This document assesses the burden of mental illness among adults in Jackson County, Michigan. It applies published prevalence rates of various mental illnesses to estimate the number of adults affected in the county. An estimated 4,779 adults have a serious mental illness such as major depression or schizophrenia. Applying rates of other mental illnesses suggests up to 19-26% of adults under the Jackson Health Network's care may have a serious or any mental illness. Most needs would fall under the network's higher levels of care coordination rather than health coaching. Screening data from local practices shows opportunities for improving depression identification and treatment.
Mental Health Policy - Mental Illness and the Criminal Justice SystemDr. James Swartz
These slides are from a lecture on the criminal justice system and mental illness and considers factors related to the criminalization of those with mental illnesses, characteristics of those with mental illness under criminal justice supervision, and the role of drug and mental health courts.
These slides are from on lecture on the role of psychotropic drugs in mental health treatment. Topics covered include the pharmaceutical industry, direct-to-consumer advertising, the CATIE and STAR*D studies, Medicare Part-D, and the role or pharmacy benefit managers.
Mental Health Policy - Defining mental illness, epidemiology, service use, an...Dr. James Swartz
These slides are from a mental health policy course. Topics covered include defining mental illness, the history and politics of the DSM, the epidemiology of mental illness in the United States, and trends in service use and access.
Mental Health Policy - The Affordablle Care Act and Mental HealthDr. James Swartz
These slides are from a lecture describing some of the main provisions of the Patient Protection and Affordable Care Act (P.L. 111-148) also known as the ACA or "Obamacare". Medicaid expansion and the health insurance exchanges are considered. Information on the status of ACA implementation is also presented.
Psychological Illness and Crime Growing in Urban life by Dr.Mahboob Khan PhdHealthcare consultant
“I believe that -Weather it is MH 370 Co-Pilot or recent thane mass murderer these people have some sort of psychological illness in common and there is greater need to do psychological assessment of every one as a mandatory test”.Public opinion surveys suggest that many people think mental illness and violence go hand in hand. A 2012 national survey found, for example, that 60% of indians thought that people with schizophrenia were likely to act violently toward someone else, while 32% thought that people with major depression were likely to do so.
Mental Health Policy - Mental Illness and the Criminal Justice SystemDr. James Swartz
These slides are from a lecture on the criminal justice system and mental illness and considers factors related to the criminalization of those with mental illnesses, characteristics of those with mental illness under criminal justice supervision, and the role of drug and mental health courts.
These slides are from on lecture on the role of psychotropic drugs in mental health treatment. Topics covered include the pharmaceutical industry, direct-to-consumer advertising, the CATIE and STAR*D studies, Medicare Part-D, and the role or pharmacy benefit managers.
Mental Health Policy - Defining mental illness, epidemiology, service use, an...Dr. James Swartz
These slides are from a mental health policy course. Topics covered include defining mental illness, the history and politics of the DSM, the epidemiology of mental illness in the United States, and trends in service use and access.
Mental Health Policy - The Affordablle Care Act and Mental HealthDr. James Swartz
These slides are from a lecture describing some of the main provisions of the Patient Protection and Affordable Care Act (P.L. 111-148) also known as the ACA or "Obamacare". Medicaid expansion and the health insurance exchanges are considered. Information on the status of ACA implementation is also presented.
Psychological Illness and Crime Growing in Urban life by Dr.Mahboob Khan PhdHealthcare consultant
“I believe that -Weather it is MH 370 Co-Pilot or recent thane mass murderer these people have some sort of psychological illness in common and there is greater need to do psychological assessment of every one as a mandatory test”.Public opinion surveys suggest that many people think mental illness and violence go hand in hand. A 2012 national survey found, for example, that 60% of indians thought that people with schizophrenia were likely to act violently toward someone else, while 32% thought that people with major depression were likely to do so.
This research is based on general practice in the psychiatric institutions. It involves a qualitative research method that that uses three peer-reviewed journal article containing information about the scope of psychiatry, emerging issues in accommodating patients and highlight on medication of mental illness
Mental Health Policy - The History of Mental Health Policy in the United StatesDr. James Swartz
These slides are from a lecture that covers the history of mental health policy in the United States over the 20th and into the 21st century. The community mental health movement, begun in the 1960s under the Kennedy administration, is especially highlighted.
Utah Leaders Dinner - Zero Suicide in Health Care 2013-11David Covington
Doug Thomas, Assistant Director for Mental Health for the Utah Division of Substance Abuse and Mental Health, leads an evening of Utah leaders to focus on suicide prevention with everyone involved. The engagement was very impressive and the dinner was filled with CEOs, military leaders, top ranking government officials and legislators. Way to create a tipping point of change, Utah!
Crisis Now: Transforming Services is Within Our Reach (March 2016)David Covington
This new report from the National Action Alliance on Suicide Prevention's Crisis Services Task Force surveyed the status of mental health crisis care and the state of the art represented by new crisis care systems and solutions. The Task Force finds gaping holes in crisis care that are contributing to criminalization of people with mental illness, the increasing suicide rate, and rising health care costs. We present consensus recommendations to improve and expand crisis care, and discuss current policy opportunities.
In 2016, the National Action Alliance for Suicide Prevention published “Crisis Now: Transforming Care is Within Our Reach.” Alignment with these practices cuts cost of care substantially, reduces the need for psychiatric hospital bed usage, ED visits and law enforcement overuse; resulting in better health and declines in suicide rate, justice system involvement/ incarcerations and psychiatric boarding. These challenges are simply greater than previously acknowledged, but the Washington State supreme court ruling on the unconstitutionality of boarding, the suicide death of Virginia State Senator Creigh Deeds’ son, the insistence of hospitals nationwide about the costs and safety and the series of violent incidents from Columbine forward are changing the expectations. These innovative approaches pioneered under the leadership of Arizona Medicaid are now being replicated throughout the US.
Selected Psychological and Social Factors Contributing to Relapse among Relap...inventionjournals
Drug abuse is a major global problem and in Kenya there has been increasing drug and alcohol abuse with serious negative effects. Treatment and rehabilitation of alcoholism is expensive and non-conclusive due to consequent relapse. This study sought to find out selected psychological and social factors contributing to relapse among recovering alcoholics of Asumbi and Jorgs Ark rehabilitation centres in Kenya. This study adopted the descriptive survey design. The population of the study comprised of all relapsed alcoholics and rehabilitation counsellors in Asumbi and Jorgs Ark rehabilitation centres in Kenya. A sample of 67 recovering alcoholics and 13 counsellors was drawn from the two purposively selected rehabilitation centres and used in the study. The study used two sets of questionnaires, one for relapsed alcoholics and another for rehabilitation counsellors. The questionnaires were piloted to validate and establish its reliability before the actual data collection. Data was collected through administration of two sets of questionnaires to the selected respondents. The data was then processed and analyzed using descriptive statistics including frequencies and percentages with the aid of Statistical Package for Social Sciences (SPSS) version 20.0 for windows. The key findings of this study indicated that the selected psychological factor that mostly contributed to relapse was dwelling on resentment that causes anger and frustration due to unresolved conflict. The social factor that mostly contributed to relapse was hanging around old drinking friends. The key conclusion was that in view of selected factors dwelling on resentment that causes anger and frustration due to unresolved conflict was the major contributor to relapse. The research findings may benefit NACADA, Ministry of Public Health, mental health agencies, psychologists, counsellors, Non-Governmental organizations, policy makers, researchers, drug abusers and alcoholics in Kenya to better understand factors contributing to relapse and devise ways and means of reducing relapse. Based on the major findings of this study, it is recommended that all stakeholders undertake measures aimed at providing a solution to continued relapse of alcoholics by improvement of rehabilitation and follow-up programmes.
Presentation by Sabrina Darrow, PhD; Serina Deen, MD, MPH; and Yan Leykin, PhD, at the UCSF Depression Center's "Depression: Pathways to Resilience and Recovery" event on September 13, 2014.
This research is based on general practice in the psychiatric institutions. It involves a qualitative research method that that uses three peer-reviewed journal article containing information about the scope of psychiatry, emerging issues in accommodating patients and highlight on medication of mental illness
Mental Health Policy - The History of Mental Health Policy in the United StatesDr. James Swartz
These slides are from a lecture that covers the history of mental health policy in the United States over the 20th and into the 21st century. The community mental health movement, begun in the 1960s under the Kennedy administration, is especially highlighted.
