scholarly journals First-person experiences of recovery in co-occurring mental health and substance use conditions

2017 ◽  
Vol 10 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Eva Brekke ◽  
Lars Lien ◽  
Larry Davidson ◽  
Stian Biong
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Social Services ◽  
Phenomenological Approach ◽  
Concurrent Disorders ◽  
Content Type ◽  
Community Factors ◽  
Four Dimensions ◽  
Individual Interviews ◽  
Recovery Orientation

Purpose The purpose of this paper is to explore and describe experiences of recovery among people with co-occurring mental health and substance use conditions (co-occurring conditions) in a rural community in Norway. Design/methodology/approach In-depth individual interviews with eight persons with co-occurring conditions were conducted, audiotaped, transcribed and analysed using a phenomenological approach. This study is part of a research project investigating recovery orientation of services in a Norwegian district. Findings The analysis yielded four dimensions of recovery: feeling useful and accepted; coming to love oneself; mastering life; and emerging as a person. Insecure and inadequate housing and limited solutions to financial problems were described as major obstacles to recovery. Research limitations/implications Further research into the facilitation of recovery as defined by persons with concurrent disorders is needed, particularly regarding the facilitation of community participation. Practical implications This study supports an increased focus on societal and community factors in promoting recovery for persons with co-occurring conditions, as well as service designs that allow for an integration of social services and health care, and for collaboration among services. Social implications The results suggest that the community can aid recovery by accepting persons with co-occurring conditions as fellow citizens and welcoming their contributions. Originality/value The paper provides an enhanced understanding of how persons with co-occurring conditions may experience recovery.

Relational recovery in co-occurring conditions: a qualitative study of first-person experiences

2020 ◽  
Vol 13 (2) ◽  
pp. 89-100
Author(s):  
Eva Brekke ◽  
Ottar Ness ◽  
Lars Lien
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Qualitative Study ◽  
Interpersonal Relationships ◽  
Design Methodology ◽  
First Person ◽  
Collaborative Approach ◽  
Content Type ◽  
Individual Interviews ◽  
Relational Process

Purpose The purpose of this paper is to explore and describe first-person experiences of relational recovery in co-occurring mental health and substance use conditions. Design/methodology/approach Within a phenomenological and collaborative approach, in-depth individual interviews with eight persons with co-occurring conditions were analysed using systematic text condensation. Findings Participants described interpersonal relationships as both supporting and hindering recovery in fundamental ways. Four categories of experiences of relational recovery were described as follows: choosing one’s child; living with loneliness and a painful past; sacrificing everything for one’s partner; and regaining trust and support. Originality/value This paper provides an enhanced understanding of how interpersonal relationships may be experienced by persons who live with co-occurring conditions. The results generally support an understanding of recovery as a relational process.

Young construction workers: substance use, mental health, and workplace psychosocial factors

2017 ◽  
Vol 10 (4) ◽  
pp. 155-168 ◽  
Author(s):  
Ken Pidd ◽  
Vinita Duraisingam ◽  
Ann Roche ◽  
Allan Trifonoff
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Substance Use ◽  
Psychological Distress ◽  
Construction Industry ◽  
Psychosocial Factors ◽  
Job Stress ◽  
Poor Mental Health ◽  
Psychological Wellbeing ◽  
Content Type

Purpose Young Australian workers are at elevated risk of mental health and alcohol and other drug related problems. The purpose of this paper is to examine the relationship between alcohol and drug (AOD) use, psychological wellbeing, and the workplace psychosocial environment among young apprentices in the construction industry. Design/methodology/approach A cross-sectional survey of a cohort of 169 construction industry apprentices in their first year of training was undertaken. The survey included measures of psychological distress (K10), quantity/frequency measures of alcohol and illicit drug use, and workplace psychosocial factors. Findings Construction industry apprentices are at elevated risk of AOD related harm and poor mental health. Levels of psychological distress and substance use were substantially higher than age/gender equivalent Australian population norms. Job stress, workplace bullying, and general social support accounted for 38.2 per cent of the variance in psychological distress. General social support moderated the effects of job stress and bullying on psychological distress. Substance use was not associated with psychological distress. However, workplace social support accounted for 2.1 per cent of the variance in AUDIT-C scores, and 2.0 per cent of the variance in cannabis use. Workplace bullying explained 2.4 per cent of the variance in meth/amphetamine use. Practical implications Construction trades apprentices are a high-risk group for harmful substance use and poor mental health. Study results indicate that psychosocial wellbeing interventions are warranted as a harm reduction strategy. Originality/value This is the first study of its kind to describe a cohort of Australian construction trade apprentices in terms of their substance use and psychological wellbeing. The study shows workplace psychosocial factors may predict young workers psychological wellbeing.

