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Luna MJ, Abram KM, Aaby DA, Welty LJ, Teplin LA. Inequities in Mental Health Services: A 16-Year Longitudinal Study of Youth in the Justice System. J Am Acad Child Adolesc Psychiatry 2024; 63:422-432. [PMID: 37516236 PMCID: PMC10818024 DOI: 10.1016/j.jaac.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To examine: (1) if youth who have mental health disorders receive needed services after they leave detention-and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder. METHOD We used data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents. RESULTS Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI: 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97). CONCLUSION Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services.
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Affiliation(s)
- María José Luna
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen M Abram
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David A Aaby
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah J Welty
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Linda A Teplin
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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Ow N, Marchand K, Liu G, Mallia E, Mathias S, Sutherland J, Barbic SP. Patterns of service utilization among youth with substance use service need: a cohort study. Subst Abuse Treat Prev Policy 2023; 18:62. [PMID: 37924116 PMCID: PMC10623844 DOI: 10.1186/s13011-023-00572-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Integrated youth services (IYS) are vital to addressing the needs of youth who use substances. Evidence on the characteristics of youths accessing these services and the types of services accessed have been limited. The objectives were to identify sociodemographic, self-reported health and mental health, patterns of service utilization (service type and frequency of visits) among youths with different levels of substance use service needs (low, moderate, and high), and to estimate the extent to which substance use service needs, self-reported health and mental health influenced the frequency of visits and types of service utilized. METHODS Data were collected from youth (12-24 years) accessing IYS centres in Canada. Information on socio-demographic factors, substance use in the last month, self-rated health measures, number of service visits, and type of services utilized were included. Poisson regression was used to estimate the relationship between substance use needs and number of service visits and the different type of services utilized. RESULTS Of 6181 youths, 48.0% were categorized as low substance use service needs, 30.6% had moderate needs and 21.4% had high needs, with higher proportion of men in the high needs group. Mental health and substance use (MHSU) services were utilized the most across all three groups, followed by counseling. The median number of visits was 4 for the low and moderate needs group and 5 in the high needs group. People with high service needs had 10% higher rate of service visits and utilized 10% more services than people with low service needs (service visits: RR = 1.1 (95%CI: 1.1-1.2); service type: RR = 1.1 (95%CI:1.0-1.1)). The rate of service visits increased by 30 to 50% and the number of services increased by 10-20% for people who rated their health good/fair/poor. Similarly, the rate of service visits increased by 40 to 60% and the number of services increased by 20% for people who rated their mental health good/fair/poor. CONCLUSIONS AND IMPACTS Our study highlighted that regardless of service needs, youth who use alcohol and drugs have complex intersecting needs that present once they access integrated youth services.
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Affiliation(s)
- Nikki Ow
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.
- Centre for Advancing Health Outcomes, 570-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- Providence Research, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
| | - Kirsten Marchand
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
- Centre for Advancing Health Outcomes, 570-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Providence Research, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Guiping Liu
- Centre for Advancing Health Outcomes, 570-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Emilie Mallia
- Foundry Central Office, 201-1190 Hornby Street, Vancouver, BC, V6Z 2K5, Canada
| | - Steve Mathias
- Foundry Central Office, 201-1190 Hornby Street, Vancouver, BC, V6Z 2K5, Canada
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Jason Sutherland
- Centre for Advancing Health Outcomes, 570-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Skye Pamela Barbic
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
- Centre for Advancing Health Outcomes, 570-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Providence Research, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Foundry Central Office, 201-1190 Hornby Street, Vancouver, BC, V6Z 2K5, Canada
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Dvir M, Sarah AK, Orna BL. Ethnic identity and barriers for using mental health services among Arab-Bedouin women coping with emotional distresses. Arch Womens Ment Health 2023; 26:609-624. [PMID: 37495825 DOI: 10.1007/s00737-023-01349-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/08/2023] [Indexed: 07/28/2023]
Abstract
The study aimed to explore barriers to mental health service attainment among Bedouin women living in different residential environments in southern Israel. We hypothesized that emotional distress and the utilization of mental health services would be influenced by the living environment and ethnic identity factors. The sample included 376 Arab-Bedouin women, 126 Arab-Bedouin women from the recognized and unrecognized villages, and 250 Arab-Bedouin women from the central localities. Quantitative methods were used, including emotional distress (GHQ12), ethnic identity scale (EIS), mental health literacy (MHLS), and barriers to mental health services attainment (BACE). Results indicated that participants from the central localities demonstrated a greater inclination to seek and utilize mental health services. Furthermore, higher rates of affirmation of ethnic identity were also found to be a predictive factor for the willingness to attain mental health services. These findings further support the role of residential environment and ethnic identity in shaping mental health service utilization patterns. Current research explored barriers to mental health services seek and attainment for Arab-Bedouin women in different residential environments in southern Israel. Ethnic identity factors and barriers such as stigma and access to resources predicted the tendency to seek help. Findings emphasize the need to address barriers to seeking help and the role of ethnic identity in mental health service attainment for Arab-Bedouin women.