Utah Leaders Dinner - Zero Suicide in Health Care 2013-11David Covington
Doug Thomas, Assistant Director for Mental Health for the Utah Division of Substance Abuse and Mental Health, leads an evening of Utah leaders to focus on suicide prevention with everyone involved. The engagement was very impressive and the dinner was filled with CEOs, military leaders, top ranking government officials and legislators. Way to create a tipping point of change, Utah!
Crisis Now: Transforming Services is Within Our Reach (March 2016)David Covington
This new report from the National Action Alliance on Suicide Prevention's Crisis Services Task Force surveyed the status of mental health crisis care and the state of the art represented by new crisis care systems and solutions. The Task Force finds gaping holes in crisis care that are contributing to criminalization of people with mental illness, the increasing suicide rate, and rising health care costs. We present consensus recommendations to improve and expand crisis care, and discuss current policy opportunities.
In 2016, the National Action Alliance for Suicide Prevention published “Crisis Now: Transforming Care is Within Our Reach.” Alignment with these practices cuts cost of care substantially, reduces the need for psychiatric hospital bed usage, ED visits and law enforcement overuse; resulting in better health and declines in suicide rate, justice system involvement/ incarcerations and psychiatric boarding. These challenges are simply greater than previously acknowledged, but the Washington State supreme court ruling on the unconstitutionality of boarding, the suicide death of Virginia State Senator Creigh Deeds’ son, the insistence of hospitals nationwide about the costs and safety and the series of violent incidents from Columbine forward are changing the expectations. These innovative approaches pioneered under the leadership of Arizona Medicaid are now being replicated throughout the US.
Selected Psychological and Social Factors Contributing to Relapse among Relap...inventionjournals
Drug abuse is a major global problem and in Kenya there has been increasing drug and alcohol abuse with serious negative effects. Treatment and rehabilitation of alcoholism is expensive and non-conclusive due to consequent relapse. This study sought to find out selected psychological and social factors contributing to relapse among recovering alcoholics of Asumbi and Jorgs Ark rehabilitation centres in Kenya. This study adopted the descriptive survey design. The population of the study comprised of all relapsed alcoholics and rehabilitation counsellors in Asumbi and Jorgs Ark rehabilitation centres in Kenya. A sample of 67 recovering alcoholics and 13 counsellors was drawn from the two purposively selected rehabilitation centres and used in the study. The study used two sets of questionnaires, one for relapsed alcoholics and another for rehabilitation counsellors. The questionnaires were piloted to validate and establish its reliability before the actual data collection. Data was collected through administration of two sets of questionnaires to the selected respondents. The data was then processed and analyzed using descriptive statistics including frequencies and percentages with the aid of Statistical Package for Social Sciences (SPSS) version 20.0 for windows. The key findings of this study indicated that the selected psychological factor that mostly contributed to relapse was dwelling on resentment that causes anger and frustration due to unresolved conflict. The social factor that mostly contributed to relapse was hanging around old drinking friends. The key conclusion was that in view of selected factors dwelling on resentment that causes anger and frustration due to unresolved conflict was the major contributor to relapse. The research findings may benefit NACADA, Ministry of Public Health, mental health agencies, psychologists, counsellors, Non-Governmental organizations, policy makers, researchers, drug abusers and alcoholics in Kenya to better understand factors contributing to relapse and devise ways and means of reducing relapse. Based on the major findings of this study, it is recommended that all stakeholders undertake measures aimed at providing a solution to continued relapse of alcoholics by improvement of rehabilitation and follow-up programmes.
Presentation by Sabrina Darrow, PhD; Serina Deen, MD, MPH; and Yan Leykin, PhD, at the UCSF Depression Center's "Depression: Pathways to Resilience and Recovery" event on September 13, 2014.
Agm10 screening for depression in stroke (v4medium)Alex J Mitchell
This is a talk from a symposium on screening for depression in neurological disease. Topic is what screener works best in stroke given the communication and cognitive difficulties that may be present.
IPOS09 - Screening For Depression What Works (June 2009)Alex J Mitchell
This is a workshop delivered in the lead upto IPOS conference 2009. It outlines the case for and against screening for depression & distress in cancer settings. The middle part of the talk (B) is from Matthew Loscalzo and not provided here.
Art As An Assessment Tool and As An InterventionShweta Tripathi
Art is not just for kids to keep them engaged rather it is an assessment tool for all age group people as well as an intervention modality which is now being used to treat peoples suffering from various illness and disorders.
A general overview on Social Work in Psychiatric Settings.
Global and National Statistics on Mental Health.
Role and Challenges of Psychiatric Social Worker.
Clients Presentation Your client can make up whatever they want.WilheminaRossi174
Clients Presentation: Your client can make up whatever they want. They can be as dramatic as they want to be. Have fun with it!
Subjective Data (4 points): (Review History questions in power point and on page 534-535 of text.)
Objective Data (4 points):
Inspection: What is the shape and size of the abdomen? Any masses or pulsations upon inspection? Skin smooth? Striae, scars, lesions?
Auscultation: Bowel Sounds Present in all 4 quadrants? Hypoactive, Normoactive, etc. Any bruits upon auscultation?
Percussion: Tympany in all 4 quadrants?
Palpation: Abdomen soft, firm? Any enlarged organs? Masses? Tenderness?
Any other objective data you found important to document?
Describe 2 Actual/Potential Risk Factors (2 points):
CHAPTER 15
15.1 INTRODUCTION
Although in some cases behavioral and psychiatric/mental are grouped under the same broad
category, behavioral health problems are generally effectively treated on an outpatient basis with
combination psychotherapy and pharmacotherapy (medications). Behavioral health professionals
are licensed by the state in which they reside to practice, and they collaborate on the management
of clients’ behavioral problems. These professionals include psychiatrists, psychologists,
psychiatric nurse practitioners, social workers, family counselors, and drug/alcohol and mental
health counselors (Parker, 2002). Such chronic problems as dementia and mental retardation are
considered psychiatric/mental problems rather than behavioral.
There is a distinct interconnectedness between mental health and health in general. The WHO
defines health as, “a state of complete physical, mental, and social well-being, and not merely the
absence of disease and infirmity” (WHO, 2001b, p. 1). Mental health on the other hand is defined
as, “a state of well-being in which the individual realizes his or her own abilities, can cope with the
normal stress of life, can work productively and fruitfully, and is able to make a contribution to his
or her community … it is determined by socioeconomic and environmental factors and it is linked
to behavior” (WHO, 2001a, p. 1; WHO 2010, p. 1). For example, people are generally resilient
enough ...
Unit-VIIIIntroduction about mental health M.sc II.pptxanjalatchi
Envisages provision of basic mental health care services at the community level. Objective: - To provide sustainable basic mental health services to the community and to integrate these services with other health services. Early detection and treatment of patients within the community itself.
For each of the learning objectives, provide an analysis of how thShainaBoling829
For each of the learning objectives, provide an analysis of how the course supported each objective.
1. Discriminate among the mechanisms of action for the major classes of drugs/medications
2. Critique evidence that supports proposed pharmacotherapeutic protocols for appropriateness of application across the lifespan
3. Integrate the teaching-learning needs of clients across the lifespan when proposing pharmacotherapies
4. Propose prescriptive therapies for selected clients evaluating safety factors while utilizing knowledge of how current health status, age, gender, culture, genetic factors, ethical concerns and prescriptive authority impact decision making
Explain how the material learned in this course, based upon the objectives, will be applicable to professional application.
Provide evidence (citations and references) to support your statements and opinions.
All references and citations should in APA format.
14
Mental Health and Social Work
Shanae Hampton
Cal Baptist University
Introduction
How well a person is able to live a full life, build and maintain relationships and pursue their education, profession or other pursuits requires them to maintain their well-being ranging from physical to mental health. When assisting others to achieve good and self-motivated changes, social workers draw on their relationship-based abilities and emphasize personalization and rehabilitation. A key issue is, "What components and obstacles of an assessment are there in order to reach these outcomes?" When it comes to health promotion and public involvement, social workers are well-suited for this role since primary care is all about these things. Social workers who deal with mental health have unique challenges in assessment, which necessitates them learning and using psychiatric principles. Identifying the need for mental health care requires an understanding of assessment principles.
For this research, the focus is on urban youth's increase in mental health cases which is more influenced by lack of access to mental health care as a result of poverty that affects many children and families in the US. Young people are the most impacted by poverty, accounting for 33% of the total number of individuals in poverty. Children who live in "high risk neighborhoods" are more likely to lack access to the mental health supports they need to manage their symptoms. Stabilization, individual treatment, and symptom management are all important aspects of aftercare for children who have been hospitalized for behavioral difficulties by the time they are six years old (Hodgkinson, 2017).