On the go – parents are working 24/7

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mbita Mbao ◽  
Johnnie Hamilton-Mason
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
African Immigrants ◽  
Social Constructionist ◽  
Community Leaders ◽  
Work Culture ◽  
Content Type ◽  
The Usa ◽  
African Community ◽  
Community Data

Purpose The purpose of this study was to explore the perceptions of African community leaders, on factors that influence substance use and mental health status of Sub-Sahara African immigrants living in the northeast region of the USA. Design/methodology/approach A social constructionist approach to grounded theory was used to understand social life’s complexity in the African community. Data analysis consisted of initial coding and focused coding, which led to the emerging of the following mid-range theories. Findings The following mid-range theories are developed: the work culture of Sub-Sahara African immigrants may influence substance-use behaviors, impact treatment for mental health and contribute to interpersonal conflicts related to marriage and parenting; there may be a relationship between the culture of privacy and spirituality because the church is often a place of comfort, and many may not seek treatment for mental health for fear of losing that community; Sub-Sahara African immigrants’ mental health and substance-use behaviors are influenced by unique factors that stem from balancing living in the new culture while also preserving their unique cultural norms. Originality/value The analysis of perceptions of African community leaders underscored “On the go” as a metaphor for describing Sub-Sahara African immigrants.

Hope and recovery: a scoping review

2014 ◽  
Vol 7 (2) ◽  
pp. 63-72 ◽  
Author(s):  
Knut Tore Sælør ◽  
Ottar Ness ◽  
Helge Holgersen ◽  
Larry Davidson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Limited Attention ◽  
Research Activity ◽  
Content Type ◽  
Recovery Processes ◽  
Ovid Medline ◽  
Substance Use Problems ◽  
Literature Searches ◽  
Broad Approach

Purpose – Hope is regarded as central to recovery processes. The phenomenon along with its implications for research and practice has, however, gained limited attention within the fields of mental health and substance use. The purpose of this paper is to explore how hope, and what may inspire it, is described within the literature by persons experiencing co-occurring mental health and substance use problems. Design/methodology/approach – The method chosen when conducting this literature review was a scoping study. This allows for a broad approach, aiming to examine research activity and identifying potential gaps within existing literature. Searches were conducted in EMBASE Ovid, PsychINFO Ovid, MEDLINE Ovid, CINAHL Ebsco, SveMed+ and Brithish Nursing Index. Findings – The authors included five articles and one book. None of these presented first-hand experiences of hope and there appears to be a gap in the literature. All included material underlined the importance of the phenomenon to those experiencing co-occurring mental health and substance use problems. Originality/value – Hope seems as important to people experiencing co-occurring problems as to anyone else. There appears to be a need for further research on how persons experiencing co-occurring problems perceive hope and what may inspire it. Hope and what people hope for take many forms and can arise unexpectedly. Practitioners need to take in account the diversity of the phenomenon and find ways of inspiring hope in collaboration with those in need of support.

A systematic review of studies examining effectiveness of therapeutic communities

2014 ◽  
Vol 35 (4) ◽  
pp. 168-184 ◽  
Author(s):  
Lynne Magor-Blatch ◽  
Navjot Bhullar ◽  
Bronwyn Thomson ◽  
Einar Thorsteinsson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Social Engagement ◽  
Complex Interventions ◽  
Criminal Activity ◽  
Therapeutic Communities ◽  
Health Issues ◽  
Content Type ◽  
Mental Health Issues