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Affiliation(s)
- Matzri Dvir
- Conflict Management & Resolution Program, Department of multidisciplinary studies Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Abu-Kaf Sarah
- Conflict Management & Resolution Program, Department of multidisciplinary studies Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Braun-Lewensohn Orna
- Conflict Management & Resolution Program, Department of multidisciplinary studies Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Opioid relapse and MOUD outcomes following civil commitment for opioid use. J Subst Abuse Treat 2022; 142:108873. [PMID: 36108441 DOI: 10.1016/j.jsat.2022.108873] [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: 02/11/2022] [Revised: 06/20/2022] [Accepted: 09/01/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Opioid use disorder (OUD) continues to present a major public health problem in the United States. Civil commitment for substance use is one mandatory form of treatment for severe opioid use that has become increasingly available in recent years, but empirical data on this approach are lacking. This study examines clinical outcomes of civil commitment in a sample of adults with severe opioid use. METHODS Participants were 121 persons with opioid use who were interviewed at the point of entry into civil commitment, then followed for 12 weeks after their release. RESULTS Prior to civil commitment, this sample exhibited serious substance use characteristics (including high rates of illicit opioid use, other substance use, and injection drug use), as well as mental health problems (diagnoses of depression and anxiety disorders). During follow-up, approximately 41 % of the sample reported at least one illicit opioid use day. More than 64 % of the sample reported at least one day of medication for opioid use disorder (MOUD) receipt, and participants were significantly less likely to use illicit opioids on days that they received MOUDs. No participants died during the follow-up period. CONCLUSIONS In this sample of persons with severe opioid use, clinical outcomes of civil commitment included illicit opioid relapse as well as varying levels of MOUD uptake. Civil commitment may be a viable method for short-term prevention of overdose for a subset of this vulnerable patient population.
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Gartner C, Bickl A, Härtl S, Loy JK, Häffner L. Differences in problem and pathological gambling: A narrative review considering sex and gender. J Behav Addict 2022; 11:267-289. [PMID: 35499928 PMCID: PMC9295224 DOI: 10.1556/2006.2022.00019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/11/2022] [Accepted: 03/22/2022] [Indexed: 12/05/2022] Open
Abstract
Background and aim A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted. Methods We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey. Results We are presenting our findings according to the categories 'prevalence' (offline, online, LGBTQI*), 'sociodemographic factors', 'preferred gambling type', 'gambling motives', 'severity', 'progression of gambling problems', 'use of professional help/motivation for treatment', 'comorbidity', 'trauma', 'violence and criminality/delinquency'. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives). Discussion and conclusion To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.
