: A Pilot Study Trialing the Bounce Back and Thrive! Resilience-Training Program With Military Families. Front Psychol 2021; 12:651522. [PMID: 34349696 PMCID: PMC8328436 DOI: 10.3389/fpsyg.2021.651522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction The resilience of Canadian military families (CMFs) - the main support of the Canadian Armed Forces service members (SMs) - is imperative. The Canadian Armed Forces aims to ensure that SMs and their families are resilient and SMs ready to respond when called upon for combat, peacekeeping or pandemic/disaster-response. Family concerns, however, can realistically distract SMs from the mission, potentially compromising themselves, their unit and the mission. Resilience-training programs such as Bounce Back and Thrive! (BBT) can help families manage the realities of military life. Objective This pilot study aimed to evaluate suitability of BBT implementation by Military Family Resource Centers (MFRCs), including whether BBT: (1) fosters resilience-building among parents, (2) facilitates CMF resilience-building, (3) can be contextualized for CMFs, and (4) supports MFRCs in cultivating a culture of resilience. Methods An exploratory qualitative design was used. BBT was offered to parents face-to-face. Participants completed focus groups after the first 6 sessions, final 4 sessions, and one-year post-intervention. Data was thematically analyzed. Results Nine military parents participated. Four major themes resulted: (1) military parent resilience-building, (2) CMF resilience-building, (3) BBT program feedback and contextualization, and (4) MFRCs as community resilience hubs. Discussion BBT enabled parents to gain a new perspective on resilience, engage in dialogue and intentionally role model resilience skills. Military-specific BBT contextualization and online-delivery formats would increase suitability and access for CMFs. Access to resilience programs delivered through MFRCs would support CMFs. Further research is warranted.
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Affiliation(s)
- Cynthia Mikolas
- Military Family Resource Centre, Canadian Forces Base Edmonton, Edmonton, AB, Canada.,Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ashley Pike
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,1 Field Ambulance, Canadian Forces Health Services, Canadian Forces Base Edmonton, Edmonton, AB, Canada.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Melina Lee
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Hope Winfield
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Royal Canadian Chaplain Service, Canadian Forces Health Services, Canadian Forces Base Edmonton, Edmonton, AB, Canada
| | - Jennifer Griffiths
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ryan Perry
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - David M Olson
- Department of Obstetrics & Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Alexandra Heber
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Joanne Olson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Phillip R Sevigny
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Philips
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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11
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Strategies Used to Support Peer Provision in Mental Health: A Scoping Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:1034-1045. [PMID: 33655461 DOI: 10.1007/s10488-021-01118-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
The employment of peer providers (people who draw on their lived experience of mental health challenges) has grown in conjunction with the increased acceptance of recovery as a key principle in mental health policy and practice. Barriers to the integration of peer providers in mental health services have been well documented. This review addresses an under-explored area by consolidating strategies undertaken by mental health organizations for the successful implementation of peer provision. A scoping review was chosen to facilitate the rapid summary and dissemination of research findings that are relevant to policymakers and practitioners. Peer-reviewed articles and grey literature were sourced from three databases, key peer support websites and a hand search of the included studies. Following screening, data were extracted from 28 studies: 25 qualitative and three mixed methods studies. The data were analyzed using thematic analysis and organized into themes. Four themes emerged from the data. Championing of peer provision initiatives by organizational leadership is central to the success and sustainability of peer provision. Leadership undergirds three strategies that were discussed: organizational preparation, recruitment, training and induction, and support and development. When peer provision is championed by organizational leadership, measures can be undertaken to prepare the organization for peer provision; recruit, train and induce peer providers successfully into the organization; and support peer providers on the job.
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12
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Arenson M, Bernat E, De Los Reyes A, Neylan TC, Cohen BE. Social support, social network size, and suicidal ideation: A nine-year longitudinal analysis from the Mind Your Heart Study. J Psychiatr Res 2021; 135:318-324. [PMID: 33545566 DOI: 10.1016/j.jpsychires.2021.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Substantial research has investigated the impact of social support on the development and course of suicidal thoughts and behaviors. However, its measurement has been inconsistent, and different facets of social support may have differential effects on suicidal ideation (SI). The present study used data from 743 veterans recruited between 2008 and 2010 as part of the Mind Your Heart Study to investigate the relationship between two aspects of social support (social network size and perceived social support) and SI over 9 years. Using the 9th item of the PHQ-9, we created two composite scores: (1, chronicity) the proportion of years the participant endorsed SI and (2, severity) the severity of SI across the follow-up period. We found that, when modeled individually, both larger social network size and greater perceived social support predicted lower SI chronicity (β=-.16, β = -0.19 respectively; ps < .001) and lower SI severity (β=-0.15 and β = -0.19, respectively; ps < .001). However, when modeled together and controlling for PTSD and depression symptoms, increased social network size but not perceived social support predicted lower SI chronicity (β=-0.09, p = .01 and β = 0.02, p = .48, respectively) and SI severity (β=-0.07, p = .045 and β = 0.01, p = .71, respectively). These findings suggest that social network size may be an important target for intervention, and that future work is needed to better delineate the effect of different features of social support on risk for suicide.