Purpose – The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment of substance-use disorders with reference to substance-use, crime, mental health and social engagement outcomes. Design/methodology/approach – A systematic search with broad inclusion criteria resulted in the review of 11 studies. The studies investigated community-based TCs, as well as TCs modified for prisoners, prisoners transitioning to community living and TCs for individuals with co-occurring substance-use and mental health issues. Findings – Results were analysed by comparing the findings of the studies under investigation, of which three studies investigated within-subjects outcomes, four compared TC treatment with a no-treatment control condition and four compared TC treatment with another treatment condition. Conclusion: consistent with previous systematic reviews of TCs, outcomes varied across studies but indicated TCs are generally effective as a treatment intervention, with reductions in substance-use and criminal activity, and increased improvement in mental health and social engagement evident in a number of studies reviewed. Research limitations/implications – Variability in outcomes suggests further TC research and research syntheses focusing on a second key research question in the evaluation of complex interventions – how the intervention works – could play an important role in understanding TC effectiveness, and for whom it is effective and in what contexts. Practical implications – Although there is some variability in treatment populations included in this review, evidence reported in other studies suggests individuals with severe substance-use disorders, mental health issues, forensic involvement and trauma histories, will benefit from TC treatment. This is supported by the literature which has found a general relationship between severity of substance use and treatment intensity (Darke et al., 2012; De Leon et al., 2008) with outcomes further enhanced by self-selection into treatment and appropriate client-treatment matching (see De Leon, 2010; De Leon et al., 2000, 2008). The weight of evidence gleaned from multiple sources of research, including randomised control trials and field outcome studies (De Leon, 2010) suggests TCs are an important and effective treatment for clients in improving at least some aspects of their quality of life, specifically mental health and social engagement, and in reducing harmful behaviours, including substance-use and crime. Variability in treatment setting and populations reflect the real-world setting in which TC treatment is delivered, providing a multifaceted treatment modality to a complex population in variable circumstances. Originality/value – The strength of the current study is that it provided a broad evaluation of TC effectiveness across a range of outcomes (substance-use, criminal activity, mental health and social engagement), and is therefore valuable in updating the current literature and providing context for future research in this area. It aimed to address a key question in evaluating complex interventions: whether they are effective as they are delivered. Findings suggest that TC treatment is generally effective for the populations of concern in reducing substance use and criminal activity and contributing to some improvement in mental health and social engagement outcomes.

Expanding the use of the ASAM CriteriaTM to make mental health level of care placements

2018 ◽  
Vol 11 (2) ◽  
pp. 49-59
Author(s):  
Walter Matthew Drymalski
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Behavioral Health ◽  
Mental Health Treatment ◽  
Independent Living ◽  
Psychotic Symptoms ◽  
Health Issues ◽  
Addiction Medicine ◽  
Content Type ◽  
Living Skills

Purpose Despite the prevalence of co-occurring mental health and substance use disorders, the assessment and placement processes for each often remain separate. The purpose of this paper is to describe an expanded use of the American Society of Addiction Medicine (ASAM) CriteriaTM to make placements into substance use, co-occurring, and mental health treatment. Design/methodology/approach A rationale for the development of two new domains (Domain 7, substance use and Domain 8, independent living skills) and preliminary data supporting the use of the ASAM CriteriaTM as a placement process for all types of behavioral health issues will be provided. Findings Dimension 3 and Domains 7 and 8 were correlated with selected clinical indices in the expected direction (Dimension 3: depression (F (4, 4650)=202.092, p<0.001), medication usage (F (4, 4,637)=174.254, p<0.001), and psychotic symptoms (F (4, 4,561)=62.954, p<0.001); Domain 7: alcohol use (F (4, 4,458)=213.786, p<0.001) and drug use (F (4, 4,471)=611.491, p<0.001); and Domain 8: functional impairment (F (4, 3,927)=815.646, p<0.001) and number of “high needs” (F (4, 3,927)=737.568, p<0.001). Research limitations/implications The limitations of this research included a lack of inter-rater reliability data and less established intake assessments. Practical implications This single placement approach for clients seeking behavioral health services can create a more efficient, person-centered intake experience. Originality/value This paper suggests that it is possible to deploy a single assessment and placement approach for all types of behavioral health issues.

scholarly journals Immigrant women, nature and mental health

2020 ◽  
Vol 16 (4) ◽  
pp. 359-372
Author(s):  
Catherine Anne Nicole Lorentzen ◽  
Berit Viken
Keyword(s):  
Mental Health ◽  
Immigrant Women ◽  
Qualitative Content Analysis ◽  
Low Cost ◽  
Cost Effective ◽  
Well Being ◽  
Natural Environments ◽  
Content Type ◽  
Individual Interviews ◽  
Effective Strategies

Purpose There is a need for cost-effective strategies to counteract mental health challenges among immigrant women. This study aims to identify how nature might improve the mental health status of immigrant women residing in Norway. Design/methodology/approach Qualitative data were gathered through individual interviews with 14 immigrant women from Iran (2), Poland (2), Palestine, Afghanistan, Congo, Kenya, Thailand, Russia, Portugal, Latvia, Colombia and Bulgaria. Findings The qualitative content analysis revealed that interaction with nature positively influenced the immigrant women’s mental health. This occurred because of the following: exposure to nature itself, leading to mood enhancements; familiarization with the new country’s culture, nature, climate and language, facilitating feelings of mastery, attachment and belonging; social interactions, promoting immediate well-being and future social support; interacting with nature in familiar ways, reducing feelings of alienation/loss; and physical activity, improving mood and stress-related conditions. These mental health improvements were a result of interactions with various types of natural environments. Originality/value This study supports the promotion of interaction with nature among immigrant women as part of low-cost public health work. Practitioners should consider multiple arenas for potential nature-related mental health gains.