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Affiliation(s)
- Corinna Gartner
- BAS Bayerische Akademie für Sucht- und Gesundheitsfragen (Unternehmergesellschaft haftungsbeschränkt), LSG Landesstelle Glücksspielsucht in Bayern, Munich, Germany
| | | | - Sabine Härtl
- BAS Bayerische Akademie für Sucht- und Gesundheitsfragen (Unternehmergesellschaft haftungsbeschränkt), LSG Landesstelle Glücksspielsucht in Bayern, Munich, Germany
| | | | - Laura Häffner
- BAS Bayerische Akademie für Sucht- und Gesundheitsfragen (Unternehmergesellschaft haftungsbeschränkt), LSG Landesstelle Glücksspielsucht in Bayern, Munich, Germany
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Amendola S, Hengartner MP, Ajdacic-Gross V, Angst J, Rössler W. Longitudinal reciprocal associations between depression, anxiety, and substance use disorders over three decades of life. J Affect Disord 2022; 302:315-323. [PMID: 35093414 DOI: 10.1016/j.jad.2022.01.101] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Studies exploring longitudinal reciprocal associations between depressive, anxiety, and substance use disorders (DD, AD and SUD, respectively) over long periods of time are mainly lacking. Therefore, the aim of the present study is to test longitudinal associations (i.e. temporal dynamics) between DD, AD and SUD from young adulthood to middle adulthood. METHODS A stratified community sample of 591 participants from the canton of Zurich, Switzerland, was interviewed with the Structured Psychopathological Interview and Rating of the Social Consequences of Psychological Disturbances for Epidemiology over seven interview waves from ages 20/21 to 49/50. Diagnostic and Statistical Manual of Mental Disorders criteria were used to evaluate the presence of DD, AD and SUD. We fitted an auto-regressive cross-lagged path analysis within a Bayesian structural equation model to test longitudinal associations. RESULTS Regarding autoregressive effects, AD (except during young adulthood) and SUD predicted themselves over the entire time period, while DD recurrently predicted itself not consistently over time. Regarding cross-lagged effects, DD predicted SUD at different time points, and vice versa. DD predicted subsequent AD in adulthood, whereas the reverse did not happen. Female gender was associated with DD and AD at all ages while male gender was associated with SUD only in young adulthood. CONCLUSIONS Reciprocal longitudinal associations were found between DD and SUD and DD usually preceded AD. Our results further confirm an increased risk of DD and AD in women and a higher risk of SUD in young men. Early treatment and broad psychosocial interventions should be provided in order to prevent chronicity and further maladjustment as well as interrupting the cycle of mutual reinforcement between DD and SUD.
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Affiliation(s)
- Simone Amendola
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza - University of Rome, Rome, Italy.
| | | | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil; Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
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Rizzo D, Mu T, Cotroneo S, Arunogiri S. Barriers to Accessing Addiction Treatment for Women at Risk of Homelessness. Front Glob Womens Health 2022; 3:795532. [PMID: 35252964 PMCID: PMC8893170 DOI: 10.3389/fgwh.2022.795532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022] Open
Abstract
Women remain under-represented in addiction treatment, comprising less than a third of clients in treatment services. Shame, stigma, and fear of legal and social repercussions (e.g., child protection involvement) are major barriers impacting on treatment-seeking for women. This is compounded for women at risk of homelessness, with practical and logistical reasons for not engaging in treatment. We conducted a qualitative study with both clinicians and service-providers, and women with lived experience of addiction and at risk of homelessness, to identify barriers to access and help-seeking within this vulnerable population. Adult women with lived experience of homelessness and addiction were invited to participate in an online focus group. Interviews were transcribed and analyzed using framework analysis. Analysis resulted in the identification of barriers to access in three areas. These were system-related, socio-cultural, and emotional barriers. We also present findings from the focus group recorded in real-time, using the novel method of digital illustration. This study highlights key factors impacting on help-seeking and access to treatment for addiction faced by women at risk of homelessness. The findings of this study highlight important areas of consideration for clinicians and service-providers working with women who experience addiction, as well as informing future research directions for this priority population. Findings are discussed in the context of exigent literature.
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Affiliation(s)
- Davinia Rizzo
- Faculty of Medicine, Nursing and Health Sciences, Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Richmond, VIC, Australia
- Turning Point, Eastern Health, Richmond, VIC, Australia
- *Correspondence: Davinia Rizzo
| | - Temika Mu
- Turning Point, Eastern Health, Richmond, VIC, Australia
| | | | - Shalini Arunogiri
- Faculty of Medicine, Nursing and Health Sciences, Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Richmond, VIC, Australia
- Turning Point, Eastern Health, Richmond, VIC, Australia
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Miller L, Mide M, Arvidson E, Söderpalm Gordh A. Clinical differences between men and women in a Swedish treatment-seeking population with gambling disorder. Front Psychiatry 2022; 13:1054236. [PMID: 36684005 PMCID: PMC9847389 DOI: 10.3389/fpsyt.2022.1054236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/02/2022] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The purpose of this study was to explore clinical differences in Swedish treatment-seeking men and women with gambling disorder (GD). As the prevalence of GD is increasing among women, even though men are still highly overrepresented, the characteristic differences between men and women seeking treatment become increasingly important. METHOD A sample of 204 patients with GD (26.5% women and 73.5% men) at an outpatient clinic were diagnosed using the SCI-GD, screened for comorbid diagnoses using the MINI, and further completed a range of self-report questionnaires measuring demographics, GD, alcohol and other drug problems, symptoms of depression and anxiety, and pathways into gambling problems. RESULTS Several characteristics differed between treatment-seeking men and women in our sample. Examples of differences between genders included age, onset age, living situation, duration, alcohol and drug problems, comorbidity, and pathways leading to gambling problems. DISCUSSION The most evident difference was that women, in addition to GD, showed more symptoms of anxiety and depression than men, while men had a higher degree of substance use problems compared to women. The differences in clinical features between men and women are important to consider in treatment planning and possibly for future gender-based interventions.
