Vocational identity of veterans with co-occurring mental health and substance use disorders

2021 ◽  
pp. 1-9
Author(s):  
Brian J. Stevenson ◽  
Stephanie J. Thrower ◽  
Lisa Mueller ◽  
Megan M. Kelly
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Relational Theory ◽  
Vocational Identity ◽  
Survey Study ◽  
Health Administration ◽  
Employment Barriers ◽  
Study Results

BACKGROUND: No studies have examined vocational identity among individuals with co-occurring mental health and substance use disorders. OBJECTIVE: Influenced by Blustein’s relational theory of working (2011), this study examined the relationships between several social-environmental variables (external/relational conflicts, employment barriers, substance abuse stigma) and vocational identity. METHODS: Eighty-four veterans receiving treatment from the Veterans Health Administration (VHA) for co-occurring mental health and substance use disorders participated in this survey study. RESULTS: Education, employment, clinical, disability, and substance abuse factors were not associated with vocational identity, but external/relational conflicts, employment barriers, and substance abuse stigma were. Multiple regression analysis found that these variables accounted for 34%of the variance in vocational identity and that external/relational conflicts was the only significant predictor. CONCLUSIONS: Findings suggest that more conflictual messages about work from external/relational sources is related to less clarity around one’s vocational interests, goals, and talents.

scholarly journals Employment After Vocational Rehabilitation Predicts Decreased Health Care Utilization in Veterans With Mental Health Diagnoses

2021 ◽  
Author(s):  
Kristen M Abraham ◽  
Ming-Un Myron Chang ◽  
Tony Van ◽  
Sandra G Resnick ◽  
Kara Zivin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Substance Use ◽  
Health Care Utilization ◽  
Vocational Rehabilitation ◽  
Substance Use Disorders ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Health Administration ◽  
Employment Services

ABSTRACT Introduction Although the benefits of employment for veterans with mental health conditions are well-known, the effect of veterans’ employment on a health system has not been evaluated. The purpose of this study was to evaluate the effect of veterans’ employment (versus unemployment) on subsequent health care utilization in the Veterans Health Administration (VHA). Materials and Methods This study used a sample of 29,022 veterans with mental health and substance use disorders who were discharged from VHA’s employment services programs between fiscal years 2006 and 2010. Veterans’ employment status (employed/unemployed) upon discharge from VHA employment programs was ascertained from program discharge forms and linked with VHA administrative health care utilization data for the subsequent 1- and 5-year periods. Results Multivariable ordinary least-squares and logistic regression models adjusted for site clustering and covariates indicated that employment (versus unemployment) predicted less health care utilization 1 year and 5 years post-discharge from employment services, including fewer outpatient mental health visits, homelessness services visits, employment services visits, primary care visits, and lower odds of mental health hospitalizations, mental health or vocational rehabilitation residential stays, and medical hospitalizations. Employment did not predict emergency department visits. Conclusions VHA’s investment in employment services for veterans with mental health and substance use disorders could reduce health care utilization system wide.

Co-Occurrence of Obsessive-Compulsive Disorder and Substance Use Disorders Among U.S. Veterans: Prevalence and Mental Health Utilization

2019 ◽  
Vol 33 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Anthony H. Ecker ◽  
Melinda A. Stanley ◽  
Tracey L. Smith ◽  
Ellen J. Teng ◽  
Terri L. Fletcher ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Obsessive Compulsive Disorder ◽  
Substance Use Disorders ◽  
Mental Healthcare ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Use ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Obsessive-compulsive disorder (OCD) and substance-use disorders (SUDs) co-occur at high rates, which is related to poorer psychosocial outcomes. Prior work suggests that, among veterans in the Veterans Health Administration (VHA), OCD is underdiagnosed and undertreated, which can compound negative effects of OCD and SUD co-occurrence. This study identified patterns of OCD and specific SUD co-occurrence and their effect on mental health and substance-use screening measures and mental healthcare utilization. Using VHA administrative data, we identified veterans with an OCD diagnosis from 2010 to 2016 (N = 38,157); 36.70% also had a SUD diagnosis. Specific SUD rates are alcohol-use disorder, 17.17%; cannabis-use disorder, 5.53%; opioid-use disorder, 3.60%; amphetamine-use disorder, 1.49%; cocaine-use disorder, 3.37%; and tobacco-use disorder, 26.50%. Veterans with co-occurring OCD and SUD used more mental health services throughout the data capture period. Findings suggest that OCD and SUD co-occur at high rates within the VHA, and that this is associated with more burden to the healthcare system. Targeted screening and treatment efforts may help address the needs of this population.

scholarly journals Mental Health Issues and Substance Use in the United States: Pulling the Power Levers

2018 ◽  
Vol 25 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Linda S. Beeber
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Mental Health Treatment ◽  
Well Being ◽  
The United States ◽  
Mental Illnesses ◽  
Health Administration

BACKGROUND: Promising treatment avenues have been developed and studied that align well with the skills of psychiatric-mental health (PMH) nurses. The treatments are relationship-driven, nimble and accessible, and recovery-guided. They emphasize a whole-person approach with care delivered by a team of experts working in a contextually coordinated way. AIMS: To describe the challenges facing the United States with regard to mental illness and substance use disorders and the ways in which PMH nurses can use their skills to mitigate these challenges. METHOD: Published research and government reports were reviewed to obtain current mental health and substance use data. RESULTS: The number of people not being treated for mental illnesses—particularly serious mental illness, major depressive episode, and suicidal thoughts—has not improved since 2009. Although inroads have been made in reducing the rate of smoking in the United States, we are facing an opioid crisis. There are limited data on marijuana use, but it is apparent that many Americans use cannabis routinely. According to the Substance Abuse and Mental Health Administration, approximately 44.7 million people need mental health treatment and 20.1 million Americans need substance use treatment, but only 10% to 30% receive it. CONCLUSIONS: PMH nurses must take a leading role in retooling the therapeutic relationship and partnering with clients, families, and caregivers to improve the quality of life and well-being of those dealing with mental illness and substance use disorders. To accomplish this essential task, the PMH nursing workforce must be robust and distributed throughout the United States.

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