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Affiliation(s)
- Melanie Arenson
- University of Maryland, College Park, 4094 Campus Drive, Campus Park, MD, 20742, USA; San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA.
| | - Edward Bernat
- University of Maryland, College Park, 4094 Campus Drive, Campus Park, MD, 20742, USA
| | - Andres De Los Reyes
- University of Maryland, College Park, 4094 Campus Drive, Campus Park, MD, 20742, USA
| | - Thomas C Neylan
- San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA; University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Beth E Cohen
- San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA; University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
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13
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Austin G, Calvert T, Fasi N, Fuimaono R, Galt T, Jackson S, Lepaio L, Liu B, Ritchie D, Theis N, Dockerty J, Doolan-Noble F, McBride D. Soldiering on only goes so far: How a qualitative study on Veteran loneliness in New Zealand influenced that support during COVID-19 lockdown. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2020. [DOI: 10.3138/jmvfh-co19-0007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: On April 25, 2020, Veterans’ Affairs in New Zealand (NZ) contacted approximately 3,000 of 8,000 known military Veterans by phone during the SARS-CoV-2 pandemic to ensure they were safe during the government-imposed lockdown. The impetus to this initiative were the findings of a cross-sectional quantitative survey of NZ Veterans, followed by the qualitative survey reported here, both carried out in 2019. The former report found 33% of 89 respondents were lonely and reported barriers to seeking support, and over half of Veterans felt uncomfortable accessing it. Methods: To understand the factors underlying loneliness, a qualitative survey was developed based on the barriers previously identified and a literature review. A purposeful sample based on gender, age, and ethnicity identified 20 respondents from the initial survey: 10 lonely and 10 non-lonely. Interviews were followed by an inductive thematic analysis, and themes and sub-themes were developed. Results: Ten of the 20 potential participants responded: 6 lonely and 4 non-lonely. Social and geographic isolation, problems with re-integration into the civilian community, and health problems were found to contribute to Veteran loneliness. Social connectedness, particularly to service peers, was the primary mitigating factor. Barriers included stoicism and perceptions of ineffective and inaccessible services. Inequity in the Veteran support system also emerged as a barrier for Veterans who had not deployed on operational missions. Discussion: During the pandemic, social connectedness will have decreased, and loneliness increased. Designing interventions with these factors in mind, and ensuring equity of access to support, should help combat Veteran loneliness.
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Affiliation(s)
- Guy Austin
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Toby Calvert
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Natasha Fasi
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Ryder Fuimaono
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Timothy Galt
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Sam Jackson
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Leanda Lepaio
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Ben Liu
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Darren Ritchie
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - Nicolas Theis
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
| | - John Dockerty
- Department of Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Fiona Doolan-Noble
- Department of General Practice and Rural Health, University of Otago, Dunedin, Otago, New Zealand
| | - David McBride
- Otago Medical School, University of Otago, Dunedin, Otago, New Zealand
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14
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Venter D. Angolan battlefield tourism: Impact on the quality-of-life of South African Defence Force (SADF) veterans. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1821986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Dewald Venter
- Faculty of Human Sciences, Vaal University of Technology, Vanderbijlpark, South Africa
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15
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Wykes T, Evans J. Gender diversity in the Journal of Mental Health - how are we doing and what do we need to do? J Ment Health 2020; 29:493-495. [PMID: 32191147 DOI: 10.1080/09638237.2020.1739254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jo Evans
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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16
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Jones S, Agud K, McSweeney J. Barriers and Facilitators to Seeking Mental Health Care Among First Responders: "Removing the Darkness". J Am Psychiatr Nurses Assoc 2020; 26:43-54. [PMID: 31509058 DOI: 10.1177/1078390319871997] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: First responders (FRs) are at significant risk for developing mental health (MH) problems due to the nature, frequency, and intensity of duty-related traumatic exposure. However, their culture strongly esteems strength and self-reliance, which often inhibits them from seeking MH care. AIMS: This study explored factors that influenced FRs' perceptions of MH problems and engagement in MH services. METHODS: A community-based approach and individual ethnographic qualitative interviews were used. Recruitment of a convenience sample of firefighters and emergency medical technicians/paramedics from across Arkansas was facilitated by our community partners. Interviews were analyzed using content analysis and constant comparison. RESULTS: Analysis generated three broad factors that influenced FRs' perception of MH problems and engagement in MH services: (a) Knowledge, (b) Barriers to help-seeking, and (c) Facilitators to help-seeking. Knowledge was an overarching factor that encompassed barriers and facilitators: A lack of knowledge was a barrier to help-seeking but increased knowledge served as a facilitator. Barriers included five subthemes: Can't show weakness, Fear of confidentiality breech, Therapist: negative experience, Lack of access and availability, and Family burden. Facilitators included five subthemes: Realizing "I'm not alone," Buy-in, Therapist: positive experience, Problems got too bad, and Recommendations. CONCLUSIONS: Findings provide unique perspectives from FRs about how to best address their MH needs. First responders, as well as mental health care providers, need a more thorough understanding of these issues in order to mitigate barriers and facilitate help-seeking. As advocates, educators, and health care providers, psychiatric nurses are well-positioned to care for this at-risk population.