Literature Review
Inequality based on race and class has been shown to be associated with a variety of negative health outcomes, including poor mental health. Increased financial disparity is associated with an increase in the prevalence of mental illness along a social gradient in mental health. However, psychiatric and psychological approaches have dominated ment ...
Answer the following questions on Mental Health ServicesThe rec.docxlisandrai1k
Answer the following questions on Mental Health Services:
The recipients of mental health services in the U.S. represent only a small percentage of those in need of services. State two (2) factors that impede access to mental illness treatment.
Name two (2) ways WWI and WWII affected the awareness of mental health disorders among the federal government and the American public? Name one (1) result of that awareness?
From colonial times through the 1960s, the primary mode of mental illness treatment was institutional. In the 1960s, mental health treatment shifted to a community-based orientation. Name two (2) factors responsible for this shift? What were the effects on patients and on the community?
As mental illness treatment shifted from the institutional to the community setting, public dollars were allocated on the basis of units of service delivered, not on results of care. Discuss the implications of this policy on the deinstitutionalized severely mentally ill.
The author states, “In contrast to widely held assumptions, mental disorders can now be diagnosed and treated as effectively as physical disorders.” Identify and discuss two (2) factors that have contributed to the persistence of erroneous assumptions about mental illness treatment. Identify one (1) factor that “allow mental disorders to be diagnosed and treated as effectively as physical disorders.”
.
Lesson 11 Mental Health StigmaReadings Please note that th.docxSHIVA101531
Lesson 11: Mental Health Stigma
Readings: Please note that the Corrigan article in the syllabus has been replaced with the Collins and Corrigan articles below:
Required
Collins, R. L., Wong, E. C., Cerully, J. L., Schultz, D., & Eberhart, N. K. (2012). Interventions to reduce mental health stigma and discrimination. http://calmhsa.org/wp-content/uploads/2011/12/Literature-Review_SDR_Final01-02-13.pdf
Corrigan, P., Morris, S., Michaels, P.J., Rafacz, J.D. & Rusch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services 63(10). doi: 10.1176/appi.ps.201100529. http://ps.psychiatryonline.org/article.aspx?articleid=1372999&RelatedWidgetArticles=true
Link, B., Phelan, J. Bresnahan, A.S. & Persosolido, B., (1999). Public conceptions of mental illness: Labels, causes, dangerousness and social distance. American
Journal of Public Health (89), 1328-1333.
http://ajph.aphapublications.org/cgi/reprint/89/9/1328.pdf
Swanson, J.W., Holzer, C.E., Ganju, V. K., Jono, R.T. (1990). Violence and psychiatric disorder in the community: Evidence from the Epidemiologic Catchment Area surveys. Hospital & Community Psychiatry,
41(7), 761-770.
http://www.bing.com/videos/search?q=Mental+Health+Stigma+Video&FORM=VIRE7#view=detail&mid=102935613330F098A046102935613330F098A046
http://www.bing.com/videos/search?q=Mental+Illness+Stigma&Form=VQFRVP#view=detail&mid=EC031B624F71269702CDEC031B624F71269702CD
https://www.youtube.com/watch?v=Zn6yw2KUIwc&feature=youtu.be
Optional
Pettigrew, L. R. & Tropp, T.F. (2005). Relationships between intergroup contact and prejudice among minority and majority status groups. Psychological Science (16)12, 951-957.
Summary
Introduction
As many of you have noted in your discussion posts, mental health stigma is a pervasive problem that profoundly affects the lives of those suffering from mental illness. Aided by newspapers, books, movies and television, persons with mental illness have been portrayed and perceived as persons with bad character, demonically possessed, weak, unpredictable, and violent. As a result, many people have separated themselves from those with mental illness out of “distrust, stereotyping, fear, embarrassment, anger and/or avoidance.” (Surgeon General’s Report, 1999).
While some progress has been made in the past 50 years, stigma (often referred to as discrimination) continues to be a significant barrier to persons with mental illness. As we have seen in our readings, several recent documents have given prominence to the issue of stigma. In SAMSHA’s 2011 strategic plan “Leading Change: A Plan for SAMHSA’s Roles and Actions, 2011-2014”, Goal 4.3.2 is to “create a behavioral health awareness campaign focused on decreasing discrimination and improving employment outcomes for persons with mental and substance use disorders.” (p. 59). SAMHSA’s most recent strategic plan: Leading the Change 2.0: Advancing the Behavioral Health of the Nation 2 ...
the importance of epidemiological studies, important historical research on mental health, techniques and processes, and epidemiological research findings on mental health during covid 19 are included.
Contents lists available at ScienceDirectPsychiatry ResearAlleneMcclendon878
Contents lists available at ScienceDirect
Psychiatry Research
journal homepage: www.elsevier.com/locate/psychres
Factors associated with depression, anxiety, and PTSD symptomatology
during the COVID-19 pandemic: Clinical implications for U.S. young adult
mental health
Cindy H. Liu (PhD)a,c,d,⁎, Emily Zhang (MA)a,c, Ga Tin Fifi Wong (BA)a,c, Sunah Hyun (PhD)a,c,
Hyeouk “Chris” Hahm (PhD)b,c
a Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
b Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
c School of Social Work, Boston University, Boston, MA, USA
d Harvard Medical School
A R T I C L E I N F O
Keywords:
Psychological stress, Loneliness
University health services
Social support
Ethnicity
COVID-19
Depression
Anxiety
PTSD
A B S T R A C T
This study sought to identify factors associated with depression, anxiety, and PTSD symptomatology in U.S.
young adults (18-30 years) during the COVID-19 pandemic. This cross-sectional online study assessed 898
participants from April 13, 2020 to May 19, 2020, approximately one month after the U.S. declared a state of
emergency due to COVID-19 and prior to the initial lifting of restrictions across 50 U.S. states. Respondents
reported high levels of depression (43.3%, PHQ-8 scores ≥ 10), high anxiety scores (45.4%, GAD-7 scores ≥
10), and high levels of PTSD symptoms (31.8%, PCL-C scores ≥ 45). High levels of loneliness, high levels of
COVID-19-specific worry, and low distress tolerance were significantly associated with clinical levels of de-
pression, anxiety, and PTSD symptoms. Resilience was associated with low levels of depression and anxiety
symptoms but not PTSD. Most respondents had high levels of social support; social support from family, but not
from partner or peers, was associated with low levels of depression and PTSD. Compared to Whites, Asian
Americans were less likely to report high levels across mental health symptoms, and Hispanic/Latinos were less
likely to report high levels of anxiety. These factors provide initial guidance regarding the clinical management
for COVID-19-related mental health problems.
1. Introduction
The COVID-19 pandemic that has upended the lives of individuals
worldwide escalated in the U.S. beginning in March of 2020. Although
research on acute and widescale stressors (e.g., natural disasters), de-
monstrates severe implications for mental health (Kessler et al., 2008),
there is no precedent for understanding the mental health effects due to
COVID-19, as prospective studies investigating the effects of a pan-
demic are virtually non-existent. In particular, the identification of risk
factors associated with depression, anxiety, and post-traumatic stress
disorder (PTSD) among U.S. young adults (18-30 years) during the
pandemic is urgently needed. Comprising more than one-third of the
current U.S. workforce, young adults (often referred to as “Millennials”
and “Generation Z”) will be a dominant workforce grou ...
Abnormal Psychology and Attitudes toward Mental IllnessPeople’s at.docxrhetttrevannion
Abnormal Psychology and Attitudes toward Mental Illness
People’s attitudes and beliefs toward mental illness are not always accurate or positive. A person’s attitude towards mental illness influences how he or she interacts and shows sympathy or support towards people with mental disorders.
People’s attitudes and beliefs can also influence how the individual suffering with a disorder feels about his or herself and perceives personal problems and psychological distress, such as one’s level of comfort to confide in other people about his or her symptoms or difficulties.
Many people have a physical illness, such as cancer, heart disease, and diabetes; however, people tend to believe that physical illness is something out of the individual’s control, which releases the individual from the blame for his or her own illness. Positive beliefs about mental illness are likely to result in more supportive and inclusive behaviors, such as being willing to hire a person with a physical illness. Positive attitudes allow individuals with a physical illness a level of acceptance and freedom to reach out for help because they do not feel ashamed for their illness compared to illnesses that are viewed by society as a personal weakness.
