Methodological Challenges in Retrospective Evaluation of Mental Health Court Effectiveness

2020 ◽  
Vol 14 (1) ◽  
pp. 87-105
Author(s):  
Kort C. Prince ◽  
Jeremiah W. Jaggers ◽  
Allyn Walker ◽  
Jess Shade ◽  
Erin B. Worwood
Keyword(s):  
Mental Health ◽  
The United States ◽  
Control Group ◽  
Mental Health Courts ◽  
Retrospective Evaluation ◽  
Group Design ◽  
Alternative Approach ◽  
Problem Solving Courts ◽  
Ideal Approach ◽  
The Ideal

Mental Health Courts (MHCs) are problem-solving courts that have been implemented throughout the United States. One critical component of MHCs is determining their effectiveness and limitations. However, unique challenges are encountered when evaluating MHCs. One major challenge, and the focus of this paper, is identifying an adequate control group. The ideal approach to determining efficacy is using a controlled group design whereby participants are randomized to treatment or control conditions. However, this approach is not possible when conducting retrospective evaluation of court data. In addition, a specific set of ethical and logistical issues arise. Propensity score matching (PSM) provides an alternative approach for comparing groups when randomization is not possible. PSM works by first identifying the characteristics that make a person likely to be in treatment. We describe our attempts to use PSM in a MHC evaluation. Specific challenges with PSM are discussed and recommendations are made for use of PSM with MHCs.

scholarly journals Implementation of NAVIGATE Coordinated Specialty Care for First Episode Psychosis: the Michigan Experience

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 177-178
Author(s):  
Eric D. Achtyes ◽  
Kari Kempema ◽  
Zhehui Luo ◽  
Katharine N. Thakkar ◽  
Catherine Adams ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Symptoms ◽  
The United States ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Control Group ◽  
Evidence Based ◽  
Block Grant ◽  
Episode Psychosis

AbstractStudy ObjectivesCoordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.MethodsIn 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.ResultsN=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.ConclusionThe implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.FundingSupported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

Human Rights Progress in Psychiatry: More Apparent Than Real (Observations and Reflections on Life in the Texas Mental Health Courts)

2006 ◽  
Vol 8 (3) ◽  
pp. 241-254
Author(s):  
John Breeding
Keyword(s):  
Mental Health ◽  
United States ◽  
Human Rights ◽  
Informed Consent ◽  
The United States ◽  
The Other ◽  
Mental Health Courts ◽  
Modern Psychiatry ◽  
History Of ◽  
The One

The history of modern psychiatry includes a legacy of coercion and infamous physical and mechanical treatments, on the one hand, and progress in human rights, particularly patient rights, on the other. The purpose of this article is to remind readers that this modern progress in psychiatry is more apparent than real. The author’s experience with recent cases in the mental health courts is discussed in order to demonstrate the ongoing abuse of human rights in psychiatry. A brief look at other aspects of the current mental health climate in the United States is also provided, along with considerations of informed consent.

scholarly journals Depression: The Impact On Second Generation Indo-Caribbeans Living in the United States

2021 ◽  
Author(s):  
Tricia Rampersad
Keyword(s):  
Mental Health ◽  
United States ◽  
Rural Areas ◽  
Second Generation ◽  
The United States ◽  
Psychological Issues ◽  
Therapeutic Modalities ◽  
The Caribbean ◽  
The Impact ◽  
The Ideal

This study examined 17 second-generation Indo-Caribbeans living in the United States and explored the psychological issues of depression and its impact on this population. The goal was to identify themes that will emerge regarding the ramifications and experiences of second-generation Indo-Caribbeans (ICs). The socio-economic was $0 to 150,000. Participants identified as male or female. Their parents were born in the Caribbean. Eighty-seven percent of participants’ families remained nuclear through their adolescence until adulthood. Those who inhabited areas where the population was predominately comprised of the same ethnicity group (ICs) experienced less depression. Depression was prevalent with ICs who grew up in the suburbs or rural areas. Eighty-two percent of participants experienced independence by college or marriage. All participants denied living a life based on what the ideal description of an Asian is. However, all the participants’ lifestyle contradicts this description of an Asian. The effects depression has on second generation ICs were never completed. There is no data except of in this study. The results allow research and access to providers. This study provides psychoeducation, therapeutic modalities and history. Results will alleviate pain and permits discussion to mental health. This work can influence the suicidal rate, murder suicide and domestic violence that occurs in IC communities.