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Affiliation(s)
- Sara Jones
- Sara Jones, PhD, APRN, PMHNP-BC, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Katherine Agud
- Katherine Agud, BS, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jean McSweeney
- Jean McSweeney, PhD, RN, FAAN, University of Arkansas for Medical Science, Little Rock, AR, USA
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17
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Roberts GA, Arnold R, Turner JE, Colclough M, Bilzon J. A Longitudinal Examination of Military Veterans' Invictus Games Stress Experiences. Front Psychol 2019; 10:1934. [PMID: 31507492 PMCID: PMC6715114 DOI: 10.3389/fpsyg.2019.01934] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/06/2019] [Indexed: 02/05/2023] Open
Abstract
This study explored patterns of change in stress variables (i.e., stressors, appraisals, emotions) encountered by wounded, injured, and sick military veterans in the build up to, during, and following an international sporting competition. The study also examined interactions between psychosocial variables and salivary biomarkers of stress and how these relate to veterans’ health, well-being, illness, and performance. 40 Invictus Games (IG) athletes and a control group of 20 military veteran athletes completed questionnaires at seven time points over a 12-week period. Furthermore, participants provided morning and evening saliva samples at four time points to measure cortisol and secretory immunoglobulin A. Multilevel growth curve analyses revealed significant changes in growth trajectories of stress-related variables. For example, team and culture stressors and anger and dejection emotions significantly increased in the build up to competition, whilst challenge appraisals and excitement and happiness emotions significantly decreased over the same time-frame. A number of the stress related variables also predicted performance, well-being, and mental health. Specifically, organizational stressors and threat appraisals were found to negatively relate to performance, well-being, and mental health. Furthermore, whilst challenge appraisals and problem focused coping positively related to veterans’ well-being, adopting emotion-focused and avoidance coping strategies negatively predicted well-being and mental health. Turning to emotions, experiencing anger, anxiety, and dejection negatively related to mental health, well-being and performance; whereas happiness and excitement displayed a positive relationship with these outcomes. The findings also highlighted that organizational stressor intensity was positively related to cortisol exposure at competition. To conclude, this study not only provides a novel, longitudinal, interdisciplinary insight into psychological and biological markers of the stress response as it relates to the performance, health, and well-being of military veterans, but also further contributes to theoretical understanding on the transactional nature of stress. Moreover, the findings significantly contribute to practice regarding how best to support this unique population in adaptively responding to and engaging with competitive sport.
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Affiliation(s)
| | - Rachel Arnold
- Department for Health, University of Bath, Bath, United Kingdom
| | - James E Turner
- Department for Health, University of Bath, Bath, United Kingdom
| | | | - James Bilzon
- Department for Health, University of Bath, Bath, United Kingdom
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18
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Gillard S. Peer support in mental health services: where is the research taking us, and do we want to go there? J Ment Health 2019; 28:341-344. [PMID: 31070066 DOI: 10.1080/09638237.2019.1608935] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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19
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Cleary M, Raeburn T, Escott P, West S, Lopez V. 'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making. Int J Ment Health Nurs 2018; 27:1266-1272. [PMID: 29741237 DOI: 10.1111/inm.12474] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 11/27/2022]
Abstract
In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers' participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care.
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Affiliation(s)
- Michelle Cleary
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia
| | - Toby Raeburn
- Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia
| | - Phil Escott
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia.,Sydney Local Health District Mental Health Service, Sydney, New South Wales, Australia
| | - Sancia West
- School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia
| | - Violeta Lopez
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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