There are misconceptions surrounding mental illnesses, which have multiple consequences for an individual suffering with a mental disorder and society. People may think that they know what mental illness is, but do not fully understand its level of impairment and debilitating effects for everyday living. People may believe that there is no hope or a successful treatment available for those suffering with a mental illness. Misconceptions surrounding mental illness are that people bring on their own problems, are weak, lack self-discipline, have “gone mad,” or that mental illness is not a real disease.
Misconceptions about mental illnesses fuel social stigmas (how people are labeled). If the greater society labels people with mental illness as being weak or at fault for their own illness, it can result in them being treated unfairly, shunned, or even oppressed by the society in which they live. People in society can exclude those with mental illness from social activities, avoid them, or overlook them for a job position, thus limiting their career opportunities and opportunities for social relationships. Because people with a mental illness can be fearful of being made to feel ashamed or excluded from society, it can influence whether the individual reaches out for help or continues with treatment or therapy.
In general, although in America people have begun to believe that mental illnesses can be treated and that people with a disorder can learn to live a normal life, this belief has not transpired into positive attitudes towards mental illness (Centers for Disease Control and Prevention, 2012). In America, one study found that people are more likely to view mental illness and other behavioral problems as being a personal weaknes.
PAGE
20
Dissertation Prospectus
Factors Influencing Individuals' Decision to Utilize Mental Health in South Texas
Submitted by:
The Prospectus Overview and Instructions
Prospectus Instructions:
1. Read the entire Prospectus Template to understand the requirements for writing your prospectus. Each section contains a narrative overview of what should be included in the section and a table with required criteria for each section. WRITE TO THE CRITERIA, as they will be used to assess the prospectus for overall quality and feasibility of your proposed research study.
2. As you draft each section, delete the narrative instructions and insert your work related to that section. Use the criterion table for each section to ensure that you address the requirements for that particular section. Do not delete/remove the criterion table as this is used by you and your committee to evaluate your prospectus.
3. Prior to submitting your prospectus for review by your chair or methodologist, use the criteria table for each section to complete a realistic self-evaluation, inserting what you believe is your score for each listed criterion into the Learner Self-Evaluation column. This is an exercise in self-evaluation and critical reflection, and to ensure that you completed all sections, addressing all required criteria for that section.
4. The scoring for the criteria ranges from a 0-3 as defined below. Complete a realistic and thoughtful evaluation of your work. Your chair and methodologist will also use the criterion tables to evaluate your work.
5. Your Prospectus should be no longer than 6-10 pages when the tables are deleted.
0
Item Not Present
1
Item is Present. Does Not Meet Expectations. Revisions are Required: Not all components are present. Large gaps are present in the components that leave the reader with significant questions. All items scored at 1 must be addressed by learner per reviewer comments.
2
Item is Acceptable. Meets Expectations.Some Revisions May Be Required Now or in the Future. Component is present and adequate. Small gaps are present that leave the reader with questions. Any item scored at 2 must be addressed by the learner per the reviewer comments.
3
Item Exceeds Expectations. No Revisions Required. Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions. No changes required.
Dissertation Prospectus
Introduction
Southern Texas encompasses different groups of people whose behavior, gender identity, and gender expression varies depending on cultural identity and norms. About a quarter of individuals in United States have a history or are experiencing a mental disorder with approximately 6% of the population having critical mental illness. These mental problems typically affect the general well-being of an individual. For instance, patients living with severe mental disorders are more likely to die in average of twenty-six years earlier than the average life expectanc ...
Methodology 11.5 pages 1. Describe what you did a seconda.docxbuffydtesurina
Methodology 1/1.5 pages
1. Describe what you did a secondary data analysis of…
Racial/Ethnic Differences in Mental Health Service Use among Adults
2. Describe where it came from..
Data received from links below to Racial/Ethnic Differences in Mental
Health Service Use among Adults and Charts of the numbers.
https://www.integration.samhsa.gov/MHServicesUseAmongAdults.pdf
https://www.samhsa.gov/data/sites/default/files/MHServicesUseAmongAdults/Appendic
es.pdf
Describe what you were looking for and how you found it.
Looking to compare mental health service use among adults. Focusing on
insurance, gender, employment, poverty status and education.
Results/Discussion 2.5 pages
Methodology Drives the Results section.
1. Describe what was found what was found during the secondary data
analysis. (Discuss the numbers!!!) (at least 1 page)
https://www.integration.samhsa.gov/MHServicesUseAmongAdults.pdf
https://www.samhsa.gov/data/sites/default/files/MHServicesUseAmongAdults/Appendices.pdf
https://www.samhsa.gov/data/sites/default/files/MHServicesUseAmongAdults/Appendices.pdf
2. Research Question 1: Are mental health service usage different among
african american than other races. (Discuss if the research question is
supported by the data and explain. If not explain as well.)
3. Null Hypothesis: African american men are more likely to obtain mental
health services between ages between ages 18-25 compared to other ethnic
groups. (Discuss whether hypothesis is supported or not supported based
on the same data collected)
4. Alternative Hypothesis: African Americans are less likely to receive
mental health care services compared to other races. (Discuss whether
hypothesis is supported or not supported based on the same data
collected)
End the discussion talking about how the data analyzed connects to the topic “Why is
there a stigma of mental health in the African American community” and either supports or
disproves my Research question.
Running head: WHY IS THERE A STIGMA OF MENTAL HEALTH IN THE AFRICAN
AMERICAN COMMUNITY 1
Why is there a stigma of mental health in the African American community
Xavier De La Cruz
Benedict College
Applied Social Work Research II SW 434 01
Dr. Miller
November 2nd, 2019
AFRICAN AMERICAN MENTAL HEALTH 2
Abstract
Everyone is susceptible to the development of mental health regardless of race, color,
gender, or identity. More than half of the citizens in the United States are recognized with a
mental illness in their lifetime, and African Americans are at higher risk of developing a mental
illness due to limited resources and other barriers. The challenge is further enhanced in the
community due to a stigma prevailing in the group that prevents most members from seeking
medical help. The lack of knowledge about mental illness calls for increased awareness of the
challenge, especially when the cond.
Hospital Care for Mental Health and Substance Abuse ConditionsLizbethQuinonez813
Hospital Care for Mental Health and Substance Abuse Conditions in
Parkinson’s Disease
Allison. W. Willis, MD, MSCI,1,2,3,4* Dylan P. Thibault, MS,1 Peter N. Schmidt, PhD,5 E. Ray Dorsey, MD, MBA,6 and
Daniel Weintraub, MD1,7,8
1Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
2
Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
3
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
4
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
5
National Parkinson’s Foundation, Miami, Florida, USA
6Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
7
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
8
Parkinson’s Disease and Mental Illness Research, Education and Clinical Centers, Philadelphia Veterans Affairs Medical Center, Philadelphia,
Pennsylvania, USA
A B S T R A C T : O b j e c t i v e : The objective of this
study was to examine mental health conditions among
hospitalized individuals with Parkinson’s disease in the
United States.
M e t h o d s : This was a serial cross-sectional study of
hospitalizations of individuals aged �60 identified in the
Nationwide Inpatient Sample dataset from 2000 to
2010. We identified all hospitalizations with a diagnosis
of PD, alcohol abuse, anxiety, bipolar disorder, depres-
sion, impulse control disorders, mania, psychosis, sub-
stance abuse, and attempted suicide/suicidal ideation.
National estimates of each mental health condition
were compared between hospitalized individuals with
and without PD. Hierarchical logistic regression models
determined which inpatient mental health diagnoses
were associated with PD, adjusting for demographic,
payer, geographic, and hospital characteristics.
R e s u l t s : We identified 3,918,703 mental health and sub-
stance abuse hospitalizations. Of these, 2.8% (n 5 104,
437) involved a person also diagnosed with PD. The major-
ity of mental health and substance abuse patients were
white (86.9% of PD vs 83.3% of non-PD). Women were
more common than men in both groups (male:female
prevalence ratio, PD: 0.78, 0.78-0.79, non-PD: 0.58, 0.57-
0.58). Depression (adjusted odds ratio 1.32, 1.31-1.34),
psychosis (adjusted odds ratio 1.25, 1.15-1.33), bipolar
disorder (adjusted odds ratio 2.74, 2.69-2.79), impulse
control disorders (adjusted odds ratio 1.51, 1.31-1.75),
and mania (adjusted odds ratio 1.43, 1.18-1.74) were more
likely among PD patients, alcohol abuse was less likely
(adjusted odds ratio 0.26, 0.25-0.27). We found no PD-
associated difference in suicide-related care.
C o n c l u s i o n s : PD patients have unique patterns of
acute care for mental health and substance abuse.
Research is needed to guide PD treatment in individuals
with ...