Changes in Sabbath-Keeping and Mental Health Over Time: Evaluation Findings From the Sabbath Living Study

2021 ◽  
pp. 009164712110462
Author(s):  
Rae Jean Proeschold-Bell ◽  
Beth Stringfield ◽  
Jia Yao ◽  
Jessica Choi ◽  
David Eagle ◽  
...  
Keyword(s):  
Mental Health ◽  
Well Being ◽  
The United States ◽  
Personal Accomplishment ◽  
Control Group ◽  
Cross Sectional ◽  
Work Related ◽  
Spiritual Well Being ◽  
Over Time ◽  
Sabbath Keeping

Work-related stress is experienced at a high level in the United States. Clergy are particularly likely to over-extend themselves to act on their sacred call. Sabbath-keeping may offer a practice that is beneficial for mental health, yet many Protestant clergy do not keep a regular Sabbath. We examined whether United Methodist clergy who attended informative Sabbath-keeping workshops reported changes in spiritual well-being and mental health post-workshop. Compared to baseline, at 3 and 9 months post-workshop, participants reported an increase in Sabbath-keeping. In adjusted random effects and Poisson models, compared to not changing Sabbath-keeping frequency, increasing Sabbath-keeping was related to only one outcome: greater feelings of personal accomplishment at work. Decreasing Sabbath-keeping was related to worse anxiety symptoms, lower spiritual well-being in ministry scores, and a higher probability of having less than flourishing mental health. For four outcomes, there were no significant associations with changes in Sabbath-keeping over time. Although lacking a control group, this study adds to cross-sectional Sabbath-keeping studies by correlating changes in Sabbath-keeping with changes in mental health outcomes over time.

Mental Health Courts

2019 ◽  
pp. 83-112
Author(s):  
David DeMatteo ◽  
Kirk Heilbrun ◽  
Alice Thornewill ◽  
Shelby Arnold
Keyword(s):  
Mental Health ◽  
United States ◽  
Substance Abuse ◽  
Mental Illness ◽  
Problem Solving ◽  
The United States ◽  
Mental Health Court ◽  
Drug Courts ◽  
Mental Health Courts ◽  
Current State

This chapter focuses on mental health courts, a problem-solving court that developed in the wake of drug courts to address the needs of offenders with mental health diagnoses or co-occurring mental health and substance abuse concerns. In this chapter, the authors first review the overrepresentation of individuals with mental illness in the criminal justice system. They then describe the history and current state of mental health courts in the United States. The chapter then provides a detailed summary of the research on mental health courts. Although there is considerably less research on mental health courts than on drug courts, the available research provides reason to be cautiously optimistic. Within this discussion, the authors also note the limitations in mental health court research. Finally, the authors conclude the chapter with a discussion of innovative mental health court practices and the future of mental health courts.

scholarly journals The Effects of Greenhouse Activities on Psychological Stress, Depression, and Anxiety among University Students Who Served in the U.S. Armed Forces

HortScience ◽  
2017 ◽  
Vol 52 (12) ◽  
pp. 1834-1839 ◽  
Author(s):  
Rosalie J. Kelley ◽  
Tina M. Waliczek ◽  
F. Alice Le Duc
Keyword(s):  
Mental Health ◽  
University Students ◽  
Military Service ◽  
Care Program ◽  
Armed Forces ◽  
The United States ◽  
Student Veterans ◽  
Control Group ◽  
Prevention Measures ◽  
The U.S

The mental health of the men and women who served in the U.S. Armed Forces is an area of great concern in the United States. Studies have shown the mental health of university students is also a concern with a growing need for support services and prevention measures. The main objective of this study was to determine the effects of participation in particular greenhouse activities on depression, anxiety, and stress levels of students who served in the U.S. Armed Forces. The study included a control group and a treatment group. Participants completed a pre- and post 21-item Depression Anxiety and Stress Scale (DASS-21) survey, along with a questionnaire designed to capture participants’ demographic information and information regarding their military service history. The treatment consisted of a 6-week indoor plant care program. Results of the study found that student veterans who participated in the plant care class had decreased levels of depression and stress when compared with the control group. In the post-test open-ended questions, student veterans described a noticeable feeling of reduced stress along with the ability to relax while having feelings of a sense of place (belonging). Participants also indicated that they would continue to grow plants as a hobby.

Problem-Solving Courts and the Criminal Justice System

2019 ◽  
Author(s):  
David DeMatteo ◽  
Kirk Heilbrun ◽  
Shelby Arnold ◽  
Alice Thornewill
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Problem Solving ◽  
Criminal Justice System ◽  
Behavioral Health ◽  
Criminal Behavior ◽  
Justice System ◽  
The United States ◽  
Team Approach ◽  
Problem Solving Courts

Individuals with behavioral health disorders are significantly overrepresented in the criminal justice system. The incarceration of offenders with substance use disorders and mental illness has contributed to dramatic growth in the incarcerated population in the United States. Problem-solving courts provide judicially supervised treatment for behavioral health needs commonly found among offenders, including substance abuse and mental health, and they treat a variety of offender populations. By addressing the problems that underlie criminal behavior, problem-solving courts seek to decrease the “revolving door” that results when offender needs are not addressed. Problem-solving courts use a team approach among the judge, defense attorney, prosecutor, and treatment providers, which is a paradigm shift in how the justice system treats offenders with special needs. Offenders in problem-solving courts are held accountable for their behavior while being provided with judicially supervised treatment designed to reduce the risk of reoffending. Despite the proliferation of problem-solving courts, there are unanswered questions about how they function, how effective they are, and the most promising ways to implement problem-solving justice. Problem-Solving Courts and the Criminal Justice System is the first book to focus broadly on problem-solving courts. The changing landscape of the criminal justice system, recent development of problem-solving courts, and ongoing shift toward offender rehabilitation underscore the need for this book. This book provides those in the fields of mental health, criminal justice, law, and related fields with a comprehensive foundation of information related to the role of problem-solving courts in reforming the criminal justice system. This book also provides researchers, academics, administrators, and policy-makers with an overview of the existing research on problem-solving courts, including the challenges faced by researchers when examining these courts.