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Affiliation(s)
- Louise Miller
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Mikael Mide
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elin Arvidson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Söderpalm Gordh
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
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Hu J, Zheng Q, Zhang Y, Liu C, Tian X, Liu X, Wang D, Ma J. Help-seeking behavior of individuals with schizophrenia in the general population of Hunan, China. Sci Rep 2021; 11:23012. [PMID: 34836983 PMCID: PMC8626485 DOI: 10.1038/s41598-021-01819-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022] Open
Abstract
This study aims to know the seeking help behavior of individuals with SZ (Schizophrenia) in Hunan province of China. Individuals (age > 15) with schizophrenia were recruited in the study after a two-stage diagnosis procedure (including questionnaire screening and face-to-face SCID interview by psychiatrists) in Hunan province. A self-designed questionnaire was used to investigate their help-seeking behavior. (1) Of the 367 participants, 68.9% (253/367) sought help; of those, 64.6% (n = 163) pursued professional psychiatric services and 30.8% (n = 78) pursued non-medical options (i.e., relatives, praying to Buddha) as the most common first choices. (2) Family history of mental disorders is significantly related to whether or not the individual with SZ seeks help, and the first choice of help is significantly related to education level. (P < 0.05). (3) Frequent reasons behind not seeking help include fear of stigmatization (72.9%), poor mental health literacy (64.5%), concerns over cost (50.6%), and limited access to medical services (47.0%). About one-third of the individuals do not seek help. Individuals with SZ tend to choose psychiatric hospitals and relatives as their first choice. Among the factors we investigated, family history of mental disorders is the most influential factor associated with help-seeking behavior. Individuals with more education tend to seek professional help first. The primary reasons for not seeking help include fear of stigmatization, lack of awareness about mental illness, concerns over cost, etc.
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Affiliation(s)
- Jiawen Hu
- School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China.,Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China
| | - Qiongjuan Zheng
- Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China
| | - Yun Zhang
- Northwest Minzu University, Lanzhou, China
| | - Chunyu Liu
- Department of Psychiatry, Department of Neuroscience & Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Xuefei Tian
- School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xuejun Liu
- Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China
| | - Dongxin Wang
- Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China.
| | - Jing Ma
- School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China.
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Rodriguez-Monguio R, Montgomery B, Drawbridge D, Packer I, Vincent GM. Substance use treatment services utilization and outcomes among probationers in drug courts compared to a matched cohort of probationers in traditional courts. Am J Addict 2021; 30:505-513. [PMID: 34414632 DOI: 10.1111/ajad.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Drug courts provide an array of substance use treatments and community-based services for probationers struggling with substance use disorders. We assessed substance use treatment services utilization and related expenditures and relapse and recidivism outcomes and identified predictors of cost of provision of substance use treatment services in a matched cohort of Massachusetts probationers in drug courts and traditional courts. METHODS This was an observational quasi-experimental study with 542 propensity-score-matched probationers initiating drug court between August 1, 2015 and February 28, 2018 and a minimum 6-month follow-up period. RESULTS A significantly greater proportion of probationers in drug courts were female, self-reported opioids as their primary drug of choice, had a history of substance use treatment, and a high and very high risk of recidivism than their counterparts in traditional courts. We estimated that the provision of substance use treatment services was $1498 more expensive for probationers in drug courts than traditional courts (p = .054). There were no statistically significant differences in relapse or recidivism rates between court systems. DISCUSSION AND CONCLUSIONS Probationer's age, gender, risk of recidivism at court intake, and enrollment length were strong predictors of expenditures on substance use treatment services. SCIENTIFIC SIGNIFICANCE This was the first study to assess substance use treatment services utilization and outcomes among probationers in drug courts and traditional courts. Drug courts served the needs of probationers disproportionally impacted by nonserious drug-related offenses struggling with substance use disorders who were at a high and very high risk of recidivism at court intake.
