Variations in Disaster Preparedness by Mental Health, Perceived General Health, and Disability Status

2009 ◽  
Vol 3 (1) ◽  
pp. 33-41 ◽  
Author(s):  
David P. Eisenman ◽  
Qiong Zhou ◽  
Michael Ong ◽  
Steven Asch ◽  
Deborah Glik ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Disaster Preparedness ◽  
General Health ◽  
Emergency Plan ◽  
Communication Plan ◽  
Disability Status ◽  
Fair Poor

ABSTRACTObjectives: Chronic medical and mental illness and disability increase vulnerability to disasters. National efforts have focused on preparing people with disabilities, and studies find them to be increasingly prepared, but less is known about people with chronic mental and medical illnesses. We examined the relation between health status (mental health, perceived general health, and disability) and disaster preparedness (home disaster supplies and family communication plan).Methods: A random-digit-dial telephone survey of the Los Angeles County population was conducted October 2004 to January 2005 in 6 languages. Separate multivariate regressions modeled determinants of disaster preparedness, adjusting for sociodemographic covariates then sociodemographic variables and health status variables.Results: Only 40.7% of people who rated their health as fair/poor have disaster supplies compared with 53.1% of those who rate their health as excellent (P < 0.001). Only 34.8% of people who rated their health as fair/poor have an emergency plan compared with 44.8% of those who rate their health as excellent (P < 0.01). Only 29.5% of people who have a serious mental illness have disaster supplies compared with 49.2% of those who do not have a serious mental illness (P < 0.001). People with fair/poor health remained less likely to have disaster supplies (adjusted odds ratio [AOR] 0.69, 95% confidence interval [CI] 0.50–0.96) and less likely to have an emergency plan (AOR 0.68, 95% CI 0.51–0.92) compared with those who rate their health as excellent, after adjusting for the sociodemographic covariates. People with serious mental illness remained less likely to have disaster supplies after adjusting for the sociodemographic covariates (AOR 0.67, 95% CI 0.48–0.93). Disability status was not associated with lower rates of disaster supplies or emergency communication plans in bivariate or multivariate analyses. Finally, adjusting for the sociodemographic and other health variables, people with fair/poor health remained less likely to have an emergency plan (AOR 0.66, 95% CI 0.48–0.92) and people with serious mental illness remained less likely to have disaster supplies (AOR 0.67, 95% CI 0.47–0.95).Conclusions: People who report fair/poor general health and probable serious mental illness are less likely to report household disaster preparedness and an emergency communication plan. Our results could add to our understanding of why people with preexisting health problems suffer disproportionately from disasters. Public health may consider collaborating with community partners and health services providers to improve preparedness among people with chronic illness and people who are mentally ill. (Disaster Med Public Health Preparedness. 2009;3:33–41)

No health without mental health—mens sana in corpore sano

2019 ◽  
pp. 177-200
Author(s):  
John Ashton
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Public Mental Health ◽  
Public Health Approach ◽  
Planned Parenthood ◽  
Psychiatric Expertise ◽  
Recent Developments ◽  
The Media

This chapter approaches the important subject of mental health and wellbeing through the lens of public health. Drawing on his own experience as a physician who specializes in psychiatry before moving into public health the author describes the struggle to move upstream from a sole focus on treating serious mental illness to the recent developments in public mental health and offers a framework for action. This draws on a historical overview of the differing emphases that have played in over the past two hundred years. This framework focuses on public health aspects as well as prevention and mitigation of harm from serious mental illness, and addresses the need for whole population approaches to mental health and mental health promotion. Examples of interventions that draw on public health interventions are given. These include the importance of planned parenthood and sexual health, the appropriate use of psychiatric expertise in support of population and community mental health, the centrality of concepts such as self-esteem, and the necessity to take a public health approach to the new challenge of dementia. Behavioural contagion, the role of the media, and the prevention of suicide are among the topics covered.

scholarly journals Longitudinal Examination of COVID-19 Public Health Measures on Mental Health for Rural Patients With Serious Mental Illness

2020 ◽  
Author(s):  
Natalie B Riblet ◽  
Susan P Stevens ◽  
Brian Shiner ◽  
Sarah Cornelius ◽  
Jenna Forehand ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Well Being ◽  
Rural Populations ◽  
Health Measures ◽  
The Impact ◽  
Rural Patients ◽  
At Home

ABSTRACT Introduction There is emerging evidence to support that the COVID-19 pandemic and related public health measures may be associated with negative mental health sequelae. Rural populations in particular may fair worse because they share many unique characteristics that may put them at higher risk for adverse outcomes with the pandemic. Yet, rural populations may also be more resilient due to increased sense of community. Little is known about the impact of the pandemic on the mental health and well-being of a rural population pre- and post-pandemic, especially those with serious mental illness. Material and Methods We conducted a longitudinal, mixed-methods study with assessments preceding the pandemic (between October 2019 and March 2020) and during the stay-at-home orders (between April 23, 2020, and May 4, 2020). Changes in hopelessness, suicidal ideation, connectedness, and treatment engagement were assessed using a repeated-measures ANOVA or Friedman test. Results Among 17 eligible participants, 11 people were interviewed. Overall, there were no notable changes in any symptom scale in the first 3-5 months before the pandemic or during the stay-at-home orders. The few patients who reported worse symptoms were significantly older (mean age: 71.7 years, SD: 4.0). Most patients denied disruptions to treatment, and some perceived telepsychiatry as beneficial. Conclusions Rural patients with serious mental illness may be fairly resilient in the face of the COVID-19 pandemic when they have access to treatment and supports. Longer-term outcomes are needed in rural patients with serious mental illness to better understand the impact of the pandemic on this population.

scholarly journals Therapeutic Social Control of People with Serious Mental Illness: An Empirical Verification and Extension of Theory

2017 ◽  
Vol 8 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Brea L. Perry ◽  
Emma Frieh ◽  
Eric R. Wright
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Control ◽  
Serious Mental Illness ◽  
Mental Health Treatment ◽  
Structured Interview ◽  
Ethical Challenges ◽  
Therapeutic Goals ◽  
Contraception Use ◽  
Client Behavior

Mental health services and psychiatric professional values have shifted in the past several decades toward a model of client autonomy and informed consent, at least in principle. However, it is unclear how much has changed in practice, particularly in cases where client behavior poses ethical challenges for clinicians. Drawing on the case of clients’ sexual behavior and contraception use, we examine whether sociological theories of “soft” coercion remain relevant (e.g., therapeutic social control; Horwitz 1982) in contemporary mental health treatment settings. Using structured interview data from 98 men and women with serious mental illness (SMI), we explore client experiences of choice, coercion, and the spaces that lie in between. Patterns in our data confirm Horwitz’s (1982) theory of therapeutic social control but also suggest directions for updating and extending it. Specifically, we identify four strategies used to influence client behavior: coercion, enabling, education, and conciliation. We find that most clients’ experiences reflect elements of ambiguous or limited autonomy, wherein compliance is achieved by invoking therapeutic goals. However, women with SMI disproportionately report experiencing intense persuasion and direct use or threat of force. We argue that it is critical to consider how ostensibly noncoercive and value-free interventions nonetheless reflect the goals and norms of dominant groups.

scholarly journals Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Mental Healthcare ◽  
Policy Reforms ◽  
Mental Health Settings ◽  
Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness

2017 ◽  
Vol 24 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jeannemarie Baker ◽  
Jasmine L. Travers ◽  
Penelope Buschman ◽  
Jacqueline A. Merrill
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Quality Care ◽  
Coordinated Care ◽  
Community Based ◽  
Provide Quality Care

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.

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