Mental Health Courts

Criminology ◽  
2019 ◽  
Author(s):  
Jason Matejkowski
Keyword(s):  
Mental Health ◽  
Problem Solving ◽  
Empirical Studies ◽  
The United States ◽  
Program Completion ◽  
Mental Illnesses ◽  
Mental Health Courts ◽  
Relative Paucity ◽  
Code Violations ◽  
And Function

Mental health courts (MHCs) are specialized dockets for defendants with mental illnesses that seek the adjudication of criminal charges and municipal code violations by using a problem-solving model. Modeled after drug treatment courts, MHCs provide an alternative to incarceration for individuals with mental illness charged with criminal offenses. Mental health courts are but one of an array of problem-solving courts (PSCs) that have proliferated over the past three decades (e.g., drug courts, veterans courts, co-occurring disorder courts) and, as such, share come commonalities with these other PSCs. The populations served by these PSCs often overlap with MHCs as do many of the courts’ approaches (e.g., the use of incentives and sanctions to motivate clients to engage in treatment and support services). This entry will focus on MHCs but, when necessary, also include references pertaining to PSCs. Although MHCs may differ somewhat in structure and function by jurisdiction, this entry begins with resources (including reports, theoretical manuscripts, and empirical studies) identifying counts, structural components, and operational approaches common to MHCs. The entry then highlights the peer-reviewed literature on MHC outcomes, including program completion, recidivism, cost analysis, as well as alternative outcomes. Given the relative paucity of literature on juvenile MHCs, this entry focuses primarily on adult MHCs. Literature on juvenile MHCs is covered near the end of this entry. Similarly, the overwhelming majority of published research and commentary on MHCs pertains to MHCs that operate in the United States. This entry reflects that current state of the research. Finally, the entry concludes with published critiques of the MHC model.

scholarly journals Peningkatan Pengetahuan dan Keterampilan Pengukuran Tekanan Cuff Pipa Endotrakeal Perawat Intensif Menggunakan Metode Simulasi dan Demonstrasi

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Fauzan Alfikrie ◽  
Achir Yani S. Hamid ◽  
Muhammad Syafwani
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cuff Pressure ◽  
Control Group ◽  
Control Group Design ◽  
Tube Cuff ◽  
Group Design ◽  
Significant Difference ◽  
Before And After ◽  
The Ideal

Background: Maintaining cuff pressure in the ideal range is the responsibility of nurse. This is needed to prevent the occurrence of complications caused by cuff pressure that is not ideal such as ischemia in the trachea and micro-aspiration.Objective: this study identified the effect of training toward nurse’s knowledge and skills intensive care unit in measuring endotrakeal tube cuff pressureMethod: This study used the quas experiment design with the pre-posttest method without control group design and analyzed statistically using the Wilcoxon test.Result: The results of the research conducted were twelve nurses in the intensive care unit at the regional general hospital in dr. Soedarso Pontianak showed a significant difference in knowledge (p 0.002, α 0.05) and skills (p 0.002, α 0.05) before and after training in endotracheal tube cuff pressure training.Conclussion: The researcher recommends that the measurement of cuff pressure be carried out in accordance with the indications so that it is expected to reduce the risk of complications caused

scholarly journals How Do Depression Medications Taken by Pilots Affect Passengers’ Willingness to Fly—A Mediation Analysis

2015 ◽  
Vol 7 (11) ◽  
pp. 200 ◽  
Author(s):  
Stephen Rice ◽  
Scott R. Winter ◽  
Keegan Kraemer ◽  
Rian Mehta ◽  
Korhan Oyman
Keyword(s):  
Mental Health ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Low Dose ◽  
Federal Aviation Administration ◽  
The United States ◽  
Control Group ◽  
High Dose ◽  
Airline Pilots ◽  
The Relationship ◽  
Practical Implications

<p>The mental health of airline pilots has been a concern for decades. In 2010, the United States Federal Aviation Administration began allowing four types of selective serotonin reuptake inhibitors (SSRIs) to be used by pilots suffering from depression. After a procedural wait period, pilots may be awarded a special issuance of their medical certificates to maintain flight currency. Missing from the literature was any research on consumer’s perceptions of pilots taking antidepressants, along with some other approved medications. Therefore, the purpose of the current study was to examine consumer’s willingness to fly once told that the pilot of their hypothetical flight was taking medication compared to a control group in which the pilot was not on any prescribed and approved medications. The current study also manipulated dosage levels and gathered affect data to determine if consumers’ responses were rationally or emotionally motivated. Across two studies, consumers were less willing to fly when the pilot was taking medication, and when the medication was a high dose opposed to a low dose. Additionally, affect was found to completely mediate the relationship between three of the four medications when compared to the control condition, suggesting that participants’ responses were emotionally driven. Finally, a discussion of the findings and practical implications of the study are provided.</p>

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