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Affiliation(s)
- Rosa Rodriguez-Monguio
- Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco (UCSF), San Francisco, California, USA.,Medication Outcomes Center, University of California San Francisco (UCSF), San Francisco, California, USA.,Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Barrett Montgomery
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University (MSU), East Lansing, Michigan, USA
| | - Dara Drawbridge
- Department of Psychiatry, Center of Excellence for Specialty Courts, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Ira Packer
- Department of Psychiatry, Center of Excellence for Specialty Courts, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Gina M Vincent
- Department of Psychiatry, Center of Excellence for Specialty Courts, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Hawlader MDH, Nabi MH, Hussain A, Al Amin SU, Zaman S, Masud I. Legal and social consequences of substance use: Results from a nationwide study in Bangladesh. J Ethn Subst Abuse 2020; 21:1-11. [PMID: 33342393 DOI: 10.1080/15332640.2020.1846008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Substance use is a major public health concern and its consequences can destroy someone's life. This study aimed to explore the legal and social consequences of substance use in Bangladesh. We conducted a nationwide descriptive cross-sectional study among relapse cases of substance use from January to December 2018. We visited 138 drug rehabilitation centers countrywide and were able to recruit 939 relapse cases, from where 28 cases were excluded due to incomplete data. Finally, data from 911 cases were analyzed. The majority (89.3%) of the study participants were 19-45 years old. Most commonly used drugs were amphetamine (76.1%), cannabis (75.0%), alcohol (54.3%), cough sirup (54.2%), heroin (47.0%) and sleeping pills (21.6%). Almost half (49.5%) of the substance users were arrested for drug use and among arrested cases, 52.1% were sent to jail. About 75% of the substance users experienced a lack of family interaction, 70% experienced destroyed family relationships, and 71.4% faced social stigma. Our study also found 60% of the participants were bullied, 50% were deprived or unwilling to have social interactions. Moreover, 13.8% of the participants left home, while 8% got divorced. Our data represented the significant impact of substance use on the legal aspect and social life of individuals. However, with a multi-dimensional treatment, rehabilitation, and social intervention approach, it is not impossible to overcome. Therefore, we believe it is imperative to focus on social awareness and to create a robust platform for health promotion and improve quality of life.
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Affiliation(s)
| | | | | | | | - Sanjana Zaman
- North South University, Dhaka, Bangladesh
- Daffodil International University, Dhaka, Bangladesh
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Najafi F, Pasdar Y, Karami Matin B, Rezaei S, Kazemi Karyani A, Soltani S, Soofi M, Rezaeian S, Zangeneh A, Moradinazar M, Hamzeh B, Jorjoran Shushtari Z, sajjadipour M, Eslami S, khosrojerdi M, Shabestari S, Mehrparvar AH, Kashi Z, Nejatizadeh A, Naghipour M, Sadeghi Boogar S, Fakhari A, Cheraghian B, Heidari H, Molavi P, Hajizadeh M, Salimi Y. Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study. BMC Psychiatry 2020; 20:229. [PMID: 32404081 PMCID: PMC7218818 DOI: 10.1186/s12888-020-02596-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Socioeconomic inequality in mental health in Iran is poorly understood. This study aimed to assess socioeconomic inequality in poor mental health among Iranian adults. METHODS The study used the baseline data of PERSIAN cohort study including 131,813 participants from 17 geographically distinct areas of Iran. The Erreygers Concentration index (E) was used to quantify the socioeconomic inequalities in poor mental health. Moreover, we decomposed the E to identify factors contributing to the observed socioeconomic inequality in poor mental health in Iran. RESULTS The estimated E for poor mental health was - 0.012 (95% CI: - 0.0144, - 0.0089), indicating slightly higher concentration of mental health problem among socioeconomically disadvantaged adults in Iran. Socioeconomic inequality in poor mental health was mainly explained by gender (19.93%) and age (12.70%). Region, SES itself, and physical activity were other important factors that contributed to the concentration of poor mental health among adults with low socioeconomic status. CONCLUSION There exists nearly equitable distribution in poor mental health among Iranian adults, but with important variations by gender, SES, and geography. These results suggested that interventional programs in Iran should focus on should focus more on socioeconomically disadvantaged people as a whole, with particular attention to the needs of women and those living in more socially disadvantaged regions.