Similar to Assessing the Burden of Mental Illness in Jackson County (20)
Hospital Care for Mental Health and Substance Abuse Conditions
Assessing the Burden of Mental Illness in Jackson County
1. Jackson Health Network
Assessing the Burden of Mental Illness among Adults in
Jackson County, Michigan
March 28, 2014
Prepared by:
Richard J. Thoune, RS, MS, MPH
County Health Officer
2. 2
Table of Contents
I. Introduction………………………………………………………………………………… 2
II. Background………………………………………………………………………………… 2
III. Community Characteristics..……………………………………………………………..… 4
IV. Assumptions……………...………………………………………………………………… 4
V. Prevalence Rates Applied to the Community Adult Population.…………….……..……… 5
VI. Discussion……………………………………..……………….…………………………… 6
VII. Current Service Delivery …………….……………………………………………..……… 8
VIII. Accessibility of Service Providers…………………………………………………..……… 8
IX. Current Network Characteristics………………………………………………….…………9
X. Limitations of this Assessment..…………………………………………………….……… 9
XI. Conclusions……………………………….………………………………………..……….10
XII. Recommendations and Next Steps………………………….………………………………10
Appendix A……………………….………………………………………. ….……………11
3. 3
I. Introduction.
This assessment has been developed to support the clinical integration efforts of the Jackson
Health Network (JHN). It focuses on adults aged ≥18 years residing in Jackson County,
Michigan. A subsequent assessment will focus on children <18 years of age. The network
has developed and is implementing a comprehensive health assessment tool through care
coordination/management that will assess the health needs of patients across 5 domains:
social (social problems), biological (medical), psychological (mental health), functional
status, and self-management. Understanding the burden of mental illness present in the
community is essential for service delivery system planning, clinically integrated care
coordination efforts, treatment at the primary care provider level, and any necessary capacity
building.
II. Background.
Mental illness is defined as “collectively all diagnosable mental disorders” or “health
conditions that are characterized by alterations in thinking, mood, or behavior (or some
combination thereof) associated with distress and/or impaired functioning.”1
Depression is
the most common type of mental illness, affecting more than 26% of the U.S. adult
population.2
It has been estimated that by the year 2020, depression will be the second
leading cause of disability throughout the world, trailing only ischemic heart disease.3
Serious mental illness is defined by the Substance Abuse and Mental Health Services
Administration (SAMHSA) as having a diagnosable mental, behavioral, or emotional
disorder that met the criteria found in the 4th edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV) and resulted in functional impairment that
substantially interfered with or limited one or more major life activities.
Evidence has shown that mental disorders, especially depressive disorders, are strongly
related to the occurrence, successful treatment, and course of many chronic diseases
including diabetes, cancer, cardiovascular disease, asthma, and obesity4
and many risk
behaviors for chronic disease; such as, physical inactivity, smoking, excessive drinking, and
insufficient sleep.
Back to Table of Contents
1
U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S.
Department of Health and Human Services; Substance Abuse and Mental Health Services Administration, Center for Mental
Health Services, National Institutes of Health, National Institute of Mental Health, 1999.
2
Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and co-morbidity of 12-month DSM-IV disorders in
the National Co-morbidity Survey Replication. Arch Gen Psychiatry 2005;62:617–627.
3
Murray CJL, Lopez AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from
Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Geneva, Switzerland;World Health Organization, 1996.
4
Chapman DP, Perry GS, Strine TW.The vital link between chronic disease and depressive disorders. Prev Chronic Dis
2005;2(1):A14.
4. 4
A current Michigan behavioral risk factor analysis indicates that the prevalence of current
smoking and SHS exposure is significantly different by mental health status, ranging from
1.35 to 2.5 times more likely.5
Mental disorders are common in the United States and internationally. An estimated 26.2
percent of Americans ages 18 and older – about one in four adults – suffer from a
diagnosable mental disorder in a given year.6
Even though mental disorders are widespread
in the population, the main burden of illness is concentrated in a much smaller proportion –
about 6 percent, or 1 in 17 – who suffer from a serious mental illness.
Within the state of Michigan, an estimated 20.6% of Michigan adults reported ever being told
by a doctor that they had a depressive disorder including depression, major depression,
dysthymia, or minor depression.7
The most recent community health assessment report (2012) completed by the Health
Improvement Organization for Jackson County indicates that approximately 17% of residents
self-report having had mental health problems within the past 12 months. The most
prevalent disorders were depression (25%) and anxiety (17%).
The Centers for Disease Control and Prevention has described the burden of mental illness on
an international and national basis by type of illness.8
It has also estimated the prevalence of
mental illness among US adults aged ≥18 years by sociodemographic characteristics from
multiple population based, ambulatory medical care and hospital discharge surveys.9
III. Community Characteristics
a. Current Community Population
The Jackson County 2010 population is 160,248.10
Within the county, 71% of the residents
are over age 18, resulting in a total of 123,053 adults. An estimated 18% of these adults are
Back to Table of Contents
5
Fussman C, Shamo F, Kiley J. Cigarette Smoking and Secondhand Smoke Exposure among Michigan Adults by Mental
Health Status. Michigan BRFSS Surveillance Brief. Vol. 7, No. 6. Lansing, MI: Michigan Department of Community
Health, Lifecourse Epidemiology and Genomics Division, Surveillance and Program Evaluation Section, Chronic Disease
Epidemiology Unit, December 2013.
6
Kessler, Chiu, Demler, Walters, op. cit., p. 617-27.
7
Fussman C. 2013. Health Risk Behaviors in the State of Michigan: 2012 Behavioral Risk Factor Survey. 26th Annual
Report. Lansing, MI: Michigan Department of Community Health, Lifecourse Epidemiology and Genomics Division,
Surveillance and Program Evaluation Section, Chronic Disease Epidemiology Unit.
8
http://www.cdc.gov/mentalhealth/basics/burden.htm
9
Centers for Disease Control and Prevention, Mental Illness Surveillance Among Adults in the United States, MMWR
2011;60(Suppl), pages 1-32.
10
http://factfinder.census.gov
5. 5
62 years of age or older, resulting in a total of 22,149 elderly persons living in Jackson
County.
IV.Assumptions
This assessment incorporates the most current network capacity evaluation completed by the
community mental health agency for Jackson County, LifeWays.11
a. LifeWays is funded to provide the necessary access and care for that proportion of their
priority adult population (Medicaid and Uninsured) with serious mental illness,
developmental disabilities, substance use disorder, and co-occurring mental illness and
substance use disorder. Estimated potentially served adult population: 45,962
b. The JHN, with 75% of community health care providers as members, expects to provide
access, care, and/or referral to community based resources for 75% of the adult
population (92,289) in the community. The JHN would provide care for serious mental
illness to 46,237 (92,289-45,962) adults. JHN would also provide mental health services
for 75% of the total adult population (92,289) for any mental illness not considered
serious.
V. Prevalence Rates Applied to the Community Adult Population
The assessment begins with the application of the overall estimate of the percent of Michigan
adults who reported ever being told by a doctor that they had a depressive disorder and the
percent of Jackson County residents who self-reported having had mental health problems
within the past 12 months. (Appendix A, Table 1)
This will be followed by applying the prevalence rates of each serious and other mental
illness to the adult population of interest. Mental illnesses will be further stratified within the
expected care levels of the JHN.
The assessment concludes with data that document the number and rate of patients who were
screened for depression within selected primary care practices in Jackson County, and
number and percent referred for health coaching assistance.
Adults with Serious Mental Illness (SMI). Serious mental illnesses include major depression,
schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder, post-
traumatic stress disorder and borderline personality disorder.12
SAMHSA estimated past
Back to Table of Contents
11
LifeWays Community Mental Health, Network Capacity Evaluation of Fiscal Years 2009-2011, December 15, 2011
12
http://www.nami.org/Template.cfm?Section=By_Illness, retrieved December 19,3013
6. 6
past year SMI among adults aged 18 or older at 3.9 percent (9.0 million adults).13
This
revised estimate is lower than the 7.3% estimate used by LifeWays in their most recent
Network Capacity Evaluation. SAMHSA’s revisions are due to improvements in methods
for estimating mental illness that are more accurate. The estimates of mental illness for those
aged 18 to 25 are most impacted by the revisions. It is also important to recognize that
although there is a generally accepted definition of serious mental illness that includes
specific disorders, any mental illness can be serious.
The 3.9% revised estimate results in an estimated 4,779 adults in Jackson County who may
have a serious mental illness. (Appendix A, Table 2) Individual estimates of the prevalence
of each of these serious mental illnesses are also available from other sources.14,15
The
application of these estimates is shown in Appendix A (Table 3).