Mental health correlates of substance use behaviors among a nationally representative sample of juvenile offenders

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steven L. Proctor ◽  
Albert M. Kopak
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Juvenile Offenders ◽  
Representative Sample ◽  
Health Knowledge ◽  
Health Issues ◽  
Content Type ◽  
Mental Health Issues ◽  
Health Domains ◽  
Nationally Representative

Purpose This paper aims to extend previous findings by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative sample of juvenile offenders. Design/methodology/approach Survey of Youth in Residential Placement interview data from 6,920 juvenile offenders (76% male) detained in 290 US facilities were analyzed to determine bivariate relationships between two indicators of substance use (acute and chronic) and seven mental health domains (depression/isolation, anxiety, anger, trauma, inattention, hallucinations and suicidality). Findings Prevalence rates of above average indications for all seven mental health domains were significantly higher among offenders under the influence of a substance at the time they committed their instant offense compared to those not under the influence. Offenders with above average indications in the seven studied mental health areas reported a higher level of chronic effects of substance use relative to those with average or below mental health indications. Practical implications The results have important implications for the assessment and treatment of co-occurring mental health issues among juvenile offenders with substance use issues. Juveniles with above average mental health indications may be more prone to experiencing a number of substance-related problems. Observed results may guide the implementation of routine assessment procedures at the juvenile detention level. Intake specialists should screen and administer comprehensive mental health assessments for juveniles who report substance intoxication at the time of their instant offense. Juvenile offenders who report clinical levels of mental health symptoms should receive a comprehensive assessment of substance use and related problems. Originality/value Although the co-occurrence of substance use and mental health issues among juvenile justice involved populations is well documented, previous research studies in this area have included a number of limitations. Relatively small offender sample populations, often from a single facility, warrant further work with a large, nationally representative sample of juvenile offenders. Inconsistency in measures of substance use and the failure to distinguish between acute and chronic measures of substance use in prior studies also require further investigation. This study contributes to the extant co-occurring substance use and mental health knowledge base by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative sample of juvenile offenders.

Substance use, mental health, chronic medical conditions and criminal justice contact in a nationally representative sample

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Albert Kopak
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Substance Use ◽  
Criminal Justice ◽  
Drug Use ◽  
Health Conditions ◽  
Chronic Medical Conditions ◽  
Content Type ◽  
Unique Approach ◽  
Criminal Justice Contact

Purpose The amount of overlap between criminal justice practices and public health is growing and more research is needed to guide new initiatives. This study was designed to assess the relationships between various chronic medical conditions, substance use severity, mental health indicators and criminal justice contact using the National Survey on Drug Use and Health. Design/methodology/approach Analyses were conducted in three stages to comprehensively examine the relationships between various indicators of physical health, mental health, substance use severity and criminal justice contact. Findings Results demonstrate indicators of substance use severity surpass physical and mental health conditions as stronger determinants of any criminal justice contact, as well as repeated interactions with police. In addition, combinations of multiple conditions increase the likelihood of criminal justice involvement, but substance use remains a consistent factor contributing to the strongest associations. These findings highlight the importance of capitalizing on the initial point of criminal justice contact to address substance use to prevent further and subsequent involvement in the system. Research limitations/implications Criminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest. Practical implications The least harmful practices should be adopted to address health conditions at the time of criminal justice contact. These practices should focus heavily on injection drug use as a primary factor associated with the prior arrest. Practices designed to divert arrestees with health conditions away from jails are needed. Law enforcement practices can significantly benefit from public health-oriented approaches. Originality/value Criminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest.

Dual diagnosis in older drinkers during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rahul Rao ◽  
Christoph Mueller ◽  
Matthew Broadbent
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Substance Use Disorder ◽  
Dual Diagnosis ◽  
Opioid Use ◽  
Content Type

Purpose There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use. Design/methodology/approach Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders. Findings In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005). Research limitations/implications The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers. Originality/value A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic.

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