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Affiliation(s)
- Farid Najafi
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- grid.412112.50000 0001 2012 5829Nutritional Sciences Department, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Kazemi Karyani
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- grid.412112.50000 0001 2012 5829Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Zangeneh
- grid.412112.50000 0001 2012 5829Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Jorjoran Shushtari
- grid.472458.80000 0004 0612 774XSocial Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mansour sajjadipour
- grid.411705.60000 0001 0166 0922South Tehran Health Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Eslami
- grid.411583.a0000 0001 2198 6209Pharmaceutical Research Center, Pharmaceutical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam khosrojerdi
- grid.412328.e0000 0004 0610 7204Cellular and molecular research center, school of medicine, Sabzevar university of medical sciences, Sabzevar, Iran
| | - Sahar Shabestari
- grid.488433.00000 0004 0612 8339Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Amir Houshang Mehrparvar
- grid.412505.70000 0004 0612 5912Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Kashi
- grid.411623.30000 0001 2227 0923Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azim Nejatizadeh
- grid.412237.10000 0004 0385 452XMolecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammadreza Naghipour
- grid.411874.f0000 0004 0571 1549Gastrointestinal and liver disease research center, Guilan University of medical sciences, Rasht, Iran
| | - Shahrokh Sadeghi Boogar
- grid.412571.40000 0000 8819 4698Gastroenterohepatology Research Center, Shiraz university of medical sciences, Shiraz, Iran
| | - Ali Fakhari
- grid.412888.f0000 0001 2174 8913Research Center of psychiatry and behavioral sciences, Tabriz University of Medical sciences, Tabriz, Iran
| | - Bahman Cheraghian
- grid.411230.50000 0000 9296 6873Department of Biostatistics and Epidemiology, school of public health, Ahvaz jundishapur university of medical sciences, Ahvaz, Iran
| | - Haydeh Heidari
- grid.440801.90000 0004 0384 8883Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Parviz Molavi
- grid.411426.40000 0004 0611 7226Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hajizadeh
- grid.55602.340000 0004 1936 8200School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Madhavan S, Bullis E, Myers R, Zhou CJ, Cai EM, Sharma A, Bhatia S, Orlando LA, Haga SB. Awareness of family health history in a predominantly young adult population. PLoS One 2019; 14:e0224283. [PMID: 31652289 PMCID: PMC6814221 DOI: 10.1371/journal.pone.0224283] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022] Open
Abstract
Family health history (FHH) is a key predictor of health risk and is universally important in preventive care. However, patients may not be aware of the importance of FHH, and thus, may fail to accurately or completely share FHH with health providers, thereby limiting its utility. In this study, we conducted an online survey of 294 young adults and employees based at a US university setting regarding their knowledge, sharing behaviors, and perceived importance of FHH, and use of electronic clinical tools to document and update FHH. We also evaluated two educational interventions (written and video) to promote knowledge about FHH and its importance to health. We found that 93% of respondents were highly aware of their FHH, though only 39% reported collecting it and 4% using an online FHH tool. Seventy-three percent of respondents, particularly women, had shared FHH with their doctor when prompted, and fewer had shared it with family members. Participants in the video group were significantly more likely to understand the benefits of FHH than those in the written group (p = 0.02). In summary, educational resources, either video or written, will be helpful to promote FHH collection, sharing, and use of online FHH tools.
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Affiliation(s)
- Sarina Madhavan
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Emily Bullis
- Duke University, Initiative for Society and Society, Durham, North Carolina, United States of America
| | - Rachel Myers
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Chris J. Zhou
- Duke University, Pratt School of Engineering, Durham, North Carolina, United States of America
| | - Elise M. Cai
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Anu Sharma
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Shreya Bhatia
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
| | - Lori A. Orlando
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Susanne B. Haga
- Duke University, Trinity Arts and Sciences, Durham, North Carolina, United States of America
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
- * E-mail:
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