Adults with Any Mental Illnesses (AMI). SAMHSA has established a definition for AMI as
having at least one mental disorder, other than a developmental or substance-use disorder, in
the past 12 months, regardless of the level of impairment. Other mental illnesses include
dysthymic disorder (chronic, mild depression), generalized anxiety disorder, social phobia,
eating disorders, attention deficit hyperactivity disorder, and personality disorders. Estimates
of the prevalence of these other mental illnesses have been applied to the Jackson County
adult population in Appendix A, Table 4.
Table 5 applies the SMI and AMI prevalence rates to the proportion of the 18 and older
population expected to be served by the JHN.
By applying twelve-month prevalence and severity of DSM-IV diagnoses for which estimates
are available16
, Tables 6 and 7 stratify the number of persons potentially affected by each
disorder by severity (serious, moderate, mild) and places them into care levels of the JHN.
Estimates for any disorder, and serious, moderate and mild severity levels by co-morbidity
levels in the Kessler et. al. study are presented in Table 8. The application of these co-
morbidity estimates in tables 9 and 10 redistributes the number of persons who may have a
serious, moderate or mild severity level mental illness by disorder.
Finally, some local data is available regarding screening for depression through a current
pilot screening project in selected primary care practices (Albion, Leslie, Spring Arbor, East
Michigan) of the JHN. These data are presented in Table 11. Practices screen using the
PHQ-2 depression screening tool. Practices may follow up a positive PHQ-2 screen by
Back to Table of Contents
13
http://www.samhsa.gov/data/2k13/NSDUH148/sr148-mental-illness-estimates.htm, retrieved December 14, 2013
14
http://www.cdc.gov/mentalhealth/basics/burden.htm
15
Kessler, Chiu, Demler, Walters, op. cit., p. 617-27.
16
Kessler, Chiu, Demler, Walters, op. cit., p. 617-27.
7. 7
administering the PHQ-9, or initiating a referral for further screening and follow up with
JHN’s health coaching staff. The PHQ-9 screens for generalized anxiety disorder, bipolar
disorder, substance abuse, and schizophrenia. Referrals for health coaching are made at the
discretion of the primary care provider.
VI.Discussion
Published research demonstrates that prevalence estimates of mental illness vary widely due
to the methodologies employed (self-report versus in person interview), question content
(specific versus broad), settings, sampling frames, age ranges and diagnostic systems used to
define disorders. However, some overall correlations between population level estimates can
be seen.
Michigan’s most recent BRFS estimates 20.6% of Michigan adults reported ever being told
by a doctor that they had a depressive disorder including depression, major depression,
dysthymia, or minor depression. Although the BRFS question is more narrowly focused on
physician diagnosed depressive disorders and is not an estimate of having been diagnosed
with any mental illness within the past 12 months, it is relatively close to the national
estimate that 26.2 percent of Americans ages 18 and older – about one in four adults – suffer
from a diagnosable mental disorder in a given year.
The most recent community health assessment report for the county indicates that
approximately 17% of residents self-report having had mental health problems within the
past 12 months. The most prevalent disorder, depression (25%), correlates well with the
26.2% national estimate. As previously stated, even though mental disorders are widespread in the
population, the main burden of illness is concentrated in a much smaller proportion – about 6 percent,
or 1 in 17 – who suffer from a serious mental illness.
Estimates of serious mental illness also vary and have changed over time. Refinements in
methodology generally result in more precise, and lower, prevalence estimates. LifeWays
Network Capacity Evaluation utilized SAMHSA’s prevalence estimate of 7.3% available at
the time the 2011 evaluation was completed; SAMHSA has now revised the prevalence
estimate down to 3.9%, which theoretically cuts in half the number of adults 18 and over
estimated to have a serious mental illness in Jackson County from 8,983 to 4,779.
However, the overall estimate of 4,779 adults with a serious mental illness is dwarfed when
individual estimates of each serious mental illness disorder are applied and totaled for either
the adult county population, or JHN covered lives. Applying these individual estimates
shows that up to 19% and 26%, respectively, of the adult population that would be cared for
by the JHN, may have a serious mental illness or any mental illness (Table 5).
Back to Table of Contents
8. 8
Stratifying the number of persons potentially affected by each disorder by severity level
(serious, moderate, mild) and placing them into care levels of the JHN suggests that a
majority of care needs will fall within care coordination levels 3 and 4 of the JHN care
model, versus level 2 health coaching (Tables 6 and 7).
The difference between the overall 3.9% estimate and aggregate 19% and 26% estimates for
serious mental illness, and any mental illness, must take into consideration a number of
factors. First, severity of illness is strongly related to co-morbidity. In the Kessler et. al.
study, more than 49% of respondents with 3 or more diagnoses were classified as serious.
Fifty-five percent carried only a single diagnosis; 22%, two diagnoses; and 23%, three or
more diagnoses. The distribution of severity was quite different from the distribution of
prevalence across classes of disorder; mood disorders had the highest percentage of serious
classifications (45%) and anxiety disorders, the lowest (22.8%). The 12 highest correlations,
each exceeding 0.60, were bipolar disorder (major depressive episode with
mania/hypomania), double depression (major depressive episode with dysthymia), anxious
depression (major depressive episode with generalized anxiety disorder), comorbid
mania/hypomania and attention-deficit/hyperactivity disorder, panic disorder with
agoraphobia, comorbid social phobia with agoraphobia, and comorbid substance disorders
(both alcohol abuse and dependence with drug abuse and dependence). The prevalence of
any disorder was estimated at 26.2%, which is very consistent with other national overall
estimates of mental illness in the general adult population.
Although the application of co-morbidity estimates in tables 9 and 10 redistributes the
number of persons who may have a serious, moderate or mild severity level mental illness by
disorder, it only reduces the overall estimated number of persons who may need treatment for
each respective disorder by 4%- 5%. It does not significantly change the distribution within
care coordination levels of the JHN care model.
After applying estimates of co-morbidity, the total number of persons that may need care for
a serious mental illness is 8,839 (19% of 46,237 covered lives), and for any mental illness
24,026 (26% of 92,289 covered lives), within a 12 month period
Table 11 captures some local data on screening for depression in four primary care practices
of the Jackson Health Network, and follow up health coaching referrals. From March 2013-
March 2014, a total of 5,046 patients were screened from an attributed patient population of
6,044, for an overall screening rate of 83%. A total of 131 (2.6%) referrals were made for
health coaching assistance. The JHN health coaching staff enrolled 62 (47%) of these
referred patients into the program.
Back to Table of Contents
9. 9
VII. Current Service Delivery
This assessment incorporates service delivery provided by Lifeways to the Medicaid and
uninsured populations in Jackson County. In 2011, LifeWays served 6,676 individuals of the
11,508 persons in the two counties they estimated to have a serious mental illness, serious
emotional disturbance, developmental disability, substance use disorder, or co-occurring
mental illness and substance use disorder. With 78% of persons served located in Jackson
County, it is estimated that 61% of the Jackson County need of 8,542 was met. The overall
penetration rate of 58.01% is less than the 2008 rate of 73.97%. LifeWays reports that the
service needs of the developmentally disabled and those with a substance use disorder were
not met, with penetration rates of 64% and 12%, respectively.
VIII. Accessibility of Service Providers
a. LifeWays reports many referrals are made out of county because their current provider
network does not have the capacity to serve consumers in need of specialized residential
services. LifeWays is reviewing their network’s current bed capacity and plans to make
recommendations to address the need for more specialized beds in the catchment area to
prevent the need to move consumers out of county.
b. They also report an unmet need for psychological testing which is resulting in out of
network referrals. LifeWays contracts with one provider for this service, but the provider
does not maintain the equipment needed to perform certain tests. When this need arises,
they send the referral to Allegiance Health under a single-case agreement to perform the
required tests. However, LifeWays reports that Allegiance Health is not interested in
adding this to their service array as they report not having capacity to accept routine
referrals from LifeWays.
c. LifeWays also reports that a children’s psychiatric inpatient provider is not available
within their two county service area. Concerns were also expressed about the availability
of crisis residential and intensive crisis stabilization services, or alternative housing
services for children whose home environment is unsafe.
IX. Current Network Characteristics
a. The overall number of LifeWays network providers is 67, between Jackson County,
Hillsdale County, and out of county providers. This is an increase in the number of out
of county providers from 6 in 2007 to 14 in 2011. Twenty two (22) are providers of
behavioral health outpatient services, twelve (12) are residential service providers, two
(2) provide outpatient and residential services, eight (8) provide psychiatric inpatient
services, and two (2) provide co-occurring mental health and substance abuse disorder
services. Fourteen (14) providers offer services in both Jackson and Hillsdale counties,
five (5) providers offer services in Jackson County only, and three (3) providers offer
Back to Table of Contents
10. 10
services in Hillsdale County only. The JHN can reasonably expect that JHN providers
would use these same providers for referrals for mental health disorders.
b. Thirty (30) providers are accredited through various accrediting bodies. LifeWays
waives the accreditation requirement for providers having a contractual arrangement of
less than $200,000 per year.
X. Limitations of this Assessment
This assessment is subject to the limitations of the various peer reviewed published
research articles and sources cited throughout the assessment.
With regard to the National Comorbidity Survey Replication (NCS-R) study by Kessler
et. al., several important population segments are underrepresented. These include the
homeless, those in institutions, and those who cannot speak English. The first two
exclusions reduce prevalence estimates.
Those with mental illness might be more reluctant to participate in mental health surveys.
The 70.9% response rate in the NCS-R study means that nearly 30% of eligible
respondents are not represented in the study’s sample. Selection bias related to mental
illness has been reported in other community surveys. To the extent that bias exists, it
will make the prevalence estimates more conservative.
Participants might have underreported 12-month prevalence. This possibility is
consistent with evidence in the methodological evidence that embarrassing behaviors are
often underreported. Underreporting bias can be reduced by using strategies aimed at
decreasing embarrassment, a number of which were used in the NCS-R study.
The interview tool used in the NCS-R study is lay-administered. However, a clinical
reappraisal study found generally good individual-level concordance between the lay
interview and a Structured Clinical Interview for DSM-IV (SCID) disorders and
conservative estimates of prevalence compared with the SCID.
The NCS-R study did not include all DSM-IV diagnoses. Schizophrenia and other
nonaffective psychoses were excluded because previous studies have shown they are
dramatically overestimated in lay-administered interviews. The exclusion of these
disorders prohibited the distribution of the number of persons who could be diagnosed
with a serious, moderate and mild severity level disorder and an adjustment for
comorbidity in tables 9 and 10. However, the distribution of these disorders by co-
morbidity level is likely consistent with all other disorders in tables 9 and 10.
XI. Conclusions
a. Using national and state level prevalence estimates, this assessment provides a reasonably
accurate estimate of the number of adults aged 18-64 in Jackson County who may have a
DSM-IV diagnosable mental illness within any given 12-month period.
Back to Table of Contents
11. 11
b. The total number of patients that may be diagnosed by JHN health care providers could
be as high as 23,264 in one year, or 26% of the JHN covered lives of 92,289.
c. Based on a distribution of severity level within care levels of the JHN, 9,735 (77%) of
these patients could be served by care coordinators, and 2,947 (23%) by health coaches.
d. The impact on health care providers and the JHN is not immediate, but can be expected
to scale up with full implementation of the comprehensive health assessment tool and
planned expansion in the number of covered lives in the network over the next 3 years.
e. The JHN needs to plan to provide screening, diagnosis, treatment and referral for
Medicaid and the uninsured that have a mental illness that is not classified as serious.
f. LifeWays reports, utilizing their array of network providers, that their overall penetration
rate for service to their priority population in 2011 was 58.01%. The only groups
identified as not having their service needs met were the developmentally disabled and
those with a substance use disorder.
g. LifeWays reports other unmet needs in the local provider network:
i. Psychological testing
ii. Children’s psychiatric inpatient provider
iii. Availability of crisis residential, intensive crisis stabilization services, and
alternative housing services for children whose home environment is unsafe.
h. The capacity of the local behavioral health/mental health provider network to meet
increased demand as a result of more screening, diagnosis, and referral is not accurately
known.
i. The current capacity and willingness of health care providers to screen, diagnose, and
treat mental illness in the practice setting is unknown, although some data from past
surveys focused on these topics may be available for review.
j. Although every effort was made to separate serious mental illness from any mental
illness in this assessment, it is likely that estimates of any mental illness includes serious
mental illness.
k. For service delivery planning and system capacity building purposes, the number of
persons with each respective disorder reflected in Tables 9 and 10 should be used.
XII. Recommendations and Next Steps
a. The results of this assessment should be used by the JHN for service delivery system
planning, including clinically integrated care coordination efforts, and screening,
diagnosis, treatment, management, and referral at the primary care provider level.
b. An assessment should be conducted to determine the current level of professional training
and education, comfort and willingness of primary care providers to screen, diagnose,
treat, manage, and refer patients for mental illness.
Back to Table of Contents
12. 12
c. An assessment should be conducted among primary care providers to determine the
extent to which care for mental illness disorders is currently being provided.
d. Primary care providers should be approached to help establish the specific mental illness
disorders that can be successfully treated and managed at the primary care level, as well
as those that should be referred for further testing, evaluation, and inpatient care.
e. A study of current and future inpatient care utilization for mental illness disorders should
be undertaken and decisions should be made about where and how this care will be
delivered, as well as the medical specialties that may be needed.
f. The Health Officer should characterize the potential demand for mental illness care by
year for 2014-2016, based on the expected number of covered lives.
g. The Health Officer, Allegiance Health Behavioral Health, Allegiance Health Prevention
and Community Health, and the JHN and should engage with the Behavioral Health
Summit and Behavioral Health Action Team to conduct a system-wide scan of the
behavioral health services system in order to:
i. Fully assess the existing and future needed capacity of the local outpatient
behavioral health/mental health provider network.
ii. Address the psychological testing, psychiatric inpatient and crisis related
services needs identified in this assessment.
iii. Seek support for additional studies and assessments that need to be
completed.
Back to Table of Contents
13. APPENDIX A: Tables
A. Prevalence Rates
Table 1 Estimated Number of Jackson County Adults 18 and Older Reporting Depressive Disorders or Having Had Mental Health Problems
Within the Past 12 Months
Total General Population Jackson County 123,053
Prevalence Rate Estimate
Reporting Depressive Disorder17
20.6% 26,141
Reporting Mental Health Problems18
17.0% 20,919
Table 2 Estimated Prevalence of Serious Mental Illness (SMI) Among Adults 18 and Older in Jackson County
Total General Population Jackson County 123,053
Prevalence Rate Estimate
Serious Mental Illness19
3.9% 4,779
Table 3 Estimated Prevalence20
of SMI by Type of Disorder, Jackson County (N=123,053)
Major Depressioni
6.7% 8,244
Schizophrenia21
1.1% 1,354
Obsessive Compulsive Disorderii
1.0% 1,230
Bipolar Disorderiii
2.6% 3,199
Panic Disorderiv
2.7% 3,322
Posttraumatic Stress Disorderv
3.5% 4,307
Borderline Personality Disorder22
1.6% 1,969
Total 23,625
17
Fussman, op. cit., p.30
18
Health Improvement Organization, 2011 Community Health Assessment Survey
19
http://www.samhsa.gov/data/2k13/NSDUH148/sr148-mental-illness-estimates.htm
20
Kessler, Chiu, Demler, Walters, op. cit., p. 617-27.
21
Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de facto mental and addictive disorders service system. Epidemiologic Catchment Area
prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry. 1993 Feb;50(2):85-94.
22
Lenzenweger, M.F., Lane, M.C., Loranger, A.W., Kessler, R.C. (2007). DSM-IV personality disorders in the National Co-morbidity Survey Replication. Biological Psychiatry,
62(6), 553-564.
14. 14
Table 4 Estimated Prevalence23
of Any Mental Illness (excluding SMI) by Type of Disorder, Jackson County (N=123,053)
Dysthymic Disordervi
1.5% 1,845
Generalized Anxiety Disordervii
3.1% 3,814
Social Phobiaviii
6.8% 8,367
Eating Disorders24,ix
4.4% 5,414
Attention Deficit Hyperactivity Disorderx
4.1% 2,243
Personality Disorders25
9.1% 11,197
Total 32,880
i
Leading cause of disability for ages 15-44; more prevalent in women than men.
ii
Median age of onset is 19 years.
iii
Median age of onset is 25 years, more common in women than men.
iv
Median age of onset is 24 years.
v
Can develop at any age, but median age of onset is 23 years.
vi
Symptoms must persist for at least two years in adults to meet criteria for diagnosis; median age of onset is 30 years.
vii
Median age of onset is 31 years; most disorders are more prevalent in women than men.
viii
Begins in childhood or adolescence, typically around 13 years of age.
ix
Women are three times as likely as men to develop eating disorders.
xx
Common mental disorder in children and adolescents, affects an estimated 4.1% of adults ages 18-44, in a given year. Prevalence rate applied to 54,716 adults, 18-44 years old,
2010 Census.
23
Kessler, Chiu, Demler, Walters, op. cit., p. 617-27.
24
Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Co-morbidity Survey Replication. Biol Psychiatry. 2007; 61:348-
58.
25
Lenzenweger, M.F., Lane, M.C., Loranger, A.W., Kessler, R.C. (2007). DSM-IV personality disorders in the National Co-morbidity Survey Replication. Biological Psychiatry,
62(6), 553-564.
15. 15
Table 5. Estimated Prevalence of SMI in 18 and Older Population Expected to be Served by JHN (N=46,237)
Major Depression 6.7% 3,104
Schizophrenia 1.1% 509
Obsessive Compulsive Disorder 1.0% 462
Bipolar Disorder 2.6% 1,202
Panic Disorder 2.7% 1,248
Posttraumatic Stress Disorder 3.5% 1,618
Borderline Personality Disorder 1.6% 740
Total 8,883
Estimated Prevalence of AMI in 18 and Older Population Expected to be Served by JHN (N=92,289)
Dysthymic Disorder 1.5% 1,384
Generalized Anxiety Disorder 3.1% 2,860
Social Phobia 6.8% 6,275
Eating Disorders 4.4% 4,060
Attention Deficit Hyperactivity Disorder1
4.1% 1,054
Personality Disorders 9.1% 8,398
Total 24,031
1
Percentage applied to 44% of 57,818 adults age 18 and older: 25,709
16. 16
Table 6. Estimated Number of SMI DSM-IV Diagnosed Disorders by Severity (serious, moderate, mild) within Care Levels of the Jackson
Health Network N=8,883
JHN Level of
Care
Type of
Intervention
MD SZ OCD BD PD PTSD BPD Total
Severity & #
Affected
n=3,104
Severity & #
Affected
n=509
Severity & #
Affected
n=462
Severity & #
Affected
n=1,202
Severity & #
Affected
n=1,248
Severity & #
Affected
n=1,618
Severity &
# Affected
n=740
5 Special
Needs
Navigator
Assistance
4 Complex,
including
LTC
Care
Coordination
Serious
944
Not Avail
Serious
234
Serious
996
Serious
559
Serious
592
Not Avail 3,325*
3 More
Complex
Mix, Higher
Utilization,
Disease
Mgt
Care
Coordination
Moderate
1,555
Not Avail
Moderate
161
Moderate
206
Moderate
368
Moderate
536
Not Avail
2,826*
2 Moderate
Complexity
Health Coach
& Behavioral
Health Care
via PCP
Mild
605
Not Avail
Mild
67
Mild
0
Mild
321
Mild
489
Not Avail
1,482*
1 Minor/No
Needs, 1st
Level
Prevention
Community
& Population
Based
Total 3,104 509 462 1,202 1,248 1,617 740 8,883
Key: MD - Major Depression
SZ - Schizophrenia
OCD - Obsessive-Compulsive Disorder
BD - Bipolar Disorder
PD - Panic Disorder
PTSD - Posttraumatic Stress Disorder
BPD - Borderline Personality Disorder
* - Row total does not include estimated number of persons with schizophrenia and borderline personality disorder
17. 17
Table 7. Estimated Number of AMI DSM-IV Diagnosed Disorders by Severity (serious, moderate, mild) within Care Levels of the Jackson
Health Network N=24,031
JHN Level of
Care
Type of
Intervention
DD GAD SP ED ADHD PD Total
Severity & #
Affected
n=1,384
Severity & #
Affected
n=2,860
Severity & #
Affected
n=6,275
Severity & #
Affected
n=4,060
Severity & #
Affected
n=1,054
Severity & #
Affected
n=8,398
5 Special
Needs
Navigator
Assistance
4 Complex,
including
LTC
Care
Coordination
Serious
687
Serious
923
Serious
1,876
Not Avail Serious
435
Not Avail 3,921*
3 More
Complex
Mix, Higher
Utilization,
Disease Mgt
Care
Coordination
Moderate
444
Moderate
1,275
Moderate
2,435
Not Avail Moderate
371
Not Avail
6,401*
2 Moderate
Complexity
Health Coach &
Behavioral
Health Care via
PCP
Mild
251
Mild
660
Mild
1,964
Not Avail Mild
247
Not Avail 3,122*
1 Minor/No
Needs, 1st
Level
Prevention
Community &
Population
Based
Total 1,382 2,858 6,275 4,060 1,053 8,398 24,026
Key: DD - Dysthymic Disorder
GAD - Generalized Anxiety Disorder
SP - Social Phobia
ED - Eating Disorder
ADHD- Attention Deficit Hyperactivity Disorder
PD - Personality Disorders
* - Row total does not include estimated number of persons with eating and personality disorders
18. 18
Table 8. Twelve-Month Prevalence Estimates for DSM-IV Disorders by Serious, Moderate and Mild Severity and Co-morbidity Levels
Total Serious Moderate Mild
Any Disorder 26.2% 22.3% 37.3% 40.4%
1 disorder 14.4% 9.6% 31.2% 59.2%
2 disorders 5.8% 25.5% 46.4% 28.2%
≥disorders 6.0% 49.9% 43.1% 7.0%
Table 9. Estimated Number of SMI DSM-IV Diagnosed Disorders Adjusted for Co-morbidity by Severity (serious, moderate, mild) within
Care Levels of the Jackson Health Network N=8,883
JHN Level of
Care
Type of
Intervention
MD SZ OCD BD PD PTSD BPD Total
Severity & #
Affected
n=3,104
Severity & #
Affected
n=509
Severity & #
Affected
n=462
Severity & #
Affected
n=1,202
Severity & #
Affected
n=1,248
Severity & #
Affected
n=1,618
Severity &
# Affected
n=740
5 Special
Needs
Navigator
Assistance
4 Complex,
including
LTC
Care
Coordination
Serious
802
Not Avail
Serious
199
Serious
847
Serious
475
Serious
503
Not Avail 2,826*
3 More
Complex
Mix, Higher
Utilization,
Disease Mgt
Care
Coordination
Moderate
1,555
Not Avail
Moderate
201
Moderate
257
Moderate
368
Moderate
536
Not Avail 2,917*
2 Moderate
Complexity
Health Coach
& Behavioral
Health Care
via PCP
Mild
571
Not Avail
Mild
62
Mild
0
Mild
302
Mild
462
Not Avail
1,397*
1 Minor/No
Needs, 1st
Level
Prevention
Community
& Population
Based
Total 2,928 509 462 1,104 1,145 1,501 740 8,389
* - Row total does not include estimated number of persons with schizophrenia and borderline personality disorder
19. 19
Table 10. Estimated Number of AMI DSM-IV Diagnosed Disorders Adjusted for Co-morbidity by Severity (serious, moderate, mild) within
Care Levels of the Jackson Health Network N=24,031
JHN Level of
Care
Type of
Intervention
DD GAD SP ED ADHD PD Total
Severity & #
Affected
n=1,384
Severity & #
Affected
n=2,860
Severity & #
Affected
n=6,275
Severity & #
Affected
n=4,060
Severity & #
Affected
n=1,054
Severity & #
Affected
n=8,398
5 Special
Needs
Navigator
Assistance
4 Complex,
including
LTC
Care
Coordination
Serious
584
Serious
785
Serious
1,595
Not Avail Serious
370
Not Avail 3,334*
3 More
Complex
Mix, Higher
Utilization,
Disease Mgt
Care
Coordination
Moderate
444
Moderate
1,275
Moderate
2,435
Not Avail Moderate
371
Not Avail
6,401*
2 Moderate
Complexity
Health Coach &
Behavioral
Health Care via
PCP
Mild
237
Mild
623
Mild
1,854
Not Avail Mild
233
Not Avail 2,947*
1 Minor/No
Needs, 1st
Level
Prevention
Community &
Population
Based
Total 1,265 2,683 5,884 4,060 974 8,398 23,264
* - Row total does not include estimated number of persons with eating and personality disorders
20. 20
Table 11. Depression screening rates in selected JHN primary care practices, March 2013-March 2014.
Attributed Number of Patients
(March 2012-March 2014)
Depression Screening
March 2013-March 2014
Referrals for Health Coaching
7,173
Attributed
Patients
#
Screened
% Screened
# of
Referrals
# (%)
# of Referrals
Accepted
Enrollment
# (%)
6,044 5,046 83% 131 2.6% 131 62 (47%)